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Michán-Doña A, Jiménez-Varo E, Escribano-Cobalea M, Casto-Jarillo C, López-Ceres A, Campos-Dávila E, Hormigo-Pozo A, Nieto-Ordoñez C, Rodríguez-Juliá MÁ, Escribano-Serrano J. Prevalence and characteristics of anemia in patients with diabetes mellitus aged 50 or older in health unit area of Cadiz (Spain). Rev Clin Esp 2024; 224:457-465. [PMID: 38879004 DOI: 10.1016/j.rceng.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/27/2024] [Indexed: 06/19/2024]
Abstract
BACKGROUND Anemia is a common comorbidity in patients with diabetes mellitus (DM), particularly in older adults. However, there is a lack of data on the prevalence and the characteristics of anemia in this population in Spain. OBJECTIVE To describe the prevalence and the characteristics of anemia in patients with DM aged 50 or older (PDM50) in a healthcare district in the province of Cádiz. METHODS A retrospective cross-sectional study was conducted that included outpatient's laboratory tests (OLT) performed over 30 months at PDM50. RESULTS The prevalence of anemia was 29.9% (95% CI: 28.7%-31.1%), predominating in women (33.3% vs 26.7%; P < 0.01), in older people stratified by decades (61.7% in 9th decade vs 12% in 5th decade; P < 0.01), and in those with kidney disease (44.7% vs 28%; P < 0.01). Most cases were mild (68.3%), normocytic (78.7%), and hypochromic (52%). Similarly, moderate-to-severe anemia was more frequent in women (39% vs 23%), their prevalence increased with age (45% in the 9th decade vs 24% in the 5th decade), and with the progression of kidney damage, either measured by a decreased glomerular filtration rate (GFR) (49% in G4 vs 25% in G1), or the presence of albuminuria (P < 0.01). No association was found between DM control, based on glycated hemoglobin (HbA1c), and anemia in either sex (P = 0.887). CONCLUSION This study describes a high prevalence of anemia in PDM50, particularly in women, in the most advantageous people and in the presence of kidney disease, even in early stages, highlighting the clinical importance of this coexistence.
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Affiliation(s)
- A Michán-Doña
- Departamento de Medicina, HU Jerez de la Frontera, AGS Norte de Cádiz, Universidad de Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - E Jiménez-Varo
- UGC Laboratorio Análisis Clínicos, HU la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - M Escribano-Cobalea
- UGC Obstetricia y Ginecología, HU Punta de Europa de Algeciras, AGS Campo de Gibraltar Oeste, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - C Casto-Jarillo
- UGC Laboratorio Análisis Clínicos, HU la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - A López-Ceres
- UGC Laboratorio Análisis Clínicos, HU la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - E Campos-Dávila
- UGC Farmacia, Hospital de la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - A Hormigo-Pozo
- UGC San Andrés Torcal, AGS Málaga Guadalhorce, Málaga, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - C Nieto-Ordoñez
- UGC San Roque, San Roque, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - M Á Rodríguez-Juliá
- UGC Velada, la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - J Escribano-Serrano
- UGC Velada, la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
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Tangri N, Alvarez CS, Arnold M, Barone S, Cebrián A, Chen H, De Nicola L, Järbrink K, Kanumilli N, Lim KS, Moriyama T, Pecoits Filho R, Ribeiro de Castro MC, Santamaria R, Schneider MP, Virgitti JB, Kushner P. Suboptimal monitoring and management in patients with unrecorded stage 3 chronic kidney disease in real-world settings: Insights from REVEAL-CKD. Eur J Clin Invest 2024:e14282. [PMID: 39023418 DOI: 10.1111/eci.14282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/28/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Clinical practice guidelines for patients with chronic kidney disease (CKD) recommend regular monitoring and management of kidney function and CKD risk factors. However, the majority of patients with stage 3 CKD lack a diagnosis code, and data on the implementation of these recommendations in the real world are limited. AIM To assess the implementation of guideline-directed monitoring and management practices in the real world in patients with stage 3 CKD without a recorded diagnosis code. METHODS REVEAL-CKD (NCT04847531) is a multinational, observational study of patients with stage 3 CKD. Eligible patients had ≥2 consecutive estimated glomerular filtration rate (eGFR) measurements indicative of stage 3 CKD recorded >90 and ≤730 days apart, lacked an International Classification of Diseases 9/10 diagnosis code corresponding to CKD any time before and up to 6 months after the second eGFR measurement. Testing of key measures of care quality were assessed. RESULTS The study included 435,971 patients from 9 countries. In all countries, the prevalence of urinary albumin-creatinine ratio and albuminuria testing was low. Angiotensin-converting enzyme inhibitor, angiotensin receptor blocker and statin prescriptions were highly variable, and sodium-glucose cotransporter-2 inhibitor prescriptions remained below 21%. Blood pressure measurements were recorded in 20.2%-89.9% of patients. CONCLUSIONS Overall, a large proportion of patients with evidence of stage 3 CKD did not receive recommended, guideline-directed monitoring and management. The variability in standard of care among countries demonstrates a clear opportunity to improve monitoring and management of these patients, most likely improving long-term outcomes.
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Affiliation(s)
- Navdeep Tangri
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christian S Alvarez
- Cardiovascular, Renal and Metabolism Epidemiology, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, USA
| | - Matthew Arnold
- Real World Evidence Data & Analytics, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
| | - Salvatore Barone
- Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, USA
| | - Ana Cebrián
- Primary Care Center Cartagena Casco, Cartagena, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Hungta Chen
- Medical/Payer Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, USA
| | - Luca De Nicola
- Department of Advanced Medical and Surgical Sciences, Nephrology and Dialysis Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Krister Järbrink
- Cardiovascular, Renal and Metabolism Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
| | - Naresh Kanumilli
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Kean-Seng Lim
- General Practice, Mt Druitt Medical Centre, Mount Druitt, New South Wales, Australia
| | | | - Roberto Pecoits Filho
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
- School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | | | - Rafael Santamaria
- Department of Nephrology, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain
| | - Markus P Schneider
- Department of Nephrology and Hypertension, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Pamela Kushner
- Clinical Professor of Family Medicine, Department of Family Medicine, University of California Irvine Medical Center, Orange, California, USA
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Bersano-Reyes PA, Nieto G, Cana-Poyatos A, Guerrero Sanz P, García-Maset R, García-Testal A. Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients. NUTR HOSP 2024; 41:628-635. [PMID: 38666342 DOI: 10.20960/nh.04850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Introduction Introduction: among the groups more affected by the COVID-19 pandemic were patients undergoing chronic hemodialysis (HD) treatment due to their comorbidities, advanced age, impaired innate and adaptive immune function, and increased nutritional risk due to their underlying inflammatory state. All of these factors contribute to a higher risk of severe complications and worse outcomes compared to the general population when infected with SARS-CoV-2. Objective: the objective of this study was to describe the nutritional characteristics of and their potential association with the prognosis of COVID-19 in patients undergoing chronic HD treatment. Method: a descriptive, retrospective, observational design. All cases of COVID-19 in patients undergoing chronic treatment at the Hemodialysis Unit of Hospital de Manises, Valencia, Spain, from the start of the pandemic to before vaccination were included. Results: for that, 189 patients were studied, who received chronic HD treatment in the hospital unit, 22 patients were diagnosed with COVID-19 (12 %) in that period. The mean age was 71 years, 10 were women, the Charlson index was 6.59 points, diabetes mellitus 10, vintage HD 51.6 months, 2 patients had previously received a currently non-functioning kidney transplant, 16 had arteriovenous fistula as vascular access, and 6 had central vascular access. The mean dialysis session time was 220.14 minutes and the initial value of the single dose of the Kt/V pool was 1.7. 16 patients had body composition measurement, a strong association (p < 0.05) was identified between mortality and BMI, as well as mortality and FTI. Furthermore, the differences between deceased and surviving groups in the serum levels of various variables related to nutritional status were analyzed, finding significant differences with p < 0.05 in the value of triglycerides and ferritin. Conclusions: higher body mass index and higher body fat content, along with lower baseline levels of triglycerides and ferritin, were significantly associated with higher COVID-19 mortality in patients on chronic hemodialysis. These findings suggest that the initial nutritional status of these patients can significantly influence the prognosis of SARS-CoV-2 infection.
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Affiliation(s)
| | - Gema Nieto
- Department of Food Technology, Food Science, and Nutrition. Universidad de Murcia
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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R, Hasan S, Hamza MB. Renal calcification in children with renal tubular acidosis: What a paediatrician should know. World J Clin Pediatr 2023; 12:295-309. [PMID: 38178934 PMCID: PMC10762599 DOI: 10.5409/wjcp.v12.i5.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/15/2023] [Accepted: 10/16/2023] [Indexed: 12/08/2023] Open
Abstract
Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification, highlighting essential aspects for clinical management. The article analyzed relevant studies to explore the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Results show that distal RTA (type 1) is particularly associated with nephrocalcinosis, which presents a higher risk of renal calcification. However, there are limitations to the existing literature, including a small number of studies, heterogeneity in methodologies, and potential publication bias. Longitudinal data and control groups are also lacking, which limits our understanding of long-term outcomes and optimal management strategies for children with RTA and renal calcification. Pediatricians play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated complications. In addition, alkaline therapy remains a cornerstone in the treatment of RTA, aimed at correcting the acid-base imbalance and reducing the formation of kidney stones. Therefore, early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected children. Further research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatrics, University Medical Center, King Abdulla Medical City, Dr. Sulaiman Al Habib Medical Group, Manama, Bahrain, Manama 26671, Manama, Bahrain
| | - Nermin Kamal Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Manama, Bahrain
- Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel Salah Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Chest Disease, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama, Manama 26671, Manama, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, The Royal College of Surgeons in Ireland - Bahrain, Busiateen 15503, Muharraq, Bahrain
| | - Samir Hasan
- Department of Pediatrics, Faculty of Medicine, Tanta University Hospital, Tanta 31511, Algharbia, Egypt
| | - Mohamed Basiony Hamza
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt
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Ortiz A, Alcázar Arroyo R, Casado Escribano PP, Fernández-Fernández B, Martínez Debén F, Mediavilla JD, Michan-Doña A, Soler MJ, Gorriz JL. Optimization of potassium management in patients with chronic kidney disease and type 2 diabetes on finerenone. Expert Rev Clin Pharmacol 2023:1-14. [PMID: 37190957 DOI: 10.1080/17512433.2023.2213888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) are at high risk of CKD progression and cardiovascular events. Despite treatment with renin-angiotensin system inhibitors and SGLT-2 inhibitors, the residual risk is substantial. There is preclinical and clinical evidence supporting a key role of mineralocorticoid receptor in cardiorenal injury in T2DM. AREAS COVERED Finerenone is a selective and nonsteroidal mineralocorticoid receptor antagonist that reduces -on preclinical studies- heart and kidney inflammation and fibrosis. Clinical trials have demonstrated that among patients with T2DM and CKD, finerenone reduces CKD progression and the risk of cardiovascular events. The incidence of adverse events is similar than for placebo. Permanent discontinuation of study drug due to hyperkalemia was low (1.7% of finerenone and 0.6% of placebo participants) as was the risk of hyperkalemia-related severe-adverse events (1.1%). We provide an overview of risk factors for hyperkalemia and management of serum potassium in people with CKD and T2DM on finerenone. EXPERT OPINION As finerenone increases potassium levels in a predictable way, patients at risk of hyperkalemia can be identified early in clinical practice and monitored for an easy management. This will allow people with T2DM and CKD to safely benefit from improved cardiorenal outcomes.
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Affiliation(s)
- Alberto Ortiz
- Nephrology and Hypertension Department, IIS-FJD and Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Beatriz Fernández-Fernández
- Nephrology and Hypertension Department, IIS-FJD and Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Francisco Martínez Debén
- Internal Medicine Department, Hospital Naval, Complexo Hospitalario Universitario de Ferrol. Departamento de Ciencias de la Salud. Universidad de La Coruña, Spain
| | - Juan Diego Mediavilla
- Internal Medicine Department, Instituto de Investigación Biosanitaria ibs, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Alfredo Michan-Doña
- Department of Medicine, Hospital Universitario de Jerez, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
| | - Maria Jose Soler
- Nephrology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Jose Luis Gorriz
- Nephrology Department, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain
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Escribano-Serrano J, Jiménez-Varo E, Escribano-Cobalea M, López-Ceres A, Casto-Jarillo C, Hormigo-Pozo A, Michán-Doña A. Is the use of the new Chronic Kidney Disease Epidemiology Consortium (CKD-EPI 2021) formula appropriate for the Spanish population? Rev Clin Esp 2023; 223:144-153. [PMID: 36796634 DOI: 10.1016/j.rceng.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/17/2022] [Indexed: 02/16/2023]
Abstract
INTRODUCTION United States nephrology societies recommend changing from the CKD-EPI 2009 equation to the new CKD-EPI 2021 equation, which does not include the race coefficient, for calculating estimated glomerular filtration rate (eGFR). It is unknown how this change might affect the distribution of kidney disease in the predominantly Caucasian Spanish population. METHODS Two databases of adults from the province of Cádiz, DB-SIDICA (N=264,217) and DB-PANDEMIA (N=64,217), that had plasma creatinine measurements recorded between 2017 and 2021 were studied. Changes in eGFR and the consequent reclassification into different categories of the KDIGO 2012 classification resulting from substituting the CKD-EPI 2009 equation for the 2021 equation were calculated. RESULTS Compared to the 2009 equation, CKD-EPI 2021 yielded a higher eGFR, with a median of 3.8mL/min/1.73m2 (IQR 2.98-4.48) in DB-SIDICA and 3.89mL/min/1.73m2 (IQR 3.05-4.55) in DB-PANDEMIA. The first consequence was that 15.3% of the total population in DB-SIDICA and 15.1% of the total population in DB-PANDEMIA were reclassified into a higher category of eGFR, as were 28.1% and 27.3%, respectively, of the population with CKD (G3-G5); no subjects were classified into the more severe category. The second consequence was that the prevalence of kidney disease decreased from 9% to 7.5% in both cohorts. CONCLUSIONS Implementing the CKD-EPI 2021 equation in the Spanish population, which is predominantly Caucasian, would increase eGFR by a modest amount (greater in men and those who are older or have a higher GFR). A significant proportion of the population would be classified into a higher eGFR category, with a consequent decrease in the prevalence of kidney disease.
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Affiliation(s)
- J Escribano-Serrano
- Unidad de Gestión Clínica San Roque, Área de Gestión Sanitaria Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain.
| | - E Jiménez-Varo
- Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain; Unidad de Gestión Clínica Laboratorio Análisis Clínicos, Hospital La Línea, Área de Gestión Sanitaria Campo de Gibraltar Este, Cádiz, Spain
| | - M Escribano-Cobalea
- Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain; Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Punta Europa de Algeciras, Área de Gestión Clínica Campo de Gibraltar Oeste, Cádiz, Spain
| | - A López-Ceres
- Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain; Unidad de Gestión Clínica Laboratorio Análisis Clínicos, Hospital La Línea, Área de Gestión Sanitaria Campo de Gibraltar Este, Cádiz, Spain
| | - C Casto-Jarillo
- Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain; Unidad de Gestión Clínica Laboratorio Análisis Clínicos, Hospital La Línea, Área de Gestión Sanitaria Campo de Gibraltar Este, Cádiz, Spain
| | - A Hormigo-Pozo
- Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain; Unidad de Gestión Clínica San Andrés-Torcal, Área de Gestión Sanitaria Málaga Guadalhorce, Málaga, Spain
| | - A Michán-Doña
- Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain; Departamento de Medicina, Hospital Universitario de Jerez, Área de Gestión Sanitaria Norte de Cádiz, Cádiz, Spain
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Frías A, Vargas F, Sandino J, Berzal R, Rivero M, Cordero L, Cavero T, Segura J, García F, Hernández E, Gutiérrez E, Auñón P, Zamanillo I, Pascual J, Morales E. Octogenarians with chronic kidney disease in the nephrology clinic: Progressors vs. non-progressors. FRONTIERS IN NEPHROLOGY 2023; 3:1114486. [PMID: 37675351 PMCID: PMC10479568 DOI: 10.3389/fneph.2023.1114486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/18/2023] [Indexed: 09/08/2023]
Abstract
Background The current definition of chronic kidney disease applied to patients over the age of 80 has increased the number of referrals to Nephrology. However not all of these patients may benefit from its assessment. This study aims to analyze the evolution of ≥80 years old patients referred to Nephrology. Methods Single-center study including patients ≥80 years old with eGFR <60 mL/min/1,73m2 who were referred to Nephrology consultation for the first time. Clinical and analytical parameters were collected retrospectively 12 months before the visit, and prospectively at baseline, and 12 and 24 months after the initial visit. We divided patients into two groups based on annual eGFR loss: progressors (>5 mL/min/1.73m2) and non-progressors (≤5 mL/min/1,73m2). Results A total of 318 patients were included, mean age was 84,9 ± 4 (80-97) years. Baseline serum creatinine was 1,65 ± 0,62 mg/dL, eGRF 35 (28-42) mL/min/1,73, and albumin/creatinine ratio 36 (7-229) mg/g. 55,7% of the patients met the definition of progressor at baseline (initial-progressors), 26,3% were progressors after a 12-month follow-up and 13,4% after 24 months. 21,2% and 11,4% of initial-progressors met this definition at 12 and 24 month follow up. The main risk factor for progression was albuminuria. No relationship was found between the nephrologist intervention and the evolution of renal function among initial non-progressors. Conclusion Elderly patients who have stable renal function at the time of referral will continue to have stable renal function over the subsequent 24 months and thus may not need to be referred to a nephrologist.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Enrique Morales
- Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain
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Escribano-Serrano J, Jiménez-Varo E, Escribano-Cobalea M, López-Ceres A, Casto-Jarillo C, Hormigo-Pozo A, Michán-Doña A. ¿Es apropiada la aplicación de la nueva ecuación Chronic Kidney Disease Epidemiology Consortium (CKD-EPI 2021) en la población española? Rev Clin Esp 2023. [DOI: 10.1016/j.rce.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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