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Batool T, Ahmad F, Bashir R, Rafaqat S. Pharmacogenetic analysis of interleukin-10 variants and tacrolimus metabolism in kidney transplant patients from Pakistani population. Mol Biol Rep 2024; 51:947. [PMID: 39215891 DOI: 10.1007/s11033-024-09873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND End stage renal disease (ESRD) occurs when the kidneys are unable to filter the waste products and excessive fluids from the blood that results into the accumulation of toxins and fluid in the body. Tacrolimus is commonly used immunosuppressant while sirolimus and cyclosporin are rarely used drugs to stop solid organ transplant rejection. The host's immunological response following transplantation produces interleukin-10 (IL-10), which influences the varied CYP3A-dependent drug disposition of tacrolimus. The aim of this study was to determine the genetic polymorphisms of IL-10 (rs1800871, rs1800872 and rs1800896) gene associated with tacrolimus metabolism in kidney transplant patients from Lahore Punjab, Pakistan. METHODS The study collected blood samples of 103 healthy individuals and 137 kidney transplant patients as control and treatment groups, respectively. We employed Tetra ARMS PCR for the genotype analysis of extracted DNA. The alleles were called on 2% agarose gel. Moreover, the study utilized SPSS software to analyze statistical significance of polymorphism. RESULTS It was found that genotypic frequencies of IL-10 (rs1800871), IL-10 (rs1800872), and IL-10 (rs1800896) were (TT: 66.4%; TC: 31.4%; CC: 2.2%), (AA: 27.7%; AC: 54%; CC: 18.2%), (AA: 64.2%; GA: 17.5%; GG: 18.3%), respectively among kidney transplant patients. All parameters show significant association at different points after transplantation. Genetic analysis showed that TC and CC genotypes in rs1800871 (OR (95%CI) = 5.721 (3.231-10.131), P < 0.001; OR (95%CI) = 3.370 (0.642-17.672), P = 0.150), AC and CC genotypes in rs1800872 (OR (95%CI) = 1.294 (0.695-2.410), P = 0.415; OR (95%CI) = 1.453 (0.671-3.147), P = 0.342), GA and GG genotypes in rs1800896 (OR (95%CI) = 42.952 (17.566-105.021), P = 0.001; OR (95%CI) = 7.040 (2.563-19.333), P = 0.342) was associated with risk of renal rejection in kidney transplant patients. Besides, genetic models showed that TT in rs1800871, AA genotypes in rs1800872 and rs1800892 were associated with risk of renal rejection under dominant model when compared to controls (OR (95%CI) = 5.721 (3.231-10.131), P < 0.001; OR (95%CI) = 1.335 (0.735-9.290), P < 0.341; OR (95%CI) = 24.629 (10.599-57.230), P < 0.001), respectively. CONCLUSION From the results, it is concluded that genetic polymorphism of IL-10 (rs1800871, rs1800872 and rs1800896) has a highly significant association with risk of renal rejection in Pakistani kidney transplant patients.
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Affiliation(s)
- Tuba Batool
- Department of Biotechnology, LCWU, Lahore, Pakistan
| | | | | | - Sana Rafaqat
- Department of Biotechnology, LCWU, Lahore, Pakistan
- Department of Clinical and Biomedical Science, University of Exeter Medical School, Exeter, UK
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Bhargava V, Meena P, Agrawaal KK, Wijayaratne D, Kar S, Qayyum A, Sultana A, Shiham I, Brown E, Mushahar L. Perceived barriers to peritoneal dialysis utilization amongst South Asian nephrologists. Perit Dial Int 2024:8968608241263396. [PMID: 39042940 DOI: 10.1177/08968608241263396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Abstract
Peritoneal dialysis (PD) is a well-established modality for kidney replacement therapy (KRT) globally, offering benefits such as better preservation of residual kidney function, improved quality of life, and reduced resource requirements. Despite these advantages, the global utilization of PD remains suboptimal, particularly in South Asia (SA), where a significant gap in PD delivery exists. This study aims to uncover the perceived barriers hindering PD utilization among nephrologists in SA. This is a cross-sectional survey involving 732 nephrologists from SA region. . The majority of respondents (44.7%) reported initiating less than six PD cases annually, reflecting low PD utilization. Cost and financial reimbursement policies emerged as major barriers, with 44.3% considering PD more expensive than haemodialysis (HD). Accessibility, negative attitudes toward PD, and fear of complications were identified as critical factors influencing PD adoption. The study also highlighted variations in PD costs among SA countries, emphasizing the need for tailored health economic strategies. This analysis provides insights into the multifaceted challenges faced by SA nephrologists in promoting PD and underscores the importance of targeted interventions.
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Affiliation(s)
- Vinant Bhargava
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Priti Meena
- Department of Nephrology, All India Institute of Medical Sciences, Bhubaneswar, India
| | | | | | - Shubharthi Kar
- Department of Nephrology, Sylhet M.A.G Osmani Medical College, Sylhet, Bangladesh
| | - Ahad Qayyum
- Department of Nephrology, Bahria Town International Hospital, Lahore, Pakistan
| | - Azmeri Sultana
- Department of Pediatric Nephrology, Dr M R Khan Shishu Hospital & Institute of Child Health, Dhaka, Bangladesh
| | - Ibrahim Shiham
- Department of Nephrology. National Uro Renal and Fertility Centre, Republic of Maldives
| | - Edwina Brown
- President of the International Society for Peritoneal Dialysis Professor of Renal Medicine, Imperial College London, Consultant Nephrologist, Imperial College Renal & Transplant Centre, Hammersmith Hospital, London, UK
| | - Lily Mushahar
- Department of Nephrology, Hospital Tuanku Ja'afar Seremban Jalan Rasah, Sembilan, Negeri Sembilan, Malaysia
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Choshi J, Flepisi B, Mabhida SE, Sekgala MD, Mokoena H, Nkambule BB, Ndwandwe D, Mchiza ZJ, Nqebelele U, Kengne AP, Dludla PV, Hanser S. Prevalence of chronic kidney disease and associated risk factors among people living with HIV in a rural population of Limpopo Province, South Africa. Front Public Health 2024; 12:1425460. [PMID: 39056083 PMCID: PMC11269117 DOI: 10.3389/fpubh.2024.1425460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Background Limited evidence informs on the prevalence of chronic kidney disease (CKD) in people living with HIV (PLWH) in South Africa. Thus, this study aimed to determine the prevalence of CKD and its associated risk factors among PLWH within the rural province of Limpopo, South Africa. Methods We conducted a cross-sectional study of 143 participants, subdivided into groups of PLWH (n = 103) and individuals without HIV (n = 43). Structured questionnaires were used to collect and capture sociodemographic information including age, sex, alcohol intake, smoking status, and educational status. Basic measurements taken included levels of cluster of differentiation 4 (CD4+) count, body mass index (BMI), blood pressure, plasma cystatin C, and fasting serum glucose levels. Plasma cystatin C-based estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) estimator to determine the prevalence of CKD. Results The prevalence of CKD was approximately 7% in PLWH. Multivariate logistic regression analysis showed that it was only diabetes mellitus (odds ratio of 5.795, 95% confidence interval, p = 0.034) and age (odds ratio of 1.078, 95% confidence interval, p = 0.039) that were significantly associated with CKD in PLWH. Conclusion Chronic kidney disease was prevalent in PLWH, and it was further associated with cardiovascular risk factors, diabetes, and ageing. As PLWH age, the burden of CKD may be increased with the increase in cardiovascular-related comorbidities such as diabetes.
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Affiliation(s)
- Joel Choshi
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
| | - Brian Flepisi
- Department of Pharmacology, University of Pretoria, Pretoria, South Africa
| | - Sihle E. Mabhida
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Machoene D. Sekgala
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Haskly Mokoena
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Zandile J. Mchiza
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Unati Nqebelele
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - André P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Phiwayinkosi V. Dludla
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa, South Africa
| | - Sidney Hanser
- Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
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Akhtar T, Pienaar AJ, Asmat K, Sikander S, Khalil F. Lived experiences of village-based patients with chronic kidney disease receiving haemodialysis at Mirpur, Azad Kashmir, Pakistan: a transcendental phenomenology study protocol. BMJ Open 2024; 14:e084862. [PMID: 38977363 PMCID: PMC11256043 DOI: 10.1136/bmjopen-2024-084862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/21/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is one of the major health issues in Pakistan, exerting notable effects on both the physical and mental well-being of individuals undergoing haemodialysis. Of particular concern to healthcare professionals is the potential adverse influence of haemodialysis on the lives of patients with CKD residing in rural areas of the country. This study will explore and describe the lived experiences and needs of patients with CKD receiving haemodialysis from the perspectives of patients and their family caregivers. METHODS AND ANALYSIS Transcendental phenomenological research design will be used. Participants will be recruited from the dialysis centre of a tertiary hospital through purposive sampling based on specific inclusion criteria. In-depth unstructured interviews, observation and document analysis will be the methods for data collection. Data will be analysed using Colaizzi's approach following the transcription of the interviews. ETHICS AND DISSEMINATION The study has been approved by the Institutional Review Board (IRB) of Shifa Tameer-e-Millat University, Pakistan (IRB # 0307-23) and written permission was obtained from the administration of the study hospital. Before giving written and verbal consent, all participants will receive detailed information about the study. Participants will maintain the freedom to withdraw from the study at any point. Confidentiality of the participants will be ensured. The study findings will be disseminated to important stakeholders and published in scientific papers and conference proceedings.
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Affiliation(s)
- Tazeem Akhtar
- Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Abel J Pienaar
- Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Kainat Asmat
- Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Siham Sikander
- Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Fareeha Khalil
- Nephrology, Shifa International Hospital, Islamabad, Pakistan
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Sai Spandana G, Viswanathan S, Barathi S D, Selvaraj J. Etiology and Outcomes in Patients With Chronic Kidney Disease and Ascites. Cureus 2024; 16:e64113. [PMID: 39119441 PMCID: PMC11306405 DOI: 10.7759/cureus.64113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Nephrogenic ascites is an uncommon disorder associated with grave prognosis. Studies on etiopathogenesis and outcomes are scarce. This study aimed to identify the etiologies of ascites in patients with chronic kidney disease (CKD) and estimate the proportion of nephrogenic ascites and the 90-day mortality. Methods This was a prospective, observational, and hospital-based study. Consecutive patients with CKD admitted to a tertiary care government teaching hospital were recruited. History, examination, investigations, and evaluation of the etiology of ascites were performed. Ascites was classified into high and low serum albumin-ascites gradient types. Patients with ascites were also followed up for three months to monitor for worsening symptoms, further workup (if necessary), and mortality. Results A total of 355 patients were recruited, with 72.5% being males. Of these, 76 were newly diagnosed with CKD. The most common comorbidities were diabetes mellitus and hypertension. Forty patients had ascites with a mean duration of CKD and hemodialysis of 20.9±23.1 months and 9.3±15.5 months, respectively. Thirteen of the 40 patients with ascites were lost to follow-up. Among the remaining 27, 13 died during follow-up. A known etiology was seen in 29 of the 40 (72.5%) patients. The multiple etiologies group (any combination of cardiac or liver disease, malignancy, and hypothyroidism) constituted 21 patients. Overall, among the 40 patients with ascites, 11 (27.5%) had nephrogenic ascites of whom, four died during follow-up. Conclusions Nephrogenic ascites was observed in 11 patients. Most patients with ascites in CKD have an identifiable etiology. The prognosis of ascites in patients with CKD in our study was dismal.
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Affiliation(s)
- Gollapudi Sai Spandana
- Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Stalin Viswanathan
- General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Deepak Barathi S
- Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Jayachandran Selvaraj
- General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
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Shafe MO, Gumede NM, Nyakudya TT, Chivandi E. Lycopene: A Potent Antioxidant with Multiple Health Benefits. J Nutr Metab 2024; 2024:6252426. [PMID: 38883868 PMCID: PMC11179732 DOI: 10.1155/2024/6252426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
Lycopene is a naturally occurring carotenoid predominantly found in tomatoes and tomato-based products. Like other phytochemicals, it exhibits health beneficial biological activities that can be exploited when it is used as a dietary supplement. In vitro and in vivo, lycopene has been demonstrated to mitigate oxidative stress-induced metabolic dysfunctions and diseases including inflammation, obesity, and diabetes mellitus. Lycopene has been shown to alleviate metabolic diseases that affect the bone, eye, kidney, liver, lungs, heart, and nervous system. This review presents the state of the art regarding lycopene's health benefits and its potential applications in health system delivery. Furthermore, lycopene's protective effects against toxins, safety in its use, and possible toxicity are explored.
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Affiliation(s)
- Mercy Omoye Shafe
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
- Department of Human Physiology, Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, Bingham University, P.M.B. 005, New Karu, Nasarawa 961002, Nigeria
| | - Nontobeko Myllet Gumede
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria 0031, South Africa
| | - Trevor Tapiwa Nyakudya
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Gezina, Pretoria 0031, South Africa
| | - Eliton Chivandi
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
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Khan A, Cheema MF, Fatima R, Cheema SS, Butt Z, Gillani S, Ahmad A, Subhan Ullah M, Jalal U, Cheema S. Prevalence of Chronic Kidney Disease in a High-Risk Population in Urban Lahore, Pakistan: A Cross-sectional Study. Cureus 2024; 16:e63296. [PMID: 39077231 PMCID: PMC11284504 DOI: 10.7759/cureus.63296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/31/2024] Open
Abstract
Background Chronic kidney disease (CKD) is a globally increasing health concern, and there is a growing focus on early screening and prevention efforts. However, the availability of data on CKD prevalence in Pakistan, particularly in the urban area of Lahore district, is limited. The objective of the Kidney Early Evaluation Program (KEEP) Lahore was to assess the prevalence of CKD in a high-risk population residing in the urban area of Lahore, Pakistan. Methods A cross-sectional study was conducted involving 254 participants, who were over 18 years old and belonged to a high-risk population according to the pre-defined operational definitions. The participants were randomly selected from various towns in Lahore. Screening camps were set up to measure serum creatinine levels and urinary albumin to creatinine ratio (UACR), and then the estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration 2021 (CKD EPI) equation. Results Out of the total 254 participants, a diagnosis of CKD was made in 62 (24.2%) individuals. Significant associations were found between CKD and risk factors including hypertension, diabetes, family history of CKD, ischemic heart disease (IHD) or congestive heart failure (CHF), intake of painkillers, and herbal medicines. However, no association was found between obesity (BMI ≥ 30) and CKD. Participants diagnosed with CKD had a mean age of 49.9 years and a mean serum creatinine level of 1.2 mg/dL, while non-CKD participants had a mean age of 43.7 years and a mean serum creatinine level of 0.7 mg/dL. Conclusion Our study revealed that CKD was prevalent in about one-fourth of the participants from the high-risk population of Lahore, indicating a high prevalence of the disease within society. Moreover, hypertension, diabetes, family history of CKD, heart disease, painkillers, and the use of herbal medicines were all significantly linked to CKD in the surveyed sample population.
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Affiliation(s)
- Afifa Khan
- Department of Nephrology, Jinnah Hospital, Lahore, PAK
| | - Manal F Cheema
- College of Medicine, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Rida Fatima
- Department of Internal Medicine, Jinnah Hospital, Lahore, PAK
| | - Sidra S Cheema
- Department of Pathology, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Zeeshan Butt
- Department of Internal Medicine, Baystate Medical Center, Springfield, USA
| | - Samreen Gillani
- Department of Internal Medicine, Fatima Memorial Hospital, Lahore, PAK
| | - Ayesha Ahmad
- Department of Internal Medicine, Jinnah Hospital, Lahore, PAK
| | | | - Urba Jalal
- Department of Internal Medicine, Jinnah Hospital, Lahore, PAK
| | - Shafiq Cheema
- Department of Nephrology, Jinnah Hospital, Lahore, PAK
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Safdar A, Akram W, Khan MA, Tahir D, Butt MH. Comparison of EKFC, Pakistani CKD-EPI and 2021 Race-Free CKD-EPI creatinine equations in South Asian CKD population: A study from Pakistani CKD community cohort. PLoS One 2024; 19:e0300428. [PMID: 38512913 PMCID: PMC10956795 DOI: 10.1371/journal.pone.0300428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION South Asian individuals possess a high risk of chronic kidney disease. There is a need to study, evaluate, and compare the newly suggested glomerular filtration rate (eGFR) equations for accurate CKD diagnosis, staging, and drug dosing. This study aimed to (1) evaluate the European Kidney Function Consortium (EKFC), Pakistani CKD-EPI, and 2021 Race-Free CKD-EPI creatinine equation in the South Asian population with CKD and (2) to examine the expected implications on both CKD classification as well as End Stage Renal Disease (ESRD) prevalence across these equations in South Asian population. METHODS We carried out a cross-sectional investigation on 385 participants, a CKD cohort ≥ 18 years, at Allama Iqbal Medical College, Jinnah Hospital, Lahore. Serum creatinine was measured by Jaffe's method and rGFR was measured by inulin clearance. RESULTS Pakistani CKD-EPI has a lower median difference at -1.33 ml/min/1.73m2 elevated precision (IQR) at 2.33 (-2.36, -0.03) and higher P30 value at 89.35% than 2021 CKD-EPI and EKFC equations. The mean difference (ml/min/1.73m2), 95% agreement limits (ml/min/1.73m2) of CKD-EPI PK: -1.18, -6.14, 2021 CKD-EPI: -5.98, -13.24 and EKFC: -5.62, -13.01 (P <0.001). These equations highly correlated to rGFR (P <0.001). An upward re-classification in GFR categories was shown by 2021 CKD-EPI and EKFC compared to the Pakistani CKD-EPI equation. However, there was an exception regarding the G5 category, where an elevated count of 217 (56.36%) was shown for CKD-EPI PK. The prevalence of ESRD was seen in entire age groups and prevailed among females more than in males overall equations. CONCLUSIONS Pakistani CKD-EPI exhibited outstanding performance, while 2021 CKD-EPI and EKFC demonstrated poor performances and could not show an adequate advantage for both CKD classification and prevalence of ESRD compared to Pakistani CKD-EPI. Therefore, Pakistani CKD-EPI appears optimal for this region and warrants future validation in other South Asian countries. In contrast, suitable measures must be implemented in Pakistani laboratories.
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Affiliation(s)
- Aqsa Safdar
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Punjab, Pakistan
| | - Waqas Akram
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Punjab, Pakistan
| | - Mahtab Ahmad Khan
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Punjab, Pakistan
| | - Danish Tahir
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Punjab, Pakistan
| | - Muhammad Hammad Butt
- Department of Medicinal Chemistry, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
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Sequira L, Prabhu A R, S Mayya S, Prasad Nagaraju S, S Nayak B. Effectiveness of a Disease Management Program (DMP) in controlling the progression of Chronic Kidney Disease among hypertensives and diabetics. F1000Res 2024; 11:1111. [PMID: 38576797 PMCID: PMC10993008 DOI: 10.12688/f1000research.123787.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/06/2024] Open
Abstract
Background The occurrence rate of stage 5 chronic kidney disease (CKD) will be 151 per million population in India in the coming years. Comorbidities like diabetes mellitus and hypertension are the usual triggers of CKD. Hence this study aimed to control the progression of CKD and to note the effectiveness of a structured education program that would help in the prevention of complications related to diabetes and hypertension. Methods This quasi-experimental study was conducted among 88 participants who had hypertension, diabetes mellitus, or both for five or more years. The study objective was to find the effect of a Disease Management Program on delaying progression of CKD in patients with hypertension or diabetes mellitus.The baseline data were obtained from demographic proforma, and the clinical data collected were the blood pressure, serum creatinine, and random blood sugar (RBS) of the participants. The management of hypertension and diabetes mellitus was taught to them. In the fourth and the eighth month, blood pressure and blood sugar were reassessed. At one-year blood pressure, blood sugar, and serum creatinine were tested. Baseline and one-year follow-up blood pressure, blood sugar, and estimated Glomerular Filtration Rate were compared. Descriptive statistics and "Wilcoxon signed-rank test" were used to analyze the data. Results In one year, the mean systolic blood pressure reduced by six mm of Hg and mean blood sugar by 24 mg/dl. The prevalence of CKD stage three and above (< 60 ml/min/m2) was nine (10.22%). The median decline in eGFR was 5 ml/min/m2 (Z= 5.925, P< 0.001). Conclusion The Disease Management Program led to improvements in blood pressure and diabetes control and median progression of CKD was estimated at five ml/min/m2/year.
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Affiliation(s)
- Leena Sequira
- Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ravindra Prabhu A
- Nephrology, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shreemathi S Mayya
- Data Science, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shankar Prasad Nagaraju
- Nephrolgy, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Baby S Nayak
- Child Health Nursing, Manipal College of Nursing. Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Mahmood K, Ahmad A, Upadhyay R, Khatoon T, Imbisat Z, Akela A. Comprehensive Surgical Audit of Live-Related Donor Nephrectomy: Procedural Parameters, Demographics, Health Assessments, Complications, and Postoperative Outcomes. Cureus 2024; 16:e57363. [PMID: 38694424 PMCID: PMC11061546 DOI: 10.7759/cureus.57363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES End-stage renal disease (ESRD) rates are on the rise globally, including in India. However, the affordability of dialysis treatment remains a significant challenge for many, with costs varying across different regions. Although cost-effective, kidney transplantation faces challenges like a surgeon shortage, lack of infrastructure, and lack of logistic support. The study examines Indian laparoscopic nephrectomy outcomes and their benefits for donor recovery. It covers kidney donor procedural details, demographics, preoperative health evaluations, complications, and one-month follow-up. METHODS Ethical approval was obtained, and the study involved 102 cases at the Indira Gandhi Institute of Medical Science, Patna, Bihar, India, from 2019 to 2023. Detailed preoperative assessments, postoperative complications, and one-month follow-up analyses were conducted. Statistical analysis employed SPSS version 17 (IBM Corp., Armonk, NY). RESULTS The results revealed an average surgery time of 152.3 min, blood loss of 205 ± 42 ml, and a hospital stay of 4.6 ± 2.2 days. The study found a female predominance (80.39%), with a mean donor age of 35.9 ± 5.2 years. Preoperative assessments showed robust patient health, with glomerular filtration rate (GFR) exceeding the expected threshold and normal urea levels, creatinine, electrolytes, liver enzymes, bilirubin, albumin, and total protein. Post-nephrectomy complications were reported, with females experiencing more difficulties than males. CONCLUSION This study underscores the efficiency and safety of laparoscopic nephrectomy in the Indian context, providing valuable insights into donor demographics, preoperative health assessments, complications, and postoperative outcomes. The findings contribute to understanding laparoscopic nephrectomy outcomes and associated risk factors despite certain limitations.
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Affiliation(s)
- Khalid Mahmood
- Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Ahsan Ahmad
- Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Rohit Upadhyay
- Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Takallum Khatoon
- Department of Anaesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Zaid Imbisat
- Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Ankur Akela
- Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, IND
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Chisty TTE, Sarif S, Jahan I, Ismail IN, Chowdhury FI, Siddiqua S, Yasmin T, Islam MN, Khan F, Subhan N, Alam MA. Protective effects of l-carnitine on isoprenaline -induced heart and kidney dysfunctions: Modulation of inflammation and oxidative stress-related gene expression in rats. Heliyon 2024; 10:e25057. [PMID: 38322874 PMCID: PMC10845729 DOI: 10.1016/j.heliyon.2024.e25057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024] Open
Abstract
The aim of this study was to evaluate the effect of l-carnitine (L-CAR) treatment on isoprenaline (ISO) administered kidney and heart impairment in male Long Evans rats. Four groups of rats were engaged in this study such as control, ISO, control + L-CAR, and ISO + L-CAR, where n = 6 in each group. The rats were also provided with chow food and water ad libitum. At the end of the study, all rats were sacrificed, and blood and tissue samples were collected for bio-chemical analysis. Oxidative stress parameters and antioxidant enzyme activities were determined in plasma and tissues. Antioxidant and inflammatory genes expression were analyzed in the kidney cortex, and histopathological studies of kidney tissues were performed. This study showed that creatinine and uric acid in plasma were significantly increased in ISO-administered rats. l-carnitine treatment lowered the uric acid and creatinine level. ISO-administered rats showed increased lipid peroxidation and declined levels of antioxidant enzymes activities in kidneys and heart. l-carnitine treatment restored antioxidant enzymes activities and protect against oxidative stress in kidney and heart. This effect is correlated with the restoration of Nrf-2-HO-1 genes expression followed by increased SOD and catalase genes expression in the kidney. l-carnitine treatment also prevented the TNF-α, IL-6, and NF-кB expression in kidneys of ISO administered rats. Histopathology staining showed that l-carnitine treatment prevented kidney damage and collagen deposition in ISO administered rats. The result of this study exhibited that l-carnitine treatment reduced oxidative stress and increased antioxidant enzyme activities by enhancing antioxidant genes expression in ISO administered rats.
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Affiliation(s)
| | - Sumaia Sarif
- Department of Pharmaceutical Sciences, North South University, Bangladesh
| | - Ishrat Jahan
- Department of Pharmaceutical Sciences, North South University, Bangladesh
| | | | | | | | - Tahmina Yasmin
- Department of Pharmaceutical Sciences, North South University, Bangladesh
| | - Md Nurul Islam
- Department of Pharmaceutical Sciences, North South University, Bangladesh
| | - Ferdous Khan
- Department of Pharmaceutical Sciences, North South University, Bangladesh
| | - Nusrat Subhan
- Department of Pharmaceutical Sciences, North South University, Bangladesh
| | - Md Ashraful Alam
- Department of Pharmaceutical Sciences, North South University, Bangladesh
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Safdar A, Akram W, Khan MA, Alvi MN. Comparison of Pakistani CKD-EPI, new Asian-modified CKD-EPI and revised Lund-Malmö study equations in a South Asian CKD population: a study from a Pakistani CKD cohort. J Nephrol 2024; 37:119-129. [PMID: 37646987 DOI: 10.1007/s40620-023-01749-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/29/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Newly proposed estimating glomerular filtration rate equations need to be studied, evaluated and compared for chronic kidney disease staging, diagnosis and medication dosing in South Asians. The objectives of the study were (1) to assess the performance of the CKD-EPIPK, CKD-EPIAsian-Modified, and LMRevised equations in the Pakistani chronic kidney disease population, and (2) to investigate prospective implications on chronic kidney disease classification and end-stage kidney disease prevalence. METHODS We conducted a cross-sectional analysis on a chronic kidney disease cohort of 385 participants 18 years of age or above. RESULTS CKD-EPIPK showed the lowest bias (- 1.33 ml/min/1.73 m2), highest precision [IQR, 2.33 (- 2.36, - 0.03)] and enhanced P30 accuracy (89.35%) compared to the CKD-EPIAsian-Modified and LMRevised equations. The mean difference (ml/min/1.73 m2), 95% limit of agreement (ml/min/1.73 m2) of the equations were; CKD-EPIAsian-Modified: - 5.98, - 13.03, LMRevised: - 4.06, - 8.13 and CKD-EPIPK: - 1.18, - 6.14 (P < 0.001). CKD-EPIAsian-Modified and LMRevised showed upward re-classification of the GFR categories compared to the CKD-EPIPK equation except in the G5 category where the highest count (217, 56.36%) was noted for the CKD-EPIPK equation. End-stage kidney disease prevailed in all age groups according to all equations, and the prevalence was high in females in all equations. CONCLUSION CKD-EPIPK showed the best performance, whereas both CKD-EPIAsian-Modified and LMRevised showed poor performance and did not offer a sufficient advantage in chronic kidney disease classification and end-stage kidney disease prevalence estimation over CKD-EPIPK. Hence, CKD-EPIPK seems ideal for South Asians, thus appropriate measures should be taken for its implementation, at least in Pakistani laboratories.
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Affiliation(s)
- Aqsa Safdar
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan.
| | - Waqas Akram
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan
| | - Mahtab Ahmad Khan
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan
| | - Muhammad Nadeem Alvi
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan
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AlRashed H, Miele J, Prasad J, Adenikinju D, Iloegbu C, Patena J, Vieira D, Gyamfi J, Peprah E. Systematic review of end stage renal disease in Pakistan: Identifying implementation research outcomes. PLoS One 2023; 18:e0296243. [PMID: 38150440 PMCID: PMC10752519 DOI: 10.1371/journal.pone.0296243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023] Open
Abstract
AIM AND OBJECTIVES The aim of this study was to conduct a systematic review analysis to identify and evaluate the available literature on implementation science outcomes research in relation to End Stage Renal Disease (ESRD) in Pakistan. METHODS A systematic database search of PubMed, Web of Science, EMBASE, Cochrane Library, CINAHL, and Ovid was conducted through October 22nd, 2022, without any restrictions on publication dates. A screening and data extraction tool, Covidence, was used to evaluate the literature against our inclusion and exclusion criteria. Furthermore, a Mixed Methods Appraisal Tool (MMAT) was used to evaluate the selected studies. RESULTS We identified four studies that presented findings of implementation outcomes research which were related to appropriateness, feasibility, and acceptability. Appropriateness was examined using knowledge scores (p = 0.022) and medication adherence scores (p < 0.05) that showed statistical significance between the control and intervention groups. Acceptability was assessed through a cross sectional quantitative descriptive study that evaluated the reasons for refusal and acceptance of treatment in a cohort of patients suffering from ESRD. Feasibility was examined in one cross sectional, and one mixed methods study that aimed to evaluate and understand the impact of initiating dialysis treatment and the feasibility of maintaining it in low-income families that care for children or adults with ESRD. CONCLUSION The preliminary results of this review indicate a gap in the availability of implementation research studies about ESRD in Pakistan. The burden of ESRD, and the implementation methods by which it is treated is notable in Pakistan and requires evidence-based measures to be implemented to support the critical healthcare delivery platforms that provide treatment.
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Affiliation(s)
- Hamad AlRashed
- Doctor of Public Health (DrPH) Program, New York University School of Global Public Health, New York, New York, United States of America
| | - Johanna Miele
- Doctor of Public Health (DrPH) Program, New York University School of Global Public Health, New York, New York, United States of America
| | - Joshua Prasad
- Doctor of Public Health (DrPH) Program, New York University School of Global Public Health, New York, New York, United States of America
| | - Deborah Adenikinju
- Department of Social and Behavioral Sciences, Global Health Program, Implementing Sustainable Evidence-Based Interventions through Engagement (ISEE) Lab, New York University School of Global Public Health, New York, New York, United States of America
| | - Chukwuemeka Iloegbu
- Department of Social and Behavioral Sciences, Global Health Program, Implementing Sustainable Evidence-Based Interventions through Engagement (ISEE) Lab, New York University School of Global Public Health, New York, New York, United States of America
| | - John Patena
- Doctor of Public Health (DrPH) Program, New York University School of Global Public Health, New York, New York, United States of America
- Department of Social and Behavioral Sciences, Global Health Program, Implementing Sustainable Evidence-Based Interventions through Engagement (ISEE) Lab, New York University School of Global Public Health, New York, New York, United States of America
| | - Dorice Vieira
- Department of Social and Behavioral Sciences, Global Health Program, Implementing Sustainable Evidence-Based Interventions through Engagement (ISEE) Lab, New York University School of Global Public Health, New York, New York, United States of America
- New York University Health Sciences Library, New York, New York, United States of America
| | - Joyce Gyamfi
- Department of Social and Behavioral Sciences, Global Health Program, Implementing Sustainable Evidence-Based Interventions through Engagement (ISEE) Lab, New York University School of Global Public Health, New York, New York, United States of America
| | - Emmanuel Peprah
- Department of Social and Behavioral Sciences, Global Health Program, Implementing Sustainable Evidence-Based Interventions through Engagement (ISEE) Lab, New York University School of Global Public Health, New York, New York, United States of America
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Wang L, Yu X, Li H, He D, Zeng S, Xiang Z. Cell and rat serum, urine and tissue metabolomics analysis elucidates the key pathway changes associated with chronic nephropathy and reveals the mechanism of action of rhein. Chin Med 2023; 18:158. [PMID: 38041193 PMCID: PMC10691122 DOI: 10.1186/s13020-023-00862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Rhein can significantly delay the progression of chronic nephropathy. However, its mechanism of action has not been adequately elaborated, which hinders its extensive clinical application. In this work, the effects of rhein on models of TGF-β-induced NRK-49F cellular fibrosis and rat renal ischemia-reperfusion fibrosis were evaluated using metabolomics and western blotting. METHODS The metabolic profiles of NRK-49F cells and rat urine, serum, and kidney tissues in the control, model, and rhein groups were investigated using UPLC-QTOF-MS. The levels of p-P65, p-IKK, p-AKT, p-P38, p-JNK and AP-1 in NRK-49F cells were measured using western blotting and immunofluorescence methods. Molecular docking and network pharmacology methods were employed to explore the relationship between the potential targets of rhein and key proteins in the NF-κB and MAPK signaling pathways. RESULTS Various potential metabolites, including sphingolipids, ceramides, phosphatidylcholine, and lysophosphatidylcholine,14-hydroxy-E4-neuroprostane E, and 5-HPETE, were present in the cell, tissue, urine, and serum samples; however, few metabolites matches exactly among the four type of biological samples. These differential metabolites can effectively differentiated between the control, model, and rhein groups. Pathway enrichment analysis of differential metabolites unveiled that sphingolipid metabolism, arachidonic acid metabolism, and glycerophospholipid metabolism were closely related to nephropathy. Phosphorylation levels of AKT, IKK, P65 and AP-1 in NRK-49F cells was reduced by rhein treatment. Network pharmacology and molecular docking showed that the potential targets of rhein might regulated the expression of MAPK and AKT in the NF-κB and MAPK signaling pathways. CONCLUSION In brief, rhein might delays the progression of chronic nephropathy via the metabolic pathways, NF-κB and MAPKs signaling pathways, which provides the foundation for its development and clinical application.
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Affiliation(s)
- Li Wang
- Department of Pharmaceutical Analysis and Drug Metabolism, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, Zhejiang, People's Republic of China
- Medical School, Hangzhou City University, Hangzhou, 310015, China
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, 310015, China
| | - Xixi Yu
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Hongju Li
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Dahong He
- Medical School, Hangzhou City University, Hangzhou, 310015, China
| | - Su Zeng
- Department of Pharmaceutical Analysis and Drug Metabolism, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, Zhejiang, People's Republic of China.
| | - Zheng Xiang
- Medical School, Hangzhou City University, Hangzhou, 310015, China.
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, 310015, China.
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Zafar R, Rehman IU, Shah Y, Ali Z, Ming LC, Khan TM. Knowledge, attitude and perceptions of pharmacists regarding renal dose adjustment among chronic kidney disease patients in Pakistan. J Pharm Policy Pract 2023; 16:102. [PMID: 37726861 PMCID: PMC10507879 DOI: 10.1186/s40545-023-00606-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) poses a significant public health challenge. CKD patients have compromised renal function, which not only alters the pharmacokinetics of drugs but also their pharmacodynamics. Adjusting drug doses for these patients is essential to achieve the intended clinical outcomes, prevent adverse drug events, and halt further progression of the disease. Pharmacists play a pivotal role in ensuring safe and appropriate therapy for CKD patients. However, there is a noticeable absence of national dosing guidelines for CKD in Pakistan, coupled with a scarcity of studies exploring the knowledge, attitude, and perception of renal dose adjustments in the country. This study aimed to evaluate the knowledge, attitudes, and perceptions of pharmacists in the Khyber Pakhtunkhwa province and Islamabad regarding renal dose adjustments. METHODOLOGY A cross-sectional study was conducted to gauge the knowledge, attitude, and perception of pharmacists working in various cities of Khyber Pakhtunkhwa and the capital city, Islamabad, from February to May 2023. The Renal Dosing Questionnaire-13 (RDQ-13) scale was employed for this purpose. The survey link was disseminated through emails, and the RDQ-13 scale was also completed in person by pharmacists from hospitals, clinics, community, and retail settings who interact with CKD patients. Univariate linear regression was employed, and factors with a p value < 0.25 were subjected to multivariate linear regression. For comparing knowledge, attitude, and perception scores of pharmacists, the independent t test and one-way ANOVA were utilized as appropriate. A p value < 0.05 was deemed statistically significant. RESULTS Of the 384 pharmacists approached, 270 completed the RDQ-13 scale, resulting in a response rate of 70.3%. The overall knowledge score regarding renal dose adjustment was 21.24 ± 2.18 (mean ± SD). Attitude scores averaged at 10.04 ± 1.81, and perception scores at 7.19 ± 2.15. Multivariate analysis indicated a positive correlation between the pharmacists' perception scores and gender, with male pharmacists scoring higher than their female counterparts. CONCLUSIONS The study underscores the importance of instituting targeted training programs for pharmacists, ensuring access to dependable resources, and promoting research and results dissemination in the realm of renal pharmacotherapy to enhance public health outcomes.
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Affiliation(s)
- Roheena Zafar
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, 23200, Pakistan.
- Department of Pharmacy, Northwest General Hospital and Research Centre, Peshawar, 25100, Pakistan.
| | - Inayat Ur Rehman
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, 23200, Pakistan.
| | - Yasar Shah
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, 23200, Pakistan
| | - Zahid Ali
- Department of Pharmacy, University of Peshawar, Peshawar, 25120, Pakistan
| | - Long Chiau Ming
- School of Medical and Life Sciences, Sunway University, 47500, Bandar Sunway, Malaysia
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, 54000, Pakistan
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16
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Ohno F, Makinose S, Tange Y. Effectiveness of combination of heat water disinfection, continuous water circulation, and minimalized dead space for dialysis piping in maintaining ultrapure dialysis fluid and preventing biofilm formation in a central dialysis fluid delivery system. J Artif Organs 2023; 26:220-225. [PMID: 36074207 DOI: 10.1007/s10047-022-01362-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/24/2022] [Indexed: 11/26/2022]
Abstract
Various benefits have been attached to purifying the dialysis fluid used for hemodialysis therapy. The central dialysis fluid delivery system can treat approximately 50 dialysis patients simultaneously and is convenient to operate. In contrast, the dialysis fluid supply piping is complicated, and bacterial growth can cause biofilms. This study aimed to develop sustainable cleaning strategies to solve the complicated dialysis fluid piping, which is a weakness of the central dialysis fluid delivery system, and provide ultrapure dialysis fluid for a long term. Combination of heat water disinfection, continuous water circulation, and minimalized dead space in the dialysis piping were designed for a central dialysis fluid delivery system and used in a clinic for 6 years. As an index of water purification, endotoxin concentrations and microbial colony counts in reverse osmosis water and dialysis fluid were measured. In addition, we performed scanning electron microscopy of the silicon tube surface that had been used for 5 years to confirm the presence or absence of biofilm formation. For 6 years, endotoxin concentrations and microbial colonies were not detected in reverse osmosis water and dialysis fluid using the multiple-patient dialysis fluid supply equipment. The purity of the dialysis fluid was maintained. No biofilm formation was observed by scanning electron microscopy. Combination of heat water disinfection, continuous water circulation, and minimalized dead space designs for dialysis piping can supply ultrapure dialysis fluid with minimal biofilm formation in the piping in the long term.
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Affiliation(s)
- Fumiyo Ohno
- Sendai Makinose Urological Clinic, Kagoshima, Japan.
| | | | - Yoshihiro Tange
- Graduate School of Health Sciences, Kyushu University of Health and Welfare, Nobeoka, Japan.
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Chang AY, Rahman M, Talukder A, Shah H, Mridha MK, Hasan M, Sarker M, Geldsetzer P. Effectiveness of a community health worker-led low-sodium salt intervention to reduce blood pressure in rural Bangladesh: protocol for a cluster randomized controlled trial. Trials 2023; 24:480. [PMID: 37501102 PMCID: PMC10375753 DOI: 10.1186/s13063-023-07518-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND High blood pressure is a major public health problem in low- and middle-income countries. Low-sodium salt substitute (LSSS) is a promising population-level blood pressure-lowering intervention requiring minimal behavioral change. The optimal method of delivering LSSS to individuals, however, is currently unknown. Community health workers (CHWs) have successfully been used to implement health interventions in Bangladesh and may provide a venue for the dissemination of LSSS. METHODS We aim to conduct a cluster-randomized controlled trial involving 309 households in rural Bangladesh previously identified and characterized by the BRAC James P Grant School of Public Health, BRAC University (BRAC JPGSPH). These households will be randomly assigned to three arms: (1) control, i.e., no intervention; (2) information only, i.e., community health workers will provide basic information on high blood pressure, the health consequences of excessive salt consumption, and feedback to the participant on the likely quantity of salt s/he consumes (estimated using a questionnaire); (3) free LSSS arm: the same information as in arm 2 will be provided, but participants will receive 6 months of free low-sodium salt along with education on the benefits of LSSS. One male and one female adult (age ≥ 18 years) in each household will be invited to participate, the exclusion criteria being households with members known to have high serum potassium levels, are taking medications known to elevate potassium levels (e.g., ACE inhibitors, ARBs, potassium-sparing diuretics), are already taking potassium supplements, or those who have known kidney disease or abnormal serum creatinine at baseline. The primary endpoint will be blood pressure at 6 months post-intervention. DISCUSSION Recent large clinical trials of LSSS in China and India have shown not only blood pressure improvements, but also stroke, major cardiac event, and all-cause mortality reductions. Nevertheless, how to best translate this intervention to population-level effectiveness remains unclear. Our study would test whether a community health worker-based program could be effectively used to disseminate LSSS and achieve measurable blood pressure benefits. TRIAL REGISTRATION ClinicalTrials.gov NCT05425030. Registered on June 21, 2022.
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Affiliation(s)
- Andrew Y Chang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, USA
- Center for Innovation in Global Health, Stanford University, Stanford, USA
- Stanford Cardiovascular Institute, Stanford University, Stanford, USA
| | - Mushfiqur Rahman
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Animesh Talukder
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Humyra Shah
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Malay Kanti Mridha
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Mehedi Hasan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Pascal Geldsetzer
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, USA.
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, USA.
- The Chan Zuckerberg Biohub, San Francisco, USA.
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Hayat M, Ahmad N, Khan SLA, Mohkumuddin S, Siddique W, Khan A, Atif M. Pattern, frequency and factors associated with inappropriate high dosing in chronic kidney disease patients at a tertiary care hospital in Pakistan. BMC Nephrol 2023; 24:118. [PMID: 37127612 PMCID: PMC10150458 DOI: 10.1186/s12882-023-03167-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/13/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Patients with chronic kidney diseases (CKD) are susceptible to the toxic drug effects if given unadjusted doses. Although Pakistan harbors a high burden of CKD patients, there is limited information available on the frequency, pattern and factors associated with unadjusted drug doses among CKD patients. METHODS This cross-sectional study conducted at Sandeman Provincial Hospital, Quetta included 303 non-dialysis ambulatory CKD patients (glomerular filtration rate < 60 ml/min/1.73m2). The patients' data were collected through a purpose designed data collection form. The appropriateness of doses was checked against the renal drug handbook-2018, Kidney Disease Improving Global Outcomes guidelines, British National Formulary-2022, and manufacturer leaflets. Data were analysed by SPSS 23 and multiple binary logistic regression analysis was used to assess the factors associated with receiving inappropriate high doses. A p-value < 0.05 was considered statistically significant. RESULTS The patients received a total of 2265 prescription lines, with a median of eight different drugs per patient (interquartile range: 6-9 drugs). A total of 34.5% (783/2265) drugs required dose adjustment. Of these, doses were not adjusted for 56.1% (440) drugs in 162 (53.4%) patients. The most common pharmacological class of drugs requiring dose adjustment were antibiotics (79.1%), followed by antidiabetics (59.2%), diuretics (57.0%), angiotensin converting enzyme inhibitors (56.9%), beta blockers (56.9%), analgesics (56.0%), angiotensin receptor blockers (55.2%), domperidone (53.9%) and antihyperlipidmics (46.1%). Patient's age of 41-60 (OR = 5.76) and > 60 years (OR = 9.49), hypertension (OR = 2.68), diabetes mellitus (OR = 3.47) and cardiovascular diseases (OR = 2.82) had statistically significant association (p-value < 0.05) with inappropriate high doses. CONCLUSION The high frequency of inappropriate high doses suggests an important quality gap in medication dosing for patients with ND-CKD at the study site. Special attention should be paid to the drugs and patients with identified risk factors for receiving inappropriate high doses.
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Affiliation(s)
- Muhammad Hayat
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Nafees Ahmad
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan.
| | | | - Syed Mohkumuddin
- Department of Nephrology, Bolan Medical College, Quetta, Pakistan
| | - Wajeeha Siddique
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Amjad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Atif
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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Vijayan M, Deshpande K, Anand S, Deshpande P. Risk Amplifiers for Vascular Disease and CKD in South Asians: When Intrinsic β-Cell Dysfunction Meets a High-Carbohydrate Diet. Clin J Am Soc Nephrol 2023; 18:681-688. [PMID: 36758530 PMCID: PMC10278793 DOI: 10.2215/cjn.0000000000000076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
South Asians, comprising almost one fourth of the world population, are at higher risk of type 2 diabetes mellitus, hypertension, cardiovascular disease, and CKD compared with other ethnic groups. This has major public health implications in South Asia and in other parts of the world to where South Asians have immigrated. The interplay of various modifiable and nonmodifiable risk factors confers this risk. Traditional models of cardiometabolic disease progression and CKD evaluation may not be applicable in this population with a unique genetic predisposition and phenotype. A wider understanding of dietary and lifestyle influences, genetic and metabolic risk factors, and the pitfalls of conventional equations estimating kidney function in this population are required in providing care for kidney diseases. Targeted screening of this population for metabolic and vascular risk factors and individualized management plan for disease management may be necessary. Addressing unhealthy dietary patterns, promoting physical activity, and medication management that adheres to cultural factors are crucial steps to mitigate the risk of cardiovascular disease and CKD in this population. In South Asian countries, a large rural and urban community-based multipronged approach using polypills and community health workers to decrease the incidence of these diseases may be cost-effective.
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Affiliation(s)
- Madhusudan Vijayan
- Barbara T. Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
- Institute for Critical Care Medicine, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
| | - Kavita Deshpande
- Department of Family Medicine, La Maestra Community Health Centers, San Diego, California
| | - Shuchi Anand
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Priya Deshpande
- Barbara T. Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
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Amjad Z, Maryam I, Munir M, Salman M, Baraka MA, Mustafa ZU, Khan YH, Mallhi TH, Hasan SS, Meyer JC, Godman B. COVID-19 Vaccines Status, Acceptance and Hesitancy among Maintenance Hemodialysis Patients: A Cross-Sectional Study and the Implications for Pakistan and Beyond. Vaccines (Basel) 2023; 11:vaccines11050904. [PMID: 37243008 DOI: 10.3390/vaccines11050904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19 vaccine hesitancy continues to be a widespread problem in Pakistan due to various conspiracy beliefs, myths and misconceptions. Since the hemodialysis population is at a higher risk of contracting infections, we sought to investigate the current COVID-19 immunization status and reasons for any vaccine hesitancy among these patients in Pakistan. This cross-sectional study was conducted among maintenance hemodialysis patients at six hospitals in the Punjab Province of Pakistan. Data were collected anonymously using a questionnaire. A total of 399 hemodialysis patients took part in the survey, the majority of them were male (56%) and aged 45-64 years. A calculated 62.4% of the patients reported receiving at least one dose of the COVID-19 vaccine. Of those vaccinated (249), 73.5% had received two doses and 16.9% had received a booster dose. The most common reasons for vaccination were "being aware they were at high risk" (89.6%), "fear of getting infected" (89.2%) and "willingness to fight against COVID-19-pandemic" (83.9%). Of the 150 patients who had not yet been vaccinated, only 10 showed a willingness to take the COVID-19 vaccine. The major reasons for refusal included "COVID-19 is not a real problem" (75%), the "corona vaccine is a conspiracy (72.1%)" and "I don't need the vaccine" (60.7%). Our study revealed that only 62% patients receiving hemodialysis were partially or completely vaccinated against COVID-19. Consequently, there is a need to initiate aggressive approaches to educate this high-risk population in order to address their concerns with vaccine safety and efficacy as well as correct current myths and misconceptions to improve the COVID-19 immunization status in this population.
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Affiliation(s)
- Zara Amjad
- Department of Paediatrics, District Head Quarter (DHQ), Bhakkar 30000, Pakistan
| | - Iqra Maryam
- Department of Medicine, Jinnah Hospital Lahore, Lahore 54000, Pakistan
| | - Maria Munir
- Department of Medicine, Faisalabad Medical University, Faisalabad 38000, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Mohamed A Baraka
- Clinical Pharmacy Program, College of Pharmacy, Al Ain Campus, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
- Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo 11651, Egypt
| | - Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa 0208, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
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Bukhari H, Ahmad A, Noorin A, Khan A, Mushtaq M, Naeem A, Iqbal MR, Naureen F, Shah Y, Qayyum A, Munib S, Azhar A, Ullah F, Khan FFS. Association of Anemia with Parathyroid Hormone Levels and Other Factors in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Cross-Sectional, Real-World Data Study in Pakistan. Int J Clin Pract 2023; 2023:7418857. [PMID: 36815007 PMCID: PMC9940945 DOI: 10.1155/2023/7418857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/12/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
End-stage renal disease (ESRD) patients are mostly managed with maintenance hemodialysis (MHD). ESRD patients on MHD also present with many complications, such as anemia, hyperparathyroidism, and hepatitis prevalence. This study depicts the real-world scenario of anemia among MHD and end-stage renal disease patients in the Pakistani population. A retrospective, multicentric, and real-world data analytical study was conducted at 4 dialysis centers in Pakistan. The study had a sample size of n = 342 patients on maintenance hemodialysis. The data were gathered from the medical records of patients. Data analysis was performed using STATA Version 16. Statistical significance was gauged at a 0.05 level of significance. According to our results, the mean age of the patients was 45 (±15) years. Most of the patients were male (n = 234, 68.4%), whereas 58.1% of the patients were maintained on twice-weekly hemodialysis. The most commonly reported comorbidities were hypertension and diabetes mellitus. The frequency of dialysis (P < 0.01) and comorbidities (P = 0.009) had a significant association with anemia in MHD patients. The majority of the patients had hyperparathyroidism (52%) with anemia. Upon performing binary logistic regression, multivariate analysis displayed a similar odds value for having anemia in patients with every additional month in the duration of hemodialysis (OR 1.01, P = 0.001), the odds of anemic patients having a positive antihepatitis-C antibody (OR 2.22, P = 0.013), and the odds of having anemia in patients in the age category below 45 years (OR 1.93, P = 0.013). In conclusion, the study results depict that every additional month in the duration of hemodialysis, age (<45 years), and positive anti-HCV antibody status, these variables were more likely to have anemia in our study MHD patients. While in our final multivariate model, no statistically significant association was observed between hyperparathyroidism and anemia.
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Affiliation(s)
- Humera Bukhari
- Nephrology Ward, Jinnah Teaching Hospital, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Aneeqa Ahmad
- District Headquarters DHQ Hospital, Faisalabad, Punjab, Pakistan
| | - Amna Noorin
- Peshawar Institute of Cardiology -M.T. I, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Aimal Khan
- Northwest General Hospital and Research Center, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Mehwish Mushtaq
- Department of Pharmacy, University of Peshawar, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Aamir Naeem
- Consultant Physician in Endocrinology, Madinat Zayed Hospital SEHA Abu Dhabi Health Services, Abu-Dhabi, UAE
| | | | - Faiza Naureen
- Department of Pharmacy, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Yasar Shah
- Department of Pharmacy, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Ahad Qayyum
- Nephrology Ward, Bahria International Hospital, Lahore, Pakistan
| | - Syed Munib
- Nephrology Ward, Institute of Kidney Disease Hayatabad Peshawar, Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Amer Azhar
- Nephrology Ward, Khyber Teaching Hospital M. T. I., Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Farman Ullah
- Nephrology Ward, Khyber Teaching Hospital M. T. I., Khyber Pakhtunkhwa, Peshawar, Pakistan
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Mardanpour M, Rezaei J, Vaisi Raygani AA, Abdi A, Salari N, Khaledi-Paveh B, Mohammadi MM. The Effect of Family-Centered and Peer-Centered Education on the Sleep Quality of Hemodialysis Patients: A Randomized Clinical Trial. SAGE Open Nurs 2023; 9:23779608231178614. [PMID: 37273547 PMCID: PMC10233576 DOI: 10.1177/23779608231178614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/07/2023] [Accepted: 05/06/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Sleep disorders in hemodialysis patients are of high prevalence affecting the lives of these patients. Objective The present study was conducted to investigate the effect of family-centered and peer-centered education on the sleep quality of hemodialysis patients. Methods In this controlled clinical trial, 90 patients were randomly assigned to three groups (control, family-centered, and peer-centered). All three groups completed Pittsburgh Sleep Quality Index before the intervention. The intervention included five training sessions conducted by the researcher according to the patients' needs to improve their sleep quality. Routine ward interventions were performed for the control group. At the end of the study, the Pittsburgh Sleep Quality Index was completed by all three groups once again. Data were collected and analyzed using SPSS version 24 software and statistical tests. Results No significant difference was found between the two intervention and control groups regarding demographic variables and variables related to sleep quality before the intervention (p < .05). However, based on the results of the Wilcoxon test, there was a statistically significant difference between the mean rank of sleep quality in the intervention and control groups after the intervention (p-value = .008), indicating that sleep hygiene education was effective in the two intervention groups. Conclusion According to the findings, the mean rank of sleep quality in the two intervention groups was significant after the training, indicating the effectiveness of family-centered and peer-centered education. Accordingly, medical healthcare managers, policymakers, and planners, including nurses, are recommended to employ these convenient, safe, and cost-free training methods and provide better sleep quality and more comfort to patients by spending a short period of time for training.
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Affiliation(s)
- Maryam Mardanpour
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jahangir Rezaei
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Vaisi Raygani
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnam Khaledi-Paveh
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Muacevic A, Adler JR, Dhrolia M, Qureshi R, Nasir K. Causes of Emergency Department Visits Among End-Stage Kidney Disease Patients on Maintenance Hemodialysis in Pakistan: A Single-Center Study. Cureus 2022; 14:e33004. [PMID: 36712748 PMCID: PMC9879309 DOI: 10.7759/cureus.33004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 12/28/2022] Open
Abstract
Background In this study, we aimed to determine the causes of emergency department (ED) visits by end-stage kidney disease (ESKD) patients on maintenance hemodialysis (MHD) in Karachi, Pakistan. Methodology We conducted a cross-sectional study that included 194 visits of ESKD patients on MHD aged ≥18 years of both genders presenting at the ED of The Kidney Centre Postgraduate Training Institute, Karachi, Pakistan between February 2021 and May 2021. The study investigated the causes behind ED visits. Frequencies were calculated for categorical variables, and a bar graph was used for the graphical representation of the causes. Results In total, 194 visits included 151 patients of whom 88 (58.3%) were males while 63 (41.7%) were females, with a mean age of 51.68 ± 15.8 years. The most common comorbidity among the ED visits was hypertension 182 (93.8%). The majority of the visits 129 (66.5%) were undergoing regular three dialysis sessions per week, 101 (52.1%) were registered for MHD at our Institute, and 69.1% of visits reported arteriovenous fistula (AVF) as the current access for hemodialysis. Around 111 (57.2%) of the visits had infection-related complications, followed by electrolyte abnormalities 74 (38.1%), cardiovascular 53 (27.3%), and pulmonary complications 41 (21.1%). Overall, 19 (9.8%), 16 (8.2%), and 14 (7.2%) patients reported access-related, neurological, and gastrointestinal complications, respectively. Conclusions Infection-related complications are a significant cause of ED visits among ESKD patients, followed by electrolyte abnormalities and systemic complications, many of which are related to the existing comorbid conditions. Risk identification of preventable causes and surveillance of existing comorbidities would help mitigate ED visits among ESKD patients.
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Sertsu A, Worku T, Fekadu G, Tura AK. Prevalence of chronic kidney disease and associated factors among patients visiting renal unit of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design. SAGE Open Med 2022; 10:20503121221116942. [PMID: 35966210 PMCID: PMC9373155 DOI: 10.1177/20503121221116942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed to assess the magnitude of chronic kidney disease among
patients attending the renal unit of St. Paul’s Hospital Millennium Medical
College, Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted among 620 randomly
selected patients who visited St. Paul’s Hospital Millennium Medical College
renal unit from 1 January to 31 December, 2019. Data on sociodemographic
characteristics, clinical conditions, behavioral risk factors, electrolytes,
and renal function tests were extracted from patients’ medical records. To
enter and analyze data, EpiData 3.1 and SPSS 22 were used, respectively.
Bivariable and multivariable logistic regression analyses were conducted to
see the association between predictor variables and chronic kidney disease.
Adjusted odds ratio at 95% confidence interval was used to describe
significant association. A p-value <0.05 was considered
to declare an association between chronic kidney disease and independent
variables. Results: Of 620 patients, 139 (22.4%; 95% confidence interval: 19.2, 25.6) and 61
(9.8%; 95% confidence interval: 7.4, 12.3) had chronic kidney disease using
cut-off value of 90 and 60 ml/min/1.73 m2, respectively. Having
urinary tract obstruction (adjusted odds ratio = 2.32; 95% confidence
interval: 1.32, 4.06), hypertension (adjusted odds ratio = 4.06; 95%
confidence interval: 2.50, 6.59), diabetes mellitus (adjusted odds
ratio = 2.80; 95% confidence interval: 1.62, 4.85), cardiovascular disease
(adjusted odds ratio = 2.54; 95% confidence interval: 1.60, 4.01), and age
(adjusted odds ratio = 1.83; 95% confidence interval: 1.44, 3.57), family
history of chronic kidney disease (adjusted odds ratio = 2.26; 95%
confidence interval: 1.36, 3.75) were factors positively associated with
having chronic kidney disease. Conclusion: Nearly, one out of five and one out of ten patients who visited the renal
unit had chronic kidney disease using the two thresholds as a cut value.
Patients with concomitant urinary tract obstruction, age, hypertension,
diabetes mellitus, cardiovascular disease, and a family history of chronic
kidney disease were more likely to develop chronic kidney disease. Regular
screening for chronic kidney disease, optimal blood sugar, and blood
pressure management should be practiced.
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Affiliation(s)
- Addisu Sertsu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Teshager Worku
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gelana Fekadu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Saputro SA, Pattanateepapon A, Pattanaprateep O, Aekplakorn W, McKay GJ, Attia J, Thakkinstian A. External validation of prognostic models for chronic kidney disease among type 2 diabetes. J Nephrol 2022; 35:1637-1653. [PMID: 34997924 PMCID: PMC9300508 DOI: 10.1007/s40620-021-01220-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/30/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Various prognostic models have been derived to predict chronic kidney disease (CKD) development in type 2 diabetes (T2D). However, their generalisability and predictive performance in different populations remain largely unvalidated. This study aimed to externally validate several prognostic models of CKD in a T2D Thai cohort. METHODS A nationwide survey was linked with hospital databases to create a prospective cohort of patients with diabetes (n = 3416). We undertook a systematic review to identify prognostic models and traditional metrics (i.e., discrimination and calibration) to compare model performance for CKD prediction. We updated prognostic models by including additional clinical parameters to optimise model performance in the Thai setting. RESULTS Six relevant previously published models were identified. At baseline, C-statistics ranged from 0.585 (0.565-0.605) to 0.786 (0.765-0.806) for CKD and 0.657 (0.610-0.703) to 0.760 (0.705-0.816) for end-stage renal disease (ESRD). All original CKD models showed fair calibration with Observed/Expected (O/E) ratios ranging from 0.999 (0.975-1.024) to 1.009 (0.929-1.090). Hosmer-Lemeshow tests indicated a good fit for all models. The addition of routine clinical factors (i.e., glucose level and oral diabetes medications) enhanced model prediction by improved C-statistics of Low's of 0.114 for CKD and Elley's of 0.025 for ESRD. CONCLUSIONS All models showed moderate discrimination and fair calibration. Updating models to include routine clinical factors substantially enhanced their accuracy. Low's (developed in Singapore) and Elley's model (developed in New Zealand), outperformed the other models evaluated. These models can assist clinicians to improve the risk-stratification of diabetic patients for CKD and/or ESRD in the regions settings are similar to Thailand.
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Affiliation(s)
- Sigit Ari Saputro
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand
- Department of Epidemiology Biostatistics Population and Health Promotion, Faculty of Public Health, Airlangga University, Surabaya, 60115, Indonesia
| | - Anuchate Pattanateepapon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand.
| | - Oraluck Pattanaprateep
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand.
| | - Gareth J McKay
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - John Attia
- School of Medicine and Public Health, and Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand
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Chen Z, Wu S, Zeng Y, Chen Z, Li X, Li J, He L, Chen M. FuZhengHuaYuJiangZhuTongLuoFang Prescription Modulates Gut Microbiota and Gut-Derived Metabolites in UUO Rats. Front Cell Infect Microbiol 2022; 12:837205. [PMID: 35669118 PMCID: PMC9165620 DOI: 10.3389/fcimb.2022.837205] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/14/2022] [Indexed: 12/14/2022] Open
Abstract
Background Alteration of intestinal flora and metabolites is closely related to chronic kidney disease (CKD) across early to advanced stages. FuZhengHuaYuJiangZhuTongLuoFang prescription (FZHY) is a Chinese herb that has been proven to effectively treat CKD, but the underlying mechanism is not clear. Methods Rats were subjected to intragastric treatment with FZHY 7, 14, and 21 days after unilateral ureteral obstruction (UUO) surgery, and kidney tissue, colon tissue, serum, and stool samples were collected. Results FZHY treatment effectively ameliorated UUO-induced renal function loss, renal injury and renal fibrosis, and colon tissue damage and fibrosis on day 7. The results of 16S flora analysis (day 7) showed that, compared with the UUO group, both the FZHY group and the sham group showed decreased levels of g_Monoglobus, g_Papillibacter, g_Eubacterium_nodatum, and g_Family_XIII_AD3011. Additionally, FZHY obviously induced the reduction of serum citrulline, glycoursodeoxycholic acid, 23-nordeoxycholic acid, 7-ketodeoxycholic acid, kahweol, lipoid B4, 4-(3,4-dihydro-2H-1,5-benzodioxepin-7-yl)-2-methyl-1,3-thiazole, taurolithocholic acid sodium salt, indoline-2-carboxylic acid, 5(S),15(S)-diHETE, and others and the increase of bilirubin, asparagine, and others, which were positively associated with the above four candidate bacteria. Moreover, FZHY increased the levels of ZO-1, occludin, and claudin-1 in the colonic mucosa and reduced the levels of CRP, TNF-α, IL-6, and IL-1 in the serum and LN, FN, Col-I, and Col-III in the tubulointerstitium of UUO rats on day 7. Conclusion Our study revealed that FZHY reduced kidney damage at the early stage of CKD by regulating the above four candidate bacteria biomarkers and gut-derived harmful metabolites, inhibiting the inflammation response and tubulointerstitial fibrosis, providing deep insight into CKD therapeutic strategy.
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Affiliation(s)
- Ziwei Chen
- Department of Nephrology, Affiliated Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital, Chengdu First People's Hospital, Chengdu, China
| | - Shaobo Wu
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Zeng
- Department of Clinical Laboratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zejun Chen
- Department of Nephrology, Affiliated Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital, Chengdu First People's Hospital, Chengdu, China
| | - Xueying Li
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Li
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Long He
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ming Chen
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Rafique Z, Sadaf S, Batool S, Javeed S, Chughtai AS, Atiq A. Morphological Spectrum of Glomerulonephritis in Medical Renal Biopsies: A Single-Center Study. Cureus 2022; 14:e22579. [PMID: 35355533 PMCID: PMC8957646 DOI: 10.7759/cureus.22579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 12/04/2022] Open
Abstract
Background Glomerulonephritis is among the most common and serious non-communicable diseases in the world, and some of them are major causes of chronic kidney disease, which eventually leads to kidney failure. In developing countries, it is the most common cause of end-stage renal disease (ESRD). Chronic kidney disease affects 10-16% of the adult population in Asia, including 21.2% in Pakistan. This study aims to determine the frequency and spectrum of glomerulonephritis at our center. Methodology This is a cross-sectional analysis of 81 renal core biopsies obtained between August 2020 and August 2021. The histopathological reports, demographic data, and relevant laboratory investigations, such as blood urea and creatinine levels, were collected. All cases were blindly reviewed by two pathologists with a special interest in medical renal pathology. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY, USA). Results The majority of the patients (46.9%) were between the ages of 21 and 40 years. There was a slight male predominance, with 44 (54.3%) of the 81 participants being male. Hematuria was reported in 20 (24.7%) patients, with mean serum urea and creatinine levels of 75 mg/dL and 2.6 mg/dL, respectively. Nephrotic syndrome was the most common indication for a renal biopsy, accounting for 54 (67.7%) of the 81 cases. Chronic glomerulonephritis is classified into two categories, namely, primary and secondary glomerulonephritis. Focal segmental glomerulosclerosis (FSGS), the leading cause of primary glomerulonephritis, was found in 25 (30.9%) 81 patients. Furthermore, lupus nephritis (9.9%) and advanced glomerulonephritis (9.9%) were found in equal proportions among secondary glomerulonephritis. Conclusions According to our study, nephrotic syndrome was the most common indication for medical renal biopsy, with FSGS being the most common primary glomerulonephritis. Lupus nephritis and advanced glomerulonephritis were the most common secondary glomerulonephritis diagnoses.
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Saeed U, Fatima B, Hussain D, Ashiq R, Naeem Ashiq M, Najam-ul-Haq M. CoTe nanorods based electrochemical sensor for quantitative detection of albumin from chronic kidney disease patients. J Electroanal Chem (Lausanne) 2022. [DOI: 10.1016/j.jelechem.2021.115999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Shih YL, Shih CC, Chen SYF, Chen JY. Elevated serum leptin levels are associated with lower renal function among middle-aged and elderly adults in Taiwan, a community-based, cross-sectional study. Front Endocrinol (Lausanne) 2022; 13:1047731. [PMID: 36619557 PMCID: PMC9816377 DOI: 10.3389/fendo.2022.1047731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Plasma leptin is considered a risk factor for obesity and cardio-metabolic disease, but the link between serum leptin and renal function is still under evaluation. In our study, we focused on the relationship between serum leptin and renal function, and we investigated the relationship in more detail. METHODS The 396 middle-aged and elderly Taiwanese adults recruited for our health survey were the subject of our research. All participants agreed to participate and signed a consent form before they joined and completed our study. We divided the participants into three groups according to eGFR tertiles and analyzed the parameters between each group. Then, we used Pearson's correlation test to investigate the relationship between eGFR levels and cardio-metabolic risk factors with adjustment for age. The scatter plot indicates the trend between serum leptin levels and eGFR levels. Participants were reclassified into three subgroups according to their leptin levels and the bar chart reveals the prevalence of chronic kidney disease (CKD) in each group. Finally, we used multivariate linear regression to evaluate the relationship between serum leptin and eGFR levels with adjustment for age, sex, smoking status, drinking status, body mass index (BMI), uric acid levels, hypertension (HTN), diabetes mellitus (DM), and dyslipidemia. RESULTS In our study, we analyzed the data from 396 eligible participants. A total of 41.4% of the participants were male, and the average age of all participants was 64.81 years ( ± 8.78). The participants in the high eGFR group were more likely to have lower serum leptin levels. Furthermore, eGFR values were negatively correlated with serum leptin levels even after adjustment for age. The prevalence of CKD in the high serum leptin group was higher than that in the low serum leptin group. Serum leptin levels showed significant negative correlations with eGFR levels (β=-0.14, p<0.01) in the multivariate linear regression after adjusting for age, sex, smoking status, drinking status, BMI, uric acid levels, HTN, DM, and dyslipidemia. CONCLUSION According to our study, serum leptin levels show a negative relationship with eGFR levels in middle-aged and elderly people in Taiwan. In addition, high serum leptin levels could be an novel marker to survey kidney failure in clinical practices.
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Affiliation(s)
- Yu-Lin Shih
- Department of Family Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chin-Chuan Shih
- General Administrative Department, United Safety Medical Group, New Taipei, Taiwan
| | - Sun-Yi-Fan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Jau-Yuan Chen,
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Liyanage T, Toyama T, Hockham C, Ninomiya T, Perkovic V, Woodward M, Fukagawa M, Matsushita K, Praditpornsilpa K, Hooi LS, Iseki K, Lin MY, Stirnadel-Farrant HA, Jha V, Jun M. Prevalence of chronic kidney disease in Asia: a systematic review and analysis. BMJ Glob Health 2022; 7:e007525. [PMID: 35078812 PMCID: PMC8796212 DOI: 10.1136/bmjgh-2021-007525] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/25/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The burden of chronic kidney disease (CKD) is growing rapidly around the world. However, there is limited information on the overall regional prevalence of CKD, as well as the variations in national prevalence within Asia. We aimed to consolidate available data and quantify estimates of the CKD burden in this region. METHODS We systematically searched MEDLINE, Embase and Google Scholar for observational studies and contacted national experts to estimate CKD prevalence in countries of Asia (Eastern, Southern and South Eastern Asia). CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or the presence of proteinuria. For countries without reported data, we estimated CKD prevalence using agglomerative average-linkage hierarchical clustering, based on country-level risk factors and random effects meta-analysis within clusters. Published CKD prevalence data were obtained for 16 countries (of the 26 countries in the region) and estimates were made for 10 countries. RESULTS There was substantial variation in overall and advanced (eGFR <30 mL/min/1.73 m2) CKD prevalence (range: 7.0%-34.3% and 0.1%-17.0%, respectively). Up to an estimated 434.3 million (95% CI 350.2 to 519.7) adults have CKD in Asia, including up to 65.6 million (95% CI 42.2 to 94.9) who have advanced CKD. The greatest number of adults living with CKD were in China (up to 159.8 million, 95% CI 146.6 to 174.1) and India (up to 140.2 million, 95% CI 110.7 to 169.7), collectively having 69.1% of the total number of adults with CKD in the region. CONCLUSION The large number of people with CKD, and the substantial number with advanced CKD, show the need for urgent collaborative action in Asia to prevent and manage CKD and its complications.
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Affiliation(s)
- Thaminda Liyanage
- The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Medicine, University of Sydney, Sydney, NSW, Australia
- Armadale Kelmscott Memorial Hospital, East Metropolitan Health Service, Perth, WA, Australia
| | - Tadashi Toyama
- Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan
| | - Carinna Hockham
- The George Institute for Global Health, Imperial College London, London, UK
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - Vlado Perkovic
- The George Institute for Global Health, Newtown, New South Wales, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, Newtown, New South Wales, Australia
- The George Institute for Global Health, Imperial College London, London, UK
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, Japan, Japan
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Kunitoshi Iseki
- Okinawa Heart and Renal Association (OHRA) and Clinical Research Support Center, Tomishiro Central Hospital, Okinawa, Japan
| | - Ming-Yen Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | - Vivekanand Jha
- The George Institute for Global Health, India, New Dehli, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
- School of Public Health, Imperial College London, London, UK
| | - Min Jun
- The George Institute for Global Health, Newtown, New South Wales, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Emami E, Heidari-Soureshjani S, Sherwin CMT. Anti-inflammatory response to curcumin supplementation in chronic kidney disease and hemodialysis patients: A systematic review and meta-analysis. AVICENNA JOURNAL OF PHYTOMEDICINE 2022; 12:576-588. [PMID: 36583173 PMCID: PMC9768855 DOI: 10.22038/ajp.2022.20049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/17/2022] [Indexed: 12/31/2022]
Abstract
Objective This study was designed to determine the association curcumin has on pro-inflammatory biomarkers in patients with chronic kidney disease (CKD (and in those receiving hemodialysis (HD). Materials and Methods This meta-analysis was undertaken following PRISMA guidelines. An extensive systematic review was undertaken until 10/11/2021 using PubMed, Web of Science (ISI), and Scopus databases. The standardized mean difference (SMD) and 95% confidence intervals (CI) were used to estimate the overall effect size of curcumin on serum high-sensitivity C-reactive protein (hs-CRP), and pro-inflammatory cytokines including interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) in patients with CKD and those receiving HD. Results Overall, ten randomized controlled trials (RCTs) comprising 523 patients were incorporated into the systematic review and meta-analysis. The results showed that when compared with control groups, there was no significant effect observed linking curcumin and IL-6 (SMD = 0.24%, 95% CI = -0.14 to 0.62, p = 0.221), TNF-α (SMD = 0.11%, 95% CI = -0.19 to 0.40, p = 0.480) or hs-CRP (SMD = -0.17%, 95% CI = -0.36 to 0.03, p = 0.093). The analysis determined no publication bias related to the influence of curcumin on IL-6, TNF-α or acute phase reactant, hs-CRP. The Egger's and Begg's test results were not statistically significant (p˃0.20). Conclusion In patients with CKD and those receiving HD, the use of curcumin supplementation has no statistically significant effect on the anti-inflammatory biomarkers reviewed in this study.
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Affiliation(s)
- Elham Emami
- Department of Pediatric Nephrology, Emam Hossein Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Heidari-Soureshjani
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran,Corresponding Author: Tel: +98-9131833509, Fax: +98-383351031,
| | - Catherine MT Sherwin
- Department of Pediatric Clinical Pharmacology, Department of Pharmacology & Toxicology, Wright State University Boonshoft School of Medicine, Dayton Children's Hospital, One Children's Plaza, Dayton, Ohio, USA
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Shi JC, Chen XH, Yang Q, Wang CM, Huang Q, Shen YM, Yu J. A simple prediction model of hyperuricemia for use in a rural setting. Sci Rep 2021; 11:23300. [PMID: 34857832 PMCID: PMC8639845 DOI: 10.1038/s41598-021-02716-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/18/2021] [Indexed: 01/20/2023] Open
Abstract
Currently, the most widely used screening methods for hyperuricemia (HUA) involves invasive laboratory tests, which are lacking in many rural hospitals in China. This study explored the use of non-invasive physical examinations to construct a simple prediction model for HUA, in order to reduce the economic burden and invasive operations such as blood sampling, and provide some help for the health management of people in poor areas with backward medical resources. Data of 9252 adults from April to June 2017 in the Affiliated Hospital of Guilin Medical College were collected and divided randomly into a training set (n = 6364) and a validation set (n = 2888) at a ratio of 7:3. In the training set, non-invasive physical examination indicators of age, gender, body mass index (BMI) and prevalence of hypertension were included for logistic regression analysis, and a nomogram model was established. The classification and regression tree (CART) algorithm of the decision tree model was used to build a classification tree model. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analyses (DCA) were used to test the distinction, accuracy and clinical applicability of the two models. The results showed age, gender, BMI and prevalence of hypertension were all related to the occurrence of HUA. The area under the ROC curve (AUC) of the nomogram model was 0.806 and 0.791 in training set and validation set, respectively. The AUC of the classification tree model was 0.802 and 0.794 in the two sets, respectively, but were not statistically different. The calibration curves and DCAs of the two models performed well on accuracy and clinical practicality, which suggested these models may be suitable to predict HUA for rural setting.
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Affiliation(s)
- Jia-Cheng Shi
- Department of Nephrology, Haining People’s Hospital, No. 2 West Qianjiang Road, Jiaxing, 314400 Zhejiang China
| | - Xiao-Huan Chen
- Department of Endocrinology and Rheumatology, The First People’s Hospital of Linping District, No. 369 Yingbin Road, Hangzhou, 311100 Zhejiang China
| | - Qiong Yang
- grid.452806.d0000 0004 1758 1729Department of Endocrinology, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Guilin, 541001 Guangxi China
| | - Cai-Mei Wang
- grid.452806.d0000 0004 1758 1729Department of Laboratory Medicine, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Guilin, 541001 Guangxi China
| | - Qian Huang
- grid.452806.d0000 0004 1758 1729Department of Endocrinology, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Guilin, 541001 Guangxi China
| | - Yan-Ming Shen
- grid.452806.d0000 0004 1758 1729Department of Endocrinology, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Guilin, 541001 Guangxi China
| | - Jian Yu
- Department of Endocrinology, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Guilin, 541001, Guangxi, China.
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Abstract
Although coronavirus disease 2019 (COVID-19) is a pandemic, it has several specificities influencing its outcomes due to the entwinement of several factors, which anthropologists have called "syndemics". Drawing upon Singer and Clair's syndemics model, I focus on synergistic interaction among chronic kidney disease (CKD), diabetes, and COVID-19 in Pakistan. I argue that over 36 million people in Pakistan are standing at a higher risk of contracting COVID-19, developing severe complications, and losing their lives. These two diseases, but several other socio-cultural, economic, and political factors contributing to structured vulnerabilities, would function as confounders. To deal with the critical effects of these syndemics the government needs appropriate policies and their implementation during the pandemic and post-pandemic. To eliminate or at least minimize various vulnerabilities, Pakistan needs drastic changes, especially to overcome (formal) illiteracy, unemployment, poverty, gender difference, and rural and urban difference.
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Affiliation(s)
- Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
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Factors Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312277. [PMID: 34886001 PMCID: PMC8657096 DOI: 10.3390/ijerph182312277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 12/25/2022]
Abstract
Diabetes and chronic kidney disease (CKD) are a major public health burden in low- and middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on the estimated glomerular filtration rate using the ‘Modification of Diet in Renal Disease’ equations and the presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model, factors associated with CKD included age 40–49 years (OR: 5.7, 95% CI: 1.3–25.4), age 50–59 years (7.0, 1.6–39), age ≥60 years (7.6, 1.7–34), being female (2.2, 1.2–3.8), being hypertensive (1.9, 1.1–3.5), and household income between 10,001 and 20,000 Bangladeshi taka, BDT (2.9, 1.0–8.2) compared with income ≤10,000 BDT. However, after adjustment of other covariates, only the duration of hypertension and household income (10,001–20,000 BDT) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.
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Jabbar A, Qureshi R, Nasir K, Dhrolia M, Ahmad A. Transudative and Exudative Pleural Effusion in Chronic Kidney Disease Patients: A Prospective Single-Center Study. Cureus 2021; 13:e18649. [PMID: 34786244 PMCID: PMC8578877 DOI: 10.7759/cureus.18649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/26/2022] Open
Abstract
Objective The aim of the study is to assess the incidence of pleural effusion and to assess its etiology in admitted chronic kidney disease patients who were admitted secondary to various causes, i.e., fluid overload, sepsis, etc. Material and methods A prospective cross-sectional observational study was conducted at the Department of Nephrology, The Kidney Centre Postgraduate Training Institute, Karachi. A total of 789 patients were admitted between August 2020-February 2021. This study comprised 280 adult chronic kidney disease (chronic kidney disease and end-stage renal disease patients who were on dialysis) patients having pleural effusion (either unilateral or bilateral) secondary to various causes. Results Among 280 patients, the mean age was 55 years with 158 (56.4%) males and 122 (43.6%) females, diabetes (76%) was present in most of the patients along with hypertension (86.1%), and most of the patients were of stage IV and V. Transudative pleural effusion was present in 212 (75.7%) patients secondary to fluid overload and heart failure was the commonest cause while 68 (24.3%) patients had exudative pleural effusion with tuberculosis being the commonest etiology, 44 (15.7%) patients needed intervention while 236 (84.3%) were treated medically. The data was entered and analyzed on SPSS version 21 (IBM Corp, Armonk, USA). The cleaning and coding of data were done before analysis. Continuous variables were expressed in mean ± standard deviation, while the frequencies with percentages were obtained for categorical variables. The Chi-square test was applied to see the association between variables. A p-value of ≤ 0.05 was considered significant. Conclusion Clarification of the cause of pleural effusion is essential. Early diagnosis and prompt treatment like thoracocentesis or in the case of patients on hemodialysis, adequate dialysis may be necessary.
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Affiliation(s)
- Asfia Jabbar
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Ruqaya Qureshi
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Kiran Nasir
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Murtaza Dhrolia
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
| | - Aasim Ahmad
- Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK
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Muhammad Saleh W, Rehman ZU, Hashmi S. Maturation and Patency Rates in Basilic Transposition Arteriovenous Fistula Under Regional Versus General Anesthesia: A Single-Center, Retrospective, Observational Study. Cureus 2021; 13:e16991. [PMID: 34540394 PMCID: PMC8422592 DOI: 10.7759/cureus.16991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/06/2022] Open
Abstract
Background Basilic transposition arteriovenous fistula (BT AVF) is a viable option for dialysis-dependent patients, which can be performed under either general or regional anesthesia. Regional anesthesia is reported to cause vascular dilatation during the perioperative period, leading to improved fistula success. Regional anesthesia is also considered safe as compared to general anesthesia in terms of hemodynamic stability. Limited and conflicting data are available comparing regional versus general anesthesia in terms of fistula maturation and patency. We aimed to compare the maturation, one-year patency rates, and complication rates in patients undergoing single-stage BT AVF in regional versus general anesthesia. Methods This retrospective observational study was conducted on patients undergoing single-stage BT AVF from January 2016 to December 2019. Patients were divided into regional (RA) vs. general anesthesia (GA) groups and compared in terms of maturation, one-year patency, and perioperative complication rates. Results Out of 152 patients, 110 (72.37%) were in GA while 42 (27.63%) were in the RA group. Elderly, female, diabetic, ischemic heart disease, and American Society of Anesthesiologists (ASA) class IV patients were more in the RA group. Other comorbid and vascular access-related factors were comparable between the groups. A trend toward higher maturation rates (97.6% vs. 92.1%) and one-year patency rates (62.5% vs. 56.6%) was observed in the RA vs. GA group, however, the difference did not attain statistical significance, p=0.359 and p=0.327, respectively. The rate of access abandonment was higher in the GA group (43.4% vs. 37.5%). The most prevalent cause of abandonment was death in the RA group while it was access failure in the GA group. Overall complication rates were comparable between both groups (20.2 % vs. 17.5%, p=0.816). Conclusion Regional anesthesia is a useful technique with potentially improved maturation and patency rates. Nevertheless, an assumed benefit of regional anesthesia in terms of anesthesia-related complications was not observed.
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Affiliation(s)
- Waryam Muhammad Saleh
- Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, PAK
- Department of Vascular and Endovascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, PAK
| | - Zia U Rehman
- Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, PAK
| | - Shiraz Hashmi
- Department of Surgery, Aga Khan University Hospital, Karachi, PAK
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Sarker MHR, Moriyama M, Rashid HU, Chisti MJ, Rahman MM, Das SK, Uddin A, Saha SK, Arifeen SE, Ahmed T, Faruque A. Community-based screening to determine the prevalence, health and nutritional status of patients with CKD in rural and peri-urban Bangladesh. Ther Adv Chronic Dis 2021; 12:20406223211035281. [PMID: 34377387 PMCID: PMC8326824 DOI: 10.1177/20406223211035281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/05/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Studies have labelled chronic kidney disease (CKD) among the adult population in urban Bangladesh. To address knowledge gaps on CKD, we aimed to generate data on prevalence, health and nutrition of CKD individuals living in rural and peri-urban Bangladesh. Methods: Participants were recruited from the Mirzapur Demographic Surveillance System by age-stratified random sampling. We screened participants by measuring serum creatinine and urine albumin to creatinine ratio, and collected socio-demographic, lifestyles and health information (phase I). After 3 months (phase II), we repeated the urine and blood tests as per the Kidney Disease Outcomes Quality Initiative guidelines. The glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation. Results: Among 928 participants, 872 completed the study. In phase I, probable CKD cases were 281 (32.2%); in phase II, confirmed cases were 192 (22.0%) (stage 1, 4.0%; stage 2, 11.8%; stage 3, 5.5%; stage 4, 0.6%; stage 5, 0.1%). In multivariable analysis, associated factors for prevalent CKD included aged ⩾60 years [adjusted odds ratio (aOR) 5.02; 95% confidence interval (CI) 1.85–13.65], hypertension (aOR 3.08; 95% CI 2.07–4.59), diabetes (aOR 2.52; 95% CI 1.60–3.96), presence of red blood cell in urine (aOR 3.20; 95% CI 1.71–5.98) and anemia (aOR 2.50; 95% CI 1.63–3.84). Conclusions: This is the first ever research on CKD prevalence in rural and peri-urban Bangladesh and recorded about 22%, which is higher than urban settings. Monitoring systems are needed to evaluate the overall burden and to mitigate risk factors with an emphasis on the rural and peri-urban population.
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Affiliation(s)
- Mohammad Habibur Rahman Sarker
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Harun Ur Rashid
- Kidney Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sumon Kumar Das
- Menzies - School of Health Research, Charles Darwin University, Darwin, Australia
| | - Aftab Uddin
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | | | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Asg Faruque
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
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Zhou H, Yao W, Pan D, Sun G. Predicational ability of phase angle on protein energy wasting in kidney disease patients with renal replacement therapy: A cross-sectional study. Food Sci Nutr 2021; 9:3573-3579. [PMID: 34262718 PMCID: PMC8269568 DOI: 10.1002/fsn3.2310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the ability of phase angle (PA) and body composition for predicting protein energy wasting (PEW) in renal replacement therapy (RRT) patients. METHODS Renal replacement therapy (RRT) patients were enrolled in this study. Body composition was measured by direct segmental multi-frequency biolectrical impedance analysis method (DSM-BIA); phase angle (PA), fat-free mass (FFM), fat mass (FM), mid-arm circumference (MAC), WC (waist circumference), and ECW/TBW (extracellular water/total body water) were obtained. Biochemicals (serum albumin, triglyceride, and cholesterol) were tested. PEW patients were classified according to ISRNM (The International Society of Renal Nutrition and Metabolism) criteria. Cutoff value of PA and related variables was calculated by ROC analysis. The ability of body composition variables as indicators to predict PEW was evaluated. RESULTS Sixty-four patients were enrolled in this study. Thirty-three patients (52.6%) were males, and forty (62.5%) patients were diagnosed with PEW. The ROC curve showed that the optimal cutoff values of PA, FFMI (fat-free mass index), MAC, WC, and BMI for PEW risk were 4.45°, 16.71, 29.7 cm, 86.4 cm, and 21.1 kg/m2, respectively. These indicators showed significant association with PEW; meanwhile, the PA and MAC can be used as the predictors for PEW with OR 6.333 (95% CI, 1.956-20.505) and 3.267 (95% CI, 1.136-9.394), respectively. Both groups have a lower BUN/Cr ratio (<20). CONCLUSION In the RRT patients, over than 60% patients were diagnosed with PEW. PA, MAC, and other body composition can be used as the independent indicators for predicting PEW in renal replacement therapy kidney disease patients.
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Affiliation(s)
- Haiteng Zhou
- Key Laboratory of Environmental Medicine and Engineering Ministry of EducationDepartment of Nutrition and Food HygieneSchool of Public HealthSoutheast UniversityNanjingChina
| | | | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering Ministry of EducationDepartment of Nutrition and Food HygieneSchool of Public HealthSoutheast UniversityNanjingChina
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering Ministry of EducationDepartment of Nutrition and Food HygieneSchool of Public HealthSoutheast UniversityNanjingChina
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Divyaveer SS, Ramachandran R, Sahay M, Singh Shah D, Akhtar F, Bello AK, Iyengar A, Johnson DW, Harris DC, Levin A, Lunney M, Rahman M, Rashid HU, Saad S, Zaidi D, Osman MA, Varughese S, Wijewickrama ES, Khan M, Ye F, Tonelli M, Okpechi IG, Jha V. International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in South Asia. Kidney Int Suppl (2011) 2021; 11:e97-e105. [PMID: 33981475 PMCID: PMC8084730 DOI: 10.1016/j.kisu.2021.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022] Open
Abstract
Information about disease burden and the available infrastructure and workforce to care for patients with kidney disease was collected for the second edition of the International Society of Nephrology Global Kidney Health Atlas. This paper presents findings for the 8 countries in the South Asia region. The World Bank categorizes Afghanistan and Nepal as low-income; Bangladesh, Bhutan, India, and Pakistan as lower-middle-income; and Sri Lanka and the Maldives as upper-middle-income countries. The prevalence of chronic kidney disease (CKD) in South Asia ranged from 5.01% to 13.24%. Long-term hemodialysis and long-term peritoneal dialysis are available in all countries, but Afghanistan lacks peritoneal dialysis services. Kidney transplantation was available in all countries except Bhutan and Maldives. Hemodialysis was the dominant modality of long-term dialysis, peritoneal dialysis was more expensive than hemodialysis, and kidney transplantation overwhelmingly depended on living donors. Bhutan provided public funding for kidney replacement therapy (dialysis and transplantation); Sri Lanka, India, Pakistan, and Bangladesh had variable funding mechanisms; and Afghanistan relied solely on out-of-pocket expenditure. There were shortages of health care personnel across the entire region. Reporting was variable: Afghanistan and Sri Lanka have dialysis registries but publish no reports, whereas Bangladesh has a transplant registry. South Asia has a large, but poorly documented burden of CKD. Diabetes and hypertension are the major causes of CKD throughout the region with a higher prevalence of infectious causes in Afghanistan and a high burden of CKD of an unknown cause in Sri Lanka and parts of India. The extent and quality of care delivery is suboptimal and variable. Sustainable strategies need to be developed to address the growing burden of CKD in the region.
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Affiliation(s)
- Smita S. Divyaveer
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raja Ramachandran
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manisha Sahay
- Department of Nephrology, Osmania Medical College and General Hospital, Hyderabad, Telangana, India
| | - Dibya Singh Shah
- Department of Nephrology and Transplant Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - Fazal Akhtar
- Sind Institute of Urology and Transplantation, Karachi, Pakistan
| | - Aminu K. Bello
- Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Arpana Iyengar
- Department of Pediatric Nephrology, St. Johns Medical College Hospital, Bangalore, India
| | - David W. Johnson
- Department of Nephrology, Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Translation Research Institute, Brisbane, Queensland, Australia
| | - David C.H. Harris
- Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
| | - Adeera Levin
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Meaghan Lunney
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Muhibur Rahman
- Department of Nephrology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
| | - Harun-Ur Rashid
- Department of Nephrology, Kidney Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Syed Saad
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Deenaz Zaidi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mohamed A. Osman
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Eranga S. Wijewickrama
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Maryam Khan
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Feng Ye
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Pan-American Health Organization/World Health Organization’s Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
| | - Ikechi G. Okpechi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa
- Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales (UNSW), New Delhi, India
- School of Public Health, Imperial College, London, UK
- Manipal Academy of Higher Education, Manipal, India
| | - ISN South Asia Regional Board
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Department of Nephrology, Osmania Medical College and General Hospital, Hyderabad, Telangana, India
- Department of Nephrology and Transplant Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
- Sind Institute of Urology and Transplantation, Karachi, Pakistan
- Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Department of Pediatric Nephrology, St. Johns Medical College Hospital, Bangalore, India
- Department of Nephrology, Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Translation Research Institute, Brisbane, Queensland, Australia
- Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Nephrology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
- Department of Nephrology, Kidney Foundation Hospital and Research Institute, Dhaka, Bangladesh
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Nephrology, Christian Medical College, Vellore, India
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Pan-American Health Organization/World Health Organization’s Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
- Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa
- Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
- George Institute for Global Health, University of New South Wales (UNSW), New Delhi, India
- School of Public Health, Imperial College, London, UK
- Manipal Academy of Higher Education, Manipal, India
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Gibertoni D, Mammana L, Gherardi G, Baschieri E, Minora F, Santoro A. Presentation and outcome of chronic kidney disease in Italian and immigrant citizens: results from the Emilia-Romagna PIRP project. J Nephrol 2021; 35:179-190. [PMID: 33595822 DOI: 10.1007/s40620-021-00984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In recent decades, high income countries (HIC) have been exposed to huge human migratory flows. Consistent with this influx, there has been a dramatic increase in the number of chronic kidney disease (CKD) patients in the immigrant population. In Italy, comparisons between Italian and immigrant CKD patients are still lacking, thus we aimed to describe the baseline clinical characteristics and the main outcomes of CKD patients who immigrated to Italy and reside in the Emilia Romagna region. METHODS This is a retrospective cohort study based on CKD patients from the Prevenzione Insufficienza Renale Progressiva (PIRP) project, which included 963 (3.1%) immigrants among the 30,702 patients seen by nephrologists between April 1st, 2004 and June 30th, 2020. We sub-divided the immigrants into seven groups based on their area of origin, and compared their baseline characteristics, CKD progression and time to end-stage kidney disease (ESKD) to those of Italian CKD patients. RESULTS At presentation, Italian subjects were on average older (73.1 years) and had less preserved kidney function (eGFR 34.3 ml/min), while South and East Asians had the highest proportion of diabetes and obesity (approximately 45% and 30%, respectively). At 4-year follow-up, about 20% of patients from South Asia, Eastern Europe and Arab Countries were diagnosed with ESKD, compared to only 11% of Italians and Latin Americans. CONCLUSIONS We found important differences between Italian and immigrant CKD patients, as well as among immigrant subgroups. First clinical encounters with nephrologists revealed that immigrants had varied patterns of clinical presentation and of nephropathy. During follow-up, immigrants showed faster kidney function decline which led to a higher risk of disease evolution and progression towards ESKD.
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Affiliation(s)
- Dino Gibertoni
- Department of Neuromotor and Biomedical Sciences, Unit of Hygiene and Public Health, University of Bologna, Bologna, Italy
| | - Leonardo Mammana
- Department of Primary Care, Bologna Healthcare Authority, Bologna, Italy
| | - Giulia Gherardi
- Specialty School of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Erica Baschieri
- Specialty School of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Francesco Minora
- Specialty School of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Antonio Santoro
- Specialty School of Nephrology, University of Bologna, Via Albertoni 15, 40138, Bologna, Italy.
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Sahay M, Jasuja S, Wai TSC, Alexander S, Jha V, Vachharajani T, Mostafi M, Pisharam JK, Jacob C, Gunawan A, Leong GB, Thwin KT, Agrawal RK, Vareesangthip K, Tanchanco R, Choong L, Herath C, Lin CC, Cuong NT, Haian HP, Akhtar SF, Alsahow A, Rana DS, Rajapurkar MM, Kher V, Verma S, Ramachandran R, Bhargava V, Puri S, Sagar G, Bahl A, Mandal S, Gupta A, Gallieni M. Aetiology, practice patterns and burden of end-stage kidney disease in South Asia and South-East Asia: A questionnaire-based survey. Nephrology (Carlton) 2021; 26:142-152. [PMID: 33169890 PMCID: PMC7615902 DOI: 10.1111/nep.13825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/11/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
AIM There is paucity of data on the epidemiology of end-stage kidney disease (ESKD) from South Asia and South-East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies. METHODS The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community-based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher-middle-income) and Group 2 (lower|lowermiddle income). Student t-test, Mann-Whitney U test and Fisher's exact test were used for comparison. RESULTS Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2-59.45 vs 47.7 years). CONCLUSION Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis.
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Affiliation(s)
- Manisha Sahay
- Department of Nephrology Osmania General Hospital, Hyderabad (+91) 9849097507
| | - Sanjiv Jasuja
- Department of Nephrology Indraprastha Apollo Hospital, Delhi (+91) 9711197981
| | - Tang Sydeny Chi Wai
- Department of Nephrology Queen Mary Hospital Hong Kong Society of Nephrology (+852) 92360037
| | | | - Vivekanand Jha
- Department of Nephrology George Institute of Global Health (+91) 85275 44733
| | - Tushar Vachharajani
- Department of Nephrology Cleveland Clinic, Ohio, United States (+1) 336 546 2713
| | - Mamun Mostafi
- Department of Nephrology Armed Forces Medical College, Bangladesh Representative from Bangladesh Renal Association (+880) 171 3035 346
| | - Jayakrishnan K Pisharam
- Department of Nephrology Ministry of Health, Brunei, Darussalam Medical Services, Brunei Representative from Brunei Society of Nephrology (+673) 817 8123
| | - Chakko Jacob
- Department of Nephrology Bangalore Baptist Hospital, India Representative from Indian Society of Nephrology (+91)9535236019
| | - Atma Gunawan
- Department of Nephrology Brawijaya University, Indonesia Representative from Society of Nephrology Indonesia (+62) 812 3300 543
| | - Goh Bak Leong
- Department of Nephrology Serdang Hospital, Malaysia Representative from Malaysian Nephrology Congress (+60) 1260 69119
| | - Khin Thida Thwin
- Department of Nephrology University Of Medicine, Myanmar Representative from Myanmar Nephro-Uro Society (+95) 95021764
| | - Rajendra Kumar Agrawal
- Department of Nephrology Bir Hospital, Nepal Nepal Society of Nephrology (+977)98 5102 3840
| | - Kriengsak Vareesangthip
- Department of Nephrology Siriraj Hospital, Mahidol University, Thailand Representative from Nephrology Society of Thailand (+66) 24198383
| | - Roberto Tanchanco
- Department of Nephrology The Medical City, Philippine Representative from Philippine Society of Nephrology (+63)9189173940
| | - Lina Choong
- Department of Nephrology Singapore General Hospital, Singapore Representative from Singapore Society of Nephrology (+65) 81253594
| | - Chula Herath
- Department of Nephrology Sri Jayewardenepura General Hospital, Srilanka Representative from Sri Lanka Society of Nephrology (+94) 773017025
| | - Chih-Ching Lin
- Department of Nephrology Taipei Veterans General Hospital, Taiwan Representative from Taiwan society of Nephrology (+886) 937024083
| | - Nguyen The Cuong
- Department of Nephrology Hochiminh City national University, Vietnam Representative from Society of Nephrology-Urology of Vietnam (+84) 912 323276
| | - Ha Phan Haian
- Department of Nephrology Viet Duc University Hospital, Vietnam Representative from- Society of Nephrology-Urology of Vietnam (+84) 913546992
| | - Syed Fazal Akhtar
- Department of Nephrology Sindh Institute of Urology and Transplantation, Pakistan Representative from Pakistan Society of Nephrology (+92)300 8249856
| | - Ali Alsahow
- Department of Nephrology Jahara Hospital, Kuwait Representative From Gulf Corporation Council (+96)599335599
| | - D S Rana
- Department of Nephrology Sir Gangaram Hospital, Delhi (+91)9811033984
| | - M M Rajapurkar
- Department of Nephrology Muljibhai Patel Urological Hospital, Gujrat (+91) 9824349500
| | - Vijay Kher
- Department of Nephrology Medanta Hospital Gurugram, Haryana (+91) 9811054118)
| | - Shalini Verma
- Clinical Research AVATAR foundation, New Delhi (+91)8586983027
| | | | - Vinant Bhargava
- Department of Nephrology Sir Ganga Ram Hospital, Delhi (+91) 9990610096
| | - Sonika Puri
- Department of Nephrology Rutgers Robert Wood Johnson Medical School, New Jersy United States +1 (732) 501 1737
| | - Gaurav Sagar
- Department of Nephrology Indraprastha Apollo Hospital, Delhi (+91) 9810995996
| | - Anupam Bahl
- Department of Nephrology Indraprastha Apollo Hospital, Delhi (+91) 9711311750
| | - Sandeep Mandal
- Department of Nephrology Columbia Asia Hospital, Gurugram (+91) 8130007368
| | - Ashwani Gupta
- Department of Nephrology Sir Ganga Ram Hospital, Delhi (+91) 9811049761
| | - Maurizio Gallieni
- Department of Nephrology ‘L. Sacco’ Department of Biomedical and Clinical Sciences University of Milano, Italy (+39) 347746 8832
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Yaqub S, Abdul Razzaque MR, Aftab A, Siddiqui NA. Outcomes of tunneled cuffed hemodialysis catheters: An experience from a tertiary care center in Karachi, Pakistan. J Vasc Access 2021; 23:275-279. [PMID: 33487073 DOI: 10.1177/1129729821989904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Tunneled cuffed catheters (TCC) are generally used as a temporary means to provide hemodialysis (HD) until permanent arteriovenous access is established. However, certain complications are associated with use of TCCs such as infections, catheter malfunction/malposition or venous stenosis. Limited data is available on outcomes and long term complications associated with TCCs in our country. The aim of this study was to study the outcomes of TCCs and associated long term complications during the course of its usage. METHODS We retrospectively studied case records of patients who had TCCs placed for HD at our institution, from January 2016 to June 2018. RESULTS A total of 116 TCCs were placed during the study period. The mean age of the population was 57.09 years; 58.6% were males. The right internal jugular vein (52.6%) was the most common site of TCC insertion followed by the left internal jugular vein (29.3%). Functioning TCCs were successfully removed in almost two-thirds of cases (65.7%) once their permanent access was mature. Development of catheter related blood stream infection (CRBSI) was seen in 22 patients (19.8%) requiring catheter removal in 14 (12.6%) patients. Mechanical complications leading to catheter removal were seen in seven patients (6.3%). The median catheter duration was 62.5 days ranging from 1 to 343 days. CONCLUSION TCCs, though associated with complications particularly CRBSI, are a viable option for short- to intermediate-term use for HD till the maturation of permanent arteriovenous access in a limited-resource setting.
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Affiliation(s)
- Sonia Yaqub
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Azib Aftab
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Chen CM, Chung YP, Liu CH, Huang KT, Guan SS, Chiang CK, Wu CT, Liu SH. Withaferin A protects against endoplasmic reticulum stress-associated apoptosis, inflammation, and fibrosis in the kidney of a mouse model of unilateral ureteral obstruction. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2020; 79:153352. [PMID: 33007732 DOI: 10.1016/j.phymed.2020.153352] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/26/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Withaferin A is a functional ingredient of a traditional medicinal plant, Withania somnifera, which has been broadly used in India for protecting against chronic diseases. This bioactive steroidal lactone possesses multiple functions such as anti-oxidation, anti-inflammation, and immunomodulation. Chronic kidney disease (CKD) is one of the major health problems worldwide with the high complication, morbidity, and mortality rates. The detailed effects and underlying mechanisms of withaferin A on CKD progression still remain to be clarified. PURPOSE We aimed to investigate whether withaferin A treatment ameliorates the development of renal fibrosis and its related mechanisms in a CKD mouse model. METHODS A mouse model of unilateral ureteral obstruction (UUO) was used to mimic the progression of CKD. Male adult C57BL/6J mice were orally administered with 3 mg/kg/day withaferin A for 14 consecutive days after UUO surgery. Candesartan (5 mg/kg/day) was used as a positive control. RESULTS Both Withaferin A and candesartan treatments significantly ameliorated the histopathological changes and collagen deposition in the UUO kidneys. Withaferin A could significantly reverse the increases in the protein levels of pro-fibrotic factors (fibronectin, transforming growth factor-β, and α-smooth muscle actin), inflammatory signaling molecules (phosphorylated nuclear factor-κB-p65, interleukin-1β, and cyclooxygenase-2), and cleaved caspase-3, apoptosis, and infiltration of neutrophils in the UUO kidneys. The protein levels of endoplasmic reticulum (ER) stress-associated molecules (GRP78, GRP94, ATF4, CHOP, phosphorylated eIF2α, and cleaved caspase 12) were increased in the kidneys of UUO mice, which could be significantly reversed by withaferin A treatment. CONCLUSION Withaferin A protects against the CKD progression that is, at least in part, associated with the moderation of ER stress-related apoptosis, inflammation, and fibrosis in the kidneys of CKD. Withaferin A may serve as a potential therapeutic agent for the development of CKD.
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Affiliation(s)
- Chang-Mu Chen
- Department of Surgery, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Yao-Pang Chung
- Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Hung Liu
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Tong Huang
- Department of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Siao-Syun Guan
- Institute of Nuclear Energy Research, Atomic Energy Council, Taoyuan, Taiwan
| | - Chih-Kang Chiang
- Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Integrated Diagnostics & Therapeutics, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
| | - Chen-Tien Wu
- Department of Nutrition, China Medical University, Taichung, Taiwan; Master Program of Food and Drug Safety, China Medical University, Taichung, Taiwan.
| | - Shing-Hwa Liu
- Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Paediatrics, National Taiwan University Hospital, Taipei, Taiwan.
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Zhou Y, Ren Q, Chen G, Jin Q, Cui Q, Luo H, Zheng K, Qin Y, Li X. Chronic Kidney Diseases and Acute Kidney Injury in Patients With COVID-19: Evidence From a Meta-Analysis. Front Med (Lausanne) 2020; 7:588301. [PMID: 33224965 PMCID: PMC7670057 DOI: 10.3389/fmed.2020.588301] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/29/2020] [Indexed: 01/08/2023] Open
Abstract
Renal involvement has been implicated in coronavirus disease 2019 (COVID-19), but the related prevalence and prognosis were largely unknown. In this meta-analysis, we searched the literature from PubMed, Embase, through bioRxiv, and medRxiv until April 26, 2020. Studies reporting chronic kidney diseases (CKDs) and/or acute kidney injury (AKI) were included. Demographics, relevant data of disease severity, and patient's prognosis were extracted and aggregated. Twenty-one thousand one hundred sixty-four patients from 52 peer-reviewed studies were included. Thirty-seven studies (n = 16,922) reported CKD in COVID-19 patients at diagnosis, and the pooled prevalence was 3.52% (95% CI, 1.98-5.48%; I 2 = 93%). Subgroup analysis showed that CKD prevalence was higher in severe cases [odds ratio (OR), 3.42; 95% CI 2.05-5.61; I 2 = 0%] compared to those with non-severe disease and deceased cases (6.46, 3.40-12.29; I 2 = 1%) compared with survivors. Pooled prevalence of CKD was lower in Chinese patients (2.56%; 95% CI, 1.79-3.47%; I 2 = 80%) compared to those outside of China (6.32%; 95% CI, 0.9-16.12%; I 2 = 93%) (p = 0.08). The summary estimates for AKI prevalence was 11.46% (95% CI, 6.93-16.94%). Patients with AKI had a higher prevalence of developing into severe cases (OR, 6.97; 95% CI, 3.53-13.75; I 2 = 0%) and mortality risk (45.79, 36.88-56.85; I 2 = 17%). The prevalence estimates of CKD or AKI were not significantly different from preprint publications (p > 0.05). Our study indicates that renal condition, either in CKD or AKI, is associated with COVID-19 prognosis, and taking care of such patients needs further awareness and investigations.
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Affiliation(s)
- Yangzhong Zhou
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qidong Ren
- School of Medicine, Tsinghua University, Beijing, China
| | - Gang Chen
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiao Jin
- School of Medicine, Tsinghua University, Beijing, China
| | - Quexuan Cui
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huiting Luo
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ke Zheng
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Qin
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuemei Li
- Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Evaluation of management and factors associated with hypertension control in hemodialysis patients at a tertiary-care hospital in Pakistan. DRUGS & THERAPY PERSPECTIVES 2020. [DOI: 10.1007/s40267-020-00763-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Banik S, Ghosh A. Prevalence of chronic kidney disease in Bangladesh: a systematic review and meta-analysis. Int Urol Nephrol 2020; 53:713-718. [PMID: 32789568 DOI: 10.1007/s11255-020-02597-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Worldwide, chronic kidney disease (CKD) is a major public health issue, with a leading cause of death and disability. The aim of our study to estimate the prevalence of CKD in the Bangladeshi population based on existing data of previous studies. METHODS In this systematic review and meta-analysis study, electronic search engines of PubMed, Google Scholar, Scopus, and the national journal databases were used to find relevant published articles until December 31, 2019. Based on predefined inclusion/exclusion criteria, nine studies were included, and RevMan V5.0 statistical software was used for meta-analysis. RESULTS The outcomes of the included studies (nine studies, a total of 225,206 participants) based on meta-analysis showed an overall prevalence of CKD in Bangladeshi people of 22.48%, which was higher than the global prevalence of CKD. The prevalence of CKD in females was higher with high heterogeneity (I2 90%) in contrast to male participants (25.32% vs. 20.31%). CONCLUSION Above all, this study revealed a higher rate of prevalence of CKD in Bangladeshi people. So, it needs more attention to concern public health policymakers and the government to control and reduce the high-risk of disability due to CKD.
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Affiliation(s)
- Sujan Banik
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh.
| | - Antara Ghosh
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
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Mahato SKS, Apidechkul T, Sriwongpan P, Hada R, Sharma GN, Nayak SK, Mahato RK. Factors associated with quality of life among chronic kidney disease patients in Nepal: a cross-sectional study. Health Qual Life Outcomes 2020; 18:207. [PMID: 32600360 PMCID: PMC7325283 DOI: 10.1186/s12955-020-01458-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/19/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) leads to decreased quality of life (QOL) by increasing the risk of death during the progression of its pathogenesis. However, many factors can be improved to support QOL. This study aimed to assess QOL among CKD patients in Nepal and to determine the factors associated with their QOL. METHOD A cross-sectional study was used for data collection. CKD cases receiving medical attention in the Bir Hospital in Mahaboudh, Kathmandu; Tribhuvan University Teaching Hospital in Maharajgunj, Kathmandu; Sumeru Hospital in Dhapakhel, Lalitpur; and Shahid Dharma Bhakta National Transplant Centre in Bhaktapur between August and October 2019 were invited to participate in the study. A validated questionnaire and the kidney disease quality of life short form (KDQOL-SF™ 1.3) were used to assess QOL. A questionnaire was completed by the researcher in face-to-face interviews. Logistic regression was used to detect the associations between variables at the significance level of α = 0.05. RESULTS A total of 440 participants were recruited into the study: 56.59% were males, 74.32% were aged between 31 and 70 years, 25.68% were illiterate, and 82.95% were unemployed. The prevalence of good QOL among CKD in the domains of the physical component summary (PCS), mental component summary (MCS), and kidney disease component summary (KDCS) with and without hemodialysis were 53.64, 22.05, 21.28, and 13.19%, respectively. After controlling for all potential confounding factors, eight variables were found to be associated with good QOL in the domain of PCS: age, education, stage of CKD, hemodialysis, transporting oneself to a hospital, health insurance, medical expenses, and perceived lack of difficulty in handling medical expenses. Six variables were associated with good QOL in the domain of MCS after controlling for all potential confounding factors: residence, stage of CKD, transporting oneself to a hospital, health insurance, medical expenses, and perceived lack of difficulty in handling medical expenses. CONCLUSIONS Public health interventions should be developed and implemented to improve QOL among CKD patients in Nepal by focusing on older female patients who have low education, live in rural areas and no health insurance.
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Affiliation(s)
- Shambhu Kumar Saxena Mahato
- School of Health Science, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province Thailand
- Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province Thailand
- Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province Thailand
| | - Pamornsri Sriwongpan
- School of Health Science, Mae Fah Luang University, Muang Chiang Rai, Chiang Rai Province Thailand
| | - Rajani Hada
- Department of Nephrology, National Academy of Health Sciences, Bir Hospital, Mahaboudh, Kathmandu, Nepal
| | | | | | - Ram Kumar Mahato
- Ministry of Health and Population, Ramshah Path, Kathmandu, Nepal
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Du Z, Chen W, Xia Q, Shi O, Chen Q. Trends and projections of kidney cancer incidence at the global and national levels, 1990-2030: a Bayesian age-period-cohort modeling study. Biomark Res 2020; 8:16. [PMID: 32435498 PMCID: PMC7222434 DOI: 10.1186/s40364-020-00195-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Identifying the temporal trends of kidney cancer (KC) incidence in both the past and the future at the global and national levels is critical for KC prevention. Methods We retrieved annual KC case data between 1990 and 2017 from the Global Burden of Disease (GBD) online database. The average annual percentage change (AAPC) was used to quantify the temporal trends of KC age-standardized incidence rates (ASRs) from 1990 to 2017. Bayesian age-period-cohort models were used to predict KC incidence through 2030. Results Worldwide, the number of newly diagnosed KC cases increased from 207.3 thousand in 1990 to 393.0 thousand in 2017. The KC ASR increased from 4.72 per 100,000 to 4.94 per 100,000 during the same period. Between 2018 and 2030, the number of KC cases is projected to increase further to 475.4 thousand (95% highest density interval [HDI] 423.9, 526.9). The KC ASR is predicted to decrease slightly to 4.46 per 100,000 (95% HDI 4.06, 4.86). A total of 90, 2, and 80 countries or territories are projected to experience increases, remain stable, and experience decreases in KC ASR between 2018 and 2030, respectively. In most developed countries, the KC incidence is forecasted to decrease irrespective of past trends. In most developing countries, the KC incidence is predicted to increase persistently through 2030. Conclusions KC incidence is predicted to decrease in the next decade, and this predicted decrease is mainly driven by the decreases in developed countries. More attention should be placed on developing countries.
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Affiliation(s)
- Zhebin Du
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
| | - Wei Chen
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
| | - Qier Xia
- 2Department of Urology, Pudong New Area People's Hospital, Shanghai, China
| | - Oumin Shi
- 3Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518020 China
| | - Qi Chen
- 1Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200127 China
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Butt N, Abbasi A, Ali Khan M, Ali M, Mahesar GB, Haleem F, Manan A. Treatment Outcomes for Patients Undergoing Hemodialysis with Chronic Hepatitis C on the Sofosbuvir and Daclatasvir Regimen. Cureus 2019; 11:e5702. [PMID: 31720170 PMCID: PMC6823026 DOI: 10.7759/cureus.5702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Hepatitis C (HCV) infection is the most commonly acquired infection for patients on hemodialysis and is associated with significant morbidity and disease progression. Direct-acting antivirals (DAAs) have revolutionized the management of HCV. However, limited data exist regarding their efficacy in end-stage renal disease (ESRD), especially for patients on dialysis in South Asia. Aims To evaluate the treatment outcomes of patients undergoing hemodialysis with chronic hepatitis C (CHC) on the sofosbuvir (SOF) and daclatasvir (DAC) regimen. Materials and methods All patients who were 18 years or older, diagnosed cases of chronic kidney disease (stage V), and undergoing maintenance hemodialysis were inducted into this study. Active HCV infection was demonstrated by polymerase chain reaction (PCR) HCV ribonucleic acid (RNA) (qualitative). All patients were then treated with a double regimen of SOF (400 mg once daily) and DAC (60 mg once daily) taken per oral for 12 weeks. Response to treatment was assessed at four, 12, and 52 weeks. Results A total of 31 out of 80 patients were inducted into the study over two years. The prevalence of HCV in hemodialysis patients was 38.75%. Sustained virological response (SVR) was achieved by 27 (87.09%) patients at one year. Four (12.90%) patients had a relapse of HCV. There was no deterioration of hepatological status in any of the patients. Overall survival at one year was 93.54%. Conclusion HCV is highly prevalent in patients undergoing hemodialysis. Prompt treatment with SOF and DAC demonstrates a good response, with negligible side effects.
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Affiliation(s)
- Nazish Butt
- Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Amanullah Abbasi
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - M Ali Khan
- Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Muhammad Ali
- Nephrology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Ghulam B Mahesar
- Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Farhan Haleem
- Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Abdul Manan
- Nephrology, Jinnah Postgraduate Medical Centre, Karachi, PAK
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Abdelaal AAM, Abdulaziz EM. Effect of exercise therapy on physical performance and functional balance in patients on maintenance renal hemodialysis: randomized controlled study. J Exerc Rehabil 2019; 15:472-480. [PMID: 31316944 PMCID: PMC6614770 DOI: 10.12965/jer.1938176.088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/28/2019] [Indexed: 01/08/2023] Open
Abstract
Physical performance (PP) and functional balance (FB) abnormalities are frequently encountered problems in patients on maintenance renal hemodialysis (MRH). Although the exercise therapy is an adjunctive to the routine medical care for patients with chronic kidney disease of various stages; but the benefits as well as the long-term effects of different exercises on the PP and FB in patients on MRH are not yet fully described. In this study; Sixty-six patients on MRH (36 males, 30 females), age 35–45 years, were randomly assigned into one of the three groups: aerobic exercise training group (AETG), resistance exercise training group (RETG), and control group (CG). The PP (evaluated using the 6-min walk test “6MWT”) and the FB (evaluated via the Berg balance scale “BBS”) were the main study outcomes evaluated prestudy (evaluation-1), after 3 months (evaluation-2) and 2 months poststudy cessation (evaluation-3). Results revealed that the PP and FB mean values and percentages of changes at evaluation-2 were 444.25±21.83 (33.1%), 413.57±28.55 (22.52%), 337±12.23 (0.33%) m, 50.05±0.89 (22.95%), 49.95±2.06 (22.52%), 41.28±1.75 (0.94%) for AETG, RETG, and CG respectively. At evaluation-3; the PP and FB mean values and the percentage of changes were 425±21.49 (27.36), 366.86±17.47 (8.5%), 336.68 (0.42%) m, 44.4±1.85 (8.06%), 42.95±2.04 (5.003%), 39.48±2.06 (−4.44%) for AETG, RETG, and CG respectively. In conclusions; both aerobic exercise training (AET) and resistance exercise training (RET) have favorable effects, with the AET has higher short and long-term favorable effects on the PP and FB than RET in patients on MRH.
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Affiliation(s)
- Ashraf Abdelaal Mohamed Abdelaal
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ehab Mohamed Abdulaziz
- Consultant in Nephrology and Internal Medicine, National Institute of Liver, Gastroenterology & Infectious Diseases, Cairo, Egypt
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