129,642 research outputs found

    Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

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    BACKGROUND: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. METHODS: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. FINDINGS: Globally, in 2017, 1路2 million (95% uncertainty interval [UI] 1路2 to 1路3) people died from CKD. The global all-age mortality rate from CKD increased 41路5% (95% UI 35路2 to 46路5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2路8%, -1路5 to 6路3). In 2017, 697路5 million (95% UI 649路2 to 752路0) cases of all-stage CKD were recorded, for a global prevalence of 9路1% (8路5 to 9路8). The global all-age prevalence of CKD increased 29路3% (95% UI 26路4 to 32路6) since 1990, whereas the age-standardised prevalence remained stable (1路2%, -1路1 to 3路5). CKD resulted in 35路8 million (95% UI 33路7 to 38路0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1路4 million (95% UI 1路2 to 1路6) cardiovascular disease-related deaths and 25路3 million (22路2 to 28路9) cardiovascular disease DALYs were attributable to impaired kidney function. INTERPRETATION: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. FUNDING: Bill & Melinda Gates Foundation

    Global, regional, and national burden of chronic kidney disease, 1990鈥2017: a systematic analysis for the Global Burden of Disease Study 2017

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    Background: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings: Globally, in 2017, 1路2 million (95% uncertainty interval [UI] 1路2 to 1路3) people died from CKD. The global all-age mortality rate from CKD increased 41路5% (95% UI 35路2 to 46路5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2路8%, 鈭1路5 to 6路3). In 2017, 697路5 million (95% UI 649路2 to 752路0) cases of all-stage CKD were recorded, for a global prevalence of 9路1% (8路5 to 9路8). The global all-age prevalence of CKD increased 29路3% (95% UI 26路4 to 32路6) since 1990, whereas the age-standardised prevalence remained stable (1路2%, 鈭1路1 to 3路5). CKD resulted in 35路8 million (95% UI 33路7 to 38路0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1路4 million (95% UI 1路2 to 1路6) cardiovascular disease-related deaths and 25路3 million (22路2 to 28路9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Funding: Bill & Melinda Gates Foundation.info:eu-repo/semantics/publishedVersio

    Gout and risk of chronic kidney disease and nephrolithiasis meta-analysis of observational studies

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    ntroduction To determine the prevalence of chronic kidney disease and nephrolithiasis in people with gout, and the association between gout and prevalent or incident chronic kidney disease and nephrolithiasis. Methods Systematic review and meta-analysis of epidemiological studies. Data sources; MEDLINE, EMBASE and CINAHL databases, hand-searched reference lists, citation history and contact with authors. Eligibility criteria: cohort, case鈥揷ontrol or cross-sectional studies which examined the occurrence of chronic kidney disease or nephrolithiasis amongst adults with gout (with or without a non-gout comparator group) in primary care or general population samples. Prevalence and risk estimate meta-analyses were performed using a random-effects model. Results Seventeen studies were included in the meta-analysis (chronic kidney disease n鈥=鈥7, nephrolithiasis n鈥=鈥8, both n鈥=鈥2). Pooled prevalence estimates of chronic kidney disease stage 鈮3 and self-reported lifetime nephrolithiasis in people with gout were 24% (95% confidence interval 19% to 28%) and 14% (95% CI 12% to 17%) respectively. Gout was associated with both chronic kidney disease (pooled adjusted odds ratio 2.41, 95% confidence interval 1.86 to 3.11) and self-reported lifetime nephrolithiasis (1.77, 1.43 to 2.19). Conclusions Chronic kidney disease and nephrolithiasis are commonly found amongst patients with gout. Gout is independently associated with both chronic kidney disease and nephrolithiasis. Patients with gout should be actively screened for chronic kidney disease and its consequences

    Intense relationship of blood pressure and stadium of chronic kidney disease at early diagnosis

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    Chronic kidney disease (CKD) is a pathological stage with multiple causes that is characterised by a very high level of urea in the body because the kidneys are unable to balance the metabolism of fluids and electrolytes. Previous research has demonstrated that high blood pressure is one of the causes of chronic kidney disease. This study was conducted to determine the relationship between blood pressure and the initial stage of chronic kidney disease. observational study of Ninety patients with chronic kidney disease (CKD) at the RSUD Dr. Soeroto, Ngawi participated in this cross-sectional. Subjects were required to have CKD stages I-IV, high blood pressure, to be hospitalised for the first time at RSUD dr Soeroto, Ngawi, and to have never been treated for hypertension. This study employed the Spearman rank test, which was analysed by SPSS (p<0.05). 64.5% of patients with chronic kidney disease have reached stage V. In contrast, 47.8% of patients with chronic kidney disease have stage 2 hypertension. The Spearman Rank test revealed a p-value of 0.000 (<0.05) between blood pressure and the stage of chronic kidney disease at the time of initial diagnosis in patients with chronic kidney disease. The correlation coefficient has a value of 0.638, making it a strong correlation. There is a strong correlation between blood pressure and the stage of chronic kidney disease at the initial diagnosis of chronic kidney disease patients at the RSUD Dr. Soeroto, Ngawi

    Hypertension Treatment for Patients with Advanced Chronic Kidney Disease

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    Chronic kidney disease is common and frequently complicated with hypertension. As a major modifiable risk factor for cardiovascular disease in this high risk population, treatment of hypertension in chronic kidney disease is of paramount importance. We review the epidemiology and pathogenesis of hypertension in chronic kidney disease and then update the latest study results for treatment including salt restriction, invasive endovascular procedures, and pharmacologic therapy. Recent trials draw into question the efficacy of renal artery stenting or renal denervation for hypertension in chronic kidney disease, as well as renin-angiotensin-aldosterone system blockade as first line therapy of hypertension in end stage renal disease. Positive trial results reemphasize salt restriction and challenge the prevailing prejudice against the use of thiazide-like diuretics in advanced chronic kidney disease. Lastly, clinical practice guidelines are trending away from recommending tight blood pressure control in chronic kidney disease

    Gambaran Kadar Kreatinin Serum Pada Pasien Penyakit Ginjal Kronik Stadium 5 Non Dialisis

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    : Chronic kidney disease is a pathophysiology process with various etiology, causing a progressive decline on kidney function, and in general ends with kidney failure (stage 5). For the last forty years, creatinine serum had been the most common and affordable detection serum to measure kidney performance. The amount of creatinine serum is increased on non-dialysis chronic kidney disease patients. Approximately, 57% of non-dialysis chronic kidney disease patients have 7-12 mg/dL creatinine level. Research objective: To understand the description of creatinine serum level on non-dialysis chronic kidney disease patients. Research method: Cross sectional descriptive, to obtain the data of creatinine serum on non-dialysis chronic kidney disease patients carried out on December 2015 鈥 January 2016 at two hospitals, which are RSUP. Prof. Dr. R. D. Kandou Manado and Rumah Sakit Advent Manado. The research sample were the blood sample from 35 people suffering a stage five non dialysis chronic kidney disease, which determined by consecutive sampling from non-probability sampling model. Result: Based on the laboratory result, the 35 patients diagnosed with a stage five non dialysis chronic kidney disease are undergoing an increase on creatinine serum (100%). Conclusion: Based on the research result, it can be concluded that the increase of creatinine level is occurred on stage five non dialysis chronic kidney disease patients

    Thiazides in advanced chronic kidney disease鈥攖ime for a randomized controlled trial?

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    Purpose of review: Chronic kidney disease is common, associated with increased cardiovascular risk, and frequently complicated by hypertension, requiring multiple agents for control. Thiazides are naturally attractive for use in this population; unfortunately, they are classically thought to be ineffective in advanced chronic kidney disease based on both theoretical considerations and the earliest studies of these agents. This report reviews the studies of thiazide use in chronic kidney disease since the 1970s, including five randomized controlled trials, all of which report at least some degree of efficacy. Recent findings: Two recent studies add further evidence for the utility and efficacy of thiazides in chronic kidney disease. Of these two, one used gold standard ambulatory blood pressure monitoring in patients with poorly controlled hypertension and advanced chronic kidney disease and found chlorthalidone reduces blood pressure. The second is the largest study to date of thiazides in chronic kidney disease; adding a fixed low-dose chlorthalidone as the first diuretic to the antihypertensive regimen improved blood pressure. Summary: These numerous small but positive studies reinforce the need for a randomized trial to demonstrate safety and efficacy of thiazides in advanced chronic kidney disease

    Pengaruh Penyakit Ginjal Kronik Terhadap Disfungsi Ereksi Pria

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    : Chronic kidney disease is decreased in kidney function that persistent and irreversible. Chronic kidney disease can lead to problems in the erectile function of men because of disorders on some factors, that are the endocrine system, the vascular system, psychological factor, and neurogenic disorder. WHO estimated that there will be an increasing number of patients with chronic kidney disease by 41.4% between the years 1995-2025 in Indonesia. Research on erectile dysfunction in patients with chronic kidney disease has not been done yet in Indonesia, especially in Manado. The Aim of this research is to know the effect of chronic kidney disease to erectile dysfunction of men. The research design for this study is observasional descriptive. The number of samples obtained as many as 34 samples of patients with stage 5 chronic kidney disease, be found 18 people (52.95%) suffering from mild erectile dysfunction, 12 people (35.29%) suffering from mild-moderate erectile dysfunction, a man (2.94%) suffering from moderate erectile dysfunction, 2 people (5.88%) suffering from severe erectile dysfunction, and a man (2.94%) with no erectile dysfunction. The conclusion is patients with chronic kidney disease can lead to problems in the erectile function, because of influence from the above factors. Suggestion on this research is necessary to check blood testosterone levels and find more samples
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