scholarly journals The State of Chronic Kidney Disease, ESRD, and Morbidity and Mortality in the First Year of Dialysis

2009 ◽  
Vol 4 (Supplement 1) ◽  
pp. S5-S11 ◽  
Author(s):  
Allan J. Collins ◽  
Robert N. Foley ◽  
David T. Gilbertson ◽  
Shu-Chen Chen
2010 ◽  
Vol 3 (2) ◽  
pp. 109-121 ◽  
Author(s):  
Kurt M. Sowers ◽  
Melvin R. Hayden

Calcific uremic arteriolopathy (CUA)/calciphylaxis is an important cause of morbidity and mortality in patients with chronic kidney disease requiring renal replacement. Once thought to be rare, it is being increasingly recognized and reported on a global scale. The uremic milieu predisposes to multiple metabolic toxicities including increased levels of reactive oxygen species and inflammation. Increased oxidative stress and inflammation promote this arteriolopathy by adversely affecting endothelial function resulting in a prothrombotic milieu and significant remodeling effects on vascular smooth muscle cells. These arteriolar pathological effects include intimal hyperplasia, inflammation, endovascular fibrosis and vascular smooth muscle cell apoptosis and differentiation into bone forming osteoblast-like cells resulting in medial calcification. Systemic factors promoting this vascular condition include elevated calcium, parathyroid hormone and hyperphosphatemia with consequent increases in the calcium × phosphate product. The uremic milieu contributes to a marked increased in upstream reactive oxygen species—oxidative stress and subsequent downstream increased inflammation, in part, via activation of the nuclear transcription factor NFκB and associated downstream cytokine pathways. Consitutive anti-calcification proteins such as Fetuin-A and matrix GLA proteins and their signaling pathways may be decreased, which further contributes to medial vascular calcification. The resulting clinical entity is painful, debilitating and contributes to the excess morbidity and mortality associated with chronic kidney disease and end stage renal disease. These same histopathologic conditions also occur in patients without uremia and therefore, the term calcific obliterative arteriolopathy could be utilized in these conditions.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pauline Maurel ◽  
Aurélie Prémaud ◽  
Paul Carrier ◽  
Marie Essig ◽  
Louise Barbier ◽  
...  

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Osaretin Oviasu ◽  
Janette E. Rigby ◽  
Dimitris Ballas

Chronic kidney disease (CKD) is a growing problem in Nigeria, presenting challenges to the nation’s health and economy. This study evaluates the accessibility to healthcare in Edo State of CKD patients diagnosed between 2006 and 2009. Using cost analysis techniques within a geographical information system, an estimated travel time to the hospital was used to examine the spatial accessibility of diagnosed patients to available CKD healthcare in the state. The results from the study indicated that although there was an annual rise in the number of diagnosed cases, there were no significant changes in the proportion of patients that were diagnosed at the last stage of CKD. However, there were indications that the travel time to the hospital for CKD treatment might be a contributing factor to the number of diagnosed CKD cases. This implies that the current structure for CKD management within the state might not be adequate.


2007 ◽  
Vol 2 (5) ◽  
pp. 938-946 ◽  
Author(s):  
Luca De Nicola ◽  
Giuseppe Conte ◽  
Paolo Chiodini ◽  
Bruno Cianciaruso ◽  
Andrea Pota ◽  
...  

2020 ◽  
Vol 5 (1) ◽  
pp. 18-25
Author(s):  
Ruth Kander

Renal bone disease increases morbidity and mortality in patients with chronic kidney disease by increasing the risk for fractures, osteoporosis and other bone problems and its association with cardiovascular disease, including calcification and arterial stiffness. Treatment of renal bone disease is through a combination of three main methods to reduce phosphate levels: dietary restriction of high-phosphate foods; dialysis clearance; and the use of phosphate binders to prevent its absorption.


2013 ◽  
Vol 27 (4) ◽  
pp. 328-332 ◽  
Author(s):  
Ana Paula Silva ◽  
André Fragoso ◽  
Ana Pinho ◽  
Nelson Tavares ◽  
Ana Camacho ◽  
...  

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Jesinta Kaparang ◽  
Emma Sy Moeis ◽  
Linda Rotty

Abstract : Bacground: Stadium V Chronic Kidney Disease is less than 15 ml/mnt GFR, there is an accumulation of toxin uremia in blood that could harm the survival of patient, it is required a substitute therapy for the kidney,which is called hemodialysis. Hemodialisis needs anticoagulation, so blood clotting in circuit extracorporeal does not occur. In its development, have been tried several kinds of anticoagulation technique and anticoagulant which is made based on the state of the patient such as heparin, but in its using it can cause side effects. The work of heparin as anticoagulant dependents on anti thrombin (AT-III) that is an inhibitor of various factor of clotting. Heparin can cause changing of homeostasis because of its effect to the function of thrombosis ( thrombosis aggregation ) even to reduce the number of thrombosis ( Heparin Induced Thrombocytopenia ) . Purpose: To know and to study about the value of thrombosis in CKD patient who endure hemodialysis in unit hemodialisis Department of Internal Medicine BLU RSUP Prof. Dr.R.D. Kandou Manado.Method : Descriptive retrospective, using secondary data medic record in unit hemodyalisis Department of Internal Medicine BLU RSUP Prof. DR .R. D. Kandou Manado. Result: The thrombocytopenia patient increased on HD > 96 X, most of them are men in range 51 – 60 years old. Conclusion: CKD patient who endure hemodyalisis generally have normal thrombosis value, number of thrombocytopenia case is 25,45 % and number of most occurrence is commonly to men Keywords: chronic kidney disease, hemodialysis, thrombocytopenia.   Abstrak: Latar Belakang: Penyakit ginjal kronik stadium V yaitu LFG kurang dari 15 ml/mnt terdapat akumulasi toksin uremia dalam darah yang dapat membahayakan kelangsungan hidup pasien, sehinga di perlukan terapi penganti ginjal, terapi pengganti ginjal tersebut berupa hemodialisis. Pada hemodialisis diperlukan antikoagulasi supaya tidak terjadi pembekuan darah didalam sirkuit ekstrakorporeal. Dalam perkembangannya telah dicoba beberapa macam teknik antikoagulasi dan antikoagulan yang dibuat berdasarkan keadaan pasien,seperti heparin tetapi dalam pengunaanya heparin dapat memberikan efek samping Kerja heparin sebagai antikoagulasi bergantung pada antitrombin (AT-III) yaitu suatu inhibitor dari berbagai faktor pembekuan. Heparin menyebabkan perubahan hemostasis karena efeknya terhadap fungsi trombosit (agregasi trombosit) bahkan menurunkan jumlah trombosit (Heparin Induced Thrombocytopenia). Tujuan:Mengetahui dan mempelajari nilai trombosit pada pasien PGK yang menjalani hemodialisis di unit hemodialisis bagian/SMF Ilmu Penyakit Dalam BLU RSUP. Prof.Dr.R.D.Kandou manado. Metode Penelitian: Deskriptif retospektif dengan mengunakan data sekunder rekam medik di unit Hemodialisis Bagian/SMF Ilmu Penyakit dalam BLU RSUP  Prof.DR. R. D. Kandou  Manado. Hasil: Pasien yang mengalami trombositopeni mengalami peningkatan pada Hemodialisis lebih dari 96 kali, terbanyak berjenis kelamin laki – laki pada kelompok umur 51 – 60 tahun. Simpulan: Pasien PGK yang menjalani hemodialisis pada umumnya mempunyai nilai trombosit normal, jumlah kasus trombositopeni 25,45%, dan angka kejadian terbanyak umumnya pada laki –laki. Kata Kunci: Penyakit ginjal kronik, hemodialisis, trombositopeni


2020 ◽  
Vol 115 (1) ◽  
pp. S68-S68
Author(s):  
Riana B. Jumamil ◽  
Joann Kwah ◽  
Juan Lin ◽  
Olga Aroniadis ◽  
Paul Feuerstadt ◽  
...  

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