scholarly journals The Relationship between Haemodialysis Procedures and Interleukin-6 Levels in Regular Hemodialysis Patients in Haji Adam Malik Central General Hospital

2021 ◽  
Vol 8 (10) ◽  
pp. 418-422
Author(s):  
Achmad Tri Wibowo ◽  
Alwi Thamrin Nasution ◽  
Radar Radius Tarigan
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Hospital ◽  
Interleukin 6 ◽  
Significant Relationship ◽  
Strong Predictor ◽  
Elevated Serum ◽  
Median Level ◽  
Before And After ◽  
Regular Hemodialysis

Introduction: Chronic kidney disease (CKD) is kidney damage characterized by the presence of protein in the urine or a decrease in the glomerular filtration rate (GFR). CKD is a global problem throughout the world, including Indonesia, which requires special attention. IL-6 is known to play a role in regulating hemostatic functions, including glucose metabolism, the hypothalamus-pituitary-adrenal (HPA) axis, influencing mood, fatigue, depression, and hematopoiesis. As an inflammatory cytokine, IL-6 is an inflammatory mediator that most plays a role in various conditions, such as infection, autoimmune disease, and cancer. In CKD patients undergoing dialysis (HD), elevated serum IL-6 levels beginning from the start of the treatment is a strong predictor of mortality. The study aimed to determine the association between hemodialysis procedures and interleukin-6 levels in regular hemodialysis CKD patients in Haji Adam Malik Central General Hospital. Methods: This is an analytical study with a cross-sectional design. A total of 20 study subjects met the inclusion criteria and exclusion criteria, underwent history taking, physical examination, anthropometry, and laboratory examination to measure hemoglobin, creatinine, albumin, and IL-6 levels. Data analysis was performed using SPSS. Results: The median level of IL-6 before hemodialysis was 10.39 pg/mL with the lowest level and the highest level being 1.50 – 74.79 pg/mL, the median level of IL-6 after hemodialysis was 29.13 pg/mL with the lowest level and the lowest level. the highest is 2.11 – 316.20 pg/mL. Based on the results of the analysis, the levels of IL-6 after hemodialysis were higher than the levels of IL-6 before hemodialysis, there was a statistically significant relationship between regular hemodialysis and interleukin-6 levels before and after in patients with kidney disease. Conclusion: Regular hemodialysis and interleukin-6 levels have a statistically significant relationship before and after hemodialysis in CKD patients. Keywords: Chronic kidney disease; haemodialysis; interleukin-6.

scholarly journals The Association between Parathyroid Hormone (PTH) Level and Hemoglobin and Hematocrit Level in Chronic Kidney Disease (CKD) Patients with Regular Hemodialysis

2021 ◽  
Vol 8 (10) ◽  
pp. 412-417
Author(s):  
Hendri Wahyudi Pinem ◽  
Alwi Thamrin Nasution ◽  
Bayu Rusfandi Nasutio
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Significant Relationship ◽  
P Value ◽  
Uremic Toxin ◽  
Cross Sectional ◽  
Minimum Value ◽  
Pth Level ◽  
Regular Hemodialysis

Introduction: Chronic Kidney Disease (CKD) is a pathophysiological process with various etiology that causes a progressive decline in kidney function and ends in kidney failure. [1] CKD is a health problem that occurs in the community and has covered globally. The 2010 Global Burden of Disease stated that CKD was the 27th leading cause of death in the world in 1990. This has increased to 18th in 2010. Parathyroid hormone is a potential factor in the incidence of anemia in CKD patients. In CKD patients, there is an increase in levels of parathyroid hormone which is a uremic toxin that inhibits erythropoietin by increasing fibrosis in the bone marrow (myelofibrosis). The role of PTH in cases of renal anemia has been extensively investigated by various clinical observational studies. This study aimed to determine the association between parathyroid hormone (PTH) levels and hemoglobin and hematocrit levels in chronic kidney disease (CKD) patients with regular hemodialysis in Haji Adam Malik Central General Hospital. Methods: This is an analytical study with a cross-sectional design. A total of 45 study subjects met the inclusion criteria and exclusion criteria, underwent history taking, physical examination, anthropometry, and laboratory examination to measure parathyroid hormone, hemoglobin, hematocrit, and albumin levels. Data analysis was performed using SPSS. Results: The measured PTH level had a minimum value of 113 pg/ml and a maximum of 595 pg/ml with an average of 431.4. The minimum hemoglobin value is 6.3 g/dl and a maximum of 11.5 g/dl with an average of 7.9, while for the hematocrit the minimum value is 19% and the maximum is 35% and the average is 24.7. The Mann-Whitney U test showed that there is a significant relationship between PTH levels and hemoglobin, indicated by a significant p value of 0.001 (p value < 0.05). A significant relationship was also found between PTH levels and hematocrit (p value = 0.039). Conclusion: Parathyroid hormone has a statistically significant relationship with haemoglobin and haematocrit levels in CKD patients with regular hemodialysis. Keywords: Chronic kidney disease; haemoglobin; haematocrit; parathyroid hormone; anemia; hemodialysis.

scholarly journals Osteoprotegerin is a marker of cardiovascular mortality in patients with chronic kidney disease stages 3–5

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gustavo Lenci Marques ◽  
Shirley Hayashi ◽  
Anna Bjällmark ◽  
Matilda Larsson ◽  
Miguel Riella ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Multivariate Analysis ◽  
Kidney Disease ◽  
Cardiovascular Mortality ◽  
Osteoclast Differentiation ◽  
Survival Rates ◽  
Elevated Serum ◽  
High Sensitivity ◽  
Intima Media Thickness

AbstractCardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD). Osteoprotegerin (OPG), known to regulate bone mass by inhibiting osteoclast differentiation and activation, might also play a role in vascular calcification. Increased circulating OPG levels in patients with CKD are associated with aortic calcification and increased mortality. We assessed the predictive role of OPG for all-cause and cardiovascular mortality in patients with CKD stages 3–5 over a 5-year follow-up period. We evaluated the relationship between OPG and all-cause and cardiovascular mortality in 145 CKD patients (stages 3–5) in a prospective observational follow-up study. Inflammation markers, including high-sensitivity C-reactive protein, standard echocardiography, and estimation of intima-media thickness in the common carotid artery, were assessed at baseline, and correlations with OPG levels were determined. The cutoff values for OPG were defined using ROC curves for cardiovascular mortality. Survival was assessed during follow up lasting for up to 5.5 years using Fine and Gray model. A total of 145 (89 men; age 58.9 ± 15.0 years) were followed up. The cutoff value for OPG determined using ROC was 10 pmol/L for general causes mortality and 10.08 pmol/L for CV causes mortality. Patients with higher serum OPG levels presented with higher mortality rates compared to patients with lower levels. Aalen–Johansen cumulative incidence curve analysis demonstrated significantly worse survival rates in individuals with higher baseline OPG levels for all-cause and cardiovascular mortality (p < 0.001). In multivariate analysis, OPG was a marker of general and cardiovascular mortality independent of sex, age, CVD, diabetes, and CRP levels. When CKD stages were included in the multivariate analysis, OPG was an independent marker of all-cause mortality but not cardiovascular mortality. Elevated serum OPG levels were associated with higher all-cause and cardiovascular mortality risk, independent of age, CVD, diabetes, and inflammatory markers, in patients with CKD.

Overview and Management of Chronic Kidney Disease Inpatients at Royal Prima General Hospital Medan in 2020

2021 ◽  
Vol 3 (1) ◽  
pp. 214-223
Author(s):  
Yuke Armika ◽  
Nerseri Barus
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Hospital ◽  
Complete Blood Count ◽  
Low Back ◽  
Research Subjects ◽  
Retrospective Case ◽  
Record Data ◽  
Retrospective Case Study

Chronic kidney disease (CKD) is a condition in which there is a gradual decline in kidney function. This disease is progressive and usually irreversible. Indications for hospitalized CKD patients with severe complications and do not allow inpatient therapy. This study was aimed to describe the overview and management of chronic kidney disease inpatient in Royal Prima General Hospital Medan. The type of research used is research with a descriptive and retrospective case study design. This study is based on medical record data related to inpatient CKD patients' diagnostic and management features at the Royal Prima General Hospital Medan in 2020. The research subjects were all inpatients diagnosed with CKD, whereas 100 research subjects with complete medical records were included in this study. It was found that the highest age group was 57-65 years, as much as 37.0%, and men as much as 27%. The chief complaint was shortness of breath at 43% and additional complaints, the most of which were fever + low back pain + edema at 38%. On physical examination, most of the inspections were weak, 55%. Most palpation was sociable 57%. There was auscultation of four abdominal regions and normal positive bowel sounds (93%). Complete blood count + blood sugar level + electrolytes + urea + creatinine 70%, the most combination medication is NaCl 0.9% + Furosemide injection 31%. Based on the length of stay, the longest was 13-14 days (20%).

Hematologic Abnormalities in Chronic Kidney Disease

2018 ◽  
Author(s):  
Michael Auerbach ◽  
John Anderson ◽  
Khalid Al Talib
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Oral Anticoagulants ◽  
Infusion Reaction ◽  
Nonvalvular Atrial Fibrillation ◽  
Novel Oral Anticoagulant ◽  
Before And After ◽  
Iv Iron ◽  
A Minor

The focus of this review is on information practical to the practicing nephrologist and internists managing patients with chronic kidney disease (CKD), with an emphasis on the quantitative aspects of risk, diagnosis, treatment, and prognosis. Consequently, anemia associated with non–dialysis-associated CKD is emphasized, with special attention to the role of erythropoiesis-stimulating agents and intravenous (IV) iron in treating the anemia of CKD, as well as sections on uremic bleeding and anticoagulation in CKD patients. Figures show a patient before and after a minor infusion reaction, an algorithm outlining grading and management of acute hypersensitivity reactions to IV iron infusions, and an algorithm for the management of uremic platelet dysfunction. Tables list Food and Drug Administration-recommended dose adjustments for novel oral anticoagulant (NOACs) in CKD patients, evidence for preprocedural withholding of NOACs, and management guidelines for anticoagulation in nonvalvular atrial fibrillation and venous thromboembolism. This review contains 2 highly rendered figures, 3 tables, and 101 references. Key words: Chronic kidney disease; CKD; Anemia of chronic kidney disease; Anemia of CKD; Uremic bleeding; Anticoagulation in CKD; Novel oral anticoagulants in CKD; NOAC CKD

Dyslipidemia is a strong predictor of myocardial infarction in subjects with chronic kidney disease

2010 ◽  
Vol 44 (3) ◽  
pp. 262-270 ◽  
Author(s):  
Martin J. Holzmann ◽  
Ingmar Jungner ◽  
Göran Walldius ◽  
Torbjörn Ivert ◽  
Tobias Nordqvist ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Strong Predictor

scholarly journals MO529PREVALENCE AND DETERMINANT FACTORS OF DEPRESSION AND ANXIETY IN PEOPLE WITH CHRONIC KIDNEY DISEASE : A MOROCCAN CROSS-SECTIONAL  STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Amina Chrifi Alaoui ◽  
Mohammed Omari ◽  
Noura Qarmiche ◽  
Omar Kouiri ◽  
Basmat Amal Chouhani ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Depression Scale ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Before And After

Abstract Background and Aims The Chronic kidney disease (CKD), like many chronic illnesses, is invariably associated with various psychiatric conditions and poorer quality of life. This study aims to assess the prevalence of depression and anxiety among CKD patient and their determinant factors. Method this is a cross sectional single center study in a Moroccan university hospital. Patients aged ≥ 18 years old and followed for more than one year were included. The data was collected using a questionnaire for sociodemographic and clinical information and the Hospital anxiety and depression scale (HADS) to assess depression and anxiety prevalence. After the description of the population’s characteristics, the statistical analysis aimed to assess the association between depression and anxiety disorders and the estimated glomerular filtration rate before and after adjustment on several confounding factors. Results 88 patients were included (63.6% of them were women, the mean age was 61.8±14.0 years), 21 were on stage 3, 46 were on stage 4, and 21 were on stage 5 of the CKD. The median of depression sub-score was 5.00[2.00; 10.0], the median of anxiety sub-score was 6.00[4.00; 9.00], and the median of the global score was 11.0[7.00; 20.0], 22.0% of included patients had depression and 22.0% had anxiety. Both depression and anxiety scores were associated to eGFR before and after adjustment (p= 0.001, p&lt;0.001and p=0.04, p=0.03 respectively). Conclusion This study showed that depression and anxiety are strongly related to the CKD progression, which should motivate both doctors and nurses to improve their psychological care toward CKD patients.

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