scholarly journals Association of malnutrition with renal function in children with kidney disease

2021 ◽  
Vol 17 (3) ◽  
pp. 100-106
Author(s):  
Resty Varia Tutupoho ◽  
Ninik Asmaningsih ◽  
Risky Vitria Prasetyo
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Inclusion Criteria ◽  
Moderate Malnutrition ◽  
Children Under 5

Background: Malnutrition is a serious and lasting burden worldwide. Woman, infants, children, and adolescents are at particular risk of malnutrition. Prevalence of malnutrition children under 5 years in 2020 was 45 million were estimated to be wasted, and 38.9 million were overweight or obese. Around 45% of deaths among children under 5 years old were related to undernutrition, especially in low- and middle-income countries. Children with kidney disease was a risk factor to become a malnutrition. Malnutrition increases morbidity and mortality in children with kidney disease. Earlier studies showed a high prevalence rate of malnutrition in children with chronic kidney disease. Objectives: The aim of the study to associate malnutrition with renal function in children with kidney disease. Methods: A cross-sectional study was conducted on children with kidney disease aged 2-17 years who met the inclusion criteria who were hospitalized at the Inpatient Department/SMF Department of Child Health Sciences, Dr. Hospital. Soetomo, Surabaya from October to December 2020 after taking approval from parents and institutional ethics committee in the department of Pediatrics. Detailed anthropometric measurements were taken and grading of malnutrition was calculated according to WHO, CDC, and Waterlow criteria. Serum creatinine was measured for each sample. Results: There were 157 samples met the inclusion criteria. Sex between male and female almost balanced (54.8%:45.2%) and the median age was 13 years-old. The most frequent diagnosis in this group was lupus nephritic (68%). Forty eight percent of total samples were malnutrition, which most of them were moderate malnutrition. Estimated glomerular filtration rate of moderate malnutrition was normal in 12 (23.5%) cases, decreased in 39 (76.5%) cases. A significant statistically was showed between malnutrition with severe estimated glomerular filtration rate (P 0.000) Conclusions: Malnutrition was a common finding in nutritional status of children with kidney disease. There was a correlation between nutritional status and renal function in children with kidney disease.

scholarly journals Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly

2021 ◽  
Author(s):  
Samel Park ◽  
Nam‐Jun Cho ◽  
Nam Hun Heo ◽  
Eun‐Jung Rhee ◽  
Hyowook Gil ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Vascular Calcification ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Tertiary Teaching

Background The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS). Methods and Results Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m 2 ) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5–8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted‐β, −0.40; 95% CI, −0.80 to −0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13–5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance ( P =0.004). Conclusions Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.

The Prevalence of Chronic Kidney Disease in Rheumatology Outpatients

2009 ◽  
Vol 54 (2) ◽  
pp. 9-12 ◽  
Author(s):  
AJ Hill ◽  
RJ Thomson ◽  
JA Hunter ◽  
JP Traynor
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Prevalence Rate ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Monthly Basis ◽  
Definition Of

Background The introduction of routine reporting of estimated glomerular filtration rate coupled with a new definition of chronic kidney disease (CKD) has led to an unprecedented focus on kidney disease in many patient groups. In light of this, we performed an audit of patients attending the rheumatology clinics to assess the prevalence of CKD in this population. Methods Over a four week period, we reviewed the renal function of all patients attending the rheumatology clinics and day ward at our hospital (n=351). Renal function was assessed using the 4-variable MDRD formula. We then interviewed those patients with estimated glomerular filtration rate (eGFR) of 59 ml/min or lower. Results We found a prevalence rate of 18% for stage 3 CKD or lower in our audit population. Surprisingly, 60.3% of patients in this category were not aware of any problems with their kidneys (n=38). Conclusions The prevalence rate of 18% for stage 3 CKD or lower is significantly higher than the five per cent reported within the general population. As a result of this audit, we now plan to ensure that these patients undergo measurement of blood pressure, eGFR, and urinalysis on a six to twelve monthly basis.

scholarly journals Variability in Estimated Glomerular Filtration Rate by Area under the Curve Predicts Renal Outcomes in Chronic Kidney Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Szu-Chia Chen ◽  
Ming-Yen Lin ◽  
Teng-Hui Huang ◽  
Chi-Chih Hung ◽  
Yi-Wen Chiu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Cox Model ◽  
Renal Outcomes ◽  
End Point

Greater variability in renal function is associated with mortality in patients with chronic kidney disease (CKD). However, few studies have demonstrated the predictive value of renal function variability in relation to renal outcomes. This study investigates the predictive ability of different methods of determining estimated glomerular filtration rate (eGFR) variability for progression to renal replacement therapy (RRT) in CKD patients. This was a prospective observational study, which enrolled 1,862 CKD patients. The renal end point was defined as commencement of RRT. The variability in eGFR was measured by the area under the eGFR curve (AUC)%. A significant improvement in model prediction was based on the −2 log likelihood ratio statistic. During a median 28.7-month follow-up, there were 564 (30.3%) patients receiving RRT. In an adjusted Cox model, a smaller initial eGFR AUC%_12M (P<0.001), a smaller peak eGFR AUC%_12M (P<0.001), and a larger negative eGFR slope_12M (P<0.001) were associated with a higher risk of renal end point. Two calculated formulas: initial eGFR AUC%_12M and eGFR slope_12M were the best predictors. Our results demonstrate that the greater eGFR variability by AUC% is associated with the higher risk of progression to RRT.

Pathophysiological impact of serum fibroblast growth factor 23 in patients with nonischemic cardiac disease and early chronic kidney disease

2014 ◽  
Vol 307 (10) ◽  
pp. H1504-H1511 ◽  
Author(s):  
Miki Imazu ◽  
Hiroyuki Takahama ◽  
Hiroshi Asanuma ◽  
Akira Funada ◽  
Yasuo Sugano ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Growth Factor ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Fibroblast Growth Factor ◽  
Cardiac Disease ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Fibroblast Growth

Although the important role of fibroblast growth factor (FGF)23 on cardiac remodeling has been suggested in advanced chronic kidney disease (CKD), little is known about serum (s)FGF23 levels in patients with heart failure (HF) due to nonischemic cardiac disease (NICD) and early CKD. The present study aimed to investigate sFGF23 levels in NICD patients and identify the responsible factors for the elevation of sFGF23 levels. We prospectively measured sFGF23 levels in consecutive hospitalized NICD patients with early CKD (estimated glomerular filtration rate ≥ 40 ml·min−1·1.73 m−2) and analyzed the data of both echocardiography and right heart catheterization. Of the 156 NICD patients (estimated glomerular filtration rate range: 41–128 ml·min−1·1.73 m−2), the most severe HF symptom (New York Heart Association class III-IV, 53% vs. 33%, P = 0.015) was found in the above median sFGF23 (39.1 pg/ml) group compared with the below median sFGF23 group. sFGF23 levels were higher in patients with HF hospitalization history compared with those without HF [median: 46.8 (interquartile range: 38.8–62.7) vs. 34.7 (interquartile range: 29.6–42.4) pg/ml, P < 0.0001]. In the multivariate analysis, HF hospitalization was independently related to elevated sFGF23 levels ( P = 0.022). Both systolic dysfunction and high plasma aldosterone concentration were identified as predictors of high sFGF23 levels ( P < 0.05). Among the neurohormonal parameters, elevated sFGF23 levels were the only factor to predict a declining left ventricular ejection fraction ( P = 0.001). These findings suggest that the progression of HF per se contributes to the elevation of sFGF23 levels even in the early stages of CKD, which leads to further myocardial dysfunction, potentially creating a vicious cycle.

Abstract 6277: Predictive Value of Estimated Glomerular Filtration Rate for Cardiovascular Events: The Treating to New Targets Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
James Shepherd ◽  
Chuan-Chuan Wun ◽  
Daniel J Wilson ◽  
Andrea L Zuckerman
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cardiovascular Events ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Lipid Lowering ◽  
Final Visit ◽  
The Relationship ◽  
Dose Dependent

We previously demonstrated a dose-dependent improvement in renal function and reduction in cardiovascular risk in TNT with intensive lipid lowering with atorvastatin (ATV) 80 mg vs 10 mg. This post hoc analysis examines the relationship between the observed improvement in estimated glomerular filtration rate (eGFR) and reduction of major cardiovascular events (MCVE). After 8 weeks open-label therapy with ATV 10 mg, 10,001 patients with CHD were randomized to double-blind therapy with either ATV 10 or 80 mg. Patients were followed for a median of 4.9 years for the occurrence of MCVEs (CHD death, nonfatal MI, and stroke). The relationship between change from baseline eGFR (using the MDRD equation) at the final visit prior to a MCVE and the risk of MCVE was assessed using a Cox proportional hazards model adjusting for baseline eGFR and other baseline characteristics. Of 9656 patients with complete renal data, 156 had a MCVE before follow-up eGFR assessment and were excluded. In the remaining 9500 patients, mean baseline eGFR was 65.3 mL/min/1.73 m 2 and mean change from baseline was 4.3 mL/min/1.73 m 2 . This represented a reduction in the risk of MCVE of 2.7% per mL increase in eGFR (HR 0.973, 95% CI 0.967– 0.980, P <0.0001). This association remained significant in patients with eGFR <60 and those with eGFR ≥60 mL/min/1.73 m 2 at baseline, with no significant interaction between eGFR change and baseline renal status ( P =0.98). A 5 mL/min on-treatment improvement in eGFR was associated with a 12.6% reduction in MCVE, while a 5 mL/min reduction was associated with a 14.4% increase in MCVE. Mean change from baseline eGFR was 3.5 mL/min/1.73 m 2 with ATV 10 mg and 5.2 mL/min/1.73 m 2 with ATV 80 mg, representing significant 9.3% and 12.4% reductions in risk, respectively. Analysis of interaction between treatment and eGFR change for prediction of MCVE demonstrated a stronger association between eGFR change and MCVE in the ATV 80 mg treatment group ( P =0.011). Improvement in eGFR was highly associated with a reduction in MCVE, irrespective of baseline renal function. This relationship was dose dependent. Improvement in eGFR may be a biomarker for the response to atorvastatin, and for the stabilization of atherosclerotic cardiovascular disease.

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