Factors associated with low trabecular bone scores in patients with end-stage kidney disease

Abstract Introduction: Glycaemic variability (GV) or glycaemic fluctuations carries a significant higher risk of diabetic-related complications, especially cardiovascular. Extensive researches have been reported, but study on the end-stage-kidney-disease (ESKD) patients on chronic haemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs non-diabetic) patients and its associated factors during haemodialysis day (HDD) and non-haemodialysis day (NHDD). Methods: We recruited 150 patients on haemodialysis, 93 patients had diabetic (DM-ESKD), and 57 non-diabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage co-efficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles during haemodialysis and non-haemodialysis day. The GV indices and its associated factors were analysed comparing between both groups during the HDD and NHDD. Results: Mean blood glucose during HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared to 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (p =<0.01). The DM-ESKD group experienced significantly higher GV indices compared to NDM-ESKD; both during haemodialysis and non-haemodialysis day, particularly in the group with HbA1c 8-10% (p= <0.01). Presence of diabetes, older age group, hyperlipidaemia, HbA1c, ferritin levels, and albumin were recognised as factors associated with GV. Conclusion: DM-ESKD patients has high glycaemic variability, especially during the haemodialysis day, therefore increasing their chance to develop future devastating complications. We identified high HbA1c, older age group, presence of hyperlipidaemia, ferritin levels, and albumin as factors associated with GV. Since these groups of patients are vulnerable to CVD mortality, urgent attention is needed to rectify it.

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Prevalence of glycemic variability and factors associated with the glycemic arrays among end-stage kidney disease patients on chronic hemodialysis

Medicine ◽

10.1097/md.0000000000026729 ◽

2021 ◽

Vol 100 (30) ◽

pp. e26729

Author(s):

Abdul Hanif Khan Yusof Khan ◽

Nor Fadhlina Zakaria ◽

Muhammad Adil Zainal Abidin ◽

Nor Azmi Kamaruddin

Keyword(s):

Kidney Disease ◽

Glycemic Variability ◽

Chronic Hemodialysis ◽

End Stage Kidney Disease ◽

Factors Associated ◽

End Stage

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Factors Associated with Burden in Caregivers of Patients with End-Stage Kidney Disease (A Systematic Review)

Healthcare ◽

10.3390/healthcare9091212 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1212

Author(s):

Bushra Alshammari ◽

Helen Noble ◽

Helen McAneney ◽

Farhan Alshammari ◽

Peter O’Halloran

Keyword(s):

Kidney Disease ◽

Health Care Providers ◽

Well Being ◽

Extensive Literature ◽

Care Providers ◽

End Stage Kidney Disease ◽

Related Factors ◽

Factors Associated ◽

Relational Factors ◽

End Stage

Background: Caring for a patient with end-stage kidney disease (ESKD) is highly stressful and can impact negatively on the physical and psychological well-being of caregivers. To accurately assess caregiver burden (CB), health care providers (HCPs) need to identify characteristics associated with an increase in CB. Aim: The aim of this review is to explore CB in caregivers of adult patients with ESKD and to identify characteristics associated with any increase in CB. Method: A comprehensive literature search was completed using five electronic databases. Medline, Embase, CINHAL, PsycINFO, and Scopus. The Joanna Briggs Institute checklist (JBI) was used to quality appraise full text papers included in the review. No time limit for the date of publication of studies was employed, to enable the inclusion of more extensive literature. Results: A total of 38 relevant studies from 18 countries were identified and included in the review. A variety of patient and caregiver factors can impact positively or negatively on CB, including socio-demographic factors of patients and caregivers, disease-related factors, situational and relational factors, environmental factors, and psychological factors. Conclusion: This review provides awareness to HCPs of the important factors associated with CB, when assessing or targeting interventions for caregivers experiencing burden.

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Ischemic Heart Disease in Patients with End-Stage Kidney Disease

Blood Purification ◽

10.1159/000441582 ◽

2015 ◽

Vol 40 (4) ◽

pp. 332-336 ◽

Cited By ~ 1

Author(s):

Yuri Tanaka ◽

Nobuhiko Joki ◽

Hiroki Hase

Keyword(s):

Heart Disease ◽

Coronary Artery ◽

Kidney Disease ◽

Myocardial Ischemia ◽

Oxygen Supply ◽

Supply And Demand ◽

End Stage Kidney Disease ◽

Factors Associated ◽

End Stage

Background: It was recently reported that the severity of coronary and carotid atherosclerosis in patients with end-stage kidney disease (ESKD) has improved over the last two decades. However, the frequency of coronary artery events observed at the initiation of dialysis remains high. Summary: Recently, 5 different clinical types of acute myocardial infarction (MI) were introduced in the third universal definition of MI. Type 2 MI, known as secondary MI, is a more heterogeneous entity, where a condition other than coronary artery narrowing contributes to an acute imbalance in oxygen supply and demand. In patients with chronic kidney disease, it has been demonstrated that type 2 MI is more common than type 1 MI, which is associated with coronary occlusive disease. It is suspected that patients with ESKD also often have type 2 MI. Factors associated with incremental increases in oxygen demand may cause myocardial ischemia in ESKD. Key Messages: Significant epicardial coronary narrowing might not be a necessary precursor of myocardial ischemia in ESKD. To prevent ischemic heart disease and improve prognosis in patients with ESKD, we need to pay attention not only to coronary stenotic lesions, but also to the factors associated with the induction of an imbalance in myocardial oxygen supply and demand.

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Prevalence Of Glycemic Variability And Factors Associated With The Glycemic Arrays Among End-Stage Kidney Disease Patients On Chronic Haemodialysis.

10.21203/rs.3.rs-41271/v2 ◽

2020 ◽

Author(s):

Abdul Hanif Khan Yusof Khan ◽

Nor Fadhlina Zakaria ◽

Muhammad Adil Zainal Abidin ◽

Nor Azmi Kamaruddin

Keyword(s):

Blood Glucose ◽

Kidney Disease ◽

Associated Factors ◽

Older Age ◽

Diabetic Patients ◽

Chronic Haemodialysis ◽

End Stage Kidney Disease ◽

Glycaemic Variability ◽

Factors Associated ◽

End Stage

Abstract Introduction: Glycaemic variability (GV) confers a significantly higher risk of diabetic-related complications, especially cardiovascular. Despite extensive research in this area, data on end-stage-kidney-disease (ESKD) patients on chronic haemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs non-diabetic) patients and its associated factors on haemodialysis days (HDD) and non-haemodialysis days (NHDD).Methods: We recruited 150 patients on haemodialysis, 93 patients with diabetic (DM-ESKD), and 57 with non-diabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage co-efficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles on HDD and NHDD. The GV indices and its associated factors of both DM-ESKD and NDM-ESKD were analysed to compare HDD vs. NHDD.Results: Mean blood glucose on HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared to 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (p =<0.01). The DM-ESKD group experienced significantly higher GV indices compared to NDM-ESKD on both HDD and NHDD, particularly in the subgroup with HbA1c 8-10% (p= <0.01). Presence of diabetes, older age, hyperlipidaemia, HbA1c, ferritin levels, and albumin were identified as factors associated with GV.Conclusion: DM-ESKD patients have high GV, especially on HDD, therefore increasing their risk of developing future complications. We identified high HbA1c, older age group, presence of hyperlipidaemia, ferritin levels, and albumin as factors associated with GV. Since these groups of patients are vulnerable to CVD mortality, urgent attention is needed to rectify it.

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