Assessment of chronic kidney disease using skin texture as a key parameter: for South Indian population

Electrodermal signal analysis using continuous wavelet transform as a tool for quantification of sweat gland activity in diabetic kidney disease

Sympathetic innervation of the sweat gland (SG) manifests itself electrically as electrodermal activity (EDA), which can be utilized to measure sudomotor function. Since SG exhibits similarities in structure and function with kidneys, quantification of SG activity is attempted through EDA signals. A methodology is developed with electrical stimulation, sampling frequency and signal processing algorithm. One hundred twenty volunteers participated in this study belonging to controls, diabetes, diabetic nephropathy, and diabetic neuropathy. The magnitude and time duration of stimuli is arrived by trial and error in such a way it does not influence controls but triggers SG activity in other Groups. This methodology leads to a distinct EDA signal pattern with changes in frequency and amplitude. The continuous wavelet transform depicts a scalogram to retrieve this information. Further, to distinguish between Groups, time average spectrums are plotted and mean relative energy (MRE) is computed. Results demonstrate high energy value in controls, and it gradually decreases in other Groups indicating a decline in SG activity on diabetes prognosis. The correlation for the acquired results was determined to be 0.99 when compared to the standard lab procedure. Furthermore, Cohen's d value, which is less than 0.25 for all Groups indicating the minimal effect size. Hence the obtained result is validated and statistically analyzed for individual variations. Thus this has the potential to get transformed into a device and could prevent diabetic kidney disease.

Sweat gland morphology and physiology in diabetes, neuropathy, and nephropathy: a review

Context: Sweat glands (SGs) play a vital role in thermal regulation. The function and structure are altered during the different pathological conditions.Objective: These alterations are studied through three techniques: biopsy, sweat analytes and electrical activity of SG.Methods: The morphological study of SG through biopsy and various techniques involved in quantifying sweat analytes is focussed on here. Electrical activities of SG in diabetes, neuropathy and nephropathy cases are also discussed, highlighting their limitations and future scope.Results and Conclusion: The result of this review identified three areas of the knowledge gap. The first is wearable sensors to correlate pathological conditions. Secondly, there is no device to look for its structure and quantify its associated function. Finally, therapeutic applications of SG are explored, especially for renal failure. With these aspects, this paper provides information collection and correlates SG with pathologies related to diabetes. Hence this could help researchers develop suitable technologies for the gaps identified.

Quantification of sweat urea in diabetes using electro-optical technique

Diabetic kidney disease is one result of prolonged elevation in blood glucose level. When insulin secretion reduces, serum urea level increases and vice versa is also true. Hence monitoring urea level in blood is important in diabetic subjects. Any change in serum urea will have impact on sweat urea concentration. Attempted in this study is to develop an optical device for quantifying sweat urea concentration. It uses light sources, light sensors with time and intensity controlled operation and suitable calibration algorithm. Sweat samples are collected from group of volunteers belonging to control and diabetes. After sedimentation and suitable pre-processing, sweat samples are irradiated by primary colour light sources operated sequentially. Reflected light intensity is used to compute the sweat urea concentration. Obtained results when compared with standard lab techniques like UV-visible absorption spectroscopy and colorimeter, correlation of 98% with error less than 3% is achieved. Results also demonstrate elevation in sweat urea level with years of diabetes, in spite of serum urea level being within limits. We extended the study on kidney disease subject and observed the influence of blood glucose on urea. Therefore the proposed device can be used to measure sweat urea periodically so that any change can be observed at an early stage and diabetic nephropathy could be prevented at large.

[Categorizing methods used in participatory research]

Hintergrund

In der Forschung gewinnen partizipative Ansätze an Bedeutung. Der Einsatz partizipativer Methoden erfolgt meist ohne eine methodologische Auseinandersetzung oder den Bezug auf eine gemeinsame Systematik.

Ziel der Arbeit

Auf der Grundlage eines Scoping-Reviews wird eine Systematisierung partizipativer Methoden vorgeschlagen. Damit wird ein Beitrag zum Diskurs über partizipative Methoden geleistet, die gesundheitliche Chancengleichheit fördern.

Material und Methoden

Nach einer Literaturrecherche wurden 44 Treffer eingeschlossen. Die Suche sowohl nach deutsch- als auch englischsprachiger Literatur basierte auf diversen Datenbanken (PubMed, PsycInfo, SocIndex, Livivo, Cochrane, Fachportal Pädagogik), einer Handsuche und einer Suche nach dem Schneeballprinzip.

Ergebnisse und Diskussion

Die Systematisierung kombiniert phasen- und formatbasierte Logiken. Als zentrale Prinzipien in den Definitionen einer partizipativen Methodologie und von partizipativen Methoden werden die Mehrdimensionalität und Phasenintegration berücksichtigt. Daraus abgeleitet werden die Hauptunterscheidung von prozessgestaltenden und forschenden Methoden. Schwerpunkte zeigen sich bei den Erhebungsmethoden und Reflexionsverfahren. Lücken im deutschsprachigen Raum sind bei Methoden gemeinsamer Entscheidungsfindungen, der Auswertung und Verwendung erkennbar.

Fazit

Die Ergebnisse helfen bei der Einordnung verschiedener Ansätze und ihres Grades an Partizipation. Für Forschung und Lehre wird die Aufmerksamkeit auf das Spektrum forschender und prozessgestaltender partizipativer Methoden gelenkt, die es einzusetzen, zu beschreiben und zu vermitteln gilt.

Detailed Review of Chronic Kidney Disease

Background

Nephropathy problems in the Udhanam region of Andhra Pradesh in India have motivated researchers to investigate the various factors related to chronic kidney disease (CKD). Initially, studies came across the markers of identification of CKD, i.e., glomerular filtration rate (GFR) and albumin creatinine rate, as global markers of identification. Cystatin C (Cys C) and its reciprocal (1/Cys C) are used to calculate GFR. This is a very easy method compared to the more accurate methods such as radiolabelled tracer clearances, which are invasive, may involve radiation, and require several hours to perform, e.g., 99-diethylene triamine penta-acetic acid (^99mTc-DTPA) and ⁵¹Cr-EDTA. This article provides the causes (or risk factors), symptoms, and complications of CKD in a clear manner such that even common people can easily understand. Once a patient is detected and proved to be affected by CKD then the patient as well as the caretakers, including doctors, must follow some constraints. Thereby it is possible to prevent CKD progression in the patient. Modern methods are needed to prevent the pathogens which are responsible for CKD.

Summary

With the help of various engineering techniques one can easily design controllers to assess as well as to prevent CKD permanently. The easiest procedure for identifying CKD is to screen people. Current recommendations suggest screening of individuals with diabetes, hypertension, cardiovascular disease, and family history of kidney diseases in the course of routine health check-ups. Much work has been done in medical sciences in the area of CKD, but there is still scope for further research. From the recent studies, advanced tools such as data mining, etc., are considered to be the current trend in the area of CKD.

Key Message

From this article, the authors propose that patients who are already affected by urinary tract infection, acute kidney injury, and a family history of CKD should be examined via some basic tests for the presence of CKD.