New Insights into Acute-on-Chronic Kidney Disease in Nephrology Patients: The CKD-REIN Study

2021 ◽  
Author(s):  
Aghilès Hamroun ◽  
Luc Frimat ◽  
Maurice Laville ◽  
Marie Metzger ◽  
Christian Combe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Birth Weight ◽  
Kidney Disease ◽  
Low Birth Weight ◽  
Hospital Discharge ◽  
Incidence Rates ◽  
High Rate ◽  
Cox Models ◽  
Ckd Stage

Abstract Background Acute-on-chronic kidney disease (ACKD) is poorly understood and often overlooked. We studied its incidence, circumstances, determinants, and outcomes in patients with CKD. Methods We used the Kidney Disease Improving Global Outcomes criteria to identify all-stage acute kidney injury (AKI) events in 3033 nephrology outpatients with CKD stage 3-5 participating in the CKD-REIN cohort study (2013-2020), and cause-specific Cox models to estimate hazard ratios (HR, 95% confidence intervals [CI]) of AKI-associated risk factors. Results At baseline, 22% of the patients (mean age 67 years, 65% men, mean eGFR 32 ml/min/1.73m2) had a history of AKI. Over a 3-year follow-up, 443 had at least one AKI event: 27% were stage 2 or 3, and 11% required dialysis; 74% involved hospitalization including 47% acquired as hospital inpatients; a third were not reported in hospital discharge reports. Incidence rates were 10.1 and 4.8 per 100 person-years in patients with and without an AKI history, respectively. In 2375 patients without this history, male sex, diabetes, cardiovascular disease, cirrhosis, several drugs, low eGFR, and serum albumin levels were significantly associated with a higher risk of AKI, as were low birth weight (<2500 g) (adjusted HR, 1.98; 95%CI, 1.35 to 2.91) and hemoglobin level (HR 1.21; 1.12 to 1.32 per 1 g/dl decrease). Within one year, only 63% of the patients had recovered their previous kidney function, 13.7% had started kidney replacement therapy, and 12.7% had died. Conclusions The study highlights the high rate of hospital-acquired AKI events in patients with CKD, and their underreporting at hospital discharge. It also reveals low birth weight and anemia as possible new risk factors in CKD patients.

Prevalence of chronic kidney disease risk factors among low birth weight adolescents

2016 ◽  
Vol 31 (9) ◽  
pp. 1509-1516 ◽  
Author(s):  
Dev Darshan K. Khalsa ◽  
Hind A. Beydoun ◽  
J. Bryan Carmody
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Birth Weight ◽  
Kidney Disease ◽  
Low Birth Weight ◽  
Disease Risk ◽  
Chronic Kidney Disease Risk

scholarly journals Strategies for Controlling Blood Pressure and Reducing Cardiovascular Disease Risk in Patients with Chronic Kidney Disease

2015 ◽  
Vol 25 (4) ◽  
pp. 515 ◽  
Author(s):  
Keith C. Norris ◽  
Susanne B Nicholas
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Risk ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Cardiovascular Disease Risk ◽  
High Rate ◽  
Ckd Stage

<p>Patients with chronic kidney disease (CKD) suffer from an increased prevalence of cardiovascular disease (CVD) risk factors, and a high rate of premature CV morbidity and mortality. The confluence of CV risk factors, in the context of cardio-metabolic perturbations that vary as renal function declines, complicates strategies for the care of patients with CKD. Understanding the ex­isting evidence for effective CVD treatment strategies can help providers better care for these patients, navigate the complex treat­ment guidelines, which often differ across major organizations, and minimize the con­flicting recommendations that new studies may pose. A pragmatic approach is to target a BP &lt;140/90 mm Hg, which frequently requires more than two or three antihyper­tensive agents. Most guidelines recommend a combination of diuretic and angiotensin converting enzyme inhibitor or angiotensin receptor blockers, along with a dihydropyri­dine calcium channel blocker, beta blocker or other agent based on co-existing medical conditions. Consideration for a lower BP goal and/or other therapeutic interventions should be based on the etiology of CKD, stage of CKD, and/or presence of protein­uria. Finally, most patients with CKD, not on dialysis, would benefit from treatment with statins and non-pharmacologic lifestyle interventions should be promoted for all pa­tients with CKD. <em>Ethn Dis. </em>2015;25(4):515- 520; doi:10.18865/ed.25.4.515</p>

MO515CONSTIPATION IN CHRONIC KIDNEY DISEASE: PREVALENCE AND RISK FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sourabh Sharma ◽  
Neha Sharma ◽  
Kailash Sharma
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Functional Constipation ◽  
Common Symptom ◽  
Psychological Burden ◽  
Ckd Stage ◽  
Stool Form ◽  
Rome Iv

Abstract Background and Aims Among various gastrointestinal disorders, constipation is one of the most common symptom in chronic kidney disease (CKD). However it is often neglected by nephrologists as self-limiting condition. Constipation impacts quality of life in multiple ways and increases socio-psychological burden. Constipation and associated risk factors have been poorly studied and most studies are retrospective. Method We enrolled CKD stage 3 to 5 patients on regular follow-up with nephrologist from June 2018 to June 2020, at a tertiary care centre in North India. Constipation was defined using Rome IV criteria (Functional constipation) which is composed of six constipation related symptoms, and diagnosis of constipation is established by presence of two or more symptoms for at least 3 months. Patients were also asked to maintain a 7 day prospective stool diary. It consisted of seven day written prospective chart of stool form and frequency. Patients were instructed to record when each bowel movement happened and to mark stool form type for each movement as described in words and pictures on Bristol Stool Form Scale (BSFS). Opioid induced constipation was defined as per Rome IV criteria. The diagnostic criteria is similar to functional constipation, but with requisite that new or worsening symptoms occurred when initiating, changing or increasing opioid therapy. Results Two hundred twenty five patients were studied out of which 59 (26.2%) patients were in CKD stage3, eighty one (36%) patients were in CKD stage4 and 85 (37.8%) patients were in stage5. Out of 85 CKD stage5 patients, 23 (27%) were on dialysis. Mean age of patients was 49.1 years. Out of 225 patients, 135 (60%) were male. Constipation symptoms and diagnosis reported in each stage has been depicted in Table 1. Clinical correlates of constipation has been depicted in Table 2. Conclusion Constipation measured using Rome IV criteria affects around two-third of CKD stage 3-5 patients. Diabetes, hypertension and opioid use has been found to be significantly associated with constipation.

scholarly journals Beberapa Faktor Risiko Kejadian Penyakit Ginjal Kronik (PGK) Stadium V pada Kelompok Usia Kurang dari 50 Tahun (Studi di RSUD dr.H.Soewondo Kendal dan RSUD dr.Adhyatma,MPH Semarang)

2018 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Ariyanto Ariyanto ◽  
Suharyo Hadisaputro ◽  
Lestariningsih Lestariningsih ◽  
Mateus Sakundarno Adi
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Herbal Medicine ◽  
Energy Drink ◽  
Regression Result ◽  
Age Group ◽  
Case Control Studies ◽  
Ckd Stage ◽  
Energy Drink Consumption

Background: Chronic Kidney Disease (CKD) stage V is an end-stage chronic kidney disease  characterized by glomerular filtration rate less than 15 mL /min /1.73 m2 and require dialysis  therapy. The purpose of this study to prove risk factors the occurrence of CKD Vin the age  group of less than 50 years.   Method: This study was a mixed method, case-control studies design were inforced with  indepht interview. Total respondents were 124 (62 cases and 62 controls) that taken by  consecutive sampling. Research instrument was a questionnaire interview. Data analysis using  univariate, bivariate (chi-square) and multivariate (logistic regression).                     Result: The variables that proved to be a risk factor for CKD V in the age group of less than 50 years were supplement energy drink consumption > 4 times/week (p=0.038; 95%CI = 1.063-7.944; OR=2.905), smoking ≥ 10 ciggarets/day (p=0.011; 95%CI=1.384-11.920; OR=4.061), and herbal medicine consumption > 4 times/week (p=0.007; 95%CI=1.431-9.949; OR=3.773). Variables that not proved were the consumption of coffee, supplements of vitamin C, soft drinks, alcohol, and NSAIDs. Qualitative results stated that the respondents consumed energy drink supplements to increase their stamina, smoke because it has become a habit, and consume herbal medicines because seen more natural and cure the sciatica fastly.Conclusion: Risk factors for the occurrence of CKD V in the age group of less than 50 years were the supplement energy drink consumption> 4 times/week, smoking ≥ 10 ciggarets/day, and the consumption of herbal medicine> 4 times/week.

scholarly journals Beberapa Faktor Risiko Kejadian Penyakit Ginjal Kronik (PGK) Stadium V pada Kelompok Usia Kurang dari 50 Tahun (Studi di RSUD dr.H.Soewondo Kendal dan RSUD dr.Adhyatma,MPH Semarang)

2018 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Ariyanto Ariyanto ◽  
Suharyo Hadisaputro ◽  
Lestariningsih Lestariningsih ◽  
Mateus Sakundarno Adi
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Herbal Medicine ◽  
Energy Drink ◽  
Regression Result ◽  
Age Group ◽  
Case Control Studies ◽  
Ckd Stage ◽  
Energy Drink Consumption

Background: Chronic Kidney Disease (CKD) stage V is an end-stage chronic kidney disease  characterized by glomerular filtration rate less than 15 mL /min /1.73 m2 and require dialysis  therapy. The purpose of this study to prove risk factors the occurrence of CKD Vin the age  group of less than 50 years.   Method: This study was a mixed method, case-control studies design were inforced with  indepht interview. Total respondents were 124 (62 cases and 62 controls) that taken by  consecutive sampling. Research instrument was a questionnaire interview. Data analysis using  univariate, bivariate (chi-square) and multivariate (logistic regression).                     Result: The variables that proved to be a risk factor for CKD V in the age group of less than 50 years were supplement energy drink consumption > 4 times/week (p=0.038; 95%CI = 1.063-7.944; OR=2.905), smoking ≥ 10 ciggarets/day (p=0.011; 95%CI=1.384-11.920; OR=4.061), and herbal medicine consumption > 4 times/week (p=0.007; 95%CI=1.431-9.949; OR=3.773). Variables that not proved were the consumption of coffee, supplements of vitamin C, soft drinks, alcohol, and NSAIDs. Qualitative results stated that the respondents consumed energy drink supplements to increase their stamina, smoke because it has become a habit, and consume herbal medicines because seen more natural and cure the sciatica fastly.Conclusion: Risk factors for the occurrence of CKD V in the age group of less than 50 years were the supplement energy drink consumption> 4 times/week, smoking ≥ 10 ciggarets/day, and the consumption of herbal medicine> 4 times/week.

scholarly journals Relationship between birth weight and chronic kidney disease: evidence from systematics review and two-sample Mendelian randomization analysis

2020 ◽  
Vol 29 (13) ◽  
pp. 2261-2274 ◽  
Author(s):  
Xinghao Yu ◽  
Zhongshang Yuan ◽  
Haojie Lu ◽  
Yixin Gao ◽  
Haimiao Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Birth Weight ◽  
Kidney Disease ◽  
Low Birth Weight ◽  
Kidney Function ◽  
Large Scale ◽  
Mendelian Randomization ◽  
Negative Relationship ◽  
Sensitivity Analyses ◽  
Inverse Association

Abstract Observational studies showed an inverse association between birth weight and chronic kidney disease (CKD) in adulthood existed. However, whether such an association is causal remains fully elusive. Moreover, none of prior studies distinguished the direct fetal effect from the indirect maternal effect. Herein, we aimed to investigate the causal relationship between birth weight and CKD and to understand the relative fetal and maternal contributions. Meta-analysis (n = ~22 million) showed that low birth weight led to ~83% (95% confidence interval [CI] 37–146%) higher risk of CKD in late life. With summary statistics from large scale GWASs (n = ~300 000 for birth weight and ~481 000 for CKD), linkage disequilibrium score regression demonstrated birth weight had a negative maternal, but not fetal, genetic correlation with CKD and several other kidney-function related phenotypes. Furthermore, with multiple instruments of birth weight, Mendelian randomization showed there existed a negative fetal casual association (OR = 1.10, 95% CI 1.01–1.16) between birth weight and CKD; a negative but non-significant maternal casual association (OR = 1.09, 95% CI 0.98–1.21) was also identified. Those associations were robust against various sensitivity analyses. However, no maternal/fetal casual effects of birth weight were significant for other kidney-function related phenotypes. Overall, our study confirmed the inverse association between birth weight and CKD observed in prior studies, and further revealed the shared maternal genetic foundation between low birth weight and CKD, and the direct fetal and indirect maternal causal effects of birth weight may commonly drive this negative relationship.

scholarly journals SP279THE LINK BETWEEN LOW BIRTH WEIGHT AND CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i437-i437
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev
Keyword(s):  
Chronic Kidney Disease ◽  
Birth Weight ◽  
Kidney Disease ◽  
Low Birth Weight

scholarly journals Does a Rising Median Income Lift All Birth Weights? County Median Income Changes and Low Birth Weight Incidence Rates for Black and White Americans

2019 ◽  
Author(s):  
David Stuart Curtis ◽  
Thomas E Fuller-Rowell ◽  
Daniel L. Carlson ◽  
Ming Wen ◽  
Michael R. Kramer
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Fixed Effects ◽  
Health Resources ◽  
Incidence Rates ◽  
Median Income ◽  
Time Varying ◽  
Smoking During Pregnancy ◽  
Black And White

Differences in low birth weight incidence (LBW) by race and place are long-standing, often embedded in enduring social ecologies where insufficient health resources are paired with an array of risk factors. Local or group-specific economic resources are known to be a fundamental contributor to these social ecologies, yet few studies have investigated how within-area changing economic conditions are linked to birth outcomes. This study examines county-level change in median income and black-white income differences as predictors of LBW incidence and LBW racial disparities. Time-varying county prevalence and black-white differences in maternal sociodemographic and health risk factors (e.g., non-marital childbearing, smoking during pregnancy) are considered as explanations for income estimates. Data come from U.S. birth records for approximately 24.8 million non-Hispanic black and white mothers with a singleton live birth (1992-2014). Records were aggregated in three-year county-period measurements for the 732 counties meeting eligibility requirements. Based on county by period fixed effects models, a $10,000 increase in county median income was associated with a reduction in LBW incidence of 2.7 per 1000 live births, and in the black-white LBW gap by 5.6 per 1000. Time-varying county maternal sociodemographic and health risks attenuated the link between median income and LBW by 72% and 31%, respectively, but not the association between median income and the racial LBW gap. Contrary to our hypothesis, conditioning on median income changes, a widening racial income difference was associated with a smaller black-white LBW gap (a finding explored in post hoc analyses). Our results suggest that, if successful in raising median income, local government efforts to stimulate economic growth and employment opportunities are likely to reduce both population incidence and black-white differences in LBW. [This draft paper is intended for review and comments only. It is not intended for citation, quotation, or other use in any form]

scholarly journals Indoxyl Sulfate and High-density Lipoprotein Cholesterol in Early Stages of Chronic Kidney Disease

2019 ◽  
Author(s):  
Li Wang ◽  
Fangfang Xiang ◽  
Jun Ji ◽  
Jianzhou Zou ◽  
Yunqin Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
High Density ◽  
Indoxyl Sulfate ◽  
Lipoprotein Cholesterol ◽  
Ckd Stage

Abstract Background: High indoxyl sulfate (IS) levels and low high-density lipoprotein cholesterol (HDL-c) levels are both risk factors of cardiovascular diseases (CVD) in chronic kidney disease (CKD) patients, the connection between which has not been clearly clarified. This study aimed to explore the relationship between IS and HDL-c levels in early stages of CKD population. Methods: Patients of CKD stage 1-3 were enrolled in this cross-sectional study. Correlations between HDL-c and IS were investigated among various clinicopathological variables.Results: A total of 205 CKD patients (96 men) with a mean age of 43.3 years old were included in this research. There were 96 patients (46 men) in CKD stage1 and 109 (50 men) in CKD stage 2 or stage 3. IS levels were significantly higher in CKD 2+3 group (1.50±1.74μg/ml vs 0.94±0.66μg/ml, p=0.007), while HCL-c levels were lower (1.19±0.39mmol/L vs 1.33±0.45 mmol/L, p=0.017) compared to CKD 1 group. Among all the patients, a negative correlation was observed between IS and HDL-c levels (r=-0.244, p=0.001). IS level was an independent risk factor for low HDL-c (<1.04mmol/L) incidence even after controlling for potential confounders (OR=1.63, 95% CI: 1.11-2.39, p=0.013). IS and HDL-c were both risk factors for predicting CKD stage 3. Conclusions: Metabolic disorder of HDL-c occurs in early CKD stages, probably attributed by increased IS level. Early management of dyslipidemia and uremic toxin retention is important for delaying disease progression and preventing cardiovascular events. Keywords: Indoxyl sulfate, High-density lipoprotein cholesterol, Chronic kidney disease, Cardiovascular disease, Lipids

Sign in / Sign up

Export Citation Format

Share Document