scholarly journals Advanced glycation endproducts and dicarbonyls in end-stage renal disease: associations with uraemia and courses following renal replacement therapy

2019 ◽  
Vol 13 (5) ◽  
pp. 855-866
Author(s):  
Remy J H Martens ◽  
Natascha J H Broers ◽  
Bernard Canaud ◽  
Maarten H L Christiaans ◽  
Tom Cornelis ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Advanced Glycation Endproducts ◽  
Advanced Glycation ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Glycation Endproducts ◽  
Ckd Stage ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background End-stage renal disease (ESRD) is strongly associated with cardiovascular disease (CVD) risk. Advanced glycation endproducts (AGEs) and dicarbonyls, major precursors of AGEs, may contribute to the pathophysiology of CVD in ESRD. However, detailed data on the courses of AGEs and dicarbonyls during the transition of ESRD patients to renal replacement therapy are lacking. Methods We quantified an extensive panel of free and protein-bound serum AGEs [N∈-(carboxymethyl)lysine (CML), N∈-(carboxyethyl)lysine (CEL), Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)ornithine (MG-H1)], serum dicarbonyls [glyoxal (GO), methylglyoxal (MGO), 3-deoxyglucosone (3-DG)] and tissue AGE accumulation [estimated by skin autofluorescence (SAF)] in a combined cross-sectional and longitudinal observational study of patients with ESRD transitioning to dialysis or kidney transplantation (KTx), prevalent dialysis patients and healthy controls. Cross-sectional comparisons were performed with linear regression analyses, and courses following renal replacement therapy were analysed with linear mixed models. Results Free and protein-bound AGEs, dicarbonyls and SAF were higher in chronic kidney disease (CKD) Stage 5 non-dialysis (CKD 5-ND; n = 52) and CKD Stage 5 dialysis (CKD 5-D; n = 35) than in controls (n = 42). In addition, free AGEs, protein-bound CML, GO and SAF were even higher in CKD 5-D than in CKD5-ND. Similarly, following dialysis initiation (n = 43) free and protein-bound AGEs, and GO increased, whereas SAF remained similar. In contrast, following KTx (n = 21), free and protein-bound AGEs and dicarbonyls, but not SAF, markedly declined. Conclusions AGEs and dicarbonyls accumulate in uraemia, which is even exaggerated by dialysis initiation. In contrast, KTx markedly reduces AGEs and dicarbonyls. Given their associations with CVD risk in high-risk populations, lowering AGE and dicarbonyl levels may be valuable.

HUBUNGAN KEPATUHAN PASIEN MENJALANI TERAPI HEMODIALISA DENGAN TINGKAT DEPRESI PASIEN GAGAL GINJAL KRONIK DI KLINIK RASYIDA MEDAN TAHUN 2015

2016 ◽  
Vol 1 (1) ◽  
pp. 39-46
Author(s):  
Jagentar P Pane
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Chi Square ◽  
Cross Sectional ◽  
Measuring Devices ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Chronic renal failure or end stage renal disease (ESRD) is a progressive disorder of renal function and irreversible regardless of the cause. Renal replacement therapy consists of hemodialysis, peritoneal dialysis and kidney transplantation. Hemodialysis therapy is a renal replacement therapy is the most widely performed and the numbers from year to year continues to increase. Dialysis.Goal:The purpose of this study was to determine the relationship between adherence to undergo hemodialysis therapy with the level of depression in patients with chronic renal failure Rasyida Clinic Medan Year 2015.Chronic renal failure or end stage renal disease (ESRD) is a progressive disorder of renal function and irreversible regardless of the cause. Renal replacement therapy consists of hemodialysis, peritoneal dialysis and kidney transplantation. Hemodialysis therapy is a renal replacement therapy is the most widely performed and the numbers from year to year continues to increase. Dialysis.Goal:The purpose of this study was to determine the relationship between adherence to undergo hemodialysis therapy with the level of depression in patients with chronic renal failure Rasyida Clinic Medan Year 2015.Method:The study design with Analitik descriptive, cross-sectional method, sampling is done with purposive sampling. Samples are 69 respondents. Compliance questionnaire measuring devices and depression. Data analysis was performed using Chi-square analysis.Result: value of p = 0.023 (p <0.05). The figure indicates that there is a significant relationship between adherence variables undergo hemodialysis therapy with levels of depression patients with chronic renal failure. Based on the data obtained by processing the majority of respondents did not obey as many as 34 people (49.3%) and respondents were obedient as many as 35 people (50.7%) and respondents were depressed as many as 21 people (30.4%) and respondents who are not depressed as much as 48 people (69.6%).Method:The study design with Analitik descriptive, cross-sectional method, sampling is done with purposive sampling. Samples are 69 respondents. Compliance questionnaire measuring devices and depression. Data analysis was performed using Chi-square analysis.Result: value of p = 0.023 (p <0.05). The figure indicates that there is a significant relationship between adherence variables undergo hemodialysis therapy with levels of depression patients with chronic renal failure. Based on the data obtained by processing the majority of respondents did not obey as many as 34 people (49.3%) and respondents were obedient as many as 35 people (50.7%) and respondents were depressed as many as 21 people (30.4%) and respondents who are not depressed as much as 48 people (69.6%).

scholarly journals Starting Renal Replacement Therapy: Is It About Time?

2019 ◽  
Vol 50 (2) ◽  
pp. 144-151
Author(s):  
Elaine Ku ◽  
Charles E. McCulloch ◽  
Kirsten L. Johansen
Keyword(s):  
Risk Factors ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Mixed Models ◽  
Actual Time ◽  
Ckd Stage ◽  
Initiation Of Dialysis ◽  
Late Initiation ◽  
Stage Renal Disease ◽  
End Stage

Background: Studies of the timing of end-stage renal disease (ESRD) have primarily defined “early” versus “late” initiation of dialysis using estimated glomerular filtration rate (eGFR)-based criteria. Our objective was to determine the theoretical time that could be spent in chronic kidney disease (CKD) stage 5 prior to reaching a conservative eGFR threshold of 5 mL/min/1.73 m2 compared to the actual time spent in CKD stage 5 by risk factors of interest. Methods: Eight-hundred and seventy Chronic Renal Insufficiency Cohort participants with CKD stage 5 who started renal replacement therapy (RRT) were included for retrospective study. We used mixed models to estimate the person-specific trajectory of renal function. We then used these individual trajectories to estimate the amount of time that would be spent in CKD stage 5 (between eGFR of 15 and 5 mL/min/1.73 m2) and compared this estimate to the actual time spent in CKD stage 5 prior to ESRD (between eGFR of 15 mL/min/1.73 m2 and ESRD). Results: We found the median observed time between eGFR of 15 mL/min/1.73 m2 to RRT was 9.6 months, but the median predicted time between eGFR of 15 mL/min/1.73 m2 to eGFR of 5 mL/min/1.73 m2 was 17.7 months. Some of the largest differences between the predicted and actual amount of time spent in CKD stage 5 were noted among those with systolic blood pressure <140 mm Hg (9.7 months longer predicted compared to actual), proteinuria <1 g/g (9.1 months), and serum albumin ≥3.5 g/dL (9.0 months). Conclusion: We found marked differences between the actual and predicted time spent in CKD stage 5 based on risk factors of interest. We believe that placing timing of dialysis initiation in the perspective of time is novel and may identify subgroups of patients who may derive particular benefit from a more concerted effort to delay RRT.

scholarly journals Quantification and Dosing of Renal Replacement Therapy in Acute Kidney Injury: A Reappraisal

2017 ◽  
Vol 44 (2) ◽  
pp. 140-155 ◽  
Author(s):  
William R. Clark ◽  
Martine Leblanc ◽  
Zaccaria Ricci ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Journal Club ◽  
Kidney Injury ◽  
Accurate Estimation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Dose Assessments ◽  
Solute Clearance

Background/Aims: Delivered dialysis therapy is routinely measured in the management of patients with end-stage renal disease; yet, the quantification of renal replacement prescription and delivery in acute kidney injury (AKI) is less established. While continuous renal replacement therapy (CRRT) is widely understood to have greater solute clearance capabilities relative to intermittent therapies, neither urea nor any other solute is specifically employed for CRRT dose assessments in clinical practice at present. Instead, the normalized effluent rate is the gold standard for CRRT dosing, although this parameter does not provide an accurate estimation of actual solute clearance for different modalities. Methods: Because this situation has created confusion among clinicians, we reappraise dose prescription and delivery for CRRT. Results: A critical review of RRT quantification in AKI is provided. Conclusion: We propose an adaptation of a maintenance dialysis parameter (standard Kt/V) as a benchmark to supplement effluent-based dosing of CRRT. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=475457

Survival During Renal Replacement Therapy for Diabetic End-Stage Renal Disease in Pima Indians

Diabetes Care ◽  
1996 ◽  
Vol 19 (12) ◽  
pp. 1333-1337 ◽  
Author(s):  
R. G. Nelson ◽  
R. L. Hanson ◽  
D. J. Pettitt ◽  
W. C. Knowler ◽  
P. H. Bennett
Keyword(s):  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Pima Indians ◽  
Stage Renal Disease ◽  
End Stage

Acute Kidney Injury and Renal Replacement Therapy

2020 ◽  
Author(s):  
Karen L. Krechmery ◽  
Diego Casali
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Kidney Injury ◽  
Treatment Modalities ◽  
Optimal Timing ◽  
Timing Of Initiation ◽  
Stage Renal Disease ◽  
End Stage

Acute kidney injury (AKI) is a common syndrome encountered in critical illness and is associated with significant morbidity and increased mortality. Despite attempts to prevent the development of AKI, its incidence continues to rise, probably due to increased recognition in the setting of clearer definitions of the stages of AKI. Despite advances in the field of Nephrology, the treatment of AKI and its complications remains difficult in clinical practice. Critical care clinicians must have an understanding of the current definitions, pathophysiology, and treatment modalities. Renal replacement therapy (RRT) is a mainstay of treatment, but a lack of consensus regarding the optimal timing for initiation remains. There is a need for further research regarding both the timing of initiation of RRT and biomarkers that might allow earlier detection, differentiation of etiologies and monitoring of interventions. This review contains 3 figures, 4 tables, and 31 references Key Words: acute kidney injury (AKI), KDIGO, renal replacement therapy (RRT), risk, injury, failure, loss of kidney function, end stage renal disease (RIFLE), nephrology  

scholarly journals Periodontal Disease in Patients Receiving Dialysis

2019 ◽  
Vol 20 (15) ◽  
pp. 3805
Author(s):  
Yasuyoshi Miyata ◽  
Yoko Obata ◽  
Yasushi Mochizuki ◽  
Mineaki Kitamura ◽  
Kensuke Mitsunari ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Periodontal Disease ◽  
Replacement Therapy ◽  
Healthy Individuals ◽  
Progressive Loss ◽  
Medical Instruments ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.

Patient-nephrologist prognostic awareness and discordance in end stage renal disease on renal replacement therapy

2020 ◽  
Vol 52 (4) ◽  
pp. 765-773
Author(s):  
Sassine Ghanem ◽  
Sami Hossri ◽  
Nicholas Fuca ◽  
Evgenia Granina ◽  
Samer Saouma ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage
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