scholarly journals Increased Interleukin-6 as Infl ammatory Response and Magnesium Defi ciency in Pre-dialysis Chronic Kidney Disease of Indonesian Children

2021 ◽  
Vol 9 (2) ◽  
pp. 93
Author(s):  
Astrid Kristina Kardani ◽  
Ninik Asmaningsih Soemyarso ◽  
Jusli Aras Aras ◽  
Risky Vitria Prasetyo ◽  
Mohammad Sjaifullah Noer

Chronic kidney disease (CKD) is a serious health problem in children, with increasing morbidity and mortality rates throughout the world. Children with CKD tend to experience magnesium (Mg) defi ciency that can stimulate an infl ammatory response in the body. One of the infl ammatory responses is an increase of Interleukin-6 (IL-6).  Study to analyze the correlation between Mg and IL-6 in pre-dialysis CKD children. The methods a cross sectional study was conducted in Dr Soetomo General Academic Hospital from November 2018 to April 2019. Children with pre-dialyis CKD were included in this study. Variables of serum Mg level (mg/dL) and infl ammatory marker (IL-6) were measured from the blood and analyzed by ELISA method. The correlation between Mg and IL-6 was analyzed with Spearman’s correlation test with p <0.05.  Result a total of 47 children (27 boys vs 20 girls) between 3 months to 18 years old, with pre-dialysis CKD and no history of magnesium supplementation were included. The primary disease that causes of CKD were lupus nephritis (38.3%), nephrotic syndrome (23.4%), urologic disorder (23.4%),  tubulopathy (10.6%) and others (4.3%). The average IL-6 level was 55.42±43.04 pg/dL and Mg level was 2.06±1.54 mg/dL. There were no signifi cant correlation between IL-6 level and Mg level with staging of CKD and duration of illness (p>0.05), but there was a signifi cant correlation between serum Mg level and IL-6 level (r=-0.748; p<0.001). Magnesium levels have a signifi cant inverse correlation with IL-6 levels in pre-dialysis CKD children. The lower the Mg levels in the blood, the higher IL-6 levels and vice versa. 

Author(s):  
S. Suneeti Kanyari ◽  
Sangram Panda ◽  
Peethala Shruthi

Background: Chronic kidney disease (CKD) is a global problem, and its prevalence is increasing dramatically. In chronic kidney disease (CKD) there is progressive loss in kidney function over a period of time. The objectives of this study were to study the socio-demographic characteristics and associated risk factors in CKD patients so as to suggest preventive measures for CKD and its long term health consequences.Methods: A cross-sectional study was conducted at MIMS Medical College, Vizianagaram, Andhra Pradesh among 194 confirmed CKD patients. A pre-tested, pre-designed questionnaire was used for collecting data on socio-demographic characteristics like age, education, occupation, residence, income etc. After completion of the questionnaire, the patients were subjected to anthropometric measurements, abdominal ultrasonography and their laboratory reports were assessed.Results: Out of 194 CKD patients, 148 were males and 46 were females. Hypertension and diabetes were present in 74.2% and 41.2% cases respectively and both of these risk factors were found to be significantly associated with CKD. Family history of diabetes/hypertension/CKD were present in 40.2% of cases and the association was found to be significant.Conclusions: Early screening and intervention is necessary for prevention of risk factors of CKD. All patients with hypertension, diabetes, family history of CKD/hypertension/diabetes, history of chronic NSAID use should be periodically screened for CKD for its early detection and effective management. 


2020 ◽  
Vol 8 (1) ◽  
pp. 106
Author(s):  
Chauverim Jeremi Gotlieb Paath ◽  
Gresty Masi ◽  
Franly Onibala

Abstract: Chronic Kidney Disease is progressive and irreversible kidney dysfunction where the body fails to maintain metabolim and fluid and electrolyte balance. Hemodialysis therapy is one of managements of CKD. Disobedience may causing failure of the therapy so it can increase mortality and morbidity numbers. Purpose: The purpose of this research is to find out the correlation beetween family support and hemodialysis adherence of patients with CKD. Method: this study used descriptive Analytic with Cross Sectional Study approach. This study involved 50 respondents with Chronic Kidney Disease using the total sampling technique. Data collection was done through the questionnaire about family’s support and hemodialysis therapy adherence of patient of CKD. The result of this study showed a significant correlation with p value=0,000 (α<0,05). Conclusion: There is a significant correlation beetween family support and hemodialysis therapy adherence of patients with CKD. Further studies are suggested to do other research about specification of family’s support with the example instrumental support.Key Words:     Chronic Kidney Disease, Family Support, Hemodialysis Therapy      Adherence. Abstrak: Gagal ginjal kronis merupakan gangguan fungsi ginjal yang progresif dan ireversibel dimana tubuh gagal untuk mempertahankan metabolisme dan keseimbangan cairan dan elektrolit. Terapi hemodialisa adalah salah satu penanganan gagal ginjal kronis. Ketidakpatuhan dapat menyebabkan kegagalan terapi sehingga meningkatkan angka mortalitas dan morbiditas. Dukungan keluarga merupakan salah satu faktor penting dalam meningkatkan kepatuhan terapi. Tujuan: ujuan penelitian ini untuk mengetahui hubungan dukungan keluarga dengan kepatuhan terapi hemodialisa pada pasien GGK. Desain Penelitian: Penelitian ini menggunakan Deskriptif Analitik dengan pendekatan cross-sectional Study. penelitian ini menggunakan 50 responden  dengan menggunakan teknik total sampling. Pengumpulan data dilakukan menggunakan kuesioner tentang dukungan keluarga dan kepatuhan menjalani terapi hemodialysis pada pasien CKD. Hasil dari penelitian ini menunjukan hubungan yang signifikan dengan nilai p=0,000 yang berarti nilai p<α=0,05. Kesimpulan: Dapat disimpulkan bahwa ada hubungan yang bermakna antara dukungan keluarga dengan kepatuhan hemodialisa pada pasien GGK. Bagi peneliti selanjutnya disarankan untuk melakukan penelitian tentang dukungan keluarga yang lebih spesifik contohnya dukungan instrumental. Kata Kunci: Gagal Ginjal Kronis, Dukungan Keluarga, Kepatuhan Hemodialisa


2009 ◽  
Vol 1 (2) ◽  
pp. 64
Author(s):  
Tetty Hendrawati ◽  
Syakib Bakri ◽  
Mansyur Arif

BACKGROUND: Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of nitric oxide synthase (NOS). ADMA reduces NO synthesis when its concentration elevates. ADMA is a novel risk factor for cardiovascular disease. Plasma ADMA accumulates in patients with endstage renal disease, due to reduced renal clearance. Hyperhomocysteinemia is often found in patients with chronic kidney disease (CKD). Homocysteine may cause ADMA to accumulate; however, the mechanism by which ADMA level elevates in hyperhomocysteinemia is still unclear. Objective of this study was to analyze the concentrations of homocysteine and ADMA and to assess the correlation between homocysteine and ADMA concentrations with the severity of chronic kidney disease.METHODS: This was a cross-sectional study on 75 patients with CKD, comprising men and women aged 40-70 years. Assessments were done on the concentrations of creatinine, homocysteine, ADMA, fasting blood glucose, cholesterol HDL and triglyceride.RESULTS: In later stage of CKD there was significantly higher tHcy concentration as compared with the earlier stage of CKD (p=0.0000). In CKD stage 2 to 4 there was a tendency for ADMA concentration to increase to a significant average (p=0.210), but ADMA concentration was lower at stage 5. There was increased ADMA along with increased tHcy concentration of around 20μ mol/L, and this then decreased. The inverse correlation between tHcy and ADMA concentrations started to appear in CKD stage 4, but this correlation was statistically insignificant (r2 =0.19; p=0.499).CONCLUSIONS: This study showed there was a correlation between homocysteine and ADMA concentrations in patients with CKD stage 2 to 5, although statistically not significant.KEYWORDS: Asymetric Dimethylarginine, Homocysteine, Chronic Kidney Disease


2021 ◽  
Vol 3 (3) ◽  
pp. 100-107
Author(s):  
Jusli Aras ◽  
Astrid Kristina Kardani ◽  
Ninik Asmaningsih Soemaryo ◽  
Risky Vitria Prasetyo ◽  
Mohammad Sjaifullah Noer ◽  
...  

Introduction: Anemia is a frequent complication of chronic kidney disease (CKD) in children and it causes an increase in morbidity, mortality and accelerates the rate of progression of CKD. Inflammation and impaired kidney clearance increase plasma hepcidin, inhibiting duodenal iron absorption and sequestering iron in macrophages. However, the role of hepcidin in increasing the risk of anemia in children with CKD is still uncertain. This study aimed to investigate the association between hepcidin levels and anemia in children with pre-dialysis CKD. Methods: A cross-sectional study was conducted at Dr. Soetomo Academic Hospital from December 2018 to February 2019. Children with pre-dialysis CKD were enrolled in this study. The subject had no history of erythropoietin administration and blood transfusion 3 months before the blood sample were withdrawn. A complete blood count, ferritin serum, transferrin saturation (TSAT) and hepcidin serum were performed. The correlations between Hepcidin and ferritin level, between ferritin level and anemia, and between TSAT and anemia were analyzed using Spearman correlation and the Mann-Whitney test. Results: A total of 47 children, 27 boys and 20 girls, ranged in age from 3 months to 18 years old. There was a significant correlation between hepcidin and ferritin levels (p=0.006) and the value of the Spearman correlation was r=0.392. While the correlation between ferritin level and anemia showed a significant result, p=0.001. However, TSAT did not show any significant correlation with anemia (p=0.230). Conclusion: There was an indirect association between hepcidin level and anemia by increasing ferritin level that induces anemia in pre-dialysis CKD children.


Author(s):  
Ade Yonata ◽  
Zulkhair Ali ◽  
Taufik Indrajaya ◽  
Ian Effendi ◽  
Novadian Suhaimi

Chronic kidney disease (CKD) is associated with high mortality rates related to cardiovascular complications. Atherosclerosis, arteriosclerosis and vascular calcification conditions are often found in CKD patients. Carotid intima media thickness (cIMT) thickening is one of the parameters of vascular disorders. A cross sectional study was conducted on patients with chronic kidney disease in the hospital. Mohammad Hoesin Palembang. Patients' blood samples were examined in the hospital laboratory. CIMT thickening was examined using echocardiography. A total of 55 patients with stage 3-5 chronic kidney disease were examined. The median cIMT is 0.8 (0.6-1.45) mm. Spearman's correlation analysis showed a significant correlation between triglyceride levels and thickening of cIMT (r = 0.303, p = 0.025). A significant correlation was also shown between phosphate levels and cIMT thickening (r = 0.290, p = 0.032). There is a significant correlation of triglyceride levels and phosphate levels to cIMT thickening in patients with chronic kidney disease in Palembang


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Akihiro Watanabe ◽  
...  

Abstract Background Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. Methods The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. Results “Elevated ALT and elevated GGT” and “elevated ALT and non-elevated GGT” significantly increased the OR for CKD when compared with “non-elevated ALT and non-elevated GGT” (OR: 2.56, 95% CI: 2.10–3.12 and OR: 2.24, 95% CI: 1.81–2.77). Compared with “AST/ALT ratio ≥ 1 and non-elevated GGT”, “AST/ALT ratio < 1 and elevated GGT” and “AST/ALT ratio < 1 and non-elevated GGT” significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36–3.15 and OR: 1.68, 95% CI: 1.52–1.87). These findings still remained after adjustment for confounders. Conclusions Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.


Biomedicines ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 19
Author(s):  
Ashani Lecamwasam ◽  
Tiffanie M. Nelson ◽  
Leni Rivera ◽  
Elif I. Ekinci ◽  
Richard Saffery ◽  
...  

(1) Background: Individuals with diabetes and chronic kidney disease display gut dysbiosis when compared to healthy controls. However, it is unknown whether there is a change in dysbiosis across the stages of diabetic chronic kidney disease. We investigated a cross-sectional study of patients with early and late diabetes associated chronic kidney disease to identify possible microbial differences between these two groups and across each of the stages of diabetic chronic kidney disease. (2) Methods: This cross-sectional study recruited 95 adults. DNA extracted from collected stool samples were used for 16S rRNA sequencing to identify the bacterial community in the gut. (3) Results: The phylum Firmicutes was the most abundant and its mean relative abundance was similar in the early and late chronic kidney disease group, 45.99 ± 0.58% and 49.39 ± 0.55%, respectively. The mean relative abundance for family Bacteroidaceae, was also similar in the early and late group, 29.15 ± 2.02% and 29.16 ± 1.70%, respectively. The lower abundance of Prevotellaceae remained similar across both the early 3.87 ± 1.66% and late 3.36 ± 0.98% diabetic chronic kidney disease groups. (4) Conclusions: The data arising from our cohort of individuals with diabetes associated chronic kidney disease show a predominance of phyla Firmicutes and Bacteroidetes. The families Ruminococcaceae and Bacteroidaceae represent the highest abundance, while the beneficial Prevotellaceae family were reduced in abundance. The most interesting observation is that the relative abundance of these gut microbes does not change across the early and late stages of diabetic chronic kidney disease, suggesting that this is an early event in the development of diabetes associated chronic kidney disease. We hypothesise that the dysbiotic microbiome acquired during the early stages of diabetic chronic kidney disease remains relatively stable and is only one of many risk factors that influence progressive kidney dysfunction.


Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.


Sign in / Sign up

Export Citation Format

Share Document