scholarly journals Cardiovascular Risk Factors in Pre-dialysis Chronic Kidney Disease patients of Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 47-53
Author(s):  
Kashyap Dahal ◽  
A. Baral ◽  
K.K. Sah ◽  
J.R. Shrestha ◽  
A. Niraula ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Traditional Risk Factors

Background and Aims: Cardiovascular disease (CVD) is the commonest cause of morbidity and mortality in patients with chronic kidney disease (CKD) due to increased prevalence of traditional and nontraditional CVD risk factors. Our study aimed to evaluate these risk factors in pre-dialysis Nepalese CKD patients. Methods: This was a cross-sectional study conducted in Department of Nephrology, Bir hospital. Total 100 consecutive pre-dialysis CKD patients were enrolled. Ten traditional and six nontraditional CVD risk factors were analyzed and compared between CKD stages. Descriptive statistics was used to illustrate the socio-demographic and clinical characteristics, chi square test for categorical variables and multiple logistic regression analysis was done to determine the risk factors of CVD in CKD patients. p-value<0.05 was considered to be statistically significant. Results: Mean patient age was 52.03}13.64 years with majority (60%) of the patients being male. Comparison of traditional risk factors in different stages depicted similar trend except for old age in Stage 3 CKD (p=0.002). Anemia (p<0.001), hyperphosphatemia (p=0.01), hyperparathyroidism (p<0.01) and cumulative nontraditional risk factors were significantly higher (p=0.01) in stage 5 CKD. The predicted CVD events by Framingham risk score showed high risk in 37% with no significant difference among the stages. Multiple logistic regression analysis showed increased body mass index, low serum albumin and increased serum phosphate as the three significant predictors for left ventricular hypertrophy. Conclusion: Our study shows that the CVD risk factors were prevailing along the various stages of CKD. The occurrence of non-traditional risk factors increased with increasing stage of CKD.

scholarly journals Hyperuricemia and Associated Factors in Children with Chronic Kidney Disease: A Cross-Sectional Study

Children ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 6
Author(s):  
Jie Xu ◽  
Lingxiao Tong ◽  
Jianhua Mao
Keyword(s):  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Multiple Logistic Regression ◽  
Sectional Study ◽  
Cross Sectional

Background: Hyperuricemia is increasingly recognized as a risk factor for chronic kidney disease (CKD) just in adults. The purpose of this study was to investigate the clinical characteristics of hyperuricemia and its associated factors in Chinese children with CKD at a single center. Methods: A cross-sectional study of 170 CKD children collected from the Department of Nephrology, The Zhejiang University Children’s Hospital was conducted. The clinical data, including anthropometric data, blood pressure measurements, and biochemical parameters, were recorded and analyzed retrospectively. The factors associated with hyperuricemia in CKD children were evaluated by Pearson and Spearman correlation analysis and multiple logistic regression analysis. Results: The mean age was 9.79 ± 4.10 years, and 72 (42.35%) were girls. Higher blood urea nitrogen (BUN), serum creatinine, cystatin C, D-dimer, lower hemoglobin, albumin, and estimated glomerular filtration rate (eGFR) were significantly associated with higher serum uric acid (SUA). In multiple logistic regression analysis, anemia and higher BUN were both positively associated factors, whereas eGFR ≥ 90 mL/min/1.73 m2 was a negatively associated factor for subjects with SUA ≥ 390 µmol/L (6.5 mg/dL). Conclusions: SUA was significantly associated with kidney risk factors in CKD children. Monitoring and controlling SUA, Hb, BUN, and Scr levels in CKD children may help to prevent the progression of CKD.

scholarly journals Association of the location and initial degree of malignant central airway stenosis with the risk of severe restenosis after interventional bronchoscopy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saibin Wang ◽  
Renzhi Zhou ◽  
Siyao Zhu ◽  
Dan Yan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Main Bronchus ◽  
Multiple Logistic Regression Analysis ◽  
Left Main Bronchus ◽  
Multiple Logistic Regression ◽  
Left Main ◽  
Initial Degree ◽  
Central Airway

Abstract Background Therapeutic bronchoscopy is one of the effective methods in the treatment and management of malignant central airway stenosis (MCAS). However, restenosis after therapeutic bronchoscopy frequently occurs and severe restenosis (SR) can be life-threatening. Therefore, this study aimed at investigating the risk factors for SR after therapeutic bronchoscopy. Methods The data of 233 consecutive cases with MCAS who were subjected to therapeutic bronchoscopy between 2015 and 2020 at a tertiary hospital were collected. Patients were divided into SR group and non-SR during 6 months after therapeutic bronchoscopy. Multiple logistic regression analysis was performed to determine the risk factors for SR. Results SR during 6 months after therapeutic bronchoscopy occurred in 39.5% (92/233) of patients. The location and the initial degree of MCAS were associated with SR, as assessed by multiple logistic regression analysis (P < 0.05). The risk of SR after therapeutic bronchoscopy in the left main bronchus, right main bronchus, and right intermediate bronchus increased, compared to the risk when of MCAS was located in the trachea (OR (95% CI) of 8.821 (1.850-25.148), 6.583 (1.791–24.189), and 3.350 (0.831–13.511), respectively). In addition, the initial degree of MCAS was positively associated with an increased risk of SR (OR 1.020; 95% CI 1.006–1.035). Conclusions MCAS located in the left main bronchus, right main bronchus and right intermediate bronchus, as well as the higher initial degree of MCAS were independent risk factors for SR during 6 months after therapeutic bronchoscopy.

Abstract P370: Risk Factors for Progression of Coronary Artery Calcification in Patients with Chronic Kidney Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Joshua D Bundy ◽  
Lawrence J Appel ◽  
Matthew Budoff ◽  
Jing Chen ◽  
Alan S Go ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Cystatin C ◽  
Coronary Artery Calcification ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk

Introduction: Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and predicts the risk of cardiovascular disease (CVD). Risk factors for the progression of CAC in patients with CKD have not been well studied. Hypothesis: We assessed the hypothesis that several established and novel CVD risk factors are associated with progression of CAC among patients with CKD. Methods: In a random subsample of 1,123 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study, CAC was measured at baseline and the follow-up visit using electron beam computed tomography (CT) or multidetector CT. CAC progression was defined as an increase of Agatston score ≥100 units during follow-up. Multiple logistic regression and mixed-effects regression models were used to assess risk factors for progression of CAC. Results: Over an average of 3-year follow-up, 332 (29.6%) participants developed CAC progression. After adjusting for age, sex, race, clinical site, total cholesterol, HDL-cholesterol, systolic blood pressure, antihypertensive treatment, diabetes, and current smoking in the multivariable models, history of CVD (odds ratio [OR] 1.53, 95% CI 1.09-2.15, p=0.02), lipid-lowering treatment (OR 1.81, 95% CI 1.28-2.55, p<0.001), higher serum phosphate (OR 1.37, 95% CI 1.17-1.61, p<0.001), hemoglobin A1c (OR 1.32, 95% CI 1.10-1.58, p=0.002), and cystatin C (OR 1.24, 95% CI 1.06-1.45, p=0.007), and lower estimated-glomerular filtration rate (eGFR) (OR 1.32, 95% CI 1.10-1.56, p=0.002) were associated with CAC progression. In addition, lower physical activity, lipid-lowering treatment, body-mass index, LDL-cholesterol, lower serum calcium, phosphate, total parathyroid hormone, fibrinogen, interleukin-6, tumor necrosis factor-α, fibroblast growth factor-23, lower eGFR, cystatin C, and 24-hour urine albumin were associated with square root transformed change in CAC score from baseline in multiple-adjusted models. These findings persisted after additional adjustment for baseline CAC score. Conclusions: In conclusion, these data suggest that reduced kidney function, calcium and phosphate metabolic disorders and inflammation, in addition to established CVD risk factors, might play a role in CAC progression among patients with CKD.

scholarly journals 447 - Risk factors associated with sleep disturbance in a general elderly Japanese population: The Arao Cohort Study

2020 ◽  
Vol 32 (S1) ◽  
pp. 167-167
Author(s):  
Kazuki Honda ◽  
Tomohisa Ishikawa ◽  
Ryuji Fukuhara ◽  
Seiji Yuki ◽  
Yusuke Miyagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Sleep Disturbance ◽  
Logistic Regression Analysis ◽  
Barthel Index ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Factors Associated

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.

scholarly journals Predictive Value of Creatinine-based Equations of Kidney Function in the Long-term Prognosis in United Arab Emirates Patients

2021 ◽  
Vol 36 (1) ◽  
pp. e217-e217
Author(s):  
Saif Al-Shamsi ◽  
Romona D. Govender ◽  
Jeffrey King
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Mortality Prediction ◽  
The Body ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Objectives: Chronic kidney disease (CKD) is an independent predictor of mortality. Several creatinine-based equations are used to assess the estimated glomerular filtration rate or creatinine clearance and mortality prediction in various ethnic populations. Similarly, renal insufficiency is associated with poor prognosis of UAE nationals with cardiovascular disease (CVD) risk factors. However, the equation that best assesses prognosis among these patients is unknown. This study aimed to compare the prognostic abilities of different creatinine-based kidney function equations for predicting all-cause mortality in UAE nationals with vascular comorbidities. Methods: This retrospective observational study analyzed 1186 patients (54.0% men) with CVD risk factors. Multivariable Cox regression analysis was used to evaluate the associations of categorical renal function stages with all-cause mortality. Measures of performance in each equation assessed with respect to all-cause mortality were evaluated and compared to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation by calculating the C-index, net reclassification index (NRI), and integrated discrimination index. Results: Over a median follow-up of 8.9 years, the cumulative incidence of all-cause mortality was 9.4% (n = 112). After multivariable adjustment, the discriminative ability for all-cause mortality was significantly higher in the body surface area-adjusted Cockcroft-Gault (BSA-CG) formula than in the CKD-EPI equation (C-indices: 0.869 vs. 0.861, respectively, p =0.037). NRI was significantly positive and favored the BSA-CG formula (0.54; 95% confidence interval: 0.35–0.64) compared to the CKD-EPI equation. Conclusions: Our findings suggest that the BSA-CG equation may have the potential to slightly improve mortality prediction compared to the CKD-EPI equation in UAE nationals with vascular risk. Further large multicenter studies are warranted to confirm our findings.

Prevalence of atheromatous and non-atheromatous cardiovascular disease by age in chronic kidney disease

2018 ◽  
Vol 35 (5) ◽  
pp. 827-836 ◽  
Author(s):  
Cédric Villain ◽  
Marie Metzger ◽  
Christian Combe ◽  
Denis Fouque ◽  
Luc Frimat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Age Groups ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Disease Epidemiology ◽  
Artery Disease

Abstract Background Although chronic kidney disease (CKD) and age are major risk factors for cardiovascular disease (CVD), little is known about the relative proportions of atheromatous and non-atheromatous CVD by age in CKD patients. Methods We used baseline data from the French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort of 3033 patients (65% men) with CKD Stages 3–4 to study crude and adjusted associations between age, the estimated glomerular filtration rate (eGFR), atheromatous CVD (coronary artery disease, peripheral artery disease and stroke) and non-atheromatous CVD (heart failure, cardiac arrhythmia and valvular heart disease). Results Mean age was 66.8 and mean Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR was 32.9 mL/min/1.73 m2. In the &lt;65, (65–74), (75–84) and ≥85 year age groups, the prevalence was, respectively, 18.7, 35.5, 42.9 and 37.8% for atheromatous CVD, and 14.9, 28.4, 38.1 and 56.4% for non-atheromatous CVD. After adjusting for albuminuria, sex and CVD risk factors, the odds ratio (OR) [95% confidence interval (CI)] for (65–74), (75–84) and ≥85 age groups (compared with the &lt;65 group) was, respectively, 1.99 (1.61–2.46), 2.89 (2.30–3.62), 2.72 (1.77–4.18) for atheromatous CVD and 2.07 (1.66–2.58), 3.15 (2.50–3.97), 7.04 (4.67–10.61) for non-atheromatous CVD. Compared with patients with an eGFR ≥30 mL/min/1.73 m2, those with an eGFR &lt;30 mL/min/1.73 m2 had a higher OR for atheromatous CVD [1.21 (1.01–1.44)] and non-atheromatous CVD [1.16 (0.97–1.38)]. Conclusions In this large cohort of CKD patients, both atheromatous and non-atheromatous CVD were highly prevalent and more frequent in older patients. In a given age group, the prevalence of atheromatous and non-atheromatous CVD was similar (except for a greater prevalence of non-atheromatous CVD after 85).

scholarly journals The feasibility of colorectal endoscopic submucosal dissection for the treatment of residual or recurrent tumor localized in therapeutic scar tissue

2017 ◽  
Vol 05 (12) ◽  
pp. E1242-E1250 ◽  
Author(s):  
Ryosuke Kobayashi ◽  
Kingo Hirasawa ◽  
Ryosuke Ikeda ◽  
Takeh de Fukuchi ◽  
Yasuaki Ishii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Time ◽  
Multiple Logistic Regression Analysis ◽  
Scar Tissue ◽  
Prolonged Treatment ◽  
Multiple Logistic Regression ◽  
Colorectal Tumors ◽  
High Risk Factors

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is used to treat superficial colorectal tumors. Previous studies have reported the efficacy of ESD for treating residual or local recurrent colorectal tumors. This study sought to evaluate the efficacy of ESD in treating these lesions and to assess factors that prevent successful ESD. Methods This retrospective study assessed 25 cases of residual or local recurrent lesions that were previously treated using EMR (18 lesions), TEM (5 lesions), ESD (1 lesion) or surgery (1 lesion), and 459 primary lesions treated using ESD between April 2008 and September 2015. Clinicopathological characteristics, treatment outcome and adverse events were compared between groups with or without scar tissue. Factors related to perforation and a prolonged treatment time, which indicate the likelihood of technical difficulties, were identified using multiple logistic regression analysis. Results In residual or local recurrent lesions groups, patients experienced more perforations (32 % vs 4 %, P < 0.001) and required a longer treatment time (117 min vs 61 min, P < 0.001) compared with the primary lesions group. Both groups showed a similar curative resection rate. Emergency surgery was not needed in any case. Multiple logistic regression analysis indicated that tumor location and therapeutic scar tissue were high risk factors for perforation, and that large tumor size and therapeutic scar tissue were high risk factors for prolonged treatment time. Conclusions ESD for residual or local recurrent colorectal tumors is a technically challenging, but effective and minimally invasive treatment. When performed carefully with sufficient proficiency, it is a useful treatment option.

scholarly journals Stunting Among Under 5-Year-Olds in Nepal: Trends and Risk Factors

2019 ◽  
Vol 24 (S1) ◽  
pp. 39-47 ◽  
Author(s):  
Shyam Sundar Budhathoki ◽  
Amit Bhandari ◽  
Rejina Gurung ◽  
Abhishek Gurung ◽  
Ashish KC
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Nutritional Status ◽  
Logistic Regression Analysis ◽  
Health Surveys ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Multiple Factors ◽  
Children Under 5

Abstract Introduction The nutritional status in the first 5 years of life has lifelong and inter-generational impacts on individual’s potential and development. This study described the trend of stunting and its risk factors in children under 5 years of age between 2001 and 2016 in Nepal. Methods The study used datasets from the 2001, 2006, 2011 and 2016 Nepal Demographic Health Surveys to describe the trend of stunting in under 5-year children. Multiple logistic regression analysis was carried out to assess the risk factors for stunting at the time of the four surveys. Results The nutritional status of under 5-year children improved between 2001 and 2016. Babies born into poorer families had a higher risk of stunting than those born into wealthier families (AOR 1.51, CI 95% 1.23–1.87). Families residing in hill districts had less risk of stunting than those in the Terai plains (AOR 0.75, CI 95% 0.61–0.94). Babies born to uneducated women had a higher risk of stunting than those born to educated women (AOR 1.57, CI 95% 1.28–1.92). Discussion Stunting among under-5-year children decreased in the years spanning 2001–2016. This study demonstrated multiple factors that can be addressed to decrease the risk of stunting, which has important implications for neurodevelopment later in life. We add literature on risk factors for stunting in under-5-year children.

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