scholarly journals Quality of diabetes mellitus therapy in patients with chronic kidney disease in the real world

2017 ◽  
Vol 11 (1) ◽  
pp. 48
Author(s):  
Beatrice Giampietro ◽  
Fabrizio Tiratterra ◽  
Antonella Paradiso ◽  
Fabiana Lanti ◽  
Chiara Villani ◽  
...  

Chronic kidney disease (CKD) is very often among diabetic patients. Some oral antidiabetic agents are not recommended in the presence of CKD. Aim of the study was to evaluate the quality of diabetes mellitus (DM) treatment in nephrophatic patients in the real world. A total of 265 subjects with type 2 DM, consecutively admitted to the internal medicine departments of two hospitals in Rome, were recruited. Patients hospitalized for hypoglycemia, decompensated DM, acute kidney failure or worsening nephropathy were excluded. For each patient, the following data were collected: age, gender, estimated glomerular filtration rate (eGFR) using the MDRD (<em>modification of diet in renal disease</em>) study equation, type of antidiabetic drug treatment. A total of 265 subjects were studied, 127 male (47.9%) and 138 female (52.1%). The mean age was 77.5 years. The mean of glycemia glycated hemoglobin (HbA1c) value was 57.5 mmol/mol (7.4%). 137 patients (51.7%) were treated with oral antidiabetic agents, 29 (10%) with both oral antidiabetic agents and insulin, 90 (34%) with insulin alone, 8 (3%) with dipeptidyl peptidase-4 inhibitors, 1 (0.4%) with incretin agents plus oral antidiabetic drugs. According to the Kidney Disease Outcomes Quality Initiative (KDOQI) classification of CKD, the sample was divided into 5 groups using eGFR criteria. For each group, mean HbA1c values, type of antidiabetic treatment, appropriateness of therapy according to guidelines and how it may affect the HbA1c levels were considered. Our data show that 30.5% of patients with CKD stage 3-5 is treated with drugs not recommended by current guidelines.

Author(s):  
Hansani Madushika Abeywickrama ◽  
Swarna Wimalasiri ◽  
Yu Koyama ◽  
Mieko Uchiyama ◽  
Utako Shimizu ◽  
...  

Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.


2018 ◽  
Vol 15 ◽  
pp. 42-49 ◽  
Author(s):  
Soraya Azmi ◽  
Adrian Goh ◽  
Noor Azimah Muhammad ◽  
Hizlinda Tohid ◽  
Mohd Radzniwan A. Rashid

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0180977 ◽  
Author(s):  
Paithoon Sonthon ◽  
Supannee Promthet ◽  
Siribha Changsirikulchai ◽  
Ram Rangsin ◽  
Bandit Thinkhamrop ◽  
...  

2019 ◽  
Vol 6 ◽  
pp. 205435811986309 ◽  
Author(s):  
Michelle Smekal ◽  
Sarah Gil ◽  
Maoliosa Donald ◽  
Heather Beanlands ◽  
Sharon Straus ◽  
...  

Background: Although numerous websites for patients with chronic kidney disease (CKD) are available, little is known about their content and quality. Objective: To evaluate the quality of CKD websites, and the degree to which they align with information needs identified by patients with CKD. Methods: We identified websites by entering “chronic kidney disease” in 3 search engines: Google.com (with regional variants for Australia, Canada, the United Kingdom, and the United States), Bing.com, and Yahoo.com. We included the first 50 unique English-language sites from each search. We evaluated website content using a 30-point scale comprising 8 priority content domains identified by patients with CKD ( understanding CKD, diet, symptoms, medications, mental/physical health, finances, travel, and work/school). We used standardized tools to evaluate usability, reliability, and readability (DISCERN, HONcode, LIDA, Reading Ease, and Reading Grade Level). Two reviewers independently conducted the search, screen, and evaluation. Results: Of the 2093 websites identified, 115 were included. Overall, sites covered a mean (SD) of 29% (17.8) of the CKD content areas. The proportion of sites covering content related to understanding CKD, symptoms, and diet was highest (97%, 80%, and 72%, respectively). The proportion of sites covering travel, finances, and work/school content was lowest (22%, 12%, and 12%, respectively). The mean (SD) scores for DISCERN, LIDA and HONcode were 68% (14.6), 71% (14.4), and 75% (17.2), respectively, considered above average for usability and reliability. The mean (SD) Reading Grade Level was 10.6 (2.8) and Reading Ease was 49.8 (14.4), suggesting poor readability. Conclusions: Although many CKD web sites were of reasonable quality, their readability was poor. Furthermore, most sites covered less than 30% of the content patients identified as important for CKD self-management. These results will inform content gaps in internet-accessible information on CKD self-management that should be addressed by future eHealth web-based tools.


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