scholarly journals Association Between Renal Dysfunction and Low HDL Cholesterol Among the Elderly in China

2021 ◽  
Vol 8 ◽  
Author(s):  
Aijun You ◽  
Yaxin Li ◽  
Brian Tomlinson ◽  
Longfei Yue ◽  
Kaijie Zhao ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Cardiovascular Health ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Community Dwelling ◽  
High Morbidity ◽  
Cross Sectional ◽  
Low Hdl

Objective: Chronic kidney disease (CKD) and cardiovascular disease (CVD) have a high morbidity and mortality among the elderly. Low levels of high-density lipoprotein cholesterol (HDL-C), a traditional risk marker for CVD, are common in CKD patients. Little is known about the association of low HDL-C with renal dysfunction in the community dwelling population.Methods: This was a population-based cross-sectional study included 4,753 participants enrolled in a prospective study, the Shanghai Elderly Cardiovascular Health (SHECH) study. Estimated glomerular filtration rate (eGFR), calculated by the Chinese Modification of Diet in Renal Disease (C-MDRD equation), was used to assess renal dysfunction. Associations between renal dysfunction and low HDL-C were evaluated using multiple logistic regression models and restricted cubic splines.Results: Of 4,649 individuals who met inclusion criteria, 620 (13.34%) had low HDL-C at <40 mg/dl. In the fully adjusted model, lower eGFR of <60 ml/min/1.73 m2 (OR, 2.03; 95% CI, 1.21–3.43) and marginal eGFR of 60 to 90 ml/min/1.73 m2 (OR, 1.26; 95% CI, 1.01–1.58) were significantly associated with low HDL-C, compared with normal eGFR of ≥90 ml/min/1.73 m2. Moreover, consistent findings were obtained in subsidiary analyses using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Fully adjusted cubic spline models indicated a significant dose-response relationship between eGFR and low HDL-C (P for non-linearity, 0.356).Conclusion: In this general elderly population, renal dysfunction was independently and significantly associated with low HDL-C, and the prevalence of low HDL-C increased with decreasing eGFR, such that even slight changes in renal function may be associated with altered lipid levels.

Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽  
2017 ◽  
Vol 63 (3) ◽  
pp. 201-209 ◽  
Author(s):  
Maximilian König ◽  
Maik Gollasch ◽  
Ilja Demuth ◽  
Elisabeth Steinhagen-Thiessen
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Elderly ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

scholarly journals MEDICATION BURDEN AND INAPPROPRIATE PRESCRIPTION RISK AMONG ELDERLY WITH ADVANCED CHRONIC KIDNEY DISEASE

2019 ◽  
Author(s):  
Clarisse Roux-Marson ◽  
Jean-Baptiste Baranski ◽  
Coraline Fafin ◽  
Guillaume Extermann ◽  
Cecile Vigneau ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Healthcare Providers ◽  
Antihypertensive Agents ◽  
The Elderly ◽  
Anticholinergic Drugs ◽  
Cross Sectional ◽  
French Study ◽  
Sectional Analysis

Abstract Background Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take. Methods This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were analyzed according to route of administration, therapeutic classification, and their potential inappropriateness for these patients, according to Beers' criteria. Results We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 88% of patients had at least 1 medication classified as a RIM, and 21% of those were contraindicated drugs. At least 1 PIM was taken by 68.9%. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine. Conclusion We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.

scholarly journals The Effect of Renal Dysfunction on Circulating Sclerostin Level in Patients with Type 2 Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Se Hwa Kim ◽  
Soo Young Yoon ◽  
Sung-Kil Lim ◽  
Yumie Rhee
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Sclerostin Level

Objective. Sclerostin is a Wnt inhibitor produced specifically by osteocytes. However, it is not currently clear whether renal dysfunction has an effect on circulating sclerostin level in patients with type 2 diabetes. The aim of the study was to evaluate this relationship. Design and Patients. We conducted a cross-sectional observational study of 302 type 2 diabetic patients with or without chronic kidney disease. Serum sclerostin level was analyzed by ELISA, and renal function was assessed by estimated glomerular filtration rate (eGFR) using chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Results. There was a strong correlation between sclerostin level with renal function presented as serum creatinine (r=0.745, P<0.001) and eGFR (r=-0.590, P<0.001). Serum sclerostin level was significantly higher in patients with CKD-G3 stage than those with CKD-G1/2 stages after adjusting for age, sex, and BMI (P=0.011). Patients with CKD-G4/5 stages had dramatically increased level of circulating sclerostin. Multiple regression analyses found that age, sex, and eGFR were independent determining factors for circulating sclerostin level. Conclusion. Our data showed that serum sclerostin levels start to increase in diabetic patients with CKD-G3 stage. Further studies are needed to establish the potential role of elevated sclerostin in diabetic patients with CKD.

scholarly journals Silent brain infarcts in chronic kidney disease patients with nonspecific neurological symptoms

2021 ◽  
Vol 9 (4) ◽  
pp. 274-279
Author(s):  
P Sasanka ◽  
◽  
Dr. T. Jaya Chandra ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Exact Test ◽  
Brain Infarcts ◽  
Significant Difference

Introduction: Silent brain infarcts (SBI) are parenchymal lesions of previous infarcts, classified astype III cerebrovascular disorder. A study was undertaken to find the relation between SBIs andnonspecific neurological complaints, an association of high sensitivity C-reactive protein (hsCRP)with silent brain infarcts. Methodology: It was a cross-sectional study conducted in the departmentof Nephrology, GSL Medical College, from January to December 2020. Individuals aged > 18 yearswith nonspecific neurological complaints were included. MRI brain, hsCRP and electrocardiogramwere also carried as per the standard protocol. Fischer exact test was used to find the statisticalsignificance; P < 0.05 was considered statistically significant. Results: A total of 51 members haveincluded the male-female ratio was 1.04. SBI was presented in 27.4% (14). Age-wise, among thecortical SBI patients, maximum (75%) were in the> 61 years group. High density lipoprotein levelswere > 40 mg/dL in 39.2%, normal triglycerides (TGL) were observed in 71% and raised hsCRP in62.7% (32). Statistically, there was no significant difference in TGL levels. hsCRP levels were raisedin 3 (75%) members with cortical SBI; statistically, there was no significant difference. Conclusion:The traditional risk factors associated with stroke were present in the patients with SBI. hsCRP wasraised in chronic kidney disease patients having NSCL and having SBI.

scholarly journals Hyperhomocysteinemia Concurrent with Metabolic Syndrome Is Independently Associated with Chronic Kidney Disease among Community-Dwelling Adults in an Urban Korean Population

2020 ◽  
Vol 17 (18) ◽  
pp. 6810
Author(s):  
Hana Moon ◽  
Hae-Jin Ko ◽  
A-Sol Kim
Keyword(s):  
Metabolic Syndrome ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Odds Ratio ◽  
Central Obesity ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Difference

Elevated homocysteine (Hcy) levels and metabolic syndrome (MetS) are associated with chronic kidney disease (CKD). We investigated the combined effects of hyperhomocysteinemia (HHcy) and MetS on CKD among community-dwelling adults in an urban area of South Korea. We also identified the combination of HHcy and individual MetS components associated with the maximal risk of CKD. A retrospective cross-sectional study involving 19,311 health examinees between 2 January 2011 and 31 December 2015 was conducted. The participants were divided into four groups—namely, the HHcy−/MetS−, HHcy−/MetS+, HHcy+/MetS−, and HHcy+/MetS+ groups. CKD was defined as a low eGFR <60 mL/min/1.73 m2 or albuminuria. The HHcy+/MetS+ group had a higher risk of CKD than the HHcy−/MetS+ group (odds ratio (OR): 1.750, p = 0.002 for males; OR: 3.224, p < 0.001 for females). The HHcy+/MetS+ group had a higher CKD risk than the HHcy+/MetS− group; however, the difference was not statistically significant (OR: 1.070, p = 0.712 for males; OR: 1.847, and p < 0.074 for females). HHcy concurrent with MetS increased the CKD risk. Among the combinations of HHcy and MetS components, the coexistence of HHcy and central obesity had the greatest effect on CKD. Therefore, the timely detection and treatment of HHcy and MetS are important for preventing CKD.

scholarly journals Prevalence of sarcopenia in community-dwelling older adults using the updated EWGSOP2 definition according to kidney function and albuminuria

2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Rafael Moreno-Gonzalez ◽  
◽  
Xavier Corbella ◽  
Francesco Mattace-Raso ◽  
Lisanne Tap ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Handgrip Strength ◽  
Bioelectrical Impedance ◽  
Community Dwelling ◽  
Cross Sectional ◽  
European Working ◽  
Community Dwelling Older Adults

Abstract Background Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. Thus, we investigated the prevalence of sarcopenia among community-dwelling older adults according to kidney function and grade of albuminuria. We also explored differences in the prevalence of sarcopenia according to three different equations for the estimation of glomerular filtration rate (eGFR). Methods A cross-sectional analysis of 1420 community-dwelling older adults (≥75 years old) included in the SCOPE study, a multicenter prospective cohort study, was conducted. Comprehensive geriatric assessment including short physical performance battery (SPPB), handgrip strength test and bioelectrical impedance analysis (BIA) was performed. Sarcopenia was defined using the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). eGFR was calculated using Berlin Initiative Study (BIS), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Full Age Spectrum (FAS) equations, and urinary albumin-to-creatinine ratio (ACR) was collected to categorize CKD according to Kidney Disease Improving Global Outcomes guidelines. Results Median age was 79.5 years (77.0–83.0), 804 (56.6%) were women. Using EWGSOP2 definition, 150 (10.6%) participants met diagnostic criteria for sarcopenia. Moreover, 85 (6%) participants had severe sarcopenia. Sarcopenia was more prevalent in participants with more advanced stages of CKD according to BIS eq. (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and also according to CKD-EPI (9.8% vs. 14.2%, p = 0.042) and FAS although not reaching statistical signification (9.8% vs. 12.7%, p = 0.119). Thus, differences in prevalence are observed among CKD categories as estimated by different equations. Prevalence of sarcopenia was also higher with increasing albuminuria categories: 9.3% in normoalbuminuric, 13.2% in microalbuminuric and 16.8% in macroalbuminuric participants, (p = 0.019). Conclusions Sarcopenia is common among community-dwelling older adults, especially among those with more advanced CKD categories, with prevalence estimates differing slightly depending on the equation used for the estimation of eGFR; as well as among those with higher albuminuria categories.

scholarly journals Assessment of the frailty level of elderly people with chronic kidney disease undergoing hemodialysis

2014 ◽  
Vol 27 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Fabiana de Souza Orlandi ◽  
Gabriela Dutra Gesualdo
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Elderly People ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

OBJECTIVE: To assess the frailty level of elderly people with chronic kidney disease undergoing hemodialysis.METHODS: This is a cross-sectional study involving 60 participants and carried out at a Renal Replacement Therapy Unit. The Edmonton Frail Scale, translated and validated to Portuguese, was used as the instrument of research.RESULTS: Around 35.0% of the elderly showed no frailty, 26.7% were vulnerable, 20.0% showed mild frailty, 13.3% moderate frailty and 5.0% severe frailty.CONCLUSION: The frailty level of elderly people with chronic kidney disease undergoing hemodialysis was high and the number of elderly people who are vulnerable to frailty was also high.

scholarly journals Hypertriglyceridemic waist phenotype and risk of chronic kidney disease in community-dwelling adults aged 60 years and older in Tianjin, China: a 7-year cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ruping Chen ◽  
Guangshan Sun ◽  
Rui Liu ◽  
Ao Sun ◽  
Yujie Cao ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Waist Circumference ◽  
Kidney Disease ◽  
Community Dwelling ◽  
Health Examination ◽  
Cross Sectional ◽  
Hypertriglyceridemic Waist ◽  
The Cross

Abstract Background The hypertriglyceridemic waist (HTGW) phenotype has been proposed to be related to the occurrence and progression of chronic kidney disease (CKD). The ageing trend of the Chinese population continues to intensify, and elderly individuals are at high risk of CKD. The purpose of this study was to investigate the cross-sectional and longitudinal associations between the HTGW phenotype and the risk of CKD by following community-dwelling adults aged 60 years and older in Tianjin, China, for 7 years. Methods This study was an observational cohort study conducted between 2013 and 2019. Of 2050 participants aged 60 years and older who underwent an annual health examination in 2013, 1605 individuals with complete data were enrolled in the cross-sectional analysis. Among them, 1271 individuals were observed until 2019. Detailed follow-up records were available for 816 participants, of whom 600 participants without CKD at baseline were eligible for inclusion in the retrospective analysis. The HTGW phenotype was defined as a waist circumference of 90 cm or more and triglyceride concentrations of 2.0 mmol/L or more in males or a waist circumference of 85 cm or more and triglyceride concentrations of 1.5 mmol/L or more in females. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and/or proteinuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). Multivariable logistic regression analyses were performed to evaluate the relationship between the HTGW phenotype and CKD. Results In 2013, the prevalence of CKD among older adults was 31.03%, and the prevalence of CKD in the HTGW phenotype group was 37.81%. Over a 7-year observation period, 195 individuals developed CKD, with an incidence rate of 32.50%. Statistically significant associations were observed between the HTGW phenotype and CKD in older adults in both cross-sectional surveys and retrospective analyses, with odds ratios and 95% confidence intervals of 1.38 (95% CI: 1.03–1.86, P = 0.033) and 2.27 (95% CI: 1.30–3.97, P = 0.004), respectively, after adjustment for confounders. Conclusions In this community-based cohort study, the HTGW phenotype was confirmed to be independently associated with an increased risk of prevalent and incident CKD in older adults aged 60 years and above in Tianjin, China.

scholarly journals Prevalence of impaired renal function and determinants in the southwest of Iran

2021 ◽  
Author(s):  
Saba Alvand ◽  
Farhad Abolnezhadian ◽  
Sudabeh Alatab ◽  
Zahra Mohammadi ◽  
Fatemeh Hayati ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Strong Association ◽  
Density Lipoprotein ◽  
Population Based ◽  
Cross Sectional Study ◽  
Stage Iii ◽  
Health Study ◽  
Cross Sectional ◽  
Ckd Stage

Abstract Background: Chronic kidney disease (CKD) is a growing global health problem with faster progression in developing countries such as Iran. Here we aimed to evaluate the prevalence and determinants of CKD stage III+.Methods: This research is part of the Khuzestan Comprehensive Health Study (KCHS), a large observational population-based cross-sectional study in which 30041 participants aged 20 to 65 were enrolled. CKD was determined with estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73m2, based on two equations of Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The multivariate logistic regression was used to evaluate the CKD stage III+ determinants.Results: Prevalence of CKD stage III+ is estimated to be 7.1 %, 5.5%, and 5.4% based on MDRD, CKD-EPI, and combination of both equations, respectively. More than 89% of CKD subjects aged higher than 40 years. In regression analysis, age more than 40 years had the strongest association with CKD stage III+ probability (OR: 8.23, 95% CI: 6.91-9.18). Higher wealth score, hypertension, High-Density Lipoprotein levels less than 40 mg/dl, and higher waist to hip ratio were all associated with CKD stage III+ while Arab ethnicity showed a protective effect (OR: 0.69, 95% CI: 0.57-0.78). Conclusion: Our findings provide detailed information on the CKD stage III+ and its determinants in the southwest region of Iran. Due to strong association between age and CKD stage III+, within a few decades we might expect a huge rise in the CKD prevalence.

scholarly journals Medication Burden And Inappropriate Prescription Risk Among Elderly With Advanced Chronic Kidney Disease

2019 ◽  
Author(s):  
Clarisse Roux-Marson ◽  
Jean-Baptiste Baranski ◽  
Coraline Fafin ◽  
Guillaume Extermann ◽  
Cecile Vigneau ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Healthcare Providers ◽  
Antihypertensive Agents ◽  
The Elderly ◽  
Anticholinergic Drugs ◽  
Cross Sectional ◽  
Dose Modification ◽  
Severe Impairment

Abstract Background Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥ 75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications (PIMs) that they take. Methods This is a cross-sectional analysis of medication profiles of individuals aged ≥ 75 years with eGFR < 20 ml/min/1.73m2 followed by a nephrologist, who collected their active prescriptions at the study inclusion visit. Medication profiles were first analyzed according to route of administration, therapeutic classification. Second, patients were classified according to their risk of potential medication-related problems, based on whether the prescription was a RIM or a PIM. RIMs and PIMs have been defined according to renal appropriateness guidelines and to Beer’s criteria in the elderly. RIMs were subclassified by 4 types of category : (a) contraindication; (b) dose modification is recommended based on creatinine clearance (CrCl); (c) dose modification based on CrCl is not recommended but a maximum daily dose is mentioned, (d) no specific recommendations based on CrCl : “use with caution”, “avoid in severe impairment”, “careful monitoring of dose is required” “reduce the dose”. Results We collected 5196 individual medication prescriptions for 556 patients, for a median of 9 daily medications [7-11]. Antihypertensive agents, antithrombotics, and antianemics were the classes most frequently prescribed. Moreover, 77.0% of patients had at least 1 medication classified as a RIM. They accounted 31.3% of the drugs prescribed and 9.25% was contraindicated drugs. At least 1 PIM was taken by 57.6% and 45.5% of patients had at least one medication classified as RIM and PIM. The prescriptions most frequently requiring reassessment due to potential adverse effects were for proton pump inhibitors and allopurinol. The PIMs for which deprescription is especially important in this population are rilmenidine, long-term benzodiazepines, and anticholinergic drugs such as hydroxyzine. Conclusion We showed potential drug-related problems in elderly patients with advanced CKD. Healthcare providers must reassess each medication prescribed for this population, particularly the specific medications identified here.

Sign in / Sign up

Export Citation Format

Share Document