89 Clinical Predictors for Progression to Chronic Kidney Disease in Mesoamerican Nephropathy

2018 ◽  
Vol 71 (4) ◽  
pp. 537
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Predictors ◽  
Mesoamerican Nephropathy

FC 070USE OF POTENTIALLY NEPHROTOXIC MEDICATIONS IN PERSONS WITH CHRONIC KIDNEY DISEASE: PARALLEL COHORT STUDIES IN SWEDISH AND U.S ROUTINE CARE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Alessandro Bosi ◽  
Juan Jesus Carrero ◽  
Jung-Im Shin ◽  
Yunwen Xu ◽  
Morgan Grams ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Drug Events ◽  
Medication Use ◽  
Kidney Injury ◽  
Routine Care ◽  
Clinical Predictors ◽  
Nephrotoxic Drugs ◽  
Study Inclusion ◽  
Swedish Cohort

Abstract Background and Aims Many adverse drug events are preventable, such as those potentially resulting from the prescription of nephrotoxic drugs to persons with chronic kidney disease (CKD). We here quantify the extent of contemporary nephrotoxic medication use in patients with CKD. Method In two observational cohorts of Swedish (Stockholm CREAtinine Measurements [SCREAM] project, Stockholm, Sweden) and U.S. (Geisinger Health System, Pennsylvania) adults with confirmed CKD stages G3-G5 undergoing routine care during 2016-2018, we explored the prescription (in U.S.) and dispensation (in Sweden) of 115 different ambulatory drugs with proven or purported nephrotoxicity during the 12 months following study inclusion. We evaluated the proportion of participants receiving nephrotoxic drugs, ranked main contributors and identified clinical predictors. Results In the Swedish cohort, there were 57880 patients (54.6% women) with median age of 80.00 (inter-quartile range [IQR]: 73.0-86.0) years and eGFR 48.9 ([IQR]: 39.9-55.0) mL/min/1.73 m2. In the U.S. cohort, there were 16255 patients (59% women) with median age of 76 years and eGFR 44 mL/min/1.73 m2. During observation, 20% (Sweden) and 17% (U.S.) of patients received at least one nephrotoxic drug. The top 3 potentially inappropriate nephrotoxic drugs identified were NSAIDs (9% and 11% of participants in U.S. and Sweden received it), antivirals (2.0% and 2.5%) and immunosuppressants (1.5% and 2.7%). Bisphosphonate use was common in Sweden (3.3% of participants), but not in U.S. (0.5%). Conversely, fenofibrates were common in U.S. (3.6%), but not in Sweden (0.13%). In adjusted analyses, patients with young age (<65 years old), women, or with CKD G3 were at higher risk of receiving nephrotoxic medications in both cohorts (P>0.05 for all). Notably, patients aware of their CKD (identified either by issued diagnosis or recent visit to a nephrologist), were at lower risk of nephrotoxic drug use (OR 0.87, 95% CI 0.82-0.92 in Sweden and 0.89, 95% CI 0.81-1.01 in U.S.). Conclusion In two geographically distinct health systems, one in five patients with CKD received potentially inappropriate nephrotoxic medications, mainly NSAIDs. Strategies to increase CKD awareness and physician’s knowledge of drug nephrotoxicity may reduce inappropriate ambulatory prescriptions and prevent iatrogenic kidney injury.

scholarly journals Clinical markers to predict progression from acute to chronic kidney disease in Mesoamerican nephropathy

2018 ◽  
Vol 94 (6) ◽  
pp. 1205-1216 ◽  
Author(s):  
Rebecca S.B. Fischer ◽  
Chandan Vangala ◽  
Sreedhar Mandayam ◽  
Denis Chavarria ◽  
Ramón García-Trabanino ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Markers ◽  
Mesoamerican Nephropathy

scholarly journals Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 213
Author(s):  
Bogdan Marian Sorohan ◽  
Andreea Andronesi ◽  
Gener Ismail ◽  
Roxana Jurubita ◽  
Bogdan Obrisca ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Pregnant Women ◽  
Cumulative Risk ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Clinical Predictors ◽  
Mean Time

Background and Objectives: Pregnant women with chronic kidney disease (CKD) are at high risk of adverse maternal and fetal outcomes. Preeclampsia (PE) superimposed on CKD is estimated to occur in 21%–79% of pregnancies. Both conditions share common features such as proteinuria and hypertension, making differential diagnosis difficult. Objective: The aim of this study was to evaluate the incidence and the clinical-biological predictors of preeclampsia in pregnant women with CKD. Material and Methods: We retrospectively analyzed 34 pregnant women with pre-existing CKD admitted to our department between 2008 and 2017. Results: Among the 34 patients, 19 (55.8%) developed PE and the mean time of occurrence was 31.26 ± 2.68 weeks of gestation. The median value of 24-h proteinuria at referral was 0.87 g/day (interquartile range 0.42–1.50) and 47.1% of patients had proteinuria of ≥1 g/day. Patients with PE tended to be more hypertensive, with a more decreased renal function at referral and had significantly higher proteinuria (1.30 vs. 0.63 g/day, p = 0.02). Cox multivariate analysis revealed that proteinuria ≥1 g/day at referral and pre-existing hypertension were independently associated with PE (adjusted hazard ratio = 4.10, 95% confidence interval: 1.52–11.02, p = 0.005, adjusted hazard ratio = 2.62, 95% confidence interval: 1.01–6.77, p = 0.04, respectively). The cumulative risk of PE was significantly higher in pregnant women with proteinuria ≥1 g/day at referral (log-rank, p = 0.003). Proteinuria ≥ 1 g/day at referral and pre-exiting hypertension predicted PE development with accuracies of 73.5% and 64.7%, respectively. Conclusions: Pregnant patients with pre-existing CKD are at high risk of developing preeclampsia, while proteinuria ≥ 1 g/day at referral and pre-existing hypertension were independent predictors of superimposed preeclampsia.

scholarly journals Clinical predictors and outcomes of patients with pericardial effusion in chronic kidney disease

2018 ◽  
Vol 41 (5) ◽  
pp. 660-665 ◽  
Author(s):  
Venkatesh Ravi ◽  
Fady Iskander ◽  
Abhimanyu Saini ◽  
Carolyn Brecklin ◽  
Rami Doukky
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pericardial Effusion ◽  
Clinical Predictors

scholarly journals Mesoamerican nephropathy: geographical distribution and time trends of chronic kidney disease mortality between 1970 and 2012 in Costa Rica

2015 ◽  
Vol 72 (10) ◽  
pp. 714-721 ◽  
Author(s):  
Catharina Wesseling ◽  
Berna van Wendel de Joode ◽  
Jennifer Crowe ◽  
Ralf Rittner ◽  
Negin A Sanati ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Costa Rica ◽  
Kidney Disease ◽  
Geographical Distribution ◽  
Time Trends ◽  
Disease Mortality ◽  
Mesoamerican Nephropathy

scholarly journals 0204 Mesoamerican nephropathy in Costa Rica: Geographical distribution and time trends of chronic kidney disease mortality between 1970 and 2012

2014 ◽  
Vol 71 (Suppl 1) ◽  
pp. A27.1-A27 ◽  
Author(s):  
Catharina Wesseling ◽  
Berna van Wendel de Joode ◽  
Jennifer Crowe ◽  
Ralf Rittner ◽  
Kristina Jakobsson
Keyword(s):  
Chronic Kidney Disease ◽  
Costa Rica ◽  
Kidney Disease ◽  
Geographical Distribution ◽  
Time Trends ◽  
Disease Mortality ◽  
Mesoamerican Nephropathy

scholarly journals Morphological and clinical findings in Sri Lankan patients with chronic kidney disease of unknown cause (CKDu): Similarities and differences with Mesoamerican Nephropathy

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0193056 ◽  
Author(s):  
Julia Wijkström ◽  
Channa Jayasumana ◽  
Rajeewa Dassanayake ◽  
Nalin Priyawardane ◽  
Nimali Godakanda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Findings ◽  
Sri Lankan ◽  
Similarities And Differences ◽  
Mesoamerican Nephropathy

scholarly journals Clinical predictors of diagnostic testing utility in the initial evaluation of chronic kidney disease

Nephrology ◽  
2016 ◽  
Vol 21 (10) ◽  
pp. 851-859 ◽  
Author(s):  
Mallika L Mendu ◽  
Andrew Lundquist ◽  
Ayal A Aizer ◽  
David E Leaf ◽  
Emily Robinson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diagnostic Testing ◽  
Initial Evaluation ◽  
Clinical Predictors
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