DNA methylation profiling identifies epigenetic differences between early versus late stages of diabetic chronic kidney disease

Author(s):  
Ashani Lecamwasam ◽  
Boris Novakovic ◽  
Braydon Meyer ◽  
Elif I Ekinci ◽  
Karen M Dwyer ◽  
...  

Abstract Background We investigated a cross-sectional epigenome-wide association study of patients with early and late diabetes-associated chronic kidney disease (CKD) to identify possible epigenetic differences between the two groups as well as changes in methylation across all stages of diabetic CKD. We also evaluated the potential of using a panel of identified 5′-C-phosphate-G-3′ (CpG) sites from this cohort to predict the progression of diabetic CKD. Methods This cross-sectional study recruited 119 adults. DNA was extracted from blood using the Qiagen QIAampDNA Mini Spin Kit. Genome-wide methylation analysis was performed using Illumina Infinium MethylationEPIC BeadChips (HM850K). Intensity data files were processed and analysed using the minfi and MissMethyl packages for R. We examined the degree of methylation of CpG sites in early versus late diabetic CKD patients for CpG sites with an unadjusted P-value <0.01 and an absolute change in methylation of 5% (n = 239 CpG sites). Results Hierarchical clustering of the 239 CpG sites largely separated the two groups. A heat map for all 239 CpG sites demonstrated distinct methylation patterns in the early versus late groups, with CpG sites showing evidence of progressive change. Based on our differentially methylated region (DMR) analysis of the 239 CpG sites, we highlighted two DMRs, namely the cysteine-rich secretory protein 2 (CRISP2) and piwi-like RNA-mediated gene silencing 1 (PIWIL1) genes. The best predictability for the two groups involved a receiver operating characteristics curve of eight CpG sites alone and achieved an area under the curve of 0.976. Conclusions We have identified distinct DNA methylation patterns between early and late diabetic CKD patients as well as demonstrated novel findings of potential progressive methylation changes across all stages (1–5) of diabetic CKD at specific CpG sites. We have also identified associated genes CRISP2 and PIWIL1, which may have the potential to act as stage-specific diabetes-associated CKD markers, and showed that the use of a panel of eight identified CpG sites alone helps to increase the predictability for the two groups.

2018 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Abdul Wakhid ◽  
Estri Linda Wijayanti ◽  
Liyanovitasari Liyanovitasari

Background: Self efficacy can optimize the quality of life of clients who undergo the healing process due to chronic diseases. Individuals with higher self-efficacy move their personal and social resources proactively to maintain and improve the quality and length of their lives so that they experience a better quality of life. Objectives: the purpose of this study was to find the correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency. Metode: This type of research was descriptive correlation with cross sectional approach. The samples in this study more 76 people with total sampling technique. The data collection tool for self efficacy was measured by General Self-Efficacy scale, for quality of life with WHOQoL-BREF. Statistical test used Kolmogorov-smirnov. Result: The result showed that self efficacy in patients with chronic kidney disease was mostly in moderate category (53,9%), quality of life in patients with chronic kidney disease was mostly in good category (68,4%). There was a correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency, the result obtained p-value of 0.000 <α (0,05). Suggestion: Patients with chronic kidney disease can maintain good quality of life by helping to generate positive self-esteem and high self efficacy.


2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Ika Setyo Rini ◽  
Titik Rahmayani ◽  
Efris Kartika Sari ◽  
Retno Lestari

Background: Chronic kidney disease (CKD) is defined as a progressive disease that causes renal failure and requires extended and long-term therapies. CKD patients need to choose one of these therapies to improve their quality of life. This study aims to investigate differences in the quality of life of chronic kidney disease patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis (CAPD).Design and Methods: The study design used is similar to the cross-sectional design. Therefore, in this study observations were carried out, a EQ_5D life quality questionnaire sheet was administered to respondents, and a purposive sampling method was used. The total number of respondents was 250 and consisted of 125 hemodialysis and CAPD patients each.Results: The results obtained using the Mann Whitney method was a p-value (0.515)> α (0.05). These results also included five components, namely the ability to move/walk to an acceptable degree, adequate self-care, performance of usual activities, minimal amount of pain/discomfort during hemodialysis and CAPD, and acceptable levels of anxiety/sadness.Conclusions: This research concludes that there is no difference in the quality of life between CKD patients  undergoing hemodialysis and CAPD.


2020 ◽  
Vol 20 (2) ◽  
Author(s):  
Maryatun Hasan

Abstrak. Penyakit ginjal kronis (PGK) merupakan penyakit yang dapat mengakibatkan penderitanya mengalami stress jangka panjang dan akhirnya bermanifestasi menjadi depresi. Depresi yang ditimbulkan dapat mempengaruhi perilaku pasien dalam hal pengaturan cairan sehingga dapat berakibat terhadap peningkatan Interdialytic Weight Gain (IDWG). Jika IDWG meningkat maka akan menimbulkan komplikasi yang dapat menghambat keberhasilan terapi hemodialisis.  Penelitian ini bertujuan untuk mengetahui gambaran tingkat depresi terhadap terjadinya peningkatan Interdialytic Weight Gain pada pasien PGK yang menjalani hemodialisis di RSUDZA Banda Aceh. Jenis penelitian ini adalah deskriptif analitik dengan pendekatan cross sectional. Pengumpulan data dilakukan pada bulan Desember 2019 menggunakan teknik accidental sampling dengan responden adalah pasien di unit hemodialisis RSUDZA Banda Aceh. Pengumpulan data dilakukan dengan menggunakan kuesioner Hamilton Rating Scale for Depression kemudian dilakukan analisis univariat untuk mengatahui gambaran dari penelitian dan bivariat dengan menggunakan uji korelasi Spearman. Berdasarkan hasil analisis statistik dengan menggunakan uji Spearman, didapatkan p value sebesar 0,000 (p0,05) dengan koefisien korelasi Spearman sebesar 0,729. Hal ini menunjukkan adanya hubungan yang signifikan antara tingkat depresi dengan peningkatan IDWG pada pasien PGK yang menjalani hemodialisis di RSUDZA Banda Aceh.Kata Kunci: Penyakit Ginjal Kronis, Hemodialisis, Depresi, Interdialytic Weight GainAbstract. Chronic kidney diasease (CKD) might cause stress which generally leads to depression. Depression is correlated to significant impairment in a patient's daily life, such as excessive Interdialytic Weight Gain (IDWG) caused by an overload of fluids. Excessive Interdialytic Weight Gain might also cause other complications that are able to interfere the process of hemodialysis therapy. The objective of this research was to identify the overview of and the correlation between depression types and Interdialytic Weight Gain (IDWG) of the chronic kidney disease patients undergoing hemodialysis therapy in dr. Zainoel Abidin Regional Public Hospital of Banda Aceh. This descriptive analytical research was conducted by means of a cross-sectional study approach. The data were collected in December 2019 by using an accidental sampling technique. The data were collected by distributing the Hamilton Rating Scale for Depression. Those data were then analyzed by using a univariate data analysis and a bivariate data analysis, especially the Spearman Correlation Coefficient. Based on the statistical analysis with the Spearman test, p-value of 0.000 (p0.05) with a Spearmen Correlation Coefficient of 0.729 was found. Hence, a significant correlation between depression levels or types and IDWG in chronic kidney disease patients undergoing hemodialysis in dr. Zainoel Abidin Regional Public Hospital of Banda Aceh was indicated.Keywords: Chronic Kidney Disease, hemodialysis, Depression, Interdialytic Weight Gain


Author(s):  
Atul V. Rajkondawar ◽  
Amit Yele

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.


2017 ◽  
Vol 24 (02) ◽  
pp. 267-272
Author(s):  
Syed Hidayet Ali ◽  
Bagwan Das ◽  
Agha Taj ◽  
Santosh Kumar ◽  
Besham Kumar

Introduction: Chronic kidney disease (CKD) is an alarmingly increasingcondition from day to day andit is assumed that malnutrition is co-existent in patients withchronic renal failure (CRF). Malnutrition also occurs in pre-dialysis patients. Such patientshave reduced body weight, depleted fat (energy) stores, loss of somatic protein (low musclemass) and low levels of different plasma proteins like pre-albumin albumin, transferrin, andothers. Objective: To ascertain the frequency of malnutrition in dialysis independent patientsof chronic kidney disease. Setting: Department of nephrology, Jinnah Postgraduate MedicalCentre Karachi. Duration of study: 6 month from 1 June 2013 – 1 December 2013. Studydesign: cross sectional study. Subjects and methods: Patients with chronic kidney disease(GFR <60ml/min/1.73m2) on conservative management irrespective of cause and sex werestudied. All Patients with CKD stage 3 and onwards i. ecreatinine clearance less than 60ml/min/1.73m2for more than 6 months were considered. Descriptive analysis of these patientswas done by: Calculating mean ± SD for age and duration of disease. Male to female ratiowas calculated. Frequency of malnutrition in undialysed patients was calculated. The effectmodifier of age, gender, duration of disease was controlled through stratification. Chi squaretest was applied and p value ≤0.05 was taken as significant. Result: Out of 137 patients, 80were males and 57 were females and the mean age of patients was 58 ±5.8. Mean duration ofdisease was 5.2 ±1.05. Moderate malnutrition cases were 58(42.3%) while severe malnutritionwas observed in 32(23.35%) cases. Conclusion: Patients of chronic kidney disease were foundto be at risk of malnutrition.


2017 ◽  
Vol 4 (2) ◽  
pp. 481
Author(s):  
Arvind Gupta ◽  
Anubha Srivastava ◽  
Upma Narain ◽  
Parag Saraswat

Background: Malnutrition is an important risk factor in patients with chronic kidney disease and in those undergoing maintenance dialysis. Subjective global assessment is a reliable method to evaluate malnutrition in these patients. This study aims to evaluate malnutrition in patients of chronic kidney disease using subjective global assesment score.Methods: A cross sectional study was conducted at SRN Hospital, Allahabad, Uttar Pradesh, India on patients attending Nephrology Unit from July 2014 to May 2015.The nutritional status of 100 patients was evaluated using dietary recall, anthropometry, biochemical parameter and subjective global assessment. There were 67 males and 23 females. Their mean age was 46.8 years. Subjective global assessment was done using 7 variables derived from medical history and physical examination. Each variable was scored from 1-5 depending on the severity. The subjective global assessment score was correlated with the standard methods.Results: Out of 100 patients 29% were mildly malnourished, 64% were moderately malnourished and 7% were severely malnourished. The age, triceps thickness, serum urea and cholesterol were correlated with the malnutrition score (r value 0.2, -0.3, 0.2, 0.4 respectively and p-value 0.3, 0.002, 0.007, 0.001 respectively). It was found that the serum albumin (r value -0.21, p-value 0.42) level did not correlate well with the subjective global assessment.Conclusions: The subjective global assessment can be used reliably to assess the malnutrition in the patients of chronic kidney disease and hence useful in prognostication of disease and is a convenient bedside tool, operable even with  paramedics.


2021 ◽  
Vol 8 (16) ◽  
pp. 1064-1067
Author(s):  
Naveen Angadi ◽  
Adarsh Bellad ◽  
Raju H. Badiger ◽  
Abhiram Narasimha ◽  
Pavan Kumar B.C. ◽  
...  

BACKGROUND Diabetes mellitus and hypertension remain one of the most common causes of chronic kidney disease. Diabetes hypertension, kidney disease syndrome is a new term introduced in medical terminology. The present study was conducted to examine clinical & laboratory profile of diabetes hypertension kidney disease syndrome – “DHKD syndrome” over a period of one year. METHODS A hospital-based observational cross-sectional study was done in the Department of General Medicine and Nephrology, outpatient department (OPD), among 120 patients with diabetes & hypertension in combination with kidney disease, with duration of diabetes > 2 years and duration of hypertension > 2 years after obtaining ethical clearance. The patients were then scored based on modified diet in renal disease (MDRD) formula and chronic kidney disease epidemiology collaboration equation (CKD EPI) formula to calculate the estimated glomerular function rate & placed into various stages of CKD. RESULTS A total of 120 subjects were included in the final analysis. The mean age was 63.64 ± 10.80. In study population of no albuminuria group, 50 % had glomerular filtration rate (GFR) of 30 - 44 (grade 3 CKD) and 50 % had GFR of < / = 15 (grade 5), among microalbuminuria group, 4.45 % had GFR of 60 - 89 (grade 2) and 1 had GFR of 45 - 59 (grade 3a), 13.64 % had GFR 30 - 44 (grade 3b), 40.91 % had GFR 15 - 29 (grade 4), 36.36 % had GFR < = 15 (grade 5), among macroalbuminuria group, 4.6 % had GFR 45 - 59 (grade 3a), 9.2 % had GFR 30 - 44 (grade 3b), 13.79 % had GFR 15 - 29 (grade 4) and 72.41 % had GFR < = 15 (grade 5). Majority had macro albuminuria. The proportion of the difference between systolic blood pressure (SBP) and macroalbuminuria was statistically significant. (P-value < 0.05) as well as proportion of the difference between insulin usage with macroalbuminuria was statistically significant. (P-value < 0.05). CONCLUSIONS Our study delivers sufficient evidence endorsing high relationship between diabetes, hypertension, and kidney disease. KEYWORDS Diabetic Nephropathy, Macroalbuminuria, Hypertension, DHKD Syndrome


2020 ◽  
Author(s):  
Zaher Nazzal ◽  
Zakaria Hamdan ◽  
Donia Masri ◽  
Oday Abu-Kaf ◽  
Mohammad Hamad

Abstract Background Chronic kidney disease (CKD) is a worldwide public health problem and diabetes is one of major risk factor for its development and progression. The aim of this study is to assess the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes treated in primary health care centers in North West Bank. Methods Patients’ data including patient characteristics, creatinine level, blood pressure, HbA1c, and hypertension and diabetes duration was collected from primary health care centers. eGFR was calculated using the CKD-EPI equation. CKD was staged according to the Kidney Disease Improving Global Outcomes System (KDIGO) 2012 guidelines. Both univariate and multivariate statistical analysis was conducted using SPSS. Results The prevalence of chronic kidney disease among diabetic adults in North West Bank was found to be 23.6% (95% CI: 19.4%-28.1%) distributed as follows: 19.7% had stage 3 CKD, 2.6% had stage 4 CKD and 1.3% had stage 5 CKD. In multivariate logistic regression, CKD was significantly associated with hypertension [adjusted OR= 4.43, P value=0.005], smoking [adjusted OR= 2.1, P value=0.01], and age [adjusted OR= 1.1, P value <0.001] Conclusions CKD is highly prevalent among Palestinian diabetic adults. Co-morbid hypertension, smoking and older age were found to increase the probability of developing this condition. Intensive screening for diabetic patients to detect CKD at earlier stages and implementation of more aggressive treatment modalities for diabetes as well as other important risk factors, especially hypertension and smoking are recommended.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Ellen W Demerath ◽  
Weihua Guan ◽  
James S Pankow ◽  
Megan L Grove ◽  
Kari E North ◽  
...  

Background and Objective: DNA methylation patterns are influenced by environmental factors, alter gene expression, and can point to genomic regions affected by behavioral and lifestyle factors, such as obesity. However, analytic strategies for high dimensional methylation data are still evolving. Here we present preliminary analyses examining cross-sectional associations between DNA methylation level and BMI in African-American adults enrolled in the Atherosclerosis Risk in Communities (ARIC) study. Methods: BMI was measured at the same study visit as the DNA sample used for analysis. We used the Illumina Infinium HumanMethylation450 BeadChip to measure average methylation levels (beta values) in bisulfite-converted peripheral blood DNA obtained from participants from the Jackson, MS and Forsyth County, NC field centers. After excluding outlier samples and CpG sites using quality control filters, a model adjusting BMI (continuous) for batch (plate) and a model additionally adjusting for a small set of potential confounders (age, sex, center, smoking) were tested, with average beta value as the dependent variable. Robust standard errors were used for statistical testing and Bonferroni-corrected p value for significance was p<1 x 10 -7 . Results: A total of 2,873 individuals and 473,788 CpG sites entered the analysis. In the minimally-adjusted analysis, there were over 300 regions distributed across all 22 autosomes with at least one significant association between BMI and CpG methylation. Adjusting for confounders sharply reduced the evidence for association to a total of approximately 20 regions on 11 autosomes. Conclusion: Use of the 450K methylation BeadChip in large epidemiologic cohorts has potential to help identify genes that are transcriptionally altered by common behavioral factors such as obesity, leading to improved understanding of related diseases. However, whereas genetic associations with disease are generally unconfounded by demographic and other covariate factors, methylation associations can be strongly affected by selection of covariates as well as other analytic choices.


2020 ◽  
Vol 8 (1) ◽  
pp. 106
Author(s):  
Chauverim Jeremi Gotlieb Paath ◽  
Gresty Masi ◽  
Franly Onibala

Abstract: Chronic Kidney Disease is progressive and irreversible kidney dysfunction where the body fails to maintain metabolim and fluid and electrolyte balance. Hemodialysis therapy is one of managements of CKD. Disobedience may causing failure of the therapy so it can increase mortality and morbidity numbers. Purpose: The purpose of this research is to find out the correlation beetween family support and hemodialysis adherence of patients with CKD. Method: this study used descriptive Analytic with Cross Sectional Study approach. This study involved 50 respondents with Chronic Kidney Disease using the total sampling technique. Data collection was done through the questionnaire about family’s support and hemodialysis therapy adherence of patient of CKD. The result of this study showed a significant correlation with p value=0,000 (α<0,05). Conclusion: There is a significant correlation beetween family support and hemodialysis therapy adherence of patients with CKD. Further studies are suggested to do other research about specification of family’s support with the example instrumental support.Key Words:     Chronic Kidney Disease, Family Support, Hemodialysis Therapy      Adherence. Abstrak: Gagal ginjal kronis merupakan gangguan fungsi ginjal yang progresif dan ireversibel dimana tubuh gagal untuk mempertahankan metabolisme dan keseimbangan cairan dan elektrolit. Terapi hemodialisa adalah salah satu penanganan gagal ginjal kronis. Ketidakpatuhan dapat menyebabkan kegagalan terapi sehingga meningkatkan angka mortalitas dan morbiditas. Dukungan keluarga merupakan salah satu faktor penting dalam meningkatkan kepatuhan terapi. Tujuan: ujuan penelitian ini untuk mengetahui hubungan dukungan keluarga dengan kepatuhan terapi hemodialisa pada pasien GGK. Desain Penelitian: Penelitian ini menggunakan Deskriptif Analitik dengan pendekatan cross-sectional Study. penelitian ini menggunakan 50 responden  dengan menggunakan teknik total sampling. Pengumpulan data dilakukan menggunakan kuesioner tentang dukungan keluarga dan kepatuhan menjalani terapi hemodialysis pada pasien CKD. Hasil dari penelitian ini menunjukan hubungan yang signifikan dengan nilai p=0,000 yang berarti nilai p<α=0,05. Kesimpulan: Dapat disimpulkan bahwa ada hubungan yang bermakna antara dukungan keluarga dengan kepatuhan hemodialisa pada pasien GGK. Bagi peneliti selanjutnya disarankan untuk melakukan penelitian tentang dukungan keluarga yang lebih spesifik contohnya dukungan instrumental. Kata Kunci: Gagal Ginjal Kronis, Dukungan Keluarga, Kepatuhan Hemodialisa


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