scholarly journals Kidney function and symptom development over time in elderly patients with advanced chronic kidney disease: results of the EQUAL cohort study

2020 ◽  
Author(s):  
Cynthia J Janmaat ◽  
Merel van Diepen ◽  
Yvette Meuleman ◽  
Nicholas C Chesnaye ◽  
Christiane Drechsler ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Kidney Function ◽  
Symptom Severity ◽  
Clinical Decision Making ◽  
Symptom Development ◽  
Symptom Index ◽  
The Mean ◽  
Kidney Function Decline

Abstract Background Initiation of renal replacement therapy often results from a combination of kidney function deterioration and symptoms related to chronic kidney disease (CKD) progression. We investigated the association between kidney function decline and symptom development in patients with advanced CKD. Methods In the European Quality study on treatment in advanced CKD (EQUAL study), a European prospective cohort study, patients with advanced CKD aged ≥65 years and a kidney function that dropped <20 mL/min/1.73 m2 were followed for 1 year. Linear mixed-effects models were used to assess the association between kidney function decline and symptom development. The sum score for symptom number ranged from 0 to 33 and for overall symptom severity from 0 to 165, using the Dialysis Symptom Index. Results At least one kidney function estimate with symptom number or overall symptom severity was available for 1109 and 1019 patients, respectively. The mean (95% confidence interval) annual kidney function decline was 1.70 (1.32; 2.08) mL/min/1.73 m2. The mean overall increase in symptom number and severity was 0.73 (0.28; 1.19) and 2.93 (1.34; 4.52) per year, respectively. A cross-sectional association between the level of kidney function and symptoms was lacking. Furthermore, kidney function at cohort entry was not associated with symptom development. However, each mL/min/1.73 m2 of annual kidney function decline was associated with an extra annual increase of 0.23 (0.07; 0.39) in the number of symptoms and 0.87 (0.35; 1.40) in overall symptom severity. Conclusions A faster kidney function decline was associated with a steeper increase in both symptom number and severity. Considering the modest association, our results seem to suggest that repeated thorough assessment of symptom development during outpatient clinic visits, in addition to the monitoring of kidney function decline, is important for clinical decision-making.

scholarly journals Associations Between Weight Loss, Kidney Function Decline, and Risk of ESRD in the Chronic Kidney Disease in Children (CKiD) Cohort Study

2018 ◽  
Vol 71 (5) ◽  
pp. 648-656 ◽  
Author(s):  
Elaine Ku ◽  
Joel D. Kopple ◽  
Charles E. McCulloch ◽  
Bradley A. Warady ◽  
Susan L. Furth ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Cohort Study ◽  
Kidney Disease ◽  
Kidney Function ◽  
Kidney Function Decline

scholarly journals Associations between urinary cysteine-rich protein 61 excretion and kidney function decline in outpatients with chronic kidney disease: a prospective cohort study in Taiwan

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051165
Author(s):  
Chun-Fu Lai ◽  
Jian-Jhong Wang ◽  
Ya-Chun Tu ◽  
Chia-Yu Hsu ◽  
Hon-Yen Wu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Kidney Function ◽  
Creatinine Ratio ◽  
Discriminative Performance ◽  
Cysteine Rich Protein ◽  
Kidney Function Decline ◽  
Egfr Decline

ObjectivesTo examine whether urinary excretion of cysteine-rich protein 61 (Cyr61), an acknowledged proinflammatory factor in kidney pathologies, increases in chronic kidney disease (CKD) and is associated with subsequent rapid kidney function decline.DesignAn observational cohort study.SettingIn the nephrology outpatient clinics of a tertiary hospital in Taiwan.ParticipantsWe enrolled 138 adult CKD outpatients (n=12, 32, 18, 18, 29 and 29 in stages 1, 2, 3a, 3b, 4 and 5 CKD, respectively) between February and October 2014 and followed them for 1 year. Their mean age was 60.46±13.16 years, and 51 (37%) of them were women.Primary outcome measuresUrinary Cyr61 levels were measured by ELISA. Rapid kidney function decline was defined as an estimated glomerular filtration rate (eGFR) decline rate ≥ 4 mL/min/1.73 m2/year or developing end-stage renal disease during subsequent 3-month or 1-year follow-up period. Models were adjusted for demographic and clinical variables.ResultsThe urine Cyr61-to-creatinine ratio (UCyr61CR) increased significantly in patients with stage 4 or 5 CKD. Multivariable linear regression analysis showed that log(UCyr61CR) was positively correlated with log(urine protein-to-creatinine ratio) (p<0.001) but negatively correlated with baseline eGFR (p<0.001) and hypertension (p=0.007). Complete serum creatinine data during the follow-up were available for 112 patients (81.2%). Among them, multivariable logistic regression identified log(UCyr61CR) was independently associated with rapid kidney function decline (adjusted OR 2.29, 95% CI 1.27 to 4.15) during the subsequent 3 months. UCyr61CR improved the discriminative performance of clinical models to predict 3-month rapid kidney function decline. In contrast, log(UCyr61CR) was not associated with rapid eGFR decline during the entire 1-year follow-up.ConclusionsElevated urinary Cyr61 excretion is associated with rapid short-term kidney function deterioration in patients with CKD. Measuring urinary Cyr61 excretion is clinically valuable for monitoring disease trajectory and may guide treatment planning.

scholarly journals Author Correction: Nonalcoholic fatty liver disease accelerates kidney function decline in patients with chronic kidney disease: a cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hye Ryoun Jang ◽  
Danbee Kang ◽  
Dong Hyun Sinn ◽  
Seonhye Gu ◽  
Soo Jin Cho ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Liver Disease ◽  
Kidney Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Kidney Function ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver ◽  
Kidney Function Decline

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

scholarly journals SO081LITHIUM EXPOSURE AND OCCURENCE OF CHRONIC KIDNEY DISEASE IN THE IRISH HEALTH SYSTEM: A COHORT STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mark Behan ◽  
Leonard Browne ◽  
Stack Austin
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Linear Regression ◽  
Health System ◽  
Multiple Linear Regression ◽  
Kidney Function ◽  
Ckd Progression ◽  
Duration Of Treatment

Abstract Background and Aims Lithium is implicated as a causative factor in the development and progression of chronic kidney disease (CKD). Few studies have assessed the independent impact of plasma levels and duration of lithium therapy on CKD progression. We examined the influence of lithium on CKD progression in the Irish health system. Method We utilised data from the Irish Kidney Disease Surveillance System (IKDSS) to explore associations of lithium levels and duration of exposure with kidney function in a regional cohort. A retrospective cohort study was conducted between 1999 to 2014 from the Midwest Region. All adult patients with lithium levels were identified and followed longitudinally. Kidney function was assessed at baseline and longitudinally using serum creatinine and estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI. Patients with &lt; 2 lithium values, missing data on creatinine were excluded. The index date was the date of the first lithium blood test. Toxicity from lithium was defined as levels &gt;1.2mmol/L as per NICE guidelines while duration of treatment was calculated based on patient –years of exposure as determined by positive blood lithium levels. Relationships between baseline kidney function, lithium levels, duration of exposure and each patients most recent eGFR value on follow up were assessed using multiple linear regression Results We identified 1,978 patients exposed to lithium from 1999-2014, mean age was 47.4 (15.6), 45.1% were men, eGFR [median (IQR)] at baseline was 84.4 (32.1) ml/min1.73m and the median duration of exposure was 3.0 years (IQR=4 years). Frequency of lithium testing increased from 1.77 in 1999 to 2.66 in 2014. In multiple linear regression, the final eGFR on follow-up was significantly lower in older patients (-0.48 ml/min/1.73m per year increase in age), P&lt;0.001; in patients with elevated baseline lithium levels (-2.18 ml/min1.73m lower per unit increase), P&lt;0.05, with long duration of exposure (-1.42 ml/min/1.73m lower for each year on lithium), P&lt;0.001, and for patients with low GFR at baseline (P&lt;0.001). Together these variables explained 58% of the variation in the final model. Conclusion Both the magnitude of and the duration of lithium exposure are both independently associated with CKD progression among lithium users in the Irish health system. Higher baseline lithium values had a more deleterious impact on kidney function. Continued efforts should be expended in minimising the risks of lithium induced nephrotoxicity through switching to alternatives and dose reduction when over possible. Funding This study is funded by the Health Research Board and the Midwest Research and Education Foundation (MKid).

scholarly journals Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka

2020 ◽  
Vol 17 (11) ◽  
pp. 4041 ◽  
Author(s):  
Hansani Madushika Abeywickrama ◽  
Swarna Wimalasiri ◽  
Yu Koyama ◽  
Mieko Uchiyama ◽  
Utako Shimizu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Short Form ◽  
Symptom Burden ◽  
Symptom Index ◽  
The Mean ◽  
Uncertain Etiology

Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.

scholarly journals Optimism is associated with chronic kidney disease and rapid kidney function decline among African Americans in the Jackson Heart Study

2020 ◽  
Vol 139 ◽  
pp. 110267
Author(s):  
LáShauntá M. Glover ◽  
Crystal Butler-Williams ◽  
Loretta Cain-Shields ◽  
Allana T. Forde ◽  
Tanjala S. Purnell ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
African Americans ◽  
Kidney Disease ◽  
Kidney Function ◽  
Jackson Heart Study ◽  
Heart Study ◽  
Kidney Function Decline
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