scholarly journals Improvement of renal function after transcatheter aortic valve replacement in patients with chronic kidney disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251066
Author(s):  
Michel V. Lemes da Silva ◽  
Antonio C. B. Nunes Filho ◽  
Vitor E. E. Rosa ◽  
Adriano Caixeta ◽  
Pedro A. Lemos Neto ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Transcatheter Aortic Valve ◽  
Stable Renal Function

Background Chronic kidney disease is commonly found in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and has marked impact in their prognosis. It has been shown however that TAVR may improve renal function by alleviating the hemodynamic barrier imposed by AS. Nevertheless, the predictors of and clinical consequences of renal function improvement are not well established. Our aim was to assess the predictors of improvement of renal function after TAVR. Methods The present work is an analysis of the Brazilian Registry of TAVR, a national non-randomized prospective study with 22 Brazilian centers. Patients with baseline renal dysfunction (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73m2) were stratified according to renal function after TAVR: increase >10% in eGFR were classified as TAVR induced renal function improvement (TIRFI); decrease > 10% in eGFR were classified as acute kidney injury (AKI) and stable renal function (neither criteria). Results A total of 819 consecutive patients with symptomatic severe AS were included. Of these, baseline renal dysfunction (estimated glomerular filtration rate [eGFR] < 60mL/min/1.73m2) was present in 577 (70%) patients. Considering variance in renal function between baseline and at discharge after TAVR procedure, TIRFI was seen in 197 (34.1%) patients, AKI in 203 (35.2%), and stable renal function in 177 (30.7%). The independent predictors of TIRFI were: absence of coronary artery disease (OR: 0.69; 95% CI 0.48–0.98; P = 0.039) and lower baseline eGFR (OR: 0.98; 95% CI 0.97–1.00; P = 0.039). There was no significant difference in 30-day and 1-year all-cause mortality between patients with stable renal function or TIRFI. Nonetheless, individuals that had AKI after TAVR presented higher mortality compared with TIRFI and stable renal function groups (29.3% vs. 15.4% vs. 9.5%, respectively; p < 0.001). Conclusions TIRFI was frequently found among baseline impaired renal function individuals but was not associated with improved 1-year outcomes.

scholarly journals Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly

2021 ◽  
Author(s):  
Samel Park ◽  
Nam‐Jun Cho ◽  
Nam Hun Heo ◽  
Eun‐Jung Rhee ◽  
Hyowook Gil ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Vascular Calcification ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Tertiary Teaching

Background The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS). Methods and Results Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m 2 ) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5–8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted‐β, −0.40; 95% CI, −0.80 to −0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13–5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance ( P =0.004). Conclusions Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.

The Prevalence of Chronic Kidney Disease in Rheumatology Outpatients

2009 ◽  
Vol 54 (2) ◽  
pp. 9-12 ◽  
Author(s):  
AJ Hill ◽  
RJ Thomson ◽  
JA Hunter ◽  
JP Traynor
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Prevalence Rate ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Monthly Basis ◽  
Definition Of

Background The introduction of routine reporting of estimated glomerular filtration rate coupled with a new definition of chronic kidney disease (CKD) has led to an unprecedented focus on kidney disease in many patient groups. In light of this, we performed an audit of patients attending the rheumatology clinics to assess the prevalence of CKD in this population. Methods Over a four week period, we reviewed the renal function of all patients attending the rheumatology clinics and day ward at our hospital (n=351). Renal function was assessed using the 4-variable MDRD formula. We then interviewed those patients with estimated glomerular filtration rate (eGFR) of 59 ml/min or lower. Results We found a prevalence rate of 18% for stage 3 CKD or lower in our audit population. Surprisingly, 60.3% of patients in this category were not aware of any problems with their kidneys (n=38). Conclusions The prevalence rate of 18% for stage 3 CKD or lower is significantly higher than the five per cent reported within the general population. As a result of this audit, we now plan to ensure that these patients undergo measurement of blood pressure, eGFR, and urinalysis on a six to twelve monthly basis.

scholarly journals Anemia and atrial fibrillation as independent risk factors for new-onset chronic kidney disease: the TAMA-MED Project-CKD and AF

2021 ◽  
Author(s):  
Tomohiro Kaneko ◽  
Eitaro Kodani ◽  
Hitomi Fujii ◽  
Risa Asai ◽  
Miyako Seki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Rapid Deterioration ◽  
New Onset

Abstract Background Various risk factors have been identified for the new-onset or rapid deterioration of chronic kidney disease. However, it is thought that many risk factors that have not yet been clarified remain. Methods Based on the results of specific annual health checkups at Tama City (n = 18,383) in 2017 and 2018, we analyzed the factors that cause new-onset chronic kidney disease and the risk factors that rapidly worsen renal function. For new-onset chronic kidney disease, proteinuria and estimated glomerular filtration rate &lt; 60 mL/min/1.73m2 were examined separately. Rapid deterioration of renal function was defined as an estimated glomerular filtration rate of ≥ 25% lower than the previous year. Results Multivariate analysis showed that, in addition to age and impaired glucose tolerance, anemia, and atrial fibrillation were risk factors for the new appearance of proteinuria. Risk factors for a decrease in estimated glomerular filtration rate &lt; 60 mL/min/1.73m2 were age and hyperuricemia. Age, systolic hypertension, urinary protein and urinary occult blood, high triglycerides, and anemia were significant risk factors for the rapid deterioration of renal function in patients with chronic kidney disease stage 3 or later. Conclusions From the results of specific annual health checkups at Tama City, atrial fibrillation, anemia, and hyperuricemia were identified as risk factors for new-onset chronic kidney disease over a short period of 1 year. Anemia was also a factor for the rapid deterioration of kidney function in subjects with renal dysfunction.

scholarly journals Variability in Estimated Glomerular Filtration Rate by Area under the Curve Predicts Renal Outcomes in Chronic Kidney Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Szu-Chia Chen ◽  
Ming-Yen Lin ◽  
Teng-Hui Huang ◽  
Chi-Chih Hung ◽  
Yi-Wen Chiu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Cox Model ◽  
Renal Outcomes ◽  
End Point

Greater variability in renal function is associated with mortality in patients with chronic kidney disease (CKD). However, few studies have demonstrated the predictive value of renal function variability in relation to renal outcomes. This study investigates the predictive ability of different methods of determining estimated glomerular filtration rate (eGFR) variability for progression to renal replacement therapy (RRT) in CKD patients. This was a prospective observational study, which enrolled 1,862 CKD patients. The renal end point was defined as commencement of RRT. The variability in eGFR was measured by the area under the eGFR curve (AUC)%. A significant improvement in model prediction was based on the −2 log likelihood ratio statistic. During a median 28.7-month follow-up, there were 564 (30.3%) patients receiving RRT. In an adjusted Cox model, a smaller initial eGFR AUC%_12M (P<0.001), a smaller peak eGFR AUC%_12M (P<0.001), and a larger negative eGFR slope_12M (P<0.001) were associated with a higher risk of renal end point. Two calculated formulas: initial eGFR AUC%_12M and eGFR slope_12M were the best predictors. Our results demonstrate that the greater eGFR variability by AUC% is associated with the higher risk of progression to RRT.

Low S-adenosylmethionine/ S-adenosylhomocysteine Ratio in Urine is Associated with Chronic Kidney Disease

2019 ◽  
Vol 51 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Maria Petrovna Kruglova ◽  
Sergej Vital’evich Grachev ◽  
Polina Olegovna Bulgakova ◽  
Alexander Vladimirovich Ivanov ◽  
Edward Danielevich Virus ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Case Control Study ◽  
Case Control ◽  
Diagnostic Indicator ◽  
Control Study

Abstract Objective To evaluate the association of S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) in urine with chronic kidney disease (CKD). Methods Case-control study including 50 patients with CKD and 20 healthy volunteers. Results SAM level and SAM/SAH ratio in urine were significantly lower in patients than in control individuals (P &lt;.001 and P = .01, respectively). The estimated glomerular filtration rate was associated with the SAM level (P = .04) and the SAM/SAH ratio in urine (P = .01). Conclusion CKD is associated not only with the decline in the SAM level but also with the decrease in the SAM/SAH ratio in urine. Thus, use of the urinary SAM/SAH ratio as a noninvasive diagnostic indicator of renal function seems promising.

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