scholarly journals A tertiary care centre profile of heart diseases among diagnosed cases of chronic kidney disease

2020 ◽  
Vol 8 (2) ◽  
pp. 652
Author(s):  
Vijay Bakhtar ◽  
Niyati Bakhtar ◽  
Neha Pandey ◽  
Nikhil Bakhtar
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Evaluation

Background: Chronic Kidney Disease (CKD) is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the predominant cause of morbidity and mortality in patients with CKD. There is limited data on cardiovascular diseases among CKD patients from developing countries including India. With the present study, the prevalence and patterns of cardiac diseases among patients with CKD were profiled.Methods: This was a cross sectional study in which 217 patients with CKD were studied over a period of two years and six months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting ECG and echocardiography.Results: One hundred eighteen (54.4%) patients had either eccentric or concentric LVH. Patients with LVH were more likely to be hypertensive (p<0.001) or anemic (p=0.034). Up to 9.2% of study subjects had valvular heart disease (rheumatic or degenerative) and 22% had pericarditis. Patients with pericarditis were more likely to have a serum urea concentration greater than 60mg/dl (p=0.327). Forty-one patients (18.9%) had left ventricular systolic failure (EF<50%). There was a statistically insignificant higher prevalence of systolic failure in patients with LVH (21% vs. 16%), (p=0.346). Thirty-eight participants (17.5%) had diastolic failure while 2% had cardiac rhythm abnormalities.Conclusions: Cardiac abnormalities are common in a relatively young Indian population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

scholarly journals A study on dermatological manifestations among chronic kidney disease patients undergoing hemodialysis in a tertiary care centre

2017 ◽  
Vol 5 (5) ◽  
pp. 1814
Author(s):  
Mookambika R. V. ◽  
S. Murugan
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages. The prevalence of  end-stage renal disease (ESRD) in India is increasing with an estimated annual incidence of about 100 per million populations. About 50-100% of patients with ESRD have at least one associated cutaneous change. These cutaneous disorders can precede or follow the initiation of hemodialysis treatment, and there are more chances to develop newer skin changes during the course of hemodialysis therapy, which may affect the quality of life. Objectives of the study was to find out the  prevalence of various dermatological manifestations in patients undergoing hemodialysis in a tertiary care centre.Methods: A cross sectional study was carried out in the general medicine department of a tertiary care Centre. All cases of chronic kidney disease were diagnosed according to the criteria of KDQQI CKD guidelines, age group between 30-60 years are included. Pediatric patients with chronic kidney disease, patients who had renal transplantations, patients on peritoneal dialysis and renal injury patients are excluded.Results: Out of the 100 study participants majority are males (60%). Majority of the patients belongs to lower socioeconomic status family (59%). Atleast one dermatological manifestation was present in all patients. 23% of the patients presented with two dermatological manifestations and 22% of the participants had three or more dermatological manifestations. Xerosis was the most common dermatological manifestation present among the patients.Conclusions: This study reflects that quality of life in dialysis patients is mainly depend on timely recognition and prompt management of these dermatological conditions.

scholarly journals A study of secondary hyperparathyroidism in patients with chronic kidney disease in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 271
Author(s):  
Vishnu Shankar H. ◽  
Mahendra Kumar K. ◽  
Jagadeesan M. ◽  
Kannan R. ◽  
Chitrambalam P. ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Population ◽  
Chronic Morbidity ◽  
Spss Software

Background: Secondary hyperparathyroidism (SHPT) is one of the less recognized complications in patients with chronic kidney disease (CKD). The prevalence of SHPT in various stages of CKD was evaluated by measuring the levels of intact parathyroid hormone (iPTH).Methods: This cross-sectional study was carried out in 100 CKD patients. Serum creatinine, calcium, phosphorous and iPTH levels were measured and statistical analysis was carried out using the SPSS software (IBM, NY, USA).Results: Among the 100 participants, the mean age (SD) was 59.3 (7.8) years. In our study population, 52% were men and the rest were females. Hypertension (75%) was the most common chronic morbidity. Prevalence of hyperparathyroidism among chronic kidney disease patients was 22% (95% CI: 14.7-30.9%). The prevalence of secondary hyperparathyroidism among dialysis and non-dialysis patients were 30% and 14% respectively which was statistically significant.Conclusions: SHPT is an important complication which is often underdiagnosed. Secondary hyperparathyroidism starts to develop when eGFR falls below 60ml/min. PTH levels starts to rise as the disease progress. Hence it is important for the treating physicians to monitor the PTH levels early in the course of CKD to prevent and treat bone mineral disease.

scholarly journals Association between Protein-Bound Uremic Toxins and Asymptomatic Cardiac Dysfunction in Patients with Chronic Kidney Disease

Toxins ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 520 ◽  
Author(s):  
Shanmugakumar Chinnappa ◽  
Yu-Kang Tu ◽  
Yi Chun Yeh ◽  
Griet Glorieux ◽  
Raymond Vanholder ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Dysfunction ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Uremic Toxins ◽  
Cross Sectional ◽  
The Individual

Although the relationship between protein-bound uremic toxins (PBUTs) and cardiac structure and cardiac mortality in chronic kidney disease (CKD) has been studied in the past, the association between cardiac dysfunction and PBUTs has not yet been studied. We therefore evaluated the association between impaired peak cardiac performance and the serum free and total concentrations of potentially cardiotoxic PBUTs. In a cross-sectional study of 56 male CKD patients (stages 2–5 (pre-dialysis)) who were asymptomatic with no known cardiac diseases or diabetes we measured peak cardiac power (CPOmax), aerobic exercise capacity (VO2max), and echocardiographic parameters of cardiac morphology and evaluated their association with PBUTs. The serum total and free concentrations of indoxyl sulfate (IXS), p-cresyl sulfate (PCS), p-cresyl glucuronide, indole acetic acid, and hippuric acid showed significant negative correlation with CPOmax and VO2max. IXS and PCS were independently associated with CPOmax and VO2max even after controlling for eGFR. No correlation between left ventricular mass index (LVMI) and PBUTs was seen. The present study for the first time has demonstrated the association between subclinical cardiac dysfunction in CKD and serum levels of a panel of PBUTs. Further studies are required to evaluate the mechanism of cardiotoxicity of the individual uremic toxins.

scholarly journals Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

2019 ◽  
Vol 7 (11) ◽  
pp. 4227
Author(s):  
Atul V. Rajkondawar ◽  
Amit Yele
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Tertiary Care ◽  
P Value ◽  
Age Group ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

scholarly journals PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS AMONG PATIENTS OF CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL FROM ASSAM: A CROSS-SECTIONAL STUDY.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Hamad Jeelani ◽  
Manzoor A. Parry ◽  
Shruti Dange
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Prevalence Of Depression

Background: Chronic kidney disease (CKD) patients are at high risk of depressive disorders because of considerable psychological stress due to physical and social changes brought on by disease. The aim of this study is to assess the prevalence of depression in patients with CKD and the factors affecting it at a public tertiary care hospital. Methods: This cross-sectional study was carried out at the renal clinic of a tertiary care hospital. Data on 629 patients diagnosed with CKD from September 2014 to April 2016 was obtained. Nine-item Patient Health Questionnaire from PRIME-MD was used to assess the depression. Results: Of all the patients, 44.7% had depression. Mild depression was found to affect 28.9% of the patients followed by moderate depression and severe depression (15.4% and 0.4%, respectively). According to multiple logistic regression, the occurrence of depression was significantly higher with age below 60 years [odds ratio (OR) 1.5, 0.9–2.7; P<0.05], male gender (OR 1.4, 1.0–3.1; P<0.05), no treatment funding (OR 2.7, 1.3–4.6; P<0.05), education less than grade 12 (OR 1.3, 1.3–3.2; P<0.05), monthly income ≤INR 20,000 (OR 1.6, 1.1–3.6; P<0.05), CKD stage V (OR 1.4 1.0– 2.9; P <0.05), Patients on hemodialysis (HD) (OR 2.5, 1.2–4.5; P<0.05), comorbidities ≥3 (OR 1.6, 1.3–3.0; P<0.05), overweight (OR 2.4, 1.3–2.9; P<0.05), and duration of CKD >2 (OR 2.4, 1.4–4.4; P<0.05). Conclusion: About 44.7% of the patients were found to have depression. Patients’ age, gender, body mass index, treatment funding, education status, income, CKD duration and stage, HD status, and comorbidities were found to be significant factors affecting depression.

scholarly journals Correlation of serum soluble Klotho with fibroblast growth factor 23 levels in chronic kidney disease patients; a single centre study

2019 ◽  
Vol 9 (1) ◽  
pp. e08-e08
Author(s):  
Yuvaraj Anand ◽  
Vijayan Madhusudan ◽  
Parthasarathy Rajeevalochana ◽  
Mathew Milly ◽  
George Deepu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Factor ◽  
Kidney Disease ◽  
Fibroblast Growth Factor ◽  
Transmembrane Protein ◽  
Fibroblast Growth Factor 23 ◽  
Tertiary Care ◽  
Fibroblast Growth ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Klotho is a single-pass transmembrane protein with a long extracellular domain and short cytoplasmic tail that appears to modulate aging. Objectives: This cross-sectional investigation was conducted at a tertiary care centre to find the possible correlation of serum Klotho with various biochemical parameters in Indian chronic kidney disease (CKD) patients. Patients and Methods: The study was conducted in 80 CKD patients (58 males, 22 females). Mean age was 54.21 ± 14.08 years (25-90 years). Participants included 55 CKD- hemodialysis (HD), 10 CKD- peritoneal dialysis (PD) and 15 CKD-non-dialysis (ND) patients. Results: Serum Klotho (sKlotho) in CKD-HD patients ranged from 0 to 374.36 ng/mL with a mean of 13.76±4.3 ng/mL (median: 0.0174 ng/mL). In PD patients, sKlotho ranged from 0 to 374.36 ng/ mL with a mean of 37.58 ± 6.56 ng/mL (median of 0.0087 ng/mL). In ND population, sKlotho ranged from 0 to 7.01 ng/mL, with a mean of 0.73 ± 0.01 ng/mL (median of 0.1687ng/mL). In CKDHD and CKD-PD patients, sKlotho was positively correlated with the fibroblast growth factor 23 (pg/mL) (P<0.001). Conclusion: Serum Klotho levels show significant positive correlation with FGF23 levels in HD and PD patients. The findings of the study indicate that high Klotho and fibroblast growth factor 23 levels may be associated with worse outcomes in chronic renal failure patients.

scholarly journals Cardiovascular morbidity and dyslipidemia in chronic kidney disease: a cross-sectional study

2018 ◽  
Vol 5 (2) ◽  
pp. 245
Author(s):  
Suresh K. ◽  
Charan Neeradi ◽  
Moneshaa S. S.
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lipid Profile ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Low Hdl ◽  
Dimensional Echocardiography ◽  
Cardiovascular Evaluation

Background: CKD is a risk factor for CVD and dyslipidemia is an important co-morbidity associated with both. CKD can lead to variations in lipid profile which can lead to atherosclerosis and thereby increase the risk for CVD.Objective was to analyse the clinical and diagnostic cardiovascular features of CKD patients and the associated variations in their lipid profile.Methods: This prospective study was conducted from May 2015 to May 2017 among 100 patients attending to Medicine department with documented biochemical and sonographic evidence of chronic kidney disease. The included participants were subjected to routine blood investigations including lipid profile and cardiovascular evaluation which included electrocardiography (ECG), chest X-ray and M-mode 2-Dimensional echocardiography. Data was recorded in a proforma and the results were analysed statistically.Results: The study included 100 patients with chronic kidney disease, majority (n=42, 42%) of them belonging to the 40-50 years age group. There was similar (p=0.78) representation of males and females in the study. Significantly (p=0.02) higher number (n=58) of alcoholics were present among the CKD patients. Significantly (p=0.04) higher proportion of patients with CKD had high TG (36%) and low HDL (30%) levels. Majority (58%) had CVD morbidity and Left ventricular hypertrophy was a characteristic feature in majority (n=15%) of the CKD patients as evaluated by ECG and ECHO.Conclusions: The study documented the association of CVD and dyslipidemia with CKD. It also revealed ECG and ECHO changes in CKD patients which can be useful predictors in determining the progression of the CVD complications in CKD.

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