scholarly journals Factors associated with chronic kidney disease of non-traditional causes among children in Guatemala

2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Alejandro Cerón ◽  
Brooke M. Ramay ◽  
Luis Pablo Méndez-Alburez ◽  
Randall Lou-Meda
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Large Scale ◽  
Pediatric Nephrology ◽  
Urban Setting ◽  
Future Research ◽  
Small Scale ◽  
Disease Etiology ◽  
Factors Associated ◽  
Household Characteristics

Objective.To identify factors associated with chronic kidney disease of non-traditional causes among children in Guatemala.Methods.A cross-sectional survey was conducted. The study population was all pediatric patients with stage 5 chronic kidney disease active in FUNDANIER’s pediatric nephrology unit (N = 156). Simple random sampling led to a total of 100 participants. Data collection consisted of a questionnaire addressing individual and household characteristics, access and utilization of health care, and place of residence when the disease began. Chronic kidney disease etiology was obtained from medical records. Municipality-level secondary data were collected. Descriptive statistics were estimated. Logistic regression was used for bivariate and multivariate analysis.Results.The odds ratio (OR) for almost all variables approached 1. Notable exceptions in household characteristics were mother’s education level up to primary school (OR 2.2727) and living in an urban setting when symptoms began (OR 0.4035). Exceptions in municipal characteristics are zones with intensive small-scale agriculture (OR 3.8923) and those with intensive large-scale agriculture (OR 0.3338). P-values and confidence intervals show that the sample was not big enough to capture statistically significant associations between variables.Conclusions.Study findings suggest that factors associated with chronic kidney disease of non-traditional causes among children in Guatemala are intensive agricultural practices in their municipality of residence, and mother’s level of education. Future research in children could use case-control designs or population-based studies in agricultural communities. Public health interventions that involve kidney function screening among children are recommended.

Chronic kidney disease long-term outcomes

2015 ◽  
Author(s):  
Monica Beaulieu ◽  
Catherine Weber ◽  
Nadia Zalunardo ◽  
Adeera Levin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Future Research ◽  
Long Term Outcomes ◽  
Ckd Progression ◽  
Factors Associated ◽  
Specific Outcome

Chronic kidney disease (CKD) is associated with a variety of outcomes, some of which are directly and indirectly related to kidney disease, but which ultimately impact on patients’ quality of life and long-term outcomes. The events to which people with CKD are exposed ultimately determine their risk and prognosis of both progression to needing renal replacement therapy, or other morbidities and mortalities. The notion of competing risk is important. The five major outcomes of CKD are: progression of CKD, progression to ESRD (either dialysis or transplantation); death; cardiovascular events; infections; and hospitalizations. Where data is available, not only the risk of the specific outcome, but the factors which may predict those outcomes are described. Each section describes what is currently known about the frequency of the outcome, the limitations of that knowledge, the risk factors associated with outcome, and implications for care and future research. Available published literature often describes outcomes in CKD populations as if it is a homogenous group of patients. But it is well documented that outcomes in those with CKD differ depending on stage or severity, and whether they are or are not known to specialists. Where possible, each section ensures that the specific CKD cohort(s) from which the information is derived is clearly described.

scholarly journals Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients

2021 ◽  
Vol 18 (15) ◽  
pp. 7806
Author(s):  
Patricia Tomás-Simó ◽  
Luis D’Marco ◽  
María Romero-Parra ◽  
Mari Carmen Tormos-Muñoz ◽  
Guillermo Sáez ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Reduced Glutathione ◽  
Genetic Material ◽  
Future Research ◽  
Control Group ◽  
Dialysis Patients ◽  
Early Stages ◽  
Molecular Lines

Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease in dialysis patients. Methods: We evaluated the oxidation process in different molecular lines (proteins, lipids and genetic material) in 155 non-dialysis patients at different stages of CKD and 45 healthy controls. To assess oxidative stress status, we analyzed oxidized glutathione (GSSG), reduced glutathione (GSH) and the oxidized/reduced glutathione ratio (GSSG/GSH) and other oxidation indicators, including malondialdehyde (MDA) and 8-oxo-2’-deoxyguanosine (8-oxo-dG). Results: An active grade of oxidative stress was found from the early stages of CKD onwards, which affected all of the molecular lines studied. We observed a heightened oxidative state (indicated by a higher level of oxidized molecules together with decreased levels of antioxidant molecules) as kidney function declined. Furthermore, oxidative stress-related alterations were significantly greater in CKD patients than in the control group. Conclusions: CKD patients exhibit significantly higher oxidative stress than healthy individuals, and these alterations intensify as eGFR declines, showing significant differences between CKD stages. Thus, future research is warranted to provide clearer results in this area.

scholarly journals The individualized, accompanied transition program “TraiN” for adolescent kidney patients – a local initiative

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Paula Collette ◽  
Luisa C. Klein ◽  
Lisa M. Körner ◽  
Gundula Ernst ◽  
Sandra Brengmann ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Management ◽  
Health Risks ◽  
Pediatric Nephrology ◽  
Young Patients ◽  
Transition Program ◽  
University Hospital ◽  
Adult Care ◽  
Local Initiative

Abstract Since the transition from pediatric and adolescent to adult care often proceeds unaccompanied and unplanned, young patients with chronic kidney disease may experience health risks and non-adherence after the transfer. The psychosocial team at the Department of Pediatric Nephrology at the University Hospital of Cologne has therefore developed its local transition program “TraiN” for patients with chronic kidney disease aged 13 years and older. It combines structure and flexibility through predefined content modules that can be individually adapted to the patients, offering continuity and sustainability through a transition contact person. In addition, the family members are offered regular psychological consultations. The timing of the transfer is chosen individually depending on the level of psychosocial and medical transition readiness. The aim of “TraiN” is to strengthen the patients’ transition competence and the responsibility for their disease management and to provide them and their families the best possible support during the transition in order to prevent possible health risks. In the near future, a scientific evaluation will be conducted aiming to determine whether “TraiN” can support young people in their independence and self-reliant disease management.

scholarly journals Vitamin D (25 ( OH) D ) in patients with chronic kidney disease stages 2-5

2016 ◽  
pp. 160-166 ◽  
Author(s):  
César Augusto Restrepo Valencia ◽  
Jose Vicente Aguirre Arango
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Statistical Methods ◽  
Laboratory Tests ◽  
Chronic Kidney Disease Stage ◽  
Sun Exposure ◽  
Disease Stage ◽  
Disease Etiology ◽  
Vitamin D Levels

Objective: To determine whether patients with chronic kidney disease (CKD) without dialysis their stage impacts the native vitamin D levels. Methods: Patients over 18 years with chronic kidney disease stage 2-5 without dialysis treatment. They demographic, anthropometric variables, degree of sun exposure, disease etiology and laboratory variables related to bone and mineral disorders were evaluated. Study analytical cross-sectional prospective. Descriptive statistical methods for quantitative and qualitative are characterized, and analytical correlation between levels of vitamin D statistical laboratory tests related to bone and mineral disorders, sun exposure and ethnicity variables for each stage were characterized. By descriptive statistical methods, quantitative and qualitative variables were characterized, and analytical statistical correlation between levels of vitamin D with laboratory tests related to bone and mineral disorders, sun exposure and ethnicity for each stage were practiced. Results: 331 patients were evaluated, with a mean age of 71 years, the mestizo majority (71%), 173 women, main etiology of CKD hypertensive nephropathy (33.2%). 21.1% of patients had normal levels of vitamin D, 70.1% insufficient, and 8.8% in deficit. Negative correlation was detected between the levels of vitamin 25(OH)D and serum creatinine, phosphorus, calcium x phosphorus product, PTH, proteins in urine 24 hours and BMI. Positive correlation for calcium and albumin. Positive statistical significance between the levels of vitamin 25(OH)D and sun exposure for 3b and 4 stages was found. Conclusions: In patients with CKD is common to detect low levels of vitamin 25(OH)D, which can contribute to the generation of secondary hyperparathyroidism.

scholarly journals The Accuracy of Emergency Physicians’ Suspicions of Active Pulmonary Tuberculosis

2021 ◽  
Vol 10 (4) ◽  
pp. 860
Author(s):  
Shiang-Jin Chen ◽  
Chun-Yu Lin ◽  
Tzu-Ling Huang ◽  
Ying-Chi Hsu ◽  
Kuan-Ting Liu
Keyword(s):  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Kidney Disease ◽  
Pulmonary Tuberculosis ◽  
General Ward ◽  
Chest Radiographs ◽  
Emergency Physicians ◽  
Active Pulmonary Tuberculosis ◽  
Factors Associated ◽  
History Of

Objective: To investigate factors associated with recognition and delayed isolation of pulmonary tuberculosis (PTB). Background: Precise identification of PTB in the emergency department (ED) remains challenging. Methods: Retrospectively reviewed PTB suspects admitted via the ED were divided into three groups based on the acid-fast bacilli culture report and whether they were isolated initially in the ED or general ward. Factors related to recognition and delayed isolation were statistically compared. Results: Only 24.94% (100/401) of PTB suspects were truly active PTB and 33.77% (51/151) of active PTB were unrecognized in the ED. Weight loss (p = 0.022), absence of dyspnea (p = 0.021), and left upper lobe field (p = 0.024) lesions on chest radiographs were related to truly active PTB. Malignancy (p = 0.015), chronic kidney disease (p = 0.047), absence of a history of PTB (p = 0.013), and lack of right upper lung (p ≤ 0.001) and left upper lung (p = 0.020) lesions were associated with PTB being missed in the ED. Conclusions: Weight loss, absence of dyspnea, and left upper lobe field lesions on chest radiographs were related to truly active PTB. Malignancy, chronic kidney disease, absence of a history of PTB, and absence of right and/or left upper lung lesions on chest radiography were associated with isolation delay.

scholarly journals Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Salisu M. Ishaku ◽  
Timothy Olusegun Olanrewaju ◽  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Gbenga A. Kayode ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gestational Hypertension ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

scholarly journals Risk factors associated with valvular calcification in patients with chronic kidney disease. Analysis of NEFRONA study

2021 ◽  
Vol 41 (3) ◽  
pp. 337-346
Author(s):  
Lidia Martínez Fernández ◽  
J. Emilio Sánchez-Alvarez ◽  
César Morís de la Tassa ◽  
José Joaquín Bande Fernández ◽  
Virtudes María ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Factors Associated ◽  
Valvular Calcification ◽  
Disease Analysis

scholarly journals Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Renoprotective Mechanisms beyond Glycemic Control

2021 ◽  
Vol 22 (9) ◽  
pp. 4374
Author(s):  
Tomoaki Takata ◽  
Hajime Isomoto
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Kidney Injury ◽  
Sglt2 Inhibitors ◽  
Pleiotropic Effects ◽  
Future Research ◽  
Diabetic Patients ◽  
Sodium Glucose Cotransporter ◽  
Stage Renal Disease

Diabetes mellitus is a major cause of chronic kidney disease and end-stage renal disease. However, the management of chronic kidney disease, particularly diabetes, requires vast improvements. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally developed for the treatment of diabetes, have been shown to protect against kidney injury via glycemic control, as well as various other mechanisms, including blood pressure and hemodynamic regulation, protection from lipotoxicity, and uric acid control. As such, regulation of these mechanisms is recommended as an effective multidisciplinary approach for the treatment of diabetic patients with kidney disease. Thus, SGLT2 inhibitors are expected to become key drugs for treating diabetic kidney disease. This review summarizes the recent clinical evidence pertaining to SGLT2 inhibitors as well as the mechanisms underlying their renoprotective effects. Hence, the information contained herein will advance the current understanding regarding the pleiotropic effects of SGLT2 inhibitors, while promoting future research in the field.

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