Dynamic thiol-disulfide balance and thioredoxin reductase enzyme levels in patients with chronic kidney disease.

Introduction: We aimed to measure the dynamic thiol-disulfide balance and thioredoxin reductase (TrxR) enzyme levels in patients with chronic kidney disease (CKD). Material and Methods: Thirty hemodialysis (HD), 30 CKD patients (stage3-5) and 30 controls were included in the study. The dynamic thiol-disulfide balance was determined by the colorimetric method developed by Erel et al. TrxR levels were determined by ELISA. Results: Native and total thiol levels of CKD and HD patients were significantly lower than that of the control group (p=0.001for both). However, disulfide levels were significantly higher in the HD group (p=0.001), but there was no significant difference between control and CKD groups(p=0.547). A notable negative correlation was found between the native and total thiol levels and IMA(r=-0.628;-0.631),BUN (r=-0.747;-0.747),and creatinine(r=-0.732;-0.721). There was a significant positive correlation between GFR and the thiol levels (r=0.835;0.824). TrxR levels were significantly higher in the patient groups compared to the controls (p=0.001).CRP levels of the patient groups were significantly higher compared to the controls (p=0.001). Conclusions: We have demonstrated that measurement of dynamic thiol-disulfide levels by using colorimetric method can contribute to the diagnosis and follow-up of the disease as a marker, because, it is easily applicable in routine clinical biochemistry laboratories and related with disease severity in CKD patients. Also, we showed that volume correction due to dialysis process should be consider in studies dealing with plasma thiol values and the final results should be given after the correction process.

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The Relationship Between Blood Pressure Variability And Renal Progression In Hypertensive Patients With Chronic Kidney Disease

Gevher Nesibe Journal, IESDR ◽

10.46648/gnj.270 ◽

2021 ◽

Vol 6 (14) ◽

pp. 80-88

Author(s):

Huseyin Duru ◽

Ekrem KARA

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Blood Pressure Measurement ◽

Rapid Progression ◽

Night Time ◽

Hypertensive Patients ◽

Significant Difference ◽

Renal Progression

Objective: To evaluate the effect of 24 hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) variability (BPV) on renal progression in hypertensive patients with chronic kidney disease (CKD) Methods: A total 59 hypertensive patients (mean age: 54.2±14.6 years, 50.8% male) with CKD who underwent 24 hours ambulatory blood pressure measurement (ABPM) were included. Data on SBP, DBP, BPV coefficients (VC) for SBP (SBP-CV) and DBP (DBP-CV) were recorded. A decrease in e-GFR of <5 ml/min/year was considered as normal renal progression and a decrease in ≥5 ml/min/year was considered as rapid renal progression. Results: Overall, 40.6% of the patients had uncontrolled HT, while 45.8% had non-dipper pattern. Mean±SD daytime and night-time SBP and SBP-VC values were 135.3±17.9 mmHg, 128.6±23.0 mmHg, 11.7±2.8 and 9.5±3.6, respectively. Mean±SD daytime and nigh-time DBP and DBP-VC values were 84.5±13.4 mmHg, 77.2±16.1 mmHg, 13.8±3.8 and 12.0±3.7, respectively. Rapid renal progression was detected in 25.4% of patients with no significant difference in daytime, night-time and total SBP, SBP-VC, DBP and DBP-VC values between patients with rapid vs. natural renal progression. The regression analysis adjusted for age, gender, presence of DM, baseline e-GFR and dipping status revealed no significant impact of SBP-VC and DBP-VC in predicting rapid progression (p> 0.05). Conclusion: In conclusion, our finding revealed no significant association between BPV and renal progression in hypertensive patients with CKD. Larger scale prospective, randomized controlled trials with longer follow-up are needed to clarify this issue.

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Abstract 13243: Diminished Daily Fluctuation of Heart Rate Variability in Patients with Chronic Kidney Disease

Circulation ◽

10.1161/circ.130.suppl_2.13243 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Hisaki Makimoto ◽

Katsuhito Fujiu ◽

Kohei Shimizu ◽

Eisuke Amiya ◽

Kazuo Asada ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Regression Analysis ◽

Kidney Disease ◽

High Frequency ◽

High Frequency Component ◽

Control Group ◽

Holter Monitor ◽

Significant Difference ◽

High Incidence ◽

Circadian Fluctuation

Introduction: Autonomic dysfunction is well known in patients with chronic kidney disease (CKD) and linked with cardiac death. In spite of a high incidence of morning death in CKD patients, circadian fluctuation in parasympathetic activation have not been studied in CKD. Hypothesis: We assessed the hypothesis that the cardiac autonomic circadian fluctuation is impaired in patients with CKD. Methods: The study population consisted of consecutive 101 patients (54 males, 70±10 years old) with CKD who underwent 24-hour Holter monitor. As a control group, 134 age and sex matched cases (66 males, 68±10 years old) without CKD who also underwent Holter monitor were recruited. Patients with diabetes orβ-blocker therapy were excluded. The high frequency component (HF), which reflected parasympathetic activity, and the low frequency to high frequency ratio (L/H ratio), which reflected, in part, sympathetic activity, were evaluated. To evaluate the contribution of CKD and other parameters to the cardiac autonomic fluctuation, the night (6PM-6AM) to day (6AM-6PM) ratio of HF and L/H ratio were analyzed utilizing a regression analysis. Results: The L/H ratio showed no significant difference during the night between the two groups, in contrast to the significant difference during the daytime. Patients with CKD showed significantly lower HF during the night as compared to control cases (P<0.05), although the daytime HF was not significantly different between the groups (Figure). Multivariate regression analysis demonstrated that CKD was independently associated with a lower night-to-day ratio of the HF and a higher night-to-day ratio of the L/H ration, even with the adjustment of age and comorbid hypertension. Conclusions: Our findings suggest that cardiac autonomic fluctuation is impaired in CKD patients. Whether a deterioration of autonomic activation might explain the high incidence of morning death in CKD patients needs to be clarified in future studies.

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Effect of Allopurinol on Inflammatory Markers in Chronic Kidney Disease Patients with Asymptomatic Hyperuricaemia

Journal of Dhaka Medical College ◽

10.3329/jdmc.v26i1.33991 ◽

2017 ◽

Vol 26 (1) ◽

pp. 12-24

Author(s):

ASM Tanim Anwar ◽

Md Nizamuddin Chowdhury ◽

Md Nazrul Islam ◽

Parvez Iftekher Ahmed ◽

Sohely Ahmed Sweety ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Uric Acid ◽

Treatment Group ◽

Kidney Disease ◽

Serum Uric Acid ◽

Chronic Kidney Disease Stage ◽

Disease Stage ◽

Control Group ◽

Base Line

This was a hospital based prospective, interventional study which included CKD stage 3- 5 patients with higher level of uric acid (male>7mg/dl, female>6mg/dl). The objective of the study was to evaluate the effect of allopurinol on inflammatory markers in patients with chronic kidney disease (stage 3-5) with asymptomatic hyperuricaemia. One hundred and twenty patients were distributed in two groups. Sixty patients were placed in treatment group and sixty in control group. Purposive sampling technique was followed. In the study mean age was 49 (±9) years in treatment group and 45 (±11) years in control groups. Male were predominant in both groups. There were no significant difference in baseline characteristics between treatment group and control group (p>0.05). Sixty patients of treatment group were administered a dose of 100 mg/d of allopurinol. Follow up assessment was done at basally, at 4 months and at 8 month after starting treatment. No significant differences were seen between baseline SBP, DBP, Hb and HbA1c with 4th month and 8th month follow up in both treatment group and control group, but mean Hb was significantly decreased in control group from the baseline after 8 month. No significant change was found in case of mean ESR at 4th and 8th month in any group. But base line mean CRP was significantly reduced in treatment group and increased in control group at 4th and 8th month of follow up. Serum uric acid was decreased in treatment group while it was significantly raised from the base line at 4th month and 8th month in control group. While comparing between two groups results showed means of serum uric acid and CRP were significantly decreased in treatment group compared to control group after 8th month. There was a positive correlation between Uric Acid with CRP level after 8 month of allopurinol treatment although this finding was not statistically significant. So, allopurinol may have a protective role in CKD by decreasing serum uric acid level and reduction of inflammatory response in patients with chronic kidney disease stage 3 - 5 with asymptomatic hyperuricaemia.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 12-24

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Effect of Allopurinol in Chronic Kidney Disease Progression in Asymptomatic Hyperuricaemic Subjects

Journal of Dhaka Medical College ◽

10.3329/jdmc.v25i1.33949 ◽

2017 ◽

Vol 25 (1) ◽

pp. 5-15

Author(s):

ASM Tanim Anwar ◽

Md Nizamuddin Chowdhury ◽

Md Nazrul Islam ◽

Parvez Iftekher Ahmed ◽

Sohely Ahmed Sweety ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Uric Acid ◽

Treatment Group ◽

Kidney Disease ◽

Serum Uric Acid ◽

Chronic Kidney Disease Stage ◽

Disease Stage ◽

Control Group ◽

And Control

This was a hospital based prospective, interventional study which included CKD stage 3- 5 patients with higher level of uric acid (male>7mg/dl, female>6mg/dl). The objective of the study was to evaluate the effect of allopurinol in chronic kidney disease (stage 3-5) progression in asymptomatic hyperuricaemic patients.One hundred and twenty patients were distributed in two groups. Sixty patients were placed in treatment group and sixty in control group. Purposive sampling technique was followed. In the study mean age was 49 (±9) years in treatment group and 45 (±11) years in control groups. Male were predominant in both groups. There were no significant difference in baseline characteristics between treatment group and control group (p>0.05). Sixty patients of treatment group were administered a dose of 100 mg/d of allopurinol. Follow up assessment was done at basally, at 4 months and at 8 month after starting treatment. No significant differences were seen between baseline SBP, DBP, Hb and HbA1c with 4th month and 8th month follow up in both treatment group and control group, but mean Hb was significantly decreased in control group from the baseline after 8 month. Serum uric acid was decreased in treatment group while it was significantly raised from the base line at 4th month and 8th month in control group. In treatment group serum creatinine was decreased and eGFR was raised from the baseline after 8 month. On the other hand, in control group serum creatinine was significantly raised and eGFR was significantly decreased from the baseline at 8th month. While comparing between two groups results showed means of serum uric acid was significantly decreased in treatment group compared to control group after 8th month. There was a negative correlation between Uric Acid with eGFR after 8 month of allopurinol treatment although this finding was not statistically significant. So, allopurinol may have a protective role in CKD progression by decreasing serum uric acid level in patients with chronic kidney disease stage 3 - 5 with asymptomatic hyperuricaemia.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 5-15

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Association between Chronic Kidney Disease and the Most Common Corneal Ectasia Disease (Keratoconus): a Nationwide Cohort Study

10.21203/rs.3.rs-38727/v3 ◽

2020 ◽

Author(s):

Ren-Long Jan ◽

Shih-Feng Weng ◽

Jhi-Joung Wang ◽

Yuh-Shin Chang

Keyword(s):

Chronic Kidney Disease ◽

Health Insurance ◽

Kidney Disease ◽

Incidence Rate ◽

Case Series ◽

Control Group ◽

Study Cohort ◽

Research Database ◽

Increased Risk ◽

Significant Difference

Abstract Background: Both keratoconus (KCN) and chronic kidney disease (CKD) are multifactorial conditions with multiple aetiologies and share several common pathophysiologies. However, the few studies that have described the relationship between KCN and CKD are limited to case reports and small case series. This study aimed to evaluate the association between KCN and CKD.Methods: The study cohort included 4,609 new-onset keratoconus patients ≥ 12 years identified by the International Classification of Diseases, Ninth Revision, Clinical Modification, code 371.6 and recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The age- , sex- , and comorbidity-matched control group included 27,654 non-KCN patients, selected from the Taiwan Longitudinal Health Insurance Database, 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence and risk of CKD were compared between the two groups. The adjusted hazard ratios (HRs) for CKD were calculated with Cox proportional hazard regression analysis. Kaplan–Meier analysis was used to calculate the cumulative CKD incidence rate. Results: The incidence rate of CKD was 1.36 times higher in KCN patients than in controls without statistically significant difference (95% confidence interval [CI] = 0.99–1.86, p = 0.06). In total, 29 male KCN patients and 90 male controls developed CKD during the follow-up period. The incidence rate of CKD was 1.92 times (95% [CI] = 1.26–2.91; p = 0.002) higher in male KCN patients than in controls. After adjusting for potential confounders, including age, hypertension, hyperlipidaemia, and diabetes mellitus, male KCN patients were 1.75 times (adjusted HR = 1.75, 95% [CI] = 1.14–2.68, p < 0.05) more likely to develop CKD. Conclusions: We found that male KCN patients have an increased risk of CKD. Therefore, it is recommended that male KCN patients should be aware of CKD.

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DIFFERENTIAL DIAGNOSTICS OF PREECLAMPSIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Nephrology (Saint-Petersburg) ◽

10.24884/1561-6274-2019-23-1-45-50 ◽

2019 ◽

Vol 23 (1) ◽

pp. 45-50

Author(s):

R. R. Temirbulatov ◽

V. F. Bezhenar ◽

A. V. Smirnov

Keyword(s):

Chronic Kidney Disease ◽

Differential Diagnosis ◽

Kidney Disease ◽

Comparison Group ◽

Differential Diagnostics ◽

Control Group ◽

Third Trimester ◽

Significant Difference ◽

Definition Of ◽

The Relationship

THE AIM: To assess the significance of prognostic markers of preeclampsia – sFlt-1 and PlGF in the differential diagnosis of preeclampsia and chronic kidney disease.PATIENTS AND METHODS:patients whom signed informed consent, was taken samples of blood in the third trimester of pregnancy. The study group included 36 patients with preeclampsia, the comparison group of 46 pregnant women with CKD and the control group included 40 healthy patients, with pregnancy without complication.RESULTS: Significant differences in the levels of serum sFlt-1 and PlGF were found: between the PE and the comparison group (CKD), as well as between the PE and the control group (CG), whereas no differences were found between the CG and CKD. The sFlt-1 level was significantly increased in PE compared with CKD and KG (5.12-fold and 4.25-fold higher, respectively). Serum PlGF levels were significantly reduced in PE relative to both CKD and KG (17.4 and 12.5 times lower, respectively). The sFlt-1/PlGF ratio was significantly increased in PE compared with CKD and the control group (approximately 25 times higher in both groups), but there was no significant difference between CKD and CG.CONCLUSION:Thus, the definition of the relationship sFlt-1, PlGF, sFlt-1/PlGF can be used in the differential diagnosis of preeclampsia and chronic kidney disease.

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Functional and Respiratory Capacity of Patients with Chronic Kidney Disease Undergoing Cycle Ergometer Training during Hemodialysis Sessions: A Randomized Clinical Trial

International Journal of Nephrology ◽

10.1155/2019/7857824 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Antonio de Olival Fernandes ◽

Yvoty Alves dos Santos Sens ◽

Vivian Bertoni Xavier ◽

Luiz Antonio Miorin ◽

Vera Lúcia dos Santos Alves

Keyword(s):

Clinical Trial ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Randomized Clinical Trial ◽

Functional Capacity ◽

Respiratory Function ◽

Cycle Ergometer ◽

Forced Expiratory Volume ◽

Control Group ◽

Significant Difference

Purpose. Exercise is recommended for patients undergoing hemodialysis, to reduce the decrease in functional capacity secondary to the progression of chronic kidney disease. A cycle ergometer can be easily added to an exercise routine during hemodialysis sessions. The purpose of this article was to assess the results of a training protocol with the cycle ergometer during hemodialysis sessions on the respiratory function and functional capacity of patients with chronic kidney disease on hemodialysis. Method. In this randomized clinical trial (NCT no. 02834026), 39 patients undergoing hemodialysis were randomly allocated into two groups: the treatment group (TG, n = 20), who underwent a cycle ergometer protocol training, and the control group (GC, n = 19), not trained. The TG attended 24 training sessions, three times a week, during the intradialytic period. Training intensity was aimed at keeping the heart rate between 50 and 70% of its maximum. All participants were evaluated before and after the eight consecutive weeks of follow-up and had biochemicals data, anthropometric, functional, and respiratory outcomes evaluated. Results. A significant difference was observed between groups in forced vital capacity, forced expiratory volume in the first second, peak expiratory flow, maximal inspiratory and expiratory pressure, and Borg score and distance covered in the six-minute walk test. Improvement was also observed in biochemical and Kt/V test results for the TG. Conclusion. The systematic training regimen with a cycle ergometer resulted in benefits in the respiratory function and functional capacity in patients with chronic kidney disease undergoing hemodialysis.

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Investigation of hallmarks of carbonyl stress and formation of end products in feline chronic kidney disease as markers of uraemic toxins

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x18783858 ◽

2018 ◽

Vol 21 (6) ◽

pp. 465-474 ◽

Cited By ~ 1

Author(s):

Emanuela Valle ◽

Liviana Prola ◽

Diana Vergnano ◽

Roberta Borghi ◽

Fiammetta Monacelli ◽

...

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Biochemical Parameters ◽

Advanced Oxidation ◽

Treated Group ◽

Control Group ◽

Advanced Oxidation Protein Products ◽

Significant Difference ◽

End Products

Objectives Cats are commonly affected by chronic kidney disease (CKD). Many reactive carbonyl intermediates and end products originating from the oxidative stress pathways are recognised as uraemic toxins and may play a role in CKD progression. The aim of the present study is to confirm whether carbonyl end-product formation is higher in cats affected by CKD and to assess whether an angiotensin-converting enzyme inhibitor (ACEi) might affect these hallmarks. Methods Twenty-two cats were divided into three groups: a control group (CG), cats with CKD and cats with CKD treated with an ACEi. Serum levels of pentosidine, carboxymethyllysine, advanced oxidation protein products, malondialdehyde, methylglyoxal and hexanoyl-lysine were measured. In addition, biochemical parameters and systolic blood pressure were evaluated. After checking for normality, comparisons between groups were performed followed by multiple comparison tests. P values ⩽0.05 were considered significant. Correlations between concentrations of the considered biomarkers and of the other metabolic parameters were investigated. Results Advanced oxidation protein products, malondialdehyde and hexanoyl-lysine concentrations were significantly higher in CKD and ACEi-treated groups compared with the CG ( P <0.05). Carboxymethyllysine increased in the ACEi-treated group when compared with the CG, whereas intermediate values of these biomarkers were found in the CKD group ( P <0.05). The ACEi-treated group showed the highest values of carboxymethyllysine, advanced oxidation protein products and hexanoyl-lysine. By contrast, the CKD group had the highest concentration of malondialdehyde. No statistically significant difference was found in the levels of pentosidine or methylglyoxal. End products correlated with creatinine and urea and with each other. Conclusions and relevance Significantly high concentrations of both intermediate and end products of carbonyl/oxidative stress were detected in CKD cats. This is the first study to have concurrently taken into account several uraemic toxins and biochemical parameters in cats affected by CKD.

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The Effect of Coaching Support on Kidney Function in Chronic Kidney Disease Patients

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5820 ◽

2021 ◽

Vol 9 (T4) ◽

pp. 106-110

Author(s):

Susanti Susanti ◽

Difran Nobel Bistara

Keyword(s):

Chronic Kidney Disease ◽

Chronic Illness ◽

Treatment Group ◽

Kidney Disease ◽

Kidney Function ◽

Complex Disease ◽

Early Stage ◽

T Test ◽

Control Group ◽

Significant Difference

BACKGROUND: Chronic kidney disease (CKD) is a chronic illness with complex disease which could lead to other underlying diseases such as diabetes mellitus (DM), hypertension, and dyslipidemia. Urban population must manage their illness due to their occupation. Coaching support is an advanced method to help individuals manage their illnesses, especially chronic illness. Symptoms and complaints in early-stage renal disorders tend to be mild, making it difficult to diagnose only by clinical examination. Impaired kidney function can lead to progressive kidney damage. AIM: This study aimed was to analyze the effect of coaching support in maintaining kidney function in patients with CKD. METHODS: This research used quasi-experiment with pre-test and post-test with control group design. Respondents in this study were 40 CKD patients which were taken by consecutive sampling technique and divided into two groups, namely, control group and treatment group. Data were collected using blood urea nitrogen and creatinine values observation sheet. Coaching support was divided into four steps of therapy, identify the disturbance, identify based on experience, use a family support system, and evaluating the results. Data were analyzed using paired t-test and independent t-test with a significance of p < 0.05. RESULTS: This study found that there was a significant difference in kidney function between the control group and the treatment group (p = 0.000). Coaching support interventions were effective on kidney function in patients with CKD. The implementation of coaching support went well because respondents and families were proactive. CONCLUSION: Coaching support should be applied by nurses as daily activity management of CKD patients at early stage to inhibit the kidney function damage progression.

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Pemberian diet modifikasi komersial dan pengaruhnya terhadap asupan makanan dan status gizi pasien penyakit ginjal kronik prehemodialisis di RSUP DR. M. Djamil Padang

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.17552 ◽

2008 ◽

Vol 5 (2) ◽

pp. 71

Author(s):

Pitri Balgis ◽

Probosuseno Probosuseno ◽

Herni Astuti

Keyword(s):

Chronic Kidney Disease ◽

Food Intake ◽

Kidney Disease ◽

Nutritional Status ◽

Control Group ◽

Standard Diet ◽

Control Group Design ◽

Commercial Diet ◽

Significant Difference ◽

Modified Diet

Background: Chronic kidney disease causes progressive deterioration of kidney function and is commonly irreversible, leading to nausea and vomiting as a consequence of high ureum and creatinine in the blood. This condition results in declining appetite which greatly affects food intake and degrading nutritional status that causes high mortality among chronic kidney patients. Therefore efforts are made on how to increase intake of chronic kidney patients.Objective: To identify the effect of nutrition therapy through commercial diet modification to nutrition intake and status of pre-hemodialysis chronic kidney patients at DR. M. Djamil Hospital, Padang.Method: The study was a quasi experiment which used pre-test and post-test with control group design. Population of the study were all patients of pre-hemodialysis chronic kidney disease hospitalized at DR. M. Djamil Hospital of Padang. Samples were patients of pre-hemodialysis chronic kidney disease at internal medicine ward. The experiment group consisted of 11 patients who got modified diet within 6 days and control group consisted of 11 patients who got hospital standard diet with α = 0.05 and ß = 10%. The study were collected from January-March 2008. Data of intake were analyzed using Nutri Survey program. Statistical t-test and chi-square were used to identify the effect of commercial modified diet to food intake, nutritional status, and increase of ureum and creatinine. Absorption level was measured from the quantity of commercial nutrition used. Perception of the patients about commercial diet was obtained through questionnaires and analyzed to get the score.Results: The group with modified diet had better energy and protein intake than the group with hospital standard diet (p < 0.05). However, there was no significant difference in nutritional status, ureum and creatinine changes between patients who got modified diet and those who got hospital standard diet (p < 0.05). The result of analysis on perception of patients about commercial diet showed that patients could accept commercial diet.Conclusion: Commercial modified diet could increase intake of energy and protein of pre-hemodialysis chronic kidney patients.

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