Pub Date : 2022-06-15eCollection Date: 2022-01-01DOI: 10.1155/2022/5330608
Borja Perez-Dominguez, Aida Lopez-Brull, Maria Plaza-Carrasco, Jose Casaña-Granell, Alicia Garcia-Testal, Josep Benitez-Martinez
Background: Chronic kidney disease is an exponentially growing medical and economic worldwide problem. There are specific elements used to assess patient's functional capacity loss and overall deterioration in order to determine the patient's clinical status, and muscle impairment is one of the most common. It is therefore necessary to develop reliable and applicable methods to determine muscle impairment in patients with chronic kidney disease.
Methods: This is a prospective, nonexperimental, descriptive methodological investigation performed in patients undergoing hemodialysis. This study analyzes the reliability and validity of muscle strength assessments performed with handheld dynamometry in patients with chronic kidney disease undergoing hemodialysis.
Results: Results show overall high reliability and validity in the assessment of muscle strength of the lower limbs.
Conclusion: To our knowledge, this is the first study to assess handheld dynamometry in patients undergoing hemodialysis, presenting promising results with a relatively affordable and easily applicable method.
{"title":"Test-Retest Reliability, Validity, and Minimal Detectable Change of the Measurement of Lower Limb Muscular Strength with Handheld Dynamometry in Patients Undergoing Hemodialysis.","authors":"Borja Perez-Dominguez, Aida Lopez-Brull, Maria Plaza-Carrasco, Jose Casaña-Granell, Alicia Garcia-Testal, Josep Benitez-Martinez","doi":"10.1155/2022/5330608","DOIUrl":"https://doi.org/10.1155/2022/5330608","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease is an exponentially growing medical and economic worldwide problem. There are specific elements used to assess patient's functional capacity loss and overall deterioration in order to determine the patient's clinical status, and muscle impairment is one of the most common. It is therefore necessary to develop reliable and applicable methods to determine muscle impairment in patients with chronic kidney disease.</p><p><strong>Methods: </strong>This is a prospective, nonexperimental, descriptive methodological investigation performed in patients undergoing hemodialysis. This study analyzes the reliability and validity of muscle strength assessments performed with handheld dynamometry in patients with chronic kidney disease undergoing hemodialysis.</p><p><strong>Results: </strong>Results show overall high reliability and validity in the assessment of muscle strength of the lower limbs.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to assess handheld dynamometry in patients undergoing hemodialysis, presenting promising results with a relatively affordable and easily applicable method.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"5330608"},"PeriodicalIF":2.1,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40401626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14eCollection Date: 2022-01-01DOI: 10.1155/2022/2984193
Walid A R Abdelhamid, Mohamed M Soliman, Ayman R A El-Hameed
Background: Chronic kidney disease (CKD) is often accompanied by anemia. High-flux membranes contribute to a reasonable removal of uremic toxins which cause anemia in CKD. Inadequate data have described the efficiency of high-flux dialysis in promoting erythropoietin responsiveness in CKD patients in the Middle East. This study was conducted to compare the efficiency of maintaining high-flux hemodialysis versus low-flux dialysis for ≥1 year in promoting erythropoietin responsiveness and to show the factors associated with erythropoietin hyporesponsiveness in Arab chronic hemodialysis patients.
Methods: It was a retrospective cohort study that involved 110 subjects who were categorized into group 1 (50 patients receiving low-flux dialysis) and group 2 (60 patients receiving high-flux dialysis). History taking, examination, and laboratory investigations were conducted for all patients every 3 months from January 2021 to January 2022.
Results: Group 2 had significantly higher weight and body mass index than group 1 but lower cholesterol and intact parathyroid hormone levels than group 1. Erythropoietin resistance index levels did not differ between the two groups upon repeated measures over a 1-year follow-up. Significant risk factors for erythropoietin hyporesponsiveness on multivariate analysis were lower weight (Odds ratio (OR): 0.966; 95% Confidence interval (CI): 0.94-0.992; p=0.011), longer hemodialysis vintage (OR: 1.172; 95% CI: 1.036-1.325; p=0.012), lower hemoglobin levels (OR: 0.531; 95% CI: 0.362-0.779; p=0.001), and higher neutrophil-to-lymphocyte ratio (OR: 2.436; 95% CI: 1.321-4.493; p=0.004).
Conclusion: High-flux dialysis was not superior to low-flux dialysis in improving erythropoietin responsiveness.
{"title":"Effects of Low-Flux and High-Flux Dialysis Membranes on Erythropoietin Responsiveness in Hemodialysis Patients.","authors":"Walid A R Abdelhamid, Mohamed M Soliman, Ayman R A El-Hameed","doi":"10.1155/2022/2984193","DOIUrl":"https://doi.org/10.1155/2022/2984193","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is often accompanied by anemia. High-flux membranes contribute to a reasonable removal of uremic toxins which cause anemia in CKD. Inadequate data have described the efficiency of high-flux dialysis in promoting erythropoietin responsiveness in CKD patients in the Middle East. This study was conducted to compare the efficiency of maintaining high-flux hemodialysis versus low-flux dialysis for ≥1 year in promoting erythropoietin responsiveness and to show the factors associated with erythropoietin hyporesponsiveness in Arab chronic hemodialysis patients.</p><p><strong>Methods: </strong>It was a retrospective cohort study that involved 110 subjects who were categorized into group 1 (50 patients receiving low-flux dialysis) and group 2 (60 patients receiving high-flux dialysis). History taking, examination, and laboratory investigations were conducted for all patients every 3 months from January 2021 to January 2022.</p><p><strong>Results: </strong>Group 2 had significantly higher weight and body mass index than group 1 but lower cholesterol and intact parathyroid hormone levels than group 1. Erythropoietin resistance index levels did not differ between the two groups upon repeated measures over a 1-year follow-up. Significant risk factors for erythropoietin hyporesponsiveness on multivariate analysis were lower weight (Odds ratio (OR): 0.966; 95% Confidence interval (CI): 0.94-0.992; <i>p</i>=0.011), longer hemodialysis vintage (OR: 1.172; 95% CI: 1.036-1.325; <i>p</i>=0.012), lower hemoglobin levels (OR: 0.531; 95% CI: 0.362-0.779; <i>p</i>=0.001), and higher neutrophil-to-lymphocyte ratio (OR: 2.436; 95% CI: 1.321-4.493; <i>p</i>=0.004).</p><p><strong>Conclusion: </strong>High-flux dialysis was not superior to low-flux dialysis in improving erythropoietin responsiveness.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"2984193"},"PeriodicalIF":2.1,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: To explore the relationship between determinants and posttransplant medication nonadherence (MNA) in adult kidney transplant recipients, and to examine the relationship between posttransplant MNA and clinical outcomes.
Methods: Using the World Health Organization's model, this retrospective, multicenter, correlational study examined the relationship between determinants, posttransplant MNA, and clinical outcomes in 16,671 adult kidney transplant recipients from the Cerner Health Facts national data warehouse.
Results: With 12% MNA, those who were nonadherent were more likely to have the social/economic factors of being younger, single, Caucasian versus Hispanic race, have the condition-related factor of mental health/substance use disorder, and have the healthcare system-related factor of government/health maintenance organization/managed care insurance (p's < 0.05). Bivariate correlations indicated both age (OR = 1.006, p=0.01) and mental health or substance use disorder diagnosis (OR = 1.26, p=0.04) were significant predictors of MNA. Patients were 0.6% more likely to be medication adherent for each year they increased in age and 26% more likely to be MNA if they were diagnosed with a mental health/substance use disorder. Nonadherent patients were less likely to be readmitted, but more likely to have complications after transplant and medication side effects (p's < 0.01).
Conclusions: Using one of the largest samples of adult kidney transplant patients, our findings support the WHO model and move the body of medication adherence intervention research forward by clarifying the importance of focusing interventions not only on the patient but on multilevel determinants. Consistent with previous studies, MNA negatively impacts transplant outcomes.
{"title":"Health Facts Medication Adherence in Transplantation (H-MAT) Study: A Secondary Analysis of Determinants and Outcomes of Medication Nonadherence in Adult Kidney Transplant Recipients.","authors":"Cynthia L Russell, Heather J Gotham, An-Lin Cheng, Suman Sahil, Preethi Yerram","doi":"10.1155/2022/9653847","DOIUrl":"https://doi.org/10.1155/2022/9653847","url":null,"abstract":"<p><strong>Aims: </strong>To explore the relationship between determinants and posttransplant medication nonadherence (MNA) in adult kidney transplant recipients, and to examine the relationship between posttransplant MNA and clinical outcomes.</p><p><strong>Methods: </strong>Using the World Health Organization's model, this retrospective, multicenter, correlational study examined the relationship between determinants, posttransplant MNA, and clinical outcomes in 16,671 adult kidney transplant recipients from the Cerner <i>Health Facts</i> national data warehouse.</p><p><strong>Results: </strong>With 12% MNA, those who were nonadherent were more likely to have the social/economic factors of being younger, single, Caucasian versus Hispanic race, have the condition-related factor of mental health/substance use disorder, and have the healthcare system-related factor of government/health maintenance organization/managed care insurance (<i>p</i>'<i>s</i> < 0.05). Bivariate correlations indicated both age (OR = 1.006, <i>p</i>=0.01) and mental health or substance use disorder diagnosis (OR = 1.26, <i>p</i>=0.04) were significant predictors of MNA. Patients were 0.6% more likely to be medication adherent for each year they increased in age and 26% more likely to be MNA if they were diagnosed with a mental health/substance use disorder. Nonadherent patients were less likely to be readmitted, but more likely to have complications after transplant and medication side effects (<i>p</i>'<i>s</i> < 0.01).</p><p><strong>Conclusions: </strong>Using one of the largest samples of adult kidney transplant patients, our findings support the WHO model and move the body of medication adherence intervention research forward by clarifying the importance of focusing interventions not only on the patient but on multilevel determinants. Consistent with previous studies, MNA negatively impacts transplant outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"9653847"},"PeriodicalIF":2.1,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40041954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Jasuja, G. Sagar, A. Bahl, Neharita Jasuja, R. Chawla, A. Bansal, M. Kanwar, S. Kansal, N. Modi, A. Ansari, Viny Kantroo, P. Dhar, C. Chatterjee, N. Ghonge, Samir Tawakley, Shalini Verma
Data comparing the clinical spectrum of COVID-19 in kidney transplant recipients (KTRs) during the first and second waves of the pandemic in India is limited. Our single-center retrospective study compared the clinical profile, mortality, and associated risk factors in KTRs with COVID-19 during the 1st wave (1st February 2020 to 31st January 2021) and the second wave (1st March-31st August 2021). 156 KTRs with PCR confirmed SARS-CoV-2 infection treated at a tertiary care hospital in New Delhi during the 1st and the second waves were analyzed. The demographics and baseline transplant characteristics of the patients diagnosed during both waves were comparable. Patients in the second wave reported less frequent hospitalization, though the intensive care unit (ICU) and ventilator requirements were similar. Strategies to modify immunosuppressants such as discontinuation of antinucleoside drugs with or without change in calcineurin inhibitors and the use of steroids were similar during both waves. Overall patient mortality was 27.5%. The demographics and baseline characteristics of survivors and nonsurvivors were comparable. A higher percentage of nonsurvivors presented with breathing difficulty, low SpO2, and altered sensorium. Both wave risk factors for mortality included older age, severe disease, ICU/ventilator requirements, acute kidney injury (AKI) needing dialysis, Chest Computerized Tomographic (CT) scan abnormalities, and higher levels of inflammatory markers particularly D-dimer and interleukin-6 levels. Conclusions. KTRs in both COVID-19 waves had similar demographics and baseline characteristics, while fewer patients during the second wave required hospitalization. The D-dimer and IL-6 levels are directly correlated with mortality.
{"title":"A Comprehensive Comparison of Clinical Presentation and Outcomes of Kidney Transplant Recipients with COVID-19 during Wave 1 versus Wave 2 at a Tertiary Care Center, India","authors":"S. Jasuja, G. Sagar, A. Bahl, Neharita Jasuja, R. Chawla, A. Bansal, M. Kanwar, S. Kansal, N. Modi, A. Ansari, Viny Kantroo, P. Dhar, C. Chatterjee, N. Ghonge, Samir Tawakley, Shalini Verma","doi":"10.1155/2022/9088393","DOIUrl":"https://doi.org/10.1155/2022/9088393","url":null,"abstract":"Data comparing the clinical spectrum of COVID-19 in kidney transplant recipients (KTRs) during the first and second waves of the pandemic in India is limited. Our single-center retrospective study compared the clinical profile, mortality, and associated risk factors in KTRs with COVID-19 during the 1st wave (1st February 2020 to 31st January 2021) and the second wave (1st March-31st August 2021). 156 KTRs with PCR confirmed SARS-CoV-2 infection treated at a tertiary care hospital in New Delhi during the 1st and the second waves were analyzed. The demographics and baseline transplant characteristics of the patients diagnosed during both waves were comparable. Patients in the second wave reported less frequent hospitalization, though the intensive care unit (ICU) and ventilator requirements were similar. Strategies to modify immunosuppressants such as discontinuation of antinucleoside drugs with or without change in calcineurin inhibitors and the use of steroids were similar during both waves. Overall patient mortality was 27.5%. The demographics and baseline characteristics of survivors and nonsurvivors were comparable. A higher percentage of nonsurvivors presented with breathing difficulty, low SpO2, and altered sensorium. Both wave risk factors for mortality included older age, severe disease, ICU/ventilator requirements, acute kidney injury (AKI) needing dialysis, Chest Computerized Tomographic (CT) scan abnormalities, and higher levels of inflammatory markers particularly D-dimer and interleukin-6 levels. Conclusions. KTRs in both COVID-19 waves had similar demographics and baseline characteristics, while fewer patients during the second wave required hospitalization. The D-dimer and IL-6 levels are directly correlated with mortality.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48441133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priskila Christy, H. Sidjabat, Anggia Augustasia Lumban Toruan, E. Moses, N. Mohd Yussof, Yessy Puspitasari, M. R. Fuadi, Aryati, F. R. Marpaung
Background Rapid and reliable tests are essential for the diagnostic laboratory confirmation of urinary tract infections (UTIs). Until now, UTI has been confirmed by the microbiology culture of urine, requiring at least 48-hour turnaround time (TAT), with a standardized microscopic method being widely favored. Automated urine flow cytometry, however, has recently been used to improve the rapid TAT by analyzing the urine sediment. This study therefore aimed to compare the diagnostic value of the Shih-Yung conventional microscopic and urine flow cytometry methods in the detection of leukocyte and bacterial parameters of patients with UTIs in an outpatient clinic. Methods A cross-sectional study was conducted on a total of 100 patients. Seventy urine samples were positive for leukocytes and nitrite chemistry, and 30 were negative for both. The measurements of urine leukocytes and bacteria were compared between Sysmex UF-5000 urine flow cytometry and the Shih-Yung method. The diagnostic value was obtained from ROC analysis of urine flow cytometry and the culture. Results A leukocyte cutoff value of 87.2/μL had a sensitivity and specificity of 98.33% and 95%, respectively, and 98.33% sensitivity and 75% specificity at a bacterial cutoff of 582.22/μL. Interestingly, our study identified strong and consistent agreement of leukocyte and bacterial parameters between urine flow cytometry and Shih-Yung (k = 0.959, p < 0.001 and k = 0.939, p < 0.001, respectively). Furthermore, through analyzing the dominance angle of the scattergram, a strong agreement was obtained with the culture result (k = 0.880, p < 0.001). Conclusions The Shih-Yung method showed consistent agreement with urine flow cytometry for the detection of leukocytes and bacteria. The use of certain cutoffs for bacterial and leukocyte parameters in urine flow cytometry demonstrated very good performance in detecting acquired symptomatic UTIs.
{"title":"Comparison of Laboratory Diagnosis of Urinary Tract Infections Based on Leukocyte and Bacterial Parameters Using Standardized Microscopic and Flow Cytometry Methods","authors":"Priskila Christy, H. Sidjabat, Anggia Augustasia Lumban Toruan, E. Moses, N. Mohd Yussof, Yessy Puspitasari, M. R. Fuadi, Aryati, F. R. Marpaung","doi":"10.1155/2022/9555121","DOIUrl":"https://doi.org/10.1155/2022/9555121","url":null,"abstract":"Background Rapid and reliable tests are essential for the diagnostic laboratory confirmation of urinary tract infections (UTIs). Until now, UTI has been confirmed by the microbiology culture of urine, requiring at least 48-hour turnaround time (TAT), with a standardized microscopic method being widely favored. Automated urine flow cytometry, however, has recently been used to improve the rapid TAT by analyzing the urine sediment. This study therefore aimed to compare the diagnostic value of the Shih-Yung conventional microscopic and urine flow cytometry methods in the detection of leukocyte and bacterial parameters of patients with UTIs in an outpatient clinic. Methods A cross-sectional study was conducted on a total of 100 patients. Seventy urine samples were positive for leukocytes and nitrite chemistry, and 30 were negative for both. The measurements of urine leukocytes and bacteria were compared between Sysmex UF-5000 urine flow cytometry and the Shih-Yung method. The diagnostic value was obtained from ROC analysis of urine flow cytometry and the culture. Results A leukocyte cutoff value of 87.2/μL had a sensitivity and specificity of 98.33% and 95%, respectively, and 98.33% sensitivity and 75% specificity at a bacterial cutoff of 582.22/μL. Interestingly, our study identified strong and consistent agreement of leukocyte and bacterial parameters between urine flow cytometry and Shih-Yung (k = 0.959, p < 0.001 and k = 0.939, p < 0.001, respectively). Furthermore, through analyzing the dominance angle of the scattergram, a strong agreement was obtained with the culture result (k = 0.880, p < 0.001). Conclusions The Shih-Yung method showed consistent agreement with urine flow cytometry for the detection of leukocytes and bacteria. The use of certain cutoffs for bacterial and leukocyte parameters in urine flow cytometry demonstrated very good performance in detecting acquired symptomatic UTIs.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44932771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-24eCollection Date: 2022-01-01DOI: 10.1155/2022/8267829
Kjellbjørn Jakobsen, Bjørn O Eriksen, Ole M Fuskevåg, Stephen J Hodges, Lars M Ytrebø
Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.
{"title":"Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate.","authors":"Kjellbjørn Jakobsen, Bjørn O Eriksen, Ole M Fuskevåg, Stephen J Hodges, Lars M Ytrebø","doi":"10.1155/2022/8267829","DOIUrl":"10.1155/2022/8267829","url":null,"abstract":"<p><p>Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2022 1","pages":"8267829"},"PeriodicalIF":1.7,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9155923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41340962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Kidney disease (KD), also known as chronic kidney disease (CKD), is a long-term underrecognized public health concern and one of the eight leading causes of death in women. Despite that, little is known about women's knowledge, perceived risk, and perceptions of CKD risk factors. In this study, we assessed knowledge, perceived risk, and perceptions of CKD risk factors among women of childbearing age in Lagos State, Nigeria. Methods Administering a pretested and structured questionnaire among 825 women aged 15–49 years, we conducted a cross-sectional descriptive study to evaluate knowledge, self-reported CKD risk factors, and risk perception among women of childbearing age in urban and semiurban communities in Lagos State, Nigeria. We used descriptive (mean, frequencies, and percentages) and bivariate statistics (chi-square) to assess sociodemographic factors influencing knowledge and perceptions of CKD risk factors. Binary and multinomial logistic regressions were further employed to assess risk perceptions of CKD factors associated with knowledge. Results Five hundred and forty (65.5%) out of 825 women reported being knowledgeable of CKD risk factors with majority of the younger adult women (15–29 years) having good knowledge than other age cohorts, with a mean age of 33.5 ± 11.5 years. The women's knowledge of CKD was found to be significantly associated with independent and dependent risk factors (p < 0.05). The major self-reported independent CKD risk factors were misuse of analgesics (NSAIDs) (OR = 1.20; p < 0.05), herbal drinks (OR = 2.30; p < 0.05), and herbal supplements (OR = 1.37; p < 0.05), while self-reported dependent CKD risk factors were hypertension (OR = 2.14; p < 0.05), family history of KD ailments (OR = 1.30; p < 0.05), and high cholesterol (OR = 1.44; p < 0.05). Similarly, majority of the women had low perceived CKD risk (54.8%), while women with CKD risk factors (independent and dependent) view themselves at decreased perceived risk for the disease compared to those who are not associated with CKD risk factors (p < 0.05). Also, findings revealed that women had poor perception of risk factors associated with CKD. The multivariate analysis of perceived risk showed that demographic factors (younger aged adults, high education, and high income), independent risk factors of CKD (misuse of NASAIDs and excessive use of herbal drink and herbal supplement), and dependent risk factors (hypertension and family history of KD ailments) were significantly associated with knowledge of CKD (p < 0.05). Conclusion Our study reveals high knowledge of CKD risk factors but low perceived risk and poor perception of the link between CKD risk factors and its ailments. Given this, there is a call for urgent measures to create sensitization and provide public CKD behavioural health interventions as well as easy communication strategies for women to secure better access to awareness intervention programmes and healthcare services.
{"title":"Knowledge and Risk Perceptions of Chronic Kidney Disease Risk Factors among Women of Childbearing Age in Lagos State, Nigeria: From a Health Demography Approach","authors":"M. Akokuwebe, E. Idemudia","doi":"10.1155/2022/5511555","DOIUrl":"https://doi.org/10.1155/2022/5511555","url":null,"abstract":"Background Kidney disease (KD), also known as chronic kidney disease (CKD), is a long-term underrecognized public health concern and one of the eight leading causes of death in women. Despite that, little is known about women's knowledge, perceived risk, and perceptions of CKD risk factors. In this study, we assessed knowledge, perceived risk, and perceptions of CKD risk factors among women of childbearing age in Lagos State, Nigeria. Methods Administering a pretested and structured questionnaire among 825 women aged 15–49 years, we conducted a cross-sectional descriptive study to evaluate knowledge, self-reported CKD risk factors, and risk perception among women of childbearing age in urban and semiurban communities in Lagos State, Nigeria. We used descriptive (mean, frequencies, and percentages) and bivariate statistics (chi-square) to assess sociodemographic factors influencing knowledge and perceptions of CKD risk factors. Binary and multinomial logistic regressions were further employed to assess risk perceptions of CKD factors associated with knowledge. Results Five hundred and forty (65.5%) out of 825 women reported being knowledgeable of CKD risk factors with majority of the younger adult women (15–29 years) having good knowledge than other age cohorts, with a mean age of 33.5 ± 11.5 years. The women's knowledge of CKD was found to be significantly associated with independent and dependent risk factors (p < 0.05). The major self-reported independent CKD risk factors were misuse of analgesics (NSAIDs) (OR = 1.20; p < 0.05), herbal drinks (OR = 2.30; p < 0.05), and herbal supplements (OR = 1.37; p < 0.05), while self-reported dependent CKD risk factors were hypertension (OR = 2.14; p < 0.05), family history of KD ailments (OR = 1.30; p < 0.05), and high cholesterol (OR = 1.44; p < 0.05). Similarly, majority of the women had low perceived CKD risk (54.8%), while women with CKD risk factors (independent and dependent) view themselves at decreased perceived risk for the disease compared to those who are not associated with CKD risk factors (p < 0.05). Also, findings revealed that women had poor perception of risk factors associated with CKD. The multivariate analysis of perceived risk showed that demographic factors (younger aged adults, high education, and high income), independent risk factors of CKD (misuse of NASAIDs and excessive use of herbal drink and herbal supplement), and dependent risk factors (hypertension and family history of KD ailments) were significantly associated with knowledge of CKD (p < 0.05). Conclusion Our study reveals high knowledge of CKD risk factors but low perceived risk and poor perception of the link between CKD risk factors and its ailments. Given this, there is a call for urgent measures to create sensitization and provide public CKD behavioural health interventions as well as easy communication strategies for women to secure better access to awareness intervention programmes and healthcare services.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44466361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Nakakita, K. Akiyama, Kazunori Karasawa, Yoei Miyabe, T. Moriyama, K. Uchida, K. Nitta
Background The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibodies) and early diagnosis have reduced the number of cases meeting the strict definition of crescentic glomerulonephritis (>50% of glomeruli are crescentic). Therefore, we analyzed the clinicopathological features and renal prognosis of glomerulonephritis cases that exhibited at least one crescentic lesion. Methods We retrospectively evaluated 265 adult patients diagnosed with glomerulonephritis with at least one crescent formation based on the results of renal biopsy. We divided the patients into two groups based on the four types of glomerulonephritis, namely, the immune-complex (type II: IgA nephropathy, IgA vasculitis with nephritis, and lupus nephritis) and pauci-immune (type III: microscopic polyangiitis) groups. Factors affecting renal prognosis (end-stage renal failure requiring renal replacement therapy) were examined in a multivariate analysis using the Cox proportional hazards model. Kaplan–Meier curves and log-rank test were used to analyze and compare time from entry to renal death. Results Renal prognosis differed significantly between the immune-complex and pauci-immune groups. Among the four types of glomerulonephritis, IgA nephropathy was the most prevalent. Multivariate analysis showed that renal function at renal biopsy and the ratio of global sclerosis independently predicted renal prognosis, but the type of glomerulonephritis was not a factor. Conclusions Renal dysfunction at renal biopsy and the ratio of global sclerosis predicted renal prognosis, because it reflects the degree of irreversible renal damage. We also suspect that the formation of at least one crescentic lesion led to the development of these predictive factors, regardless of the type of glomerular disease and degree of crescent formation.
{"title":"Analysis of Various Types of Glomerulonephritis with Crescents at a Single Center","authors":"T. Nakakita, K. Akiyama, Kazunori Karasawa, Yoei Miyabe, T. Moriyama, K. Uchida, K. Nitta","doi":"10.1155/2022/1749548","DOIUrl":"https://doi.org/10.1155/2022/1749548","url":null,"abstract":"Background The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibodies) and early diagnosis have reduced the number of cases meeting the strict definition of crescentic glomerulonephritis (>50% of glomeruli are crescentic). Therefore, we analyzed the clinicopathological features and renal prognosis of glomerulonephritis cases that exhibited at least one crescentic lesion. Methods We retrospectively evaluated 265 adult patients diagnosed with glomerulonephritis with at least one crescent formation based on the results of renal biopsy. We divided the patients into two groups based on the four types of glomerulonephritis, namely, the immune-complex (type II: IgA nephropathy, IgA vasculitis with nephritis, and lupus nephritis) and pauci-immune (type III: microscopic polyangiitis) groups. Factors affecting renal prognosis (end-stage renal failure requiring renal replacement therapy) were examined in a multivariate analysis using the Cox proportional hazards model. Kaplan–Meier curves and log-rank test were used to analyze and compare time from entry to renal death. Results Renal prognosis differed significantly between the immune-complex and pauci-immune groups. Among the four types of glomerulonephritis, IgA nephropathy was the most prevalent. Multivariate analysis showed that renal function at renal biopsy and the ratio of global sclerosis independently predicted renal prognosis, but the type of glomerulonephritis was not a factor. Conclusions Renal dysfunction at renal biopsy and the ratio of global sclerosis predicted renal prognosis, because it reflects the degree of irreversible renal damage. We also suspect that the formation of at least one crescentic lesion led to the development of these predictive factors, regardless of the type of glomerular disease and degree of crescent formation.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48087537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mansi Gupta, I. Rao, S. Nagaraju, S. Bhandary, Jayanti Gupta, Ganesh T. C. Babu
Methods A systematic search was conducted on PubMed, Embase, and the Google scholar for eligible studies through September 2021. The quality of selected articles was assessed using JBI checklist. Higgins and Thompson's I2 statistic was used to see the degree of heterogeneity. Based on degree of heterogeneity, fixed or random effects model was used to estimate pooled effect using inverse variance method. Results were expressed as hazard ratios and odds ratios with 95% CIs. Results After scrutinizing 18017 articles, data from ten relevant studies (seven prospective and three retrospective) was extracted. DR was significantly associated with DKD progression with a pooled HR of 2.42 (95% CI: 1.70–3.45) and a pooled OR of 2.62 (95% CI: 1.76–3.89). There was also a significant association between the severity of DR and risk of progression of DKD with a pooled OR of 2.13 (95% CI: 1.82–2.50) for nonproliferative DR and 2.56 (95% CI: 2.93–.33) for proliferative DR. Conclusion Our study suggests that presence of DR is a strong predictor of risk of kidney disease progression in DKD patients. Furthermore, the risk of DKD progression increases with DR severity. Screening for retinal vascular changes could potentially help in prognostication and risk-stratification of patients with DKD.
{"title":"Diabetic Retinopathy Is a Predictor of Progression of Diabetic Kidney Disease: A Systematic Review and Meta-Analysis","authors":"Mansi Gupta, I. Rao, S. Nagaraju, S. Bhandary, Jayanti Gupta, Ganesh T. C. Babu","doi":"10.1155/2022/3922398","DOIUrl":"https://doi.org/10.1155/2022/3922398","url":null,"abstract":"Methods A systematic search was conducted on PubMed, Embase, and the Google scholar for eligible studies through September 2021. The quality of selected articles was assessed using JBI checklist. Higgins and Thompson's I2 statistic was used to see the degree of heterogeneity. Based on degree of heterogeneity, fixed or random effects model was used to estimate pooled effect using inverse variance method. Results were expressed as hazard ratios and odds ratios with 95% CIs. Results After scrutinizing 18017 articles, data from ten relevant studies (seven prospective and three retrospective) was extracted. DR was significantly associated with DKD progression with a pooled HR of 2.42 (95% CI: 1.70–3.45) and a pooled OR of 2.62 (95% CI: 1.76–3.89). There was also a significant association between the severity of DR and risk of progression of DKD with a pooled OR of 2.13 (95% CI: 1.82–2.50) for nonproliferative DR and 2.56 (95% CI: 2.93–.33) for proliferative DR. Conclusion Our study suggests that presence of DR is a strong predictor of risk of kidney disease progression in DKD patients. Furthermore, the risk of DKD progression increases with DR severity. Screening for retinal vascular changes could potentially help in prognostication and risk-stratification of patients with DKD.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47091944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Spinowitz, S. Fishbane, M. Fukagawa, M. Ford, Nicolas Guzman, A. Rastogi
Background Evidence of longitudinal serum potassium (sK+) concentrations in hyperkalemic hemodialysis patients is sparse. Objective These post hoc analyses of the placebo arm of the phase 3b DIALIZE study (NCT03303521) explored the course of hyperkalemia in hemodialysis patients receiving placebo. Methods In DIALIZE, 196 patients receiving hemodialysis three times weekly were randomized to placebo or sodium zirconium cyclosilicate 5 g starting dose once daily on nondialysis days for 8 weeks. In these post hoc analyses of placebo patients overall (n = 86) and by predialysis sK+ subgroups at randomization <5.5 mmol/L, 5.5 to <6.0 mmol/L, 6.0 to <6.5 mmol/L, and ≥6.5 mmol/L, we assessed mean predialysis sK+ concentration by visit and the proportions of patients with mean predialysis sK+ ranges of 4.0–5.0 and 4.0–5.5 mmol/L by visit. Results In placebo patients, the mean predialysis sK+ concentration at randomization was 5.9 mmol/L, and 5.8 mmol/L at the end of the study (day 57). For placebo patients overall and across all predialysis sK+ subgroups, the mean predialysis sK+ concentration remained ≥5.0 mmol/L for all visits over 8 weeks. Overall, 7–21% and 27–62% of placebo patients had predialysis sK+ ranges of 4.0–5.0 and 4.0–5.5 mmol/L, respectively, at any visit. The proportions of placebo patients with either predialysis sK+ range were greatest for those who were least hyperkalemic (<5.5 mmol/L) and generally decreased with increasing predialysis sK+ concentration. Conclusions Patients receiving placebo and hemodialysis maintained high predialysis sK+ concentrations over 8 weeks following a hyperkalemic event. Most placebo patients remained hyperkalemic and may be at continued risk of adverse events.
{"title":"Course of Hyperkalemia in Patients on Hemodialysis","authors":"B. Spinowitz, S. Fishbane, M. Fukagawa, M. Ford, Nicolas Guzman, A. Rastogi","doi":"10.1155/2022/6304571","DOIUrl":"https://doi.org/10.1155/2022/6304571","url":null,"abstract":"Background Evidence of longitudinal serum potassium (sK+) concentrations in hyperkalemic hemodialysis patients is sparse. Objective These post hoc analyses of the placebo arm of the phase 3b DIALIZE study (NCT03303521) explored the course of hyperkalemia in hemodialysis patients receiving placebo. Methods In DIALIZE, 196 patients receiving hemodialysis three times weekly were randomized to placebo or sodium zirconium cyclosilicate 5 g starting dose once daily on nondialysis days for 8 weeks. In these post hoc analyses of placebo patients overall (n = 86) and by predialysis sK+ subgroups at randomization <5.5 mmol/L, 5.5 to <6.0 mmol/L, 6.0 to <6.5 mmol/L, and ≥6.5 mmol/L, we assessed mean predialysis sK+ concentration by visit and the proportions of patients with mean predialysis sK+ ranges of 4.0–5.0 and 4.0–5.5 mmol/L by visit. Results In placebo patients, the mean predialysis sK+ concentration at randomization was 5.9 mmol/L, and 5.8 mmol/L at the end of the study (day 57). For placebo patients overall and across all predialysis sK+ subgroups, the mean predialysis sK+ concentration remained ≥5.0 mmol/L for all visits over 8 weeks. Overall, 7–21% and 27–62% of placebo patients had predialysis sK+ ranges of 4.0–5.0 and 4.0–5.5 mmol/L, respectively, at any visit. The proportions of placebo patients with either predialysis sK+ range were greatest for those who were least hyperkalemic (<5.5 mmol/L) and generally decreased with increasing predialysis sK+ concentration. Conclusions Patients receiving placebo and hemodialysis maintained high predialysis sK+ concentrations over 8 weeks following a hyperkalemic event. Most placebo patients remained hyperkalemic and may be at continued risk of adverse events.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45860507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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