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Search Results: 1 - 10 of 25128 matches for " Kidney Disease "
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Antihypertensive Therapy in Non-Diabetic Chronic Kidney Disease Associated with Proteinuria in Adults  [PDF]
Khawar Maqsood, Adeel Siddiqui, Geoffrey Teehan
Open Journal of Nephrology (OJNeph) , 2013, DOI: 10.4236/ojneph.2013.33024

Controlling blood pressure and reducing proteinuria are common goals in Chronic Kidney Disease associated with hypertension and proteinuria and lead to fewer cardiovascular outcomes. This review summarizes the available literature.

Pathogenesis and Prevention of Progression of Chronic Kidney Disease  [PDF]
Anil K. Mandal
Open Journal of Internal Medicine (OJIM) , 2015, DOI: 10.4236/ojim.2015.53010
Abstract: This treatise of chronic kidney disease (CKD) describes association of hypertension, diabetes and congestive heart failure (CHF) with CKD. CKD is defined by estimated glomerular filtration rate (eGFR) of less than 60 ml/min for three months or more. CKD is generally irreversible but not necessarily progressive. Thus progression of CKD into end stage renal disease (ESRD) is the concern here and what can be done to reduce the progression of CKD. Exact data of CKD with progression are unavailable but high incidence of ESRD (dialysis) eleven times more in 2011 than in 1980 accordingly to United States (US) Renal Data System is a testimonial to progression of CKD in patients with diabetes, hypertension, CHF and other renal diseases. US Renal Data System reveals that ESRD has soared in parallel with marketing of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) drugs, providing strong indirect evidence that these drugs are someway instrumental in the progression of CKD into ESRD. These drugs produce acute renal failure which is an independent risk factor for CKD. Thus shift in therapy with enthusiastic use of ACEI/ARB drugs has led to dialysis bonanza throughout the world benefiting the professionals and corporations at the expense of vegetative life of the patients associated with family and societal burdens. The ways to turn the pendulum is to treat diabetes with insulin and hypertension with beta blocker, calcium channel blocker and diuretic therapy, and avoid the use of ACEI/ARB drugs. It is important to understand that diuretic orally, by intravenous boluses or by continuous infusion, is the cornerstone of therapy for CHF, whereas ACEI/ARB drugs markedly impair the efficacy of diuretics by lowering the blood pressure to a very low level thereby reducing renal perfusion. An evidence for that is marked elevation of BUN with comparatively slight increase of serum creatinine. Thus with the approaches stated above, CKD is less likely to progress; hence rate of ESRD is likely to decrease.
The Role of Zinc in Chronic Kidney Disease Patients on Hemodialysis: A Systematic Review  [PDF]
L. C. Neto, M. R. Bacci, L. C. Sverzutt, M. G. Costa, B. C. A. Alves, F. L. Fonseca
Health (Health) , 2016, DOI: 10.4236/health.2016.84036
Abstract: Objective: Zinc has been studied for its antioxidant and anti-inflammatory properties and also for its immune function in end stage renal disease patients. The aim of this review is to clarify whether there is a relationship between zinc levels and ESRD patients in hemodialysis. Methodology: A search through LILACS and MEDLINE database using the keywords “zinc”, “chronic kidney disease” and “hemodialysis” was performed. Articles in English and Portuguese performed in humans with the previous words were selected. Studies with subjects younger than 18 years of age were excluded. Moreover, exclusion criteria included patients with absence of diagnosis of end stage renal disease and not in hemodialysis; patients treated with peritoneal dialysis, absence of abstract available, absence of clear association between zinc deficiency and worse prognosis. Results: The search found a total of 214 articles. A total of 44 publications were selected after appliance of exclusion criteria. Conclusion: Zinc deficiency is highly prevalent, and it not only showed influence on inflammatory and immunological processes, but also interfered with metabolism and other systems. Zinc supplementation was considered positive. In summary, lower zinc levels are related to end stage renal disease patients in hemodialysis and supplementation seems to be a promising approach in such cases.
Renal Disease among HIV Positive Patients in Senegal  [PDF]
Khodia Fall, Mouhamadou Moustapha Cissé, Ahmed Tall Lemrabott, Maria Faye, Mouhamed Cherif Dial, Atoumane Faye, Seynabou Fall, Moustapha Faye, Alex Keita, Mansour Mbengue, Seynabou Diagne, Niakhaleen Keita, Bacary Ba, Abdou Niang, Boucar Diouf, El Hadji Fary Ka
Open Journal of Nephrology (OJNeph) , 2017, DOI: 10.4236/ojneph.2017.74012
Abstract: Introduction: Renal disease (RD) in human immunodeficiency virus (HIV) infection is a decisive turning point in the development and prognosis of this disease. In Africa, the prevalence varies between 2.5% and 48.6%. In Senegal, little data are available in the literature. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and progressional aspects in patients living with HIV (PLWHIV). Patients and methods: This was a retrospective, descriptive and analytical study carried out over a 10-year period in the Department of Internal Medicine and Nephrology at the Aristide Le Dantec Hospital in Dakar, Senegal. We included all 15-year old and above PLHIV with available CD4 count and viral load. Results: Out of 248 PLHIV, 32 had kidney disease (KD), which means a hospital prevalence of 12.9%. The mean age was 51.22 ± 10 years (extremes of 36 and 77 years) with a sex ratio (male/female) of 1.28. Renal signs were dominated by glomerular nephropathy syndrome. It was present at 80%. Tubulo-interstitial nephropathy syndrome and chronic uremic syndrome accounted for 6.25% and 3.1% of cases, respectively. Renal function Impairment was present in 21 patients with 18 cases of acute kidney injury (85.7%) and 3 cases of chronic renal failure (14.3%), including 2 in stage 5 of chronic kidney disease. Renal biopsy (RB) was indicated and performed in 20 (62.5%) patients with glomerular signs in 12 patients (60%). Glomerular lesions were dominated by focal and segmental glomerulosclerosis (FSGS) in 6 cases, membraneous nephropathy (MN) in 4 cases and minimal change disease (MCD) in 2 cases. Tubulo-interstitial and vascular lesions were present in 45% and 12.5% of cases, respectively. In highly active antiretroviral therapy (HAART), 12 (37.5%) patients had total remission, 9 (28.12%) had partial remission. One (3.12%) death from severe metabolic acidosis on chronic renal failure was deplored. Conclusion: This study illustrates the high prevalence of RD in PLHIV in our exercise context.
Epidemiological, Clinical and Evolutive Profile of Autosomal Dominant Polycystic Kidney Disease (ADPKD) in Togo  [PDF]
Tsevi Yawovi Mawufemo, Amekoudi Eyram Yoan, Djagadou Kodjo Agbeko, Sabi Kossi Akomola, Nemi Komi Dzidzonu, Kodjo Kossi, Tona Komlan Georges, Dolaama Badomta, Attisso Eugene, Hadabia D’daah, Djibril Mohaman Awalou
Open Journal of Nephrology (OJNeph) , 2018, DOI: 10.4236/ojneph.2018.84013
Abstract: Objective: To describe the epidemiological, clinical and evolutionary profile of ADPKD in Togo. Methods: A retrospective descriptive transversal study over a period of 8 years (2011-2018) which focused on the analysis of patients’ records diagnosed with ADPKD. The diagnosis of ADPKD was retained on the basis of the ultrasound criteria of PEI. Results: During the study period, 27 patients had polycystic kidney disease with a prevalence of 0.87%. The average age was 51.6 ± 16.4 years. There were 10 men (37%) and 17 women (63%), a sex ratio (M/F) of 0.58. The concept of family cystic kidney disease was found in 6 (22.2%) patients. The clinical presentations were dominated by arterial high blood pressure, abdominal pain and abdominal mass respectively in 77%, 63% and 63% of cases. Five patients (18.5%) had a glomerular filtration rate (GFR) greater than 90 ml/min, 17 (62.9%) had a GFR < 60 ml/min. All patients (100%) had multiple renal cysts, 16 patients (59.3%) had dedifferentiated kidneys. Six patients (22.2%) had liver cysts, one patient (3.7%) had lithiasis. Genetic was not achieved because of the poor technical platform and the high cost of these tests. Conclusion: ADPKD is common in our department. It appears to be associated with a high rate of chronic renal failure.
Epidemiological, Clinical and Biological Aspects of Kidney Disease in People Living with HIV Naive Antiretroviral Therapy at CHU Sylvanus Olympio of Lome (TOGO)  [PDF]
Kossi Akomola Sabi, Badomta Dolaama, Eyram Yoan Makafui Amekoudi, Awereou Kotosso, Befa Noto-Kadou-Kaza, Claude Mawufemo Tsevi, Komlan George Tona, Eugene Ametepe Attisso, Schyldia Bonou-Selegbe, Hamat Ibrahim, Guillaume Abderhamman Mahamat, Jaques Vigan, Majeste Ihou Wateba
Open Journal of Nephrology (OJNeph) , 2019, DOI: 10.4236/ojneph.2019.91003
Abstract: Introduction: Human immunodeficiency virus (HIV) infection is a common cause of kidney disease worldwide. HIV-related renal diseases are associated with high morbidity and mortality in Sub-Saharan African countries. The aim is to describe the epidemiological, clinical and biological aspects of kidney disease in people living with HIV naive antiretroviral therapy in Lomé in Togo. Methods: This was a cross-sectional study done in the department of Infectious and Tropical Diseases in Lomé from ESOPE database. Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. Kidney disease was defined as GFR less than 90 mL/min/1.73 m2. Results: In total, 3118 HIV-infected ART-naive patients were included in this study. Among them, the prevalence of renal disease at the beginning of their care, was 41.8% or 1303 patients [95% CI: 40.0% - 43.5%]. The median estimated GFR was 94.7 ml/min/1.73 m2: 2.9% had eGFR < 15 ml/min/1.73 m2. The median age was 40 years [IQR = 34 - 48 years] with a sex ratio at 0.45. BMI median was 20.6 Kg/m2. Most of patients (30.8%) were at clinic OMS stage 1. Median CD4 was 165/uL [IQR = 72 - 274/uL]; median hemoglobin was 10.4 g/dl [IQR = 8.8 - 11.9 g/dl]; median glycemia was 0.84 g/l [IQR = 0.75 - 0.95 g/l]. Most of patients (99.9%) had HIV-1. 8.5% had hyperleukocytosis, and all patients had thrombopenia. Conclusion: The incidence of kidney disease is high in Togolese HIV-infected ART naive patients.
A Prospective Study on Clinical Profile of Autosomal Dominant Polycystic Kidney Disease (ADPKD) in Jammu for a Period of 1 Year  [PDF]
Ashwani Kumar, Zaffar kawoosa, Sajad Hamid, Surendar Kumar Bali, Mymoona Akhter, Shahnawaz Hamid
Open Journal of Nephrology (OJNeph) , 2012, DOI: 10.4236/ojneph.2012.24020

The Present Study was conducted in department of Medicine, Govt. Medical College, jammu, Where a total of 41 patients29 males and 12 femalesfulfilled the inclusion criteria of ADPKD, were gathered during the period of 1 year starting from Nov. 2011 to Oct. 2012. All the patients were subjected to a detailed history, clinical examination and laboratory investigations. X-ray chest (PA view), ECG and ultrasound of abdomen for kidneys, liver and spleen were done. Intravenous pyelogram and CT scan of abdomen was done when a definitive diagnosis of (ADPKD) could not be made on abdominal ultrasound. Echocardiography was done to evaluate cardiac murmurs and associated mitral valve prolapse, based on standard criteria. Male to female patients with ADPKD was 2.42:1. Maximum 17 (41.5%) patients of both gender were seen in 30 - 40 years age group, Family history of ADPKD was present in 18 (43.9%) patients; Hypertension, alone or in combination with renal failure, was present in 65.8% patients; Hypertension alone was present in 19 (46.3%) patients;8 (19.5%) patients with hypertension had renal failure; Low back pain was present in 24 (58.5%) and abdominal pain in 22 (53.7%) patients; 15 (36.6%) patients presented with at least one episode of gross haematuria; Headache was experienced by 18 (43.9%) patients. On clinical examination, 24 (58.5%) were found to have palpable kidney and 10 (24.4%) had palpable liver. Spleen was palpable in 1 (2.4%) patient, Murmur of mitral valve prolapse was found in 2 (4.9%) Patients; 3 (7.3%) patients having left ventricular hypertrophy; mean Hb was 11.2 g/dL. The liver cysts were found in 24.4% of the patients; Out of 10 (24.4%) patients with hepatic cyst involvement, 1 patient each was found to have evidence of portal hypertension and evidence of hepatic cyst infection. In the present study, hypertension was most common presentation of this disease. So, control of hypertension is very important to prevent progression of this disease. Patients who are detected to have ADPKD should be regularly followed-up to prevent further progression by timely intervention. Also, family members of patients should be screened for disease and initiate treatment as early as possible.

Transfusion, erythropoiesis-stimulating agent therapy, and kidney transplant wait time  [PDF]
Robert M. Perkins, H. Lester Kirchner, Rajesh Govindasamy
Open Journal of Internal Medicine (OJIM) , 2012, DOI: 10.4236/ojim.2012.21001
Abstract: Aim: Anemia is highly prevalent among patients wait-listed for renal transplant, and management with blood transfusion or erythropoietin stimulating agents may impact transplant wait time. The purpose of this study was to examine the impact of blood transfusion and erythropoiesis stimulating agent therapy on renal transplant wait time. Methods: We retrospectively analyzed all adult patients listed for first deceased donor kidney transplantation at two transplant centers in Central Pennsylvania between 2004 and 2008. The exposures of interest were blood transfusion and erythropoietin stimulating agent therapy. Cox proportional hazards were used to model time to deceased donor kidney transplant. Results: Among 407 patients listed for transplant, 84 received a deceased donor kidney during a median follow-up of 26.3 months. In an adjusted Cox proportional hazards model, with erythropoiesis stimulating agent and transfusion both treated as time-dependent exposures, UNOS inactive status at listing date (hazard ratio [HR] 0.81; 95% CI 0.73 - 0.89; P < 0.001) and transfusion during the wait list period (HR 0.27; 95% CI 0.11 - 0.69; P = 0.01) independently predicted longer transplant wait time. Erythropoiesis stimulating agent use prior to or after transplant wait listing date did not independently predict wait time. Conclusion: Blood transfusion while waitlisted for kidney transplant is strongly associated with prolonged wait time.
The Frequency of Fibromyalgia Syndrome and the Quality of Life in Patients with Peritoneal Dialysis  [PDF]
Muyesser Okumus, Hulya Parpucu, Seher Kocaoglu, Esma Ceceli, Murat Duranay, P?nar Borman
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2012, DOI: 10.4236/ojra.2012.24017
Abstract: ,b>Objective: The aim of this study was to determine the frequency of fibromyalgia (FM) in patients on Peritoneal Dialysis (PD) and to investigate its impact on the quality of life of that population. Methods: A hundred and twenty four patients with end stage renal disease who had undergone PD, and a control group of 54 age and sex-matched healthy volunteers were included to the study. Demographic characteristics including age, sex, disease and dialysis duration were recorded. Fibromyalgia Impact Questionnaire (FIQ) and Nottingham Health Profile (NHP) were also measured. Results: The mean age of the patients (68 female, 56 male) and control subjects (36 female, 18 male) were 43.5 ± 13.4 and 41.2 ± 9.2 years respectively. The prevalence of FM in the PD patients and controls were determined as 9.7% (12 patients) and 11.1% (6 controls) respectively and were found to be similar (p = 0.983). The mean score of sub- groups of NHP except pain and emotion subgroups, were significantly higher in PD patients than in the control group. The mean FIQ levels, the scores of all the subgroups of NHP except the social subgroup were significantly higher in PD patients with FM than in those without FM. Conclusion: In conclusion although the prevalence of FM appears to be similar in PD patients and control subjects, the functional disability is common and quality of life is worse in PD patients with FM than in patients without FM. Detection and treatment of FM may lead to improvement in the quality of life of PD patients with this syndrome.
Depression in Chronic Kidney Disease and Hemodialysis Patients  [PDF]
C. P. Andrade, R. C. Sesso
Psychology (PSYCH) , 2012, DOI: 10.4236/psych.2012.311146
Abstract: Depression is the most common psychiatric condition in Chronic Kidney Disease (CKD), but there are few studies that analyzed this condition in patients in different phases of disease. This article aims to evaluated depression in CKD patients, comparing patients in different phases of disease. Methods: We evaluated 134 patients with CKD submitted to conservative ambulatory treatment, and 36 patients with end-stage renal disease undergoing hemodialysis (HD). To evaluate depression, we used the Beck Depression Inventory (BDI), and the Beck Depression Inventory—SF (BDI-SF), a subscale that allows evaluate only the cognitive aspects of depression. Functional capacity was evaluated using the Karnofsky Performance Scale, and clinical and sociodemographic variables were also investigated. Results: Using BDI, depression was identified in 37.3% of patients in conservative treatment and in 41.6% in HD patients (p > 0.05). This percentage reduced when the BDI-SF was used, to 11.1% in conservative CKD patients and 13.8% in HD patients (p > 0.05). Depression was associated with marital status, professional activity, income, comorbidities and functional capacity. Discussion: We observed high prevalence of depression in patients with CKD undergoing conservative or hemodialysis treatment. Depression was associated with some clinical and sociodemografic variables and with functional capacity.
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