scholarly journals Why the incidence in dialysis in the Lisbon and Tagus Valley Region (LVTR) is two to three times higher than in other regions of the country

2021 ◽  
Vol 35 (2) ◽  
Author(s):  
Martins Prata ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Management ◽  
Regional Difference ◽  
Close Correlation ◽  
Comprehensive Analysis ◽  
Management Platform ◽  
Number Of Patients ◽  
The Difference ◽  
Tagus Valley

The analysis of data from the Ministry of Health’s Integrated Chronic Kidney Disease Management Platform (PI -GID), reveals the existence of a striking regional difference in the incidence in dialysis. This difference is characterized by high levels of incidence in all regions, except the Alentejo, and extremely high levels in the Lisbon and Tagus Valley region. In this region, the incidence values are two to three times higher than in the others. The difference between regions is the result of a different number of patients starting hemodialysis, since the incidence in peritoneal dialysis is low and similar in all of them. It is difficult to find justification for such a discrepancy since the prevalence of factors usually responsible for the higher or lower level of incidence in dialysis does not differ significantly between them. A probable explanation may lie in the difference found in the concentration of public hemodialysis centers, a fact that may determine a difference in the criteria used for the entry of patients undergoing substitutive treatment of renal function. In fact, we found a close correlation between the number of public hemodialysis centers per million inhabitants and the level of incidence in dialysis. A more comprehensive analysis of the data from the Ministry of Health’s Integrated Chronic Kidney Disease Management Platform (PI -GID), if allowed, would be of enormous interest, not only to explain this discrepancy in the incidence of dialysis between regions, but because it could probably allow an explanation for Portugal having (one of) the highest levels of dialysis incidence in Europe

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.

FEATURES OF CHRONIC KIDNEY DISEASE IN ELDERLY PATIENTS

2020 ◽  
pp. 113-120
Author(s):  
О. Н. Курочкина
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Clinical Situation ◽  
Chronic Glomerulonephritis ◽  
Hypertensive Nephropathy ◽  
Number Of Patients ◽  
Rate Of Decline ◽  
People Group ◽  
Group 1

Изучены особенности течения хронической болезни почек (ХБП) у пожилых пациентов на основании анализа регистра ХБП за 2015-2018 гг. В регистре 484 пациента, из них 231 (47,7%) мужчина, 253 (52,3%) женщины, средний возраст - 58,8±15,8 года. Пациенты были разделены на три группы: 1-я - 218 человек до 59 лет; 2-я - 207 человек 60-74 лет; 3-я - 59 человек 75 лет и старше. В 1-й группе ведущей причиной ХБП явился хронический гломерулонефрит -27,1%, во 2-й - хронический тубулоинтерстициальный нефрит (ТИН) - 21,7%, диабетическая нефропатия (ДН) - 20,8% и гипертоническая нефропатия - 15,9%; в 3-й - ТИН (27,1%), хронический пиелонефрит (ПН) - 15,9% и ДН (13,6%). С возрастом увеличивалась частота встречаемости ТИН ( р <0,1), ПН ( р <0,05), ишемической болезни почек ( р <0,05), подагрической нефропатии ( р <0,1). Среднее снижение СКФ - 3,99 мл/мин на 1,73 мза год наблюдения. Темп снижения СКФ в 1-й группе - 3,36±1,8 мл/мин на 1,73 мза год, во 2-й - 2,43±1,2 ( р <0,001 между 1-йи 2-й группой), в 3-й - 1,82±1,1 мл/мин на 1,73 мза год. Наблюдали отрицательную корреляцию с возрастом ( р <0,05). Формирование регистра больных с ХБП позволяет знать количество больных и причины ХБП у пациентов пожилого и старческого возраста, оценивать клиническую ситуацию, темпы снижения СКФ и выбирать лечебную тактику у этих пациентов. The purpose of the work is to study the characteristics of the course of chronic kidney disease in elderly patients based on the analysis of the register of chronic kidney disease (CKD) for 2015-2018. in the Department of Nephrology, the Komi Republican Clinical Hospital. There are 484 patients in the register, of whom 231 are men (47,7%), 253 women (52,3%). The average age is 58,8±15,8 years old. The patients were divided into 3 groups: persons under the age of 59 years old - 218 people (group 1); from 60 to 74 years old - 207 people (group 2); and over 75 years old - 59 people (group 3). Most patients are between the ages of 60 and 69 years old. In the 1 group, the chronic glomerulonephritis is the leading cause of CKD - 27,1%; in the 2 group - the chronic tubulo-interstitial nephritis (TIN) - 21,7%, the diabetic nephropathy (DN) - 20,8% and the hypertensive nephropathy - 15,9%; in the 3 group - TIN (27,1%), the chronic pyelonephritis (PN) (15,9%) and DN (13,6%). With increasing age, the incidence of TIN ( p <0,1), MO ( p <0,05), coronary kidney disease (IBP) ( p <0,05), gouty nephropathy ( p <0,1) were raised. The average reduction in GFR is 3,99 ml/min/1,73 m per year of observation. The rate of decline in GFR in the 1st group is 3,36±1,8 ml/min/1,73 m per year, in the 2 - 2,43±1,2 ( p <0,001 between group 1 and 2), in the 3 group - 1,82±1,1; with aging the negative correlation was observed ( p <0,05). 39 patients received hemodialysis, including: in the 1 group - 20 people (9%), in the 2 group - 18 (8,7%), in the 3 group - 1 patient (1,7%). Making the register of the patients with CKD allows us to know the number of patients and the causes of CKD among the patients of elderly and senile ages, to assess the clinical situation, the rate of decline in GFR and treatment tactics in these patients.

scholarly journals P0754FGF23 AND URINARY PHOSPHATE EXCRETION FOR ESTIMATION OF NEPHRON NUMBER: DIFFERENCES BETWEEN CHRONIC KIDNEY FAILURE AND KIDNEY TRANSPLANTATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marzia Pasquali ◽  
Natalia De Martini ◽  
Lida Tartaglione ◽  
Silverio Rotondi ◽  
Marta Catalfamo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Mineral Metabolism ◽  
Chronic Kidney Failure ◽  
Serum Levels ◽  
Nephron Number ◽  
Phosphate Excretion ◽  
Single Nephron ◽  
The Difference

Abstract Background and Aims Assuming that FGF23 levels correlate with phosphate excretion per nephron, nephron number can be estimated by measuring FGF23 levels and urinary phosphate excretion (FEP). Kuro-O proposed that the ratio of FEP to serum FGF23 levels should correlate with nephron number and is defined as the Nephron Index (NI). The aim of the study is calculating NI as nephron number estimation in patients affected by various degree of chronic kidney disease, both transplanted and not. Method In 147 CRF patients kidney function, mineral metabolism biomarkers and NI were evaluated. Nephron Index was calculated following Kuro-o’s equation (kuro-o 2019): NI=FEP·Ps·eGFRFGF23 Observed patients were divided into two groups: patients with CKD (noTX) and transplanted ones (TX). Results noTX group was made up of 67 patients (40 males and 27 females) affected by CKD stages from G1 to G5. TX group was composed by 80 patient (49 males and 31 females) with various degree of CKD (G1T-G4T) showing mean graft age of 83,2 ± 54,8 months (range: 10,3-268,0). The two groups differed for age (mean age 59 ± 15,6 years in CKD, 55± 10,3years in TX). Mean eGFR did not differ between TX and noTX but NI was higher in TX since FEP was higher despite lower FGF23 levels in TX. The difference in FGF23 levels does not appear to depend on Klotho and PTH whose serum levels were no different between Tx and noTx. (Table1). As far as correlations are concerned, NI correlated with eGFR, FGF23, PTH and 1,25D in both group, while NI correlated with FEP only in the TX group. It's interesting that no correlation existed between FGF23 and sP, FEP, eGFR and sKlotho in TX differently from noTX (Table2). Discussion. NI could not be properly defined as nephron number estimation in TX pts. However it may represent higher function of residual nephrons, since higher FEP did not correlate to FGF23 and could be determined by compensatory hyperfiltration (increased single nephron GFR) in transplanted patients. Conclusion After kidney transplantation, high NI value could have a functional meaning rather than represent residual number of nephrons.

scholarly journals Outcome of acute kidney injuries following chronic kidney disease: A systematic review in Nawaz Sharif kidney hospital Swat

2022 ◽  
Vol 7 (1) ◽  
pp. 11-17
Author(s):  
Rahmat Ali Khan ◽  
Syed Munib ◽  
Mohammad Shahzad ◽  
Mufti Baleegh ◽  
Liaqat Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Age Distribution ◽  
Kidney Injury ◽  
Acute Glomerulonephritis ◽  
Duration Of Symptoms ◽  
Number Of Patients ◽  
Acute Mi

  Background: Acute kidney injury may increase the risk for CKD and end-stage renal disease. In an attempt to summarize the literature and provide more compelling evidence, we conducted a systematic review comparing the  risk for CKD (chronic kidney disease), AKI (Acute kidney injury), Acute gastroententeritis, postnatal   AKI, Acute MI (myocardial infarction), AKI  2ndry to chemotherapy, AKI  2ndry to abstractive Nephropathy, AKI 2ndry to sepsis, AKI 2ndry to Drugs (NSAIDS and ARBS), AKI 2ndry to AGN (acute Glomerulonephritis), AKI 2ndry to Rhabdomyolysis, and lest AKI 2ndry to Malaria, death in patients with AKI,HD, CKD (chronic kidney disease). There have been several important developments in the literature recently regarding the association between acute kidney injury (AKI) and chronic kidney disease (CKD). First, when the National Kidney Foundation promulgated their highly influential Kidney Disease Outcomes Quality Initiative CKD guidelines in 2002, six chapters were devoted to the complications associated with decreased glomerular filtration rate (GFR) including hypertension, anemia, nutritional status, bone disease/disorders of calcium, and phosphorus metabolism, neuropathy Objective: To study the outcomecute kidney injury following chronic kidney disease; systematic review.  Methods: This was a prospective observational study from January 2018 to December 2020. Patients visiting department of Nephrology Nawaz Sharif Kidney center Swat, number of patients included study 351. All ages and both sexes were considered. Patients treated elsewhere or who has undergone in this study. Complete medical history, detailed examination like age, sex, diagnosis, and outcome, of AKI, examination under microscope and investigations, and necessary blood investigations were carried out. Results: Three fifty one (351) patients were included in this study. The age distribution showed (75%) patients between 40-95 years and 25(25%) between 32-39 years. Mean age was 43 years with Standard Deviation of ± 35.66. Among 351 patients 162 (45%) patients were male and 189 (55%) patients were female. Duration of symptoms in 24(17%) was <4 months and 112(75%) had >4 months, with mean of 4 months and SD ± 2.315. Total 351 participants AKI 45(12%) postnatal AKI 33(9%) Acute MI 18(6%) AKI 2ndry chemotherapy 15(5.72%) AKI 2ndry to abstractive Nephropathy 55 (14%) AKI 2ndry to sepsis 63 (17%) AKI 2ndry to Drugs (NSAIDS and ARBS)   54 (14%) CKD (chronic kidney disease) 48 (15%) AKI 2ndry to Rhabdomylysis 18(6%) Conclusions: The study concludes that the acute kidney injury following CKD systematic reviewing among patients presenting with AKI,CHD ,AKI sepsis, ,AKI Drugs(NSIAD)  in local hospital  settings This can be reduced with proper health education in general public regarding prevention of the disease and hence its complications.  

scholarly journals The Difference of Potassium Level in Stage 5 Kidney Chronic Disease Patients Whose Using New and Re-use Hemodialyzer in RSD dr. Soebandi Jember

2019 ◽  
Vol 5 (3) ◽  
pp. 148
Author(s):  
Yuli Hermansyah ◽  
Dinda Ayu Wanodya Supriatiningsih ◽  
Bagus Hermansyah
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Potassium Level ◽  
Good Condition ◽  
Total Sample ◽  
Kidney Replacement Therapy ◽  
Quasi Experimental ◽  
The Difference ◽  
The Cost

Stage 5 chronic kidney disease (CKD) is a condition where the renal function decrease, marked by the GFR value < 15/ml/minute/1,73 m2 with or without kidney damage history for 3 months or more that needs kidney replacement therapy, including hemodialysis. In Indonesia, hemodialysis was chosen for 82% from all the cases that needs kidney replacement therapy. However, the cost for hemodialysis therapy is considered as too expensive and burdens The National Health Insurance, Badan Penyelenggara Jaminan Sosial (BPJS), allowing the reuse of hemodialyzer as an alternative for cost-effectiveness. Re-use hemodialyzer is a term for using the same hemodialyzer for the same patient but on different therapy session. The main purpose of this research is to investigate the difference of Potassium level in stage 5 chronic kidney disease patients whose using new and re-use hemodialyzer in RSD dr. Soebandi Jember. This research used quasi experimental design by using blood sample that will be measured for the potassium level after using new hemodialyzer and re-use hemodialyzer for the 4th time in Hemodialysis Installation of RSD dr. Soebandi Jember on December 2018. Total sample of 19 patients chosen using inclusion and exclusion criteria. Collected data were analyzed using paired t-test. The result of statistical test shows that there is no significance potassium level difference in stage 5 chronic kidney disease whose using new and re-use hemodialyzer for the 4th time (p=0,094). The effectivity of hemodialyzer that still has a good condition and hemodialysis therapy that has been done in accordance with the procedure until the 4th reuse is the main factor of this result.   Keywords: CKD, potassium, re-use hemodialyzer

scholarly journals Prevalence and Risk Factors for Chronic Kidney Disease in Family Relatives of a Cameroonian Population of Hemodialysis Patients: A CrossSectional Study

2019 ◽  
Vol 4 (1) ◽  
pp. 12-17
Author(s):  
Mazou Ngou Temgoua ◽  
Gloria Ashuntantang ◽  
Marie José Essi ◽  
Joël Nouktadie Tochie ◽  
Moussa Oumarou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fasting Blood Glucose ◽  
Hemodialysis Patients ◽  
Biological Data ◽  
Sub Saharan Africa ◽  
Herbal Remedies ◽  
Maintenance Hemodialysis ◽  
Number Of Patients

Background: In sub-Saharan Africa (SSA), the trend in the number of patients admitted for maintenance hemodialysis is on the rise. The identification of risk factors for chronic kidney disease (CKD) ensures adequate primary and secondary preventive measures geared at reducing the burden of CKD in low-resource settings. A family history of CKD is an established risk factor for CKD in high-income countries. However, data on family predisposition to CKD is scarce in the literature on SSA. Objective: The current study aimed to determine the prevalence and risk factors of CKD in family relatives of a Cameroonian population of hemodialysis patients (HDP) followed-up in a major hemodialysis referral center in Cameroon. Methods: The current cross-sectional study was conducted over four months on a consecutive sample of first-degree family relatives of end-stage renal disease patients undergoing maintenance hemodialysis at the hemodialysis unit of the General Hospital of Yaoundé. For each participating family relative, socio-demographic characteristics, clinical data, and biological data including fasting blood glucose, proteinuria, and serum creatinine were collected. Results: A total of 82 first-degree family relatives of HDP were recruited. The prevalence of CKD among the participants was 15.8%. The main identified risk factors for CKD were age (P = 0.0015), female gender (P = 0.0357), hypertension (P = 0.0004), regular intake of herbal remedies (P = 0.0214), and diabetes mellitus (P = 0.0019). Conclusion: Overall, the current findings suggest an urgent need for population education, routine screening of CKD, and the identification of risk factors in first-degree family relatives of HDP in Cameroon.

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