Prevalence and Characterization of Chronic Kidney Disease Associated Pruritus in Patients Undergoing Maintenance Hemodialysis

2017 ◽  
Vol 3 (1) ◽  
pp. 89-96
Author(s):  
Puneeta Gupta ◽  
◽  
Reeta Sood ◽  
Rajesh Gupta ◽  
Abhinav Gupta ◽  
...  
Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 772
Author(s):  
Ana Pimentel ◽  
Jordi Bover ◽  
Grahame Elder ◽  
Martine Cohen-Solal ◽  
Pablo Antonio Ureña-Torres

Although frequently silent, mineral and bone disease (MBD) is one of the most precocious complication of chronic kidney disease (CKD) and is omnipresent in patients with CKD stage 5. Its pathophysiology is complex, but basically, disturbances in vitamin D, phosphate, and calcium metabolism lead to a diverse range of clinical manifestations with secondary hyperparathyroidism usually being the most frequent. With the decline in renal function, CKD-MBD may induce microstructural changes in bone, vascular system and soft tissues, which results in macrostructural lesions, such as low bone mineral density (BMD) resulting in skeletal fractures, vascular and soft tissue calcifications. Moreover, low BMD, fractures, and vascular calcifications are linked with increased risk of cardiovascular mortality and all-cause mortality. Therefore, a better characterization of CKD-MBD patterns, beyond biochemical markers, is helpful to adapt therapies and monitor strategies as used in the general population. An in-depth characterization of bone health is required, which includes an evaluation of cortical and trabecular bone structure and density and the degree of bone remodeling through bone biomarkers. Standard radiological imaging is generally used for the diagnosis of fracture or pseudo-fractures, vascular calcifications and other features of CKD-MBD. However, bone fractures can also be diagnosed using computed tomography (CT) scan, magnetic resonance (MR) imaging and vertebral fracture assessment (VFA). Fracture risk can be predicted by bone densitometry using dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QTC) and peripheral quantitative computed tomography (pQTC), quantitative ultrasound (QUS) and most recently magnetic resonance micro-imaging. Quantitative methods to assess bone consistency and strength complete the study and adjust the clinical management when integrated with clinical factors. The aim of this review is to provide a brief and comprehensive update of imaging techniques available for the diagnosis, prevention, treatment and monitoring of CKD-MBD.


2021 ◽  
Vol 15 (8) ◽  
pp. 2013-2016
Author(s):  
Shahid Ishaq ◽  
Muhammad Imran ◽  
Hashim Raza ◽  
Khuram Rashid ◽  
Muhammad Imran Ashraf ◽  
...  

Aim: To determine correlation of iron profile in children with different stages of chronic kidney disease (CKD) presenting to tertiary care hospital. Methodology: A total of 81 children with chronic kidney disease stage having glomerular filtration rate (GFR) less than 90 (ml/min/m2) aged 1 – 14 years of either sex were included. Three ml serum sample was taken in vial by hospital duty doctor for serum ferritin level, serum iron, transferrin saturation and total iron binding capacity. The sample was sent to hospital laboratory for reporting. Iron profiling was done evaluating hemoglobin (g/dl), serum iron (ug/dl), serum ferritin (ng/ml), transferrin saturation (%) and total iron binding capacity (ug/dl) while iron load was defined as serum ferritin levels above 300 ng/ml. Correlation of iron profile with different stages of CKD was determined applying one-way analysis of variance (ANOVA). Results: In a total 81 children, 46 (56.8%) were boys while overall mean age was 7.79±2.30 years. Mean duration on hemodialysis was 11.52 ± 9.97 months. Iron overload was observed in 26 (32.1%) children. Significant association of age above 7 years (p=0.031) and residential status as rural (p=0.017) was noted with iron overload whereas iron overload was increasing with increase in stages of CKD (p=0.002). Hemoglobin levels decreased significantly with increase in stages of CKD (p<0.001). Serum iron levels increased significantly with increase in the CKD stages (p=0.039). Serum ferritin levels were increasing significantly with the increase in CKD stages (p=0.031). Transferrin saturation also increased significant with increase in CKD stages (p=0.027). Conclusion: High frequency of iron overload was noted in children with CKD on maintenance hemodialysis and there was linear relationship with stages of CKD and iron overload. Significant correlation of hemoglobin, serum iron, serum ferritin and transferrin saturation was observed with different stages of CKD. Keywords: Iron overload, maintenance hemodialysis, ferritin level.


2019 ◽  
Vol 12 (1) ◽  
pp. 77-82
Author(s):  
Ewa Kwiatkowska ◽  
Martyna Opara ◽  
Sebastian Kwiatkowski ◽  
Leszek Domański ◽  
Małgorzata Marchelek-Myśliwiec ◽  
...  

Background: According to the currently applicable KDIGO-2012 and ERBP 2013 guidelines, iron metabolism assessments for patients with Chronic Kidney Disease (CKD) are performed using such parameters as ferritin concentration and Transferrin Saturation (TSAT). Their values are to be treated as a basis on which to decide on providing iron substitution. Patients with Stage 5 CKD on maintenance hemodialysis commonly suffer from malnutrition syndrome and inflammation. One of the markers for malnutrition and inflammation is low transferrin concentration. Our study focused on establishing what percentage of patients this applied to and whether or not the transferrin saturation figure was artificially inflated in such cases. Materials and Methods: The study group included 66 patients with Stage 5 CKD on maintenance hemodialysis. Such data were analyzed as complete blood count, iron and ferritin concentrations, and Transferrin Saturation (TSAT). Other parameters - age, sex, time from their first hemodialysis, and the quality of their dialysis in the last six months – the Kt/V average. Results: It was found that only 12% of the study group patients had their transferrin concentrations above the lower limit of normal. The TSAT value correlated negatively with transferrin concentration. Transferrin concentration correlated negatively with time from first hemodialysis or ferritin concentration, and positively with body weight. Normal transferrin concentration was only seen in patients with ferritin concentrations of up to 400 μg/L. The group was divided according to transferrin concentration of <1.5 g/L or >1.5 g/L. These groups differed significantly in ferritin concentration and transferrin saturation. (p = 0.0005 and p = 0.004, respectively). The 1.5 g/L transferrin concentration point divides patients with mild and medium malnutrition. It is also the minimum transferrin content necessary to achieve hemoglobin values ≥10 g/dL determined using the ROC curve. Conclusion: Low transferrin concentrations cause abnormally high TSAT values. In most patients on maintenance hemodialysis, this marker is not useful for assessing the availability of iron for erythropoiesis.


2019 ◽  
Vol 4 (1) ◽  
pp. 12-17
Author(s):  
Mazou Ngou Temgoua ◽  
Gloria Ashuntantang ◽  
Marie José Essi ◽  
Joël Nouktadie Tochie ◽  
Moussa Oumarou ◽  
...  

Background: In sub-Saharan Africa (SSA), the trend in the number of patients admitted for maintenance hemodialysis is on the rise. The identification of risk factors for chronic kidney disease (CKD) ensures adequate primary and secondary preventive measures geared at reducing the burden of CKD in low-resource settings. A family history of CKD is an established risk factor for CKD in high-income countries. However, data on family predisposition to CKD is scarce in the literature on SSA. Objective: The current study aimed to determine the prevalence and risk factors of CKD in family relatives of a Cameroonian population of hemodialysis patients (HDP) followed-up in a major hemodialysis referral center in Cameroon. Methods: The current cross-sectional study was conducted over four months on a consecutive sample of first-degree family relatives of end-stage renal disease patients undergoing maintenance hemodialysis at the hemodialysis unit of the General Hospital of Yaoundé. For each participating family relative, socio-demographic characteristics, clinical data, and biological data including fasting blood glucose, proteinuria, and serum creatinine were collected. Results: A total of 82 first-degree family relatives of HDP were recruited. The prevalence of CKD among the participants was 15.8%. The main identified risk factors for CKD were age (P = 0.0015), female gender (P = 0.0357), hypertension (P = 0.0004), regular intake of herbal remedies (P = 0.0214), and diabetes mellitus (P = 0.0019). Conclusion: Overall, the current findings suggest an urgent need for population education, routine screening of CKD, and the identification of risk factors in first-degree family relatives of HDP in Cameroon.


2021 ◽  
Vol 25 (6) ◽  
pp. 87-92
Author(s):  
A. M. Mambetova ◽  
D. V. Bizheva ◽  
I. K. Thabisimova

BACKGROUND. Natriuretic peptides have cardio- and renoprotective effects, inhibiting inflammatory and proliferative processes. The role of natriuretic peptides in the early diagnosis and characterization of chronic kidney disease (CKD) and cardiovascular complications as the disease development and progresses has not been studied.TNEAIM: to study the level of natriuretic peptides in children depending on the stage of CKD development and to assess the significance of this indicator.PATIENTS AND METHODS. The study involved 93 children with congenital diseases of the urinary system at the age from 3 to 18 years. Three groups were identified: group I - 54 patients with CKD stage I , group II - 29 patients with CKD stage II; Group III - 10 children with CKD stages IV-V (patients with CKD stages IV and V were combined due to their small amount). Control group - 10 clinically healthy children of the corresponding age. The N-terminal propeptide of natriuretic hormone (NT-proBNP) was determined in the blood by the enzyme-linked immunosorbent assay.RESULTS. An increase in the level of NT-proBNP by 28.7% takes place already in the early stages of CKD. With the progression of CKD, an increase in the level of NT-proBNP was noted from 57.4 % in children in the group of patients with stage I CKD to 80 % in children in group III patients. The maximum concentrations of NT-proBNP, many times higher than those in CKD stages I and II, were observed in children with CKD stages IV-V. The degree of increase in the level of NT-proBNP correlated with the severity of CKD.CONCLUSION. In the diagnosis and characterization of CKD and cardiorenal syndrome in children, the determination of the level of natriuretic peptides is of great importance. A high level of natriuretic peptides characterizes the presence of cardiorenal relationships and can be used as an additional criterion for assessing the severity of CKD, including at the early stages of its development.


Sign in / Sign up

Export Citation Format

Share Document