scholarly journals The Effectof Exercise to Glomerular Filtration Barrier System in Diabetic Rat

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Microvascular Complications ◽  
Diabetic Rat ◽  
World Population ◽  
Glomerular Filtration Barrier ◽  
Middle Income ◽  
Middle Income Countries ◽  
Filtration Barrier ◽  
The World

People with diabetes mellitus are spread all over the world. Currently, it is estimated that nearly 425 million (8.8% of the world population), 20 - 79 years old, most (79%) are in low and middle income countries. The estimated number of people with diabetes will increase in 2045 to 625 million [1]. Along with these results the number of macro and microvascular complications is also expected to increase. About 40% of diabetics experience proteinuria in the form of microalbuminuria which is a sign of the progression of chronic kidney disease. Without special intervention 20-40% of patients with microalbuminuria will develop overtnepropathy and around 20% after 20 years theonsetof overt nepropathy will become CKD (Chronic kidney disease) [2].

scholarly journals Prevalence, incidence and associated mortality of cardiovascular disease in patients with chronic kidney disease in low- and middle-income countries: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016412 ◽  
Author(s):  
Mazou N Temgoua ◽  
Celestin Danwang ◽  
Valirie Ndip Agbor ◽  
Jean Jacques Noubiap
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Published Data ◽  
Final Report ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Incidence And Mortality ◽  
Statistical Heterogeneity

IntroductionChronic kidney disease (CKD) is a global public health problem, with cardiovascular disease (CVD) being the major cause of mortality in these patients. Despite a high burden of CKD among patients in low/middle-income countries (LMICs), evidence on the distribution of CVD among these patients is lacking. This review seeks to determine the prevalence, incidence and mortality risks of CVD in patients with CKD in LMICs.Methods and analysisA systematic search of Medline, Scopus, Embase, Cumulative Index of Nursing and Allied Health and WHO Global Health Library databases for published studies reporting on the prevalence, incidence and associated mortality risk of CVD in CKD patients in LMICs will be conducted from 1 May 1987 to 1 July 2017 with no language restriction. Two authors will independently screen, select studies, extract data and assess the risk of bias in each study. Clinically homogeneous studies will be pooled after assessing for clinical and statistical heterogeneity using the χ2test on Cochrane’s Q statistic which is quantified by I2values; assuming that I2values of 25%, 50% and 75% represent low, medium and high heterogeneity, respectively. Funnel-plot analysis and Egger’s test will be used to detect publication bias. Results will be presented according to WHO Regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia and Western Pacific).Ethics and disseminationThis proposed study will not require ethical approval as it will be based on published data. We will publish the final report of this review in a peer-reviewed journal, and the findings will be disseminated to the appropriate health authorities.

scholarly journals Tuberculosis in patients with chronic kidney disease: atypical presentation and diagnostic dilemma

2018 ◽  
Vol 8 (3) ◽  
pp. 1-2
Author(s):  
Ravi R. Pradhan
Keyword(s):  
Public Health ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Patient ◽  
Public Health Problem ◽  
Diagnostic Dilemma ◽  
Middle Income ◽  
Extra Pulmonary Tuberculosis ◽  
Middle Income Countries ◽  
Significant Public Health

Tuberculosis (TB) is a serious public health problem, and more common in developing countries like Nepal. Worldwide, it is the second most frequent cause of death from infectious disease. Patient with chronic kidney disease (CKD) under mainte­nance dialysis are more likely to develop TB compared to general population. Given the increasing prevalence of CKD in TB endemic areas, a merging of CKD and TB epidemics could have significant public health implications, especially in low- to middle-income countries like Nepal. Because of increased frequency of extra-pulmonary tuberculosis in patient with CKD, the clinical presentation is atypical and leads to diagnostic dilemma.

Chronic kidney disease and the aging population

2014 ◽  
Vol 17 (1) ◽  
pp. 6-10
Author(s):  
Marcello Tonelli ◽  
Miguel Riella
Keyword(s):  
Public Policy ◽  
Chronic Kidney Disease ◽  
Economic Development ◽  
Kidney Disease ◽  
General Population ◽  
Population Aging ◽  
Aging Population ◽  
Middle Income ◽  
Middle Income Countries ◽  
Socio Economic Development

The proportion of older people in the general population is steadily increasing worldwide, with the most rapid growth in low- and middle-income countries [1]. This demographic change is to be celebrated, because it is the consequence of socio-economic development and a better life expectancy. However, population aging also has important implications on society – in diverse areas including health systems, labour markets, public policy, social programmes, and family dynamics [2]. A successful response to the aging population will require capitalising on opportunities this transition offers, as well as effectively addressing its challenges.

Endoplasmic reticulum stress inhibition limits the progression of chronic kidney disease in the Dahl salt-sensitive rat

2017 ◽  
Vol 312 (1) ◽  
pp. F230-F244 ◽  
Author(s):  
Victoria Yum ◽  
Rachel E. Carlisle ◽  
Chao Lu ◽  
Elise Brimble ◽  
Jasmine Chahal ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Endoplasmic Reticulum ◽  
Kidney Disease ◽  
Er Stress ◽  
Glomerular Filtration ◽  
Renal Pathology ◽  
Myogenic Response ◽  
Glomerular Filtration Barrier ◽  
Chemical Chaperone ◽  
Filtration Barrier

Proteinuria is one of the primary risk factors for the progression of chronic kidney disease (CKD) and has been implicated in the induction of endoplasmic reticulum (ER) stress. We hypothesized that the suppression of ER stress with a low molecular weight chemical chaperone, 4-phenylbutyric acid (4-PBA), would reduce the severity of CKD and proteinuria in the Dahl salt-sensitive (SS) hypertensive rat. To induce hypertension and CKD, 12-wk-old male rats were placed on a high-salt (HS) diet for 4 wk with or without 4-PBA treatment. We assessed blood pressure and markers of CKD, including proteinuria, albuminuria, and renal pathology. Furthermore, we determined if HS feeding resulted in an impaired myogenic response, subsequent to ER stress. 4-PBA treatment reduced salt-induced hypertension, proteinuria, and albuminuria and preserved myogenic constriction. Furthermore, renal pathology was reduced with 4-PBA treatment, as indicated by lowered expression of profibrotic markers and fewer intratubular protein casts. In addition, ER stress in the glomerulus was reduced, and the integrity of the glomerular filtration barrier was preserved. These results suggest that 4-PBA treatment protects against proteinuria in the SS rat by preserving the myogenic response and by preventing ER stress, which led to a breakdown in the glomerular filtration barrier. As such, alleviating ER stress serves as a viable therapeutic strategy to preserve kidney function and to delay the progression of CKD in the animal model under study.

scholarly journals The incidence of and risk factors for late presentation of childhood chronic kidney disease: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244709
Author(s):  
Lucy Plumb ◽  
Emily J. Boother ◽  
Fergus J. Caskey ◽  
Manish D. Sinha ◽  
Yoav Ben-Shlomo
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Failure ◽  
Meta Analysis ◽  
Late Presentation ◽  
Cochrane Library ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Background When detected early, inexpensive measures can slow chronic kidney disease progression to kidney failure which, for children, confers significant morbidity and impacts growth and development. Our objective was to determine the incidence of late presentation of childhood chronic kidney disease and its associated risk factors. Methods We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library and CINAHL, grey literature and registry websites for observational data describing children <21 years presenting to nephrology services, with reference to late presentation (or synonyms thereof). Independent second review of eligibility, data extraction, and risk of bias was undertaken. Meta-analysis was used to generate pooled proportions for late presentation by definition and investigate risk factors. Meta-regression was undertaken to explore heterogeneity. Results Forty-five sources containing data from 30 countries were included, comprising 19,339 children. Most studies (37, n = 15,772) described children first presenting in kidney failure as a proportion of the chronic kidney disease population (mean proportion 0.43, 95% CI 0.34–0.54). Using this definition, the median incidence was 2.1 (IQR 0.9–3.9) per million age-related population. Risk associations included non-congenital disease and older age. Studies of hospitalised patients, or from low- or middle-income countries, that had older study populations than high-income countries, had higher proportions of late presentation. Conclusions Late presentation is a global problem among children with chronic kidney disease, with higher proportions seen in studies of hospitalised children or from low/middle-income countries. Children presenting late are older and more likely to have non-congenital kidney disease than timely presenting children. A consensus definition is important to further our understanding and local populations should identify modifiable barriers beyond age and disease to improve access to care.

scholarly journals Chronic kidney disease in low-income to middle-income countries: the case for increased screening

2017 ◽  
Vol 2 (2) ◽  
pp. e000256 ◽  
Author(s):  
Cindy George ◽  
Amelie Mogueo ◽  
Ikechi Okpechi ◽  
Justin B Echouffo-Tcheugui ◽  
Andre Pascal Kengne
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries

scholarly journals Understanding the Mechanisms of Proteinuria: Therapeutic Implications

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Jorge E. Toblli ◽  
P. Bevione ◽  
F. Di Gennaro ◽  
L. Madalena ◽  
G. Cao ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Strong Predictor ◽  
Large Body ◽  
Glomerular Filtration Barrier ◽  
Glomerular Diseases ◽  
Filtration Barrier ◽  
Wide Range

A large body of evidence indicates that proteinuria is a strong predictor of morbidity, a cause of inflammation, oxidative stress and progression of chronic kidney disease, and development of cardiovascular disease. The processes that lead to proteinuria are complex and involve factors such as glomerular hemodynamic, tubular absorption, and diffusion gradients. Alterations in various different molecular pathways and interactions may lead to the identical clinical end points of proteinuria and chronic kidney disease. Glomerular diseases include a wide range of immune and nonimmune insults that may target and thus damage some components of the glomerular filtration barrier. In many of these conditions, the renal visceral epithelial cell (podocyte) responds to injury along defined pathways, which may explain the resultant clinical and histological changes. The recent discovery of the molecular components of the slit diaphragm, specialized structure of podocyte-podocyte interaction, has been a major breakthrough in understanding the crucial role of the epithelial layer of the glomerular barrier and the pathogenesis of proteinuria. Thispaper provides an overview and update on the structure and function of the glomerular filtration barrier and the pathogenesis of proteinuria, highlighting the role of the podocyte in this setting. In addition, current antiproteinuric therapeutic approaches are briefly commented.

scholarly journals Early detection of chronic kidney disease in low-income and middle-income countries: development and validation of a point-of-care screening strategy for India

2019 ◽  
Vol 4 (5) ◽  
pp. e001644 ◽  
Author(s):  
Christina Bradshaw ◽  
Dimple Kondal ◽  
Maria E Montez-Rath ◽  
Jialin Han ◽  
Yuanchao Zheng ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Detection ◽  
Low Income ◽  
Point Of Care ◽  
Screening Strategy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Urine Dipstick ◽  
Using Data

IntroductionAlthough deaths due to chronic kidney disease (CKD) have doubled over the past two decades, few data exist to inform screening strategies for early detection of CKD in low-income and middle-income countries.MethodsUsing data from three population-based surveys in India, we developed a prediction model to identify a target population that could benefit from further CKD testing, after an initial screening implemented during home health visits. Using data from one urban survey (n=8698), we applied stepwise logistic regression to test three models: one comprised of demographics, self-reported medical history, anthropometry and point-of-care (urine dipstick or capillary glucose) tests; one with demographics and self-reported medical history and one with anthropometry and point-of-care tests. The ‘gold-standard’ definition of CKD was an estimated glomerular filtration rate <60 mL/min/1.73 m2 or urine albumin-to-creatinine ratio ≥30 mg/g. Models were internally validated via bootstrap. The most parsimonious model with comparable performance was externally validated on distinct urban (n=5365) and rural (n=6173) Indian cohorts.ResultsA model with age, sex, waist circumference, body mass index and urine dipstick had a c-statistic of 0.76 (95% CI 0.75 to 0.78) for predicting need for further CKD testing, with external validation c-statistics of 0.74 and 0.70 in the urban and rural cohorts, respectively. At a probability cut-point of 0.09, sensitivity was 71% (95% CI 68% to 74%) and specificity was 70% (95% CI 69% to 71%). The model captured 71% of persons with CKD and 90% of persons at highest risk of complications from untreated CKD (ie, CKD stage 3A2 and above).ConclusionA point-of-care CKD screening strategy using three simple measures can accurately identify high-risk persons who require confirmatory kidney function testing.

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