scholarly journals Correlation of Uric Acid with Glomerular Filtration Rate in Chronic Kidney Disease

2018 ◽  
Vol 56 (212) ◽  
pp. 724-727 ◽  
Author(s):  
Milan Khadka ◽  
Binod Pantha ◽  
Lochan Karki

Introduction: Chronic Kidney Disease is a worldwide public health problem that affects millions of people from all racial and ethnic groups. Identification of a Chronic Kidney Disease is a major risk factor for cardiovascular morbidity and mortality and is attributed to hyperuricemia. Evidences show that high serum uric acid contribute directly to glomerulosclerosis, interstitial fibrosis and atherosclerosis that correction of hyperuricemia associated with Chronic Kidney Disease will slow the progression of chronic renal failure.  Methods: A hospital based cross-sectional study on chronic kidney disease patients including 57 patients on conservative treatment attending Bir Hospital with diagnosis of chronic kidney disease was performed. Detailed clinical history, examination and investigations including uric acid were done. Chronic Kidney Disease staging was done according to estimated glomerular filtration rate estimated by Cockcroft-Gault equation. Prevalence rate of hyperuricemia in Chronic Kidney Disease and its stages were calculated and compared with each other. Results: A total of 57 Chronic Kidney Disease cases were enrolled, with male to female ratio of 2:1 and mean age 51.63±17.75 years. Hyperuricemia was present in 55 (96.49%) of study population. Though prevalence of hyperuricemia increased with Chronic Kidney Disease stage, there was no significant difference in mean value of uric acid in different stages. Hyperuricemia and stages of Chronic Kidney Disease had negative correlation which was statistically significant. Conclusions: Hyperuricemia is highly prevalent among Chronic Kidney Disease patients with conservative management. The severity of hyperuricemia increases as Chronic Kidney Disease stage progresses.

2013 ◽  
Vol 154 (11) ◽  
pp. 415-425
Author(s):  
Ferenc Kovács ◽  
Enikő Sárváry ◽  
Ádám Remport

Introduction: The degree of glomerular filtration rate determines the stages of chronic renal disease and, therefore, knowledge on its estimation is essential. Aims: Two standardized creatinine based estimated glomerular filtration rate equations and five equations based on the immunoturbidimetric determination of cystatin C were compared. Methods: The distribution of the analytes and the equations, their relations, as well as the differences among the estimated glomerular filtration rates and their chronic kidney disease stages assignments were studied. Results: The equations based on cystatin C classified more patient into stage 1, while the creatinine based ones more into stages 2, 3 and 4. The equations published as Grubb1, Grubb2 and Larsson classified more patients while the equations created by Tan and Sjöström classified fewer into stage 5 compared to the creatinine based equations. The equations of Grubb1 and Grubb2 resulted in the most similar stage assignment. The occurence of stages between 3 and 5 was the lowest using the equation of Sjöström. Conclusions: The different equations for the estimation of glomerular filtration rate modify significantly the chronic kidney disease stage assignment which may have an influence on the treatment and outcome measures of the patients. Orv. Hetil., 2013, 154, 415–425.


2018 ◽  
Vol 3 (2) ◽  
pp. 403-407
Author(s):  
Anusmriti Pal ◽  
Laxman Mandal

Introduction: Chronic Kidney Disease (CKD) is a progressive loss in renal function over period of many months or years. As compared to the past decades, the number of kidney diseases leading to end CKD is increasing in Nepal. The disease is associated with the decreased glomerular filtration rate (GFR). There is decline in nephron function and number generally quantitated as reduction in glomerular filtration rate. As the GFR declines, there is accumulation of metabolic end products excreted by Kidney. Chronic kidney disease is identified by blood tests, creatinine and urea are two such substances routinely measured. Serum amylase is a pancreatic digestive enzyme that normally acts extracellular to cleave starch into smaller carbohydrate groups and, finally, into monosaccharide's. It is produced by 40-45% from the pancreas and (45%) reabsorbed by tubular cells. Elevations in serum total amylase among patients with CKD is due to impaired renal clearance and seen mostly when the creatinine clearance is below 50 ml/min. Several studies have been reported on this but there are no studies that have been done so far in Nepalese context.Objectives: This study is designed to correlate serum amylase with CKD stage three to stage five in patients of chronic renal disease irrespective of hemodialysis and prevalence of risk factors of CKD and different factors that may affect the level of serum amylase in patients presenting to Bir Hospital Nephrology department, Nepal.Methods: The study was a cross-sectional, observational, descriptive, hospital based carried out in Nephrology Unit of Bir hospital both inpatient or outpatient irrespective of hemodialysis from March 2014 to March 2015. Patients with increased serum amylase due to acute Pancreatitis, Mumps, Intestinal Obstruction, Peptic Ulcer, Cancer, other than renal cause were excluded. The results were analyzed using SPSS version 11 and Microsoft Excel by correlation coefficient. Result: Present study shows that among 126 patients, the prevalence of age group was from 15 years to 78 years with majority being male. The serum amylase levels were significantly higher in Chronic Kidney Disease Stage V with significant p-value. At 80-100 Serum Amylase level had strong correlation of 0.504 for CKD III stage and significant at 10 percent level. The correlation between CKD IV at 80-100 was significant at 10 percent but weak of 0.189. Whereas, CKD V was highly significant but negative at more than 161 Serum Amylase.Conclusion: From the study it was concluded that in Chronic Kidney Disease, Serum amylase was found to be higher as the eGFR decreases. BJHS 2018;3(2)6:403-407. 


2018 ◽  
Vol 72 ◽  
pp. 108-115
Author(s):  
Paweł Wróbel ◽  
Rafał Januszek ◽  
Władysław Sułowicz

Introduction: The diagnosis and classification of chronic kidney disease (CKD) are based on the glomerular filtration rate value. The simplest way to evaluate glomerular filtration rate is to estimate it based on serum creatinine concentration using one of many specific mathematical formulas. None of the formulas created for this purpose are perfect. Differences in eGFR values are frequently observed in specific stages of chronic kidney disease by KDIGO classification based on different formulas. Aim: The aim of the study is to compare the eGFR value in patients previously diagnosed with CKD treated in the Outpatient Nephrology Unit of the University Hospital in Krakow using the selected formulas. Material/Methods: The study was performed in a group of 882 patients (392 women, 490 men) aged 65.0 ± 14.8 years. GFR values were estimated using Bjornsson, the abbreviated MDRD, and CKD-EPI formulas. These values were then compared according to chronic kidney disease stage and age groups: above and below 60 years. Results: The mean eGFR value was for Bjornsson formula- 47.2 ± 21.1 ml/min/1.73m2, abbreviated MDRD formula- 38.8 ± 15.2 ml/min/1.73m2, and CKD-EPI formula- 37.7 ± 15.9 ml/min/1.73m2. There was a large concordance in eGFR values obtained using the CKD-EPI and abbreviated MDRD formulas in every stage of chronic kidney disease and in both age groups. The Bjornsson formula significantly increased the number of patients in early stages of CKD, G1 - 33 vs 2 (abbreviated MDRD) and 6 (CKD-EPI), G2- 186 vs 70 (abbreviated MDRD) and 69 (CKD-EPI). Conclusions: CKD-EPI and abbreviated MDRD formulas have a similar usefulness in GFR value estimation in patients with diagnosed chronic kidney disease. Lower eGFR values achieved using abbreviated MDRD formula and CKD-EPI equation in comparison with Bjornsson’s formula may result in an increased number of patients diagnosed with CKD.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245619
Author(s):  
Théo Delbove ◽  
François Gueyffier ◽  
Laurent Juillard ◽  
Emilie Kalbacher ◽  
Delphine Maucort-Boulch ◽  
...  

Aim To assess the effect of periodontal treatment (PT) on glomerular filtration rate (GFR), systemic inflammation, or mortality in patients with chronic kidney disease (CKD). Methods A literature search was performed on PubMed and Web of Science databases on articles published until December 2019. The PRISMA guidelines were used throughout the manuscript. Results Of the total studies found, only 18 met the inclusion criteria; four retrospective and 14 prospective studies (including 3 randomized controlled trials–RCT). After PT, 3 studies investigated GFR, 2 found significant improvement; 11 (including 2 RCTs) investigated C-reactive protein levels, 9 found a significant improvement (including the 2 RCTs); 5 (including 3 RCTs) investigated Interleukine-6 level, 4 found a significant improvement (including 2 RCTs) and 2 studies evaluated mortality, one (retrospective study) found a significant difference. Conclusions Within the limitations of the present study, PT seems to improve CKD status, especially by reducing the systemic inflammation. Further RCTs are needed to confirm the results and specifically assess the influence of different types of PT in CKD patients. Taking into consideration the ability of PT to prevent further tooth loss and denutrition, early management of periodontitis is extremely important in patients with impaired renal function.


2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Kunimi Maeda ◽  
Chieko Hamada ◽  
Satoshi Horikoshi ◽  
Yasuhiko Tomino

Purpose. To explore factors contributing to chronic kidney disease (CKD) progression and change in estimated glomerular filtration rate over time (ΔeGFR) as a risk factor in predialysis patients under multidisciplinary managements. Methods. Among 113 CKD patients, eGFR, serum creatinine, total protein, albumin, urea nitrogen, uric acid, calcium, inorganic phosphate, total cholesterol, urinary creatinine, urinary protein (UP), hemoglobin A1c, hemoglobin, and hematocrit were analyzed. Results. ΔeGFR analysis in the first six months presented a positive slope (remission group) in 43 patients (38%) and a negative slope (no-remission group) in 70 patients (62%). Three-year dialysis-free rate was 89.4% in the remission group and 39.3% in the no-remission group, with a significant difference (). To explore factors contributing to dialysis initiation by stepwise Cox regression, baseline eGFR (HR 0.706, ) and ΔeGFR in the first six months of treatment (HR 0.075, ) were identified. To investigate factors affecting remission and no remission by stepwise logistic regression, age (odds ratio 1.06, ) and UP excretion (odds ratio 1.223, ) were identified. Conclusion. Monitoring of ΔeGFR and UP is not only useful in suppressing CKD 3 progression, but also in deciding strategies to achieve remission in individual patients.


2021 ◽  
Vol 33 (2) ◽  
pp. 147-151
Author(s):  
Amir Mohammad Kaiser ◽  
Rafi Nazrul Islam ◽  
Miliva Mozaffor ◽  
Salahuddin Feroz ◽  
Md Mustafizur Rahman

Introduction: Ultrasound measurements of the intima media thickness (IMT) in the carotid arteries is a strong predictor for cardiovascular events both in the general and diseased population. Materials & Methods: This cross-sectional analytic study was conducted to observe correlation of CIMT with age, body mass index (BMI) and glomerular filtration rate (GFR) in chronic kidney disease (CKD). The study was done in Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, on 80 chronic kidney disease patients, from July 2014 to June 2015. All the biochemical parameters were measured according to the standard laboratory techniques. Body mass index (BMI) was calculated by person’s body weight divided by height. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula. CIMT measurement was done by duplex study of carotid vessels through high resolution B-mode ultrasound. Results: Mean age of the patients was 36.1±9.5 years. 20 (25%), 26 (32.5%) and 34 (42.5%) patients were in CKD stage 3, 4 and 5 respectively. Age, serum creatinine and GFR showed statistically significant difference among stage 3, 4 and 5 CKD patients (p<0.001). However, no difference was evident in BMI and mean CIMT among stage 3, 4 and 5 CKD patients. Significant positive correlations were found between age and CIMT (r=+0.332; p=0.003) and BMI and CIMT (r=+0.294; p=0.008). However, no significant correlation was evident with estimated glomerular filtration rate (eGFR) and CIMT (r=–0.181; p=0.109). Conclusion: Age, serum creatinine and estimated glomerular filtration rate showed statistically significant difference among different stages of CKD patients (stage 3, 4 and 5). There were significant positive correlations found in between age and CIMT as well as BMI and CIMT in chronic kidney disease patients, with an exception to GFR and CIMT. Medicine Today 2021 Vol.33(2): 147-151


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