scholarly journals Chronic Kidney Disease-CKD

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Vipul J. Kakkad
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Energy Level ◽  
Serum Creatinine ◽  
Clinical Improvement ◽  
Clinical Evaluation ◽  
Well Being ◽  
Ozone Therapy ◽  
Stage 4 ◽  
Stage 1

Total Number of CKD patients treated with OZONE THERAPY (rectal or IV saline): 40 (Most of them are under the treatment of Nephrologists) Two categories: - Serum Creatine 3 till 14 (Stage 4-5) No. of pts.17 1) Improvement observed for Stage 1-2-3 that is 1st category: On the basis of Clinical evaluation & Pathological criteria, 100% pts. improvement, with stable patho & physiological criteria, for more than 18 months 2) Improvement observed - for Stage 4-5 that is 2nd category: - On the basis of Clinical evaluation & Pathological criteria, 80% pts. Improved - Clinically & Pathologically. (Stable for > 3 months). - No improvement was observed in 20% of pts. 60% patients have shown Clinical & Pathological improvement & maintained for 6-12months. 80% patients have shown Clinical & Pathological improvement & maintained for 3-6 months. Clinical improvement as follows: - Anorexia decreased - Sense of well-being improved - Energy level increased - Edema decreased - No changes in weight except +/- 1kg. Pathological improvement: - Hb improved - Serum Creatinine & Serum BUN reduction - Proteinuria decreased. Ozone rectal insufflation are found to be more effective than IV ozone saline. Conclusion: Patients who received rectal ozone continuously for more then 10 procedures are better improved and could maintain the improvement.

The Epidemic of Chronic Kidney Disease in Patients Referred to a Hematologist for Anemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5521-5521
Author(s):  
Brian Zimmer ◽  
Dana Wentzel ◽  
James Reed ◽  
Sherrine Eid ◽  
Eliot Friedman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
General Population ◽  
Serum Creatinine ◽  
Strong Association ◽  
Chart Audit ◽  
Stage 4 ◽  
The Mean ◽  
Stage 1

Abstract NHANES survey estimates the prevalence of CKD to be approximately 11% in the general population and 25% in the population over 65 years of age, and the prevalence of Chronic Kidney Disease (CKD) associated anemia approaches 75% in Stage 5 CKD. Despite the high prevalence of CKD, and its strong association with anemia, many patients diagnosed with anemia and referred to a hematologist for evaluation frequently have the diagnosis of CKD overlooked, especially if one is using a serum creatinine to assess renal function. A more accurate method of assessing renal function and to appropriately stage CKD is the use of an estimated glomerular filtration rate (eGFR) utilizing the modified MDRD equation. With the realization that CKD clearly has become known as a significant magnifier of cardiovascular risk (CVR), the importance of making the diagnosis of CKD has become quite apparent. Hypothesis: Patients referred to a hematologist for evaluation of anemia represent a population enriched with CKD. A retrospective chart audit was performed on patients being referred to a hematology practice from community physicians for the evaluation of anemia from January 2004 through December 31, 2005. All patients with a prior knowledge of CKD and a history of malignancy or myelodysplastic process were excluded from the study. The cohort consisted of 256 patients (37.5 % male and 62.5 % female) with a mean age of 67.56 ± 15.9 years. The mean serum creatinine was 1.16 ± .74 mg/dL with a mean calculated GFR by the modified MDRD (4 variable) equation of 69.9 ± 34.2 ml/min/1.73 m2. The mean ± SEM serum creatinine by stage of CKD in our patient population is: Stage 1: 0.67 ± 0.14 mg/dL, Stage 2: 0.92 ± 0.15 mg/dL, Stage 3: 1.40 ± 0.29 mg/dL, Stage 4: 2.23 ± 0.53 mg/dL, and Stage 5: 5.2 ± 2.89 mg/dL. Conservatively, we defined CKD as GFR <60 as urinalysis, imaging, or biopsy data were not available. In conclusion, an astounding 42.2 % of patients referred to a hematologist for the evaluation of anemia have CKD as compared to an estimated prevalence of 11 % in the general population reported by K/DOQI. Not only were these patients not aware of their diagnosis of CKD, but, of note also is the fact that 5.1 % were not aware of the presence of advanced CKD (GFR < 30) and 4 patients had Stage 5 CKD without awareness. 55.8 % of the patients over the age of 65 with anemia have CKD as compared to an estimated 25 % of the general population over the age of 65. This information stresses the need to assess all anemia patients for CKD and to appropriately stage them. Given the well accepted association between CKD and CVR, physicians caring for these patients can then stress the need for aggressive pursuit of both traditional and non traditional risk factor reduction to circumvent the significant CVR that is present in this population. Prevalence of Abnormal Renal Function by GFR Frequency Percent *K/DOQI = National Kidney Foundation’s Kidney Disease Outcome Quality Initiative GFR > 90 (Normal /K/DOQI* Stage 1) 51 19.9 GFR 89 - 60 (K/DOQI Stage 2) 97 37.9 GFR 59 - 30 (K/DOQI Stage 3) 95 37.1 GFR 29 - 15 (K/DOQI Stage 4) 9 3.5 GFR < 15 (K/DOQI Stage 5) 4 1.6

Chronic kidney disease

2020 ◽  
pp. 4830-4860
Author(s):  
Alastair Hutchison
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
The United States ◽  
Protein Excretion ◽  
Stage 4 ◽  
Ckd Stage ◽  
Stage 1

Chronic kidney disease (CKD) is defined as kidney damage lasting for more than 3 months characterized by structural or functional abnormalities of the kidney, with or without decreased glomerular filtration rate (GFR). CKD has been subdivided into six stages depending on the estimated GFR (eGFR) and degree of proteinuria: CKD stage 1 is eGFR greater than 90 ml/min (per 1.73 m2) with other evidence of renal disease; CKD stage 2 is eGFR 60 to 89 ml/min, with other evidence of renal disease; CKD stage 3a is eGFR 45 to 59 ml/min; CKD stage 3b is eGFR 30 to 44 ml/min; CKD stage 4 is eGFR 15 to 29 ml/min; and CKD stage 5 is eGFR less than 15 ml/min. At each stage the CKD is further categorized according to the degree of proteinuria based on the albumin:creatinine ratio (ACR), from A1 (no increase in protein excretion) to A3 (severe proteinuria). The eGFR is least accurate when the serum creatinine is within or near the normal range. Mild CKD is common, with about 10% of the population of the United States of America having CKD stage 1, 2, or 3 (combined), but advanced CKD is relatively rare (about 0.2% are receiving renal replacement therapy). Patients with CKD stage 1, 2, or 3 are at relatively low risk of progressing to require renal replacement therapy, but are at high risk of death from cardiovascular disease. This chapter discusses the definition, aetiology, and pathophysiology of CKD, followed by sections on the prevention of progression, medical management of the consequences of CKD (including diet, CKD mineral and bone disorders, advanced hyperparathyroidism, and anaemia), and preparation for renal replacement therapy or conservative management of uraemia.

scholarly journals Adapting wellbeing research tools for Aboriginal and Torres Strait Islander people with Chronic Kidney Disease

2019 ◽  
Author(s):  
Tricia Nagel ◽  
Michelle Sweet ◽  
Kylie Dingwall ◽  
Stefanie Puszka ◽  
Jaqueline Hughes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Outcome Measures ◽  
Torres Strait Islander ◽  
Research Team ◽  
Torres Strait Islander People ◽  
Stage 4 ◽  
Interpreter Service ◽  
Torres Strait ◽  
Stage 1

Abstract Background There is an acute need to develop wellbeing measures and interventions that are appropriate for Aboriginal and Torres Strait Islander people, including residents of remote communities who have chronic physical conditions. The Kessler 10, Patient Health Questionnaire 9, and EuroQoL are valid, reliable, and commonly used tools to assess various aspects of wellbeing but have not yet been translated to Aboriginal and Torres Strait Islander languages. Similarly, the Stay Strong App is a brief, culturally responsive, e-mental health intervention, but has not been used with Aboriginal and Torres Strait Islander people with Chronic Kidney Disease. Methods We aimed to pilot test the above tools with Aboriginal and Torres Strait Islander Australians with Chronic Kidney Disease Stage 5 (CKD-5) and develop revised versions suitable for use in a clinical trial using a four-stage multi-method approach. Stage 1: Pilot testing of outcome measures and Stay Strong App intervention in a purposive sample of five haemodialysis patients and carers to examine acceptability. Stage 2: Translation of outcome measures through collaboration between the Aboriginal Interpreter Service, Aboriginal and Torres Strait Islander research officers and research team. Stage 3: Conversion of revised outcome measures to electronic format. Stage 4: Collaboration of research team and an Expert Panel in an iterative approach to adapt the Stay Strong App. Results Stage 1: Pilot testing of outcome measures identified three areas of difficulty: explanation of time frames and frequency responses, translation of the terms ‘worthless’ and ‘hopeless’, and fatigue and boredom related to the assessment process. Stage 2: Translation of most items was uncontroversial. Discrepancies between team member views and local interpretations of specific terms were addressed. Final drafts were forwarded to the Aboriginal Interpreter Service for translation. Stage 3: Audio translations in 11 languages were integrated into an interactive Outcome Measures App. Stage 4: A new renal version of the Stay Strong App was developed through research team and expert panel consensus. Conclusion The four-stage approach allowed adaptation of the tools for use within a future trial of wellbeing interventions for Aboriginal and Torres Strait Islander people receiving haemodialysis. Trial registration: ACTRN12617000249358 Registered 17 February 2017.

THE STUDY ON SERUM WITH eGFR IN PATIENTS OF CHRONIC KIDNEY DISEASE

2021 ◽  
pp. 23-25
Author(s):  
Brahmarshi Das ◽  
Narendranath Hait ◽  
Titol Biswas ◽  
Debarshi Jana
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cross Sectional Study ◽  
Newly Diagnosed ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Ckd Stage ◽  
The Mean ◽  
Stage 1

INTRODUCTION: Chronic Kidney Disease (CKD) is dened as a disease characterized by alterations in either kidney structure or function or both for a minimum of 3 months duration. According to the National Kidney Foundation criteria, 1 CKD has been classied into ve stages with stage 1 being the earliest or mildest CKD state and stage 5 being the most severe CKD stage. To stage CKD, it is necessary to estimate the GFR rather than relying on serum creatinine concentration. Glomerular ltration rate (GFR), either directly measured by computing urinary clearance of ltration marker such as inulin or estimated by calculating from different equations using serum creatinine. is the most commonly used parameter to assess kidney function. AIM AND OBJECTIVES: a) Establish relationship between serum CKD and eGFR MATERIAL AND METHOD: A Cross-sectional study on 100 cases of newly diagnosed Chronic Kidney Disease patients and matched control subjects is undertaken to study.100 Patients who are newly diagnosed as CKD are selected after proper initial screening. RESULT AND ANALYSIS: In case, the mean eGFR (mean± s.d.) of patients was 25.1500 ± 11.8929. In control, the mean eGFR (mean± s.d.) of patients was 87.2200 ± 17.8295. Difference of mean eGFR in two groups was statistically signicant (p<0.0001). In case, the mean creatinine (mean± s.d.) of patients was 3.6350 ± 2.4419 mg/dl. In control, the mean creatinine (mean± s.d.) of patients was .9435 ± .1317 mg/dl. Difference of mean creatinine in two groups was statistically signicant (p<0.0001). CONCLUSION: eGFR was strongly associated with CKD that also statistically signicant. The positive correlation was found in eGFR.

scholarly journals A Transversal Study of Biochemical Profile, Urinalysis, UPC, Electrolytes and Blood Pressure in Dogs with Chronic Kidney Disease

2020 ◽  
Vol 48 ◽  
Author(s):  
José Francisco Antunes Ribeiro ◽  
Tácia Tavares Aquinas Liguori ◽  
André Nanny Vieira Le Sueur ◽  
Carlos Roberto Padovani ◽  
Maria Jaqueline Mamprim de Arruda Monteiro ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Retrospective Study ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Multiple Comparisons ◽  
Serum Phosphate ◽  
Biochemical Profile ◽  
Stage 4 ◽  
Ckd Stage ◽  
Transversal Study

Background: Chronic kidney disease (CKD) affects both dogs and cats, mainly elderly animals, due to tubulointerstitial inflammation associated with the increase of fibrosis through the excess deposition of extracellular matrix (ECM) which leads to decrease glomerular filtration. Many different underlying renal diseases can affect the kidneys of dogs such as congenital or acquired in origin. Therefore, the main objective of this transversal study was to evaluate the epidemiology through clinical and laboratory evaluation of 225 client-owned dogs with CKD.Materials, Methods & Results: Complete blood count (CBC), urinalysis, and biochemical profile were retrospectively selected and evaluated from 225 client-owned dogs with CKD of both sexes, different ages, and breeds from the patient population of the Nephrology and Urology Small Animal Service of the Teaching Hospital of the School of Veterinary Medicine and Animal Science - São Paulo State University from 2011 to 2017. All dogs were divided in groups according to the International Renal Interest Society (IRIS) CKD grading and statistical analysis was performed according to Kruskal-Wallis non-parametric test complemented with Dunn's multiple comparisons test, and analysis of variance for the model with a factor complemented with the test of multiple comparisons of Tukey. In this retrospective study, we observed that most dogs in all groups were elderly (≥ 9 years old). CBC demonstrated lower RBC’s (P < 0.005), hemoglobin (P < 0.001), hematocrit (Ht%) [P < 0.001] at the highest stage of the disease. However, urinary specific gravity (USG) did not demonstrate significant differences between the disease stages, but urinary protein: creatinine ratio (UPC) was statistically different (P < 0.01) between IRIS-CKD stages 1 and 4. Furthermore, serum phosphate concentrations demonstrated significantly higher levels in dogs at IRI-CKD stage 4 compared with IRIS-CKD stage 3 (P < 0.001).Discussion: The analysis of 225 dogs with CKD showed that 130 animals were elderly, older than 9 years, and according to previous studies, 15% of dogs over 10 years of age are diagnosed of CKD, presenting significant morbidity and mortality. Laboratory findings such as the presence of non-regenerative anemia is expected in dogs with CKD. In our study, the degree of anemia corresponded with the stage of the disease, similarly to serum creatinine concentrations. Another important laboratory finding in diagnosing CKD is the early detection of the kidney's abilities in concentrating its tubular filtrate. In this retrospective study, isosthenuria was not significant due to all dogs presented CKD as criteria of inclusion, especially those without azotemia, although, proteinuria was reported in 90% of the population investigated. Electrolyte imbalances are also expected in CKD. However, despite serum sodium, potassium, and total calcium did not demonstrate significant results, serum phosphate had its significance between IRIS-CKD stage 3 and stage 4. Hence, despite the age factor of most dogs in all groups, with the association of laboratory results such as serum creatinine, serum phosphorus, ionized calcium, erythrogram, isosthenuria, SBP, and the degree of proteinuria, it was possible to perform early diagnosis of CKD even in dogs with IRIS-CKD Stage 1 in a stable and hydrated patient. With the proper diagnostic, staging and substaging according to IRIS guidelines, these parameters can be monitored, predicting longevity and good quality of life, or progression of the disease with a more reserved prognosis.

scholarly journals MIF associated with pulmonary hypertension susceptibility and severity in non-dialysis Chronic kidney disease patients

2020 ◽  
Vol 18 ◽  
pp. 205873922096119
Author(s):  
Jianhua Wu ◽  
Naifeng Guo ◽  
Xiaolan Chen
Keyword(s):  
Chronic Kidney Disease ◽  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Stage 4 ◽  
Stage 1

Pulmonary hypertension (PAH) is one of the more serious complications of Chronic kidney disease (CKD), and its exact pathogenesis has not been clarified. As an upstream proinflammatory factor, macrophage migration inhibitor (MIF) is involved in the occurrence and development of many diseases. This study aimed to detect the relationship between serum MIF and PAH in non-dialysis CKD patients. A total of 382 non-dialysis CKD patients were enrolled in this study. Bio-Plex cytokine assay was used to detect MIF. CKD patients were divided into the PAH group and non-PAH group according to echocardiographic results. Relative risk was determined by logistic regression analysis. The pulmonary artery pressure in the CKD group was higher than that in the control group ( p < 0.01). Pulmonary arterial pressure was higher in stage 4 to 5 CKD patients than in Stage 1 to 3 CKD patients ( p < 0. 01), and the incidence of PAH was also increased ( p < 0. 01). MIF in the CKD group were higher than in the control group ( p < 0.05). MIF in CKD patients with PAH were higher than those without PAH ( p < 0.05). Multivariate logistic regression analysis showed that MIF is correlated with PAH (OR = 10.745; 95% CI 2.288–89.447, p < 0.05). PAH is common in non-dialysis CKD patients, and with the deterioration of kidney disease, the incidence of PAH is gradually increased, indicating that MIF plays an important role in the development of PAH in CKD patients.

scholarly journals Serum indices based on creatinine and cystatin C predict mortality in patients with non-dialysis chronic kidney disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Li Lin ◽  
I-Chen Chang ◽  
Hung-Hsiang Liou ◽  
Chih-Hsien Wang ◽  
Yu-Hsien Lai ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Serum Markers ◽  
Categorical Variables ◽  
Receiver Operating Characteristic Curves ◽  
Cox Proportional Hazard Models ◽  
Basic Characteristics ◽  
Stage 1

AbstractSerum indices based on creatinine and cystatin C, including creatinine/cystatin C ratio (Cr/CysC), ratio and difference of estimated glomerular filtration rate (eGFR) based on cystatin C and creatinine (eGFRcys/eGFRcre and eGFRDiff), and serum creatinine × eGFRcys, are recently identified serum markers for sarcopenia. We aimed to evaluate the association between these serum indices and mortality in patients with chronic kidney disease (CKD). A single-center retrospective cohort study included 1141 adult patients with stage 1–5 CKD between 2016 and 2018. Basic characteristics, comorbidities, laboratory parameters, and serum creatinine and cystatin C values were obtained. Patients were followed up until death, dialysis, transfer to another hospital, or end of the study. The median age (interquartile range) of our participants was 71 (62–81) years. During a median follow-up of 39 months, 116 (10.2%) patients died. Compared to the survivor group, Cr/CysC, eGFRcys/eGFRcre, eGFRDiff, and Cr × eGFRcys were all lower in the non-survivors (p < 0.001 for all). The receiver operating characteristic curves of serum indices for predicting mortality showed that all four indices had significant discriminative power. Based on the Cox proportional hazard models, lower values of four serum indices, both as continuous and categorical variables, independently predicted mortality. Our findings suggest that low serum indices of Cr/CysC, eGFRcys/eGFRcre, eGFRDiff, and Cr × eGFRcys are independent indicators of mortality in patients with non-dialysis CKD.

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].

Sign in / Sign up

Export Citation Format

Share Document