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Chronic Kidney Disease


Presentation

  • We present the case of a non-dialyzed patient with chronic kidney disease and biopsy-proven calciphylaxis who presented with painful cutaneous ulcers on both legs.[ncbi.nlm.nih.gov]
  • A 34-year-old man with severe kidney function loss secondary to renal TB initially presented with urinary symptoms, including dysuria and polacyuria.[ncbi.nlm.nih.gov]
  • Results: A total of 181 neonates presented with CKD. Their mean age at the time of presentation was 11.1 days (95% confidence interval [CI]: 9.5-12.8) and the mean creatinine level was 106.5 µmol/ (95% CI: 91.3-121.7).[ncbi.nlm.nih.gov]
  • OBJECTIVE: To determine the outcome of chronic kidney disease (CKD) patients presenting for dialysis on the basis of referral to nephrologist. STUDY DESIGN: Observational study.[ncbi.nlm.nih.gov]
  • We present a case of F. philomiragia pneumonia with peripheral edema and bacteremia in a renal transplant patient and review the diverse reports of F. philomiragia infections.[ncbi.nlm.nih.gov]
Weight Gain
  • Dialysis started one year later, and was followed by weight gain of about 5 kg.[ncbi.nlm.nih.gov]
  • "Exercise may have an array of health benefits to these patients ranging from keeping their diabetes under control, maintaining healthy muscles and blood vessels to controlling weight gains after a transplant that are associated with prescribed medications[sciencedaily.com]
  • Physical activity can help lower blood pressure, control diabetes, and prevent weight gain. Ask your health care provider about physical activities that would be right for you. Avoid certain drugs and supplements.[choosingwiselycanada.org]
  • For those taking prednisone for long periods of time, these effects can be significant, including weight gain (especially around the face and trunk), moodiness, sleep disturbances, cataracts, and osteoporosis (weakening of the bones).[kidshealth.org]
Nausea
  • A 69-year-old male was admitted to the hospital with a chief complaint of abdominal pain, nausea, and vomiting. He had an extensive past medical history, including diabetes mellitus type 2 and chronic kidney disease stage III.[ncbi.nlm.nih.gov]
  • Abstract Posterior reversible encephalopathy syndrome is a clinicoradiologic syndrome characterized by seizure, headache, nausea, vomiting, altered mental status, visual disturbance, or visual loss, together with radiologic findings.[ncbi.nlm.nih.gov]
  • Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia, nocturia, lassitude, fatigue, pruritus, decreased mental acuity, muscle twitches and cramps, water retention, undernutrition, peripheral neuropathies[msdmanuals.com]
  • Symptoms often start only when the kidneys are working quite poorly, and may include high blood pressure, changes in your urine, tiredness , nausea, and itching - see Kidney disease symptoms . If you notice any such symptoms, see your doctor.[healthdirect.gov.au]
  • Kidney Disease Symptoms More frequent urination, especially at night Feeling tired and having less energy Trouble sleeping Nausea Headaches Weight loss and/or loss of appetite Swelling in feet, ankles or around the eyes due to fluid buildup There are[mottchildren.org]
Hypertension
  • AND chronic kidney disease Hypertensive heart AND chronic kidney disease with congestive heart failure Hypertensive heart and CKD Hypertensive heart and CKD, w CHF Hypertensive heart and kidney disease Hypertensive heart and kidney disease with chf Hypertensive[icd9data.com]
  • 403 Hypertensive chronic kidney disease 403.0 Malignant hypertensive renal disease 403.00 Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage I through stage IV, or unspecified convert 403.00 to ICD-10-CM 403.01 Hypertensive[icd9data.com]
  • Most common was chronic kidney disease of unknown cause, associated with neither diabetes nor hypertension.[ncbi.nlm.nih.gov]
  • Prevalence of chronic kidney disease risk factors was: diabetes mellitus, 9%; hypertension, 20.9%; family history of chronic kidney disease, 16.5%; family history of diabetes mellitus, 18.5%; family history of hypertension, 30.6%; obesity, 21%; central[ncbi.nlm.nih.gov]
  • Age, history of hypertension, preoperative eGFR, and eGFR at 1 year were predictive factors at univariate analysis.[ncbi.nlm.nih.gov]
Lethargy
  • Symptoms of anaemia include: tiredness lethargy shortness of breath (dyspnoea) palpitations (awareness of heartbeat) Anaemia can occur because of many other conditions and your doctor will investigate to rule out any other possible causes.[hse.ie]
  • Case study 2 June, 83 years of age, is a female nursing home resident with a 3 month history of lethargy, anorexia and itch.[racgp.org.au]
  • Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy).[en.wikipedia.org]
  • Specific symptoms usually develop only in severe CKD, and include anorexia, nausea, vomiting, fatigue, weakness, pruritus, lethargy, peripheral oedema, dyspnoea, insomnia, muscle cramps, pulmonary oedema, nocturia, polyuria and headache.[patient.info]

Workup

  • Kashani, Biomarkers for Early Detection of Acute Kidney Injury, The Journal of Applied Laboratory Medicine: An AACC Publication, September 2017, jalm.2017.023325; DOI: 10.1373/jalm.2017.023325 (May 1, 2017) Arora, P Chronic Kidney Disease Workup.[labtestsonline.it]
  • Other benefits of early nephrology referral include proper patient education regarding options for renal replacement therapy as well as pre-emptive transplantation, and timely workup and placement of an arteriovenous fistula in those patients opting for[en.wikipedia.org]
  • […] stenosis, renal atheroembolic disease, atherosclerosis with aortorenal occlusion, and certain cases of necrotizing vasculitis (eg, polyarteritis nodosa) Renal biopsy: Can be useful in identifying intrarenal causes of AKI and directing targeted therapy See Workup[emedicine.com]
LDL Increased
  • However, although low LDL is associated with a higher risk of cardiovascular disease overall, in blacks high LDL increases cardiovascular risk two-fold.[jasn.asnjournals.org]
Glomerular Filtration Rate Decreased
  • Her estimated glomerular filtration rate decreased from an admission value of 34 mL/min/1.73 m2 to 13 mL/min/1.73 m2. CT scan showed retroperitoneal haematoma.[ncbi.nlm.nih.gov]

Treatment

  • Treatment of CKD anemia aims to normalize RBC count and serum hemoglobin. Clinically, the various fluxes of iron transport and accumulation are not measured so that changes during disease (e.g., CKD) and treatment are unknown.[ncbi.nlm.nih.gov]
  • Since there are limited treatments for CKD, others with CKD may benefit from acupuncture and herbal treatments.[ncbi.nlm.nih.gov]
  • After treatment, blood potassium remained in the normal range.[ncbi.nlm.nih.gov]
  • Few studies have examined the safety and efficacy of pharmacotherapy for treatment of dyslipidemia in the CKD population, and ongoing studies such as the Study of Heart and Renal Protection (SHARP) should help clarify the current treatment guidelines.[doi.org]

Prognosis

  • The Kaplan-Meier survival curves demonstrated that patients with a higher TFF1 and TFF3 alone, or in combination with macroalbuminuria, had a significantly worse renal prognosis.[ncbi.nlm.nih.gov]
  • In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy.[ncbi.nlm.nih.gov]
  • Chronic Kidney Disease Prognosis Consortium (CKD-PC) is a research group composed of investigators representing cohorts from around the world. Investigators share data for the purpose of collaborative meta-analyses to study prognosis in CKD.[jhsph.edu]
  • Abstract Late referral in chronic kidney disease (CKD) is associated with irregular care and poor prognosis.[ncbi.nlm.nih.gov]
  • In contrast, CKD-only patients had a good prognosis and did not appear to require statin treatment.[ncbi.nlm.nih.gov]

Etiology

  • Especially in children, early diagnosis and detection of the etiologic factors are important to improve their health outcomes.[ncbi.nlm.nih.gov]
  • The authors present a case of chronic diarrhea in a hemodialysis (HD) patient with an unknown etiology. After about one year and several failed interventions, synbiotic therapy was performed.[ncbi.nlm.nih.gov]
  • CONCLUSION: Congenital anomalies of the kidneys and urinary tract is the most common etiology in neonates with CKD. Chronic kidney disease in neonates is associated with high morbidity and mortality rates.[ncbi.nlm.nih.gov]
  • In patients with advanced chronic kidney disease, anticoagulant therapy should be administered carefully, and the etiology of retroperitoneal hematoma should be further investigated.[ncbi.nlm.nih.gov]
  • Clinical presentation depends a lot on etiology. Children with chronic kidney disease can have growth disorder, edema and cola colored urine (due to RBC casts).[radiopaedia.org]

Epidemiology

  • Several recent epidemiologic studies have shown that obesity and the metabolic syndrome are independent predictors of CKD.[cjasn.asnjournals.org]
  • A cross-sectional analytical epidemiological study was conducted based on active screening for chronic kidney disease and risk factors in persons aged 18 years during 2009-2011.[ncbi.nlm.nih.gov]
  • Long Beach, the Department of Epidemiology, University of California, Los Angeles (UCLA), and the Los Angeles Biomedical Research Institute at Harbor–UCLA, Torrance — all in California (K.K.[doi.org]
  • Graziano, Nicolucci, Tognoni, and Strippoli: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/A, 66030 S. Maria Imbaro (Chieti), Italy. Dr.[doi.org]
  • A cross-sectional analytical epidemiological study was carried out using active screening for chronic kidney disease and associated risk factors in individuals aged 18 years in the Bajo Lempa Region, a rural, coastal area in El Salvador.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Lowered hArg concentrations are associated with higher risk for these conditions, although a clear pathophysiological explanation for this association has not been established.[ncbi.nlm.nih.gov]
  • The pathophysiology of cardiovascular disease in CKD is under investigation but to date, treatment options are limited. Blood pressure control and statins have the strongest supportive evidence.[ncbi.nlm.nih.gov]
  • To explain the pathophysiology of PRES, the hypertension/hyperperfusion and hypoperfusion/vasoconstriction theories have been proposed. Patients with CKD have many complications including uraemia, hypertension, and immunosuppression.[ncbi.nlm.nih.gov]
  • The senile plaques (SPs) in the brain are one of the most pathophysiological characteristics of cognitive dysfunction and its major constituent amyloid β (Aβ) released from amyloid precursor protein (APP) by β (BACE1) and γ (presenilin 1) secretases .[ncbi.nlm.nih.gov]
  • Each is accompanied by discussion of pathophysiology, diagnosis, and treatment options. Newer investigational results are integrated into the existing body of knowledge.[ncbi.nlm.nih.gov]

Prevention

  • Prevention It is not too ambitious to consider CKD prevention. Hypertension and diabetes are the major causes of CKD in developed nations.[jasn.asnjournals.org]
  • Treating the condition that is causing the problem may help prevent or delay CKD. People who have diabetes should control their blood sugar and blood pressure levels and should not smoke.[nlm.nih.gov]
  • Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. JAMA. 1998 ; 279 : 1615–1622.[circ.ahajournals.org]
  • Together these findings reveal a role for ERRγ in directing independent and HNF1β-integrated programs for energy production and use essential for normal renal function and the prevention of kidney disease.[ncbi.nlm.nih.gov]
  • The results of the Diabetes Prevention Program (DPP) funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) show that moderate exercise, a healthier diet, and weight reduction can prevent the development of type 2 diabetes[healthypeople.gov]

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