The Relationship between Health-Promoting Behaviors and Resilience in Patients with Chronic Kidney Disease

This cross-sectional research study explored differences in health-promoting behavior and resilience among three groups of chronic kidney disease patients (high-risk, early chronic kidney disease; early CKD and pre-end stage renal disease; pre-ESRD) treated at the Nephrology outpatient clinic in northern Taiwan. A total of 150 CKD outpatients were interviewed using structured questionnaires including a CKD Health to Promote Lifestyle Scale, and resilience scale. We found that the pre-ESRD group had lower resilience than either high-risk or early CKD groups. Factors affecting pre-ESRD resilience were gender, occupational status, diabetes and health-promoting behaviors. Factors affecting resilience of the high-risk group included level of education and health-promoting behaviors while factors affecting resilience in the early CKD group involved whether they are employed and health promoting behaviors. A significant positive correlation was found between health promoting behavior and resilience in all study subjects. Multiple regression analysis found that factors which could effectively predict resilience in patients at high-risk for CKD were gender, whether the patient had a job, nutrition, self-actualization, and stress level, accounting for 69.7% of the variance. Therefore, nursing education should focus on health promotion advocacy throughout the life of not only patients but also their families.

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Potentially inappropriate prescribing in people with chronic kidney disease: cross-sectional analysis of a large population cohort

British Journal of General Practice ◽

10.3399/bjgp.2020.0871 ◽

2020 ◽

pp. BJGP.2020.0871

Author(s):

Clare Elizabeth MacRae ◽

Stewart Mercer ◽

Bruce Guthrie

Keyword(s):

Chronic Kidney Disease ◽

High Risk ◽

Kidney Disease ◽

Large Population ◽

Inappropriate Prescribing ◽

Prescribing Patterns ◽

Potentially Inappropriate Prescribing ◽

Cross Sectional ◽

Stage 4 ◽

Ckd Stage

Background: Many drugs should be avoided or require dose-adjustment in chronic kidney disease (CKD). Previous estimates of potentially inappropriate prescribing rates have been based on data on a limited number of drugs and mainly in secondary care settings. Aim: To determine the prevalence of contraindicated and potentially inappropriate primary care prescribing in a complete population of people with CKD. Method: Cross-sectional study of prescribing patterns in a complete geographical population of people with CKD defined using laboratory data. Drugs were organised by British National Formulary advice. Contraindicated (CI) drugs: “avoid”. Potentially high risk (PHR) drugs: “avoid if possible”. Dose inappropriate (DI) drugs: dose exceeded recommended maximums. Results: 28,489 people with CKD were included in analysis, of whom 70.0% had CKD 3a, 22.4% CKD 3b, 5.9% CKD 4, and 1.5% CKD 5. 3.9% (95%CI 3.7-4.1) of people with CKD stages 3a-5 were prescribed one or more CI drug, 24.3% (95%CI 23.8-24.8) PHR drug, and 15.2% (95% CI 14.8-15.62) DI drug. CI drugs differed in prevalence by CKD stage, and were most commonly prescribed in CKD stage 4 with a prevalence of 36.0% (95%CI 33.7–38.2). PHR drugs were commonly prescribed in all CKD stages ranging from 19.4% (95%CI 17.6-21.3) in stage 4 to 25.1% (95%CI 24.5–25.7) in stage 3b. DI drugs were most commonly prescribed in stage 4, 26.4% (95%CI 24.3-28.6). Conclusion: Potentially inappropriate prescribing is common at all stages of CKD. Development and evaluation of interventions to improve prescribing safety in this high-risk populations are needed.

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Pediatric problems of stratification of the severity of stages, cardiovascular complications and renal forecast of chronic kidney disease by NKF-K / DOQI (2002) and KDIGO (2012) classifications

Nephrology (Saint-Petersburg) ◽

10.36485/1561-6274-2021-25-3-9-19 ◽

2021 ◽

Vol 25 (3) ◽

pp. 9-19

Author(s):

N. D. Savenkova ◽

O. P. Grigoreva

Keyword(s):

Chronic Kidney Disease ◽

High Risk ◽

Kidney Disease ◽

Pediatric Patients ◽

Cardiovascular Complications ◽

High Risk Group ◽

Cardiovascular Pathology ◽

Cardiovascular Prognosis ◽

Renal Prognosis

Chronic kidney disease (CKD) in children is a global problem worldwide. The article discusses the problem of stratification of CKD severity according to the classifications of the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI) (2002) and Kidney Disease Improving Global Outcomes (KDIGO) (2012) in pediatric patients. There are limitations in assessing severity of CKD stages C1-5 according to NKF-K / DOQI (2002) and KDIGO (2012) in children under 2 years of age who have a low glomerular filtration rate in contrast to adults. The stratification of the severity of stages 1-5 of CKD, cardiovascular complications and renal prognosis in children and adolescents according to the classifications NKF-K / DOQI (2002) [3] and KDIGO (2012) [14] are discussed. In adult patients with CKD, there is a compelling case for identifying of C3a and C3b sub stages in 3 stages of CKD according to KDIGO (2012) was that renal and cardiovascular prognosis are different with GFR 45-59 ml/min/1.73 m 2and GFR 30-44 ml/min/1.73 m 2 . The prognosis of the risk of developing cardiovascular diseases and complications for stages C2-5 in accordance with the KDIGO classification (2012) in children and adults differ. As follows from the publications, children with CKD in the pre-dialysis stages C2-4 form a high-risk group, with C4-5 on dialysis a group of very high risk of complications associated with cardiovascular pathology. Cardiovascular complications account for more than 30 % of all deaths of pediatric patients with CKD C4-5 on dialysis. The arguments justifying the allocation of CKD stages C1-5 in children under 2 years of age in accordance with the classification of NKF-K/DOQI (2002) are presented.

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The Effect of Admission Renal Function on the Treatment and Outcome of Patients with Acute Coronary Syndrome

Cardiorenal Medicine ◽

10.1159/000455239 ◽

2017 ◽

Vol 7 (3) ◽

pp. 169-178 ◽

Cited By ~ 4

Author(s):

Zach Rozenbaum ◽

Sydney Benchetrit ◽

Saar Minha ◽

Yoram Neuman ◽

Meital Shlezinger ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Acute Coronary Syndrome ◽

Renal Function ◽

High Risk ◽

Kidney Disease ◽

Angiotensin Receptor Blockers ◽

High Risk Group ◽

Inverse Association ◽

Invasive Treatment ◽

Coronary Syndrome

Background: Chronic kidney disease is a frequent comorbidity among patients with acute coronary syndrome (ACS). We aimed to evaluate treatment characteristics in ACS patients according to their renal function and to assess the effect of differences in therapy on clinical outcomes. Methods: Included were patients with ACS enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) during 2000-2013. Excluded were patients with cardiogenic shock at presentation. The estimated glomerular filtration rate (eGFR) was calculated using the simplified Modification of Diet in Renal Disease (MDRD) formula. The distribution of the eGFRs was divided into 4 categories (<45, 45-59.9, 60-74.9, and ≥75 mL/min/1.73 m2). The primary endpoint was all-cause mortality at 1 year. Results: A total of 13,194 patients with ACS were included. Patients with a reduced eGFR were less likely to be admitted to a coronary care unit and had lower rates of coronary angiograms and subsequent percutaneous coronary interventions. Furthermore, as the eGFR was lower, the patients were less frequently treated with aspirin, clopidogrel, β-blockers, and ACE inhibitors/angiotensin receptor blockers. We demonstrated an inverse association between renal function and 1-year mortality, with the highest mortality rates observed in the group with the lowest eGFR (HR = 3.8, 95% CI 2.9-4.9, p < 0.0001). Differences in mortality remained significant following a multivariate analysis for all the baseline characteristics as well as for invasive and medical treatment (HR = 2.7, 95% CI 1.9-3.7, p < 0.0001). Conclusions: ACS patients with chronic kidney disease represent a high-risk group with an increased mortality risk. Despite this high risk, these patients are less frequently selected for an invasive treatment strategy and are less commonly treated with guideline-based medications. However, reduced renal function was associated with higher mortality regardless of the variations in therapy.

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THE PREDICTING FACTORS FOR CHRONIC KIDNEY DISEASE AMONG HIGH-RISK POPULATION IN LOWER NORTHERN, THAILAND

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.20/no.2/art.357 ◽

2020 ◽

Vol 20 (2) ◽

pp. 268-275

Author(s):

Primprapha Konkaew ◽

Pattama Suphunnakul

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Health Literacy ◽

High Risk ◽

Kidney Disease ◽

Sampling Technique ◽

High Risk Population ◽

Cross Sectional ◽

Risk Population ◽

High Risk Populations

This research aimed to explore the factors predicting chronic kidney disease (CKD) in the high-risk population. A cross-sectional study had been conducted in the high-risk populations investigated with and without CKD were the participants. A total of 1,463 samples was enrolled by a multistage sampling technique was used to recruit participants from five provinces in the lower northern of Thailand. Data were collected using a questionnaire and analyzed with descriptive statistics, and binary logistic regression. The results were revealed the risk factors affecting CKD including aged, dyslipidemia, being ill of diabetes mellitus, being unable to control blood pressure, being unable to control blood sugar level, taking add more salty seasoning to the cooked food, cooking with sodium salt over the prescribed amount, using the non-steroidal anti-inflammatory drug, lack of exercise, herbal plants consumption as drugs that are toxic to the kidney, edema, foamy urine, and nocturia. All risk factors were able to co-predict the risk to CKD about 83.2% at the 0.05 level of significance. Therefore, to prevent early states with CKD in the high-risk populations, the focus should be on encouraging health literacy because health literary it has a positive relationship with health-promoting behaviors. The health care provider needs to concentrate on increasing health literacy for self– management with them.

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PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS AMONG PATIENTS OF CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL FROM ASSAM: A CROSS-SECTIONAL STUDY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i11.717 ◽

2019 ◽

Vol 3 (11) ◽

Author(s):

Hamad Jeelani ◽

Manzoor A. Parry ◽

Shruti Dange

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Factors Affecting ◽

Prevalence Of Depression

Background: Chronic kidney disease (CKD) patients are at high risk of depressive disorders because of considerable psychological stress due to physical and social changes brought on by disease. The aim of this study is to assess the prevalence of depression in patients with CKD and the factors affecting it at a public tertiary care hospital. Methods: This cross-sectional study was carried out at the renal clinic of a tertiary care hospital. Data on 629 patients diagnosed with CKD from September 2014 to April 2016 was obtained. Nine-item Patient Health Questionnaire from PRIME-MD was used to assess the depression. Results: Of all the patients, 44.7% had depression. Mild depression was found to affect 28.9% of the patients followed by moderate depression and severe depression (15.4% and 0.4%, respectively). According to multiple logistic regression, the occurrence of depression was significantly higher with age below 60 years [odds ratio (OR) 1.5, 0.9–2.7; P<0.05], male gender (OR 1.4, 1.0–3.1; P<0.05), no treatment funding (OR 2.7, 1.3–4.6; P<0.05), education less than grade 12 (OR 1.3, 1.3–3.2; P<0.05), monthly income ≤INR 20,000 (OR 1.6, 1.1–3.6; P<0.05), CKD stage V (OR 1.4 1.0– 2.9; P <0.05), Patients on hemodialysis (HD) (OR 2.5, 1.2–4.5; P<0.05), comorbidities ≥3 (OR 1.6, 1.3–3.0; P<0.05), overweight (OR 2.4, 1.3–2.9; P<0.05), and duration of CKD >2 (OR 2.4, 1.4–4.4; P<0.05). Conclusion: About 44.7% of the patients were found to have depression. Patients’ age, gender, body mass index, treatment funding, education status, income, CKD duration and stage, HD status, and comorbidities were found to be significant factors affecting depression.

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Prescription of high-risk medications among patients with chronic kidney disease: a cross-sectional study from the Washington, Wyoming, Alaska, Montana and Idaho region Practice and Research Network

Family Practice ◽

10.1093/fampra/cmy001 ◽

2018 ◽

Vol 35 (5) ◽

pp. 589-594 ◽

Cited By ~ 1

Author(s):

Janelle Guirguis-Blake ◽

Gina A Keppel ◽

John Holmes ◽

Rex W Force ◽

William Kriegsman ◽

...

Keyword(s):

Chronic Kidney Disease ◽

High Risk ◽

Kidney Disease ◽

Cross Sectional Study ◽

Research Network ◽

Sectional Study ◽

Cross Sectional

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International prescribing patterns and polypharmacy in older people with advanced chronic kidney disease: results from the European Quality study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa064 ◽

2020 ◽

Cited By ~ 2

Author(s):

Samantha Hayward ◽

Barnaby Hole ◽

Rachel Denholm ◽

Polly Duncan ◽

James E Morris ◽

...

Keyword(s):

Chronic Kidney Disease ◽

High Risk ◽

Kidney Disease ◽

Older People ◽

Reference Group ◽

Practice Variation ◽

High Risk Group ◽

Prescribing Patterns ◽

International Differences ◽

Cardiovascular Medications

Abstract Background People with chronic kidney disease (CKD) are at high risk of polypharmacy. However, no previous study has investigated international prescribing patterns in this group. This article aims to examine prescribing and polypharmacy patterns among older people with advanced CKD across the countries involved in the European Quality (EQUAL) study. Methods The EQUAL study is an international prospective cohort study of patients ≥65 years of age with advanced CKD. Baseline demographic, clinical and medication data were analysed and reported descriptively. Polypharmacy was defined as ≥5 medications and hyperpolypharmacy as ≥10. Univariable and multivariable linear regressions were used to determine associations between country and the number of prescribed medications. Univariable and multivariable logistic regression were used to determine associations between country and hyperpolypharmacy. Results Of the 1317 participants from five European countries, 91% were experiencing polypharmacy and 43% were experiencing hyperpolypharmacy. Cardiovascular medications were the most prescribed medications (mean 3.5 per person). There were international differences in prescribing, with significantly greater hyperpolypharmacy in Germany {odds ratio (OR) 2.75 [95% confidence interval (CI) 1.73–4.37]; P < 0.001, reference group UK}, the Netherlands [OR 1.91 (95% CI 1.32–2.76); P = 0.001] and Italy [OR 1.57 (95% CI 1.15–2.15); P = 0.004]. People in Poland experienced the least hyperpolypharmacy [OR 0.39 (95% CI 0.17–0.87); P = 0.021]. Conclusions Hyperpolypharmacy is common among older people with advanced CKD, with significant international differences in the number of medications prescribed. Practice variation may represent a lack of consensus regarding appropriate prescribing for this high-risk group for whom pharmacological treatment has great potential for harm as well as benefit.

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The Economic Burden of Chronic Kidney Disease in Vietnam

Health Services Insights ◽

10.1177/11786329211036011 ◽

2021 ◽

Vol 14 ◽

pp. 117863292110360

Author(s):

Hai-Yen Nguyen-Thi ◽

Thanh-Nhan Le-Phuoc ◽

Nhan Tri Phat ◽

Dat Truong Van ◽

Thuy-Trang Le-Thi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Economic Burden ◽

Cross Sectional Study ◽

Cross Sectional ◽

Factors Affecting ◽

Ckd Stage ◽

Stage 1 ◽

The Cost

Our objective is to analyze the economic burden of chronic kidney disease (CKD) in Vietnam, particularly in District 2 Hospital at Ho Chi Minh City in 2019. This is a descriptive cross-sectional study. The data source is the medical records of the patients. Encoding the data, analyzing treatment cost, regression modeling, and verification were performed using Stata 15 software. Patients with stage 3 CKD account for the highest proportion of the CKD patient population. CKD comorbidities include hypertension, diabetes, cardiovascular disease, and anemia, which increase the treatment fees of patients. Approximately half of the patients with CKD have diabetes or cardiovascular disease. Treatment costs increase as the condition of the patient worsens (except for stage 1 and 2 CKD). The total expenses of all CKD patients in District 2 Hospital were USD 916 423 988.60. Five main factors that affect the treatment fee of a patient: CKD stage, age, gender, and the presence of diabetes, cardiovascular disease, and anemia. The regression model correctly predicts 96% of cases and can explain 64.15% of the fluctuations in costs. The cost of CKD treatment was higher than Vietnam’s per capita GDP in 2019, and the primary factors affecting costs are comorbidities and dialysis.

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