Association between incident depression and clinical outcomes in patients with chronic kidney disease

Clinical Kidney Journal, Journal Year: 2023, Volume and Issue: 16(11), P. 2243 - 2253

Published: May 26, 2023

Depression is highly prevalent and related to increased morbidity mortality in patients on dialysis, but less known among with earlier stages of CKD. This study investigated the associations between depression clinical outcomes CKD not receiving dialysis.We identified 157 398 adults 3-5 previously diagnosed from Stockholm CREAtinine Measurements (SCREAM) project. The primary included hospitalization, progression (>40% decline eGFR, initiation kidney replacement therapy, or death due CKD), major adverse cardiovascular events (MACE; myocardial infarction, stroke, death), all-cause mortality. Survival analyses were used estimate incident health outcomes, adjusting for socio-demographics, disease severity, healthcare utilization, comorbidities, concurrent use medications.During a median follow-up 5.1 (interquartile range: 2.3-8.5) years, 12 712 (8.1%) received an diagnosis depression. A total 634 471 hospitalizations (4 600 935 hospitalized days), 42 866 MACEs, 66 635 deaths recorded, 9795 individuals met criteria progression. In multivariable-adjusted analyses, was associated elevated rate days [rate ratio: 1.77, 95% confidence interval (CI): 1.71-1.83], as well [hazard ratio (HR): 1.38, CI: 1.28-1.48], MACE (HR: 1.22, 1.18-1.27), 1.41, 1.37-1.45). association more evident after one year 1.47, 1.36-1.59). Results robust across range sensitivity analyses.Among nondialysis-dependent 3-5, poor prognosis, including progression, MACE,

Language: Английский

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Prognostic Capability of Clinical SYNTAX Score in Patients with Complex Coronary Artery Disease and Chronic Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Reviews in Cardiovascular Medicine, Journal Year: 2024, Volume and Issue: 25(1), P. 18 - 18

Published: Jan. 10, 2024

Background: The SYNTAX score (SS) is useful for predicting clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). (CSS), developed by combining parameters with the SS, enhances risk model's ability to predict outcomes. However, prior research has not yet evaluated prognostic capacity of CSS complex artery disease (CAD) and chronic renal insufficiency (CRI) who are PCI. We aimed demonstrate potential assessing long-term adverse events this high-risk patient cohort. Methods: A total 962 left main and/or three-vessel CAD CRI were enrolled study spanning from January 2014 September 2017. was calculated multiplying SS modified age, creatinine, ventricular ejection fraction (ACEF) (age/ejection + 1 each 10 mL creatinine clearance <60 mL/min per 1.73 m2). categorized into three groups based on their values: low-CSS group (CSS <18.0, n = 321), mid-CSS (18.0 ≤ < 28.3, 317), high-CSS ≥28.3, 324) as tertiles CSS. primary endpoints all-cause mortality (ACM) cardiac (CM). secondary included myocardial infarction (MI), unplanned revascularization, stroke, major cerebrovascular (MACCE). Results: At median 3-year follow-up, exhibited higher rates ACM (19.4% vs. 6.6% 3.6%, p 0.001), CM (15.6% 5.1% 3.2%, 0.003), MACCE (33.8% 29.0% 20.0%, 0.005) comparison low groups. Multivariable Cox regression analysis revealed that an independent predictor all (p 0 .05). Moreover, C-statistics (0.666 0.597, 0.021) (0.668 0.592, 0.039) significantly than those SS. Conclusions: substantially enhanced prediction following

Language: Английский

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Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study

BMJ Open, Journal Year: 2022, Volume and Issue: 12(3), P. e057509 - e057509

Published: March 1, 2022

This study aimed to determine population-based prevalence of chronic kidney disease (CKD) and its associated factors in Nepal.The was a nationwide cross-sectional study.Cross-sectional survey conducted nationally representative sample 12 109 Nepalese adult from 2016 2018 on selected non-communicable diseases examined. Multistage cluster sampling with mix probability proportionate size systematic random used for the selection individuals aged 20 years above.Primary outcome this CKD Nepal. A participant considered have if urine albumin-to-creatinine ratio greater than or equal 30 mg/g and/or estimated glomerular filtration rate is less 60 mL/min/1.73 m2 at baseline follow-up using modification diet renal equations. The secondary measure covariate adjusted association risk calculated multivariable binary logistic regression.The overall Nepal 6.0% (95% CI 5.5 6.6). Factors independently included older age (adjusted OR (AOR) 2.6, 95% 1.9 3.6), Dalit caste (AOR 1.6, 1.1 2.3), hypertension 2.4, 2.0 3.0), diabetes mellitus 3.2, 2.5 4.1), raised total cholesterol 1.3, 1.0 1.6) increased waist-to-hip 1.2 2.3).This shows that population substantial, it several cardiometabolic traits. These findings warrant longitudinal studies identify causes effective strategies prevent it.

Language: Английский

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Acute Kidney Injury Associates with Long-Term Increases in Plasma TNFR1, TNFR2, and KIM-1: Findings from the CRIC Study

Journal of the American Society of Nephrology, Journal Year: 2022, Volume and Issue: 33(6), P. 1173 - 1181

Published: March 16, 2022

Some markers of inflammation-TNF receptors 1 and 2 (TNFR1 TNFR2)-are independently associated with progressive CKD, as is a marker proximal tubule injury, kidney injury molecule (KIM-1). However, whether an episode hospitalized AKI may cause long-term changes in these biomarkers unknown.

Language: Английский

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Interactive effects of intrinsic capacity and obesity on the KDIGO chronic kidney disease risk classification in older patients with type 2 diabetes mellitus

Diabetology & Metabolic Syndrome, Journal Year: 2023, Volume and Issue: 15(1)

Published: Jan. 2, 2023

Abstract Background Intrinsic capacity (IC) is a novel concept focusing on normal and healthy aging. The effect of IC the risk chronic kidney disease (CKD) according to KDIGO category in older type 2 diabetes mellitus (T2DM) patients has rarely been studied. We investigated whether decline associated with CKD 2012 categories. Methods This cross-sectional study. exposure variables (IC score body mass index) outcome variable (KDIGO categories CKD) were collected at same timepoint. A total 2482 subjects T2DM managed through care program enrolled. five domains IC, namely locomotion, cognition, vitality, sensory, psychological assessed. Based these domains, composite was calculated. classified definition. Univariate multivariate analyses used assess association between CKD. Results increased parallel (p for trend < 0.0001). In analysis, compared those an 0, odds ratio having moderately very high 1.76 (1.31–2.37) times higher 2–5. Furthermore, prevalence moderate severe obesity. Moreover, there synergistic interaction obesity (synergy index = 1.683; 95% CI 0.630–3.628), proportion caused by this 25.6% (attributable 0.256). Conclusions Our findings indicate that may be closely related addition, obesity, increase stage.

Language: Английский

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Demystifying the connection between periodontal disease and chronic kidney disease – An umbrella review

Journal of Periodontal Research, Journal Year: 2023, Volume and Issue: 58(5), P. 874 - 892

Published: July 21, 2023

Abstract Chronic kidney disease (CKD) and poor oral health are inter‐related their significant impact on each other is well established in the literature. Many systematic reviews meta‐analyses have demonstrated a strong relationship between CKD periodontitis, where periodontal treatment has shown potential improving outcomes. However, quality of studies heterogeneity results show variation. The aim this umbrella review was to current with an emphasis generate clinically relevant guidelines maintain patients CKD. This conducted reported alignment Joanna Briggs Institute PRISMA 2020 guidelines. protocol prior commencing registered JBI PROSPERO (CRD42022335209). Search strings were for PubMed, Embase, Web Science, Cochrane Database Systematic Reviews, Dentistry & Oral Science Source up April 2022. All that considered periodontitis or included. Of 371 identified through search, 18 met inclusion criteria. Ten assessed status focus CKD, five reviewed outcomes, two included both effectiveness one qualitatively health‐related life failure. Findings indicate there bidirectional disease. In view existing literature disease, specific recommendations management among proposed medical professionals, dental aged care workers based evidence collated review.

Language: Английский

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Increased risk of kidney failure in patients with genetic kidney disorders

Journal of Clinical Investigation, Journal Year: 2024, Volume and Issue: 134(17)

Published: Sept. 2, 2024

BACKGROUNDIt is unknown whether the risk of kidney disease progression and failure differs between patients with without genetic disorders.METHODSThree cohorts were evaluated: prospective Cure Glomerulonephropathy Network (CureGN) 2 retrospective from Columbia University, including 5,727 adults children any etiology who underwent whole-genome or exome sequencing. The effects monogenic disorders APOL1 kidney-risk genotypes on failure, estimated glomerular filtration rate (eGFR) decline, remission rates evaluated along diagnostic yields impact American College Medical Genetics secondary findings (ACMG SFs).RESULTSMonogenic identified in 371 (6.5%), high-risk 318 (5.5%), ACMG SFs 100 (5.2%). Family history was strongest predictor disorders. After adjustment for traditional factors, associated an increased (hazard ratio [HR] = 1.72), higher eGFR decline (-3.06 vs. 0.25 mL/min/1.73 m2/year), lower complete (odds ratioNot achieving CR 5.25). High-risk (HR 1.67) faster (-2.28 m2), replicating prior findings. not personal family diseases, but predicted to care 70% cases.CONCLUSIONSMonogenic remission, suggesting opportunities early identification intervention based molecular diagnosis.TRIAL REGISTRATIONNA.FUNDINGNational Institute Diabetes Digestive Kidney Diseases grants U24DK100845 (formerly UM1DK100845), U01DK100846 UM1DK100846), U01DK100876 UM1DK100876), U01DK100866 UM1DK100866), U01DK100867 UM1DK100867), U24DK100845, DK081943, RC2DK116690, 2U01DK100876, 1R01DK136765, 5R01DK082753, RC2-DK122397; NephCure International; Department Defense Research Awards PR201425, W81XWH-16-1-0451, W81XWH-22-1-0966; National Center Advancing Translational Sciences grant UL1TR001873; Library Medicine R01LM013061; Human Genome 2U01HG008680.

Language: Английский

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Renal Histologic Analysis Provides Complementary Information to Kidney Function Measurement for Patients with Early Diabetic or Hypertensive Disease

Journal of the American Society of Nephrology, Journal Year: 2021, Volume and Issue: 32(11), P. 2863 - 2876

Published: Aug. 4, 2021

Significance Statement CKD is defined by both functional changes (such as in eGFR and proteinuria) renal histologic alterations. Although kidney function acutely regulated, such interstitial fibrosis, tubular atrophy, glomerulosclerosis could represent chronic damage, thus might provide additional information about disease severity. In an analysis of 859 tissue samples, the authors found that relationship between not linear. At stages 3–5, correlates with fibrosis/tubular atrophy reasonably well, whereas at earlier stages, poorly estimates damage. Patients diabetes, hypertension, or Black race had more severe damage same eGFR. The inclusion significantly improved decline estimation. Background diabetic hypertensive rarely undergo biopsy because nephrologists commonly believe biopsy-related risk outweighs potential benefits obtaining to guide clinical decisions. may However, whether provides complementary clinically used measurements, proteinuria, unclear. Methods We performed a standardized semiquantitative nephrectomies obtained from individuals without diabetes mellitus hypertension varying degrees dysfunction. Changes glomeruli, tubules, interstitium, vasculature were scored using 17 descriptive parameters manner. multivariable linear logistic regression analyses unbiased, hierarchical clustering assess associations alterations variables. Results well degree fibrosis (IFTA). patients 1–2, was highly variable estimated Individuals mellitus, IFTA, level. Inclusion estimation, even early stages. Conclusions Histologic important method for evaluation, especially Some present relatively structural despite preserved

Language: Английский

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Association between estrogen and kidney function: population based evidence and mutual bidirectional Mendelian randomization study

Clinical and Experimental Nephrology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 18, 2025

Language: Английский

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Chronic kidney disease: causes, treatment, management, and future scope

Elsevier eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 99 - 111

Published: Jan. 1, 2025

Language: Английский

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