scholarly journals Predictors Of The Development Of Chronic Kidney Disease In Patients With Chronic Obstructive Pulmonary Disease

Author(s):  
Kayumova Gulnoz Karimovna ◽  
◽  
Akhmedova Nilufar Sharipovna ◽  

The aim of the study was to identify predictors of decreased glomerular filtration in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. We analyzed 145 case histories of patients diagnosed with COPD. The majority (84.1%, n = 122) of them are males (the average age of men is 60.7 ± 0.9 years, the average age of women is 62.0 ± 2.7 years). A comparative analysis of the prevalence of risk factors for chronic kidney disease (CKD) in patients with COPD: age, gender, smoking, arterial hypertension, overweight, etc. The glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD – EPI) formula, according to which the patients were divided into 6 groups: group 1 - hyperfiltration, group 2 - GFR CKD – EPI ≥ 90 ml / min / 1 , 73 m2, 3rd - GFR CKD – EPI 60–89 ml / min / 1.73 m2, 4th - GFR CKD – EPI 45–59 ml / min / 1.73 m2, 5th - GFR CKD – EPI 30 - 44 ml / min / 1.73 m2 and 6th-GFR CKD-EPI <30 ml / min / 1.73 m2. Results. Patients with COPD have a high incidence of CKD risk factors. A correlation was found between the prevalence of CKD risk factors and the severity of COPD. The main predictors of the development of CKD in patients with COPD: duration of COPD> 9 years, body mass index> 26.5 kg / m2, smoking index> 51.3, albumin> 44.0 g / l, total protein> 70.0 g / L, forced expiratory volume in the first second ≤ 1.6 L, right atrial size> 35.5 mm, systolic pressure in the pulmonary artery> 36.6 mm Hg. Art., the thickness of the posterior wall of the left ventricle> 10.5 mm, Tiffno's index ≤ 62%. Conclusion. It was found that patients with COPD have a high incidence of both traditional and nonspecific risk factors for a decrease in GFR.

Author(s):  
Nicolas Padilla-Raygoza ◽  
Gilberto Flores-Vargas ◽  
Efraín Navarro-Olivos ◽  
María de Jesús Gallardo-Luna ◽  
Francisco Javier Magos-Vazquez ◽  
...  

Aims: COVID-19 has been a big public health challenge around the world in the past several months. The aim of this study is to describe the epidemic and report of fatality of confirmed cases of COVID-19 in the Mexican state of Guanajuato, until October 2, 2020. Study Design:  Cross-sectional, quantitative, analytical study. Place and Duration of Study: Registries of confirmed cases for COVID-19 in Mexican population from January until October 2, 2020, from National System of Epidemiological Surveillance/ General Direction of Epidemiology/ Secretary of Health, Mexico. Methodology: Based on the National Epidemiological Surveillance System Database from Mexico was used in this study. Data were collected on age, sex, comorbidities (i.e., diabetes, chronic obstructive pulmonary disease, asthma, hypertension, cardiovascular disease, immunosuppression, chronic kidney disease, obesity, and smoking), date of death, and real-time reverse transcription polymerase test results. Statistical analyses used were Case Fatality Ratio, Chi- squared test and P-value to show relationships among variables. Odds Ratio and confidence intervals at 95% were reported to show the effect of comorbidities on death due to COVID-19. Also, a Bayesian network model was fitted to assess the statistical dependence among risk factors, comorbidities, and death. Results: There were 100,109 suspected cases, of which 41.69% were positive for SARS-CoV-2. Being older than 60 and male had a higher effect on fatality by COVID-19. In Guanajuato state, 1,457 (48.68%) of deaths occurred in Mexican Institute of Social Security, with a case fatality ratio of 15.63%; meanwhile, in the Ministry of Health from Guanajuato State occurred 1,260 (42.10%) of the deaths with a case fatality ratio of 4.14%. Diabetes (OR 5.16, CI95% 4.77–5.59), chronic obstructive pulmonary disease (OR 6.34, CI95% 5.37–7.49), immunosuppression (OR 2.85, CI95% 2.17–3.76), cardiovascular disease (OR 4.20, CI95% 3.51–5.02), hypertension (OR 4.74, CI95% 4.39–5.11), chronic kidney disease (OR 6.27, CI95% 5.30–7.42), obesity (OR 1.87, CI95% 1.72–2.03), and smoking (OR 1.60, CI95% 1.41–1.81) had effect on death by COVID-19. Asthma had a preventive effect on death (OR=0.72, CI95% 0.54–0.97), but this effect is diluted after adjusting by sex and age. In all cases, age and sex, acted as confounder. Conclusion: Among the Guanajuato population with COVID-19, the main risk factor for dying were age and sex. However, diabetes, chronic obstructive pulmonary disease, immunosuppression, cardiovascular disease, chronic kidney disease, obesity, and smoking are risk factors for dying. Although, comorbidities and risk factors are highly correlated.  HIV/AIDS has no effect on fatality from SARS-CoV-2 disease and whereas asthma shows to be a protective factor.


2018 ◽  
Vol 1 (69) ◽  
pp. 115-122 ◽  
Author(s):  
А Бакина ◽  
A Bakina ◽  
Валентина Павленко ◽  
Valentina Pavlenko

Chronic obstructive pulmonary disease (COPD) has many systemic effects, one of which is impaired renal function. Existing studies prove that patients with COPD often have risk factors for developing chronic kidney disease (CKD). Many risk factors for developing COPD are common for the onset of CKD. However, in routine clinical practice, there is an underestimation of the incidence of renal dysfunction in COPD patients, while in-depth and targeted studies reveal changes in renal function in patients with COPD. Topical methods for identifying initial changes in renal function in COPD patients are the study of the glomerular filtration rate, the evaluation of the level of microalbuminuria, the study of the index of resistance of renal vessels. The importance of identifying CKD in the early stages in COPD patients is determined by the increased risk of cardiovascular events and the onset of cardiorenal syndrome in patients.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Franziska C. Trudzinski ◽  
◽  
Mohamad Alqudrah ◽  
Albert Omlor ◽  
Stephen Zewinger ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031346 ◽  
Author(s):  
Bruno Moita ◽  
Ana Patricia Marques ◽  
Ana Maria Camacho ◽  
Pedro Leão Neves ◽  
Rui Santana

ObjectivesIdentification of rehospitalisations for heart failure and contributing factors flags health policy intervention opportunities designed to deliver care at a most effective and efficient level. Recognising that heart failure is a condition for which timely and appropriate outpatient care can potentially prevent the use of inpatient services, we aimed to determine to what extent comorbidities and material deprivation were predictive of 1 year heart failure specific rehospitalisation.SettingAll Portuguese mainland National Health Service (NHS) hospitals.ParticipantsA total of 68 565 hospitalisations for heart failure principal cause of admission, from 2011 to 2015, associated to 45 882 distinct patients aged 18 years old or over.Outcome measuresWe defined 1 year specific heart failure rehospitalisation and time to rehospitalisation as outcome measures.ResultsHeart failure principal diagnosis admissions accounted for 1.6% of total hospital NHS budget, and over 40% of this burden is associated to patients rehospitalised at least once in the 365-day follow-up period. 22.1% of the patients hospitalised for a principal diagnosis of heart failure were rehospitalised for the same cause at least once within 365 days after previous discharge. Nearly 55% of rehospitalised patients were readmitted within 3 months. Results suggest a mediation effect between material deprivation and the chance of 1 year rehospitalisation through the effect that material deprivation has on the prevalence of comorbidities. Heart failure combined with chronic kidney disease or chronic obstructive pulmonary disease increases by 2.8 and 2.2 times, respectively, the chance of the patient becoming a frequent user of inpatient services for heart failure principal cause of admission.ConclusionsOne-fifth of patients admitted for heart failure are rehospitalised due to heart failure exacerbation. While the role of material deprivation remained unclear, comorbidities considered increased the chance of 1 year heart failure specific rehospitalisation, in particular, chronic kidney disease and chronic obstructive pulmonary disease.


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