559 results on '"End stage renal disease"'
Search Results
2. Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study
- Author
-
Ejin Kim, Hyuk Huh, Yongwon Mo, Jae Yoon Park, Jiyun Jung, Hajeong Lee, Sejoong Kim, Dong Ki Kim, Yon Su Kim, Chun Soo Lim, Jung Pyo Lee, Yong Chul Kim, and Ho Kim
- Subjects
Chronic kidney disease ,End stage renal disease ,Mortality ,Ozone ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Epidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD. Methods We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed. Results In the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3. The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014–1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035–1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044–1.054) at the district unit and 1.04 (95%CI: 1.031–1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008–1.017) for administrative districts and 1.04 (95% confidence interval: 1.031–1.05) for individual addresses. Conclusions This study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment.
- Published
- 2024
- Full Text
- View/download PDF
3. Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study.
- Author
-
Kim, Ejin, Huh, Hyuk, Mo, Yongwon, Park, Jae Yoon, Jung, Jiyun, Lee, Hajeong, Kim, Sejoong, Kim, Dong Ki, Kim, Yon Su, Lim, Chun Soo, Lee, Jung Pyo, Kim, Yong Chul, and Kim, Ho
- Subjects
CHRONIC kidney failure ,CHRONICALLY ill ,OZONE ,PROPORTIONAL hazards models ,COHORT analysis - Abstract
Background: Epidemiologic studies on the effects of long-term exposure to ozone (O
3 ) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD. Methods: We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed. Results: In the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3 . The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014–1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035–1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044–1.054) at the district unit and 1.04 (95%CI: 1.031–1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008–1.017) for administrative districts and 1.04 (95% confidence interval: 1.031–1.05) for individual addresses. Conclusions: This study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment. [ABSTRACT FROM AUTHOR]- Published
- 2024
- Full Text
- View/download PDF
4. Intravenous difelikefalin for the treatment of hemodialysis pruritus.
- Author
-
Mahmoud, Rami H., Mahmoud, Omar, and Yosipovitch, Gil
- Subjects
ITCHING ,CHRONIC kidney failure ,HEMODIALYSIS ,HEMODIALYSIS patients - Abstract
Patients with chronic kidney disease (CKD) undergoing hemodialysis often experience significant itch secondary to their condition and a subsequent reduction in their overall quality of life. Current treatments are underwhelming, necessitating the search for new, effective therapeutic options to combat itch in this population. The purpose of this review is to explore the available data for the use of intravenous difelikefalin in patients with CKD undergoing hemodialysis. The pathophysiology of CKD-associated itch is multifactorial, with one proposed mechanism involving an imbalance in the endogenous opioid system, favoring upregulation of itch-activating μ-opioid receptors (MORs) and downregulation of itch-inhibiting κ-opioid receptors (KORs). Dysregulation of the immune system is also involved. Difelikefalin is a recent FDA approved treatment that functions as peripherally acting KOR agonist, targeting this imbalance in the endogenous opioid system seen in CKD patients with itch and having an anti-inflammatory effect on immune cells. Clinical data on intravenous difelikefalin is promising regarding its ability to reduce itch in CKD patients on hemodialysis and improve patient quality of life, with few, mild adverse side effects. As intravenous difelikefalin becomes more widely used in the clinical setting, further studies assessing long-term efficacy and safety will be needed. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. Risk of Chronic Kidney Disease Progression
- Published
- 2023
6. Efficacy of Diuretics in Kidney Disease
- Author
-
Tammy Lisa Sirich, Assistant Professor of Medicine
- Published
- 2022
7. Renal Embolization-Induced Uremic Swine Model for Assessment of Next-Generation Implantable Hemodialyzers.
- Author
-
Moyer, Jarrett, Wilson, Mark W., Sorrentino, Thomas A., Santandreu, Ana, Chen, Caressa, Hu, Dean, Kerdok, Amy, Porock, Edward, Wright, Nathan, Ly, Jimmy, Blaha, Charles, Frassetto, Lynda A., Fissell, William H., Vartanian, Shant M., and Roy, Shuvo
- Subjects
- *
RENAL replacement therapy , *CHRONIC kidney failure , *KIDNEY failure , *THERAPEUTIC embolization , *ARTIFICIAL implants , *KIDNEYS , *RETROPERITONEUM - Abstract
Reliable models of renal failure in large animals are critical to the successful translation of the next generation of renal replacement therapies (RRT) into humans. While models exist for the induction of renal failure, none are optimized for the implantation of devices to the retroperitoneal vasculature. We successfully piloted an embolization-to-implantation protocol enabling the first implant of a silicon nanopore membrane hemodialyzer (SNMHD) in a swine renal failure model. Renal arterial embolization is a non-invasive approach to near-total nephrectomy that preserves retroperitoneal anatomy for device implants. Silicon nanopore membranes (SNM) are efficient blood-compatible membranes that enable novel approaches to RRT. Yucatan minipigs underwent staged bilateral renal arterial embolization to induce renal failure, managed by intermittent hemodialysis. A small-scale arteriovenous SNMHD prototype was implanted into the retroperitoneum. Dialysate catheters were tunneled externally for connection to a dialysate recirculation pump. SNMHD clearance was determined by intermittent sampling of recirculating dialysate. Creatinine and urea clearance through the SNMHD were 76–105 mL/min/m2 and 140–165 mL/min/m2, respectively, without albumin leakage. Normalized creatinine and urea clearance measured in the SNMHD may translate to a fully implantable clinical-scale device. This pilot study establishes a path toward therapeutic testing of the clinical-scale SNMHD and other implantable RRT devices. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
8. Ignorance is Not Bliss: The Case for Comprehensive Reproductive Counseling for Women with Chronic Kidney Disease.
- Author
-
Iltis, Ana S., Mehta, Maya, and Sawinski, Deirdre
- Abstract
The bioethics literature has paid little attention to matters of informed reproductive decision-making among women of childbearing age who have chronic kidney disease (CKD), including women who are on dialysis or women who have had a kidney transplant. Women with CKD receive inconsistent and, sometimes, inadequate reproductive counseling, particularly with respect to information about pursuing pregnancy. We identify four factors that might contribute to inadequate and inconsistent reproductive counseling. We argue that women with CKD should receive comprehensive reproductive counseling, including information about the possibility of pursuing pregnancy, and that more rigorous research on pregnancy in women with CKD, including women on dialysis or who have received a kidney transplant, is warranted to improve informed reproductive decision making in this population. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
9. Palm Tocotrienols in Chronic Hemodialysis (USA) (PATCH)
- Author
-
DaVita Dialysis, Great Lakes Dialysis, LLC, National University of Malaysia, Universiti Putra Malaysia, Ministry of Health, Malaysia, National Kidney Foundation, PEMANDU, Henry Ford Hospital, Kidney Foundation Hospital and Research Institute, Bangladesh, Fortis Hospital, India, and Pramod Khosla, Professor
- Published
- 2022
10. Retrospective analysis of SGLT2 inhibitors in heart failure with preserved ejection fraction
- Author
-
John S. Clemmer, Taylor J. Ward, and Seth T. Lirette
- Subjects
Heart failure with preserved ejection fraction ,Heart failure ,SGLT2 inhibitors ,Antihypertensive therapy ,Chronic kidney disease ,End stage renal disease ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Heart failure (HF) is one of the leading causes of cardiovascular morbidity and mortality. HF with preserved ejection fraction (HFpEF), or diastolic failure, accounts for half of all HF cases and differs from HF with reduced ejection fraction (HFrEF). Patients with HFpEF are typically older, female, and commonly seen with chronic kidney disease (CKD), one of the leading independent risk factors for mortality in these patients. Unfortunately, drugs that had shown significant improvements in mortality in HFrEF have not shown similar benefits in HFpEF. Recently, sodium glucose transporter 2 inhibitors (SGLT2i) have been shown to reduce cardiovascular morbidity and mortality in HFrEF patients and slow down CKD progression. This study aimed to elucidate the impact of this drug class on mortality and risk of end stage renal disease in patients with HFpEF, which is currently unclear. Methods and results We retrospectively analysed the Research Data Warehouse containing electronic health records from de‐identified patients (n = 1 266 290) from the University of Mississippi Medical Center from 2013 to 2022. HFpEF patients had an average follow‐up of 4 ± 2 years. Factors associated with increased all‐cause mortality during HFpEF included age, male sex, and CKD. Interestingly, the only treatments associated with significant improvements in survival were angiotensin converting enzyme inhibitors/angiotensin receptor blockers and SGLT2i, regardless of CKD or diabetes status. Additionally, SGLT2i use was also associated with significant decrease in the risk of end stage renal disease. Conclusions Our results support the use of SGLT2i in an HFpEF population with relatively high rates of hypertension, CKD, and black race and suggests that improvements in mortality may be through preserving kidney function.
- Published
- 2023
- Full Text
- View/download PDF
11. Frequency of Subclinical Hypothyroidsim Among Patients with end Stage Renal Disease on Hemodialysis Presenting to A Tertiary Care Hospital
- Author
-
Wajid Abdullah, Salman Tahir Shafi, Irfan Ahmad, and Sana Ashraf
- Subjects
Chronic kidney disease ,End stage renal disease ,Subclinical hypothyroidism ,Medicine ,Medicine (General) ,R5-920 - Abstract
Objective: Aim of this study was to determine the frequency of subclinical hypothyroidism among patients with end stage renal disease presenting to tertiary care hospital. Study Design: Cross sectional study. Place and Duration of Study: Department of Nephrology, Sharif Medical City Hospital, Lahore. Pakistan, from Mar 2020 to Dec 2020. Methodology: A total of 200 cases studied. Informed consent was obtained from them. Data was noted in the proforma. Using aseptic techniques blood sample was taken for testing serum TSH and free T4 levels through radioimmunoassay. Results were collected by the researcher next day and were labeled and noted as subclinical hypothyroidism according to its clinical definition. Privacy of the data was maintained. Results: In 200 study cases age interval was 15-80 years with mean age of 46.22±19.67 years. The minimum Serum TSH level was 4.1 and maximum was 4.6 with mean serum TSH level was 4.31±0.16. The minimum Serum T4 levels was 0.5 and maximum was 2.1 with mean Serum T4 levels was 1.28±0.68. Duration of chronic kidney disease was 3-60 months with mean duration of 17.58±14.14 months. It was observed that there were 56.5% male patients while females were 43.5%. Subclinical Hypothyroidism was present in 9.5% patients with ESRD reporting to tertiary care hospital while it was absent in 90.5% patients. Conclusion: The frequency of subclinical hypothyroidism was found as 9.5% among patients with end stage renal disease presenting to tertiary care hospital.
- Published
- 2023
- Full Text
- View/download PDF
12. Investigating the knowledge, attitude, and practice of the people towards prevention and early detection of chronic kidney disease, and their association with demographic variables.
- Author
-
Teklezgi, Mehari Gebre, Mengesha, Solomon Kalayu, and Gebru, Yared Tbebu
- Subjects
- *
CHRONIC kidney failure , *LOGISTIC regression analysis , *KIDNEY failure , *INDEPENDENT variables , *CARDIOVASCULAR diseases - Abstract
Chronic kidney disease (CKD) is a worldwide public health problem related to adverse results of end-stage renal disease (ESRD), kidney failure, cardiovascular disease (CVD), and premature death. The study is aimed to investigate the knowledge, attitude, and practice toward the prevention and early detection of chronic kidney disease. Two ordinal variables and one nominal response variable with 20 predictor variables were independently fitted. Ordinal multicategories , such as proportional odds, continuation ratio, and partial proportional models for attitude and practice, whereas the baseline multicategory logit model for knowledge was fitted. The findings implied that some predictors have a significant effect on attitude, whereas other covariates have a significant effect on practice. Moreover, as there are two independent logit models for the nominal response, in the first logit model Monthly income and Diabetes2, whereas in the second logit model, Smo_R_CKD3 and Diabetes2 have a significant effect on knowledge. In conclusion, more educated ones have more knowledge and attitude toward the prevention and early detection of chronic kidney disease, also more likely to perform preventive and early detecting practices. People are inadequately informed on the prevention and early detection of CKD, especially those who are with low income, are at risk of developing CKD and its complications. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
13. Retrospective analysis of SGLT2 inhibitors in heart failure with preserved ejection fraction.
- Author
-
Clemmer, John S., Ward, Taylor J., and Lirette, Seth T.
- Subjects
HEART failure ,VENTRICULAR ejection fraction ,CHRONIC kidney failure ,SODIUM-glucose cotransporter 2 inhibitors ,ACE inhibitors ,ANGIOTENSIN-receptor blockers ,ALDOSTERONE antagonists ,ELECTRONIC health records - Abstract
Aims: Heart failure (HF) is one of the leading causes of cardiovascular morbidity and mortality. HF with preserved ejection fraction (HFpEF), or diastolic failure, accounts for half of all HF cases and differs from HF with reduced ejection fraction (HFrEF). Patients with HFpEF are typically older, female, and commonly seen with chronic kidney disease (CKD), one of the leading independent risk factors for mortality in these patients. Unfortunately, drugs that had shown significant improvements in mortality in HFrEF have not shown similar benefits in HFpEF. Recently, sodium glucose transporter 2 inhibitors (SGLT2i) have been shown to reduce cardiovascular morbidity and mortality in HFrEF patients and slow down CKD progression. This study aimed to elucidate the impact of this drug class on mortality and risk of end stage renal disease in patients with HFpEF, which is currently unclear. Methods and results: We retrospectively analysed the Research Data Warehouse containing electronic health records from de‐identified patients (n = 1 266 290) from the University of Mississippi Medical Center from 2013 to 2022. HFpEF patients had an average follow‐up of 4 ± 2 years. Factors associated with increased all‐cause mortality during HFpEF included age, male sex, and CKD. Interestingly, the only treatments associated with significant improvements in survival were angiotensin converting enzyme inhibitors/angiotensin receptor blockers and SGLT2i, regardless of CKD or diabetes status. Additionally, SGLT2i use was also associated with significant decrease in the risk of end stage renal disease. Conclusions: Our results support the use of SGLT2i in an HFpEF population with relatively high rates of hypertension, CKD, and black race and suggests that improvements in mortality may be through preserving kidney function. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
14. Open-Label Extension Study for the Long-Term Efficacy and Safety of Roxadustat in Participants With Dialysis and Non-Dialysis Chronic Kidney Disease
- Author
-
AstraZeneca and Astellas Pharma Inc
- Published
- 2021
15. Health equity in dialysis care: Time for action
- Author
-
Senthilkumar Ramasamy, Vinay Rathore, Abhiruchi Galhotra, and Sanjana Agrawal
- Subjects
chronic kidney disease ,dialysis ,end stage renal disease ,equity ,Public aspects of medicine ,RA1-1270 - Abstract
The development of chronic kidney disease and its progression to End Stage Renal Disease requiring renal replacement therapy remains a significant source of reduced quality of life and premature mortality. The global dialysis population and treatment gap is growing, especially in low- and middle- income countries. In India, 70% of those starting dialysis, die or discontinue treatment in the initial period due to the high cost of treatment and lack of access to dialysis therapy. Achieving health equity requires ensuring access to the resources that needs to be healthy, and addressing social determinants of health involves needs factors that influence the health outcomes. Universal Health Coverage requires an alternate model to address the substantial Out-Of-Pocket-Expenditure borne by these patients for traveling and medications.
- Published
- 2023
- Full Text
- View/download PDF
16. Prevalence of depression and anxiety and their predictors among patients undergoing maintenance hemodialysis in Northern China: a cross-sectional study
- Author
-
Yan Meng, Hao-tian Wu, Jia-le Niu, Yuan Zhang, Hua Qin, Liang-liang Huang, Xiao-jun Zhang, Lei Yu, Hong-yan Yu, Tao Yan, and Jian-rong Zhao
- Subjects
Chronic kidney disease ,chronic renal failure ,end stage renal disease ,maintenance hemodialysis ,depression ,anxiety ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective To investigate the prevalence of depression and anxiety in patients undergoing maintenance hemodialysis (MHD) in Hohhot, a large city on the northern border of China, and to identify independent risk factors for depression and anxiety in these patients.Methods Patients receiving MHD for >3 months were enrolled in the four largest hemodialysis centers between September 2020 and December 2020. Depression and anxiety were assessed using the Zung self-rated depression scale (SDS) and Zung self-rated anxiety scale (SAS), respectively, with demographic and other data collected for logistic regression analyses.Results Among 305 MHD patients included in this study, the prevalence of depression was 55.1%, including 27.5%, 21.0%, and 6.6% with mild, moderate and severe cases, respectively. The prevalence of anxiety was 25.9%, with 20.0%, 4.6%, and 1.3% having mild, moderate, and severe cases, respectively. An independent protective factor for depression was family income of ≥1415 US dollars/month relative to
- Published
- 2022
- Full Text
- View/download PDF
17. Endocrine disruptors in dialysis therapies: A literature review
- Author
-
Guillaume Cambien, Antoine Dupuis, Jérémy Guihenneuc, Marc Bauwens, Mohamed Belmouaz, and Sarah Ayraud-Thevenot
- Subjects
Endocrine disruptors ,Dialysis ,Chronic kidney disease ,Exposure ,Plasticizers ,End stage renal disease ,Environmental sciences ,GE1-350 - Abstract
Endocrine disrupting chemicals (EDCs) were defined as “an exogenous substance or mixture that alters function(s) of the endocrine system and consequently causes adverse health effects”. These compounds are mainly eliminated by the renal route. However, patients with end-stage kidney disease treated by dialysis (ESKDD) can no longer eliminate these EDCs efficiently. Furthermore, EDCs exposure could occur via leaching from medical devices used in dialysis therapy. As a result, ESKDD patients are overexposed to EDCs. The aims of this study were to summarize EDCs exposure of ESKDD patients and to evaluate the factors at the origin of this exposure. To handle these objectives, we performed a literature review. An electronic search on PubMed, Embase and Web of science databases was performed. Twenty-six studies were finally included. The EDCs reported in these studies were Bisphenol A (BPA), Bisphenol S (BPS), Bisphenol B (BPB), Nonylphenol, Di(2-ethylhexyl) phthalate (DEHP), Di-n-butyl phthalate (DBP), and Butylbenzyl phthalate (BBP). Regarding the environment of dialysis patients, BPA, BPB, BPS, DEHP, DBP and nonylphenol have been found. Environmental exposure affects EDCs blood levels in ESKDD patients who are overexposed to BPA, BPS, BPB and DEHP. For ESKDD patients, dialyzers with housing in polycarbonate and fibers in polysulfone seem to overexpose them to BPA. Regarding dialysis therapy, peritoneal dialysis seems to decrease patient exposure vs hemodialysis therapy, and hemodiafiltration therapy seems to reduce this exposure vs hemodialysis therapy. Regarding DEHP, levels tend to increase during dialysis and when DEHP plasticizer is used in PVC devices. Finally, in the European Union a regulation on medical devices was adopted on 5 April 2017 and has been applied recently. This regulation will regulate EDCs in medical devices and thereby contribute to reconsideration of their conceptions and, finally, to reduction of ESKDD patients’ exposure.
- Published
- 2023
- Full Text
- View/download PDF
18. Knowledge, Attitudes and Perceptions of Dental Hygiene and Dental Therapy Students towards End-stage Renal Disease: A pilot study.
- Author
-
Bast, Kendall P., Arnett, Michelle C., Lindgren, Bruce R., Drake, Miranda A., and Reibel, Yvette
- Subjects
- *
CHRONIC kidney failure , *CONFIDENCE , *PROFESSIONS , *HEALTH occupations students , *CROSS-sectional method , *MEDICAL care , *MANN Whitney U Test , *MENTAL health , *DENTAL therapists , *DENTAL hygienists , *DESCRIPTIVE statistics , *STUDENT attitudes , *STATISTICAL sampling , *DATA analysis software , *ORAL manifestations of general diseases - Abstract
Purpose Chronic kidney disease is highly prevalent in the general population and can progress to end-stage renal disease (ESRD). The purpose of this pilot study was to assess dental hygiene and dental therapy students' knowledge, attitudes, and perceptions towards ESRD and evaluate the feasibility of a larger scale study. Methods A convenience sample (n=59) of dental hygiene (DH) and dual degree DH/dental therapy students were invited to participate in an electronic survey for the pilot study. The investigator designed survey consisted of a total of 37 items: demographics (4), perceived knowledge, confidence, importance and attitudes (14), knowledge of chronic kidney disease (18). The knowledge questions were adapted from the Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) with permission. Descriptive statistics and the non-parametric two-sample Wilcoxon rank sum test were used to analyze the data. Results Twenty-five participants completed the survey for a 42% response rate. Fewer than half (36%) perceived having some knowledge regarding ESRD, its oral manifestations (28%) and mental health implications (12%). The importance of managing oral health for ESRD was rated by most respondents as "very important" or "extremely important" (76%). Respondent attitudes indicated high interest (68%) regarding employment in hospital settings to care for individuals with ESRD. Knowledge scores from the CKD-SMKT were low in the categories of general knowledge of ESRD and dental hygiene care modifications for individuals with ESRD. Conclusion Results of this pilot study indicate that using a validated instrument on a national sample is feasible to determine the knowledge, attitudes and perceptions of dental hygiene students regarding ESRD. Future research should include knowledge and awareness of hypertension, diabetes, and the role that management of chronic kidney disease plays in the prevention of ESRD. [ABSTRACT FROM AUTHOR]
- Published
- 2023
19. Prevalence of depression and anxiety and their predictors among patients undergoing maintenance hemodialysis in Northern China: a cross-sectional study.
- Author
-
Meng, Yan, Wu, Hao-tian, Niu, Jia-le, Zhang, Yuan, Qin, Hua, Huang, Liang-liang, Zhang, Xiao-jun, Yu, Lei, Yu, Hong-yan, Yan, Tao, and Zhao, Jian-rong
- Subjects
- *
ANXIETY , *POOR families , *INCOME , *MENTAL depression , *LOGISTIC regression analysis - Abstract
To investigate the prevalence of depression and anxiety in patients undergoing maintenance hemodialysis (MHD) in Hohhot, a large city on the northern border of China, and to identify independent risk factors for depression and anxiety in these patients. Patients receiving MHD for >3 months were enrolled in the four largest hemodialysis centers between September 2020 and December 2020. Depression and anxiety were assessed using the Zung self-rated depression scale (SDS) and Zung self-rated anxiety scale (SAS), respectively, with demographic and other data collected for logistic regression analyses. Among 305 MHD patients included in this study, the prevalence of depression was 55.1%, including 27.5%, 21.0%, and 6.6% with mild, moderate and severe cases, respectively. The prevalence of anxiety was 25.9%, with 20.0%, 4.6%, and 1.3% having mild, moderate, and severe cases, respectively. An independent protective factor for depression was family income of ≥1415 US dollars/month relative to <157 US dollars/month (odds ratio [OR] 0.209, 95% confidence interval [CI] 0.065–0.673), and predictors of depression included ≥3 comorbidities (OR 18.527, 95% CI 1.674–205.028) and severe pruritus (OR 15.971, 95% CI 5.173–49.315). Independent predictors of anxiety included infrequent exercise (OR 3.289, 95% CI 1.411–7.664) and severe pruritus (OR 5.912, 95% CI 1.733–20.168). The correlation between depression and anxiety in these patients was significant (rs = 0.775, p < 0.001). MHD patients in Northern China had high prevalence rates of depression (55.1%) and anxiety (25.9%). Lower family income, more comorbidities, and a higher degree of pruritus were predictors of depression, while infrequent exercise and severe pruritus were predictors of anxiety. Depression correlated significantly with anxiety. Attention should be given to family income, comorbidity, exercise, and pruritus severity for improved management of depression and anxiety among MHD patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
20. Renal Embolization-Induced Uremic Swine Model for Assessment of Next-Generation Implantable Hemodialyzers
- Author
-
Jarrett Moyer, Mark W. Wilson, Thomas A. Sorrentino, Ana Santandreu, Caressa Chen, Dean Hu, Amy Kerdok, Edward Porock, Nathan Wright, Jimmy Ly, Charles Blaha, Lynda A. Frassetto, William H. Fissell, Shant M. Vartanian, and Shuvo Roy
- Subjects
end stage renal disease ,acute kidney injury ,chronic kidney disease ,dialysis ,hemodialysis ,artificial organs ,Medicine - Abstract
Reliable models of renal failure in large animals are critical to the successful translation of the next generation of renal replacement therapies (RRT) into humans. While models exist for the induction of renal failure, none are optimized for the implantation of devices to the retroperitoneal vasculature. We successfully piloted an embolization-to-implantation protocol enabling the first implant of a silicon nanopore membrane hemodialyzer (SNMHD) in a swine renal failure model. Renal arterial embolization is a non-invasive approach to near-total nephrectomy that preserves retroperitoneal anatomy for device implants. Silicon nanopore membranes (SNM) are efficient blood-compatible membranes that enable novel approaches to RRT. Yucatan minipigs underwent staged bilateral renal arterial embolization to induce renal failure, managed by intermittent hemodialysis. A small-scale arteriovenous SNMHD prototype was implanted into the retroperitoneum. Dialysate catheters were tunneled externally for connection to a dialysate recirculation pump. SNMHD clearance was determined by intermittent sampling of recirculating dialysate. Creatinine and urea clearance through the SNMHD were 76–105 mL/min/m2 and 140–165 mL/min/m2, respectively, without albumin leakage. Normalized creatinine and urea clearance measured in the SNMHD may translate to a fully implantable clinical-scale device. This pilot study establishes a path toward therapeutic testing of the clinical-scale SNMHD and other implantable RRT devices.
- Published
- 2023
- Full Text
- View/download PDF
21. Health Literacy and its Related Factors in Dialysis Patients: A Cross-sectional Study in Iran.
- Author
-
Yazdinejad, Tahereh, Karamoozian, Ali, Mousavi, Maryam Alsadat, Banseshi, Mohammad Reza, Borhaninejad, Vahid Reza, and Iranpour, Abedin
- Subjects
HEALTH self-care ,HEALTH literacy ,HEMODIALYSIS patients ,CROSS-sectional method ,MEDICAL care costs ,CHRONIC kidney failure - Abstract
Background: Inadequate health literacy (HL) in dialysis patients increases the risk of poor self-care and decreases severe self-care and severe negative health outcomes in these patients. This study aimed to investigate HL and its related factors in dialysis patients in Kerman, Iran, in 2021. Methods: This cross-sectional study was performed on 280 dialysis patients who referred to Kerman (Iran) dialysis centres. The participants were selected through multi-stage sampling method. The study was conducted using the Iranian Health Literacy Questionnaire (IHLQ). The higher score shows a better HL. Results: The mean age of the subjects was 57.75±13.87 years. The mean score of HL was 9.12±4.54 out of 20 points. During multivariate regression, there was a significant relationship between HL and age (β=-0.08, P=0.02) and level of education (elementary/ literacy (β=4.607, P<0.001), middle school (β=6.38, P<0.001), high school (β=8.573, P<0.001) and academic education (β=9.410, P<0.001), and there was a significant relationship between HL and eye disease (β=-0.903, P=0.001). Conclusion: Most participants did not have adequate HL, while HL as the most important determinant of self-care can improve patients’ quality of life and reduce their health care costs. Therefore, in order to increase self-care, planning and necessary interventions, the HL of these patients seems to be necessary. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
22. Micronutrients and Renal Outcomes: A Prospective Cohort Study.
- Author
-
Chen, Chun-Yu, Chiu, Chun-Hui, Wu, I-Wen, Hsu, Heng-Jung, Chen, Yih-Ting, Hsu, Cheng-Kai, Pan, Heng-Chih, Lee, Chin-Chan, and Sun, Chiao-Yin
- Abstract
Background: Micronutrients are essential in maintaining normal human physiology. Data regarding the association between micronutrients and renal outcomes in chronic kidney disease (CKD) are lacking. Methods: This prospective observational cohort study enrolled 261 patients with CKD stages 1–5 and 30 subjects with normal renal function. Baseline serum zinc (Zn), selenium (Se), chromium, manganese, and copper, and laboratory tests were performed at enrolment. The primary endpoint was the presence of end-stage renal disease (ESRD) requiring long-term renal replacement therapy. Results: The median follow-up periods of renal and non-renal survivals were 67.78 and 29.03 months, respectively. Multiple linear regression showed that Zn and Se (β ± SE: 24.298 ± 8.616, p = 0.005; 60.316 ± 21.875, p = 0.006, respectively) levels were positively correlated with renal function. Time to ESRD was significantly longer for those with Zn levels ≥1287.24 ng/g and Se levels ≥189.28 ng/g (both p < 0.001). Cox regression analysis identified a higher Zn level as an independently negative predictor of ESRD after adjusting for renal function (hazard ratio, 0.450, p = 0.019). Conclusion: Serum Se and Zn concentrations are positively associated with renal function and better renal outcomes. A higher Zn concentration could independently predict better renal survival. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
23. More Frequent Dialysis (>3 Treatments Per Week) (MFD)
- Published
- 2019
24. Comparison of Dialysis Therapies on Cognitive Function
- Published
- 2019
25. TARGTEPO Treatment for Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD)
- Author
-
Medgenics Medical Israel Ltd.
- Published
- 2018
26. Treatment of Autonomous Hyperparathyroidism in Post Renal Transplant Recipients
- Published
- 2018
27. Assessment of Coronary Heart disease In Low Likelihood patients with End Stage kidney disease (ACHILLES) : comparison between Coronary Computed Tomography Angiography and Myocardial Perfusion Imaging
- Author
-
Capuano, Ermanno
- Subjects
616.1 ,Cardiovascular Imaging ,Coronary Computed Tomography Angiography ,Myocardial Perfusion Scintigraphy ,End Stage Renal Disease ,Chronic Kidney Disease - Abstract
Purpose: To evaluate the diagnostic performance of Coronary Computed Tomography Angiography (CCTA) in predicting Myocardial Perfusion Scintigraphy (MPS) perfusion defects in low likelihood patients with End Stage Renal Disease (ESRD) awaiting transplant. Materials and Methods: In total, 131 consecutive patients with ESRD awaiting transplant were prospectively enrolled in this study (86 men; 54±9years). All patients underwent MPS as per standard of care and in addition non-enhanced CT for calcium scoring (CAC score) and Coronary Computed Tomography Angiography (CCTA). Results: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CAC score in predicting MPS perfusion defects were 88%, 35%, 28% and 92%, respectively. The sensitivity, specificity, PPV and NPV of CCTA in predicting MPS perfusion defects at the patient level were 55%, 87%, 57% and 87%, respectively, and 48%, 92%, 41% and 94% at the vessel level. The diagnostic performance of CCTA in predicting MPS perfusion defects improved when patients with CAC score higher than 1000 (15/70, 21%) were excluded from the analysis. In patients with positive CAC score up to 1000 sensitivity, specificity, PPV and NPV at the patient level were 60%, 93%, 75% and 86% respectively. These were 53%, 91%, 36% and 95%, respectively, at the vessel level. Conclusion: Non-enhanced CT for CAC score and CCTA can be considered useful diagnostic tools in the ESRD population, particularly in identifying patients without coronary artery disease. This approach however had limitations in the presence of high CAC score.
- Published
- 2017
28. Prevalence and risk factors of chronic kidney disease among commercial motorcyclists in Ado-Ekiti, Ekiti State, Nigeria
- Author
-
Funmilayo A. Ibitoba, Oluwaseyi A. Akpor, and Oghenerobor B. Akpor
- Subjects
Prevalence ,Risk factors ,Chronic kidney disease ,End stage renal disease ,Renal replacement therapy ,Science - Abstract
Chronic kidney disease (CKD) is a silent killer that has become a global public health issue in the past decades and affects more than 10% of the population worldwide. The study aimed to investigate the prevalence and risk factors of CKD among commercial motorcyclists in Ado-Ekiti. The study adopted a descriptive cross-sectional survey design. A multistage sampling technique was employed to select 310 respondents. Socio-demographic data, knowledge, and risk factors for CKD were determined using a standardized questionnaire while CKD prevalence and incidence of end stage renal disease were investigated with biophysical measurements and laboratory investigations. Descriptive analyses were used to answer the research questions while inferential statistics were used to test hypotheses at a significant level of p
- Published
- 2022
- Full Text
- View/download PDF
29. A cross-sectional study to evaluate etiopathogenesis, clinical features, complications, and treatment of patients of chronic kidney disease.
- Author
-
Patel, Dushyant Shantilal, Patel, Nirav Rasiklal, Patel, Jagdishkumar Virabhai, and Chavda, Avani Bipinchandra
- Subjects
CHRONIC kidney failure ,CHRONICALLY ill ,KIDNEYS ,ITCHING ,DIABETIC nephropathies - Published
- 2022
- Full Text
- View/download PDF
30. PAIN MANAGEMENT OF PATIENTS WITH CHRONIC KIDNEY DISEASE.
- Author
-
DELALIĆ, ĐIĐI and PRKAČIN, INGRID
- Abstract
Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
31. Ramadan Fasting and Patients with Renal Problems: A Literature Review
- Author
-
Naina Mohamed Pakkir Maideen and Abdurazak Jumale
- Subjects
islamic fasting ,ramadan fasting ,chronic kidney disease ,diabetic nephropathy ,renal colic ,dialysis ,end stage renal disease ,Medicine (General) ,R5-920 - Abstract
Millions of Muslims across the world observe Islamic fasting during the holy month of Ramadan and other days of lunar calendar year. The believers of Islam do not eat or drink from just before the sunrise until the sunset during fasting. Absence of fluid intake during Islamic fasting leads to dehydration, which may affect the renal health and though the sick are exempted from Islamic fasting majority of patients may prefer to fast during Ramadan. Hence, this review aims to summarise the effects of Islamic fasting specifically in patients with renal problems including chronic kidney disease (CKD), nephrolithiasis, urolithiasis, end stage renal disease (ESRD) and the patients on kidney transplants, hemodialysis, peritoneal dialysis and intestinal dialysis. This literature review conducted through searching in databases like Medline, PubMed, PMC, Google Scholar, ScienceDirect, DOAJ, Cochrane Library, and reference lists. The restriction of water during Ramadan fasting could result in acute tubular cell injury and hence the patients with Chronic Kidney Disease should consult their healthcare professionals at least a month before Ramadan and should fast under close medical supervision [21]. The patients with renal colic willing to fast during Ramadan should be advised to consume adequate amounts of water during non-fasting hours and to reduce the potential risk of dehydration while the patients on dialysis and the recipients of kidney who are willing to fast during Ramadan should be monitored closely. Overall, the patients with renal problems could fast safely during Ramadan under medical supervision.
- Published
- 2021
- Full Text
- View/download PDF
32. Chronic kidney disease in Cameroon: a scoping review
- Author
-
Jerry Brown Aseneh, Ben-Lawrence A. Kemah, Stephane Mabouna, Mbeng Emmanuel Njang, Domin Sone Majunda Ekane, and Valirie Ndip Agbor
- Subjects
Chronic kidney disease ,End stage renal disease ,Cameroon ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Objectives This scoping review sought to summarize available data on the prevalence, associated factors, etiology, comorbidities, treatment, cost and mortality of chronic kidney disease (CKD) in Cameroon. Methods We searched PubMed, Scopus and African Journals Online from database inception to 31 March, 2020 to identify all studies published on the prevalence, associated factors, etiology, comorbidities, treatment, cost and mortality of CKD in Cameroon. Results Thirty studies were included. The prevalence of CKD varied from 3 to 14.1 and 10.0%–14.2% in rural and urban areas, respectively. The prevalence of CKD in patients with hypertension, diabetes mellitus, and human immunodeficiency virus was 12.4–50.0, 18.5%, and 3.0–47.2%, respectively. Hypertension (22.3–59.1%), chronic glomerulonephritis (15.8–56.2%), and diabetes mellitus (15.8–56.2%) were the most common causes of CKD. The cause was unknown in 13.5–17.0% of the cases. Advanced age, hypertension, diabetes mellitus, and obesity were frequent associated factors. Hemodialysis was the main treatment modality in patients with End Stage Renal Disease (ESRD). The monthly cost of management of non-dialyzed CKD was 163 US dollars. The one-year mortality rate of ESRD was 26.8–38.6%. Conclusion Chronic kidney disease affects about one in 10 adults in the general population in Cameroon. Patients with hypertension, diabetes mellitus, and human immunodeficiency virus bear the greatest burden of CKD in Cameroon. Advanced age, hypertension, diabetes mellitus, and obesity are major factors associated with CKD. Chronic kidney disease in Cameroon is associated with high morbidity and mortality and huge economic cost on the patient.
- Published
- 2020
- Full Text
- View/download PDF
33. A Pilot Observational Study Assessing Long-Term Changes in Clinical Parameters, Functional Capacity and Fall Risk of Patients With Chronic Renal Disease Scheduled for Hemodialysis
- Author
-
Damiano D. Zemp, Olivier Giannini, Pierluigi Quadri, Mauro Tettamanti, Lorenzo Berwert, Soraya Lavorato, Silvio Pianca, Curzio Solcà, and Eling D. de Bruin
- Subjects
chronic kidney disease ,end stage renal disease ,hemodialysis (HD) ,physical activity ,motor capacity ,cognitive capacity ,Medicine (General) ,R5-920 - Abstract
BackgroundPatients with end-stage renal disease are known to be particularly frail, and the cause is still widely seen as being directly related to specific factors in renal replacement therapy. However, a closer examination of the transitional phase from predialysis to long-term hemodialysis leads to controversial explanations, considering that the frailty process is already well-described in the early stages of renal insufficiency. This study aims to describe longitudinally and multifactorially changes in the period extending from the decision to start the replacement therapy through to the end of 2 years of hemodialysis. We hypothesized that frailty is pre-existent in the predialysis phase and does not worsen with the beginning of the replacement therapy. Between 2015 and 2018 we recruited 25 patients (72.3 ± 5.7 years old) in a predialysis program, with the expectation that replacement therapy would begin within the coming few months.MethodsThe patients underwent a baseline visit before starting hemodialysis, with 4 follow-up visits in the first 2 years of treatment. Health status, physical performance, cognitive functioning, hematology parameters, and adverse events were monitored during the study period.ResultsAt baseline, our sample had a high variability with patients ranging from extremely frail to very fit. In the 14 participants that did not drop out of the study, out of 32 clinical and functional measures, a statistically significant worsening was only observed in the Short Physical Performance Battery (SPPB) score (p < 0.01, F = 8.50) and the number of comorbidities (p = 0.01, F = 3.94). A careful analysis, however, reveals a quite stable situation in the first year of replacement therapy, for both frail and fit participants and a deterioration in the second year that in frail participants could lead to death.ConclusionOur results should stimulate a reassessment about the role of a predialysis program in reducing complications during the transitional phase, but also about frailty prevention programs once hemodialysis has begun, for both frail and fit patients, to maintain satisfactory health status.
- Published
- 2022
- Full Text
- View/download PDF
34. Assessment of Relationship between Galectin-3 and Biochemical Parameters in Peritoneal Dialysis Patients with Left Ventricular Hypertrophy
- Author
-
Sultan Alouffi, Ahmed Alsalloom, Menawer Alharbi, Wajid Khan, and Waleed Tamimi
- Subjects
cardiovascular disease ,chronic kidney disease ,end stage renal disease ,heart failure ,Medicine - Abstract
Introduction: Cardiovascular complications are considered as the main cause of mortality in patients with End-Stage Renal Disease (ESRD). Cardiovascular Disease (CVD) includes disorders of the Left Ventricular Hypertrophy (LVH) of the heart which is the most frequent cardiac alteration in ESRD. Galectin-3 (GAL-3), a β-galactoside-binding protein has been proposed to be a new clinical biomarker that reflects cardiac fibrosis in patients with Heart Failure (HF). Aim: To evaluate the relationship between GAL-3 and biochemical parameters in Peritoneal Dialysis (PD) patients with and without LVH. Materials and Methods: This cross-sectional study enrolled 45 patients (25 women and 20 men) with ESRD who were categorised as having CVD with (n=12) or without (n=33) LVH. Demographic, biochemical and clinical characteristics of 45 patients were analysed. The relationship of plasma GAL-3 levels was analysed with the biochemical parameters for both the groups of patients. For comparison between groups, Student unpaired t-test was used for the data of normal distribution while Mann-Whitney test was used for data of non-Gaussian distribution. Pearson’s correlation test was performed to examine various correlations. Results: Significantly high number (83.3%) of female patients were observed in ESRD with LVH. The groups did not differ significantly in their demographic, and biochemical and clinical parameters. There was significant increase in Left Ventricular End-Diastolic Diameters (LVEDD), Left Ventricular (LV) mass and LV mass index in patients with LVH as compared to the patients without LVH. The levels of GAL-3 showed slight increase (91±23.98 ng/mL) levels in LVH patients as compared to the patients without LVH (83.68±32.8 ng/mL). Exponential positive correlation between serum levels of GAL-3 and creatinine in ESRD patients without LVH (r=0.563, p=0.001). GAL-3 also showed positive correlations with urea without (r=0.563, p=0.001) as well as and uric acid (r=0.416, p=0.0178) for ESRD patients without LVH. However, GAL-3 showed no association with uric acid and urea (r=0.04487, p=0.896; r=0.2383, p=0.48) in ESRD patients with LVH. Conclusion: GAL-3 positively correlated to the biochemical parameters in ESRD patients. Patients with LVH only showed positive correlation between GAL-3 and creatinine. Moreover, GAL-3 could not be used as the biomarker because it did not correlate with established diagnostic parameter like LV mass and LV mass index. Hence, in this study GAL-3 is not a potential clinical biomarker for the progression of cardiovascular complications in ESRD patients. Overall, these data reflect the need for further investigation of GAL-3 to HF in patients with ESRD.
- Published
- 2020
- Full Text
- View/download PDF
35. American Indian chronic Renal insufficiency cohort study (AI-CRIC study)
- Author
-
Mark L. Unruh, Soraya Arzhan, Harold I. Feldman, Helen C. Looker, Robert G. Nelson, Thomas Faber, David Johnson, Linda Son-Stone, Vernon S. Pankratz, Larissa Myaskovsky, Vallabh O. Shah, and the CRIC study investigators
- Subjects
Chronic kidney disease ,Cardiovascular disease ,American Indians ,AI-CRIC ,End stage Renal disease ,Environmental exposure ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Chronic kidney disease (CKD) is an increasing epidemic globally that is associated with adverse health outcomes including end stage kidney disease (ESKD), cardiovascular disease (CVD), and death. American Indians (AIs) have a higher prevalence of CKD than most other racial/ethnic groups, due in part to a high prevalence of type 2 diabetes. Other genetic and environmental factors not yet identified may also contribute to the disproportionate burden of CKD in AIs. Method We will establish 3 clinical centers to recruit AIs from the Southwest United States (US) to expand the Chronic Renal Insufficiency Cohort (CRIC) study. We will follow the current CRIC protocol for kidney and cardiovascular measures and outcomes, which include ambulatory monitoring of kidney function and the use of mobile health technologies for CVD sub-phenotyping, and compare the outcomes in AIs with those in other racial/ethnic groups in CRIC. Discussion AI-CRIC will identify the role of various risk factors for rapid loss of kidney function among AIs of the Southwest US. In addition, to better understand the natural history of CKD and CVD in this high-risk population, we will identify unique risk factors for CKD and CVD progression in AIs. We will also compare event rates and risk factors for kidney and cardiovascular events in AIs with the other populations represented in CRIC.
- Published
- 2020
- Full Text
- View/download PDF
36. Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review
- Author
-
Hilda O. Hounkpatin, Simon D. S. Fraser, Rory Honney, Gavin Dreyer, Alison Brettle, and Paul J. Roderick
- Subjects
Chronic kidney disease ,Epidemiology ,End stage renal disease ,Ethnicity ,Pre-dialysis ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background There are a growing number of studies on ethnic differences in progression and mortality for pre-dialysis chronic kidney disease (CKD), but this literature has yet to be synthesised, particularly for studies on mortality. Methods This scoping review synthesized existing literature on ethnic differences in progression and mortality for adults with pre-dialysis CKD, explored factors contributing to these differences, and identified gaps in the literature. A comprehensive search strategy using search terms for ethnicity and CKD was taken to identify potentially relevant studies. Nine databases were searched from 1992 to June 2017, with an updated search in February 2020. Results 8059 articles were identified and screened. Fifty-five studies (2 systematic review, 7 non-systematic reviews, and 46 individual studies) were included in this review. Most were US studies and compared African-American/Afro-Caribbean and Caucasian populations, and fewer studies assessed outcomes for Hispanics and Asians. Most studies reported higher risk of CKD progression in Afro-Caribbean/African-Americans, Hispanics, and Asians, lower risk of mortality for Asians, and mixed findings on risk of mortality for Afro-Caribbean/African-Americans and Hispanics, compared to Caucasians. Biological factors such as hypertension, diabetes, and cardiovascular disease contributed to increased risk of progression for ethnic minorities but did not increase risk of mortality in these groups. Conclusions Higher rates of renal replacement therapy among ethnic minorities may be partly due to increased risk of progression and reduced mortality in these groups. The review identifies gaps in the literature and highlights a need for a more structured approach by researchers that would allow higher confidence in single studies and better harmonization of data across studies to advance our understanding of CKD progression and mortality.
- Published
- 2020
- Full Text
- View/download PDF
37. Chronic kidney diseases: A realm for preventive nephrology
- Author
-
Rahul Pal, Vinay Rathore, Abhiruchi Galhotra, and Varun Mamidi
- Subjects
chronic kidney disease ,complications of ckd ,end stage renal disease ,preventive nephrology ,Medicine - Abstract
Chronic Kidney Disease (CKD) is emerging as a major public health priority worldwide. It is a chronic condition influenced by lifestyle and behavior. The risk factors for CKD are highly prevalent among the Indian population, and the number of Indians at risk is increasing. Preventive measures focusing on reducing the prevalence of CKD by limiting exposure to risk factors could be cost effective in a country like India. Kidney diseases disproportionally affect disadvantaged populations and reduce the number of productive years of life. Furthermore, the prospect of financial burden discourages many patients from undergoing treatment, thereby leading to preventable morbidity and death. The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. Blood pressure control, inhibition of the renin-angiotensin system and disease-specific interventions are the cornerstones of therapy. Health literacy and self-management are critical to improving the outcomes of chronic conditions such as chronic kidney disease. Primary Care and Family physicians act as a bridge between the nephrologist specialist and the CKD patients; which will help in improving the quality of life, reduce physical and psychologic limitations and complications associated with CRF, and help patients return to their families, jobs, and social lives
- Published
- 2020
- Full Text
- View/download PDF
38. Growth Hormone Secretagogue MK-0677 Effect on IGF-1 Levels in ESRD Patients
- Author
-
National Institutes of Health (NIH), Merck Sharp & Dohme LLC, and Warren K Bolton, Principal Investigator
- Published
- 2017
39. Different Doses of Oral Melatonin Supplements in Chronic Kidney Disease (CKD)-Associated Sleep Disorders
- Published
- 2017
40. Efficacy of Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation in Hemodialysis Patients
- Published
- 2016
41. Safety Study of Soluble Ferric Pyrophosphate (SFP) in Dialysate in CKD Patients Receiving Chronic Hemodialysis
- Published
- 2016
42. Effect of Sit Less, Interact, Move More (SLIMM) Regimen on Patients With Chronic Kidney Disease (CKD) (SLIMM)
- Author
-
Srinvasan Beddhu, MD
- Published
- 2016
43. Mucocutaneous manifestations of patients with chronic kidney disease under hemodialysis: A cross‐sectional study of 49 patients.
- Author
-
Tajalli, Farzam, Mirahmadi, Seyed‐Mohamad‐Sadegh, Mozafarpoor, Samaneh, Goodarzi, Azadeh, Nasiri Partovi, Mitra, and Lakestani, Davood
- Subjects
- *
CHRONIC kidney failure , *CHRONICALLY ill , *HEMODIALYSIS , *DENTAL discoloration , *CUTANEOUS manifestations of general diseases , *CROSS-sectional method , *ITCHING - Abstract
Chronic kidney disease (CKD) is a common medical problem with well‐known dermatologic manifestations, some of which highly disturb the patients' quality of life. This cross‐sectional study was designed to identify the prevalence and type of cutaneous involvement in CKD patients. The skin manifestations of 49 patients with CKD undergoing hemodialysis at Akhavan Hospital in Kashan, Iran, were recorded over 2 months. Diabetes (35%) was the most common cause of chronic renal failure in the patients, and the most common skin manifestations were xerosis (95.9%), uremic pigmentation (89.8%), scleral discoloration (87.8%), dental discoloration (85.2% among the patients with natural teeth), dry mouth (65.3%), varicosity (61.2%), pruritus (57.1%), skin atrophy (49%), lentigo (46.9%), subungual hyperkeratosis (42.9%), half and half nail dystrophy (34.7%), and purpura (26.5%). Mucocutaneous involvement has a very high prevalence in CKD patients undergoing hemodialysis, and some of the cases are medically and cosmetically disturbing; therefore, with better knowledge about the type and prevalence of these involvements, the consequences can be better predicted and managed. Further studies are recommended to be conducted on the association between these signs and CKD grade, and clinical trials are also required for establishing the treatment options available for these signs and then assessing the patients' quality of life as a primary outcome measure. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
44. Signatures of Gait Movement Variability in CKD Patients Scheduled for Hemodialysis Indicate Pathological Performance Before and After Hemodialysis: A Prospective, Observational Study
- Author
-
Damiano D. Zemp, Olivier Giannini, Pierluigi Quadri, Marco Rabuffetti, Mauro Tettamanti, and Eling D. de Bruin
- Subjects
chronic kidney disease ,end stage renal disease ,hemodialysis ,physical activity ,gait ,variability ,Medicine (General) ,R5-920 - Abstract
Background: The frailty status of hemodialysis patients is well-known, but the role of the therapy in the frailty process is not yet clear. Nowadays gait analysis in nephrology is neglected, although gait performance is known to be related to frailty and kidney function. We hypothesized that gait quality and physical activity level is already affected before, and does not change because of the start of hemodialysis.Methods: Fourteen patients (72.3 ± 5.7 years old) in a pre-dialysis program underwent an instrumental gait analysis and their physical activity was monitored for a week. This protocol was repeated 3, 6, 12, and 24 months after the first hemodialysis session.Results: At baseline, our sample showed a conservative gait with pathologic gait variability, high dual-task cost, and a sedentary lifestyle. No statistically significant change was found in any parameter in the analyzed period, but there was a tendency toward an improvement of gait quality and physical activity in the first year of treatment, and a decline in the second year.Conclusion: Elderly patients in the pre-dialysis stage show a conservative gait, however variability was in a pathological range and did not change post-hemodialysis. This hints toward changes in the central nervous system due to the kidney disease. This finding suggests the importance of gait analysis in the early stages of renal disease in the diagnosis of changes in the nervous system due to kidney failure that affect gait. Early detection of these changes would potentially allow a prevention program tailored to this population to be developed.
- Published
- 2021
- Full Text
- View/download PDF
45. Micronutrients and Renal Outcomes: A Prospective Cohort Study
- Author
-
Chun-Yu Chen, Chun-Hui Chiu, I-Wen Wu, Heng-Jung Hsu, Yih-Ting Chen, Cheng-Kai Hsu, Heng-Chih Pan, Chin-Chan Lee, and Chiao-Yin Sun
- Subjects
micronutrient ,chronic kidney disease ,zinc ,selenium ,end stage renal disease ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: Micronutrients are essential in maintaining normal human physiology. Data regarding the association between micronutrients and renal outcomes in chronic kidney disease (CKD) are lacking. Methods: This prospective observational cohort study enrolled 261 patients with CKD stages 1–5 and 30 subjects with normal renal function. Baseline serum zinc (Zn), selenium (Se), chromium, manganese, and copper, and laboratory tests were performed at enrolment. The primary endpoint was the presence of end-stage renal disease (ESRD) requiring long-term renal replacement therapy. Results: The median follow-up periods of renal and non-renal survivals were 67.78 and 29.03 months, respectively. Multiple linear regression showed that Zn and Se (β ± SE: 24.298 ± 8.616, p = 0.005; 60.316 ± 21.875, p = 0.006, respectively) levels were positively correlated with renal function. Time to ESRD was significantly longer for those with Zn levels ≥1287.24 ng/g and Se levels ≥189.28 ng/g (both p < 0.001). Cox regression analysis identified a higher Zn level as an independently negative predictor of ESRD after adjusting for renal function (hazard ratio, 0.450, p = 0.019). Conclusion: Serum Se and Zn concentrations are positively associated with renal function and better renal outcomes. A higher Zn concentration could independently predict better renal survival.
- Published
- 2022
- Full Text
- View/download PDF
46. Aging and Renal Disease: Old Questions for New Challenges.
- Author
-
Yu-Hsiang Chou and Yung-Ming Chen
- Subjects
- *
CHRONIC kidney failure , *DISEASE progression , *PHYSIOLOGICAL aspects of aging - Abstract
Chronic kidney disease (CKD) is a growing problem among aging population, and the number of individuals at risk of end stage renal disease is rising. Part of the reason lies in incomplete understanding of the pathways underlying renal aging and kidney disease, as well as insufficient delivery of evidence-based treatment to elderly patients with CKD. This review aims to address these unsolved issues by delineating updated mechanisms of renal senescence and summarizing recent findings on key clinical aspects of CKD in the elderly. Challenges and obstacles in caring for older people with CKD are discussed, with an emphasis on modification of risk factors, prevention of acute kidney injury, stabilization of progression and decision on dialysis initiation. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
47. EVALUATION OF SOME BIOCHEMICAL PARAMETERS AND THE EFFECT OF OXIDATIVE STREES DURING HEMODIALYSIS IN PATIENTS WITH CHRONIC RENAL DISEASE.
- Author
-
Attia, Rana Ibrahim and Naji Abed, Nazar Ahmed
- Subjects
OXIDATIVE stress ,HEMODIALYSIS ,CHRONIC kidney failure ,CHRONIC diseases ,LIPOPROTEINS - Abstract
Chronic kidney disease (CKD) is a form of kidney disease in which kidney function loss occurs progressively over months to years and develops with age. Based on the glomerular filtration rate (GFR), five stages of chronic renal failure (CRF) and stage 5 are also referred to as End-stage renal disease (ESRD). Dialysis therapies replace some of these functions by removal of waste and removal of fluid. Urea, creatinine and uric acid are identify impaired renal function. Dyslipidemia is one of the mechanisms underlying this elevated cardiovascular risk. Uremic lipoprotein profile includes changes in triglyceriderich lipoproteins, Low-density lipoprotein (LDL) particles and decreased High density lipoprotein (HDL). Enhanced oxidative stress and uremic environment can lipoprotein disorder. In patients with hemodialysis, cardiovascular disease (CVD) is a highly common complication and the first cause of death. Procedure for hemodialysis contributes to inflammation and oxidative stress. Malondialdehyde has been used as a biomarker of oxidative stress in blood . Glutathione plays a crucial role in essential physiological processes, resulting in effects related to various pathophysiological diseases such as maintenance of redox balance redox, oxidative stress reduction. Low serum ferritin levels indicate reduced iron stores and multiple different diseases, including renal disease. High levels of sodium are a significant risk factor for hypertension and are also associated with an increased risk of heart and kidney disease. Low dialysate potassium concentrations to reduce serum potassium levels are associated with a high risk of sudden heart failure. Calcium imbalance increases the risk of vascular calcification and cardiovascular events. High levels of serum phosphorus are associated with negative cardiovascular outcomes and mortality in dialysis patients. Results from this study that in dialysis patients there are many risk factors for developing CVD, such as inflammation, oxidative stress and vascular calcification [ABSTRACT FROM AUTHOR]
- Published
- 2021
48. Study to Assess Fixed Dosing of AMG 223 in Subjects With Chronic Kidney Disease on Hemodialysis With Hyperphosphatemia
- Published
- 2016
49. Risk Stratification in End Stage Renal Disease (ESRD) - ISAR Study (ISAR)
- Author
-
Else Kröner Fresenius Foundation, AIT Austrian Institute of Technology GmbH, Ludwig-Maximilians - University of Munich, FH Aachen, University of applied sciences, and PD Dr. Christoph Schmaderer, PD Dr. med. Christoph Schmaderer
- Published
- 2016
50. Single-dose baclofen-induced neurotoxicity in a patient with end stage renal disease: case report
- Author
-
Emad Khazneh, Alaa Shamlawi, Kamel Jebrin, Zakaria Hamdan, and Osama Sawalmeh
- Subjects
Baclofen ,Toxicity ,Neurotoxicity ,End stage renal disease ,ESRD ,Chronic kidney disease ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Baclofen is a centrally acting GABAB receptor agonist and it is used widely for the treatment of spasticity, persistent hiccups and multiple sclerosis. The renal system is the main route of excretion, thus people with suboptimal renal function are prone to baclofen intoxication. Multiple doses of baclofen have been associated with toxicity, but it is very unusual that single dose can do so. Case presentation A 47 year old female patient with end stage renal disease (ESRD) presented with a sudden onset of altered mental status and state of unconsciousness after the ingestion of one tablet of baclofen 25 mg. All other possible causes were ruled out and a diagnosis of baclofen toxicity was considered. The patient showed dramatic improvement after an extra two sessions of hemodialysis. Conclusions We highly recommend that more educational efforts are made for health care professionals about the possible risk of baclofen toxicity among kidney-impaired patients. We also recommend avoiding baclofen use if evidence of chronic renal disease is present and to seek other alternatives for pain management.
- Published
- 2018
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.