scholarly journals Hubungan kadar serum albumin dengan kejadian morbiditas dan mortalitas pada pasien penyakit ginjal kronik dengan hemodialisis di RS Dr. Sardjito Yogyakarta

2006 ◽  
Vol 3 (2) ◽  
pp. 79
Author(s):  
La Banudi ◽  
Ahmad Husain Asdie ◽  
Susetyowati Susetyowati

Background: Chronic kidney disease is a characterized by decreasing kidney function with creatine clearance test <15 mL/minute. At such condition toxic in the body accumulates so that dialysis is needed to eliminate it. Blood albumin serum level may indicate nutrition status and is closely related to morbidity and mortality of hemodialysis patients.Objective: To find out association between albumin serum level and occurrence of morbidity and mortality among patients of chronic kidney disease with hemodialysis.Method: The study was observational with prospective cohort design. It was conducted at Dialysis Installation of Dr. Sardjito Hospital from August 2004 to December 2005. Population were all patients of hemodialysis. Samples were purposively taken using inclusion criteria with as many as 44 minimal samples. Dependent variables were morbidity and mortality. Independent variables  were albumin serum level, age and long time hemodialysis. Data analysis was done in phases, univariable, and then bivariable.Results: There was association between albumin serum level and morbidity at observation I (p=0.021), observation II (p=0.036), and observation III (p=0.012) which indicated that p<0.05. There was also association between albumin serum level and mortality at observation I (p=0.011), observation II, III and IV (p=0.000) which indicated that p<0.05.Conclusion: There was association between albumin serum level and morbidity and mortality of chronic kidney disease patients with hemodialysis.

2018 ◽  
Vol 22 (4) ◽  
pp. 40-49 ◽  
Author(s):  
A. R. Volkova ◽  
O. D. Dygun ◽  
B. G. Lukichev ◽  
S. V. Dora ◽  
O. V. Galkina

Disturbance of the thyroid function is often detected in patients with different profiles. A special feature of patients with chronic kidney  disease is the higher incidence of various thyroid function  disturbances, especially hypothyroidism. It is known that in patients  with chronic kidney disease (CKD) iodine excretion from the body is  violated, since normally 90% of iodine is excreted in urine.  Accumulation of high concentrations of inorganic iodine leads to the  formation of the Wolf-Chaikoff effect: suppression of iodine  organization in the thyroid gland and disruption of the thyroid  hormones synthesis. Peripheral metabolism of thyroid hormones is  also disturbed, namely, deiodinase type I activity is suppressed and  peripheral conversion of T4 into T3 is inhibited (so-called low T3  syndrome). Therefore, patients with CKD are often diagnosed with  hypothyroidism, and the origin of hypothyroidism is not always  associated with the outcome of autoimmune thyroiditis. The article  presents an overview of a large number of population studies of  thyroid gland dysfunction in patients with CKD, as well as  experimental data specifying the pathogenetic mechanisms of  thyroid dysfunction in patients with CKD. Therapeutic tactics are still  not regulated. However, in a number of studies, replacement therapy with thyroid hormones in patients with CKD had some advantages.


2018 ◽  
Vol 37 (5) ◽  
pp. 825-834
Author(s):  
Chang Kyun Choi ◽  
Sun-Seog Kweon ◽  
Young-Hoon Lee ◽  
Hae-Sung Nam ◽  
Kyeong-Soo Park ◽  
...  

2010 ◽  
Vol 3 (2) ◽  
pp. 109-121 ◽  
Author(s):  
Kurt M. Sowers ◽  
Melvin R. Hayden

Calcific uremic arteriolopathy (CUA)/calciphylaxis is an important cause of morbidity and mortality in patients with chronic kidney disease requiring renal replacement. Once thought to be rare, it is being increasingly recognized and reported on a global scale. The uremic milieu predisposes to multiple metabolic toxicities including increased levels of reactive oxygen species and inflammation. Increased oxidative stress and inflammation promote this arteriolopathy by adversely affecting endothelial function resulting in a prothrombotic milieu and significant remodeling effects on vascular smooth muscle cells. These arteriolar pathological effects include intimal hyperplasia, inflammation, endovascular fibrosis and vascular smooth muscle cell apoptosis and differentiation into bone forming osteoblast-like cells resulting in medial calcification. Systemic factors promoting this vascular condition include elevated calcium, parathyroid hormone and hyperphosphatemia with consequent increases in the calcium × phosphate product. The uremic milieu contributes to a marked increased in upstream reactive oxygen species—oxidative stress and subsequent downstream increased inflammation, in part, via activation of the nuclear transcription factor NFκB and associated downstream cytokine pathways. Consitutive anti-calcification proteins such as Fetuin-A and matrix GLA proteins and their signaling pathways may be decreased, which further contributes to medial vascular calcification. The resulting clinical entity is painful, debilitating and contributes to the excess morbidity and mortality associated with chronic kidney disease and end stage renal disease. These same histopathologic conditions also occur in patients without uremia and therefore, the term calcific obliterative arteriolopathy could be utilized in these conditions.


2017 ◽  
Vol 81 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Kazuhiro Harada ◽  
Susumu Suzuki ◽  
Hideki Ishii ◽  
Kenshi Hirayama ◽  
Toshijiro Aoki ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yusaku Hashimoto ◽  
Takahiro Imaizumi ◽  
Sawako Kato ◽  
Yoshinari Yasuda ◽  
Takuji Ishimoto ◽  
...  

AbstractThe influence of body mass or metabolic capacity on the association between alcohol consumption and lower risks of developing chronic kidney disease (CKD) is not fully elucidated. We examined whether the body mass index (BMI) affects the association between drinking alcohol and CKD. We defined CKD as an estimated glomerular filtration rate decline < 60 mL/min/1.73 m2 and/or positive proteinuria (≥ 1+). Participants were 11,175 Japanese individuals aged 40–74 years without baseline CKD who underwent annual health checkups. Daily alcohol consumption at baseline was estimated using a questionnaire, and the participants were categorized as “infrequent (occasionally, rarely or never),” “light (< 20 g/day),” “moderate (20–39 g/day),” and “heavy (≥ 40 g/day).” Over a median 5-year observation period, 936 participants developed CKD. Compared with infrequent drinkers, light drinkers were associated with low CKD risks; adjusted hazard ratios (95% confidence intervals) were 0.81 (0.69–0.95). Stratified by BMI (kg/m2), moderate drinkers in the low (< 18.5), normal (18.5–24.9), and high (≥ 25.0) BMI groups had adjusted hazard ratios (95% confidence intervals) of 3.44 (1.60–7.42), 0.75 (0.58–0.98), and 0.63 (0.39–1.04), respectively. Taken together, the association between alcohol consumption and CKD incidence was not the same in all the individuals, and individual tolerance must be considered.


2020 ◽  
Vol 8 (9) ◽  
pp. 4426-4430
Author(s):  
Bhuvnesh Sharma ◽  
Gyanendra Datta Shukla ◽  
Parul Sharma

Kidneys plays a vital role in homeostasis by maintaining the body fluid and removing the harmful toxins out of the body through urine formation. Chronic kidney disease is a type of kidney disease which is pro-gressive in nature and there is gradual loss of kidney function over a period of months or years and have complex and different etio-pathologies. With the growing number of cases and keeping in mind the availa-ble conventional line of treatment and its financial burden on patient, Ayurveda through its holistic line of management, either in the form of Shamana & Shodhana or in the form of dietary advices stand distinct and it seems to be effective and safe. And by including proper daily dietary rules and regimens in patients of Chronic kidney disease (CKD) it can be very effectively managed. Here Trinpanchmool, Punarnava, Gokshur used in Basti. Basti plays a vital role here in CKD, it helps in expelling out the uremic toxins which originates in gut thereby improving the quality of life and reducing the sign and symptoms of dis-ease.


2021 ◽  
Vol 9 (2) ◽  
pp. 93
Author(s):  
Astrid Kristina Kardani ◽  
Ninik Asmaningsih Soemyarso ◽  
Jusli Aras Aras ◽  
Risky Vitria Prasetyo ◽  
Mohammad Sjaifullah Noer

Chronic kidney disease (CKD) is a serious health problem in children, with increasing morbidity and mortality rates throughout the world. Children with CKD tend to experience magnesium (Mg) defi ciency that can stimulate an infl ammatory response in the body. One of the infl ammatory responses is an increase of Interleukin-6 (IL-6).  Study to analyze the correlation between Mg and IL-6 in pre-dialysis CKD children. The methods a cross sectional study was conducted in Dr Soetomo General Academic Hospital from November 2018 to April 2019. Children with pre-dialyis CKD were included in this study. Variables of serum Mg level (mg/dL) and infl ammatory marker (IL-6) were measured from the blood and analyzed by ELISA method. The correlation between Mg and IL-6 was analyzed with Spearman’s correlation test with p <0.05.  Result a total of 47 children (27 boys vs 20 girls) between 3 months to 18 years old, with pre-dialysis CKD and no history of magnesium supplementation were included. The primary disease that causes of CKD were lupus nephritis (38.3%), nephrotic syndrome (23.4%), urologic disorder (23.4%),  tubulopathy (10.6%) and others (4.3%). The average IL-6 level was 55.42±43.04 pg/dL and Mg level was 2.06±1.54 mg/dL. There were no signifi cant correlation between IL-6 level and Mg level with staging of CKD and duration of illness (p>0.05), but there was a signifi cant correlation between serum Mg level and IL-6 level (r=-0.748; p<0.001). Magnesium levels have a signifi cant inverse correlation with IL-6 levels in pre-dialysis CKD children. The lower the Mg levels in the blood, the higher IL-6 levels and vice versa. 


2021 ◽  
pp. 17-25
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
S. V. Batyukina ◽  
N. A. Shatalova ◽  
N. M. Doldo ◽  
...  

Chronic kidney disease is one of the most common diseases in general medical practice, due to their secondary damage to the kidneys in arterial hypertension, chronic heart failure, and diabetes mellitus. The coexistence of hypertension and diabetes increases the likelihood of developing chronic kidney failure tenfold. In turn, chronic kidney disease is an important independent risk factor for the development of cardiovascular complications, including fatal ones, due to the direct relationship of the pathogenetic mechanisms of cardiorenal relationships. Approaches to the treatment of chronic kidney disease should be aimed both at preventing the risks of developing renal dysfunction, and at treating existing pathology. The multifactorial nature of the disease and the complex etiopathogenetic relationships determine the need to optimize existing approaches to the treatment of chronic kidney disease in multimorbidity patients with concomitance cardiovascular diseases and diabetes mellitus. This is also due to the fact that, unlike other target organs, compensation for background disease does not always prevent further deterioration of kidney function. According to the recommendations of the main scientific communities, in such cases, it is advisable to start therapy with the most effective angiotensin-converting enzyme inhibitors that combine nephro-and cardioprotective effects and have a dual route of elimination from the body, which is especially important in multimorbidity, the aim to prevent polypharmacy, reduce the risk of drug interactions and, consequently, side effects. This article reviews the literature data indicating the high efficacy and safety of the angiotensin converting enzyme inhibitor fosinopril in patients with chronic kidney disease in combination with cardiovascular diseases and diabetes mellitus.


2010 ◽  
pp. 4174-4188
Author(s):  
Aine Burns ◽  
Caroline Ashley

The kidney plays a critical role in the elimination of many drugs from the body, hence consideration should be given to a patient’s renal function whenever any drug is prescribed. Much kidney disease is unrecognized, but the widespread reporting of estimated glomerular filtration rates (eGFR) has brought greater awareness of the prevalence of chronic kidney disease (CKD) and thereby encouraged medical practitioners to take account of reduced renal function when prescribing. CKD is very often one of many coexisting comorbid conditions, especially in elderly patients, when particularly careful thought must be given to appropriate drug dosing and the possibility of drug interactions....


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