scholarly journals Chronic Kidney Disease Patients Visiting Various Hospital Departments: An Analysis in a Hospital in Central Tokyo, Japan

2022 ◽  
Vol 12 (1) ◽  
pp. 39
Author(s):  
Akira Fukui ◽  
Kohei Takeshita ◽  
Akio Nakashima ◽  
Yukio Maruyama ◽  
Takashi Yokoo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Records ◽  
Protein Concentration ◽  
Healthcare Providers ◽  
Dipstick Test ◽  
Progress Management ◽  
Wide Range ◽  
Urine Dipstick Test ◽  
Clinical Departments

To further improve care for chronic kidney disease (CKD) patients, healthcare providers’ awareness of CKD must be raised. Proteinuria testing is essential for CKD care, and collaboration with specialists is recommended for advanced cases. We reviewed data from the electronic medical records of outpatients at our hospital to analyze the clinical departments visited by CKD patients, and the frequency of proteinuria testing and referrals to nephrologists. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or a urine protein concentration (U-pro) ≥ +1. We found that 31.1% of the CKD tests in September 2021 were performed in clinical departments other than internal medicine. Furthermore, within 1 year, 68.0% of CKD patients identified in September 2020 underwent a urine dipstick test, and 33.7% underwent a quantitative test for urinary protein or albumin. Additionally, 27.5% of individuals with an eGFR < 30 mL/min/1.73 m2 or U-pro ≥ +1 identified by non-nephrology departments in September 2020 visited the nephrology department within 1 year. Repeated assessments of these quality indicators may be useful for progress management in improving CKD care. Because CKD patients visited various departments in our hospital, campaigns to raise CKD awareness must reach a wide range of healthcare providers in hospitals.

scholarly journals Gambaran Pasien yang Menjalani Prosedur Bedah Emergensi di RSUP Prof. Dr. R. D. Kandou Manado Periode Januari - September 2019

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Utrecht Suleman ◽  
Angelica M. J. Wagiu ◽  
Stephanus J. Ch. Tangel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Surgical Procedures ◽  
Emergency Surgery ◽  
Medical Records ◽  
Health Centers ◽  
Surgical Patients ◽  
Age Group ◽  
Adult Age ◽  
Epidural Hemorrhage

Abstract: Emergency surgery is performed to avoid further complications of the disease or to save the patient's life. Albeit, there are lack of data in various health centers in Indonesia regarding the evaluation of emergency surgical patients, This study was aimed to obtain the profile of patients undergoing emergency surgical procedures in the Emergency Department of Surgery at Prof. Dr. R. D. Kandou Hospital Manado from January to September 2019. This was a retrospective and descriptive study using patients’ medical records. The results showed that there were 540 patients in this study. Most of the patients were adult age group (18-59 years) as many as 343 patients (63.5%), males 366 patients (67.8%), and non-traumatic cases 436 patients (80.4%). The most common cases of trauma was epidural hemorrhage as many as 23 patients (4.3%) meanwhile the most common non-traumatic cases was chronic kidney disease as many as 122 patients (22.6%). According to the type of surgery, CDL insertion and laparotomy were performed on 131 patients each (24.3%). In conclusion, most patients undergoing emergency surgical procedures were 18-59 years old, males, and non-traumatic cases.Keywords: emergency surgery, traumatic cases, non-traumatic cases Abstrak: Bedah emergensi dilakukan dalam keadaan sangat darurat untuk menghindari komplikasi lanjut dari proses penyakit atau untuk menyelamatkan jiwa pasien. Data mengenai pasien bedah emergensi di berbagai pusat kesehatan di Indonesia masih sangat kurang. Penelitian ini bertujuan untuk mendapatkan gambaran pasien yang menjalani prosedur bedah emergensi di IGD Bedah RSUP Prof. Dr. R. D. Kandou Manado periode Januari sampai September 2019. Jenis penelitian ialah deskriptif retrospektif, menggunakan data rekam medik pasien. Hasil penelitian menunjukkan bahwa dari 540 pasien, didapatkan pasien terbanyak dari golongan usia dewasa (18-59 tahun) yaitu 343 pasien (63,5%), jenis kelamin laki-laki 366 pasien (67,8%), dan kasus non-trauma 436 pasien (80,4%). Kasus trauma terbanyak yaitu epidural hemorrhage pada 23 pasien (4,3%) sedangkan kasus non trauma terbanyak chronic kidney disease pada 122 pasien (22,6%). Menurut jenis tindakan operasi yang terbanyak ialah insersi CDL dan laparotomy, masing-masing 131 pasien (24,3%). Simpulan penelitian ini ialah pasien yang menjalani prosedur bedah emergensi terbanyak ialah usia 18-59 tahun, jenis kelamin laki-laki, dan jenis kasus non-trauma.Kata kunci: bedah emergensi, kasus trauma, kasus non-trauma

scholarly journals Gambaran Anemia pada Subjek Penyakit Ginjal Kronik Stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yordhan Tamsil ◽  
Emma Sy. Moeis ◽  
Frans Wantania
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Records ◽  
Iron Status ◽  
Descriptive Study ◽  
Transfusion Therapy ◽  
Female Age ◽  
Stage 4 ◽  
Almost All ◽  
Age Range

Abstract: Anemia is a complication of chronic kidney disease (CKD) that often occurs. Moreover, it can occur earlier than other complications of CKD in almost all patients with late stage kidney disease. This study was aimed to obtain the profile of anemia in subjects with stage 4 and 5 of chronic kidney disease. This was a retrospective and descriptive study using medical records of patients with CKD associated with anemia for two years. The results showed that of 428 CKD patients, 131 suffered from anemia (30.60%). The majority of patients were female (54.19%), age range 60-69 years (44.27%), non-dialysis stage 5 of CKD patients (74.04%), had sufficient iron status (79.38%). However, 15,26% of the 131 patients got blood transfusion therapy. In conclusion, the majority of CKD patients were stage 5 ND, female, age range of 60-69 years, had sufficient iron status, and were not treated with blood transfusion.Keywords: chronic kidney disease, anemia Abstrak: Anemia merupakan komplikasi penyakit ginjal kronik (PGK) yang sering terjadi, bahkan dapat terjadi lebih awal dibandingkan komplikasi PGK lainnya dan hampir pada semua pasien penyakit ginjal tahap akhir. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada subyek penyakit ginjal kronik stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah metode deskriptif retroskpektif dengan mengunakan data rekam medik pasien PGK dengan anemia selama dua tahun. Hasil penelitian memperlihatkan dari 428 pasien PGK didapatkan 131 pasien dengan anemia pada PGK (30,60%). Mayoritas pasien ialah jenis kelamin perempuan (54,19%), usia 60-69 tahun (44,27%), dan PGK derajat 5 non-dialisis (74,04%), memiliki status besi cukup (79,38%). Terdapat 15,26% dari pasien yang mendapatkan terapi transfusi darah. Simpulan penelitian ini ialah pasien terbanyak dengan derajat 5 ND, jenis kelamin perempuan, rentang usia 60-69 tahun, dengan status besi cukup, dan tidak mendapat terapi transfusi darah.Kata kunci: penyakit ginjal kronik, anemia

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 Chronic Kidney Disease Prediction using Machine Learning Models

2019 ◽  
Vol 9 (1) ◽  
pp. 6364-6367
Keyword(s):  
Machine Learning ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Failure ◽  
Bone Diseases ◽  
Machine Learning Algorithms ◽  
Knowledge Generation ◽  
Good Prediction ◽  
Worst Case ◽  
Wide Range

The field of biosciences have advanced to a larger extent and have generated large amounts of information from Electronic Health Records. This have given rise to the acute need of knowledge generation from this enormous amount of data. Data mining methods and machine learning play a major role in this aspect of biosciences. Chronic Kidney Disease(CKD) is a condition in which the kidneys are damaged and cannot filter blood as they always do. A family history of kidney diseases or failure, high blood pressure, type 2 diabetes may lead to CKD. This is a lasting damage to the kidney and chances of getting worser by time is high. The very common complications that results due to a kidney failure are heart diseases, anemia, bone diseases, high potasium and calcium. The worst case situation leads to complete kidney failure and necessitates kidney transplant to live. An early detection of CKD can improve the quality of life to a greater extent. This calls for good prediction algorithm to predict CKD at an earlier stage . Literature shows a wide range of machine learning algorithms employed for the prediction of CKD. This paper uses data preprocessing,data transformation and various classifiers to predict CKD and also proposes best Prediction framework for CKD. The results of the framework show promising results of better prediction at an early stage of CKD

Concomitant Burkholderiapseudomallei and Staphylococcus aureus Infection in a chronic kidney disease patient: A Case Report and Literature Review

2021 ◽  
Vol 20 (2) ◽  
pp. 456-458
Author(s):  
Norjihan Abdul Hamid ◽  
Mohd Zulfakar Mazlan ◽  
Zeti Norfidiyati Salmuna
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Patient ◽  
Medical Science ◽  
Disease Patient ◽  
Asymptomatic Infection ◽  
Clinical Presentations ◽  
Wide Range ◽  
Diagnostic Microbiology ◽  
And Staphylococcus Aureus

Melioidosis can happen in humans and animals. It has a wide range of clinical presentations that include asymptomatic infection, ulcers or abscesses of the skin, pneumonia, and multiple internal organ abscesses that may lead to fulminant septic shock. The organism presence in soil and surface of the water. We present a case of a non-diabetic chronic kidney disease patient presented with multiple carbuncles and respiratory melioidosis in which we are able to isolate B. pseudomallei after prolonging the plate incubation for 48-hours. We also suggested available tests in most diagnostic microbiology laboratory for identification of the organism. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.456-458

Epidemiology of calcium, phosphate, and parathyroid hormone disturbances in chronic kidney disease

2018 ◽  
Author(s):  
Patrick Biggar ◽  
Hansjörg Rothe ◽  
Markus Ketteler
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Bone Biopsy ◽  
Normal Population ◽  
Laboratory Parameter ◽  
Risk Indicator ◽  
Calcium Balance ◽  
Wide Range

Chronic kidney disease-mineral and bone disorders (CKD-MBD), calcium, phosphate, and parathyroid hormone are biomarkers of mortality and cardiovascular risk. Hyperphosphataemia is a prominent and pathophysiologically most plausible risk indicator. Calcium balance and load appear to be more important than serum concentrations. Parathyroid hormone is a less reliable marker with a relatively wide range extending above that applicable for a normal population especially when used as a singular laboratory parameter without additional assessment of bone metabolism, for example, bone-specific alkaline phosphatase and bone biopsy. There is not a single prospective controlled hard-outcome study that provides us with unequivocal evidence that such an isolated laboratory parameter-based treatment approach will lead to significant clinical improvements. As CKD-MBD is complex, clinical decisions would be made easier by informative prospective trials.

scholarly journals The dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) trial: baseline characteristics

2020 ◽  
Vol 35 (10) ◽  
pp. 1700-1711 ◽  
Author(s):  
David C Wheeler ◽  
Bergur V Stefansson ◽  
Mikhail Batiushin ◽  
Oleksandr Bilchenko ◽  
David Z I Cherney ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Enzyme Inhibitor ◽  
Kidney Diseases ◽  
Sglt2 Inhibitor ◽  
Adverse Outcomes ◽  
Chronic Glomerulonephritis ◽  
Hypertensive Nephropathy ◽  
Wide Range ◽  
Baseline Characteristics

Abstract Background The Dapagliflozin and Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD; NCT03036150) trial was designed to assess the effect of the sodium–glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin on kidney and cardiovascular events in participants with CKD with and without type 2 diabetes (T2D). This analysis reports the baseline characteristics of those recruited, comparing them with those enrolled in other trials. Methods In DAPA-CKD, 4304 participants with a urinary albumin:creatinine ratio (UACR) ≥200 mg/g and estimated glomerular filtration rate (eGFR) between 25 and 75 mL/min/1.73 m2 were randomized to dapagliflozin 10 mg once daily or placebo. Mean eGFR was 43.1 mL/min/1.73 m2 and median UACR was 949 mg/g (108 mg/mmol). Results Overall, 2906 participants (68%) had a diagnosis of T2D and of these, 396 had CKD ascribed to a cause other than diabetes. The most common causes of CKD after diabetes (n = 2510) were ischaemic/hypertensive nephropathy (n = 687) and chronic glomerulonephritis (n = 695), of which immunoglobulin A nephropathy (n = 270) was the most common. A total of 4174 participants (97%) were receiving an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 1882 (43.7%) diuretics, 229 (5.3%) mineralocorticoid receptor antagonists and 122 (2.8%) glucagon-like peptide 1 receptor agonists. In contrast to the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE), the DAPA-CKD trial enrolled participants with CKD due to diabetes and to causes other than diabetes. The mean eGFR of participants in the DAPA-CKD trial was 13.1 mL/min/1.73 m2 lower than in CREDENCE, similar to that in the Finerenone in Reducing Kidney Failure and Disease Progression in DKD (FIDELIO-DKD) trial and the Study Of diabetic Nephropathy with AtRasentan (SONAR). Conclusions Participants with a wide range of underlying kidney diseases receiving renin–angiotensin system blocking therapy have been enrolled in the DAPA-CKD trial. The trial will examine the efficacy and safety of dapagliflozin in participants with CKD Stages 2–4 and increased albuminuria, with and without T2D.

scholarly journals Felodipine in Treatment of Arterial Hypertension and Ischemic Heart Disease

2020 ◽  
Vol 16 (4) ◽  
pp. 654-662
Author(s):  
O. D. Ostroumova ◽  
I. A. Alautdinova ◽  
A. I. Kochetkov ◽  
S. N. Litvinova
Keyword(s):  
Chronic Kidney Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Ischemic Heart Disease ◽  
Arterial Hypertension ◽  
Ischemic Heart ◽  
Sufficient Evidence ◽  
Clinical Effects ◽  
First Line ◽  
Wide Range

Cardiovascular diseases are the leading cause of death both in the world and in the Russian Federation. The most significant contributors to the increase in mortality are arterial hypertension (AH) and ischemic heart disease (IHD). Dihydropyridine calcium channel blockers (CCBs) are the first line of treatment for these conditions. This is noted in the clinical guidelines for the diagnosis and treatment of AH and in the guidelines for the management of patients with chronic coronary syndromes. CCBs are a heterogeneous group of drugs that have both general and individual pharmacokinetic and pharmacodynamic properties. They are used in patients with AH and/or IHD, including those with concomitant diseases (diabetes mellitus, chronic kidney disease, bronchial asthma, chronic obstructive pulmonary disease, peripheral arterial disease). Felodipine is one of the CCBs. It has a combination of clinical effects, allowing the drug to be prescribed as a first-line therapy for AH, IHD and a combination of these diseases. This is noted in the registered indications for its use. This CCB has a sufficient evidence base of clinical trials demonstrating not only good antihypertensive and antianginal potential of the drug, but also the nephroprotection and cerebroprotection properties. The nephroprotective effect of felodipine is associated with a slowdown in the progression of chronic kidney disease, and the cerebroprotective effect is associated with a decrease in the risk of stroke and an improvement in cognitive functioning. The safety profile of felodipine is favorable: peripheral edema develops much less frequently. This is confirmed by the results of comparative studies. Felodipine is recommended for a wide range of patients with AH, IHD and their combination due to such clinical and pharmacological properties.

Strategies designed to increase the motivation for and adherence to dietary recommendations in patients with chronic kidney disease

2020 ◽  
Author(s):  
Raíssa Antunes Pereira ◽  
Marle S Alvarenga ◽  
Carla Maria Avesani ◽  
Lilian Cuppari
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Healthcare Providers ◽  
Poor Adherence ◽  
Counseling Skills ◽  
Dietary Recommendations ◽  
Factors Associated ◽  
The Poor ◽  
Positive Results ◽  
Counseling Approach

Abstract Chronic kidney disease (CKD) often requires several dietary adjustments to control the disease-related disturbances. This is challenging for both patients and healthcare providers, and particularly for dietitians, who deal closely with the poor adherence to dietary recommendations. Factors associated with poor adherence within the CKD scenario and the need for a shift in the paradigm have already been indicated in several studies; however, rarely are any different and/or potential strategies actually formulated in order to change this paradigm. In this review, we aimed to explore the concepts and factors surrounding adherence to dietary recommendations in CKD and further describe certain potential strategies for a nutritional counseling approach. Such strategies, while poorly explored within CKD, have shown positive results in other chronic disease scenarios. It is timely, therefore, for healthcare providers to acquire these new counseling skills; nevertheless, this would require a rethinking of the traditional attitudes and approaches in order to build a partnership, based on a nonjudgmental and compassionate style in order to guide behavior change. The reflections presented in this review may contribute towards enhancing motivation and the adherence to dietary recommendations in CKD patients.

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