scholarly journals Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii18-ii22 ◽  
Author(s):  
Francesca Mallamaci ◽  
Anna Pisano ◽  
Giovanni Tripepi
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Sedentary Lifestyle ◽  
Public Health Problem ◽  
Epidemiological Studies ◽  
Dialysis Patients ◽  
Increased Risk ◽  
Reduced Physical Activity

Abstract It is well known from observational studies that sedentary lifestyle and reduced physical activity are common in dialysis and chronic kidney disease (CKD) patients and associate with an increased risk of morbidity and mortality in this patient population. Epidemiological studies indicate that CKD patients undergo physical activity ~9 days/month and 43.9% of dialysis patients report not exercising at all. On the basis of awareness about the strong link between sedentary lifestyle and adverse clinical outcomes, the National Kidney Foundation and Kidney Disease: Improving Global Outcomes have provided specific recommendations for physical activity in patients with kidney disease. Given the fact that CKD is a public health problem and it is still debated which type of exercise should be prescribed in these patients, this review focuses on the most robust evidence accumulated so far on the beneficial effect of various types of physical exercise on clinical outcomes in CKD and dialysis patients. This review does not treat this very important topic in another CKD category of patients, such as kidney-transplanted patients, for whom a special issue should be dedicated.

Epidemiology of gout

2016 ◽  
Author(s):  
Samantha Hider ◽  
Edward Roddy
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Epidemiological Studies ◽  
Dietary Factors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Increased Risk

Gout is the most prevalent inflammatory arthritis in men. Data from epidemiological studies conducted in several countries suggest that the prevalence and incidence of gout have risen over the last few decades, although incidence may have stabilized recently. Dietary factors (animal purines, alcohol, and fructose), co-morbid medical conditions (obesity, metabolic syndrome, hypertension, and chronic kidney disease), and medications (diuretics, aspirin, beta blockers, angiotensin converting-enzyme inhibitors, and non-losartan angiotensin II receptor blockers) have been confirmed to be risk factors for both hyperuricaemia and gout. In contrast, low-fat dairy products, coffee, vitamin C, calcium channel antagonists, and losartan appear to reduce the risk of developing gout. People with gout are themselves at increased risk of developing cardiovascular disease and chronic kidney disease, independent of traditional risk factors for these conditions.

scholarly journals Asymptomatic Ventricular Arrhythmia and Clinical Outcomes in Chronic Kidney Disease: A Pilot Study

2016 ◽  
Vol 7 (1) ◽  
pp. 66-73 ◽  
Author(s):  
Fabiana Oliveira Bastos Bonato ◽  
Renato Watanabe ◽  
Marcelo Montebello Lemos ◽  
José Luiz Cassiolato ◽  
Myles Wolf ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Pilot Study ◽  
Kidney Disease ◽  
Ventricular Arrhythmia ◽  
Clinical Outcomes ◽  
Cardiovascular Events ◽  
Composite Outcome ◽  
Ventricular Extrasystoles ◽  
Increased Risk

Background/Aims: Ventricular arrhythmia is associated with increased risk of cardiovascular events and death in the general population. Sudden death is a leading cause of death in end-stage renal disease. We aimed at evaluating the effects of ventricular arrhythmia on clinical outcomes in patients with earlier stages of chronic kidney disease (CKD). Methods: In a prospective study of 109 nondialyzed CKD patients (estimated glomerular filtration rate 34.8 ± 16.1 ml/min/1.73 m2, 57 ± 11.4 years, 61% male, 24% diabetics), we tested the hypothesis that the presence of subclinical complex ventricular arrhythmia, assessed by 24-hour electrocardiogram, is associated with increased risks of cardiovascular events, hospitalization, and death and with their composite outcome during 24 months of follow-up. Complex ventricular arrhythmia was defined as the presence of multifocal ventricular extrasystoles, paired ventricular extrasystoles, nonsustained ventricular tachycardia, or R wave over T wave. Results: We identified complex ventricular arrhythmia in 14% of participants at baseline. During follow-up, 11 cardiovascular events, 15 hospitalizations, and 4 deaths occurred. The presence of complex ventricular arrhythmia was associated with cardiovascular events (p < 0.001), hospitalization (p = 0.018), mortality (p < 0.001), and the composite outcome (p < 0.001). In multivariate Cox regression analysis, adjusting for demographic characteristics, complex ventricular arrhythmia was associated with increased risk of the composite outcome (HR 4.40; 95% CI 1.60-12.12; p = 0.004). Conclusion: In this pilot study, the presence of asymptomatic complex ventricular arrhythmia was associated with poor clinical outcomes in nondialyzed CKD patients.

scholarly journals Posture and physical activity in dialysis patients

2019 ◽  
Vol 65 (2) ◽  
Author(s):  
Magdalena Szałowska-Bojarun ◽  
Aleksandra Gawlikowska-Sroka
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Kidney Disease ◽  
Physical Fitness ◽  
Sedentary Lifestyle ◽  
The Body ◽  
Dialysis Patients ◽  
Positive Effects ◽  
Negative Effect

A review of the literature concerning posture and physical activity among dialysis patients was performed in order to determine strategies for improving physical activity and thus quality of life in this group of patients. Correct posture ensures harmonious functioning of the body with optimal efficiency. A sedentary lifestyle has a negative effect on posture and reduces a person’s physical fitness. Haemodialysis forces patients to sit or lie down for long periods of time, while the consequences of chronic disease additionally predispose them to a sedentary lifestyle. Patients with chronic kidney disease treated by dialysis are particularly likely to exhibit sedentary behaviour, and thus are less physically active. The physical fitness of dialysis patients deteriorates due to kidney disease, but also because of concomitant diseases. It is very important to educate patients about the positive effects of physical activity, as well as to promote exercise as a necessary element of treatment for improving their quality of life.

scholarly journals The association of physical function and physical activity with all-cause mortality and adverse clinical outcomes in nondialysis chronic kidney disease: a systematic review

2018 ◽  
Vol 9 (11) ◽  
pp. 209-226 ◽  
Author(s):  
Heather J. MacKinnon ◽  
Thomas J. Wilkinson ◽  
Amy L. Clarke ◽  
Douglas W. Gould ◽  
Thomas F. O’Sullivan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Clinical Outcomes ◽  
Research Quality ◽  
Measurement Tool ◽  
Cochrane Central Register ◽  
Renal Transplant Recipients ◽  
All Cause Mortality

Objective: People with nondialysis-dependent chronic kidney disease (CKD) and renal transplant recipients (RTRs) have compromised physical function and reduced physical activity (PA) levels. Whilst established in healthy older adults and other chronic diseases, this association remains underexplored in CKD. We aimed to review the existing research investigating poor physical function and PA with clinical outcome in nondialysis CKD. Data sources: Electronic databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials) were searched until December 2017 for cohort studies reporting objective or subjective measures of PA and physical function and the associations with adverse clinical outcomes and all-cause mortality in patients with nondialysis CKD stages 1–5 and RTRs. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42016039060). Review methods: Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare and Research Quality (AHRQ) standards. Results: A total of 29 studies were included; 12 reporting on physical function and 17 on PA. Only eight studies were conducted with RTRs. The majority were classified as ‘good’ according to the AHRQ standards. Although not appropriate for meta-analysis due to variance in the outcome measures reported, a coherent pattern was seen with higher mortality rates or prevalence of adverse clinical events associated with lower PA and physical function levels, irrespective of the measurement tool used. Sources of bias included incomplete description of participant flow through the study and over reliance on self-report measures. Conclusions: In nondialysis CKD, survival rates correlate with greater PA and physical function levels. Further trials are required to investigate causality and the effectiveness of physical function and PA interventions in improving outcomes. Future work should identify standard assessment protocols for PA and physical function.

scholarly journals Impact of chronic kidney disease on in-hospital mortality and clinical outcomes of catheter ablation of ventricular tachycardia: Insights from the national readmission database

2021 ◽  
Author(s):  
Mahmoud Khalil ◽  
Ahmed Maraey ◽  
Amro Aglan ◽  
Emmanuel akintoye ◽  
Mahmoud Salem ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Kidney Disease ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Readmission Rate ◽  
Increased Risk ◽  
Vt Ablation ◽  
National Readmission Database

Background: Catheter ablation is an effective treatment for ventricular tachycardia (VT), albeit the decision to undergo this procedure is often influenced by underlying comorbidities. The present study aims at evaluating the effects of chronic kidney disease (CKD) on clinical outcomes of VT ablation. Methods: We identified 7,212 patients who presented between 2016-2018 and underwent catheter ablation for VT. Their clinical data were retrospectively accrued from the national readmission database (NRD) using the corresponding diagnosis codes. We compared clinical outcomes between patients with chronic kidney disease (CKD-group) and patients without. Odds ratios (OR) for the primary and secondary outcomes were calculated, and multivariable regression analysis was utilized to adjust for confounding variables. Results: Compared with patients without CKD, patients in CKD-group were older (mean age 67.9 vs. 60.5 years, P <0.01), had a longer mean length of stay (8.73 vs. 5.69 days, P <0.01), and higher in-hospital mortality (OR 2.24, 95% confidence interval (CI) (1.29-3.88), P<0.01). CKD-group patients had increased risk of developing acute kidney injury (10% vs. 8.6%, P<0.01) and 30-day readmission rate due to VT (OR 1.77, 95% CI (1.17-2.69), P<0.01). Conclusion: In patients with CKD, VT ablation is associated with worse clinical outcomes in-hospital mortality and 30-day readmission rate. This significantly influences the decision-making prior to performing this procedure.

scholarly journals Pulmonary embolism in a 51-year-old woman with chronic kidney disease

2021 ◽  
Vol 40 (2) ◽  
pp. 160-165
Author(s):  
Triwedya Indra Dewi ◽  
Melawati Hasan ◽  
Fathy Fathini
Keyword(s):  
Chronic Kidney Disease ◽  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Kidney Disease ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Right Heart Failure ◽  
Diagnostic Tools ◽  
Number Of Patients ◽  
Increased Risk

Background Chronic kidney disease (CKD) is a worldwide public health problem both in terms of the number of patients and the cost of treatment. Chronic kidney disease seems to be the main driver of pulmonary embolism (PE) in dialysis patients. The diagnosis of PE is difficult due to its non-specific signs and symptoms, especially in many comorbidities with similar features. Chronic kidney disease plays a role in both the incidence of venous thromboembolism and the manifestations of pulmonary hypertension, resulting in an increased risk of morbidity and mortality. Advances in the management of patients with suspected PE have improved diagnostic accuracy. An approach using several diagnostic tools with different characteristics, such as D-dimer measurement, and imaging tests-predominantly computed tomography pulmonary angiography (CTPA) - can help evaluate the diagnosis. Case DescriptionHere we report the case of a 51-year-old woman with a history of chronic kidney disease, who presented with sudden worsening of dyspnea. Further examination showed signs of right heart failure with a high probability of pulmonary hypertension on echocardiography. Based on the general features it is difficult to distinguish between acute pulmonary embolism and chronic pulmonary hypertension, both of which can be caused by the underlying chronic kidney disease. Nevertheless, gold standard imaging using CTPA confirmed the diagnosis of pulmonary embolism, with underlying pulmonary hypertension from chronic kidney disease. ConclusionsThe diagnosis of pulmonary embolism with comorbidities is challenging. The availability of diagnostic modalities will confer different advantages and particular accuracy to meet the challenges in diagnosis.

scholarly journals Moderate–Vigorous Physical Activity and Clinical Outcomes in Adults with Nondialysis Chronic Kidney Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3365
Author(s):  
Ji Kim ◽  
Young Hyun ◽  
Kyu-Beck Lee ◽  
Sung Lee ◽  
Hayne Park ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Lower Risk ◽  
Vigorous Physical Activity ◽  
Moderate Amount ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
End Stage

The health benefits of physical activity (PA) are well known. However, the association between an adequate amount of moderate–vigorous PA (MVPA) and clinical outcomes has limited evidence in chronic kidney disease (CKD). We assessed PA using a self-administered questionnaire. The amount of MVPA was categorized into four groups: none, low, moderate, and high (0, <7.5, 7.5–14.9, and 15.0–29.9 metabolic equivalent-hours/week, respectively). We analyzed the association between the amount of MVPA and clinical outcomes. Among a total of 1909 adults with CKD, adults with MVPA showed various beneficial outcomes compared to those with no MVPA in a Kaplan–Meier curve followed over a median of 5.9 years. In multivariable-adjusted Cox proportional hazard models, a low and a moderate amount of MVPA was associated with a lower risk of all-cause death. A moderate amount of MVPA was associated with a lower risk of cardiovascular events. A high amount of MVPA was associated with a lower risk of end-stage kidney disease in ESKD in 1324 adults with eGFR <60 mL/min/1.73 m2. Age and sex modified the relationships between MVPA and clinical outcomes. MVPA is associated with various beneficial outcomes across the amount of MVPA. PA plans should be tailored for individual adults with CKD.

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