PURPOSE: The purpose of this study was to investigate the occurrence of first onset of constipation during the rehabilitation stage and risk factors for constipation in patients with cerebral vascular disease (CVD). METHODS: Participants for this retrospective study were 214 CVD patients admitted to rehabilitation units. First onset of constipation and factors influencing constipation such as dependency level were recorded for 14 days during the rehabilitation stage. Survival analysis with Cox proportional hazard model and descriptive statistics were conducted. RESULTS: Age, patients'severity, types of diet, and dependency level were different between constipation and non-constipation groups. In survival analysis, 99% of participants developed constipation within 14 days after admission to rehabilitation units. Median constipation occurrence time was 7.4 days. Patients who were immobile and had tube feedings were more likely to develop constipation 4.07 times (95% CI: 1.018~16.301, p=.047) and 2.09 times (95% CI: 1.001~4.377, p=.050) respectively compared to patients who were independent and had a regular diet, respectively. CONCLUSION: Most CVD patients experienced constipation within 2 weeks after entering the rehabilitation stage. Constipation was linked to types of diet and dependency level. These factors associated with constipation should be considered when caring for patients in rehabilitation.
Constipation* ; Diet ; Humans ; Proportional Hazards Models ; Rehabilitation* ; Retrospective Studies ; Risk Factors ; Stroke ; Survival Analysis ; Vascular Diseases*

BACKGROUND: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survival benefit in this highly catabolic condition. METHODS: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014. The study end point was defined as death that occurred within 30 days after the initiation of CRRT. RESULTS: Patients were categorized into three groups according to tertiles of body mass index (BMI). During ≥30 days after the initiation of CRRT, 39 patients (57.4%) in the highest tertile died, as compared with 58 patients (78.4%) in the lowest tertile (P = 0.02). In a multivariable analysis adjusted for cofounding factors, the highest tertile of BMI was significantly associated with a decreased risk of death (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.37–0.87; P = 0.01). This significant association remained unaltered for 60-day (HR, 0.64; 95% CI, 0.43–0.94; P = 0.03) and 90-day mortality (HR, 0.66; 95% CI, 0.44–0.97; P = 0.03). CONCLUSION: This study showed that a higher BMI confer a survival benefit over a lower BMI in AKI patients undergoing CRRT.
Acute Kidney Injury* ; Body Mass Index* ; Epidemiologic Studies ; Humans ; Mortality* ; Obesity ; Observational Study ; Renal Replacement Therapy*

BACKGROUND: Cardiovascular disease and chronic kidney disease share several common risk factors. The Framingham risk score is hypothesized to predict chronic kidney disease development. We determined if the Framingham risk scoring system can correctly predict incident chronic kidney disease in the general population. METHODS: This study included 9,080 subjects who participated in the Korean Genome and Epidemiology Study between 2001 and 2014 and had normal renal function. The subjects were classified into low- (< 10%), intermediate- (10–20%), and high- (> 20%) risk groups based on baseline Framingham risk scores. The primary endpoint was de novo chronic kidney disease development (estimated glomerular filtration rate [eGFR], < 60 mL/min/1.73 m²). RESULTS: During a mean follow-up duration of 8.9 ± 4.3 years, 312 (5.3%), 217 (10.8%), and 205 (16.9%) subjects developed chronic kidney disease in the low, intermediate, and high risk groups, respectively (P < 0.001). Multivariable analysis after adjustment for confounding factors showed the hazard ratios for the high- and intermediate risk groups were 2.674 (95% confidence interval [CI], 2.197–3.255) and 1.734 (95% CI, 1.447–2.078), respectively. This association was consistently observed irrespective of proteinuria, age, sex, obesity, or hypertension. The predictive power of this scoring system was lower than that of renal parameters, such as eGFR and proteinuria, but increased when both were included in the prediction model. CONCLUSION: The Framingham risk score predicted incident chronic kidney disease and enhanced risk stratification in conjunction with traditional renal parameters in the general population with normal renal function.
Cardiovascular Diseases ; Cohort Studies ; Epidemiology ; Follow-Up Studies ; Genome ; Glomerular Filtration Rate ; Hypertension ; Obesity ; Prospective Studies ; Proteinuria ; Renal Insufficiency, Chronic ; Risk Factors