scholarly journals Survival Analysis of Chronic Kidney Disease Patients with Hemodialysis in West Java. Indonesia, Year 2007 - 2018

2020 ◽  
Vol 52 (3) ◽  
pp. 172-179
Author(s):  
Afiatin ◽  
Dwi Agustian ◽  
Kurnia Wahyudi ◽  
Pandu Riono ◽  
Rully M. A. Roesli
Keyword(s):  
Chronic Kidney Disease ◽  
Survival Analysis ◽  
Survival Rate ◽  
Kidney Disease ◽  
Demographic Data ◽  
Survival Rates ◽  
Treatment Quality ◽  
West Java ◽  
Dialysis Treatment ◽  
The Impact

The prevalence of chronic kidney disease on dialysis or CKD5D is increasing with a significant impact on disease burden in many countries. Patients are usually listed in the national renal registries, which report demographic data, incidence, prevalence, and outcome. The survival rate is an important outcome measure to characterize the impact of treatment in the CKD5 patient population in the national and international renal registries. Indonesian Society of Nephrology (InaSN) has the Indonesian Renal Registry program to collect data that was endorsed to monitor dialysis treatment quality in Indonesia. IRR releases an annual report, but there is no survival analysis yet. This study aimed to discover the five-year survival rate of CKD5D patients in West Java between 2007–2018 and its factor based on the IRR database. A retrospective cohort study was performed by gaining all patients' data from the IRR database, then data on all of the patients from West Java province who completed a 5-year follow-up on December 31, 2018. Kaplan-Meier analysis and Cox proportional hazard's model were used to analyze the risk factors. There were 3,199 data included in this study. In total, the 1, 2, 3, 4, and 5 year survival rates are 82%, 70%, 62%, 58%, and 55 %, respectively. Patients whose age is above 55 years and with unknown underlying kidney disease have a worse survival rate with a hazard ratio of 1.28 and 1.50, respectively. Further exploration of IRR data will provide better information on dialysis treatment in Indonesia.

scholarly journals Effect of an Oral Adsorbent, AST-120, on Dialysis Initiation and Survival in Patients with Chronic Kidney Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Shingo Hatakeyama ◽  
Hayato Yamamoto ◽  
Akiko Okamoto ◽  
Kengo Imanishi ◽  
Noriko Tokui ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Survival Rate ◽  
Kidney Disease ◽  
Dialysis Initiation ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Oral Adsorbent ◽  
Matched Study ◽  
The Impact ◽  
Free Rate

The oral adsorbent AST-120 has the potential to delay dialysis initiation and improve survival of patients on dialysis. We evaluated the effect of AST-120 on dialysis initiation and its potential to improve survival in patients with chronic kidney disease. The present retrospective pair-matched study included 560 patients, grouped according to whether or not they received AST-120 before dialysis (AST-120 and non-AST-120 groups). The cumulative dialysis initiation free rate and survival rate were compared by the Kaplan-Meier method. Multivariate analysis was used to determine the impact of AST-120 on dialysis initiation. Our results showed significant differences in the 12- and 24-month dialysis initiation free rate (P<0.001), although no significant difference was observed in the survival rate between the two groups. In conclusion, AST-120 delays dialysis initiation in chronic kidney disease (CKD) patients but has no effect on survival. AST-120 is an effective therapy for delaying the progression of CKD.

scholarly journals A survival analysis of COVID-19 in the Mexican population

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Guillermo Salinas-Escudero ◽  
María Fernanda Carrillo-Vega ◽  
Víctor Granados-García ◽  
Silvia Martínez-Valverde ◽  
Filiberto Toledano-Toledano ◽  
...  
Keyword(s):  
Public Health ◽  
Chronic Kidney Disease ◽  
Survival Analysis ◽  
Kidney Disease ◽  
Health Services ◽  
Older Age ◽  
Mexican Population ◽  
Public Health Services ◽  
Risk Of Death ◽  
The Impact

Abstract Background At present, the Americas report the largest number of cases of COVID-19 worldwide. In this region, Mexico is the third country with most deaths (20,781 total deaths). A sum that may be explained by the high proportion of people over 50 and the high rate of chronic diseases. The aim of this analysis is to investigate the risk factors associated with COVID-19 deaths in Mexican population using survival analysis. Methods Our analysis includes all confirmed COVID-19 cases contained in the dataset published by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health. We applied survival analysis to investigate the impact of COVID-19 on the Mexican population. From this analysis, we plotted Kaplan-Meier curves, and constructed a Cox proportional hazard model. Results The analysis included the register of 16,752 confirmed cases of COVID-19 with mean age 46.55 ± 15.55 years; 58.02% (n = 9719) men, and 9.37% (n = 1569) deaths. Male sex, older age, chronic kidney disease, pneumonia, hospitalization, intensive care unit admission, intubation, and health care in public health services, were independent factors increasing the risk of death due to COVID-19 (p < 0.001). Conclusions The risk of dying at any time during follow-up was clearly higher for men, individuals in older age groups, people with chronic kidney disease, and people hospitalized in public health services.

Clinical outcomes after surgical or transcatheter aortic valve replacement in patients with chronic kidney disease: an analysis in 29 893 patients from the German Aortic Valve Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Mas-Peiro ◽  
G Faerber ◽  
T Bauer ◽  
S Bleiziffer ◽  
R Bekeredjian ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aortic Valve ◽  
Survival Rates ◽  
Funding Source ◽  
Intermediate Risk ◽  
Transcatheter Aortic Valve ◽  
All Cause Mortality ◽  
Risk Patients ◽  
The Impact

Abstract Background Chronic kidney disease (CKD) is a key risk factor in patients undergoing transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Purpose We analyzed the impact of eGFR and different stages of chronic kidney disease (CKD), on short- and mid-term survival in patients undergoing TAVI or SAVR. Methods Data from 29893 patients enrolled in the German Aortic Valve registry (GARY) from January 2011 to December 2015 receiving TAVI (n=12834) or SAVR (n=17059) at 88 sites were included. The impact of renal impairment, as measured by eGFR and CKD stages, was investigated. The primary endpoint was 1-year cumulative all-cause mortality. A propensity score method was used to compare TAVI vs. SAVR in patients with intermediate risk and mild-to-moderate renal disease being eligible for both therapies. Results Higher CKD stages were significantly associated to lower in-hospital, 30-day- and 1-year survival rates. Both TAVI- and SAVR-treated patients in CKD 3a, 3b, 4, and 5 stages showed significant and gradually increasing HR values for 1-year all-cause mortality. The same trend persisted in multivariable analysis, although HR values for CKD 3a and 5 did not reach significance in TAVI patients, whereas CKD 4+5 did not reach statistical significance in SAVR. Likewise, eGFR as a continuous variable was a significant predictor for 1-year mortality, with the best cut-off points being 47.4 mL/min/1.73 m2 for TAVI and 59.8 mL/min/1.73 m2 for SAVR. Significant 8.6% and 9.0% increases in 1-year mortality were observed for every 5-mL reduction in eGFR for TAVI and SAVR, respectively. No significant differences in survival were found between TAVI and SAVR in a matched group of intermediate-risk patients potentially eligible for both therapies (HR [(95% CI] for TAVI vs SAVR 1.24 [0.76, 2.02], p=0.240). Conclusions CKD≥3b and CKD≥3a is an independent major risk factor for mortality in patients undergoing TAVI and SAVR, respectively. In the overall population of patients with severe aortic stenosis, an appropriate stratification based on CKD substage may contribute to a better selection of patients suitable for such therapies. TAVI and SAVR appear to achieve similar survival rates in intermediate-risk patients with moderate-to-severe renal dysfunction. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Unrestricted grants by medical device companies (Edwards Lifesciences, JenaValve Technology, Medtronic, Sorin, St. Jude Medical, Symetis S.A.). Unrestricted support by funding statisticians by the DZHK (Deutsches Zentrum für Herz-Kreislaufforschung).

scholarly journals The Psychosocial and Somatic Effects of Relocation from Remote Canadian First Nation Communities to Urban Centres on Indigenous Peoples with Chronic Kidney Disease (CKD)

2021 ◽  
Vol 18 (7) ◽  
pp. 3838
Author(s):  
Denise Genereux ◽  
Lida Fan ◽  
Keith Brownlee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Indigenous Peoples ◽  
Health Care Professionals ◽  
Medical Condition ◽  
Geographical Location ◽  
Well Being ◽  
First Nation ◽  
Urban Centre ◽  
The Impact

Chronic kidney disease, also referred to as end-stage renal disease (ESRD), is a prevalent and chronic condition for which treatment is necessary as a means of survival once affected individuals reach the fifth and final stage of the disease. Dialysis is a form of maintenance treatment that aids with kidney functioning once a normal kidney is damaged. There are two main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). Each form of treatment is discussed between the patient and nephrologist and is largely dependent upon the following factors: medical condition, ability to administer treatment, supports, geographical location, access to necessary equipment/supplies, personal wishes, etc. For Indigenous Peoples who reside on remote Canadian First Nation communities, relocation is often recommended due to geographical location and limited access to both health care professionals and necessary equipment/supplies (i.e., quality of water, access to electricity/plumbing, etc). Consequently, the objective of this paper is to determine the psychosocial and somatic effects for Indigenous Peoples with ESRD if they have to relocate from remote First Nation communities to an urban centre. A review of the literature suggests that relocation to urban centres has negative implications that are worth noting: cultural isolation, alienation from family and friends, somatic issues, psychosocial issues, loss of independence and role adjustment. As a result of relocation, it is evident that the impact is profound in terms of an individuals’ mental, emotional, physical and spiritual well-being. Ensuring that adequate social support and education are available to patients and families would aid in alleviating stressors associated with managing chronic kidney disease.

scholarly journals An Update on Hepatocellular Carcinoma in Chronic Kidney Disease

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3617
Author(s):  
Fabrizio Fabrizi ◽  
Roberta Cerutti ◽  
Carlo M. Alfieri ◽  
Ezequiel Ridruejo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Stage ◽  
Survival Rates ◽  
International Study ◽  
Public Health Issue ◽  
Advanced Chronic Kidney Disease ◽  
Ablative Techniques ◽  
Risk Of Cancer

Chronic kidney disease is a major public health issue globally and the risk of cancer (including HCC) is greater in patients on long-term dialysis and kidney transplant compared with the general population. According to an international study on 831,804 patients on long-term dialysis, the standardized incidence ratio for liver cancer was 1.2 (95% CI, 1.0–1.4) and 1.5 (95% CI, 1.3–1.7) in European and USA cohorts, respectively. It appears that important predictors of HCC in dialysis population are hepatotropic viruses (HBV and HCV) and cirrhosis. 1-, 3-, and 5-year survival rates are lower in HCC patients on long-term dialysis than those with HCC and intact kidneys. NAFLD is a metabolic disease with increasing prevalence worldwide and recent evidence shows that it is an important cause of liver-related and extra liver-related diseases (including HCC and CKD, respectively). Some longitudinal studies have shown that patients with chronic hepatitis B are aging and the frequency of comorbidities (such as HCC and CKD) is increasing over time in these patients; it has been suggested to connect these patients to an appropriate care earlier. Antiviral therapy of HBV and HCV plays a pivotal role in the management of HCC in CKD and some combinations of DAAs (elbasvir/grazoprevir, glecaprevir/pibrentasvir, sofosbuvir-based regimens) are now available for HCV positive patients and advanced chronic kidney disease. The interventional management of HCC includes liver resection. Some ablative techniques have been suggested for HCC in CKD patients who are not appropriate candidates to surgery. Transcatheter arterial chemoembolization has been proposed for HCC in patients who are not candidates to liver surgery due to comorbidities. The gold standard for early-stage HCC in patients with chronic liver disease and/or cirrhosis is still liver transplant.

scholarly journals Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

2021 ◽  
Vol 18 (8) ◽  
pp. 4370
Author(s):  
A Kim ◽  
Hayeon Lee ◽  
Eun-Jeong Shin ◽  
Eun-Jung Cho ◽  
Yoon-Sook Cho ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medication Management ◽  
Medication Use ◽  
Potentially Inappropriate Medications ◽  
Management Service ◽  
Ckd Stage ◽  
The Impact

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

scholarly journals Osteoprotegerin is a marker of cardiovascular mortality in patients with chronic kidney disease stages 3–5

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gustavo Lenci Marques ◽  
Shirley Hayashi ◽  
Anna Bjällmark ◽  
Matilda Larsson ◽  
Miguel Riella ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Multivariate Analysis ◽  
Kidney Disease ◽  
Cardiovascular Mortality ◽  
Osteoclast Differentiation ◽  
Survival Rates ◽  
Elevated Serum ◽  
High Sensitivity ◽  
Intima Media Thickness

AbstractCardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD). Osteoprotegerin (OPG), known to regulate bone mass by inhibiting osteoclast differentiation and activation, might also play a role in vascular calcification. Increased circulating OPG levels in patients with CKD are associated with aortic calcification and increased mortality. We assessed the predictive role of OPG for all-cause and cardiovascular mortality in patients with CKD stages 3–5 over a 5-year follow-up period. We evaluated the relationship between OPG and all-cause and cardiovascular mortality in 145 CKD patients (stages 3–5) in a prospective observational follow-up study. Inflammation markers, including high-sensitivity C-reactive protein, standard echocardiography, and estimation of intima-media thickness in the common carotid artery, were assessed at baseline, and correlations with OPG levels were determined. The cutoff values for OPG were defined using ROC curves for cardiovascular mortality. Survival was assessed during follow up lasting for up to 5.5 years using Fine and Gray model. A total of 145 (89 men; age 58.9 ± 15.0 years) were followed up. The cutoff value for OPG determined using ROC was 10 pmol/L for general causes mortality and 10.08 pmol/L for CV causes mortality. Patients with higher serum OPG levels presented with higher mortality rates compared to patients with lower levels. Aalen–Johansen cumulative incidence curve analysis demonstrated significantly worse survival rates in individuals with higher baseline OPG levels for all-cause and cardiovascular mortality (p < 0.001). In multivariate analysis, OPG was a marker of general and cardiovascular mortality independent of sex, age, CVD, diabetes, and CRP levels. When CKD stages were included in the multivariate analysis, OPG was an independent marker of all-cause mortality but not cardiovascular mortality. Elevated serum OPG levels were associated with higher all-cause and cardiovascular mortality risk, independent of age, CVD, diabetes, and inflammatory markers, in patients with CKD.

scholarly journals New Pathogenic Concepts and Therapeutic Approaches to Oxidative Stress in Chronic Kidney Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-21 ◽  
Author(s):  
José Pedraza-Chaverri ◽  
Laura G. Sánchez-Lozada ◽  
Horacio Osorio-Alonso ◽  
Edilia Tapia ◽  
Alexandra Scholze
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Cardiovascular Complications ◽  
Vitamin D Metabolism ◽  
Therapy Options ◽  
Mitochondrial Alterations ◽  
Inflammatory Processes ◽  
The Impact

In chronic kidney disease inflammatory processes and stimulation of immune cells result in overproduction of free radicals. In combination with a reduced antioxidant capacity this causes oxidative stress. This review focuses on current pathogenic concepts of oxidative stress for the decline of kidney function and development of cardiovascular complications. We discuss the impact of mitochondrial alterations and dysfunction, a pathogenic role for hyperuricemia, and disturbances of vitamin D metabolism and signal transduction. Recent antioxidant therapy options including the use of vitamin D and pharmacologic therapies for hyperuricemia are discussed. Finally, we review some new therapy options in diabetic nephropathy including antidiabetic agents (noninsulin dependent), plant antioxidants, and food components as alternative antioxidant therapies.

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