China
Africa
Explore chapters and articles related to this topic
Urinary Tract Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Chronic kidney disease (CKD), previously known as chronic renal insufficiency or chronic renal failure, is the result of a heterogeneous group of disorders leading to a progressive impairment of renal function. CKD is classified according to glomerular filtration rate (GFR) into five stages, the most severe of which (end-stage renal disease or ESRD) is characterized by insufficient renal function to sustain life, requiring dialysis or kidney transplantation (Table 17.6) [21]. Without proper treatment, ESRD is fatal. Older studies used serum Cr to classify CKD, although the relationship between serum Cr and CKD stage in pregnancy is not as predictable as in the non-pregnant state. (Table 17.7). However, first trimester (or preconception) Cr can still be used to estimate prognosis in pregnancy (Table 17.8).
Nutrition, Chronic Kidney Disease, and Kidney Failure
Published in David Heber, Zhaoping Li, Primary Care Nutrition, 2017
Chronic renal insufficiency is the ninth leading cause of death in the United States, according to the Centers for Disease Control and Prevention (2012). In this disease, the kidneys are damaged and cannot filter blood effectively. This damage can cause wastes to build up in the body and lead to other health problems, including cardiovascular disease (CVD), anemia, and bone disease. People with early CKD tend not to feel any symptoms. The only ways to detect CKD are through a blood test to estimate kidney function, and a urine test to assess kidney damage. If left untreated, chronic renal insufficiency leads to renal failure.
Polypharmacy and Rational Prescribing
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Mikhail Zhukalin, Christopher J. Williams, Michael Reed, Dale C. Strasser
The treatment of neuropathic pain (i.e., pain involving the central or peripheral nervous system) in the older adult involves only a few first-line agents. Gabapentin and Pregabalin work in the central nervous system on voltage-dependent calcium channels and are commonly used to treat pain associated with diabetic neuropathy, postherpetic neuralgia, fibromyalgia, and poststroke and spinal cord injury dysesthesia. Common side effects include edema, somnolence, dizziness, and abnormal thinking [45,46]. Both of these medications are excreted by the kidneys and require adjustments in dosing in patients with chronic renal insufficiency.
Analysis of the clinical characteristics of tigecycline-induced hypofibrinogenemia
Published in Journal of Chemotherapy, 2023
Haibo Lei, Xiang Liu, Zuojun Li, Chunjiang Wang
Acute or chronic renal insufficiency often occurs at the same time in some patients. Joan et al. found that 30% of tigecycline accumulated in patients with severe renal insufficiency [26]. Renal impairment has been suggested to be a risk factor for tigecycline-induced hypofibrinogenemia. Zhang et al. found that renal failure (whether requiring dialysis or not requiring dialysis) was a risk factor for tigecycline-induced hypofibrinogenemia (OR [95% CI]: 2.450 [1.335-4.496]) [23]. David et al. found that renal impairment was not related to a higher risk of FIB decreases in a real-world setting [22]. However, they still consider renal insufficiency to be a possible risk factor due to its clinical relevance. Based on reports of tigecycline-induced hypofibrinogenemia, we found that renal insufficiency may be a risk factor for hypofibrinogenemia induced by tigecycline. Further study is needed to verify the relationship between tigecycline-induced hypofibrinogenemia and renal function.
Vascular complications in prediabetes and type 2 diabetes: a continuous process arising from a common pathology
Published in Current Medical Research and Opinion, 2022
Ulrike Gottwald-Hostalek, Mike Gwilt
The Chronic Renal Insufficiency Cohort followed a population of 3,701 subjects with chronic kidney disease (CKD) for an average of 7.5 y28. The main composite renal outcome included end-stage renal disease (renal transplantation or dialysis), a 50% decline in eGFR from baseline to ≤5 mL/min/1.73 m2, or doubling of urine protein:creatinine ratio to ≥0.22 g/g creatinine. Subjects with prediabetes (based on ADA criteria for HbA1c or FPG) were not at greater risk of the composite renal outcome vs. NGT (adjusted HR 1.13 [95%CI, 0.96–1.32]), although diabetes increased the risk of this outcome significantly (adjusted HR 1.47 [95% CI, 1.27–1.70]). However, there was a 23% increase in the adjusted risk of progression of proteinuria (p = .002) associated with prediabetes vs. no prediabetes, vs. a risk increase of 50% for T2D (p < .001). Thus, the presence of prediabetes did not affect a broad renal composite outcome significantly, although there was a sign of early renal injury signified by exacerbation of proteinuria.
Pulmonary vascular diseases
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Jason Weatherald, Sanjay Mehta, Andrew M. Hirsch
Currently, patients with comorbidities such as mild chronic parenchymal lung disease and moderate-to-severe PH present a diagnostic dilemma and are usually classified and treated as group 1 PAH.9 However, 2 recent studies found that such patients are fundamentally different from “classic” idiopathic PAH patients without lung disease.10,11 In the ASPIRE registry, patients classified as idiopathic PAH and mild parenchymal lung disease, based on pulmonary function testing or chest imaging, tend to be older, more often male, had lower diffusion capacity for carbon monoxide and were more likely to have a significant smoking history.10 Patients with mild lung disease tended not see improvements in exercise capacity or quality of life with PAH therapies and had worse survival. Similarly, a cluster analysis from the COMPERA registry defined a similar group of idiopathic PAH patients who were predominantly older men with a smoking history, had a low diffusion capacity for carbon monoxide and worse survival.11 A Canadian study also found that chronic renal insufficiency at diagnosis and worsening renal function over 6 months, were poor prognostic factors in PAH.12 Together these studies highlight the importance and complexities of medical comorbidities on PAH diagnosis and treatment.