scholarly journals Chronic kidney disease as a risk factor for acute stroke

2021 ◽  
Vol 13 (4) ◽  
pp. 382-397
Author(s):  
O. N. Rzhevskaya ◽  
A. Y. Moiseeva ◽  
A. N. Esaulenko ◽  
A. V. Pinchuk ◽  
Kh. G. Alidzhanova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Vascular System ◽  
Drug Clearance ◽  
Economic Consequences ◽  
Stroke Treatment ◽  
Thrombotic Complications ◽  
New Treatment ◽  
End Stage

One of the most relevant issues of nephrology, neurology, and cardiology is the management and treatment of patients with chronic kidney disease and stroke. Patients with chronic kidney disease have a risk of both thrombotic complications and bleeding, and they have a high risk of both ischemic and hemorrhagic stroke. Chronic kidney disease significantly worsens the outcome of stroke by limiting the treatment due to reduced drug clearance and side effects. Hemodialysis which causes drastic hemodynamic and biochemical changes leads to the "stress" of the cerebral vascular system, increasing the risk of stroke; kidney transplantation reduces the risk of stroke due to functional recovery. Chronic kidney disease and stroke have significant socio-economic consequences. Patients with end-stage chronic kidney disease, as a rule, are not included in clinical trials; and stroke treatment tactics have not been developed for them. This review examines the interaction between kidneys and brain, the pathophysiology and epidemiology of stroke in all stages of chronic kidney disease, after kidney transplantation and discusses the management and treatment of chronic kidney disease patients with stroke.The investigation of the factors responsible for the high prevalence of brain lesions in chronic kidney disease will allow developing new treatment methods.

scholarly journals Matrix metalloproteinase-8 and osteoprotegerin in saliva of children with chronic kidney disease

2021 ◽  
pp. 62-68
Author(s):  
Н.С. Морозова ◽  
Н.Б. Захарова ◽  
Д.Ю. Лакомова ◽  
Л.Д. Мальцева ◽  
О.Л. Морозова
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Comparison Group ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
End Stage ◽  
Stage 1 ◽  
Group 1

Изменения минерального гомеостаза являются причиной костных нарушений зубочелюстной системы (ЗЧС) при хронической болезни почек (ХБП) у детей и могут развиваться задолго до появления клинических проявлений уремической токсинемии на 2-й стадии ХБП. В последние годы большое внимание уделяется неинвазивным методам диагностики патологии полости рта у детей. Наиболее известными индикаторами нарушения костного метаболизма считают матриксную металлопротеиназу 8 (ММР-8) и остеопротогерин (OPG). Цель исследования - установить закономерности изменения содержания ММР-8 и OPG в слюне детей с различной тяжестью ХБП. Объект и методы. Проведено исследование содержания ММР-8 и OPG в слюне у 76 детей, которые были разделены на равные группы по 19 человек: 1 группа - дети с ХБП 1-2 степени, получающие медикаментозное лечение; 2 группа - дети с терминальной стадией ХБП, получающие заместительную почечную терапию в объёме гемодиализа; 3 группа - дети через год после перенесённой трансплантации почки; 4 группа (группа сравнения) - дети с малой хирургической патологией, не имеющие патологии почек. Сбор слюны осуществлялся абсорбционным методом до медикаментозной коррекции основного заболевания утром до приема пищи. Исследование ММР-8 и OPG проводили методом твердофазного иммуноферментного анализа. Результаты. Установлено, что содержание ММР-8 и OPG в слюне у детей с различной степенью ХБП было значительно выше по отношению к группе сравнения. Максимальные значения ММР-8 регистрировались во 2-й группе у детей с терминальной ХБП, находящихся на гемодиализе. Повышение содержания OPG в слюне отмечалось в 1 группе детей с ХБП 1-2-й степени и 3-й группе пациентов, через год после перенесённой трансплантации почки. Заключение. Полученные результаты показывают возможность использования слюны в качестве биологической жидкости для диагностики доклинических этапов нарушения костного метаболизма у детей с ХБП, а ММР-8 и OPG в слюне могут рассматриваться в качестве предиктивных и прогностических маркеров. Changes in mineral homeostasis cause bone disorders of the dentition in children with chronic kidney disease (CKD) and may develop long before the onset of clinical manifestations of uremic toxemia in stage 2 CKD. In recent years, much attention has been paid to noninvasive methods for diagnosing oral pathology in children. The most common indicators of metabolic bone disorders are matrix metalloproteinase-8 (MMP-8) and osteoprotogerin (OPG). The aim of the study was to establish the patterns of changes in salivary concentrations of MMP-8 and OPG in children with various severity of CKD. Subject and methods. Salivary levels of MMP-8 and OPG were studied in 76 children divided into four equal groups: group 1, children with stage 1-2 CKD receiving a drug treatment; group 2, children with end-stage CKD receiving renal replacement therapy with hemodialysis; group 3, children one year after the kidney transplantation; and group 4 (comparison group), children with a minor surgical pathology without a kidney pathology. Saliva samples were collected by the absorption method before administration of drugs for the underlying disease, one hour before the morning meal. Salivary concentrations of MMP-8 and OPG were measured by enzyme-linked immunosorbent assay. Results. Salivary levels of MMP-8 and OPG were significantly higher in children with various severity of CKD than in the comparison group. The highest values of MMP-8 were observed in group 2 children with end-stage CKD on hemodialysis. Increased salivary OPG was noted in group 1 children with stage 1-2 CKD and in group 3 patients one year after the kidney transplantation. Conclusion. Saliva can be used as a biological fluid for diagnosis of preclinical stages of bone metabolism disorders in children with CKD, and salivary MMP-8 and OPG can be considered as predictive and prognostic markers.

[PP.07.18] CHRONIC KIDNEY DISEASE, END STAGE RENAL DISEASE, AND KIDNEY TRANSPLANTATION IN SURINAME

2017 ◽  
Vol 35 ◽  
pp. e142
Author(s):  
V. Nannan Panday ◽  
F.S. Diemer ◽  
Y.C. Haan ◽  
A. Punwasi ◽  
C. Rommy ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

Determinants of Willingness to Accept Kidney Transplantation Among Chronic Kidney Disease Patients in Ghana

2020 ◽  
Author(s):  
Vincent Boima ◽  
Maame-Boatemaa Amissah-Arthur ◽  
Ernest Yorke ◽  
Dzifa Dey ◽  
Delali Fiagbe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
Treatment Option ◽  
End Stage Renal Disease ◽  
Willingness To Accept ◽  
Willingness To Donate ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background The burden of chronic kidney disease in Africa is three to four times higher than high-income countries and the cost of treatment is beyond the reach of most affected persons. The ultimate treatment for end stage renal disease is kidney transplantation which is not available in most African countries. As kidney transplantation is a budding treatment in Ghana, this study assessed factors which could influence Chronic kidney disease patients’ willingness to accept it as a treatment option. Aim The aim of this study was to assess the determinants of willingness to accept kidney transplantation as a treatment option for end stage renal disease among chronic kidney disease patients in Ghana. Methods This cross-sectional survey was carried out among chronic kidney disease patients in Korle-Bu Teaching Hospital. Consecutive sampling method was used to recruit consenting patients. Structured questionnaire and standardized research instruments were used to obtain information on demographic, socio-economic characteristics, knowledge about transplant, perception of transplantation, religiosity and spirituality. Logistic regression model was used to assess the determinants of willingness to accept kidney transplantation. Results 342 CKD patients participated in the study of which 56.7% (n = 194) were males. The mean age of the participants was 50.24 ± 17.08 years. The proportion of participants willing to accept kidney transplantation was 67.3% (95%CI: 62.0–72.2%). The factors which influenced participants’ willingness to accept this treatment include; willingness to attend a class on kidney transplantation (p < 0.016), willingness to donate a kidney if they had the chance (p < 0.005), perception that living person could donate a kidney (p < 0.001) and perception of improved quality of life after transplant (p < 0.005). The barriers for accepting kidney transplantation were anticipated complications of transplant surgery and financial constraints. Conclusion More than two-thirds of CKD patients were willing to accept kidney transplantation and this is influenced by multiple factors. Government health agencies must consider full or partial coverage of kidney transplantation through the existing national health insurance scheme. Further, efficient educational programmes are required to improve patients and physician’s knowledge on the importance of kidney transplantation.

scholarly journals Determinants of willingness to accept kidney transplantation among chronic kidney disease patients in Ghana

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
V. Boima ◽  
M. B. Amissah-Arthur ◽  
E. Yorke ◽  
D. Dey ◽  
Delali Fiagbe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Willingness To Accept ◽  
Willingness To Donate ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background The burden of chronic kidney disease in Africa is three to four times higher compared to high-income countries and the cost of treatment is beyond the reach of most affected persons. The best treatment for end stage renal disease is kidney transplantation which is not available in most African countries. As kidney transplantation surgery is emerging in Ghana, this study assessed factors which could influence the willingness of patients with chronic kidney disease to accept it as a mode of treatment. Methods This cross-sectional survey was carried out among patients with chronic kidney disease in Korle-Bu Teaching Hospital. A consecutive sampling method was used to recruit consenting patients. A structured questionnaire and standardized research instruments were used to obtain information on demographic, socio-economic characteristics, knowledge about transplantation, perception of transplantation, religiosity and spirituality. Logistic regression model was used to assess the determinants of willingness to accept a kidney transplant. Results 342 CKD patients participated in the study of which 56.7% (n = 194) were male. The mean age of the participants was 50.24 ± 17.08 years. The proportion of participants who were willing to accept a kidney transplant was 67.3% (95%CI: 62.0–72.2%). The factors which influenced participants’ willingness to accept this treatment included; willingness to attend a class on kidney transplantation (p < 0.016), willingness to donate a kidney if they had the chance (p < 0.005), perception that a living person could donate a kidney (p < 0.001) and perceived improvement in quality of life after transplantation (p < 0.005). The barriers for accepting kidney transplantation were anticipated complications of transplant surgery and financial constraints. Conclusion More than two-thirds of CKD patients were willing to accept a kidney transplant and this is influenced by multiple factors. Government health agencies must consider full or partial coverage of kidney transplantation through the existing national health insurance scheme. Further, efficient educational programmes are required to improve both patients’ and physicians’ knowledge on the importance of kidney transplantation in the management of end stage renal disease in Ghana.

scholarly journals Willingness to pay for kidney transplantation among chronic kidney disease patients in Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244437
Author(s):  
V. Boima ◽  
K. Agyabeng ◽  
V. Ganu ◽  
D. Dey ◽  
E. Yorke ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Renal Disease ◽  
Willingness To Pay ◽  
Kidney Transplant ◽  
Treatment Option ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

Background Kidney transplantation is the preferred treatment for patients with end stage renal disease. However, it is largely unavailable in many sub-Sahara African countries including Ghana. In Ghana, treatment for end stage renal disease including transplantation, is usually financed out-of-pocket. As efforts continue to be made to expand the kidney transplantation programme in Ghana, it remains unclear whether patients with Chronic Kidney Disease (CKD) would be willing to pay for a kidney transplant. Aim The aim of the study was to assess CKD patients’ willingness to pay for kidney transplantation as a treatment option for end stage renal disease in Ghana. Methods A facility based cross-sectional study conducted at the Renal Outpatient clinic and Dialysis Unit of Korle-Bu Teaching Hospital among 342 CKD patients 18 years and above including those receiving haemodialysis. A consecutive sampling approach was used to recruit patients. Structured questionnaires were administered to obtain information on demographic, socio-economic, knowledge about transplant, perception of transplantation and willingness to pay for transplant. In addition, the INSPIRIT questionnaire was used to assess patients’ level of religiosity and spirituality. Contingent valuation method (CVM) method was used to assess willingness to pay (WTP) for kidney transplantation. Logistic regression model was used to determine the significant predictors of WTP. Results The average age of respondents was 50.2 ± 17.1 years with most (56.7% (194/342) being male. Overall, 90 out of the 342 study participants (26.3%, 95%CI: 21.7–31.3%) were willing to pay for a kidney transplant at the current going price (≥ $ 17,550) or more. The median amount participants were willing to pay below the current price was $986 (IQR: $197 –$1972). Among those willing to accept (67.3%, 230/342), 29.1% (67/230) were willing to pay for kidney transplant at the prevailing price. Wealth quintile, social support in terms of number of family friends one could talk to about personal issues and number of family members one can call on for help were the only factors identified to be significantly predictive of willingness to pay (p-value < 0.05). Conclusion The overall willingness to pay for kidney transplant is low among chronic kidney disease patients attending Korle-Bu Teaching Hospital. Patients with higher socio-economic status and those with more family members one can call on for help were more likely to pay for kidney transplantation. The study’s findings give policy makers an understanding of CKD patients circumstances regarding affordability of the medical management of CKD including kidney transplantation. This can help develop pricing models to attain an ideal poise between a cost effective but sustainable kidney transplant programme and improve patient access to this ultimate treatment option.

scholarly journals Gender Differences in Kidney Transplantation – 10-Year Retrospective Study

2018 ◽  
Vol 18 (3) ◽  
pp. 24-29
Author(s):  
L Kovacikova ◽  
L Bena ◽  
E Lackova ◽  
Z Zilinska ◽  
K Granak ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Lupus Erythematosus ◽  
Treatment Options ◽  
Survival Rates ◽  
Significant Difference ◽  
The World ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Chronic kidney disease represents a world-wide health problem affecting approximately 195 million women around the world. Risk of development of chronic kidney disease is greater in women; therefore, the World Kidney Day 2018 was dedicated to kidney disease, treatment options, and its specifics in female patients. Materials and Methods: We retrospectively analysed a cohort of 1,457 patients after kidney transplantation from all transplant centres in Slovakia over a period of ten years from 2005 – 2015.The parameters taken into account were cause of end-stage renal disease (ESRD), outcome of transplantation in a context of differences between the genders. Results: During the ten-year period there were 557 transplanted women vs. 900 men. Among female recipient the dominant cause of ESRD was tubulointerstitial nephritis (males 22.3% vs. females 32.1%, p < 0.0001), other causes of ESRD where females were significantly more represented than men included polycystic kidney disease (males 11.6% vs. females 17.6%, p = 0.0013) and systemic lupus erythematosus (males 0.2% vs. females 2.3 %, p = 0.0001). There was no significant difference in 12-month, 5-year, and 10-year both graft and patient survival rates between men and women. Female recipients wait for kidney transplantation significantly longer in spite of comparable time spent on dialysis (males 32.9 months vs. females 39.4 months, p < 0.0001). Conclusion: Despite comparable patient and graft survival rates in male and female recipients in our study there are other studies showing that gender as well as gender mismatch significantly influence the outcomes of transplantation.

scholarly journals Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (1) ◽  
pp. 326
Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Root Canal ◽  
Dialysis Patients ◽  
Root Canal Therapy ◽  
Risk Of Death ◽  
Stage Renal Disease ◽  
End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

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