531-P: Weight Change and the Incidences of End-Stage Renal Disease and Proliferative Diabetic Retinopathy in Patients with Newly Diagnosed Diabetes Mellitus: A Nationwide Cohort Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 531-P
Author(s):  
HYUK-SANG KWON ◽  
KI-HO SONG
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Cohort Study ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Newly Diagnosed ◽  
Stage Renal Disease ◽  
End Stage ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

scholarly journals Retinopathy and Neuropathy in Patients with End Stage Renal Disease on Haemodialysis- A Hospital Based Study

2015 ◽  
Vol 6 (1) ◽  
pp. 14-19
Author(s):  
Nazneen Mahmood ◽  
Shaila Safia Chowdhury
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Neurological Manifestation ◽  
Diabetic Patients ◽  
Hypertensive Retinopathy ◽  
Medical College ◽  
Stage Renal Disease ◽  
End Stage

Bacground: Chronic renal failure is irreversible and progressive process that results in end stage renal disease (ESRD) where the patient has to be dependent on renal replacement therapy for survival. Retinopathy and neuropathy are often asymptomatic in their most treatable stage; delay in diagnosis can result in significant increase in the patient's risk of visual loss and disability. Ocular condition is also an indicator of the metabolic control of the disease process. This study is an attempt to access the ocular status/complications as well as neurological manifestation associated with end stage renal disease on haemodialysis.Methodology: This is a cross sectional descriptive type of observational study on patients of end stage renal disease getting haemodialysis in Medical College for Women and Hospital. Duration of study was 3 years from January 2011 to December 2013. This study is an attempt to access the ocular status/complications as well as neurological manifestation associated with end stage renal disease on haemodialysis.Result: Among 81 patients, 42 patients had hypertension (HTN) and 19 had diabetes mellitus (DM) and 20 had other causes of chronic kidney disease(CKD). In our study, out of 19 patients of diabetes mellitus, 73.68%(14) had diabetic retinopathy(DR) and 26.32%(5) had normal fundus. All the 42 patients had hypertensive retinopathy(HR). Regarding fundal examination of patients with hypertensive retinopathy(HR), 32.26% had gradel, and 17.74%, 43.55% and 6.45% were of grade ll, lll, lV respectively. It was found that non-proliferative changes in ocular fundal examination in diabetic patients were the commonest abnormality. On fundal examination of diabetic retinopathy (DR), 26.32% had normal fundus, 26.32% had dot and blot haemorrhages, 21.05% had hard exudates and cotton wool, 21.05% had new vascularization while 5.26% had retinal detachment.The following types of neuropathy were seen among our patients; 48.15% had symmetrical distal sensory motor polyneuropathy, 19.75% had a symmetrical polyneuropathy, 19.75% had mononeuropathy and cranial nerve palsies were detected in 12.35%.Conclusion: Detailed ocular and neurological examination should be undertaken in patients of end stage renal disease(ESRD) on maintenance haemodialysis(HD) for early diagnosis and treatment of the complications. Awareness is needed of the potential ocular and neurological complications of the disease process.Anwer Khan Modern Medical College Journal Vol. 6, No. 1: January 2015, Pages 14-19

scholarly journals Do Bacteremic Patients with End-Stage Renal Disease Have a Fever When Presenting to The Emergency Department? A Paired, Retrospective Cohort Study.

2019 ◽  
Author(s):  
Leonard Mermel ◽  
Sarah L. Weatherall ◽  
Alison B. Chambers
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Cohort Study ◽  
Renal Disease ◽  
Retrospective Cohort Study ◽  
End Stage Renal Disease ◽  
Emergency Departments ◽  
Retrospective Cohort ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Fever is a common symptom when patients present to Emergency Departments. It is unclear if the febrile response of bacteremic hemodialysis-dependent patients differs from bacteremic patients not receiving hemodialysis. The objective of this study was to compare Emergency Departments triage temperatures of patients with and without hemodialysis-dependent end-stage rental disease who have Staphylococcus aureus bacteremia and determine the incidence of afebrile S. aureus bacteremia.Methods Paired, retrospective cohort study of 37 patients with and 37 patients without hemodialysis hospitalized with Methicillin-resistant or Methicillin-susceptible S. aureus bacteremia. Emergency Department triage temperatures were reviewed for all patients, as were potential confounding variables.Results 54% (95% CI, 38-70%) and 82% (95% CI 65-91%) of hemodialysis and non-hemodialysis patients did not have a detectable fever (<100.4°F) at triage. Triage temperatures were 100.5°F (95% CI 99.9-101.2°F) and 99.0°F (95% CI 98.4-99.6°F) in the hemodialysis and non-hemodialysis cohorts, respectively (p<0.001). Triage temperature in patients with and without diabetes mellitus was 99.2°F (95% CI 98.4-99.9°F) and 100.4°F (95% CI 99.7-101.0°F), respectively (p=0.03). We were unable to detect a significant effect of diabetes mellitus and other potential confounding variables on differences in temperature between the hemodialysis and non-hemodialysis cohorts (all interactions p > 0.19).Conclusions Hemodialysis-dependent patients with S. aureus bacteremia had significantly higher temperatures than non- hemodialysis-dependent end stage renal disease patients but more than half of patients were without detectable fever at triage, possibly reflecting use of insensitive methods for measuring temperature. Absence of fever at presentation to the Emergency Department should not delay blood culture acquisition in patients who are at increased risk of S. aureus bacteremia.

scholarly journals Prevalence of Newly Diagnosed End-Stage Renal Disease Patients in a Tertiary Hospital of Central Nepal, Chitwan: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Madhav Ghimire ◽  
Shreeju Vaidya ◽  
Hari Prasad Upadhyay
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: End-stage renal disease patients are in rising trend globally, and they have been foundto occur predominantly in developing countries. Many studies have been published before, withinand across the countries, to know the clinicodemographic profile of end-stage renal disease patients.However, no such studies were done in Chitwan, Nepal. This study’s main objective was to find theprevalence of newly diagnosed end-stage renal disease patients. Methods: A hospital-based descriptive cross-sectional study was carried out in the Department ofNephrology from May 2016 to April 2019. Convenient sampling was done, and all the consecutivenew end-stage renal disease patients were included in the study. The ethical approval was takenfrom the Institutional Review Committee (reference number. 2016/COMSTH/IRC/042). Theprevalence and demographic profile of new end-stage renal disease patients were studied. The datawere analyzed with appropriate statistical tools. Results: A total of 250 new end-stage renal disease patients were found among 2200 admittedpatients. The prevalence of new end-stage renal disease was found to be 250 (11.36%). Out of 250patients, males were 156 (62.4%), and females were 94 (37.6%). The mean age was 49.6±15.5 years. Thecommonest cause of the incident end-stage renal disease was Type 2 Diabetes mellitus 89 (35.6%). Conclusions: The prevalence of new end-stage renal disease was found to be quite high. Thecommonest cause of the incident end-stage renal disease was Type 2 Diabetes Mellitus.

scholarly journals Do Bacteremic Patients with End-Stage Renal Disease Have a Fever When Presenting to The Emergency Department? A Paired, Retrospective Cohort Study.

2019 ◽  
Author(s):  
Sarah L. Weatherall ◽  
Alison B. Chambers ◽  
Leonard Mermel
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Cohort Study ◽  
Renal Disease ◽  
Retrospective Cohort Study ◽  
End Stage Renal Disease ◽  
Retrospective Cohort ◽  
Confounding Variables ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Fever is a common symptom when patients present to Emergency Departments. It is unclear if the febrile response of bacteremic hemodialysis-dependent patients differs from bacteremic patients not receiving hemodialysis. The objective of this study was to compare Emergency Departments triage temperatures of patients with and without hemodialysis-dependent end-stage rental disease who have Staphylococcus aureus bacteremia and determine the incidence of afebrile S. aureus bacteremia. Methods: Paired, retrospective cohort study of 37 patients with and 37 patients without hemodialysis hospitalized with Methicillin-resistant or Methicillin-susceptible S. aureus bacteremia. Emergency Department triage temperatures were reviewed for all patients, as were potential confounding variables. Results: 54% (95% CI, 38-70%) and 82% (95% CI 65-91%) of hemodialysis and non-hemodialysis patients did not have a detectable fever (<100.4°F) at triage. Triage temperatures were 100.5°F (95% CI 99.9-101.2°F) and 99.0°F (95% CI 98.4-99.6°F) in the hemodialysis and non-hemodialysis cohorts, respectively (p<0.001). Triage temperature in patients with and without diabetes mellitus was 99.2°F (95% CI 98.4-99.9°F) and 100.4°F (95% CI 99.7-101.0°F), respectively (p=0.03). We were unable to detect a significant effect of diabetes mellitus and other potential confounding variables on differences in temperature between the hemodialysis and non-hemodialysis cohorts (all interactions p > 0.19). Conclusions: Hemodialysis-dependent patients with S. aureus bacteremia had significantly higher temperatures than non- hemodialysis-dependent end stage renal disease patients but more than half of patients were without detectable fever at triage, possibly reflecting use of insensitive methods for measuring temperature. Absence of fever at presentation to the Emergency Department should not delay blood culture acquisition in patients who are at increased risk of S. aureus bacteremia.

Risk of corneal ulcer in patients with end-stage renal disease: a retrospective large-scale cohort study

2017 ◽  
Vol 102 (7) ◽  
pp. 868-872 ◽  
Author(s):  
Ren-Long Jan ◽  
Ming-Cheng Tai ◽  
Shih-Feng Weng ◽  
Chun Chang ◽  
Jhi-Joung Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Health Insurance ◽  
Renal Disease ◽  
Incidence Rate ◽  
End Stage Renal Disease ◽  
Corneal Ulcer ◽  
Research Database ◽  
Stage Renal Disease ◽  
End Stage

Background/AimsTo investigate the risk of corneal ulcer in patients with end-stage renal disease (ESRD).MethodsThis retrospective, nationwide, matched cohort study included 92 967 patients with ESRD recruited between 2000 and 2009 from the Taiwan National Health Insurance Research Database. The same number of age-matched and sex-matched patients without ESRD were selected from the Taiwan Longitudinal Health Insurance Database, 2000 as the control group. Data for each patient were collected from the index date until December 2011. Corneal ulcer incidence rate and risk were compared between the groups. A Cox proportional hazards regression was used to calculate the HR for a corneal ulcer after adjustment for potential confounders. The cumulative corneal ulcer incidence rate was calculated using Kaplan-Meier analysis.ResultsIn total, 660 patients with ESRD and 591 controls showed a corneal ulcer during follow-up; thus, the corneal ulcer incidence rate in patients with ESRD was 1.54 times (95% CI 1.38–1.72) that in the control patients. After adjustment for potential confounders, including diabetes mellitus and HIV disease, patients with ESRD were 1.17 times (95% CI 1.03 to 1.33) more likely to develop a corneal ulcer in the cohort for the total sample. Among patients with diabetes mellitus, the corneal ulcer incidence rate was significantly higher in the ESRD group, and diabetes mellitus significantly increased corneal ulcer risk even after adjustment for other confounders in the cohort.ConclusionESRD increases the risk of a corneal ulcer, particularly in patients with ESRD with diabetes mellitus. Regular ocular examinations are suggested for patients with ESRD.

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