Peculiarities of vascular remodeling in patients with chronic kidney disease stage 5D: prognostic role of the intima-media thickness

Nephrology ◽  
2021 ◽  
Vol 3_2021 ◽  
pp. 31-37
Author(s):  
M.N. Kolomyitseva Kolomyitseva ◽  
M.Z. Gasanov Gasanov ◽  
M.M. Batyushin Batyushin ◽  
O.M. Manukyan Manukyan ◽  
L.I. Rudenko Rudenko ◽  
...  
Author(s):  
Kamal Lochan Behera ◽  
BH. V. K. Praveen Varma ◽  
D. S. S. K. Raju ◽  
Suresh Babu Sayana

Background: Chronic Kidney Disease (CKD) is characterized by irreversible sclerosis and loss of nephrons. The renal mass progressively declines over a prolonged period, depending on the underlying etiology. In CKD the most common feature is hypovitaminosis D which alter the vascular smooth muscle cell proliferation and reprogram the osteoblastic changes, finally leading to increase arterial wall thickness.Methods: A cross sectional study carried out over a 2-year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh, India. 120 in which 60 are normal healthy individuals and 60 are CKD patients with stage 3 to 5. In all the participants serum creatinine, blood urea, serum triglycerides serum total cholesterol, HDL cholesterol estimated and serum 25 OH vitamin D are estimated.Results: The diagnostic criteria for CKD like blood urea, serum creatinine and eGFR were significantly higher in CKD when compared to control. In the present study, systolic and diastolic blood pressure was significantly increased in CKD compared with control. The Carotid Intima Media Thickness (CIMT) both left and right side were significant higher in CKD when compared with control. There is a significantly decreased levels of serum vitamin D in CKD (14.53 ng/mL±6.88) when compared with control (28.87 ng/mL±6.28).Conclusions: Present study finding suggested that there is a raised value of CIMT in CKD patients. High triglycerides, cholesterol and decreased HDL and declined vitamin D low hemoglobin, decreased eGFR, increased systolic blood pressure, raised CIMT value were found to be significantly increased in CKD patients.


2019 ◽  
pp. 2-3

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].


Author(s):  
Adhi Permana ◽  
Ian Effendi ◽  
Taufik Indrajaya

Chronic kidney disease is associated with a high mortality rate, especially cardiovascular disease associated with mineral and bone disorders. Sclerostin is an inhibitor of Wnt signaling which has the effect of increasing the occurrence of vascular calcification in patients with chronic kidney disease. There are several studies that show different results. Carotid intima media thickness ultrasound examination is a tool to identify atherosclerosis which is part of vascular calcification. The aim of this study is to look at the correlation of sclerostin with carotid intima media thickness (CIMT) in patients with chronic kidney disease undergoing hemodialysis. In this cross section, the concentration of sclerostin was measured by examination of enzymed linked immunosorbent assay. CIMT measurement by ultrasound mode B examination. There were 40 patients in this study. The mean sclerostin level was 256.68 ± 127.76 pg / ml. Sclerostin levels are declared high if above 162 pg / ml there are 30 people. CIMT thickening was present in 11 patients. There was no significant correlation of serum sclerostin with CIMT in patients with chronic kidney disease undergoing hemodialysis (r-0.32 p0,847). In multivariate linear regression, hemodialysis duration is an independent factor that is significantly significant with CIMT. There was no significant correlation of serum sclerostin with CIMT in patients with chronic kidney disease undergoing hemodialysis.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1049-P
Author(s):  
ELVIRA GOSMANOVA ◽  
DARREN E. GEMOETS ◽  
LAURENCE S. KAMINSKY ◽  
CSABA P. KOVESDY ◽  
AIDAR R. GOSMANOV

2020 ◽  
Vol 24 (1) ◽  
pp. 60-66
Author(s):  
I. V. Lavrishcheva ◽  
A. Sh. Rumyantsev ◽  
M. V. Zakharov ◽  
N. N. Kulaeva ◽  
V. M. Somova

BACKGROUND. The lack of data on the epidemiology of presarcopenia/sarcopenia leads to an underestimation of the role of this condition in the structure of morbidity and mortality of haemodialysis patients in theRussian Federation. THE AIM: to study the epidemiological aspects of presarcopenia /sarcopenia in patients with chronic kidney disease stage 5d. PATIENTS AND METHODS. This study comprised 317 patients receiving programmed bicarbonate haemodialysis for 8.2 ± 5.1 years, among them 171 women and 146 men, the average age was 57.1 ± 11.3 years. The assessment of the presence of sarcopenia was performed using the method recommended by the European Working Group on Sarcopenia in Older People. RESULTS. The prevalence of presarcopenia was 0.7 % and sarcopenia 29.6 %. The incidence of skeletal muscle mass deficiency according to muscle mass index (IMM) was 30.3 %, 48.7 % showed a decrease in muscle strength according to dynamometry, and low performance of skeletal muscles according to 6 minute walk test was determined in 42.8 %. Sarcopenia patients were significantly characterized by lower body mass index, as well as higher body fat mass values. The duration of haemodialysis (χ2 = 22.376, p = 0.0001) and the patient's age (χ2 = 10.545 p = 0.014) were an independent risk factors for the development of sarcopenia. CONCLUSION. Sarcopenia is recorded more frequently in hemodialysis patients than presarcopenia. Its prevalence increases among patients of older age groups and with a hemodialysis duration of more than 5 years. The age and experience of dialysis make their independent contribution to the development of this syndrome.


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