scholarly journals Hypoglycemic therapy in patients on hemodialysis and peritoneal dialysis

2010 ◽  
Vol 13 (4) ◽  
pp. 87-92
Author(s):  
Irina Arkad'evna Bondar' ◽  
Vadim Valer'evich Klimontov
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Peritoneal Dialysis ◽  
Renal Insufficiency ◽  
Renal Disease ◽  
Carbohydrate Metabolism ◽  
Chronic Renal Disease ◽  
Developed Countries ◽  
Hypoglycemic Therapy

Diabetes mellitus (DM) is a leading cause of renal insufficiency in developed countries. Most cases of chronic renal disease in DM patients are dueto diabetic nephropathy. The impairment of renal function at later stages of diabetic nephropathy is accompanied by complicated changes in the regulationof carbohydrate metabolism most of which require hypoglycemic therapy to be corrected

The use of dipeptidyl peptidase-4 inhibitors for the treatment of patients with type 2 diabetes mellitus and chronic renal disease

2013 ◽  
Vol 58 (6) ◽  
pp. 43-48
Author(s):  
M. Sh. Shamkhalova ◽  
M. V. Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Disease ◽  
Carbohydrate Metabolism ◽  
Chronic Renal Disease ◽  
Financial Burden ◽  
Number Of Patients ◽  
Dipeptidyl Peptidase 4 Inhibitors

The rapid increase in the number of patients with type 2 diabetes mellitus and renal pathology necessitates the revision of the presently adopted approaches to renal replacement therapy with a view of relieving the economic and financial burden imposed by the use of expensive therapeutic methods on the health budgets of the developed countries. The importance of achievement and maintenance of the target blood sugar levels for the prevention of the development and progression of renal lesions has been demonstrated in a series of large-scale clinical studies. Compensation of disorders of carbohydrate metabolism at the late stages of chronic renal disease in the patients presenting with diabetes mellitus encounters difficulties arising from the danger of hypoglycemia associated with the impairment of renal gluconeogenesis, cumulation of antiglycemic agents and their metabolites, decreased clinical significance of glycated hemoglobin levels under conditions of developing anemia and marked hyperglycemia. Discontentedness with the currently available means for the control of carbohydrate metabolism that fail to meet the up-to-date-requirements for the effectiveness and safety in a given clinical situation accounts for the ever increasing interest in the possibility of using innovative incretin-based medicines taking into account their pharmacological profile (they are known to change insulin secretion in response to variations in blood glucose levels, improve the function of beta-cells, have beneficial effect on the cardiovascular system, and control body weight).

Plasma D Dimer: A Useful Marker of Fibrin Breakdown in Renal Failure

1989 ◽  
Vol 61 (03) ◽  
pp. 522-525 ◽  
Author(s):  
M P Gordge ◽  
R W Faint ◽  
P B Rylance ◽  
H Ireland ◽  
D A Lane ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Monoclonal Antibodies ◽  
Diabetic Nephropathy ◽  
Renal Disease ◽  
Plasma Concentrations ◽  
Significant Negative Correlation ◽  
Healthy Controls ◽  
D Dimer

SummaryD dimer and other large fragments produced during the breakdown of crosslinked fibrin may be measured by enzyme immunoassay using monoclonal antibodies. In 91 patients with renal disease and varying degrees of renal dysfunction, plasma D dimer showed no correlation with renal function, whereas FgE antigen, a fibrinogen derivative which is known to be cleared in part by the kidney, showed a significant negative correlation with creatinine clearance. Plasma concentrations of D dimer were, however, increased in patients with chronic renal failure (244 ± 3l ng/ml) (mean ± SEM) and diabetic nephropathy (308 ± 74 ng/ml), when compared with healthy controls (96 ± 13 ng/ml), and grossly elevated in patients with acute renal failure (2,451 ± 1,007 ng/ml). The results indicate an increase in fibrin formation and lysis, and not simply reduced elimination of D dimer by the kidneys, and are further evidence of activated coagulation in renal disease. D dimer appears to be a useful marker of fibrin breakdown in renal failure.

Educational technology for patient with chronic renal disease: integrative review / Tecnologia educativa para paciente com doença renal crônica: revisão integrativa / Tecnología educativa voltada al paciente con enfermedad renal crónica: revisión integradora

2018 ◽  
Vol 7 (2) ◽  
pp. 72
Author(s):  
Cristiano Batista Gonçalves
Keyword(s):  
Health Promotion ◽  
Educational Technology ◽  
Renal Insufficiency ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Integrative Review ◽  
Tecnología Educativa

Objetivo: analisar a produção científica nacional e internacional sobre tecnologias educativas voltadas à promoção da saúde do paciente com doença renal crônica. Metodologia: trata-se de uma revisão integrativa da literatura; utilizou-se a questão norteadora: Quais as evidências disponíveis na literatura científica sobre tecnologias educativas voltadas à promoção da saúde do paciente com doença renal crônica?; não houve imposição de limite de tempo, e utilizou-se as bases de dados SciELO, MEDLINE, LILACS e CINAHL, com cruzamento dos seguintes descritores: renal insufficiency, educational technology, health promotion. Resultados: incluíram-se seis estudos nesta revisão e elencou-se quatro categorias sobre as tecnologias educativas: software para computador ou dispositivo móvel, material impresso, programa educacional via telefone e website. Conclusão: diferentes tecnologias educativas construídas evidenciam a preocupação dos profissionais da saúde em promover a longitudinalidade do cuidado e integralidade da saúde aos indivíduos com doença renal crônica, como também lhes instiga a tornarem-se protagonistas no cuidado da sua saúde.Descritores: Insuficiência Renal Crônica. Tecnologia Educacional. Promoção da Saúde.

Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 191-195 ◽  
Author(s):  
Chia-Te Liao ◽  
Chih-Chung Shiao ◽  
Jenq-Wen Huang ◽  
Kuan-Yu Hung ◽  
Hsueh-Fang Chuang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Clinical Laboratory ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Measure Data ◽  
Chi Square ◽  
Artery Disease

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.

scholarly journals PGNMID in a patient with diabetes mellitus

2021 ◽  
pp. 239936932098478
Author(s):  
Joana Marques ◽  
Patrícia Cotovio ◽  
Mário Góis ◽  
Helena Sousa ◽  
Fernando Nolasco
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Renal Disease ◽  
Renal Involvement ◽  
Organ Damage ◽  
Therapeutic Implications ◽  
Stage Renal Disease

Diabetic nephropathy is a well known complication of diabetes mellitus and the leader cause of end -stage renal disease worldwide. Nonetheless, other forms of renal involvement can occur in diabetic population. Since it has prognostic and therapeutic implications, differentiating non-diabetic renal disease from diabetic nephropathy is of great importance. We report an 80-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with rapid deterioration of renal function, nephrotic proteinuria, microscopic hematuria and leukocyturia. The atypical clinical presentation prompted us to perform a kidney biopsy. A diagnosis of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (light chain only variant) was made, with however some chronic histological aspects which made us took a conservative therapeutic attitude. We emphasize that other causes of chronic proteinuric kidney disease should be considered in patients with type 2 diabetes mellitus, based on clinical suspicion, absence of other organ damage and mostly if an atypical presentation is seen. We review the spectrum of monoclonal gammopathies of renal significance, focusing on this rare and newly describe entity.

Chronic renal disease in pregnancy: obstetric outcomes and effect of pregnancy on renal function

2011 ◽  
Vol 96 (Supplement 1) ◽  
pp. Fa102-Fa102
Author(s):  
T. J. Bonnett ◽  
A. Khalid ◽  
D. Throssell ◽  
T. Farrell ◽  
R. P. Jokhi
Keyword(s):  
Renal Function ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Obstetric Outcomes ◽  
In Pregnancy

scholarly journals Erythrocyte Sedimentation Rate in Patients with Renal Insufficiency and Renal Replacement Therapy

2021 ◽  
Author(s):  
Anna Buckenmayer ◽  
Lotte Dahmen ◽  
Joachim Hoyer ◽  
Sahana Kamalanabhaiah ◽  
Christian S. Haas
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Replacement Therapy ◽  
Sedimentation Rate ◽  
Inflammatory Markers ◽  
Erythrocyte Sedimentation ◽  
Esrd Patients

Abstract Background: The erythrocyte sedimentation rate (ESR) is a simple laboratory diagnostic tool for estimating systemic inflammation. It remains unclear, if renal function affects ESR, thereby compromising its validity. This pilot study aims to compare prevalence and extent of ESR elevations in hospitalized patients with or without kidney disease. In addition, the impact of renal replacement therapy (RRT) modality on ESR was determined.Methods: In this single-center, retrospective study, patients were screened for ESR values. ESR was compared in patients with and without renal disease and/or RRT. In addition, ESR was correlated with other inflammatory markers, the extent of renal insufficiency and clinical characteristics.Results: A total of 203 patients was identified, showing an overall elevated ESR in the study population (mean 51.7±34.6 mm/h). ESR was significantly increased in all patients with severe infection, active vasculitis or cancer, respectively, independent from renal function. Interestingly, there was no difference in ESR between patients with and without kidney disease or those having received a prior renal transplant or being on hemodialysis. However, ESRD patients treated with peritoneal dialysis presented with a significantly higher ESR (78.3±33.1 mm/h, p<0.001), while correlation with other inflammatory markers was not persuasive.Conclusions: We showed that ESR: (1) does not differ between various stages of renal insufficiency; (2) may be helpful as a screening tool also in patients with renal insufficiency; and (3) is significantly increased in ESRD patients on peritoneal dialysis per se, while it seems not to be affected by hemodialysis or renal transplantation (see graphical abstract as supplementary material).

Effects of sulindac on renal function and prostaglandin synthesis in patients with moderate chronic renal insufficiency

1986 ◽  
Vol 70 (5) ◽  
pp. 501-505 ◽  
Author(s):  
C. D. Mistry ◽  
C. J. Lote ◽  
R. Gokal ◽  
W. J. C. Currie ◽  
M. Vandenburg ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Insufficiency ◽  
Creatinine Clearance ◽  
Chronic Renal Disease ◽  
Renal Plasma Flow ◽  
Plasma Renin ◽  
Breakdown Product ◽  
Predisposing Factor ◽  
A Minor ◽  
Therapeutic Doses

1. The renal effects of therapeutic doses of sulindac were studied in nine patients with stable renal insufficiency, mean creatinine clearance 37.0 ± 2.2 ml min−1 1.73 m−2 (range 24.7–54.6 ml min−1 1.73 m−2). 2. Nine days' treatment with sulindac produced a small, but significant, reduction in the mean creatinine clearance (37.0 ± 2.2 to 34.7 ± 2.2 ml min−1 1.73 m−2; P < 0.02) and 99mTc diethylenetriaminepenta-acetate (DTPA) clearance (35.5 ± 3.4 to 31.4 ± 3.6 ml min−1 1.73 m−2; P < 0.02) without altering body weight, effective renal plasma flow [131I]hippuran clearance), plasma renin activity (PRA), 24 h urinary volume or electrolyte excretion. 3. After discontinuation of sulindac, creatinine clearance returned to pretreatment values. 4. In five female patients, pretreatment urinary excretion of the 6-ketoprostaglandin F1α (6-keto-PGF1α), a stable breakdown product of prostacyclin (PGI2), was significantly reduced (P < 0.02) when compared with four healthy controls, whereas prostaglandin E2 (PGE2) was unchanged. Administration of sulindac did not significantly alter the excretion rate of PGE2 or 6-ketoPGF1α in this group of patients. 5. In chronic renal disease with moderate renal impairment, reduced renal prostacyclin synthesis may be an important predisposing factor to the renal toxicity associated with the use of nonsteroidal anti-inflammatory drugs (NSAID). Short term use of sulindac in therapeutic doses does not appear to influence the excretion of prostaglandins and produces only a minor reversible change in renal function; used cautiously it may have advantages over other NSAID in these patients.-

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