Academic literature on the topic 'Non-Dialysis Dependent Chronic kidney disease (NDD-CKD)'
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Journal articles on the topic "Non-Dialysis Dependent Chronic kidney disease (NDD-CKD)"
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Toft, Gunnar, Uffe Heide-Jørgensen, Heleen van Haalen, Glen James, Katarina Hedman, Henrik Birn, Christian F. Christiansen, and Reimar W. Thomsen. "Anemia and clinical outcomes in patients with non-dialysis dependent or dialysis dependent severe chronic kidney disease: a Danish population-based study." Journal of Nephrology 33, no. 1 (October 5, 2019): 147–56. http://dx.doi.org/10.1007/s40620-019-00652-9.
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Abstract Background Routine clinical evidence is limited on clinical outcomes associated with anemia in patients with severe chronic kidney disease (CKD). Methods We linked population-based medical databases to identify individuals with severe CKD (eGFR < 30 mL/min/1.73 m2) in Northern Denmark from 2000 to 2016, including prevalent patients as of 1 January 2009 or incident patients hereafter into the study. We classified patients as non-anemic (≥ 12/≥ 13 g/dl hemoglobin (Hgb) in women/men), anemia grade 1 (10–12/13 g/dl Hgb in women/men), 2 (8–10 g/dl Hgb), and 3+ (< 8 g/dl Hgb), allowing persons to contribute with patient profiles and risk time in consecutively more severe anemia grade cohorts. Patients were stratified by dialysis status and followed for clinical outcomes. Results We identified 16,972 CKD patients contributing with a total of 28,510 anemia patient profiles, of which 3594 had dialysis dependent (DD) and 24,916 had non-dialysis dependent (NDD) severe CKD. Overall, 14% had no anemia, 35% grade 1 anemia, 44% grade 2 anemia and 17% grade 3+ anemia. Compared to patients with no anemia, adjusted hazard ratios (HRs) for NDD patients with grade 3+ anemia were elevated for incident dialysis (1.91, 95% CI 1.61–2.26), any acute hospitalization (1.74, 95% CI 1.57–1.93), all-cause death (1.82, 95% CI 1.70–1.94), and MACE (1.14, 95% CI 1.02–1.26). Similar HRs were observed among DD patients. Conclusions Among NDD or DD patients with severe CKD, presence and severity of anemia were associated with increased risks of incident dialysis for NDD patients and with acute hospitalizations, death and MACE for all patients.
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You, Amy S., Kamyar Kalantar-Zadeh, Elani Streja, Christina Park, John J. Sim, Ekamol Tantisattamo, Jui-Ting Hsiung, et al. "Mortality Risk in Chronic Kidney Disease Patients Transitioning to Dialysis: Impact of Opiate and Non-Opiate Use." American Journal of Nephrology 51, no. 9 (2020): 715–25. http://dx.doi.org/10.1159/000509451.
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Background: Population-based studies show there is a high prevalence of chronic kidney disease (CKD) patients suffering from chronic pain. While opiates are frequently prescribed in non-dialysis-dependent CKD (NDD-CKD) patients, there may be toxic accumulation of metabolites, particularly among those progressing to end-stage renal disease (ESRD). We examined the association of opiate versus other analgesic use during the pre-ESRD period with post-ESRD mortality among NDD-CKD patients transitioning to dialysis. Methods: We examined a national cohort of US Veterans with NDD-CKD who transitioned to dialysis over 2007–14. Among patients who received ≥1 prescription(s) in the Veterans Affairs (VA) Healthcare System within 1 year of transitioning to dialysis, we examined associations of pre-ESRD analgesic status, defined as opiate, gabapentin/pregabalin, other non-opiate analgesic, versus no analgesic use, with post-ESRD mortality using multivariable Cox models. Results: Among 57,764 patients who met eligibility criteria, pre-ESRD opiate and gabapentin/pregabalin use were each associated with higher post-ESRD mortality (ref: no analgesic use), whereas non-opiate analgesic use was not associated with higher mortality in expanded case-mix analyses: HRs (95% CIs) 1.07 (1.05–1.10), 1.07 (1.01–1.13), and 1.00 (0.94–1.06), respectively. In secondary analyses, increasing frequency of opiate prescriptions exceeding 1 opiate prescription in the 1-year pre-ESRD period was associated with incrementally higher post-ESRD mortality (ref: no analgesic use). Conclusions: In NDD-CKD patients transitioning to dialysis, pre-ESRD opiate and gabapentin/pregabalin use were associated with higher post-ESRD mortality, whereas non-opiate analgesic use was not associated with death. There was a graded association between increasing frequency of pre-ESRD opiate use and incrementally higher mortality.
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Montenegro, Julia, Márcia Klein, Carla Prado, and Maria Inês Barreto Silva. "Bone Mineral Metabolism and Muscle Alterations in Non-dialysis Dependent Patients With Chronic Kidney Disease." Current Developments in Nutrition 5, Supplement_2 (June 2021): 38. http://dx.doi.org/10.1093/cdn/nzab033_038.
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Abstract Objectives Abnormal bone mineral density (BMD) is common in chronic kidney disease (CKD) and related with higher risk of disease progression, cardiovascular disease, and mortality. The aim of this study was to assess BMD, its change overtime and association with body composition and biochemical parameters of mineraly metabolism. Methods This was a longitudinal study of patients with NDD-CKD (stages 3–5) undergoing interdisciplinary treatment at an outpatient Nephrology Clinic and instructed to follow a low protein diet. Dual energy X-ray absorptiometry (DXA) was performed to estimate body composition and BMD (T-score). Mineral metabolism parameters included parathormone (PTH), calcium, phosphorus and vitamin D. Glomerular filtration rate was estimated (eGFR) by the CKD-EPI equation. Osteopenia was defined as T-score < -1.0. Baseline and follow-up comparisons between groups with and without osteopenia were performed by two-way ANOVA. Correlations were adjusted by sex, age and eGFR. Results Forty-five patients (56% males) aged 64.4 ± 9.9 y and eGFR 31.4 ± 10.9 ml/min completed a follow-up of ∼3 years (2.7 ± 1.3). As expected, a reduction in renal function was observed (median = −1.10 ml/min; 95% CI: −8.8 to 0.64, P < 0.05). BMD and appendicular skeletal muscle (ASM) decreased: 1.06 ± 0.15 vs. 1.05 ± 0.03g/cm2 (P = 0.03) and 20.3 ± 4.6 vs. 18.9 ± 0.8kg (P = 0.01), respectively. Prevalence of osteopenia was 42.2% with no significant change overtime. Patients with osteopenia presented with higher (P < 0.0001) change in ASM (median: −1.58kg; 95% CI: −3.8 to 0.66 vs. −0.83; −4.0 to 2.4) and in LST (−1.08 kg; −5.0 to 2.8 vs. 0.88; −4.6 to 6.3), compared with patients without osteopenia. Changes in eGFR and mineral metabolism parameters were similar between groups. T-score change was negatively correlated with change in LST (r = 0.66; P = 0.04) and PTH (r = −0.70; P = 0,03), and with baseline LST (r = −0.35; P = 0.04) independent of age, sex and eGFR. Body fat increased (22.7 kg ± 8.1 vs. 23.8 kg ± 8.7; P = 0.04) during follow up, but it was not significantly correlated with T-score. Conclusions Prevalence of osteopenia was high in patients with NDD-CKD, and BMD decreased after 3 years, which was associated with a reduction in LST and increase in PTH, independent of eGFR, age, and sex. LST should be monitored in NDD-CKD to prevent risk for abnormal BMD. Funding Sources FAPERJ
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Wittbrodt, Eric T., Glen James, Supriya Kumar, Heleen van Haalen, Hungta Chen, James A. Sloand, and Kamyar Kalantar-Zadeh. "Contemporary outcomes of anemia in US patients with chronic kidney disease." Clinical Kidney Journal 15, no. 2 (October 6, 2021): 244–52. http://dx.doi.org/10.1093/ckj/sfab195.
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ABSTRACT Background Long-term clinical outcome data from patients with non-dialysis-dependent (NDD) chronic kidney disease (CKD) are lacking. We characterized patients with NDD-CKD and anemia using real-world data from the USA. Methods This retrospective longitudinal observational study evaluated integrated Limited Claims and Electronic Health Record Data (IBM Health, Armonk, NY), including patients ≥18 years with two or more estimated glomerular filtration rate (eGFR) measures <60 mL/min/1.73 m2 ≥90 days apart. Anemia was defined as the first observed hemoglobin <10 g/dL within 6-month pre- and post-CKD index date. Data were analyzed from January 2012 to June 2018. Patients with documented iron-deficiency anemia at baseline were excluded. Results Comprising 22 720 patients (57.4% female, 63.9% CKD stage 3, median hemoglobin 12.5 g/dL), median (interquartile range) follow-up for patients with and without anemia were 2.9 (1.5–4.4) and 3.8 (2.2–4.8) years, respectively. The most prevalent comorbidities were dyslipidemia (57.6%), type 2 diabetes mellitus (38.8%) and uncontrolled hypertension (20.0%). Overall, 23.3% of patients had anemia, of whom 1.9% and <0.1% received erythropoiesis-stimulating agents (ESAs) or intravenous iron, respectively. Anemia prevalence increased with CKD stage from 18.2% (stage 3a) to 72.8% (stage 5). Patients with anemia had a higher incidence rate of hospitalizations for heart failure (1.6 versus 0.8 per 100 patient-years), CKD stage advancement (43.5 versus 27.5 per 100 patient-years), and a 40% eGFR decrease (18.1 versus 7.3 per 100 patient-years) versus those without anemia. Conclusions Anemia, frequently observed in NDD-CKD and associated with adverse clinical outcomes, is rarely treated with ESAs and intravenous iron. These data suggest that opportunities exist for improved anemia management in patients with NDD-CKD.
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Sumida, Keiichi, Charles Dyer Diskin, Miklos Z. Molnar, Praveen K. Potukuchi, Fridtjof Thomas, Jun Ling Lu, Connie M. Rhee, et al. "Pre-End-Stage Renal Disease Hemoglobin Variability Predicts Post-End-Stage Renal Disease Mortality in Patients Transitioning to Dialysis." American Journal of Nephrology 46, no. 5 (2017): 397–407. http://dx.doi.org/10.1159/000484356.
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Background: Hemoglobin variability (Hb-var) has been associated with increased mortality both in non-dialysis dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD) patients. However, the impact of Hb-var in advanced NDD-CKD on outcomes after dialysis initiation remains unknown. Methods: Among 11,872 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 through September 2011, we assessed Hb-var calculated from the residual SD of at least 3 Hb values during the last 6 months before dialysis initiation (prelude period) using within-subject linear regression models, and stratified into quartiles. Outcomes included post-transition all-cause, cardiovascular, and infection-related mortality, assessed in Cox proportional hazards models and adjusted for demographics, comorbidities, length of hospitalization, medications, estimated glomerular filtration rate (eGFR), type of vascular access, Hb parameters (baseline Hb [i.e., intercept] and change in Hb [i.e., slope]), and number of Hb measurements. Results: Higher prelude Hb-var was associated with use of iron and antiplatelet agents, tunneled dialysis catheter use, higher levels of baseline Hb, change in Hb, eGFR, and serum ferritin. After multivariable adjustment, higher prelude Hb-var was associated with higher post-ESRD all-cause and infection-related mortality, but not cardiovascular mortality (adjusted hazard ratios [95% CI] for the highest [vs. lowest] quartile of Hb-var, 1.10 [1.02–1.19], 1.28 [0.93–1.75], and 0.93 [0.79–1.10], respectively). Conclusions: High pre-ESRD Hb-var is associated with higher mortality, particularly from infectious causes rather than cardiovascular causes. Further research is required to clarify the underlying mechanisms and true causal nature of the observed association.
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Tomás-Simó, Patricia, Luis D’Marco, María Romero-Parra, Mari Carmen Tormos-Muñoz, Guillermo Sáez, Isidro Torregrosa, Nuria Estañ-Capell, Alfonso Miguel, José Luis Gorriz, and María Jesús Puchades. "Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients." International Journal of Environmental Research and Public Health 18, no. 15 (July 23, 2021): 7806. http://dx.doi.org/10.3390/ijerph18157806.
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Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease in dialysis patients. Methods: We evaluated the oxidation process in different molecular lines (proteins, lipids and genetic material) in 155 non-dialysis patients at different stages of CKD and 45 healthy controls. To assess oxidative stress status, we analyzed oxidized glutathione (GSSG), reduced glutathione (GSH) and the oxidized/reduced glutathione ratio (GSSG/GSH) and other oxidation indicators, including malondialdehyde (MDA) and 8-oxo-2’-deoxyguanosine (8-oxo-dG). Results: An active grade of oxidative stress was found from the early stages of CKD onwards, which affected all of the molecular lines studied. We observed a heightened oxidative state (indicated by a higher level of oxidized molecules together with decreased levels of antioxidant molecules) as kidney function declined. Furthermore, oxidative stress-related alterations were significantly greater in CKD patients than in the control group. Conclusions: CKD patients exhibit significantly higher oxidative stress than healthy individuals, and these alterations intensify as eGFR declines, showing significant differences between CKD stages. Thus, future research is warranted to provide clearer results in this area.
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Vida, Carmen, Carlos Oliva, Claudia Yuste, Noemí Ceprián, Paula Jara Caro, Gemma Valera, Ignacio González de Pablos, Enrique Morales, and Julia Carracedo. "Oxidative Stress in Patients with Advanced CKD and Renal Replacement Therapy: The Key Role of Peripheral Blood Leukocytes." Antioxidants 10, no. 7 (July 20, 2021): 1155. http://dx.doi.org/10.3390/antiox10071155.
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Oxidative stress plays a key role in the pathophysiology of chronic kidney disease (CKD). Most studies have investigated peripheral redox state focus on plasma, but not in different immune cells. Our study analyzed several redox state markers in plasma and isolated peripheral polymorphonuclear (PMNs) and mononuclear (MNs) leukocytes from advanced-CKD patients, also evaluating differences of hemodialysis (HD) and peritoneal dialysis (PD) procedures. Antioxidant (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH)) and oxidant parameters (xanthine oxidase (XO), oxidized glutathione (GSSG), malondialdehyde (MDA)) were assessed in plasma, PMNs and MNs from non-dialysis-dependent-CKD (NDD-CKD), HD and PD patients and healthy controls. Increased oxidative stress and damage were observed in plasma, PMNs and MNs from NDD-CKD, HD and PD patients (increased XO, GSSG and MDA; decreased SOD, CAT, GPX and GSH; altered GSSG/GSH balance). Several oxidative alterations were more exacerbated in PMNs, whereas others were only observed in MNs. Dialysis procedures had a positive effect on preserving the GSSG/GSH balance in PMNs. Interestingly, PD patients showed greater oxidative stress than HD patients, especially in MNs. The assessment of redox state parameters in PMNs and MNs could have potential use as biomarkers of the CKD progression.
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Islam, Md Tanvir, and Nurun Nahar Mukta. "Comparative study on nutritional status, food intake pattern and lifestyle between dialyzed and non-dialyzed kidney patients in Dhaka, Khulna and Rajshahi divisions of Bangladesh." Asian-Australasian Journal of Food Safety and Security 1, no. 1 (November 21, 2017): 25–34. http://dx.doi.org/10.3329/aajfss.v1i1.55758.
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Chronic kidney disease (CKD) is a worldwide public health problem. As per nephrologists' estimation, the CKD population grows at approximately 5% annually and in 2022, over 29 million people will be afflicted with CKD in Bangladesh. The objective of this study was to compare nutritional status, food intake pattern, and lifestyle between dialyzed and non-dialyzed kidney patients in Bangladesh. It was a cross-sectional comparative study of patients aged 18 to 85 year old to compare nutritional status, food intake pattern, and lifestyle between dialyzed and non-dialyzed kidney patients. Sample was conducted in three divisions Dhaka, Khulna and Rajshahi in Bangladesh. Data on food intake pattern, height, weight, GFR, other diseases along with kidney disease, physical activity, smoking and socioeconomic status etc. were collected from fifteen clinical centers and sometimes from household via in-person interviews. A total of 244 patients aged were selected among them 152 people were dialyzed patients and 92 people were Non-dialyzed patients. We found a relationship among dietary food habit, lifestyle factors and health outcomes such as chronic kidney disease progression, heart disease and death. Patients had a mean monthly family income of 23683.46, a mean monthly expenditure on food of 3815.2 and a mean monthly expenditure on treatment of 13317.69. According to our findings, highest dialysis patients were sedentary than non-dialysis patients were active at their active life (20-40 Years). From this study it was investigated that, 41.0% patients have not changed their addiction habit after diagnosis, where 20.1% dialysis patients and 20.9% non-dialysis patients have not changed their addiction habit totally. Another significant finding of this study was that dialysis patients had poor consumption from 16 groups. It can be highlighted that, the prevalence of the diseases were higher in urban people than rural people. This study suggests that additional research is needed to investigate the optimal dietary recommendations and body mass index levels to prevent disease progression and poor outcomes among individuals with CKD. The prevalence of HD-CKD and NDD-CKD can be said to be SES dependent. Chronic kidney disease and its complications, which involve most organ systems, can be prevented, but awareness and use of accurate methods are needed to enable timely diagnosis.
Asian Australas. J. Food Saf. Secur. 2017, 1 (1), 25-34
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Abdelazeem, Basel, Joseph Shehata, Kirellos Said Abbas, Nahla Ahmed El-Shahat, Bilal Malik, Pramod Savarapu, Mostafa Eltobgy, and Arvind Kunadi. "The efficacy and safety of roxadustat for the treatment of anemia in non-dialysis dependent chronic kidney disease patients: An updated systematic review and meta-analysis of randomized clinical trials." PLOS ONE 17, no. 4 (April 1, 2022): e0266243. http://dx.doi.org/10.1371/journal.pone.0266243.
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Background Roxadustat (ROX) is a new medication for anemia as a complication of chronic kidney disease (CKD). Our meta-analysis aims to evaluate the efficacy and safety of ROX, especially on the cardiovascular risks, for anemia in NDD-CKD patients. Methods Electronic databases were searched systematically from inception to July 2021 to look for randomized control trials (RCTs) that evaluated ROX NDD-CKD patients. Hemoglobin level and iron utilization parameters, including ferritin, serum iron, transferrin saturation (TSAT), total iron-binding capacity (TIBC), transferrin, and hepcidin were analyzed for efficacy. Pooled risk ratios (RRs) and standardized mean differences (SMDs) were calculated and presented with their 95% confidential intervals (CIs). Results Nine RCTs included a total of 3,175 patients in the ROX group and 2,446 patients in the control group. When compared the control group, ROX increased Hb level significantly (SMD: 1.65; 95% CI: 1.08, 2.22; P< 0.00001) and improved iron utilization parameters by decreasing ferritin (SMD: -0.32; 95% CI: -0.51, -0.14; P = 0.0006), TSAT (SMD: -0.19; 95% CI: -0.32, -0.07; P = 0.003), and hepcidin (SMD: -0.74; 95% CI: -1.09, -0.39; P< 0.0001) and increasing TIBC (SMD: 0.99; 95% CI: 0.76, 1.22; P< 0.00001) and transferrin (SMD: 1.20; 95% CI: 0.70, 1.71; P< 0.00001). As for safety, ROX was associated with higher serious adverse effects (RR: 1.07; 95% CI: 1.01, 1.13; P = 0.01), deep venous thrombosis (DVT) (RR: 3.80; 95% CI: 1.5, 9.64; P = 0.08), and hypertension (HTN) (RR: 1.37; 95% CI: 1.13, 1.65; P = 0.001). Conclusion We concluded that ROX increased Hb level and improved iron utilization parameters in NDD-CKD patients, but ROX was associated with higher serious adverse effects, especially DVT and HTN. Our results support the use of ROX for NDD-CKD patients with anemia. However, higher-quality RCTs are still needed to ensure its safety and risk of thrombosis.
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Karangizi, A. H. K., D. Chanouzas, A. Fenton, P. Moss, P. Cockwell, C. J. Ferro, and L. Harper. "Cytomegalovirus seropositivity is independently associated with cardiovascular disease in non-dialysis dependent chronic kidney disease." QJM: An International Journal of Medicine 113, no. 4 (October 15, 2019): 253–57. http://dx.doi.org/10.1093/qjmed/hcz258.
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Abstract Background Cardiovascular disease (CVD) is the leading cause of early death in patients with chronic kidney disease (CKD). Previous work has described an association between Cytomegalovirus (CMV) seropositivity and CVD amongst patients with dialysis dependent end stage renal disease. Whether CMV seropositivity is associated with CVD in non-dialysis dependent CKD has not been established. Aim Investigate whether past CMV infection is associated with prevalent CVD in patients with non-dialysis dependent CKD. Design A retrospective observational study using the Renal Impairment in Secondary Care cohort, a study evaluating bio-clinical determinants of outcomes in patients with progressive CKD. Methods We assayed cryopreserved serum samples collected at inception for anti-CMV IgG antibodies from 764 patients with stages 2 to 5 CKD (pre-dialysis) and investigated its relationship with prevalent CVD. Results Median estimated glomerular filtration was 24 ml/min/1.73 m2 (IQR 19–32). Sixty-eight percent of patients were CMV seropositive. CMV seropositivity was associated with older age, non-Caucasian ethnicity, diabetes and higher social deprivation index score. On univariable analysis, CMV seropositivity correlated with higher systolic blood pressure (P = 0.044), prevalent CVD (P < 0.001), ischaemic heart disease (P < 0.001) and cerebrovascular disease (P = 0.022). On multivariable analysis, CMV seropositive patients nearly twice as likely to have CVD compared to seronegative patients [Odds Ratio (OR) = 1.998, CI 1.231–3.242, P = 0.005]. Conclusions In patients with non-dialysis CKD, CMV seropositivity is independently associated with a higher prevalence of CVD.
Dissertations / Theses on the topic "Non-Dialysis Dependent Chronic kidney disease (NDD-CKD)"
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Geneen, Louise. "Resistance (exercise) training in non-dialysis dependent chronic kidney disease (CKD stage 3) and validation of ultrasound in the measurement of muscle size and structure in haemodialysis patients (CKD stage 5)." Thesis, Queen Margaret University, 2014. https://eresearch.qmu.ac.uk/handle/20.500.12289/7416.
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Aim: This thesis set out to make an original contribution to knowledge with regard to methods of assessing muscle size and architecture in the CKD and ESRD population, and to assess the ability to improve the muscle size and architecture, and symptoms of uraemia, by implementing an anabolic intervention (resistance exercise training) in the CKD population. Outcome measures: Ultrasound was shown to have high validity (against gold standard MRI measures; ICCs: VLACSA 0.96, VL depth 0.99, fat depth 0.98) and intra-rater reliability (ICCs: VL depth 0.98, total muscle depth 0.97, fat depth 0.99; MDC: VL depth 0.14cm, total muscle depth 0.19cm, fat depth 0.22cm) in measuring regional body composition at the mid-VL site in the CKD population. There were significant (p<0.01) correlations between US-derived measures of (mid-VL) muscle size and architecture with strength and function (larger muscle mass and/or pennation angle positively correlated with higher strength and/or functional performance). Patient-reported uraemic symptoms were worse (p<0.01) in those with reduced strength and/or function. Intervention results: An anabolic (resistance training) intervention (12-weeks, randomized to once [RT1 n=7] or three times [RT3 n=10] per week, 80%1RM) brought about significant improvements over time (p<0.01) in all measures of muscle size and architecture (VL depth, total muscle depth, VLACSA, pennation angle). Interaction effects (group*time) were only seen in pennation angle (p<0.05) and VLACSA (p<0.01) where RT3 gains were greater than RT1 from week 8 onwards. All measures of strength, function, and uraemic symptoms improved over time (p<0.01) with no interaction effects (no difference from greater training frequency/ volume). Clinical and research implications: The intervention results suggest implementing a RT form of “prehabilitation” in early stage (CKD3) patients just once per week is sufficient to bring about statistically and clinically important changes in strength and function that benefit the patient through reduced frequency and/or intrusiveness of uraemic symptoms (improved health-related quality of life), with minimal time-commitment. Further research should examine if there is additional benefit to the significantly greater increases in VLACSA and pennation angle observed in RT3, with regards to long-term maintenance of functional improvements, and whether an RT1 or RT3 programme delays the progression of CKD, the need for RRT, and patient mortality.
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Simba, Kudakwashe. "The impact of vascular calcification among dialysis dependent South African CKD patients. A five year follow up study. Cardiovascular mortality and morbidity, ethnic variation and hemodynamic correlates." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31257.
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BACKGROUND
Vascular calcification is a major risk factor for cardiovascular morbidity and mortality in patients with end stage renal disease (ESRD). In Western countries, Blacks with ESRD appear to have lesser degrees of vascular calcification compared to non-Blacks. However, there is no published data on the association of ethnic differences in vascular calcification and survival in ESRD from Sub-Saharan Africa.
METHODS
This study assessed the 5-year change in vascular calcification and mortality in a previously published cohort of patients with ESRD. Vascular calcification was assessed by abdominal aortic calcification score (lateral abdominal radiograph) and vascular stiffness by pulse wave velocity.
RESULTS
Sixty-six of the original 74 participants, studied a baseline, were identified. The median age was 46.6 years (37.6-59.2) and 57.6% were women. Abdominal aortic calcification showed no progression among Blacks [baseline range 0-5, follow up range 0-8 (p=1.00)], but a nonsignificant trend to progression among non-Blacks [baseline range 0-19, follow up range 0-22 (p=0.066)]. Black participants did not display a survival advantage (p=0.870). Overall, sepsis was the most common cause of mortality (64% of those with an identifiable cause of death). Non-Blacks had higher parathyroidectomy rates than Blacks with 9/30 cases compared to 2/36 (p=0.036). After adjustment for parathyroidectomy at follow up, the odds ratio of having abdominal vascular calcification score of ≥1 amongst non-Blacks was 8.6-fold greater compared to Blacks (p= 0.03). Central aortic systolic pressures (CASP) and pulse wave velocities (PWV) were higher in the study population than age matched normative values. At follow up, a positive correlation (r=0.3) was observed between PWV and abdominal aortic calcification (p=0.04). Elevated baseline coronary artery calcification score and FGF-23 level at baseline were not associated with a difference in mortality.
CONCLUSION
There was no significant progression in vascular calcification among Blacks. After adjusting for increased parathyroidectomy rates, there was a greater progression of vascular calcification amongst non-Blacks compared to Blacks highlighting possible ethnic differences in calcium phosphate metabolism in patients with ESRD. The lack of vascular calcification progression in Blacks was not however associated with improved survival, but the sample size was small.
Books on the topic "Non-Dialysis Dependent Chronic kidney disease (NDD-CKD)"
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Andreucci, Michele, Jose Luis Gorriz, Carlo Garofalo, and Michele Provenzano, eds. Management of Patients With Non-Dialysis Dependent Chronic Kidney Disease (ND-CKD). Frontiers Media SA, 2022. http://dx.doi.org/10.3389/978-2-88974-577-7.
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Bramham, Kate, and Catherine Nelson-Piercy. Pregnancy in patients with chronic kidney disease and on dialysis. Edited by Norbert Lameire and Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0295_update_001.
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Chronic kidney disease (CKD) affects a small but increasing minority of women becoming pregnant. It is associated with additional risks depending on pre-pregnancy glomerular filtration rate, proteinuria, and hypertension. Some drugs are contraindicated in pregnancy. These are powerful reasons for counselling all women of childbearing age about pregnancy in CKD. With minor CKD the main issue is moderately increased risk of pregnancy-associated hypertension and pre-eclampsia. More advanced CKD is associated with reduced fertility, progressively increased risk of pre-term delivery and a significant chance of permanent loss of maternal renal function. Distinguishing pre-eclampsia from the natural effects of pregnancy on manifestations of CKD can be challenging. Blood pressure targets may be modified during pregnancy and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are contraindicated. Dialysis may be initiated if pregnancy occurs at advanced levels of CKD. Pregnancy may also occur in patients on dialysis, usually in women with some residual native renal function. More intensive dialysis may improve outcomes.
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Beaulieu, Monica, Catherine Weber, Nadia Zalunardo, and Adeera Levin. Chronic kidney disease long-term outcomes. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0097.
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Chronic kidney disease (CKD) is associated with a variety of outcomes, some of which are directly and indirectly related to kidney disease, but which ultimately impact on patients’ quality of life and long-term outcomes. The events to which people with CKD are exposed ultimately determine their risk and prognosis of both progression to needing renal replacement therapy, or other morbidities and mortalities. The notion of competing risk is important. The five major outcomes of CKD are: progression of CKD, progression to ESRD (either dialysis or transplantation); death; cardiovascular events; infections; and hospitalizations. Where data is available, not only the risk of the specific outcome, but the factors which may predict those outcomes are described. Each section describes what is currently known about the frequency of the outcome, the limitations of that knowledge, the risk factors associated with outcome, and implications for care and future research. Available published literature often describes outcomes in CKD populations as if it is a homogenous group of patients. But it is well documented that outcomes in those with CKD differ depending on stage or severity, and whether they are or are not known to specialists. Where possible, each section ensures that the specific CKD cohort(s) from which the information is derived is clearly described.
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Jardine, Alan G., and Rajan K. Patel. Lipid disorders of patients with chronic kidney disease. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0102.
Full textAbstract:
The risk of developing cardiovascular (CV) disease is increased in patients with chronic kidney disease (CKD) and although dyslipidaemia is a major contributory factor to the development of premature CV disease, the relationship is complex. Changes in lipid fractions are related to glomerular filtration rate and the presence and severity of proteinuria, diabetes, and other confounding factors. The spectrum of CV disease changes from lipid-dependent, atheromatous coronary disease in early CKD to lipid-independent, non-coronary disease, manifesting as heart failure, and sudden cardiac death in advanced and end-stage renal disease. Statin-based lipid-lowering therapy is proven to reduce coronary events across the spectrum of CKD. The relative reduction in overall CV events, however, diminishes as CKD progresses and the proportion of lipid-dependent coronary events declines. There is nevertheless a strong argument for the use of statin-based therapy across the spectrum of CKD. The argument is particularly strong for those patients with progressive renal disease who will eventually require transplantation, in whom preventive therapy should start as early as possible. The SHARP study established the benefits and endorses the use of lipid-lowering therapy in CKD 3-4 but uncertainty about the value of initiation of statin therapy in CKD 5 remains. There is, however, no rationale for stopping agents started earlier in the course of the illness for compelling indications, particularly in those who will ultimately be transplanted. The place of high-density lipoprotein-cholesterol raising and triglyceride lowering therapy needs to be assessed in trials. Modifying dyslipidaemia in CKD has demonstrated that lipid-dependent atheromatous cardiovascular disease is only one component of the burden of CV disease in CKD patients, that this is proportionately less in advanced CKD, and that modification of lipid profiles is only one part of CV risk management.
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Freda, Benjamin J., and Gregory L. Braden. Other toxic acute tubulointerstitial nephritis. Edited by Adrian Covic. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0085.
Full textAbstract:
Chronic kidney disease (CKD) is often the result of incomplete recovery of renal function from a variety of causes of acute tubulointerstitial injury. Exposure to ethylene glycol, chlorinated hydrocarbons, paraquat, or toxic mushrooms often causes severe acute kidney injury (AKI), leading to chronic tubulointerstitial nephritis (TIN) and CKD, including end-stage renal disease. Ethylene glycol intoxication often leads to chronic TIN and CKD from direct renal tubular toxicity and from interstitial calcium oxalate deposition. Chlorinated hydrocarbon exposure can cause dialysis-dependent AKI, but only rarely causes CKD from interstitial calcium deposition. Paraquat intoxication causes dose-dependent AKI and often Fanconi syndrome in up to 50% of patients, but only 15% of these patients survive, so CKD is rarely seen as a complication. The toxic mushrooms Cortinarius and Amanita phalloides often cause delayed AKI leading to CKD, chronic dialysis, or renal transplantation.
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Rees, Lesley. Growth and development. Edited by Norbert Lameire and Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0291.
Full textAbstract:
Enabling achievement of full height potential in a child with chronic kidney disease (CKD) is one of the major and most challenging goals for the paediatric nephrologist. Short stature is associated with psychological maladjustment and with increased morbidity and mortality. The causes of poor growth are multifactorial and include poor nutrition, and metabolic, haematological, and endocrine disturbances. The most vulnerable times are the periods of most rapid growth, that is, infancy and puberty. Growth during infancy is principally dependent on nutrition so many infants need supplemental enteral feeding. Growth delay correlates with severity of CKD, with those on dialysis faring the worst such that by CKD stage 5, approximately 25% of patients are below the normal range for height. Height achieved post transplant is dependent on graft function and is better in younger children and those who have the best height attainment pre transplant. The use of steroid-free immunosuppressive regimens is encouraging. The prognosis for final height is improving.
Book chapters on the topic "Non-Dialysis Dependent Chronic kidney disease (NDD-CKD)"
1
Icard, Phil, and Stephen R. Hooper. "Cognitive and Behavioral Challenges of Chronic Kidney Disease." In Cognitive and Behavioral Abnormalities of Pediatric Diseases. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195342680.003.0061.
Full textAbstract:
Chronic kidney disease (CKD) affects children and adults of all ages. The term encompasses patients with kidney function below approximately 75% of normal and extends down to include those with dialysis or kidney transplant–dependent kidney failure. With progressively less kidney function, the body begins to accumulate waste products that the kidney fails to clear and is at risk for an ever-increasing number and variety of complications related to kidney failure. Over the past two decades, the neurodevelopmental effects of CKD have been studied in numerous modestly sized studies (Gipson et al. 2004). Further, progress in the medical management of children with CKD over the past decades has resulted in increased patient survival (USRDS 2003). Despite these important advances in the care of children with CKD, recent investigations have continued to reflect a variety of cognitive and social-behavioral concerns associated with CKD. This chapter provides an overview of the work conducted to date addressing the cognitive and behavioral functioning of children and adolescents with CKD. This overview will include an initial discussion of neurological findings, including structure imaging and electrophysiological studies. Additionally, the neurocognitive and social-behavioral findings in CKD are described. Finally, we provide data addressing the developmental continuity of these types of challenges in adult survivors of childhood-onset CKD. The relationship between CKD and central nervous system (CNS) dysfunction has a longstanding history in the literature (Gipson et al. 2004). Early studies showing high rates of developmental delay and encephalopathy in pediatric CKD patients called attention to the significant neurological impairments caused by kidney disease (Polinsky, Kaiser, and Stover 1987). Chronic kidney disease impacts the nervous system in many ways, perhaps most significantly by not effectively filtering neurotoxic chemicals and metabolites from the bloodstream. Over time, the circulation of harmful biochemicals through the brain and its periphery has the potential to significantly impact the structure and organization of the nervous system. Even early treatments for CKD (e.g., aluminum phosphate binders) were found to have an averse affect on the developing brain, and have subsequently been eliminated from contemporary treatment protocols.
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Costa, Dilar, and Filipa Aguiar. "Self-Management of Blood Pressure Control at Home in Chronic Kidney Disease: Nursing Interventions and Health Gains." In Outpatient Care [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96416.
Full textAbstract:
One of the advantages of HBPM (Home Blood Pressure Measurement) compared to office measurement is being a strong predictor of cardiovascular morbidity and mortality in hypertensive patients, including those with chronic kidney disease (CKD). However, studies with renal patients not dependent on dialysis are scarce. HBPM is an important tool in the regular monitoring of blood pressure (BP) and in patient’s involvement in its long-term self-management. Nurses have an important role here and their involvement in the process is essential. Nurses must be aware of the latest recommendations as well as they should teach, train, guide and supervise patients. This chapter summarizes information about CKD and hypertension, the importance of measuring blood pressure at home in CKD and describes nursing interventions in this field. Nurses have a role in enabling patients to optimize their self-management skills. Nurse-delivered interventions have been shown to contribute to improved patient outcomes. Nurses can educate patients about proper blood pressure monitoring techniques at home, and also interpreting and evaluating the results and managing the therapeutic regimen. Evidence shows the effects of interventions performed by nurses in improving and controlling BP, such as teaching, training, counseling, motivational interview, coaching, nurse–patient relationship, communication, negotiation, and support.