The estimated prevalence of CKD among adults in Poland is 5.8% (∼1 724 960 patients). Its prevalence was lower than expected. CKD is more frequent in older subjects, smokers and people with comorbidities such as AH and DM.
IntroductionGranulomatosis with polyangiitis (GPA) is a necrotising vasculitis of small arteries and veins. In its classical manifestation GPA affects the upper and lower respiratory tract and kidneys. However, other organs, including those of the gastrointestinal tract, may be affected as well.AimTo present the clinical manifestations of gastrointestinal tract involvement in patients with GPA.Material and methodsWe analysed case records of 34 patients with GPA treated in the Department of Nephrology, Transplantology, and Internal Medicine of the Medical University of Gdansk from 1991 to 2009.ResultsIn 9 of 34 patients, 2 men and 7 women, aged 18 to 74 years, gastrointestinal complications were observed in the course of GPA. In two of them a localised and in seven a generalised type of GPA was diagnosed. The main symptoms relating to gastrointestinal tract were: oral mucosa ulcerations, gum mucosa hypertrophy, dyspepsia, vomiting, stomachache, gastrointestinal haemorrhage, diarrhoea, and symptoms of gastrointestinal tract perforation. Two patients required urgent surgical treatment. In 2 of the 5 patients who developed gastrointestinal bleeding, it was the direct cause of death. The histopathological confirmation of specificity of changes in gastrointestinal tract was established only in 2 cases. Tissue samples collected during endoscopy usually revealed only nonspecific inflammation or the presence of ulcers.ConclusionsTherapeutic strategies accepted for GPA treatment are effective in treating patients with gastrointestinal involvement in the course of the disease. Some complications require surgical intervention.
Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease. Along with the increasing prevalence of diabetes, DKD is expected to affect a higher number of patients. Despite the major progress in the therapy of DKD and diabetes mellitus (DM), the classic clinical diagnostic tools in DKD remain insufficient, delaying proper diagnosis and therapeutic interventions. We put forward a thesis that there is a need for novel markers that will be early, specific, and non-invasively obtained. The ongoing investigations uncover new molecules that may potentially become new markers of DKD—among those are: soluble α-Klotho and proteases (ADAM10, ADAM17, cathepsin, dipeptidyl peptidase 4, caspase, thrombin, and circulating microRNAs). This review summarizes the current clinical state-of-the-art in the diagnosis of DKD and a selection of potential novel markers, based on up-to-date literature.
PurposeKidney filtration decreases with age, which results in an increased frequency of chronic kidney disease (CKD) in the elderly population. The purpose of the study was to assess the prevalence and epidemiology of CKD in the Polish elderly population.MethodsA representative sample of the Polish elderly population, composed of 918 people (F 452, M 466) in the age of ≥75 years, was chosen. All participants had their history, anthropometric measures and biochemical parameters (creatinine, fasting glucose, complete cholesterol) evaluated. CKD was diagnosed when eGFR was <60 ml/min/1.73 m2. The comorbidities, anthropometric and social factors connected with the onset of CKD were also analyzed.ResultsThe prevalence of CKD in the analyzed population was 26.9% (F 32.0%, M 15.8%), which gives an estimated number of 495,590 (95% CI 396,363–594,817) patients in the study subpopulation. The majority of these people were in the G3A category—70.1%, while the remaining fell under the G3B—25.7%, G4—3.1% and G5—1.1% categories. Disease awareness among the participants was found to be at 17%. Arterial hypertension (AH) was more frequent in people with CKD (91.0 vs. 80.3%, P < 0.001), whereas diabetes mellitus (DM) prevalence was comparable in both CKD and non-CKD groups (11.7 vs. 11.4%, ns). In the examined group, DM had no influence on the frequency of CKD. In contrast, the presence of cardiovascular diseases substantially increased the chances of developing CKD (OR 1.87, P < 0.05).Conclusion1. The prevalence of CKD in the Polish elderly population was 26.9%. 2. Awareness of CKD is low. 3. DM, increasing age and AH did not increase the risk of CKD. 4. Coexistence of cardiovascular diseases increased the risk of having CKD.
Introduction and Aims: The frequency of Chronic Kidney Disease (CKD) increases with age, however its significance in elderly is not certain. The aim of our study was to analyze the classic risk factors of CKD development and their influence on CKD prevalence in elderly Polish population aged 75+. Methods: Data from 918 participants (F 452, M 466) of the cross-sectional epidemiological study Wobasz Senior were analyzed. CKD was detected if the MDRD formula based eGFR was <60 mL/min/1.73m2. Creatinine (Jaffe reaction), LDL and total cholesterol concentration were measured. Diagnosis of diabetes mellitus (DM)
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