scholarly journals Surgical Outcomes and Fusion Rate Following Spine Fusion Surgeries in Patients with Chronic Kidney Disease: According to Kidney Function

2021 ◽  
Author(s):  
Dae Jean Jo ◽  
Ho Yong Choi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Surgical Outcomes ◽  
Lumbar Fusion ◽  
Fusion Rate ◽  
Spine Fusion ◽  
High Morbidity ◽  
The Difference ◽  
Stage Renal Disease

Abstract PURPOSE. To evaluate the surgical outcomes and fusion rate following lumbar fusion surgeries in patients with chronic kidney disease (CKD) according to kidney function.METHODS. From March 2017 to February 2021, 54 consecutive adult patients with CKD who underwent spine fusion surgery were enrolled. According to the glomerular filtration rate (GFR) categories, 35 patients were classified into the non-end-stage renal disease (ESRD) group (GFR categories 3a–4, eGFR 15–59 mL/min/1.73 m2) and 19 patients into the ESRD group (GFR category 5, eGFR <15 mL/min/1.73 m2).RESULTS. Baseline characteristics did not differ between the groups. The mean number of fused vertebrae (4.9 ± 2.3 vs. 4.1 ± 2.0, p = 0.122), operative time (228.4 ± 129.6 min vs. 160.5 ± 87.5 min, p = 0.113), and surgical bleeding (743.1 ± 630.5 mL vs. 539.5 ± 384.4 mL, p = 0.354) did not differ between the groups. The rates of medical complications (25.7% vs. 52.6%, p = 0.048) and 3-month readmission (8.6% vs. 35.3%, p = 0.045) were significantly different between the groups. The 3-month mortality tended to be higher in the ESRD group (10.5%) than which in the non-ESRD group (2.9%), but the difference was not statistically significant (p = 0.280). The rate of pseudarthrosis was significantly higher in the ESRD group (35.3%) than in the non-ESRD group (9.1%, p = 0.047).CONCLUSIONS. Surgeons should be aware of the high morbidity and the pseudarthrosis when considering spine surgeries in patients with ESRD.

scholarly journals Urinary uromodulin independently predicts end-stage renal disease and rapid kidney function decline in a cohort of chronic kidney disease patients

Medicine ◽  
2019 ◽  
Vol 98 (21) ◽  
pp. e15808 ◽  
Author(s):  
Dominik Steubl ◽  
Matthias Block ◽  
Victor Herbst ◽  
Wolfgang Andreas Nockher ◽  
Wolfgang Schlumberger ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Function ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
Kidney Function Decline

scholarly journals Regional Anesthesia: Boon for Chronic Kidney Disease Patients Undergoing Vascular Access Surgery

2019 ◽  
Vol 5 (02) ◽  
pp. 37-41
Author(s):  
Prapti Rath ◽  
Archana Shivashankar ◽  
Luv Luthra ◽  
Nivedita Mitta
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Regional Anesthesia ◽  
Indian Population ◽  
High Morbidity ◽  
Dialysis Access ◽  
Vascular Access Surgery ◽  
Stage Renal Disease ◽  
End Stage ◽  
Access Surgery

AbstractThe incidence of chronic kidney disease (CKD) is alarmingly high in Indian population with a steep rise in end-stage renal disease patients requiring dialysis access. The preexisting comorbidities associated with high morbidity further necessitate an anesthetic plan which provides benefits intraoperatively as well postoperatively. Different anesthesia techniques can be employed in CKD patients which are associated with complications. The aim of this review is to study the role and benefits of regional anesthesia in CKD patients.

Current Approaches in the Treatment of Chronic Kidney Disease Mineral and Bone Disorder

2008 ◽  
Vol 21 (3) ◽  
pp. 196-213 ◽  
Author(s):  
Priscilla P. How ◽  
Darius L. Mason ◽  
Alan H. Lau
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Mineral Metabolism ◽  
High Morbidity ◽  
Mineral And Bone Disorder ◽  
Vitamin D Analogs ◽  
Bone Disorder ◽  
Stage Renal Disease

Patients with chronic kidney disease (CKD) develop mineral and bone disorder (MBD), a common and important complication, as a result of impaired phosphorus excretion and reduced vitamin D activation. Altered mineral metabolism is now recognized as an independent cardiovascular risk factor in end-stage renal disease patients and contributes to the risk for accelerating vascular calcification. CKD patients are at high risk for cardiovascular disease and vascular calcification which account for the high morbidity and mortality in this patient population. Pharmacotherapeutic interventions are necessary to manage and treat the condition. Multiple classes of agents including phosphorus binders, vitamin D analogs, and calcimimetics are now available to treat CKD-MBD. Recent data have shown that treatment with sevelamer and vitamin D analogs are associated with a reduction in calcification and cardiovascular mortality and improved survival. This article provides an overview of the strategies and considerations for the management of CKD-MBD, as well as their implications on clinical outcomes.

Abstract P019: Association Between Hypertension and Kidney Function Trajectory: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Casey M Rebholz ◽  
Yuan Chen ◽  
Kunihiro Matsushita ◽  
Josef Coresh ◽  
Morgan E Grams
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Hypertension Status ◽  
Atherosclerosis Risk In Communities ◽  
Stage Renal Disease ◽  
End Stage ◽  
Study Participants ◽  
Kidney Function Decline

Introduction: Cardiovascular disease, including hypertension, increases the risk of kidney disease progression. The relationship between hypertension and change in kidney function has not been fully elucidated. We hypothesized that hypertension is associated with faster kidney function decline. Methods: Hypertension status was assessed among Atherosclerosis Risk in Communities (ARIC) Study participants at baseline (1987-89) and defined as systolic blood pressure ≥140, diastolic blood pressure ≥90, or anti-hypertensive medication use in the last two weeks. Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) was calculated using creatinine measured at baseline and follow-up study visits (1990-92; 1996-98; 2011-13) and an eGFR value of 15 mL/min/1.73 m 2 was imputed for incident end-stage renal disease cases. Results: After excluding those with missing baseline measurements of blood pressure, missing serum creatinine, and prevalent end-stage renal disease, there were 15,622 study participants. Baseline mean age was 55 years, 55% were female, 26% were black, and 35% had hypertension. Mean annual eGFR decline was 1.98 mL/min/1.73 m 2 per year among those with hypertension and 1.54 mL/min/1.73 m 2 per year among those without hypertension, after adjusting for demographic characteristics and co-morbidities (Figure, p<0.001). Participants with hypertension at baseline were more likely to develop chronic kidney disease than those without hypertension. Over 25 years, for those with hypertension and those without hypertension, respectively, the probability of developing chronic kidney disease stage 3A (eGFR <60 mL/min/1.73 m 2 ) was 55.3% and 44.5%, stage 3B (eGFR <45 mL/min/1.73 m 2 ) was 24.3% and 19.1%, stage 4 (eGFR <30 mL/min/1.73 m 2 ) was 9.2% and 7.7%, and stage 5 (eGFR <15 mL/min/1.73 m 2 ) was 3.9% and 3.5%. Conclusion: Hypertension status was associated with faster kidney function decline. Absolute risk increase was greater for earlier kidney disease stages.

scholarly journals 899. Use of Dolutegravir/Rilpivirine in Treatment of HIV in PLWH with CKD and ESRD

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S540-S541
Author(s):  
Jungwook Kang ◽  
Yae Ji Kim
Keyword(s):  
Chronic Kidney Disease ◽  
Viral Load ◽  
Kidney Disease ◽  
Kidney Function ◽  
Adverse Drug Events ◽  
Medical Center ◽  
Retrospective Chart Review ◽  
Viral Load Suppression ◽  
Downstate Medical ◽  
Stage Renal Disease

Abstract Background Dolutegravir and rilpivirine is a novel two-drug single-tablet regimen for human immunodeficiency virus (HIV) that does not require dose adjustment in patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD). Although there are no studies proving the efficacy and safety of this regimen for patients with CKD and ESRD, there are a few studies that support the use of dolutegravir in hemodialysis. Methods A retrospective chart review was performed on patients who received dolutegravir and rilpivirine from November 2017 to July 2020 in the HIV clinic at SUNY Downstate Medical Center. The primary endpoint was the viral load suppression rate (defined as viral load less than 50 copies/ml) at 6 months of therapy compared between two groups of patients with varying kidney function: chronic kidney disease (defined as creatinine clearance (CrCl) under 60 mL/min) and normal kidney function (defined as CrCl higher than or equal to 60 mL/min). Viral load suppression rate was compared using logistic regression. Secondary outcomes were any reported adverse drug events and the discontinuations of the study medication. Results Overall viral load suppression at 6 months was achieved in 31 out of 36 patients (86.1%). 13 out of 14 patients (92.9%) with CrCl greater than or equal to 60 mL/min at baseline achieved viral load suppression at 6 months, whereas 18 out of 22 patients (81.8%) with CrCl under 60 mL/min at baseline achieved viral load suppression at 6 months (p=0.367). With adjustments for age, gender, and the history of Acquired Immunodeficiency Syndrome, the result was still insignificant. One adverse event of headache was reported in the group with baseline CrCl under 60 mL/min. Three cases of discontinuation were reported in this group due to resistance, headache, and drug-drug interaction. Conclusion The use of dolutegravir and rilpivirine for the treatment of HIV infection in adults with CKD or ESRD on hemodialysis was both safe and effective in African American population. Disclosures All Authors: No reported disclosures

scholarly journals Erythropoietin dose and survival of hemodialysis patients

2017 ◽  
Vol 4 (07) ◽  
pp. 1432
Author(s):  
Mahdi Mohammadian ◽  
Hamid Salehiniya ◽  
Salman Khazaei ◽  
Abdollah Mohammadian-Hafshejani
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Kidney Function ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Major Health Problem ◽  
Major Health ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease (CKD) is known as a major health problem worldwide (Levey et al., 2007). The CKD is defined as a stage of disease in which the patient's kidney function is less than a half of normal capacity (2). If the kidney function is 10% to 15% less than the normal capacity, the patient has reached the End Stage Renal Disease (ESRD). At this stage, the kidney transplant or dialysis with hemodialysis or peritoneal dialysis is necessary for patient's survival (Levey et al., 2002).

scholarly journals Pulmonary embolism in chronic kidney disease and end-stage renal disease hospitalizations: Trends, outcomes, and predictors of mortality in the United States

2021 ◽  
Vol 9 ◽  
pp. 205031212110229
Author(s):  
Jagmeet Singh ◽  
Sushmita Khadka ◽  
Dhanshree Solanki ◽  
Asim Kichloo ◽  
Harshil Shah ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Pulmonary Embolism ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Function ◽  
End Stage Renal Disease ◽  
Normal Kidney ◽  
Normal Kidney Function ◽  
Stage Renal Disease ◽  
End Stage

Background: It is well-known that patients with chronic kidney disease and end-stage renal disease are at increased risk of pulmonary embolism than patients with normal kidney function. However, the data on trends, outcomes, and predictors of mortality in pulmonary embolism patients with chronic kidney disease and end-stage renal disease in the United States are limited. Methods: We queried the National Inpatient Sample database from 2010 to 2014. International Classification of Diseases-Ninth Revision-Clinical Modification codes were used to identify patients with normal kidney function, chronic kidney disease, and end-stage renal disease. The frequency of pulmonary embolism, complications, in-hospital mortality, and length of stay were calculated for each cohort. Multivariable logistic regression models were constructed to determine the predictors of mortality. Results: In the study population (2010–2014), there were 766,176 pulmonary embolism hospitalizations with normal kidney function, 79,824 with chronic kidney disease, and 9147 with end-stage renal disease. Among the study cohorts, the mortality rate was 2.7% in normal kidney function, 4.5% in chronic kidney disease, and 6.8% in end-stage renal disease hospitalizations. Median length of stay was highest in the end-stage renal disease cohort and lowest in the normal kidney function cohort. After adjusting for confounders, pulmonary embolism patients with chronic kidney disease died 1.15 times more often than those with normal kidney function and pulmonary embolism patients with end-stage renal disease died 4.2 times more often than those with normal kidney function. Conclusion: The mortality rate and length of stay in pulmonary embolism patients with chronic kidney disease and end-stage renal disease were significantly higher than those in pulmonary embolism patients with normal kidney function. Also, pulmonary embolism patients with chronic kidney disease and end-stage renal disease were at higher risk of in-hospital mortality than those with normal kidney function. There was statistically significant higher risk of mortality in elderly and Black patients with pulmonary embolism and concurrent chronic kidney disease or end-stage renal disease.

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