Prevalence Of Kidney Damage Research Articles

Kidney damage in HIV infection: pathogenetic aspects, clinical and morphological variants and the role of antiretroviral therapy

The review analyzes the prevalence and pathogenetic aspects of HIV infection. The main clinical and morphological variants of kidney damage in HIV infection are outlined. The prevalence of kidney damage in HIV infection is 20–30%, which are represented by such clinical and morphological variants as HIV-associated nephropathy (VAN), immunocomplex HIV-associated kidney disease, and thrombotic microangiopathy. In patients with HIV infection who are not treated with antiretroviral therapy (ART) the most common type of kidney disease is HIVAT. A decrease in the number of CD4+ cells, high viral load, advanced age, and the presence of kidney pathology in the next of kin are risk factors for the development of HIVAT. Specific risk factors for kidney damage in HIV infection are the use of antiretroviral drugs (tenofovir), the uncontrolled use of which is accompanied by tubular dysfunction. In HIV infection, the degree of immunodeficiency correlates with the severity of kidney damage. The most common histopathological manifestations of kidney damage in individuals with HIV infection are focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, immunoglobulin A nephropathy, and mesangioproliferative glomerulonephritis. Hypertension, nephrotic syndrome, and reduced CD4+ cells are predictive of renal failure in HIV infection. In patients with HIV infection who are treated with ART the appearance of hypokalemia, nocturia, polyuria, microhematuria, and/or subnephrotic proteinuria is indicative of tubulointerstitial disease. To assess the total filtration function of the kidneys in people with HIV infection, the most acceptable formula is CKD-EPI.

Prevalence of kidney damage in Chinese elderly: a large-scale population-based study

BackgroundIn China, both population aging and kidney damage has become emerging public health challenges. Despite the number of elders is huge, data on kidney damage in this population are scarce. The present study aimed to describe the prevalence of kidney damage among older adults in Wuhan, China.MethodsTo describe the prevalence of kidney damage among Chinese elderly, the health screening data of 350,881 adults older than 65 years in Wuhan, China were collected and analyzed. Kidney damage was defined as eGFR less than 60 mL/min per 1·73 m2 or the presence of proteinuria. Decreased renal function was defined as an eGFR < 60 mL/min/1.73 m2. Proteinuria was defined as urine protein ≥1+ and without urine WBC or nitrite positive. The associated risk factors of eGFR decline and kidney damage were analyzed by multivariate logistic regression.ResultsThe age-standardized prevalence of kidney damage, decreased renal function and proteinuria was 17.2, 13.5 and 5.3%. Among the patients, up to 74.4% was stage 3. The prevalence of kidney damage and eGFR decline were higher in suburbs than in urban (18.3% vs 16.0 and 14.6% vs 12.4%). Factors independently associated with kidney damage were age, female, BMI, abdominal circumference, hypertension, diabetes, stroke and coronary heart disease.ConclusionsKidney damage has become an important public health problem in Chinese elderly. More attention should be paid to elderly lived in suburbs or rural area in our further work.

Identification of high-risk population and prevalence of kidney damage among asymptomatic central government employees in Delhi, India.

Chronic kidney disease (CKD) has attained epidemic proportions in India due to increased incidence of diabetes and hypertension (HTN). It was surmised that identification of only high-risk groups (HRGs) through a questionnaire would be sufficient to identify cases of kidney damage (KD). The study attempted to device a questionnaire to classify the subjects in to HRG and low-risk group (LRG) and assess the extent of early KD. The central government employees were classified into HRG and LRG based on "SCreening for Occult REnal Disease (SCORED)" and "EXTENDED" questionnaire formulated after addition of 10 more parameters apart from diabetes and HTN. Urine examination by dipstick, quantitative microalbumin, serum creatinine, and estimated glomerular filtration rate were assessed to determine KD. The data were analyzed for risk-group classification. Sensitivity was calculated based on the number of KD cases in the HRG. Of the 1104 employees screened, 58% and 42% were classified in HRG and LRG, respectively. There were 306 KD cases of whom, 65% were in the HRG. The sensitivity of the EXTENDED questionnaire to detect CKD was much higher (60%) compared to the SCORED questionnaire (25%). The prevalence of KD according to stage was: stage-1, 13.4%; stage-2, 9.9%; and late stages (3, 4, and 5), 4.5%. Microalbuminuria and dipstick-positive proteinuria showed statistically higher proportion in the HRG (25% and 4.1%) than in the LRG (19% and 1%, respectively) (P <0.05). Although the EXTENDED questionnaire was more sensitive in detecting KD, only screening the high-risk population will leave behind 35% of KD cases. There is, therefore, a need for mass screening at regular intervals.

Prevalence of Chronic Kidney Disease (CKD) and Identification of Associated Risk Factors among Rural Population by Mass Screening

The prevalence of Chronic Kidney Disease (CKD) is rapidly increasing worldwide. Population-based studies on the prevalence of kidney damage are limited in developing countries. The present work relates to a population-based screening study in a rural population. Objectives: The study was performed to investigate the prevalence of chronic kidney disease (CKD) in rural residents and find out the association of the associated risk factors and variables. Methods: This is a descriptive cross sectional study. The demographic variables included were age, sex, marital status, religion, occupation, socioeconomic status, monthly income. The clinical variable was hypertension. The risk factors under the study were Body Mass Index (BMI), smoking habit, hypertension, and diabetes mellitus. Data pertaining to biochemical investigations were urine for albumin, serum creatinine and random serum glucose. CKD suspected patients were subjected to repeat serum creatinine and urinary albumin testing three months after the initial testing to confirm diagnosis of true CKD. Results: 1240 patients of which 650 were males and 590 females, aged between 18 and 65 years were entered into this study. The result evidenced over-all CKD prevalence 19 % determined by Cockcroft-Gault and 19.5 % MDRD equations. Stage 3 CKD was found to be predominant in both Cockcroft-Gault (12.8%) and MDRD equations (13.2%). The risk factors were thought to be associated with CKD which demonstrated association with hypertension (19.3%), diabetes (4.9%) and others (1.3%). A total of 206(88%) patients determined by Cockcroft-Gault and 210 (89.4%) by MDRD equations were diagnosed as having CKD in 2nd follow up visit (3 months after the 1st visit). Conclusion: It appears from this study that one out of three people in this population at risk remained undiag-nosed as CKD and with poorly controlled CKD risk factors. This is a growing problem and a challenge to this country. On priority basis CKD needs to be addressed through the development of multidisciplinary health teams and establishment of improved communication between traditional health care givers and nephrology services. DOI: http://dx.doi.org/10.3329/cbmj.v1i1.13825 Community Based Medical Journal Vol.1(1) 2012 20-26

Relationship between kidney damage and stroke types in Japanese patients

Kidney disease is a known risk factor for stroke. This study investigated the relationship between kidney damage and stroke types. A total of 525 incident stroke patients were registered and followed for 1 year. The prevalence of kidney damage [proteinuria and/or renal insufficiency (estimated glomerular filtration rate<60 ml/min/1.73 m(2))] in incident stroke and its effects on 1-year prognosis were examined. Among all stroke patients, kidney damage and its component (proteinuria and renal insufficiency) were commonly observed (48.2, 25.5, and 33.9%, respectively). The prevalence of ischemic stroke was significantly higher in patients with kidney damage (75.9%) than in those without (58.9%). The most frequent type of stroke among all patients with kidney damage and renal insufficiency only was cardioembolic infarction. In contrast, in patients with proteinuria only and patients without kidney damage, the most frequent type was subcortical and subarachnoid hemorrhage, respectively. Multiple logistic regression analysis showed that kidney damage or the combination of its components were independently associated with 1-year death [odds ratio (OR) 3.04, 95% confidence interval (CI) 1.40–6.59, P = 0.005 for kidney damage, OR 2.82, 95% CI 1.05–7.58, P = 0.040 for proteinuria only, and OR 5.77, 95% CI 2.23–15.0, P<0.001 for both proteinuria and renal insufficiency]. In addition, for 1-year outcomes, there were selective associations between ischemic stroke and proteinuria and between hemorrhagic stroke and renal insufficiency. This study shows that kidney damage is common in Japanese stroke patients, and proteinuria and renal insufficiency are differentially related to development and prognosis, depending stroke types.

Addressing the epidemic of chronic kidney disease in Australia

The Australia Diabetes, Obesity and Lifestyle Study (AUSDIAB) study provided, for the first time in Australia, a snapshot of the prevalence of kidney damage, reduced kidney function, hypertension and diabetes in the adult population. With this information, and the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) registry, that has recorded kidney failure statistics for many years, the extent of the chronic kidney disease burden in Australia is being better defined. This burden is even more pronounced in the Indigenous population where the incidence of kidney disease and kidney failure is increased several-fold. Diabetes is the second most common cause of kidney failure among Australians. The number of patients with diabetes accepted to dialysis has doubled in the last 7 years, the mean body weight of patients commencing dialysis has increased 7 kg in the past decade and the mean age at acceptance to dialysis is rising in a linear fashion (presently 60 years). These facts, together with a static transplant rate, all point to the prevalence of dialysis likely staying at or increasing beyond the present yearly growth rate of 6-7%. The evidence shows that a large proportion of chronic kidney disease patients are dying of cardiovascular risk factors before they reach dialysis or transplantation. There are many gaps in delivering appropriate preventative treatment to these patients. A relatively small reduction in the rise in dialysis numbers that might flow from an effective prevention of progression program, could make a significant impact on the spiralling numbers and associated cost of kidney failure treatment in Australia. We now need to develop and implement a national kidney disease strategy designed to address the whole continuum of chronic kidney disease from its earliest stage right through to dialysis and transplantation.