STUDY OF OUTCOME OF CHRONIC KIDNEY DISEASE IN DIABETIC PATIENTS IN THANJAVUR MEDICAL COLLEGE HOSPITAL

2021 ◽  
pp. 17-20
Author(s):  
S.Hema Akilandeswari ◽  
K. Rajkanth ◽  
S. Janani
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Medical College Hospital ◽  
Diabetic Patients ◽  
Type I ◽  
Strong Positive Correlation ◽  
College Hospital ◽  
Medical College

Background: Diabetes Mellitus is one of the common causes of Chronic Kidney Disease which usually leads to end-stage kidney disease. Thus this study was planned to nd out the outcome of CKD in DM, disease progression, appropriate management and the complications. Methods: A cross sectional study among Diabetes Mellitus patients with Chronic Kidney Disease attending the Department of Nephrology and Department of Medicine in Thanjavur Medical College Hospital during the period of July and August 2018. The duration of study period was 2 months. All patients who attended the outpatient department (OPD) and in-patients departments with Type I and Type II diabetes mellitus associated with chronic kidney disease, on any line of management were included in this study. A total of 101 patients were included. Statistical Package for Social Sciences (SPSS for Windows V20) was used for data analysis. Results: Poor glycemic control, albuminuria, hypertriglyceridemia (greater than 150), increase in LDLlevels (greater than 100), BMI (greater than or equal to 25), poor BP control and a longer duration of diabetes mellitus had a strong positive correlation with decrease in eGFR less than 60 ml/min. Glycemic control, weight reduction and adequate BPcontrol retard the progression of CKD. Conclusion: Albuminuria and decline in eGFR both are independent risk factors for diabetic CKD and are strong predictors of morbidity and mortality from a major vascular event, especially cardiovascular complications and stroke.

scholarly journals Lifestyle Pattern and Knowledge about Diabetes Mellitus

2019 ◽  
Vol 31 (2) ◽  
pp. 102-104
Author(s):  
Kartick Chanda Shaha ◽  
Shima Akhter Khatun ◽  
Nafisa Mustafa ◽  
Farzana Ahmed ◽  
Mohammed Asaduzzaman Khan
Keyword(s):  
Diabetes Mellitus ◽  
Medical College Hospital ◽  
High Rate ◽  
Outpatient Department ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
College Hospital ◽  
Medical College ◽  
Adherence To Diet

Introduction:The aim of the present study was to assess the pattern of lifestyle and knowledge about diabetes mellitus among type 2 diabetic patients at two tertiary level hospitals in Mymensingh Materials and Methods: A descriptive, cross sectional study was conducted from July 2015 to December 2015 among 300 patients attending at Medicine outpatient department of the Community Based Medical College Hospital and Endocrine outpatient department of the Mymensingh Medical College Hospital after obtaining requisite consent from the patients. Data were collected through the interviewing of the patients. The collected data were entered into the computer and analyzed by using SPSS version 20.1. The study was approved by the institutional ethical committee. Results: In a pool of 300 type 2 diabetics, Most of the patients (57.3%) belonged to the middle age group 41-60 years. More than half of the respondents were female (n=223, 74.3%). 97% patients were found to have knowledge about timing of dose regimen. Majority of patient’s (35.7%) knowledge about hypoglycemia was poor. The rate of adherence to diet was 51%. The rate of adherence to exercise was 68.3%. Conclusion: Majority of type 2 DM patients displayed optimal level of diabetes knowledge. There was a high rate of non adherence to diet and exercise recommendations by patients suffering from type 2 diabetes mellitus. So continuous patient education and awareness program are required. Medicine Today 2019 Vol.31(2): 102-104

scholarly journals Clinical Profiles of Chronic Kidney Disease Patients at the Time of Maiden Presentation: An Experience at the Nephrology Ward, Chittagong Medical College Hospital

1970 ◽  
Vol 21 (2) ◽  
pp. 7-10
Author(s):  
Abul Kashem ◽  
Pradip Kumar Dutta ◽  
Md Nurul Huda ◽  
Saibal Das ◽  
Emran Bin Yunus ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Key Words ◽  
Medical College Hospital ◽  
College Teachers ◽  
College Hospital ◽  
Medical College ◽  
Clinical Profiles

Key words: CKD patients; Renam status at maiden presentation; Nephrology ward of CMCHDOI: 10.3329/jcmcta.v21i2.7729 Journal of Chittagong Medical College Teachers' Association 2010: 21(2):7-10

scholarly journals Cutaneous Manifestations of Chronic Kidney Disease-An Observational Study in 100 Cases

2012 ◽  
Vol 7 (1) ◽  
pp. 33-36 ◽  
Author(s):  
JA Leena ◽  
MMSU Islam ◽  
AS Ahmed ◽  
DS Ahmed ◽  
MM Rahman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Obstructive Uropathy ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
College Hospital ◽  
Hypertensive Nephropathy ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
Medical College

Chronic Kidney Disease (CKD) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of haemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. This cross sectional study was performed in 100 cases of CKD admitted in nephrology department of Dhaka Medical College Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2008 to August 2008 to evaluate the prevalence of dermatologic problems. Among them most belong to 2nd to 5th decade, 68 are male and rests are female. Glomerulonephritis (44%), Diabetes mellitus (22%), Obstructive uropathy (13%) and Hypertensive nephropathy (12%) are found common causes of CKD. Among these patients 38% patients were treated with conservative treatment, 31% with intermittent peritoneal dialysis (IPD), 19% with haemodialysis and 12% with some form of immunosuppressive therapy. Total 88% of study population had some form of skin disorder; pallor was the most common (82%), while xerosis (61%), pruritus (53%), pigmentation (37%) and bacterial infection (37%) were other common problems. Purpura and fungal infection was 29% and 27% respectively. Viral infection (9%), dermatitis (4%), gynaecomastia (1%), kyrle's disease (3%) are relatively less common findings. Lindsay's nail was seen in 23% of patients and was more prevalent in glomerulonephritis and diabetic patients with prevalence of 13% and 9% respectively. Other nail changes included koilonychia (4%), subungual hyperkeratosis (1%), splinter hemorrhages (3%) onychomycosis (8%) and Beau's lines (1%). So, CKD is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment.DOI: http://dx.doi.org/10.3329/fmcj.v7i1.10296Faridpur Med. Coll. J. 2012;7(1): 33-36

scholarly journals Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Renoprotective Mechanisms beyond Glycemic Control

2021 ◽  
Vol 22 (9) ◽  
pp. 4374
Author(s):  
Tomoaki Takata ◽  
Hajime Isomoto
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Kidney Injury ◽  
Sglt2 Inhibitors ◽  
Pleiotropic Effects ◽  
Future Research ◽  
Diabetic Patients ◽  
Sodium Glucose Cotransporter ◽  
Stage Renal Disease

Diabetes mellitus is a major cause of chronic kidney disease and end-stage renal disease. However, the management of chronic kidney disease, particularly diabetes, requires vast improvements. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally developed for the treatment of diabetes, have been shown to protect against kidney injury via glycemic control, as well as various other mechanisms, including blood pressure and hemodynamic regulation, protection from lipotoxicity, and uric acid control. As such, regulation of these mechanisms is recommended as an effective multidisciplinary approach for the treatment of diabetic patients with kidney disease. Thus, SGLT2 inhibitors are expected to become key drugs for treating diabetic kidney disease. This review summarizes the recent clinical evidence pertaining to SGLT2 inhibitors as well as the mechanisms underlying their renoprotective effects. Hence, the information contained herein will advance the current understanding regarding the pleiotropic effects of SGLT2 inhibitors, while promoting future research in the field.

scholarly journals Association of Retinopathy with Chronic Kidney Disease in Diabetes Mellitus

2018 ◽  
Vol 8 (3) ◽  
pp. 210-214
Author(s):  
Rushda Sharmin Binte Rouf ◽  
SM Ashrafuzzaman ◽  
Zafar Ahmed Latif
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Strong Association ◽  
Albumin Excretion Rate ◽  
Cross Sectional Study ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Cross Sectional

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214

Abstract 558: Association of Chronic Kidney Disease and Diabetes Mellitus with 5-Year Outcomes after Acute Myocardial Infarction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kazuoki Dai ◽  
Masaharu Ishihara ◽  
Ichiro Inoue ◽  
Takuji Kawagoe ◽  
Yuji Shimatani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Survival Rate ◽  
Kidney Disease ◽  
Independent Predictor ◽  
Diabetic Patients ◽  
Kaplan Meier ◽  
Significant Difference

Several studies have shown that both chronic kidney disease (CKD) and diabetes mellitus are risk factors for mortality in patients with acute myocardial infarction (AMI). This study was undertaken to investigate influence of CKD on the prognostic significance of diabetes in patients with AMI. Between January 1996 and December 2005, 888 patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain. CKD was difined estimated glomerular filtration rate (eGFR) of less than 60.0 ml/minute/1.73 m 2 of body-surface area (stage3–5). Kaplan-Meier method was used to compare 5-year survival of diabetic and non-diabetic patients, in the presence (n=337) or absence (n=551). Kaplan-Meier curves for 5-year survival rate are shown in Figure . In the absence of CKD, there was no significant difference in 5-year survival rate between patients with diabetes and those without (93 % v.s. 94 %, p=0.82). In patients with CKD, however, diabetes was associated with lower 5-year survival rate (65 % v.s. 87 %, p<0.001). Multivariate analysis showed that diabetes was an independent predictor for 5-year survival in patients with CKD (OR 3.2, 95%CI 1.8–5.8, p=0.0002), but not in patients without CKD (OR 1.1, 95%CI 0.4–2.5, p=0.82). Diabetes mellitus was an independent predictor for death after AMI in patients with CKD. Aggressive treatment after AMI should be advocated in diabetic patients with CKD.

Knowledge of Hypoglycemic Symptoms and their Self-Management among patients with Type II Diabetes Mellitus

2021 ◽  
Vol 15 (11) ◽  
pp. 2961-2962
Author(s):  
Aneel Kumar ◽  
Zahid Ali Shaikh ◽  
Sham Lal Prithiani ◽  
Bashir Ahmed Shaikh ◽  
Imdad Ali Ansari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Self Management ◽  
Type I ◽  
Type Ii ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Adequate Knowledge

Aim: To determine knowledge of hypoglycaemic symptoms & their self-management among pts with type II diabetes mellitus. Study Design: Descriptive, cross-sectional. Place and duration of study: OPD Clinic of Department of Medicine, Chandka Medical College Hospital Larkana from 23rd May 2019 to 22nd November 2019. Methodology: One hundred and thirty five patients with type II diabetes mellitus of age 35- 60 years were selected. Patients with type I DM and neuro-psychiatric illness were excluded. The symptoms of hypoglycemia and their responses to those symptoms were recorded. Results: The mean age of 47.07±6.04years and majority of the patients 83 (61.48%) were between 46-60 years of age. Seventy two (53.33%) were male and 63 (46.67%) were females. Mean duration of diabetes mellitus was 6.90±3.86 years. Adequate knowledge of hypoglycemic symptoms and their self-management among patients with type II diabetes mellitus was found in 62 (56.9%) patients. Conclusion: Hypoglycemic patients are significantly unaware of their condition and have a very low knowledge about hypoglycemia and its self-management. Keywords: Type II diabetes, Hypoglycemic symptoms, Knowledge

scholarly journals The effect of comorbidities on glycemic control among Colombian adults with diabetes mellitus: a longitudinal approach with real-world data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuel Urina-Jassir ◽  
Lina Johana Herrera-Parra ◽  
Juliana Alexandra Hernández Vargas ◽  
Ana María Valbuena-García ◽  
Lizbeth Acuña-Merchán ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Early Onset ◽  
National Registry ◽  
Real World Data ◽  
Logistic Regression Models ◽  
Statistical Interaction ◽  
Longitudinal Approach

Abstract Background Achieving an optimal glycemic control has been described to reduce the incidence of diabetes mellitus (DM) related complications. The association between comorbidities and glycemic control remains unclear. Our aim is to evaluate the effect of comorbidities on glycemic control in people living with DM. Methods A retrospective longitudinal study on data from the National Registry of Chronic Kidney Disease from 2014 to 2019 in Colombia. The outcome was poor glycemic control (PGC = HbA1c ≥7.0%). The association between each comorbidity (hypertension (HTN), chronic kidney disease (CKD) or obesity) and PGC was evaluated through multivariate mixed effects logistic regression models. The measures of effect were odds ratios (OR) and their 95% confidence intervals (CI). We also evaluated the main associations stratified by gender, insurance, and early onset diabetes as well as statistical interaction between each comorbidity and ethnicity. Results From 969,531 people at baseline, 85% had at least one comorbidity; they were older and mostly female. In people living with DM and CKD, the odds of having a PGC were 78% (OR: 1.78, CI 95%: 1.55-2.05) higher than those without CKD. Same pattern was observed in obese for whom the odds were 52% (OR: 1.52, CI 95%: 1.31-1.75) higher than in non-obese. Non-significant association was found between HTN and PGC. We found statistical interaction between comorbidities and ethnicity (afro descendant) as well as effect modification by health insurance and early onset DM. Conclusions Prevalence of comorbidities was high in adults living with DM. Patients with concomitant CKD or obesity had significantly higher odds of having a PGC.

scholarly journals Prevalence of chronic kidney disease stages 3-5 among patients with type 2 diabetes mellitus in Bangladesh

2017 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Hasna Fahmima Haque ◽  
Tasrina Shamnaz Samdani ◽  
Shahana Zaman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Significant Risk ◽  
Duration Of Diabetes

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24

scholarly journals Cardiorenal syndrome in patients with chronic kidney disease and diabetes mellitus

2013 ◽  
Vol 16 (3) ◽  
pp. 90-96
Author(s):  
Irina Mikhailovna Kutyrina ◽  
Tatiana Evgen'evna Rudenko ◽  
Svetlana Alekseevna Savel'eva ◽  
Mikhail Yur'evich Shvetsov ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiorenal Syndrome ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Related Factors ◽  
Myocardial Remodelling ◽  
History Of

AIM: Combination of cardiovascular and renal disease is currently viewed as a unified cardiorenal syndrome (CRS). The aim of our study was to assess the CRS prevalence and risk factors associated with left ventricular hypertrophy (LVH) in patients with pre-dialysis stages of chronic kidney disease (CKD) of various etiology. MATERIALS AND METHODS: We enrolled 172 patients with CKD to participate in this study. First group consisted of 83 patients with nondiabetic CKD at 2nd through 4th stage (mean age 46-15 years, 51% male and 29% female). Mean glomerular filtration rate (GFR) was 37.2 ml/min (33.9-41.4 with 95% CI); creatinine plasma clearance was 2.9 mg/dl (2.6-3.2). Second group consisted of 89 patients with type 2 diabetes mellitus (T2DM) and CKD at 1st?2nd stage (40% male and 60% female) with albuminuria (mean age 57.3-7.1 years). Duration of diabetes in this sampling was 10.4-7.1 years. All patients underwent standard clinical examination, supplemented with echocardiography to evaluate the influence of general and CKD-related risk factors for LVH. RESULTS: LVH was diagnosed in 37.3% of non-diabetic patients with CKD at 2nd through 4th stage. Aside from classic cardiovascular riskfactors (including age, gender, arterial hypertension, family history of cardiovascular diseases, hypercholesterolemia), we observed theimpact of kidney-related factors (anemia, plasma creatinine, disturbance of calcium-phosphorus metabolism). CKD progression wasassociated with elevation in the incidence of concentric and eccentric LVH). Patients with T2DM were diagnosed with LVH in 36% ofcases. Increased myocardial mass correlated with plasma levels of uric acid, HbA1c, obesity and albuminuria. There was also a firmassociation between diabetic nephropathy, left ventricular myocardial remodelling and a history of cardiovascular events. CONCLUSION: In patients with diabetes mellitus and CKD cardiorenal syndrome develops at pre-dialysis stages due to both classic and kidney-related cardiovascular risk factors.

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