Abstract 13243: Diminished Daily Fluctuation of Heart Rate Variability in Patients with Chronic Kidney Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hisaki Makimoto ◽  
Katsuhito Fujiu ◽  
Kohei Shimizu ◽  
Eisuke Amiya ◽  
Kazuo Asada ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Kidney Disease ◽  
High Frequency ◽  
High Frequency Component ◽  
Control Group ◽  
Holter Monitor ◽  
Significant Difference ◽  
High Incidence ◽  
Circadian Fluctuation

Introduction: Autonomic dysfunction is well known in patients with chronic kidney disease (CKD) and linked with cardiac death. In spite of a high incidence of morning death in CKD patients, circadian fluctuation in parasympathetic activation have not been studied in CKD. Hypothesis: We assessed the hypothesis that the cardiac autonomic circadian fluctuation is impaired in patients with CKD. Methods: The study population consisted of consecutive 101 patients (54 males, 70±10 years old) with CKD who underwent 24-hour Holter monitor. As a control group, 134 age and sex matched cases (66 males, 68±10 years old) without CKD who also underwent Holter monitor were recruited. Patients with diabetes orβ-blocker therapy were excluded. The high frequency component (HF), which reflected parasympathetic activity, and the low frequency to high frequency ratio (L/H ratio), which reflected, in part, sympathetic activity, were evaluated. To evaluate the contribution of CKD and other parameters to the cardiac autonomic fluctuation, the night (6PM-6AM) to day (6AM-6PM) ratio of HF and L/H ratio were analyzed utilizing a regression analysis. Results: The L/H ratio showed no significant difference during the night between the two groups, in contrast to the significant difference during the daytime. Patients with CKD showed significantly lower HF during the night as compared to control cases (P<0.05), although the daytime HF was not significantly different between the groups (Figure). Multivariate regression analysis demonstrated that CKD was independently associated with a lower night-to-day ratio of the HF and a higher night-to-day ratio of the L/H ration, even with the adjustment of age and comorbid hypertension. Conclusions: Our findings suggest that cardiac autonomic fluctuation is impaired in CKD patients. Whether a deterioration of autonomic activation might explain the high incidence of morning death in CKD patients needs to be clarified in future studies.

scholarly journals Dynamic thiol-disulfide balance and thioredoxin reductase enzyme levels in patients with chronic kidney disease.

2021 ◽  
Author(s):  
Huseyin Erdal ◽  
Oguzhan Ozcan ◽  
Faruk Turgut ◽  
Salim Neselioglu ◽  
Ozcan Erel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Biochemistry ◽  
Colorimetric Method ◽  
Thioredoxin Reductase ◽  
Control Group ◽  
Total Thiol ◽  
Significant Difference ◽  
Patient Groups

Introduction: We aimed to measure the dynamic thiol-disulfide balance and thioredoxin reductase (TrxR) enzyme levels in patients with chronic kidney disease (CKD). Material and Methods: Thirty hemodialysis (HD), 30 CKD patients (stage3-5) and 30 controls were included in the study. The dynamic thiol-disulfide balance was determined by the colorimetric method developed by Erel et al. TrxR levels were determined by ELISA. Results: Native and total thiol levels of CKD and HD patients were significantly lower than that of the control group (p=0.001for both). However, disulfide levels were significantly higher in the HD group (p=0.001), but there was no significant difference between control and CKD groups(p=0.547). A notable negative correlation was found between the native and total thiol levels and IMA(r=-0.628;-0.631),BUN (r=-0.747;-0.747),and creatinine(r=-0.732;-0.721). There was a significant positive correlation between GFR and the thiol levels (r=0.835;0.824). TrxR levels were significantly higher in the patient groups compared to the controls (p=0.001).CRP levels of the patient groups were significantly higher compared to the controls (p=0.001). Conclusions: We have demonstrated that measurement of dynamic thiol-disulfide levels by using colorimetric method can contribute to the diagnosis and follow-up of the disease as a marker, because, it is easily applicable in routine clinical biochemistry laboratories and related with disease severity in CKD patients. Also, we showed that volume correction due to dialysis process should be consider in studies dealing with plasma thiol values and the final results should be given after the correction process.

scholarly journals Association between Chronic Kidney Disease and the Most Common Corneal Ectasia Disease (Keratoconus): a Nationwide Cohort Study

2020 ◽  
Author(s):  
Ren-Long Jan ◽  
Shih-Feng Weng ◽  
Jhi-Joung Wang ◽  
Yuh-Shin Chang
Keyword(s):  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
Incidence Rate ◽  
Case Series ◽  
Control Group ◽  
Study Cohort ◽  
Research Database ◽  
Increased Risk ◽  
Significant Difference

Abstract Background: Both keratoconus (KCN) and chronic kidney disease (CKD) are multifactorial conditions with multiple aetiologies and share several common pathophysiologies. However, the few studies that have described the relationship between KCN and CKD are limited to case reports and small case series. This study aimed to evaluate the association between KCN and CKD.Methods: The study cohort included 4,609 new-onset keratoconus patients ≥ 12 years identified by the International Classification of Diseases, Ninth Revision, Clinical Modification, code 371.6 and recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The age- , sex- , and comorbidity-matched control group included 27,654 non-KCN patients, selected from the Taiwan Longitudinal Health Insurance Database, 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence and risk of CKD were compared between the two groups. The adjusted hazard ratios (HRs) for CKD were calculated with Cox proportional hazard regression analysis. Kaplan–Meier analysis was used to calculate the cumulative CKD incidence rate. Results: The incidence rate of CKD was 1.36 times higher in KCN patients than in controls without statistically significant difference (95% confidence interval [CI] = 0.99–1.86, p = 0.06). In total, 29 male KCN patients and 90 male controls developed CKD during the follow-up period. The incidence rate of CKD was 1.92 times (95% [CI] = 1.26–2.91; p = 0.002) higher in male KCN patients than in controls. After adjusting for potential confounders, including age, hypertension, hyperlipidaemia, and diabetes mellitus, male KCN patients were 1.75 times (adjusted HR = 1.75, 95% [CI] = 1.14–2.68, p < 0.05) more likely to develop CKD. Conclusions: We found that male KCN patients have an increased risk of CKD. Therefore, it is recommended that male KCN patients should be aware of CKD.

DIFFERENTIAL DIAGNOSTICS OF PREECLAMPSIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2019 ◽  
Vol 23 (1) ◽  
pp. 45-50
Author(s):  
R. R. Temirbulatov ◽  
V. F. Bezhenar ◽  
A. V. Smirnov
Keyword(s):  
Chronic Kidney Disease ◽  
Differential Diagnosis ◽  
Kidney Disease ◽  
Comparison Group ◽  
Differential Diagnostics ◽  
Control Group ◽  
Third Trimester ◽  
Significant Difference ◽  
Definition Of ◽  
The Relationship

THE AIM: To assess the significance of prognostic markers of preeclampsia – sFlt-1 and PlGF in the differential diagnosis of preeclampsia and chronic kidney disease.PATIENTS AND METHODS:patients whom signed informed consent, was taken samples of blood in the third trimester of pregnancy. The study group included 36 patients with preeclampsia, the comparison group of 46 pregnant women with CKD and the control group included 40 healthy patients, with pregnancy without complication.RESULTS: Significant differences in the levels of serum sFlt-1 and PlGF were found: between the PE and the comparison group (CKD), as well as between the PE and the control group (CG), whereas no differences were found between the CG and CKD. The sFlt-1 level was significantly increased in PE compared with CKD and KG (5.12-fold and 4.25-fold higher, respectively). Serum PlGF levels were significantly reduced in PE relative to both CKD and KG (17.4 and 12.5 times lower, respectively). The sFlt-1/PlGF ratio was significantly increased in PE compared with CKD and the control group (approximately 25 times higher in both groups), but there was no significant difference between CKD and CG.CONCLUSION:Thus, the definition of the relationship sFlt-1, PlGF, sFlt-1/PlGF can be used in the differential diagnosis of preeclampsia and chronic kidney disease.

scholarly journals Functional and Respiratory Capacity of Patients with Chronic Kidney Disease Undergoing Cycle Ergometer Training during Hemodialysis Sessions: A Randomized Clinical Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio de Olival Fernandes ◽  
Yvoty Alves dos Santos Sens ◽  
Vivian Bertoni Xavier ◽  
Luiz Antonio Miorin ◽  
Vera Lúcia dos Santos Alves
Keyword(s):  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomized Clinical Trial ◽  
Functional Capacity ◽  
Respiratory Function ◽  
Cycle Ergometer ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Significant Difference

Purpose. Exercise is recommended for patients undergoing hemodialysis, to reduce the decrease in functional capacity secondary to the progression of chronic kidney disease. A cycle ergometer can be easily added to an exercise routine during hemodialysis sessions. The purpose of this article was to assess the results of a training protocol with the cycle ergometer during hemodialysis sessions on the respiratory function and functional capacity of patients with chronic kidney disease on hemodialysis. Method. In this randomized clinical trial (NCT no. 02834026), 39 patients undergoing hemodialysis were randomly allocated into two groups: the treatment group (TG, n = 20), who underwent a cycle ergometer protocol training, and the control group (GC, n = 19), not trained. The TG attended 24 training sessions, three times a week, during the intradialytic period. Training intensity was aimed at keeping the heart rate between 50 and 70% of its maximum. All participants were evaluated before and after the eight consecutive weeks of follow-up and had biochemicals data, anthropometric, functional, and respiratory outcomes evaluated. Results. A significant difference was observed between groups in forced vital capacity, forced expiratory volume in the first second, peak expiratory flow, maximal inspiratory and expiratory pressure, and Borg score and distance covered in the six-minute walk test. Improvement was also observed in biochemical and Kt/V test results for the TG. Conclusion. The systematic training regimen with a cycle ergometer resulted in benefits in the respiratory function and functional capacity in patients with chronic kidney disease undergoing hemodialysis.

scholarly journals Investigation of hallmarks of carbonyl stress and formation of end products in feline chronic kidney disease as markers of uraemic toxins

2018 ◽  
Vol 21 (6) ◽  
pp. 465-474 ◽  
Author(s):  
Emanuela Valle ◽  
Liviana Prola ◽  
Diana Vergnano ◽  
Roberta Borghi ◽  
Fiammetta Monacelli ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Biochemical Parameters ◽  
Advanced Oxidation ◽  
Treated Group ◽  
Control Group ◽  
Advanced Oxidation Protein Products ◽  
Significant Difference ◽  
End Products

Objectives Cats are commonly affected by chronic kidney disease (CKD). Many reactive carbonyl intermediates and end products originating from the oxidative stress pathways are recognised as uraemic toxins and may play a role in CKD progression. The aim of the present study is to confirm whether carbonyl end-product formation is higher in cats affected by CKD and to assess whether an angiotensin-converting enzyme inhibitor (ACEi) might affect these hallmarks. Methods Twenty-two cats were divided into three groups: a control group (CG), cats with CKD and cats with CKD treated with an ACEi. Serum levels of pentosidine, carboxymethyllysine, advanced oxidation protein products, malondialdehyde, methylglyoxal and hexanoyl-lysine were measured. In addition, biochemical parameters and systolic blood pressure were evaluated. After checking for normality, comparisons between groups were performed followed by multiple comparison tests. P values ⩽0.05 were considered significant. Correlations between concentrations of the considered biomarkers and of the other metabolic parameters were investigated. Results Advanced oxidation protein products, malondialdehyde and hexanoyl-lysine concentrations were significantly higher in CKD and ACEi-treated groups compared with the CG ( P <0.05). Carboxymethyllysine increased in the ACEi-treated group when compared with the CG, whereas intermediate values of these biomarkers were found in the CKD group ( P <0.05). The ACEi-treated group showed the highest values of carboxymethyllysine, advanced oxidation protein products and hexanoyl-lysine. By contrast, the CKD group had the highest concentration of malondialdehyde. No statistically significant difference was found in the levels of pentosidine or methylglyoxal. End products correlated with creatinine and urea and with each other. Conclusions and relevance Significantly high concentrations of both intermediate and end products of carbonyl/oxidative stress were detected in CKD cats. This is the first study to have concurrently taken into account several uraemic toxins and biochemical parameters in cats affected by CKD.

scholarly journals The Effect of Coaching Support on Kidney Function in Chronic Kidney Disease Patients

2021 ◽  
Vol 9 (T4) ◽  
pp. 106-110
Author(s):  
Susanti Susanti ◽  
Difran Nobel Bistara
Keyword(s):  
Chronic Kidney Disease ◽  
Chronic Illness ◽  
Treatment Group ◽  
Kidney Disease ◽  
Kidney Function ◽  
Complex Disease ◽  
Early Stage ◽  
T Test ◽  
Control Group ◽  
Significant Difference

BACKGROUND: Chronic kidney disease (CKD) is a chronic illness with complex disease which could lead to other underlying diseases such as diabetes mellitus (DM), hypertension, and dyslipidemia. Urban population must manage their illness due to their occupation. Coaching support is an advanced method to help individuals manage their illnesses, especially chronic illness. Symptoms and complaints in early-stage renal disorders tend to be mild, making it difficult to diagnose only by clinical examination. Impaired kidney function can lead to progressive kidney damage. AIM: This study aimed was to analyze the effect of coaching support in maintaining kidney function in patients with CKD. METHODS: This research used quasi-experiment with pre-test and post-test with control group design. Respondents in this study were 40 CKD patients which were taken by consecutive sampling technique and divided into two groups, namely, control group and treatment group. Data were collected using blood urea nitrogen and creatinine values observation sheet. Coaching support was divided into four steps of therapy, identify the disturbance, identify based on experience, use a family support system, and evaluating the results. Data were analyzed using paired t-test and independent t-test with a significance of p < 0.05. RESULTS: This study found that there was a significant difference in kidney function between the control group and the treatment group (p = 0.000). Coaching support interventions were effective on kidney function in patients with CKD. The implementation of coaching support went well because respondents and families were proactive. CONCLUSION: Coaching support should be applied by nurses as daily activity management of CKD patients at early stage to inhibit the kidney function damage progression.

scholarly journals Pemberian diet modifikasi komersial dan pengaruhnya terhadap asupan makanan dan status gizi pasien penyakit ginjal kronik prehemodialisis di RSUP DR. M. Djamil Padang

2008 ◽  
Vol 5 (2) ◽  
pp. 71
Author(s):  
Pitri Balgis ◽  
Probosuseno Probosuseno ◽  
Herni Astuti
Keyword(s):  
Chronic Kidney Disease ◽  
Food Intake ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Control Group ◽  
Standard Diet ◽  
Control Group Design ◽  
Commercial Diet ◽  
Significant Difference ◽  
Modified Diet

Background: Chronic kidney disease causes progressive deterioration of kidney function and is commonly irreversible, leading to nausea and vomiting as a consequence of high ureum and creatinine in the blood. This condition results in declining appetite which greatly affects food intake and degrading nutritional status that causes high mortality among chronic kidney patients. Therefore efforts are made on how to increase intake of chronic kidney patients.Objective: To identify the effect of nutrition therapy through commercial diet modification to nutrition intake and status of pre-hemodialysis chronic kidney patients at DR. M. Djamil Hospital, Padang.Method: The study was a quasi experiment which used pre-test and post-test with control group design. Population of the study were all patients of pre-hemodialysis chronic kidney disease hospitalized at DR. M. Djamil Hospital of Padang. Samples were patients of pre-hemodialysis chronic kidney disease at internal medicine ward. The experiment group consisted of 11 patients who got modified diet within 6 days and control group consisted of 11 patients who got hospital standard diet with α = 0.05 and ß = 10%. The study were collected from January-March 2008. Data of intake were analyzed using Nutri Survey program. Statistical t-test and chi-square were used to identify the effect of commercial modified diet to food intake, nutritional status, and increase of ureum and creatinine. Absorption level was measured from the quantity of commercial nutrition used. Perception of the patients about commercial diet was obtained through questionnaires and analyzed to get the score.Results: The group with modified diet had better energy and protein intake than the group with hospital standard diet (p < 0.05). However, there was no significant difference in nutritional status, ureum and creatinine changes between patients who got modified diet and those who got hospital standard diet (p < 0.05). The result of analysis on perception of patients about commercial diet showed that patients could accept commercial diet.Conclusion: Commercial modified diet could increase intake of energy and protein of pre-hemodialysis chronic kidney patients.

scholarly journals EFFECT OF PROGRESSIVE MUSCULAR RELAXATION ON ANXIETY LEVELS IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING HEMODIALYSIS IN THE GENERAL HOSPITAL OF TUGUREJO SEMARANG, INDONESIA

2017 ◽  
Vol 3 (4) ◽  
pp. 383-389
Author(s):  
Ary Astuti ◽  
Anggorowati Anggorowati ◽  
Andrew Johan
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rating Scale ◽  
Psychosocial Problems ◽  
Nursing Intervention ◽  
Control Group ◽  
P Value ◽  
Muscular Relaxation ◽  
Significant Difference ◽  
And Control

Background: Patients with chronic kidney disease undergoing hemodialysis suffer changes in lifestyle, which cause physical and psychosocial problems, particularly anxiety. Progressive Muscular Relaxation is considered as an intervention to reduce anxiety.Objective: This study aims to examine the effect of progressive muscular relaxation in in reducing anxiety in patients with chronic kidney disease undergoing hemodialysis.Methods: This study used a quasi-experimental design involved 78 respondents, with 38 randomly assigned in the intervention and control group. The progressive muscular relaxation was performed on 14 muscle groups for 4-week period. Hamilton Anxiety Rating Scale was used to measure anxiety. Univariate, bivariate and multivariate analyses were performed for data analyses.Results: The results showed a statistically significant difference in anxiety values between the intervention and control group with p-value 0.000 (<0.05).Conclusion: There was a significant effect of progressive muscular relaxation in reducing anxiety in patients with chronic kidney disease undergoing hemodialysis. The results of this study is expected to be one reference in making the  progressive muscular relaxation as a nursing intervention in reducing anxiety in patients undergoing hemodialysis. 

scholarly journals Acute kidney injury in children with chronic kidney disease is associated with faster decline in kidney function

2020 ◽  
Author(s):  
Nabil Melhem ◽  
Pernille Rasmussen ◽  
Triona Joyce ◽  
Joanna Clothier ◽  
Christopher J. D. Reid ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Kidney Injury ◽  
End Point ◽  
Significant Difference

Abstract Background This study aimed to investigate the association of acute kidney injury (AKI) with change in estimated glomerular filtration rate (eGFR) in children with advanced chronic kidney disease (CKD). Methods Single centre, retrospective longitudinal study including all prevalent children aged 1–18 years with nondialysis CKD stages 3–5. Variables associated with CKD were analysed for their potential effect on annualised eGFR change (ΔGFR/year) following multiple regression analysis. Composite end-point including 25% reduction in eGFR or progression to kidney replacement therapy was evaluated. Results Of 147 children, 116 had at least 1-year follow-up in a dedicated CKD clinic with mean age 7.3 ± 4.9 years with 91 (78.4%) and 77 (66.4%) with 2- and 3-year follow-up respectively. Mean eGFR at baseline was 29.8 ± 11.9 ml/min/1.73 m2 with 79 (68%) boys and 82 (71%) with congenital abnormalities of kidneys and urinary tract (CAKUT). Thirty-nine (33.6%) had at least one episode of AKI. Mean ΔGFR/year for all patients was − 1.08 ± 5.64 ml/min/1.73 m2 but reduced significantly from 2.03 ± 5.82 to − 3.99 ± 5.78 ml/min/1.73 m2 from youngest to oldest age tertiles (P < 0.001). There was a significant difference in primary kidney disease (PKD) (77% versus 59%, with CAKUT, P = 0.048) but no difference in AKI incidence (37% versus 31%, P = 0.85) between age tertiles. Multiple regression analysis identified age (β = − 0.53, P < 0.001) and AKI (β = − 3.2, P = 0.001) as independent predictors of ΔGFR/year. 48.7% versus 22.1% with and without AKI reached composite end-point (P = 0.01). Conclusions We report AKI in established CKD as a predictor of accelerated kidney disease progression and highlight this as an additional modifiable risk factor to reduce progression of kidney dysfunction. Graphical abstract

scholarly journals Predictors of Taste Dysfunction and Its Severity Among Patients With Chronic Kidney Disease

2021 ◽  
pp. 014556132110197
Author(s):  
Tajudeen Yusuf ◽  
Yemi R. Raji ◽  
Taye J. Lasisi ◽  
Adekunle Daniel ◽  
O. T. Bamidele ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Poor Quality ◽  
Control Group ◽  
College Hospital ◽  
Significant Difference ◽  
And Gender ◽  
The University ◽  
Taste Dysfunction ◽  
And Control

Background: Patients with chronic kidney disease (CKD) often complain of taste dysfunction. The prevalent taste dysfunction among patients with CKD predisposes them to malnutrition, poor quality of life, and worsen disease prognoses. To appropriately treat the taste dysfunction in this group of patients, it’s imperative that factors that predict taste dysfunction and its severity are identified for prompt treatment. Aim: To identify factors associated with taste dysfunction and its severity among patients with CKD. Materials and Methods: This was a hospital-based case–control study of adult patients with CKD at the University College Hospital, Ibadan, Nigeria. The control group was made up of age- and gender-matched healthy volunteers with no clinical and laboratory evidence of CKD. Relevant clinical and social data obtained include demographics, symptoms, and signs of taste dysfunction and its risk factors. The 4 basic taste modalities namely sweet, sour, bitter, and salt taste senses of the participants were tested with validated “taste strips.” Factors that predict taste dysfunction were identified among the spectrum of the disease. Results: There were 100 patients with CKD and 100 healthy controls, age ranges between 19 and 86 years (mean ± standard deviation [SD] = 46.3 ± 13.9 years) and 20 and 85 years (mean ± SD = 43.4 ± 14.9 years), respectively. There was no statistically significant difference between cases and control gender distribution ( P = .57). Hypogeusia was found in 27.0% of patients with CKD, while total taste function score of all the control was within normal range. Increasing duration of CKD was identified as a predictor of taste dysfunction among patients with CKD (odds ratio: 4.889, P = .038). The stages of CKD had no statistically significant relationship with the severity of taste dysfunction ( P = .629). Conclusion: The prevalence of taste dysfunction among patients with CKD was high and this showed significant correlation with increasing duration of CKD; in contrast, the severity of CKD is not significant in the development of taste dysfunction.

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