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.

Abstract 321: Impact Of Chronic Kidney Disease On Heart Failure Outcomes In A Minority Cohort

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
TAOPHEEQ MUSTAPHA ◽  
VARIJA BHOGIREDDY ◽  
HARTMAN MADU ◽  
ADU BOACHIE ◽  
ABDUL OSENI ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
African American ◽  
Kidney Disease ◽  
Prognostic Impact ◽  
Mortality And Morbidity ◽  
Ckd Stage ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

BACKGROUND: Heart failure (HF) and Chronic kidney disease (CKD) are major public health problems that often co-exist with a resultant high mortality and morbidity. Most of the studies evaluating their reciprocal prognostic impact have focused on mortality in majority populations. There is limited literature on the impact of CKD on HF morbidities in ethnic minorities. AIMS: Our study seeks to compare HF outcomes in patients with or without CKD in an African-American predominant cohort. METHODS: We obtained data from the NGH at Meharry Heart Failure Cohort; a comprehensive retrospective HF database comprised of patient care data (HF admissions, non-HF admissions, and emergency room visits) were assessed from January 2006 to December 2008. The study group consist of 306 subjects with a mean age of 65±15 years. 81% were African-American (AA), 19% Caucasian and 48.5% are females. Following the NKF KDOQI guidelines, 5 stages of CKD were outlined based on GFR. RESULTS: The overall prevalence of CKD in this population is 54.2%. CKD stage 1 was most prevalent with 45.8%, prevalence for stages 2-5 are 21.6%, 18.3%, 9.5% and 4.9% respectively. The comparison of the mean of ER visits, non HF hospitalizations and HF hospitalizations between normal and CKD patients was done using independent t-test and showed no significant difference in the mean number of ER visits (p=0.564), or HF hospitalizations(p=0.235). However, there is a statistically significant difference in the mean number of non -HF hospitalizations between normal and CKD patients (p=0.031). CONCLUSION: This study shows that the prevalence of CKD in this minority -predominant HF cohort is similar to prior studies in majority populations. However, only the non-HF hospitalizations were significantly increased in the CKD group. Future prospective studies will be needed to define the implications of this in the management of HF patients with CKD.

Analysing the impact of a guideline for the use of new potassium binders for treatment of chronic hyperkalaemia to maximise inhibition of renin–angiotensin–aldosterone system (RAAS) within the general nephrology clinic?

2020 ◽  
Author(s):  
Priyank Patel ◽  
Andrew Frankel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Ckd Stage ◽  
The Mean ◽  
Potassium Binders ◽  
The Impact ◽  
Chronic Use

Abstract Background Renin–angiotensin–aldosterone system (RAAS) inhibitors provide significant cardiorenal benefits with improved long-term outcomes for patients. This is most significant for patients receiving maximal RAAS inhibition, but some patients are unable to tolerate this therapy because of hyperkalaemia. Recently published National Institute for Health and Care Excellence (NICE) technology appraisal guidance recommended using sodium zirconium cyclosilicate (SZC) and patiromer for patients with chronic kidney disease (CKD) stage 3b to 5 or heart failure with reduced ejection fraction, who are not taking an optimised dosage of RAAS inhibitor because of hyperkalaemia. Objective Determine the impact of a locally produced guideline on effective implementation of NICE recommendation for use of SZC or patiromer to help maximise inhibition of the renin–angiotensin–aldosterone system within the general nephrology clinic. Methods A local guideline to practically support the implementation of recommendations made by NICE in the chronic use of new potassium binders was produced. One hundred sequential patients in a general nephrology clinic with non-immune chronic kidney disease (CKD 3 to 5) had their electronic records reviewed. Those with an indication for RAAS inhibition were identified. Results Of the 100 consecutive patients audited, 46 were female and 54 were male. The mean age of these patients was 64 and the mean estimated glomerular filtration rate (eGFR) was 33. Sixty-eight patients had an indication for being on RAAS inhibition with only 10 on maximal doses. Of the remaining 58 patients, 26 (45%) were limited by hyperkalaemia. Of these 26 patients, 12 of these patients (46%) had hyperkalaemia associated with an episode of acute kidney injury (AKI). Therefore, 14% of patients attending a general nephrology clinic were identified suitable for SZC and patiromer. Conclusions A significant proportion (14%) of unselected patients attending a general nephrology clinic were not on optimum RAAS inhibition due to hyperkalaemia. These patients would meet the criteria established within a working guideline for the implementation of the chronic use of SZC or patiromer and are likely to attain prognostic long-term benefit by using these new potassium binders to maximise RAAS inhibition. This analysis has implications for renal centres across the UK.

scholarly journals The Enormity of Chronic Kidney Disease in Nigeria: The Situation in a Teaching Hospital in South-East Nigeria

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Ifeoma I. Ulasi ◽  
Chinwuba K. Ijoma
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Teaching Hospital ◽  
Dialysis Unit ◽  
Female Patients ◽  
Prohibitive Cost ◽  
Stage Renal Disease ◽  
The Impact ◽  
Esrd Patients

Background. The magnitude of the problem of chronic kidney disease (CKD) is enormous, and the prevalence keeps rising. To highlight the burden of CKD in developing countries, the authors looked at end-stage renal disease (ESRD) patients seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria.Method. ESRD patients seen from 01/05/1990 to 31/12/2003 were recruited. Records from A&E Department, medical-out-patients, wards and dialysis unit were used.Results. A total of 1001 male versus 537 female patients were reviewed. About 593 male versus 315 female patients had haemodialysis. The mean age was years and 86.5% were <60 years. Primary renal disease could not be determined in 51.6% while hypertension and glomerulonephritis accounted for −17.2% and 14.6%, respectively. Death from renal causes constituted 22.03% of medical deaths.Conclusion. The prognosis for CKD patients in Nigeria is abysmal. Only few patients had renal-replacement-therapy (RRT). The prohibitive cost precludes many patients. This underscores the need for preventive measures to reduce the impact of CKD in the society.

Assessment of the association between neuropeptide Y and chronic kidney disease progression

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Saeed Abdel Wahab Saeed ◽  
Haitham Ezzat Abdelaziz ◽  
Nahla Mohamed Teama ◽  
Hend Ahmed Abouelsaad
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Neuropeptide Y ◽  
Complete Blood Count ◽  
Strong Association ◽  
T Test ◽  
Abdominal Ultrasonography ◽  
Organ Systems ◽  
The Mean

Abstract Background Neuropeptide Y (NPY) is a sympathetic neurotransmitter with wide-ranging effects in various organ systems, from the central nervous system (CNS) to the cardiovascular (CV) system, the bone and the renal system. There is a strong association between serum concentration of NpY and deterioration of eGFR and proteinuria as suggested by recent studies [1,2], however, its real effect on chronic kidney disease (CKD) progression is uncertain. Purpose of the study Assess the relationship between NpY and progression of CKD. Settings and Design An observational, prospective case-control study of thirty CKD adult patients and thirty healthy control adult subjects. Methods and Material All participants were conducted to renal function tests (serum creatinin, blood urea, serum Na, K, P and Ca and calculation of estimated glomerular filtration rate), complete blood count, urinary protein/creatinin ratio, serum NpY and pelvi-abdominal ultrasonography at baseline and repeated for the patients only after six months as follow up. Statistical analysis used Statistical presentation and analysis of the present study was conducted, using the mean, standard deviation, student t-test, Paired t-test, Chi-square, Linear Correlation Coefficient and Analysis of variance [ANOVA] tests by SPSS V17. Results The mean of serum NpY was 438.333 ± 206.850 at baseline then became 630.667 ± 264.926 after follow up. Urinary PCR ranged from 0.2- 3.1 at baseline to 0.2- 2 after six months. The patients’ group mean eGFR was 36.900±17.851 and became 31.373±17.852 ml/min/1.73m2. Conclusion Serum NpY could be a useful marker that can be used as diagnostic and progression predictor for CKD.

scholarly journals Effectiveness of a Planned Teaching Program on the Knowledge of Staff Nurses with Regard to the Nutritional Requirements of Patients with Chronic Kidney Disease

2021 ◽  
Author(s):  
Sarita Telma Fernandes ◽  
Fatima Dsilva ◽  
Sushma Marita Dsouza
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Knowledge Score ◽  
Staff Nurses ◽  
Nutritional Requirements ◽  
Knowledge Level ◽  
Teaching Program ◽  
Before And After ◽  
Level Of Knowledge ◽  
The Mean

Abstract Objective This study was done to evaluate the effectiveness of a planned teaching program on the knowledge of staff nurses with regard to the nutritional requirements of patients with chronic kidney disease. Methods Uncontrolled before-and-after study was conducted among staff nurses of a hospital. Convenient sampling was used to select the participants. Pretest knowledge was assessed using a structured questionnaire among staff nurses. After the pretest, the experimental group was administered a planned teaching program for 60 minutes. On the 7th, 14th, 21st, and 28th day the posttests were conducted by delivering the same tool to determine the posttest level of knowledge after the administration of the planned teaching program. Results The staff nurses’ pretest knowledge scores reveal that the majority (77.5%) had an average knowledge level and 10% had poor knowledge levels. The effectiveness of the planned teaching program showed that the mean pretest knowledge score of the staff nurses (x̄ 1=16.10) was significantly lower than the mean posttest knowledge scores of the participants (x̄ 2 = 20.78, x̄ 3 = 24.35, x̄ 4 = 24.20, and x̄ 5 = 28.75). Conclusion In this study, the planned teaching program was found to be efficient on the knowledge level of staff nurses regarding the nutritional requirements of patients with chronic kidney disease.

scholarly journals Analyzing the Impact of Large Dams on Seismicity Patterns around Their Locations

2021 ◽  
Vol 68 (1) ◽  
pp. 3-17
Author(s):  
Mina Parvizishad ◽  
Simin Naseri ◽  
Ramin Nabizadeh ◽  
Abdollah Sohrabi Bidar ◽  
Amir Hossein Mahvi ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
T Test ◽  
Dam Construction ◽  
Seismicity Patterns ◽  
Regional Seismicity ◽  
Large Dams ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Impact

Abstract Dam construction is one of the most popular solutions for managing water resources. In recent years, changes in patterns of regional seismicity associated with large impoundment dams have raised concerns among environmentalists. In this study, five large dams located in Iran were studied from this perspective. The Gutenberg-Richter, linear regression and T-test were used to examine the seismic changes in the radius of 100 km of each of the dams during a twenty-five-year period before and after the construction of the dams. The results revealed that the seismicity level and relative density of large and small earthquakes in three of these dams have increased after dam construction. A significant difference between the magnitude of earthquakes, as well as the number of earthquakes before and after the construction of dams in the region, was recognized. However, the results of the T-test statistical analysis indicated that the mean depth of the earthquakes and their distance from the dams before and after construction have not changed significantly. Overall, these results indicated that the construction of large impoundment dams has been associated with some changes in patterns of regional seismicity. The findings would guide researchers to further investigate the type of impacts that dam construction may have on seismicity patterns.

The impact of gender and NASH on chronic kidney disease before and after liver transplantation

2013 ◽  
Vol 34 (8) ◽  
pp. 1259-1266 ◽  
Author(s):  
Lynn A. Fussner ◽  
Michael R. Charlton ◽  
Julie K. Heimbach ◽  
Chun Fan ◽  
Ross Dierkhising ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Liver Transplantation ◽  
Kidney Disease ◽  
Before And After ◽  
The Impact

Impact of Drug Use and Comorbidities on In-Hospital Falls in Patients with Chronic Kidney Disease

2007 ◽  
Vol 41 (10) ◽  
pp. 1638-1643 ◽  
Author(s):  
Mallik V Angalakuditi ◽  
Joseph Gomes ◽  
Kim C Coley
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Drug Use ◽  
Gastrointestinal Disease ◽  
Statistical Tests ◽  
Data Repository ◽  
Retrospective Case ◽  
Patients At Risk ◽  
The Mean ◽  
Control Study

Background: In-hospital falls are a major problem in healthcare institutions and contribute to morbidity and mortality in this setting. Patients with chronic kidney disease (CKD) were previously found to be at higher risk for experiencing an in-hospital fall. Objective: To evaluate the association between comorbidities and drug use with the risk of in-hospital falls in adults with CKD. Methods: A retrospective case-control study was conducted in patients with CKD hospitalized between January 1, 1998, and June 30, 2003. Cases included patients who experienced an in-hospital fait, were 18 years of age or older, and had been hospitalized for more than 24 hours. For every case, 2 controls were identified and matched for CKD, age, and sex. Information about comorbidities and drug use was collected from an electronic medical data repository. Statistical tests performed were t-tests, χ2 analysis, and multivariate logistic regression, using occurrence of a fall as the dependent variable and race, comorbidities, and drug groups as covariates. Results: There were 635 fall cases that met study criteria. The mean age of patients was 68 ± 15 years, 54% were female, and 82% were white. There were 1270 matched controls with CKD who were included in the regression analysis. Comorbidities that increased the likelihood of experiencing an in-hospital fall were dementia (OR 2.63), pneumonia (OR 1.72), gastrointestinal disease (OR 1.41), and diabetes (OR 1.31). Drugs associated with an in-hospital fall were antidepressants (OR 1.65) and anticonvulsants (OR 1.52). Conclusions: Several comorbidities, especially dementia, significantly increase the risk of experiencing an in-hospital fall in patients with CKD. Drugs that place CKD patients at risk include antidepressants and anticonvulsants.

scholarly journals Oral symptoms and oral health in patients with chronic kidney disease

2018 ◽  
Vol 66 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Maria Auxiliadora Gomes do NASCIMENTO ◽  
Maria Sueli Marques SOARES ◽  
Eduardo CHIMENOS KÜSTNER ◽  
Dasaiev Monteiro DUTRA ◽  
Raquel Lopes CAVALCANTI
Keyword(s):  
Chronic Kidney Disease ◽  
Oral Health ◽  
Kidney Disease ◽  
Dental Calculus ◽  
Cross Sectional ◽  
Periodontal Index ◽  
Community Periodontal Index ◽  
Oral Symptoms ◽  
The Mean ◽  
The Impact

ABSTRACT Objective: Chronic kidney disease is characterized by progressive and irreversible loss of kidney function. The impact of this disease on oral health also presents controversial results. The aim of the study was to determine oral health conditions and oral symptoms of patients with Chronic kidney disease undergoing hemodialysis. Methods: A cross-sectional study on a population with chronic renal failure was performed. Anamnesis and oral examination, decayed, miss and filled teeth (DMFT) index, community periodontal index, simplified oral hygiene index (OHI-S) and gingival index were conducted. Data were processed using SPSS v.s. 20.0 using descriptive statistics and Fischer’s exact test and ANOVA test (p<0.05). Results: 64.9% of all the individuals were male. The mean age was 50.7±14.8 years. 82.4% had symptoms oral while 44.6% had xerostomia and 31.1% dysgeusia. The mean DMFT was 20.49+8.68, the GI was low in 78.4% and the OHI-S was satisfactory in 73%; according to the community periodontal index, the presence of dental calculus occurred in 52.7%, periodontal pockets 41.9% and gingivitis 2.7%. There was a statistically significant association between xerostomia (p=0.017) and number of drugs consumed and between dysgeusia and OHI-S (p=0.011). Conclusion: The results suggest that oral symptoms such as dry mouth and dysgeusia, are common in Chronic kidney disease patients undergoing hemodialysis. Dental calculus and periodontal disease in Chronic kidney disease may be severe even if low amount of biofilm is present. It is important that dentists know the most prevalent oral symptoms in the patient with Chronic kidney disease, as well as knowing that the periodontal condition of this patient should be carefully supervised.

scholarly journals Benefits of intradialytic physiotherapy in quality of life, pain, edema and respiratory function of patients with chronic kidney disease

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Hugo Machado Sanchez ◽  
Denise Mendes Batista do Nascimento ◽  
Kassia de Castro ◽  
Eliane Gouveia de Morais Sanchez ◽  
Jair Pereira de Melo Junior ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Respiratory Function ◽  
Treatment Protocol ◽  
Before And After ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
The Impact

Abstract Introduction: Patients with chronic kidney disease suffer from a decline in quality of life and respiratory function, for various reasons related to this condition. Objective: To verify the influence of intradialytic physiotherapy on the quality of life and respiratory function in chronic renal patients. Methods: The sample was non-probabilistic and consisted of 51 individuals, of both sexes, aged between 30 and 60 years. The WHOQOL-Bref, an evaluation form, the Manovacuometer and Peak Flow were used to detect the impact of the physiotherapeutic intervention before and after an eight-week treatment protocol. Results: There was a difference in the comparison of the general QOL before and after (p = 0.006) the intervention, as well as in the improvement of the maximal forced expiratory flow peak (p = 0.001), the PEmax (p = 0.000), peak forced expiratory flow rate (0.017) and pain (p = 0.006). There was also improvement of edema (p = 0.013) and cramps (p = 0.000). Conclusion: The benefits of intradialytic physiotherapy in improving QOL and respiratory function in chronic kidney patients are explicit.

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