Chronic Kidney Disease and Urological Disorders: An Overview

2020 ◽  
Vol 15 (2) ◽  
pp. 223-231
Author(s):  
S. Lai ◽  
A. Sciarra ◽  
F. Pierella ◽  
S. Pastore ◽  
L. Piloni ◽  
...  

Introduction: Chronic Kidney Disease (CKD) is a highly prevalent condition and it is a major risk factor for End-Stage Renal Disease (ESRD), cardiovascular disease, and premature death. Some congenital and acquired anomalies of the kidneys and lower urinary tract (CAKUT and CALUT) are well-known causes of CKD and ESRD, but often remain undiagnosed and their prevalence is underestimated. This study aims to provide an overview that considered mainly some of the major congenital and acquired urological diseases that could lead to renal clinical manifestations common even to the most widespread renal pathologies, for which often underdiagnosed. Materials and Methods: PubMed search was conducted for available English literature describing the actual knowledge on congenital and acquired urological disorders determining acute and chronic kidney disease. Prospective and retrospective studies as well as meta-analyses and latest systematic reviews were included. Results: Most of the studies examined and reviewed were discarded for wrong population or intervention or deemed unfit, and only 87 met the inclusion criteria for the review. The studies included in the review related to urological disorders that may determine chronic and acute kidney disease. Conclusion: Some urological diseases, as CAKUT and CALUT, especially in adults, show symptoms, as renal failure, proteinuria and hypertension, very common to other kidney diseases, for this reason may remain undiagnosed and their prevalence is not completely known. Therefore, in doubtful cases, non-invasive and inexpensive tests, as cystourethrogram, should be made, to rule out urological disorders and if necessary, ultrasonography, urography and scintigraphy, might allow a correct and early diagnosis of these defects and thus adequate therapy, preventing or at least slowing down an evolution toward CKD and ESRD.

Author(s):  
I. Dudar ◽  
I. Mykhaloiko

Chronic kidney disease (CKD) has become a global public health problem because of its high prevalence and the accompanying increase in the risk of end-stage renal disease, cardiovascular disease, and premature death. At present there is a number of experimental and clinical data that show that one of the important mechanisms of the pathogenesis of CKD is a violation of the blood coagulation system (hemostasis) both locally in the kidneys and with the capture of the microcirculatory channel of other organs, therefore an important task for specialists in the  nephrology, as well as doctors of other specialties is  understanding  the functioning of the system of hemostasis in normal and in various kidney diseases and the correction of this pathology with drugs. There are several types of haemostasis disorders that may occur in CKD: disseminated intravascular coagulation syndrome (DIC), arterial and venous thrombosis and bleeding. In this review, we tried to determine the place of the DIC in the development and progress of the CKD and to assess the prospects for further research.


2019 ◽  
Vol 6 (2) ◽  
pp. 335
Author(s):  
Sanjeev Kumar Khunte ◽  
Jitendra Kumar ◽  
Prakash Khunte

Background: Chronic kidney disease (CKD) is a clinical syndrome due to irreversible renal dysfunction leading to excretory, metabolic and synthetic failure culminating into accumulation of non-protein nitrogenous substances and present with various clinical manifestations. Elevated circulating concentrations of CRP are a common phenomenon in ESRD patients. The prevalence and magnitude of inflammation increases as renal function declines.Methods: The current cross-sectional observation study was conducted in Rajendra institute of medical sciences, Ranchi during study period October 2015 to September 2017 on admitted patients with chronic kidney disease. 90 patients of different age groups between 16-75 years were enrolled in the study. Samples were selected by using simple random sampling method. Informed consent was obtained from all the patients.Results: 85.6% of the patients studied were males and 14.4% of the patients were females. Most cases of CKD were associated with hypertension (77.8%) out of which there were 62 males and 8 females, followed by DM (25.5%) where there were 20 males and 3 females. 44.4% cases had an elevated level of hs-CRP (more than 3 mg/L) while 55.6% patients had hs-CRP below 3 mg/l. Out of 40 high hs-CRP patients, 35 were male and 5 were female. Patients with elevated creatinine level had significant high hs-CRP level.Conclusions: Chronic kidney diseases, Cardiovascular disease, HS-CRP, Inflammation


2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.


2021 ◽  
Author(s):  
Roser Torra ◽  
Mónica Furlano ◽  
Alberto Ortiz ◽  
Elisabet Ars

Abstract Inherited kidney diseases (IKDs) are among the leading causes of early-onset chronic kidney disease (CKD) and are responsible for at least 10–15% of cases of kidney replacement therapy (KRT) in adults. Pediatric nephrologists are very aware of the high prevalence of IKDs among their patients, but this is not the case for adult nephrologists. Recent publications have demonstrated that monogenic diseases account for a significant percentage of adult cases of CKD. A substantial number of these patients have received a non-specific/incorrect diagnosis or a diagnosis of CKD of unknown etiology, which precludes correct treatment, follow-up and genetic counseling. There are a number of reasons why genetic kidney diseases are difficult to diagnose in adulthood: a) adult nephrologists, in general, are not knowledgeable about IKDs, b) existence of atypical phenotypes, c) genetic testing is not universally available, d) family history is not always available or may be negative, e) lack of knowledge of various genotype–phenotype relationships, f) conflicting interpretation of the pathogenicity of many sequence variants.


2020 ◽  
Author(s):  
Marcin Adamczak ◽  
Piotr Kuczera ◽  
Andrzej Wiecek

Kidneys play the major role in the synthesis and degradation of several hormones. Different coexisting conditions such as inflammation, malnutrition and metabolic acidosis and applied treatment may also cause endocrine abnormalities in chronic kidney disease (CKD) patients. A tendency towards decreased thyroxin and triiodothyronine with normal serum concentrations of reversed triiodothyronine (as opposed to other chronic non-thyroid, non-kidney diseases) and thyroid stimulating hormone are observed. As far as the somatotopic axis is concerned, in CKD normal serum concentration of growth hormone and its effector – the insulin-like growth factor are observed. Nevertheless, due to the phenomenon of GH/IGF-1 “resistance” CKD patients usually present a phenotype resembling GH deficiency. Serum prolactin concentrations are often elevated in CKD women and men. This leads to the dysregulation of the pituitary-gonadal axis causing hypogonadism and it’s clinical consequences regardless of patient’s gender. The alterations in hormones of gonadal origin caused by uremia, together with hyperprolactinemia lead to the development of sexual dysfunction and infertility in men and women. The alterations of thyroid, pituitary gland and gonads associated with CKD are discussed in this chapter. This review contains 4 tables, and 64 references. Keywords: chronic kidney disease, hypothyroidism, hyperthyroidism, growth hormone, recombinant human GH, insulin-like growth factors, hemodialysis


Author(s):  
Mehtap Çelakıl ◽  
Yasemin Çoban

Abstract Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the important causes of mortality and morbidity in childhood. Early diagnosis and treatment of the underlying primary disease may prevent most of CKD patients from progressing to ESRD. There is no study examining chronic kidney diseases and dialysis modalities in Syrian immigrant children. We aimed to retrospectively research the etiologic, sociodemographic, and clinical factors in CKD among Syrian refugee children, and at the same time, to compare the clinical characteristics of patients with ESRD on peritoneal dialysis and hemodialysis. Methods: Our study included a total of 79 pediatric Syrian patients aged from 2-16 years monitored at Hatay State Hospital pediatric nephrology clinic with diagnosis of various stages of CKD and with ESRD. Physical-demographic features and clinical-laboratory information were retrospectively screened. Results: The most common cause of CKD was congenital anomalies of the kidneys and urinary tracts (CAKUT) (37.9%). Other causes were urolitiasis (15.1%), nephrotic syndrome (10.1%), spina bifida (8.8%), hemolytic uremic syndrome (7.5%), and glomerulonephritis (7.5%). Twenty-five patients used hemodialysis due to bad living conditions. Only 2 of the patients with peritoneal dialysis were using automatic peritoneal dialysis (APD), with 5 using continuous ambulatory peritoneal dialysis (CAPD). Long-term complications like left ventricle hypertrophy and retinopathy were significantly higher among hemodialysis patients. There was no difference identified between the groups in terms of hypertension and sex. Conclusion: Progression to ESRD due to preventable reasons is very frequent among CKD patients. For more effective use of peritoneal dialysis in pediatric patients, the responsibility of states must be improved.


2019 ◽  
Author(s):  
Milena Miszczuk ◽  
Verena Müller ◽  
Christian E. Althoff ◽  
Andrea Stroux ◽  
Daniela Widhalm ◽  
...  

AbstractAbdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA. Two groups of patients (100/group), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis. SRC (73% vs. 57%; p<0.001) and CKD (31% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analysis, CKD, but not SRC, showed a strong association with AAA. Knowledge about pathobiological mechanisms and association between CKD and AAA could provide better diagnostic and therapeutic approaches for these patients.


2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Flávia Silveira ◽  
Káthia Zuntini ◽  
Márcia Silveira ◽  
Lohanna Tavares ◽  
Juliana Mendes ◽  
...  

OBJECTIVES: This study aims to present the confirmed cases of SARS-CoV-2 infection in pediatric patients with chronic and acute kidney diseases admitted to a tertiary pediatric hospital. METHODS: Descriptive and retrospective observational study with all children hospitalized between March and June 2020 who had, simultaneously, SARS-CoV-2 infection and renal pathologies. Of this total of patients, those who had another underlying disease besides the renal disease were excluded. RESULTS: During the period, nine children with kidney disease were admitted to the hospital and had infection confirmed by the new coronavirus through positive RT-PCR. Regarding the underlying disease, seven had only kidney disease, three of whom had stage 5 chronic kidney disease; one, with stage 1 chronic kidney disease; one, with cortic-sensitive nephrotic syndrome; and two, with acute kidney injury. Two patients in this study had already undergone kidney transplantation, used immunosuppressants and had their doses reduced due to the infectious condition. Only one required oxygen therapy and transfer to the intensive care unit, but was not intubated and returned to the ward within 24 hours. CONCLUSIONS: According to the cases described, the pediatric population with kidney disease, including those using immunosuppressants due to acute transplant rejection, seems to evolve without severe COVID-19, therefore there is no great divergence in relation to the population of the same healthy age group.


2021 ◽  
Vol 10 (18) ◽  
pp. 4140
Author(s):  
Łukasz Kuźma ◽  
Anna Tomaszuk-Kazberuk ◽  
Anna Kurasz ◽  
Małgorzata Zalewska-Adamiec ◽  
Hanna Bachórzewska-Gajewska ◽  
...  

Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications.


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