Humans ; Kidney Failure, Chronic ; epidemiology ; physiopathology ; therapy ; Singapore ; epidemiology

No abstract available.
Adolescent ; Adult ; Comparative Study ; Female ; Hemodynamics* ; Human ; Hypertension/etiology* ; Hypertension/physiopathology ; Kidney Failure, Chronic/physiopathology* ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Male ; Middle Age ; Nephrectomy

Advanced chronic kidney disease is associated with impaired spermatogenesis and testicular damage. Semen analysis typically shows a decreased volume of ejaculate, oligo- or complete azoospermia, and a low percentage of motile sperm. Erectile dysfunction (ED) is also common in patients with chronic renal failure (CRF) and is observed in excess of 50% of these patients. There have been ongoing improvements in survival and quality of life after renal transplantation. One of the most impressive aspects of successful renal transplantation in the young people is the ability of the male patient to father a child. In this article we first review pathophysiology of reproductive failure in end-stage renal disease (ESRD), then ED in ESRD and its management are discussed, finally sexual function in renal transplant patients and management of ED in these patients are reviewed.
Erectile Dysfunction ; therapy ; Humans ; Kidney Failure, Chronic ; physiopathology ; surgery ; Kidney Transplantation ; Male ; Reproduction

Child ; Disease Progression ; Humans ; Kidney ; abnormalities ; physiopathology ; Kidney Diseases ; congenital ; physiopathology ; therapy ; Kidney Failure, Chronic ; etiology ; physiopathology ; prevention & control ; Ureteral Obstruction ; etiology ; physiopathology ; therapy

OBJECTIVEThe evaluation of curative effect of CRF by Bushen Jianpi Huoxue Paidu and combination western medicine.

METHODGather articles mainly of VIP Information and Wanfang Data of the decade to cure CRF by Bushen Jianpi Huoxue Paidu and combination western medicine with random controlled way, and geostatistical analyse with RevMan4. 2 downloading from Cochrane Collaboration.

RESULTThe control group was 3.82 (95% CI, 2.72-5.38), in neurofunction 2 al impairment. The serum creatinine SMD = -0.72 (95% CI, -1.08-(-)0.35). Urea Nitrogen WMD = -3.32 (95% CI, -4.34-(-)2.29), P < 0.05.

CONCLUSIONIn addition to the routine treatment, the method of Bushen Jianpi Huoxue Paidu can be used by using some Chinese drugs to enhance the clinical effect.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Kidney ; drug effects ; physiopathology ; Kidney Failure, Chronic ; drug therapy ; physiopathology ; Randomized Controlled Trials as Topic

Drugs, Chinese Herbal ; pharmacology ; Humans ; Kidney Failure, Chronic ; mortality ; physiopathology ; Renal Dialysis ; methods ; mortality ; Survival Rate

Bone Diseases, Metabolic ; physiopathology ; Bone and Bones ; metabolism ; physiopathology ; Child ; Child Nutrition Disorders ; physiopathology ; Child Nutritional Physiological Phenomena ; physiology ; Humans ; Infection ; physiopathology ; Kidney Failure, Chronic ; physiopathology

OBJECTIVEAccurate and reliable assessment of renal function is important in the management of children with chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best index of assessing kidney function. For assessment of GFR, both gold standard tests and prediction equations have been used. The well-known 24-hour endogenous creatinine clearance (Ccr), the Schwartz formula and the Filler formula are increasingly used in daily clinical practice. However, there are few studies on the applicability of these prediction equations for estimating GFR in Chinese children with CKD. The aim of this study was to compare these prediction equations estimating GFR with an isotope clearance method [isotope glomerular filtration rate (rGFR)] in such patients.

METHODChildren aged 1-16 years who underwent isotope (99m)Tc-diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) GFR testing (Gates' method) between the year of 2002 and 2005 were studied retrospectively. GFR was estimated using: (1) 24-hour Ccr, which was calculated using the standard formula: [urine creatinine (milligrammes per millilitre) × 24-hour urine volume/serum creatinine (milligrammes per millilitre) × 1440] × [1.73 (m(2))/body surface area (m(2))]; (2) the Schwartz formula, which is: eGFR (ml/min per 1.73 m(2)) = k × height (centimetres)/serum creatinine (micromoles per litre), where k is 62 in males at 13 years of age and older, 40 in infants, and 49 in all other children; and (3) the Filler formula, which is: logGFR = 1.962 + [1.123 × log(1/Cys C)], where cystatin C is measured in milligrammes per litre. Serum and urinary creatinine levels were detected by alkaline kinetic method. Serum cystatin C was analysed by particle-enhanced immunoturbidimetric assay. Bias and precision were evaluated.

RESULTThirty subjects (18 males and 12 females; mean age 9.4 years) fulfilling both inclusion criteria and exclusion criteria were included in this study. The mean (SD) rGFR was 81.57 (36.92) ml/min per 1.73 m(2); 18 subjects were in CKD stage I, 8 in CKD stage II, 8 in CKD stage III, and 1 in CKD stage IV. Only the mean 24 h Ccr-eGFR was slightly higher than rGFR (0.4 ml/min per 1.73 m(2) higher). Within 95% limits of agreement, the maximum absolute value of bias was about 50 ml/min per 1.73 m(2). Accuracy (estimated GFR values within ± 30% of rGFR) for all formulae was poor, ranging from 23.3% to 43.3%. All formulae overestimate or underestimate rGFR in different CKD stages.

CONCLUSIONIn Chinese children with CKD, there was a significant difference between measured GFR and estimated GFR using 24h Ccr, Schwartz formula and Filler formula. More suitable GFR predictive equations to assess glomerular function of such patients should be developed.

Adolescent ; Child ; Child, Preschool ; Female ; Glomerular Filtration Rate ; Humans ; Infant ; Kidney Failure, Chronic ; physiopathology ; Kidney Function Tests ; Male ; Renal Insufficiency, Chronic ; physiopathology

The aim of this study was to evaluate the evolution of lupus activity in end-stage renal disease (ESRD) patients due to lupus nephritis and to determine the long-term prognosis. We reviewed the clinical courses of 45 patients with ESRD due to systemic lupus erythematosus (SLE). We analyzed the course of SLE following the onset of ESRD, with special attention to the clinical and serological manifestations, survival time on dialysis, and renal transplantation outcome. Disease activity was measured using the SLE Disease Activity Index (SLEDAI). Of the 45 patients, 21 patients were being treated with hemodialysis (HD), 11 were undergoing peritoneal dialysis (PD), and 13 underwent transplantation. Duration of follow- up was 53 +/- 29 months. The SLEDAI score on commencement of renal replacement therapy was not significantly different among the 3 groups (HD: 4.2 +/- 4.2, PD: 4.3 +/- 2.3, Transplant: 3.2 +/- 1.9). However, disease activity scored by follow-up maximal SLEDAI during dialysis or transplantation showed a significant increase after peritoneal dialysis (HD: 5.0 +/- 3.6, PD: 7.4 +/- 3.7, Transplant: 2.2 +/- 1.7, p < 0.05). When the individual changes in the maximal SLEDAI score were considered, a significant increase was apparent after peritoneal dialysis (p < 0.05), but not after either hemodialysis or renal transplantation. There was no significant difference in cumulative survival rate, and also in technique or graft survival rates of the 3 groups. Among the variables tested, follow-up maximal SLEDAI score was the only significant factor associated with patient survival (odds ratio: 1.15, p < 0.05). The incidence (36% versus 19%) of high disease activity was greater, but not significantly, in the peritoneal dialysis group, as compared to the hemodialysis group. Clinical activity of SLE was apparent in 65% of patients in the first year of dialysis, but none showed any activity after the third year of dialysis. We found that although lupus disease activity declined after patients progressed to ESRD, lupus disease activity still affected patients' survival. An incremental increase in postdialysis lupus activity was not uncommon, especially during the first one year of dialysis. During the follow-up period, maximal SLEDAI score increased significantly after peritoneal dialysis. However, the long-term prognosis was not significantly different according to the treatment modality.
Adult ; Disease Progression ; Female ; Human ; Kidney Failure, Chronic/*mortality/*physiopathology ; Lupus Nephritis/*mortality/*physiopathology ; Male ; Survival Analysis

Cardiovascular disease is one of the most common complications and the main cause of death in patients with chronic kidney disease. Uremic toxins are the primary cause of cardiovascular disease in renal insufficiency. In patients with chronic kidney disease, the protein-bound uremic toxins represented by indoxyl sulfate are difficult to be removed by conventional dialysis and are extremely toxic. In recent years, studies have confirmed that the occurrence of cardiovascular disease induced by chronic kidney disease is closely related to the accumulation of indoxyl sulfate. Indoxyl sulfate can induce oxidative stress to cause endothelial injury, smooth muscle cell proliferation and migration, and promote the occurrence of atherosclerosis, thereby affecting multiple systems throughout the body. This article reviews the research progress of uremic toxin indoxyl sulfate in end-stage renal diseases associated cardiovascular diseases.
Cardiovascular Diseases ; complications ; physiopathology ; Humans ; Indican ; toxicity ; Kidney Failure, Chronic ; complications ; physiopathology ; Oxidative Stress ; Toxins, Biological ; toxicity