scholarly journals Contemporary National Outcomes of Acute Myocardial Infarction-Cardiogenic Shock in Patients with Prior Chronic Kidney Disease and End-Stage Renal Disease

2020 ◽  
Vol 9 (11) ◽  
pp. 3702
Author(s):  
Saraschandra Vallabhajosyula ◽  
Lina Ya’Qoub ◽  
Vinayak Kumar ◽  
Dhiran Verghese ◽  
Anna V. Subramaniam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Coronary Angiography ◽  
Hospital Mortality ◽  
End Stage Renal Disease ◽  
Ckd Stage ◽  
Stage Renal Disease ◽  
End Stage

Background: There are limited data on acute myocardial infarction with cardiogenic shock (AMI-CS) stratified by chronic kidney disease (CKD) stages. Objective: To assess clinical outcomes in AMI-CS stratified by CKD stages. Methods: A retrospective cohort of AMI-CS during 2005–2016 from the National Inpatient Sample was categorized as no CKD, CKD stage-III (CKD-III), CKD stage-IV (CKD-IV) and end-stage renal disease (ESRD). CKD-I/II were excluded. Outcomes included in-hospital mortality, use of coronary angiography, percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS). We also evaluated acute kidney injury (AKI) and acute hemodialysis in non-ESRD admissions. Results: Of 372,412 AMI-CS admissions, CKD-III, CKD-IV and ESRD comprised 20,380 (5.5%), 7367 (2.0%) and 18,109 (4.9%), respectively. Admissions with CKD were, on average, older, of the White race, bearing Medicare insurance, of a lower socioeconomic stratum, with higher comorbidities, and higher rates of acute organ failure. Compared to the cohort without CKD, CKD-III, CKD-IV and ESRD had lower use of coronary angiography (72.7%, 67.1%, 56.9%, 61.1%), PCI (53.7%, 43.8%, 38.4%, 37.6%) and MCS (47.9%, 38.3%, 33.3%, 34.2%), respectively (all p < 0.001). AKI and acute hemodialysis use increased with increase in CKD stage (no CKD–38.5%, 2.6%; CKD-III–79.1%, 6.5%; CKD-IV–84.3%, 12.3%; p < 0.001). ESRD (adjusted odds ratio [OR] 1.25 [95% confidence interval {CI} 1.21–1.31]; p < 0.001), but not CKD-III (OR 0.72 [95% CI 0.69–0.75); p < 0.001) or CKD-IV (OR 0.82 [95 CI 0.77–0.87] was predictive of in-hospital mortality. Conclusions: CKD/ESRD is associated with lower use of evidence-based therapies. ESRD was an independent predictor of higher in-hospital mortality in AMI-CS.

scholarly journals In-hospital mortality of acute myocardial infarction in patients with and without renal dysfunction

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Abdul Rehman Abid ◽  
Muhammad Tahir Mohyuddin ◽  
Liaqat Ali ◽  
Muhammad Shahid Naveed ◽  
Nadeem Hayat Mallick
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Renal Insufficiency ◽  
Renal Disease ◽  
Hospital Mortality ◽  
Renal Dysfunction ◽  
End Stage Renal Disease ◽  
Study Population ◽  
Stage Renal Disease ◽  
End Stage

Objective: To compare in-hospital mortality of acute myocardial Infarction in patients having normal renal functions with renal dysfunction patients. Setting: Emergency ward, Coronary care units and cardiology wards of the Punjab Institute of Cardiology Lahore. Study design: It was a comparative study. Sample size: 1000 consecutive patients presenting with acute myocardial infarction admitted to the Punjab Institute of cardiology Lahore were studied from 1st March 2004 to 15th August 2004. Results: After fulfilling the inclusion criteria 1000 patients were studied. The mean age of the study population was 60.8+9.38 years. Total number of males in the study population was 642(64.2%) while female patients were 358(35.8%). Patients with any degree of renal dysfunction, except those with end-stage renal disease were more likely to present with anterior MI than were patients without renal dysfunction. Patients with end-stage renal disease and more severe renal dysfunction were more likely to develop heart failure during hospitalization, to experience atrial fibrillation, and to have mechanical complications. Streptokinase therapy was used less frequently in patients with any degree of renal dysfunction than in patients without renal dysfunction, despite a similar incidence of MI. In-hospital mortality was 51(12%) in Group I patients, 46(16.6%) in Group II patients, 36(22%) in Group III patients, 35(27.7%) in Group IV patients and 5(35.7%) in Group V patients with a p value of <0.0001. Severe renal insufficiency had the maximum in-hospital mortality with OR of 5.4 and 95% confidence interval of 2.9-10.3 followed by end stage renal disease OR 5.1 (CI 2.2-12.1), moderate renal insufficiency OR 4.1 (CI 2.3-7.2) and mild renal insufficiency OR 1.9(CI 1.1-3.1) with a p value of <0.0001. Similarly congestive heart failure during hospital stay was observed in 20(4.7%) patients in Group I, 17(6.1%) patients in Group II, 15(9.4%) patients in Group III, 16(12.6%) patients in Group IV and 4(28.6%) patients in Group V. Similar trends were observed in mechanical complications and post myocardial arrhythmias in the study population, Conclusion: Patients with renal dysfunction who have acute MI are a high-risk population and suffer from increased mortality once they are admitted to the hospital. This is because of presence of more risk factors in this sub set of patients.

scholarly journals Comparison of Lipid Profile Among the Different Stages of Chronic Kidney Disease in Children

KYAMC Journal ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 137-142
Author(s):  
Muhammad Mozammel Haque ◽  
Mosammat Afroza Jinnat ◽  
Shafi Ahmed ◽  
Ranjit Ranjan Roy ◽  
Mohammad Akteruzzaman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Lipid Profile ◽  
End Stage Renal Disease ◽  
Obstructive Uropathy ◽  
Group I ◽  
Ckd Stage ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic Kidney Disease (CKD) is associated with significantly increased morbidity and mortality. Children with (CKD)/End stage renal disease (ESRD) exhibit various co-morbidities, including dyslipidemia. Hypertriglyceridemia is inversely correlated with renal function. Children with advanced chronic kidney disease or end stage renal disease developed atherosclerosis and cardiovascular disease. Objectives: To measure the lipid profile in kidney disease and comparison of lipid profile among the different stages of CKD. Materials and Methods: A cross sectional analytic study to measure and compare lipid profile in fifty children with different stages of chronic kidney disease during January 2016 to June 2016 by purposive sampling technique and divided into two groups, Children with CKD stage iii and iv included in Group I and CKD stage V and V(D) included in Group II. Results: Out of Fifty children with CKD, 28(56%) were male and 22 (44%) male, 30(60%) were of11-15 year age group and 32(64%) were from rural area and 18(36%) from urban area. The etiology of CKD in two groups glomerulonephritis were 14(28%), obstructive uropathy 15 (30%), hypoplasia/dysplasia 9(18%), polycystic kidney disease 9(18%) and acute kidney injury 3(6%). All the cases were anemic, 26(52%) were hypertensive and 20(40%) had osteodystrophy. Conclusion: Dyslipidemia specially hypertriglyceridemia is common in children with CKD. Hypertriglyceridemia is inversely related to severity of CKD stages. KYAMC Journal Vol. 10, No.-3, October 2019, Page 137-142

scholarly journals Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (1) ◽  
pp. 326
Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Root Canal ◽  
Dialysis Patients ◽  
Root Canal Therapy ◽  
Risk Of Death ◽  
Stage Renal Disease ◽  
End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

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