scholarly journals P0961PHYSICAL REHABILITATION OF PATIENTS WITH CHRONIC KIDNEY DISEASE OF PRE -DIALYSIS STAGES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Durdona Saipova
Keyword(s):  
Chronic Kidney Disease ◽  
Oxygen Consumption ◽  
Kidney Disease ◽  
Physical Performance ◽  
Physical Training ◽  
Stress Test ◽  
Laboratory Data ◽  
Public Health Problem ◽  
Rehabilitation Program ◽  
Maximum Oxygen Consumption

Abstract Background and Aims Chronic kidney disease is a global public health problem. Poor physical condition and skeletal muscle depletion are associated with the combined effects of uremic acidosis, protein-energy deficiency and inflammatory depletion, which leads to further exacerbation of a sedentary lifestyle. The aim of the determination of physical performance and the effectiveness of physical training during the 12-week program in patients with CKD of pre-dialysis stages. Method We examined 130 patients with CKD 2-4 stages. Clinical parameters (BP, BMI, mid-thigh circumference, mid-shoulder circumference, mid-calf circumference), laboratory data (serum creatinine, serum cholesterol, serum albumin, serum phosphorus, serum calcium) were evaluated in all patients according to the formula CKD-EPI 2011. Physical performance was determined by the results of cardiopulmonary stress test. In accordance with the initial data of the patients, a 12-week physical rehabilitation program was individually selected, which included morning exercises, physiotherapy exercises and dosed walking . The data obtained were subjected to statistical processing. Results The average age of patients was 54.8 years. Of these, 52 women (40%) and 78 (60%) men. The estimated glomerular filtration rate varied from 30 to 60 ml / min / 1.73 m2, which corresponded to the indicators of the pre-dialysis stages of CKD. After a 12-week rehabilitation program, the maximal oxygen consumption (V O2peak) increased in 70% of regularly engaged patients by 1.2 times (22.31 ml / min / kg and 27.05 ml / min / kg, respectively), and in 30% of those who did not pass the course Exercise therapy, the indicator of maximum oxygen consumption after 12 weeks was 21.7 ml / min / kg (with an initial 23.7 ml / min / kg) The average blood pressure decreased slightly (from 111 ± 5 initially to 106 ± 5 mm Hg after 12 weeks, p<0.05) When measuring anthropometric parameters, it was found that the circle the mid-thigh increased from 46.5 ± 6.0 cm to 0.6 cm, the circumference of the middle of the shoulder increased from 31.1 ± 4.0 cm to 0.4 cm. The circumference of the middle part of the lower leg was initially 356.7 ± 3.8 cm, and after 12 weeks of training it increased 0.3 cm. In 9 patients, these parameters did not change after a 12-week program. Conclusion Regular physical training led to an increase in the maximum oxygen consumption by 1.2 times. It was noted that regular training contributes to a slight increase in muscle mass in patients with CKD. The importance of regularity of physical therapy classes was also revealed.

scholarly journals Breath Ammonia Is a Useful Biomarker Predicting Kidney Function in Chronic Kidney Disease Patients

Biomedicines ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 468
Author(s):  
Ming-Jen Chan ◽  
Yi-Jung Li ◽  
Chao-Ching Wu ◽  
Yu-Chen Lee ◽  
Hsiao-Wen Zan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Characteristic Curve ◽  
Laboratory Data ◽  
Public Health Problem ◽  
Exhaled Breath ◽  
Ckd Stage ◽  
Significant Difference ◽  
Stage 1

Chronic kidney disease (CKD) is a public health problem and its prevalence has increased worldwide; patients are commonly unaware of the condition. The present study aimed to investigate whether exhaled breath ammonia via vertical-channel organic semiconductor (V-OSC) sensor measurement could be used for rapid CKD screening. We enrolled 121 CKD stage 1–5 patients, including 19 stage 1 patients, 26 stage 2 patients, 38 stage 3 patients, 21 stage 4 patients, and 17 stage 5 patients, from July 2019 to January 2020. Demographic and laboratory data were recorded. The exhaled ammonia was collected and rapidly measured by the V-OSC sensor to correlate with kidney function. Results showed no significant difference in age, sex, body weight, hemoglobin, albumin level, and comorbidities in different CKD stage patients. Correlation analysis demonstrated a good correlation between breath ammonia and blood urea nitrogen levels, serum creatinine levels, and estimated glomerular filtration rate (eGFR). Breath ammonia concentration was significantly elevated with increased CKD stage compared with the previous stage (CKD stage 1/2/3/4/5: 636 ± 94; 1020 ± 120; 1943 ± 326; 4421 ± 1042; 12781 ± 1807 ppb, p < 0.05). The receiver operating characteristic curve analysis showed an area under the curve (AUC) of 0.835 (p < 0.0001) for distinguishing CKD stage 1 from other CKD stages at 974 ppb (sensitivity, 69%; specificity, 95%). The AUC was 0.831 (p < 0.0001) for distinguishing between patients with/without eGFR < 60 mL/min/1.73 m2 (cutoff 1187 ppb: sensitivity, 71%; specificity, 78%). At 886 ppb, the sensitivity increased to 80% but the specificity decreased to 69%. This value is suitable for kidney function screening. Breath ammonia detection with V-OSC is a real time, inexpensive, and easy to administer measurement device for screening CKD with reliable diagnostic accuracy.

scholarly journals A Systematic Review and Meta-Analysis of Pharmacogenetic Studies in Patients with Chronic Kidney Disease

2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Genotype Distribution ◽  
Global Public Health ◽  
High Prevalence ◽  
Additive Inheritance

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.

scholarly journals THE EFFECT OF ARTISTIC GYMNASTICS AND STEP AEROBICS ON PHYSICAL PERFORMANCE IN FIRST-YEAR FEMALE UNIVERSITY STUDENTS NOT RELATED TO SPORT

2019 ◽  
Vol 19 (3) ◽  
pp. 66-73 ◽  
Author(s):  
M Avdeeva ◽  
T Belicheva
Keyword(s):  
Oxygen Consumption ◽  
University Students ◽  
Physical Performance ◽  
First Year ◽  
Maximum Oxygen Consumption ◽  
Standing Long Jump ◽  
Long Jump ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Aim. The article deals with establishing the effect of step aerobics and artistic gymnastics on physical performance in first year female university students. Materials and methods. 80 full-time female university students participated in the study. The first group practiced artistic gymnastics (Group 1, n = 40), the second group (Group 2, n = 40) – step aerobics. The mean age was 18.35 ± 0.04 years. In September and December 2017, their physical development, physical fitness, physical performance, respiratory and cardiovascular systems were assessed based on standard procedures using the data of maximum oxygen consumption and the step test. Results. At the beginning of the experiments, there were no statistically significant differences between Group 1 and Group 2. The mean maximum oxygen consumption values corresponded to satisfactory performance (39.85 ± 0.37 – Group 1, 38.92 ± 0.42 – Group 2, р = 0.1). At the end of the experiment, there were statistically significant differences in terms of the mean maximum oxygen consumption: 40.73 ± 0.21 – Group 1 and 41.61 ± 0.21 – Group 2. The results of the ranking showed that the majority of participants demonstrated an increase in physical performance. Group 1 showed an increase in the standing long jump, Group 2 improved 2000 m running time and the standing long jump. Group 2 also demonstrated a decrease in heart rate and an increase in adaptation capacities. Conclusion. The lessons of artistic gymnastics during a semester do not influence significantly physical performance but improve speed-strength characteristics. Step aerobics influences positively physical performance, speed-strength characteristics, and the cardio­vascular system in first-year female university students not related to sport.

Association between Serum Asymetrical Dimethylarginine Level and Cardiac Functions in Chronic kidney Disease Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Saeed Abdelwahab Saeed ◽  
Ashraf Hassan Abd-elmobdy ◽  
Mostafa Ashour Mahmoud Farag Ammar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Function ◽  
Tissue Doppler Imaging ◽  
Public Health Problem ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Major Public Health Problem ◽  
Cardiac Functions ◽  
Laboratory Investigations

Abstract Background Chronic kidney disease (CKD) is a major public health problem worldwide and is associated with a considerable increase in morbidity and mortality, cardiovascular disease is most common cause of death among chronic kidney disease patients. Objectives The aim of study was to determine the association between serum ADMA level and cardiac functions assessed by tissue Doppler imaging in chronic kidney disease patients. Patients and Methods our study conducted on 90 patients from outpatient clinic or inpatient department of national institute of nephrology and urology. Results All patients were subjected to full history, full clinical examination, laboratory investigations including: serum urea, serum albumin, complete blood picture, serum electrolytes (calcium and phosphorus), PTH, serum ADMA, lipid profile and echocardiography and Tissue Doppler imaging. Conclusion Serum ADMA is negatively correlated with diastolic function among CKD patients, tissue Doppler imaging is more accurate than echocardiography to estimate diastolic function.

P0737THE ASSOCIATION BETWEEN CYSTATIN C AND ARTERIAL STIFFNESS IN NON-CKD PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nejc Piko ◽  
Tadej Petreski ◽  
Robert Ekart ◽  
Radovan Hojs ◽  
Sebastjan Bevc
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Myocardial Perfusion ◽  
Arterial Stiffness ◽  
Arterial Hypertension ◽  
Cystatin C ◽  
Laboratory Data ◽  
Applanation Tonometry ◽  
Serum Cystatin C

Abstract Background and Aims Serum cystatin C (cysC) is produced by all nucleated cells at a constant rate, is filtered freely by the glomerulus and metabolized after tubular reabsorption. It is influenced less by age, gender and muscle mass compared to serum creatinine. These properties make it an important marker in detecting renal impairment. Arterial stiffness is a hallmark of atherosclerosis and is connected to cardiovascular events and mortality. In patients with chronic kidney disease (CKD), cysC correlates with increased arterial stiffness, but less is known about the association between cysC and arterial stiffness in non-CKD patients. Method The study was performed at the University Medical Centre Maribor between October 1st 2018 and January 1st 2020. Basic demographic and laboratory data were recorded. To estimate glomerular filtration rate (eGFR), Chronic Kidney Disease Epidemiology (CKD-EPI) equation was used. Patients with previously diagnosed CKD and/or eGFR ≤ 60 ml/min/1.73m2 at the time of admission, known malignancy, thyroid disease and/or on steroid therapy were not enrolled in the study. Arterial stiffness was measured with applanation tonometry (Sphygmocor®, Australia), carotid-femoral pulse wave velocity (cfPWV) was used as the gold standard of central arterial stiffness and subendocardial viability ratio (SEVR) was used as the marker of myocardial perfusion. SPSS® version 22 was used for statistical analysis. Results 111 patients (65.8% male, average age 64.3±9.4 years) were included in our study. Most common comorbidities were arterial hypertension (n=86, 77.5%), hyperlipidaemia (n=64, 57.7%) and diabetes mellitus (n=22, 19.8%). Mean creatinine value was 77.7±13.8 μmol/L (range 49-108 μmol/L), mean eGFR was 81.3±9.4 ml/min/1.73m2 (range 62-90 ml/min/1.73m2) and mean value of cysC was 0.94±0.18 mg/L (range 0.67-1.63 mg/L). Mean SEVR value was 165.7±36.1% (range 92-299%) and mean cfPWV value was 10.1±2.4 m/s (range 6.2-16.8 m/s). Significant correlation was found between cysC and SEVR (r=-0.316, p&lt;0.001) and between cysC and cfPWV (r=0.472, p&lt;0.001). Multiple regression analysis of arterial stiffness indices and cysC, age, gender, diabetes mellitus, arterial hypertension, eGFR and hyperlipidemia, showed statistically significant association between cysC and cfPWV (ß=0.220, p=0.038) and cysC and SEVR (ß=-0.278, p=0.017). Conclusion Serum cysC is independently associated with increased arterial stiffness, reduced myocardial perfusion and increased cardiovascular risk in non-CKD patients.

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.

Flt3 inhibition alleviates chronic kidney disease by suppressing CD103+ dendritic cell-mediated T cell activation

2018 ◽  
Vol 34 (11) ◽  
pp. 1853-1863 ◽  
Author(s):  
Ruifeng Wang ◽  
Titi Chen ◽  
Chengshi Wang ◽  
Zhiqiang Zhang ◽  
Xin Maggie Wang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
T Cells ◽  
T Cell ◽  
Kidney Disease ◽  
T Cell Activation ◽  
Cell Activation ◽  
Kidney Injury ◽  
Public Health Problem ◽  
Global Public Health ◽  
Flt3 Inhibitor

Abstract Background Chronic kidney disease (CKD) is a global public health problem, which lacks effective treatment. Previously, we have shown that CD103+ dendritic cells (DCs) are pathogenic in adriamycin nephropathy (AN), a model of human focal segmental glomerulosclerosis (FSGS). Fms-like tyrosine kinase 3 (Flt3) is a receptor that is expressed with high specificity on tissue resident CD103+ DCs. Methods To test the effect on CD103+ DCs and kidney injury of inhibition of Flt3, we used a selective Flt3 inhibitor (AC220) to treat mice with AN. Results Human CD141+ DCs, homologous to murine CD103+ DCs, were significantly increased in patients with FSGS. The number of kidney CD103+ DCs, but not CD103− DCs or plasmacytoid DCs, was significantly decreased in AN mice after AC220 administration. Treatment with AC220 significantly improved kidney function and reduced kidney injury and fibrosis in AN mice. AC220-treated AN mice had decreased levels of inflammatory cytokines and chemokines, tumor necrosis factor-α, interleukin (IL)-1β, IL-6, CCL2 and CCL5 and reduced kidney infiltration of CD4 T cells and CD8 T cells. The protective effect of AC220 was associated with its suppression of CD103+ DCs-mediated CD8 T cell proliferation and activation in AN mice. Conclusion Flt3 inhibitor AC220 effectively reduced kidney injury in AN mice, suggesting that this inhibitor might be a useful pharmaceutical agent to treat CKD.

scholarly journals Chronic Kidney Disease: The Complex History of the Organization of Long-Term Care and Bioethics. Why Now, More Than Ever, Action is Needed

2019 ◽  
Vol 16 (5) ◽  
pp. 785 ◽  
Author(s):  
Elisabetta Versino ◽  
Giorgina Piccoli
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cause Of Death ◽  
Public Health Problem ◽  
Models Of Care ◽  
Term Care ◽  
Healthcare Budget ◽  
Kidney Morphology ◽  
Disease Study ◽  
Kidney Scarring

Chronic kidney disease (CKD) has been redefined in the new millennium as any alteration of kidney morphology, function, blood, or urine composition lasting for at least 3 months. This broad definition also encompasses diseases or conditions that are associated with normal kidney function, such as a kidney scarring from an acute pyelonephritis episode or a single kidney, as a result of kidney donation. CKD is a relevant public health problem. According to the 2015 Global Burden of Disease Study, it was the 12th leading cause of death, leading to 1.1 million deaths, worldwide, each year. The role of CKD as a cause of death is evident where renal replacement therapy (RRT) is not available, however, its role in increasing death risk is not easily calculated. RRT consumes about 3–5% of the global healthcare budget where dialysis is available without restrictions. While the prevalence of CKD is increasing overall as lifespans extend, being linked to diabetes, hypertension, obesity, and atherosclerosis, CKD is at least partly preventable and its effects may be at least partly counterbalanced by early and appropriate care. We will welcome papers on all aspects of CKD, including organization, cost, and models of care. Papers from developing countries will be particularly welcomed.

Quality over quantity? Association of skeletal muscle myosteatosis and myofibrosis on physical function in chronic kidney disease

2018 ◽  
Vol 34 (8) ◽  
pp. 1344-1353 ◽  
Author(s):  
Thomas J Wilkinson ◽  
Douglas W Gould ◽  
Daniel G D Nixon ◽  
Emma L Watson ◽  
Alice C Smith
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Physical Performance ◽  
Rating Scale ◽  
Handgrip Strength ◽  
Rectus Femoris ◽  
Muscle Quality ◽  
Muscle Size ◽  
Cross Sectional

Abstract Background Chronic kidney disease (CKD) is characterized by adverse changes in body composition, which are associated with poor clinical outcome and physical functioning. Whilst size is the key for muscle functioning, changes in muscle quality specifically increase in intramuscular fat infiltration (myosteatosis) and fibrosis (myofibrosis) may be important. We investigated the role of muscle quality and size on physical performance in non-dialysis CKD patients. Methods Ultrasound (US) images of the rectus femoris (RF) were obtained. Muscle quality was assessed using echo intensity (EI), and qualitatively using Heckmatt’s visual rating scale. Muscle size was obtained from RF cross-sectional area (RF-CSA). Physical function was measured by the sit-to-stand-60s (STS-60) test, incremental (ISWT) and endurance shuttle walk tests, lower limb and handgrip strength, exercise capacity (VO2peak) and gait speed. Results A total of 61 patients (58.5 ± 14.9 years, 46% female, estimated glomerular filtration rate 31.1 ± 20.2 mL/min/1.73 m2) were recruited. Lower EI (i.e. higher muscle quality) was significantly associated with better physical performance [STS-60 (r = 0.363) and ISWT (r = 0.320)], and greater VO2peak (r = 0.439). The qualitative rating was closely associated with EI values, and significant differences in function were seen between the ratings. RF-CSA was a better predictor of performance than muscle quality. Conclusions In CKD, increased US-derived EI was negatively correlated with physical performance; however, muscle size remains the largest predictor of physical function. Therefore, in addition to the loss of muscle size, muscle quality should be considered an important factor that may contribute to deficits in mobility and function in CKD. Interventions such as exercise could improve both of these factors.

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