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Ckd stage 4

Bharat V Shah, Zamurrud M Patel
BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem and more so in India. With limited availability and high cost of therapy, barely 10 % of patients with incident end stage renal disease (ESRD) cases get treatment in India. Therefore, all possible efforts should be made to retard progression of CKD. This article reviews the role of low protein diet (LPD) in management of CKD subjects and suggests how to apply it in clinical practice. DISCUSSION: The role of LPD in retarding progression of CKD is well established in animal experimental studies...
October 21, 2016: BMC Nephrology
Taner Basturk, Ozlem Sari, Yener Koc, Nezaket Eren, Mahmoud Isleem, Ekrem Kara, Mustafa Sevinc, Tamer Sakaci, Elbis Ahbap, Nuri B Hasbal, Feyza B Caglayan, Abdulkadir Unsal
BACKGROUND: Neutrophilgelatinase-associated lipocalin (NGAL) has been proven to be a useful biomarker for early detection of acute kidney injury, but it is not known whether adding NGAL measurements to conventional risk factors will improve the risk assessment in the setting of chronic kidney disease (CKD). The aim of the present study was to examine the correlation of NGAL with early stage renal impairment in CKD and to evaluate its prognostic value in these subjects. METHODS: This is a prospective observational cohort study of 54 patients with early stage (stage 1-2) CKD...
October 21, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Zhenchuan Lin, Chen Zhao, Qimei Luo, Xi Xia, Xueqing Yu, Fengxian Huang
INTRODUCTION: Nowadays prevalence of restless legs syndrome (RLS) in chronic kidney disease (CKD) patients was reported in many studies, while the results varied. The aim of our study was to investigate the prevalence of RLS in this population, considering different data collecting measures and diagnostic criteria. METHODS: MEDLINE, Embase, PsycINFO, and Scopus databases were searched for relevant studies. We limited the analyses to studies using clinical interview or questionnaire for diagnosis...
October 20, 2016: Renal Failure
Yong-Muh Ng, Soo-Kun Lim, Pei-San Kang, Khairul Azmi Abdul Kadir, Mei-Ling Sharon Tai
BACKGROUND: Epidemiological studies have shown an inverse relationship between vitamin D levels and cardiovascular diseases. However, this does not infer a causal relationship between the two. Chronic kidney disease (CKD) patients have a high prevalence of vitamin D deficiency and carotid atherosclerosis. Therefore, in this study we have aimed to determine the association between serum 25-hydroxyvitamin D levels and carotid atherosclerosis in the CKD population. METHODS: 100 CKD stage 3-4 patients were included in the study...
October 18, 2016: BMC Nephrology
Jong-Chan Youn, Hee Tae Yu, Hyeon Chang Kim, Suk-Won Choi, Seong-Woo Han, Kyu-Hyung Ryu, Eui-Cheol Shin, Sungha Park
OBJECTIVE: Chronic kidney disease (CKD) is associated with increased arterial stiffness, which is a well-known predictor of future cardiovascular events. However, the underlying mechanism of arterial stiffening in CKD is not well known. Accelerated immune aging, characterized by expansion of immunosenescent T cell fraction might be involved in the pathogenesis of arterial stiffening in CKD. We aimed to evaluate the relationship between arterial stiffness and immunosenescent T cell (CD8CD57 or CD8CD28 T cell) fraction in patients with CKD...
September 2016: Journal of Hypertension
Daniel W Jones
Hypertension and Chronic Kidney Disease are both common. The vast majority of patients with chronic kidney disease (CKD) have hypertension. Hypertension can be both a cause and a result of CKD. Many patients with CKD, both diabetic and non-diabetic have overt proteinuria (>300 mg/day). Patients with proteinuria are at higher risk for progression of kidney disease and for atherosclerosis. Because patients with CKD are often excluded from hypertension trials with hard outcomes, there has been until recently less data than ideal to consider in making decisions...
September 2016: Journal of Hypertension
David Wheeler
Hypertension is the most prevalent complication of chronic kidney disease (CKD). Lowering high blood pressure slows progressive loss of kidney function and may also reduce the associated risk of cardiovascular complications, a common cause of premature death in CKD patients.Current International Guidelines produced by Kidney Disease: Improving Global Outcomes (KDIGO) acknowledges that no single BP target is optimal for all CKD patients, and encourages individualization of treatment depending on age, the severity of albuminuria and comorbidities...
September 2016: Journal of Hypertension
Sadayoshi Ito
The presence of chronic kidney disease (CKD) is a strong risk factor not only for end stage kidney disease (ESKD) but also cerebro-cardiovascular disease (CVD). CKD is defined as GFR < 60ml/min/1.73m and/or the evidence of renal damages for more than 3 months. Epidemiological studies have shown that albuminuria even as little as 10mg/gCr is a strong risk factor for CVD, especially stroke. The significance of albuminuria can be recognized when we think of the fact that the amount of albumin in 24 hour-GFR is as large as 6 kg (4...
September 2016: Journal of Hypertension
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
Yaw A Nyame, Helen Liang, Hans C Arora, Bradley C Gill, Peter Caputo, Daniel Ramirez, Matthew J Maurice, Khaled Fareed, Robert J Stein, Georges-Pascal Haber, Andrew J Stephenson, Amr Fergany, Jihad Kaouk
PURPOSE: Currently no data exists to guide renal surgeons on the perioperative use of renin-angiotensin (RAS) blockers despite their potential cardiorenal benefits. This study aims to assess the impact of resuming RAS blockers on postoperative renal function and adverse cardiac events following partial nephrectomy. PATIENTS AND METHODS: This is an observational analysis of patients undergoing robotic-assisted laparoscopic partial nephrectomy from 2006-2014 at a single institution...
October 13, 2016: Journal of Urology
Jan H Cornel, George L Bakris, Susanna R Stevens, Michael Alvarsson, Willem A Bax, Lee-Ming Chuang, Samuel S Engel, Renato D Lopes, Darren K McGuire, Axel Riefflin, Helena Wachslicht Rodbard, Isaac Sinay, Tsvetalina Tankova, Julio Wainstein, Eric D Peterson, Rury R Holman
OBJECTIVE: To evaluate chronic kidney disease (CKD) and cardiovascular outcomes in TECOS (Clinical trial reg. no. NCT00790205, participants with type 2 diabetes and cardiovascular disease treated with sitagliptin, a dipeptidyl peptidase 4 inhibitor, according to baseline estimated glomerular filtration rate (eGFR). RESEARCH DESIGN AND METHODS: We used data from 14,671 TECOS participants assigned in a double-blind design to receive sitagliptin or placebo added to existing therapy, while aiming for glycemic equipoise between groups...
October 14, 2016: Diabetes Care
Channa Jayasumana, Carlos Orantes, Raul Herrera, Miguel Almaguer, Laura Lopez, Luis Carlos Silva, Pedro Ordunez, Sisira Siribaddana, Sarath Gunatilake, Marc E De Broe
Increase in the prevalence of chronic kidney disease (CKD) is observed in Central America, Sri Lanka and other tropical countries. It is named chronic interstitial nephritis in agricultural communities (CINAC). CINAC is defined as a form of CKD that affects mainly young men, occasionally women. Its aetiology is not linked to diabetes, hypertension, glomerulopathies or other known causes. CINAC patients live and work in poor agricultural communities located in CINAC endemic areas with a hot tropical climate, and are exposed to toxic agrochemicals through work, by ingestion of contaminated food and water, or by inhalation...
October 13, 2016: Nephrology, Dialysis, Transplantation
Yuta Matsukuma, Kosuke Masutani, Shigeru Tanaka, Akihiro Tsuchimoto, Kiichiro Fujisaki, Kumiko Torisu, Ritsuko Katafuchi, Hideki Hirakata, Kazuhiko Tsuruya, Takanari Kitazono
Recently, low serum uric acid (SUA) levels and high SUA levels, have emerged as risk factors for cardiovascular disease, as well as for the incidence of acute kidney injury and chronic kidney disease (CKD). However, the effect of low SUA on the progression of CKD remains unclear. To evaluate the association between SUA and renal prognosis in patients with immunoglobulin A nephropathy (IgAN), one of the most common causes of CKD, we retrospectively followed 1218 patients who were diagnosed with primary IgAN by kidney biopsy between October 1979 and December 2010...
October 13, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Hao Shen, Yan Xu, Jingfen Lu, Chunfang Ma, Yadong Zhou, Qiong Li, Xu Chen, Ao Zhu, Guorong Shen
BACKGROUND: Cardiovascular disease (CVD) is often comorbid with chronic kidney disease (CKD). Small low-density lipoprotein cholesterol (sdLDL-C) has also been found to increase risk for CVD. The goal of the present study was to determine the nature of the relationship between sdLDL-C concentration and CVD in patients with CKD. METHODS: One-hundred and forty-five subjects (113 men and 32 women) with CKD (Stage 3 and Stage 4) participated this retrospective study...
October 6, 2016: BMC Nephrology
James T McCarthy, Rokea A El-Azhary, Michelle T Patzelt, Amy L Weaver, Robert C Albright, Alina D Bridges, Paul L Claus, Mark D P Davis, John J Dillon, Ziad M El-Zoghby, LaTonya J Hickson, Rajiv Kumar, Robert D McBane, Kathleen A M McCarthy-Fruin, Marian T McEvoy, Mark R Pittelkow, David A Wetter, Amy W Williams
OBJECTIVE: To report on the survival and the associations of treatments upon survival of patients with calciphylaxis seen at a single center. PATIENTS AND METHODS: Using the International Classification of Diseases, Ninth Revision diagnosis code of 275.49 and the keyword "calciphylaxis" in the dismissal narrative, we retrospectively identified 101 patients with calciphylaxis seen at our institution between January 1, 1999, through September 20, 2014, using a predefined, consensus-developed classification scheme...
October 2016: Mayo Clinic Proceedings
Marcin Zaniew, Arend Bökenkamp, Marcin Kołbuc, Claudio La Scola, Federico Baronio, Anna Niemirska, Maria Szczepańska, Julia Bürger, Angela La Manna, Monika Miklaszewska, Anna Rogowska-Kalisz, Jutta Gellermann, Argyroula Zampetoglou, Anna Wasilewska, Magdalena Roszak, Jerzy Moczko, Aleksandra Krzemień, Dariusz Runowski, Grzegorz Siteń, Iga Załuska-Leśniewska, Patrizia Fonduli, Franca Zurrida, Fabio Paglialonga, Zoran Gucev, Dusan Paripovic, Rina Rus, Valerie Said-Conti, Lisa Sartz, Woo Yeong Chung, Se Jin Park, Jung Won Lee, Yong Hoon Park, Yo Han Ahn, Przemysław Sikora, Constantinos J Stefanidis, Velibor Tasic, Martin Konrad, Franca Anglani, Maria Addis, Hae Il Cheong, Michael Ludwig, Detlef Bockenhauer
BACKGROUND: Lowe syndrome (LS) and Dent-2 disease (DD2) are disorders associated with mutations in the OCRL gene and characterized by progressive chronic kidney disease (CKD). Here, we aimed to investigate the long-term renal outcome and identify potential determinants of CKD and its progression in children with these tubulopathies. METHODS: Retrospective analyses were conducted of clinical and genetic data in a cohort of 106 boys (LS: 88 and DD2: 18). For genotype-phenotype analysis, we grouped mutations according to their type and localization...
October 5, 2016: Nephrology, Dialysis, Transplantation
Márcio Galindo Kiuchi, Shaojie Chen, Gustavo Ramalho E Silva, Luis Marcelo Rodrigues Paz, Tetsuaki Kiuchi, Ary Getulio de Paula Filho, Gladyston Luiz Lima Souto
BACKGROUND: Atrial fibrillation (AF) frequently complicates chronic kidney disease (CKD). AF treatment is challenging and requires complete pulmonary vein isolation (PVI). Recently, renal sympathetic denervation (RSD) has been reported to reduce AF recurrence when performed alongside PVI. METHODS: A prospective therapeutic study of patients with controlled hypertension and paroxysmal AF was undertaken. Renal function was evaluated using estimated glomerular filtration rate...
October 4, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Anna Machowska, Jia Sun, Abdul Rashid Qureshi, Naohito Isoyama, Paul Leurs, Björn Anderstam, Olof Heimburger, Peter Barany, Peter Stenvinkel, Bengt Lindholm
BACKGROUND: Circulating advanced glycated end-products (AGEs) including pentosidine accumulating in chronic kidney disease (CKD) patients due to retention and increased formation are thought to contribute to cardiovascular disease (CVD). Here we evaluated factors linked to increased plasma pentosidine and its association with mortality in patients with different stages of CKD and undergoing different treatments. METHODS: Plasma pentosidine, biomarkers of inflammation, oxidative stress and nutritional status were investigated in CKD 1-2 (n = 37), CKD 3-4 (n = 54), CKD 5 non-dialyzed (CKD5-ND; n = 386), peritoneal dialysis (PD; n = 74) and hemodialysis (HD; n = 195) patients...
2016: PloS One
Giuseppe Turchetti, S Bellelli, M Amato, S Bianchi, P Conti, A Cupisti, V Panichi, A Rosati, F Pizzarelli
This study aims to estimate the mean annual social cost per patient with chronic kidney disease (CKD) by stages 4 and 5 pre-dialyses and cost components in Italy. The multicenter cross-sectional study included all adult outpatients in charge of the 14 main Nephrology Centers of Tuscany Region during 7 weeks from 2012 to 2013. Direct medical costs have been estimated using tariffs for laboratory tests, diagnostic exams, visits, hospitalization and prices for drugs. Non-medical costs included expenses of low-protein special foods, travel, and formal and informal care...
October 3, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
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