scholarly journals Association of Kidney-Related Safety Events with Incident Chronic Kidney Disease in Veterans

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Helman SR ◽  
◽  
Stewart PM ◽  
Siddiqui T ◽  
Fink JC ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Heart Catheterization ◽  
Stepwise Logistic Regression ◽  
Retrospective Case ◽  
Left Heart Catheterization ◽  
Incident Chronic Kidney Disease ◽  
Contrast Exposure ◽  
The Impact

Objective: The impact of Nonsteroidal Anti-Inflammatory Drugs (NSAID) and iodine-based contrast exposures on developing Chronic Kidney Disease (CKD) is controversial. We examined the association of these exposures with the development of CKD in a Veteran population. Methods: A retrospective case-control study of 154,448 veterans from the Veterans Affairs (VA) Corporate Data Warehouse (CDW) database between 2005 and 2014 was conducted to assess the association between incident stage 3 CKD with Acute Kidney Injury (AKI), NSAID use, iodine-based contrast exposures, and comorbid conditions. Stepwise logistic regression was used to determine multivariable adjusted Odds Ratios (OR). Results: The mean age was 59 (SD±13), and the median eGFR was 84 (IQR: 73, 96). AKI was associated with increased odds of CKD (inpatient: OR=3.76, 95% CI: 3.44, 4.11; outpatient: OR=4.73, 95% CI: 4.09, 5.46) and demonstrated escalated odds with >1 episode (inpatient: OR=5.72, 95% CI: 4.71, 6.95; outpatient: OR=8.36, 95% CI: 6.32, 11.06). Months of NSAID prescriptions was associated with CKD, with ORs at >0-6 months, >6-12 months, and >12 months of 1.27 (95% CI: 1.23, 1.32), 1.54 (95% CI: 1.46, 1.63), and 1.69 (95% CI: 1.62, 1.77) respectively. Iodine-based contrast exposure was associated with increased odds of CKD, with ORs for 1-2 Computed Tomography (CT) scans, ≥3CT scans, and left heart catheterization of 1.29 (95% CI: 1.24, 1.35), 1.29 (95% CI: 1.20, 1.28), and 1.38 (95% CI: 1.17, 1.63) respectively. Conclusion: AKI events, NSAID use, and iodine-based contrast exposures are associated with increased odds for developing stage 3 CKD in veterans.

scholarly journals Effects of a Pre-Dialysis Patient Education Program on the Relative Frequencies of Dialysis Modalities

2013 ◽  
Vol 33 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Werner Ribitsch ◽  
Bernd Haditsch ◽  
Ronald Otto ◽  
Gernot Schilcher ◽  
Franz Quehenberger ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Frequency Distribution ◽  
Education Program ◽  
Incidence Rates ◽  
Care Group ◽  
Control Group ◽  
Patient Education Program ◽  
Incident Chronic Kidney Disease ◽  
The Impact

BackgroundPre-dialysis education can guide the choice of the dialysis modality best tailored to meet the needs and preferences of individual patients with chronic kidney disease.MethodsIn a retrospective single-center cohort study, we evaluated the impact of a pre-dialysis education program on the incidence rates of patients using hemodialysis (HD) and peritoneal dialysis (PD) in our unit. The frequency distribution of dialysis modalities between people attending our education program and people not attending the program (control group) was analyzed for the 4-year period 2004 – 2008.ResultsFrom among all the incident chronic kidney disease 5D patients presenting during the 4-year period, we analyzed 227 who started dialysis either with an arteriovenous fistula or a PD catheter. In that cohort, 70 patients (30.8%) took part in the education program, and 157 (69.2%) did not receive structured pre-dialysis counseling. In the group receiving education, 38 patients (54.3%) started with PD, and 32 (45.7%), with HD. In the standard-care group not receiving education, 44 patients (28%) started with PD, and 113 (72%), with HD ( p < 0.001).ConclusionsOur multidisciplinary pre-dialysis program had a significant impact on the frequency distribution of dialysis modalities, increasing the proportion of patients initiating dialysis with PD.

Recanalization of Chronic Total Occlusions in Patients With vs Without Chronic Kidney Disease: The Impact of Contrast-Induced Acute Kidney Injury

2018 ◽  
Vol 34 (10) ◽  
pp. 1275-1282 ◽  
Author(s):  
Lorenzo Azzalini ◽  
Soledad Ojeda ◽  
Ozan M. Demir ◽  
Joseph Dens ◽  
Masaki Tanabe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Chronic Total Occlusions ◽  
The Impact

scholarly journals Carbohydrate-Rich Diet Is Associated with Increased Risk of Incident Chronic Kidney Disease in Non-Diabetic Subjects

2019 ◽  
Vol 8 (6) ◽  
pp. 793 ◽  
Author(s):  
Ki Heon Nam ◽  
Seong Yeong An ◽  
Young Su Joo ◽  
Sangmi Lee ◽  
Hae-Ryong Yun ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Significant Risk ◽  
Carbohydrate Intake ◽  
Dietary Carbohydrate ◽  
Increased Risk ◽  
Significant Difference ◽  
Incident Chronic Kidney Disease ◽  
The Impact

Despite the potential relationship with metabolic derangements, the association between dietary carbohydrate intake and renal function remains unknown. The present study investigated the impact of dietary carbohydrate intake on the development of incident chronic kidney disease (CKD) in a large-scale prospective cohort with normal renal function. A total of 6746 and 1058 subjects without and with diabetes mellitus (DM) were analyzed, respectively. Carbohydrate intake was assessed by a 24-h dietary recall food frequency questionnaire. The primary endpoint was CKD development, defined as a composite of estimated glomerular filtration rate (eGFR) of ≤60 mL/min/1.73 m2 and the development of proteinuria. CKD newly developed in 20.1% and 36.0% of subjects during median follow-ups of 140 and 119 months in the non-DM and DM subjects, respectively. Categorization of non-DM subjects into dietary carbohydrate density quartiles revealed a significantly higher risk of CKD development in the third and fourth quartiles than in the first quartile (P = 0.037 for first vs. third; P = 0.001 for first vs. fourth). A significant risk elevation was also found with increased carbohydrate density when carbohydrate density was treated as a continuous variable (P = 0.008). However, there was no significant difference in the incident CKD risk among those with DM according to dietary carbohydrate density quartiles. Carbohydrate-rich diets may increase the risk of CKD development in non-DM subjects.

scholarly journals Acute kidney injury in 3182 patients admitted with COVID-19: a single center retrospective case-control study

2021 ◽  
Author(s):  
Fabio L Procaccini ◽  
Roberto Alcázar Arroyo ◽  
Marta Albalate Ramón ◽  
Esther Torres Aguilera ◽  
Juan Martín Navarro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Respiratory Distress ◽  
Kidney Function ◽  
Case Control Study ◽  
Kidney Injury ◽  
Case Control ◽  
Retrospective Case ◽  
Control Study

Abstract Background Acute kidney injury (AKI) may develop in COVID-19 patients and may be associated with a worse outcome. The aim of this study is to describe AKI incidence during the first 45 days of the SARS-CoV2 pandemic in Spain, its reversibility and the association with mortality. Methods Observational retrospective case-control study based on patients hospitalized between March 1 and April 15, 2020 with SARS-CoV2 infection and AKI. Confirmed AKI cases were compared with stable kidney function patients for baseline characteristics, analytical data, treatment and renal outcome. Patients with end-stage kidney disease were excluded. Results AKI incidence was 17.22% among 3182 admitted COVID-19 patients and acute kidney disease (AKD) incidence was 6.82%. The most frequent causes of AKI were prerenal (68.8%) and sepsis (21.9%). Odds ratio for AKI was increased in patients with pre-existent hypertension (OR 2.58, 95% CI 1.71-3.89) and chronic kidney disease (OR 2.14, 95% CI 1.33-3.42) and in those with respiratory distress (OR 2.37, 95% CI 1.52-3.70). Low arterial pressure at admission increased the risk for stage 3 AKI (OR 1.65, 95% CI 1.09-2.50). Baseline kidney function was not recovered in 45.73% of overall AKI cases and in 52.75% of AKI patients with prior chronic kidney disease. Mortality was 38.5% compared to 13.4% of the overall sample population. AKI increased mortality risk at any time of hospitalization (HR 1.45, 95% CI 1.09-1.93). Conclusions AKI is frequent in COVID-19 patients and is associated to mortality, independently from acute respiratory distress syndrome. AKD was also frequent and merits adequate follow-up.

scholarly journals Low eGFR Is a Strong Predictor of Worse Outcome in Hospitalized COVID-19 Patients

2021 ◽  
Vol 10 (22) ◽  
pp. 5224
Author(s):  
Antonio Mirijello ◽  
Pamela Piscitelli ◽  
Angela de Matthaeis ◽  
Michele Inglese ◽  
Maria Maddalena D’Errico ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Strong Predictor ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Composite Outcome ◽  
Glucose Levels ◽  
History Of ◽  
Clinical Records ◽  
The Impact

Background: The clinical course of COVID-19 is more severe in elderly patients with cardio-metabolic co-morbidities. Chronic kidney disease is considered an independent cardiovascular risk factor. We aimed to evaluate the impact of reduced eGFR on the composite outcome of admission to ICU and death in a sample of consecutive COVID-19 hospitalized patients. Methods: We retrospectively evaluated clinical records of a consecutive sample of hospitalized COVID-19 patients. A total of 231 patients were considered for statistical analysis. The whole sample was divided in two groups on the basis of eGFR value, e.g., ≥ or < 60 mL/min/1.73 m2. Patients with low eGFR were further divided among those with a history of chronic kidney disease (CKD) and those without (AKI, acute kidney injury). The primary outcome was a composite of admission to ICU or death, whichever occurred first. The single components were secondary outcomes. Results: Seventy-nine (34.2%) patients reached the composite outcome. A total of 64 patients (27.7%) died during hospitalization, and 41 (17.7%) were admitted to the ICU. A significantly higher number of events was present among patients with low eGFR (p < 0.0001). Age (p < 0.001), SpO2 (p < 0.001), previous anti-platelet treatment (p = 0.006), Charlson’s Comorbidities Index (p < 0.001), serum creatinine (p < 0.001), eGFR (p = 0.003), low eGFR (p < 0.001), blood glucose levels (p < 0.001), and LDH (p = 0.003) were significantly associated with the main outcome in univariate analysis. Low eGFR (HR 1.64, 95%CI 1.02-2.63, p = 0.040) and age (HR per 5 years 1.22, 95%CI 1.10-1.36, p < 0.001) were significantly and independently associated with the main outcome in the multivariate model. Patients with AKI showed an increased hazard ratio to reach the combined outcome (p = 0.059), while those patients with both CKD had a significantly higher probability of developing the combined outcome (p < 0.001). Conclusions: Patients with reduced eGFR at admission should be considered at high risk for clinical deterioration and death, requiring the best supportive treatment in order to prevent the worst outcome.

The Impact of Preexisting Chronic Kidney Disease on the Severity and Recovery of Acute Kidney Injury

Nephron ◽  
2018 ◽  
Vol 139 (3) ◽  
pp. 254-268 ◽  
Author(s):  
Sung Yoon Lim ◽  
Yoon Sook Ko ◽  
Hee Young Lee ◽  
Ji Hyun Yang ◽  
Myung Gyu Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
The Impact

scholarly journals Klotho, the elusive kidney-derived anti-ageing factor

2019 ◽  
Vol 13 (2) ◽  
pp. 125-127 ◽  
Author(s):  
Maria Dolores Sanchez-Niño ◽  
Beatriz Fernandez-Fernandez ◽  
Alberto Ortiz
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Diagnosis ◽  
Cardiovascular Mortality ◽  
Causes Of Death ◽  
Negative Impact ◽  
Kidney Injury ◽  
Ckd Progression ◽  
The Impact

Abstract Chronic kidney disease (CKD) is one of the fastest growing causes of death worldwide. Only early diagnosis will allow prevention of both CKD progression and the negative impact of CKD on all-cause and cardiovascular mortality. Klotho is a protein produced by the kidneys that has anti-ageing and phosphaturic properties, preventing excess positive phosphate balance. There is evidence that Klotho downregulation is one of the earliest consequences of kidney injury. Thus the development of reliable assays to monitor Klotho levels may allow an early diagnosis of CKD and monitoring the impact of therapies aimed at preserving Klotho expression or at preventing CKD progression. However, the performance of Klotho assays has been suboptimal so far. In this issue of Clinical Kidney Journal, Neyra et al. explore methods to improve the reliability of Klotho assays.

Sign in / Sign up

Export Citation Format

Share Document