European Journal of Molecular & Clinical Medicine

Background: Anemia is a common complication in Chronic kidney disease (CKD) patients. It has a multi-factorial pathogenesis. Replenishing iron stores and giving ESAs are the main lines of treatment. There is a general agreement on the optimal route for iron supplementation in ESRD patients with the IV route but there is no such agreement on the optimal route for iron supplementation in pre-dialysis CKD patients. Erythropoiesis stimulating agents (ESAs) treatment represent an economic burden and has been linked to possible cardiovascular side effects. This study amid to assessing the efficacy of erythropoietin in treatment of anemia in CKD patients. Methods: A prospective cohort study was conducted in chronic kidney disease patients who had undergone hemodialysis in Met-Ghamr hospital of nephrology from February 2019 to July 2019. Included 50 patients on maintenance hemodialysis, we tested the efficacy through comparing the efficacy low fixed ESA dose (4000 IU IV once weekly) versus high fixed dose (4000 IU IV three times weekly). We divided group into two groups, group A and group B. group A were put on a fixed dose of 4000 IU Epoetin alfa once weekly and group B were put on a fixed dose of 4000 IU Epoetin alfa three times weekly. Results: After 6 months, We found a significant difference in hemoglobin response of the two subgroups in favor of subgroup IID (P = 0.004). Conclusion: That low dose ESAs is less effective in correction of anemia in dialysis patients than high dose ESAs.

The purpose of this study was to determine the relationship between individual characteristics and discharge planning implementation with the compliance level of chronic kidney disease patients undergoing hemodialysis.A cross sectional designduring July - September 2020 with 105 respondents using simple random sampling. The independent variables were individual characteristics and implementation of discharge planning and the dependent variable was adherence.Data were collected using a questionnaire that was tested for validity and reliability, then data were analyzed using Chi Square test with a significance value P <0.05. Respondents with the highest adherence were women (88.9%; P = 0.015), age range 46 - 55 years (87.8%; P = 0.033), married status (81.1%; 0.031), working (89.5%; P = 0.028), Secondary education level (84.2%; P = 0.043), good knowledge (85.1%; P = 0.026), long hemodialysis> 5 years (93.3%; P = 0.016) and had a history of diabetes mellitus (90.9%; P = 0.035).The discharge planning element also has significant relation (all P <0.05), including sufficient medication (90.0%), a good environment (88.9%), good treatment (100.0%), good health teaching (87.0%), good outpatient referral (100.0%) and good diet (86.7). The level of compliance of hemodialysis patients is very important to improve the quality of life of patients, patient compliance is influenced by the demographic characteristics of the individual and discharge planning in the hospital.

Objective: to investigate the characteristics of the clinical course of community-acquired pneumonia in patients with constant kidney infection. The ponder included 120 patients with pneumonia: 40 patients had no history of renal pathology (group M), 80 patients endured from inveterate kidney infection (GFR for 3 months some time recently the improvement of pneumonia 30-60 ml / min / 1.7 m2, group M + CKD ). Confirmation of the determination was carried out on the premise of chest X-ray, the detailing of the conclusion included deciding the sort of pneumonia - croupous or central intersecting.
In a comparative evaluation of the X-ray picture within the explored groups, it was famous that in patients with pneumonia against the foundation of CKD, lobar and central intersecting pneumonia with a huge penetrate volume were altogether more frequent (p <0.001). Within the flow of follow-up, the larger part of patients (78 out of 120 patients, 65%) appeared positive clinical and radiological elements, 20 patients (16.67%) appeared no critical elements, and 22 patients (18.33%) had clinical and radiological elements. negative. Negative clinical and radiological flow was more frequently watched within the group of patients in whom pneumonia developed against the background of CKD (p <0.01).

Patients with Chronic Kidney Disease (CKD) develop a tendency to bleed and
thromboembolism, so the indication for anticoagulants at the attachment of atrial
fibrillation (AF) is complex. AF is the most common chronic heart arrhythmia, and
thromboembolism and ischemic stroke in particular are the main complications. In recent
years, new oral anticoagulants have been developed and they have shown superiority over
the classic antivitamin K anticoagulants in preventing the risk of stroke, systemic embolism
and bleeding, providing an effective alternative to these resources

Background: Chronic kidney disease (CKD) is an emerging public health problem that affects 5–10% of the world population. With the availability of recent treatment modalities including renal replacement therapy, the survival of CKD patients has increased considerably which has led to an increased focus on health-related quality of life (HRQoL). Health-related quality of life represents the impact of the disease or its treatment on the subjective feelings of patients about their physical, mental, spiritual, emotional, social, and functional wellbeing. Quality of life among dialysis patients has been shown to be lower as compared to pre-dialysis CKD patients and is an independent risk factor for mortality in dialysis patients. Family support is an important factor that serves as a support system for the patients to face health problems.
Purpose: To examine levels of family support and the correlation of family support and quality of life (QoL) among CKD on hemodialysis (HD) patients.
Methods: This cross-sectional observational study was conducted in August-November 2020 and recruited chronic HD patients from Wahidin Sudirohusodo Hospital in Makassar, Indonesia. The demographic data of HD patients were collected. Quality of life was assessed using the validated Indonesian version of the Short Form-36 (SF-36) questionnaire which consists of Physical Component Summary (PCS) and Mental Component Summary (MCS) and family support that was assessed using the validated “Dukungan Keluarga” questionnaire. The data were analyzed using SPSS version 22.0 statistical software.
Results: A total of 60 subjects (39 males and 21 females) were included. The mean age was 48.9±12.1 years old. About 55% of the subjects was graduated from college. About 86.7% subject was married. About 55% of the subject is not working. About 53.3% of subjects have a family income lower than the regional minimum wage. The mean duration of HD was 22.1±28.6 months. The mean score of family support was 53±8,2. Family support score has a significant positive correlation with each domain of PCS and MCS, the higher score of family support is in accordance with higher score of PCS and MCS.
Conclusion: CKD on HD patients’ quality of life was significantly affected by family support

The study explores theory of relativity of acid levels with nephritic function, moreover as its role as a prognostic marker of cardio tube risk in chronic excretory organ diseases within the course of variable regression analysis, taking into consideration the adjustment of potential risk issues, the amount of uric acid was found to be a major factor influencing calculable capillary vessel filtration rate. The results of this study showed that elevated humor uric acid levels are related to the next risk of kidney malfunction.

Background: Chronic kidney disease (CKD) is an independent risk factor and caused high morbidity and mortality for coronary artery disease (CAD). Several scoring systems can be used in assessing the severity of CAD, one of which is using the SYNTAX score (SXscore). Smoking is one of the risk factors for the progression of CAD and CKD. Several observational studies have under-reported the smoking factor influencing the rela-tionship between eGFR and SXscore.
Methods: This research is an observational study with a cross-sectional approach conduct-ed at the Wahidin Sudirohusodo Hospital Makassar from July-August 2020. This study involved 62 CAD and CKD patients undergoing angiography. The estimated glomerular filtration rate was based on chronic kidney disease epidemiology collaboration (CKD-EPI).
Coronary angiography results were converted to SXscore and smoking grade based on the Brinkman index.
Results: This study involved 62 CAD and CKD patients male (71%), aged ≥ 55 years (77.4%), hypertension (71%), diabetes (35.5%), smoking (50%), eGFR G3a & G3b (53.9. %) and SXscore medium-high (50%). The results showed that lower eGFR could increase the SXscore (p < 0.001), especially in smoking subjects (p < 0.001). Multivariate analysis showed that gender was the most significant factor contributing to the relationship between eGFR and SXscore
Conclusion : The lower eGFR could increase the SXscore, where this correlation was more significant in smoking patients. Multivariate analysis showed that gender was the most significant factor contributing to the relationship between eGFR and SXscore.

The research describes the concept of healthiness of the physical activity for patients with chronic kidney disease, moreover because the effect of 12-week physical training on physical activity in patients with chronic disease of stage 3-4 who are on a low-protein diet.
At the identical time, patients with variety of chronic diseases aside from CKD also suffer from poor physical performance and muscle atrophy, but more evidence has been accumulated of the positive effect of exercise in such patients [3].
Increased physical activity is related to improved ability to perform everyday activities, professional tasks. Therefore, regular exercise is usually recommended for such patients within the DOPPS study, patients who performed regular physical activity had the next quality of life related to health, good fitness and sleep quality indicators, with fewer patients with limited physical activity and lack of appetite [4].

This article describes the features of the clinical course of the disease, assesses the quality of life, diagnostic criteria for the disease, modern classification and tactics of hypotensive therapy in patients with chronic kidney disease, Pathogenetic mechanisms of chronic kidney disease, Correspondence of the stages of chronic kidney disease to the ICD-10 coding.
Various modern studies are described to assess the quality of life of patients using the SF-36 questionnaire, which includes 8 scales: physical functioning, role functioning due to physical state, pain intensity, general health, vital activity, social functioning, role functioning due to emotional state and mental health.

Purpose of the study: to check some indicators of the immunohemogram in patients with community acquired respiratory disorder on the background of CKD.
Materials and methods. one hundred twenty patients with community-acquired respiratory disorder were examined: forty patients with respiratory disorder (group Pn) and eighty respiratory disorder, that developed against the background of chronic nephrosis (group Pn+ CKD). The management cluster (CG) consisted of twenty healthy individuals. The study found that the amount of leukocytes was exaggerated within the Mon + CKD cluster by 162.24% than in the CG (p <0.001), within the Mon cluster 263.14% on top of within the CG and twenty seven.79% than within the cluster Mon + CKD (p <0.001). In patients with Mon, the quantitative relation of the amount of neutrophils to lymphocytes significantly exaggerated (p <0.001 compared with the CG and also the Mon + CKD group), reflective the shift of the formula to the left, and within the Mon + CKD cluster this quantitative relation remained unchanged, despite the increase within the absolute variety of leukocytes. In patients with respiratory disorder with background CKD, a marked increase in T-lymphocytes was determined because of a population of CD8 and CD95 cells (p <0.001 compared with CG and also the Mon group). a rise in IgM concentration prevailed within the pneumonia cluster, and a rise in immune serum globulin prevailed within the PN + CKD cluster (p <0.001).
Conclusion. Respiratory disorder related to CKD is related to associate active general inflammatory response involving non-specific immunity and also the depletion of its cellular part, as well as activation of immunity because of chronic inflammation and chronic matter stimulation.

The aim of the study was to review the features of the functional state of the kidneys in patients with cardiopathy, betting on the presentation of the components of the metabolic syndrome. For the research we examined 197 male patients with chronic heart condition (CHF) of ischemic genesis of II-III functional class (FC) in line with NYHA. Metabolic syndrome in patients with chronic heart failure HFmrEF exacerbates impaired renal function, which has developed together of the most pathogenetic links in chronic heart condition. it's been established that because the metabolic syndrome progresses (attachment of T2DM to other components of the metabolic syndrome), the phenomena of functional kidney failure increase. Evidence of the importance of the metabolic syndrome within the nature of the clinical manifestations of chronic coronary failure HFmrEF is that the established dependence of the identified disorders on the severity of the metabolic syndrome.

Chronic kidney disease (CKD) is an overall medical issue, influencing a huge number of people. Magnesium (Mg ++) is the fourth most abundant and second most important intracellular extract in the body. In patients with CKD and end stage renal disease (ESRD), Mg ++ homeostasis may change. The present study is to assess the levels of serum magnesium in chronic kidney disease patients. The current cross-sectional study was performed to assess serum magnesium levels in cases with CKD and to detect the correlation of serum magnesium with clinical features and severity of renal impairment. The serum magnesium among patients with CKD had hyper magnesium. The serum magnesium level rises as kidney function deteriorates. There is significant fall in serum magnesium level after dialysis. Its estimation helps in evaluating conservative treatment and dialysis in CKD. Hence early evaluation and treatment of underlying cause for CKD is necessary to prevent further complication and kidney damage.

The study of various aspects of the problem of common hypomicroelementosis caused by a deficiency of essential trace elements copper and zinc, in particular among women of fertile age, in the population is extremely relevant and important, taking into account the social significance and importance of this population for society , because of what the condition will be health in a given population depends on the state of such important socially significant processes as the healthy development of future generations