scholarly journals 1272Patterns of multimorbidity show strong association between many chronic condition pairs

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Steph Gordon ◽  
Tylie Baylis
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Treatment Guidelines ◽  
Strong Association ◽  
National Health Survey ◽  
Associated Conditions ◽  
Australian Bureau Of Statistics

Abstract Background Many people with chronic conditions do not have a single condition: 4.9 million (20%) Australians had multimorbidity (2 or more chronic conditions) in 2017–18. Understanding which conditions co-occur can inform treatment guidelines. This study performs new analysis on Australian Bureau of Statistics 2017–18 National Health Survey data to identify conditions that commonly co-occur, and that co-occur at a higher than expected prevalence. Methods Analysis was restricted to people aged 45 and over (most people with multimorbidity). Using 10 selected chronic conditions, weighted age-adjusted estimates of observed and expected events for each combination of 2 conditions were calculated. To identify pairs of conditions that co-occurred at a higher than expected prevalence, the ratio of observed to expected prevalence was assessed using a 95% confidence interval. Results Over half of the condition pairs tested were significantly associated. The most strongly associated conditions were asthma with COPD (with co-occurrence 3.5 times as high as expected), diabetes with chronic kidney disease (2.5 times as high), and cardiovascular diseases with chronic kidney disease (2.3 times as high). Conclusions Multimorbidity is common, with many conditions co-occurring more frequently than expected by chance. Developing treatment guidelines that consider common multimorbidities would support holistic patient care. Key messages Many chronic condition pairs occur together in individuals more often than would be expected by chance. There were strong associations between asthma and COPD, diabetes and chronic kidney disease, and cardiovascular diseases and chronic kidney disease.

scholarly journals Prevalence of anemia and cardiovascular diseases in chronic kidney disease patients: a single tertiary care centre study

2017 ◽  
Vol 4 (1) ◽  
pp. 247 ◽  
Author(s):  
Swaraj Sathyan ◽  
Sunil George ◽  
Poornima Vijayan
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Strong Association ◽  
Left Ventricular ◽  
Newly Diagnosed ◽  
National Kidney Foundation ◽  
Study Population ◽  
Prevalence Of Anemia

Background: Chronic kidney disease (CKD) is recognized as a global health issue having high mortality and morbidity rates putting a substantial burden on global resources. CKD has become a recognised independent risk factor for several adverse health outcomes including cardiovascular disease (CVD). Anaemia is an anticipated consequence as renal function declines, and can develop at any stage of CKD. There is a strong association between anemia and cardiovascular complications in CKD patients and many studies have proven that anemia plays a key role in worsening CVD in CKD patients. The objective of this study was to study the prevalence of anemia and cardiovascular diseases in CKD patients and establish an association between them.Methods: This study was conducted between January 2008 and June 2008 for a period of six months at a Government tertiary referral institution in south India. During this period, all newly diagnosed cases of chronic kidney disease based on the National Kidney foundation definition were included in this study. All the patients were evaluated based on detailed history taking, clinical examination and laboratory investigations after an informed consent was obtained from them. Staging of CKD was done based on the national kidney foundation (NKF/KDIGO) staging system. GFR was estimated using the abbreviated MDRD (Modification of Diet in Renal Disease) formula.Results: Of the 333 newly diagnosed CKD patients, a large majority (264, 79.28%) of the patients in the study presented in stage 5 CKD. The mean Hb in the study was 8.42±2.20 g/dl. Anemia was present in 90.39% while 25.53% had an Hb of <7g/dl. The prevalence of anemia increased from stage 3 (66.6%) to stage 5 (94.7%) and this correlation was statistically significant (p<0.0005). 167 (50.15% ) were found to have some form of cardiovascular disease, of which 120 (71.86%) were males and 47 (28.14%) were females. 83.93% had left ventricular hypertrophy, 16.17% had ischemic heart disease and 7.78% had congestive heart failure. 56.3% of patients in the age group 41-60 years had cardiovascular disease. The correlation between cardiovascular disease and age was statistically significant (p = 0.04139). And it was found that cardiovascular disease was more common when the cause of CKD was Diabetic nephropathy (65.8%) and hypertensive nephrosclerosis (84.6%). The correlation between the cardiovascular disease and etiological diagnosis of CKD was statistically significant. (p<0.0005).Cardiovascular disease was present in 61.2 % of the study population with diabetes mellitus and in 56.4% of the study population with hypertension. The correlations between CVD and diabetes and hypertension were statistically significant. Cardiovascular disease was present in 61.2% of the study population with Hemoglobin <7 gm/dl, 41.7% with Hb between 7-11 gm/dl and the correlation between cardiovascular disease and the level of Hb was highly significant in CKD patients.Conclusions: Thus there is a strong association between the clinical trial of anemia, CKD and CVD and prompt identification and management of common risk factors and adequate correction of anemia is necessary to slow progression of CKD and prevent cardiovascular events.

scholarly journals PATIENT WITH MYELODYSPLASTIC SYNDROME IN EMERGENCY DEPARTMENT

2019 ◽  
Vol 141 (7-8) ◽  
pp. 247-249
Keyword(s):  
Chronic Kidney Disease ◽  
Emergency Department ◽  
Kidney Disease ◽  
Myelodysplastic Syndromes ◽  
Specific Treatment ◽  
Reference Value ◽  
Front Wall ◽  
Hematopoietic Stem ◽  
Coronary Syndrome ◽  
Associated Conditions

Myelodysplastic syndromes (MDS) are a group of clonal disorders arising from hematopoietic stem cells and are generally characterized by inefficient hematopoiesis and dysplasia. The International Prognostic Scoring Sytem (IPSS) is an important standard for assessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). Ineffective hematopoiesis leading to anemia is the most common cause of the arrival of patients with MDS in the emergency room . Patients with MDS have a number of associated conditions such as chronic kidney disease and hypertension, and may be present as acute coronary syndrome. We report a case of a 83-year-old female with MDS that was diagnosed in 2014 and had no specific treatment. She presented to the emergency department at the beginning of 2016 because of epigastric and chest pain that began in the morning. Diagnosis of subacute STEMI with a scar formed on front wall and elevated high-sensitivity troponin (hsTnI) which amounted to 1,369 ng / L (reference value < 15.6 ng / L) was made, and the patient was hospitalized in the Coronary Care Unit . The care for this population of patients, mainly elderly, in the emergency department requires a comprehensive approach due to the presence of associated conditions such as hypertension, chronic kidney disease and ischemic heart disease. Cardiovascular diseases (CVD) are the leading cause of death in all countries worldwide.

scholarly journals Association of Retinopathy with Chronic Kidney Disease in Diabetes Mellitus

2018 ◽  
Vol 8 (3) ◽  
pp. 210-214
Author(s):  
Rushda Sharmin Binte Rouf ◽  
SM Ashrafuzzaman ◽  
Zafar Ahmed Latif
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Strong Association ◽  
Albumin Excretion Rate ◽  
Cross Sectional Study ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Cross Sectional

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214

scholarly journals Association of simple renal cysts and chronic kidney disease with large abdominal aortic aneurysm

2019 ◽  
Author(s):  
Milena Miszczuk ◽  
Verena Müller ◽  
Christian E. Althoff ◽  
Andrea Stroux ◽  
Daniela Widhalm ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Strong Association ◽  
Renal Cysts ◽  
Aortic Aneurysms ◽  
Control Group ◽  
Abdominal Aortic ◽  
And Control ◽  
Charité Berlin

AbstractAbdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA. Two groups of patients (100/group), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis. SRC (73% vs. 57%; p<0.001) and CKD (31% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analysis, CKD, but not SRC, showed a strong association with AAA. Knowledge about pathobiological mechanisms and association between CKD and AAA could provide better diagnostic and therapeutic approaches for these patients.

Possibilities of using fosinopril in treatment of patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus

2021 ◽  
pp. 17-25
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
S. V. Batyukina ◽  
N. A. Shatalova ◽  
N. M. Doldo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
The Body ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Secondary Damage

Chronic kidney disease is one of the most common diseases in general medical practice, due to their secondary damage to the kidneys in arterial hypertension, chronic heart failure, and diabetes mellitus. The coexistence of hypertension and diabetes increases the likelihood of developing chronic kidney failure tenfold. In turn, chronic kidney disease is an important independent risk factor for the development of cardiovascular complications, including fatal ones, due to the direct relationship of the pathogenetic mechanisms of cardiorenal relationships. Approaches to the treatment of chronic kidney disease should be aimed both at preventing the risks of developing renal dysfunction, and at treating existing pathology. The multifactorial nature of the disease and the complex etiopathogenetic relationships determine the need to optimize existing approaches to the treatment of chronic kidney disease in multimorbidity patients with concomitance cardiovascular diseases and diabetes mellitus. This is also due to the fact that, unlike other target organs, compensation for background disease does not always prevent further deterioration of kidney function. According to the recommendations of the main scientific communities, in such cases, it is advisable to start therapy with the most effective angiotensin-converting enzyme inhibitors that combine nephro-and cardioprotective effects and have a dual route of elimination from the body, which is especially important in multimorbidity, the aim to prevent polypharmacy, reduce the risk of drug interactions and, consequently, side effects. This article reviews the literature data indicating the high efficacy and safety of the angiotensin converting enzyme inhibitor fosinopril in patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus.

scholarly journals Dietary Patterns of Patients with Chronic Kidney Disease: The Influence of Treatment Modality

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1920 ◽  
Author(s):  
Fernanda Santin ◽  
Daniela Canella ◽  
Camila Borges ◽  
Bengt Lindholm ◽  
Carla Avesani
Keyword(s):  
Chronic Kidney Disease ◽  
Food Intake ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Dietary Patterns ◽  
Treatment Modality ◽  
National Health Survey ◽  
Alcoholic Beverages ◽  
Linear Regression Models ◽  
Treatment Groups

Background: We analyzed the dietary patterns of Brazilian individuals with a self-declared diagnosis of chronic kidney disease (CKD) and explored associations with treatment modality. Methods: Weekly consumption of 14 food intake markers was analyzed in 839 individuals from the 2013 Brazil National Health Survey with a self-declared diagnosis of CKD undergoing nondialysis (n = 480), dialysis (n = 48), or renal transplant (n = 17) treatment or no CKD treatment (n = 294). Dietary patterns were derived by exploratory factor analysis of food intake groups. Multiple linear regression models, adjusted by sociodemographic and geographical variables, were used to evaluate possible differences in dietary pattern scores between different CKD treatment groups. Results: Two food patterns were identified: an “Unhealthy” pattern (red meat, sweet sugar beverages, alcoholic beverages, and sweets and a negative loading of chicken, excessive salt, and fish) and a “Healthy” pattern (raw and cooked vegetables, fruits, fresh fruit juice, and milk). The Unhealthy pattern was inversely associated with nondialysis and dialysis treatment (β: −0.20 (95% CI: −0.33; −0.06) and β: −0.80 (−1.16; −0.45), respectively) and the Healthy pattern was positively associated with renal transplant treatment (β: 0.32 (0.03; 0.62)). Conclusions: Two dietary patterns were identified in Brazilian CKD individuals and these patterns were linked to CKD treatment modality.

The Epidemic of Chronic Kidney Disease in Patients Referred to a Hematologist for Anemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5521-5521
Author(s):  
Brian Zimmer ◽  
Dana Wentzel ◽  
James Reed ◽  
Sherrine Eid ◽  
Eliot Friedman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
General Population ◽  
Serum Creatinine ◽  
Strong Association ◽  
Chart Audit ◽  
Stage 4 ◽  
The Mean ◽  
Stage 1

Abstract NHANES survey estimates the prevalence of CKD to be approximately 11% in the general population and 25% in the population over 65 years of age, and the prevalence of Chronic Kidney Disease (CKD) associated anemia approaches 75% in Stage 5 CKD. Despite the high prevalence of CKD, and its strong association with anemia, many patients diagnosed with anemia and referred to a hematologist for evaluation frequently have the diagnosis of CKD overlooked, especially if one is using a serum creatinine to assess renal function. A more accurate method of assessing renal function and to appropriately stage CKD is the use of an estimated glomerular filtration rate (eGFR) utilizing the modified MDRD equation. With the realization that CKD clearly has become known as a significant magnifier of cardiovascular risk (CVR), the importance of making the diagnosis of CKD has become quite apparent. Hypothesis: Patients referred to a hematologist for evaluation of anemia represent a population enriched with CKD. A retrospective chart audit was performed on patients being referred to a hematology practice from community physicians for the evaluation of anemia from January 2004 through December 31, 2005. All patients with a prior knowledge of CKD and a history of malignancy or myelodysplastic process were excluded from the study. The cohort consisted of 256 patients (37.5 % male and 62.5 % female) with a mean age of 67.56 ± 15.9 years. The mean serum creatinine was 1.16 ± .74 mg/dL with a mean calculated GFR by the modified MDRD (4 variable) equation of 69.9 ± 34.2 ml/min/1.73 m2. The mean ± SEM serum creatinine by stage of CKD in our patient population is: Stage 1: 0.67 ± 0.14 mg/dL, Stage 2: 0.92 ± 0.15 mg/dL, Stage 3: 1.40 ± 0.29 mg/dL, Stage 4: 2.23 ± 0.53 mg/dL, and Stage 5: 5.2 ± 2.89 mg/dL. Conservatively, we defined CKD as GFR <60 as urinalysis, imaging, or biopsy data were not available. In conclusion, an astounding 42.2 % of patients referred to a hematologist for the evaluation of anemia have CKD as compared to an estimated prevalence of 11 % in the general population reported by K/DOQI. Not only were these patients not aware of their diagnosis of CKD, but, of note also is the fact that 5.1 % were not aware of the presence of advanced CKD (GFR < 30) and 4 patients had Stage 5 CKD without awareness. 55.8 % of the patients over the age of 65 with anemia have CKD as compared to an estimated 25 % of the general population over the age of 65. This information stresses the need to assess all anemia patients for CKD and to appropriately stage them. Given the well accepted association between CKD and CVR, physicians caring for these patients can then stress the need for aggressive pursuit of both traditional and non traditional risk factor reduction to circumvent the significant CVR that is present in this population. Prevalence of Abnormal Renal Function by GFR Frequency Percent *K/DOQI = National Kidney Foundation’s Kidney Disease Outcome Quality Initiative GFR > 90 (Normal /K/DOQI* Stage 1) 51 19.9 GFR 89 - 60 (K/DOQI Stage 2) 97 37.9 GFR 59 - 30 (K/DOQI Stage 3) 95 37.1 GFR 29 - 15 (K/DOQI Stage 4) 9 3.5 GFR < 15 (K/DOQI Stage 5) 4 1.6

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