Chronic kidney disease (CKD) and hypertension are very common chronic diseases. Active and standardized treatment of hypertension in patients with CKD can not only delay the progress of renal disease, but also reduce the risk of cardiovascular events. In recent years, although the guidelines for hypertension have put forward detailed suggestions for the management of hypertension in CKD patients, there are differences in the recommendation of blood pressure target value for CKD patients. Combined with the latest guidelines, this review interprets the blood pressure measurement methods, diagnostic criteria, antihypertensive targets and drug therapy in patients with CKD.
ObjectiveTo investigate the health literacy level and its influencing factors among follow-up patients with chronic kidney disease (CKD).MethodsFrom March to August 2018, 248 patients from the CKD Follow-up Management Center, West China Hospital, Sichuan University were included. Basic information questionnaire and chronic diseases health literacy scale were used. Analysis of variance and t test were used in univariate analysis, and multiple linear stepwise regression was used in multivariate analysis, to explore the influencing factors of health literacy score.ResultsThe average health literacy score of the 248 CKD patients (97.24±12.22) were in medium to low level. Listed from high to low, the score of each dimension was: ability to obtain information (4.24±0.50), willingness to improve health (4.17±0.66), competence to communicate and interact with others (3.95±0.59), and willingness to support financially (3.41±1.10). The result of multiple linear stepwise regression showed that whether followed up on time, families’ monthly income per capita, and the patients’ age were independent influencing factors of health literacy score (P<0.05).ConclusionsThe health literacy level of follow-up patients with CKD remains to be improved. Medical personnel should pay attention to whether patients with CKD are followed up on time, make targeted intervention, and improve the self-management of patients so as to delay the disease progress of CKD.
Chronic kidney diseases (CKD) with long duration and a variety of complications have caused great physical and psychological problems for patients, and the overall quality of life of patients is low. Taijiquan, as a traditional Chinese techniques project, is beneficial to improving cardiopulmonary function, enhancing lower limb muscle strength, and reducing cardiovascular and cerebrovascular risks. We summarized the latest progress in clinical research concerning taijiquan as exercise rehabilitation for patients with CKD, aiming to promote the clinical application of taijiquan and other traditional exercises in the rehabilitation process of CKD patients and improve the overall quality of life of CKD patients.
ObjectiveTo observe whether proteinuria is relate to the decline of residual renal function (RRF) in peritoneal dialysis (PD) patients. MethodsThis is a prospective cohort study including 45 PD patients (underwent PD between January 2011 and January 2013) with a 12-month follow-up. All the patients were divided into 2 groups with respect to the initial proteinuria level: massive proteinuria group A (n=20) and non-massive proteinuria group B (n=25) at baseline. We established regression models to do univariate analysis and multivariate analysis of the relationship between the decline of RRF≥50% of baseline and the indices of age, sex, PD-associated peritonitis, baseliner residual glomerular filtration rate (rGFR), initial proteinuria, and use of ACEI/ARB. ResultsThe primary outcome (RRF>50% of baseline) at 12 months was 65% in group A, and 80% in group B (P<0.05). Based both on the results of univariate and multivariate Cox regression analysis, non-massive proteinuria and higher rGFR at baseline were factors to protect RRF from decline (P<0.05). ConclusionThe study demonstrates that massive proteinuria and lower rGFR at baseline may be associated with a rapid decline of RRF in PD patients. Treatment aimed at reducing albuminuria may lead to protect RRF and improve life quality of patients.
Chronic kidney diease has a high incidence. It is a major disease that seriously endangers human health. The integrated management of chronic kidney disease, through etiological treatment of chronic kidney disease, delaying the deterioration of renal function, and the combination of hemodialysis, peritoneal dialysis and kidney transplantation for end-stage kidney disease treatment, is a scientific and effective full-course management of chronic kidney disease. The integrated management of chronic kidney disease is the key to reduce the mortality and disability rates. At the same time, it is a more important and far-reaching task to emphasize early popularization of science, screening, prevention and intervention to reduce the incidence of kidney disease.
Objective To assess the efficacy and safety of prescribing medicinal charcoal for treatment of adult chronic kidney disease. Methods We searched the Cochrane Controlled Trial Register (The Cochrane Library Issue 1, 2009), MEDLINE (1950 to January 2009), EMbase (1980 to January 2009), and Chinese Biomedical Database (1977 to January 2009) to screen randomized controlled trials (RCTs) concerning use of medicinal charcoal for treatment of adult chronic kidney disease. We evaluated the bias risk of the included RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version 4.2.2.The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analysis. Results Seven trials involving 347 patients met the criteria. Meta-analysis showed: (1) Medicinal charcoal was better than routine treatment on the improvement of blood urea nitrogen [MD= –0.69, 95%CI (–1.13, –0.24), P=0.002], serum creatinine [MD= – 0.51, 95%CI (–0.94, – 0.08), P=0.02] and the mean change of glomerular filtration rate per month (Plt;0.001). Compared with routine treatment, medicinal charcoal had similar effects on the improvement of 24 hours urinary protein and the mean change of blood pressure; (2) Compared with placebo, and medicinal charcoal was not superior to placebo in improving the incidence of end stage kidney diseases, serum creatinine, creatinine clearance rate, 24 hour urinary protein (Pgt;0.05); (3) Adverse events with constipation, flatulenceand nausea occurred to medicinal charcoal groups. Conclusion Overall, the evidence is not b enough, and more large, high-quality randomized controlled trials are needed to confirm or refute the available evidence.
In 2020, chronic kidney disease has become one of the top 10 causes of death in the world. More and more evidence shows that proper exercise rehabilitation is beneficial to the health of patients with chronic kidney disease, which can improve the survival rate and slow down the decline of renal function. However, existing studies have significant differences in form, intensity, duration, and specific implementation methods of sports rehabilitation, which need to be further standardized and unified. This article introduces the impact of exercise rehabilitation on patients with chronic kidney disease and the clinical application of Chinese traditional exercises in patients with chronic kidney disease, and mainly discusses the application experience of exercise rehabilitation characterized by “Three-in-one Taiji” in the Department of Nephrology of West China Hospital of Sichuan University. It aims to provide a basis for the model innovation of integrated management of chronic kidney disease in China.
Objective To assess the clinical efficacy of Cordyceps sinensis in the treatment of chronic kidney diseases. Methods Randomized or quasi-randomized controlled trials (RCTs or quasi-RCTs) were identified from MEDLINE (1996 to Oct. 2005), EMbase (1984 to Oct. 2005), The Cochrane Central Register of controlled Trials (Issue 3, 2005) and CBMdisc (1978 to Oct. 2005). We also handsearched related published and unpublished data and their references. Data were extracted and evaluated by two reviewers independently with a designed extraction form. RevMan4.2.7 software was used for data analysis. Results One RCT and 5 quasi-RCTs involving 434 patients were included. Results of meta-analysis were presented as follows: ① Response rate: five studies showed that, compared with the blank control group, significant differences were observed after the treatment with Cordyceps (RR 2.13, 95%CI 1.06 to 4.26); one study showed that there was no difference between Cordyceps and Shenyankangfu tablet (RR 2.17, 95%CI 0.73 to 6.460). ② Total effective rate: five studies showed that, compared with the blank control group, significant differences were observed after the treatment with Cordyceps (RR1.94, 95 %CI 1.14 to 3.30); one study showed that there was no difference between Cordyceps and Shenyankangfu tablet (RR 1.39, 95%CI 0.89 to 2.16). ③ Adverse reactions: adverse reactions were rare only with mild symptoms. Conclusions Cordyceps sinensis may improve the response rate and total effective rate of chronic kidney diseases. More high quality trials are required.
Chronic kidney disease (CKD) has been highlighted as one of the most important public health problems due to sharply climbing incidence and prevalence. To efficiently attenuate the disease burden and improve the disease management, not only active and effective treatment should be administrated, but also comprehensive follow-up nursing management with innovative and evolving spirits should be implemented. Thus dynamic changes of diseases could be acquired in time and patients are under appropriate medical instruction as soon as possible. This editorial is based on quickly developing medical big data resources and advanced internet techniques, from both aspects of patients and health care providers, briefly talking about integrated management strategy of CKD and its future development in China.
Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.