scholarly journals Association between albuminuria and thyroid function in patients with chronic kidney disease

Endocrine ◽  
2021 ◽  
Author(s):  
Walter Reinhardt ◽  
Nils Mülling ◽  
Stefan Behrendt ◽  
Sven Benson ◽  
Sebastian Dolff ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Function ◽  
Filtration Rate ◽  
Creatinine Ratio ◽  
Protein Loss ◽  
Reverse T3 ◽  
Thyroid Antibody ◽  
Hormone Status ◽  
The Relationship

Abstract Purpose The relationship between proteinuria and thyroid function remains controversial in patients with chronic kidney disease (CKD). We prospectively investigated the association between kidney and thyroid function in thyroid antibody-negative patients through all CKD stages. Methods We enrolled 184 nondialysis patients (mean age: 63.1 ± 16.9 years) without previous thyroid disease or thyroid-specific antibodies. Kidney function was assessed by estimating the glomerular filtration rate (eGFR) classified according KDIGO (CKD G1–5). Kidney damage was assessed by albuminuria (albumin-to-creatinine ratio, ACR) and classified as mild, moderate, or severe (ACR1: <300, ACR2: 300–3000, and ACR3: 3000 mg/g). To evaluate thyroid function, TSH, T4, fT4, T3, fT3, reverse T3 (rT3), and thyroxine-binding globulin (TBG) were measured. Results rT3 concentrations correlated negatively with albuminuria (r = −0.286, p < 0.001) and were significantly lower in patients with severe albuminuria than in those with mild or moderate albuminuria (ACR3: 0.28 vs. ACR2: 0.32 vs. ACR1: 0.36 nmol/l, p < 0.001). The severity of albuminuria revealed no impact on TSH, fT4, T3, fT3, and TBG. EGFR correlated with increasing T4, fT4, T3, fT3, and TBG (T4: r = 0.289, p < 0.01; fT4: r = 0.196, p < 0.01; T3: r = 0.408, p < 0.01; fT3: r = 0.390, p < 0.01) but not with rT3. Conclusions In thyroid antibody-negative patients presenting advanced CKD (stages 4 and 5), even severe kidney protein loss failed to influence thyroid hormone status. However, albuminuria severity correlated negatively with rT3, which was significantly lower in patients with albuminuria in the nephrotic range.

scholarly journals HbA1c in a primary care cohort with diabetes and chronic kidney disease: the East and North Hertfordshire Institute of Diabetes and Endocrinology (ENHIDE) Diabetes Renal Telehealth Project

2020 ◽  
Vol 20 (2) ◽  
pp. 130-137
Author(s):  
Peter H Winocour ◽  
Karen Moore-Haines ◽  
Keith Sullivan ◽  
Anne Currie ◽  
Andrew Solomon ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Hospital Admissions ◽  
Dietary Management ◽  
Creatinine Ratio ◽  
Comprehensive Review

Aim: Diabetes mellitus and chronic kidney disease (CKD) commonly co-occur. Control of glycaemia is nuanced, and should be individualised. The Diabetes Renal Telehealth Project identified 2,356 adults with diabetes and CKD, and evaluated determinants and patterns of HbA1c in order to identify under-treatment or potential over-treatment of glycaemia.Method: Comprehensive review of GP diabetes registers by the clinical investigators.Results: The study subjects (52% male, 48% female) were aged 77 years (range 19–103) with median estimated glomerular filtration rate 52 (range 3–171) mL/min and median albumin to creatinine ratio 34 (range <0.05–1428) mg/mmol. 81% were solely managed in primary care. Median HbA1c was 57 (range 10–148) mmol/mol (7.4% (3.1–15.7%)) and at the 58 mmol/mol target in 64%. Anaemia was present in 31%. 22% were solely on dietary management, 29% on insulin therapy (6 in 10 of whom were also on additional agents) and 19% were on sulfonylurea (8 in 10 of whom were on additional agents excluding insulin). Patterns of HbA1c over 2 years were stable for 44%, variable in 19%, rising in 12% and improved in 8%. The 13% initially considered at increased hypoglycaemic risk based on HbA1c measures alone had worse renal function and were more frequently anaemic (both p<0.0005), and 83% were treated with insulin and/or sulfonylureas. Hypoglycaemia hospital admissions were low with 10 people admitted over the study period. There was a reduction in age with increasing quintiles of HbA1c, and those with HbA1c >75 mmol/mol (9.0%) were youngest (mean age 68 years, p<0.001).Conclusions: The majority of people with diabetes and CKD are elderly and managed in primary care, with anaemia in 31%, potentially affecting HbA1c interpretation. Iatrogenic hypoglycaemic risk was identified in 10%, with suboptimal glycaemic control (HbA1c >9% (75 mmol/mol)) through under-treatment in 9%. This study uncovered unmet clinical need, requiring both escalation and de-escalation of glycaemic therapies. 

scholarly journals The Role of Hyperuricemia in the Pathogenesis and Progressivity of Chronic Kidney Disease

2021 ◽  
Vol 9 (F) ◽  
pp. 428-435
Author(s):  
Gede Wira Mahadita ◽  
Ketut Suwitra
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Filtration Rate ◽  
Stage Iv ◽  
Review Of The Literature ◽  
The Relationship ◽  
Uric Acid Secretion

In humans, the end product of purine metabolism is uric acid. Over 70% of uric acid is excreted through the kidneys. When renal function is impaired, uric acid secretion is also impaired. This directly correlates the prevalence of hyperuricemia with the severity of chronic kidney disease (CKD). It has been reported that the prevalence of hyperuricemia in patients with Stage I-III CKD is 40–60% and up to 70% in patients with Stage IV-V CKD. Some studies found a link between serum uric acid levels and decreased glomerular filtration rate (GFR), an independent risk factor for CKD development. Because CKD and serum uric acid levels are related, the relationship between the two frequently generates controversy. As such, this review of the literature discusses the role of uric acid in the pathogenesis and progression of CKD.

scholarly journals Body Mass Index and the Relationship with Chronic Kidney Disease in a Tertiary Care Hospital in Romania

2016 ◽  
Vol 62 (2) ◽  
pp. 225-229
Author(s):  
Carmen Denise Caldararu ◽  
Dorin Tarta ◽  
Raluca Pop ◽  
Mirela Gliga ◽  
Emilian Carasca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Body Mass ◽  
Filtration Rate ◽  
Overweight And Obesity ◽  
The Relationship

AbstractObesity and chronic kidney disease are epidemic size. Chronic kidney disease (CKD) appears to be more common in obese, although interrelation is not supported by all authors.Aim: The aim of the study was to investigate the effects of overweight and obesity on glomerular filtration rate (GFR) and the relationship between body mass index (BMI) and other risk factors for CKD.Methods: This is a cross-sectional study on 627 patients admitted in a Nephrology Department between January 2007 - December 2011. Patients were divided according to eGFR in a CKD group and a non-CKD group. Patients were divided based on BMI in: normal (<25 kg/m2), overweight (≥ 25 kg/m2 and ≤30 kg/m2) and obese (>30 kg/m2). Demographical, clinical and laboratory data (serum creatinine, lipid parameters, etc) were used for the statistical analysis. The relationship between BMI (as a marker of obesity and overweight), glomerular filtration rate and other possible risk factors for chronic kidney disease was studied.Results: 43.70% patients were obese and 33.17% overweight. CKD prevalence was 58.69%. Logistic regression analysis showed that systolic blood pressure was the main determinant of CKD in our patients.Conclusion: Lack of association between BMI and CKD was demonstrated in our study.

48 Chronic kidney disease prevalence and glomerular filtration rate trends in children with type 1 diabetes

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e34-e34
Author(s):  
Kristen L Favel ◽  
Cherry Mammen
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Type 1 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
The Relationship

Abstract Primary Subject area Nephrology Background Children with type 1 diabetes (T1D) are at risk for acute kidney injury (AKI) secondary to diabetic ketoacidosis, as well as chronic kidney disease (CKD) from diabetic nephropathy. Objectives The primary objective of this study was to assess the prevalence of abnormalities in estimated glomerular filtration rate (eGFR) in children with T1D. As a secondary objective, we sought to explore the relationship between clinical characteristics and trends in eGFR. Design/Methods This ambispective cohort study involved children aged 18 years or younger with T1D (n = 420), followed in the diabetes clinic at British Columbia Children’s Hospital (BCCH), the tertiary pediatric hospital in Vancouver, British Columbia, Canada. Data was collected from the BCCH paper and electronic health records. CKD was defined as eGFR less than 60 mL/min/1.73 m2. Being at risk of CKD was defined as having a mildly decreased eGFR (60 to &lt; 90 mL/min/1.73 m2) and/or hyperfiltration (eGFR ≥140 mL/min/1.73 m2). eGFR was calculated using the modified Schwartz formula (36.5 x height in cm / serum creatinine in umol/L). Linear regression analysis was used to describe the relationship between eGFR and duration of T1D. Results Of the 420 participants, 225 (54%) were male, with a median age at T1D diagnosis of 6.1 years and T1D duration of 4.8 years (range &lt; 1.0-15.0 years). One-hundred and eighty-six (44%) children were hospitalized for DKA, of which 89 (48%) developed AKI. No participants had an eGFR &lt; 60 mL/min/1.73 m2, and 317 (76%) had normal renal function. Fifty-one participants (12%) had an eGFR &lt; 90 mL/min/1.73 m2, and 52 (12%) demonstrated hyperfiltration. When analyzed as a cohort cross-sectionally based on duration of T1D, there was a significant linear decline in eGFR of 1.4 ml/min/1.73 m2 per year (95% CI -1.95, -0.87 mL/min/1.73 m2). Conclusion In a large group of pediatric patients with type 1 diabetes, 24% were at risk for chronic kidney disease based on a mildly decreased GFR and/or hyperfiltration. The pattern of eGFR decline over time is concerning and relevant, as this cohort is at risk for CKD secondary to diabetic kidney disease. Strategies are needed to improve the follow-up and management of early CKD in children with type 1 diabetes to maintain their renal function into adulthood, and more studies are needed to quantify further change in eGFR in the young adult population.

scholarly journals Meta-analyses identify DNA methylation associated with kidney function and damage

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Pascal Schlosser ◽  
Adrienne Tin ◽  
Pamela R. Matias-Garcia ◽  
Chris H. L. Thio ◽  
Roby Joehanes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Dna Methylation ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Urinary Albumin ◽  
Creatinine Ratio

AbstractChronic kidney disease is a major public health burden. Elevated urinary albumin-to-creatinine ratio is a measure of kidney damage, and used to diagnose and stage chronic kidney disease. To extend the knowledge on regulatory mechanisms related to kidney function and disease, we conducted a blood-based epigenome-wide association study for estimated glomerular filtration rate (n = 33,605) and urinary albumin-to-creatinine ratio (n = 15,068) and detected 69 and seven CpG sites where DNA methylation was associated with the respective trait. The majority of these findings showed directionally consistent associations with the respective clinical outcomes chronic kidney disease and moderately increased albuminuria. Associations of DNA methylation with kidney function, such as CpGs at JAZF1, PELI1 and CHD2 were validated in kidney tissue. Methylation at PHRF1, LDB2, CSRNP1 and IRF5 indicated causal effects on kidney function. Enrichment analyses revealed pathways related to hemostasis and blood cell migration for estimated glomerular filtration rate, and immune cell activation and response for urinary albumin-to-creatinineratio-associated CpGs.

scholarly journals HUBUNGAN INDEKS MASSA TUBUH DENGAN LAJU FILTRASI GLOMERULUS PADA MAHASISWA DENGAN OBESITAS DI FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Fadel Baladraf ◽  
Eko E. Surachmanto ◽  
Emma Sy. Moeis
Keyword(s):  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Body Mass ◽  
Filtration Rate ◽  
Pearson Correlation ◽  
Obstructive Sleep ◽  
The Relationship

Abstract. Obesity is the big worldwide healthy problem. Obesity itself is a complex disorder of appetite regulation and energy metabolism are controlled by specific biological factors. Individual with obesity will increase the risk of cardiometabolic syndrome, type-2 diabetes, hypertension, dyslipidemia, coronary heart disease, osteoarthritis, stroke, gallblader disease, obstructive sleep apnea, gastroesophageal reflux disease (GERD), chronic kidney disease, and some kind of cancer (endometrial, breast, and colon). The relationship between obesity and chronic kidney disease (CKD) are mediated through several biological mechanism, including hormonal factors, inflammation, oxidative stress, and endothelial dysfunction.The purpose of this research is to know the relationship between body mass index with glomerular filtration rate. This research uses analytic methods to observational cross-sectional stdy design. Data collected from measurements of weight and height, plasma creatinine and by using the Cockroft-Gault formula.Result from the study conducted on 29 people sample consisted of 18 men and 11 women, by using the pearson correlation test can be seen a strong correlation between body mass index with glomerular filtration rate with p=0,000 (p<0,01). Conclusion: body mass index has a relationship (correlation) or significantly stronger with glomerular filtration rate Key word: obesity, glomerular filtration rate, chronic kidney disease (CKD)  Abstrak.Obesitas merupakan masalah kesehatan di seluruh dunia. Obesitas sendiri merupakan suatu kelainan kompleks pengaturan nafsu makan dan metabolisme energi yang dikendalikan oleh beberapa faktor biologik spesifik. Individu dengan obesitas akan mengalami peningkatan risiko Cardiometabolic syndrome, Diabetes tipe-2, hipertensi, dislipidemia, Penyakit jantung koroner, osteoarthritis, stroke, Penyakit kandung empedu, Obstructive sleep apnea, Gastroesophageal reflux disease (GERD), Penyakit ginjal kronik dan Beberapa kanker (endometrium, payudara, dan usus besar). Hubungan antara obesitas dan penyakit ginjal kronik (PGK) dimediasi melalui beberapa mekanisme biologis, termasuk faktor hormonal, peradangan, stres oksidatif, dan disfungsi endotel.Tujuan penelitian ini adalah mengetahui hubungan antara indeks massa tubuh dengan laju filtrasi glomerulus pada orang dengan obesitas. Metode penelitian bersifat analitik observasional dengan rancangan studi potong lintang.Data diperoleh dari pengukuran berat badan dan tinggi badan, kreatinin plasma dan dengan menggunakan formula Cockroft-Gault.Dari penelitian yang dilakukan pada 29 orang sampel yang terdiri dari 18 laki-laki dan 11 perempuan dengan menggunakan uji pearson correlation dapat dilihat adanya hubungan yang kuat antara indeks massa tubuh dengan laju filtrasi glomerulus dengan nilai p=0.000 (p<0,01). Simpulan: indeks massa tubuh mempunyai hubungan (korelasi) kuat atau signifikan dengan laju filtrasi glomerulus Kata kunci: obesitas, laju filtrasi glomerulus, penyakit ginjal kronis (PGK).

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