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Objective: Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) in CKD, choosing antihypertensive strategies with the highest nephro-protective effect is crucial for preventing or reversing end-stage renal disease (ESRD) progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact of clinical use of antihypertensive drug therapy in patients with CKD and ESRD. Methods: It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-dialysis dependent (NDD) and dialysis-dependent (DD) CKD. This study was conducted for six months in the Nephrology department, Osmania General Hospital, Hyderabad, India. The data collected and entered into Microsoft Excel (2007) and mean, SD and range were calculated using SPSS version 25. Results: Antihypertensive drugs were prescribed alone or in combination based on the co-morbidities associated with CKD and HTN. Loop diuretics (Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66%+DD = 27.45%) of which calcium channel blockers+loop diuretic+sympatholytic accounts for 19.16% (NDD = 5.88%+DD = 13.73%). Conclusion: The practice of prescribing antihypertensive drugs for the management of HTN and to achieve BP targets in CKD and ESRD remains uncertain. The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better delivery of evidence-based treatment.
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Background: A decrease in the glomerular filtration rate (GFR) shows chronic kidney disease (CKD). It may develop any structural or functional renal abnormalities. Methods: 140 total number of cases were included. This study was conducted in the Department of Pathology in Krishna Mohan Medical College & Hospital, Mathura, U.P, India. Result: The mean fasting blood sugar was 133.29 ± 12.63; the mean Post prandial blood sugar was 155.82 ± 12.56. The mean Hb1Ac were 6.16 ± 1.36 and serum creatinine was 3.76 ± 1.36 mg/dl. Finally, the mean hemoglobin for the whole sample was 10.74 ± 2.17 gm%. Conclusion: This study concludes that in future one could carried out research on large sample size along with a matched control group, simultaneous assessment of other biochemical parameters, and burden of various other metabolic for better results.
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[Objective]To discuss the clinical experiences and unique views of professor CHEN Hongyu in treating chronic kidney disease at the fifth stage (non-dialysis).[Method]To analyze the professor CHEN Hongyu's understanding about the pathogenesis of chronic kidney disease and her academic point of view that treating from spleen and kidney. To sum up the clinical experiences in treating CKD5 (non-dialysis) according to invigorating the spleen and kidney, and analyze typical clinical case. [Result] Professor CHEN Hongyu considers that the root cause of CKD is the spleen and kidney deficiency and often accompanied by pathogenic dampness or blood stasis or turbidity toxin. Also rheumatic is an important risk factor for prompting disease activity and protracted course, which is easy to cause kidney deficiency, renal bi and is usually poor for the prognosis. Professor CHEN Hongyu considers protecting spleen and stomach and invigorating the spleen and kidney as the fundamental law, making good use of application of modern technology, emphasizing the combination of macro and micro, treatment based on syndrome differentiation,which has obvious curative effect to remit or eliminate clinical symptoms in patients with chronic renal disease, beneficial to delay the progress of the renal function and improve life quality.[Conclusion] Professor CHEN Hongyu 's experience in treating chronic kidney disease fifth stage(non-dialysis) is worth learning and spreading.
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The aim of this study is to obtain body composition parameters for early detection of PEM in non dialysis CKD (ND-CKD) patients. The study was carried out using the cross sectional design. The subjects of the study consist of 45 ND-CKD patients and 45 healthy subjects matched for age, gender, height and body mass index (BMI). The nutritional status of patients and healthy subjects were classified based on BMI (WHO, 1995) into low, normal and high nutritional status groups. Fat free mass (FFM), FFM-index (FFM-I) and percentage of fat mass (FM percentage) in patients measured by anthropometric technique showed no significant difference with healthy subjects. Using the BIA method, FFM and FFM-I were significantly lower in the ND-CKD patients compared to the healthy subjects (p < 0,05). Significant difference in FFM, FFM-I, FM and FM percentage was observed between the patients with different nutritional status. (p < 0,001). Trend analysis statistical test showed that there is linear correlation of FFM, FFM-I and FM with nutritional status classification. FFM, FFM-I, FM and FM percentage in ND-CKD patients were not significantly different between the three stages of CKD. There was an acceptable degree of agreement between BMI with FFM-I for nutritional assessment in ND-CKD patients. The Receiver Operating Curve test showed the cut off points of FFM-I 14.23 kg/m2 to differentiate undernutrition and normal nutritional status in ND-CKD patients. This study showed FFM-I has good correlation with BMI and can be used to differentiate degrees of nutritional status in stage 3, 4 and 5 ND-CKD patients. FFM-I considered predictor parameters for nutritional status screening in ND-CKD patients.
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Estado Nutricional , Insuficiência Renal CrônicaRESUMO
OBJECTIVE To elucidate the hospital-acquired infections of chronic kidney disease non-dialysis patients and associated factors.METHODS Clinical data of 996 non-dialysis patients between Jun 1,2003 and Jun 1,2006 were enrolled in this retrospective study of hospitalized cases,there were 112 cases of hospital-acquired infections.The infection site,pathogens,renal function,serum albumin and hemoglobin were analyzed.RESULTS During above period 124 hospital-acquired infection episodes occurred.The infection rate was 11.2%,It was significantly higher than rate of hospital-acquired infection of our hospital at the same time(P