scholarly journals МОДИФІКАЦІЯ ФАКТОРІВ РИЗИКУ СЕРЦЕВО-СУДИННИХ УСКЛАДНЕНЬ В ПЛАНІ ОПТИМІЗАЦІЇ ЛІКУВАННЯ ХВОРИХ ІЗ ХРОНІЧНОЮ ХВОРОБОЮ НИРОК СЕАНСАМИ ПРОГРАМНОГО ГЕМОДІАЛІЗУ

Author(s):  
I. L. Kuchma

<p class="1">The number of patients with chronic kidney disease (CKD) in substitution therapy sessions dialysis program in Ukraine is growing. Improvement of methods of renal replacement therapy (RRT), chronic kidney disease, in particular, the use of modern dialysis technology has led to a significant increase in the life expectancy of patients. However, the mortality of the disease remains high. In its structure heavily reliant on cardiovascular disease, according to the National registry of patients with chronic kidney disease in 2011 it was 72 %. In this regard, there is actual determination of risk factors for these complications and the search for new methods to ensure their prevention. The author studied the effect of individually tailored and standard hemodialysis treatment programs on the risk factors of cardiovascular complications in patients with CKD. It is concluded that the custom-fitted options at the time of hemodialysis and ultrafiltration properties klirensovyh dialyzer electrolyte composition of the dialysate can achieve better results in the management of risk factors in patients with CKD.</p>

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 378.2-378
Author(s):  
A. Chudinov ◽  
I. Belyaeva ◽  
M. Pervakova ◽  
V. Mazurov ◽  
O. Inamova ◽  
...  

Background:ANCA-associated systemic vasculitis (AAV) is characterized by a high incidence of complications and high mortality. The most significant complications during the first 3 years of the disease are infectious and cardiovascular. Development of chronic kidney disease also impairs the prognosis of AAV. Refractory to induction therapy can significantly increase the severity of organ lesions in patients with AAV.Objectives:The aim of this study was to determine risk factors for complications and refractory course in patients with AAV.Methods:Patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA) were observed during the first 3 years of the disease and included in this study between 2010 and 2018. Most common infectious complications requiring inpatient treatment were pneumonia, mycosis, sepsis, purulent arthritis, purulent otitis media. Cardiovascular complications included pulmonary thromboembolism, myocardial infarction, ischemic stroke, venous thrombosis.Results:In total 209 (165 [79%] female and mean age 51.8 ± 13.2 years) AAV patients (94 GPA; 46 MPA; and 69 EGPA) were included in the analysis. Risk factors for infectious complications were BVAS level at the beginning of induction therapy > 25 (OR – 2.92, 95% CI (1.53;5.45) p<0.001), usage of prednisone in doses more than 60 mg / day at the induction of remission (OR – 2.76, 95% CI (1.45;5.29) p=0.003), usage of prednisone in doses ≥ 10 mg / day after 6 months of induction therapy (OR – 2.60, 95% CI (1.38;4.93) p=0.003), ANCA-PR3 positivity (OR – 2.25, 95% CI (1.13;4.46) p=0.017) and presence of diabetes mellitus in the AAV onset (OR – 1.77, 95% CI (1.14;3.45) p=0.038). Patients with AAV had following risk factors for cardiovascular complications: male (OR – 2.28, 95% CI (1.33;3.88) p=0.002), BVAS level > 25 (OR – 2.1, 95% CI (1.11;3.16) p=0.008) and presence of coronary artery disease in the AAV onset (OR – 2.2, 95% CI (1.18;4.10) p=0.015). ANCA positivity (OR – 5.62, 95% CI (2.1;14.9) p<0.001), presence of rapidly progressive glomerulonephritis in the first 3 months from onset AAV (OR – 5.02, 95% CI (3.42;7.35) p<0.001) and over 60 years of age (OR – 2.17, 95% CI (1.38;3.44) p=0.001) were risk factors of development of chronic kidney disease. Risk factors for refractory to induction therapy in patients with AAV were ANCA-PR3 positivity (OR – 3.13, 95% CI (1.63;6.02) p<0.001), BVAS level > 25 (OR – 2.63, 95% CI (1.74;4.34) p<0.001), initiation of therapy after 4 months from the onset of clinical manifestations (OR – 2.17, 95% CI (1.26;3.91) p=0.005). We additionally defined that identification of pathological phenotypes of alpha-1-antitrypsin was risk factors for refractory course in patients with GPA manifestations (OR – 2.66, 95% CI (1.12;6.33) p=0.048).Conclusion:Our study has shown that high disease activity, ANCA positivity and comorbid pathology increase risk of serious complications. Early administration of immunosuppressive therapy, adequate steroid dosing and use of risk factors for complications and refractory course in clinical practice can significantly improve the prognosis of AAV.Disclosure of Interests:None declared


2019 ◽  
Vol 4 (1) ◽  
pp. 12-17
Author(s):  
Mazou Ngou Temgoua ◽  
Gloria Ashuntantang ◽  
Marie José Essi ◽  
Joël Nouktadie Tochie ◽  
Moussa Oumarou ◽  
...  

Background: In sub-Saharan Africa (SSA), the trend in the number of patients admitted for maintenance hemodialysis is on the rise. The identification of risk factors for chronic kidney disease (CKD) ensures adequate primary and secondary preventive measures geared at reducing the burden of CKD in low-resource settings. A family history of CKD is an established risk factor for CKD in high-income countries. However, data on family predisposition to CKD is scarce in the literature on SSA. Objective: The current study aimed to determine the prevalence and risk factors of CKD in family relatives of a Cameroonian population of hemodialysis patients (HDP) followed-up in a major hemodialysis referral center in Cameroon. Methods: The current cross-sectional study was conducted over four months on a consecutive sample of first-degree family relatives of end-stage renal disease patients undergoing maintenance hemodialysis at the hemodialysis unit of the General Hospital of Yaoundé. For each participating family relative, socio-demographic characteristics, clinical data, and biological data including fasting blood glucose, proteinuria, and serum creatinine were collected. Results: A total of 82 first-degree family relatives of HDP were recruited. The prevalence of CKD among the participants was 15.8%. The main identified risk factors for CKD were age (P = 0.0015), female gender (P = 0.0357), hypertension (P = 0.0004), regular intake of herbal remedies (P = 0.0214), and diabetes mellitus (P = 0.0019). Conclusion: Overall, the current findings suggest an urgent need for population education, routine screening of CKD, and the identification of risk factors in first-degree family relatives of HDP in Cameroon.


2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Cai-Mei Zheng ◽  
Kuo-Cheng Lu ◽  
Chia-Chao Wu ◽  
Yung-Ho Hsu ◽  
Yuh-Feng Lin

Vascular calcification is common in ESRD patients and is important in increasing mortality from cardiovascular complications in these patients. Hyperphosphatemia related to chronic kidney disease is increasingly known as major stimulus for vascular calcification. Hyperphosphatemia and vascular calcification become popular discussion among nephrologist environment more than five decades, and many researches have been evolved. Risk factors for calcification are nowadays focused for the therapeutic prevention of vascular calcification with the hope of reducing cardiovascular complications.


2020 ◽  
Vol 16 (6) ◽  
pp. 1031-1038
Author(s):  
T. V. Pavlova

Anticoagulant therapy in elderly patients with atrial fibrillation and concomitant diseases is often the challenge for clinicians. The high risk of stroke is inherent in atrial fibrillation, and it increases when combined with coronary heart disease and chronic kidney disease. On the other hand, the comorbidity increases the risk of bleeding. Older age is also the risk factor of thrombotic and hemorrhagic complications. As a consequence, the choice of specific anticoagulant should be based on a solid evidences, obtained both from randomized clinical trials and from daily clinical practice. In the ROCKET AF trail the direct oral anticoagulant rivaroxaban showed a tendency to reduce the risk of thromboembolism by 20% compared with warfarin in the patients aged 75 years and older. The safety of rivaroxaban has been evaluated in the XANTUS POOLED program. According to the follow-up results for 12 months, more than 96% of patients didn't have any adverse event, and the number of patients with major bleeding was 1.5%. Several meta-analyzes reported a reduction of cardiovascular complications in patients treated by rivaroxaban. In the ROCKET AF trail, a “renal” dose of rivaroxaban (15 mg OD) was studied in patients with chronic kidney disease. The efficacy and safety of rivaroxaban were validated in this patients, and a simple algorithm for selecting the dose of this drug in patients with chronic kidney disease was provided. 


Author(s):  
Samir Derouiche ◽  
Tissir Cheradid ◽  
Massaouda Guessoum

Purpose: This study was conducted aiming at evaluating some risk factors in patients with Chronic Kidney Disease (CKD) in Djamaa (El Oued, Algeria) region. Materials and Methods: Our study is based on 77 voluntary individuals divided into healthy man and women reserved as a control with average age of 46.61± 2.84 years old and CKD patients with average age of 46.03± 2.95 years old; their origin covers the whole Djamaa (El Oued, Algeria) region and they were selected from the dialysis service of SAAD DEHLEB hospital Djamaa (El Oued Algeria). Risk of certain socio-clinical factors has been estimated by the determination of the value of Odd Ratio (OR). Results: Our study reports show a strong association between clinical factors such as Diabetes, urinary problems and Arterial hyper pressure (OR= 5.135, 6.60 and 78.276; P ≤0.05) with chronic kidney disease, respectively, but in this study we show that the Renal herbal medicine and History of kidney disease are the most dangerous risk factors, (OR = 20.00, OR =25,45 ; p≤0.001), respectively, for spices and Amount of water (OR ranging from 0.232 to 0.352; P ≤0.032) are important protective factors against this disease. Conclusion: Lifestyle is a contributing factor in CKD attainment in the region of Djamaa (El Oued, Algeria), which requires high sensitivity to modify these behaviors for limited progression of the disease in this region.


2014 ◽  
Vol 9 (1) ◽  
pp. 25-32
Author(s):  
MK Khan ◽  
HU Rashid ◽  
S Yesmine ◽  
IH Mahmoo ◽  
SMA Habib ◽  
...  

Background: Chronic Kidney Disease is a major public health and clinical problem throughout the world including Bangladesh. The prevalence of cardiovascular complications is much higher in patients with CKD regardless of stages than normal population. Considering this view, a cross sectional study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, with an aim to assessing the cardiovascular complications & associated risk factors among the patients with chronic kidney disease (CKD) stage III-V before dialysis. Methods: A total of 109 patients were selected consecutively who had a diagnosis of CKD and an estimated GFR of less than 60 ml/min/1.73m2 of stages III to V and who had not received any form of renal replacement therapy, during a period of June 2006 to July 2007. Results: The study included 63 males and 46 females with age ranging from 18 to 65 years having a mean age 45.5±12.2 years. Left ventricular failure, left ventricular hypertrophy (by ECG and echocardiography), cardiomegally by X-ray were identified as significant cardiovascular complications among the patients of CKD stage V (p<0.05). However , logistic regression analysis revealed that hypertension and CKD stages appeared to be the important predictors of cardiovascular complications p<0.05). Data analysis found that hypertension, smoking and anemia appeared to be important risk factors for cardiovascular complications in CKD patients (p<0.05) by bi-variate analysis. Conclusion: Though the study findings did not generalize the CKD patients in Bangladesh due to small sample size, however, heart failure and left ventricular hypertrophy significantly appeared to be the main cardiovascular complications in CKD stage V compared to other two stages (stage III and IV)(p<0.05). Anemia, hypertension were identified as important risk factors (p<0.05). DOI: http://dx.doi.org/10.3329/uhj.v9i1.19508 University Heart Journal Vol. 9, No. 1, January 2013; 25-32


2012 ◽  
Vol 38 (1) ◽  
pp. 18-22 ◽  
Author(s):  
M Saha ◽  
MO Faroque ◽  
KS Alam ◽  
MM Alam ◽  
S Ahmed

The study was carried out to see prevalence of Chronic Kidney Disease (CKD) specific cardiovascular risk factors and cardiovascular events among patients with Chronic Kidney Disease stage-V (CKD-V) before starting dialysis therapy in the department of Nephrology of National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. Among CKD specific cardiovascular risk factors, anemia showed the highest prevalence (96.7%) in study population. More than fifty percent of CKD-V patients had both hypocalcaemia and hyperphosphataemia. Calcium-Phosphate Product (CaXP) was elevated among 23 percent of the population. C-reactive protein, an acute phase protein was positive in 78% of CKD-V patients. Besides, among traditional risk factors, Hypertension and Diabetes Mellitus were present in 83.3% and 23% of the study population respectively. The prevalence of cardiovascular events among CKD-V patients showed that 18.3% had ischemic heart disease, 38% heart failure, 4.7% arrhythmia and 9% left ventricular hypertrophy. Females were significantly prone to develop cardiovascular events than their male counterpart (p=0.028). Diabetes was significantly higher in patients with cardiovascular complications than in patients without cardiovascular complications (p=0.021). DOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10447 Bangladesh Med Res Counc Bull 2012; 38: 18-22


2020 ◽  
Vol 17 (1) ◽  
pp. 35-44
Author(s):  
Delia Timofte ◽  
Dorin Dragoș ◽  
Adina Măndiţă ◽  
Andra-Elena Balcangiu-Stroescu ◽  
Maria-Daniela Tănăsescu ◽  
...  

AbstractStroke is a public health problem especially in developed countries, being an important cause of death and disability. The prevalence of chronic kidney disease (CKD) in the general population varies from country to country. The percentage of afflicted patients is on the rise, mainly due to the high incidence of diabetes mellitus (DM) complicated with diabetic nephropathy (DN) and of the kidney vascular diseases (hypertensive nephroangiosclerosis and ischemic nephropathy). In patients with CKD, strokes are relatively frequent, especially hemorrhagic ones, due to a host of risk factors, both modifiable and unmodifiable.Cardiovascular complications (which may be prevented by risk factors control) are the main culprit for the relatively high mortality rate of CKD patients, frequently leading to their death before the initiation of renal replacement treatment (dialysis, kidney transplant).


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