Chinese observational prospective study of ageing population with chronic kidney disease (C-OPTION): a study protocol

IntroductionThe proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk.Methods and analysisThis is a prospective, multicentre, cohort study. The study population comprises ~3000 patients with predialysis CKD, aged ≥65 years, recruited between March 2016 and December 2017. After the baseline assessments, these patients will be followed for 5 years or until the occurrence of primary outcomes. Assessments that include anthropomorphic measures, laboratory tests, questionnaires, and blood and urine specimen collection will be performed at baseline and at follow-ups. Data on demographic information, cognitive function, depression, risk of malnutrition, physical activity and quality of life will be collected. The primary outcomes are incidence of end-stage renal disease, loss of renal function (≥40% decline in glomerular filtration rate from baseline), and death. The secondary outcomes are acute coronary syndrome, hospitalisation for heart failure or unstable angina, cerebrovascular events, and peripheral arterial disease.Ethics and disseminationThis study protocol has been approved by the ethics committees of the Chinese People’s Liberation Army General Hospital and the participating centres. All the participants gave written informed consent before data collection. The findings of the study will be published in peer-reviewed journals and will be presented at national or international conferences.Trial registration numberNCT03246204; Pre-results.

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The Association Between Household Income, Food Security, and Prevalence of Chronic Kidney Disease in Elderly Patients

10.21203/rs.3.rs-913699/v1 ◽

2021 ◽

Author(s):

Hyuk Huh ◽

Je Hun Song ◽

Hong Yeop Kim ◽

Hoseok Koo ◽

Kyung Don Yoo

Keyword(s):

Chronic Kidney Disease ◽

Food Security ◽

Chronic Disease ◽

Kidney Disease ◽

Food Insecurity ◽

Low Income ◽

Household Income ◽

The Elderly ◽

Income Level ◽

Elderly Group

Abstract This study aimed to clarify the association between food security and the prevalence of chronic disease. We analyzed the variables of The Korea National Health and Nutrition Examination Survey V (2010–2012), and VI (2013–2015) while merging data of the food security questionnaire of four years. We included 15,945 participants, performed propensity score matched analysis by quartile of household income (i.e., low, low-mid, high-mid, high) and sex, and presented the results by age group. Systolic blood pressure and proportion of current smokers were significantly higher in the elderly group, compared with the middle-aged group. The prevalence of hypertension, diabetes mellitus (DM), metabolic syndrome, and chronic kidney disease (CKD) did not differ significantly by income level in the elderly group. The food security questionnaire revealed that food security insurance was significantly lower in the low-income level (1st quartile), compared with that in the high-income level (4th quartile). The logistic regression analysis for the association between the prevalence of chronic disease and food insecurity confirmed no significant association with hypertension and DM. Food insecurity might be associated with CKD prevalence, especially in the elderly population.

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A PILOT STUDY: PLASMA GALECTIN-3 LEVEL IN HEART FAILURE PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.13 ◽

2017 ◽

pp. 101-106

Author(s):

Thi Thanh Hien Bui ◽

Hieu Nhan Dinh ◽

Anh Tien Hoang

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Acute Coronary Syndrome ◽

Kidney Disease ◽

Heart Failure Patients ◽

Coronary Syndrome ◽

Nyha Classification ◽

Galectin 3 ◽

Severe Chronic Kidney Disease ◽

Esc Guidelines

Background: Despite of considerable advances in its diagnosis and management, heart failure remains an unsettled problem and life threatening. Heart failure with a growing prevalence represents a burden to healthcare system, responsible for deterioration of patient’s daily activities. Galectin-3 is a new cardiac biomarker in prognosis for heart failure. Serum galectin-3 has some relation to heart failure NYHA classification, acute coronary syndrome and clinical outcome. Level of serum galectin-3 give information for prognosis and help risk stratifications in patient with heart failure, so intensive therapeutics can be approached to patients with high risk. Objective: To examine plasma galectin-3 level in hospitalized heart failure patients, investigate the relationship between galectin-3 level with associated diseases, clinical conditions and disease progression in hospital. Methodology: Cross sectional study. Result: 20 patients with severe heart failure as NYHA classification were diagnosed by The ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2012) and performed blood test for serum galectin-3 level. Increasing of serum galectin-3 level have seen in all patients, mean value is 36.5 (13.7 – 74.0), especially high level in patient with acute coronary syndrome and patients with severe chronic kidney disease. There are five patients dead. Conclusion: Serum galectin-3 level increase in patients with heart failure and has some relation to NYHA classification, acute coronary syndrome. However, level of serum galectin-3 can be affected by severe chronic kidney disease, more research is needed on this aspect Key words: Serum galectin-3, heart failure, ESC Guidelines, NYHA

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Problems with interpreting troponins in chronic kidney disease patients for ruling out acute coronary syndrome

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2020.12.051 ◽

2021 ◽

Vol 41 ◽

pp. 14-15

Author(s):

Tikal Kansara ◽

Monil Majmundar ◽

Craig Basman ◽

Ferdinand Visco

Keyword(s):

Chronic Kidney Disease ◽

Acute Coronary Syndrome ◽

Kidney Disease ◽

Coronary Syndrome

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P0296LAST HIT ‘' INFECTIONS'’ BROUGHT THE END: CHRONIC KIDNEY DISEASE TO RENAL REPLACEMENT TREATMENT

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0296 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Feyza Bora ◽

Emine Asar ◽

Fatih Yılmaz ◽

Ümit Çakmak ◽

Fevzi F Ersoy ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Outpatient Clinic ◽

Artery Bypass ◽

Kidney Injury ◽

The Elderly ◽

Severe Form ◽

Vaccination Programs ◽

Cardiac Decompensation ◽

Replacement Treatment

Abstract Background and Aims It is evident that Chronic Kidney Disease (CKD) influences the risk of developing AKI (Acute Kidney Injury) and recent studies suggest that CKD patients who experienced an episode of AKI are more likely to progress to end stage renal disease (ESRD) than patients without CKD. AKI-CKD association might originate from common comorbidities associated with both AKI and CKD, such as diabetes and/or hypertension, and concurrent increase in interventions leading to frequent exposure to various nephrotoxins. AKI in the elderly has been shown to increase the risk of progression to CKD to ESRD. AKI is common in critically ill patients, and those patients with the most severe form of AKI, requiring RRT, have a mortality rate of 50–80 %. Patients with an eGFR <45 ml/min per 1.73m2 who experienced an episode of dialysis-requiring AKI were at very high risk for impaired recovery of renal function. Our aim was to determine the reasons that initiate hemodialysis (renal decompensation) in patients with regular follow-up in the low clearance polyclinic without renal replacement treatment (RRT). Method The retrospective study included predialysis CKD patients who had followed up regularly and had undergone RRT in recent 4 years. Data on baseline characteristics and medical history were obtained from patient hospital records. Results Of the 228 patients, 155 (68%) were male and 73 (32%) were female. The mean age was 58 years (45-66). Diabetes Mellitus was the first in the etiology of CKD (26,3 %), the second was unknown (12,7 %), the third was hypertension (11,8 %). 145 patients (63,6%) underwent regular hemodialysis (HD) (62 years, 55-69), 25 patients (11%) began peritoneal dialysis (PD), 58 patients (25%) had renal transplantation. 52 patients underwent HD with renal decompensation, 22 (%42,3) had working arteriovenous fistula (AVF). There was no decompensation in patients with PD or transplantation plan. 34 patients started HD because of infections (65%), 8 patients (15%) after operations (4 was Coronary Artery Bypass Grafting-CABG), 6 patients (%11,5) after coronary angiography, 4 patients (7,5%) with cardiac decompensation. 2 patients died during the hospitalisation for infections. Of 145 HD patients, 89 (%61,4) had AVF. The patients who had renal decompensation were more older 63 (58-70), have lower Hgb 9,7 g/L (9,1-10,7) and albumin 3,5 g/L (3,2-3,9) level (p<0,05). There was no difference in eGFR at the beginning of HD between renal decompensation and other HD patients. 42 patients did not undergo HD at the time we suggested during visits. Of them 9 patients (%21) had renal decompensation (6 infections,3 CABG), 17 patients (%40) had AVF. 3 of them died. The others underwent HD for uremic complications. Conclusion We have shown that infections are as the leading cause of renal decompensation. Most of our patients who started to RRT from our low clearance outpatient clinic have chosen HD for RRT. Prevention of infections via vaccination programs or early diagnosis at regular policlinic or telephone visits, and informing patients adequately about nephrotoxic drugs or the conditions that may cause renal decompensation are among the first tasks of the predialysis outpatient clinic. Transition of CKD patients to RRTs, with proper preparation, neither late nor early- at the most appropriate time- should be among in our goals. This may reduce the cost of ESRD patients.

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