scholarly journals Gambaran kadar ureum pada pasien penyakit ginjal kronik stadium 5 non dialisis

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Irendem K. A. Loho ◽  
Glady I. Rambert ◽  
Mayer F. Wowor
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Laboratory Tests ◽  
Filtration Rate ◽  
Descriptive Study ◽  
Clinical Syndrome ◽  
Blood Samples ◽  
Pathophysiological Process ◽  
Ckd Stage ◽  
Observational Descriptive Study

Abstract: Chronic kidney disease (CKD) is a pathophysiological process with diverse etiology, resulting in a progressive decreased in renal function, and generally ends up with kidney failure. In CKD patient, the level of urea increases -uremia- a clinical syndrome that occurs in all organs due to the increased level of urea. During catabolism process, protein is broken down into amino acids and deamination ammonia which is further synthesized to become urea. Increased level of urea depends on the glomerular filtration rate (GFR). Decreased of GFR (<15ml / min) can cause renal failure and uremia. This study aimed to determine the levels of urea in patients with stage 5 CKD non-dialysis. This was an observational descriptive study. This study was conducted from December 2015 to January 2016 at two hospitals, Prof. Dr. R. D. Kandou Hospital and Adventist Hospital Manado. Samples were blood samples of all patients suffering from CKD stage 5 non-dyalisis within the specified time. The results of laboratory tests showed that of 35 patients diagnosed with stage 5 CKD non-dialysis all had increased urea levels (100%). Conclusion: There was an increase in urea level of patients with stage 5 chronic kidney disease non-dialysis either of outpatients or inpatients.Keywords: urea serum, stage 5 non-dialysis chronic kidney disease.Abstrak: Penyakit ginjal kronik (PGK) merupakan suatu proses patofisiologi dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif dan umumnya berakhir dengan gagal ginjal. Umumnya pada PGK terjadi peningkatan kadar ureum dan mengakibat-kan terjadinya uremia yaitu suatu sindrom klinik yang terjadi pada semua organ akibat meningkatnya kadar ureum. Dalam proses katabolisme, protein dipecah menjadi asam amino dan deaminasi ammonia yang selanjutnya disintesis menjadi urea. Peningkatan kadar ureum bergantung pada tingkat laju filtrasi glomerulus (LFG). Pada penurunan LFG (<15ml/mnt) dapat terjadi gagal ginjal dan uremia. Penelitian ini bertujuan untuk mengetahui gambaran kadar ureum pada pasien penyakit ginjal kronik stadium 5 non-dialisis. Jenis penelitian ini ialah deskriptif observasional. Penelitian dilakukan sejak Desember 2015-Januari 2016 di RSUP Prof. Dr. R. D. Kandou dan RS Advent Teling Manado. Sampel penelitian ialah sampel darah dari semua pasien yang menderita penyakit ginjal kronik stadium 5 nondialisis dalam kurun waktu yang ditentukan. Hasil pemeriksaan laboratorium dari 35 pasien yang terdiagnosis penyakit ginjal kronik stadium 5 non dialisis memperlihatkan peningkatan kadar ureum serum (100%). Simpulan: Terjadi peningkatan kadar ureum serum pada pasien penyakit ginjal kronik stadium 5 non-dialisis baik yang dirawat jalan maupun dirawat inap.Kata kunci: ureum, penyakit ginjal kronik stadium 5 non dialisis

scholarly journals Effect of Atorvastatin and Losartan on Glomerular Filtration Rate in Patients With Mild to Moderate Chronic Kidney Disease

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 43-47
Author(s):  
Md Moniruzzaman Khan ◽  
Zesmin Fauzia Dewan ◽  
AKM Shahidur Rahman ◽  
Bakhtiare Md Shoeb Nomany ◽  
Ahmed Salam Mir ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
Cell Damage ◽  
Renoprotective Effect ◽  
Ckd Stage

Background: Atorvastatin, a member of HMG CO-A reductase inhibitors, has been shown to have renoprotective effect in patients with Chronic Kidney Disease (CKD). Statins are supposed to decrease the oxidized lipid particles, suppress the activity of inflammatory mediators and prevent vascular thrombosis and thus could minimize renal cell damage. Losartan, an antihypertensive drug also diminishes proteinuria in patients with chronic kidney diseases or diabetes mellitus. Therefore the effect of concurrent use of atorvastatin and losartan on Glomerular Filtration Rate (GFR) could be a matter of interest from both Pharmacological and Clinical perspective. Objective: To assess the renoprotective effect of atorvastatin and losartan in patients with chronic kidney disease treated at Bangabandhu Sheikh Mujib Medical University (BSMMU). Materials and Method: Total forty four (44) patients suffering from CKD (stage one to stage three) were enrolled into two groups. Patients in Group A, received atorvastatin (10 mg) and losartan (50 mg) once daily for eight weeks. Patients in Group B, received losartan but not atorvastatin for the same duration. Serum creatinine level was measured at the commencement and also after eight weeks to calculate estimated glomerular filtration rate (eGFR) in individual patients with MDRD (Modification of Diet in Renal Disease) study equation. Results: There was significant (P < 0.001) reduction of Serum Creatinine and significant (P < 0.001) increase in e GFR in the patients, treated with atorvastatin and losartan. Conclusion: Concurrent administration of atorvastatin and losartan increased glomerular filtration rate (GFR) significantly in patients with chronic kidney disease. KYAMC Journal Vol. 10, No.-1, April 2019, Page 43-47

Early Glomerular Filtration Rate Loss as a Marker of Diabetic Nephropathy

2012 ◽  
Vol 08 (01) ◽  
pp. 40 ◽  
Author(s):  
George Jerums ◽  
Elif Ekinci ◽  
Sianna Panagiotopoulos ◽  
Richard J MacIsaac ◽  
◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Clinical Level ◽  
Ckd Stage

In the early 1980s, studies in type 1 diabetes suggested that glomerular filtration rate (GFR) loss begins with the onset of macroalbuminuria. However, recent evidence indicates that up to one-quarter of subjects with diabetes reach a GFR of less than 60 ml/min/1.73 m2(chronic kidney disease [CKD] stage 3) before developing micro- or macroalbuminuria. Furthermore, the prospective loss of GFR can be detected in early diabetic nephropathy (DN) well before CKD stage 3. Early GFR loss usually reflects DN in type 1 diabetes but, in older patients with type 2 diabetes, the assessment of early GFR loss needs to take into account the effects of aging. The assessment of GFR is now feasible at clinical level, using formulas based on serum creatinine, age, gender, and ethnicity. Overall, the estimation of early GFR loss is more accurate with the Chronic Kidney Disease Epidemiology (CKD–EPI) formula than with the Modification of Diet in Renal Disease (MDRD) study formula, but there is some evidence that the CKD-EPI formula does not exhibit better performance than the MDRD formula for estimating GFR in diabetes. Both formulas underestimate GFR in the hyperfiltration range. Formulas based on the reciprocal of cystatin C can also be used to estimate GFR, but their cost and lack of assay standardization have delayed their use at clinical level. In summary, early GFR loss is an important marker of DN as well as a potentially reversible target for interventions in DN.

scholarly journals Serum Amylase in Patients of Chronic Kidney Disease Stage Three to Stage Five

2018 ◽  
Vol 3 (2) ◽  
pp. 403-407
Author(s):  
Anusmriti Pal ◽  
Laxman Mandal
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Serum Amylase ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Amylase Level ◽  
Ckd Stage

Introduction: Chronic Kidney Disease (CKD) is a progressive loss in renal function over period of many months or years. As compared to the past decades, the number of kidney diseases leading to end CKD is increasing in Nepal. The disease is associated with the decreased glomerular filtration rate (GFR). There is decline in nephron function and number generally quantitated as reduction in glomerular filtration rate. As the GFR declines, there is accumulation of metabolic end products excreted by Kidney. Chronic kidney disease is identified by blood tests, creatinine and urea are two such substances routinely measured. Serum amylase is a pancreatic digestive enzyme that normally acts extracellular to cleave starch into smaller carbohydrate groups and, finally, into monosaccharide's. It is produced by 40-45% from the pancreas and (45%) reabsorbed by tubular cells. Elevations in serum total amylase among patients with CKD is due to impaired renal clearance and seen mostly when the creatinine clearance is below 50 ml/min. Several studies have been reported on this but there are no studies that have been done so far in Nepalese context.Objectives: This study is designed to correlate serum amylase with CKD stage three to stage five in patients of chronic renal disease irrespective of hemodialysis and prevalence of risk factors of CKD and different factors that may affect the level of serum amylase in patients presenting to Bir Hospital Nephrology department, Nepal.Methods: The study was a cross-sectional, observational, descriptive, hospital based carried out in Nephrology Unit of Bir hospital both inpatient or outpatient irrespective of hemodialysis from March 2014 to March 2015. Patients with increased serum amylase due to acute Pancreatitis, Mumps, Intestinal Obstruction, Peptic Ulcer, Cancer, other than renal cause were excluded. The results were analyzed using SPSS version 11 and Microsoft Excel by correlation coefficient. Result: Present study shows that among 126 patients, the prevalence of age group was from 15 years to 78 years with majority being male. The serum amylase levels were significantly higher in Chronic Kidney Disease Stage V with significant p-value. At 80-100 Serum Amylase level had strong correlation of 0.504 for CKD III stage and significant at 10 percent level. The correlation between CKD IV at 80-100 was significant at 10 percent but weak of 0.189. Whereas, CKD V was highly significant but negative at more than 161 Serum Amylase.Conclusion: From the study it was concluded that in Chronic Kidney Disease, Serum amylase was found to be higher as the eGFR decreases. BJHS 2018;3(2)6:403-407. 

Early Glomerular Filtration Rate Loss as a Marker of Diabetic Nephropathy

2010 ◽  
Vol 8 (1) ◽  
pp. 27 ◽  
Author(s):  
George Jerums ◽  
Elif Ekinci ◽  
Sianna Panagiotopoulos ◽  
Richard J MacIsaac ◽  
◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Clinical Level ◽  
Ckd Stage

In the early 1980s, studies in type 1 diabetes suggested that glomerular filtration rate (GFR) loss begins with the onset of macroalbuminuria. However, recent evidence indicates that up to one-quarter of subjects with diabetes reach a GFR of less than 60 ml/min/1.73 m2(chronic kidney disease [CKD] stage 3) before developing micro- or macroalbuminuria. Furthermore, the prospective loss of GFR can be detected in early diabetic nephropathy (DN) well before CKD stage 3. Early GFR loss usually reflects DN in type 1 diabetes but, in older patients with type 2 diabetes, the assessment of early GFR loss needs to take into account the effects of ageing. The assessment of GFR is now feasible at clinical level, using formulas based on serum creatinine, age, gender and ethnicity. Overall, the estimation of early GFR loss is more accurate with the Chronic Kidney Disease Epidemiology (CKD–EPI) formula than with the Modification of Diet in Renal Disease (MDRD) study formula, but there is some evidence that the CKD-EPI formula does not exhibit better performance than the MDRD formula for estimating GFR in diabetes. Both formulas underestimate GFR in the hyperfiltration range. Formulas based on the reciprocal of cystatin C can also be used to estimate GFR, but their cost and lack of assay standardisation have delayed their use at clinical level. In summary, early GFR loss is an important marker of DN as well as a potentially reversible target for interventions in DN.

Blood Urea Nitrogen Levels to Verify Estimated Glomerular Filtration Rate, as Derived from 2 Commonly Used Equations

2019 ◽  
Vol 50 (3) ◽  
pp. 298-305
Author(s):  
Sheng-Feng Lin ◽  
Hao-En Teng ◽  
Hsiu-Chen Lin
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Blood Urea Nitrogen ◽  
Filtration Rate ◽  
Urea Nitrogen ◽  
Disease Epidemiology ◽  
Nitrogen Levels ◽  
Ckd Stage

Abstract Background A blood urea nitrogen to creatinine ratio (BCR) of 20 or greater indicates various physiological conditions. Whether glomerular filtration rate (GFR) estimates obtained using the Modification of Diet in Renal Disease (MDRD) study equation and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) study equations are affected by a high BCR remains unknown. Methods Patients who underwent urine creatinine clearance (CrCl) and serum blood urea nitrogen (BUN) and creatinine assessments on the same day were enrolled in our study. Those with BCR of 20 or greater and less than 20 were categorized into high- and low-BCR groups. The concordance on diagnosing chronic kidney disease (CKD) stages by using urine CrCl level and serum GFR estimates was assessed. Results More disagreement in CKD stage diagnosis was observed in the high-BCR group (weighted κ = 0.600 and 0.541 for the MDRD and CKD-EPI study equations, respectively) than in the low-BCR group (weighted κ = 0.816 and 0.758, respectively). Conclusions A BCR of 20 or greater caused misestimation of the CKD stage. GFR estimates for patients with high BCR should be interpreted cautiously.

scholarly journals Gambaran kadar natrium dan klorida pada pasien penyakit ginjal kronik stadium 5 non-dialisis

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Ryan Yefta Tambajong ◽  
Glady I. Rambert ◽  
Mayer F. Wowor
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Salt Intake ◽  
Descriptive Study ◽  
Significant Progress ◽  
Chloride Level ◽  
Progressive Decline ◽  
Probability Sampling ◽  
Consecutive Sampling ◽  
Pathophysiological Process

Abstract: Chronic kidney disease (CKD) is a pathophysiological process with a variety of etiology, causing a progressive decline in kidney function, and generally ends with kidney failure. Although significant progress has been made for the treatment of CKD, it was not satisfying yet, especially at the final stage of the disease. Reducing salt intake is one of the options. Approximately, 60% of non-dialysis CKD patients suffered from hyponatremia with normal chloride levels. This study aimed to obtain the profile of the sodium and chloride levels in non-dialysis CKD patients. This was a descriptive study and was carried out at two hospitals, Prof. Dr. R. D. Kandou Hospital Manado and Advent Hospital Manado. Samples were blood samples of 35 patients suffering from stage 5 non-dialysis CKD determined by using consecutive sampling of non-probability sampling model. The results showed that based on the laboratory result, there were 19 patients diagnosed with stage 5 non-dialysis CKD with hyponatremia (54.3%) and 19 patients with imbalance chloride levels consisted of 8 patients with hypochloremia (22.9%) and 8 patients with hyperchloremia (22.9%). Conclusion: In stage five non-dialysis chronic kidney disease patients, sodium and chloride imbalance commonly occurred as hyponatremia, however, hypo and hyperchloremia had the same occurence. Keywords: sodium level, chloride level, stage 5 chronic kidney disease, non-dialysis Abstrak: Penyakit ginjal kronik (PGK) adalah suatu proses patofisologis dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif, dan umumnya berakhir dengan gagal ginjal. Meskipun kemajuan signifikan telah diperoleh dalam pengobatan PGK, hasil pengobatan tersebut belum memuaskan, terutama pada pasien dengan tahap akhir penyakit. Pengurangan asupan garam ialah salah satu opsi tersebut. Sekitar 60% dari pasien PGK non-dialisis mengalami hiponatremia dengan kadar klorida yang masih normal. Penelitian ini bertujuan untuk mengetahui gambaran kadar natrium dan klorida pada pasien PGK stadium 5 non-dialisis. Jenis penelitan ini deskriptif. Penelitian dilakukan pada dua rumah sakit, yaitu RSUP Prof. Dr. R. D. Kandou Manado dan Rumah Sakit Advent Manado. Sampel penelitian ialah sampel darah dari 35 pasien yang menderita PGK stadium 5 non-dialisis yang ditentukan dengan cara non-probability sampling jenis consecutive sampling. Hasil penelitian memperlihatkan bahwa berdasarkan hasil pemeriksaan laboratorium yang dilakukan terdapat 19 pasien (54,3%) yang terdiagnosis PGK stadium 5 non-dialisis mengalami hiponatremia dan 19 pasien mengalami gangguan keseimbangan kadar klorida, yang terdiri dari 8 pasien (22,9%) mengalami hipokloremia dan 8 pasien (22,9%) mengalami hiperkloremia. Simpulan: Pada pasien penyakit ginjal kronik stadium 5 non-dialisis, gangguan keseimbangan kadar natrium dan klorida yang sering terjadi ialah hiponatremia, sedangkan kejadian hipokloremia dan hiperkloremia ditemukan sama banyak.Kata kunci: kadar natrium, kadar klorida, penyakit ginjal kronik stadium 5, non dialisis

scholarly journals Evaluation of Thyroid Hormones and Some Biochemical Variables in Patients with Chronic Kidney Disease

2020 ◽  
pp. 985-992
Author(s):  
Sama S. Salih ◽  
Jabbar H. Yenzeel ◽  
Ali j. Alsaady
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Kidney Function ◽  
Healthy Subjects ◽  
Filtration Rate ◽  
Control Group ◽  
Blood Samples ◽  
Permanent Loss ◽  
Medical City

Chronic kidney disease (CKD) is a permanent loss of kidney function which is diagnosed when the glomerular filtration rate (GFR) is under 60 ml\min\1.73m2 for more than three months. The present study was conducted at Kidney Transplant and Dialysis Center in the Medical City in Baghdad from October 2018 to April 2019. Sixty CKD patients with an age ranged of 40 to 65 years and 25 healthy subjects were involved in this study. Blood samples were collected to evaluate the levels of kidney function parameters and thyroid hormones. The levels of urea, creatinine and uric acid showed highly significant (p ≤ 0.01) increases in CKD patient in comparison with the control group, while the values of GFR and creatinine clearance showed highly significant (p ≤ 0.01) decreases. The results of thyroid hormones showed highly significant (p < 0.01) decreases in the levels of T3 and T4 along with a highly significant (p < 0.01) increase in the level of TSH in the patients.

Observations from a teaching hospital in Ireland: changing from MDRD to CKD-EPI eGFR in routine practice

2020 ◽  
pp. jclinpath-2020-206713
Author(s):  
Janice Lee Veronica Reeve ◽  
Marion Davis ◽  
Patrick Joseph Twomey
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Clinical Chemistry ◽  
Routine Practice ◽  
Estimated Gfr ◽  
Ckd Stage ◽  
Service Application ◽  
Improved Accuracy ◽  
Older Males

Estimates of glomerular filtration rate (eGFR) help assess kidney function. Estimated GFR can be used to classify patients into one of six Chronic Kidney Disease (CKD) categories as recommended by the Kidney Disease Improving Global Outcomes clinical practice guidelines; CKD1 ≥90, CKD2 60–89, CKD3a 45–59, CKD3b 30–44, CKD4 15–29 or CKD5 ≤15 mL/min/1.73 m2. The Modification of Diet and Renal Disease (MDRD) study formula was widely adopted to calculate eGFR. The CKD Epidemiology Collaboration (CKD-EPI) formula improved accuracy of CKD staging at eGFR ≥60 mL/min/1.73 m2. MDRD and CKD-EPI eGFR were calculated on 111 444 serum creatinine results from adult patients measured as part of the routine Clinical Chemistry service. Application of CKD-EPI eGFR reclassified 18% to a lower (13.9%) or higher (4.0%) CKD stage. CKD staging was lower when <65 years and higher when ≥65 years. Females were more often reclassified compared with males (2.6% vs 0.8%). Overall, CKD-EPI eGFR classified less with CKD (stages 3a-5), unless ≥75 years. Older males and inpatients had higher CKD stages when CKD-EPI eGFR was applied. It has been recommended to replace MDRD eGFR with CKD-EPI eGFR. In general, doing this will have little impact, however, for some patients their CKD classification will be different.

scholarly journals Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation

2020 ◽  
Vol 13 (5) ◽  
pp. 828-833
Author(s):  
Nans Florens ◽  
Laurence Dubourg ◽  
Laurent Bitker ◽  
Emilie Kalbacher ◽  
François Philit ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Lung Transplant ◽  
Filtration Rate ◽  
University Hospital ◽  
Post Transplantation ◽  
Ckd Stage

Abstract Background Chronic kidney disease (CKD) after lung transplantation (LT) is underestimated. The aim of the present study was to measure the loss of glomerular filtration rate (GFR) 1 year after LT and to identify the risk factors for developing Stage ≥3 CKD. Methods LT patients in the University Hospital of Lyon had a pre- and post-transplantation measurement of their GFR (mGFR), and GFR was also estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Results During the study period, 111 patients were lung transplant candidates, of which 91 had a pre-transplantation mGFR, and 29 had a mGFR at 1 year after LT. Six patients underwent maintenance haemodialysis after transplantation. Mean mGFR was 106 mL/min/1.73 m2 before LT and 58 mL/min/1.73 m2 1 year after LT (P &lt; 0.05) with a mean loss of 48 mL/min/1.73 m2 per patient. The risk of developing Stage ≥3 CKD after LT was higher in patients with lower pre-LT mGFR (odds ratio for each 1 mL/min/1.73 m2 increase: 0.94, 95% confidence interval 0.88–0.99). Receiver operator characteristics curves for the sensitivity and specificity of eGFR and mGFR for the prediction of CKD Stage ≥3 after LT found that pre-LT mGFR of 101 mL/min/1.73 m2 and pre-LT eGFR of 124 mL/min/1.73 m2 were the optimal thresholds for predicting Stage ≥3 CKD after LT. Conclusion The present study underlines the value of mGFR in the pre-LT stage and found major renal function loss after LT, and consequently two-thirds of patients have Stage ≥3 CKD at 1 year. All patients with a pre-LT mGFR &lt;90 mL/min/1.73 m2 warrant particular attention.

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