Effect Of Chronic Kidney Disease Research Articles

P0247PREGNANCY IN WOMEN WITH NEPHROTIC-RANGE PROTEINURIA

Abstract Background and Aims The adverse effects of chronic kidney disease on pregnancy and pregnancy on renal function have been described, but the effect of severe proteinuria in early pregnancy is not known. The aim of this study was to evaluate the obstetric and renal outcomes of pregnant women with severe proteinuria manifesting in early pregnancy. Method We retrospectively assessed the records of over 400 women with renal disease who were cared for during pregnancy in Queen Charlottes and Chelsea hospital and identified women with nephrotic range proteinuria in early pregnancy. Their records were reviewed and outcomes were compared to women with CKD and little or no proteinuria in early pregnancy. Results The study included 99 women with renal disease, of these 37 with severe proteinuria, and 62 patients who had mild or no proteinuria. The baseline GFR and blood pressure in the groups was similar. There were significantly more women with glomerular diseases in the group with proteinuria. The group with severe proteinuria had significantly higher rates of delivery by C-section, and prematurity including severe prematurity (<34 weeks). They had lower average birth weight and more babies born with very low birth weight. Their renal outcomes were poorer, with a lower eGFR at 3 years and a higher rate of advanced CKD and renal replacement therapy. In the women with proteinuria, the level of scarring on renal biopsy was found to be a significant predictor of several poor outcomes, including premature birth and developing advanced kidney disease. Conclusion Severe proteinuria early in pregnancy is associated with lower birth weight, greater prematurity and poorer renal function in the long term. Physicians treating these women must be aware that they are at a higher risk of complications than women with renal disease without severe proteinuria.

Urine headspace analysis with field asymmetric ion mobility spectrometry for detection of chronic kidney disease.

Electronic noses (eNoses) are an emerging class of experimental diagnostic tools. They are based on the detection of volatile organic compounds. Urine is used as sample medium in several publications but neither the effect of chronic kidney disease (CKD) on the analysis nor the potential to detect CKD has been explored. Materials & methods: We utilized an eNose based on field asymmetric ion mobility spectrometry (FAIMS) technology to classify urine samples from CKD patients and controls. Results: We were able to differentiate extremes of kidney function with an accuracy of 81.4%. Conclusion: In this preliminary study, applying eNose technology we were able to distinguish the patients with impaired kidney function from those with normal kidney function.

Misdosing of Non–Vitamin K Antagonist Oral Anticoagulants in Primary Care

PurposePrescription patterns of non–vitamin K antagonist oral anticoagulants (NOACs) are unknown among primary care physicians, where most patients with nonvalvular atrial fibrillation (NVAF) are diagnosed and followed up. The goal of this study was to evaluate overdosing and underdosing of NOACs in patients with NVAF followed up in primary care and determine their clinical predictors. MethodsThis multicenter cross-sectional study included all patients with NVAF followed up in 13 primary care units in the center region of Portugal. Patients receiving antithrombotic regimens other than NOACs and patients with missing data were excluded. FindingsThe study included 858 patients with NVAF on an NOAC regimen. Overall, 30.3% were prescribed an off-label dosage (25.4% with infratherapeutic dosing [ITD] and 4.9% with supratherapeutic dosing). Chronic kidney disease (odds ratio, 14.0; 95% CI, 5.4–36.5; P < 0.001) and female sex (odds ratio, 2.6; 95% CI, 1.2–5.7; P < 0.001) were independent predictors of supratherapeutic dosing. We also found a significant effect of chronic kidney disease on ITD (odds ratio, 0.22; 95% CI, 0.258–0.678; P < 0.001). ImplicationsIn primary care, NOACs are frequently prescribed with unadjusted dosages, generally infratherapeutic. Attention should be paid to women and patients with chronic kidney disease.

Impact of renal function on the immediate and long-term outcomes of percutaneous recanalization of coronary chronic total occlusions: A systematic review and meta-analysis

BackgroundRenal impairment is associated with worse in-hospital and long-term outcomes after coronary artery revascularization, yet limited evidence is available on its impact on short- and long-term outcomes after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). MethodsWe conducted a systematic review of the literature and subsequent random-effect meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement to evaluate the effect of chronic kidney disease (CKD), defined as estimated glomerular filtration rate < 60 ml/min/1.73 m2, on CTO PCI. The outcomes of this study were in-hospital death, procedural failure, contrast-induced acute kidney injury and all-cause death at follow-up. ResultsEight studies, with a total of 8439 patients (of whom 2256 had CKD) were included in the analysis. CKD was associated with higher technical (relative risk [RR] = 1.44, 95% confidence interval [CI] 1.14–1.82, p = .002) and procedural (risk ratio-RR = 1.40, 95% CI 1.00–1.96, p = .05) failure, higher in-hospital mortality (RR = 4.96, 95% CI 2.49–9.87 p < .001), bleeding complications (RR = 3.43, 95% CI 1.80–6.52, p < .001) and contrast-induced acute kidney injury (RR = 2.75, 95% CI 1.16–6.51, p = .001). CKD was also associated with higher all-cause mortality during long-term follow-up (RR = 3.56, 95% CI 1.08–5.99, p < .001). ConclusionCompared with patients with normal renal function, CKD is associated with lower success and higher risk of acute and long-term complications after CTO PCI. Kidney function should be considered during decision-making on CTO recanalization.

Urinary proteome and metabolome in dogs (Canis lupus familiaris): The effect of chronic kidney disease

Chronic kidney disease (CKD) is a progressive and irreversible disease. Although urine is an ideal biological sample for proteomics and metabolomics studies, sensitive and specific biomarkers are currently lacking in dogs. This study characterised dog urine proteome and metabolome aiming to identify and possibly quantify putative biomarkers of CKD in dogs. Twenty-two healthy dogs and 28 dogs with spontaneous CKD were selected and urine samples were collected. Urinary proteome was separated by SDS-PAGE and analysed by mass spectrometry, while urinary metabolome was analysed in protein-depleted samples by 1D 1H NMR spectra. The most abundant proteins in urine samples from healthy dogs were uromodulin, albumin and, in entire male dogs, arginine esterase. In urine samples from CKD dogs, the concentrations of uromodulin and albumin were significantly lower and higher, respectively, than in healthy dogs. In addition, these samples were characterised by a more complex protein pattern indicating mixed glomerular (protein bands ≥65 kDa) and tubular (protein bands <65 kDa) proteinuria. Urine spectra acquired by NMR allowed the identification of 86 metabolites in healthy dogs, belonging to 49 different pathways mainly involved in amino acid metabolism, purine and aminoacyl-tRNA biosynthesis or tricarboxylic acid cycle. Seventeen metabolites showed significantly different concentrations when comparing healthy and CKD dogs. In particular, carnosine, trigonelline, and cis-aconitate, might be suggested as putative biomarkers of CKD in dogs. SignificanceUrine is an ideal biological sample, however few proteomics and metabolomics studies investigated this fluid in dogs and in the context of CKD (chronic kidney disease). In this research, applying a multi-omics approach, new insights were gained regarding the molecular changes triggered by this disease in canine urinary proteome and metabolome. In particular, the involvement of the tubular component was highlighted, suggesting uromodulin, trigonelline and carnosine as possible biomarkers of CKD in dogs.

Study The Effects Of Chronic Kidney Disease On The Level Of Thyroid Hormones In Iraqi Patients

Chronic kidney disease is consider to be a major health issue which affecting high percent of population worldwide. This study attempted to determine the effects of chronic kidney disease on the function of thyroid gland by measuring its hormones levels . There were 70 subjects included in this study their age between 20 to 70 years divided into two groups, patients and control groups each one contain 35 persons. Blood was obtained from the all subjects for measuring the levels of thyroid hormones . There was increasing in the incidence of chronic kidney disease in the fifties of age as the results of this study revealed. The levels of thyroid hormones recorded significantly P≤0.05 decreasing in patients with chronic kidney disease when compared with healthy persons. For conclude, chronic kidney disease leads to significant changes in the levels of thyroid hormones that need to be carefully interpreted in these patients.

OUTCOMES OF CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

The effect of chronic kidney disease (CKD) on in-hospital outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has not been well defined. This retrospective observational study, conducted at 5 tertiary hospitals in New York, compared CTO PCI patients with and

Effect of chronic kidney disease on outcomes of total joint arthroplasty: a meta-analysis

BackgroundThis meta-analysis was conducted to evaluate the differences in preoperative comorbidities, postoperative mortality, the rate of periprosthetic joint infection (PJI), and revision rate after total joint arthroplasty (TJA) between patients with chronic kidney disease (CKD)(CKD group) and patients with normal kidney function (non-CKD group).MethodsWe searched MEDLINE, EMBASE, and the Cochrane Library for studies assessing the effect of CKD on TJA outcome. This meta-analysis included studies that (1) compared the outcomes of TJA between the CKD and non-CKD groups; (2) compared the outcomes of TJA based on CKD stage; and (3) evaluated the risk factors for morbidity or mortality after TJA. We compared the mortality, PJI, and revision rate between CKD and non-CKD groups, and between dialysis-dependent patients (dialysis group) and non-dialysis-dependent patients (non-dialysis group).ResultsEighteen studies were included in this meta-analysis. In most studies that assessed preoperative comorbidities, the number and severity of preoperative comorbidities were reported to be higher in the CKD group than in the non-CKD group. The risk of mortality was found to be higher in the CKD and dialysis groups compared with the respective control groups. In the studies based on administrative data, the unadjusted odds ratio (OR) of PJI was significantly higher in the CKD group than in the non-CKD group; however, no significant difference between the groups was noted in the adjusted OR. After total hip arthroplasty (THA), the risk of PJI was higher in the dialysis group than in the non-dialysis group. No significant difference was noted between the groups in the rate of PJI following total knee arthroplasty. The revision rate did not significantly differ between the CKD and non-CKD groups in the studies that were based on administrative data. However, the unadjusted OR was significantly higher in the dialysis group than in the non-dialysis group.ConclusionsPreoperative comorbidities and mortality risk were higher in the CKD and dialysis groups than in their respective control groups. The risk of revision was greater in the dialysis group than in the non-dialysis group, and the risk of PJI in the dialysis group became even greater after THA. Surgeons should perform careful preoperative risk stratification and optimization for patients with CKD scheduled to undergo TJA.

CRT-100.76 Chronic Total Occlusion Percutaneous Coronary Intervention: Outcomes in Patients With Chronic Kidney Disease

The effect of chronic kidney disease (CKD) on in-hospital outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has not been well defined. This retrospective observational study, conducted at 5 tertiary hospitals in New York, compared CTO PCI patients with and

Effect of chronic kidney disease on clinical findings in osteoporosis patients

Effect of chronic kidney disease on clinical findings in osteoporosis patients

Calcification of the cavernosal bodies may be responsible for development of erectile dysfunction in uremic apolipoprotein E deficient (apoE−/−) mice

Introduction and objectiveErectile dysfunction's physiopathology in uremia is complex and multifactorial, involving a combination of classical risk factors and specific uremia-related risk factors such as increased oxidative stress, endothelial dysfunction and inflammation. The aim of the study is to investigate the effect of chronic kidney disease (CKD) on vascular calcification and endothelial function of cavernosal bodies in apolipoprotein E deficient (apoE−/−) mice, a well known model of erectile dysfunction. Materials and methodsEight-week-old male apoE−/− mice were randomly assigned to the following 3 groups: (i) subtotally nephrectomised (SNX apoE−/−, 12 mice), (ii) uninephrectomised (UNX apoE−/−, 11 mice) or (iii) sham operated (sham-op apoE−/−, 15 mice). At 16 weeks after surgery, aortas and penile erectile tissues were harvested for histological studies to assess atherosclerosis, vascular calcification, nitrotyrosine staining, total collagen content and macrophage staining. ResultsAt sacrifice, SNX and UNX mice had significantly higher serum urea, total cholesterol, and triglyceride concentrations than sham-op controls. Atherosclerotic lesions in thoracic aorta were significantly larger in uremic apoE−/− mice than in controls. There were no atheromatous lesions in cavernosal bodies or penile artery observed in any group. However, SNX and UNX animals showed a significant increase in calcification score, collagen content and nitrotyrosine staining in cavernosal bodies when compared with controls. The degree of macrophage infiltration was comparable between the 3 groups. ConclusionIn conclusion, even mild renal dysfunction, i.e., after uninephrectomy increases calcification score and aggravates endothelial function of cavernosal bodies in apoE−/− mice and this effect might be linked to increased oxidative stress in penile endothelium.

Retracted: Chronic Kidney Disease—Effect of Oxidative Stress

Retracted: Chronic Kidney Disease—Effect of Oxidative Stress

P66 Mathematical Model of the Renal Microcirculation and Effects of Chronic Kidney Disease

BackgroundDiabetes is one of the leading causes of chronic kidney disease (CKD) worldwide. CKD is directly linked to increased morbidity and mortality. The role of vascular changes in diabetes and underlying mechanism of kidney disease is not well understood.MethodsWe present a mathematical model of the small arteries in the kidney incorporating anatomical and dynamic features. It consists of a symmetrical bifurcating treeself-similar in length, cross-sectional area and wave speed. Each generation is related to the previous one by the scaling factors e.g. ln + 1 = λln, this gives properties (e.g. surface area, resistance) for each generation by a priori knowledge of the renal artery. We assume the flow is one-dimensional and laminar. Vessel walls are treated as porousmedia to find the glomerulus transmural flux. Effects of compliance are introduced by a pressure-area relationship based on circumferential stress in thin vessel walls. The set of ordinary differential equations is solved numerically.ResultsThe results are in accordance with physiological measurements and indicate that pressure in the vasculature is highly sensitive to changes in vessel geometry, which also affects the transmural flux in the glomerulus. Changes in the structure of the arterial wall (e.g. Young’s modulus) alter the dynamics of the flow with an increased effect in the micro-circulation.ConclusionThis is a functional model describing the behaviour of the small vasculature in the kidney. The model is computationally inexpensive, can be used for analysis and tested with in vivo data in pathological conditions.

THE IMPACT OF ANTIHYPERTENSIVE DRUG THERAPY IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

Objective: Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) in CKD, choosing antihypertensive strategies with the highest nephro-protective effect is crucial for preventing or reversing end-stage renal disease (ESRD) progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact of clinical use of antihypertensive drug therapy in patients with CKD and ESRD.&#x0D; Methods: It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-dialysis dependent (NDD) and dialysis-dependent (DD) CKD. This study was conducted for six months in the Nephrology department, Osmania General Hospital, Hyderabad, India. The data collected and entered into Microsoft Excel (2007) and mean, SD and range were calculated using SPSS version 25.&#x0D; Results: Antihypertensive drugs were prescribed alone or in combination based on the co-morbidities associated with CKD and HTN. Loop diuretics (Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66%+DD = 27.45%) of which calcium channel blockers+loop diuretic+sympatholytic accounts for 19.16% (NDD = 5.88%+DD = 13.73%). &#x0D; Conclusion: The practice of prescribing antihypertensive drugs for the management of HTN and to achieve BP targets in CKD and ESRD remains uncertain. The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better delivery of evidence-based treatment.

Hearing and Kidney: Effects of Chronic Kidney Disease on Various Auditory Parameters – Results from a Tertiary Care Hospital in India

Background: An association between chronic kidney disease (CKD) and hearing loss was first described in patients with Alport syndrome. Patients with CKD develop sensorineural hearing loss with the progression of the disease. Studies using BAER as an index of auditory function among patients with CKD showed evidence of various degrees of auditory dysfunction.&#x0D; Materials and methods: 100 adult CKD patients (stage 3 – 5 and 5D) and 50 controls were included in the study. Clinical and biochemical parameters were assessed and all the patients and controls underwent Pure Tone Audiometry (PTA) and Brainstem Auditory Evoked Response (BAER) evaluation.&#x0D; Results: When hearing thresholds were compared between the patients and controls PTA showed an increase in hearing threshold in all patient groups. This increase was more noticeable at higher frequencies (4 and 8 kHz). Compared with healthy controls, a highly significant delay was observed in CKD patients in both absolute and interpeak latencies in BAER in the present study.&#x0D; Conclusion: The present study provides a concrete evidence to the otherwise disputed relation of auditory function in CKD proving that hearing is permanently affected by ESRD at all levels of the auditory neural pathway.&#x0D; J MEDICINE JAN 2020; 21 (1) : 31-35

Effect Ultrafiltration Rate On Blood Pressure Chronic Kidney Disease Patient During Hemodyalisis: A Literature Review

Introduction: Data from the Kidney Foundation Diatrans Indonesia stated that the number of patients with renal failure in Indonesia is estimated to increase 4,400 patients each year. One of the adverse effects of chronic kidney disease is the disorder of blood filtration. Interventions applicable to patients with impaired filtration include hemodialysis therapy. Complications that often occur in patients undergoing hemodialysis are hemodynamic disorders, especially blood pressure to drop or intradialytic hypotension. Objective: This study aims to review some literature on the effect of ultrafiltration rate on blood pressure of patients with chronic kidney disease who undergo hemodialysis. Method: Journal article search is done electronically using multiple databases: PubMed database, Google Scholar, Science Direct and Mendeley from January 2007 to November 2017. Keywords used were "Ultrafiltration / Ultrafiltration rate", "Blood Pressure", "intradialytic intradialytic / intradialytic hypertension", "Hemodialysis", "Chronic Kidney Disease / CKD" to obtain three articles for review. Result: Ultrafiltration rate can be expressed as having an effect on blood pressure in a hemodialysis patient. Discussion: When hemodialysis, ultrafiltration is done to attract excess fluid in the blood. The amount of fluid secreted during hemodialysis can affect the drop in blood pressure due to a decrease in the volume of blood being pumped. This is related to the reduced volume of strokes produced by the heart. Conclusions: Ultrafiltration rate affects the blood pressure of patients undergoing hemodialysis.

Effects of Chronic Kidney Disease on Hemiarthroplasty Outcomes for Fragility Hip Fracture in Diabetic Patients: A Nationwide Population-Based Observational Study

BackgroundThe aim of this study is to compare perioperative outcomes, readmission, and mortality after hemiarthroplasty for hip fractures in diabetic patients with different renal function statuses. MethodsIn this retrospective population-based cohort study, diabetic patients who received primary hemiarthroplasty for hip fracture between January 1997 and December 2013 were identified from the Taiwan National Health Insurance Research Database. Primary outcomes were perioperative outcomes including infection and revision. Secondary outcomes were all-cause readmission and mortality. ResultsA total of 29,535 diabetic patients were included: 8270 patients had chronic kidney disease (CKD group), 1311 patients underwent permanent dialysis (dialysis group), and 19,954 patients did not have CKD (non-CKD group). During a mean follow-up of 4.5 years, these 3 groups had comparable risks of any infection, including superficial and deep infection. Dialysis patients had a significantly higher risk of revision than did CKD and non-CKD patients (subdistribution hazard ratio 1.65, 95% confidence interval 1.16-2.36; subdistribution hazard ratio 1.57, 95% confidence interval 1.10-2.24, respectively). Compared with the non-CKD group, the dialysis group had significantly higher risks of readmission and mortality at all time points, namely 3 months after surgery, 1 year after surgery, and the final follow-up. The CKD group also had higher risks of readmission and mortality than did the non-CKD group at all time points. ConclusionCKD is associated with poor outcomes following hemiarthroplasty for fragility hip fracture. CKD patients may have higher risks of surgical complications including revision than non-CKD patients, and they have significantly elevated risks of readmission and mortality.

Effect of Chronic Kidney Disease on Mortality Outcomes of Heart Failure with Stable Mid-Range Ejection Fraction

Background Heart failure with mid-range ejection fraction (HFmrEF) of 40-49% is an under-recognized class of CHF. In patients with HFmrEF and stable ejection fraction (EF) of 1 year, the effect of CKD on mortality outcomes is unclear. Objectives We sought to determine if the presence of CKD can result in a higher mortality rate in patients with HFmrEF and stable EF of 1 year. Methods At our academic center, we evaluated 2593 baseline echo studies and their subsequent echo studies to identify HFmrEF patients with stable EF of 1 year. Student's T-test and chi-square test were used to assess baseline differences between CKD and non-chronic kidney disease (NCKD) patients. Kaplan Meier survival analysis was conducted and Log-rank p values were calculated to assess the association of the different groups with all-cause mortality, cardiac mortality, and non-cardiac mortality. Multivariate Cox regression was adjusted for age, gender, race, HTN, DM, CAD, NYHA class, OSA, and Malignancy. Results A total of 132 patients were included in our study. Thirty-three patients (25%) had CKD. The race was the only significantly different characteristic between the two groups, p-value of 0.003. Follow up period was 58.7 ± 29.1 months. CKD patients had higher all-cause and non-cardiac mortality rates (figures 1 and 2) than NCKD patients, p-value of 0.012 and 0.007 respectively. In adjusted model, all-cause and non-cardiac mortality rates remained higher in CKD patients (HR = 2.020, 95% CI = 1.06-3.83, p-value = 0.031) and (HR = 4.461, 95% CI = 1.51-13.11, p-value = 0.007) respectively. Cardiac mortality rate difference was not significant with p-value 0.084. Conclusion We found that patients with CKD and stable mid-range EF of 1 year had significantly higher all-cause mortality and non-cardiac mortality compared to patients with NCKD. Further studies are needed to validate our results.

The Effects of Chronic Kidney Disease on Liver Function Tests: The Laboratory Interpretation Perspective

The aim of the study was to determine the levels of routinely measured liver function tests such as liver enzymes (AST, ALT, ALP, GGT & LDH), serum proteins (albumin and total) and serum bilirubins in patients with Chronic Kidney Disease (CKD). Clinical management of CKD involves frequent laboratory monitoring of liver function tests. It is therefore important to understand the levels of these biochemistry parameters in both healthy individuals and those with CKD for easier and accurate interpretation. A cross-sectional study of two groups of study subjects including patients with CKD and control group was used. A total of 180 subjects with CKD were recruited for the study plus another 200 healthy subjects who served as the control group and were recruited from among blood donors. About 2.0 mL of venous blood specimen was removed from each patient and from control subjects. Levels of the enzymes Aspartate Transaminase (AST), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT), Gamma Glutamyl Transferase (γ-GT) and Lactate Dehydrogenase (LDH) were measured. Levels of serum protein and bilirubin were also determined in the two groups of study subjects. The Kolmogrov-Smirnov test was used to test the data for normality. The data obtained was parametric in nature and was tabulated as a mean and standard deviation. Parametric method of data analysis was used. Descriptive statistics used included parameters of location and parameters of dispersion. Means differences between investigated groups (control and chronic kidney disease patients) were assessed by ANOVA and post Anova statistical analysis. There were statistically significant differences (p<0.05) in the levels of serum protein and liver enzymes between patients with CKD and control group but no significant differences in the levels of serum bilirubin (p>0.05). The results suggest that those patients with CKD exhibited low levels of AST and ALT while the levels of ALP, GGT, and LDH were relatively higher. The levels of serum proteins were relatively lower in patients with CKD as compared to the control group. There is, therefore, the need for a keen interpretation of liver function tests in patients suffering from CKD.

The effect of chronic kidney disease on CYP2B expression and activity in male Wistar rats.

Chronic kidney disease (CKD) is characterized by progressive reduction in kidney function over time. CKD affects greater than 10% of the population and its incidence is on the rise due to the growing prevalence of its risk factors. Previous studies demonstrated CKD alters nonrenal clearance of drugs in addition to reducing renal clearance. We assessed the function and expression of hepatic CYP2B enzymes using a rat model of CKD. CKD was induced in Wistar rats by supplementing their chow with adenine and confirmed through the detection of elevated uremic toxins in plasma. Liver enzymes AST and ALT were unchanged by the adenine diet. Bupropion was used as a probe substrate for hepatic CYP2B function using rat liver microsomes. The resulting metabolite, hydroxy‐bupropion, and bupropion were quantified by ultra‐performance liquid chromatography coupled to time‐of‐flight mass spectrometry. Level of mRNA and protein were determined by RT‐PCR and Western blot, respectively. The results of our study demonstrate that CYP2B1 is downregulated in a rat model of CKD. CYP2B1 mRNA level was significantly decreased (88%, P < 0.001) in CKD relative to control. Similarly, maximal enzymatic velocity (V max) for CYP2B was decreased by 46% in CKD relative to control (P < 0.0001). Previous studies involving patients with CKD demonstrated altered bupropion pharmacokinetics compared to control. Hence, our results suggest that these alterations may be mediated by attenuated CYP2B hepatic metabolism. This finding may partially explain the alterations in pharmacokinetics and nonrenal drug clearance frequently observed in patients with CKD.