scholarly journals Prevalence of chronic kidney diseases and determinants among TDF users of pregnant and lactating women based on eGFR-cg, and MDRD-4 in hospital setting of north east Amhara, Ethiopia

2018 ◽  
Vol 6 (1) ◽  
pp. 6
Author(s):  
Eyob Gebretsadikk ◽  
Azmach Hadush ◽  
Mohammed Hussien ◽  
Getahun Asres
Keyword(s):  
High Risk ◽  
Kidney Diseases ◽  
Hospital Setting ◽  
Risk Estimate ◽  
Hiv Positive ◽  
Tubular Damage ◽  
Chronic Kidney Diseases ◽  
Lactating Women ◽  
Method Of Calculation ◽  
Incidence Of Ckd

In recent days, it is common to see increasing incidence of Fanconi, proximal kidney tubular damage and chronic kidney diseases-CKD among high risk populations that drew the clinicians’ attention to monitor closely. Among these risk populations with potential CKD incidence; HIV positive patients who uses TDF as a component of HAART need to be monitored for the incidence of CKD as a toxicity of TDF before initiation and during treatment despite the fact that the current monitoring practice in Ethiopia in most hospitals remain to be poor. Hence this study aimed at measuring the incidence of CKD among high risk segment of HIV positive pregnant and lactating women who uses TDF as part of their HAART treatment. Using a non-proportionate stratified sampling, a total of 111 HIV+ pregnant and lactating women who are on TDF based HAART treatment were enrolled to measure the incidence of CKD based on NKF K/DOQI Classification. Using the Android application of Medicalc GFR-cg, and MDRD-4; the prevalence of stage-2 CKD was 16.2 % (60-89 ml/min) and Stage 5-CKD/Renal Failure who require dialysis were 3.6% (CrCl < 15ml/min/1.72m2) by both method of calculation CrCl (GFR-cg and MDRD-4). Women who were lactating had a relative risk of 0.918 (95% CI lies within 0.845-0.998) of acquiring CKD (P= 0.045). The other associated factors were BMI less than 18.5 (P= 0.004 and adjusted OR of 7.82), WHO clinical stage-1 (P=0.014, odds ratio of 5.4 and 95% CI of 1.24-24.42), baseline CD4 count > 500 (P=0.02), and duration on TDF (> 12 months on treatment) and low haematocrit of 30 had a higher risk of falling into Stage 2 CKD with cohort risk estimate of 4.103 (95 % CI of 1.02, 16.54). The risk estimate of WHO stage 2 to acquire stage-4 CKD was 1.087 (95% CI of 1.002, 1.180) statistically significant (P=0.05.). The prevalence of stage 2 CKD among pregnant and lactating women by GFR-cg method of calculation was higher than MDRD-4 calculation. In this study, MDRD-4 method underestimated stage 2 CKD. Hence it is worth and highly recommended to use GFR-cg method in the baseline and during treatment monitoring of TDF toxicity to the kidney particularly for diagnosing the early stage of CKD.

A cross sectional study on assessment of risk of diabetes mellitus using Indian diabetic risk score in a medical college teaching hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 32-40
Author(s):  
Singam Sivasankar Reddy ◽  
Syeda Rahath ◽  
Rakshitha H N ◽  
Godson K Lal ◽  
Swathy S ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Risk Score ◽  
Hospital Setting ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patient Counselling ◽  
Related Quality

The objective of the study was to evaluate the risk of diabetes mellitus in elderlywith age above 20 years in a hospital setting using Indian Diabetes risk score and to provide patient counselling regarding their life style modifications and health related quality of life among participants with high risk of developing diabetes.A total of 125 non diabetic patients were interviewed with a pre designed selfstructured questionnaire (IDRS). Participants were chosen voluntarily and a written consent was obtained before the administration of the questionnaire from individual patients. In our study we observed that out of 125 patients,males 26[59%]and 18[41%] females were at high risk, males 39[58.2%] and 28[41.8%] females were at moderate risk, males 5[35.7%] and 9[64.3%] females were at low risk of developing diabetes mellitus.

scholarly journals Nephrotoxicity of Herbal Products in Europe—A Review of an Underestimated Problem of Nephrotoxicity of Herbal Products

2021 ◽  
Vol 22 (8) ◽  
pp. 4132
Author(s):  
Katarzyna Kiliś-Pstrusińska ◽  
Anna Wiela-Hojeńska
Keyword(s):  
Kidney Diseases ◽  
Herbal Medicines ◽  
Kidney Injury ◽  
Herbal Products ◽  
Chronic Kidney Diseases ◽  
European Origin ◽  
Synthetic Drugs ◽  
The Many ◽  
Pharmacologically Active ◽  
Traditional Chinese Herbal Medicines

Currently in Europe, despite the many advances in production technology of synthetic drugs, the interest in natural herbal medicines continues to increase. One of the reasons for their popular use is the assumption that natural equals safe. However, herbal medicines contain pharmacologically active ingredients, some of which have been associated with adverse effects. Kidneys are particularly susceptible to injury induced by toxins, including poisonous constituents from medicinal plants. The most recognized herb-induced kidney injury is aristolochic acid nephropathy connected with misuse of certain Traditional Chinese herbal medicines. Data concerning nephrotoxicity of plant species of European origin are scarce. Here, we critically review significant data of the nephrotoxicity of several plants used in European phytotherapy, including Artemisia herba-alba, Glycyrrhiza glabra, Euphorbia paralias, and Aloe). Causative mechanisms and factors predisposing to intoxications from the use of herbs are discussed. The basic intention of this review is to improve pharmacovigilance of herbal medicine, especially in patients with chronic kidney diseases.

scholarly journals Kidney organoid systems for studies of immune-mediated kidney diseases: challenges and opportunities

2021 ◽  
Author(s):  
Melissa C. Stein ◽  
Fabian Braun ◽  
Christian F. Krebs ◽  
Madeleine J. Bunders
Keyword(s):  
Kidney Diseases ◽  
Three Dimensional ◽  
Renal Tissue ◽  
Chronic Kidney Diseases ◽  
Immune Mediated ◽  
Primary Epithelial Cell ◽  
Challenges And Opportunities ◽  
Underlying Mechanisms ◽  
Global Population

AbstractAcute and chronic kidney diseases are major contributors to morbidity and mortality in the global population. Many nephropathies are considered to be immune-mediated with dysregulated immune responses playing an important role in the pathogenesis. At present, targeted approaches for many kidney diseases are still lacking, as the underlying mechanisms remain insufficiently understood. With the recent development of organoids—a three-dimensional, multicellular culture system, which recapitulates important aspects of human tissues—new opportunities to investigate interactions between renal cells and immune cells in the pathogenesis of kidney diseases arise. To date, kidney organoid systems, which reflect the structure and closer resemble critical aspects of the organ, have been established. Here, we highlight the recent advances in the development of kidney organoid models, including pluripotent stem cell-derived kidney organoids and primary epithelial cell-based tubuloids. The employment and further required advances of current organoid models are discussed to investigate the role of the immune system in renal tissue development, regeneration, and inflammation to identify targets for the development of novel therapeutic approaches of immune-mediated kidney diseases.

scholarly journals Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London

2020 ◽  
pp. bjophthalmol-2020-317373
Author(s):  
Anindyt Nagar ◽  
Sam Myers ◽  
Diana Kozareva ◽  
Mark Simcoe ◽  
Christopher Hammond
Keyword(s):  
High Risk ◽  
Genetic Diseases ◽  
Family Doctor ◽  
Family Members ◽  
Hospital Setting ◽  
High Risk Group ◽  
Cascade Screening ◽  
Specialist Referral ◽  
High Risk Family ◽  
African Caribbean

Background/aimsCascade screening has been used successfully in relatives of patients with inherited cancers and other genetic diseases to identify presymptomatic disease. This study was designed to examine if this approach would be successful in a high-risk group: first-degree relatives (FDR) of African-Caribbean glaucoma patients resident in London.MethodsAfrican-Caribbean patients (probands) with glaucoma from an inner London hospital setting in a deprived area were asked to disseminate personalised information to their FDR over the age of 30 and to arrange a free hospital-based screening. Data collected, including optical coherence tomography imaging, were reviewed by a glaucoma specialist and if glaucoma was diagnosed or suspected, local specialist referral via family doctor was made.Results203 probands were recruited from glaucoma clinics. 248 suitable FDR were identified as potentially eligible to attend screening. 57 (23%) FDR made contact with the research team of whom 18 (7%) attended a subsequent screening visit. No patients were diagnosed with glaucoma; one participant was diagnosed as glaucoma suspect. Reasons for poor uptake included reluctance by probands to involve their family members, and retirees spending significant time abroad.ConclusionCascade screening of FDR of African-Caribbean glaucoma patients in inner city London was unsuccessful. Research confidentiality guidance prohibiting research teams directly contacting family members was a barrier. Greater community engagement, community-based screening and permission to contact FDR directly might have improved uptake.

scholarly journals Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Perceived Social Support ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

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