scholarly journals AFRAN guidelines on COVID-19 and the kidney

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Anthony Were
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Capital City ◽  
Central China ◽  
World Health ◽  
Immunosuppressed Patient ◽  
African Continent ◽  
Renal Complications ◽  
The World

COVID-19, a disease caused by the novel virus SARS-CoV-2, was declared a pandemic by the World Health Organization on 11 March 2020. It originated from Wuhan, the capital city of the Hubei province in central China. It has now spread to almost every country in the world and all the continents except Antarctica and has been associated with significant fatalities.COVID-19 infection has been documented in 47 countries in Africa, with almost 85,000 cases and 2,760 deaths as at 16 May 2020. The mortality is significantly lower in Africa than elsewhere for reasons that are still unclear. In the typical case, a patient presents with fever or respiratory symptoms such as cough or difficulty in breathing, usually within 14 days of coming into contact with an infected person. Acute kidney injury may occur as part of multisystem involvement in the very ill patient and is often managed in the intensive care unit. Our patients with chronic kidney disease, including those on chronic dialysis, will easily get infected with SARS-CoV-2 if exposed, due to their immunosuppressed state. Similarly, the immunosuppressed patient who has received a kidney transplant requires special precautions to prevent and manage infection with SARS-CoV-2. The transplantation operation itself also requires clear guidelines to prevent coronavirus infection.The executive committee of the African Association of Nephrology (AFRAN) convened a special project committee of senior nephrologists from across the continent to develop guidelines relevant to the African continent on the management of the renal complications of COVID-19 and on the management of COVID-19 in patients with chronic kidney disease. The guidelines include recommendations on the prevention and management of COVID-19 in patients receiving kidney replacement therapy with haemodialysis, peritoneal dialysis or a kidney transplant. The article, titled ‘Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa’, is published on page 109 of this issue and represents an impressive collaboration by African nephrologists. These guidelines will be of practical value across the length and breadth of the African continent, from the well resourced to the most disadvantaged settings. The guidelines will also be of value to other parts of the world with respect to COVID-19 and the kidney. On behalf of AFRAN, I wish to congratulate the colleagues who contributed to the development of these guidelines. We are sure that the information they contain will greatly benefit the management of COVID-19 in Africa. Anthony WerePresident, African Association of Nephrology.

Oxford Desk Reference Nephrology

2021 ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Kidney Diseases ◽  
Medical Problems ◽  
Adult Kidney ◽  
Number Of Patients ◽  
The World ◽  
Patients Experience ◽  
Desk Reference

Written for the busy nephrologist and internist who need easy to access information on the diagnosis, investigation, and treatment of patients with kidney disease, the Oxford Desk Reference Nephrology is presented in a way that is not only easy to read and digest but also is detailed enough to allow an in depth understanding of the complex mix of metabolic, immunological, and genetic causes of both acute and chronic kidney disease. The kidneys are rarely affected by disease in isolation; the book comprehensively covers the multisystem disorders that require a multidisciplinary approach, including the cardiological, rheumatological, haematological, infectious, oncological, and urological aspects of kidney disease. In parallel, it extensively describes the myriad multisystem complications of progressive chronic kidney disease with practical advice on how these should be investigated and managed. The importance of understanding the evolution of kidney disease in children and young adults is covered, as in many parts of the world there is no distinction between adult and paediatric nephrology. Therefore, it is important that nephrologists have a sound grasp of both paediatric and adult kidney diseases. The number of patients with advanced kidney disease treated with a kidney transplant or receiving dialysis is increasing in all parts of the world. All nephrologists will manage patients on dialysis or who have a kidney transplant and all internists will encounter these patients. Thus, it is imperative that they have an understanding of these treatments and the commonly encountered medical problems such patients experience.

scholarly journals Validation of the Brazilian version of WHODAS 2.0 in patients on hemodialysis therapy

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Shamyr Sulyvan Castro ◽  
Camila Ferreira Leite ◽  
Juliana Elisa Baldin ◽  
Marilita Falangola Accioly
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
World Health Organization ◽  
World Health ◽  
World Health Organization Quality ◽  
Brazilian Version ◽  
The World ◽  
Health Organization

Abstract Introduction: Chronic kidney disease and hemodialysis normally have an impact on the functioning. Objective: To validate the Brazilian version of the World Health Organization Disability Assessment Schedule 2.0 in individuals with chronic kidney disease on hemodialysis treatment. Methods: The 36-item version was applied to interview 51 individuals with chronic kidney disease undergoing dialysis treatment. To ascertain the instrument’s applicability, its internal consistency and test-retest stability were studied. To check the validity, a convergent/divergent analysis was performed. Results: The participants answered the questions on the main instrument at two timepoints and on the World Health Organization Quality of Life Abbreviated instrument and the Kidney Disease Quality of Life - Short FormTM 1.3 once each. Cronbach’s α coefficient was appropriate in all domains except the “Getting along” domain. The test-retest coefficients were above the recommended value (> 0.70). Convergent and divergent validity analysis also showed consistent results by correlation coefficient assessment. Conclusion: The instrument is valid and reliable. This study supports the use of the questionnaire by presenting its appropriate psychometric properties. We suggest that some care should be taken specifically in the sexual questions of the “Getting along” domain.

Risk Factor Identification, Classification and Prediction Summary of Chronic Kidney Disease

2020 ◽  
Vol 13 ◽  
Author(s):  
Pramila Arulanthu ◽  
Eswaran Perumal
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Diagnosis ◽  
Medical Data ◽  
Machine Learning Algorithms ◽  
World Health ◽  
Medical Field ◽  
Data Set ◽  
Medical Issues ◽  
Health Organization

: The medical data has an enormous quantity of information. This data set requires effective classification for accurate prediction. Predicting medical issues is an extremely difficult task in which Chronic Kidney Disease (CKD) is one of the major unpredictable diseases in medical field. Perhaps certain medical experts do not have identical awareness and skill to solve the issues of their patients. Most of the medical experts may have underprivileged results on disease diagnosis of their patients. Sometimes patients may lose their life in nature. As per the Global Burden of Disease (GBD-2015) study, death by CKD was ranked 17th place and GBD-2010 report 27th among the causes of death globally. Death by CKD is constituted 2·9% of all death between the year 2010 and 2013 among people from 15 to 69 age. As per World Health Organization (WHO-2005) report, 58 million people expired by CKD. Hence, this article presents the state of art review on Chronic Kidney Disease (CKD) classification and prediction. Normally, advanced data mining techniques, fuzzy and machine learning algorithms are used to classify medical data and disease diagnosis. This study reviews and summarizes many classification techniques and disease diagnosis methods presented earlier. The main intention of this review is to point out and address some of the issues and complications of the existing methods. It is also attempts to discuss the limitations and accuracy level of the existing CKD classification and disease diagnosis methods.

Data Science and real world health data improve precision for diagnosis: Acute Kidney Injury, acute-on-chronic and Chronic Kidney Disease (Preprint)

2021 ◽  
Author(s):  
Karen Triep ◽  
Alexander Benedikt Leichtle ◽  
Martin Meister ◽  
Georg Martin Fiedler ◽  
Olga Endrich
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Data Science ◽  
Query Language ◽  
Correct Diagnosis ◽  
Kidney Injury ◽  
Data Driven ◽  
World Health ◽  
Discharge Data ◽  
The Individual

BACKGROUND The criteria for the diagnosis of kidney disease outlined in “The Kidney Disease: Improving Global Outcomes (KDIGO)” are based on a patient’s current, historical and baseline data. The diagnosis of acute (AKI), chronic (CKD) and acute-on-chronic kidney disease requires past measurements of creatinine and back-calculation and the interpretation of several laboratory values over a certain period. Diagnosis may be hindered by unclear definition of the individual creatinine baseline and rough ranges of norm values set without adjustment for age, ethnicity, comorbidities and treatment. Classification of the correct diagnosis and the sufficient staging improves coding, data quality, reimbursement, the choice of therapeutic approach and the patient’s outcome. OBJECTIVE With the help of a complex rule-engine a data-driven approach to assign the diagnoses acute, chronic and acute-on-chronic kidney disease is applied. METHODS Real-time and retrospective data from the hospital’s Clinical Data Warehouse of in- and outpatient cases treated between 2014 – 2019 is used. Delta serum creatinine, baseline values and admission and discharge data are analyzed. A KDIGO based standard query language (SQL) algorithm applies specific diagnosis (ICD) codes to inpatient stays. To measure the effect on diagnosis, Text Mining on discharge documentation is conducted. RESULTS We show that this approach yields an increased number of diagnoses as well as higher precision in documentation and coding (unspecific diagnosis ICD N19* coded in % of N19 generated 17.8 in 2016, 3.3 in 2019). CONCLUSIONS Our data-driven method supports the process and reliability of diagnosis and staging and improves the quality of documentation and data. Measuring patients’ outcome will be the next step of the project.

scholarly journals Chronic kidney disease – pediatric risk factors

PRILOZI ◽  
2016 ◽  
Vol 37 (1) ◽  
pp. 9-13
Author(s):  
Velibor Tasic ◽  
Aleksandra Janchevska ◽  
Nora Emini ◽  
Emilija Sahpazova ◽  
Zoran Gucev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pediatric Nephrologist ◽  
Children And Adolescent ◽  
The World ◽  
Stage Renal Disease ◽  
End Stage ◽  
Standard Risk ◽  
Final Consequence

Abstract The knowledge about the progression of chronic kidney disease is an important issue for every pediatric nephrologist and pediatrician in order to implement appropriate measures to prevent wasting of renal function and the final consequence – end stage renal disease with the need for the dialysis and transplantation. Therefore it is important to know, treat or ameliorate the standard risk factors such as hypertension, proteinuria, anemia, hyperparathyroidism etc. In this review devoted to the World Kidney Day 2016 we will pay attention to the low birth parameters, obesity, hyperuricemia and smoking which emerged as particularly important risk factors for children and adolescent with chronic kidney disease.

scholarly journals The Unravelled Link between Chronic Kidney Disease and Hepatitis C Infection

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Fabrizio Fabrizi ◽  
Piergiorgio Messa ◽  
Paul Martin
Keyword(s):  
Chronic Kidney Disease ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
World Health ◽  
Adjusted Relative Risk ◽  
Hepatitis C Infection ◽  
Increased Risk

The 2011 report of the World Health Organization General Assembly on noncommunicable diseases identified chronic kidney disease as a worldwide health issue posing a heavy economic burden. Hepatitis C virus infection, which is responsible for over 1 million deaths resulting from cirrhosis and liver cancer, is linked to chronic kidney disease in several ways; some forms of renal disease are precipitated by hepatitis C and patients with end-stage chronic renal disease are at increased risk for acquiring HCV. The aim of this review is to update the evidence on the relationship between hepatitis C infection and chronic kidney disease. Information has been accumulated in the last decade indicating that HCV plays an adverse effect on the incidence and progression of chronic kidney disease; a novel meta-analysis of observational studies (seven longitudinal studies; 890,560 unique individuals) found a relationship between hepatitis C seropositivity and incidence of reduced estimated glomerular filtration rate (adjusted relative risk, 1.70; 95% CI, 1.20; 2.39; P=0.002) in the adult general population. In addition to conventional risk factors, hepatitis C may be an additional factor for the development of chronic kidney disease, and an atheromasic activity of hepatitis C virus has been mentioned. The link between hepatitis C and atherosclerosis could also explain the excess risk of cardiovascular mortality that has been observed among hepatitis C virus seropositive patients undergoing maintenance dialysis. A number of biologically plausible mechanisms related to hepatitis C virus have been hypothesized to contribute to atherosclerosis. Implementation of effective treatment intervention towards hepatitis C is required to decrease the healthcare burden of hepatitis C and to prevent the progression of chronic renal disease.

scholarly journals Paracrine Proangiogenic Function of Human Bone Marrow-Derived Mesenchymal Stem Cells Is Not Affected by Chronic Kidney Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Femke C. C. van Rhijn-Brouwer ◽  
Bas W. M. van Balkom ◽  
Diana A. Papazova ◽  
Diënty H. M. Hazenbrink ◽  
Anke J. Meijer ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Bone Marrow ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Galactosidase Activity ◽  
Kidney Transplant Recipients ◽  
Paracrine Factors ◽  
Differentiation Capacity ◽  
Scratch Wound

Background. Cell-based therapies are being developed to meet the need for curative therapy in chronic kidney disease (CKD). Bone marrow- (BM-) derived mesenchymal stromal cells (MSCs) enhance tissue repair and induce neoangiogenesis through paracrine action of secreted proteins and extracellular vesicles (EVs). Administration of allogeneic BM MSCs is less desirable in a patient population likely to require a kidney transplant, but potency of autologous MSCs should be confirmed, given previous indications that CKD-induced dysfunction is present. While the immunomodulatory capacity of CKD BM MSCs has been established, it is unknown whether CKD affects wound healing and angiogenic potential of MSC-derived CM and EVs. Methods. MSCs were cultured from BM obtained from kidney transplant recipients (N=15) or kidney donors (N=17). Passage 3 BM MSCs and BM MSC-conditioned medium (CM) were used for experiments. EVs were isolated from CM by differential ultracentrifugation. BM MSC differentiation capacity, proliferation, and senescence-associated β-galactosidase activity was assessed. In vitro promigratory and proangiogenic capacity of BM MSC-derived CM and EVs was assessed using an in vitro scratch wound assay and Matrigel angiogenesis assay. Results. Healthy and CKD BM MSCs exhibited similar differentiation capacity, proliferation, and senescence-associated β-galactosidase activity. Scratch wound migration was not significantly different between healthy and CKD MSCs (P=0.18). Healthy and CKD BM MSC-derived CM induced similar tubule formation (P=0.21). There was also no difference in paracrine regenerative function of EVs (scratch wound: P=0.6; tubulogenesis: P=0.46). Conclusions. Our results indicate that MSCs have an intrinsic capacity to produce proangiogenic paracrine factors, including EVs, which is not affected by donor health status regarding CKD. This suggests that autologous MSC-based therapy is a viable option in CKD.

scholarly journals SARS-CoV-2-specific humoral and cellular immunity in renal transplant and haemodialysis patients treated with convalescent plasma

2020 ◽  
Author(s):  
Monika Lindemann ◽  
Adalbert Krawczyk ◽  
Sebastian Dolff ◽  
Margarethe Konik ◽  
Hana Rohn ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
T Cell ◽  
Kidney Disease ◽  
Plasma Treatment ◽  
Kidney Transplant ◽  
Antiviral Treatment ◽  
T Cell Responses ◽  
Close Monitoring ◽  
Cell Responses ◽  
Alternative Treatment Option

AbstractBackgroundWhen patients with chronic kidney disease are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) they can face two specific problems: Virus-specific immune responses may be impaired and remdesivir, an antiviral drug described to shorten the time to recovery, is contraindicated. Antiviral treatment with convalescent plasma could be an alternative treatment option.MethodsIn this case series we present two kidney transplant recipients and two patients dependent on haemodialysis who were infected with SARS-CoV-2 and received convalescent plasma. Antibodies against the spike 1 protein of SARS-CoV-2 were determined sequentially by IgG ELISA and neutralization assay and specific T cell responses by interferon-gamma ELISpot.ResultsPrior to treatment, in three patients antibodies were undetectable by ELISA (ratio < 1.1), corresponding to low neutralizing antibody titers (≤ 1:40). One patient was also negative to the ELISpot and two showed weak responses. After convalescent plasma treatment we observed an increase of SARS-CoV-2-specific antibodies (IgG ratio and neutralization titer) and of specific T cell responses. After intermittent clinical improvement one kidney transplant recipient again developed typical symptoms at day 12 after treatment and received a second cycle of convalescent plasma treatment. Altogether, three patients clinically improved and could be discharged from hospital. However, one multimorbid female in her early eighties deceased.ConclusionsOur data suggest that the success of convalescent plasma therapy may only be temporary in patients with chronic kidney disease; which requires an adaptation of the treatment regimen. Close monitoring after treatment is needed for this patient group.

scholarly journals Quality of life and spirituality of patients with chronic kidney disease: pre- and post-transplant analysis

2020 ◽  
Vol 73 (suppl 5) ◽  
Author(s):  
Letícia Meazzini de Olivera ◽  
Meiry Fernanda Pinto Okuno ◽  
Dulce Aparecida Barbosa ◽  
Ricardo de Castro Cintra Sesso ◽  
Gerson Scherrer Júnior ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Disease Burden ◽  
Four Dimensions ◽  
Post Transplant ◽  
Transplant Patients

ABSTRACT Objective: to compare the quality of life (QoL) of patients under dialysis and after kidney transplant; correlate the QoL of transplant patients to sociodemographic, morbid and spirituality/religiosity variables. Method: prospective study with a quantitative approach, with a sample of 27 patients who underwent peritoneal dialysis or dialysis undergoing kidney transplant. QoL and spirituality were assessed by the KDQOL-SF and WHOQOL-SRPB tools, being correlated with sociodemographic and economic variables. Results: the dimensions of total mental component, kidney disease effects and kidney disease burden showed significant improvement in the post-transplant period, with p <0.0004. There was a significant correlation between four dimensions of spirituality and seven dimensions of QoL; p ranged from 0.04 to 0.006. Conclusion: there was a significant improvement in QoL in the post-transplant period. The dimensions of spirituality: wholeness and integration, spiritual connection, wonder and inner peace were positively correlated with seven dimensions of QoL.

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