Risk of Kidney Dysfunction IN Nafld

2020 ◽  
Vol 26 (10) ◽  
pp. 1045-1061 ◽  
Author(s):  
Alessandro Mantovani ◽  
Chiara Zusi ◽  
Andrea Dalbeni ◽  
Giorgio Grani ◽  
Elena Buzzetti
Keyword(s):  
Kidney Function ◽  
Systemic Disease ◽  
Convincing Evidence ◽  
Alcoholic Fatty Liver ◽  
Common Chronic Disease ◽  
Potential Association ◽  
Independent Association ◽  
Meta Analyses ◽  
Stage Renal Disease ◽  
End Stage

Background: The timely identification of traditional and non-traditional precursors and risk factors for chronic kidney disease (CKD) (a common systemic disease defined as a decreased kidney function documented by reduced glomerular filtration rate, or markers of kidney damage, or both) is relevant in clinical practice, as CKD increases the risk of end-stage renal disease and other serious comorbidities. A possible relationship between non-alcoholic fatty liver disease (NAFLD) (which is to date the most common chronic disease worldwide) and CKD has recently gained significant attention of researchers. Methods : A systematic literature search using appropriate keywords was made in order to identify relevant articles that have investigated the association between NAFLD and CKD. Results: Several observational studies and meta-analyses have reported the existence of an independent association between NAFLD and risk of CKD in patients with and without diabetes. However, whilst the association between NAFLD and risk of prevalent CKD is strong across various patient populations, whether NAFLD is independently associated with the development and progression of CKD is still debatable. Moreover, emerging evidence now suggests a potential association between patatin-like phospholipase domain-containing protein-3 (PNPLA3) rs738409 genotype (the most important genetic variant associated to NAFLD) and decreasing kidney function, independent of NAFLD. Conclusions : Convincing evidence now indicates that CKD is increased among patients with NAFLD. For this reason, patients with NAFLD should be regularly monitored for renal function and, on the other hand , NAFLD should be considered in all patients with CKD, especially if they are obese or have type 2 diabetes.

Abstract 145: Rates of Transfusion and Progression to End-Stage Renal Disease in Chronic Kidney Disease Patients Undergoing Transradial Versus Transfemoral Cardiac Catheterization - An Analysis from the VA CART Program

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Amit N Vora ◽  
Maggie A Stanislawski ◽  
John S Rumsfeld ◽  
Thomas M Maddox ◽  
Mladen Vidovich ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Catheterization ◽  
High Risk Population ◽  
Post Procedure ◽  
Increased Risk ◽  
Significant Difference ◽  
Independent Association ◽  
Stage Renal Disease ◽  
End Stage

Background: Patients with chronic kidney disease (CKD) are at increased risk of bleeding and transfusion after cardiac catheterization. Whether rates of these complications or progression to new dialysis are increased in this high-risk population undergoing transradial (TR) access compared to transfemoral (TF) access is unknown. Methods: From the Veterans Affairs Clinical Assessment, Reporting, and Tracking (CART) Program between 10/2007-09/2012 we identified 40,160 CKD patients undergoing cardiac catheterization with baseline glomerular filtration rate (GFR) ≤ 60 ml/min. We used multivariable Cox modeling to determine the independent association between TR access and post-procedure transfusion as well as progression to new dialysis using TF as the reference. Results: Overall, 3,828 (9.5%) of CKD patients underwent TR access and tended to be slightly younger but overall had similar rates of CKD severity compared with TF patients (GFR 45-60 ml/min: 77.0% vs. 77.0%; GFR 30-44 ml/min: 19.7% vs. 19.3%; GFR 15-29 ml/min: 3.3% vs. 3.7%, p=0.35). TR patients had longer fluoroscopy times (8.1 vs 6.9 minutes, p=<0.0001) but decreased contrast use (90.0 vs 100.0 ml, p=<0.0001). Among the 31,692 patients with a full year of follow-up, 42 (1.7%) of TR patients and 545 (1.9%) of TF patients progressed to new dialysis within 1 year (p=0.64). However, only 33 (0.9%) of TR patients compared with 570 TF patients (1.6%) needed post-procedure blood transfusion (p=0.0006). After multivariable adjustment, there was no significant difference in progression to ESRD between TR and TF patients but TR was associated with a significant decrease in transfusion (Figure). Conclusion: Among CKD patients undergoing cardiac catheterization in the VA health system, TR access is associated with a decreased risk for post-procedure transfusion compared with TF access. There was no significant difference between the two approaches with respect to progression to ESRD. These data suggest that TR is a reasonable option for patients with any level of CKD undergoing cardiac catheterization.

Staphylococcus-induced glomerulonephritis: potential role for corticosteroids

2021 ◽  
Vol 14 (1) ◽  
pp. e237011
Author(s):  
Rui Filipe Nogueira ◽  
Nuno Oliveira ◽  
Vítor Sousa ◽  
Rui Alves
Keyword(s):  
Kidney Function ◽  
Potential Role ◽  
Graft Infection ◽  
Clinical Manifestations ◽  
Rapidly Progressive Glomerulonephritis ◽  
Vascular Graft Infection ◽  
Systemic Corticosteroids ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage

Staphylococcus aureus is a troublesome pathogen, responsible for a broad range of clinical manifestations, ranging from benign skin infections to life-threatening conditions such as endocarditis and osteomyelitis. The kidney can be affected through a rapidly progressive glomerulonephritis mediated by an inflammatory reaction against a superantigen deposited in the glomerulus during the infection’s course. This glomerulopathy has a poor prognosis, often leading to chronically impaired kidney function, eventually progressing to end-stage renal disease. Treatment rests on antibiotherapy. Despite the inflammatory role in this disease’s pathophysiology, most authors discourage a simultaneous immunosuppressive approach given the concomitant infection. However, there are some reports of success after administration of systemic corticosteroids in these patients. We present a 66-year-old man with a staphylococcus-induced glomerulonephritis brought on by a vascular graft infection, with rapidly deteriorating kidney function despite extraction of the infected graft and 3 weeks of antibiotherapy with achievement of infection control. Kidney function improved after the introduction of corticosteroids. This case highlights the potential role of corticosteroids in selected cases of staphylococcus-induced glomerulonephritis, particularly those in which the infection is under control.

Abstract P218: Carotid Intima-media Thickness and Incident End-stage Renal Disease: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Yuanjie Pang ◽  
Yingying Sang ◽  
Shoshana Ballew ◽  
Morgan Grams ◽  
Gerardo Heiss ◽  
...  
Keyword(s):  
Renal Disease ◽  
Kidney Function ◽  
End Stage Renal Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Imt ◽  
Media Thickness ◽  
Hazard Ratios ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Carotid intima-media thickness (IMT) has been reported to predict kidney function decline. However, whether carotid IMT is associated with a hard kidney endpoint, end-stage renal disease (ESRD), has not been investigated. Hypothesis: We assessed the hypothesis that increased carotid IMT is associated with ESRD risk. Methods: We studied 13,197 ARIC participants at visit 1 (1987-1989) without history of cardiovascular disease including coronary heart disease, stroke and heart failure and assessed whether carotid IMT measured by B-mode ultrasound is associated with ESRD risk using Cox proportional-hazards models. Regarding carotid IMT parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation and internal carotid arteries) measurements. Results: Mean age was 54.0 (SD 5.7) years, and there were 3,373 (25.6%) blacks and 7,370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1,000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid IMT was significantly associated with ESRD risk (hazard ratios between quartiles 4 and 1, 1.43 [95%CI: 1.01-2.04] for overall mean IMT and 1.73 [95%CI: 1.22-2.44] for overall maximum IMT). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific IMTs, the associations with ESRD were most robust for bifurcation carotid. The adjusted hazard ratios between quartiles 4 and 1 were 1.48 (95%CI: 1.04-2.11) for mean bifurcation IMT and 1.42 (95%CI: 0.99-2.03) for maximum bifurcation IMT. Conclusions: Carotid IMT was independently associated with incident ESRD in the general population. Our findings suggest the shared etiology between atherosclerosis and ESRD and highlight the importance of monitoring kidney function over time in individuals with subclinical atherosclerosis.

scholarly journals Pulse Pressure Relationships with Demographics and Kidney Function in Ashanti, Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Debasish Banerjee ◽  
Jacob Plange-Rhule ◽  
Nihil Chitalia ◽  
Kwabena Kumi ◽  
Frank B. Micah ◽  
...  
Keyword(s):  
Kidney Function ◽  
Pulse Pressure ◽  
Multivariate Regression Analysis ◽  
West African ◽  
African Population ◽  
Rural Village ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
The City

Introduction. Hypertension, particularly pulse pressure [PP] is a major risk factor for end-stage renal disease. However, the effect of individual components of hypertension namely PP, systolic [SBP] and diastolic blood pressure [DBP] on kidney function, in the general African population is unknown. Methods. Data were collected on 944 participants [aged 40-75 y], living in villages in the area around the city of Kumasi, Ghana, on demographics, medications, height, weight, BP and 24-hour creatinine clearance (CrCl). Results. The demographic and clinical characteristics were: age 55(11) [mean (SD)] years, females 62%, rural village-dwellers 52%, diabetes 1·5%, BMI 21(4) kg/m2, 24-hourCrCl as a measure of glomerular filtration rate (GFR) 84(23) ml/min/1.73 m2. 29% had BP >140/90 mmHg; SBP and DBP were 125/74(26/14) mmHg, PP was 51(17) mmHg. PP increased with age by 0.55(95% CI: 0.46,0.64) mmHg/year. PP was higher (53(17) v 49(15) mmHg; p < 0.001) in the semiurban participants. GFR decreased both with increasing PP [-0.19 (-0.27,-0.10 ml/min/1.73 m2/mmHg; p < 0.001] and SBP [-0.09 (-0.14,-0.03) ml/min/1.73 m2/mmHg; p < 0.001] but there was no significant relationship with DBP [-0.04 (-0.15,0.06)]. After adjusting for SBP, the relationship between GFR and PP became steeper [-0.31 (-0.50,-0.12) ml/min/1.73 m2/mmHg; p < 0.001]. Using multivariate regression analysis that included PP, age, gender, BMI, only increasing age [-0.75 (-0.88,-0.62)] and decreasing BMI [0.49 (0.16,0.81)] were associated with decreased kidney function. Conclusions. In this homogeneous West-African population, PP increased with age and had a steeper relationship with declining kidney function than SBP or DBP.

The Relationship between Anemia and Chronic Kidney Disease (CKD) in Older Nursing Facility (NF) Residents.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5507-5507
Author(s):  
Andrew Artz ◽  
Bruce Robinson ◽  
Bruce Culleton ◽  
Cathy Critchlow ◽  
Angela Sciarra ◽  
...  
Keyword(s):  
Kidney Function ◽  
Nursing Facility ◽  
Who Criteria ◽  
Race And Gender ◽  
Mdrd Equation ◽  
Stage Disease ◽  
Independent Association ◽  
And Gender ◽  
End Stage ◽  
The Impact

Abstract Anemia is a common condition among older NF residents that often has unidentified causes. CKD is common in older adults and frequently contributes to anemia. However, the association between declining kidney function and the prevalence and severity of anemia in NF residents has not been well characterized. We retrospectively analyzed the independent association of CKD and anemia among older residents in 372 NFs across the US. Any resident who was admitted to a NF between 01 Jan 2002 and 31 Dec 2003, was still active as of 31 Jan 2004, was ≥ 65 years of age, and had more than one serum creatinine (SCr) measurement and more than one hemoglobin (Hb) documented during the admittance period, was considered. Residents who had end-stage disease, were comatose, or were receiving dialysis were excluded. CKD was conservatively defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (MDRD equation). Anemia was defined using the WHO criteria for anemia (< 13 g/dL for men and < 12 g/dL for women). Regression analysis was used to determine the association between kidney function and Hb levels after adjusting for age, race, and gender. Of the 10315 residents identified, 6200 were eligible for this study: 85% (5291/6200) were white, 70% (4354/6200) were female, and the mean ± SD age was 83.1 ± 7.9 years. Anemia was found in 59.6% (3697/6200) residents as defined by the WHO criteria and CKD was present in 43.1% (2671/6200) residents. The odds of having anemia was 1.47 times greater (95% CI: 1.33, 1.63) for residents with CKD than those without CKD. The severity of anemia also increased with the presence and severity of CKD. The odds ratio increased to 1.65 (95% CI: 1.49, 1.84) after adjusting for age, race, and gender. Of those with CKD, 36.4% (972/2671) had a Hb < 11 g/dL, however, only 5.1% (50/972) and 25.4% (247/972) received erythropoiesis-stimulating protein (ESP) and iron therapies, respectively. Our data suggest CKD contributes to the high prevalence of anemia in older NF residents. These results reinforce the importance of evaluating kidney function and Hb level in older NF residents. Future studies evaluating the impact of anemia and benefits of anemia therapy are warranted in this setting.

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

Serum Beta-Trace Protein versus Glomerulus Filtration Rate as a Predictor for Kidney Function among Hypertensive Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 127
Author(s):  
Ranisa Handayani ◽  
Yuyun Widaningsih ◽  
Fitriani Mangarengi ◽  
Uleng Bahrun
Keyword(s):  
Logistic Regression ◽  
Renal Disease ◽  
Kidney Function ◽  
End Stage Renal Disease ◽  
Filtration Rate ◽  
Hypertensive Patients ◽  
Regression Test ◽  
Stage Renal Disease ◽  
End Stage ◽  
Logistic Regression Test

Beta-Trace Protein (BTP) is a low-molecular-weight glycoprotein that can convert prostaglandin H2 into prostaglandin D2 and is associated with the vascular function's alteration. Serum beta-trace protein has been proposed as a promising marker in predicting kidney function in hypertensive patients. This study aimed to analyze the correlation between BTP and glomerulus filtration rate, particularly in hypertensive patients. A cross-sectional survey was conducted on 70 hypertensive participants admitted to Dr. Wahidin Sudirohusodo Hospital from July-August 2019. Beta-trace protein, serum urea, creatinine, blood pressure, and anthropometric were measured. The Glomerulus Filtration Rate (GFR) with Cockcroft Gault was graded using GFR stages. The hypertension was graded according to the category of the European Society of Cardiology (ESC) 2018. A descriptive test, Kruskal-Wallis test, Fisher exact test, Spearman correlation test, and logistic regression test were performed at a confidence level of 95%. Significant differences were found between the age, systole, diastole, blood urea, creatinine, and GFR (p=< 0.05). There was a significant difference between GFR and the degree of hypertension (p=< 0.001), but no differences were found in the mean value of BTP and the degree of hypertension (p=0.348). A significant negative correlation was found between GFR and BTP (p=0.028, r = -0.263). Logistic regression test s showed that the increased BTP led to 2.591 times greater possibility of end-stage renal disease with GFR < 15 mL/min/ 2 1.73 m (crude odds ratio 95% CI 1.168-5.475). Serum beta-trace protein possesses a prognostic ability of glomerulus filtration rate and can be used to predict the odd of end-stage renal disease in hypertensive patients.

scholarly journals Unexpected Abscess Localization of the Anterior Abdominal Wall in an ADPKD Patient Undergoing Hemodialysis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Nikos Sabanis ◽  
Eleni Paschou ◽  
Eleni Gavriilaki ◽  
Maria Mourounoglou ◽  
Sotirios Vasileiou
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Systemic Disease ◽  
Intestinal Barrier ◽  
Infectious Complications ◽  
Monogenic Disorders ◽  
Increased Risk ◽  
Autosomal Dominant Polycystic Kidney ◽  
Stage Renal Disease ◽  
End Stage

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is one of the most common monogenic disorders and the leading inheritable cause of end-stage renal disease worldwide. Cystic and noncystic extrarenal manifestations are correlated with variable clinical presentations so that an inherited disorder is now considered a systemic disease. Kidney and liver cystic infections are the most common infectious complications in ADPKD patients. Furthermore, it is well known that ADPKD is commonly associated with colonic diverticular disease which recently has been reported to be linked to increased risk of infection on hemodialysis patients. Herein, we present a case of anterior abdominal wall abscess caused byEnterococcus faecalisin a patient with ADPKD undergoing hemodialysis. Although the precise pathway of infection remains uncertain, the previous medical history as well as the clinical course of our patient led us to hypothesize an alternative route of infection from the gastrointestinal tract through an aberrant intestinal barrier into the bloodstream and eventually to an atypical location.

Hemodialysis Decreases the Etiologically-Related Early Vascular Aging Observed in End-Stage Renal Disease: A 5-Year Follow-Up Study

2016 ◽  
Vol 43 (1-3) ◽  
pp. 18-30 ◽  
Author(s):  
Daniel Bia ◽  
Cintia Galli ◽  
Yanina Zócalo ◽  
Rodolfo Valtuille ◽  
Sandra Wray ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Pulse Wave ◽  
Vascular Aging ◽  
Control Subjects ◽  
Potential Association ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Aims: To analyze the early vascular aging (EVA) in end-stage renal disease (ESRD) patients, attempting to determine a potential association between EVA and the etiology of ESRD, and to investigate the association of hemodialysis and EVA in ESRD patients during a 5-year follow-up period. Methods: Carotid-femoral pulse wave velocity (cfPWV) was obtained in 151 chronically hemodialyzed patients (CHP) and 283 control subjects, and in 25 CHP, who were followed-up after a 5-year lapse. Results: cfPWV increased in ESRD patients compared to control subjects. The cfPWV-age relationship was found to have a steeper increase in ESRD patients. The highest cfPWV and EVA values were observed in patients with diabetic nephropathy. Regression analysis demonstrated a significant reduction of the EVA in HD patients on a 5-year follow-up. Conclusion: Patients in ESRD showed higher levels of EVA. cfPWV and EVA differed in ESRD patients depending on their renal failure etiology. CHP showed an EVA reduction after a 5-year follow-up period.

Sign in / Sign up

Export Citation Format

Share Document