scholarly journals Association of Serum Phosphate with Low Handgrip Strength in Patients with Advanced Chronic Kidney Disease

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3605
Author(s):  
Ping-Huang Tsai ◽  
Hsiu-Chien Yang ◽  
Chin Lin ◽  
Chih-Chien Sung ◽  
Pauling Chu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Serum Phosphate ◽  
Advanced Chronic Kidney Disease ◽  
Progressive Decline ◽  
Appendicular Skeletal Muscle

Muscle wasting and hyperphosphatemia are becoming increasingly prevalent in patients who exhibit a progressive decline in kidney function. However, the association between serum phosphate (Pi) level and sarcopenia in advanced chronic kidney disease (CKD) patients remains unclear. We compared the serum Pi levels between advanced CKD patients with (n = 51) and those without sarcopenia indicators (n = 83). Low appendicular skeletal muscle mass index (ASMI), low handgrip strength, and low gait speed were defined per the standards of the Asian Working Group for Sarcopenia. Mean serum Pi level was significantly higher in advanced CKD patients with sarcopenia indicators than those without sarcopenia indicators (3.88 ± 0.86 vs. 3.54 ± 0.73 mg/dL; p = 0.016). Univariate analysis indicated that serum Pi was negatively correlated with ASMI, handgrip strength, and gait speed. Multivariable analysis revealed that serum Pi was significantly associated with handgrip strength (standardized β = −0.168; p = 0.022) and this association persisted even after adjustments for potential confounders. The optimal serum Pi cutoff for predicting low handgrip strength was 3.65 mg/dL, with a sensitivity of 82.1% and specificity of 56.6%. In summary, low handgrip strength is common in advanced CKD patients and serum Pi level is negatively associated with handgrip strength.

scholarly journals Serum phosphate as an additional marker for initiating hemodialysis in patients with advanced chronic kidney disease

2015 ◽  
Vol 38 (6) ◽  
pp. 531-537 ◽  
Author(s):  
Yueh-An Lu ◽  
Shen-Yang Lee ◽  
Hui-Yi Lin ◽  
Yen-Chun Liu ◽  
Huang-Kai Kao ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Phosphate ◽  
Advanced Chronic Kidney Disease ◽  
Additional Marker

scholarly journals Sarcopenia is an independent predictor of hospitalization in chronic kidney disease outpatients

2019 ◽  
Author(s):  
Hye Yun Jeong ◽  
Wooyeol Ahn ◽  
Jun Chul Kim ◽  
Yu Bum Choi ◽  
Jinkwon Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Strength ◽  
Proportional Hazards ◽  
Handgrip Strength ◽  
Cox Proportional Hazards ◽  
Chronic Illnesses ◽  
Free Survival ◽  
Cox Proportional Hazards Models ◽  
Appendicular Skeletal Muscle

AbstractBackgroundPatients with chronic kidney disease (CKD) experience much more marked and earlier muscle wasting than subjects who do not have chronic illnesses. However, a few studies that have examined sarcopenia have been reported in CKD patients. We investigated the prevalence of sarcopenia in predialysis and dialysis outpatients with CKD and explored its relationship with the clinical outcomes.MeasurementsSarcopenia was defined as reduced muscle strength accompanied by decreased adjusted appendicular skeletal muscle (ASM), while those patients who exhibited only one of these characteristics were categorized as presarcopenic patients. ASM was measured by bioimpedence analysis, and muscle strength was evaluated by handgrips. ASM was adjusted by weight (ASM/wt). Patients were prospectively followed for up to 2 years.ResultsOne hundred seventy-nine patients were recruited (114 male and 65 female patients who were classified into 103 predialysis patients and 76 dialysis patients, with 44.7% having diabetes). Their mean age was 60.6 ± 13.5 years old. The prevalence of sarcopenia was 9.5%, while 55.9% of the patients were categorized as presarcopenic. The ASM/wt index showed significant correlations with age, handgrip strength, HOMA-IR and frailty scores. Multivariate Cox proportional hazards models demonstrated that the risk of hospitalization was significantly higher for patients with presarcopenia [hazard ratio (HR), 2.48; 95% confidence interval (CI), 1.180–5.230], and the risk of hospitalization was much higher for patients with sarcopenia than for patients in the nonsarcopenic group (HR, 9.11; 95% CI, 2.295–25.182)ConclusionsSarcopenia and presarcopenia, which were defined using the ASM/wt index and handgrip strength, predicted a poorer, hospitalization-free survival in CKD patients

scholarly journals 338. Multicenter Evaluation of Superinfection Occurrence and Impact on Clinical Outcomes in Patients with COVID-19

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S273-S274
Author(s):  
Taryn A Eubank ◽  
Katherine Perez ◽  
William L Musick ◽  
Kevin W Garey
Keyword(s):  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Treatment Algorithm ◽  
Occurrence Rate ◽  
Stepwise Logistic Regression ◽  
Increased Risk ◽  
Baseline Characteristics

Abstract Background The coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread globally throughout late 2019. During this pandemic, concern for bacterial and fungal superinfections has been present during the treatment of these patients. Methods Hospitalized, adult patients with laboratory confirmed and symptomatic COVID-19 disease admitted between March 12, 2020 and May 31, 2020 were eligible for inclusion in this study. Data was obtained from electronic medical records and the hospital system’s clinical surveillance program including demographics, comorbidities, hospitalization dates, laboratory values, mechanical ventilation, positive blood and respiratory cultures, treatment administration for COVID-19 as defined by the system’s fluid treatment algorithm, and discharge disposition. Outcomes of this analysis include overall bacterial and fungal superinfection occurrence rate within 28 days of admission, patient characteristics that correlate with a higher risk of a superinfection, and the effect on 28-day mortality. Patient Population Flow diagram of patient inclusion. Results A total of 404 patients were included in the study analyses of which 56 (13.9%) had a documented superinfection within 28-days from admission. The most common superinfection organisms observed were Staphylococcus spp. (36.9%), Candida spp. (16.7%), and Klebsiella spp. (13.1%). Mortality was significantly higher in patients with superinfections (12.1% vs 5.8%, p < 0.001). To best assess characteristics that place patients at a higher risk of superinfection, a backwards, stepwise, multivariable logistic regression was performed. Black ethnicity, chronic kidney disease, intensive care unit (ICU) upon admission, lymphocytopenia, and receipt of tocilizumab were found to more likely have a superinfection within 28-days from admission. Baseline Characteristics Comparison and analysis of baseline characteristics in patients with or without superinfection present. 28-day Mortality Day-28 mortality comparison in patients with or without superinfection. Mortality was observed in 7/58 patients with a superinfection versus 20/346 patients without superinfection present (p < 0.001). Multivariable analysis results for increased superinfection risk. All baseline characteristics with univariate analysis resulting in a p value of < 0.2 were included in the backwards, stepwise logistic regression model. Conclusion In conclusion, our retrospective cohort study reports a superinfection rate of 13.9%. Presence of a superinfection significantly increases the likelihood of mortality within 28-days from admission. Characteristics that have a significant correlation to increased risk of superinfections include Black ethnicity, chronic kidney disease, ICU upon admission, and receipt of tocilizumab. Disclosures Kevin W. Garey, Pharm.D., M.S., FASHP, Summit Therapeutics (Research Grant or Support)

scholarly journals Sarcopenia is an independent predictor of hospitalization in chronic kidney disease outpatients

2020 ◽  
Author(s):  
Hye Yun Jeong ◽  
Taeyoung Yang ◽  
Hyeyeon Lee ◽  
Wooyeol Ahn ◽  
Jun Chul Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Strength ◽  
Proportional Hazards ◽  
Handgrip Strength ◽  
Cox Proportional Hazards ◽  
Chronic Illnesses ◽  
Free Survival ◽  
Cox Proportional Hazards Models ◽  
Appendicular Skeletal Muscle

Abstract Background/AimsPatients with chronic kidney disease (CKD) experience much more marked and earlier muscle wasting than subjects who do not have chronic illnesses. However, a few studies that have examined sarcopenia have been reported in CKD patients. We investigated the prevalence of sarcopenia in predialysis and dialysis outpatients with CKD and explored its relationship with the clinical outcomes.MethodsSarcopenia was defined as reduced muscle strength accompanied by decreased adjusted appendicular skeletal muscle (ASM), while those patients who exhibited only one of these characteristics were categorized as presarcopenic patients. ASM was measured by bioimpedence analysis, and muscle strength was evaluated by handgrips. ASM was adjusted by weight (ASM/wt). Patients were prospectively followed for up to 2 years.ResultsOne hundred seventy-nine patients were recruited (114 male and 65 female patients who were classified into 103 predialysis patients and 76 dialysis patients, with 44.7% having diabetes). Their mean age was 60.6 ± 13.5 years old. The prevalence of sarcopenia was 9.5%, while 55.9% of the patients were categorized as presarcopenic. The ASM/wt index showed significant correlations with age, handgrip strength, HOMA-IR and frailty scores. Multivariate Cox proportional hazards models demonstrated that the risk of hospitalization was significantly higher for patients with presarcopenia [hazard ratio (HR), 2.48; 95% confidence interval (CI), 1.180–5.230], and the risk of hospitalization was much higher for patients with sarcopenia than for patients in the nonsarcopenic group (HR, 9.11; 95% CI, 2.295–25.182)ConclusionsSarcopenia and presarcopenia, which were defined using the ASM/wt index and handgrip strength, predicted a poorer, hospitalization-free survival in CKD patients.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

KECEMASAN PASIEN PENYAKIT GINJAL KRONIS YANG MENJALANI HEMODIALISA

2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Devi Novita Damanik
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rating Scale ◽  
Femoral Vein ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Emotional Disturbances ◽  
Hamilton Anxiety Rating Scale ◽  
One Year ◽  
Severe Anxiety

Background: Anxiety is a condition of psychological and physiological disorders characterized by cognitive, somatic, emotional disturbances and components of behavioral sequences. Purpose: This study aims to describe the anxiety of chronic kidney disease patients undergoing hemodialysis. Methods: This study uses univariate analysis which will describe the anxiety level of chronic kidney disease patients undergoing hemodialysis. The anxiety variable was measured using the HARS (Hamilton Anxiety Rating Scale) anxiety instrument with a validity value of 0.68 dd 0.93 and a reliability value of 0.93. The population in this study were all chronic kidney disease patients who underwent hemodialysis and experienced anxiety. The sampling technique used in this study was purposive sampling technique. The sample in this study were patients with chronic kidney disease who met the requirements of the study patients, namely: Patients who underwent hemodialysis for less than one year, patients undergoing hemodialysis with femoral vein puncture, patients undergoing hemodialysis twice a week. Results: The results showed that the study respondents had a mild anxiety rate of 9 patients (56.25%), moderate anxiety as many as 8 patients (21.875%) and severe anxiety as many as 8 patients (21.875%). Conclusion: conclusions and implications for nursing practice. The results showed a high incidence of anxiety in patients undergoing hemodialysis and distributed evenly on mild, moderate and severe anxiety.

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