Volume 4, Issue 2 (December 2018)
Elderly Health Journal 2018, 4(2): 49-54 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Tay C L. Associated Factors of Chronic Kidney Disease among Hyponatraemic Elderly Patients Attending a Primary Care Clinic. Elderly Health Journal 2018; 4 (2) :49-54
URL: http://ehj.ssu.ac.ir/article-1-131-en.html
URL: http://ehj.ssu.ac.ir/article-1-131-en.html
Department of Primary Care Medicine, Simpang Health Clinic, District of Larut, Matang and Selama, Taiping Perak, Ministry of Health, Malaysia , chailitay329@gmail.com
Abstract: (2911 Views)
Introduction: Chronic kidney disease (CKD) emerges to be an important geriatric health issue. It may progress to end stage renal failure and affect the quality of life. However, little is known about the associated factors of CKD. So this study aimed to determine the associated factors of CKD among hyponatraemic elderly.
Methods: This is a retrospective study of hyponatraemic patients aged ≥ 60 years attending outpatient clinic in 2014. Blood test results of glucose, potassium, creatinine, medical history, blood pressure, medication and demographic data were captured from patient records. Each patient’s estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI Creatinine Equation. CKD is defined as eGFR of < 60 ml/min/1.73m2. SPSS 21 was used to do the analysis.
Results: Totally 257 patients with mean age of 72.9 ± 7.3 years were enrolled in this study. Of them 73 (28.4 %) elderly had CKD. The mean eGFR was 72.62 ± 24.14 ml/min/1.73m2, mean BP was (135.75 ± 18/10) mmHg. Of the participants, 134 (52.1 %) were men, 151 (58.8 %) were diabetics, 247 (96.1 %) had hypertension. The independent associated factors of CKD were increasing age (OR 1.08; 95 % CI 1.03-1.13; p = 0.002), hyperglycaemia (OR 1.10; 95 % CI 1.02-1.18; p = 0.017) and the use of loop diuretics (OR 5.15; 95 % CI 1.52-17.38; p = 0.008).
Conclusion: Hyperglycaemia and loop diuretics usage are found to be significantly associated with CKD among elderly patients attending a primary care clinic. Hence every effort should be made to optimise glucose control and cautious in the usage of loop diuretics to retard the decline in renal function.
Methods: This is a retrospective study of hyponatraemic patients aged ≥ 60 years attending outpatient clinic in 2014. Blood test results of glucose, potassium, creatinine, medical history, blood pressure, medication and demographic data were captured from patient records. Each patient’s estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI Creatinine Equation. CKD is defined as eGFR of < 60 ml/min/1.73m2. SPSS 21 was used to do the analysis.
Results: Totally 257 patients with mean age of 72.9 ± 7.3 years were enrolled in this study. Of them 73 (28.4 %) elderly had CKD. The mean eGFR was 72.62 ± 24.14 ml/min/1.73m2, mean BP was (135.75 ± 18/10) mmHg. Of the participants, 134 (52.1 %) were men, 151 (58.8 %) were diabetics, 247 (96.1 %) had hypertension. The independent associated factors of CKD were increasing age (OR 1.08; 95 % CI 1.03-1.13; p = 0.002), hyperglycaemia (OR 1.10; 95 % CI 1.02-1.18; p = 0.017) and the use of loop diuretics (OR 5.15; 95 % CI 1.52-17.38; p = 0.008).
Conclusion: Hyperglycaemia and loop diuretics usage are found to be significantly associated with CKD among elderly patients attending a primary care clinic. Hence every effort should be made to optimise glucose control and cautious in the usage of loop diuretics to retard the decline in renal function.
Type of Study: Research |
Subject:
General
Received: 2018/11/20 | Accepted: 2018/12/10 | Published: 2018/12/29
Received: 2018/11/20 | Accepted: 2018/12/10 | Published: 2018/12/29
References
1. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. The Journal of the American Medical Association. 2007; 298(17): 2038-47.
2. Kheder-Elfekih R, Yannoutsos A, Blacher J, London GM, Safar ME. Hypertension and chronic kidney disease: respective contribution of mean and pulse pressure and arterial stiffness. Journal of Hypertension. 2015; 33(10): 2010-15.
3. Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte disorders in community subjects: Prevalence and risk factors. The American Journal of Medicine. 2013; 126(3): 256-63.
4. Lim LM, Tsai NC, Lin MY, Hwang DY, Lin HY, Lee JJ, et al. Hyponatremia is associated with fluid imbalance and adverse renal outcome in chronic kidney disease patients treated with diuretics. Scientific Reports. 2016; 6: 1-10.
5. Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM, et al. A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia. Kidney International. 2013; 84(5): 1034-40.
6. MacIsaac RJ, Ekinci EI, Premaratne E, Lu ZX, Seah JM, Li Y, et al. The chronic kidney disease-epidemiology collaboration (CKD-EPI) equation does not improve the underestimation of glomerular filtration rate (GFR) in people with diabetes and preserved renal function. BMC Nephrology. 2015; 16: 1-13.
7. Yusoff SN, Zulkifli Z. Rethinking of old age: the emerging challenge for Malaysia. International Proceedings of Economics Development and Research. 2014; 71(13): 69-73.
8. Malabu UH, Porter D, Vangaveti VN, Kazi M, Kennedy RL. Prevalence of hyponatremia in acute medical admissions in tropical Asia Pacific Australia. Asian Pacific Journal of Tropical Medicine. 2014: 7(1): 40-3.
9. Bash LD, Coresh J, Köttgen A, Parekh RS, Fulop T, Wang Y, et al. Defining incident chronic kidney disease in the research setting: the ARIC study. American Journal of Epidemiology. 2009; 170(4): 414-24.
10. Matsushita K, Mahmoodi BK, Woodward M, Emberson JR, Jafar TH, Jee SH, et al. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. The Journal of the American Medical Association. 2012; 307(18): 1941-51.
11. Fastbom J, Wills P, Cornelius C, Viitanen M, Winblad B. Levels of serum creatinine clearance over the age of 75: a study of an elderly Swedish population. Archives of Gerontology and Geriatrics. 1996; 23(2): 179-88.
12. Kummer S, Gersdorff VG, Kemper MJ, Oh J. The influence of gender and sexual hormones on incidence and outcome of chronic kidney disease. Pediatric Nephrology. 2012; 27(8): 1213-9.
13. Keane WF, Brenner BM, De Zeeuw D, Grunfeld JP, McGill J, Mitch WE, et al. The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: the RENAAL study. Kidney International. 2003; 63(4): 1499-507.
14. Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. American Journal of Kidney Diseases.2004; 43(5 suppl 1): S1-S290.
15. Loyd J, Wright P. Are thiazide diuretics an effective treatment for hypertension in patients with chronic kidney disease?. The Journal of Oklahoma State Medical Association. 2008; 101(5): 84-85.
16. Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH. Chronic kidney disease, fluid overload and diuretics: a complicated triangle. PLoS ONE. 2016; 11(7): 1-13.
17. Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C, et al. Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third national health and nutrition examination survey (1988–1994). Archives of Internal Medicine. 2001: 161(9): 1207-16.
18. Nigwekar SU, Waikar SS. Diuretics in acute kidney injury. Seminars in Nephrology. 2011; 31(6): 523-34.
19. Cotter G, Metra M, Milo-Cotter O, Dittrich HC, Gheorghiade M. Fluid overload in acute heart failure-Re-distribution and other mechanisms beyond fluid accumulation. European Journal of Heart Failure. 2008: 10(2): 165–9.
20. McKie PM, Schirger JA, Benike SL, Harstad LK, Chen HH. The effects of dose reduction of furosemide on glomerular filtration rate in stable systolic heart failure. A Journal of the American College of Cardiology: Heart failure. 2014; 2(6): 675-7.
21. Vander AJ, Carlson J. Mechanism of the effects of furosemide on renin secretion in anesthetized dogs. Circulation Research. 1969; 25: 145-52.
22. American Heart Association Nutrition Committee, Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American heart association nutrition committee. Circulation. 2006; 114(1): 82-96.
23. Adler AI, Stratton IM, Neil HAW, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. The British Medical Journal. 2000; 321(7258): 412-9.
24. Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation. 2003; 107(22): 2864-9.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
