scholarly journals Spontaneous changes in the rate of decline in reciprocal serum creatinine: errors in predicting the progression of renal disease from extrapolation of the slope.

1992 ◽  
Vol 2 (7) ◽  
pp. 1186-1191
Author(s):  
B V Shah ◽  
A S Levey
Keyword(s):  
Renal Disease ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Chronic Renal Disease ◽  
Linear Regression Analysis ◽  
Effect Of Therapy ◽  
The Mean ◽  
Rate Of Decline ◽  
Stage Renal Disease ◽  
End Stage

The slope of reciprocal serum creatinine (1/Pcr) versus time has been used to measure the rate of progression of chronic renal disease, predict the interval until onset of end-stage renal disease, and assess the effect of therapy. In order to determine the errors that might result from extrapolating the slope of 1/Pcr versus time beyond the interval of observation, we applied a method of linear regression analysis to search for spontaneous changes in slope in 21 patients from New England Medical Center and 56 patients in three published studies in whom the decline in 1/Pcr appeared constant (r greater than or equal to 0.84 for the correlation of 1/Pcr versus time). Significant changes in the slope (breakpoints) were identified in one third to one half of the 77 patients and appeared to be spontaneous. The second slope was less steep in 49 patients (6.1%); the mean value for serum creatinine at the time of the breakpoint was 5.3 mg/dL; the mean change in slope (absolute value) was 0.005 dL/mg/month (adults) and 0.017 dL/mg/month (children); and the mean error in prediction of the interval until the final value for serum creatinine was 27% of the actual interval. We conclude that spontaneous breakpoints in the slope of 1/Pcr versus time are very frequent, even among patients with an apparent constant rate of decline. Breakpoints may cause errors in extrapolating the slope to predict the interval until the onset of end-stage renal disease and to assess the effect of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurodevelopmental Progress of Young Children With Chronic Renal Disease

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 68-72
Author(s):  
Denis F. Geary ◽  
Katerina Haka-Ikse
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Chronic Renal Disease ◽  
Neurodevelopmental Outcome ◽  
Developmental Level ◽  
Developmentally Delayed ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Better Than

Neurodevelopmental progress was prospectively studied in 33 children with chronic renal disease during a mean of 1.68 years. The mean age of the children when first evaluated was 1.11 years. Children with all levels of renal dysfunction were included, although end stage renal disease developed in 17 at some time during the study. When last evaluated, 10 of the children were developmentally delayed, 8 mildly delayed, and 2 moderately delayed. The developmental level achieved was significantly related to the children's growth and to the severity of their renal impairment. Also found was a strong correlation between the developmental quotients at first and final evaluations. This finding suggests that improvement throughout time is unlikely and underlines the need for early diagnosis and treatment of such infants. These observations suggest that the neurodevelopmental outcome of infants with chronic renal disease is considerably better than previously reported.

scholarly journals Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Age Group ◽  
Calcium Phosphorus ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

scholarly journals Serum Prolidase Activity and Oxidative Stress in Diabetic Nephropathy and End Stage Renal Disease: A Correlative Study with Glucose and Creatinine

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Akhilesh Kumar Verma ◽  
Subhash Chandra ◽  
Rana Gopal Singh ◽  
Tej Bali Singh ◽  
Shalabh Srivastava ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetic Nephropathy ◽  
Blood Glucose ◽  
Renal Disease ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Prolidase Activity ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Oxidative Stress

Association of oxidative stress and serum prolidase activity (SPA) has been reported in many chronic diseases. The study was aimed at evaluating the correlation of glucose and creatinine to SPA and oxidative stress in patients with diabetic nephropathy (DN) and end stage renal disease (ESRD) concerned with T2DM. 50 healthy volunteers, 50 patients with T2DM, 86 patients with DN, and 43 patients with ESRD were considered as control-1, control-2, case-1, and case-2, respectively. Blood glucose, creatinine, SPA, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were measured by colorimetric tests. SPA, TOS, and OSI were significantly increased in case-1 and case-2 than control-1 and control-2, while TAS was significantly decreased(P<0.001). Blood glucose was linearly correlated to SPA, TOS, TAS, and OSI in control-2, case-1 and case-2(P<0.001). Serum creatinine was linearly correlated with SPA, TOS, TAS and OSI in control-2 and case-1(P<0.001). In case-2, serum creatinine was significantly correlated with SPA only(P<0.001). Thus, the study concluded that SPA and oxidative stress significantly correlated with blood glucose and creatinine. SPA, TOS, TAS, and OSI can be used as biomarkers for diagnosis of kidney damage.

Significance of serum creatinine values in new end-stage renal disease patients

1999 ◽  
Vol 34 (4) ◽  
pp. 694-701 ◽  
Author(s):  
Jeffrey C. Fink ◽  
Rachel A. Burdick ◽  
Stacy J. Kurth ◽  
Steven A. Blahut ◽  
Nancy C. Armistead ◽  
...  
Keyword(s):  
Renal Disease ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

The effects of cyclophosphamide and mycophenolate on end-stage renal disease and death of lupus nephritis

Lupus ◽  
2011 ◽  
Vol 20 (13) ◽  
pp. 1442-1449 ◽  
Author(s):  
HS Koo ◽  
YC Kim ◽  
SW Lee ◽  
DK Kim ◽  
K-H Oh ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Rank Test ◽  
Systemic Steroid ◽  
Diagnostic Code ◽  
Composite Outcome ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Debate continues about the optimal treatment modality of lupus nephritis (LN). We compared the efficacy and safety of intravenous cyclophosphamide (CYC) and mycophenolate mofetil (MMF) for LN treatment in Korea. After searching for systemic lupus erythematosus (SLE) patients diagnosed between 1998 and 2007 with the diagnostic code of ICD10, we selected the 71 patients who were treated with CYC or MMF without any other immunosuppressant except systemic steroid. Composite outcome was defined as progression to end-stage renal disease (ESRD) and/or all-cause mortality. The initial manifestations of the CYC group were more severe than those of the MMF group. The mean daily MMF dose was 980 ± 100 mg for 21.67 ± 18.25 months. The mean monthly dose per CYC pulse therapy was 850 ± 30 mg for 17.04 ± 13.15 months. The incidence of composite outcome was 5/20 (25%) in the MMF group and 4/51 (7.8%) in the CYC group. The relative risk (RR) for composite outcome in the CYC group was 0.249 (95% CI for RR: 0.067–0.934, p = 0.039) compared with the MMF group with Cox's hazard proportional analysis. In Kaplan–Meier analysis, the probability of composite outcome was lower in the CYC group than in the MMF group (Log rank test p-value = 0.026). The results of this retrospective study suggest that intravenous CYC therapy may be more efficacious in averting ESRD and death than MMF. These results need to be confirmed in a larger randomized controlled trial.

scholarly journals Proteinuria and serum creatinine after 12 months of treatment for lupus nephritis as predictors of long-term renal outcome: a case–control study

2022 ◽  
Vol 62 (1) ◽  
Author(s):  
Fernanda Nogueira Holanda Ferreira Braga ◽  
Marta Maria das Chagas Medeiros ◽  
Antonio Brazil Viana Junior ◽  
Matheus Eugênio de Sousa Lima ◽  
Levi Coelho Maia Barros ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Serum Creatinine ◽  
Roc Curve ◽  
End Stage Renal Disease ◽  
Renal Outcome ◽  
Renal Outcomes ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Lupus nephritis (LN) is a major source of morbidity and mortality in patients with systemic lupus erythematosus (SLE), with 10–25% of patients progressing to end-stage renal disease (ESRD). Objective This study aims to elucidate the predictive capabilities of 24-h proteinuria (24PTU) and serum creatinine (sCr) after 12 months of treatment with respect to long-term renal outcomes in LN in a single-center cohort of LN patients. Methods A retrospective analysis was performed on 214 patients diagnosed with LN followed in our center. Values of 24PTU and sCr were assessed at baseline and after 3, 6 and 12 months, and after 5 years and/or the last evaluation. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for 3 months or longer. End-stage renal disease (ESRD) was defined as the need for permanent dialysis. Receiver operating characteristics curves (ROC) were used to test the best cut-off value of 24PTU and sCr at 12 months who predict bad long-term renal outcomes.  Results The mean follow-up period was 11.2 ± 7.2 years. The best cut-off values for 24PTU and sCr as predictor of CKD were, respectively, 0.9 g/24 h and 0.9 mg/dL. ROC curve for 24PTU had a slightly lower performance than ROC curve for sCr as predictor for CKD (PTU AUC = 0.68; sCr AUC = 0.70), but sensitivity and specificity were better for 24PTU (24PTU: sensitivity = 63.5%, specificity = 71.2%; sCr: sensitivity = 54.8%, specificity = 75.3%). When the outcome was ESRD the best cut-off points were 0.9 g/24hs and 1.3 mg/dL for 24PTU and sCr, respectively, and the curve performance was better for 24PTU (PTU AUC = 0.72; sCr AUC = 0.61). Conclusions In this ethnically diverse population with LN followed for a long time (> 10 years), levels of 24PTU > 0.9/day at 12 months was a good predictor of bad long-term renal outcome. The serum creatinine > 0.9 mg/dL and > 1.3 mg/dL at 12 months were also good predictors of CKD and ESRD, respectively. Patients with 24PTU < 0.9 g/day and sCr < 1.3 mg/dL at 12 months are not likely to develop ESRD because of the high negative predictive values (NPV) (93.2% and 82%). 24PTU and sCr are relevant as components for a treat-to-target strategy for LN treatment, since their high NPV corroborates their importance as good predictors of long-term renal outcome.

Extent of Fall in Serum Potassium by Medical Therapy in End Stage Renal Disease

2021 ◽  
Vol 15 (8) ◽  
pp. 1871-1873
Author(s):  
Sadaf Sarwar ◽  
Tahir Ullah Khan ◽  
Atif Masood ◽  
Faisal Amin Baig ◽  
Arsalan Nawaz ◽  
...  
Keyword(s):  
Renal Disease ◽  
Medical Treatment ◽  
Serum Potassium ◽  
End Stage Renal Disease ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Change In Mean

Aim: To observe the mean alteration in potassium levels one-hour post-antihyperkalemic treatment in end stage renal disease patients presenting with hyperkalemia. Study design: Quazi interventional (experimental) study. Place and duration of study: Department of Medicine, Sir Ganga Ram Hospital Lahore from 28th June 2018 to 27th December 2018. Methodology: Sixty patients of both genders with age range between 14 to 70 years having stage 5 CKD (thrice-weekly dialysis dependent) for at least 6 months with raised serum potassium (>5.5 mEq/L). These patients were given medical treatment in the form of salbutamol nebulization, injectable calcium gluconate, and 100ml 25% dextrose water solution neutralized with Humulin R Insulin 12 units. Serum potassium was reassessed 1 hour after the treatment. Mean change in serum potassium was observed and was compared across various subgroups of patients. A written informed consent was taken from each patient. Results: In the current study, mean age of our studied population was 50.6±10.4 years with male-gender dominance (81.7%). Mean ESRD duration was 11.8±3.7 months while the mean BMI was 27.6±3.6Kg/m2. 15 (25.0%) patients were obese. The serum potassium level at presentation ranged from 5.6mEq/L to 6.9mEq/L with a mean of 6.25±0.39mEq/L. The serum potassium level 1 hour after medical treatment ranged from 4.8mEq/L to 6.3mEq/L with a mean of 5.58±0.43mEq/L. This change in mean serum potassium was significant (p-value<0.001) on paired sample t-test. The change in serum potassium level ranged from 0.5-0.9mEq/L with a mean of 0.676±0.123mEq/L. Similar mean change in serum potassium level was observed when stratified for age, gender, BMI and duration of ESRD. Keywords: End Stage Renal Disease, Hemodialysis, Hyperkalemia, Medical Treatment

Differences between KT/V Measured during Dialysis and KT/V Predicted from Manufacturer Clearance Data

1992 ◽  
Vol 15 (8) ◽  
pp. 465-469 ◽  
Author(s):  
L.K. Saha ◽  
J.C. Van Stone
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Urea Clearance ◽  
Blood Flows ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

We retrospectively analyzed data from 3,863 dialysis treatments in 329 end-stage renal disease patients over a period of 33 months to evaluate the accuracy of in vitro KT/V estimated by manufacturer's urea clearance data in relation to in vivo measured KT/V. In 1,087 urea clearances measured, mean actual clearance was 87% of predicted. At all blood flows, actual clearances were significantly lower than predicted (8-16% lower than predicted). In 2,807 KT/V measurements, predicted KT/V was 1.238 ± 0.005 whereas the mean of actual measured KT/V was 16% lower or 1.024 ± 0.005 (P < 0.0001). At different blood flows and with different dialyzers, predicted KT/V overestimated actual values. With increasing numbers of reuse, actual/predicted clearance ratios and actual/predicted KT/V ratios progressively dropped. Prescribing dialysis treatments using manufacturer's in vitro generated clearance data can lead to marked underdialysis of patients.

scholarly journals Neutrophil to Lymphocyte Ratio in Patients with End Stage Renal Disease in Benue State University Teaching Hospital, Makurdi, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 250-255
Author(s):  
MO Ogiator ◽  
JE Ojobi ◽  
OO Ijachi
Keyword(s):  
Renal Disease ◽  
Systemic Inflammation ◽  
Teaching Hospital ◽  
End Stage Renal Disease ◽  
Healthy Subjects ◽  
University Teaching ◽  
State University ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Chronic Kidney Disease (CKD) leads to end-stage renal disease (ESRD) and cardiovascular events. An important determinant of progression in CKD is chronic systemic inflammation which can be evaluated using the neutrophil to lymphocyte ratio (NLR). We aimed to investigate the value of NLR in patients with ESRD compared with healthy subjects. This was a retrospective study that analyzed data from patients with end-stage renal disease and equal number of age and sex matched control (healthy subjects) seen at Benue State University Teaching Hospital Makurdi from October 1st, 2012 to 31st December 2015. Out of the 118 patients studied 70(59.3) were males while 48 (40.7) were females. The mean age of the study population was 45.9 ± 16.4. The mean NLR for patients with ESRD was 3.55± 4.01 while that of healthy subjects was 1.29± 0.25. The mean NLR for patients was 3.47±4.01 for males and 3.68±4.06 for females while for the healthy subjects the mean NLR was 1.30±0.27 for males 1.27±0.22 for females. This study revealed elevated NLR in patients with ESRD. NLR reflects systemic inflammation. The availability of this ratio (NLR) can help improve outcome of patients with CKD.

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