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blood bicarbonate level in CKD

Biagio Raffaele Di Iorio, Lucia Di Micco, Stefania Marzocco, Emanuele De Simone, Antonietta De Blasio, Maria Luisa Sirico, Luca Nardone, On Behalf Of Ubi Study Group
BACKGROUND: Metabolic acidosis is a common complication of chronic kidney disease; current guidelines recommend treatment with alkali if bicarbonate levels are lower than 22 mMol/L. In fact, recent studies have shown that an early administration of alkali reduces progression of CKD. The aim of the study is to evaluate the effect of fruit and vegetables to reduce the acid load in CKD. METHODS: We conducted a case-control study in 146 patients who received sodium bicarbonate...
January 17, 2017: Nutrients
Ezgi Coskun Yenigun, Cenk Aypak, Didem Turgut, Mehmet Zafer Aydin, Fatih Dede
BACKGROUND: There is a strong association between chronic kidney disease (CKD) and cardiovascular events. Increased arrhythmia risk in kidney disease is one of the main predominant factors in increased mortality and sudden cardiac death. To estimate this risk, noninvasive measurement of repolarization abnormalities including QT interval and its heart rate-corrected value (QTc) with surface ECG, are commonly used parameters in clinical practice. The aim of this study is to examine the effect of CKD-related problems - mainly acidosis - on QT intervals...
August 19, 2016: International Journal of Artificial Organs
A Tahir, K McLaughlin, G Kline
BACKGROUND: As the field of Primary Aldosteronism (PA) becomes ever expanded, diagnosis of PA is increasingly diagnosed by endocrinologists. With increased PA screening, many of the cases are now found in patients with complex co-morbidities in addition to their hypertension. Post adrenalectomy renal impairment with hyperkalemia is now increasingly seen in these complex patients, as evidenced by the numerous reports on this issue that have appeared within the past 3 years. We present a small case series to illustrate the breadth of the problem, along with a discussion about how such CKD/hyperkalemic events may be predicted...
July 27, 2016: BMC Endocrine Disorders
Fernando Caravaca-Fontán, Boris Gonzales-Candia, Enrique Luna, Francisco Caravaca
INTRODUCTION: The cause of vitamin D deficiency in chronic kidney disease (CKD) is probably multi-factorial; however, the relative importance of each potential determinant is uncertain. AIMS: To determine factors associated with serum levels of 25-hydroxy vitamin D (25OHD) and their relative importance in a cohort of pre-dialysis CKD patients. MATERIAL AND METHODS: Incident patients admitted to a CKD outpatient clinic were included. Those who were receiving vitamin D supplements or anticonvulsants were excluded...
September 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
K Nanda Kumar, Veena R Shah, Beena K Parikh, Sumedha Sonde
A 48-year-old female patient with end-stage renal failure developed unexplained severe lactic acidosis (LA) associated with hyperglycemia during robotic-assisted laparoscopic renal transplantation. Initial treatment with sodium bicarbonate and insulin infusion were ineffective in treating acidemia. Postoperatively, intravenous administration of thiamine resulted in rapid improvement of LA and blood sugar levels. Uremia and chronic hemodialysis might be the causes behind the quantitative/qualitative deficiency of thiamine unmasked during the surgical stress...
July 2015: Indian Journal of Critical Care Medicine
Robert Yenchek, Joachim H Ix, Dena E Rifkin, Michael G Shlipak, Mark J Sarnak, Melissa Garcia, Kushang V Patel, Suzanne Satterfield, Tamara B Harris, Anne B Newman, Linda F Fried
BACKGROUND AND OBJECTIVES: Cross-sectional studies have found that low serum bicarbonate is associated with slower gait speed. Whether bicarbonate levels independently predict the development of functional limitation has not been previously studied. Whether bicarbonate was associated with incident persistent lower extremity functional limitation and whether the relationship differed in individuals with and without CKD were assessed in participants in the Health, Aging, and Body Composition study, a prospective study of well functioning older individuals DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Functional limitation was defined as difficulty in walking 0...
December 5, 2014: Clinical Journal of the American Society of Nephrology: CJASN
Alessandra M Bales, Rosa M A Moysés, Luciene M dos Reis, Fabiana G Graciolli, James Hung, Manuel Carlos Martins Castro, Rosilene M Elias
PURPOSE: Hyperleptinemia and metabolic acidosis (MA) are frequently observed in patients on hemodialysis (HD). While the role of leptin in patients on HD is not completely understood, HD only partially corrects MA. Both leptin and acidosis have effect on bone disease. The goal of the present study was to evaluate the effects of MA correction on chronic kidney disease-mineral and bone disorder laboratory parameters and leptin levels. METHODS: Forty-eight patients on HD, aged 43±19 years, were prospectively studied...
January 2015: International Urology and Nephrology
Dilara Bayram, M Tuğrul Sezer, Salih İnal, Atila Altuntaş, Veysel Kıdır, Hikmet Orhan
BACKGROUND: Hyperuricemia and metabolic acidosis have emerged as important risk factors for progression of kidney disease. In this study, we aimed to investigate the effects of allopurinol on metabolic acidosis and endothelial functions in hyperuricemic stage 2-4 chronic kidney disease (CKD) patients. METHODS: Thirty patients with stage 2-4 CKD and serum uric acid levels over 5.5 mg/dl were included in the study group. They were prescribed 300 mg/day per oral allopurinol treatment for three months...
June 2015: Clinical and Experimental Nephrology
Muhammad R Toor, Anjali Singla, Jin K Kim, Xenia Sumin, Maria V DeVita, Michael F Michelis
A variety of therapeutic modalities are available to alter the abnormalities seen in patients with chronic kidney disease (CKD). A comprehensive plan can now be developed to slow the progression of CKD. Two clinical cases of delay in the need for renal replacement therapy are described. This delay was achieved by using recognized recommendations for optimal diabetes therapy (HbA1c target 7 %), goals for blood pressure levels, reduction of proteinuria, and the proper use of ACEI/ARB therapies. Recent recommendations include BP <140/90 mmHg for patients <60 years old and <150/90 mmHg for older patients unless they have CKD or diabetes...
November 2014: International Urology and Nephrology
Yu-Ji Lee, Seong Cho, Sung Rok Kim
AIMS: Metabolic acidosis is a common manifestation of chronic kidney disease (CKD) and appears to be associated with CKD progression and mortality. We evaluated whether serum bicarbonate level is associated with albuminuria in patients with stage 3 and 4 CKD. METHODS: This was a retrospective cross-sectional study of outpatients with CKD stages 3 - 4 (estimated glomerular filtration rate 15 - 59 mL/minutes/1.73 m2). Serum bicarbonate levels, serum creatinine levels, and random urinary albumin-to-creatinine ratios (UA/Cr) examined on the same day were required for enrollment...
June 2014: Clinical Nephrology
C Tzanno-Martins, B M M Biavo, O Ferreira-Filho, E Ribeiro-Junior, M V S João-Luiz, S Degaspari, C Scavone, E Kawamoto
Sevelamer hydrochloride is an ionic exchange resin with high affinity for phosphate. This phosphate-binding agent has few serious adverse reactions with the advantage of reducing total and low density lipoprotein (LDL) cholesterol levels. However, it is controversial as to whether sevelamer hydrochloride can modulate the inflammatory response via endotoxin reduction. Therefore, a single-center, open-label, prospective and randomized study was performed to compare the clinical efficacy, safety and anti-inflammatory activity of two sevelamer hydrochloride tablet forms a branded tablet form, Renagel (Genzyme manufacturer) and its generic equivalent (EMS manufacturer)...
January 2014: International Journal of Immunopathology and Pharmacology
Tsung-Yen Lin, Chien-Hui Ou, Tzong-Shin Tzai, Yat-Ching Tong, Chien-Chen Chang, Hong-Lin Cheng, Wen-Horng Yang, Yung-Ming Lin
OBJECTIVES: To validate the predictive value of Fournier's Gangrene Severity Index in patients with Fournier gangrene and to facilitate patient mortality risk-stratification by simplifying the Fournier's Gangrene Severity Index. METHODS: From January 1989 to December 2011, 85 male patients with clinically-documented Fournier's gangrene undergoing intensive treatment and with complete medical records were recruited. The demographic information and nine parameters of Fournier's Gangrene Severity Index were compared between survivors and non-survivors...
July 2014: International Journal of Urology: Official Journal of the Japanese Urological Association
Boris Rogachev, Svetlana Tsesis, Benjamin F Gruenbaum, Shaun E Gruenbaum, Matthew Boyko, Moti Klein, Yoram Shapira, Marina Vorobiev, Alexander Zlotnik
BACKGROUND: Previous study has demonstrated the efficacy of hemodialysis in reducing blood glutamate levels. The purpose of the present study is to investigate whether peritoneal dialysis (PD) may be effective in lowering blood glutamate levels, which may serve as a potential tool for improving neurological function after brain injury. METHODS: Two liters of dialysis solution were infused over 10 minutes into 18 patients with stage V chronic kidney disease. Blood samples were collected immediately before initiation of PD, and hourly for a total of 5 blood samples...
July 2013: Journal of Neurosurgical Anesthesiology
Kirsten Thompson, Joseph Flynn, Daryl Okamura, Li Zhou
OBJECTIVE: To evaluate the effect on serum potassium of treating infant formula or expressed breast milk (EBM) with sodium polystyrene sulfonate (SPS) before patient consumption. DESIGN AND SETTING: Retrospective cohort study of patients at Seattle Children's Hospital who received SPS-treated formula or EBM. SUBJECTS AND INTERVENTION: Thirteen patients less than 2 years of age with a diagnosis of hyperkalemia and acute kidney injury or chronic kidney disease that had received formula or EBM pretreated with SPS between September 2009 and May 2012 were identified...
September 2013: Journal of Renal Nutrition
Josette A Rivera, Ann M O'Hare, G Michael Harper
Chronic kidney disease is common and associated with significant morbidity. Given the high risk of cardiovascular morbidity and mortality in patients with chronic kidney disease, it is important to identify and treat related risk factors. However, there is growing uncertainty about the benefits of some recommended treatment targets. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines recommend an A1C level of less than 7 percent in patients with diabetes mellitus, although there is no evidence that treatment to this goal reduces cardiovascular events or progression to end-stage renal disease...
October 15, 2012: American Family Physician
George C Kosmadakis, Stephen G John, Emma L Clapp, Joao L Viana, Alice C Smith, Nicolette C Bishop, Alan Bevington, Paul J Owen, Christopher W McIntyre, John Feehally
BACKGROUND: There is increasing evidence of the benefit of regular physical exercise in a number of long-term conditions including chronic kidney disease (CKD). In CKD, this evidence has mostly come from studies in end stage patients receiving regular dialysis. There is little evidence in pre-dialysis patients with CKD Stages 4 and 5. METHODS: A prospective study compared the benefits of 6 months regular walking in 40 pre-dialysis patients with CKD Stages 4 and 5...
March 2012: Nephrology, Dialysis, Transplantation
Vandana Menon, Hocine Tighiouart, Nubia Smith Vaughn, Gerald J Beck, John W Kusek, Allan J Collins, Tom Greene, Mark J Sarnak
BACKGROUND: A low serum bicarbonate level is prevalent in chronic kidney disease (CKD); however, its relationship to long-term outcomes is unclear. STUDY DESIGN: Cohort study. SETTING & PARTICIPANTS: The Modification of Diet in Renal Disease (MDRD) Study examined the effects of dietary protein restriction and blood pressure control on progression of kidney disease. This analysis includes 942 screened but non-randomized individuals and 839 randomized participants with baseline serum bicarbonate measurements with stage 2-4 CKD...
November 2010: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ashima Gulati, Vijesh Sridhar, Tathagata Bose, Pankaj Hari, Arvind Bagga
BACKGROUND: The relative effectiveness and safety of sevelamer, a mineral-free phosphate binder, for treatment of hyperphosphatemia in children with chronic kidney disease is uncertain. AIM: This study was designed to compare the efficacy and acceptability of sevelamer hydrochloride to calcium acetate as a phosphate binder in pediatric patients with chronic kidney disease. METHODS: A 12-week open-label trial of sevelamer hydrochloride vs calcium acetate was initiated in 22 patients, aged 2-18, with CKD stages 3 and 4...
December 2010: International Urology and Nephrology
Viviane O Leal, Alvimar G Delgado, Maurilo Leite, William E Mitch, Denise Mafra
OBJECTIVE: We investigated the influence of potential renal acid load (PRAL) and renal function on the degree of metabolic acidosis in patients with chronic kidney disease (CKD). DESIGN: This was a cross-sectional study. SETTING: This study was conducted at the Nephrology Outpatient Division of the Hospital Universitário Clementino Fraga Filho (Rio de Janeiro, Brazil). PATIENTS: Thirty CKD patients undergoing conservative treatment were divided according to plasma HCO(3)(-) values into acidotic (HCO(3)(-) <or=22 mM, n = 15) and nonacidotic (HCO(3)(-) >22 mM, n = 15)...
March 2009: Journal of Renal Nutrition
Csaba P Kovesdy, Shahram Ahmadzadeh, John E Anderson, Kamyar Kalantar-Zadeh
BACKGROUND: Treatment of secondary hyperparathyroidism (SHPT) with activated vitamin D analogues is associated with better survival in patients receiving dialysis. It is unclear whether such a benefit is present in patients with predialysis chronic kidney disease (CKD). METHODS: We examined the association of oral calcitriol treatment with mortality and the incidence of dialysis in 520 male US veterans (mean [SD] age, 69.8 [10.3] years; 23.5% black) with CKD stages 3 to 5 and not yet receiving dialysis (mean [SD] estimated glomerular filtration rate, 30...
February 25, 2008: Archives of Internal Medicine
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