scholarly journals Antidiabetic and Other Therapies Used in Subjects with Diabetes and Chronic Kidney Disease in a Hospital-Based Clinic Population in Greece

2021 ◽  
Vol 10 (10) ◽  
pp. 2104
Author(s):  
Ilias Migdalis ◽  
Nikolaos Papanas ◽  
Ioannis Ioannidis ◽  
Alexios Sotiropoulos ◽  
Athanasios Raptis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Physicians ◽  
Public Hospitals ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Cross Sectional ◽  
Mean Values ◽  
Dipeptidyl Peptidase 4 Inhibitors

(1) Background: Type 2 diabetes mellitus (T2DM) is the main cause of chronic kidney disease (CKD). In Greece, in a population from hospital-based diabetes clinics (n = 1759), the overall prevalence of diabetic chronic kidney disease (DCKD) was 45% including mild, moderate, and severe CKD. The aim of this study was to describe and analyze how T2DM patients with mild-to-severe CKD are managed by diabetologists in Greece and assess the achievement rates in glycemic, blood pressure and low-density lipoprotein-cholesterol (LDL-C) control. (2) Methods: This cross-sectional multicenter study took place from June 2015 to March 2016 and collected data from diabetes centers in public hospitals all over Greece. (3) Results: With regard to the anti-diabetes treatment, most participants were on metformin, DPP-4 (Dipeptidyl Peptidase-4 inhibitors) inhibitors and insulin. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers were the most prescribed medications for hypertension. For the management of dyslipidemia, most participants were on statins. For patients with DCKD, the levels of HbA1c, blood pressure and LDL-C were 7.2%, 137.7/76.9 mmHg and 95.9 mg/dL, respectively (mean values). (4) Conclusions: The outcomes of this study suggest that management of DCKD can be further improved and should be enhanced. These results may contribute to the whole health care system in Greece. In addition, the better understanding of therapeutic strategies used by diabetologists treating these patients offers educational benefits to primary care physicians, which can result in an overall more successful and efficient management of subjects with T2DM and DCKD.

scholarly journals Blood pressure control in chronic kidney disease: A cross-sectional analysis from the German Chronic Kidney Disease (GCKD) study

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202604 ◽  
Author(s):  
Markus P. Schneider ◽  
Karl F. Hilgers ◽  
Matthias Schmid ◽  
Silvia Hübner ◽  
Jennifer Nadal ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

scholarly journals The quality of life of chronic kidney disease patients with hypertension treated with angiotensin system-related agents

2020 ◽  
Vol 11 (4) ◽  
pp. 6633-6639
Author(s):  
Mohammed Salim KT ◽  
Saravanakumar RT ◽  
Dilip C ◽  
Amrutha KP
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Converting Enzyme Inhibitors ◽  
Angiotensin System ◽  
The Impact

The chronic kidney disease (CKD) co-exist with hypertension in approximately 80 to 85 per cent of patients. The CKD stages can be defined by glomerular filtration rate (GFR), and the deterioration of kidney function or reduction in GFR has observed in those with uncontrolled blood pressure (BP). We had conducted a prospective study to analyse the impact of the angiotensin system-related agents on the quality of life of CKD patients with hypertension. The SF-36 questionnaire, direct patients interview and medical records were the sources for retrieval of information. We observed that male patients were more prone to CKD than female. Hypertension was the primary (77.8%) aetiology behind the incidence of CKD. The angiotensin-converting enzyme inhibitors (ACEI) was responsible for very low (58%) and low (44%) health disabilities to the patients. In contrast, the angiotensin receptor blockers (ARB) even though it has a limited adverse effect, the patients complained of medium (9%) and high disabilities than the ACEIs. The discontinuation of the antihypertensive drugs by the CKD patients was almost negligible (3.4%). The study concludes that a balanced diet and reasonable blood pressure control is essential to prevent the progression of CKD and to improve the quality of life.

scholarly journals PENGARUH PEMBERIAN OBAT ANTIHIPERTENSI TERHADAP KUALITAS HIDUP PASIEN HIPERTENSI DENGAN GANGGUAN GINJAL KRONIK DI INSTALASI HEMODIALISA RSUP DR. HASAN SADIKIN BANDUNG

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Anggun Hari Kusumawati ◽  
Lia Amalia ◽  
Rubin Surachno Gondodiputro ◽  
Cherry Rahayu
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Outcome ◽  
Outcome Quality ◽  
National Kidney Foundation ◽  
Cross Sectional ◽  
Antihypertension Therapy

ABSTRAK Hipertensi merupakan penyebab gangguan ginjal kronik melalui suatu proses yang mengakibatkan hilangnya sejumlah besar nefron fungsional yang progresif dan irreversible. The Kidney Disease Outcome Quality Initiative (K/DOQI) of the national kidney foundation (NKF) merekomendasikan target tekanan darah pada pasien gangguan ginjal kronik < 140/90 mmHg sehingga dapat mengurangi risiko terjadinya penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian obat antihipertensi terhadap kualitas hidup pasien GGK yang menjalani hemodialisis di RSUP DR.Hasan Sadikin Bandung. Penelitian menggunakan desain cross sectional observational konkuren dengan mengkaji data rekam medis dan status harian pasien selama periode Desember 2015-Febuari 2016 dan hasil pengisian kuisioner Kidney Disease and Quality of Life (KDQOLTM-36). Subyek penelitian merupakan pasien GGK yang menjalani hemodialisis dan mendapatkan terapi obat antihipertensi (OAH), laki-laki dan perempuan, usia lebih dari 18 tahun. Terdapat perbedaan bermakna penurunan tekanan darah sistolik(p=0,011) dan diastolik (p=0,023) untuk setiap terapi OAH, kombinasi 2 OAH memberikan efek penurunan tekanan darah sistolik dan diastolik yang paling baik dan berbeda bermakna (p=0,001). Pengobatan tunggal dan kombinasi dua obat antihipertensi memberikan efek penurunan tekanan darah yang paling baik.Setiap jenis terapi obat antihipertensi tidak memberikan perbedaan bermakna terhadap kualitas hidup kecuali domain aspek efek penyakit (p=0,041). Kata kunci : Hipertensi, gagal ginjal kronik, hemodialisis, antihipertensi, KDQOL, kualitas hidup. 40 ABSTRACT Background: Hypertension is the leading cause of chronic kidney disease (CKD) through a process that resulted in loss of a large number of functional nephron on progressive and irreversible. The Kidney Disease Outcome Quality Initiative (K/DOQI) of The National Kidney Foundation (NKF) recommends a target blood pressure values of < 130/80 mmHg in CKD patients, it can reduce the risk of cardiovascular disease. Objective : The purpose of this study is to understand the antihypertension medication effects to the quality of life of hemodialysis patients in RSUP DR.Hasan Sadikin Bandung. Methods : The design of study is cross sectional observational with concurrent medical record with patients daily status analyses during December 2015 - February 2016 with questionnaire by the Kidney Disease and Quality of Life (KDQOL-36. Results : The analysis result shows significant differences in the reduction of systolic (p=0, 011) and diastolic (p=0, 023) blood pressure in each group of antihypertension therapy. Furthermore, 2 combination of antihypertension therapy gives the most significant different in reduction of systolic and diastolic blood pressure (p=0, 001). Conclusions : Second combination of antihypertension therapy can be reduce of blood pressure better than other therapy. Second combinations of antihypertension therapy is best for decrease of blood pressure and creatinin serum. In all domain of quality of lifes, symptom/problems have a highest score, and burden of kidney disease have a lowest score of quality of life. Keywords : chronic kidney disease, hemodialysis, antihypertension, KDQOL, quality of life.

scholarly journals Association between MR-proADM concentration and treatment intensity of antihypertensive agents in chronic kidney disease patients with insufficient blood pressure control

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Motoshi Iwao ◽  
Ryota Tanaka ◽  
Yosuke Suzuki ◽  
Takeshi Nakata ◽  
Kohei Aoki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Antihypertensive Drugs ◽  
Antihypertensive Agents ◽  
Pressure Control ◽  
Ultra Performance Liquid Chromatography ◽  
Treatment Intensity ◽  
Cross Sectional ◽  
Intensity Score

AbstractResponse to antihypertensive drugs in patients with chronic kidney disease (CKD) has great interindividual variability. Adrenomedullin (ADM) is produced abundantly in hypertension, but clearance is very rapid. Mid-regional proADM (MR-proADM) produced from an ADM precursor is considered a surrogate biomarker for quantification of ADM. We investigated the association of MR-proADM with antihypertensive resistance in CKD patients with poor blood pressure (BP) control. This cross-sectional study analyzed 33 CKD patients with poor BP control defined as failure to achieve target BP despite at least two classes of antihypertensive drugs. Treatment intensity score was calculated to facilitate comparability of antihypertensive regimens across subjects taking different drugs. Plasma MR-proADM concentration was measured using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Plasma MR-proADM concentration correlated with estimated glomerular filtration rate (eGFR) (r =  − 0.777, p < 0.001). Treatment intensity score correlated positively with plasma MR-proADM concentration (r = 0.355, p = 0.043), and the correlation was further enhanced after correction by weight (r = 0.538, p = 0.001). Single and multiple regression analysis identified MR-proADM concentration (p = 0.005) as independently associated with weight-corrected treatment intensity score. MR-proADM may be useful as a biomarker to determine the therapeutic intensity of antihypertensive drugs in CKD patients with poor BP control.

Epidemiology of gout

2016 ◽  
Author(s):  
Samantha Hider ◽  
Edward Roddy
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Epidemiological Studies ◽  
Dietary Factors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Increased Risk

Gout is the most prevalent inflammatory arthritis in men. Data from epidemiological studies conducted in several countries suggest that the prevalence and incidence of gout have risen over the last few decades, although incidence may have stabilized recently. Dietary factors (animal purines, alcohol, and fructose), co-morbid medical conditions (obesity, metabolic syndrome, hypertension, and chronic kidney disease), and medications (diuretics, aspirin, beta blockers, angiotensin converting-enzyme inhibitors, and non-losartan angiotensin II receptor blockers) have been confirmed to be risk factors for both hyperuricaemia and gout. In contrast, low-fat dairy products, coffee, vitamin C, calcium channel antagonists, and losartan appear to reduce the risk of developing gout. People with gout are themselves at increased risk of developing cardiovascular disease and chronic kidney disease, independent of traditional risk factors for these conditions.

Practical guidance for the use of potassium binders in the management of hyperkalaemia in patients with heart failure and/or chronic kidney disease

2021 ◽  
pp. 1-11
Author(s):  
Patricia Campbell ◽  
Paul McKeveney ◽  
Kay Donegan ◽  
Charlie Ataliotis ◽  
Carol Patton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physiological Role ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Patients With Heart Failure ◽  
Raas Inhibitors ◽  
Potassium Binders

Given the critical physiological role of potassium, it is understandable that the development of severe hyperkalaemia requires effective management to reduce its effects, which include muscle weakness, paralysis and cardiac arrhythmias. Hyperkalaemia most often results from the failure of renal adaptation to potassium imbalance. Patients who are most susceptible to the development of hyperkalaemia include those with chronic kidney disease and those with heart failure. These patients are often treated with renin–angiotensin–aldosterone system (RAAS) inhibitors, such as angiotensin-converting enzyme inhibitors and angiotensin II-receptor blockers, but the development of hyperkalaemia can require down-titration or cessation of RAAS inhibitors. This presents a significant challenge to nephrologists, cardiologists and healthcare professionals treating these patients as this can prevent them from receiving maximum guideline-directed RAAS inhibitor therapy. Panellists in this roundtable discussion shared their clinical experiences of using potassium binders to manage hyperkalaemia in patients with chronic kidney disease and patients with heart failure (illustrated with case studies) in Northern Ireland and considered recommendations for the implementation and maintenance of chronic potassium-lowering treatment.

scholarly journals Chronic Kidney Disease: Current State of the Problem

2020 ◽  
Vol 16 (6) ◽  
pp. 938-947
Author(s):  
M. M. Batiushin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Depressive Disorders ◽  
Public Awareness ◽  
Full Range ◽  
Harmful Effect ◽  
Lifestyle Changes ◽  
Angiotensin Ii Receptor ◽  
Receptor Antagonists ◽  
Converting Enzyme Inhibitors

Chronic kidney disease (CKD) is characterized by increasing prevalence, catalyzing properties in relation to cardiovascular and general mortality, and, in most cases, is asymptomatic, which means late diagnostic verifiability. The global average prevalence of CKD is 13.4%, and CKD C3-5 is 10.6%. The main causes of CKD C5 are diabetes mellitus (DM, 46.9%), hypertension (28.8%) and to a lesser extent, glomerulonephritis (7.1%) and polycystic diseases (2.8%), while other causes account for a total of 14.4%. Despite the simple diagnosis of CKD, one of the key problems of modern therapeutic and pediatric clinics is its low detection rate at the early stages, which, according to some data, reaches 96.6%. This review provides data on the criteria for the diagnosis of CKD, as well as more detailed consideration of the course of CKD in patients with DM, hypertension, and heart failure. Attention is paid to the medicinal origin of CKD, as well as to the development of anxiety and depressive disorders in CKD. General issues of treatment of patients with CKD are considered in detail. Lifestyle changes are an important part of the fight against the development and progression of CKD. Currently, Smoking, alcohol, and physical inactivity have been shown to have a harmful effect on the risk of developing and progressing CKD. Diet plays a certain preventive role. The main drugs with nephroprotective properties are angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists. Both classes of drugs are effective in proteinuric forms of nephropathies and in combination/association of CKD with diabetes or hypertension. The review also provides data on the nephroprotective properties of mineralocorticoid receptor antagonists, endothelin receptor antagonists, and sodium-glucose co-transporter-2 inhibitors. Given the high importance of identifying and effectively treating patients with CKD, it is necessary to focus on early detection of CKD, especially in high-risk groups. It is necessary to raise public awareness by creating and implementing programs for primary prevention of CKD, as well as awareness of patients, motivating them to follow the doctor's recommendations for a long time, including as part of the implementation of a non-drug strategy to combat CKD. It is important to use the full range of methods of drug therapy for CKD, including measures of universal nephroprotection. It should be remembered that the cost of late diagnosis of CKD is a reduction in life expectancy, primarily due to high rates of cardiovascular mortality, disability, and high-cost medication and kidney replacement therapy.

scholarly journals Analysis of Self-Efficacy and Characteristics of Patients with Chronic Kidney Disease Underwent Hemodialysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Rahma Edy Pakaya ◽  
Yuliana Syam ◽  
Syahrul Syahrul
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Body Weight ◽  
Kidney Disease ◽  
Self Efficacy ◽  
Survey Method ◽  
Social Activities ◽  
Religious Activities ◽  
Cross Sectional ◽  
Gender Education

Introduction: Increased awareness and understanding of the overall burden of CKD is required in managing disease independently. Self-efficacy can support self-management behavior. Objectives:  This study aims to determine the self-efficacy of patients with chronic kidney disease undergoing hemodialysis based on patient characteristics. Method: This study used an analytic survey method with a cross-sectional study approach. Sampling with purposive sampling with a sample size of 80 people. Data were analyzed with Mann Whitney, Kruskall-Wallis, Spearman Correlation depending on the type of data available with a confidence level of 95%. Results: The results of self-efficacy analysis based on the characteristics of patients with chronic kidney disease undergoing hemodialysis found that there was a correlation between the length of HD and the patient's self-efficacy (p: 0.008) where the patient's self-efficacy would increase along with the addition of the patient's HD duration (r: 0.293). As for age, number of comorbidities, gender, education, marriage status, employment, financing, religious activities, social activities, blood pressure, and body weight were not related to patient self-efficacy (p> 0.05). Conclusion: Patient self-efficacy related to blood pressure. As for age, a number of comorbidities, gender, education, marriage status, employment, financing, religious activities, social activities, length of HD, and body weight were not related to patient self-efficacy. 

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