scholarly journals Non-linear progression of chronic kidney disease and associated factors in hypertensive patients: a 4-year cohort study

2020 ◽  
Author(s):  
Luciana Saraiva da Silva ◽  
Tiago Ricardo Moreira ◽  
Rodrigo Gomes da Silva ◽  
Rosângela Minardi Mitre Cotta
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Associated Factors ◽  
Multivariate Analyses ◽  
Multivariate Logistic Regression ◽  
Ckd Progression ◽  
Hypertensive Patients ◽  
Explanatory Variables ◽  
Non Linear

Abstract Background Recent studies suggest that the progression of chronic kidney disease (CKD) is not linear, but we do not have clear evidence on this issue, especially in hypertensive patients. We sought to evaluate the progression of CKD and associated factors over four years in a cohort of hypertensive patients. Methods We conducted a prospective cohort study during the years 2012 and 2016, with hypertensive patients diagnosed with CKD (n = 113). The progression of CKD was assessed through the evolution of the glomerular filtration rate (GFR) and the change in the stage of CKD between 2012 and 2016. Sociodemographic, economic, lifestyle, clinical, anthropometric, and biochemical variables were evaluated. The strength of the association between CKD progression and explanatory variables was assessed by odds ratio (OR) and their respective 95% confidence intervals using univariate and multivariate logistic regression. Results Regarding progression, 78.1% of the CKD patients did not progress over four years. When assessing the CKD trajectory (2012–2016) through the evolution of GFR, there was a mean reduction of 1.3 mL/min/1.73m² in four years. In the group that progressed, there was a reduction of 13 mL/min/1.73m², while in the group that did not progress, there was an increase of 2 mL/min/1.73m². In the multivariate analyses, age (p = 0.047), diabetes mellitus (DM) (p = 0.042), and urea (p = 0.050) were independently associated with CKD progression. Conclusions The findings of the present study showed a non-linear progression of CKD over the four years, contrary to what is traditionally expected. Age, DM and urea were independently associated with CKD progression.

scholarly journals SO081LITHIUM EXPOSURE AND OCCURENCE OF CHRONIC KIDNEY DISEASE IN THE IRISH HEALTH SYSTEM: A COHORT STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mark Behan ◽  
Leonard Browne ◽  
Stack Austin
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Linear Regression ◽  
Health System ◽  
Multiple Linear Regression ◽  
Kidney Function ◽  
Ckd Progression ◽  
Duration Of Treatment

Abstract Background and Aims Lithium is implicated as a causative factor in the development and progression of chronic kidney disease (CKD). Few studies have assessed the independent impact of plasma levels and duration of lithium therapy on CKD progression. We examined the influence of lithium on CKD progression in the Irish health system. Method We utilised data from the Irish Kidney Disease Surveillance System (IKDSS) to explore associations of lithium levels and duration of exposure with kidney function in a regional cohort. A retrospective cohort study was conducted between 1999 to 2014 from the Midwest Region. All adult patients with lithium levels were identified and followed longitudinally. Kidney function was assessed at baseline and longitudinally using serum creatinine and estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI. Patients with < 2 lithium values, missing data on creatinine were excluded. The index date was the date of the first lithium blood test. Toxicity from lithium was defined as levels >1.2mmol/L as per NICE guidelines while duration of treatment was calculated based on patient –years of exposure as determined by positive blood lithium levels. Relationships between baseline kidney function, lithium levels, duration of exposure and each patients most recent eGFR value on follow up were assessed using multiple linear regression Results We identified 1,978 patients exposed to lithium from 1999-2014, mean age was 47.4 (15.6), 45.1% were men, eGFR [median (IQR)] at baseline was 84.4 (32.1) ml/min1.73m and the median duration of exposure was 3.0 years (IQR=4 years). Frequency of lithium testing increased from 1.77 in 1999 to 2.66 in 2014. In multiple linear regression, the final eGFR on follow-up was significantly lower in older patients (-0.48 ml/min/1.73m per year increase in age), P<0.001; in patients with elevated baseline lithium levels (-2.18 ml/min1.73m lower per unit increase), P<0.05, with long duration of exposure (-1.42 ml/min/1.73m lower for each year on lithium), P<0.001, and for patients with low GFR at baseline (P<0.001). Together these variables explained 58% of the variation in the final model. Conclusion Both the magnitude of and the duration of lithium exposure are both independently associated with CKD progression among lithium users in the Irish health system. Higher baseline lithium values had a more deleterious impact on kidney function. Continued efforts should be expended in minimising the risks of lithium induced nephrotoxicity through switching to alternatives and dose reduction when over possible. Funding This study is funded by the Health Research Board and the Midwest Research and Education Foundation (MKid).

scholarly journals Association between health related quality of life and progression of chronic kidney disease

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
Chang Seong Kim ◽  
Eun Hui Bae ◽  
Yun Kyu Oh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Summary Score ◽  
Health Related Quality ◽  
Ckd Progression ◽  
Related Quality ◽  
Health Related

AbstractThe impact of health-related quality of life (HRQOL) on outcomes remains unclear in chronic kidney disease (CKD) patients despite its importance in socioeconomic aspects and individual health. We aim to identify the relationship between HRQOL and progression of CKD in pre-dialysis patients. A total 1622 patients with CKD were analyzed in the KoreaN cohort Study for Outcomes in patients With Chronic Kidney Disease, a prospective cohort study. CKD progression was defined as one or more of the following: initiation of dialysis or transplantation, a two-fold increase in baseline serum creatinine levels, or a 50% decline in the estimated glomerular filtration rate during the follow-up period. The group with CKD progression had lower scores of HRQOL than the group without CKD progression. A fully adjusted Cox proportional hazard ratio model showed that each low baseline physical and mental component summary score was associated with a higher risk of CKD progression. In Kaplan-Meier survival analysis using propensity score matched data, only low physical component summary scores showed statistical significance with CKD progression. Our study highlights low physical component summary score for an important prognostic factor of CKD progression. Risk-modification interventions for high-risk patients may provide benefits to individuals.

scholarly journals Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: a cross-sectional study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Degena Bahrey ◽  
Gebreamlak Gebremedhn ◽  
Teklewoini Mariye ◽  
Alem Girmay ◽  
Woldu Aberhe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Teaching Hospitals ◽  
Sectional Study ◽  
Diabetic Mellitus ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Objective The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected 578 hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0. Result Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 (22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7%, 27.3% and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI 1.43 (1.07–1.81)], uncontrolled hypertension 4.434 [AOR (95% CI 9.45 (1.34, 14.73)], overweight/obese [AOR (95% CI 7.422 (2.72, 20.28)], dyslipidemia [AOR (95% CI) 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.

Smoking, Smoking Cessation, and Progression of Chronic Kidney Disease: Results From KNOW-CKD Study

2020 ◽  
Author(s):  
Sangmi Lee ◽  
Shinchan Kang ◽  
Young Su Joo ◽  
Changhyun Lee ◽  
Ki Heon Nam ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Smoking Cessation ◽  
Cohort Study ◽  
Kidney Disease ◽  
Kidney Function ◽  
Primary Outcome ◽  
Incidence Rates ◽  
Ckd Progression ◽  
Increased Risk ◽  
Never Smokers

Abstract Introduction In patients with chronic kidney disease (CKD), studies investigating the association between smoking and deterioration of kidney function are scarce. Aims and Methods We analyzed data for 1,951 patients with an estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73 m2 enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD) from 2011 to 2016. Patients were categorized by smoking load. Primary outcome was a composite of a ≥50% reduction in eGFR, initiation of dialysis, or kidney transplantation. Results There were 967 never-smokers and 369, 276, and 339 smokers who smoked <15, 15 to 29, ≥30 pack-years, respectively. During a mean follow-up of 3.0 years, the incidence rates (95% confidence interval [CI]) of the primary outcome were 54.3 (46.4–63.5), 46.9 (35.9–61.4), 69.2 (52.9–90.6), and 76.3 (60.7–96.0) events per 1,000 person-yr in never-, <15, 15 to 29, and ≥30 pack-year smokers. In cause-specific hazard model after adjustment of confounding factors, smokers were associated with 1.09 (0.73–1.63), 1.48 (1.00–2.18), and 1.94 (1.35–2.77) fold increased risk (95% CI) of primary outcome in <15, 15–29, and ≥30 pack-year smokers compared with never-smokers. The association of longer smoking duration with higher risk of CKD progression was evident particularly in patients with eGFR < 45 mL/min/1.73 m2 and proteinuria ≥ 1.0 g/g. In contrast, the risk of adverse kidney outcome decreased with longer smoking-free periods among former-smokers. Conclusions These findings suggest potentially harmful effects of the degree of exposure to smoking on the progression of CKD. Implications Among patients with CKD, there has been lack of studies on the association between smoking and CKD progression and studies to date have yielded conflicting results. In this prospective cohort study involving Korean CKD patients, smoking was associated with significantly higher risk of worsening kidney function. Furthermore, the risk of adverse kidney outcome was incrementally higher as smoking pack-years were higher. As the duration of smoking cessation increased, the hazard ratios for adverse kidney outcome were attenuated, suggesting that quitting smoking may be a modifiable factor to delay CKD progression.

scholarly journals Metabolomics of Chronic Kidney Disease Progression: A Case-Control Analysis in the Chronic Renal Insufficiency Cohort Study

2016 ◽  
Vol 43 (5) ◽  
pp. 366-374 ◽  
Author(s):  
Eugene P. Rhee ◽  
Clary B. Clish ◽  
Julia Wenger ◽  
Jason Roy ◽  
Sammy Elmariah ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Disease Progression ◽  
Chronic Renal Insufficiency ◽  
Case Control ◽  
Plasma Metabolites ◽  
Control Analysis ◽  
Ckd Progression

Background: Whereas several longitudinal metabolomics studies have been conducted in individuals with normal estimated glomerular filtration rate (eGFR) at baseline, disease progression among individuals with established chronic kidney disease (CKD) has not been rigorously examined. Methods: We performed a nested case-control study of rapid CKD progression in the Chronic Renal Insufficiency Cohort Study, profiling baseline plasma from 200 individuals each with eGFR slope <-3 ml/min/1.73 m2/year (cases) or between -1 and +1 ml/min/1.73 m2/year (controls), matched on baseline eGFR and proteinuria. To directly assess how the kidney modulates circulating metabolites, we profiled plasma from the aorta and renal vein of 25 hospital-based individuals. Results: At baseline, cases and controls had a mean eGFR of 41.7 ± 13.3 and 45.0 ± 14.5 ml/min/1.73 m2, respectively. Ten plasma metabolites were nominally associated with CKD progression in logistic regression models adjusted for age, sex, race/ethnicity, hypertension, systolic and diastolic blood pressure, diabetes, eGFR and proteinuria; no metabolite achieved the Bonferroni-adjusted significance threshold (p < 0.0003). In a cross-sectional analysis, all 6 of the metabolites that were higher in cases than controls were significantly associated with eGFR at baseline. By contrast, threonine, methionine and arginine were lower in cases than in controls and had no association with baseline eGFR. Furthermore, in the hospital-based cohort that underwent renal arteriovenous sampling, these 3 metabolites were net released from the kidney. Combining these metabolites into a panel of markers further strengthened their association with CKD progression. Conclusion: Our results motivate interest in arginine, methionine and threonine as potential indicators of renal metabolic function and markers of renal prognosis.

scholarly journals Knowledge and Practices towards Prevention and Early Detection of Chronic Kidney Disease and Associated Factors among Hypertensive Patients in Gondar Town, North West Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Daniel Asmelash ◽  
Elias Chane ◽  
Getahun Desalegn ◽  
Sewmalet Assefa ◽  
Getie lake Aynalem ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Early Detection ◽  
Educational Status ◽  
Multivariate Logistic Regression ◽  
Hypertensive Patients ◽  
Prevention And Early Detection ◽  
Gondar Town ◽  
Knowledge And Practice

Background. Chronic kidney disease is a global health problem with serious adverse effects, including kidney failure, cardiovascular disease, and premature death. Improving awareness and practice on the impact, prevention, and early detection of chronic kidney disease will reduce the significant economic and public health burden. Methods. A cross-sectional study was conducted to determine knowledge and practice towards prevention and early detection of chronic kidney disease and its associated factors among hypertensive patients in Gondar town in 2019. The study included hypertensive patients visiting health institutions from February to March 2019. Data was collected using a semistructured questionnaire and individuals who fulfilled our inclusion criteria were selected using a systemic random sampling technique. Epi Info software version 7 was used for data entry, and SPSS version 20 was used for descriptive and logistic regression analysis. Result. Out of a total of 442 participants, 434 completed the questionnaire, with a response rate of 98.1%. Of the total, 298 (68.7%) had good knowledge of chronic kidney disease with a mean knowledge score of 8.78 ± 2.80 and 210 (48.4%) had good practice with mean practice score of 6.58 ± 1.61. Educational status, residence, and duration of hypertension were significantly associated with the knowledge and practice scores of the participants in the multivariate logistic regression analysis. Conclusion. More than half of the participants had good knowledge about chronic kidney disease and its risk factors. However, the level of preventive practice among participants was low. The educational status, residence, and duration of hypertension were significantly associated variables with knowledge and practice scores in multivariate logistic regression.

scholarly journals Knowledge towards Prevention and Early Detection of Chronic Kidney Disease and Associated Factors among Hypertensive Patients at a Chronic Illness Clinic of Jimma Town Public Hospitals

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Belachew Tegegne ◽  
Tigist Demeke ◽  
Shemsedin Amme ◽  
Afework Edmealem ◽  
Sewunet Ademe
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Detection ◽  
Associated Factors ◽  
Public Hospitals ◽  
Hypertensive Patients ◽  
Prevention And Early Detection ◽  
History Of ◽  
Study Participants ◽  
Jimma Town

Background. Morbidity and mortality due to chronic kidney disease are increasing among hypertensive patients in Sub-Saharan Africa. The majority of hypertensive patients with chronic kidney disease are not diagnosed at an early stage because of poor knowledge. However, to the best of our knowledge, there is no study conducted in Ethiopia about knowledge of hypertensive patients towards prevention and early detection of chronic kidney disease. Thus, the aim of this study was to assess knowledge towards prevention and early detection of chronic kidney disease and associated factors among hypertensive patients at Jimma town public hospitals, Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 332 hypertensive patients using an interviewer-administered questionnaire and medical record reviewing from April 5 to May 21, 2019. Study participants were selected using simple random sampling. Data were collected by using a standardized questionnaire. Data were entered into Epidata version 3.1 and analyzed by SPSS version 23. Descriptive statistics and bivariable and multivariable logistic regression were applied. To identify factors, a 95% confidence level and P value of less than 0.05 were considered. Results. Over half (59.6%) were males, and the mean (±SD) age of participants was 54.92 (12.91) years. Among the total participants, more than half of them (47.9%) had good knowledge. Attending secondary education ( AOR = 2.9 , P = 0.014 ), higher education ( AOR = 5.4 , P = 0.001 ), working in private sectors ( AOR = 4.3 , P = 0.001 ), taking three and above drugs per day ( AOR = 0.55 , P = 0.016 ), and having a family history of kidney disease ( AOR = 2.3 , P = 0.012 ) were significantly associated with knowledge. Conclusion and Recommendation. Near to half of the study participants had good knowledge towards prevention and early detection of chronic kidney disease. Attending secondary education and above, working in private sectors, taking three and above drugs per day, and having a family history of kidney disease were independent predictors of knowledge. Hypertensive patients should be encouraged to be aware of risk factors of CKD, and health care providers should educate hypertensive patients about the prevention and early detection of chronic kidney disease.

scholarly journals Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: A cross-sectional study

2019 ◽  
Author(s):  
Degena Bahrey ◽  
Gebreamlak Gebremedhn ◽  
Teklewoini Mariye ◽  
Alem Girmay ◽  
Woldu Aberhe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Teaching Hospitals ◽  
Sectional Study ◽  
Diabetic Mellitus ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Objective: The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected five hundred seventy eight hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0. Result: Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 ( 22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7% , 27.3 % and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI = 1.43 (1.07-1.81) ] , uncontrolled hypertension 4.434 [AOR ( 95%CI =9.45 (1.34, 14.73) ] , overweight/obese [AOR ( 95%CI =7.422 ( 2.72, 20.28) ] , dyslipidemia [AOR (95% CI) = 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) = 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.

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