scholarly journals Mineral Metabolites, Angiotensin II Inhibition and Outcomes in Advanced Chronic Kidney Disease

2015 ◽  
Vol 42 (5) ◽  
pp. 361-368 ◽  
Author(s):  
Anna J. Jovanovich ◽  
Michel B. Chonchol ◽  
Atousa Sobhi ◽  
Jessica B. Kendrick ◽  
Alfred K. Cheung ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
End Stage Renal Disease ◽  
Mineral Metabolism ◽  
Dialysis Initiation ◽  
Advanced Chronic Kidney Disease ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage ◽  
Lower Hazard

Background: Evidence suggests that the renin-angiotensin-aldosterone system (RAAS) interacts with the vitamin D-fibroblast growth factor 23-Klotho axis. We investigated whether circulating mineral metabolism markers modify outcomes in response to RAAS inhibition in subjects with advanced chronic kidney disease (CKD). Methods: In this retrospective cohort study, we analyzed the association of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) use with all-cause mortality and dialysis initiation among 1,753 subjects (1,099 CKD, estimated glomerular filtration rate 18 ± 6 ml/min/1.73 m2 and 654 end-stage renal disease [ESRD]) from the Homocysteine in Kidney and End Stage Renal Disease (HOST) study. A propensity score analysis accounted for indication bias and Cox regression models adjusted for mineral metabolism markers. Results: Mean follow-up was 3.2 years; 714 (41%) subjects died and 615 (56%) initiated dialysis. In adjusted analyses, all subjects treated with ACEI/ARB had a significantly lower hazard of death (hazards ratio (HR) 0.81, 95% CI 0.70-0.95, p = 0.007). Those with CKD not on dialysis and treated with ACEI/ARB trended toward a lower hazard of dialysis initiation (HR 0.86, 95% CI 0.73-1.01, p = 0.06). The association with mortality did not differ by level of mineral metabolism marker (p for interaction >0.16); however, the relationship with dialysis initiation differed according to the median serum phosphorus level (p for interaction <0.001). Conclusions: RAAS inhibition was associated with decreased all-cause mortality independent of disordered mineral metabolism among mostly male HOST subjects with advanced CKD and ESRD. However, among those with CKD not requiring dialysis, the renoprotection associated with RAAS inhibition was attenuated by higher serum phosphorus levels. Further studies are needed to confirm this association.

scholarly journals Comparing the Effect of Folic Acid and Pentoxifylline on Delaying Dialysis Initiation in Patients with Advanced Chronic Kidney Disease

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2192
Author(s):  
Hsun Yang ◽  
Shiun-Yang Juang ◽  
Kuan-Fu Liao ◽  
Yi-Hsin Chen
Keyword(s):  
Chronic Kidney Disease ◽  
Folic Acid ◽  
Kidney Disease ◽  
Index Date ◽  
Dialysis Initiation ◽  
Nutrient Loss ◽  
Research Database ◽  
Advanced Chronic Kidney Disease ◽  
Stage Renal Disease ◽  
End Stage

Background: We hypothesized that the nutrient loss and chronic inflammation status may stimulate progression in advanced chronic kidney disease. Therefore, we aimed to generate a study to state the influence of combined nutritional and anti-inflammatory interventions. Methods: The registry from the National Health Insurance Research Database in Taiwan was searched for 20–90 years individuals who had certified end-stage renal disease. From January 2005 through December 2010, the diagnosis code ICD-9 585 (chronic kidney disease, CKD) plus erythropoiesis-stimulating agent (ESA) use was defined as entering advanced chronic kidney disease. The ESA starting date was defined as the first index date, whereas the initiation day of maintenance dialysis was defined as the second index date. The duration between the index dates was analyzed in different medical treatments. Results: There were 10,954 patients analyzed. The combination therapy resulted in the longest duration (n = 2184, median 145 days, p < 0.001) before the dialysis initiation compared with folic acid (n = 5073, median 111 days), pentoxifylline (n = 1119, median 102 days, p = 0.654), and no drug group (control, n = 2578, median 89 days, p < 0.001). Lacking eGFR data and the retrospective nature are important limitations. Conclusions: In patients with advanced CKD on the ESA treatment, the combination of folic acid and pentoxifylline was associated with delayed initiation of hemodialysis.

Predictors of advanced chronic kidney disease and end-stage renal disease in HIV-positive persons

AIDS ◽  
2014 ◽  
Vol 28 (2) ◽  
pp. 187-199 ◽  
Author(s):  
Lene Ryom ◽  
Amanda Mocroft ◽  
Ole Kirk ◽  
Michael Ross ◽  
Peter Reiss ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hiv Positive ◽  
Advanced Chronic Kidney Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Chronic Kidney Disease-Associated Pruritus

Toxins ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 527
Author(s):  
Puneet Agarwal ◽  
Vinita Garg ◽  
Priyanka Karagaiah ◽  
Jacek C. Szepietowski ◽  
Stephan Grabbe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
End Stage Renal Disease ◽  
English Language ◽  
Advanced Chronic Kidney Disease ◽  
Primary Care Doctors ◽  
Stage Renal Disease ◽  
End Stage ◽  
Distressing Condition

Pruritus is a distressing condition associated with end-stage renal disease (ESRD), advanced chronic kidney disease (CKD), as well as maintenance dialysis and adversely affects the quality of life (QOL) of these patients. It has been reported to range from 20% to as high as 90%. The mechanism of CKD-associated pruritus (CKD-aP) has not been clearly identified, and many theories have been proposed to explain it. Many risk factors have been found to be associated with CKD-aP. The pruritus in CKD presents with diverse clinical features, and there are no set features to diagnose it.The patients with CKD-aP are mainly treated by nephrologists, primary care doctors, and dermatologists. Many treatments have been tried but nothing has been effective. The search of literature included peer-reviewed articles, including clinical trials and scientific reviews. Literature was identified through March 2021, and references of respective articles and only articles published in the English language were included.

scholarly journals Effect of Homocysteine Lowering on Mortality and Vascular Disease in Advanced Chronic Kidney Disease and End-stage Renal Disease

JAMA ◽  
2007 ◽  
Vol 298 (10) ◽  
pp. 1163 ◽  
Author(s):  
Rex L. Jamison ◽  
Pamela Hartigan ◽  
James S. Kaufman ◽  
David S. Goldfarb ◽  
Stuart R. Warren ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Vascular Disease ◽  
End Stage Renal Disease ◽  
Advanced Chronic Kidney Disease ◽  
Stage Renal Disease ◽  
End Stage
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