scholarly journals Cognitive function before and after dialysis initiation in adults with chronic kidney disease—a new perspective on an old problem?

2017 ◽  
Vol 91 (4) ◽  
pp. 784-786 ◽  
Author(s):  
Osasuyi Iyasere ◽  
Edwina A. Brown
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Dialysis Initiation ◽  
Before And After ◽  
New Perspective

scholarly journals PERBANDINGAN FUNGSI KOGNITIF SEBELUM DAN SESUDAH DIALISIS PADA SUBJEK PENYAKIT GINJAL KRONIK YANG MENJALANI HEMODIALISIS

e-CliniC ◽  
2015 ◽  
Vol 3 (3) ◽  
Author(s):  
Siska A. Manus ◽  
Emma Sy. Moeis ◽  
Veny Mandang
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Average Rate ◽  
Reduction Rate ◽  
Descriptive Study ◽  
Primary Data ◽  
Inclusion Criteria ◽  
Before And After ◽  
Male Patients

Abstract: Chronic Kidney Disease (CKD) is a pathophysicological process with various causes, resulting in the decline of progressive kidney function and in kidney failure. Currently, CKD cases are rising quickly particularly in developing countries and have become the main health problem worldwide because it has been the risk factor of cardiovascular diseases. CKD can cause failure of organs due to the increased toxin level. The increase of blood ureum level could harm all cells, including neuron cells. One of the therapies of CKD is hemodyalisis. This study aimed to obtain the ratio of cognitive function before and after undergoing hemodyalisis among CKD patients. This was a descriptive study using the primary data obtained directly from the patients undergoing hemodyalisis at the hemodyalisis unit, Department of Internal Diseases Prof. Dr. R. D. Kandou Hospital, Manado. The population in this study was patients who had undergone hemodyalisis more than 208 times or for 2 years and had met the inclusion criteria. The results showed that CDK male patients were 43,3% and female patients 56,7%. Before undergoing hemodialysis, the average ureum level was 124.7, and after undergoing hemodyalisis, the average ureum level was 97.3 with 20.4% Urea Reduction Rate (URR). Before undergoing hemodialysis, the average cognitive function was 27.6, and after hemodialysis, the average rate was 28,6. Conclusion: There was a significant decrease of average blood ureum level and a significant increase of cognitive function among CKD patients who had undergone hemodyalisis.Keywords: chronic kidney disease, hemodyalisis, ureum, cognitive functionAbstrak: Penyakit Ginjal Kronik (PGK) adalah suatu proses patofisiologi dengan penyebab yang beragam, mengakibatkan penuruan fungsi ginjal yang progresif, dan biasanya berakhir dengan gagal ginjal. Kasus Penyakit Ginjal Kronik saat ini meningkat dengan cepat terutama di negara-negara berkembang dan telah menjadi masalah utama kesehatan di seluruh dunia karena merupakan faktor resiko terjadinya penyakit jantung dan pembuluh darah. PGK dapat mengakibatkan peningkatan kadar ureum dalam tubuh yang dapat merusak semua sel termasuk sel neuron. Penelitian ini bertujuan untuk mengetahui perbandingan fungsi kognitif sebelum dan sesudah dialisis pada pasien PGK. Penelitian ini mengguakan metode deskriptif berdasarkan data primer yang didapatkan secara langsung dari pasien yang menjalani terapi hemodialisis di Unit Hemodialisis Bagian Ilmu Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado. Populasi penelitian yaitu pasien PGK yang telah menjalani terapi hemodialisis. Hasil penelitian menunjukkan bahwa pasien PGK berjenis kelamin laki-laki sebesar 43,3% dan perempuan sebesar 56,7%. Sebelum menjalani hemodialisis nilai rerata ureum 124,7 dan sesudah nilai rerata ureum menjadi 97,3 dengan rerata Urea Reduction Rate (URR) 20,4%. Sebelum menjalani hemodialisis rerata fungsi kognitif 27,6 dan sesudah hemodialisis rerata menjadi 28,6. Simpulan: Terjadi penurunan bermakna dari nilai rerata ureum serta terjadi peningkatan bermakna dari nilai rerata fungsi kognitif sesudah pasien PGK menjalani hemodialisis.Kata kunci: penyakit ginjal kronik, hemodialisis, ureum, fungsi kognitif

scholarly journals ASSESSMENT OF COGNITIVE FUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 11 ◽  
Author(s):  
Maheshwari P
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Cognitive Assessment ◽  
Ckd Stage ◽  
Significant Difference ◽  
Initiation Of Dialysis ◽  
Before And After ◽  
One Way Anova

Objectives: The objectives of this study were to evaluate cognitive profile in patients with chronic kidney disease (CKD) pre-dialysis and post-dialysis, to assess the severity of cognitive impairment in patients with kidney disease before and after dialysis, and to determine the association of cognitive impairment in relation to dialysis.Methods: A total of 59 patients were recruited with CKD Stage V on dialysis for >6 months. Cognitive function of the patient was assessed by Montreal Cognitive Assessment test scale method for three intervals (before dialysis and two intervals post-dialysis), and the incidence of impairment was analyzed using one-way ANOVA variance test.Results: Among the 59 patients, there were 13 patients with the age of 18–33 years (22.033%), 11 patients with from age 34 to 49 years (18.64%), 21 patients at the age of 50–65 years (35.59%), and 15 patients around 66–80 years (25.42%). From the above categories, population with the age of 50–65 years is at maximum affected by CKD. Among the 59 patients, 24 patients (40.677%) are male and 35 patients (59.33%) are female. There was a mild significant difference seen in cognitive functioning between pre-dialysis and post-dialysis (p≤0.02).Conclusion: It was found that patients with CKD had mild-to-moderate cognitive dysfunction due to morbidities associated with CKD. Inthis study, significant differences of cognitive function result in CKD patients and the severity of cognitive impairment was associatedwith the severity of the kidney disease, which improved with dialysis. Finally, our study suggests that cognitive performance wasimproved after initiation of dialysis and that further management through medications could provide a better outcome in cognitiveperformance.

Hematologic Abnormalities in Chronic Kidney Disease

2018 ◽  
Author(s):  
Michael Auerbach ◽  
John Anderson ◽  
Khalid Al Talib
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Oral Anticoagulants ◽  
Infusion Reaction ◽  
Nonvalvular Atrial Fibrillation ◽  
Novel Oral Anticoagulant ◽  
Before And After ◽  
Iv Iron ◽  
A Minor

The focus of this review is on information practical to the practicing nephrologist and internists managing patients with chronic kidney disease (CKD), with an emphasis on the quantitative aspects of risk, diagnosis, treatment, and prognosis. Consequently, anemia associated with non–dialysis-associated CKD is emphasized, with special attention to the role of erythropoiesis-stimulating agents and intravenous (IV) iron in treating the anemia of CKD, as well as sections on uremic bleeding and anticoagulation in CKD patients. Figures show a patient before and after a minor infusion reaction, an algorithm outlining grading and management of acute hypersensitivity reactions to IV iron infusions, and an algorithm for the management of uremic platelet dysfunction. Tables list Food and Drug Administration-recommended dose adjustments for novel oral anticoagulant (NOACs) in CKD patients, evidence for preprocedural withholding of NOACs, and management guidelines for anticoagulation in nonvalvular atrial fibrillation and venous thromboembolism. This review contains 2 highly rendered figures, 3 tables, and 101 references. Key words: Chronic kidney disease; CKD; Anemia of chronic kidney disease; Anemia of CKD; Uremic bleeding; Anticoagulation in CKD; Novel oral anticoagulants in CKD; NOAC CKD

scholarly journals MO529PREVALENCE AND DETERMINANT FACTORS OF DEPRESSION AND ANXIETY IN PEOPLE WITH CHRONIC KIDNEY DISEASE : A MOROCCAN CROSS-SECTIONAL  STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Amina Chrifi Alaoui ◽  
Mohammed Omari ◽  
Noura Qarmiche ◽  
Omar Kouiri ◽  
Basmat Amal Chouhani ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Depression Scale ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Before And After

Abstract Background and Aims The Chronic kidney disease (CKD), like many chronic illnesses, is invariably associated with various psychiatric conditions and poorer quality of life. This study aims to assess the prevalence of depression and anxiety among CKD patient and their determinant factors. Method this is a cross sectional single center study in a Moroccan university hospital. Patients aged ≥ 18 years old and followed for more than one year were included. The data was collected using a questionnaire for sociodemographic and clinical information and the Hospital anxiety and depression scale (HADS) to assess depression and anxiety prevalence. After the description of the population’s characteristics, the statistical analysis aimed to assess the association between depression and anxiety disorders and the estimated glomerular filtration rate before and after adjustment on several confounding factors. Results 88 patients were included (63.6% of them were women, the mean age was 61.8±14.0 years), 21 were on stage 3, 46 were on stage 4, and 21 were on stage 5 of the CKD. The median of depression sub-score was 5.00[2.00; 10.0], the median of anxiety sub-score was 6.00[4.00; 9.00], and the median of the global score was 11.0[7.00; 20.0], 22.0% of included patients had depression and 22.0% had anxiety. Both depression and anxiety scores were associated to eGFR before and after adjustment (p= 0.001, p<0.001and p=0.04, p=0.03 respectively). Conclusion This study showed that depression and anxiety are strongly related to the CKD progression, which should motivate both doctors and nurses to improve their psychological care toward CKD patients.

scholarly journals Diabetes potentiates ROS production in granulocytes from patients with chronic kidney disease

2021 ◽  
Vol 9 (1) ◽  
pp. 9-14
Author(s):  
Jose Augusto Nogueira-Machado ◽  
Gabriela Rossi Ferreira ◽  
Caroline Maria Oliveira Volpe ◽  
Pedro Henrique Villar-Delfino ◽  
Fabiana Rocha Silva
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Nadph Oxidase ◽  
Ros Generation ◽  
Ros Production ◽  
Clinical Prognosis ◽  
Before And After ◽  
Healthy Control ◽  
Toll Receptor

Background: Type 2 diabetes (DM2) and chronic kidney disease (CKD) are inflammatory pathologies. Diabetes is characterized by hyperglycemia and CKD by the gradual and irreversible loss of kidney function. Both diseases develop oxidative stress, and reactive oxygen species (ROS) play a pivotal role in the pathogenesis. This study aimed to determine ROS production by granulocytes from renal patients (CKD) with or without diabetes. Methods: Granulocytes from patients with DM2, CKD, CKD-DM2, and healthy controls were purified using the Ficoll-Hypaque gradient method. Granulocyte ROS generation in the absence or the presence of PDB (an activator of NADPH-oxidase) or Concanavalin A (Toll- receptor 3,9 activator) was evaluated in a luminol-dependent chemiluminescence method. The cell-free DNA in the serum of DM2, CKD, and CKD-DM2 patients was measured by the fluorescence method before and after hemodialysis. Results: Our results show a significant increase in ROS production by granulocytes from patients with CKD, DM2, and CKD-DM2 compared to healthy control (p<0.05). CKD-DM2 group produced the most significant ROS levels with or without NADPH-oxidase activation. ROS production showed a significant increase in the presence of ConA. In contrast, mitochondrial (internal) ROS showed a different ROS response. DNA extrusion was higher in the CKD-DM2 group after hemodialysis suggesting cell death. Conclusion: The results demonstrated that CKD-DM2 patients produced high ROS generation levels and increased DNA extrusion after hemodialysis. It may suggest that CKD-DM2 disease is more severe and has a worse clinical prognosis.

Effect of parameters of renal replacement therapy on platelet aggregation activity

2020 ◽  
Author(s):  
Т.В. Марченко ◽  
А.В. Гончарова ◽  
И.Н. Соловьева ◽  
Е.О. Марченко ◽  
А.М. Исаева
Keyword(s):  
Chronic Kidney Disease ◽  
Platelet Aggregation ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Normal Range ◽  
Dialysis Therapy ◽  
Before And After ◽  
Aggregation Activity

Цель исследования: оценить влияние параметров заместительной почечной терапии (ЗПТ) на агрегационную активность тромбоцитов у пациентов с хронической болезнью почек (ХБН). Материалы и методы. Было выполнено 25 процедур гемодиализа (ГД) и 10 процедур гемодиафильтрации (ГДФ) 35 больным с ХБП. Изучали динамику агрегационной активности тромбоцитов до и после экстракорпоральных процедур. Результаты. После процедуры ГД агрегация тромбоцитов снижалась, а после процедуры ГДФ нарастала, не выходя за пределы нормальных значений. Параметры процедур ЗПТ на агрегацию тромбоцитов значимого влияния не оказывали. Заключение. Разовая процедура ЗПТ протяженностью не более 4 ч, проводимая с учетом всех современных требований к диализной терапии, не оказывает негативного влияния на функциональную активность тромбоцитов. Процедура ГДФ приводит к непринципиальному росту агрегационной активности тромбоцитов. Aim: to assess the effect of renal replacement therapy (RRT) parameters on platelet aggregation activity in patients with chronic kidney disease (CKD). Materials and methods. For 35 patients with CKD 25 hemodialysis (HD) procedures and 10 hemodiafiltration (HDF) procedures were performed. We studied the dynamics of platelet aggregation activity before and after extracorporeal procedures. Results. After the HD procedure, platelet aggregation decreased, and after the HDF procedure it increased, without going outside the normal range. Parameters of RRT procedures did not have a significant effect on platelet aggregation. Conclusion. A single RRT procedure not more than 4 hours with all nowadays requirements for dialysis therapy does not adversely affect the functional platelets activity. The HDF procedure leads to an unprincipled increasing of platelet aggregation activity.

scholarly journals A Study of Executive Function in Patients with Chronic Kidney Disease before and after a Single Session of Hemodialysis

2020 ◽  
Vol 11 (02) ◽  
pp. 250-255
Author(s):  
Vasantmeghna S. Murthy ◽  
Vedant S. Shukla
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Statistical Tests ◽  
T Test ◽  
Emotional States ◽  
Single Session ◽  
Dialysis Unit ◽  
Before And After ◽  
The Mean ◽  
The Impact

Abstract Background Executive functions (EFs) are critical to daily life and sensitive to our physiological functioning and emotional states. The number of people living with chronic kidney disease (CKD) on hemodialysis (HD) globally is increasing steadily. We aimed to determine the impact of a single session of HD on EFs in patients with CKD receiving maintenance HD (MHD). Methods This was a quasi-experimental study conducted at the department of psychiatry and dialysis unit of a tertiary hospital. Patients undergoing MHD underwent screening to rule out delirium, using the Confusion Assessment Method prior to EF testing. The tests of EF used were the Trail-Making Test—Part B (TMT-B) and Frontal Assessment Battery (FAB), both of which were administered before and after a session of HD. Statistical tests used were Wilcoxon matched pairs signed ranks test, paired t-test, single sample t-test, and correlation analyses. Results The mean time taken on TMT-B before HD was 195.36 seconds and after HD, 171.1 seconds; difference is significant (p = 0.0001). The mean FAB score was 13.19 before HD and 14.83 after HD; the difference is significant (p < 0.0001). Significant differences were observed on similarities (p = 0.003), lexical fluency (p = 0.02), and go–no go (p = 0.003) subtests of FAB. Mean TMT-B scores before and after HD differed significantly from that of a reference study (reference TMT-B 150.69 seconds), p = 0.0002 and 0.04, respectively. Conclusion We conclude that patients with CKD on MHD, in general, have worse executive cognitive functioning compared with healthy populations. A session of HD results in significant improvement in these functions.

scholarly journals Comparing the Effect of Folic Acid and Pentoxifylline on Delaying Dialysis Initiation in Patients with Advanced Chronic Kidney Disease

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2192
Author(s):  
Hsun Yang ◽  
Shiun-Yang Juang ◽  
Kuan-Fu Liao ◽  
Yi-Hsin Chen
Keyword(s):  
Chronic Kidney Disease ◽  
Folic Acid ◽  
Kidney Disease ◽  
Index Date ◽  
Dialysis Initiation ◽  
Nutrient Loss ◽  
Research Database ◽  
Advanced Chronic Kidney Disease ◽  
Stage Renal Disease ◽  
End Stage

Background: We hypothesized that the nutrient loss and chronic inflammation status may stimulate progression in advanced chronic kidney disease. Therefore, we aimed to generate a study to state the influence of combined nutritional and anti-inflammatory interventions. Methods: The registry from the National Health Insurance Research Database in Taiwan was searched for 20–90 years individuals who had certified end-stage renal disease. From January 2005 through December 2010, the diagnosis code ICD-9 585 (chronic kidney disease, CKD) plus erythropoiesis-stimulating agent (ESA) use was defined as entering advanced chronic kidney disease. The ESA starting date was defined as the first index date, whereas the initiation day of maintenance dialysis was defined as the second index date. The duration between the index dates was analyzed in different medical treatments. Results: There were 10,954 patients analyzed. The combination therapy resulted in the longest duration (n = 2184, median 145 days, p < 0.001) before the dialysis initiation compared with folic acid (n = 5073, median 111 days), pentoxifylline (n = 1119, median 102 days, p = 0.654), and no drug group (control, n = 2578, median 89 days, p < 0.001). Lacking eGFR data and the retrospective nature are important limitations. Conclusions: In patients with advanced CKD on the ESA treatment, the combination of folic acid and pentoxifylline was associated with delayed initiation of hemodialysis.

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