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Background: Chronic kidney disease (CKD) is public health burden and rising rapidly in prevalence in developing countries especially in Sub-Saharan Africa. CKD increases with advancing age and comorbidities like hypertension, diabetes and obesity. However, there is no data on CKD the prevalence and risk factors associated among the hypertensive adult patients in Wajir county. This study aimed at estimating the prevalence and establishing risk factors associated with CKD among hypertensive patients in Wajir county and sought to recommend viable preventive measures. Methods: Analytical cross-sectional study design utilized, non-probability consecutive sampling was adopted to obtain sample size of 293 respondent attending medical outpatient clinic at Wajir county referral hospital between September to December 2023. The study utilised primary data that were collected using structured questionnaires and secondary data from the laboratory result. Results: Key findings revealed majority of hypertensive patients have CKD (45.40%), highlighting a critical health concern in the region. The study found most CKD cases were in early stages (stages 1 and 2), some had progressed to severe stages (stages 4 and 5). Regression analysis identified several demographic and clinical factors associated with CKD development, including age, gender, and education, and employment status, family history of CKD and difficulty in medication compliance. Conclusions: there is high prevalence of chronic kidney disease among hypertensive adults in Wajir county. With nearly half of hypertensive patients also suffering from CKD, there is an undeniable public health crisis at hand in Wajir county. Study recommended initiation of targeted screening programs.
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Background: Sickle cell disease (SCD) is an important and growing global health problem. Kidney damage is one of the most common complications of SCD. We aimed to determine the prevalence of acute kidney injury (AKI) in children with SCD in our context.Methods: Cross-sectional and analytical study from January 2022 to September 2022, including SCD children aged from 6 months to 17 years during their hospitalisation. We measured the estimated glomerular filtration (eGFR) rate using the combined creatinine and cystatin C formula for kids (CKiDScr-Cys C). Univariate analyses were performed to measure the relationship between variables and AKI and eGFR, followed by a multivariate analysis using logistic regression.Results: Of the 137 children, we included 82 boys (60%) and 55 girls (40%). The mean eGFR was 112�.3 ml/min/1.73 m2. A total of 36 subjects, or 26.3% (95% CI [18.9-33.6%)), had acute AKI. Comparison of characteristics by AKI status showed significant differences according the number of transfusions (p<0.01), and hemoglobin level (p<0.027), eGFR had a negative correlation with the number of transfusions r=-0.308 (-0.477; -0.117); p<0.01. Multivariate analysis showed that nutritional status was a protective factor of AKI (p<0.01), and the number of transfusions was a predictive factor of AKI in SCD in our context (p<0.001).Conclusions: The results from our study are an urgent alarm to implement the existing management programs on SCD from screening to universal access of hydroxyurea in order to reduce complications and mortality related to this pathology.
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Introduction: CKD patients suffer from increased rate of mortality and morbidity due to cardiovascular diseases, compared to general population. Cardiometabolic biomarker N- Terminal Pro-BNP has become a useful tool for quick screening and assessment for cardiovascular diseases. The aim of the present study is to find out the relationship between serum NT-Pro-BNP level and cardiometabolic risk factors among CKD patients without symptoms or history of cardiac diseases. Materials & Methods: This cross-sectional study among 149 CKD patients was conducted from January to December 2020 at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka. Anticoagulant free venous blood samples were assayed for serum NT-Pro-BNP by electrochemiluminescence immunoassay. Serum creatinine, total cholesterol, triglyceride, high-density lipoprotein, calcium, phosphate, uric acid, eGFR, albumin and total protein of the study population were assessed and recorded during data collection. Results: Mean age of study population was 50.0 ± 12.4 years, male predominant (53%). Mean serum NT-Pro-BNP level was lowest (335.7 ± 213.3 pg/ml) for patients with CKD stage 1 and highest (15644.6 ± 2197.5 pg/ml) for patients with CKD stage 5. Mean serum creatinine was lowest (1.55 ± 1.54 mg/dl) for CKD stage 1 patients and highest (5.71 ± 2.75 mg/dl) for CKD stage 5 patients and this was statistically significant (p < 0.05). Mean serum total cholesterol, triglyceride, phosphate and uric acid were increased with disease severity and this increase was statistically significant (p < 0.05). Mean eGFR, serum albumin and total protein were decreasing with disease severity, and this decrease was also statistically significant (p < 0.05). Serum NT-Pro-BNP had significant positive correlation (r = 0.61, p < 0.05) with serum creatinine and significant negative correlation with total cholesterol, triglycerides, serum phosphorus, serum uric acid, eGFR and serum albumin. Conclusion: Serum NT-Pro-BNP could be the potential screening tool for CKD with cardiovascular diseases and can provide prognostic information of major cardiovascular events.
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Objective The aim of this study was to evaluate the efficacy and side effects of sacubitril/valsartan in the treatment of patients with chronic kidney disease(CKD)at stage 5 with resistant hypertension,and to explore the cardiovascular benefits and security of medical in the patients.Methods Patients with CKD5 resistant hypertension diagnosed and treated in the First Affiliated Hospital of Guangxi Medical University from September 2020 to March 2022 were selected and divided into the observation group(treated with routine treatment of kidney disease at end-stage and sacubitril/valsartan)and control group(include droutine treatment of renal disease at end-stage and ACEI or ARB drugs)according to treatment strategy.The patients in both two groups were treated with adequate dialysis treatment and conventional drug treatment of renal disease at end-stage.The patients were followed up for at least 3 months,the clinical efficacy of three months after treated with sacubitril/valsartan was observed,and the efficacy indicators and security indicators and adverse cardiovascular events were observed,the occurrence of adverse effects during the period of drug use were compared with the control group.Results A total of 110 patients were included in this study and there were 55 cases in each group.There were no significant differences in gender,age,age of dialysis,etiology,dialysis mode and blood pressure between the two groups(P>0.05).The Systolic blood pressure(SBP),diastolic blood pressure(DBP),b-type urinary natriuretic peptide precursor(Pro-BNP)and cardiac function grade in the observation group after treatment was significantly decreased compared with before treatment.The left ventricular ejection fraction(LVEF)and the ratio of LVEF<50%in the observation group was significantly reduced after treatment(P<0.05).SBP,DBP and Pro-BNP decreased 3 months after treatment compared with the baseline before treatment,and improved significantly in the first month after treatment(P<0.05).The decrease of DBP and BNP before and after treatment was significantly different between the two groups,and the decrease of DBP and BNP was more significant in the observation group(P<0.05).The difference of LVEF and left ventricular end diastolic diameter(LVEDD)between the two groups before and after treatment was statistically significant,and the improvement was more obvious in the observation group(P<0.05).There were no significant differences in the safety indicators of serum potassium,estimated glomerular filtration rate(eGFR)and liver function between two groups before and after treatment(P>0.05).In terms of adverse reactions,only 1 case in the control group developed hyperkalemia within 3 months of follow-up,and no hypotension or other adverse reactions occurred in the two groups.Conclusions The treatment of patients with CKD stage 5 hypertension with sacubitril/valsartan has obvious cardiovascular benefits.Sacubitril/Valsartan has efficacy in lowering blood pressure,improving cardiac function and reducing volume load,with less adverse events and higher safety than control group.
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ObjectiveTo explore the correlation between serum albumin levels and coronary artery calcification (CAC) in patients with early-stage chronic kidney disease (CKD), as well as the value of serum albumin levels in predicting the incidence and severity of CAC. MethodsThe study included 391 early-stage CKD patients who underwent coronary computed tomography angiography (CTA) at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2019 and December 2022. Demographic and biochemistry data, as well as the coronary CTA results, were collected. Based on the coronary artery calcification score (CACS), all patients were divided into non-CAC group (CACS=0, n=184) and CAC group (CACS>0, n=207). All patients were further divided into 3 groups based on the serum albumin levels: group A (serum albumin levels<35 g/L, n=30), group B (35 g/L≤ serum albumin levels< 40 g/L, n=198) and group C (serum albumin levels≥ 40 g/L, n=163). Univariate and multivariate binary logistic regression analyses were conducted to investigate the association between serum albumin levels and CAC in early-stage CKD patients. Differences in CAC among groups were analyzed by using post-hoc multiple comparisons and ordinal logistic regression model analysis. ResultsPatients with CAC had significantly lower serum albumin levels than those without CAC (P<0.05). There was a negative correlation between serum albumin levels and CACS in early-stage CKD patients (P<0.01), as serum albumin decreased in levels, CAC increased in severity. ConclusionsOur study shows that early-stage CKD patients with lower serum albumin levels have a higher incidence of CAC. Low serum albumin level is an independent risk factor for CAC progression.
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Abstract Background: Vitamin D insufficiency is a prevalent issue in patients suffering from CKD. The purpose of this study was to determine whether serum 25(OH)D levels are associated with all-cause and cardiovascular mortality in patients with CKD. Methods: To examine the associations between 25(OH)D levels and cardiovascular mortality, this retrospective cohort study used the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007‒2018 database. A total of 2,668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. The associations were assessed using Cox proportional hazards regression, restricted cubic splines, Kaplan-Meier survival curves, and competing risks survival analysis. Furthermore, subgroup and sensitivity analyses were performed. Results: During a median follow-up of 72 months in a weighted population of 11,715,452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause mortality (HR= 0.85, 95 % CI 0.77~0.94) and cardiovascular mortality (SHR= 0.80, 95 % CI 0.67~0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile). Compared to group Q1, both group Q3 (HR = 0.71, 95 % CI 0.54‒0.93) and group Q4 (HR = 0.72, 95 % CI 0.55‒0.94) exhibited a significantly reduced mortality risk. Weighted restricted cubic splines revealed an inverse J-shaped linear association between levels of 25(OH) D and all-cause mortality ((PNonliner > 0.05). Subgroup analysis and sensitivity analysis yielded similar findings. Conclusions: All-cause mortality and cardiovascular disease-related mortality were significantly increased by lower 25(OH)D levels, both as continuous and categorical variables. 25(OH)D has an inverse J-shaped linear association with all-cause and cardiovascular mortality.
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Purpose: Vascular endothelial growth factor inhibitors (anti?VEGF) have been shown to be effective in the treatment of diabetic macular edema. However, there is little information about the systemic effects of intraocular administration of anti?VEGF drugs in patients with coexistent diabetic nephropathy because it can produce adverse renal effects. Methods: This retrospective cohort study analyzed the effect of intravitreal anti?VEGF drugs (bevacizumab, ranibizumab, or aflibercept) on eFGR and microalbuminuria (MicA) in patients with diabetic macular edema and nonproliferative retinopathy without chronic kidney disease (CKD). Results: Sixty?six patients were included, 54.5% male and 45.5% female, with a mean age of 66.70 ± 11.6 years. The mean follow?up of patients with antiangiogenic treatment was 42.5 ± 28.07 months, and the mean number of injections was 10.91 ± 7.54. In 12.1% of the cases, there was a worsening of the glomerular filtration rate (eFGR) and a 19.7% worsening of the microalbuminuria (MicA). The number of injections was not related to the worsening of the eFGR (P = 0.74) or the MicA (P = 0.239). No relationship was found between the type of drug and the deterioration of the GFR (P = 0.689) or the MicA (P = 0.53). Conclusions: Based on the results, there is a small proportion of patients with increase in MicA and the decrease in eFGR after anti?VEGF therapy, and these was no associated with the number of injection or the drug type. Ophthalmologists should be aware of renal damage in order to do a close monitoring of renal function and proteinuria after intravitreal administration of anti?VEGF mainly in hypertensive patients.
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Background: Low dose of pegylated erythropoietin (PegEPO) is better than conventional erythropoietin stimulating agents (ESAs) in improving hyporesponsiveness and maintaining stable haemoglobin (Hb) levels in renal anaemic patients undergoing hemodialysis. This real-world study aimed to assess effectiveness and safety of low-dose PegEPO (30 µg/0.3 mL), administered at different time-points in renal anaemia patients on dialysis. Methods: HEMEPEG (HEMoglobin outcomE with PegEPO) was a multicentre, retrospective, cross-sectional, observational study of renal anaemia patients receiving PegEPO up to 3 months. The study assessed an increase in Hb, patients achieving Hb 10-12 g/dl, and Hb increase by ?1 and ?2 g/dl. Results: Data from 223 out of 273 patients from 19 Indian centers were analyzed. PegEPO was administered weekly to 132 patients (59.19%), with 38.64% being diabetic and 77.27% previously treated with ESAs. Ten day dosing was given to 91 patients (40.81%), including 46.15% diabetic patients and 72.53% previously treated with ESAs. A Significant (p<0.0001) increase in mean Hb levels from baseline to day 30, 60 and 90 were observed for both studied groups, with a target Hb of 10-12 g/dl achieved in 51.08% and 52.85% of patients in the respective groups after 3 months. An increase in Hb by ?1 and ?2 g/dl were observed in weekly (68.67% and 45.78%) and 10-day group (77.14% and 50.00%) patients, respectively. Conclusions: PegEPO (30 µg/0.3 mL) was effective treatment of renal anaemia and diabetic chronic kidney disease (CKD) patients on dialysis when administered weekly or every 10 days over a 3-month treatment period.
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Background: Globally, the Case Fatality Rate (CFR) due CoVID19 ranges from 0.1-4.7%. CoVID-19 death remained 0.5% till April 2021 in Assam as compared to India (1.3%). Though pre-existing diseases greatly contributes to CFR yet its association study from India is scarce. This study documents association of such death with comorbidities in a tertiary hospital of Assam. Methods: Retrospective analysis of 234 COVID death from May 2020 to December 2020 in Jorhat Medical College (JMCH) were done. Demography, comorbidities at admission and blood parameters were analyzed in Epi-Info version7.2.4.0. Continuous variables were presented as mean±SD or median (interquartile ranges) and correlated with death. Results: Out of 3781 confirmed cases admitted in JMCH, 234 died (72% male) with CFR of 0.06. Highest deaths occurred between 61 to 70 years. Median duration of disease was 4 days (IQR 2-8days). Acute respiratory distress or pneumonia was most common (53.1%) symptom followed by septicemia (24.6%) at admission. Diabetes mellitus (36.6%), hypertension (24.8%), diabetes with hypertension (11.4%) and chronic kidney diseases (22.4%) were common chronic comorbidities. About 64% cases had thrombocytopenia, and 66.9% had leukocytosis at admission. Many cases had coronary artery diseases, left ventricular failure, post-operative complications, post-partum complications, severe hemoptysis, severe anemia, metabolic encephalopathy, acute myocardial infarction, non-ketotic coma and acute gastroenteritis and SARS-COV2 infection. Conclusions: CoVID19 associated mortality in Assam was low and mostly among elderly with chronic comorbidities. CKD was most significantly associated with mortality. Superimposed bacterial infection at admission contributed to many fatal outcomes in COVID19, thus warranting proper empirical antibiotic.
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Aims: Renal Failure and Chronic Kidney Disease (CKD) represent major health problems that affect more than 10% of the general population worldwide amounting to more than 800 million individuals. CKD is a congruence of many diseases like Diabetes, Hypertension, hypercholesterolemia, and different cardiovascular diseases as well as epigenetic factors contributing to the development of this Disease. We undertook this work as a pilot study to establish a database of genetic variants for novel or existing genes involved in the development and progress of CKD in the Saudi population. Methods: Patients' blood samples of 12 donors suffering from CKD were used to perform the Whole Exome Sequencing (WES) on genomic DNA on the Illumina Platform. Bioinformatics algorithms were used to perform different callset to explore different mechanisms such as nucleic acids interconversion, INDELS search as well as Transition/Transversion (Ts/Tv) ratio determination. Results: Patterns of Transition and Transversion Ratio (Ts &Tv) in the Patient samples demonstrated the dominance of transition substitutions over transversion. Our data revealed the mean ratio metrics of (Ts/Tv) is roughly 2.75 which is consistent with former literature findings. Indels with less than 3 bp have a total count of more than 1e+05 whereas those with larger gap are present at the level of trace. Since there is an intrinsic relation between nucleotides interconversions and the transition and transversion mechanisms, and based on the higher rate of transition over transversion mechanisms, our study supports this assertion at the levels of the nucleotides, with the state nucleotides conversion being as (67% A?G, 64% G?A, 67% T?C, and 67% C?T) which mirrors the dominance of transition effects and lower representation of transversion effects as exemplified by lower state of interconversion of : (13% T?A), (12% A?T), (19% C?G), (17% C?G), (17% G?T) and (20% T?G). Conclusion: CKD is a widespread disease that overlaps the spectrum of many diseases’ spectrum in terms of gene variant expressions. The transition and Transversion ratio profile is around 2.75. Nucleotides interconversions rim with the concept of transition and transversion and INDELS counts and distribution favor the shorter length as compared with larger INDELS.
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Resumen La definición de la enfermedad renal crónica (ERC) es la disminución del filtrado glomerular (FG) por debajo de 60 ml/min/1.73 m2, durante tres o más meses, acompañada por anormalidades estructurales o funcionales. México reporta una incidencia de 467/1 000 00 casos de ERC. La modalidad de diálisis más utilizada es la diálisis peritoneal y la complicación más común es la peritonitis. Se obtuvo la prevalencia de peritonitis en pacientes con diálisis peritoneal del HCM en 2021, determinar las comorbilidades asociadas a la ERC, la diferencia entre diálisis automatizada y continua ambulatoria, sus desenlaces y la mortalidad global. Estudio observacional, descriptivo, transversal. Pacientes con diálisis peritoneal atendidos durante 2021 en nefrología del HCM. Se recolectaron y analizaron los datos, utilizando estadística descriptiva e inferencial determinado la prevalencia de peritonitis, las diferencias entre la modalidad de diálisis peritoneal y los episodios de peritonitis. Se analizaron 339 pacientes atendidos en el HCM, durante un año, la prevalencia de peritonitis fue de 0.2625 peritonitis/paciente/año, las comorbilidades fueron la hipertensión (70.5%) y la diabetes mellitus (65.19%), entre los grupos de diálisis peritoneal automatizada y diálisis peritoneal continua ambulatoria no hubo diferencia y la mortalidad general fue 6.48%. La peritonitis es la principal complicación en diálisis peritoneal, la prevalencia en el HCM esta por abajo de la media del país y del mundo siendo esta del 26.25%. Las Guías de la Sociedad Internacional de la Diálisis Peritoneal recomiendan mantener una prevalencia por abajo de 0.5 episodios de peritonitis por paciente por año.
Abstract The definition of the Chronic Kidney Disease (CKD) is the decrease in glomerular filtration rate (GFR) below 60 ml/min/1.73 m2, for 3 or more months, accompanied by structural or functional abnormalities. Mexico reports an incidence of 467/1,000,000 cases of CKD. The most used dialysis modality is peritoneal dialysis, and the most common complication is peritonitis. We obtained the prevalence of peritonitis in patients with peritoneal dialysis in HCM in 2021, to determine the comorbidities associated with CKD, the difference between automated and continuous ambulatory dialysis, its outcomes, and overall mortality. Observational, descriptive, cross-sectional study. Patients with peritoneal dialysis attended during 2021 in HCM nephrology. Data were collected and analyzed using descriptive and inferential statistics to determine the prevalence of peritonitis and the differences between the modality of peritoneal dialysis and the episodes of peritonitis. The prevalence of peritonitis was 0.2625 peritonitis/patient/year, and the comorbidities were hypertension (70.5%) and diabetes mellitus (65.19%), between the groups of Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis there was no difference, and the overall mortality was 6.48%. Peritonitis is the main complication in peritoneal dialysis, the prevalence of HCM is below the country and world average of 26.25%. International Guidelines recommend maintaining a prevalence below 0.5 episodes of peritonitis per patient per year.
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Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients. Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose. Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.
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Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients. Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose. Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.
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A study of Lipid profile in CKD patient is subject of interest due to impact on the individual and society as dyslipidaemia is one of the traditional risk factors for CVD which is responsible for most of the morbidity & mortality in CKD patient. And its study can lead to therapeutical result affecting both short term and long-term outcomes. To identify and analyse lipid AIMS & OBJECTIVE - alteration in CKD patients and study the correlation between renal function and lipid abnormalities in CKD Our study is hospital METHODS – based descriptive observational study for duration of 18 months. Study included 100 patients RESULTS – in which mean age was 51.88 and male to female ratio of 1.5:1. Prevalence of Lipid Profile abnormalities seen as HDL decreased in 100% patient and Cholesterol, LDL, Triglyceride increased in 40%, 24%, 64% patients respectively Dyslipidaemia is common among pa CONCLUSION - tients with CKD and predominant lipid profile abnormalities were reduced HDL and elevated Triglycerides. Hence regular monitoring of lipid profile should be done in patients of CKD
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Background: In chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal magnesium absorption hence insufficient to maintain homeostasis. But related data are relatively sparse and not readily available, especially in Bangladesh context. Aim of the study: The aim of the study was to assess the pattern of serum magnesium level in different stages of CKD patients. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Medicine and the Department of Nephrology, Dhaka Medical College Hospital (DMCH) for nine months’ period. Approval for the study was taken from the ethical review committee of DMC before the commencement of the study. Diagnosed patients of chronic kidney disease (CKD) were approached for the inclusion of the study. Informed written consent was taken from each patient. All patients were subjected to detailed history taking, physical examination, and relevant investigations. For the study purpose, serum magnesium was done for all patients. Results: After compiling data from all participants, statistical analysis was performed using the statistical package for social science (SPSS) version 22 for windows, and a p < 0.05 was considered statistically significant. Mean age of the patients was 53 years with male predominance (male 64% vs female 36%). Of all, 6.7% of cases had hypomagnesemia and 55.3% had hypermagnesemia. The mean serum magnesium level was 2.68±0.81 mg/dl. Assessment of serum magnesium in a different stages of CKD showed that hypermagnesemia is associated with higher staging (p<0.05), and there is a negative correlation between lower e-GFR with serum magnesium ((r=-0.753, p<0.01). Conclusion: Nearly two-third of CKD patients were found with altered magnesium level in the form of hypomagnesemia or hypermagnesemia in this study. Serum magnesium was found increased in higher stages of CKD. That means serum magnesium level increases along with higher stage of the disease. Urinary magnesium excretion also decreases when eGFR of patient decreased.
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Background: Chronic Kidney Disease (CKD) is a growing public health problem affecting millions of people worldwide. Along with its well-known systemic effects, CKD has been associated with various ocular abnormalities, including uveitis, macular edema, and retinal vascular changes. Early detection and management of these ocular complications can prevent significant visual loss and improve the quality of life of patients with CKD. This highlights the importance of regular ophthalmic examinations as part of the comprehensive management of CKD. The aim of this study was to evaluate the ocular status of chronic kidney disease. Material & Methods: This was an observational study. The present study was conducted on 150 Patients attending the Department of Ophthalmology at Dr. Sirajul Islam Medical College and Hospital Ltd, Dhaka, Bangladesh. The duration of the study was 2 years. All collected data was entered in MS Excel and Statistical analysis was done using the SPSS-24 version. Results: The study analyzed a population between the ages of 40-59 years, with a slight majority of women (52.67%) and moderate CKD (64.00%). The most common cause of CKD in the population was hypertension and diabetes (52.00%). 66.67% of 300 eyes had good vision (6/18 or better), while the remainder had impaired or legally blind vision (increasing as the severity of CKD increases). Ocular anterior segment findings showed that lid oedema and conjunctival pallor were present in 3.5% and 56.9% of the eyes, respectively. Dry eyes and cataract were present in 5.6% and 11.1% of the eyes, respectively. Hypertensive retinopathy was present in 48.00% of eyes in the moderate CKD group, and diabetic retinopathy was present in 32.00% of eyes in the severe and end-stage CKD groups. Maculopathy and vitreous hemorrhage were present in 12.67% and 6.33% of eyes in the end-stage CKD group. Of the 100 eyes with poor or blind visual acuity, 24 (24%) were affected by Maculopathy and 21 (21%) by Cystoid Macular Edema. The causes of visual impairment were also listed with their corresponding percentage. Conclusion: In CRF patients, eye exams can detect ocular problems. Early treatment prevents negative outcomes and those with a history of abnormal renal function need close monitoring due to increased risk of vision loss. Awareness of ocular complications is important, as well as thorough eye exams and control of diabetes and hypertension for maintaining eye health.
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Hemodialysis is the most commonly used treatment modality for end stage renal disease. A 6 months observational study was conducted in the Dialysis unit of Kasturba Hospital, Manipal to study the clinical profile, quality of life with the help of KDQoL SF 36 questionnaire and factors affecting quality of life of hemodialysis patients. A total of 45 participants were included who initiated dialysis in the year 2018 and 2019 and were receiving dialysis in our hospital. Out of 45 participant 77.8% were males and 22.2% were females, the mean age was 55.29 (11.29) years. 23 patient-initiated dialysis in the year 2018 22 patients-initiated dialysis in the year 2019. The prevalence of hypertension, diabetes mellitus and cardiovascular diseases in this population were found to be 95.2%, 35.6% and 8.9% respectively. The mean scores of the sub scales were analyzed with the help of scoring manual and descriptive statistics. In the result it was found the hemoglobin, intradialytic weight gain were found to be positively correlated with the Physical component summary (PCS) and Mental component summary (MCS). Effects of kidney disease was found to be very strongly and positively correlated with dialysis vintage. In the result of the study due to its smaller population we cannot determine more factors which were affecting the Quality of life scores.
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Vitamin D deficiency is one of the prominent nutritional deficiencies in India that needs special attention. The effects of hypovitaminosis D on skeletal and cardiovascular functions are well known. However, its effect on metabolic disorders like type 2 diabetes mellitus (T2DM) is still left unexplored. In the present study, our primary aim is to find out the potential effect of hypovitaminosis D in T2DM patients. The study was conducted on 250 T2DM patients mainly from Madhya Pradesh, India. Among them, 125 had hypovitaminosis D (case group) and were compared against the control group of 125 patients with normal serum vitamin D. We were mainly investigating the major T2DM-related complications including chronic kidney disease (CKD), coronary heart disease (CHD and recurrent infections. Major organ functions including liver, kidney, and cardiac functions were affected by hypovitaminosis D in T2DM patients when compared to control counterparts. We also noticed an association between hypovitaminosis D and the exacerbation of T2DM comorbidities. Our findings show the importance of maintaining normal serum vitamin D levels in T2DM patients to avoid further complications.
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Background: To analyze the effects of oral alkali therapy on renal function, nutritional status and bone density in patients of diabetic kidney disease. Material & Methods: A randomized controlled trial was conducted on 60 patients of age>18 years with diabetic kidney disease who were not on dialysis and had plasma bicarbonate levels between 16 and 20 mmol/l. Patients were randomly divided into two groups: Test group (n=30) which received oral alkali therapy as sodium bicarbonate and control group (n=30) who did not receive oral alkali therapy. The patients were followed for 12 months to compare the improvement. Results: In comparison to controls, test group showed a significant improvement in the Hb (0.7 vs. 0.25, P =0.003), significantly less decrease in eGFR (-2.25 vs. -2.9, P=0.049), non-significant less increase in creatinine (-0.26 ± 0.4 vs. -0.43 ± 0.33, P=0.09), significant improvement in bicarbonate levels (7.5 vs. 1, p<0.0001), significant restoration of albumin (0.32 vs. 0.05, P<.0001), significant fall in iPTH levels (50 vs. 25, p=0.007) and ALP levels (32 vs. 12, p=0.015). Bone density (0.28 ± 0.17 vs. 0.01 ± 0.13, P<.0001) and clinical well-being VAS scores improved significantly among the cases (9.83 ± 5.65 vs. -1.67 ± 7.11, P<.0001). Conclusion: In conclusion, oral alkali therapy slows the rate of decline of renal function and the development of end stage renal disease in patients with advanced stages of CKD. This cheap and simple strategy, which is in line with current renal consensus documents, also improves the nutritional status of patients and bone density.
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Background: Chronic kidney disease is characterized by the progressive and irreversible loss of kidney function over a period of months and years. Due to antigenic similarity, the cochlea and kidney have similar physiological mechanisms namely active transport of fluid and electrolytes achieved by stria vascularis in the cochlea and glomeruli in the kidney. Objective was to inspect the relation between hemodialysis and development of tinnitus and vertigo in CKD patients. Methods: Prospective observational study conducted at Srinivas Institute of medical science, Mangalore, 88 patients were enrolled in this study. Results: Out of 88 patients studied 09 patients (10.22%) complain of tinnitus, 12 patients (13.63%) complain of vertigo, 48 patients (54.54%) had both tinnitus and vertigo, and the remaining 19 patients (21.59%) didn’t develop any tinnitus or vertigo symptoms. The pure tone audiometry results in these individuals were indicative of inner ear pathology. The statistical analysis was done using SPSS 22. Conclusions: Vertigo and tinnitus are common with haemodialysis in patients with chronic kidney disease as 78.40% were affected with either tinnitus or vertigo or with both.