Many patients show signs of chronic kidney disease before diabetes diagnosis
(Veterans Affairs Research Communications) Many patients who will later be diagnosed with diabetes show signs of chronic kidney disease even before their diabetes diagnosis, according to a study by Veterans Affairs researchers and colleagues in Tennessee. The researchers looked at data on more than 36,000 veterans who were diagnosed with diabetes between 2003 and 2013.
A morbidly-obese 57-year-old diabetic and hypertensive man with chronic kidney disease, diastolic heart failure, and bilateral hearing loss was found to have soft tissue masses/densities in the lateral aspect of both auditory canals on local examination and on imaging. He underwent biopsies of both ear canal masses and histologic examination revealed amyloid deposits in the dermis. These deposits were confirmed as AL (amyloid light chain) kappa-type amyloid by laser mass spectrometry. A systemic work-up showed plasma cell dyscrasia with 9% kappa light chain restricted plasma cells in the bone marrow as well as amyloid depo...
Conclusion IgAVN in elderly patients is characterized by severe renal involvement. Elderly patients are at higher risk than adults for treatment-related adverse events. PMID: 30101942 [PubMed - as supplied by publisher]
In this issue ofJAMA, Webster and colleagues report the results of the Triple Pill vs Usual Care Management for Patients with Mild-to-Moderate Hypertension (TRIUMPH) pragmatic randomized clinical trial that evaluated the efficacy of a low-dose combination pill containing 20 mg of telmisartan, 2.5 mg of amlodipine, and 12.5 mg of chlorthalidone compared with usual care among 700 adults with hypertension in Sri Lanka. The primary outcome was the proportion of patients whose blood pressure (BP) was controlled at 6 months, which was defined as a systolic/diastolic BP of less than 140/90 mm Hg or less than 130/80 mm Hg among pa...
The aim of the study was to improve the frequency of diagnosing chronic kidney disease (CKD) in seniors with diabetes. Less than 10% of those with stages 2 or 3 CKD and less than 50% with stage 4 CKD know they have renal impairment. A pre-post study design was implemented in 2 primary care facilities. The study sample was 222 older adults aged> 55 years with diabetes. A medical record audit verified the number of patients diagnosed with CKD doubled from 16 preintervention to 32 postintervention (P = .014).
In this study, total 150 individuals, as control, type2 diabetic patients without complication and with CKD were included. Blood samples were collected from all the samples to estimate blood glucose, HbA1c, serum creatinine, fructosamine levels and lipid profile. Statistical analysis i.e. regression and correlation between serum fructosamine and other documented risk factors for diabetic CKD has been done. P
ConclusionsA parsimonious risk prediction model that uses five key clinical variables predicts hypoglycemia during hospitalization at the time of admission. More than one-quarter of patients at low risk of hypoglycemia had a score below the threshold. They could be identified at the time of admission by applying the HyDHo Score, and may need less intensive glucose monitoring in hospital.
CONCLUSION: CAR at diagnosis can be an independent predictor of all-cause mortality, comparable to DM, the conventional risk factor of mortality. PMID: 30091320 [PubMed - in process]
Conditions: Chronic Kidney Disease; End Stage Kidney Disease; Chronic Kidney Disease Mineral and Bone Disorder; Renal Osteodystrophy; Secondary Hyperparathyroidism Intervention: Other: Kidney disease Sponsors: Columbia University; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Recruiting
Abstract AIM: To evaluate racial differences, and ocular and systemic determinants of macular thickness (MT), measured by spectral-domain optical coherence tomography (SD-OCT) in a normal multiethnic Asian population. METHOD: MT was measured from a 6×6 mm2 central macular area using the Cirrus high-definition OCT (HD-OCT) (Carl Zeiss Meditec, Dublin, CA). The associations between ocular and systemic factors with MT were evaluated using linear regression analyses with generalised estimating equation models to account for intereye correlation. RESULTS: 7447 healthy eyes (2577 Chinese, 2072 Mal...