Prevalence of chronic kidney disease and its related risk factors in elderly of southern iran: a population-based study

The effectiveness of curcumin as a safe agent on hearing threshold improvement in patients with chronic kidney disease: a double-blind, placebo-controlled trial

Hearing impairment in patients with chronic kidney disease (CKD), can affect the quality of life. At present, hearing dysfunction does not have an approved pharmacologic therapy. This study aimed to investigate the protective effects and possible mechanisms of curcumin as a therapeutic agent on hearing impairment in patients with chronic kidney disease. We conducted a randomized controlled trial of 40 chronic kidney disease patients not on dialysis with hearing impairment. Participants were randomly divided into two groups. One group received curcumin daily and the other received a placebo for 12 weeks. The interval between III and V waves, latency of wave V, auditory brain stem response (ABR) threshold, speech reception threshold (SRT), and speech discrimination score (SDS) were evaluated and analyzed before and after the intervention. After treatment, in the curcumin group, III-V waves interval and the latency of wave V were significantly reduced (P value < 0.0001), also ABR threshold was demonstrated a significant improvement (P value < 0.0001). In the trial group, the SDS was increased (P = 0.001) and the SRT was attenuated (P < 0.0001). We had either significant deterioration due to the course of the disease or insignificant changes in the placebo group. Daily administration of curcumin, can significantly improve hearing impairment in CKD patients. Accordingly, curcumin should be considered as a therapeutic option for treating hearing impairment in patients with chronic kidney disease.

Relationship between heavy metal concentrations and Chronic kidney disease in population of Hoveyzeh cohort study: A cross-sectional study in Iran

BACKGROUND

Chronic kidney disease (CKD) is a multifactorial disease whose prevalence is increasing worldwide. CKD affects 700 million to 1 billion people worldwide, with a prevalence of 9.1% to 13.4%. In Iran, the reported prevalence of CKD is 15.14%, even higher than the global prevalence. Some studies introduced heavy metals as possible risk factors of CKD. We conducted the first study in Iran to examine the relationship between 10 selected urinary heavy metals and CKD in the Hovayzeh cohort study population.

METHODS

In this cross-sectional study, urine samples were collected from two groups of ca ses (suffering from CKD) and controls (without CKD) with equal size (47 people each). Analysis of the 10 sellected heavy metals in the samples was conducted using inductively coupled plasma emission spectroscopy. Basic Information was obtained from the Howayizeh Cohort Study Center. The data was analyzed using SPSS-26 and Excel-2016 software.

RESULTS

There were no significant differences between urinary heavy metal concentrations of case and control groups (P < 0.05). While, the concentration of As, Cr, Cu, Mn, and Ni exceeded the reference limits of Germany, Canada, England, and Belgium. Se and Cd also surpassed the reference limits of England. After adjusting for confounding variables for each μg/l increase in urinary Cd, Ni, Pb, and Se the OR of CKD increased by 20.2%, 4.8%, 3.1%, and 2.6%, respectively. Although, these relationships were not statistically significant. In addition, two groups of heavy metals had a positive and significant correlation: (1) Se, Zn, As, Cu, and Cr; (2) Pb, Cd, and As; and (3) Cd and Ni.

CONCLUSION

we found no significant relationship between urinary heavy metal and CKD. However, there was significant positive correlation in some of urinary heavy metals may indicate their shared resources. Furthermore, the concentration of most heavy metals in the urine of the participants was higher than the reference limits of these metals in the urine of healthy people from other countries. Thus, the elevated levels of these metals could still pose a risk to human health. Therefore, it is necessary to conduct prospective studies with a larger sample size in this area.

Impact of Red Complex Bacteria and TNF-α Levels on the Diabetic and Renal Status of Chronic Kidney Disease Patients in the Presence and Absence of Periodontitis

Scientific evidence shows a positive association in the etiopathogenesis of periodontitis and chronic kidney disease (CKD). Various confounding factors, such as obesity, diabetes, and inflammation, also play a significant role in the progression of CKD, which remains unexplored. We hypothesise the role of red complex bacteria with various confounding factors associated with chronic kidney disease. The study comprised a total of 120 participants categorised into 4 groups: the control group (C), periodontitis subjects without CKD (P), periodontally healthy chronic kidney disease subjects (CKD), and subjects having both periodontitis and CKD (P + CKD), with 30 subjects in each group. Demographic variables, and periodontal, renal, and diabetic parameters were recorded. Tumour necrosis factor (TNF)-α levels and those of red complex bacteria such as Prophyromonas gingivalis (P.g), Treponema denticola (T.d), and Tonerella forsythia (T.f) were assessed, and the obtained results were statistically analysed. Among the various demographic variables, age showed a level of significance. Mean PI, GI, CAL, and PPD (the proportion of sites with PPD ≥ 5 mm and CAL ≥ 3 mm) were elevated in the P + CKD group. Diabetic parameters such as fasting blood sugar (FBS) and HbA1c levels were also greater in the P + CKD group. Renal parameters such as eGFR and serum creatinine levels were greater in CKD patients. The estimation of red complex periodontal pathogens such as Pg, Td and Tf levels were significantly greater in the P and P + CKD groups. Pearson correlation analysis revealed significant correlation of red complex bacteria with all variables. Greater levels of P.g, T.d and T.f were found in the P groups, thus indicating their important role in the initiation and progression of inflammation of periodontitis and CKD, with diabetes as one of the confounding factors. The study also confirmed a log-linear relationship between TNF-α levels and red complex bacteria, thereby demonstrating the role of inflammatory biomarkers in periodontal disease progression that could contribute to the development of systemic inflammation such as CKD.

Nutritional Status Associated to Red Cell Distribution Width, Length of Stay, and Clinical Outcome patient with Chronic Kidney Diseases

INTRODUCTION: Red cell distribution width (RDW) shows the heterogeneity of erythrocyte size associated with inflammation and various clinical conditions including in patients with chronic kidney disease (CKD). Systemic inflammation and oxidative stress were commonly found in CKD patients. AIM: This study aimed to examine the relationship of nutritional status, length of hospital stay (LOS), and clinical outcome to RDW in CKD patients. METHODS: We conducted a retrospective cohort study of 1736 patients CKD patients who admitted from January 2017 to August 2020, aged between 18 and 60 years and were hospitalized at Wahidin General Hospital. From those, 239 were consulted with clinical nutrition specialist, of which 59 patients eligible with the criteria inclusion. Data were collected through medical records and through electronic data (biochemical data). RDW was categorized into normal and high RDW group, nutritional status based on subjective global assessment (SGA), LOS <10 days and clinical outcome based on conditions at the time of hospital discharged. Data were analyzed using SPSS version 25.0. RESULTS: The data of 59 patients were analyzed, the mean age was 50.42 years (normal RDW) and 47.24 years (high RDW), most of them are women (57.7% vs. 60.6%). There were 42 patients with moderate malnutrition (23 normal RDW and 19 high RDW) and 17 patients with severe malnutrition (3 normal RDW and 14 with high RDW). The study found a significant differences between normal RDW and high RDW (p 0.021), but not significant differences in LOS (p 0.890) and clinical outcome (p 0.968). There were a significant differences in the levels of hemoglobin (p = 0.001), RBG (p = 0.030), and serum sodium level (p = 0.010). Patient with LOS < 10 days had lower sodium levels and more severe anemia when compared with LOS > 10 days and the poor clinical outcome had a heavier degree of anemia compared to the good clinical outcomes. CONCLUSION: Poor nutritional status was associated with an increase in RDW, degree of anemia, and sodium level.

An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran

Background: Aortic arch calcification (AAC) is very common in hemodialysis patients and is associated with cardiovascular events and the incidence of arteriovenous fistula (AVF) failure. In order to predict the prognosis of patients, a study was conducted to determine the annual failure rate of AVF and its related factors. Methods: This cross-sectional study was performed on 145 patients with end-stage renal disease (ESRD) who were AVF candidates, visiting a referral center in Golestan province of Iran. After the insertion of intravenous arterial fistulas, posterior-anterior chest x-rays were captured, and the grafts were classified by a radiologist. Patients were followed for one year, and the rates of fistula failure (FF) and cardiovascular mortality were recorded. Finally, the data were entered into SPSS 19 software and analyzed by the Chi-square test. Results: Of 112 patients followed up for one year, 56.2% were men. During the one-year follow-up period, 5.3% of the patients developed arteriovenous FF, and this event was more common in men, but the difference was not statistically significant. The majority of the AVF candidates had a history of diabetes and hypertension, but no association was found between the one-year FF rate and these two diseases. Nearly 7.7% of the patients had grade III calcification, but no significant relationship was observed between the AAC grade and AVF failure rate. Conclusions: The rate of one-year FF was higher among ESRD patients with a history of chronic kidney diseases. Our results also demonstrated that the mortality rate is higher in patients with a high degree of AAC and patients with medical history (cardiovascular disease and diabetes).

Renal Failure among Women of Reproductive Age in Burundi: Estimating the Prevalence and Associated Factors Using Population-Based Data

Background

Renal failure is a leading cause of morbidity and mortality in many resource-constrained settings. In developing countries, little has been known about the prevalence and predisposing factors of renal failure using population-based data. The objective of this study was to examine the prevalence and associated factors of renal failure among women of reproductive age in Burundi.

Methods

We used nationally representative cross-sectional data from the 2016-2017 Burundi Demographic and Health Survey (BDHS). Data on 17,269 women of reproductive age were included. The outcome variable was a renal failure as determined by the patient's report. Percentage, chi-square test, and multivariable logistic regression model were used to analyze the data. The results from the logistic regression model were presented as adjusted odds ratio (AOR) and confidence interval (95% CI). The significance level was set at p < 0.05.

Results

The overall prevalence of renal failure was 5.0% (95% CI: 4.4%, 5.7%). Higher-aged women were more likely to have a renal failure when compared with women aged 15-19 years. Rural dwellers were 1.65 times as likely to have a renal failure when compared with women in the urban residence (AOR = 1.65; 95% CI: 1.24, 2.20). Women who had secondary + education had a 39% reduction in the odds of renal failure when compared with women with no formal education (AOR = 0.61; 95% CI: 0.46, 0.81). Health insurance coverage accounted for a 23% reduction in the odds of renal failure when compared with women who were not covered by health insurance (AOR = 0.77; 95% CI: 0.63, 0.93). Women who had a terminated pregnancy were 1.50 times as likely to have a renal failure when compared with women with no history of terminated pregnancy (AOR = 1.50; 95% CI: 1.24, 1.82). Furthermore, women with a history of contraceptive use were 1.32 times as likely to have a renal failure when compared with women without a history of contraceptive use (AOR = 1.32; 95% CI: 1.11, 1.57).

Conclusion

Lack of formal education, having no health insurance coverage, and ever used anything or tried to delay or avoid getting pregnant were the modifiable risk factors of renal failure. The nonmodifiable risk factors were old age, rural residence, certain geographical regions, and having a history of pregnancy termination. Understanding the risk factors of renal failure will help to instigate early screening, detection, and prompt treatment initiation. In addition, early detection of the risk factors can help to reduce the adverse health impact including maternal death.

Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta-Analysis and Systematic Review

The aim of this study was to determine the prevalence of CKD in the Iranian general population. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google scholar) and national databases (SID, Magiran) were searched until December 30, 2017. The quality of the studies was evaluated using the Hoy instrument. Out of 1170 initial studies, 9 studies with a total of 70 605 participants were included in the final stage of this study. Based on the results of the random effect method (95% CI), the overall prevalence of chronic kidney disease in 70 605 people was 15.14% (I²  = 99.77%). The prevalence of CKD in female patients (18.80%) was 1.7 times higher than in male patients (10.83). The results of the present study indicate a higher than the global average prevalence of CKD in Iran and the need for additional attention of policy makers on better planning for control and implementation of screening programs in high-risk populations, such as patients with hypertension and diabetes.

The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results

BACKGROUND

This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES).

MATERIALS AND METHODS

In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants.

RESULTS

The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01).

CONCLUSION

The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population.

Survival of Kidney Retransplant Compared With First Kidney Transplant: A Report From Southern Iran

OBJECTIVES

Kidney retransplant is increasingly performed, but patient survival is controversial. The aim of this study was to evaluate the outcomes of patients with second kidney grafts and compare survival rates of recipients with first and second kidney transplant procedures.

MATERIALS AND METHODS

This was a retrospective study analyzing records from the Shiraz University of Medical Sciences transplant ward. Survival rates of retrans?lanted patients were compared with a randomly selected group of first kidney recipients. Factors related to retransplant survival were evaluated. Data were analyzed by SPSS version 16.0, and P < .05 was consi?ered as significant.

RESULTS

This study included 200 patients with first kidney transplants and 68 patients with kidney retransplants. We found that 1-, 3-, 5-, and 7-year graft survival rates were 91.9%, 87.2% ,86.3%, and 86.3% among retransplanted patients versus 98.3%, 95.4%, 90.2%, and 88.7% among the first transplant group (P = .130). Hospital stay duration after transplant, kidney rejection rate during hospitalization, delayed graft function, and creatinine levels at discharge were significantly associated with survival in retransplanted patients (P < .05).

CONCLUSIONS

Kidney retransplants can yield desirable outcomes and is the treatment of choice in patients who have lost their graft. Careful screening for risk factors should be consider for obtaining better results in second kidney transplant procedures.