scholarly journals Chronic Kidney Disease in Disadvantaged Populations

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
David Martins ◽  
Lawrence Agodoa ◽  
Keith Norris
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Rapid Progression ◽  
Disease Treatment ◽  
Disadvantaged Populations ◽  
Treatment And Prevention ◽  
Prevention Guidelines ◽  
Disproportionate Burden

Disadvantaged populations across the globe exhibit a disproportionate burden of chronic kidney disease (CKD) because of differences in CKD occurrence and outcomes. Although many CKD risk factors can be managed and modified to optimize clinical outcomes, the prevailing socioeconomic and cultural factors in disadvantaged populations, more often than not, militate against optimum clinical outcomes. In addition, disadvantaged populations exhibit a broader spectrum of CKD risk factors and may be genetically predisposed to an earlier onset and a more rapid progression of chronic kidney disease. A basic understanding of the vulnerabilities of the disadvantaged populations will facilitate the adaptation and adoption of the kidney disease treatment and prevention guidelines for these vulnerable populations. The purpose of this paper is to examine recent discoveries and data on CKD occurrence and outcomes in disadvantaged populations and explore strategies for the prevention and treatment of CKD in these populations based on the established guidelines.

scholarly journals Clustering Heatmap for Visualizing and Exploring Complex and High-dimensional Data Related to Chronic Kidney Disease

2020 ◽  
Vol 9 (2) ◽  
pp. 403 ◽  
Author(s):  
Cheng-Sheng Yu ◽  
Chang-Hsien Lin ◽  
Yu-Jiun Lin ◽  
Shiyng-Yu Lin ◽  
Sen-Te Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Complex Disease ◽  
Early Recognition ◽  
Adverse Outcomes ◽  
Rapid Decline ◽  
Rapid Progression

Background: Preventive medicine and primary health care are essential for patients with chronic kidney disease (CKD) because the symptoms of CKD may not appear until the renal function is severely compromised. Early identification of the risk factors of CKD is critical for preventing kidney damage and adverse outcomes. Early recognition of rapid progression to advanced CKD in certain high-risk populations is vital. Methods: This is a retrospective cohort study, the population screened and the site where the study has been performed. Multivariate statistical analysis was used to assess the prediction of CKD as many potential risk factors are involved. The clustering heatmap and random forest provides an interactive visualization for the classification of patients with different CKD stages. Results: uric acid, blood urea nitrogen, waist circumference, serum glutamic oxaloacetic transaminase, and hemoglobin A1c (HbA1c) were significantly associated with CKD. CKD was highly associated with obesity, hyperglycemia, and liver function. Hypertension and HbA1c were in the same cluster with a similar pattern, whereas high-density lipoprotein cholesterol had an opposite pattern, which was also verified using heatmap. Early staged CKD patients who are grouped into the same cluster as advanced staged CKD patients could be at high risk for rapid decline of kidney function and should be closely monitored. Conclusions: The clustering heatmap provided a new predictive model of health care management for patients at high risk of rapid CKD progression. This model could help physicians make an accurate diagnosis of this progressive and complex disease.

scholarly journals Circulating Lactonase Activity but Not Protein Level of PON-1 Predicts Adverse Outcomes in Subjects with Chronic Kidney Disease

2019 ◽  
Vol 8 (7) ◽  
pp. 1034 ◽  
Author(s):  
Chrysan J. Mohammed ◽  
Yanmei Xie ◽  
Pamela S. Brewster ◽  
Subhanwita Ghosh ◽  
Prabhatchandra Dube ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Prognostic Value ◽  
Oxidant Stress ◽  
Adverse Outcomes ◽  
Protein Levels ◽  
Traditional Risk Factors ◽  
Apparently Healthy

The burden of cardiovascular disease and death in chronic kidney disease (CKD) outpaces that of the other diseases and is not adequately described by traditional risk factors alone. Diminished activity of paraoxonase (PON)-1 is associated with increased oxidant stress, a common feature underlying the pathogenesis of CKD. We aimed to assess the prognostic value of circulating PON-1 protein and PON lactonase activity on adverse clinical outcomes across various stages and etiologies of CKD. Circulating PON-1 protein levels and PON lactonase activity were measured simultaneously in patients with CKD as well as a cohort of apparently healthy non-CKD subjects. Both circulating PON-1 protein levels and PON lactonase activity were significantly lower in CKD patients compared to the non-CKD subjects. Similarly, across all stages of CKD, circulating PON-1 protein and PON lactonase activity were significantly lower in patients with CKD compared to the non-CKD controls. Circulating PON lactonase activity, but not protein levels, predicted future adverse clinical outcomes, even after adjustment for traditional risk factors. The combination of lower circulating protein levels and higher activity within the CKD subjects were associated with the best survival outcomes. These findings demonstrate that diminished circulating PON lactonase activity, but not protein levels, predicts higher risk of future adverse clinical outcomes in patients with CKD.

scholarly journals Elevated potassium levels in patients with chronic kidney disease: occurrence, risk factors and clinical outcomes—a Danish population-based cohort study

2017 ◽  
Vol 33 (9) ◽  
pp. 1610-1620 ◽  
Author(s):  
Reimar W Thomsen ◽  
Sia K Nicolaisen ◽  
Pål Hasvold ◽  
Ricardo Garcia Sanchez ◽  
Lars Pedersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Population Based ◽  
Danish Population ◽  
Disease Occurrence

scholarly journals Predictive factors of rapid linear renal progression and mortality in patients with chronic kidney disease

2020 ◽  
Author(s):  
Ibrahim Ali ◽  
Rajkumar Chinnadurai ◽  
Sara T. Ibrahim ◽  
Darren Green ◽  
Philip Kalra
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Pressure ◽  
Adverse Outcomes ◽  
Cox Proportional Hazards Model ◽  
Rapid Progression ◽  
Ckd Progression ◽  
Factors Associated ◽  
Rapid Progressors

Abstract Background Risk factors predictive of rapid linear chronic kidney disease (CKD) progression and its associations with end-stage renal disease (ESRD) and mortality requires further exploration, particularly as patients with linear eGFR trajectory represent a clear paradigm for understanding true CKD progression. Methods A linear regression slope was applied to all outpatient estimated glomerular filtration rate (eGFR) values for patients in the Salford Kidney Study who had ≥2years follow-up, ≥4 eGFR values and baseline CKD stages 3a-4. An eGFR slope (ΔeGFR) of ≤-4ml/min/1.73m2/yr defined rapid progressors, whereas -0.5 to +0.5ml/min/1.73m2/yr defined stable patients. Binary logistic regression was utilised to explore variables associated with rapid progression and Cox proportional hazards model to determine predictors for mortality prior to ESRD. Results There were 157 rapid progressors (median ΔeGFR -5.93ml/min/1.73m2/yr) and 179 stable patients (median ΔeGFR -0.03ml/min/1.73m2/yr). Over 5 years, rapid progressors had an annual rate of mortality or ESRD of 47 per 100 patients compared with 6 per 100 stable patients. Factors associated with rapid progression included younger age, female gender, higher diastolic pressure, higher total cholesterol:high density lipoprotein ratio, lower albumin, lower haemoglobin and a urine protein:creatinine ratio of >50g/mol. The latter three factors were also predictive of mortality prior to ESRD, along with older age, smoking, peripheral vascular disease and heart failure. Conclusions There is a heterogenous interplay of risk factors associated with rapid linear CKD progression and mortality in patients with CKD. Furthermore, rapid progressors have high rates of adverse outcomes and require close specialist monitoring.

scholarly journals Predictive Factors of Rapid Linear Renal Progression and Mortality in Patients with Chronic Kidney Disease

2020 ◽  
Author(s):  
Ibrahim Ali ◽  
Rajkumar Chinnadurai ◽  
Sara T. Ibrahim ◽  
Darren Green ◽  
Philip Kalra
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Pressure ◽  
Adverse Outcomes ◽  
Cox Proportional Hazards Model ◽  
Rapid Progression ◽  
Ckd Progression ◽  
Factors Associated ◽  
Rapid Progressors

Abstract Background: Risk factors predictive of rapid linear chronic kidney disease (CKD) progression and its associations with end-stage renal disease (ESRD) and mortality requires further exploration, particularly as patients with linear eGFR trajectory represent a clear paradigm for understanding true CKD progression.Methods: A linear regression slope was applied to all outpatient estimated glomerular filtration rate (eGFR) values for patients in the Salford Kidney Study who had ≥ 2 years follow-up, ≥ 4 eGFR values and baseline CKD stages 3a-4. An eGFR slope (ΔeGFR) of ≤-4 ml/min/1.73 m2/yr defined rapid progressors, whereas − 0.5 to + 0.5 ml/min/1.73 m2/yr defined stable patients. Binary logistic regression was utilised to explore variables associated with rapid progression and Cox proportional hazards model to determine predictors for mortality prior to ESRD.Results: There were 157 rapid progressors (median ΔeGFR − 5.93 ml/min/1.73 m2/yr) and 179 stable patients (median ΔeGFR − 0.03 ml/min/1.73 m2/yr). Over 5 years, rapid progressors had an annual rate of mortality or ESRD of 47 per 100 patients compared with 6 per 100 stable patients. Factors associated with rapid progression included younger age, female gender, higher diastolic pressure, higher total cholesterol:high density lipoprotein ratio, lower albumin, lower haemoglobin and a urine protein:creatinine ratio of > 50 g/mol. The latter three factors were also predictive of mortality prior to ESRD, along with older age, smoking, peripheral vascular disease and heart failure.Conclusions: There is a heterogenous interplay of risk factors associated with rapid linear CKD progression and mortality in patients with CKD. Furthermore, rapid progressors have high rates of adverse outcomes and require close specialist monitoring.

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