scholarly journals The Effect of Nutritional Interventions on Long-Term Patient Survival in Advanced Chronic Kidney Disease

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 621
Author(s):  
Almudena Pérez-Torres ◽  
M. Elena González García ◽  
Marta Ossorio-González ◽  
Laura Álvarez García ◽  
M. Auxiliadora Bajo ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Nutrition Education ◽  
Hospital Admissions ◽  
Patient Survival ◽  
Nutritional Intervention ◽  
Control Group ◽  
Nutritional Interventions ◽  
Positive Effects ◽  
End Stage

Patients with end-stage kidney disease (ESKD) are at high risk of malnutrition and subsequent related mortality when starting dialysis. However, there have been few clinical studies on the effect of nutritional interventions on long-term patient survival. A 2-year longitudinal study was conducted from January 2012 to December 2016. A total of 186 patients with non-dialysis ESKD started the nutritional education program (NEP), and 169 completed it. A total of 128 patients participated in a NEP over 6 months (personalized diet, education and oral supplementation, if needed). The control group (n = 45) underwent no specific nutritional intervention. The hospitalization rate was significantly lower for the patients with NEP (13.7%) compared with the control patients (26.7%) (p = 0.004). The mortality odds ratio for the patients who did not receive NEP was 2.883 (95% CI 0.993–8.3365, p = 0.051). The multivariate analysis showed an independent association between mortality and age (OR, 1.103; 95% CI 1.041–1.169; p = 0.001) and between mortality and the female sex (OR, 3.332; 95% CI 1.054–10.535; p = 0.040) but not between mortality and those with NEP (p = 0.051). Individualized nutrition education has long-term positive effects on nutritional status, reduces hospital admissions and increases survival among patients with advanced CKD who are starting dialysis programs.

scholarly journals Pros and cons of gastric bypass surgery in individuals with obesity and type 2 diabetes: nationwide, matched, observational cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023882 ◽  
Author(s):  
Vasileios Liakopoulos ◽  
Stefan Franzén ◽  
Ann-Marie Svensson ◽  
Mervete Miftaraj ◽  
Johan Ottosson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Gastric Bypass ◽  
Kidney Disease ◽  
Secondary Outcome ◽  
Control Group ◽  
Positive Effects ◽  
All Cause Mortality

ObjectivesLong-term effects of gastric bypass (GBP) surgery have been presented in observational and randomised studies, but there are only limited data for persons with obesity and type 2 diabetes mellitus (T2DM) regarding postoperative complications.DesignThis is a nationwide observational study based on two quality registers in Sweden (National Diabetes Register, NDR and Scandinavian Obesity Surgery Register, SOReg) and other national databases.SettingAfter merging the data, we matched individuals with T2DM who had undergone GBP with those not surgically treated for obesity on propensity score, based on sex, age, body mass index (BMI) and calendar time. The risks of postoperative outcomes (rehospitalisations) were assessed using Cox regression models.ParticipantsWe identified 5321 patients with T2DM in the SOReg and 5321 matched controls in the NDR, aged 18–65 years, with BMI >27.5 kg/m² and followed for up to 9 years.Primary and secondary outcome measuresWe assessed risks for all-cause mortality and hospitalisations for cardiovascular disease, severe kidney disease, along with surgical and other medical conditions.ResultsThe results agree with the previously suggested lower risks of all-cause mortality (49%) and cardiovascular disease (34%), and we also found positive effects for severe kidney disease but significantly increased risks (twofold to ninefold) of several short-term complications after GBP, such as abdominal pain and gastrointestinal conditions, frequently requiring surgical procedures, apart from reconstructive plastic surgery. Long-term, the risk of anaemia was 92% higher, malnutrition developed approximately three times as often, psychiatric diagnoses were 33% more frequent and alcohol abuse was three times as great as in the control group.ConclusionsThis nationwide study confirms the benefits and describes the panorama of adverse events after bariatric surgery in persons with obesity and T2DM. Long-term postoperative monitoring and support, as better selection of patients by appropriate specialists in interdisciplinary settings, should be provided to optimise the outcomes.

Efficacy of Tai Chi on Patients With Chronic Kidney Disease

2021 ◽  
pp. 109980042110479
Author(s):  
Mei Ha ◽  
Yuhui Yang ◽  
Yu Shi ◽  
Ya Lu ◽  
Kun Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tai Chi ◽  
Gene Profile ◽  
Positive Effects ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Previous systematic reviews elucidate the efficacy of Tai Chi on the rehabilitation and treatment for various chronic diseases. Yet, no consensus has been reached on its efficacy and safety from those with chronic kidney disease (CKD). Therefore, we conducted a systematic review to critically summarize what is already known about the prevailing benefits of Tai Chi for CKD patients. There was no evidence that Tai Chi had adverse effects on CKD patients. Long-term Tai Chi exercises could improve quality of life, cardiorespiratory fitness, and physical motor function for the end-stage renal disease (ERSD) patients undergoing dialysis. Regular Tai Chi exercises might exert modest influences in delaying CKD progression for mild–moderate CKD patients. However, there is insufficient evidence to demonstrate positive effects of Tai Chi exercises on bone health of the ESRD patients. Accordingly, rigorously designed, longer-term studies of Tai Chi are warranted to identify its efficacy on CKD patients across different stages, especially targeting potential mechanisms in terms of Tai Chi altering biological gene profile expressions.

Educational intervention for food consciousness: A randomized study protocol

2021 ◽  
pp. 026010602110118
Author(s):  
Carina C Palazzo ◽  
Barbara E Leghi ◽  
Pereira Alfredo ◽  
Rosa W Diez Garcia
Keyword(s):  
Nutrition Education ◽  
Eating Behavior ◽  
Randomized Study ◽  
Intervention Group ◽  
Nutritional Intervention ◽  
Control Group ◽  
Adult Women ◽  
Nutritional Interventions ◽  
Food Experience ◽  
Eating Experience

Background: Contemporary living conditions present opportunities that promote obesity. In addition, traditional nutritional intervention have been considered inefficient, and there is a demand for the development and evaluation of strategies not based on the traditional paradigm of diets. Aim: The aim of this study is to describe the Food and Nutrition Education Program with Sensory and Cognitive Exercises (PESC), which seeks to promote consciousness of eating experience and body signals appreciation to adult women and thus to make them less vulnerable to food consumption stimuli. Method: This protocol outlines a randomized study that will include 60 adult women. PESC is based on the sensory influence for eating behavior and on the Triple-Aspect Monism theory of consciousness. It is composed of exercises that explore sensory, cognitive and emotional aspects of food experience in order to promote it into a conscious process. The program consists of four weekly workshops that explore themes related to the current obesogenic environment problematic. The intervention group ( n=30) will be evaluated at the beginning of the first workshop and after the last one. The control group ( n=30) will not participate on the workshops and will be evaluated twice, with a one-month interval. Conclusions: This study will contribute substantially to the development of nutritional interventions based on sensory aspects and consciousness of food experience. Therefore, PESC is considered an innovative approach with regard to improving individuals’ eating behavior. Trial registry: This clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC), http://www.ensaiosclinicos.gov.br/rg/RBR-4qgpg5/,numberRBR-4qgpg5 .

scholarly journals Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond

2021 ◽  
Vol 10 (6) ◽  
pp. 1175
Author(s):  
Emaad M. Abdel-Rahman ◽  
Faruk Turgut ◽  
Jitendra K. Gautam ◽  
Samir C. Gautam
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Severe Form ◽  
Clinical Syndrome ◽  
Current Evidence ◽  
Clinical Predictors ◽  
End Stage

Acute kidney injury (AKI) is a common clinical syndrome characterized by rapid impairment of kidney function. The incidence of AKI and its severe form AKI requiring dialysis (AKI-D) has been increasing over the years. AKI etiology may be multifactorial and is substantially associated with increased morbidity and mortality. The outcome of AKI-D can vary from partial or complete recovery to transitioning to chronic kidney disease, end stage kidney disease, or even death. Predicting outcomes of patients with AKI is crucial as it may allow clinicians to guide policy regarding adequate management of this problem and offer the best long-term options to their patients in advance. In this manuscript, we will review the current evidence regarding the determinants of AKI outcomes, focusing on AKI-D.

Age dependence of brachial cuff-based ambulatory PWV in end-stage kidney disease patients undergoing long-term peritoneal dialysis

2021 ◽  
pp. 089686082199692
Author(s):  
Vasilios Vaios ◽  
Panagiotis I Georgianos ◽  
Georgia Vareta ◽  
Dimitrios Divanis ◽  
Evangelia Dounousi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Pulse Wave ◽  
Age Dependence ◽  
End Stage Kidney Disease ◽  
End Stage

Background: The newly introduced device Mobil-O-Graph (IEM, Stolberg, Germany) combines brachial cuff oscillometry and pulse wave analysis, enabling the determination of pulse wave velocity (PWV) via complex mathematic algorithms during 24-h ambulatory blood pressure monitoring (ABPM). However, the determinants of oscillometric PWV in the end-stage kidney disease (ESKD) population remain poorly understood. Methods: In this study, 81 ESKD patients undergoing long-term peritoneal dialysis underwent 24-h ABPM with the Mobil-O-Graph device. The association of 24-h oscillometric PWV with several demographic, clinical and haemodynamic parameters was explored using linear regression analysis. Results: In univariate analysis, among 21 risk factors, 24-h PWV exhibited a positive relationship with age, body mass index, overhydration assessed via bioimpedance spectroscopy, diabetic status, history of dyslipidaemia and coronary heart disease, and it had a negative relationship with female sex and 24-h heart rate. In stepwise multivariate analysis, age ( β: 0.883), 24-h systolic blood pressure (BP) ( β: 0.217) and 24-h heart rate ( β: −0.083) were the only three factors that remained as independent determinants of 24-h PWV (adjusted R 2 = 0.929). These associations were not modified when all 21 risk factors were analysed conjointly or when the model included only variables shown to be significant in univariate comparisons. Conclusion: The present study shows that age together with simultaneously assessed oscillometric BP and heart rate are the major determinants of Mobil-O-Graph-derived PWV, explaining >90% of the total variation of this marker. This age dependence of oscillometric PWV limits the validity of this marker to detect the premature vascular ageing, a unique characteristic of vascular remodelling in ESKD.

scholarly journals Initial renal histology and early response predict outcomes of Brazilian lupus nephritis patients

Lupus ◽  
2019 ◽  
Vol 29 (1) ◽  
pp. 83-91
Author(s):  
G Vajgel ◽  
C B L Oliveira ◽  
D M N Costa ◽  
M A G M Cavalcante ◽  
L M Valente ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Lupus Nephritis ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Estimated Glomerular Filtration Rate ◽  
Interstitial Fibrosis ◽  
End Stage ◽  
Class Iv

Objective We analyzed baseline and follow-up characteristics related to poorer renal outcomes in a Brazilian cohort of admixture race patients with lupus nephritis. Methods Overall, 280 outpatients with a diagnosis of systemic lupus erythematosus and previous kidney biopsy of lupus nephritis were recruited from August 2015 to December 2018 and had baseline laboratory and histologic data retrospectively analyzed; patients were then followed-up and data were recorded. The main outcome measure was the estimated glomerular filtration rate at last follow-up. Secondary analyses assessed the impact of initial kidney histology and treatment in long-term kidney survival. Results Median duration of lupus nephritis was 60 months (interquartile range: 27–120); 40 (14.3%) patients presented progressive chronic kidney disease (estimated glomerular filtration rate <30 and ≥10 ml/min/1.73 m2) or end-stage kidney disease at last visit. Adjusted logistic regression analysis showed that class IV lupus nephritis (odds ratio 14.91; 95% confidence interval 1.77–125.99; p = 0.01) and interstitial fibrosis ≥25% at initial biopsy (odds ratio 5.87; 95% confidence interval 1.32–26.16; p = 0.02), lack of complete or partial response at 12 months (odds ratio 16.3; 95% confidence interval 3.74–71.43; p < 0.001), and a second renal flare (odds ratio 4.49; 95% confidence interval 1.10–18.44; p = 0.04) were predictors of progressive chronic kidney disease. In a Kaplan-Meier survival curve we found that class IV lupus nephritis and interstitial fibrosis ≥25% were significantly associated with end-stage kidney disease throughout follow-up (hazard ratio 2.96; 95% confidence interval 1.3–7.0; p = 0.036 and hazard ratio 4.96; 95% confidence interval 1.9–12.9; p < 0.0001, respectively). Conclusion In this large cohort of admixture race patients, class IV lupus nephritis and chronic interstitial damage at initial renal biopsy together with non-response after 1 year of therapy and relapse were associated with worse long-term renal outcomes.

scholarly journals Long-term combined inhaled therapy with ipratropium bromide and ambroxol of heavy smoking patients with chronic obstructive lung disease

2005 ◽  
pp. 102-106
Author(s):  
A. R. Tatarsky ◽  
E. V. Sukhanova ◽  
E. V. Bobkov ◽  
A. B. Kiryukhin
Keyword(s):  
Ipratropium Bromide ◽  
Clinical Status ◽  
Control Group ◽  
Chronic Obstructive ◽  
Cell Content ◽  
Heavy Smoking ◽  
Positive Effects ◽  
Copd Patients ◽  
Inhaled Therapy

The study was aimed to investigate the efficiency of long-term combined inhaled therapy with ipratropium bromide and ambroxol via compressor pneumatic nebulizer in 86 COPD patients. Significant improvement in clinical status, physical tolerance and cell content (macrophages, neutrophils) of induced sputum was revealed in all the patients in comparison with a control group. Mild to moderate COPD patients had considerable improvement in FEV1. The authors concluded that the proposed treatment had resulted in the positive effects.

scholarly journals The Association Between Age of Onset of Type 2 Diabetes with Long-term Risk of End Stage Kidney Disease: A National Registry Study

2020 ◽  
Author(s):  
Jedidiah I Morton ◽  
Danny Liew ◽  
Stephen P McDonald ◽  
Jonathan E Shaw ◽  
Dianna J Magliano
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Cumulative Incidence ◽  
Age Of Onset ◽  
End Stage Kidney Disease ◽  
Onset Of Diabetes ◽  
End Stage ◽  
Effect Of Age

<b>Objective</b>: The long-term risk of end-stage kidney disease (ESKD) in type 2 diabetes is poorly described, as is the effect that younger age of diabetes onset has on this risk. Therefore, we aimed to estimate the effect of age of onset on the cumulative incidence of ESKD from onset of type 2 diabetes. <p><b>Research Design and Methods: </b>This study included 1,113,201 people with type 2 diabetes registered on the Australian National Diabetes Services Scheme (NDSS) followed from 2002 until 2013. The NDSS was linked to the Australia and New Zealand Dialysis and Transplant Registry and the Australian National Death Index. </p> <p><b>Results: </b>Between 2002 and 2013,<b> </b>there were 7,592 incident cases of ESKD during 7,839,075 person-years of follow up. In the first 10-15 years following onset of diabetes, the incidence of ESKD was highest in those with an older age of onset of diabetes, whereas over longer durations of diabetes the incidence of ESKD became higher in those with younger-onset diabetes. After 40 years of diabetes, the cumulative incidence of ESKD was 11.8% and 9.3% in those diagnosed with diabetes aged 10-29 and 30-39 years, respectively. When death from ESKD without renal replacement therapy was included, incidence of ESKD remained higher in older onset diabetes for the initial 20 years, with no clear effect of age thereafter.</p> <p><b>Conclusions: </b>The long-term risk of ESKD in type 2 diabetes is high, which disproportionately affects those with younger-onset of diabetes as they are more likely to survive to longer diabetes durations.</p>

Demographics and long‐term outcomes of children with end‐stage kidney disease: a 20‐year territory‐wide study

Nephrology ◽  
2021 ◽  
Author(s):  
Eugene Yu Hin Chan ◽  
Desmond Yat Hin Yap ◽  
Wilfred Hing Sang Wong ◽  
Tsz Wai Ho ◽  
Pak Chiu Tong ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Long Term Outcomes ◽  
End Stage Kidney Disease ◽  
End Stage
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