scholarly journals Predicting Renal Failure Progression in Chronic Kidney Disease Using Integrated Intelligent Fuzzy Expert System

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jamshid Norouzi ◽  
Ali Yadollahpour ◽  
Seyed Ahmad Mirbagheri ◽  
Mitra Mahdavi Mazdeh ◽  
Seyed Ahmad Hosseini
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Kidney Disease ◽  
Diastolic Blood Pressure ◽  
Absolute Error ◽  
Ckd Progression ◽  
Anfis Model ◽  
Inference System ◽  
Clinical Records

Background.Chronic kidney disease (CKD) is a covert disease. Accurate prediction of CKD progression over time is necessary for reducing its costs and mortality rates. The present study proposes an adaptive neurofuzzy inference system (ANFIS) for predicting the renal failure timeframe of CKD based on real clinical data.Methods.This study used 10-year clinical records of newly diagnosed CKD patients. The threshold value of 15 cc/kg/min/1.73 m2of glomerular filtration rate (GFR) was used as the marker of renal failure. A Takagi-Sugeno type ANFIS model was used to predict GFR values. Variables of age, sex, weight, underlying diseases, diastolic blood pressure, creatinine, calcium, phosphorus, uric acid, and GFR were initially selected for the predicting model.Results.Weight, diastolic blood pressure, diabetes mellitus as underlying disease, and currentGFR(t)showed significant correlation with GFRs and were selected as the inputs of model. The comparisons of the predicted values with the real data showed that the ANFIS model could accurately estimate GFR variations in all sequential periods (Normalized Mean Absolute Error lower than 5%).Conclusions.Despite the high uncertainties of human body and dynamic nature of CKD progression, our model can accurately predict the GFR variations at long future periods.

scholarly journals Chronic kidney disease in children: problems of arterial hypertension

2019 ◽  
Vol 23 (5) ◽  
pp. 47-55
Author(s):  
I. A. Karimdzhanov ◽  
G. K. Iskanova ◽  
N. A. Israilova
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Risk Factor ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Ckd Progression ◽  
Vascular Regulation ◽  
Target Organs

The review contains materials on the course of chronic kidney disease (CKD) in children with arterial hypertension (AH). The relationship between CKD and AH was shown, where hastening of CKD progression to end-stage renal failure in the presence of AH was established. The regulation of AH in children is necessary for the treatment of CKD, because AH is not established on time, is not well controlled and is often masked. Impaired vascular regulation, fluid overload, increased cardiac output, and peripheral vascular resistance, alone or in combination, can lead to hypertension in CKD. The use of modern methods for monitoring and controlling blood pressure is crucial to improve the management of AH and prevent damage to target organs in children. 24-hour blood pressure measurements are an important tool in determining the prognosis and treatment of children with CKD. To identify impaired renal function in CKD, a large number of biomarkers are used. Glomerular filtration rate (GFR), serum creatinine and cystatin C are currently used as biomarkers for renal failure. Recently, biomarkers, including KIM-1, LFABP, NGAL, and IL-18 have been proposed as markers of acute kidney injury, and they may be useful in the future for early detection of CKD progression in children. In newborns and children of early and older age, hypertension occurs due to renovascular and parenchymal diseases.AH is considered a marker of CKD severity and is a risk factor for progressive deterioration of kidney function, as well as thedevelopment of cardiovascular diseases. Sympathetic hyperactivity, excessive formation of free radicals, reduced bioavailability of nitric oxide (NO) and excessive production of angiotensin II leads to an increase in blood pressure. Obesity or an increase in body mass index (BMI) is currently considered as a risk factor not only for cardiovascular diseases and diabetes but also for CKD. Hyperuricemia and CKD are closely related, as the accumulation of uric acid is associated with hypertension, metabolic syndrome and microalbuminuria, which are also risk factors for the progression of CKD. AH has a detrimental effect on target organs, including the kidneys, eyes, and heart. Lifestyle modifications, weight control, healthy eating, reduced sodium intake, maintenance exercises and basic drug therapy using angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers can slow the progression of CKD in children.

Systolic and Diastolic Blood Pressure Analysis in Each Etiology of Pra-Hemodialysis Chronic Kidney Disease

2015 ◽  
Vol 33 ◽  
pp. e41
Author(s):  
Ricardo Adrian Nugraha ◽  
Michael Jonatan ◽  
Pranawa Martosuwignjo ◽  
Sri Murtiwi
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diastolic Blood Pressure ◽  
Pressure Analysis

Serum Magnesium, Blood Pressure, and Risk of Hypertension and Chronic Kidney Disease Progression in the CRIC Study

Hypertension ◽  
2021 ◽  
Author(s):  
Simon Correa ◽  
Xavier E. Guerra-Torres ◽  
Sushrut S. Waikar ◽  
Finnian R. Mc Causland
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Progression ◽  
Lower Risk ◽  
Serum Magnesium ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Ckd Progression ◽  
Baseline Serum

Magnesium is involved in the regulation of blood pressure (BP). Abnormalities in serum magnesium are common in chronic kidney disease (CKD), yet its association with the development of hypertension and CKD progression in patients with CKD is unclear. We analyzed data from 3866 participants from the CRIC Study (Chronic Renal Insufficiency Cohort). Linear regression assessed the association of serum magnesium with baseline systolic BP (SBP) and diastolic BP (DBP). Logistic regression explored the association of serum magnesium with various definitions of hypertension. Cox proportional hazards models explored assessed the risk of incident hypertension and CKD progression. Mean serum magnesium was 2.0 mEq/L (±0.3 mEq/L). Higher magnesium was associated with lower SBP (−3.4 mm Hg [95% CI, −5.8 to −1.0 per 1 mEq/L]) and lower DBP (−2.9 mm Hg [95% CI, −4.3 to −1.5 per 1 mEq/L]). Higher magnesium was associated with a lower risk of American Heart Association–defined hypertension (SBP≥130 mm Hg or DBP≥80 mm Hg) at baseline (adjusted hazard ratio, 0.65 [95% CI, 0.49–0.86 per 1 mEq/L]), a lower risk of suboptimally controlled BP (SBP≥120 mm Hg or DBP≥80 mm Hg; adjusted odds ratio, 0.58 [95% CI, 0.43–0.78 per 1 mEq/L]). In time-to-event analyses, higher baseline serum magnesium was associated with a nominally lower risk of incident CRIC-defined hypertension (adjusted hazard ratio, 0.77 [95% CI, 0.46–1.31 per 1 mEq/L]). Higher magnesium was associated with a significantly lower risk of CKD progression (adjusted hazard ratio, 0.68 [95% CI, 0.54–0.86 per 1 mEq/L]). In patients with CKD, higher serum magnesium is associated with lower SBP and DBP, and with a lower risk of hypertension and CKD progression. In patients with CKD, whether magnesium supplementation could optimize BP control and prevent disease progression deserves further investigation.

Anaesthesia of the patient with chronic kidney disease

2020 ◽  
Vol 25 (11) ◽  
pp. 268-276
Author(s):  
Oscar Bautista Díaz-Delgado ◽  
Briony Alderson
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Cardiac Output ◽  
Kidney Disease ◽  
The Body ◽  
Renal Physiology ◽  
Successful Management ◽  
Emergency Procedures ◽  
Routine Procedures

Chronic kidney disease is common, particularly in geriatric animals. General anaesthesia is usually required for routine procedures (dental prophylaxis, ovariohysterectomy or castration) and emergency procedures, which may have profound effects on the body, especially on cardiac output, subsequent blood pressure and on the perfusion of different vital organs. It is essential to understand the effects of renal dysfunction on the patient, as well as the effects that anaesthesia and surgery may have on the kidneys. The understanding of renal physiology, along with the effect of drug choices, is key to successful management of chronic renal failure.

Serum Markers of Low-Turnover Bone Disease in Mexican Children with Chronic Kidney Disease Undergoing Dialysis

2006 ◽  
Vol 26 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Marcela Ávila-Díaz ◽  
Mario Matos ◽  
Elvia García-López ◽  
María-del-Carmen Prado ◽  
Florencia Castro-Vázquez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Alkaline Phosphatase ◽  
Kidney Disease ◽  
Diastolic Blood Pressure ◽  
Serum Calcium ◽  
Bone Disease ◽  
Linear Growth ◽  
Serum Markers ◽  
Z Score

Background The frequency of low-turnover bone disease (LTBD) in patients with chronic kidney disease (CKD) has increased in past years. This change is important because LTBD is associated with bone pain, growth delay, and higher risk for bone fractures and extraosseous calcifications. LTBD is a histological diagnosis. However, serum markers such as parathyroid hormone (PTH) and calcium levels offer a noninvasive alternative for diagnosing these patients. Objective To describe the prevalence of LTBD in pediatric patients with renal failure undergoing some form of renal replacement therapy, using serum calcium and intact PTH levels as serum markers. Methods In this cross-sectional study, 41 children with CKD undergoing dialysis treatment (31 on continuous ambulatory peritoneal dialysis and 10 on hemodialysis) were included. There were no inclusion restrictions with respect to gender, cause of CKD, or dialysis modality. The children were studied as outpatients. The demographic data, CKD course, time on dialysis, phosphate-binding agents, and calcitriol prescription were registered, as well as weight, height, Z-score for height, linear growth rate, and Z-score for body mass index. Serum calcium, phosphorus, aluminum, PTH, alkaline phosphatase, osteocalcin, glucose, creatinine, urea, cholesterol, and triglycerides were measured. Results There were 20 (48.8%) children with both PTH <150 pg/mL and corrected total calcium >10 mg/dL who were classified as having LTBD[(+)]; the remaining 21 (51.2%) children were classified as having no LTBD[(–)]. The LTBD(+) patients were younger (11.2 ± 2.7 vs 13.2 ± 2.4 years, p < 0.01) but they had no differences regarding Z-scores for height. Linear growth in 6 months was less than expected in both groups (-0.15 ± 0.23 cm/month), but the difference between expected and observed growth was higher in the LTBD(+) group (-0.24 ± 0.14 vs –0.07 ± 0.28 cm/mo, p < 0.03). LTBD(+) patients also had lower serum creatinine (8.69± 2.75 vs 11.19 ± 3.17 mg/dL, p < 0.01), higher serum aluminum levels [median (range) 38.4 (9 – 106) vs 28.1 (9 – 62) μg/L, p < 0.05], and lower systolic blood pressure (112.0 ± 10.3 vs 125.0 ±12.9 mmHg, p < 0.015) and diastolic blood pressure (76.0 ± 9.7 vs 84.5 ± 8.2 mmHg, p < 0.017). A significant correlation was found between PTH and alkaline phosphatase ( r = 0.68, p < 0.001), but not between PTH and aluminum. Conclusion The LTBD(+) biochemical profile was found in 48.8% of the children and was associated with impaired linear growth. Aluminum contamination, evidenced by higher serum aluminum levels, may have had a pathogenic role in these disorders. Higher systolic and diastolic blood pressure levels may be related to higher serum PTH levels.

scholarly journals Determiner of Poor Sleep Quality in Chronic Kidney Disease Patients Links to Elevated Diastolic Blood Pressure, hs-CRP, and Blood-count-based Inflammatory Predictors

2019 ◽  
Vol 11 (1) ◽  
pp. 100-6
Author(s):  
Maulana Antiyan Empitu ◽  
Ika Nindya Kadariswantiningsih ◽  
Mochammad Thaha ◽  
Cahyo Wibisono Nugroho ◽  
Eka Arum Cahyaning Putri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sleep Quality ◽  
Diastolic Blood Pressure ◽  
Blood Count ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Lymphocyte Ratio ◽  
Hs Crp

BACKGROUND: Sleep deprivation is strongly associated with cardiovascular disease (CVD) via sympathetic overstimulation and systemic inflammation in general population. However, the significance of poor sleep quality in chronic kidney disease (CKD) is still underexplored.METHODS: This study assessed the sleep quality of 39 with non-dialysis CKD (ND CKD) patients and 25 hemodialysis CKD (HD CKD) patients using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Poor sleeper was defined as individual with PSQI > 5.RESULTS: The prevalence of poor sleeper (30% vs. 60%, p=0.029) and the cummulative PSQI (ND CKD 4.5±4.4, HD CKD 8±6, p=0.038) are different between ND CKD and HD CKD groups. Among the ND CKD, there are association between short sleep duration (< 5 hours per day) with elevated diastolic blood pressure groups (r=0.421, p<0.05); habitual sleep efficiency with platelet-to-lymphocyte ratio (r= 0.532, p<0.0001); daytime dysfunction with increased hs-CRP (r=0.345, p=0.032) and neutrophil-to-lymphocyte ratio (r=0.320, p=0.046). In HD CKD group, a requirement to use sleep medication was associated with elevated highsensitivity C-reactive protein (hs-CRP) level (r=0.434, p=0.030) and decreased monocyte-to-lymphocyte ratio (r=- 0.410, p=0.042); daytime dysfunction was associated with serum hs-CRP (r=0.452, p=0.023).CONCLUSION: This study revealed that some features of poor sleep quality in CKD patients including low sleep efficiency, daytime dysfunction and requirement to use sleep medication were associated with increased diastolic blood pressure, hs-CRP and blood-count-based inflammatory predictors. Thus, this finding prompt to pay closer attention to sleep complaints in the management of CVD risk factors in CKD patients.KEYWORDS: sleep quality, chronic kidney disease, blood pressure, inflammation

scholarly journals Lower Diastolic Blood Pressure was Associated with Higher Incidence of Chronic Kidney Disease in the General Population Only in those Using Antihypertensive Medications

2019 ◽  
Vol 44 (5) ◽  
pp. 973-983
Author(s):  
Daisuke Uchida ◽  
Ryo Kido ◽  
Hiroo Kawarazaki ◽  
Masaru Murasawa ◽  
Ayami Ando ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Diastolic Blood Pressure ◽  
Estimated Glomerular Filtration Rate ◽  
Antihypertensive Medications ◽  
Adjusted Risk ◽  
General Japanese Population ◽  
Incidence Of Ckd

Background/Aims: The association of diastolic blood pressure (DBP) with incidence of chronic kidney disease (CKD) in the general population is not well examined. Methods: Using national health check-up database from 2008 to 2011 in the general Japanese population aged 39–74 years, we evaluated the association between DBP and incidence of CKD 2 years later in 127,954 participants without CKD. DBP was categorized by every 5 mm Hg from the lowest (<60 mm Hg) to the highest category (>100 mm Hg) and was further stratified into those with and without antihypertensive medications (BP meds). We calculated the OR for estimating adjusted risk of incident CKD using logistic regression model. Results: Participants were 62% female and 25.9% with BP meds, mean age of 76 years with estimated glomerular filtration rate of 78.2 ± 13.4 and DBP of 76 ± 11 mm Hg. Two years later, 12,379 (9.7%) developed CKD. Compared to DBP 60–64 mm Hg without BP meds as reference, multivariate analysis showed no difference in CKD risk at any DBP category among those without BP meds. However, in those with BP meds, risk increased according to lower DBP from 95 to 60 mm Hg (p for trend 0.05) with OR 1.51 (95% CI 1.14–1.99) in DBP <60 mm Hg. In subgroup analysis within those with or without BP meds, CKD risk was lower at higher DBP (p for trend 0.02) only in those without BP meds. Conclusion: Lower DBP was associated with higher risk of incident CKD only in the general population taking antihypertensive medication.

scholarly journals Evaluation of Urinary Big Endothelin-1 in Feline Spontaneous CKD

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2144
Author(s):  
Marco Giraldi ◽  
Saverio Paltrinieri ◽  
Camilla Piazza ◽  
Paola Scarpa
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Urine Samples ◽  
Ckd Progression ◽  
Creatinine Concentration ◽  
Endothelin 1 ◽  
Urine Creatinine ◽  
Advanced Stages

The endothelin-1 (ET-1) system has been implicated in the development and progression of chronic kidney disease (CKD). No information on big ET-1 in feline urine is available. The purpose of this study was to evaluate if urinary big endothelin-1 (bigET-1) is associated with feline CKD. Sixty urine samples were prospectively collected from 13 healthy cats at risk of developing CKD and 22 cats with CKD of different International Renal Interest Society (IRIS) stages (1–4). Urinary bigET-1 was measured using a commercially available ELISA. BigET-1 normalized to urine creatinine (bigET-1:UC) was compared amongst stages and substages, as proposed by IRIS, and correlated with serum creatinine concentration, proteinuria and blood pressure. BigET-1:UC at the time of inclusion was compared between cats that remained stable and cats that progressed after 12 months. BigET-1:UC was significantly higher (p = 0.002) in cats at IRIS stages 3–4 (median: 21.9; range: 1.88–55.6), compared to all other stages, and in proteinuric (n = 8, median: 11.0; range: 0.00–46.4) compared with nonproteinuric cats (n = 38 median: 0.33; range: 0.00–55.6) (p = 0.029). BigET-1:UC was not associated with CKD progression. Urinary bigET-1 increased in advanced stages of CKD and in proteinuric patients, suggesting that ET-1 may be indicative of the severity of feline CKD.

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