scholarly journals Intravenous neurotropic vitamin b injection in chronic kidney disease patients on dialysis: patient’s perspective

2020 ◽  
Vol 11 (SPL4) ◽  
Author(s):  
Rizaldy Taslim Pinzon ◽  
Radian Adhiputra Antonius
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Daily Activity ◽  
Treatment Quality ◽  
Vitamin B ◽  
Dialysis Patients ◽  
Risk Of Mortality ◽  
Intravenous Vitamin

Chronic kidney disease is characterized by a decrease in glomerular filtration rate and lasts over 3 months. Meanwhile, patient perspectives include patient compliance in treatment and care programs. Vitamin B combination plays a role in reducing the risk of mortality for cardiovascular disease. This study aims in measuring perspective on patients with chronic kidney disease undergoing hemodialysis to intravenous vitamin B injection. This is a cohort retrospective study of patients on dialysis that were injected with intravenous vitamin B two times a week after dialysis. The subjects studied were chronic kidney disease patients who underwent hemodialysis at Bethesda Hospital Yogyakarta and Panti Rapih Hospital Yogyakarta, Indonesia. This study involved 58 patients, comprising 38 male (65.5%) and 20 females (34.5%). Total 41 patients (70.7%) with age under 60 years. The most common comorbidities were hypertension (86.2%), diabetes mellitus (25.9%), and cardiovascular disease (20.7%). Patients' perspectives on improvement of fatigue symptoms are higher in patients with hypertension comorbidity (88.9%), sleep quality higher in diabetes mellitus comorbidity (80%), daily activity higher in patients with other comorbidity (84.6%) and mood higher in other comorbidity (88.9%). Overall, most of the patients were satisfied with the treatment (98.3%), satisfied that it reduced fatigue (96.6%), said no side effects appeared (91.4%), were confident in the treatment (94.8%), considered it resulted in greater benefit than costs (84.5%). Patients' perspectives in the treatment of intravenous vitamin B combination injections for chronic dialysis patients have satisfactory treatment quality.

scholarly journals Impact of Retinopathy and Systemic Vascular Comorbidities on All-Cause Mortality

2021 ◽  
Author(s):  
Zhuoting Zhu ◽  
Xianwen Shang ◽  
Wei Wang ◽  
Jason Ha ◽  
Yifan Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Vascular Risk ◽  
Term Survival ◽  
Joint Effects ◽  
Risk Of Mortality ◽  
All Cause Mortality

AbstractAims/hypothesisTo investigate the joint effects of retinopathy and systemic vascular comorbidities on mortality.MethodsThis study included 5703 participants (≥40 years old) from the 2005-2008 National Health and Nutrition Examination Survey. The Early Treatment Diabetic Retinopathy Study grading scale was used to evaluate the retinopathy status. Systemic vascular comorbidities included diabetes mellitus (DM), high blood pressure (HBP), chronic kidney disease (CKD) and cardiovascular disease (CVD). Time to death was calculated as the time from baseline to either the date of death or censoring (December 31st, 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models.ResultsAfter adjusting for confounders, the presence of retinopathy predicted higher all-cause mortality (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.09-1.81). The all-cause mortality among participants with both retinopathy and systemic vascular comorbidities including DM (HR, 1.63; 95% CI, 1.06-2.50), HBP (HR, 1.46; 95% CI, 1.03-2.08), CKD (HR, 1.71; 95% CI, 1.24-2.35) and CVD (HR, 1.88; 95% CI, 1.19-2.96) was significantly higher than that among those without either condition.Conclusions/interpretationIn this prospective study, individuals with retinopathy had increased all-cause mortality. The joint effects of retinopathy and major systemic vascular comorbidities increased the all-cause mortality further, suggesting that more extensive vascular risk factor assessment and management are needed to detect the burden of vascular pathologies and improve long-term survival in individuals with retinopathy.Research in contextWhat is already known about this subject?Retinopathy has been recognized as an independent risk factor for mortality.What is the key question?What are the joint effects of retinopathy and systemic vascular comorbidities (including diabetes mellitus, hypertension and chronic kidney disease and cardiovascular disease) on mortality?What are the new findings?Consistent evidence on the increased risk of mortality among individuals with retinopathy was noted in a large sample of middle-aged and older adults.The co-occurrence of retinopathy and systemic vascular conditions (diabetes mellitus, hypertension and chronic kidney disease and cardiovascular disease) further increased all-cause mortality independent of other covariates.How might this impact on clinical practice in the foreseeable future?Individuals with retinopathy may benefit from a comprehensive vascular assessment.Intensive vascular risk reduction is needed in the management of patients with retinopathy and and micro- or macrovascular disorders.Highlighted the importance of retinopathy screening using retinal imaging for identifying individuals at high risk of mortality, particularly among individuals with systemic vascular comorbidities.

scholarly journals COVID-19 in patients with chronic kidney disease stage 5

2021 ◽  
pp. 38-47
Author(s):  
I. Dudar ◽  
E. Krasyuk ◽  
A. Shymova ◽  
Y. Hryhorieva ◽  
M. Malasaiev ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Dialysis Patients ◽  
Duration Of Treatment ◽  
Dialysis Treatment ◽  
Patients With Diabetes

The study aimed to determine the frequency of COVID-19, specific of process and the mortality rate among dialysis patients with COVID-19. Materials and methods: The retrospective study included 764 patients with CKD VD, who received dialysis treatment at the Kyiv City Center for Nephrology and Dialysis, which is the clinical base of the Institute of Nephrology of the National Academy of  Medical  Sciences since September 1, 2020. until December 31, 2020. 155 patients were diagnosed with coronavirus disease. The study was conducted in two stages. In the first stage, dialysis patients with coronavirus disease were divided into groups depending on the severity of the disease. The second stage of the study was determined the influence of age, duration of dialysis treatment, gender, cause of chronic kidney disease VD, obesity, diabetes mellitus and cardiovascular pathology on the course of coronavirus disease, as well as complications and mortality from COVID-19  among the dialysis population. Results: 155 cases of COVID-19 were registered among 764 dialysis patients. Mild coronavirus disease was diagnosed in 38 (24.5%) patients, moderate and severe in 64 (41.3%) and 53 (34.2%) patients, respectively. Oxygen support was required for 76 patients (79%), and artificial lung ventilation was used for 17 (10.9%) patients. Factors associated with severe coronavirus disease in this category of patients were found to be obesity (BMI> 30 kg / m2), diabetes mellitus, concomitant cardiovascular disease, and the need for oxygen support.  In this category of patients, obesity (BMI>30 kg/m2), cardiovascular disease, diabetes mellitus and require supplement oxygen are associated with severe Coronavirus disease COVID-19. There was no significant effect on the severity of coronavirus disease in the age of patients and duration of dialysis treatment. The duration of treatment in patients with diabetes was significantly higher (p <0.05), a direct strong correlation between BMI and duration of treatment was demonstrated. Survival was significantly higher in the group of patients who did not require oxygen support (78% vs. 56%) and had a BMI <30 kg / m2 (87% vs. 37%). Conclusions: the incidence of coronavirus disease among the dialysis cohort was 20.2% of cases. Patients treated with peritoneal dialysis had a significantly lower incidence. Severe coronavirus disease has been associated with obesity, cardiovascular disease, and the need for oxygen support. Men were more likely to have COVID-19 than women. There is no connection between the severe course of coronavirus disease with the age of patients and the duration of dialysis treatment. The duration of treatment of Coronavirus disease in the group of patients with diabetes and high BMI was longer. The following complications predominated in patients with COVID-19: thrombosis of arteriovenous fistula and atrial fibrillation.  During the study period, 20 (12.9%) deaths were registered. Patient survival was higher in the group of patients without oxygen support and with a lower BMI.

scholarly journals Prescribing Trend of Antirheumatic Drugs in Taiwan and Risk of Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Nationwide Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Chien-Ying Lee ◽  
Chih-Jaan Tai ◽  
Ya-Fang Tsai ◽  
Yu-Hsiang Kuan ◽  
Chiu-Hsiang Lee ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Control Group ◽  
Research Database ◽  
Antirheumatic Drugs ◽  
Prescribing Trend

We aimed to investigate the prescribing trend of antirheumatic drugs and assess the risk of cardiovascular disease in patients with rheumatoid arthritis in Taiwan. This study was a retrospective cohort study, conducted based on the Taiwan National Health Insurance Research Database. The study subjects were 15,366 new rheumatoid arthritis patients from 2003 to 2010. To avoid selection bias, we applied propensity score matching to obtain general patients, as the control group. Cox proportional hazard model was used to evaluate the risk of cardiovascular disease in rheumatoid arthritis patients. The most common prescriptions of rheumatoid arthritis were nonsteroidal anti-inflammatory drugs. After controlling for related variables, rheumatoid arthritis patients had a higher risk of cardiovascular disease than general patients (adjusted hazard ratio [aHR] = 1.31; 95% confidence interval [CI]: 1.23-1.39). Age was the most significantly associated risk factor with the cardiovascular disease. Other observed risk factors for cardiovascular disease included hypertension (aHR = 1.57, 95% CI: 1.48-1.65), diabetes mellitus (aHR = 1.47, 95% CI: 1.38-1.57), and chronic kidney disease (aHR = 1.48, 95% CI: 1.31-1.66). Patients with rheumatoid arthritis indeed had a higher risk of incident cardiovascular diseases. Besides, age, hypertension, diabetes mellitus, and chronic kidney disease were also associated with a higher risk of cardiovascular disease.

scholarly journals Markers of endothelial damage in patients with chronic kidney disease on hemodialysis

2017 ◽  
Vol 312 (4) ◽  
pp. F673-F681 ◽  
Author(s):  
Andrés Carmona ◽  
Maria L. Agüera ◽  
Carlos Luna-Ruiz ◽  
Paula Buendía ◽  
Laura Calleros ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Prognostic Markers ◽  
Plasma Concentrations ◽  
Endothelial Damage ◽  
Inflammatory State ◽  
Monocyte Subpopulations ◽  
Elisa Data

Patients with Stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins (Ang) to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (Madrid, Spain): 80 patients with DM and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD142+/CD16+, CD14+/CD162+) were analyzed by flow cytometry, and the plasma concentrations of Ang1 and Ang2 were quantified by ELISA. Data on CVD were gathered over the 5.5 yr after these samples were obtained. MV level, monocyte subpopulations (CD14+/CD162+ and CD142+/CD16+), and Ang2-to-Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) was associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2-to-Ang1 ratio can be used as predictors for CVD. In addition, MV level has a potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.

scholarly journals Immunometabolic Dysregulation at the Intersection of Obesity and COVID-19

2021 ◽  
Vol 12 ◽  
Author(s):  
Collins N. Khwatenge ◽  
Marquette Pate ◽  
Laura C. Miller ◽  
Yongming Sang
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Immune Responses ◽  
Metabolic Disorders ◽  
Acute Infection ◽  
Meta Analyses ◽  
Metabolic Comorbidities ◽  
Interdisciplinary Intervention

Obesity prevails worldwide to an increasing effect. For example, up to 42% of American adults are considered obese. Obese individuals are prone to a variety of complications of metabolic disorders including diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease. Recent meta-analyses of clinical studies in patient cohorts in the ongoing coronavirus-disease 2019 (COVID-19) pandemic indicate that the presence of obesity and relevant disorders is linked to a more severe prognosis of COVID-19. Given the significance of obesity in COVID-19 progression, we provide a review of host metabolic and immune responses in the immunometabolic dysregulation exaggerated by obesity and the viral infection that develops into a severe course of COVID-19. Moreover, sequela studies of individuals 6 months after having COVID-19 show a higher risk of metabolic comorbidities including obesity, diabetes, and kidney disease. These collectively implicate an inter-systemic dimension to understanding the association between obesity and COVID-19 and suggest an interdisciplinary intervention for relief of obesity-COVID-19 complications beyond the phase of acute infection.

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