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Ckd ethnic

David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
Éric Sagou Yayo, Mireille Aye, Jean-Louis Konan, Arlette Emième, Marie-Laure Attoungbre, Appolinaire Gnionsahé, Étienne Cavalier, Dagui Monnet, Pierre Delanaye
Glomerular filtration rate (GFR) estimation is fundamental in clinical nephrology. It is usually estimated from equations based on serum creatinine. An ethnic factor is currently recommended for the black population for the two most used equations, i.e. the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations. However, these factors were determined from African-American subjects. Therefore, their use in the African subject (non-American) remained questionable...
September 24, 2016: Néphrologie & Thérapeutique
Adam Shardlow, Natasha J McIntyre, Richard J Fluck, Christopher W McIntyre, Maarten W Taal
BACKGROUND: Chronic kidney disease (CKD) is commonly managed in primary care, but most guidelines have a secondary care perspective emphasizing the risk of end-stage kidney disease (ESKD) and need for renal replacement therapy. In this prospective cohort study, we sought to study in detail the natural history of CKD in primary care to better inform the appropriate emphasis for future guidance. METHODS AND FINDINGS: In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom...
September 2016: PLoS Medicine
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
Kalvin C Yu, Paul A D'Avanzo, Leigh Nesheiwat, Richard E Greene, Antonio Urbina, Perry N Halkitis, Farzana Kapadia
Data from a cross-sectional study of a clinic-based sample of older people living with HIV (PLWH; n = 100) were used to examine associations between biomarkers of physical health and neurocognitive impairment (NCI). In this sample, anemia, chronic kidney disease (CKD) stages 4-5, and hypocalcemia were associated with impairment in executive functioning or processing speed. Furthermore, participants with anemia were more likely to have CD4+ T cell counts <200 cells/mm(3) (χ(2) [1] = 19.57, p < ...
August 27, 2016: Journal of the Association of Nurses in AIDS Care: JANAC
Raul Fernandez-Prado, Esmeralda Castillo-Rodriguez, Fernando Javier Velez-Arribas, Carolina Gracia-Iguacel, Alberto Ortiz
Direct oral anticoagulants (DOACs) may require dose reduction or avoidance when glomerular filtration rate is low. However, glomerular filtration rate is not usually measured in routine clinical practice. Rather, equations that incorporate different variables use serum creatinine to estimate either creatinine clearance in mL/minute or glomerular filtration rate in mL/minute/1.73m(2). The Cockcroft-Gault equation estimates creatinine clearance and incorporates weight into the equation. By contrast, the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations estimate glomerular filtration rate and incorporate ethnicity but not weight...
September 6, 2016: American Journal of Medicine
Thomas Dienemann, Naohiko Fujii, Paula Orlandi, Lisa Nessel, Susan L Furth, Wendy E Hoy, Seiichi Matsuo, Gert Mayer, Shona Methven, Franz Schaefer, Elke S Schaeffner, Laura Solá, Bénédicte Stengel, Christoph Wanner, Luxia Zhang, Adeera Levin, Kai-Uwe Eckardt, Harold I Feldman
BACKGROUND: Chronic kidney disease (CKD) is a global health burden, yet it is still underrepresented within public health agendas in many countries. Studies focusing on the natural history of CKD are challenging to design and conduct, because of the long time-course of disease progression, a wide variation in etiologies, and a large amount of clinical variability among individuals with CKD. With the difference in health-related behaviors, healthcare delivery, genetics, and environmental exposures, this variability is greater across countries than within one locale and may not be captured effectively in a single study...
2016: BMC Nephrology
Anubha Mahajan, Aylin R Rodan, Thu H Le, Kyle J Gaulton, Jeffrey Haessler, Adrienne M Stilp, Yoichiro Kamatani, Gu Zhu, Tamar Sofer, Sanjana Puri, Jeffrey N Schellinger, Pei-Lun Chu, Sylvia Cechova, Natalie van Zuydam, Johan Arnlov, Michael F Flessner, Vilmantas Giedraitis, Andrew C Heath, Michiaki Kubo, Anders Larsson, Cecilia M Lindgren, Pamela A F Madden, Grant W Montgomery, George J Papanicolaou, Alex P Reiner, Johan Sundström, Timothy A Thornton, Lars Lind, Erik Ingelsson, Jianwen Cai, Nicholas G Martin, Charles Kooperberg, Koichi Matsuda, John B Whitfield, Yukinori Okada, Cathy C Laurie, Andrew P Morris, Nora Franceschini
We analyzed genome-wide association studies (GWASs), including data from 71,638 individuals from four ancestries, for estimated glomerular filtration rate (eGFR), a measure of kidney function used to define chronic kidney disease (CKD). We identified 20 loci attaining genome-wide-significant evidence of association (p < 5 × 10(-8)) with kidney function and highlighted that allelic effects on eGFR at lead SNPs are homogeneous across ancestries. We leveraged differences in the pattern of linkage disequilibrium between diverse populations to fine-map the 20 loci through construction of "credible sets" of variants driving eGFR association signals...
September 1, 2016: American Journal of Human Genetics
F Wei, N E A Drummen, A E Schutte, L Thijs, L Jacobs, T Petit, W Y Yang, W Smith, Z Y Zhang, Y M Gu, T Kuznetsova, P Verhamme, K Allegaert, R Schutte, E Lerut, P Evenepoel, C Vermeer, J A Staessen
OBJECTIVE: Vitamin K (VK) dependent carboxylation of matrix Gla protein (MGP) protects the macrocirculation against calcification. Whether glomerular filtration (GFR), a renal microvascular trait, is related to circulating desphospho-uncarboxylated MGP (dp-ucMGP) has not been explored before. We therefore investigated our hypothesis in our Flemish Study on Environment, Genes and Health Outcomes (FLEMENGHO) and sought replication in the South African Study Regarding the Influence of Sex, Age and Ethnicity on Insulin Sensitivity and Cardiovascular Function (SAfrEIC)...
September 2016: Journal of Hypertension
G Norton, H L Booysen, A Raymond, P Sareli, H-C Hsu, P H Dessein, A J Woodiwiss
OBJECTIVE: The recent Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimated glomerular filtration rate (eGFR) is recommended for use in European populations. However, because the relationship between creatinine and GFR varies between ethnicities, the CKD-EPI equation may not perform as well in African as it does in Caucasian populations. We aimed to identify whether the CKD-EPI equation is more closely associated with end organ changes than previous equations in a group of black African descent...
September 2016: Journal of Hypertension
Ravi Kiran Munnur, Nitesh Nerlekar, Dennis T L Wong
Coronary artery disease (CAD) is the leading cause of death and disability worldwide. Atherosclerosis, which is the primary pathophysiologic mechanism for the development of plaque leading to CAD, is a multifactorial process resulting from a complex interplay between genetic susceptibility and various risk factors such as hypertension (HT), dyslipidaemia, diabetes mellitus (DM) and smoking. In addition, influences from other disease states such as chronic kidney disease (CKD), obesity and the metabolic syndrome as well as gender and ethnic diversity also contribute to the disease process...
August 2016: Cardiovascular Diagnosis and Therapy
Daniel Murphy, Charles E McCulloch, Feng Lin, Tanushree Banerjee, Jennifer L Bragg-Gresham, Mark S Eberhardt, Hal Morgenstern, Meda E Pavkov, Rajiv Saran, Neil R Powe, Chi-Yuan Hsu
Background: Trends in the prevalence of chronic kidney disease (CKD) are important for health care policy and planning. Objective: To update trends in CKD prevalence. Design: Repeated cross-sectional study. Setting: NHANES (National Health and Nutrition Examination Survey) for 1988 to 1994 and every 2 years from 1999 to 2012. Participants: Adults aged 20 years or older. Measurements: Chronic kidney disease (stages 3 and 4) was defined as an estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1...
October 4, 2016: Annals of Internal Medicine
Julius Okel, Ike G Okpechi, Bilal Qarni, Timothy Olanrewaju, Mark J Courtney, Valerie Luyckx, Sarala Naicker, Aminu K Bello
An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care...
July 29, 2016: Clinical Nephrology
Fergus J Caskey
Despite well-established, publicly-funded national health systems, kidney disease inequalities exist in Europe. There are differences between countries in rates of treated end-stage renal disease, at least some of which appears explained by organizational and economic factors. Pooling of chronic kidney disease (CKD) prevalence data is allowing new like-for-like comparisons between countries, which suggest that there are also differences in underlying rates of kidney disease. The few studies that exist suggest a paradoxically lower rate of earlier stages of kidney disease in ethnic minority groups, which have long been known to have higher rates of end-stage disease...
July 29, 2016: Clinical Nephrology
Jerry Fan, Hasan Salameh
BACKGROUND: Chronic kidney disease (CKD) accounts for a significant proportion of the morbidity and mortality in the United States. CKD is defined as glomerular filtration rate (GFR) <60ml/min/1.73m2 or clear evidence of renal damage from biopsy. All-cause cardiovascular risk increases with decreasing GFR. Clinically, detection of CKD is through changes in creatinine clearance which estimates GFR, an indicator of kidney function. We reviewed conventional and nonconventional cardiovascular risk factors associated with CKD...
July 22, 2016: Current Vascular Pharmacology
Abrar Ahmed Wagan, Tafazzul E Haque Mahmud, Aflak Rasheed, Zafar Ali Zafar, Ata Ur Rehman, Amjad Ali
OBJECTIVE: To determine the 10-year Cardiovascular risk score with QRISK-2 and Framingham risk calculators in Rheumatoid Arthritis and Non Rheumatoid Arthritis subjects and asses the usefulness of QRISK-2 and Framingham calculators in both groups. METHODS: During the study 106 RA and 106 Non RA patients age and sex matched participants were enrolled from outpatient department. Demographic data and questions regarding other study parameters were noted. After 14 hours of fasting 5 ml of venous blood was drawn for Cholesterol and HDL levels, laboratory tests were performed on COBAS c III (ROCHE)...
May 2016: Pakistan Journal of Medical Sciences Quarterly
Jason P Swindle, Wing W Chan, Katherine Waltman Johnson, Laura Becker, Cori Blauer-Peterson, Aylin Altan
OBJECTIVE: To examine the association of patient/clinical characteristics with mortality and readmission following a heart failure (HF)-related hospitalization. RESEARCH DESIGN AND METHODS: Claims data, linked to laboratory, race/ethnicity, and mortality data, from a large US health plan were utilized to identify individuals with ≥1 inpatient claim with a diagnosis code for HF (1 January 2008-30 September 2012). Study variables were analyzed using descriptive and multivariable approaches to identify patient/clinical characteristics associated with post-discharge outcomes...
August 2, 2016: Current Medical Research and Opinion
Serena Low, E Shyong Tai, Lee Ying Yeoh, Yan Lun Liu, Jian Jun Liu, Kristin Hui Xian Tan, Sharon Fun, Chang Su, Xiao Zhang, Tavintharan Subramaniam, Chee Fang Sum, Su Chi Lim
AIM: To elucidate the natural history of chronic kidney disease(CKD), which is defined as estimated glomerular filtration rate(eGFR)<60ml/min/1.73m(2) and/or increase of urinary albumin-to-creatinine ratio (uACR)≥30mg/g), and to identify factors associated with its onset and progression. METHODS: Prospective cohort study on individuals with T2DM attending Diabetes Centre in a regional hospital in Singapore from 2002. There were 553 patients with no pre-existing CKD for "onset" analysis and 967 patients with pre-existing CKD for "progression" analysis...
September 2016: Journal of Diabetes and its Complications
Vibha Bhatnagar, Erin L Richard, Wei Wu, Caroline M Nievergelt, Michael S Lipkowitz, Janina Jeff, Adam X Maihofer, Sanjay K Nigam
BACKGROUND: In the setting of chronic kidney disease (CKD), altered extra-renal urate handling may be necessary to regulate plasma uric acid. The Remote Sensing and Signaling Hypothesis (Nigam S. What do drug transporters really do? Nat Rev Drug Discov 2015; 14: 29-44) suggests that multispecific solute carrier (SLC) and ATP-binding cassette (ABC) drug transporters in different tissues are part of an inter-organ communication system that maintains levels of urate and other metabolites after organ injury...
June 2016: Clinical Kidney Journal
F Gaillard, M Flamant, S Lemoine, S Baron, M-O Timsit, D Eladari, C Fournier, C Prot-Bertoye, J-P Bertocchio, E Vidal-Petiot, L Lamhaut, E Morelon, M-N Péraldi, F Vrtovsnik, G Friedlander, A Méjean, P Houillier, C Legendre, M Courbebaisse
The value of estimated glomerular filtration rate (eGFR) in living kidney donors screening is unclear. A recently published web-based application derived from large cohorts, but not living donors, calculates the probability of a measured GFR (mGFR) lower than a determined threshold. Our objectives were to validate the clinical utility of this tool in a cohort of living donors and to test two other strategies based on chronic kidney disease epidemiology collaboration (CKD-EPI) and on MDRD-eGFR. GFR was measured using (51) Cr- ethylene-diamine tetraacetic acid urinary clearance in 311 potential living kidney donors (178 women, mean age 50 ± 11...
June 6, 2016: American Journal of Transplantation
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