HUBUNGAN LAJU FILTRASI GLOMERULUS DENGAN KADAR HEMOGLOBIN DAN KALSIUM PADA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS

2021 ◽  
Vol 3 (2) ◽  
pp. 272-284
Author(s):  
Fiora Ladesvita ◽  
Lilis Mulyani

Chronic Kidney Disease (CKD) didefinisikan sebagai kerusakan ginjal dengan penurunan Glomerular Filtration Rate (GFR) kurang dari 60 ml/menit/1,73 m2 yang terjadi selama lebih dari tiga bulan. Penurunan fungsi ginjal dapat menyebabkan produksi hormon eritropoietin yang berfungsi untuk memproduksi sel darah berkurang sehingga dapat menyebabkan penurunan kadar hemoglobin. Selain itu, kerusakan ginjal dapat menyebabkan penurunan aktivasi vitamin D yang dapat menyebabkan penyerapan kalsium di usus berkurang. Tujuan dari penelitian ini adalah untuk mengetahui hubungan GFR dengan kadar hemoglobin dan kadar kalsium pada pasien CKD yang menjalani hemodialisis. Penelitian ini menggunakan desain cross sectional dengan pendekatan retrospektif menggunakan rekam medis pasien CKD yang menjalani hemodialisis dari bulan Januari sampai Desember 2020. Penelitian ini dilakukan pada 95 sampel dengan metode consecutive sampling. Uji korelasi pearson menunjukkan nilai p 0,000 dan nilai r 0,974 untuk korelasi antara GFR dan kadar hemoglobin. Juga pengujian menunjukkan nilai p 0,000 dan nilai r 0,950 untuk korelasi antara GFR dan kadar kalsium. Kesimpulannya, ada hubungan yang signifikan antara GFR dengan kadar hemoglobin dan kadar kalsium.   Kata kunci: Penyakit Ginjal Kronis, Laju Filtrasi Glomerulus, Hemoglobin, Kalsium

2020 ◽  
Vol 13 (4) ◽  
pp. 674-683 ◽  
Author(s):  
Jonas Björk ◽  
Ulf Nyman ◽  
Marie Courbebaisse ◽  
Lionel Couzi ◽  
R Neil Dalton ◽  
...  

Abstract Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved. Methods In a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation. Results 7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%. Conclusions None of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.


Author(s):  
Francisco Veríssimo Veronese ◽  
Eduardo C. Gomes ◽  
Joana Chanan ◽  
Maicon A. Carraro ◽  
Eduardo G. Camargo ◽  
...  

AbstractThe Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals.This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by theIn the group as a whole,CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m


2021 ◽  
Vol 17 (8) ◽  
pp. 596-603
Author(s):  
N. Karlovich ◽  
Т. Mokhort ◽  
Е. Sazonоva

Background. The results of studies evaluating the levels of adiponectin, leptin and their ratios in chronic kidney disease (CKD) are conflicting. It is assumed that hyperleptinemia and changes in adiponectin clearance are consequences of a decrease in the glomerular filtration rate, they exacerbate renal impairment and may affect the prognosis of survival due to cardiovascular events. It is known that secondary hyperaparathyroidism is the most frequent complication of CKD, which not only affects calcium-phosphorus metabolism and bone tissue, but also contributes to the development of pathological processes involving other hormonal and metabolic markers. Of greatest interest is the assessment of adipocytokine levels in the development of secondary hyperparathyroidism against the background of CKD as an independent factor of increasing cardiovascular risks. The purpose of the study was to assess adipocytokine levels (adiponectin, leptin) and their ratios in patients with different stages of chronic kidney disease and their relationship with manifestations of secondary hyperparathyroidism. Materials and methods. This cross-sectional study enrolled 160 people with CKD and 40 healthy individuals as a comparison group. Results. Leptin level reduction and an increase in the proportion of patients with hypoleptinemia with a decrease in the glomerular filtration rate were found, which may be an important factor determining nutritional status. Correlations were revealed between leptin level, body mass index (ρ = 0.411) and patients’ age (ρ = 0.189), as well as between leptin/adiponectin and adiponectin/leptin ratios (ρ = 0.395 and ρ = –0.395) and body mass index in patients with CKD persisting in subgroups by stage of renal failure. A relationship was found with sex for leptin and a decrease in its levels below normal values in both men and women. Conclusions. The proportion of patients with hyperadiponectinemia was significantly higher among those with end-stage CKD compared to patients with stages 1–2. There was no statistically significant relationship between adipocytokine and parathyroid hormone levels and the presence of secondary hyperparathyroidism in patients examined.


2017 ◽  
Vol 5 (4) ◽  
pp. 315-322
Author(s):  
Mark Fernandez Bedoya ◽  
Maria A. Hegeman

Continued progression of kidney disease will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Estimates of glomerular filtration rate (GFR) that are based on serum creatinine are routinely used; however, they are imprecise, potentially leading to the overdiagnosis of chronic kidney disease. The purpose of this study is to evaluate the glomerular filtration rate from serum creatinine in Brazil patients with chronic kidney disease (CKD). Multiple equations exist to estimate glomerular filtration rate (GFR); however, there is no consensus on which is superior for risk classification in patients with chronic kidney disease (CKD). Renal function was analyzed through serum creatinine and glomerular filtration rate (GFR) estimated according to the CG, MDRD and CKD-EPI equations, available on the websites of the Brazilian Nephrology Society (SBN) and the (NKF) by using cross-sectional analyses in diverse populations totaling 3949 participants.


Author(s):  
Ni Made Rindra Hermawathi ◽  
Arifoel Hajat ◽  
Yetti Hernaningsih ◽  
Widodo Widodo

Chronic Kidney Disease (CKD) is a condition characterized by kidney damage and a decrease of Glomerular Filtration Rate of less than 60 mL/ min/1.73 m2 in more than three months. Anemia is the most common complication in patients with CKD who regularly undergo hemodialysis. Reticulocyte Hemoglobin Equivalent (Ret-He) is a new parameter that can reflect the storage of iron for erythropoiesis. This study compared the Ret-He level pre and post-hemodialysis and evaluated the effect of ultrafiltration (UF) hemodialysis to Ret-He level in CKD patients. This research was an observational analytical study. Samples were 50 patients with CKD who underwent hemodialysis regularly in Dr. Soetomo Hospital Surabaya by consecutive sampling from August–September 2017. The measurement of the Ret-He level pre ultrafiltration hemodialysis was divided into UF < 2 L and UF ≥ 2 L. Both groups showed homogenous results. The group with UF < 2 L increased significantly from pre to post ultrafiltration (p=0.010). The group with UF ≥ 2 L was not increased considerably from 30.57±3.62 to 32.69±3.45 (p=0.413). Ret-He level in the group with UF < 2 L was 0.81±1.10, significantly higher than the group with UF  ≥ 2 L  0.12±0.83 (p=0.017). The difference of Ret-He level pre and post ultrafiltration was significant in UF < 2 L. There was a significant increase of the Ret-He level in hemodialysis with  UF < 2 L compared to UF ≥ 2 L. The measurement of Ret-He should be performed before hemodialysis due to an increase in Ret-He after ultrafiltration hemodialysis.


2020 ◽  
Author(s):  
Nipun de Silva ◽  
M.N.F. Mufeena ◽  
Gayathri Sam ◽  
Shashika Dayarathna ◽  
Deepthi Kumari ◽  
...  

Abstract Objectives: To compare carriage rates of Staphylococcus aureus in patients with and without chronic kidney disease (CKD) and identify associated factors. Results: We enrolled 64 CKD (A-1 = 13, A-2 = 17, A-3 = 34) and 56 non-CKD controls (B). Patients were categorized as: stage 5 CKD on haemodialysis (A-1), stage 5 CKD not on haemodialysis (A-2), renal transplant recipients with glomerular filtration rate > 60 ml/min (A-3) and those having chronic medical diseases with glomerular filtration rate > 60 ml/min/m2 (B). Median age = 57 years (range = 17–77). Nasal or axillary Staphylococcus aureus carriage was seen in 5 (38.5%), 2 (11.8%), 5 (14.7%) and 9 (16.1%) patients from A-1 to A-3 and B groups respectively. All isolated organisms were methicillin sensitive. Haemodialysis (p = 0.035) and antibiotic use in the preceding month (p = 0.02) were associated with carriage. Demographic factors and co-morbidities were not associated with carriage.


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