ABSTRACT
BACKGROUND: The prevalence of end-stage renal disease in Taiwan is the highest in the world; haemodialysis accounts for about 7% of the expenditure of the National Health Insurance. Nursing home residents with chronic kidney disease (CKD) have not been identified yet in Taiwan, along with associated risk factors. The objective of this study is to investigate the risk factors of CKD in long-term care facilities in Taiwan and those significantly associated with the presence of CKD. METHODS: The nursing home residents who received health examination between January and June 2012, age ≥ 55 years, were enrolled in this study. They were categorized into two subgroups according to estimated glomerular filtration rate (eGFR): < 60 and ≥ 60 mL/min. Risk factors were evaluated per recommendations from the National Kidney Foundation: body mass index (BMI), waist circumference, blood pressure, fasting glucose and lipid profile. Metabolic syndrome among the residents was also identified. RESULTS: Fifty-three nursing home residents were enrolled in the final study; 16 (30%) had eGFR below 60 mL/min, and nine (56%) of them had BMI higher than 25 kg/m2. The residents with advanced CKD had significantly higher BMI, triglyceride and lower high-density lipoprotein (HDL). Twelve (75%) had metabolic syndrome. Central obesity was observed in 10 (63%) with advanced CKD. CONCLUSION: Most of the nursing home elderly with advanced CKD have poor control of associated risk factors, including obesity, hypertension, dyslipidaemia and hyperglycaemia. For them, metabolic syndrome may be a major contributant to the aetiology. Monitoring their BMI and waist circumference is a simple but effective way to suspect the presence of CKD.
ABSTRACT
AIM: The moderate, severe chronic kidney disease (CKD) and end stage renal disease (ESRD) are well-recognized risk factors of bone loss. However, it is uncertain whether mild CKD stage affects bone mineral density (BMD). The objective of this study is to investigate whether mild and/or more severe reduction of GFR is associated with BMD decreasing. METHODS: Between April and November 2011, 305 patients were included in this study. Estimated glomerular filtration rate (GFR) was calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. According to the GFR, we divided the participants into 3 groups: CKD stage I, stage II and stage ≥III. BMD was compared between different groups. RESULTS: Eighty-one women and 65 men were enrolled in the final study. The average age was 65.6. According to the eGFR, 54 (37.0%), 70 (47.9%) and 22 (15.1%) participants were classified into CKD stage I, II and ≥III, respectively. The mean T-score was -1.351±1.879.A significant bone loss was found in the stage ≥III group, especially in women (P<0.05). BMD decreasing was found significantly in male participants with CKD stage II (P=0.041). CONCLUSION: BMD significantly decreased in men with mild renal dysfunction. A significant BMD decreasing was also found in the group of CKD stage ≥III, especially in women. We suggest osteoporosis screening is necessary in patients with poor renal function.
Subject(s)
Bone Density/physiology , Kidney/physiopathology , Osteoporosis/etiology , Renal Insufficiency, Chronic/complications , Aged , Calcaneus/diagnostic imaging , Early Diagnosis , Female , Glomerular Filtration Rate , Humans , Male , Mass Screening , Middle Aged , Osteoporosis/diagnosis , Osteoporosis/diagnostic imaging , Osteoporosis/physiopathology , Renal Insufficiency, Chronic/physiopathology , Severity of Illness Index , Sex Factors , UltrasonographyABSTRACT
The combined toxicity of lead (Pb) and nine phenols were measured. The result indicated that the combined toxicity is not only dependent on the Pb concentrations but also on the positions of substituted groups of phenols. Quantitative structure-activity relationship equations were built from the combined toxicity and physico-chemical descriptors of phenols in the different Pb concentrations. The combined toxicity was related to water solubility and the third order molecular connectivity index ((3)X) in low Pb concentration, to solute excess molar refractivity (E) and ionization constant (pKa) in medium Pb concentration and to dipolarity/polarizability (S) in high Pb concentration.
