جستجوی مقالات مرتبط با کلیدواژه « chronic kidney diseases » در نشریات گروه « پزشکی »

The study aims to investigate the impact of chronic kidney diseases (CKD) on the auditory processing abilities of patients, including uremic neuropathy. The impairment of auditory processing may result in communication, social, and emotional problems in their lives. Accordingly, this study analyzes the communication abilities and speech perception of noise in CKD patients to identify potential auditory disorders rapidly.

In this cross-sectional-comparative study, the authors randomly selected 30 CKD patients and 29 normal adults aged 20-55, all of whom had normal peripheral hearing. The participants underwent the consonant-vowel (CV) test with five signal-to-noise ratios (SNR) and silence. Additionally, the participants completed the speech, spatial, and qualities of hearing scale questionnaire (SSQ), which consisted of three subscales. The scores of the two groups were compared using the Mann-Whitney U test.

In both groups, the recognition scores for consonant-vowel decreased as the noise level increased. However, the normal group consistently outperformed the CKD patients at all noise levels. Regarding the three subscales of the SSQ, the patients obtained lower scores than the normal group, but this difference was not statistically significant.

Chronic renal failure appears to have a negative impact on speech perception abilities in noise, suggesting auditory neurological involvement in CKD. Although patient self-assessment did not indicate any speech processing disability, conducting regular and periodic assessments of central hearing in CKD patients is still advisable. Early diagnosis of hearing disability can help mitigate its consequences, and appropriate rehabilitation measures should be taken if a disability is detected.

 End-stage kidney disease (ESKD) is a major global public health problem. Knowledge of its epidemiology is crucial for its prevention and the optimal care.

 The objective was to study the epidemiological characteristics of patients on chronic hemodialysis, their outcomes and explore their perceptions of therapeutic modalities, through a prospective cohort.

 A prospective study conducted between February 2019 and January 2020, at two public hemodialysis centers in Oujda, Morocco.

 Around 183 patients were enrolled. The mean age was 53±17 years. The initial nephropathy was undetermined in 37% of cases and dominated by diabetes in 25.7%. About 43% of patients had pre-dialytic nephrology follow-up. Only 32% patients initiated their hemodialysis by an arterialvenous fistula (AVF). The mean hemoglobin rate was 10.3±1.8 g/dL. Moreover, 74 % of patients were under erythropoietin. Serum calcium, phosphorus, vitamin D, and parathormone were within target ranges in 67%, 52%, 61%, and 51% of cases, respectively. Since, 80% of patients were not clearly informed about therapeutic modalities. The majority of patients opted for kidney transplantation (KT), with two major constraints preventing its realization, consisting the lack of related living donors and financial resources. Besides, 29% of patients were hospitalized for cardiovascular and infectious causes during the study year. The survival rate at 1 and 5 years after the start of dialysis was 97.2% and 95% respectively.

 Early detection of chronic kidney diseases in high-risk people, their rigorous follow-up and early referral to the nephrologist would improve the quality of care. The promotion of KT and PD would better meet the hemodialysis patients’ needs with better outcomes and lower costs.

Determining sleep quality in hemodialysis patients and kidney transplant recipients can provide valuable clinical information for planning treatment and care in this group of patients. Thus, we compared sleep quality between hemodialysis patients and kidney transplant recipients.

In this cross-sectional study, 60 transplant patients and 60 hemodialysis patients were select-ed using convenience sampling method. The Pittsburgh Sleep Quality Index (PSQI) with 89% validity and 86% reliabil-ity was used to assess patients' sleep quality.

The mean PSQI score was higher in the hemodialysis group (7.78) than the kidney transplantation group (6.15). This indicates that the sleep quality in hemodialysis patients is worse than in patients after kidney transplantation (P = 0.028). The frequency of poor sleep quality in hemodialysis patients was higher than in kidney transplant patients [50(83.3%) vs. 37(61.7%)].

The results of this study indicate that kidney transplant recipients have better sleep quality than hemodial-ysis patients.

Peritoneal dialysis is an effective modality of renal replacement therapy in end-stage renal disease. The initial step in peritoneal dialysis management is securing the Peritoneal Dialysis Catheter (PDC). This study aims to compare the infective and mechanical complications of the surgical versus the percutaneous catheter insertion technique.

This retrospective analytical study was conducted on end-stage renal disease patients who attended the Department of Nephrology, ESIC Medical College, and Super Specialty Hospital. The study was conducted from January 2019 to June 2020. The records of 25 patients who underwent percutaneous PDC and 5 patients who underwent open surgical PDC technique were reviewed. The complications (mechanical and infective complications) at 3-, 6-, and 12-month intervals among the study groups were considered the primary outcome variables, and catheter and patient survival at 1-year interval were considered the secondary outcome variables. The student t test and the Chi-square test were used to compare the study groups. The data were analyzed via the coGuide software.

No significant differences in baseline parameters were observed among the groups (P>0.05). The infective complications, namely the peritonitis rate and the exit site infection were reported more in the surgical technique of PDC placement compared to percutaneous placement (20% vs 16% and 20% vs 0%, respectively); however, the difference was not statistically significant. Catheter migration was higher in surgical technique compared to the percutaneous technique (20% vs 4%) but it was not statistically significant.

Both the percutaneous and surgical techniques reported similar rates of complications, technique survival, and patient survival. Further randomized control trials or prospective cohort studies are needed to analyze the effectiveness and complications of these techniques.

Chronic kidney disease (CKD) is a worldwide medical condition with increasing frequency that impairs the quality of life of children. This study aimed to assess the clinical signs and causes of CKD in children in Zahedan, Iran.
This cross-sectional study was run on 489 children up to 20 years with stages of 3 to 5 CKDs, in Zahedan during 2010-2019. Informed written consent was obtained from the patients’ parents. Data analysis was performed by SPSS 20 considering 0.05 as significant level.
Amongst the clinical manifestations, edema (16.4%), (FTT) (13.5%), urinary symptoms (12.3%) and vomiting (11.5%) were more common and congenital structural anomalies (41.7%) were the most common cause of hospital admission. From among the studied children with CKD, 65.8% had stage 5, about 44.4% had conservative treatment and in total, 19.00% died. Most of the laboratory parameters were different in death and survival cases, for instance, Systolic and diastolic BP were higher in deaths when platelet blood was lower. Main causes of CKD (congenital structural anomalies, cystic/hereditary/congenital disease, glomerular diseases, Renal Tubular Disease, unknown origin and stone) had a significant association with gender (X2=13.42, p=0.02), treatments (X2=70.77, p<0.001), stage of CKD (X2=40.31, p<0.001) and survival (X2=11.59, p=0.041). Stages of CKD had a significant relation with treatment (X2=118.18, p<0.001), and survival (X2=26.5, p<0.001).
The causes of CKD were significantly associated with treatments, stage of CKD, and survival. Stages of CKD had significant associations with treatment and survival. Therefore, more attention to children with these signs is essential for early diagnosis and proper treatment.

Implication for health policy/practice/research/medical education: Patients with chronic kidney diseases exhibit a very high cardiovascular risk. The COVID-19 outbreak has worsened this risk by the addition of a new cardiac pathology and the exacerbation of pre-existing cardiovascular diseases in patients with chronic impairment of kidney function. Please cite this paper as: Asserraji M, Maoujoud M, Belarbi M, Zemraoui N. Collision of COVID-19 pandemic with cardiovascular risk in chronic kidney disease patients; a heavy “triple peine”. J Nephropathol. 2021;10(1):e01. DOI: 10.34172/jnp.2021.01.

Chronic kidney disease (CKD) is a progressive condition that affects many aspects of patient’s life with adverse outcomes of kidney failure, cardiovascular disease (CVD), and premature death. Malnutrition is a relatively common problem in these patients that may be the result of inadequate intake, increased catabolism, or loss of nutrients in the dialysis. The aim of this study was to review the nutritional status and requirements of CKD patients in Iran using previous studies.
Search engines including PubMed, Scopus, Embase, Science Direct, Google scholar, Magiran, and scientific information database (SID) were applied with keywords such as chronic kidney disease, malnutrition, renal disease, end stage renal disease, nutritional deficiency, malnutrition, quality of life, vitamin deficiency, wasting, and Iran to find related articles published up to 2016.
The persistence of malnutrition increases susceptibility to infectious and cardiovascular diseases, delays wound healing, and finally increases morbidity and mortality.
Considering the importance of nutritional status in patients with chronic kidney disease, it is necessary to design and development of more effective strategies to optimize nutritional status of these patients.

Cardirenal syndrome,as a complex pathophysiological disorder of the heart and kidneys,whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other, has been under focus of interest for a long time.In this review we intend to define the interaction between the kidneys and the heart and different circulating components to characterize the pathophysiological course of the syndrome and discuss the new approaches for the management of this entity.

Restless legs syndrome (RLS) may be associated with increased morbidity and mortality among end-stage renal disease (ESRD) patients; however, it is a disorder that is neglected in dialysis centers.. The goal of this study was to investigate the clinical factors associated with RLS among ESRD patients..Patients and This cross-sectional study was conducted on ESRD patients undergoing maintenance hemodialysis (HD) in three HD centers in Ahvaz city in Southwest Iran. Blood samples were obtained prior to a dialysis session to check the routine laboratory test results and assess the adequacy of dialysis. The presence of RLS was assessed by using the international RLS study group (IRLSSG) diagnostic criteria. The IRLSSG rating scale was also used to evaluate the severity of the RLS symptoms.. Of the 139 HD patients enrolled in this study, 60 were female (43.2%) and 79 were male (56.8%), with a mean age of 51.82 ± 13.31 years. The prevalence of RLS was 15.8% (22 patients), with 50% of them (11 patients) having severe or very severe symptoms. There was a significant relationship between RLS and longer durations of dialysis (P < 0.001). The mean level of serum ferritin was lower in patients without RLS, but it was not significant (P = 0.065). No significant differences were found according to age, gender, dialysis shifts, and hemoglobin (Hb) level among patients with and without RLS.. We conclude that a significant percentage of ESRD patients undergoing maintenance HD have severe or very severe RLS symptoms. The presence of RLS is associated to longer durations of dialysis..

Chronic kidney disease (CKD) is increasing worldwide and can lead to end-stage renal disease (ESRD). Because few patients with ESRD in the Republic of Guinea have access to haemodialysis, we retrospectively evaluated the prevalence of CKD, ESRD and access to supportive therapies.Patients and 579 CKD patients (304 males; mean age: 44 ± 16 years) were admitted into Conakry nephrology department, the only centre in the Republic of Guinea, between 2009 and 2013. Most patients (63%) resided within Conakry (the capital), 12.5% came from lower Guinea, 11.7% from middle Guinea, 7.9% from upper Guinea and 4.8% from forest Guinea. Reasons for referral were increased serum creatinine (49.5%), hypertension (27%) and diffuse edema (17%). Also, 11% were diabetic, 12.5% were smokers, 17% were HIV-positive, 8.3% were HBV-positive and 15% were HCV-positive. The most frequent symptom at admission was nausea/vomiting (56%). Upon admission, 70.5% of patients already had ESRD. Although no kidney biopsies were performed it was assumed that 34% and 27% of patients had vascular nephropathy and chronic glomerulonephritis, respectively. Of the 385 ESRD patients, only 140 (36.3%) had access to haemodialysis (two sessions/week, 4 hours each). Most patients that received haemodialysis resided within the Conakry region (P < 0.0001). There were significant associations between mortality and (i) terminal stage of CKD (P = 0.0005), (ii) vascular nephropathy (P = 0.002), and (iii) nephropathies of unknown origin (P = 0.0001). A fourfold increase in haemodialysis machines is needed in Conakry, plus four new nephrology/haemodialysis centres within the Republic of Guinea, each holding ≥30 haemodialysis machines.

In children with chronic kidney disease (CKD), growth retardation is not a rare problem. Factors such as malnutrition, anemia, metabolic acidosis, inadequate dialysis and growth hormone resistance may cause growth failure in these children. Growth stimulation in these children can be done by supraphysiologic doses of recombinant human GH (rhGH). It stimulates growth in prepubertal CKD children, in end-stage renal disease, and after kidney transplantation. Its underlying mechanism may be the reversal of hypercatabolic state of uremia or increases in the circulating level of insulin-like growth factor (IGF). We recommend starting the treatment when the patient height falls below the third percentile and spontaneous catch-up growth does not happen despite stabilization of other contributing factors. It is better to start rhGH therapy at a young age because there is a better response in preterminal CKD than those on dialysis. We use rhGH in CKD children at a dose of 0.045 to 0.05 mg/kg/day subcutaneously every evening and a height taller than the third percentile of the general population is our minimal goal.

Chronic Kidney Disease (CKD) is defined as renal injury and/or a glomerular filtration rate below 60mL/min/1.73m2 for more than 3 months. Neurologic symptoms in CKD include fatigue, poor concentration, headache, drowsiness, memory loss, seizures, and peripheral neuropathy. Obsessive-Compulsive Disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. Common obsessions include contamination and thoughts of harming loved ones or oneself. Washing and cleaning compulsions are common in children, as is checking. The purpose of this study was to investigate the relationship between OCD and CKD. In this case-control study, we evaluated 186 children aged 6-17 years old who were visited in the pediatric clinics of Amir-Kabir Hospital, Arak, Iran. The control group consisted of 93 healthy children and the case group included 93 age and sex matched children with stage 1 to 3 CKD. Then, the children’s behavioral status was evaluated using the Children’s Yale-Brown Obsessive-Compulsive Scale (C-YBOCS). The C-YBOCS is helpful in identifying children with OCD. The data was analyzed using descriptive and analytical statistics in SPSS-16. Compulsion was detected in 31 cases (33.3%) with CKD and 7 controls (7.5%), and obsession was found in 3 cases (3.2%) with CKD and 4 controls (4.3%). The difference in compulsion was significant (P-value=0.021) while the difference in obsession was not significant between the 2 groups (p-value=0.3). The most common symptom in CKD children with compulsion was silent repetition of words. Compulsion is more common in CKD versus non-CKD children. The observed correlation between compulsion and CKD makes psychological counseling mandatory in children with CKD.

Low quality of life in hemodialysis patients is a major factor leading to cardiovascular diseases and other important outcomes such as hospitalization and death. The present study attempted to examine the impacts of training intervention on perceived psychological health and quality of life among hemodialysis patients. In this cross-sectional intervention study, 51 hemodialysis patients were examined using census sampling method. The Short Form (SF-36) Health Survey was used to assess psychological quality of life for these patients. For 7 patients with psychological health scores (1SD) lower than the mean score, a supplementary questionnaire (Hamilton rating scale for depression and anxiety) was administered by a psychologist, to confirm existence of and identify the type of a psychological disorder. Then a training course on coping and communicating skills was developed and implemented. The effect of training program on patients’ targeted skills was examined by post-intervention administration of the Hamilton rating scale. T-test was used for comparison of the mean values between the two genders. While women gained higher mean scores than men in role physical, role emotional, vitality, mental health, social functioning, and bodily pain, and men scored higher in physical functioning and general health. No significant difference in HRQOL dimensions was found between the two genders, but in bodily pain (P < 0.05). After training, a 20% enhancement in the coping and communicating skills was achieved. Training of hemodialysis patients can lead to improvement of their coping and communicative skills, thereby enhancing their quality of life. Hence this study recommends systematic inclusion of training-based HRQOL improvement interventions as an integral part of a comprehensive hemodialysis patient treatment strategy.