CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: The Epidemiology and Outcome of Acute Renal Failure and the Impact on Chronic Kidney Disease

2006 ◽  
Vol 19 (6) ◽  
pp. 450-454 ◽  
Author(s):  
Clay A. Block ◽  
Anton C. Schoolwerth
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Critical Care ◽  
Kidney Disease ◽  
The Impact ◽  
Critical Care Issues

HIV-associated kidney disease in the context of an aging population

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 485 ◽  
Author(s):  
Claire Naftalin ◽  
Bavithra Nathan ◽  
Lisa Hamzah ◽  
Frank A. Post
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Kidney Disease ◽  
General Population ◽  
Life Expectancy ◽  
Hiv Care ◽  
Developed World

Acute renal failure and chronic kidney disease are more common in HIV-infected patients compared with the general population. Several studies have shown age to be a risk factor for HIV-associated kidney disease. The improved life expectancy of HIV-infected patients as a result of widespread use of antiretroviral therapy has resulted in progressive aging of HIV cohorts in the developed world, and an increased burden of cardiovascular and kidney disease. Consequently, HIV care increasingly needs to incorporate strategies to detect and manage these non-infectious co-morbidities.

scholarly journals Faktor yang berhubungan dengan tingkat depresi pada pasien gagal ginjal kronis yang menjalani tindakan hemodialisa

2020 ◽  
Vol 14 (1) ◽  
pp. 101-109
Author(s):  
Indra Maulana ◽  
Iwan Shalahuddin ◽  
Taty Hernawaty
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Kidney Disease ◽  
Psychosocial Factors ◽  
Health Workers ◽  
Depression Score ◽  
Cross Sectional ◽  
Depression Level ◽  
The Impact

Psychosocial factors: The depression level  in patients with chronic kidney disease maintained on dialysisBackground: Chronic renal failure undergoing hemodialysis therapy in the world is almost 1.5 million people, and in Indonesia there are approximately 0.2 people with chronic renal failure undergoing hemodialysis therapy. The impact of hemodialysis on the physical that will occur in patients become weak tired in living their daily lives, against the psychological impact that will occur on sleep problems, impurity and depression, the impact on social and economic conditions that will occur to patients on social relationships, and on the environment the client will also have an impact on the social environment in which he lives. Therefore hemodialysis therapy will have an impact on the quality of life of patients.Purpose: To determine Psychosocial factors: the depression level  in patients with chronic kidney disease maintained on dialysisMethod: A descriptive correlational study by a cross sectional design approach. The sample used was 40 respondents, data collection techniques using questionnaires and direct observation with results calculated based on the total answers to questions given by respondents with criteria: score <17 = no sign of depression, score 18-24 = mild depression, score 25-34 = moderate depression and a score of 35-51 = severe depression, while the bivariate test used chi-squareResults: There was a relationship among factors such as: age, educational, sex, duration of maintaine of hemodialysis therapy and sleep patterns with the depression level in patients with chronic kidney disease under maintained on dialysis at Garut dr. Slamet Hospital.Conclusion: Health workers (nurses) to provide motivational and therapeutic informing in implementing hemodialysis therapy so that patients are more excited and better understand the importance of hemodialysis and to reduce the level of depression.Keywords: Depression level; Patients; Chronic kidney disease; DialysisPendahuluan: Penyakit gagal ginjal kronik yang menjalani terapi hemodialisis di dunia hampir sekitar 1,5 juta orang, dan di indonesi hampitr sekitar 0,2 jiwa penderita gagal ginjal kronik yang menjalani terapi hemodialisis. Dampak hemodialisis terhadap fisik yang akan terjadi pada pasien menjadi lemah lelah dalam menjalani kehidupan sehari-hari, terhadap psikologis dampak yang akan terjadi pada masalah tidur, kecemasaan dan depresi, dampak terhadap sosial dan ekonomi yang akan terjadi pada pasien pada hubungan sosialnya, dan pada lingkungan klien juga akan berdampak pada sosial lingkungan dimana dia tinggal. Maka dari itu terapi hemodialisis akan berdampak pada kualitas hidup pasien.Tujuan: Mengetahui faktor-faktor yang berhubungan dengan tingkat depresi pada pasien gagal ginjal kronis yang menjalani tindakan HemodialisaMetode: Menggunakan rancangan deskriptif korelasional dengan pendekatan desain cross sectional dengan sampel sebanyak 40 responden, teknik pengambilan data menggunakan kuesioner dan observasi langsung dengan hasil dihitung berdasarkan  total jawaban dari pertanyaan yang diberikan responden dengan kriteri skor <  17 = tidak ada depresi,  skor 18-24 = depresi ringan,  skor 25-34= depresi sedang dan skor 35-51= depresi berat                        sedangkan uji bivariat menggunakan chi-square.Hasil: Menunjukan adanya hubungan antara faktor : usia, pendidikan, jenis kelamin, lamanya periode menjalani terapi hemodialisa dan pola tidur. Semua faktor tersebut sangat  berhubungan dengan tingkat depresi pada pasien gagal ginjal kronik yang menjalani tindakan hemodialisa di Ruang Hemodialisa RSUD dr. Slamet Garut.Simpulan: Petugas kesehatan (perawat) agar memberikan motivasi dan terapeutik informing dalam pelaksanaan terapi hemodialisa agar pasien lebih bersemangat dan lebih memahami pentingnya hemodialisa serta untuk mengurangi tingkat depresi.

scholarly journals A brief grief over bowel relief

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 26 ◽  
Author(s):  
Kamalpreet S Parmar ◽  
Malvinder S Parmar
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Disease ◽  
Bowel Preparation ◽  
Sodium Phosphate ◽  
Careful Monitoring ◽  
Oral Sodium Phosphate ◽  
Oral Sodium

Oral sodium phosphate (OSP) solution is commonly used as bowel purgative before colonoscopy. Its safety has recently been questioned with several reports of acute renal failure and chronic kidney disease following its use. All of the cases reported are following bowel preparation for colonoscopy. I present a case of acute renal failure following OSP solution given to relieve constipation. This report further highlights the dangers of OSP and the importance of caution and careful monitoring when OSP solution is used as a cathartic, or for bowel preparation before colonoscopy.

Renal disease

2018 ◽  
Author(s):  
Quentin Milner
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Impaired Renal Function ◽  
Anaesthetic Management

This chapter describes the anaesthetic management of the patient with renal disease. The topics include estimation of renal function, chronic kidney disease, renal replacement therapy (including haemodialysis), acute renal failure, and the patient with a transplanted kidney. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. The effects of impaired renal function on the elimination of anaesthetic drugs are discussed.

scholarly journals LB005KIDNEY IMPLICATIONS OF THE INITIAL EGFR RESPONSE TO SGLT2 INHIBITION WITH EMPAGLIFLOZIN: THE ‘EGFR DIP’ IN EMPA-REG OUTCOME

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bettina J Kraus ◽  
Matthew Weir ◽  
George Bakris ◽  
Michaela Mattheus ◽  
David Cherney ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Disease ◽  
Risk Reduction ◽  
Predictive Factors ◽  
Odds Ratio ◽  
Risk Category ◽  
Outcome Trial ◽  
Baseline Characteristics ◽  
The Impact

Abstract Background and Aims Empagliflozin (EMPA) reduces cardiovascular and renal risk in patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD). EMPA induces an initial ‘dip’ in estimated glomerular filtration rate (eGFR). Although considered to be of haemodynamic origin and largely reversible, this needs to be better understood. We investigated whether the initial eGFR dip after EMPA initiation was influenced by baseline characteristics and/or might have an impact on the EMPA-induced risk reduction in kidney outcomes. Method In the EMPA-REG OUTCOME trial, patients with T2D and established CVD were treated (1:1:1) with EMPA 10 mg, 25 mg or placebo (PBO), in addition to standard of care. In this post hoc analysis, 6,668 participants who received at least one dose of study drug and had an available eGFR value at both baseline and Week 4 were categorised by initial percentage eGFR change from baseline. A multivariate logistic regression model was used to identify which baseline characteristics are predictive of an initial eGFR dip &gt;10% in EMPA-treated participants versus PBO. Across these predictive baseline factors, we investigated the occurrence of incident or worsening nephropathy, hard kidney outcomes (defined as doubling of serum creatinine with eGFR [MDRD] ≤45 ml/min/1.73 m2 or initiation of renal replacement therapy or death from renal disease), and kidney safety (narrow standardized MedDRA query acute renal failure). The impact of an eGFR dip &gt;10% on the risk reduction with EMPA for incident or worsening nephropathy was assessed using Cox regression analysis adjusting for such eGFR dip. Results In the EMPA-REG OUTCOME trial cohort, an initial eGFR dip of &gt;10% from baseline at Week 4 occurred in more than twice as many participants on EMPA (28.3%) compared to PBO (13.4%). However, a more pronounced eGFR dip of &gt;30% was uncommon, occurring in only 1.4% and 0.9%, respectively. Within the EMPA group, participants with an eGFR dip &gt;10% were significantly older, had longer diabetes duration and showed a higher KDIGO (Kidney Disease: Improving Global Outcomes) risk category. Diuretic use and/or higher KDIGO risk category at baseline were predictive of an initial eGFR dip of &gt;10% in EMPA vs. PBO. The average odds ratio [OR; 95% CI] for an eGFR dip &gt;10% with EMPA was 2.7 [2.3–3.0]. In subgroups with a dipping odds ratio below vs. above that average, beneficial treatment effects with EMPA on incident or worsening nephropathy and the hard kidney outcome were consistent (panel A). Also, an eGFR dip &gt;10% did not affect risk reduction for the primary kidney outcome (panel B). Acute renal failure rates were generally lower or similar in EMPA vs. PBO, regardless of baseline predictive factors for an eGFR dip. Conclusion T2D patients with more advanced kidney disease and/or on diuretic therapy at baseline were more likely to have an initial eGFR dip &gt;10% with EMPA. However, EMPA treatment appeared to be safe and was associated with improved kidney outcomes, regardless of these baseline predictive factors or an initial eGFR dip &gt;10%.

Chronic Kidney Disease

2016 ◽  
pp. 565-570
Author(s):  
Carrie A. Schinstock
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Relative Increase ◽  
Absolute Increase ◽  
Definition Of ◽  
Stage 1

The term acute kidney injury (AKI) has replaced acute renal failure in contemporary medical literature. AKI denotes a rapid deterioration of kidney function within hours to weeks, resulting in the accumulation of nitrogenous metabolites in addition to fluid, electrolyte, and acid-base imbalances. The definition of AKI was refined to a 3-stage definition, with criteria for stage 1 as follows: 1) an absolute increase in serum creatinine (SCr) by at least 0.3 mg/dL from baseline within 48 hours; or 2) a relative increase in SCr to at least 1.5 times baseline within the past 7 days; or 3) urine output decreased to less than 0.5 mL/kg/h for 6 hours.

scholarly journals Uric Acid as a Marker of Kidney Disease: Review of the Current Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Christin Giordano ◽  
Olga Karasik ◽  
Kelli King-Morris ◽  
Abdo Asmar
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Uric Acid ◽  
Kidney Disease ◽  
Current Literature ◽  
Predictive Models ◽  
Potential Role ◽  
Poor Prognostic Factor

Uric acid has been implicated in the pathophysiology of renal disease; however renal clearance makes a causal relationship difficult to prove. We examine the current literature to support a potential role of uric acid in the development of kidney disease and to determine the potential to use uric acid as a marker for future renal decline. After review, we conclude that uric acid is definitively linked to the development of chronic kidney disease and can be a poor prognostic factor for the development of acute renal failure, as well. However, further human research is needed before predictive models utilizing uric acid can be developed and used in the clinical setting.

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