Displaying publications 1 - 20 of 91 in total

  1. Liyanage T, Ninomiya T, Perkovic V, Woodward M, Stirnadel-Farrant H, Matsushita K, et al.
    Nephrology (Carlton), 2017 Jun;22(6):456-462.
    PMID: 27187157 DOI: 10.1111/nep.12821
    AIM: The burden of chronic kidney disease (CKD) is growing rapidly around the world. However, there is limited information on the overall regional prevalence of CKD, as well as the prognostic implications and treatment patterns in Asian region. We have established the Asian Renal Collaboration (ARC) with the goal of consolidating region-wide data regarding CKD.

    METHODS: This collaborative project will synthesize data and perform meta-analyses of observational studies conducted in Asia. Studies will be identified through a systematic literature search including abstracts, proceedings of meetings, electronic databases such as MEDLINE and EMBASE. Personal enquiry among collaborators and experts in the region will identify additional studies, or other data sources such as registries. Both cross-sectional and longitudinal studies that describe the prevalence of CKD and its complications will be included, as will longitudinal studies that describe important clinical outcomes for people with CKD. Individual participant data will be sought, where possible, from each of the studies included in the collaboration for baseline parameters and subsequent outcomes, in order to maximize flexibility and consistency of data analyses.

    CONCLUSIONS: This study is an initiative offering a unique opportunity to obtain information about the prevalence and manifestations of CKD in Asia, as well as its risk factors. The ARC will also provide insights into important outcomes including progression of CKD, CKD complications, cardiovascular disease and death. These findings will improve our understanding of kidney disease in Asia, and thus help inform service provision, preventive care and further research across the region.

    Matched MeSH terms: Renal Insufficiency, Chronic/epidemiology*
  2. Khan YH, Mallhi TH, Sarriff A, Khan AH, Tanveer N
    J Coll Physicians Surg Pak, 2018 Dec;28(12):960-966.
    PMID: 30501836 DOI: 10.29271/jcpsp.2018.12.960
    Chronic kidney disease (CKD) is an asymptomatic disease associated with high morbidity and life-threatening complications that lead to decreased life expectancy. Worldwide prevalence of CKD is escalating at an alarming rate. Large population-based representative surveys have been reported in Western countries to estimate the prevalence of the disease. However, there is paucity of data as far as developing nations are concerned. Asia is the world's largest continent accommodating maximum number of under-developed and developing countries with an unclear picture of prevalence of CKD. Current review attempts to give an insight to the prevalence of CKD in this region by combining population-based surveys. This review will assist in estimating the burden of CKD in Asia, so that appropriate control measures could be designed.
    Matched MeSH terms: Renal Insufficiency, Chronic/epidemiology*
  3. Tallman DA, Sahathevan S, Karupaiah T, Khosla P
    Nutrients, 2018 Dec 07;10(12).
    PMID: 30544535 DOI: 10.3390/nu10121945
    Patients with chronic kidney disease (CKD) are often instructed to adhere to a renal-specific diet depending on the severity and stage of their kidney disease. The prescribed diet may limit certain nutrients, such as phosphorus and potassium, or encourage the consumption of others, such as high biological value (HBV) proteins. Eggs are an inexpensive, easily available and high-quality source of protein, as well as a rich source of leucine, an essential amino acid that plays a role in muscle protein synthesis. However, egg yolk is a concentrated source of both phosphorus and the trimethylamine N-oxide precursor, choline, both of which may have potentially harmful effects in CKD. The yolk is also an abundant source of cholesterol which has been extensively studied for its effects on lipoprotein cholesterol and the risk of cardiovascular disease. Efforts to reduce dietary cholesterol to manage dyslipidemia in dialysis patients (already following a renal diet) have not been shown to offer additional benefit. There is a paucity of data regarding the impact of egg consumption on lipid profiles of CKD patients. Additionally, egg consumption has not been associated with the risk of developing CKD based on epidemiological studies. The egg yolk also contains bioactive compounds, including lutein, zeaxanthin, and vitamin D, which may confer health benefits in CKD patients. Here we review research on egg intake and CKD, discuss both potential contraindications and favorable effects of egg consumption, and describe the need for further research examining egg intake and outcomes in the CKD and end-stage renal disease population.
    Matched MeSH terms: Renal Insufficiency, Chronic/diet therapy*; Renal Insufficiency, Chronic/epidemiology*
  4. Almualm Y, Zaman Huri H
    Glob J Health Sci, 2015;7(4):96-109.
    PMID: 25946939 DOI: 10.5539/gjhs.v7n4p96
    Chronic Kidney Disease has become a public health problem, imposing heath, social and human cost on societies worldwide. Chronic Kidney Disease remains asymptomatic till late stage when intervention cannot stop the progression of the disease. Therefore, there is an urgent need to detect the disease early. Despite the high prevalence of Chronic Kidney Disease in Malaysia, screening is still lacking behind. This review discusses the strengths and limitations of current screening methods for Chronic Kidney Disease from a Malaysian point of view. Diabetic Kidney Disease was chosen as focal point as Diabetes is the leading cause of Chronic Kidney Disease in Malaysia. Screening for Chronic Kidney Disease in Malaysia includes a urine test for albuminuria and a blood test for serum creatinine. Recent literature indicates that albuminuria is not always present in Diabetic Kidney Disease patients and serum creatinine is only raised after substantial kidney damage has occurred.  Recently, cystatin C was proposed as a potential marker for kidney disease but this has not been studied thoroughly in Malaysia.  Glomerular Filtration Rate is the best method for measuring kidney function and is widely estimated using the Modification of Diet for Renal Disease equation. Another equation, the Chronic Kidney Disease Epidemiology Collaboration Creatinine equation was introduced in 2009. The new equation retained the precision and accuracy of the Modification of Diet for Renal Disease equation at GFR < 60ml/min/1.73m2, showed less bias and improved precision at GFR>60ml/min/1.73m2. In Asian countries, adding an ethnic coefficient to the equation enhanced its performance. In Malaysia, a multi-ethnic Asian population, the Chronic Kidney Disease Epidemiology Collaboration equation should be validated and the Glomerular Filtration Rate should be reported whenever serum creatinine is ordered. Reporting estimated Glomerular Filtration Rate will help diagnose patients who would have been otherwise missed if only albuminuria and serum creatinine are measured.
    Matched MeSH terms: Renal Insufficiency, Chronic/blood; Renal Insufficiency, Chronic/diagnosis*; Renal Insufficiency, Chronic/urine
  5. Khor BH, Narayanan SS, Chinna K, Gafor AHA, Daud ZAM, Khosla P, et al.
    Nutrients, 2018 Sep 21;10(10).
    PMID: 30248953 DOI: 10.3390/nu10101353
    Blood fatty acids (FAs) are derived from endogenous and dietary routes. Metabolic abnormalities from kidney dysfunction, as well as cross-cultural dietary habits, may alter the FA profile of dialysis patients (DP), leading to detrimental clinical outcomes. Therefore, we aimed to (i) summarize FA status of DP from different countries, (ii) compare blood FA composition between healthy controls and DP, and (iii) evaluate FA profile and clinical endpoints in DP. Fifty-three articles from 1980 onwards, reporting FA profile in hemodialysis and peritoneal DP, were identified from PubMed, Embase, and the Cochrane library. Studies on pediatric, predialysis chronic kidney disease, acute kidney injury, and transplant patients were excluded. Moderate to high levels of n-3 polyunsaturated fatty acids (PUFA) were reported in Japan, Korea, Denmark, and Sweden. Compared to healthy adults, DP had lower proportions of n-3 and n-6 PUFA, but higher proportion of monounsaturated fatty acids. Two studies reported inverse associations between n-3 PUFAs and risks of sudden cardiac death, while one reported eicosapentaenoic acid + docosahexaenoic acid)/arachidonic acid ratio was inversely associated with cardiovascular events. The relationship between all-cause mortality and blood FA composition in DP remained inconclusive. The current evidence highlights a critical role for essential FA in nutritional management of DP.
    Matched MeSH terms: Renal Insufficiency, Chronic/blood*; Renal Insufficiency, Chronic/complications; Renal Insufficiency, Chronic/ethnology; Renal Insufficiency, Chronic/therapy
  6. Begum R, Khan TM, Ming LC
    J Epidemiol Glob Health, 2016 12;6(4):325-326.
    PMID: 27095074 DOI: 10.1016/j.jegh.2016.03.004
    Matched MeSH terms: Renal Insufficiency, Chronic/epidemiology*
  7. Chidambaram R
    J Coll Physicians Surg Pak, 2014 Dec;24(12):955.
    PMID: 25523738 DOI: 12.2014/JCPSP.955955
    Matched MeSH terms: Renal Insufficiency, Chronic/complications*
  8. Mun PS, Ting HN, Ong TA, Wong CM, Ng KH, Chong YB
    PLoS ONE, 2015;10(6):e0130011.
    PMID: 26066351 DOI: 10.1371/journal.pone.0130011
    This paper investigates the dielectric properties of urine in normal subjects and subjects with chronic kidney disease (CKD) at microwave frequency of between 0.2 GHz and 50 GHz. The measurements were conducted using an open-ended coaxial probe at room temperature (25°C), at 30°C and at human body temperature (37°C). There were statistically significant differences in the dielectric properties of the CKD subjects compared to those of the normal subjects. Statistically significant differences in dielectric properties were observed across the temperatures for normal subjects and CKD subjects. Pearson correlation test showed the significant correlation between proteinuria and dielectric properties. The experimental data closely matched the single-pole Debye model. The relaxation dispersion and relaxation time increased with the proteinuria level, while decreasing with the temperature. As for static conductivity, it increased with proteinuria level and temperature.
    Matched MeSH terms: Renal Insufficiency, Chronic/urine*
  9. Sabanayagam C, Teo BW, Tai ES, Jafar TH, Wong TY
    BMC Nephrol, 2013;14:86.
    PMID: 23590421 DOI: 10.1186/1471-2369-14-86
    Chronic kidney disease (CKD) is an emerging public health problem worldwide. Previous studies have shown an association between blood pressure (BP) and CKD. However, it is not clear if there are ethnic differences in this association. We examined the association between BP and CKD in a multi-ethnic Asian population in Singapore.
    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis*; Renal Insufficiency, Chronic/ethnology*; Renal Insufficiency, Chronic/physiopathology
  10. Ibrahim N, Teo SS, Che Din N, Abdul Gafor AH, Ismail R
    PLoS ONE, 2015;10(7):e0129015.
    PMID: 26131714 DOI: 10.1371/journal.pone.0129015
    Chronic kidney disease (CKD) is commonly associated with various negative health outcomes. The aim of this study was to examine the influence of personality and social support on health-related quality of life in patients with chronic kidney disease. Health-related quality of life (HRQoL) is the quality of life studied in relation to health, and it provides important information of patients' coping with their health issues.
    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis; Renal Insufficiency, Chronic/etiology; Renal Insufficiency, Chronic/epidemiology*
  11. Chai SC, Sulaiman WAW, Saad AZM, Rasool AH, Shokri AA
    Indian J Nephrol, 2019 1 17;28(6):421-426.
    PMID: 30647495 DOI: 10.4103/ijn.IJN_402_17
    Maturation of arteriovenous fistula (AVF) involves complex vascular remodeling. In this study, we evaluated the changes of skin microvascular perfusion over the extremity with AVF maturation using the laser Doppler fluximetry (LDF). A total of 45 patients with chronic kidney disease, Stages IV-V, were included; they had undergone AVF creation from July 2014 to June 2016 at our institute. The measurement of skin microvascular perfusion was accomplished proximal and distal to the fistula anastomosis site: pre- and post-operative day 1, week 2, week 6, and week 12. Thirty-two patients with mean age of 55.6 had achieved AVF maturation. There were 40.6% radial-based and 59.4% brachial-based AVF. There was a 32.8% reduction of mean skin perfusion distal to the fistula by day 1 compared to the baseline perfusion; however, perfusion increased 47% by week 2 compared to day 1 and no dramatic change was subsequently noted. There was an increase of mean skin perfusion, proximal to fistula anastomosis, over 12 weeks with 35.8% at day 1 from the baseline. However, the changes of the mean skin perfusion were not statistically significant. There was no significant relation of skin perfusion changes with the type of fistula, diabetes mellitus, hypertension, and hyperlipidemia. LDF successfully detected the subclinical change of skin microvascular perfusion in relation to AVF creation. Reduction of skin perfusion distal to the fistula suggests that in patients with existing perfusion inadequacy of extremities, they may experience ischemic symptoms as early as day 1 postoperation, and require close monitoring for distal limb ischemic-related complications.
    Matched MeSH terms: Renal Insufficiency, Chronic
  12. Ganesan I, Rajah S
    Pediatr. Nephrol., 2012 Jul;27(7):1125-30.
    PMID: 22382467 DOI: 10.1007/s00467-012-2128-6
    BACKGROUND: This study aims to predict risk factors for urological anomalies in children with anorectal malformations (ARM) and describes the clinical features of patients who have developed chronic kidney disease.

    METHODS: We retrospectively reviewed infants with ARM who received surgery and were followed at the Sabah Women and Children's Hospital, Malaysia, from 1986 to 2010.

    RESULTS: One hundred and twenty-two children with anorectal malformations were studied, after excluding 24 children with incomplete data. Three factors were significant as predictors of the presence of a urological anomaly: high ARM lesion (OR 3.12, 95%CI 1.1-8.9), the presence of genital abnormality (OR 2.95, 95%CI 1.10-7.91) and cloacal anomaly in girls (OR 8.27, 95% CI 1.91-35.6). The most common anomalies were vesicoureteric reflux, single kidney and neurogenic bladder. Chronic kidney disease (CKD) was noted in 5.7%, in children who had recurrent urinary tract infections, neurogenic bladder or complex renal tract pathology; end-stage renal failure was seen in only 0.8% of children with ARM.

    CONCLUSION: Urological anomalies were seen in 23% of patients, but the overall incidence of CKD and end-stage renal disease is low. Early identification of infants with ARM at risk of renal failure may be important for renal survival.

    Matched MeSH terms: Renal Insufficiency, Chronic/complications*; Renal Insufficiency, Chronic/epidemiology
  13. Chidambaram R
    J Coll Physicians Surg Pak, 2017 Jan;27(1):44-46.
    PMID: 28292368 DOI: 2520
    Oral rehabilitation in medically compromised patients like chronic kidney disease (CKD) needs special dental care. Many papers have been published on dental considerations for such individuals. However, literature citing oral care for patients with risk factors of CKD are scarce. Resistant hypertension, one such risk factor, is closely related to CKD. Furthermore, the associated increased prevalence and adverse renal/cardiac outcomes motivated the author to report its unexplored association/impact during dental care. The importance of assessing glomerular filtration rate is highlighted to better understand patients' medical conditions.
    Matched MeSH terms: Renal Insufficiency, Chronic/epidemiology*; Renal Insufficiency, Chronic/physiopathology
  14. Lim TS, Shanmuganathan M, Wong I, Goh BL
    BMC Nephrol, 2017 Mar 29;18(1):108.
    PMID: 28356062 DOI: 10.1186/s12882-017-0540-7
    BACKGROUND: For peritoneal dialysis patients, the likelihood of conception is low and the probability of getting through the pregnancy successfully is even lower. Almost 60 years after the first reported case of a successful pregnancy in a dialysis patient, many issues concerning pregnancy in dialysis patients remain unresolved. Our patient's pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. We describe here the course of her uneventful pregnancy which we hope will contribute to the overall knowledge and management of pregnancy in elderly patients receiving peritoneal dialysis.

    CASE PRESENTATION: We report a successful elderly multigravid pregnancy, in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). Her pregnancy was detected early and she was closely managed by the nephrologist and obstetrician. She tolerated the same PD prescription throughout 36 weeks of pregnancy with daily ultrafiltration of 500-1500mls. Her blood pressure remained well controlled without the need of any antihypertensive medication. Her total Kt/V ranged from 1.93 to 2.73. Her blood parameters remained stable and she was electively admitted at 36 weeks for a trans-peritoneal lower segment caesarian section and bilateral tubal ligation.

    CONCLUSIONS: At the age of 42, our case is the oldest reported successful pregnancy in a patient on peritoneal dialysis. With careful counselling and meticulous follow up, we have shown that woman in the early stage of end stage renal failure can successfully deliver a full term baby without any complications. Therefore, these women should not be discourage from conceiving even if they are in advanced maternal age for pregnancy.

    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis*; Renal Insufficiency, Chronic/therapy*
  15. Rehman IU, Khan TM
    BMC Nephrol, 2017 Oct 02;18(1):302.
    PMID: 28969584 DOI: 10.1186/s12882-017-0717-0
    BACKGROUND: Chronic kidney disease (CKD) has become a major public health issue worldwide in the past few years. Pruritus is a common, well-recognized complication often seen in patients with chronic renal failure. For assessment of pruritus, different tools are used but these tools are unable to identify the changes and variations in the severity of pruritus. The aim of our study was to validate the Urdu-version of the Urdu-version of the 5D itch scale among patients suffering from chronic kidney disease in Pakistan.

    METHOD: The 5D itch scale was translated from English into Urdu following translation guidelines for translation. Face and content validity was determined by a panel of experts and piloted. For retest, the Urdu version of the 5D itch scale was administered at baseline and two weeks.

    RESULTS: A total of 50 participants with end stage renal disease were recruited, and of these, 64% were males. Exploratory factor analysis revealed that the 5D-IS had 2-factor loadings: "Pattern and activity" and "Distribution" with Kaiser-Mayer-Olkin (KMO) = 0.802, Bartlett's test of sphericity was significant (df = 28, p chronic kidney disease in Pakistan.

    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis*; Renal Insufficiency, Chronic/epidemiology*
  16. Leong SS, Wong JHD, Md Shah MN, Vijayananthan A, Jalalonmuhali M, Ng KH
    Br J Radiol, 2018 Sep;91(1089):20180235.
    PMID: 29869920 DOI: 10.1259/bjr.20180235
    OBJECTIVE: To investigate the use of shear wave elastography (SWE)-derived estimates of Young's modulus (YM) as an indicator to detect abnormal renal tissue diagnosed by estimated glomerular filtration rate (eGFR).

    METHODS: The study comprised 106 chronic kidney disease (CKD) patients and 203 control subjects. Conventional ultrasound was performed to measure the kidney length and cortical thickness. SWE imaging was performed to measure renal parenchymal stiffness. Diagnostic performance of SWE and conventional ultrasound were correlated with serum creatinine, urea levels and eGFR.

    RESULTS: Pearson's correlation coefficient revealed a negative correlation between YM measurements and eGFR (r = -0.576, p < 0.0001). Positive correlations between YM measurements and age (r = 0.321, p < 0.05), serum creatinine (r = 0.375, p < 0.0001) and urea (r = 0.287, p < 0.0001) were also observed. The area under the receiver operating characteristic curve for SWE (0.87) was superior to conventional ultrasound alone (0.35-0.37). The cut-off value of less or equal to 4.31 kPa suggested a non-diseased kidney (80.3% sensitivity, 79.5% specificity).

    CONCLUSION: SWE was superior to renal length and cortical thickness in detecting CKD. A value of 4.31 kPa or less showed good accuracy in determining whether a kidney was diseased or not. Advances in knowledge: On SWE, CKD patients show greater renal parenchymal stiffness than non-CKD patients. Determining a cut-off value between normal and diseased renal parenchyma may help in early non-invasive detection and management of CKD.

    Matched MeSH terms: Renal Insufficiency, Chronic/classification; Renal Insufficiency, Chronic/pathology
  17. Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM, et al.
    Kidney Int., 2013 Nov;84(5):1034-40.
    PMID: 23760287 DOI: 10.1038/ki.2013.220
    In this population-based study, we determine the prevalence of chronic kidney disease in West Malaysia in order to have accurate information for health-care planning. A sample of 876 individuals, representative of 15,147 respondents from the National Health and Morbidity Survey 2011, of the noninstitutionalized adult population (over 18 years old) in West Malaysia was studied. We measured the estimated glomerular filtration rate (eGFR) (CKD-EPI equation); albuminuria and stages of chronic kidney disease were derived from calibrated serum creatinine, age, gender and early morning urine albumin creatinine ratio. The prevalence of chronic kidney disease in this group was 9.07%. An estimated 4.16% had stage 1 chronic kidney disease (eGFR >90 ml/min per 1.73 m(2) and persistent albuminuria), 2.05% had stage 2 (eGFR 60-89 ml/min per 1.73 m(2) and persistent albuminuria), 2.26% had stage 3 (eGFR 30-59 ml/min per 1.73 m(2)), 0.24% had stage 4 (eGFR 15-29 ml/min per 1.73 m(2)), and 0.36% had stage 5 chronic kidney disease (eGFR <15 ml/min per 1.73 m(2)). Only 4% of respondents with chronic kidney disease were aware of their diagnosis. Risk factors included increased age, diabetes, and hypertension. Thus, chronic kidney disease in West Malaysia is common and, therefore, warrants early detection and treatment in order to potentially improve outcome.
    Study name: National Health and Morbidity Survey (NHMS-2011)
    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis; Renal Insufficiency, Chronic/epidemiology*; Renal Insufficiency, Chronic/physiopathology; Renal Insufficiency, Chronic/urine
  18. Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH, Jummaat F
    Nephrology (Carlton), 2017 Jan;22(1):25-34.
    PMID: 26718476 DOI: 10.1111/nep.12713
    AIM: Despite increase global prevalence of End stage renal disease (ESRD) and subsequent need for renal replacement therapy (RRT), relatively little is known about disease progression and prognosis of earlier stages of CKD. Current study was conducted to examine rate of CKD progression, predictors of ESRD and death.

    METHODS: A total 621 patients with estimated glomerular filtration rate (eGFR) of 15-59ml/min/1.73m(2) (CKD stage 3 & 4) were selected and followed up for 10 years or until ESRD or death, whichever occurred first. Subjects who did not meet inclusion criteria were excluded (n=1474).

    RESULTS: Annual cumulative decline in eGFR was 3.01±0.40 ml/min/1.73m(2) . Overall disease progression was observed in 60% patients while 18% died. Among patients with CKD stage 3, 21% progressed to stage 4, 10% to stage 5ND (non-dialysis) and 31% to RRT while mortality was observed in 16% patients. On the other hand, 8% patients with CKD stage 4 progressed to stage 5ND, 31% to RRT and mortality was observed in 24% cases. Patients with CVD, higher systolic blood pressure, elevated phosphate levels, heavy proteinuria, microscopic hematuria and use of diuretics were more likely to develop ESRD. Advancing age, low eGFR, low systolic blood pressure, low hemoglobin and baseline diabetes were found to be significant predictors of mortality while being female reduced risk of mortality.

    CONCLUSION: Our data suggest that, in this CKD cohort, patients were more likely to develop ESRD than death. Prime importance should be given to mild forms of CKD to retard and even reverse CKD progression.

    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis; Renal Insufficiency, Chronic/mortality; Renal Insufficiency, Chronic/epidemiology*; Renal Insufficiency, Chronic/therapy
  19. Ismail MD, Jalalonmuhali M, Azhari Z, Mariapun J, Lee ZV, Zainal Abidin I, et al.
    BMC Cardiovasc Disord, 2018 09 24;18(1):184.
    PMID: 30249197 DOI: 10.1186/s12872-018-0919-9
    BACKGROUND: Patients with renal impairment often left out from most major clinical trials assessing the optimal treatment for ST-elevation myocardial infarction (STEMI). Large body of evidence from various cardiovascular registries reflecting more 'real-world' experience might contribute to the knowledge on how best to treat this special cohort. We aim to analyze the outcomes of Malaysian STEMI patients with renal impairment treated with coronary angioplasty.

    METHODS: Utilizing the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014, STEMI patients treated with percutaneous coronary intervention (PCI) were stratified into presence (GFR chronic kidney disease (CKD). Patient's demographics, extent of coronary artery disease, procedural data, discharge medications, short (in-hospital) and long (1 year) term outcomes were critically assessed.

    RESULTS: A total of 6563 patients were included in the final analysis. STEMI CKD cohort was predominantly male (80%) with mean age of 61.02 ± 9.95 years. They had higher cardiovascular risk factors namely diabetes mellitus (54.6%), hypertension (79.2%) and dyslipidemia (68.8%) in contrast to those without CKD. There were notably higher percentage of CKD patients presented with Killip class 3 and 4; 24.9 vs 8.7%. Thrombolytic therapy remained the most commonly instituted treatment regardless the status of kidney function. Furthermore, our STEMI CKD cohort also was more likely to receive less of evidence-based treatment upon discharge. In terms of outcomes, patients with CKD were more likely to develop in-hospital death (OR: 4.55, 95% CI 3.11-6.65), MACE (OR: 3.42, 95% CI 2.39-4.90) and vascular complications (OR: 1.88, 95% CI 0.95-3.7) compared to the non-CKD patients. The risk of death at 1-year post PCI in STEMI CKD patients was also reported to be high (HR: 3.79, 95% CI 2.84-5.07).

    CONCLUSION: STEMI and CKD is a deadly combination, proven in our cohort, adding on to the current evidence in the literature. We noted that our STEMI CKD patients tend to be younger than the Caucasian with extremely high prevalence of diabetes mellitus. The poor outcome mainly driven by immediate or short term adverse events peri-procedural, therefore suggesting that more efficient treatment in this special group is imperative.

    Matched MeSH terms: Renal Insufficiency, Chronic/diagnosis; Renal Insufficiency, Chronic/mortality; Renal Insufficiency, Chronic/epidemiology*; Renal Insufficiency, Chronic/physiopathology
  20. Al-Shdaifat EA, Manaf MR
    Indian J Med Sci, 2013 May-Jun;67(5-6):103-16.
    PMID: 24326762 DOI: 10.4103/0019-5359.122734
    Hemodialysis treatment is a costly procedure that requires specific resources. It has a considerable burden on patients, caregivers, and healthcare system. The aim of this study was to estimate the economic burden borne by the Ministry of Health (MOH) in Jordan, with a focus on direct medical, direct non-medical, and indirect cost.
    Matched MeSH terms: Renal Insufficiency, Chronic/economics*; Renal Insufficiency, Chronic/therapy
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