scholarly journals KETAHANAN HIDUP PASIEN GAGAL GINJAL DENGAN METODE KAPLAN MEIER (Studi Kasus di Rumah Sakit Umum Daerah dr. R. Soedjati Soemodiarjo Purwodadi)

2018 ◽  
Vol 7 (3) ◽  
pp. 270-280
Author(s):  
Immawati Ainun Habibah ◽  
Tatik Widiharih ◽  
Suparti Suparti
Keyword(s):  
Chronic Kidney Disease ◽  
Survival Analysis ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Life Time ◽  
Terminal Phase ◽  
Type Iii ◽  
Kaplan Meier ◽  
Observation Process ◽  
Ckd Stage

Chronic Kidney Disease (CKD) is a failure of kidney function that which get slowly and can not recover. Most of the patients CKD get death sudden becuse of cardiovascular complications (related to the heart and blood vessels) however only minor part can reach terminal phase (CKD stage 5) which need replacement therapy of Kidney. Replacement therapy of Kidney are hemodialysis, peritoneal dialysis, and Kidney transplant. Because of that, the importance to study how long the patient opportunity is life endurance analysis.  Survival analysis methods to life depend from the life time and status of individual life time. Survival analysis uses Kaplan-Meier method. During the observation process, there is different observations so censor type III is choosen. Censor type III is censoring type which research is done to individual in and out for determine time, because of that estimation value of survival can be caunted using Kaplan Meier method with censor type III. This research uses medical records data from the patients with kidney failure period 1 January 2014 until 30 November 2017 in RSUD dr.R. Soedjati Soemodiarjo Purwodadi Grobogan Regency. The results of the analysis and discussion are known that if hemodialysis getting longer done, estimation value of survival. With an average estimate of survival is 776 days. Keywords: Chronic Kidney Disease, Survival Analysis, Kaplan Meier

Total serum magnesium in cats with chronic kidney disease with nephrolithiasis

2019 ◽  
Vol 21 (12) ◽  
pp. 1172-1180 ◽  
Author(s):  
Fernanda Chicharo Chacar ◽  
Marcia Mery Kogika ◽  
Andréa C Ferreira ◽  
Khadine K Kanayama ◽  
Archivaldo Reche
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Magnesium ◽  
Magnesium Concentration ◽  
Total Serum ◽  
Serum Magnesium Concentration ◽  
Electrolyte Disturbances ◽  
Kaplan Meier ◽  
Ckd Stage ◽  
Stage 1

ObjectivesMagnesium has been ‘the forgotten ion’ for many years. Over the past decade, however, the role of magnesium in essential physiological functions and several illness conditions have been elucidated. Nevertheless, the investigation of magnesium in cats with chronic kidney disease (CKD) and nephrolithiasis is yet to be determined. The purpose of this study was to investigate whether CKD cats with nephrolithiasis have changes in total serum magnesium concentrations, and whether magnesium disorders may be associated with other electrolyte disturbances, as well as with prognosis. We also aimed to evaluate whether total serum magnesium concentration differs between CKD cats with and without nephrolithiasis.MethodsTotal serum magnesium concentrations were assessed in 42 cats with CKD with stage 1–4 nephrolithiasis. The correlation between magnesium and other electrolytes, as well as Kaplan–Meier survival analysis, were performed. We also selected 14 control cats with CKD without nephrolithiasis age-matched with 14 cats with CKD with nephrolithiasis.ResultsHypermagnesemia was observed in 16/42 (38.1%) and hypomagnesemia in 6/42 (14.3%) cats. Serum magnesium abnormalities were observed in cats of all stages, and marked hypermagnesemia was noted in cats with stage 4 CKD with nephrolithiasis ( P <0.001). There was a negative correlation between total serum magnesium and ionized calcium ( r = −0.64; P <0.01), and a positive correlation between total serum magnesium and serum phosphorus ( r = 0.58, P = 0.01). Cats with CKD with nephrolithiasis and hypomagnesemia or hypermagnesemia had higher mortality than those with normal total serum magnesium concentration ( P <0.01), regardless of CKD stage. There was no difference in total serum magnesium concentration between CKD cats with and without nephrolithiasis.Conclusions and relevanceCats with CKD with nephrolithiasis have magnesium abnormalities. Hypomagnesemia and hypermagnesemia were associated with an increase in mortality, and thus total serum magnesium abnormalities may be used as prognostic factors in these cases.

Chronic kidney disease

2020 ◽  
pp. 4830-4860
Author(s):  
Alastair Hutchison
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
The United States ◽  
Protein Excretion ◽  
Stage 4 ◽  
Ckd Stage ◽  
Stage 1

Chronic kidney disease (CKD) is defined as kidney damage lasting for more than 3 months characterized by structural or functional abnormalities of the kidney, with or without decreased glomerular filtration rate (GFR). CKD has been subdivided into six stages depending on the estimated GFR (eGFR) and degree of proteinuria: CKD stage 1 is eGFR greater than 90 ml/min (per 1.73 m2) with other evidence of renal disease; CKD stage 2 is eGFR 60 to 89 ml/min, with other evidence of renal disease; CKD stage 3a is eGFR 45 to 59 ml/min; CKD stage 3b is eGFR 30 to 44 ml/min; CKD stage 4 is eGFR 15 to 29 ml/min; and CKD stage 5 is eGFR less than 15 ml/min. At each stage the CKD is further categorized according to the degree of proteinuria based on the albumin:creatinine ratio (ACR), from A1 (no increase in protein excretion) to A3 (severe proteinuria). The eGFR is least accurate when the serum creatinine is within or near the normal range. Mild CKD is common, with about 10% of the population of the United States of America having CKD stage 1, 2, or 3 (combined), but advanced CKD is relatively rare (about 0.2% are receiving renal replacement therapy). Patients with CKD stage 1, 2, or 3 are at relatively low risk of progressing to require renal replacement therapy, but are at high risk of death from cardiovascular disease. This chapter discusses the definition, aetiology, and pathophysiology of CKD, followed by sections on the prevention of progression, medical management of the consequences of CKD (including diet, CKD mineral and bone disorders, advanced hyperparathyroidism, and anaemia), and preparation for renal replacement therapy or conservative management of uraemia.

scholarly journals Association between Multidimensional Prognostic Index and Hospitalization and Mortality among Older Adults with Chronic Kidney Disease on Conservative or on Replacement Therapy

2020 ◽  
Vol 9 (12) ◽  
pp. 3965
Author(s):  
Silvia Lai ◽  
Maria Amabile ◽  
Sandro Mazzaferro ◽  
Giovanni Imbimbo ◽  
Anna Mitterhofer ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Prognostic Index ◽  
Moderate Risk ◽  
Multidimensional Evaluation ◽  
Ckd Stage

The prevalence of renal disease is constantly increasing in older adults and a prognostic evaluation by a valid tool may play a key role in treatment management. We aimed to assess the association(s) between the multidimensional prognostic index (MPI) and both the hospitalization and mortality among older adults with renal disease. Patients with chronic kidney disease (CKD) (stage 3–5 KDOQI) and on dialysis were considered. Clinical parameters were registered at baseline and after 2 years. In all the patients, the MPI was calculated and divided into grade 0 (low risk), 1 (moderate risk), and 2 (severe risk). Hospitalizations and mortality were recorded during the follow-up and analyzed according to MPI grade. A total of 173 patients, with a median age of 76 years, on conservative (n = 105) and replacement therapy (32 patients on hemodialysis, 36 patients on peritoneal dialysis) were enrolled. Of them, 60 patients were in MPI grade 0, 102 in grade 1, and 11 in grade 2. The median duration of all the hospitalizations was 6 days and the number of deaths was 33. MPI significantly correlated with days of hospitalization (r = 0.801, p < 0.00001) and number of hospitalizations per year (r = 0.808, p < 0.00001), which was higher in MPI grade 2 compared to grade 1 (p < 0.001) and to grade 0 (p < 0.001). We found a significant association between MPI grades and mortality (p < 0.001). Our results indicate that MPI was associated with outcomes in patients with renal disease, suggesting that a multidimensional evaluation should be implemented in this clinical setting.

scholarly journals FAMILIAL MEDITERRANEAN FEVER COMPLICATED BY CHRONIC KIDNEY DISEASE STAGE 5 DESCRIPTION OF THE CLINICAL CASE

2021 ◽  
Vol 127 (4) ◽  
pp. 44-47
Author(s):  
Maria Palchukovska ◽  
Lyudmila Liksunova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Familial Mediterranean Fever ◽  
Replacement Therapy ◽  
Clinical Case ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Ckd Stage ◽  
Mediterranean Fever ◽  
End Stage

this clinical case demonstrates renal amyloidosis – the most severe complication of familial Mediterranean fever (FMF). This clinical case gives an example of rapid evolution of renal failure in the lack of treatment. 62 years old man, Armenian, consults  a physician with such complaints as evening fever up to 38° for a month, frequent urination and dark urine. Biochemical blood test revealed an increase in the following indices: creatinine-489 μmol / l, urea 28.3 μmol / l, uric acid 619 μmol / l. GFR-6ml / min. No amyloid deposits were detected by biopsy of the buccal mucosa. The diagnosis of FMF, chronic kidney disease (CKD) stage 5. Initiation of treatment. Tenkhoff catheter installation. Treatment includes сontinuous ambulatory peritoneal dialysis (CAPD) in mode 4 exchanges with a glucose solution of 1.36% 2.0 liters. The dynamics of treatment is positive in  presence of constant replacement therapy. A feature of this clinical case is the insidious development of secondary (AA) amyloidosis in uncontrolled patient, which leads to the development of end-stage chronic kidney disease (CKD). This case demonstrates the need of constant examination and treatment of the patients with end-stage CKD by renal replacement therapy, which significantly reduces the quality of patient`s life.

scholarly journals Urine Trefoil Factors as Prognostic Biomarkers in Chronic Kidney Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Toshio Yamanari ◽  
Hitoshi Sugiyama ◽  
Keiko Tanaka ◽  
Hiroshi Morinaga ◽  
Masashi Kitagawa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Chronic Glomerulonephritis ◽  
Spot Urine ◽  
Kaplan Meier ◽  
Ckd Stage ◽  
Renal Prognosis ◽  
Renal Progression ◽  
Tff Peptides

Introduction. Trefoil factor family (TFF) peptides are increased in serum and urine in patients with chronic kidney disease (CKD). However, whether the levels of TFF predict the progression of CKD remains to be elucidated. Methods. We determined the TFF levels using peptide-specific ELISA in spot urine samples and performed a prospective cohort study. The association between the levels of urine TFFs and other urine biomarkers as well as the renal prognosis was analyzed in 216 CKD patients (mean age: 53.7 years, 47.7% female, 56.9% with chronic glomerulonephritis, and mean eGFR: 58.5 ml/min/1.73 m2). Results. The urine TFF1 and TFF3 levels significantly increased with the progression of CKD stages, but not the urine TFF2 levels. The TFF1 and TFF3 peptide levels predicted the progression of CKD ≥ stage 3b by ROC analysis (AUC 0.750 and 0.879, resp.); however, TFF3 alone predicted CKD progression in a multivariate logistic regression analysis (odds ratio 3.854, 95% confidence interval 1.316–11.55). The Kaplan-Meier survival curves demonstrated that patients with a higher TFF1 and TFF3 alone, or in combination with macroalbuminuria, had a significantly worse renal prognosis. Conclusion. The data suggested that urine TFF peptides are associated with renal progression and the outcomes in patients with CKD.

scholarly journals Imbalanced turnover of collagen type III is associated with disease progression and mortality in high-risk chronic kidney disease patients

2020 ◽  
Author(s):  
Federica Genovese ◽  
Daniel Guldager Kring Rasmussen ◽  
Morten A Karsdal ◽  
Mark Jesky ◽  
Charles Ferro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Progression ◽  
Collagen Type ◽  
Pathological Feature ◽  
Collagen Type Iii ◽  
Ckd Progression ◽  
Type Iii ◽  
Ckd Stage ◽  
Fibrotic Scar

Abstract Background Tubulointerstitial fibrosis is a major pathological feature in chronic kidney disease (CKD) and collagen type III (COL3) is a major component of the renal fibrotic scar. We hypothesized that a dysregulated turnover of COL3 is an important determinant of CKD progression. We assessed the relationship between fragments reflecting active formation (PRO-C3) and degradation (C3M) of COL3 and CKD disease progression and mortality in a prospective cohort of CKD patients. Methods We measured PRO-C3 and C3M in urine (uPRO-C3 and uC3M) and serum (sPRO-C3 and sC3M) of 500 patients from the Renal Impairment in Secondary Care study. Disease progression was defined as a decline in estimated glomerular filtration rate &gt;30% or the start of renal replacement therapy within 12 and 30 months. Results Levels of uC3M/creatinine decreased, whereas levels of uPRO-C3/creatinine and sPRO-C3 increased with increasing CKD stage. uC3M/creatinine was inversely and independently associated with disease progression by 12 months {odds ratio [OR] 0.39 [95% confidence interval (CI) 0.18–0.83]; P = 0.01 per doubling of uC3M/creatinine} with development of end-stage renal disease [hazard ratio (HR) 0.70 (95% CI 0.50–0.97); P = 0.03 per doubling of uC3M/creatinine]. sPRO-C3 at baseline was independently associated with increased mortality [HR 1.93 (95% CI 1.21–3.1); P = 0.006 per doubling of sPRO-C3] and disease progression by 30 months [OR 2.16 (95% CI 1.21–3.84); P = 0.009 per doubling of sPRO-C3]. Conclusions Dynamic products of COL3 formation and degradation were independently associated with CKD progression and mortality and may represent an opportunity to link pathological processes with targeted treatments against fibrosis.

P0203EARLY DETECTION OF BREAST ARTERIAL CALCIFICATION IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Basma Sultan ◽  
Hamdy Omar ◽  
Housseini Ahmed ◽  
Mahmoud Elprince ◽  
Osama Anter adly ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lipid Profile ◽  
Statistical Significance ◽  
University Hospital ◽  
Arterial Calcification ◽  
Control Group ◽  
Inpatient Ward ◽  
Stage 4 ◽  
Ckd Stage

Abstract Background and Aims Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. Conclusion Although it is difficult to determine the definite stage at which the risk of VC begins but in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3 and became significantly higher in stage 4. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.

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