scholarly journals Combining hand grip strength with nutritional screening tools in elderly patients with chronic kidney disease

2021 ◽  
Vol 16 (1-2) ◽  
pp. 47-53
Author(s):  
Anja Vukomanović ◽  
Ivica Vrdoljak ◽  
Ines Panjkota Krbavčić ◽  
Tea Vrdoljak Margeta ◽  
Martina Bituh
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Receiver Operating Characteristic ◽  
Grip Strength ◽  
Operating Characteristic ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Hand Grip

Malnutrition in vulnerable patient populations must be rapidly detected using techniques that are easy to incorporate into everyday clinical practice. The new recommendations defined the 7-point Subjective Global Assessment (SGA) as optimal for nutritional assessment in chronic kidney disease (CKD), while Geriatric Nutrition Risk Index (GNRI) demands additional examination in elderly. This study aimed to determine the accuracy of several concise tools used in the clinical practice and the correlation of this tools with functional method hand grip strength (HGS) in elderly patients with CKD. In this cross-sectional study, anthropometric and functional data for 50 elderly hemodialysis patients were analyzed using numerous survey-based tools for screening nutritional status (Malnutrition Screening Tool – MST, Nutritional Risk Screening 2002 - NRS2002, Malnutrition Universal Screening Tool - MUST, Mini Nutritional Assessment - MNA, GNRI), which we compared to the standard 7-point SGA nutritional assessment tool. The sensitivity, specificity, and accuracy of these tools for detecting malnutrition were compared with the standard by using receiver operating characteristic (ROC) curve analysis. 7-point SGA classified 36.6% of participants as well nourished, and 63.4% as mildly to moderately malnourished, while the simplest alternative methods showed lower accuracy, classifying much higher proportions of participants as well nourished (MST, 92.0%; NRS2002, 80.4%). MNA had the highest accuracy based on receiver operating characteristic curves. HGS correlated moderately with 7-point SGA (r = 0.331), MNA (r = 0.410), and GNRI (r = 0.320). Our small study suggests that MNA is the best tool for malnutrition risk screening in elderly with CKD. Combining HGS with concise tools, such as GNRI, may provide better results and unburden healthcare professionals.

Serum syndecan-1, hyaluronan and thrombomodulin levels in patients with lupus nephritis

Rheumatology ◽  
2020 ◽  
Author(s):  
Kelvin Y C Yu ◽  
Susan Yung ◽  
Mel K M Chau ◽  
Colin S O Tang ◽  
Desmond Y H Yap ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Receiver Operating Characteristic ◽  
Healthy Subjects ◽  
Area Under Curve ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Area ◽  
Characteristic Area ◽  
Renal Lupus ◽  
Receiver Operating

Abstract Objectives We investigated circulating syndecan-1, HA and thrombomodulin levels in patients with biopsy-proven Class III/IV ± V LN and their clinico-pathological associations. Patients with non-renal SLE or non-lupus chronic kidney disease, and healthy subjects served as controls. Methods Serum syndecan-1, HA and thrombomodulin levels were determined by ELISAs. Results Syndecan-1, HA and thrombomodulin levels were significantly higher during active LN compared with remission (P < 0.01, for all), and correlated with the level of proteinuria, estimated glomerular filtration rate, anti-dsDNA antibodies, complement 3 and serum creatinine. Longitudinal studies showed that syndecan-1 and thrombomodulin levels increased prior to clinical renal flare by 3.6 months, while HA level increased at the time of nephritic flare, and the levels decreased in parallel with treatment response. Receiver operating characteristic curve analysis showed that syndecan-1 and thrombomodulin levels distinguished patients with active LN from healthy subjects, LN patients in remission, patients with active non-renal lupus and patients with non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.98, 0.91, 0.82 and 0.95, respectively, for syndecan-1; and area under curve of 1.00, 0.84, 0.97 and 0.79, respectively, for thrombomodulin). HA level distinguished active LN from healthy subjects, LN patients in remission and non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.82, 0.71 and 0.90, respectively) but did not distinguish between renal vs non-renal lupus. Syndecan-1 and thrombomodulin levels correlated with the severity of interstitial inflammation, while HA level correlated with chronicity grading in kidney biopsies of active LN. Conclusion Our findings suggest potential utility of serum syndecan-1, thrombomodulin and HA levels in clinical management, and their potential contribution to LN pathogenesis.

scholarly journals POS-605 CORRELATION OF HAND GRIP STRENGTH WITH QUALITY OF LIFE CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS

2021 ◽  
Vol 6 (4) ◽  
pp. S264
Author(s):  
A. PERMANA ◽  
I. Effendi ◽  
Z. Ali ◽  
N. Suhaimi ◽  
S. Suprapti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Grip Strength ◽  
Hand Grip Strength ◽  
Hand Grip

Assessment of Nutritional Status in Children With Chronic Kidney Disease Using Hand Grip Strength Tool

2018 ◽  
Vol 28 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Ashraf Mohamed Abd El Basset Bakr ◽  
Bothina Mohamed Hasaneen ◽  
Dina AbdelRasoul Helal Bassiouni
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Nutritional Status ◽  
Grip Strength ◽  
Hand Grip Strength ◽  
Hand Grip

scholarly journals Design and methodology of the Aging Nephropathy Study (AGNES): a prospective cohort study of elderly patients with chronic kidney disease

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Venceslau A. Coelho ◽  
Giovani GN. Santos ◽  
Carla M. Avesani ◽  
Cicero Italo L. Bezerra ◽  
Luana Cristina A. Silva ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Study Design ◽  
Nutritional Assessment ◽  
Dialysis Initiation ◽  
Body Composition Assessment ◽  
Link Type ◽  
Ckd Stage

Abstract Background Renal replacement therapy (RRT) is usually indicated for patients with chronic kidney disease (CKD) with glomerular filtration rate below 10 ml/ml/min/1.73m2. However, the need for RRT and timing of dialysis initiation are debatable for patients aged 70 years or older. We here describe the study design and methodology of the Aging Nephropathy Study (AGNES) protocol that aims at evaluating to what extent geriatric-related conditions such as frailty, cognitive dysfunction, and presence of comorbidities have an impact on survival and RRT initiation in this group of patients. In this manuscript we provide detailed information about the AGNES study design and methodology. Methods AGNES is a prospective observational cohort that aim to investigate clinical, biochemical and demographic factors associated with RRT initiation and mortality of patients with CKD stage 4 or 5 who are aged 70 years and older. We plan to include 200 patients over 5 years. Clinically stable outpatients on conservative management for at least 6 months will be recruited from the Nephrogeriatric Clinic at the Hospital das Clinicas da Universidade de Sao Paulo, Brazil. Eligible patients are submitted to a full clinical examination, geriatric assessment, and blood test at baseline. Following the baseline visit the patients are being monitored during an observational follow up period of at least 12 months during which patients will be contacted in the clinic at their regular follow up or by phone until either RRT initiation or death occurs. This cohort includes evaluation of cognition by the education-adjusted 10-point Cognitive Screener (10-CS), frailty by Fried index score, a complete nutritional assessment (by body composition assessment, global subjective assessment and dietary intake), comorbidities by Charlson comorbidity index and biochemical markers including FGF-23 and Klotho. Discussion The AGNES cohort, a real-world study of current clinical practice in elderly patients with advanced CKD prior to dialysis initiation, will shed light into progression of CKD and its complications, indications of RRT and factors determining survival. This investigation will elucidate to what extent geriatric conditions, nutritional status and clinical factors are associated with survival, quality of life and RRT initiation in elderly CKD patients not yet on dialysis. Trial registration Registered on ClinicalTrials.gov on 18 October 2019 (NCT04132492).

scholarly journals Guidelines adherence in the prevention and management of chronic kidney disease in patients with diabetes mellitus on the background of recent European recommendations – a registry-based analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peter Bramlage ◽  
Stefanie Lanzinger ◽  
Sascha R. Tittel ◽  
Eva Hess ◽  
Simon Fahrner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Analysis Data ◽  
Disease Diagnosis ◽  
Diabetic Patients ◽  
European Society Of Cardiology

Abstract Background Recent European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) guidelines provide recommendations for detecting and treating chronic kidney disease (CKD) in diabetic patients. We compared clinical practice with guidelines to determine areas for improvement. Methods German database analysis of 675,628 patients with type 1 or type 2 diabetes, with 134,395 included in this analysis. Data were compared with ESC/EASD recommendations. Results This analysis included 17,649 and 116,747 patients with type 1 and type 2 diabetes, respectively. The analysis showed that 44.1 and 49.1 % patients with type 1 and type 2 diabetes, respectively, were annually screened for CKD. Despite anti-diabetic treatment, only 27.2 % patients with type 1 and 43.5 % patients with type 2 achieved a target HbA1c of < 7.0 %. Use of sodium-glucose transport protein 2 inhibitors (1.5 % type 1/8.7 % type 2 diabetes) and glucagon-like peptide-1 receptor agonists (0.6 % type 1/5.2 % type 2 diabetes) was limited. Hypertension was controlled according to guidelines in 41.1 and 67.7 % patients aged 18–65 years with type 1 and 2 diabetes, respectively, (62.4 vs. 68.4 % in patients > 65 years). Renin angiotensin aldosterone inhibitors were used in 24.0 and 40.9 % patients with type 1 diabetes (micro- vs. macroalbuminuria) and 39.9 and 47.7 %, respectively, in type 2 diabetes. Conclusions Data indicate there is room for improvement in caring for diabetic patients with respect to renal disease diagnosis and treatment. While specific and potentially clinically justified reasons for non-compliance exist, the data may serve well for a critical appraisal of clinical practice decisions.

scholarly journals New Potential Biomarkers for Chronic Kidney Disease Management—A Review of the Literature

2020 ◽  
Vol 22 (1) ◽  
pp. 43
Author(s):  
Irina Lousa ◽  
Flávio Reis ◽  
Idalina Beirão ◽  
Rui Alves ◽  
Luís Belo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Renal Damage ◽  
Recent Literature ◽  
Therapeutic Interventions ◽  
Review Of The Literature ◽  
Medical Need ◽  
Early Use ◽  
Reasonable Approach

The prevalence of chronic kidney disease (CKD) is increasing worldwide, and the mortality rate continues to be unacceptably high. The biomarkers currently used in clinical practice are considered relevant when there is already significant renal impairment compromising the early use of potentially successful therapeutic interventions. More sensitive and specific biomarkers to detect CKD earlier on and improve patients’ prognoses are an important unmet medical need. The aim of this review is to summarize the recent literature on new promising early CKD biomarkers of renal function, tubular lesions, endothelial dysfunction and inflammation, and on the auspicious findings from metabolomic studies in this field. Most of the studied biomarkers require further validation in large studies and in a broad range of populations in order to be implemented into routine CKD management. A panel of biomarkers, including earlier biomarkers of renal damage, seems to be a reasonable approach to be applied in clinical practice to allow earlier diagnosis and better disease characterization based on the underlying etiologic process.

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