SONOGRAPHIC FINDINGS OF PATIENTS WITH CHRONIC KIDNEY DISEASE

Objective: To describe the morphologic and hemodynamic changes of renal interlobar artery on ultrasonography, and to evaluate the relationship between RI and kidney size, glomerular filtration rate, and causes of chronic kidney disease. Materials and methods: A cross-sectional study of 50 chronic kidney disease patients from stage 3, and 50 healthy individuals. RI, peak systolic velocity (PSV), end diastolic velocity (EDV) of renal interlobar artery, renal size was measured. Results: The mean RI in chronic kidney disease group and healthy group was 0.68 ± 0.05 and 0.57 ± 0.04 (p <0.05), respectively. RI increases with the stage of chronic kidney disease. There were statistically significant differences in RI of renal lobar arteries between chronic pyelonephritis and chronic glomerulonephritis (p <0.05). There was strong negative correlation and a statistically significant difference between renal lobar renal artery RI with kidney size (horizontal, vertical and thickness) and glomerular filtration level. Conclusion: Renal artery resistance index in patients with chronic kidney disease was higher than in the healthy group. The greater the kidney failure is, the more reduction in size and renal function, and the more increase in renal artery resistance index. Key words: morphologic, hemodynamic, chronic kidney disease, ultrasonography

Effect of periodontal treatment on the glomerular filtration rate, reduction of inflammatory markers and mortality in patients with chronic kidney disease: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0245619 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245619

Author(s):

Théo Delbove ◽

François Gueyffier ◽

Laurent Juillard ◽

Emilie Kalbacher ◽

Delphine Maucort-Boulch ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Glomerular Filtration ◽

Systemic Inflammation ◽

Filtration Rate ◽

Periodontal Treatment ◽

Early Management ◽

Protein Levels ◽

Aim To assess the effect of periodontal treatment (PT) on glomerular filtration rate (GFR), systemic inflammation, or mortality in patients with chronic kidney disease (CKD). Methods A literature search was performed on PubMed and Web of Science databases on articles published until December 2019. The PRISMA guidelines were used throughout the manuscript. Results Of the total studies found, only 18 met the inclusion criteria; four retrospective and 14 prospective studies (including 3 randomized controlled trials–RCT). After PT, 3 studies investigated GFR, 2 found significant improvement; 11 (including 2 RCTs) investigated C-reactive protein levels, 9 found a significant improvement (including the 2 RCTs); 5 (including 3 RCTs) investigated Interleukine-6 level, 4 found a significant improvement (including 2 RCTs) and 2 studies evaluated mortality, one (retrospective study) found a significant difference. Conclusions Within the limitations of the present study, PT seems to improve CKD status, especially by reducing the systemic inflammation. Further RCTs are needed to confirm the results and specifically assess the influence of different types of PT in CKD patients. Taking into consideration the ability of PT to prevent further tooth loss and denutrition, early management of periodontitis is extremely important in patients with impaired renal function.

Usefulness of Change in Estimated Glomerular Filtration Rate as a Predicting Factor of Progression of Chronic Kidney Disease

ISRN Nephrology ◽

10.5402/2013/351364 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Kunimi Maeda ◽

Chieko Hamada ◽

Satoshi Horikoshi ◽

Yasuhiko Tomino

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Glomerular Filtration ◽

Odds Ratio ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Negative Slope ◽

Stepwise Logistic Regression ◽

Purpose. To explore factors contributing to chronic kidney disease (CKD) progression and change in estimated glomerular filtration rate over time (ΔeGFR) as a risk factor in predialysis patients under multidisciplinary managements. Methods. Among 113 CKD patients, eGFR, serum creatinine, total protein, albumin, urea nitrogen, uric acid, calcium, inorganic phosphate, total cholesterol, urinary creatinine, urinary protein (UP), hemoglobin A1c, hemoglobin, and hematocrit were analyzed. Results. ΔeGFR analysis in the first six months presented a positive slope (remission group) in 43 patients (38%) and a negative slope (no-remission group) in 70 patients (62%). Three-year dialysis-free rate was 89.4% in the remission group and 39.3% in the no-remission group, with a significant difference (). To explore factors contributing to dialysis initiation by stepwise Cox regression, baseline eGFR (HR 0.706, ) and ΔeGFR in the first six months of treatment (HR 0.075, ) were identified. To investigate factors affecting remission and no remission by stepwise logistic regression, age (odds ratio 1.06, ) and UP excretion (odds ratio 1.223, ) were identified. Conclusion. Monitoring of ΔeGFR and UP is not only useful in suppressing CKD 3 progression, but also in deciding strategies to achieve remission in individual patients.

Diagnosis of Chronic Kidney Disease by Three-Dimensional Contrast-Enhanced Ultrasound Combined with Augmented Reality Medical Technology

Journal of Healthcare Engineering ◽

10.1155/2021/5542822 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Yan Zhuang ◽

Juanjuan Sun ◽

Jiaqiang Liu

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Augmented Reality ◽

Renal Artery ◽

Medical Technology ◽

Three Dimensional ◽

Resistance Index ◽

3D Ultrasound ◽

Renal Parenchyma ◽

Kidney Volume

Chronic kidney disease is a worldwide clinical and public health problem. As a risk factor for cardiovascular and cerebrovascular diseases, the disease has gradually become one of the causes of morbidity and death. As a routine method of screening for kidney disease, ultrasound is very important in improving the rate of early detection and accuracy of chronic kidney disease. This article explores the value of applying 3D ultrasound in conjunction with augmented reality medical technology in chronic kidney disease, observing changes in kidney tumor at different stages with percutaneous 3D ultrasound in patients with chronic kidney disease. Volunteers with chronic kidney disease were selected for this experiment. Among them, 160 males and 140 females were diagnosed as chronic kidney disease by clinical or renal pathological biopsy, and they all met the K/DOQI diagnostic criteria for chronic kidney disease. The selected subjects met the criteria and were divided into 5 groups, each with 60 patients, to explore the correlation of properties such as three-dimensional ultrasound kidney volume in different stages of chronic kidney disease. Experiments have shown that, with the increase in the stages of chronic kidney disease, the elasticity and volume of the renal parenchyma decrease, and the resistance index of the renal artery becomes larger, P < 0.05 ; the difference is statistically significant, indicating that the elasticity of the renal parenchyma is associated with chronic kidney disease. The stage is negatively correlated, and the resistance index of the renal artery is positively correlated with the stage of chronic kidney disease. That is, as the stage of chronic kidney disease increases, the three-dimensional volume of the kidney shows a decreasing trend and the resistance index of the renal artery shows an increasing trend. Speed shows a declining trend and there is some correlation between the three.

Correlation of Carotid Artery Intima-Media Thickness with Age, Body Mass Index and Glomerular Filtration Rate in Chronic Kidney Disease Patients

Medicine Today ◽

10.3329/medtoday.v33i2.56062 ◽

2021 ◽

Vol 33 (2) ◽

pp. 147-151

Author(s):

Amir Mohammad Kaiser ◽

Rafi Nazrul Islam ◽

Miliva Mozaffor ◽

Salahuddin Feroz ◽

Md Mustafizur Rahman

Keyword(s):

Body Mass Index ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Glomerular Filtration ◽

Body Mass ◽

Filtration Rate ◽

Intima Media Thickness ◽

Significant Difference ◽

Positive Correlations

Introduction: Ultrasound measurements of the intima media thickness (IMT) in the carotid arteries is a strong predictor for cardiovascular events both in the general and diseased population. Materials & Methods: This cross-sectional analytic study was conducted to observe correlation of CIMT with age, body mass index (BMI) and glomerular filtration rate (GFR) in chronic kidney disease (CKD). The study was done in Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, on 80 chronic kidney disease patients, from July 2014 to June 2015. All the biochemical parameters were measured according to the standard laboratory techniques. Body mass index (BMI) was calculated by person’s body weight divided by height. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula. CIMT measurement was done by duplex study of carotid vessels through high resolution B-mode ultrasound. Results: Mean age of the patients was 36.1±9.5 years. 20 (25%), 26 (32.5%) and 34 (42.5%) patients were in CKD stage 3, 4 and 5 respectively. Age, serum creatinine and GFR showed statistically significant difference among stage 3, 4 and 5 CKD patients (p<0.001). However, no difference was evident in BMI and mean CIMT among stage 3, 4 and 5 CKD patients. Significant positive correlations were found between age and CIMT (r=+0.332; p=0.003) and BMI and CIMT (r=+0.294; p=0.008). However, no significant correlation was evident with estimated glomerular filtration rate (eGFR) and CIMT (r=–0.181; p=0.109). Conclusion: Age, serum creatinine and estimated glomerular filtration rate showed statistically significant difference among different stages of CKD patients (stage 3, 4 and 5). There were significant positive correlations found in between age and CIMT as well as BMI and CIMT in chronic kidney disease patients, with an exception to GFR and CIMT. Medicine Today 2021 Vol.33(2): 147-151

Abstract 33: Combination of Allogeneic Mesenchymal and Kidney-derived Stem Cells Promotes Kidney Repair in a Swine Model of Chronic Kidney Disease

Circulation Research ◽

10.1161/res.121.suppl_1.33 ◽

2017 ◽

Vol 121 (suppl_1) ◽

Author(s):

Angela C Rieger ◽

Bryon A Tompkins ◽

Makoto Natsumeda ◽

Victoria Florea ◽

Jose Rodriguez ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Stem Cells ◽

Kidney Disease ◽

Cell Therapy ◽

Renal Artery ◽

Swine Model ◽

Creatinine Ratio ◽

Urine Protein ◽

Increased Risk ◽

Background: Chronic kidney disease (CKD) has a high prevalence (~14% of the population) and is associated with a significantly increased risk of cardiovascular disease and a 15-fold higher rate of mortality than the general population. Current therapies slow disease progression but do not repair organ damage, leading to end-stage renal disease. Stem cell therapy has the potential to promote repair via neovascularization and antifibrotic effects. We tested the renal reparative capacity of allogeneic mesenchymal stem cells (MSCs) and kidney ckit+ stem cells (c-kit) in an established swine model of CKD. Methods: Yorkshires pigs (n=27) underwent 5/6 nephrectomy via renal artery embolization and 4-weeks later received either: MSC (10х10 6 ), c-kit (10х10 6 ), combination (MSC+c-kit; 1:1 ratio [5х10 6 each]), or placebo (each n=5). Allogeneic cell therapy was delivered via the patent renal artery of the remnant kidney. Kidney functional parameters and renal MRI were measured at baseline, and at 4- and 12-weeks (euthanasia) post-embolization. Results: The CKD model was validated from baseline to 4 weeks by an increased creatinine: (Δ1.1 ± 0.15 mg/dl; p<0.0001), BUN (Δ13.50 ± 2.99mg/dl; p=0.0003), and urine protein/creatinine ratio (Δ0.311mg/g; p=0.018), and decreased GFR (Δ49.82 ±6.41 ml/min; p=0.0002). Mean arterial pressure (MAP) was not different between groups from baseline to 4 weeks. After 12 weeks, there was a significant difference in MAP between groups (p=0.04), with an increase in the placebo group (19.97± 8.65 mmHg, p=0.08). BUN and creatinine levels improved in all of the groups from 4-12 weeks. GFR also improved in all the groups, but with the greatest effect in the combination group (76± 23.83ml/min; p= 0.03) from 4-12 weeks. Urine protein/creatinine ratio did not change in placebo but decreased in cell treated groups. There was no evidence of immune rejection as evaluated in a complete body necropsy. Conclusion: Allogeneic MSCs and kidney-derived stem cells are safe in a CKD swine model. The combination of stem cells was shown to be more efficacious in improving kidney function. These novel findings have important implications for the advancement of cell therapy for CKD.

Can measurement of the foetal renal parenchymal thickness with ultrasound be used as an indirect measure of nephron number?

Journal of Developmental Origins of Health and Disease ◽

10.1017/s204017442000015x ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Sonja Brennan ◽

David Watson ◽

Michal Schneider ◽

Donna Rudd ◽

Yogavijayan Kandasamy

Keyword(s):

Chronic Kidney Disease ◽

Blood Flow ◽

Kidney Disease ◽

Renal Artery ◽

Artery Blood Flow ◽

Nephron Number ◽

Foetal Growth ◽

Significant Difference ◽

Prospective Longitudinal ◽

Parenchymal Thickness

Abstract Chronic kidney disease continues to be under recognised and is associated with a significant global health burden and costs. An adverse intrauterine environment may result in a depleted nephron number and an increased risk of chronic kidney disease. Antenatal ultrasound was used to measure the foetal renal parenchymal thickness (RPT), as a novel method to estimate nephron number. Foetal renal artery blood flow was also assessed. This prospective, longitudinal study evaluated the foetal kidneys of 102 appropriately grown and 30 foetal growth-restricted foetuses between 20 and 37 weeks gestational age (GA) to provide vital knowledge on the influences foetal growth restriction has on the developing kidneys. The foetal RPT and renal artery blood flow were measured at least every 4 weeks using ultrasound. The RPT was found to be significantly thinner in growth-restricted foetuses compared to appropriately grown foetuses [likelihood ratio (LR) = 21.06, P ≤ 0.0001] and the difference increases with GA. In foetuses with the same head circumference, a growth-restricted foetus was more likely to have a thinner parenchyma than an appropriately grown foetus (LR = 8.9, P = 0.0028), supporting the principle that growth-restricted foetuses preferentially shunt blood towards the brain. No significant difference was seen in the renal arteries between appropriately grown and growth-restricted foetuses. Measurement of the RPT appears to be a more sensitive measure than current methods. It has the potential to identify infants with a possible reduced nephron endowment allowing for monitoring and interventions to be focused on individuals at a higher risk of developing future hypertension and chronic kidney disease.

Correlation of Uric Acid with Glomerular Filtration Rate in Chronic Kidney Disease

Journal of Nepal Medical Association ◽

10.31729/jnma.3700 ◽

2018 ◽

Vol 56 (212) ◽

pp. 724-727 ◽

Cited By ~ 1

Author(s):

Milan Khadka ◽

Binod Pantha ◽

Lochan Karki

Keyword(s):

Chronic Kidney Disease ◽

Uric Acid ◽

Kidney Disease ◽

Glomerular Filtration ◽

Filtration Rate ◽

Chronic Kidney Disease Stage ◽

Disease Stage ◽

Female Ratio ◽

Introduction: Chronic Kidney Disease is a worldwide public health problem that affects millions of people from all racial and ethnic groups. Identification of a Chronic Kidney Disease is a major risk factor for cardiovascular morbidity and mortality and is attributed to hyperuricemia. Evidences show that high serum uric acid contribute directly to glomerulosclerosis, interstitial fibrosis and atherosclerosis that correction of hyperuricemia associated with Chronic Kidney Disease will slow the progression of chronic renal failure. Methods: A hospital based cross-sectional study on chronic kidney disease patients including 57 patients on conservative treatment attending Bir Hospital with diagnosis of chronic kidney disease was performed. Detailed clinical history, examination and investigations including uric acid were done. Chronic Kidney Disease staging was done according to estimated glomerular filtration rate estimated by Cockcroft-Gault equation. Prevalence rate of hyperuricemia in Chronic Kidney Disease and its stages were calculated and compared with each other. Results: A total of 57 Chronic Kidney Disease cases were enrolled, with male to female ratio of 2:1 and mean age 51.63±17.75 years. Hyperuricemia was present in 55 (96.49%) of study population. Though prevalence of hyperuricemia increased with Chronic Kidney Disease stage, there was no significant difference in mean value of uric acid in different stages. Hyperuricemia and stages of Chronic Kidney Disease had negative correlation which was statistically significant. Conclusions: Hyperuricemia is highly prevalent among Chronic Kidney Disease patients with conservative management. The severity of hyperuricemia increases as Chronic Kidney Disease stage progresses.

Correlation of Duplex Ultrasonographic Parameters with Glomerular Filtration Rate in Chronic Kidney Disease

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v17i01.1277 ◽

2019 ◽

Vol 17 (01) ◽

pp. 32-37

Author(s):

Karun Devkota ◽

Mukesh Kumar Gupta ◽

Ashok Raj Pant ◽

Prahlad Karki

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Glomerular Filtration ◽

Filtration Rate ◽

Resistive Index ◽

P Value ◽

Diastolic Velocity ◽

Parenchymal Thickness ◽

Renal Length

Background: Chronic kidney disease encompasses a spectrum of different pathophysiological processes associated with abnormal renal function and a progressive decline in glomerular filtration rate. Duplex ultrasonography is widely available and important imaging investigation required in the work?up of chronic kidney disease. The objective of the study was to assess correlation of renal duplex ultrasonographic parameters with decreased glomerular filtration rate in patients with chronic kidney disease.Methods: This was a crosssectional hospital-based study. A total of sixty-two patients with chronic kidney disease referred for ultrasonography were included in the study. Patients were evaluated by duplex ultrasonography. Correlation of renal length, parenchymal thickness, cortical thickness, cortical echogenicity, peak systolic velocity, end diastolic velocity pulsatility index and resistive index with glomerular filtration rate was evaluated by using Pearson’s correlation coefficient.Results: Chronic kidney disease was seen more prevalent in 41-50 years of age group. The major risk factors associated with Chronic kidney disease was Hypertension and Diabetes Mellitus. A significant positive correlation of renal length, parenchymal thickness, cortical thickness (p value < 0.01) and end diastolic velocity (p value < 0.05) with eGFR and significant negative correlation of cortical echogenicity, resistive index and pulsatility index (p value < 0.01) with eGFR was derived.Conclusions: Duplex sonographic findings of renal length, parenchymal thickness, cortical thickness, cortical echogenicity, end diastolic velocity, pulsatility index and resistive index are found to be useful parameters in evaluation of chronic kidney disease.Keywords: Chronic kidney disease; duplex ultrasonography; glomerular filtration rate.