scholarly journals SP227PREDICTION OF MORTALITY IN ELDERLY PATIENTS WITH CHRONIC KIDNEY DISEASE - THE ROLE OF CYSTATIN C

2016 ◽  
Vol 31 (suppl_1) ◽  
pp. i162-i162
Author(s):  
Nina Hojs ◽  
Maša Knehtl ◽  
Robert Ekart ◽  
Radovan Hojs ◽  
Sebastjan Bevc
2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i126-i126
Author(s):  
Sebastjan Bevc ◽  
Nina Hojs ◽  
Masa Knehtl ◽  
Nejc Piko ◽  
Robert Ekart ◽  
...  

2020 ◽  
Vol 4 (4) ◽  
pp. 108-112
Author(s):  
Konstantina Papakonstantinopoulou ◽  
Ioannis Sofianos

World’s population is aging. The elderly are at high risk for both chronic kidney disease (CKD) and hip fractures. Severe chronic kidney disease is a well-known risk factor for fractures and death especially in the elderly. Mild and moderate stages of kidney disease are often undiagnosed and/or untreated, thus their effect on fracture risk is not well established. Many ways of estimating glomerular filtration rate (GFR) have been developed but there are very few studies recommending the best and most valuable method for estimated GFR (eGFR) calculation that could correlate with fracture risk. In this mini- review we searched the literature concerning the use of cystatin C in the estimation of GFR related to the risk of hip fractures in the elderly. Our goal was to review the most important recent evidence on whether cystatin C could become a useful biomarker for the prediction of fracture risk. We concluded that there is evidence to support the use of cystatin C in hip fracture risk prediction in elder patients with chronic kidney disease.


Author(s):  
Joana Tavares ◽  
Josefina Santos ◽  
Filipa Silva ◽  
João Oliveira ◽  
Jorge Malheiro ◽  
...  

ABSTRACT Introduction: Estimated glomerular filtration rate (eGFR) based on serum cystatin-C (sCys) seems as accurate as when based on serum creatinine (sCr), but sCys seems a better predictor of adverse outcomes. We aimed to study whether sCys could be a reliable tool for the prediction of adverse outcomes in elderly patients with severe chronic kidney disease (CKD). Methods: A group of 348 elderly patients with non-end-stage CKD (stages 1-4, according to eGFR-EPI sCr and/or sCys), referred to our consultation unit during 2016, was retrospectively studied and divided into four exclusive categories: CKD_stage4_neither (eGFR-sCr≥30mL/min; eGFR-sCys≥30mL/min), CKD_stage4_sCr_only (eGFR-sCr<30mL/min), CKD_stage4_sCys_only (eGFR-sCys<30mL/min) and CKD_stage4_combined (eGFRsCr<30mL/min; eGFR-sCys<30mL/min). Baseline characteristics, predictors of death, and clinical events (cardiovascular events and admissions for cardiovascular, acute kidney injury or infectious events) were explored until December 2018. Results: A 77±7.4 year-old cohort, with a modified Charlson Comorbidty Index (mCCI) of 3 (IQR:1-4), was followed-up during 29 (IQR: 26-33) months. There were no significant differences between the characteristics of the stage 4 groups. Survival analysis was stratified by follow-up at 12 months, and in the first year, survival curves of CKD_stage4_sCys_only and CKD_stage4_combined groups were significantly lower than the other groups (p=0.028). Adjusting for age, sex, and mCCI, CKD_stage4_sCys_only, conversely to CKD_stage4_sCr_only, had higher rates of clinical events (p<0.05) than CKD_stage4_neither group. Conclusion: In elderly patients with discordant CKD staging, sCys-based eGFR seems to be a better predictor of adverse outcomes than sCr-based eGFR. Patients with stage 4 CKD defined by sCr alone seem to behave similar to those with less severe CKD.


2018 ◽  
Vol 22 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Sebastjan Bevc ◽  
Nina Hojs ◽  
Maša Knehtl ◽  
Robert Ekart ◽  
Radovan Hojs

2021 ◽  
Vol 48 (1) ◽  
pp. 13-16
Author(s):  
D. Genov ◽  
A. Kundurdgiev ◽  
I. Ivanova ◽  
M. Nikolova ◽  
V. Pencheva ◽  
...  

Abstract Background: The diagnosis of chronic kidney disease (CKD) is usually delayed, when significant functional renal impairment has already occurred. The diagnosis is complex and clinical and laboratory investigations play a crucial role. There are well-established markers of CKD – serum creatinine and cystatin C. However, the search for new reliable biomarkers that aid in the assessment of kidney function and predict the evolution of the disease is still in progress. Objective: To investigate the role of serum uromodulin (sUmod) as a marker for early diagnosis of renal impairment in patients with CKD. Materials and Methods: We investigated 70 patients, 28 male and 42 female, mean age 56.53 ± 11.753, with CKD in a prospective observational study. All patients were admitted to the Clinic of Nephrology at the “St. Ivan Rilski” University Hospital between April and November 2019. After obtaining written informed consent, laboratory blood and urine tests, abdominal ultrasound and sUmod investigations were performed in all patients. Results: Plasma uromodulin levels showed decrease with the increasing of the severity of renal impairment. sUmod displayed inverse correlation with serum creatinine (r = -0.467, p < 0.0001), cystatin C (r = -0.430, p < 0.0001) and urea (r = -0.495, p < 0.0001) and a positive correlation with eGFR (r = 0.628, p < 0.0001). Conclusion: The results of our study show that sUmod levels significantly correlate with all established laboratory parameters used for the evaluation of renal impairment. It can be used as a potential early biomarker for CKD diagnosis.


2016 ◽  
Vol 2 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Tae Jung Kim ◽  
Min Kyoung Kang ◽  
Han-Gil Jeong ◽  
Chi Kyung Kim ◽  
Yerim Kim ◽  
...  

Introduction Cystatin C has been suggested as a sensitive marker of renal function. A high level of cystatin C is related to cardiovascular disease and stroke in elderly patients. We investigated the relationship between levels of cystatin C and early neurological deterioration with acute ischaemic stroke in elderly patients without chronic kidney disease. Patients and methods We evaluated a total of 771 elderly patients (mean age, 72.2; male, 59.0%) without chronic kidney disease who were admitted following acute ischaemic stroke between March 2010 and January 2015. The patients were divided into four groups based on the quartiles of serum cystatin C values. Early neurological deterioration was defined as an increase of ≥2 points from the baseline National Institutes of Health Stroke Scale score during the 7 days following onset. We compared the clinical characteristics and cystatin C concentrations between patients with and without early neurological deterioration. Results Eighty-six patients (11.2%) experienced early neurological deterioration. The percentage values of the higher (third and fourth) quartiles were significantly higher in the early neurological deterioration group (30.2% vs. 24.4% and 34.9% vs. 23.8%, P = 0.002). After adjustment for covariates, higher cystatin C levels were independently associated with a higher risk of early neurological deterioration: odds ratio (95% confidence interval) for second quartile 1.59 (0.70–3.58), third quartile 2.75 (1.25–6.04), fourth quartile 3.12 (1.36–7.16); P for trend 0.026. Discussion and conclusions This study demonstrated that cystatin C concentrations in elderly patients without chronic kidney disease were associated with early neurological deterioration following acute stroke. This suggests that cystatin C level could be a useful predictor for early neurological deterioration following acute stroke.


Objective: the present study was aimed to evaluate the role of pharmaceutical services in improving the outcome of mineral bone disorder in patients with advanced chronic kidney disease. Methodology: One hundred and twenty patients with chronic kidney disease-mineral bone disorder (CKD-MBD) screened for eligibility, seventy-six patients enrolled in the study and randomly allocated into two groups: pharmaceutical care and usual care, both groups interviewed by the pharmacist using specific questionnaire for assessing the quality of life (QoL). All the drug related problems (DRPs) including drug-drug interactions (DDIs) were recorded by the pharmacist. Blood samples were collected and utilized for analyzing the levels of vitamin D, phosphorous, calcium, albumin and parathyroid hormone at baseline and three months after. The pharmaceutical care group received all the educations about their medications and how to minimize DRPs; improve the QoL. Additionally, the pharmaceutical intervention included correcting the biochemical parameters. Results: Pharmaceutical care significantly improved patients QoL and minimized DRPs and DDIs. It was also effective in improving the biochemical parameters. Conclusion: Pharmaceutical care has a positive impact on improving the outcome of patients with CKD-MBD through attenuating DRPs, improving the biochemical parameters and the QoL.


Sign in / Sign up

Export Citation Format

Share Document