PCI Outcomes in High-Risk Groups (Diabetes Mellitus, Smoker, Chronic Kidney Disease and the Elderly)

2012 ◽  
Vol 1 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Anouska Moynagh ◽  
Marie Claude Morice
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Risk Groups ◽  
The Elderly

scholarly journals Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e015069 ◽  
Author(s):  
Samar Abd ElHafeez ◽  
Davide Bolignano ◽  
Graziella D’Arrigo ◽  
Evangelia Dounousi ◽  
Giovanni Tripepi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
General Population ◽  
Risk Groups

scholarly journals The Impact of Pharmacist-delivered Motivational Interviewing on Chronic Kidney Disease Identification and Management in Patients with Diabetes Mellitus and Low Socioeconomic Status

2019 ◽  
Vol 10 (4) ◽  
pp. 8
Author(s):  
Keri Lillian DePatis ◽  
Catherine Harrington
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Motivational Interviewing ◽  
Urinary Albumin ◽  
Secondary Outcome ◽  
High Risk Patients ◽  
Patients With Diabetes ◽  
Risk Patients

Purpose: Chronic kidney disease (CKD) is a common complication among patients with diabetes mellitus; however, noncompliance with the recommended annual screening is common. Increased screening among high-risk patients is important to identify the early stages CKD, potentially resulting in earlier treatment, slower progression, fewer complications, and decreased healthcare expenditures. Motivational interviewing (MI) has previously been shown to be effective for various behaviors, such as smoking cessation and cholesterol level control. The objective of this study is to evaluate the effectiveness of pharmacist-delivered MI compared to typical education (TE) methods in increasing CKD screening and subsequent angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) initiation in high-risk patient populations. Methods: Pharmacists screened diabetic patients within their chronic disease management clinic to identify patients that are at high-risk for CKD, indicated by a score of 4 or greater on the validated SCORED screening tool. High-risk patients were randomized to one of four groups to receive either one or two face-to-face education sessions from a pharmacist or student pharmacist using either MI or TE methods. Patients were then given the option to have their urine tested with a dipstick to detect albumin and creatinine, provided at no cost. The primary outcome was to determine the rate of urinary albumin testing, and the secondary outcome was to determine the rate of ACE-I or ARB initiation in patients found to have albuminuria. Results: There were no significant differences in the rates of urinary albumin screening (87% in TE vs. 100% in MI, P = 0.4828) or subsequent ACE-I/ARB initiation (100% in TE and 50% in MI, P = 1.000) between education groups. Of the high-risk patients who underwent urinary albumin screening, 54% (n=15) were found to have proteinuria Conclusions: While it appears that MI does not impact patient acceptance rates of microalbuminuria screening and ACE-I/ARB initiation, this study demonstrates the feasibility of pharmacist-delivered microalbuminuria screening in patients at high-risk for CKD in the outpatient setting.   Article Type: Practice-Based Research

scholarly journals Risk of venous thrombosis in patients with chronic kidney disease: identification of high-risk groups

2013 ◽  
Vol 11 (4) ◽  
pp. 627-633 ◽  
Author(s):  
G. Ocak ◽  
W. M. Lijfering ◽  
M. Verduijn ◽  
F. W. Dekker ◽  
F. R. Rosendaal ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Venous Thrombosis ◽  
Risk Groups ◽  
Disease Identification

scholarly journals Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus

2015 ◽  
Vol 87 (4) ◽  
pp. 784-791 ◽  
Author(s):  
Daniela Dunkler ◽  
Maria Kohl ◽  
Georg Heinze ◽  
Koon K. Teo ◽  
Annika Rosengren ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
High Risk ◽  
Kidney Disease ◽  
Social Factors

scholarly journals Classification of patients at risk for chronic kidney disease by use of eGFR and albuminuria

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Jelena Seferović ◽  
Višnja Ležaić
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
High Risk ◽  
Kidney Disease ◽  
Blood Pressure Measurement ◽  
Staging System ◽  
The Elderly ◽  
High Risk Group ◽  
Hypertensive Patients

Introduction. Screening for chronic kidney disease (CKD) has been advisedin high-risk populations. However, data on the prevalence of early asymptomaticstages vary and depend on the definition of CKD. In the present studysubjects at risk for CKD (patients with diabetes mellitus type 2-DM2, withhypertension and older than 60 years without diabetes and hypertension)were classified in categories defined by eGFR and albuminuria staging system.Methods. After regular check-up in primary health center, 285 consecutivepatients at risk for CKD, were selected: 75 patients with well-controlled DM2without hypertension, 130 with hypertension and 80 subjects older than 60years without diabetes or hypertension. Screening included a questionnaire,blood pressure measurement, single albuminuria determined by immunonephelometry,and eGFR estimation using MDRD.Results. Six DM2 patients, 15 withe hyprtension and 12 elderly had eGFR<60(assessed in ml/min/1.73m2) with optimal albuminuria. High albuminuriawas observed in one DM2 and four hypertensive patients, and 28 elderly.When eGFR and albuminuria staging system for predicting risk for majorCKD outcomes was used, 41.2% of the elderly were classified in the moderateand 8.8% in the high risk group, for DM2 patients these percentages were9.3% and 0%, and for hypertensive patients 16.9% and 4.7%, respectively.Conclusion. The majority of examined patients did not have CKD, and in allthree groups most individuals with reduced eGFR did not have albuminuria>30mg/g. Using the classification of CKD based on eGFR and albuminuria,

Abstract 13275: The Intermountain Risk Score is a Robust Predictor of Mortality in Patients With Chronic Kidney Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Allen C Rassa ◽  
Benjamin D Horne ◽  
Raymond McCubrey ◽  
Tami L Bair ◽  
Joseph B Muhlestein ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Risk Score ◽  
Complete Blood Count ◽  
Strong Predictor ◽  
Risk Groups ◽  
Major Advance ◽  
Ckd Stage ◽  
Medium Risk

Introduction: Chronic kidney disease (CKD) is a common disorder associated with increased cardiovascular mortality. The Intermountain Risk Score (IMRS) is an electronic risk calculator that utilizes the complete blood count (CBC), basic metabolic panel (BMP), age and sex to predict all-cause mortality. We tested whether IMRS predicts mortality in CKD patients (pts) and is additive to CKD staging. We also tested whether serum phosphate (PO4) or urinary albumin (U-alb)/creatinine (Cr) ratio adds predictive value. Methods: From October 2005 to May 2013, pts with CKD classes IIIa-V seen in the Intermountain Healthcare system with concurrent BMP and CBC tests were followed for survival at 1y (N=3,872) and 5y (N=3,727). Survival analyses were performed for pre-defined IMRS low-, medium- and high-risk groups for combined and separate CKD stages, and for PO4 and U-alb/Cr. Receiver operator characteristic curves were used to generate c-statistics. Results: For pts across the spectrum of CKD, mortality was significantly increased with medium- and high-risk compared to low-risk IMRS categories (1y medium-risk hazard ratio [HR]=4.60 [95% CI: 2.97, 7.12], 1y high-risk: HR=17.6, [11.46, 27.14]; and 5y medium-risk HR=2.5 [1.9, 3.2], 5y high-risk: HR=6.87 [5.44, 8.68], P < 0.001 for all). When adjusted for CKD stage, IMRS remained predictive (1y: HR=3.85 [2.47, 5.99] for medium-risk, HR=12.66 [8.11, 19.76] for high-risk; and 5y: HR=2.30 [1.80, 2.95] for medium-risk, HR=5.55 [4.36, 7.06] for high-risk, P < 0.001 for all). IMRS predicted 1y mortality more efficiently (c=0.735 [se 0.013]) than CKD stage (c=0.660 [se 0.013]); while combining IMRS and CKD stage increased the c-statistic to c=0.759 (se 0.014). PO4 predicted mortality (HR=1.23 [1.15-1.31]) but added only slightly to the IMRS 1y predictive ability (c=0.741 [se 0.016]). U-alb/Cr was not independently associated with mortality (HR=1.01 [0.99-1.01]). Conclusion: IMRS is a strong predictor of mortality in patients with CKD and is robustly complementary to CKD stage in refining risk stratification. Given the universal electronic availability and low cost of CBC and BMP, IMRS may represent a major advance in CKD risk assessment and management.

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