Racial disparities in renal function: the role of racial discrimination. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

2018 ◽  
Vol 72 (11) ◽  
pp. 1027-1032 ◽  
Author(s):  
Lidyane V Camelo ◽  
Luana Giatti ◽  
Roberto Marini Ladeira ◽  
Rosane Harter Griep ◽  
José Geraldo Mill ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Longitudinal Study ◽  
Kidney Disease ◽  
Racial Disparities ◽  
Racial Discrimination ◽  
Adult Health ◽  
Related Factors ◽  
Cross Sectional ◽  
Black And White

BackgroundRacial discrimination may play a significant role in higher incidence and poorer prognosis of chronic kidney disease among Black individuals. This study set out to investigate the association between racial discrimination and renal function and to estimate the contribution of racial discrimination to existing racial disparities in renal function.MethodsA cross-sectional analysis using baseline data (2008–2010) of 14 355 participants (35–74 years) in the Brazilian Longitudinal Study of Adult Health cohort study. Renal function was estimated based on estimated glomerular filtration rates (eGFR) obtained by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Racial discrimination was assessed using a modified version of the Lifetime Major Events Scale ; race/colour was self-reported. Covariates included were age, sex, level of education and selected health-related factors.ResultsRacial discrimination was reported by 31.6%, 6.3% and 0.8% of Black, Brown and White individuals, respectively. The older the age, the lower the prevalence of racial discrimination among Blacks. Racial discrimination was independently associated with lower mean eGFR (β=−2.38; 95% CI −3.50 to −1.25); however, associations were limited to individuals aged under 55 years. In this age group, eGFR differences between Black and White individuals were reduced by 31% when exposure to racial discrimination was accounted for.ConclusionBlacks are approximately 40 times more likely to report racial discrimination than Whites. Racial discrimination was associated with lower mean eGFR and explained a significant portion of eGFR differences between Black and White individuals aged under 55 years. Exposure to experiences of racial discrimination should be accounted for in studies investigating racial disparities in renal function.

Thyrotropin levels are associated with chronic kidney disease among healthy subjects in cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

2017 ◽  
Vol 21 (6) ◽  
pp. 1035-1043 ◽  
Author(s):  
Érique José F. Peixoto de Miranda ◽  
Márcio Sommer Bittencourt ◽  
Alessandra C. Goulart ◽  
Itamar S. Santos ◽  
Silvia Maria de Oliveira Titan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Longitudinal Study ◽  
Kidney Disease ◽  
Healthy Subjects ◽  
Adult Health ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

scholarly journals HUBUNGAN ANTARA MEROKOK DENGAN GAMBARAN FUNGSI GINJAL PADA KARYAWAN PT.X

2021 ◽  
Vol 7 (3) ◽  
pp. 147-152
Author(s):  
Nur Syamsi ◽  
Andi Alfia Muthmainnah Tanra ◽  
Mariani Rasjid HS
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Analytical Study ◽  
Smoking Habit ◽  
Cross Sectional ◽  
Consecutive Sampling ◽  
Study Results ◽  
Cross Sectional Design ◽  
Global Health Problem

The chronic kidney disease is a global health problem with increasing prevalence and incidence and a poor prognosis. Therefore, those brought about by risk factors are primarily those which can be modified and controlled for their occurrence.  One of the risk factor is smoking habit. The objective of this study was to determine the associations between smoking and renal function profiles in PT.X employees. The study was conducted by using descriptive analytical study with a cross sectional design based on smoking habits and blood test samples of employees. The sample were 40 employees in PT.X which determined by consecutive sampling. The results showed that there were no associations between smoking with age (p = 0.222) and azotemia (p = 1.00) but there were associations between smoking and blood creatinine levels (p = 0.001), urea (p = 0.023), eGFR (p. = 0.001), and the stages of chronic kidney disease (p = 0.047).  Based on the study results, in can be concluded that there were associations between smoking and renal function profiles among employees of PT. X

scholarly journals The Effect of Renal Dysfunction on Circulating Sclerostin Level in Patients with Type 2 Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Se Hwa Kim ◽  
Soo Young Yoon ◽  
Sung-Kil Lim ◽  
Yumie Rhee
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Sclerostin Level

Objective. Sclerostin is a Wnt inhibitor produced specifically by osteocytes. However, it is not currently clear whether renal dysfunction has an effect on circulating sclerostin level in patients with type 2 diabetes. The aim of the study was to evaluate this relationship. Design and Patients. We conducted a cross-sectional observational study of 302 type 2 diabetic patients with or without chronic kidney disease. Serum sclerostin level was analyzed by ELISA, and renal function was assessed by estimated glomerular filtration rate (eGFR) using chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Results. There was a strong correlation between sclerostin level with renal function presented as serum creatinine (r=0.745, P<0.001) and eGFR (r=-0.590, P<0.001). Serum sclerostin level was significantly higher in patients with CKD-G3 stage than those with CKD-G1/2 stages after adjusting for age, sex, and BMI (P=0.011). Patients with CKD-G4/5 stages had dramatically increased level of circulating sclerostin. Multiple regression analyses found that age, sex, and eGFR were independent determining factors for circulating sclerostin level. Conclusion. Our data showed that serum sclerostin levels start to increase in diabetic patients with CKD-G3 stage. Further studies are needed to establish the potential role of elevated sclerostin in diabetic patients with CKD.

scholarly journals Periodontal Status in Chronic Kidney Disease Patients

2017 ◽  
Vol 1 ◽  
Author(s):  
Lam Do Ai Nguyen ◽  
Thao Thi Thu Nguyen ◽  
Thuy Anh Vu Pham
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Periodontal Status ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<div><p class="AbstractTitle"><strong>Objectives:</strong> To compare periodontal status of chronic kidney disease patients with those in non-chronic kidney disease patients and to explore the relationship between periodontitis and chronic kidney disease in a group of Vietnamese.</p></div><p class="AbstractContent"><strong>Methods:</strong> A cross sectional study was conducted on 240 adults including 120 chronic kidney disease patients (group 1) and 120non-chronic kidney disease patients (group 2). The socio-demographic characteristic, dental and smoking habits were investigated by the questionnaire. Periodontal status (PPD, CAL, BOP) were examined. The periodontal status was compared between 2 groups. Multiple logistic regression analysis was performed to examine the relationship between chronic kidney disease and periodontitis after adjusting related factors.</p><p class="AbstractContent"><strong>Results</strong>: The clinically periodontal parameters in group 1 were all higher compared to those in group 2 (p&lt;0.001). The OR for periodontitis in patients who with age more than 60 years or brushed their teeth less than 2 times per day or had no scaling or in current smokers or with chronic kidney disease were 1.93; 4.27; 7.95; 4.21; 2.94 compared to counterparts, respectively (p&lt;0.05).</p><p class="AbstractContent"><strong>Conclusion:</strong> The periodontal status of chronic kidney disease patients was found worse than those in non-chronic kidney disease patients. The chronic kidney disease was significantly related to periodontitis.</p>

scholarly journals Shen Shuai II Recipe Attenuates Renal Interstitial Fibrosis by Improving Hypoxia via the IL-1β/c-Myc Pathway

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Liuyi Yang ◽  
Meng Wang ◽  
Yuan Zhou ◽  
Jing Yang ◽  
Chaoyang Ye ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Kidney Disease ◽  
Protein Expression ◽  
Interstitial Fibrosis ◽  
Renal Interstitial Fibrosis ◽  
Related Factors

Background. Renal interstitial fibrosis is a pathological manifestation of progression of chronic kidney disease induced by various factors. Shen Shuai II Recipe (SSR) has been used in clinical practice for more than 20 years, and clinical studies have confirmed that SSR significantly improves the renal function of patients with chronic kidney disease. However, the specific mechanisms underlying its efficacy require further research. This study aims to explore the influencing factors of renal interstitial fibrosis in the context of hypoxia via the IL-1β/c-Myc pathway and the potential molecular mechanisms of SSR intervention in vivo and in vitro. Methods. A rat model of chronic renal failure was developed by performing 5/6 (ablation/infarction, A/I) surgery on randomly selected, male Sprague Dawley rats. Thirty-six successfully modeled rats were randomly divided into three groups: 5/6 (A/I), 5/6 (A/I) + SSR, and 5/6 (A/I) + losartan. Another 12 rats were used as the sham group. After 8 weeks of the corresponding intervention, renal function, liver function, and protein expression of renal-fibrosis-related factors, HIF-1α, IL-1β, and c-Myc, were detected. In vitro analysis was performed using hypoxia-induced rat renal tubular epithelial cells (NRK-52E) and IL-1β-stimulated rat renal interstitial fibroblasts (NRK-49F). IL-1β concentration in the culture medium and IL-1β protein expression in hypoxic NRK-52E treated with different concentrations of SSR were investigated. Furthermore, we also studied the changes in protein expression of c-Myc and fibrosis-related factors after c-Myc gene silencing in IL-1β-stimulated NRK-49F treated with SSR. Results. Shen Shuai II Recipe significantly reduced RIF and downregulated the expression of HIF-1α, c-Myc, and IL-1β proteins in 5/6 (A/I) rats with chronic renal failure. It also inhibited IL-1β secretion from NRK-52E induced by hypoxia, which in turn inhibited fibroblast activation mediated by the IL-1β/c-Myc pathway, and finally reduced the overproduction of the extracellular matrix. Conclusion. The renoprotective effects of SSR in rats with chronic renal failure may be related to its inhibition of hypoxia via the IL-1β/c-Myc pathway. Thus, SSR is a potentially effective drug for delaying the progression of renal interstitial fibrosis.

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 Spectrum and dosing of urate-lowering drugs in a large cohort of chronic kidney disease patients and their effect on serum urate levels: a cross-sectional analysis from the German Chronic Kidney Disease study

2019 ◽  
Author(s):  
Jan T Kielstein ◽  
Markus Heisterkamp ◽  
Jiaojiao Jing ◽  
Jennifer Nadal ◽  
Matthias Schmid ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Multivariate Regression Analysis ◽  
Serum Urate ◽  
Suboptimal Control ◽  
Cross Sectional ◽  
The Mean ◽  
Disease Study ◽  
Sectional Analysis

Abstract Background Despite a plethora of studies on the effect of urate-lowering therapy (ULT) in patients with chronic kidney disease (CKD), current guidelines on the treatment of hyperuricaemia and gout vary, especially concerning the need for dose adjustment of allopurinol, whose main metabolite is accumulating with declining renal function. Data on allopurinol dosing and its relationship to renal function, co-medication and sex and the resulting urate level in large cohorts are missing. Methods We studied a subgroup of 2378 patients of the German Chronic Kidney Disease (GCKD) study to determine prescription patterns of ULT among CKD patients under nephrological care and the relationship of ULT dose to urate levels. Prescription and dosing of ULT were manually abstracted from the patient’s paper charts at the baseline visit, in which all currently used medications and their dosing were recorded. Results In this cohort, 39.6% were women, the mean estimated glomerular filtration rate (eGFR) was 51.3 ± 19.3 mL/min/1.73 m2 and the mean age was 59.0 ± 12.4 years. Of the 2378 examined patients, 666 (28.0%) received ULT. The dose of ULT was available for 572 patients. The main ULT agent was allopurinol (94.4%), followed by febuxostat (2.9%) and benzbromarone (2.6%). Of the 540 patients who used allopurinol with a reported daily dose, 480 had an eGFR <60 mL/min/1.73 m2 and 320 had an eGFR <45 mL/min/1.73 m2, 31.5% of the latter (n = 101) received a dose >150 mg/day, the recommended maximal dose for this level of eGFR. The prescribed dose was not related to eGFR: the median eGFR for patients taking 100, 150 and 300 mg/day was 40 [interquartile range (IQR) 32–49], 43 (34–52) and 42 (35–54) mL/min/1.73 m2, respectively. Patients with lower doses of allopurinol had higher serum urate levels than patients with higher (than recommended) allopurinol doses. Sex, alcohol intake, eGFR, use of diuretics and treatment with allopurinol were independent determinants of serum urate levels in multivariate regression analysis. Conclusions The most frequently used drug to lower serum urate levels in this CKD cohort was allopurinol. Even in patients regularly seen by nephrologists, the dose of allopurinol is often not adjusted to the current eGFR. Patients with higher ULT doses achieved better control of their serum urate levels. Lowering of serum urate in CKD patients requires balancing potential adverse effects of allopurinol with suboptimal control of serum urate levels.

scholarly journals Racial Disparities in End-of-Life Communication and Preferences among Chronic Kidney Disease Patients

2016 ◽  
Vol 44 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Nwamaka D. Eneanya ◽  
Julia B. Wenger ◽  
Katherine Waite ◽  
Stanley Crittenden ◽  
Derya B. Hazar ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
End Of Life ◽  
Cultural Beliefs ◽  
Stage Iv ◽  
Cross Sectional ◽  
Black And White ◽  
Black Patients ◽  
Eol Care ◽  
White Patients

Background: Previous studies on end-of-life (EOL) care among patients with chronic kidney disease (CKD) have been largely limited to White hemodialysis patients. In this study, we sought to explore racial variability in EOL communication, care preferences and advance care planning (ACP) among patients with advanced CKD prior to decisions regarding the initiation of dialysis. Methods: We performed a cross-sectional study between 2013 and 2015 of Black and White patients with stage IV or V CKD (per the Modified Diet in Renal Disease estimation of GFR <30 ml/min/1.73 m2) from 2 academic centers in Boston. We assessed experiences with EOL communication, ACP, EOL care preferences, hospice knowledge, spiritual/religious and cultural beliefs, and distrust of providers. Results: Among 152 participants, 41% were Black. Black patients were younger, had less education, and lower income than White patients (all p < 0.01). Black patients also had less knowledge of hospice compared to White patients (17 vs. 61%, p < 0.01). A small fraction of patients (8%) reported having EOL discussions with their nephrologists and the majority had no advance directives. In multivariable analyses, Blacks were more likely to have not communicated EOL preferences (adjusted OR 2.70, 95% CI 1.08-6.76) and more likely to prefer life-extending treatments (adjusted OR 3.06, 95% CI 1.23-7.60) versus Whites. Conclusions: As Black and White patients with advanced CKD differ in areas of EOL communication, preferences, and hospice knowledge, future efforts should aim to improve patient understanding and promote informed decision-making.

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