scholarly journals Association of pesticides and kidney function among adults in the US population 2001-2010

2021 ◽  
Author(s):  
En-Tzu Wan ◽  
Darsy Darssan ◽  
Shamshad Karatela ◽  
Simon Reid ◽  
Nicholas Osborne
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Dichlorophenoxyacetic Acid ◽  
Cross Sectional ◽  
Agricultural Communities ◽  
Health And Nutrition ◽  
Increased Risk ◽  
Pesticide Exposures ◽  
2,4 Dichlorophenoxyacetic Acid

Abstract Background Chronic kidney disease with unknown cause (CKDu) is prevalent in tropical and agricultural communities, however, its aetiology remains unclear. The objective of this study was to examine the association between pesticide exposures and the risk of kidney function loss using four waves of the National Health and Nutrition Examination Survey (NHANES) to identify a pathological pathway. Methods We pooled data from four cross-sectional waves of NHANES, providing 41,847 participants in total. Sub-population analyses for 2,4-dichlorophenoxyacetic acid (2,4-D), 3,5,6- trichloropyridinol, 3-phenoxybenzoic acid (3-PBA) and Malathion were conducted using. Logistic regression to estimate the odds ratios (ORs) and 95% CIs of the association between log-pesticide levels and kidney function. Results We found that Malathion acid increased the risk of low kidney function among the Malathion sub-population (aOR = 1.26, 95% CI = 1.01–1.56) in the adjusted model. Significantly increased risk of low kidney function was not found among the 2,4-D (aOR = 0.88, 95% CI = 0.72–1.09), 3,5,6-trichloropyridinol (aOR = 0.96, 95% CI = 0.83–1.12) and 3-PBA (aOR = 1.03, 95% CI = 0.94–1.13) subpopulations. Conclusions Our findings provide evidence of altered kidney function in people exposed to Malathion, highlighting the need to focus on Malathion acid as a potential cause of renal injury or chronic kidney disease.

scholarly journals Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie A. Hamilton ◽  
Wisdom P. Nakanga ◽  
Josephine E. Prynn ◽  
Amelia C. Crampin ◽  
Daniela Fecht ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Potential Risk ◽  
Cross Sectional ◽  
Tropical Countries ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
The Mean

Abstract Background An epidemic of chronic kidney disease of unknown cause (CKDu) is occurring in rural communities in tropical regions of low-and middle-income countries in South America and India. Little information is available from Southern African countries which have similar climatic and occupational characteristics to CKDu-endemic countries. We investigated whether CKDu is prevalent in Malawi and identified its potential risk factors in this setting. Methods We conducted a cross-sectional study from January–August 2018 collecting bio samples and anthropometric data in two Malawian populations. The sample comprised adults > 18 years (n = 821) without diabetes, hypertension, and proteinuria. Estimates of glomerular filtration rate (eGFR) were calculated using the CKD-EPI equation. Linear and logistic regression models were applied with potential risk factors, to estimate risk of reduced eGFR. Results The mean eGFR was 117.1 ± 16.0 ml/min per 1.73m2 and the mean participant age was 33.5 ± 12.7 years. The prevalence of eGFR< 60 was 0.2% (95% confidence interval (95% CI) 0.1, 0.9); the prevalence of eGFR< 90 was 5% (95% CI =3.2, 6.3). We observed a higher prevalence in the rural population (5% (3.6, 7.8)), versus urban (3% (1.4, 6.7)). Age and BMI were associated with reduced eGFR< 90 [Odds ratio (OR) (95%CI) =3.59 (2.58, 5.21) per ten-year increment]; [OR (95%CI) =2.01 (1.27, 3.43) per 5 kg/m2 increment] respectively. No increased risk of eGFR < 90 was observed for rural participants [OR (95%CI) =1.75 (0.50, 6.30)]. Conclusions Reduced kidney function consistent with the definition of CKDu is not common in the areas of Malawi sampled, compared to that observed in other tropical or sub-tropical countries in Central America and South Asia. Reduced eGFR< 90 was related to age, BMI, and was more common in rural areas. These findings are important as they contradict some current hypothesis that CKDu is endemic across tropical and sub-tropical countries. This study has enabled standardized comparisons of impaired kidney function between and within tropical/subtropical regions of the world and will help form the basis for further etiological research, surveillance strategies, and the implementation and evaluation of interventions.

scholarly journals Association of Pesticides and Kidney Function among Adults in the US Population 2001–2010

2021 ◽  
Vol 18 (19) ◽  
pp. 10249
Author(s):  
En-Tzu Wan ◽  
Darsy Darssan ◽  
Shamshad Karatela ◽  
Simon A. Reid ◽  
Nicholas John Osborne
Keyword(s):  
Kidney Function ◽  
Organophosphate Pesticides ◽  
Cross Sectional ◽  
Pooled Data ◽  
Health And Nutrition ◽  
Increased Risk ◽  
Pesticide Exposures ◽  
Function Loss ◽  
The Us ◽  
Adjusted Model

Chronic kidney disease of unknown cause is prevalent in a range of communities; however, its etiology remains unclear. We examined the association between pesticide exposures and the risk of kidney function loss using four waves of the National Health and Nutrition Examination Survey (NHANES) to identify a pathological pathway. We pooled data from four cross-sectional waves of NHANES, with 41,847 participants in total. Exposure to malathion increased the risk of low kidney function (aOR = 1.26, 95% CI = 1.01–1.56) in the adjusted model. Increased risk of low kidney function was not found among those exposed to 2,4-D (aOR = 0.88, 95% CI = 0.72–1.09), 3,5,6-trichloropyridinol (aOR = 0.96, 95% CI = 0.83–1.12), and 3-PBA (aOR = 1.03, 95% CI = 0.94–1.13). Our findings provide evidence of altered kidney function in people exposed to malathion, highlighting the potential of organophosphate pesticides’ role in renal injury.

scholarly journals Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e025694 ◽  
Author(s):  
Cindy George ◽  
Tandi E Matsha ◽  
Rajiv T Erasmus ◽  
Andre P Kengne
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Cell ◽  
Kidney Function ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mixed Ancestry ◽  
Cross Sectional ◽  
Haematological Profile ◽  
Rbc Indices

ObjectivesThe objectives were to characterise the haematological profile of screen-detected chronic kidney disease (CKD) participants and to correlate the complete blood count measures with the commonly advocated kidney function estimators.MethodsThe current cross-sectional study used data, collected between February 2015 and November 2016, of 1564 adults of mixed-ancestry, who participated in the Cape Town Vascular and Metabolic Health study. Kidney function was estimated using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and anaemia as haemoglobin level <13.5 g/dL (men) and <12 g/dL (women).ResultsBased on the MDRD and CKD-EPI equations, the crude prevalence of CKD was 6% and 3%. Irrespective of the equation used, median red blood cell (RBC) indices were consistently lower in those with CKD compared with those without CKD (all p<0.0001). Despite not showing any significant difference in total white blood cell (WBC) count between the two groups, the number of lymphocytes were lower (p=0.0001 and p<0.0001 for MDRD and CKD-EPI, respectively) and neutrophil count (both p<0.0297) and the ratio of lymphocytes to neutrophil (both p<0.0001) higher in the CKD group compared with those without CKD; with the remaining WBC indices similar in the two groups. The platelet count was similar in both groups. Of the screen-detected CKD participants, 45.5% (MDRD) and 57.8% (CKD-EPI) were anaemic, with the prevalence increasing with increasing severity of CKD, from 37.2% (stage 3) to 82.4% (stages 4–5). Furthermore, CKD-EPI-estimated kidney function, but not MDRD, was positively associated with RBC indices.ConclusionThough it remains unclear whether common kidney function estimators provide accurate estimates of CKD in Africans, the correlation of their estimates with deteriorating RBC profile, suggests that advocated estimators, to some extent approximate kidney function in African populations.

Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽  
2017 ◽  
Vol 63 (3) ◽  
pp. 201-209 ◽  
Author(s):  
Maximilian König ◽  
Maik Gollasch ◽  
Ilja Demuth ◽  
Elisabeth Steinhagen-Thiessen
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Elderly ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

scholarly journals The evaluation of kidney function in living kidney donor candidates

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0003052021
Author(s):  
Neetika Garg ◽  
Emilio D. Poggio ◽  
Didier Mandelbrot
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Creatinine Clearance ◽  
Kidney Function ◽  
The United States ◽  
Estimated Gfr ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Increased Risk ◽  
Measured Gfr

Living kidney donors incur a small increased risk of end-stage kidney disease (ESKD), of which pre-donation glomerular filtration rate (GFR) is an important determinant. As a result, kidney function assessment is central to the donor candidate evaluation and selection process. This article reviews the different methods of GFR assessment including estimated GFR, creatinine clearance and measured GFR, and the current guidelines on GFR thresholds for donor acceptance. Estimated GFR obtained using the 2009 Chronic Kidney Disease Epidemiology Collaboration equation, while the best of estimating estimations, tends to underestimate and has limited accuracy, especially near normal GFR values. In the United States, the Organ Procurement and Transplantation Network policy on living donation mandates either measured GFR or creatinine clearance as part of evaluation. Measured GFR is considered the gold standard, although there is some variation in performance characteristics depending on the marker and technique used. Major limitations of creatinine clearance are dependency on accuracy of timed collection, and overestimation as a result of distal tubular creatinine secretion. GFR declines with healthy aging, and most international guidelines recommend use of age-adapted selection criteria. The 2017 Kidney Disease: Improving Global Outcomes Guideline for the Evaluation and Care of Living Kidney Donors diverges from other guidelines and recommends using absolute cut-off of <60 ml/min/1.73m2 for exclusion and of ≥90 ml/min/1.73m2 for acceptance, and determination of candidacy with intermediate GFR based on long-term ESKD risk. However, several concerns for this strategy exist, including inappropriate acceptance of younger candidates due to underestimation of risk, and exclusion of older candidates whose kidney function is in fact appropriate for age. Role of cystatin C and other newer biomarkers, as well as data on impact of pre-donation GFR on not just ESKD risk but also advanced chronic kidney disease risk and cardiovascular outcomes are needed.

scholarly journals The Association Between Dietary Inflammatory Index and Parathyroid Hormone in Adults With/Without Chronic Kidney Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Zheng Qin ◽  
Qinbo Yang ◽  
Ruoxi Liao ◽  
Baihai Su
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Subgroup Analysis ◽  
Positive Association ◽  
Dietary Recall ◽  
Inflammatory Index ◽  
Health And Nutrition ◽  
Increased Risk ◽  
Pth Level

Aims: We aimed to assess the association between dietary inflammation index (DII) with parathyroid hormone (PTH) and hyperparathyroidism (HP) in adults with/without chronic kidney disease (CKD).Methods: Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey (NHANES). The participants who were &lt;18 years old, pregnant, or missing the data of DII, PTH, and CKD were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between DII with PTH and the HP in the population with CKD/non-CKD.Results: A total of 7,679 participants were included with the median DII of −0.24 (−2.20 to 1.80) and a mean PTH level of 43.42 ± 23.21 pg/ml. The average PTH was 45.53 ± 26.63 pg/ml for the participants in the highest tertile group compared with 41.42 ± 19.74 pg/ml in the lowest tertile group (P &lt; 0.0001). The rate of HP was 11.15% overall, while the rate in the highest DII tertile was 13.28 and 8.60% in the lowest DII tertile (P &lt; 0.0001). The participants with CKD tended to have higher PTH levels compared with their counterparts (61.23 ± 45.62 vs. 41.80 ± 19.16 pg/ml, P &lt; 0.0001). A positive association between DII scores and PTH was observed (β = 0.46, 95% CI: 0.25, 0.66, P ≤ 0.0001), and higher DII was associated with an increased risk of HP (OR = 1.05, 95% CI: 1.02, 1.08, P = 0.0023). The results from subgroup analysis indicated that this association was similar in the participants with different renal function, gender, age, BMI, hypertension, and diabetes statuses and could also be appropriate for the population with CKD.Conclusions: Higher consumption of a pro-inflammatory diet appeared to cause a higher PTH level and an increased risk of HP. Anti-inflammatory dietary management may be beneficial to reduce the risk of HP both in the population with and without CKD.

scholarly journals Perbedaan Kadar Hemoglobin pada Penderita Gagal Ginjal Kronik Sebelum dan Setelah Melakukan Hemodialisa

2021 ◽  
Vol 8 (1) ◽  
pp. 146-151
Author(s):  
Virania Arvianti ◽  
◽  
Septian Septian ◽  
Aturut Yansen ◽  
◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Secondary Data ◽  
Sampling Technique ◽  
Chronic Kidney Failure ◽  
Wilcoxon Test ◽  
Cross Sectional ◽  
Significant Difference ◽  
Before And After

IntroductionAnemia is the most common occurrence in chronic kidney disease undergoing hemodialysis therapy. In the condition of chronic kidney disease, the decline in kidney function can occur slowly and chronically until the kidneys do not function at all. Hemodialysis is one of the therapies used to replaced kidney function. During hemodialysis, a decrease in hemoglobin levels often occurs, this is due to the disruption of the hormon erythropoietin. Objective:determine the differences in hemoglobin levels in patients with chronic kidney disease before and after hemodialysis at Bhayangkara TK. I Raden Said SukantoHospital. Method: The design of this research is cross sectional using secondary data and the sampling technique of this research was random sampling with a total of 133 patients. Result: The normality test was carried out first using the Kolmogorov-Smirnova test which showed the results were not normally distributed with a sig value of 0.001. the next test was the Wilcoxon test with a sig (2-tailed_ value of 0.002 with an average hemoglobin level of 8,81 g/dL before hemodialysis and 9,09 g/dL after hemodialysis. Conclusion:Based on the results of the study means that there is a significant difference in a patient with chronic kidney failure before and after hemodialysis.

scholarly journals Clonal hematopoiesis of indeterminate potential is associated with worse kidney function and anemia in a cohort of patients with advanced chronic kidney disease

2021 ◽  
Author(s):  
Caitlyn Vlasschaert ◽  
Amy J. M. McNaughton ◽  
Wilma Hopman ◽  
Bryan Kestenbaum ◽  
Cassianne Robinson-Cohen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Hematopoietic Stem ◽  
Clonal Hematopoiesis ◽  
Lower Baseline ◽  
Increased Risk ◽  
Aging Populations ◽  
Lower Egfr ◽  
Age And Sex

Background: Clonal hematopoiesis of indeterminate potential (CHIP) is an inflammatory premalignant disorder resulting from acquired genetic mutations in hematopoietic stem cells. CHIP is common in aging populations and associated with cardiovascular morbidity and overall mortality, but its role in chronic kidney disease (CKD) has not been investigated. Methods: We performed targeted sequencing to detect CHIP mutations in a cohort of 87 adults with eGFR < 60 ml/min/1.73m2. Kidney function, hematologic, and mineral bone disease parameters were assessed cross-sectionally at baseline, and a total of 2,091 creatinine measurements and 3,382 hemoglobin measurements were retrospectively collected over the following 12-year period. Results: At baseline, 20 of 87 (23%) cohort participants had CHIP detected. Those with CHIP had lower baseline eGFR (22.3 +/- 11.2 vs. 28.2 +/- 11.5 ml/min/1.73 m2, P = 0.04) in age- and sex-adjusted regression models. Individuals with CHIP had a 2.5-fold increased risk of incident 50% decline in eGFR or ESKD in a Cox proportional hazard model adjusted for age and sex (95% confidence interval, 1.3-4.7). The annualized rate of eGFR decline adjusted for age and sex was -2.3 +/- 1.1 ml/min/1.73m2 per year in those with CHIP versus -1.6 +/- 0.5 ml/min/1.73m2 per year in those without CHIP. Further, those with CHIP had lower hemoglobin at baseline (11.6 +/- 0.3 vs. 12.8 +/- 0.2 g/dL, P = 0.0003) and throughout the follow-up period despite a greater use of erythropoiesis-stimulating agents. Conclusion: In those with pre-existing CKD, CHIP was associated with lower eGFR at baseline, faster progression of CKD, and anemia.

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