Prevalence and risk factors of acquired long QT syndrome in hospitalized patients with chronic kidney disease

2018 ◽  
Vol 67 (2) ◽  
pp. 289-294 ◽  
Author(s):  
Peng Liu ◽  
Dan Han ◽  
Xuanzi Sun ◽  
Hui Tan ◽  
Zhigang Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Serum Potassium ◽  
Hospitalized Patients ◽  
Qtc Prolongation ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Qt Syndrome

Patients with chronic kidney disease (CKD) have a high risk of fatal arrhythmias. The extended severe corrected QT (QTc) interval is a hallmark of ventricular arrhythmias and sudden cardiac death. The objective of this study was to evaluate the prevalence of acquired long QT syndrome (aLQTS) in hospitalized patients with CKD and search for potential risk factors to improve clinical risk stratification in patients with CKD. Information about patients with CKD was retrospectively collected in our hospital between January 2013 and June 2017. The prevalence of aLQTS in different stages of CKD was evaluated. The common risk factors for QTc prolongation in patients with CKD were compiled, and multivariable logistic regression analysis was used to evaluate how each factor was related to aLQTS in CKD. A total of 804 patients with CKD (299 females, 37.2%) participated in our study. The prevalence of aLQTS among all 804 patients was 56.97%, and the prevalence of QTc prolongation (>500 ms) was 10.07%. Among the elderly, impaired kidney function, hemodialysis, low serum potassium and low left ventricular ejection fraction (LVEF) were associated with QTc prolongation in patients with CKD. The prevalence of aLQTS is much higher and increases with the decline of kidney function in hospitalized patients with CKD, which is related to older age, impaired kidney function, hemodialysis, serum potassium and low LVEF.

scholarly journals Acquired long QT syndrome in chronic kidney disease patients

Renal Failure ◽  
2019 ◽  
Vol 42 (1) ◽  
pp. 54-65 ◽  
Author(s):  
Peng Liu ◽  
Lu Wang ◽  
Dan Han ◽  
Chaofeng Sun ◽  
Xiaolin Xue ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Long Qt Syndrome ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Qt Syndrome

scholarly journals Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress

2020 ◽  
Vol 44 ◽  
pp. 1 ◽  
Author(s):  
Catharina Wesseling ◽  
Jason Glaser ◽  
Julieta Rodríguez-Guzmán ◽  
Ilana Weiss ◽  
Rebekah Lucas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Heat Stress ◽  
Kidney Disease ◽  
Kidney Function ◽  
Population Based ◽  
Occupational Risk Factors ◽  
Infectious Risk ◽  
Main Driver ◽  
Low Prevalence

The death toll of the epidemic of chronic kidney disease of nontraditional origin (CKDnt) in Mesoamerica runs into the tens of thousands, affecting mostly young men. There is no consensus on the etiology. Anecdotal evidence from the 1990s pointed to work in sugarcane; pesticides and heat stress were suspected. Subsequent population-based surveys supported an occupational origin with overall high male-female ratios in high-risk lowlands, but small sex differences within occupational categories, and low prevalence in non-workers. CKDnt was reported in sugarcane and other high-intensity agriculture, and in non-agricultural occupations with heavy manual labor in hot environments, but not among subsistence farmers. Recent studies with stronger designs have shown cross-shift changes in kidney function and hydration biomarkers and cross-harvest kidney function declines related to heat and workload. The implementation of a water-rest-shade intervention midharvest in El Salvador appeared to halt declining kidney function among cane cutters. In Nicaragua a water-rest-shade program appeared sufficient to prevent kidney damage among cane workers with low-moderate workload but not among cutters with heaviest workload. Studies on pesticides and infectious risk factors have been largely negative. Non-occupational risk factors do not explain the observed epidemiologic patterns. In conclusion, work is the main driver of the CKDnt epidemic in Mesoamerica, with occupational heat stress being the single uniting factor shown to lead to kidney dysfunction in affected populations. Sugarcane cutters with extreme heat stress could be viewed as a sentinel occupational population. Occupational heat stress prevention is critical, even more so in view of climate change.

scholarly journals Risk Factors Associated with Mortality among Chronic Kidney Disease Patients on Regular Hemodialysis Presenting in Emergency Services

2021 ◽  
Vol 2 (1) ◽  
pp. 001-007
Author(s):  
Tirtha Man Shrestha ◽  
Laxman Bhusal ◽  
Ram Prasad Neupane ◽  
Rajan Ghimire ◽  
Pratap Narayan Prasad
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Emergency Room ◽  
Serum Potassium ◽  
Potassium Level ◽  
Emergency Visit ◽  
Survivor Group ◽  
Regular Hemodialysis

Background: With the increasing number of Chronic Kidney Disease (CKD), emergency visit of these patients is also increasing. This study tried to find some of the reasons for which patients with CKD visit the emergency room and the reasons for their mortality. Method: A cross-sectional study was done in the emergency room of Tribhuvan University Teaching Hospital, Kathmandu, Nepal. We conducted this study from 1 May 2018 to 31 October 2018 among the adult CKD patients under regular hemodialysis. We used a convenience sampling method. Three hundred patients were included. We studied the following variables: patient’s age, sex, risk factors, laboratory parameter during the emergency visit (viz. hemoglobin, pH, serum bicarbonate level, and potassium level), emergency hemodialysis, blood transfusion, and clinical outcome during emergency room stay. Result: We enrolled 300 patients in the study. The mean age was 45.04 years in the mortality group and 45.69 years in the survival group 152 (50.7%) of patients had hypertension. Mean hemoglobin was 6.52gm% (SD = 1.93). Mean hemoglobin in survivor and the non-survivor group was 6.59 gm% and 5.58 gm% respectively. Serum creatinine was 1220.87 micromol/l and 1064.01 micromol/l in mortality and survivor group respectively. Likewise, serum potassium was 6.13 mEq/l and 5.74 mEq/l among mortality and survivor groups respectively. Binary logistic regression showed significant association (p <0.05) of anemia, emergency dialysis and presence of sepsis with the mortality. There was significant correlation of presence of comorbidities, anemia, serum creatinine, serum potassium level, and sepsis with mortality. Area under the Receiver Operating Curve to predict mortality among CKD patients was 0.660 for potassium and 0.598 for serum creatinine. Conclusion: Anemia, increased serum creatinine, and hyperkalemia was significantly correlated with mortality in chronic kidney disease and were causes of frequent visits in the emergency room. Therefore, we should address these factors during the management of CKD patients.

scholarly journals Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243191
Author(s):  
Kunchok Dorjee ◽  
Hyunju Kim ◽  
Elizabeth Bonomo ◽  
Rinchen Dolma
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Severe Disease ◽  
Hospitalized Patients ◽  
Smoking History ◽  
The Us

Introduction Progression of COVID-19 to severe disease and death is insufficiently understood. Objective Summarize the prevalence of risk factors and adverse outcomes and determine their associations in COVID-19 patients who were hospitalized. Methods We searched Medline, Embase and Web of Science for case-series and observational studies of hospitalized COVID-19 patients through August 31, 2020. Data were analyzed by fixed-effects meta-analysis using Shore’s adjusted confidence intervals to address heterogeneity. Results Seventy-seven studies comprising 38906 hospitalized patients met inclusion criteria; 21468 from the US-Europe and 9740 from China. Overall prevalence of death [% (95% CI)] from COVID-19 was 20% (18–23%); 23% (19–27%) in the US and Europe and 11% (7–16%) for China. Of those that died, 85% were aged≥60 years, 66% were males, and 66%, 44%, 39%, 37%, and 27% had hypertension, smoking history, diabetes, heart disease, and chronic kidney disease (CKD), respectively. The case fatality risk [%(95% CI)] were 52% (46–60) for heart disease, 51% (43–59) for COPD, 48% (37–63) for chronic kidney disease (CKD), 39% for chronic liver disease (CLD), 28% (23–36%) for hypertension, and 24% (17–33%) for diabetes. Summary relative risk (sRR) of death were higher for age≥60 years [sRR = 3.6; 95% CI: 3.0–4.4], males [1.3; 1.2–1.4], smoking history [1.3; 1.1–1.6], COPD [1.7; 1.4–2.0], hypertension [1.8; 1.6–2.0], diabetes [1.5; 1.4–1.7], heart disease [2.1; 1.8–2.4], CKD [2.5; 2.1–3.0]. The prevalence of hypertension (55%), diabetes (33%), smoking history (23%) and heart disease (17%) among the COVID-19 hospitalized patients in the US were substantially higher than that of the general US population, suggesting increased susceptibility to infection or disease progression for the individuals with comorbidities. Conclusions Public health screening for COVID-19 can be prioritized based on risk-groups. Appropriately addressing the modifiable risk factors such as smoking, hypertension, and diabetes could reduce morbidity and mortality due to COVID-19; public messaging can be accordingly adapted.

scholarly journals Disparities in Chronic Kidney Disease Progression by Medicare Advantage Enrollees

2021 ◽  
pp. 949-957
Author(s):  
Clarissa Jonas Diamantidis ◽  
Lindsay Zepel ◽  
Virginia Wang ◽  
Valerie A. Smith ◽  
Sarah Hudson Scholle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Race And Ethnicity ◽  
Fixed Effects ◽  
Geographic Location ◽  
Study Entry ◽  
Medicare Advantage ◽  
Ckd Progression

<b><i>Introduction:</i></b> The prevalence of chronic kidney disease (CKD) in Medicare beneficiaries has quadrupled in the past 2 decades, but little is known about risk factors affecting the progression of CKD. This study aims to understand the progression in Medicare Advantage enrollees and whether it differs by provider recognition of CKD, race and ethnicity, or geographic location. In a large cohort of Medicare Advantage (MA) enrollees, we examined whether CKD progression, up to 5 years after study entry, differed by demographic and clinical factors and identified additional risk factors of CKD progression. <b><i>Methods:</i></b> In a cohort of 1,002,388 MA enrollees with CKD stages 1–4 based on 2013–2018 labs, progression was estimated using a mixed-effects model that adjusted for demographics, geographic location, comorbidity, urine albumin-to-creatinine ratio, clinical recognition via diagnosed CKD, and time-fixed effects. Race and ethnicity, geographic location, and clinical recognition of CKD were interacted with time in 3 separate regression models. <b><i>Results:</i></b> Mean (median) follow-up was 3.1 (3.0) years. Black and Hispanic MA enrollees had greater kidney function at study entry than other beneficiaries, but their kidney function declined faster. MA enrollees with clinically recognized CKD had estimated glomerular filtration rate levels that were 18.6 units (95% confidence interval [CI]: 18.5–18.7) lower than levels of unrecognized patients, but kidney function declined more slowly in enrollees with clinical recognition. There were no differences in CKD progression by geography. After removal of the race coefficient from the eGFR equation in a sensitivity analysis, kidney function was much lower in all years among Black MA enrollees, but patterns of progression remained the same. <b><i>Discussion/Conclusions:</i></b> These results suggest that patients with clinically recognized CKD and racial and ethnic minorities merit closer surveillance and management to reduce their risk of faster progression.

scholarly journals Predictive Value of Creatinine-based Equations of Kidney Function in the Long-term Prognosis in United Arab Emirates Patients

2021 ◽  
Vol 36 (1) ◽  
pp. e217-e217
Author(s):  
Saif Al-Shamsi ◽  
Romona D. Govender ◽  
Jeffrey King
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Mortality Prediction ◽  
The Body ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Objectives: Chronic kidney disease (CKD) is an independent predictor of mortality. Several creatinine-based equations are used to assess the estimated glomerular filtration rate or creatinine clearance and mortality prediction in various ethnic populations. Similarly, renal insufficiency is associated with poor prognosis of UAE nationals with cardiovascular disease (CVD) risk factors. However, the equation that best assesses prognosis among these patients is unknown. This study aimed to compare the prognostic abilities of different creatinine-based kidney function equations for predicting all-cause mortality in UAE nationals with vascular comorbidities. Methods: This retrospective observational study analyzed 1186 patients (54.0% men) with CVD risk factors. Multivariable Cox regression analysis was used to evaluate the associations of categorical renal function stages with all-cause mortality. Measures of performance in each equation assessed with respect to all-cause mortality were evaluated and compared to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation by calculating the C-index, net reclassification index (NRI), and integrated discrimination index. Results: Over a median follow-up of 8.9 years, the cumulative incidence of all-cause mortality was 9.4% (n = 112). After multivariable adjustment, the discriminative ability for all-cause mortality was significantly higher in the body surface area-adjusted Cockcroft-Gault (BSA-CG) formula than in the CKD-EPI equation (C-indices: 0.869 vs. 0.861, respectively, p =0.037). NRI was significantly positive and favored the BSA-CG formula (0.54; 95% confidence interval: 0.35–0.64) compared to the CKD-EPI equation. Conclusions: Our findings suggest that the BSA-CG equation may have the potential to slightly improve mortality prediction compared to the CKD-EPI equation in UAE nationals with vascular risk. Further large multicenter studies are warranted to confirm our findings.

Stratification and Assessment of Risk Factors of Chronic Kidney Disease in Hospitalized Patients

2020 ◽  
Vol 49 (2) ◽  
pp. 19-24
Author(s):  
Mohammad Kamrul Hasan ◽  
Md Haidar Ali ◽  
Md Ashikur Rahman ◽  
Mariam Mille ◽  
Ashiqur Rahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Salt Intake ◽  
Kidney Diseases ◽  
Hospitalized Patients ◽  
Health Concern ◽  
Global Public Health ◽  
College Hospital ◽  
Female Ratio

Chronic kidney disease (CKD) has become a global public health concern. The adverse outcome of CKD are high in number in developing countries due to scarcity of facilities for renal replacement therapy and high cost of services for management of ESRD. It is one of the leading cause of hospital deaths. CKD is strongly associated with diabetes, hypertension, glomerulonephritis and elevated lipids.  Therefore, identifying the preventable risk factors, pathophysiological mechanisms and stratification of CKD helps in decreasing and slowing its progression. This study was conducted for the staging of chronic kidney disease (CKD) and assessment of the risk factors with CKD in hospitalized patients of Dhaka Medical College Hospital in collaboration with Medicine and Nephrology department. This was a cross sectional observational study where 125 patients having chronic kidney diseases (CKD) were diagnosed on the basis of history, clinical examinations and investigations, who had fulfill the inclusion and exclusion criteria admitted in the department of medicine and department of nephrology from January to December 2016. Sampling method was purposive sampling. A specifically designed questionnaire were used to get the personal and medical history data. Blood and urine samples were collected and data was analyzed using SPSS (22.00). Out of 125 patients, no Stage-1 patient was found, remaining were   Stage- 2 CKD 7.2%, Stage- 3 CKD 63.2%, Stage- 4 CKD was 25.6%,  and  Stage- 5 CKD was 4%. Among 125 participants, 52.0% had glomerulonephritis (GN), 31.2% had diabetes mellitus (DM) and 9.6% had hypertension (HTN). Mean age was 48.41 (±13.99) years, mean body weight was 50.61 (±10.73) Kg, mean BMI was 22.9 (±1.69), male female ratio was 3.6:1.  Age group 51 to 60 years were suffering more. The association between CKD and other risk factors including obesity and overweight, use of tobacco, diabetes and hypertension were highly significant. The commonest risk factors for CKD like DM and HTN are also alarmingly high and obviously adding to the existing burden of CKD. Early detection of the risk factors of CKD, early referral to nephrologist, appropriate treatment of hypertension, DM, GN and other risk factors, life style modification with specific emphasis on reduction in salt intake, physical exercise, and abstinence from smoking would retard progression of kidney disease to an advanced stage. Bangladesh Med J. 2020 May; 49(2) : 19-24

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