Brain white matter microstructure in end‐stage kidney disease, cognitive impairment, and circulatory stress

2019 ◽  
Author(s):  
Mohamed T. Eldehni ◽  
Aghogho Odudu ◽  
Christopher W. Mcintyre
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Kidney Disease ◽  
End Stage Kidney Disease ◽  
Brain White Matter ◽  
White Matter Microstructure ◽  
Circulatory Stress ◽  
End Stage

scholarly journals Changes in measures of cognitive function in patients with end-stage kidney disease on dialysis and the effect of dialysis vintage: A longitudinal cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252237
Author(s):  
Karumathil M. Murali ◽  
Judy Mullan ◽  
Steven Roodenrys ◽  
Hicham I. Cheikh Hassan ◽  
Maureen Lonergan
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Analysis Of Covariance ◽  
End Stage Kidney Disease ◽  
Change Scores ◽  
Dialysis Vintage ◽  
One Year ◽  
End Stage

Introduction Prevalence of cognitive impairment increases with worsening severity of chronic kidney disease (CKD) and majority of end-stage kidney disease (ESKD) patients on dialysis have cognitive impairment. Trends of cognitive function (CF) in this population are less well known with published studies reporting conflicting results. Methods We assessed CF in a cohort of non-dialysis CKD and ESKD patients undergoing dialysis using modified mini-mental state examination (3MS), trail-making test (TMT-A & B) scores and Stroop task, and evaluated demographics, comorbidities and depression using Beck depression inventory at baseline. We repeated tests of CF and depression ≥ 1-year after baseline in both groups and compared change scores in CF and depression between ESKD/ CKD sub-groups. Among ESKD patients we compared change scores between patients with dialysis vintage of <1-year and >1-year. Analysis of covariance was used to adjust for the effect of age on these change scores. Results At baseline (N = 211), compared to CKD (N = 108), ESKD (N = 103) patients had significantly worse CF based on 3MS and TMT-A & B scores, and depression scores. On follow-up (N = 160) 3MS scores, especially the memory subscale significantly improved in ESKD, but worsened in CKD, with no significant changes in TMT A /TMT-B, or depression scores after adjusting for age. Among ESKD patients, 3MS, especially memory subscale improved in patients with dialysis vintage <1-year compared to >1-year. The 51 patients who discontinued after baseline assessment had worse baseline CF scores suggesting differential attrition. Conclusion Though baseline cognitive scores were worse in ESKD patients on dialysis, compared to CKD, their 3MS, especially memory subscale improved on follow-up. Among ESKD patients, the improvement was significant only in patients who have been on dialysis for less than one-year which may indicate a beneficial effect of clearance of uraemic toxins. Differential attrition of study subjects may have impacted the observed results.

scholarly journals Air Pollution and Gerontological Constructs Among Patients With End-Stage Kidney Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 270-271
Author(s):  
Mara McAdams-DeMarco ◽  
Miranda Jones ◽  
Yijing Feng ◽  
Jeremy Walston ◽  
Nadia Chu ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cognitive Impairment ◽  
Particulate Matter ◽  
Kidney Disease ◽  
Fine Particulate Matter ◽  
End Stage Kidney Disease ◽  
Household Level ◽  
Fine Particulate ◽  
End Stage ◽  
The Impact

Abstract Frailty is triggered by inflammatory pathways among patients with end-stage kidney disease (ESKD). Exposure to air pollution is associated with increased inflammation and as such may be a determinant of frailty in patients with ESKD. Therefore, we sought to estimate the impact of household-level exposure to fine particulate matter (particles &lt;2.5μm in diameter [PM2.5]) on frailty and other gerontological constructs among patients with ESKD. We leveraged a prospective, two-center cohort study of 1,482 adults with ESKD (2014-2019) from 40 US states. The physical frailty phenotype (PFP), SPPB, ADL/IADL dependence and 3MS global cognitive impairment were assessed at transplant evaluation. Household-level air pollution was estimated as annual average PM2.5 concentrations at each participant’s address using SEDAC national air pollution data. We estimated the odds of these gerontologic constructs using adjusted logistic regression by quartiles of PM2.5 concentrations accounting for confounders including socioeconomic status. Compared to patients with PM2.5 concentrations in the lowest quartile (&lt;9.3µg/m3), those with exposure to the 3rd quartile (10.0-11.1µg/m3) had 1.50-fold (95%CI:1.04-2.17) increased odds of frailty. However, exposure to PM2.5 concentrations in the second (9.3-10.0µg/m3) and fourth quartiles (&gt;11.1µg/m3) were not significant. Those with PM2.5 in the 3rd (OR=1.60, 95%CI:1.19-2.16) or 4th (OR=1.61, 95%CI:1.20-2.16) quartile had an increased risk of having dependence in ADLs or IADLs. PM2.5 was not associated with SPPB or cognitive impairment. Among ESKD patients, fine particulate matter was associated with greater frailty and dependence burden, although these association may not be linear. Further study of the role of inflammation on these associations are needed.

Impaired Vitamin D Signaling Is Associated With Frequent Development of Renal Cell Tumor in End-stage Kidney Disease

2020 ◽  
Vol 40 (11) ◽  
pp. 6525-6530
Author(s):  
JANOS DOCS ◽  
DANIEL BANYAI ◽  
TIBOR FLASKO ◽  
ARPAD SZANTO ◽  
GYULA KOVACS
Keyword(s):  
Vitamin D ◽  
Kidney Disease ◽  
Renal Cell ◽  
Cell Tumor ◽  
End Stage Kidney Disease ◽  
Vitamin D Signaling ◽  
End Stage

scholarly journals Cardiopulmonary exercise testing (CPET) in patients with end-stage kidney disease (ESKD): principles, methodology and clinical applications of the optimal tool for exercise tolerance evaluation

2021 ◽  
Author(s):  
Eva Pella ◽  
Afroditi Boutou ◽  
Aristi Boulmpou ◽  
Christodoulos E Papadopoulos ◽  
Aikaterini Papagianni ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Intolerance ◽  
End Stage Kidney Disease ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise ◽  
Functional Reserves ◽  
Increased Risk ◽  
End Stage

Abstract Chronic kidney disease (CKD), especially end-stage kidney disease (ESKD), is associated with increased risk for cardiovascular events and all-cause mortality. Exercise intolerance as well as reduced cardiovascular reserve are extremely common in patients with CKD. Cardiopulmonary exercise testing (CPET) is a non-invasive, dynamic technique that provides an integrative evaluation of cardiovascular, pulmonary, neuropsychological and metabolic function during maximal or submaximal exercise, allowing the evaluation of functional reserves of these systems. This assessment is based on the principle that system failure typically occurs when the system is under stress and, thus, CPET is currently considered to be the gold-standard for identifying exercise limitation and differentiating its causes. It has been widely used in several medical fields for risk stratification, clinical evaluation and other applications but its use in everyday practice for CKD patients is scarce. This article describes the basic principles and methodology of CPET and provides an overview of important studies that utilized CPET in patients with ESKD, in an effort to increase awareness of CPET capabilities among practicing nephrologists.

Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker

2021 ◽  
Author(s):  
Micaella Sotera Hansen ◽  
Wubshet Tesfaye ◽  
Beena Sewlal ◽  
Bharati Mehta ◽  
Kamal Sud ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Psychosocial Factors ◽  
Social Worker ◽  
End Stage Kidney Disease ◽  
Factors Affecting ◽  
The Social ◽  
End Stage ◽  
The Impact

Chronic kidney disease, pregnancy and haemodialysis: Case reports from a single centre in Kenya and literature review

2021 ◽  
pp. 1753495X2098540
Author(s):  
Samuel K Kabinga ◽  
Jackline Otieno ◽  
John Ngige ◽  
Seth O Mcligeyo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Case Reports ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Review Of Literature ◽  
Single Centre ◽  
End Stage Kidney Disease ◽  
Women Of Reproductive Age ◽  
End Stage

Chronic kidney disease (CKD) and end stage kidney disease are prevalent even in women of reproductive age. These are known to reduce fertility and successful pregnancy. There are chances of conception even in advanced CKD, though laden with complications. We present two cases of women who conceived in advanced CKD and are on haemodialysis in a tertiary hospital in Kenya and review of literature.

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