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Pu S, Peng H, Li Y, Huang X, Shi Y, Song C. Development of standardized nursing terminology for the process documentation of patients with chronic kidney disease. Front Nutr 2024; 11:1324606. [PMID: 38362106 PMCID: PMC10867265 DOI: 10.3389/fnut.2024.1324606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction European Nursing care Pathways (ENP) is a professional care language that utilizes software to map care processes and utilize the data for research purposes, process control, and personnel requirement calculations. However, there is a lack of internationally developed terminology systems and subset specifically designed for the nutritional management of CKD. The aim of this study was to create a subset of the standardized nursing terminology for nutrition management in patients with chronic kidney disease (CKD). Materials and methods According to the guidelines for subset development, four research steps were carried out: (i) Translation of version 3.2 of the ENP (chapter on kidney diseases) and understanding of the framework structure and coding rules of the ENP; (ii) Identification of relevant six-dimensional nursing terms; (iii) Creation of a framework for the subset; (iv) Review and validation by experts. Results A subset for CKD nutritional care was created as part of this project, comprising 630 terms, with 17 causal relationships related to nursing diagnoses, 115 symptoms, 31 causes, 34 goals/outcomes, 420 intervention specifications and 13 resources, including newly developed care terms. All terms within the subset have been created using a six-step maintenance procedure and a clinical standard pathway for nutrition management in the SAPIM mode. Implications for nursing practice This terminology subset can facilitate standardized care reports in CKD nutrition management, which is used to standardize nursing practice, quantify nursing, services, guidance on care decisions, promoting the exchange and use of CKD nutrition data and serve as a reference for the creation of standardized subset of nursing terminology in China.
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Affiliation(s)
- Shi Pu
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hongmei Peng
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yang Li
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xia Huang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yu Shi
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Caiping Song
- President Office, The Second Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China
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Masrouri S, Tamehri Zadeh SS, Pishgahi M, Azizi F, Shapiro MD, Hadaegh F. Kidney function decline is associated with mortality events: over a decade of follow-up from Tehran Lipid and Glucose Study. J Nephrol 2024; 37:107-118. [PMID: 37665526 DOI: 10.1007/s40620-023-01756-z] [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: 03/06/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND To investigate the association between estimated glomerular filtration rate (eGFR) change and mortality risk in a cohort from the Middle East and North Africa region with increasing chronic kidney disease burden. METHODS We included 2210 participants aged ≥ 50 years from the prospective cohort of the Tehran Lipid and Glucose Study. The interval for eGFR measurement was between the examinations in 2002-2005 to 2009-2011, and participants were followed through March 2018. Glomerular filtration rate was estimated from serum creatinine using the CKD-EPI creatinine equation. We assessed the association of rapid kidney function decline, (defined as annual eGFR decline ≥ 3 ml/min/1.73 m2 per year); ≥ 30% eGFR decline over six years; and certain drop in kidney function (≥ 25% eGFR decline plus drop in eGFR category) with mortality outcomes. RESULTS During a median follow-up of 14.3 years after recruitment, 315 all-cause and 112 cardiovascular disease deaths were recorded. The multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause death for rapid kidney function decline, ≥ 30% decline in eGFR over 6 years, and drop in kidney function were 1.68 (1.24-2.27), 2.01 (1.46-2.78), and 1.49 (1.11-1.98), respectively. The HRs of all-cause death and for rapid kidney function decline in those without and with chronic kidney disease were 1.41 (1.03-1.91) and 3.38 (1.69-6.76), respectively. Similar findings were observed regarding cardiovascular disease-related and non-cardiovascular disease-related mortality. CONCLUSIONS Estimated GFR decline is associated with an increased mortality risk, indicating its ability to provide additional prognostic information beyond traditional risk predictors in the general population.
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Affiliation(s)
- Soroush Masrouri
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, Velenjak, P.O. Box: 19395-4763, Tehran, Iran
| | - Seyed Saeed Tamehri Zadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, Velenjak, P.O. Box: 19395-4763, Tehran, Iran
| | - Mehdi Pishgahi
- Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, Velenjak, P.O. Box: 19395-4763, Tehran, Iran.
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da Silva AJ, dos Santos Lopes AC, Mota APL, Silva ACSE, Dusse LMS, Alpoim PN. Pediatric chronic kidney disease: blood cell count indexes as inflammation markers. J Bras Nefrol 2023; 45:458-469. [PMID: 37948452 PMCID: PMC10726671 DOI: 10.1590/2175-8239-jbn-2022-0190en] [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: 02/01/2023] [Accepted: 06/11/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. AIM To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). METHODS We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. RESULTS Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. CONCLUSION The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.
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Affiliation(s)
- Aislander Junio da Silva
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Cristina dos Santos Lopes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Paula Lucas Mota
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Luci Maria Sant’Ana Dusse
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Patrícia Nessralla Alpoim
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
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Zhang F, Hu N, Li J, Pu M, Li X, Li Y, Liao D. The correlation of urinary strontium with the risk of chronic kidney disease among the general United States population. Front Public Health 2023; 11:1251232. [PMID: 37780453 PMCID: PMC10534960 DOI: 10.3389/fpubh.2023.1251232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Background This study sought to illustrate whether urinary strontium levels were related to developing chronic kidney disease (CKD) in the United States population. Methods A total of 5,005 subjects were identified from the National Health and Nutrition Examination Survey 2011-2016. Survey-weighted logistic regression analysis, multivariate linear regression analysis, restricted cubic spline (RCS) plots curve and stratified analyses were undertaken to explicate the correlation between urinary strontium and CKD. Results With the increase of urinary strontium, the incidence rate of CKD and urinary albumin to creatinine ratio (UACR) levels gradually decreased, and estimated glomerular filtration rate (eGFR) levels gradually increased. After controlling all confounders, only urinary strontium in the fourth quartile was correlated to a lower CKD prevalence (OR: 0.59; 95% CI, 0.44-0.79) compared to the lowest quartile. Multivariate linear regression analysis showed that urinary strontium was positively correlated with eGFR but negatively with UACR. RCS curve suggested a nonlinear relationship between urinary strontium and CKD (P for non-linearity <0.001). Stratified analyses indicated no significant difference in the correlation between urinary strontium and CKD among different subgroups. Conclusion Urinary strontium was strongly correlated with a low risk of CKD, and this association was non-linear among the US population.
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Affiliation(s)
- Fenglian Zhang
- Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Na Hu
- Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Jiayue Li
- Chengdu Medical College, Chengdu, China
| | - Ming Pu
- Chengdu Medical College, Chengdu, China
| | - Xinchun Li
- North Sichuan Medical College, Nanchong, China
| | - Yuanmei Li
- Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Dan Liao
- Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
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Elorza CLC, dos Santos A, Celeri EHRV. Quality of life, depression and anxiety in children and adolescents with CKD and their primary caregivers. J Bras Nefrol 2023; 45:335-343. [PMID: 36745054 PMCID: PMC10697160 DOI: 10.1590/2175-8239-jbn-2022-0036en] [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: 04/01/2022] [Accepted: 11/17/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) requires long-lasting treatments and severe changes in the routine of children, which may favor a low quality of life (QoL) and damage to their mental health and that of their primary caregivers (PC). The present study aimed to investigate the presence of anxiety and depression and to analyze the QoL of children and adolescents diagnosed with CKD at stages 3, 4, and 5, and their PC. METHODS We carried out an observational case-control study with 29 children and adolescents and their PC as the case group and 53 as the control group. International instruments, validated for the Brazilian population, were used: Child Anxiety Inventory (STAI-C), Pediatric Quality of Life Inventory (PEDSQL), Child Depression Inventory (CDI), Beck Anxiety and Depression Inventory (BAI; BDI), and the WHOQOL-bref. RESULTS The study identified statistically significant differences in the PEDSQL total score (control group, 72.7 ± 19.5; case group, 63.3 ± 20.6; p = 0.0305) and in the psychosocial (control group, 70.5 ± 20.5 and case group, 61.4 ± 19.7; p = 0.0420) and school health dimensions (control group, 72.9 ± 21.0 and case group, 55.2 ± 19.8; p = 0.0003) and the presence of psychiatric comorbidity (depression and anxiety symptoms) in the case group (p = 0.02). As for PC, the study showed statistical significance for the prevalence of depression (p = 0.01) and anxiety (p = 0.02) symptoms. CONCLUSION Patients with CKD have lower QoL indices and more psychiatric comorbidities, and their PC are affected by the disease, with higher indices of depression and anxiety.
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Affiliation(s)
- Cibele Longobardi Cutinhola Elorza
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Campinas, SP,
Brazil
| | - Amilton dos Santos
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Departamento de Psicologia Médica e Psiquiatria, Campinas, SP, Brazil
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HOU X, HUANG L, Zhang H, XIN Q, LI H, YE H, ZHANG Y. Adsorption Resin/Polyethersulfone Membrane Used for Plasma Separation and Middle Molecular Toxins Adsorption. J IND ENG CHEM 2023. [DOI: 10.1016/j.jiec.2023.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Elorza CLC, Santos Junior AD, Celeri EHRV. Qualidade de vida, depressão e ansiedade em crianças e adolescentes com DRC e seus cuidadores primários. J Bras Nefrol 2023. [DOI: 10.1590/2175-8239-jbn-2022-0036pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
RESUMO Introdução: A doença renal crônica (DRC) requer tratamentos duradouros e alterações severas na rotina de crianças, o que pode favorecer baixa qualidade de vida (QV) e danos à sua saúde mental e à de seus cuidadores primários (CP). O presente estudo teve como objetivo investigar a presença de ansiedade e depressão e analisar a QV de crianças e adolescentes diagnosticados com DRC nos estágios 3, 4, 5, e seus CP. Métodos: Realizamos estudo observacional de caso-controle com 29 crianças e adolescentes e seus CP como grupo de casos e 53 como grupo controle. Utilizamos instrumentos internacionais, validados para a população brasileira: Inventário de Ansiedade Traço-Estado Infantil (IDATE-C), Questionário Pediatric Quality of Life (PEDSQL), Inventário de Depressão Infantil (CDI), Inventário de Ansiedade e Depressão de Beck (BAI; BDI), e o WHOQOL-bref. Resultados: O estudo identificou diferenças estatisticamente significativas no escore total do PEDSQL (grupo controle, 72,7 ± 19,5; grupo de casos, 63,3 ± 20,6; p = 0,0305), no psicossocial (grupo controle, 70,5 ± 20,5; grupo de casos, 61,4 ± 19,7; p = 0,0420), nas dimensões de saúde escolar (grupo controle, 72,9 ± 21,0; grupo de casos, 55,2 ± 19,8; p = 0,0003) e na presença de comorbidade psiquiátrica (sintomas de depressão e ansiedade) no grupo de casos (p = 0,02). Quanto aos CP, o estudo demonstrou significância estatística para a prevalência de sintomas de depressão (p = 0,01) e ansiedade (p = 0,02). Conclusão: Pacientes com DRC apresentam índices mais baixos de QV e mais comorbidades psiquiátricas, e seus CP são afetados pela doença, com índices maiores de depressão e ansiedade.
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Diabetes tipo 2 e transplante renal: estudo comparativo sobre adesão medicamentosa. ACTA PAUL ENFERM 2023. [DOI: 10.37689/acta-ape/2023ao03461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Schlickmann DS, Molz P, Brand C, Dos Santos C, da Silva TG, Rieger A, Benito PJ, Reuter CP, Renner JDP, Rech Franke SI. Liver and kidney function markers among gym users: the role of dietary supplement usage. Br J Nutr 2021; 128:1-8. [PMID: 34511159 DOI: 10.1017/s0007114521003652] [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: 11/07/2022]
Abstract
Dietary supplements have been increasingly used by gym users and are often consumed without the guidance of a health professional. Moreover, the indiscriminate supplements use can have adverse health effects, such as changes in liver and kidney function. The aim of this study was to verify the association between dietary supplements intake with alterations in the liver and kidney function among gym users. A cross-sectional study was conducted with 594 gym users (mean age 37 (sd 14) years, 55·2 % women) from a city in southern Brazil. A questionnaire was used to evaluate the use of dietary supplements. The markers of the liver (alanine aminotransferase, aspartate aminotransferase (AST), alkaline phosphatase, γ-glutamyltransferase) and renal (creatinine and urea) function were also evaluated on a subsample of the study population. Data were analysed by binary logistic regression, adjusted for sex, age and education. The prevalence of dietary supplement intake was 36·0 %. Individuals who intake dietary supplements showed a higher prevalence to present slight alterations in the AST enzyme and in the urea after adjustments for potential confounders. In conclusion, the use of dietary supplement was associated with slight alterations in AST enzyme and in the urea among gym users. These findings show the importance of using supplements correctly, especially with guidance from professionals trained to avoid possible risks to health.
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Affiliation(s)
- Diene S Schlickmann
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
- Laboratory of Experimental Nutrition, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Patrícia Molz
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
- Laboratory of Experimental Nutrition, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Caroline Dos Santos
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
- Laboratory of Experimental Nutrition, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Thalia G da Silva
- Laboratory of Experimental Nutrition, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Alexandre Rieger
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Pedro J Benito
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences, Universidad Politécnica de Madrid (UPM), Madrid, España
| | - Cézane P Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Jane D P Renner
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Silvia I Rech Franke
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
- Laboratory of Experimental Nutrition, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
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de Resende MAS, Ferreira EDS, Dias HH, Santos DS, Batistelli CRS, Borges LD, Comini LDO, Moreira TR, da Costa GD, da Silva EF, da Silva RG, Cotta RMM. Low-grade albuminuria in adult and elderly individuals with diabetes mellitus and arterial hypertension accompanied by Primary Health Care. Sci Rep 2021; 11:17565. [PMID: 34475440 PMCID: PMC8413384 DOI: 10.1038/s41598-021-96652-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Abstract
Diabetes mellitus (DM) and arterial hypertension (AH) are the two main clinical conditions related to Chronic Kidney Disease (CKD); disease also identify by the levels of low-grade albuminuria (LGA). Few studies have simultaneously investigated the associations of glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) with LGA. Our study aimed to investigate and compare the association of HbA1c and FPG with the probability of LGA in adult and elderly individuals with DM and AH, within the scope of Primary Health Care (PHC). Cross-sectional study involving 737 Brazilians individuals previously diagnosed with hypertension and/or diabetes. Tests for HbA1c, FPG and LGA were performed. LGA was defined as the highest quartile of albumin urinary (≥ 13 mg/g) among individuals with urinary LGA < 30 mg / g. A significant increase in the prevalence of LGA was found with increasing levels of HbA1c (p < 0.001). There was a significant association of HbA1c with LGA (p < 0.001) and increased probability of LGA for participants with HbA1c ≥ 6.5% compared to those with Hba1c < 5.7% (OR [95% CI]: 2.43 [1.32-4.46], p < 0.05), after adjusting for confounding factors, except when adjusted for FPG (p = 0.379 and p = 0.359, respectively). HbA1c and FPG were significantly associated in a collinear manner with an increased probability of LGA in adult and elderly individuals with DM and AH.
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Affiliation(s)
| | - Emily de Souza Ferreira
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
| | - Heloísa Helena Dias
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Daniel Souza Santos
- Department of Nursing and Medicine, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | | | - Luiza Delazari Borges
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Luma de Oliveira Comini
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Tiago Ricardo Moreira
- Department of Nursing and Medicine, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Glauce Dias da Costa
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | | | - Rodrigo Gomes da Silva
- Department of Nursing and Medicine, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
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Silva EFD, Cotta RMM, Mendonça ÉT, Oliveira DMD, Cardoso SA, Colodette RM, Moreira TR. Optimal Cutoff of the TG/HDL-c ratio for Cardiovascular Risk in Hypertensive and Diabetic Patients Monitored by Primary Health Care in a city in Minas Gerais. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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He P, Bai M, Hu JP, Dong C, Sun S, Huang C. Significance of Neutrophil Gelatinase-Associated Lipocalin as a Biomarker for the Diagnosis of Diabetic Kidney Disease: A Systematic Review and Meta-Analysis. Kidney Blood Press Res 2021; 45:497-509. [PMID: 32623432 DOI: 10.1159/000507858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/13/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Neutrophil gelatinase-associated lipocalin (NGAL) is a promising marker for the diagnosis of diabetic kidney disease (DKD), but its utility is currently debated. This meta-analysis aims to evaluate the diagnostic value of NGAL for DKD. METHOD MEDLINE, Embase, -Cochrane Library, CNKI, and CBM databases were searched up to April 13, 2019. In bivariate random-effect models, the diagnostic performance of NGAL for DKD was assessed using pooled estimates of sensitivity, specificity, likelihood ratio, diagnostic odds ratio, and hierarchical summary receiver-operating characteristic analysis. RESULTS Nineteen studies were eligible for the meta-analysis. Serum NGAL had a pooled sensitivity and specificity of 0.79 (95% confidence intervals [CI] 0.60-0.91) and 0.87 (0.75-0.93) (7 studies, 1,238 patients). The pooled positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were 5.97 (3.03-11.76) and 0.24 (0.11-0.51). For urine NGAL, the pooled sensitivity, specificity, LR+, and LR- were 0.85 (0.74-0.91), 0.74 (0.57-0.86), 3.26 (1.87-5.67), and 0.21 (0.12-0.35), respectively (10 studies, 1,369 patients). The pooled sensitivity and specificity for kidney disease in normoalbuminuric patients with diabetes was 0.90 (0.82-0.95) and 0.97 (0.90-0.99) for both serum NGAL and 0.94 (0.87-0.98) and 0.90 (0.81-0.96) for urine NGAL (4 studies, 221 patients). NGAL appeared to perform similarly in subgroup analysis. CONCLUSION The meta-analysis has shown that NGAL may be useful for DKD classification and also has a potential diagnostic value for normoalbuminuric kidney disease. Large-scale prospective studies are required to clarify its role in the diagnosis and risk stratification of patients with DKD.
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Affiliation(s)
- Peng He
- Department of Nephrology, Xijin Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ming Bai
- Department of Nephrology, Xijin Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jin-Ping Hu
- Department of Nephrology, Xijin Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chen Dong
- Graduate School, The Fourth Military Medical University, Xi'an, China
| | - Shiren Sun
- Department of Nephrology, Xijin Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chen Huang
- Department of Nephrology, Xijin Hospital, The Fourth Military Medical University, Xi'an, China,
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Brito CP, Moraes IG, Luders C, de Brito CMM, Yamaguti WP. Relationship of phase angle and peak torque of knee extensors with the performance in six-minute step test in haemodialysis patients. BMC Nephrol 2021; 22:56. [PMID: 33557771 PMCID: PMC7869460 DOI: 10.1186/s12882-021-02256-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/25/2021] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Chronic kidney disease is a systemic disease affecting not only renal function, but also endocrine, cardiovascular, and skeletal muscle systems, with broad impact on functionality. Therefore, the assessment of body composition, peripheral muscle function, and exercise tolerance is also of great importance in this population. In addition, the development of reliable strategies that use feasible tools in clinical practice is of great importance in the functional diagnosis, clinical management and prescription of physical activity. OBJECTIVE To assess the relationship between phase angle and peak torque of knee extensors with the performance in six-minute step test of patients with chronic kidney disease undergoing haemodialysis. METHODS Observational and cross-sectional study at Haemodialysis Centre of Sírio-Libanês Hospital. The evaluations took place 3 days before the haemodialysis sessions. On the first day, patients underwent anthropometric evaluation and biochemical tests (lactate, urea, creatinine, albumin, ferritin and growth factor similar to insulin type 1 [IGF1]). On the second day, performed electrical bioimpedance and exercise tolerance assessed using the six-minute step test. On the last day, the evaluation of knee extensor muscles strength using isokinetic dynamometry was performed. RESULTS Eighteen subjects were included, with a mean age of 62.3 ± 17.6 years. A positive linear correlation was observed between the phase angle, derived from the electrical bioimpedance, and the performance in six-minute step test in these patients. It was also possible to observe a linear correlation between phase angle and IGF1, handgrip strength, peak torque of knee extensors and quality of life questionnaire. The peak torque of knee extensors also presented a linear correlation with IGF1, the performance in six-minute step test and mal-nutrition and inflammation score. CONCLUSION Phase angle and peak torque of knee extensors were correlated with the performance in six-minute step test. Therefore, the phase angle seems to be an important marker of reduced peripheral muscle function and exercise tolerance in haemodialysis patients.
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Affiliation(s)
- Camila Porto Brito
- Hospital Sírio-Libanês, Rehabilitation Centre, Dona Adma Jafet Street, 91 - Bela Vista, São Paulo, SP, 01308-050, Brazil
| | - Igor Gutierrez Moraes
- Hospital Sírio-Libanês, Rehabilitation Centre, Dona Adma Jafet Street, 91 - Bela Vista, São Paulo, SP, 01308-050, Brazil
| | - Cláudio Luders
- Hospital Sírio-Libanês, Haemodialysis Centre, Dona Adma Jafet, 91 - Bela Vista, São Paulo, SP, 01308-050, Brazil
| | - Christina May Moran de Brito
- Hospital Sírio-Libanês, Rehabilitation Centre, Dona Adma Jafet Street, 91 - Bela Vista, São Paulo, SP, 01308-050, Brazil
| | - Wellington Pereira Yamaguti
- Hospital Sírio-Libanês, Rehabilitation Centre, Dona Adma Jafet Street, 91 - Bela Vista, São Paulo, SP, 01308-050, Brazil.
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Amaral TLM, Amaral CDA, Vasconcellos MTLD, Monteiro GTR. [Chronic kidney disease among adults in Rio Branco, State of Acre: a population-based survey]. CIENCIA & SAUDE COLETIVA 2021; 26:339-350. [PMID: 33533855 DOI: 10.1590/1413-81232020261.22402018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 04/24/2019] [Indexed: 01/13/2023] Open
Abstract
The scope of this study was to establish the prevalence of CKD and associated factors among young adults (18-59 years of age) from Rio Branco in the State of Acre. It involved a population-based survey conducted in 2014, in the urban and rural areas of the municipality and CKD was defined as the glomerular filtration rate (GFR) < 60ml/min/1.73m², estimated by the CKD-EPI, and the presence of albuminuria > 29 mg/g. Association measures were estimated by logistic regression, with a confidence level of 95%. The overall prevalence of CKD was 6.2%. The presence of CKD was higher among women, aged 40 to 59 years, with non-white skin color, with lower schooling, and of sedentary disposition. There were statistically significant differences in the distribution according to the presence of CKD in the hypertension, diabetes and hospitalization variables over the past 12 months. CKD among adults was associated with the female sex (OR: 2.41, 95%CI: 1.14-5.12), diabetes (OR: 4.67, 95%CI: 1.28-17.03) and arterial hypertension (OR: 1.98; 95%CI: 1.16-3.37). CKD reveals a high prevalence and is associated with chronic diseases, calling for the need for public health measures for early detection and prevention of its progression.
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Affiliation(s)
- Thatiana Lameira Maciel Amaral
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. BR 364 Km 04 Distrito Industrial, Campus Universitário. 69920-900 Rio Branco AC Brasil.
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da Veiga GL, da Costa Aguiar Alves B, Perez MM, Raimundo JR, de Araújo Encinas JF, Murad N, Fonseca FLA. Kidney Diseases: The Age of Molecular Markers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1306:13-27. [PMID: 33959903 DOI: 10.1007/978-3-030-63908-2_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Kidney diseases are conditions that increase the morbidity and mortality of those afflicted. Diagnosis of these conditions is based on parameters such as the glomerular filtration rate (GFR), measurement of serum and urinary creatinine levels and equations derived from these measurements (Wasung, Chawla, Madero. Clin Chim Acta 438:350-357, 2015). However, serum creatinine as a marker for measuring renal dysfunction has its limitations since it is altered in several other physiological situations, such as in patients with muscle loss, after intense physical exercise or in people on a high protein diet (Riley, Powers, Welch. Res Q Exerc Sport 52(3):339-347, 1981; Juraschek, Appel, Anderson, Miller. Am J Kidney Dis 61(4):547-554, 2013). Besides the fact that serum creatinine is a marker that indicates glomerular damage, it is necessary the discovery of new biomarkers that reflect not only glomerular damage but also tubular impairment. Recent advances in Molecular Biology have led to the generation or identification of new biomarkers for kidney diseases such as: Acute Kidney Failure (AKI), chronic kidney disease (CKD), nephritis or nephrotic syndrome. There are recent markers that have been used to aid in diagnosis and have been shown to be more sensitive and specific than classical markers, such as neutrophil gelatinase associated lipocalin (NGAL) or kidney injury molecule-1 (KIM-1) (Wasung, Chawla, Madero. Clin Chim Acta 438:350-357, 2015; George, Gounden. Adv Clin Chem 88:91-119, 2019; Han, Bailly, Abichandani, Thadhani, Bonventre. Kidney Int 62(1):237-244, 2002; Fontanilla, Han. Expert Opin Med Diagn 5(2):161-173, 2011). However, early diagnostic biomarkers are still necessary to assist the intervention and monitor of the progression of these conditions.
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Affiliation(s)
| | | | | | | | | | - Neif Murad
- Cardiology Department, Centro Universitário Saúde ABC, Santo André, Brazil
| | - Fernando Luiz Affonso Fonseca
- Division of Clinical Analysis, Centro Universitário Saúde ABC, Santo André, Brazil.,Pharmaceutical Science Department, Universidade Federal de São Paulo/UNIFESP - Diadema, Butantã, São Paulo, Brazil
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Bekheirnia N, Glinton KE, Rossetti L, Manor J, Chen W, Lamb DJ, Braun MC, Bekheirnia MR. Clinical Utility of Genetic Testing in the Precision Diagnosis and Management of Pediatric Patients with Kidney and Urinary Tract Diseases. KIDNEY360 2020; 2:90-104. [PMID: 35368817 PMCID: PMC8785738 DOI: 10.34067/kid.0002272020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/29/2020] [Indexed: 02/04/2023]
Abstract
Background As genetic testing increasingly integrates into the practice of nephrology, our understanding of the basis of many kidney disorders has exponentially increased. Given this, we recently initiated a Renal Genetics Clinic (RGC) at our large, urban children's hospital for patients with kidney disorders. Methods Genetic testing was performed in Clinical Laboratory Improvement Amendments-certified laboratories using single gene testing, multigene panels, chromosomal microarray, or exome sequencing. Results A total of 192 patients were evaluated in this clinic, with cystic kidney disease (49/192) being the most common reason for referral, followed by congenital anomalies of the kidney and urinary tract (41/192) and hematuria (38/192). Genetic testing was performed for 158 patients, with an overall diagnostic yield of 81 out of 158 (51%). In the 16 out of 81 (20%) of patients who reached a genetic diagnosis, medical or surgical treatment of the patients were affected, and previous clinical diagnoses were changed to more accurate genetic diagnoses in 12 of 81 (15%) patients. Conclusions Our genetic testing provided an accurate diagnosis for children and, in some cases, led to further diagnoses in seemingly asymptomatic family members and changes to overall medical management. Genetic testing, as facilitated by such a specialized clinical setting, thus appears to have clear utility in the diagnosis and counseling of patients with a wide range of kidney manifestations.
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Affiliation(s)
- Nasim Bekheirnia
- Section of Pediatric Renal Disease, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Kevin E. Glinton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Linda Rossetti
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Joshua Manor
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Wuyan Chen
- PreventionGenetics Diagnostic Laboratory, Marshfield, Wisconsin
| | - Dolores J. Lamb
- Department of Urology, Englander Institute for Precision Medicine and Center for Reproductive Genomics, Weill Cornell Medicine, New York, New York
| | - Michael C. Braun
- Section of Pediatric Renal Disease, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Mir Reza Bekheirnia
- Section of Pediatric Renal Disease, Department of Pediatrics, Baylor College of Medicine, Houston, Texas,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
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Enfermagem no transplante renal: comparação da demanda de cuidado entre escalas. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Castro TLB, Oliveira RH, Sousa JAG, Romano MCC, Guedes JVM, Otoni A. Alteración de la función renal: prevalencia y factores asociados en pacientes de riesgo. REVISTA CUIDARTE 2020. [DOI: 10.15649/cuidarte.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La enfermedad renal crónica (ERC) en sus primeras etapas no presenta manifestaciones clínicas y, por lo tanto, la mayoría de las personas solo se acercan a las unidades de salud cuando ya están en la fase terminal de la enfermedad, lo cual sigue siendo habitual en Brasil. Objetivo: Identificar la prevalencia de la tasa estimada de filtración glomerular (TFG) alterada y los factores asociados en usuarios del sistema de salud único que sufran de diabetes mellitus y/o hipertensión sistémica de alto riesgo de enfermedad cardiovascular. Materiales y métodos: Se realizó un estudio transversal con las historias clínicas de 331 usuarios del Centro Estatal de Atención Especializada ubicado en el centro oeste de Minas Gerais, Brasil entre septiembre de 2017 y junio de 2019. Se realizaron un análisis univariado descriptivo y una regresión logística multivariante. Resultados: Del total de participantes, 118 (35,6%) tenían la TFG alterada. Se identificó una asociación significativa entre la alteración de la TFG y la edad: los ancianos ≥ 60 años tenían 5,53 veces más posibilidades de tener la TFG alterada. Los participantes que utilizaron la polifarmacia tenían 2,64 veces más probabilidades de que se alterara la TFG. Discusión: En consonancia con estudios similares, se registró la falta de seguimiento del inicio y el desarrollo de la ERC en las primeras etapas, lo que implica un enfoque tardío y acciones limitadas para preservar las funciones renales. Conclusiones: Se identificó una alta prevalencia de TFG alterada (35,6%) sin registros en las tablas que pudieran conducir a un enfoque preventivo de la degeneración de la función renal. La edad avanzada y la polifarmacia se identificaron como variables independientes en la alteración de la función renal.
Como citar este artículo: Castro, Tássia Lima Bernardino; Oliveira, Rayane Hellen; Sousa, João Antônio Gomides; Romano, Márcia Christina Caetano; Guedes,Guedes, João Victor Marques; Otoni, Alba. Função renal alterada: prevalência e fatores associados em pacientes de risco. Revista Cuidarte. 2020; 11(2): e1019. http://dx.doi.org/10.15649/cuidarte.1019
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Effectiveness of fixed-dose combination of paritaprevir, ritonavir, ombitasvir, and dasabuvir in patients with chronic hepatitis C virus infection and chronic kidney diseases: real-life experiences. Eur J Gastroenterol Hepatol 2019; 31:534-539. [PMID: 30672829 DOI: 10.1097/meg.0000000000001334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Both hepatitis C virus infection (HCV) and chronic kidney disease (CKD) have been comorbid illnesses with increasing morbidity and mortality. The present study was conducted to present real-life experiences about treatment of HCV and CKD with a fixed-dose combination of paritaprevir 150 mg/day, ritonavir 100 mg/day as a booster, ombitasvir 25 mg/day, and dasabuvir 250 mg twice/day, the PROD regimen. PATIENTS AND METHODS This was a multicenter, retrospective cohort study. Seventy-five patients with both HCV and CKD were treated with a PROD-based regimen with or without ribavirin. Fifty-three of 75 patients were on maintenance hemodialysis program. Seven patients had compensated liver cirrhosis. The patients with genotype 1a or compensated liver cirrhosis were treated with the PROD regimen and ribavirin in a dose of 200 mg every other day for 12 weeks. The patients with genotype 1b were treated with PROD for 12 weeks. The patients with genotype 4 were treated with a combination of paritaprevir, ritonavir, ombitasvir, and ribavirin 200 mg every other day. RESULTS All patients except one were HCV-RNA negative (98.6%) at the end of treatment. One patient had decompensated after the fourth day of therapy. She stopped the treatment, and she was exitus after 2 months. Two patients died of reasons not related to the drugs 2 months after negativity of HCV-RNA. Sustained viral rate 12 weeks after treatment was found in 96% of the patients. CONCLUSION The PROD regimen was very effective and safe for treatment in patients with HCV and CKD who were in stages 4 and 5.
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Li DY, Yin WJ, Yi YH, Zhang BK, Zhao J, Zhu CN, Ma RR, Zhou LY, Xie YL, Wang JL, Zuo SR, Liu K, Hu C, Zhou G, Zuo XC. Development and validation of a more accurate estimating equation for glomerular filtration rate in a Chinese population. Kidney Int 2019; 95:636-646. [PMID: 30709663 DOI: 10.1016/j.kint.2018.10.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/08/2018] [Accepted: 10/04/2018] [Indexed: 12/25/2022]
Abstract
Previously published equations to estimate glomerular filtration rate (GFR) have limited accuracy in Asian populations. We aimed to develop and validate a more accurate equation for estimated GFR (eGFR) in the Chinese population, using data from 8571 adults who were referred for direct measurement of GFR by renal dynamic imaging (mGFR) at 3 representative hospitals in China. Patients from the Third Xiangya Hospital were included in our development (n=1730) and internal validation sets (n=1042) and patients from the other hospitals comprised the external validation set (n=5799). We excluded patients who were prescribed medications known to influence the tubular secretion of creatinine, patients on dialysis, kidney transplant recipients, and patients with missing creatinine values or with creatinine >700 μmol/l. We derived a novel eGFR equation by linear regression analysis and compared the performance to 12 creatinine-based eGFR equations, including previously published equations for use in Chinese or Asian populations. In the development and internal validation sets, the novel Xiangya equation had high accuracy (accuracy within 30% [P30], 79.21% and 84.33%, respectively), low bias (mean difference between mGFR and eGFR, -1.97 and -1.85 ml/min per 1.73 m2, respectively), and high precision (interquartile range of the differences, 21.13 and 18.88 ml/min per 1.73 m2, respectively). In external validation, the Xiangya equation had the highest P30 among all eGFR equations, with P30 ≤ 75% for the other 12 equations. This novel equation provides more accurate GFR estimates in Chinese adults and could replace existing eGFR equations for use in the Chinese population.
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Affiliation(s)
- Dai-Yang Li
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Jun Yin
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yi-Hu Yi
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Bi-Kui Zhang
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha, China
| | - Jun Zhao
- Department of Clinical Pharmacy, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Chao-Nan Zhu
- School of Medicine, Zhejiang University, Hangzhou, China
| | - Rong-Rong Ma
- Department of Clinical Pharmacy, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ling-Yun Zhou
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yue-Liang Xie
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiang-Lin Wang
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Shan-Ru Zuo
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Kun Liu
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Can Hu
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ge Zhou
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Cong Zuo
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China; Center of Clinical Pharmacology, Third Xiangya Hospital, Central South University, Changsha, China.
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dos Santos EM, Brito DJDA, Calado IL, França AKT, Lages JS, Monteiro Junior FDC, dos Santos AM, Salgado Filho N. Sodium excretion and associated factors in urine samples of African descendants in Alcântara, Brazil: a population based study. Ren Fail 2018; 40:22-29. [PMID: 29298567 PMCID: PMC6014324 DOI: 10.1080/0886022x.2017.1419967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/13/2017] [Accepted: 12/14/2017] [Indexed: 10/28/2022] Open
Abstract
In most countries, salt intake has been excessive and constitutes one of the main risk factors for disease development, especially hypertension. Factors such as age, gender, sedentary lifestyle, smoking, African descent, obesity, dietary habits and family history of hypertension may be associated with high blood pressure. Studies show a positive association between the excretion of sodium and increased blood pressure. We evaluated the urinary excretion of sodium and associated factors in isolated urine samples of African descendants from remaining Quilombos. We performed a cross-sectional, population-based study with 1162 African descendants living in remaining quilombos in Alcântara, Maranhão, Brazil. Demographic, nutritional, clinical and laboratory data were analyzed. Urinary sodium excretion was estimated using the Kawasaki equation. A multivariate linear regression model was used to identify the variables related to sodium excretion. The average age was 37.6 ± 11.8 years and 51.2% were women. The prevalence of hypertension was 21.3%. The average urinary excretion of sodium was high, especially among the hypertensive (217.9 ± 90.1 vs. 199.2 ± 83.0 mmol/d; p = .002). After an adjusted analysis, only the waist circumference (odds ratios (OR) = 1.16; confidence intervals(CI)95%: 1.03-1.30), triglyceride (OR = 1.13; CI95%: 1.05-1.22), systolic blood pressure (OR = 1.19; CI95%: 1.08-1.32) and Chronic Kidney Disease Epidemiology (CKD-EPI;OR = 1.24; CI95%: 1.15-1.35) remained related to urinary sodium excretion. African descendants had a high rate of sodium excretion, especially among those who had hypertension. Abdominal adiposity, triglyceride and systolic blood pressure levels and renal function by CKD-EPI equation were associated to urinary sodium excretion.
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Affiliation(s)
| | - Dyego José de Araújo Brito
- Department of Nephrology, University Hospital of Federal University of Maranhão, São Luis, Maranhão, Brazil
| | - Isabela Leal Calado
- Department of Health Sciences, Federal University of Maranhão, São Luis, Maranhão, Brazil
| | | | - Joyce Santos Lages
- Department of Public Health, Federal University of Maranhão, São Luis, Maranhão, Brazil
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Yu ZK, Yang B, Zhang Y, Li LS, Zhao JN, Hao W. Modified Huangqi Chifeng decoction inhibits excessive autophagy to protect against Doxorubicin-induced nephrotic syndrome in rats via the PI3K/mTOR signaling pathway. Exp Ther Med 2018; 16:2490-2498. [PMID: 30210600 PMCID: PMC6122515 DOI: 10.3892/etm.2018.6492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 06/15/2018] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to investigate whether modified Huangqi Chifeng decoction (MHCD) could be an effective treatment against Doxorubicin-induced nephrosis in rats and whether it regulates autophagy via the phosphoinositide-3 kinase/mammalian target of rapamycin (PI3K/mTOR) signaling pathway. A total of 40 male Sprague-Dawley rats were randomly divided into blank, model, telmisartan and MHCD groups. The rat model of nephrosis was induced by intragastric administration of Doxorubicin for 8 weeks. Rats were housed in metabolic cages and urine was collected once every 2 weeks to measure 24-h protein levels. Blood samples were obtained from the abdominal aorta and levels of albumin (ALB), total cholesterol (TCH), triacylglyceride (TG) and serum creatinine (Scr) were assessed. Renal pathological changes were examined using hematoxylin-eosin, Masson's trichome and periodic acid-Schiff staining. Podocytes and autophagosomes were observed using an electron microscope. The expression and distribution of microtubule-associated proteins 1A/1B light chain 3B (LC3), LC3-I, LC3-II, beclin-1, PI3K and mTOR were determined using immunohistochemistry and western blotting. At weeks 6 and 8, 24-h proteinuria significantly decreased in the MHCD group compared with the model group (P<0.05). Compared with the model group, the MHCD group exhibited significantly reduced levels of TG, TCH and Scr, as well as significantly increased ALB levels (P<0.05). MHCD was demonstrated to prevent glomerular and podocyte injury. The number of autophagosomes was significantly decreased and the expression of beclin-1, LC3, LC3-I and LC3-II was inhibited following MHCD treatment compared with the model group (P<0.05). MHCD treatment significantly increased the expression of PI3K and mTOR in Doxorubicin nephrotic rats compared with the model group (P<0.05). In conclusion, MHCD was demonstrated to ameliorate proteinuria and protect against glomerular and podocyte injury by inhibiting excessive autophagy via the PI3K/mTOR signaling pathway.
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Affiliation(s)
- Zi-Kai Yu
- Department of Nephropathy, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
| | - Bin Yang
- Department of Pathology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
| | - Yu Zhang
- Department of Nephropathy, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
| | - Liu-Sheng Li
- Department of Nephropathy, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
| | - Jin-Ning Zhao
- Experimental Research Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
| | - Wei Hao
- Experimental Research Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R. China
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Santos EMD, Brito DJDA, França AKDCT, Lages JS, Santos AMD, Salgado Filho N. Association between estimated glomerular filtration rate and sodium excretion in urine of African descendants in Brazil: a population-based study. ACTA ACUST UNITED AC 2018; 40:248-255. [PMID: 29738041 PMCID: PMC6533955 DOI: 10.1590/2175-8239-jbn-3864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/04/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Excessive salt intake is a risk factor for the development of chronic kidney disease (CKD). Objective: To evaluate the association between estimated glomerular filtration rate (eGFR) and sodium excretion in urine samples of Brazilians of African ancestry. METHODS Cross-sectional, population-based study of 1,211 Brazilians of African ancestry living in Alcântara City, Maranhão, Brazil. Demographic, nutritional, clinical, and laboratory data were analyzed. The urinary excretion of sodium was estimated using the Kawasaki equation. Calculations of eGFR were based on the Chronic Kidney Disease Epidemiology Collaboration equation. Multivariate linear-regression model was used to identify the relationship between sodium excretion and eGFR. RESULTS Mean age was 37.5±11.7 years and 52.8% were women. Mean urinary excretion of sodium was 204.6±15.3 mmol/day and eGFR was 111.8±15.3 mL/min/1.73m2. According to multivariate linear regression, GFR was independently correlated with sodium excretion (β=0.11; p<0.001), age (β=-0.67; p<0.001), female sex (β=-0.20; p<0.001), and body mass index (BMI; β=-0.09; p<0.001). CONCLUSIONS The present study showed that age, female sex, BMI, and correlated negatively with eGFR. Sodium excretion was the only variable that showed a positive correlation with eGFR, indicating that high levels of urinary sodium excretion may contribute to hyperfiltration with potentially harmful consequences.
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Affiliation(s)
| | - Dyego José de Araújo Brito
- Universidade Federal do Maranhão, Departamento de Nefrologia do Hospital Universitário, São Luís, MA, Brasil
| | | | - Joyce Santos Lages
- Universidade Federal do Maranhão, Departamento de Saúde Pública, São Luís, MA, Brasil
| | | | - Natalino Salgado Filho
- Universidade Federal do Maranhão, Departamento de Nefrologia do Hospital Universitário, São Luís, MA, Brasil
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Salgado-Filho N, Lages JS, Brito DJ, Salgado JV, Silva GE, Santos AM, Monteiro-Júnior FC, Santos EM, Silva AA, Araújo DV, Sesso RC. Prevalence of chronic kidney disease and comorbidities in isolated African descent communities (PREVRENAL): methodological design of a cohort study. BMC Nephrol 2018; 19:43. [PMID: 29482502 PMCID: PMC5828073 DOI: 10.1186/s12882-018-0839-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is considered a serious public health problem, both in Brazil and worldwide, with an increasing number of cases observed inrecent years. Especially, CKD has been reported to be highly prevalent in those of African descent. However, Brazil lacks data from early-stage CKD population studies, and the prevalence of CKD is unknown for both the overall and African descent populations. Hence, the present study aimsto estimate the prevalence of early-stage CKD and its associated risk factors in African-Brazilians from isolated African-descent communities. Herein, the detailed methodology design of the study is described. METHODS This population-based, prospective, longitudinal, cohort study (PREVRENAL) is performed in three stages: first, clinical, nutritional, and anthropometric evaluations; measurements of serum and urinary markers; and examinations of comorbiditieswere performed. Second, repeated examinations of individuals with CKD, systemic arterial hypertension, and/or diabetes mellitus; image screening; and cardiac risk assessment were performed. Third, long-term monitoring of all selected individuals will be conducted (ongoing). Using probability sampling, 1539 individuals from 32 communities were selected. CKD was defined asaglomerular filtration rate (GFR) ≤60 mL/min/1.73m2 and albuminuria > 30 mg/day. DISCUSSION This study proposes to identify and monitor individuals with and without reduced GFR and high albuminuria in isolated populations of African descendants in Brazil. As there are currently no specific recommendations for detecting CKD in African descendants, four equations for estimating the GFR based on serum creatinine and cystatin C were used and will be retrospectively compared. The present report describes the characteristics of the target population, selection of individuals, and detection of a population at risk, along with the imaging, clinical, and laboratory methodologies used. The first and second stages have been concluded and the results will be published in the near future. The subsequent (third) stage is the long-term, continuous monitoring of individuals diagnosed with renal abnormalities or with CKD risk factors. The entire study population will be re-evaluated five years after the study initiation. The expectation is to obtain information about CKD evolution among this population, including the progression rate, complication development, and cardiovascular events.
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Affiliation(s)
- Natalino Salgado-Filho
- Kidney Disease Prevention Centre and Department of Medicine I, Federal University of Maranhão, São Luís, MA Brasil
| | - Joyce Santos Lages
- Department of Public Health, Federal University of Maranhão, São Luís, MA Brazil
| | - Dyego José Brito
- Kidney Disease Prevention Centre and Department of Medicine I, Federal University of Maranhão, São Luís, MA Brasil
| | - João Victor Salgado
- Kidney Disease Prevention Centre and Department of Physiological Sciences, Federal University of Maranhão, São Luís, MA Brazil
| | - Gyl Eanes Silva
- Department of Pathology and Radiology, Ribeirao Preto School of Medicine, University of Sao Paulo, Ribeirão Preto, SP Brazil
| | | | | | - Elisangela Milhomen Santos
- Kidney Disease Prevention Centre and Department of Medicine I, Federal University of Maranhão, São Luís, MA Brasil
| | | | - Denizar Vianna Araújo
- Department of Internal Medicine, Rio de Janeiro State University, Rio de Janeiro, RJ Brazil
| | - Ricardo Castro Sesso
- Discipline of Nephrology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP Brazil
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Silveira Santos CGD, Romani RF, Benvenutti R, Ribas Zahdi JO, Riella MC, Mazza do Nascimento M. Acute Kidney Injury in Elderly Population: A Prospective Observational Study. Nephron Clin Pract 2017; 138:104-112. [PMID: 29169177 DOI: 10.1159/000481181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/31/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND/AIMS Acute kidney injury (AKI) has been reported as a recognized condition among the elderly population; however, its clinical epidemiology is still poorly evaluated. We propose to evaluate the epidemiological profile of AKI in hospitalized elderly patients and the variables associated with renal replacement therapy (RRT) dependency at discharge after an episode of AKI. METHODS This prospective observational study enrolled 286 elderly patients (aged ≥60 years), who had a diagnosis of AKI and were admitted to a tertiary care hospital. Clinical data were analyzed, which included RRT indication, referral time to nephrologist support, standby period in the emergency care units (ECU) before a transfer to an intensive care unit, staff criteria used to indicate palliative care, and the incidence of patients who stayed on chronic dialysis for at least 6 months after discharge. RESULTS The overall hospital mortality was 56.3%. Acute Kidney Injury Network (AKIN) 3 at the time of admission was significantly higher in patients who underwent RRT. Intrinsic AKI (p < 0.001), AKIN 3 (p < 0.001), RRT (p < 0.001), and increased length of stay in ECUs (p = 0.01) all had a significantly higher prevalence among non-survivors. On multivariate analysis, however, only renal aetiology (intrinsic AKI) was independently associated with mortality (OR 2.88; 95% CI [1.29-6.13]). Approximately 85% of the discharged patients (n = 125) were dialysis free and 36.4% of them who had a previous diagnosis of chronic kidney disease (CKD) upon admission had a worse renal function. Age, AKIN 3, RRT, prior history of CKD, diabetes mellitus, and the number of hemodialysis sessions showed to have an impact on dialysis dependence. Furthermore, 24 of 161 patients who had a dialysis indication were placed on palliative care. CONCLUSIONS The severity of AKI and the need for RRT were risk factors for mortality and dependence on dialysis. Antecedents of CKD seem to be associated with a poor renal outcome following an AKI episode. Starting RRT had an impact on the clinical decision to enroll these patients into palliative care.
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Affiliation(s)
- Cássia Gomes da Silveira Santos
- Post-Graduate Internal Medicine Program of Hospital de Clínicas do Paraná, UFPR, Curitiba, Brazil.,Department of Nephrology, Hospital do Idoso Zilda Arns, Curitiba, Brazil
| | - Rafael Fernandes Romani
- Department of Nephrology, Hospital do Idoso Zilda Arns, Curitiba, Brazil.,ProRenal Foundation Brazil, Curitiba, Brazil
| | - Ricardo Benvenutti
- Department of Nephrology, Hospital do Idoso Zilda Arns, Curitiba, Brazil
| | | | | | - Marcelo Mazza do Nascimento
- Post-Graduate Internal Medicine Program of Hospital de Clínicas do Paraná, UFPR, Curitiba, Brazil.,Department of Nephrology, Hospital do Idoso Zilda Arns, Curitiba, Brazil.,ProRenal Foundation Brazil, Curitiba, Brazil
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Lešnik A, Piko N, Železnik D, Bevc S. Dehydration of Older Patients in Institutional Care and the Home Environment. Res Gerontol Nurs 2017; 10:260-266. [DOI: 10.3928/19404921-20171013-03] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/15/2017] [Indexed: 12/14/2022]
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Jung IY, Ann HW, Kim JJ, Lee SJ, Kim J, Seong H, Oh DH, Kim YC, Kim EJ, Jeong SJ, Ku NS, Choi JY, Song YG, Kim JM. The incidence and clinical characteristics by gender differences in patients with Kikuchi-Fujimoto disease. Medicine (Baltimore) 2017; 96:e6332. [PMID: 28296758 PMCID: PMC5369913 DOI: 10.1097/md.0000000000006332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare, self-limiting disorder that typically affects the cervical lymph nodes (LNs). Although initially described in young women, KFD also occurs in men. There are no reports on the clinical manifestations and characteristics of male KFD patients. Therefore, this study was conducted to assess the incidence of KFD among males, as well as the most frequent clinical characteristics of these patients. A retrospective, cross-sectional study was performed at a tertiary hospital of patients pathologically confirmed as having KFD from LN biopsy specimens. Clinical and laboratory data, and treatment outcomes of the enrolled patients, were analyzed by gender. A total of 254 patients diagnosed with KFD were enrolled. There were 189 females and 65 males (2.9:1). The mean age was 32.6 ± 11.3 years. Compared to the female patients, the males had more frequent manifestations of fever (48% vs 67%, P = 0.008), headache (9% vs 20%, P = 0.013), bilateral lymphadenopathy (31% vs 46%, P = 0.029), thrombocytopenia (14% vs 29%, P = 0.014), elevated C-reactive protein (CRP) (35% vs 78.4%, P < 0.001), elevated liver enzymes (15% vs 41%, P < 0.001), and elevated lactate dehydrogenase (LDH) (61% vs 80%, P = 0.021). Male patients had fewer autoimmune features (9% vs 2%, P = 0.043) and fewer positive antinuclear antibodies (32% vs 10%, P = 0.006). In this study, 25.6% of the enrolled patients were male, with a 2.9:1 female-to-male sex ratio. Male patients showed a distinctive profile characterized by a higher frequency of fever, headache, bilateral lymphadenopathy, and thrombocytopenia, as well as elevated liver enzymes, CRP, and LDH.
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Affiliation(s)
- In Young Jung
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hea Won Ann
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Ju Kim
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se Ju Lee
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinnam Kim
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Seong
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Hyun Oh
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong Chan Kim
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Jin Kim
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Jin Jeong
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nam Su Ku
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun Yong Choi
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Goo Song
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - June Myung Kim
- Department of Internal Medicine
- AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yang P, Chen N, Wang RR, Li L, Jiang SP. Inappropriateness of medication prescriptions about chronic kidney disease patients without dialysis therapy in a Chinese tertiary teaching hospital. Ther Clin Risk Manag 2016; 12:1517-1524. [PMID: 27785039 PMCID: PMC5066999 DOI: 10.2147/tcrm.s116789] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background With the increasing incidence rate of chronic kidney disease (CKD), inappropriate use of medicine in CKD patients is an important issue, as it may cause adverse effects in patients and progression to chronic renal failure. Objective The aim of this study is to assess the frequency of inappropriate medicine use among CKD patients. Methods A cross-sectional study was conducted from November 1 to December 1, 2014 in a Chinese teaching tertiary hospital. All medication prescriptions for CKD patients with serum creatinine level above normal value were enrolled. The prescriptions, including unreasonable dosage, contraindicated, and cautiously used medicines in CKD patients, were evaluated and the related medications were also analyzed and classified. Results Two hundred and two patients were included, and a total of 1,733 lines of medication prescriptions were evaluated. The prevalence of inappropriate medication prescriptions in CKD patients was 15.18%, of which, unreasonable dosage (n=56), contraindicated (n=46), and cautiously used medicines (n=161) accounted for 3.23%, 2.65%, and 9.29%, respectively. Spearman’s rank correlation coefficient implied that there was a significant correlation between the severity of renal insufficiency and frequency of inappropriate medication prescriptions (P=0.02, r=0.056). Among the inappropriate medication prescriptions, nutraceutical and electrolytes (n=65, 24.71%), cardiovascular drugs (n=61, 23.19%), and antimicrobial drugs (n=55, 20.91%) represented the top three medicine categories in CKD patients. Conclusion The study confirmed that inappropriate medication prescriptions were prevalent in CKD patients. Improving the quality of medication prescriptions in CKD patients is necessary.
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Affiliation(s)
- Ping Yang
- Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Na Chen
- Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Rong-Rong Wang
- Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Lu Li
- Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Sai-Ping Jiang
- Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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Małkiewicz A, Skrzypkowska M, Słomiński B, Siebert J, Gutknecht P, Myśliwska J. The GG genotype of the -152 G/A vascular endothelial growth factor (VEGF) polymorphism predisposes to hypertension-related chronic kidney disease. Mol Biol Rep 2016; 43:967-75. [PMID: 27382979 DOI: 10.1007/s11033-016-4035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/29/2016] [Indexed: 11/28/2022]
Abstract
Our purpose was to determine whether the VEGF -152 G/A polymorphism could be associated with chronic kidney disease and endothelial dysfunction in hypertensive patients. There were 100 healthy volunteers enrolled into the control group. The group of patients was constituted by 99 consecutively admitted hypertensive patients referred to our Institution by their general practitioner. All patients were treated with anti-hypertensive polytherapy. Presented study revealed that the hypertensive patients bearing the GG genotype were characterized by the highest values of diastolic blood pressure and markers of endothelial damage such as Angiogenin, Endostatin, CRP as well as von Willebrandt factor. In addition, higher number of immature endothelial progenitor cells with CD34(+)CD133(+), CD34(+)CD133(-) markers was observed in GG hypertensive carriers while in normotensive individuals no differences were found. Such phenomenon may indicate an increased mobilization of bone-marrow derived endothelial progenitors. It may testify to the preserved compensatory mechanism in chronic kidney disease (CKD) patients until the G3a stage of the disease. Moreover, patients with higher estimated glomerular filtration rate (eGFR) level had lower of vWf and Endostatin values, and higher level of VEGF. Taken together our findings clearly indicate the -152 GG hypertensive carriers as more prone to develop CKD. We can suspect that the VEGF -152 GG genotype is strongly associated with hypertension-dependent CKD.
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Affiliation(s)
- Anna Małkiewicz
- Department of Immunology, Medical University of Gdańsk, 80-211, Gdańsk, Poland.
| | - Maria Skrzypkowska
- Department of Immunology, Medical University of Gdańsk, 80-211, Gdańsk, Poland
| | - Bartosz Słomiński
- Department of Immunology, Medical University of Gdańsk, 80-211, Gdańsk, Poland
| | - Janusz Siebert
- Department of Family Medicine, Medical University of Gdańsk, 80-210, Gdańsk, Poland
| | - Piotr Gutknecht
- Department of Family Medicine, Medical University of Gdańsk, 80-210, Gdańsk, Poland
| | - Jolanta Myśliwska
- Department of Immunology, Medical University of Gdańsk, 80-211, Gdańsk, Poland
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The GA genotype of the −1154 G/A (rs1570360) vascular endothelial growth factor (VEGF) is protective against hypertension-related chronic kidney disease incidence. Mol Cell Biochem 2016; 418:159-65. [DOI: 10.1007/s11010-016-2741-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/15/2016] [Indexed: 12/15/2022]
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Microalbuminuria is a late event in patients with hypertension: Do we need a lower threshold? J Saudi Heart Assoc 2015; 29:30-36. [PMID: 28127216 PMCID: PMC5247301 DOI: 10.1016/j.jsha.2015.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/16/2015] [Accepted: 12/16/2015] [Indexed: 01/19/2023] Open
Abstract
Background Microalbuminuria (MA) is a marker of vascular damage. However, many studies have observed an increased risk at lower levels of albuminuria than are currently used to define MA. Aim To verify early cardiovascular changes occurring before MA in hypertensive patients. Materials and methods One hundred and fifty hypertensive patients and 60 normotensive individuals were divided into normotensive individuals with normal left ventricular (LV) geometry (Group I), hypertensive patients with normal LV geometry (Group II), and hypertensive patients with abnormal LV geometry (Group III). The LV mass index, ambulatory arterial stiffness index, flow-mediated dilatation of the brachial artery, and intima-media thickness (IMT) of the common carotid were assessed. Urinary albumin/creatinine ratio was determined using a morning spot-urine sample. Results Compared with Group I, ambulatory arterial stiffness index and IMT were significantly increased and flow-mediated dilatation was significantly decreased in Group II; however, MA did not differ between both groups. These changes were augmented when Group III was compared with Group II. MA significantly increased in Group III compared with Group II. Receiver operating characteristic analysis revealed that MA, with a cut-off value of 19.25 mg/g, predicted increased IMT, and abnormal LV geometry in a statistically significant manner. Conclusion Many vascular changes, in the form of increased IMT, reduced vasodilator capacity, and increased arterial stiffness, preceded MA and any change in LV geometry. The results presented here strengthen the usefulness of adopting a lower cut-off to define MA.
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Guo M, Niu JY, Li SR, Ye XW, Fang H, Zhao YP, Gu Y. Gender differences in the association between hyperuricemia and diabetic kidney disease in community elderly patients. J Diabetes Complications 2015; 29:1042-9. [PMID: 26387809 DOI: 10.1016/j.jdiacomp.2015.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 01/23/2023]
Abstract
AIMS To investigate gender differences of the associations between hyperuricemia and diabetic kidney disease (DKD) in elderly patients with type 2 diabetes mellitus (T2DM) based on electronic health records (EHR). METHODS A total of 20,207 older diabetic patients (mean age 71±7years) were investigated based on the EHR from 2012 to 2013 in the Minhang District of Shanghai-China. The status of hyperuricemia, albuminuric DKD and the odds ratios of DKD relative to hyperuricemia were analyzed among 8541 men and 11,666 women. RESULTS The overall rate of hyperuricemia was 20.5% (males: 17.2%, females: 23.0%) and that of albuminuric DKD was 36.2% (males: 32.2%, female: 39.1%) in these diabetic patients. Hyperuricemia was independently associated with increased risk of reduced renal function and albuminuria (p<0.001) in both genders. After adjustment of traditional DKD risk factors, hyperuricemia had a stronger association with albuminuric DKD in males (OR 1.67, 95% CI: 1.48-1.88) than in females (OR 1.23, 95% CI: 1.12-1.35). CONCLUSIONS This study showed an independent association of hyperuricemia with albuminuric DKD that was stronger in elderly males for the first time in China based on EHR. The level of uric acid should be monitored and managed in older diabetic patients.
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Affiliation(s)
- Mei Guo
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Jian-Ying Niu
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - She-Ran Li
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Xian-Wu Ye
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Hong Fang
- Center for Disease Prevention and Control of Minhang District, No. 965 Zhongyi Road, Shanghai 201101, China
| | - Yan-Ping Zhao
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Yong Gu
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China; Department of Nephrology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai 200040, China.
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