scholarly journals Cross-sectional study examining the accuracy of self-reported smoking status as compared to urinary cotinine levels among workers at risk for chronic kidney disease of unknown origin in Guatemala

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050374
Author(s):  
Jaime Butler-Dawson ◽  
Joaquin Barnoya ◽  
Stephen Brindley ◽  
Lyndsay Krisher ◽  
Wenyi Fan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Kidney Disease ◽  
Low Income ◽  
Smoking Prevalence ◽  
Smoking Status ◽  
Unknown Origin ◽  
Agricultural Workers ◽  
Cross Sectional ◽  
Urinary Cotinine

ObjectivesThere is a lack of information on cotinine levels in rural populations in low-income and middle-income countries like Guatemala. Therefore, there is a need to explore smoking status and biomarkers of tobacco use in epidemiological research in rural, low-income populations, in particular those at-risk for chronic kidney disease of unknown origin (CKDu).DesignWe evaluated self-reported smoking status against urinary cotinine levels, the gold standard biomarker of tobacco smoke exposure, among agricultural workers at four separate cross-sectional time points.SettingGuatemala.Participants283 sugarcane workers.Primary outcome measuresCompared self-reported smoking status and urinary cotinine levels in two agricultural worker studies.ResultsSelf-reported smoking prevalence was 12% among workers. According to cotinine levels (≥50 ng/mL), the smoking prevalence was 34%. Self-reported smoking status had 28% sensitivity and 96% specificity. Urinary cotinine levels show that smoking prevalence is underestimated in this worker population.ConclusionsAccording to our findings, smoking status should be objectively measured with biomarkers rather than self-reported in CKDu epidemiological research. Self-reported smoking status is likely an underestimate of the true smoking prevalence among agricultural workers. Research on the CKDu epidemic in Central America and other parts of the world might be underestimating tobacco exposure as a potential contributor to the development of CKDu.

scholarly journals The Serum Metabolome Identifies Biomarkers of Dietary Acid Load in 2 Studies of Adults with Chronic Kidney Disease

2019 ◽  
Vol 149 (4) ◽  
pp. 578-585 ◽  
Author(s):  
Casey M Rebholz ◽  
Aditya Surapaneni ◽  
Andrew S Levey ◽  
Mark J Sarnak ◽  
Lesley A Inker ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fruits And Vegetables ◽  
Smoking Status ◽  
Cross Sectional ◽  
Dietary Acid Load ◽  
Nutrition Research ◽  
Net Endogenous Acid Production ◽  
Dietary Acid ◽  
Acid Load

ABSTRACT Background Dietary acid load is a clinically important aspect of the diet that reflects the balance between acid-producing foods, for example, meat and cheese, and base-producing foods, for example, fruits and vegetables. Methods We used metabolomics to identify blood biomarkers of dietary acid load in 2 independent studies of chronic kidney disease patients: the African American Study of Kidney Disease and Hypertension (AASK, n = 689) and the Modification of Diet in Renal Disease (MDRD, n = 356) study. Multivariable linear regression was used to assess the cross-sectional association between serum metabolites whose identity was known (outcome) and dietary acid load (exposure), estimated with net endogenous acid production (NEAP) based on 24-h urine urea nitrogen and potassium, and adjusted for age, sex, race, randomization group, measured glomerular filtration rate, log-transformed urine protein-to-creatinine ratio, history of cardiovascular disease, BMI, and smoking status. Results Out of the 757 known, nondrug metabolites identified in AASK, 26 were significantly associated with NEAP at the Bonferroni threshold for significance (P < 6.6 × 10−5). Twenty-three of the 26 metabolites were also identified in the MDRD study, and 13 of the 23 (57%) were significantly associated with NEAP (P < 2.2 × 10−3), including 5 amino acids (S-methylmethionine, indolepropionylglycine, indolepropionate, N-methylproline, N-δ-acetylornithine), 2 cofactors and vitamins (threonate, oxalate), 1 lipid (chiro-inositol), and 5 xenobiotics (methyl glucopyranoside, stachydrine, catechol sulfate, hippurate, and tartronate). Higher levels of all 13 replicated metabolites were associated with lower NEAP in both AASK and the MDRD study. Conclusion Metabolomic profiling of serum specimens from kidney disease patients in 2 study populations identified 13 replicated metabolites associated with dietary acid load. Additional studies are needed to validate these compounds in healthy populations. These 13 compounds may potentially be used as objective markers of dietary acid load in future nutrition research studies.

scholarly journals Identification of People at Risk of Developing Chronic Kidney Disease among Rural Disadvantageous Population in Bangladesh

2020 ◽  
pp. 21-29
Author(s):  
Tanjina Rahman ◽  
Akibul Islam Chowdhury ◽  
Mohammad Asadul Habib ◽  
Harun Ur- Rashid ◽  
Shakib Arefin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Kidney Disease ◽  
Rural Areas ◽  
Medical Condition ◽  
Low Cost ◽  
Dipstick Test ◽  
Related Factors ◽  
Cross Sectional ◽  
Early Management

Background: Chronic kidney disease (CKD) is a global disease and the prevalence of CKD is increasing in both developed and developing countries. The current study aimed to assess subjects in the rural areas of Sylhet district in Bangladesh to identify individuals who may be predisposed to at risk for developing CKD. Methods: A cross-sectional study was carried out among 996 subjects from Sylhet district of Bangladesh. Data were collected by using a standard questionnaire from 82 villages. Data about socio-demographic, medical history and anthropometric and biochemical parameters were collected. Urine dipstick test was done for both albumin and glucose. Descriptive statistics and ANOVA-test were performed for statistical analysis. Results: The study revealed that people living in rural areas of Sylhet in Bangladesh are at risk of developing CKD and the hidden cause behind it includes not only diabetes and hypertension, but also other lifestyle related factors. Younger participants were found to be at less risk compared to older participants for developing CKD. From urinary dipstick test, 2% and 3.3% subjects had severe traces of albumin and glucose in their urine. Approximately 16% of subjects had hypertension. From the data of 99 out of 996 subjects for urine albumin dipstick test, 98 respondents were identified as stage I CKD patients and only one was identified as stage II CKD patients. Conclusion: As dialysis and transplants are unsustainable in the long term, it is important to seek preventive strategies when patients are in pre-dialysis state and identify and manage those at high risk. Nutrition and life-style choices can play key roles to achieve this. So, urgent low-cost programs are needed to identify people who are at risk of CKD as well as address their current medical condition to initiate early management of CKD patients.

scholarly journals Associations between socioeconomic status and blood cadmium levels in Korea

2019 ◽  
Vol 41 ◽  
pp. e2019018
Author(s):  
Yongho Jee ◽  
Sung-il Cho
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Formal Education ◽  
Smoking Status ◽  
Smoking History ◽  
Cross Sectional ◽  
Urinary Cotinine ◽  
Blood Cadmium ◽  
Strong Negative Association

OBJECTIVES: Although smoking is associated with both low socioeconomic status and blood cadmium (Cd) levels, the association between socioeconomic status and Cd levels remains unclear. Therefore, our study aimed to examine this association and to clarify whether smoking is a confounding or mediating variable in this relationship.METHODS: Data (n=7,734) were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008- 2011), including years that contained data on blood Cd and urinary cotinine levels. We investigated the associations of income, education, and occupation with blood Cd levels. Smoking was investigated by categorizing participants by smoking status (never, former, and current) and pack-years into quartiles. The weekly frequency of rice and barley intake was analyzed to gain insights into participants’ dietary patterns. Additionally, urinary cotinine levels were used to ensure the validity of the smoking variables.RESULTS: Participants earning a low income and with less formal education had higher blood Cd levels. After controlling for smoking, the association between income and Cd levels substantially weakened. Further controlling for education, the association between income and Cd levels disappeared. However, there was a strong negative association between education and Cd levels, even after controlling for smoking history, pack-years, and urinary cotinine levels.CONCLUSIONS: In cross-sectional data from the KNHANES, blood Cd levels were significantly higher among those with a low income and less formal education. Smoking history contributed to, but did not fully explain, these associations.

scholarly journals Screening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019778 ◽  
Author(s):  
David Flood ◽  
Pablo Garcia ◽  
Kate Douglas ◽  
Jessica Hawkins ◽  
Peter Rohloff
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Low Income ◽  
Haemoglobin A1c ◽  
Ckd Progression ◽  
Community Based ◽  
Cross Sectional ◽  
Resource Limited ◽  
Increased Risk

ObjectiveScreening is a key strategy to address the rising burden of chronic kidney disease (CKD) in low-income and middle-income countries. However, there are few reports regarding the implementation of screening programmes in resource-limited settings. The objectives of this study are to (1) to share programmatic experiences implementing CKD screening in a rural, resource-limited setting and (2) to assess the burden of renal disease in a community-based diabetes programme in rural Guatemala.DesignCross-sectional assessment of glomerular filtration rate (GFR) and urine albumin.SettingCentral Highlands of Guatemala.ParticipantsWe enrolled 144 adults with type 2 diabetes in a community-based CKD screening activity carried out by the sponsoring institution.Outcome measuresPrevalence of renal disease and risk of CKD progression using Kidney Disease: Improving Global Outcomes definitions and classifications.ResultsWe found that 57% of the sample met GFR and/or albuminuria criteria suggestive of CKD. Over half of the sample had moderate or greater increased risk for CKD progression, including nearly 20% who were classified as high or very high risk. Hypertension was common in the sample (42%), and glycaemic control was suboptimal (mean haemoglobin A1c 9.4%±2.5% at programme enrolment and 8.6%±2.3% at time of CKD screening).ConclusionsThe high burden of renal disease in our patient sample suggests an imperative to better understand the burden and risk factors of CKD in Guatemala. The implementation details we share reveal the tension between evidence-based CKD screening versus screening that can feasibly be delivered in resource-limited global settings.

scholarly journals A cross-sectional study to assess impact of COVID-19 infection amongst patients with chronic kidney disease

2021 ◽  
Vol 8 (3) ◽  
pp. 1466
Author(s):  
Harshalkumar N. Mahajan ◽  
Smita S. Chavhan ◽  
Chinmay Gokhale ◽  
Balkrishna B. Adsul ◽  
Maharudra Kumbhar ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diffuse Alveolar Damage ◽  
Unknown Origin ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Duration Of Hospitalization ◽  
Potential Impact

Background: In December 2019, a series of unknown origin cases of acute respiratory illness occurred in Wuhan, Hubei Province, China. Although diffuse alveolar damage and acute respiratory failure were the main features of COVID-19, the involvement of other organs needed to be explored. After lung infection, the virus may enter the blood, accumulate in the kidney, and cause damage to resident renal cells. Hence, this study was planned to analyze the potential impact of this pandemic of COVID-19 amongst the chronic kidney disease (CKD) patients.Methods: Cross-sectional observational study was conducted at Seven Hills Dedicated Covid-19 hospital, Andheri, Mumbai. Data was collected from hospital records of CKD patients admitted in the study duration.Results: This study was conducted on 310 patients. Mean age was 53.33+14.21 years, and 191 (61.6%) of patients were male while mean duration of hospitalization was 16.78+10.31. Majority of the patients presented with symptoms like fever 80%, breathlessness 61.3%, and co-morbidities like Diabetes Mellitus 65.5% followed by Hypertension 61.8%. Patients (15.5%) over age of 60 years tested swab report positive for more than 5 times. Recovery rate being 76.1% while mortality rate found to be 23.87%.Conclusions: Early detection and effective intervention may help to reduce deaths among CKD patients with COVID-19.

scholarly journals Metabolic Phenotypes and Chronic Kidney Disease: A Cross-Sectional Assessment of Patients from a Large Federally Qualified Health Center

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 175
Author(s):  
Kathleen E. Adair ◽  
Nicholas von Waaden ◽  
Matthew Rafalski ◽  
Burritt W. Hess ◽  
Sally P. Weaver ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Center ◽  
Smoking Status ◽  
Normal Weight ◽  
Metabolic Phenotype ◽  
Cross Sectional ◽  
Federally Qualified Health Center ◽  
Logistic Regressions ◽  
Metabolically Healthy

The purpose of this study is to determine if renal function varies by metabolic phenotype. A total of 9599 patients from a large Federally Qualified Health Center (FQHC) were included in the analysis. Metabolic health was classified as the absence of metabolic abnormalities defined by the National Cholesterol Education Program Adult Treatment Panel III criteria, excluding waist circumference. Obesity was defined as body mass index >30 kg/m2 and renal health as an estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2. Linear and logistic regressions were used to analyze the data. The metabolically healthy overweight (MHO) phenotype had the highest eGFR (104.86 ± 28.76 mL/min/1.72 m2) and lowest unadjusted odds of chronic kidney disease (CKD) (OR = 0.46, 95%CI = 0.168, 1.267, p = 0.133), while the metabolically unhealthy normal weight (MUN) phenotype demonstrated the lowest eGFR (91.34 ± 33.28 mL/min/1.72 m2) and the highest unadjusted odds of CKD (OR = 3.63, p < 0.0001). After controlling for age, sex, and smoking status, the metabolically unhealthy obese (MUO) (OR = 1.80, 95%CI = 1.08, 3.00, p = 0.024) was the only phenotype with significantly higher odds of CKD as compared to the reference. We demonstrate that the metabolically unhealthy phenotypes have the highest odds of CKD compared to metabolically healthy individuals.

HUBUNGAN EFIKASI DIRI DENGAN KUALITAS HIDUP PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS

2018 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Abdul Wakhid ◽  
Estri Linda Wijayanti ◽  
Liyanovitasari Liyanovitasari
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Self Efficacy ◽  
Healing Process ◽  
Sampling Technique ◽  
P Value ◽  
Cross Sectional ◽  
Kolmogorov Smirnov

Background: Self efficacy can optimize the quality of life of clients who undergo the healing process due to chronic diseases. Individuals with higher self-efficacy move their personal and social resources proactively to maintain and improve the quality and length of their lives so that they experience a better quality of life. Objectives: the purpose of this study was to find the correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency. Metode: This type of research was descriptive correlation with cross sectional approach. The samples in this study more 76 people with total sampling technique. The data collection tool for self efficacy was measured by General Self-Efficacy scale, for quality of life with WHOQoL-BREF. Statistical test used Kolmogorov-smirnov. Result: The result showed that self efficacy in patients with chronic kidney disease was mostly in moderate category (53,9%), quality of life in patients with chronic kidney disease was mostly in good category (68,4%). There was a correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency, the result obtained p-value of 0.000 <α (0,05). Suggestion: Patients with chronic kidney disease can maintain good quality of life by helping to generate positive self-esteem and high self efficacy.

scholarly journals Elevated alanine aminotransferase and low aspartate aminotransferase/alanine aminotransferase ratio are associated with chronic kidney disease among middle-aged women: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Akihiro Watanabe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Relationship Of

Abstract Background Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. Methods The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. Results “Elevated ALT and elevated GGT” and “elevated ALT and non-elevated GGT” significantly increased the OR for CKD when compared with “non-elevated ALT and non-elevated GGT” (OR: 2.56, 95% CI: 2.10–3.12 and OR: 2.24, 95% CI: 1.81–2.77). Compared with “AST/ALT ratio ≥ 1 and non-elevated GGT”, “AST/ALT ratio < 1 and elevated GGT” and “AST/ALT ratio < 1 and non-elevated GGT” significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36–3.15 and OR: 1.68, 95% CI: 1.52–1.87). These findings still remained after adjustment for confounders. Conclusions Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.

Sign in / Sign up

Export Citation Format

Share Document