BACKGROUND AND AIMS Elderly population is a vulnerable group, and cardiometabolic risk factors are highly prevalent among them. This situation complicates when the renal function becomes impaired. The aim of this study was to evaluate the association of renal function with cardiometabolic risk factors among the elderly subjects. METHOD This cross-sectional study was conducted among a group of elderly population (>60 years) living in three different elderly residential complexes. Written informed consent was taken from all. Study population underwent detail history taking, physical examination and relevant investigations. Renal function (eGFR) was estimated by CKD-EPIcr formula. Renal (eGFR, Ur ACR), cardiac (blood pressure, BMI, waist/hip ratio) and metabolic risk factors (lipids, albumin, uric acid, HbA1c) were evaluated. All information was recorded in separate case record form. Collected data were checked for errors and then analysed using the statistical software SPSS 16. RESULTS Around 145 subjects were included. About 42% were from 60–65 years of age, 37% from 66–70 years and rest > 70 years. Mean age was 68 ± 5 years with male 52%. Mean eGFR was 71 ± 2 and in male versus female it was 75 ± 22 versus 66 ± 24 mL/min/1.73 m2 (P < .032) . In 20% elderly eGFR was observed < 60 mL/min/1.73 m2. Prevalence of DM, HTN and obesity was 33%, 46% and 9%, respectively. Age (69 ± 5 and 67 ± 5 years, P < .012), waist/hip ratio (1.01 ± 0.16 and 0.97 ± 0.07,  P < .04), serum creatinine (1.6 ± 0.4 and 0.9 ± 0.2 mg/dL,  P < .001), urinary ACR (320 ± 565 and 82 ± 213 mg/g,  P < .001) were significantly altered among patients with impaired renal function (<60 versus >60 mL/min). CONCLUSION This study showed that various cardiometabolic risk factors among elderly patients are significantly higher in those with impaired renal function.

BACKGROUND AND AIMS The role of cardiac biomarker, NT-pro-BNP and its rising over time may identify chronic kidney disease (CKD) patients at increased risk of cardiovascular morbidity and mortality. Additionally, this may be correlated with altered cardio-metabolic risk factors predicting adverse outcomes. In this study, serum NT-pro-BNP level at different stages of CKD patients was measured to observe its association with different cardiac and metabolic risk factors METHOD This was a cross-sectional study carried out on stable CKD patients, stages 1–5, attending the outpatient department of a tertiary renal care facility. Serum creatinine, estimated glomerular filtration rate (eGFR) and urinary ACR were measured as renal function tests. While cardio-metabolic risk factors included blood pressure, body mass index (BMI), lipid profile, serum albumin, uric acid and hsCRP. Statistical analyses of the results were obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). RESULTS Patients of CKD 5 (30%), stage 4 (23%), stage 3 (26%), stage 2 (18%) and in stage 1 (6.7%) included 149 subjects. In stages 1–5 respectively, they were matched for age 48 ± 12, 48 ± 12, 51 ± 14, 50 ± 12, and 50 ± 11 years, (P = NS); BMI 24 ± 0.9 24 ± 1, 24 ± 1, 24 ± 1 and 24 ± 1 kg/m2, (P = NS) and serum creatinine was variable as 1.5 ± 1.5, 1.7 ± 0.7, 2.6 ± 2.0, 3.0 ± 1.6 and 5.7 ± 2.7mg% (P < 0.001). The mean NT-proBNP had a rising pattern in stages 1–5 showing 335 ± 674, 790 ± 1717, 1221 ± 1994, 2875 ± 6139 and 15645 ± 14741 pg/mL, (P < 0.001). There were positive correlations of NT-pro-BNP with serum creatinine (P < 0.001); CKD stages (P < 0.001). TG (P < 0.003); phosphate (P < 0.008) and negative correlation with serum albumin (P < 0.001). CONCLUSION Higher levels of NT-pro-BNP are seen in advancing stages of CKD. The positive association of NT-pro-BNP with lipids, phosphate and negative relation with albumin indicates its possible prognostic value for cardio-metabolic risk assessment.

Background and Aims Maintenance hemodialysis (MHD) patients have been identified as a high-risk group for COVID-19 infection. Serological testing can be used to monitor disease prevalence & evaluate screening measures & protocols aiming at limiting transmission within dialysis units. This study was conducted to observe the sero prevalence of COVID-19 infection among maintenance hemodialysis patients. Method The study was conducted during the 3rd wave of covid-19 infection. Total 194 in-center MHD patients were included from three dialysis centers. Relevant history regarding covid-19 symptom, testing, managements and vaccination were collected. During our study a serum sample was collected to test IgG antibody against nucleocapsid protein (NP) (cut-off positive when >1.5) and spike protein (S) (cut-off positive when >50 AIU/L) of COVID-19 infection and tested by Chemiluminescent microparticle immunoassay (CMIA) method developed by Abbott (FDA-EUA approved). Results Mean age of the MHD subjects was 48±12 years where male was 60%. Duration of MHD was 31±22 (6-120) months. Renal pathology was DN in 31%, possible GN 31%,HTN 19% and rest from others .From records past covid infection was clinically diagnosed in 39% of which 10% based on RT-PCR and another 29% fell into suspected category (i.e. symptom with/or suggestive serology). Presentation pattern was mild in 75%, moderate 15% (requiring oxygen), severe in 5% (requiring hospitalization) and asymptomatic rest 5%. Vaccine against covid-19 was availed by 38%. In vaccinated vs. non-vaccinated patients the IgG for NP was positive in 63% vs. 561%(P = 0.65) and IgG for S in 99% vs. 98%(P = 0.56). These indicate naturally acquired immunity in most before any vaccination. The IgG titer against spike (S) protein between vaccinated and non-vaccinated groups was 7743±8920 and 5386± 6839 AIU/L (p = 0.06). The correlation study showed that IgG titer against S has no correlation with dialysis duration, age, BMI, Hb%, serum albumin or Kt/V. Similarly IgG titer against NP shows mostly no significant correlation with laboratory parameters. Conclusion These data demonstrate that seroprevalence in hemodialysis population based on antibody against nucleocapsid protein shows only half infected by SARS-CoV-2 where as antibody against spike protein indicates larger number of patients are naturally infected even before vaccinated. Therefore for seroprevalence studies both antibody testing should be used to identify greater population infected until more sensitive tools are established.

Background and Aims The traditional and non-traditional lipid have been recognized to be involved in various atherosclerotic disease process. Several studies showed that, there is relation with renal function and dyslipidemia. Early detection of these modifiable risk factors and initiation of treatment may prevent or retard the progression of renal disease. Aim of this study was to evaluate the association of the traditional and non-traditional lipid abnormalities with renal function. Methods This cross sectional study was carried out in a rural area of Bangladesh. Renal function was evaluated by estimation of enzymatic creatinine, eGFR (CKD-EPI) and spot ACR. Total cholesterol (TC), triglyceride (TG), LDL and HDL was measured as traditional lipids and Apo-A1, APO-B, Lipo (a) as non-traditional lipids. Traditional dyslipidemia (TDLP) and non-traditional dyslipidemia (nTDLP) means abnormality in any of their components. Other tests include urine microscopy, Hb%, FBS, HbA1c, serum albumin and uric acid as additional risk marker. Results Total 201 patients were included for analysis. The mean age was 41± 13 years and male/female ratio 48:52. Around 48% were overweight. Among these 20% were hypertensive, 14% diabetic, nephropathy in13% and rest 53% had no known chronic disease. The mean value of creatinine was 0.8±0.2 mg%; eGFR was 94±23 ml/min/1.73m2, ACR was 9.70 (median), TG 182±104 mg/dl, TC 96 ±47 mg/dl; LDL 121 ± 39 mg/dl and HDL 38±6. The value of Apo-Al was 1.3 g/l (0.2-13.9), Apo-B 1.04 g/l (0.2-2.6) and Lipoprotein (a) was 17.3mg/dl (1.1-81.8). Mean value of FBS was 6.2 ±2.3 mmol/l, HbA1c 6.1 ±1.5%, Hb% 13.5 ± 1.6 g% and albumin was 4.8 ±0.5 mg%. When measured the TDLP was present in 81% and normal traditional lipids present in 19%. Similarly as a whole 50% had nTDLP and non-traditional lipids were normal in other half. Around 16% were free from both TDLP and nTDLP. The eGFR was lower in – TG >150 group than in < 150 (90 ± 24 vs. 98 ± 21 mg%, p<0.02); TC >200 than <200 (91 ± 23 vs. 100 ± 22 mg%, p<0.001); LDL >100 and < 100 (91± 23 vs. 100 ± 22 mg%, p<0.015) but no difference for components of nTDLP. The ACR was higher (> 30 mg/g) in 76% vs 24% (p<0.001) when TG is > 150 and < 150 mg%; 60% vs. 40% (p<0.05) when TC is > 200 and < 200mg%; and 81% vs. 19% (p<0.04) when LDL > 100 and < 100mg%. No such difference for renal functional parameters for non-traditional lipid components. In this study, eGFR had significant negative correlation with TC (r = -0.34 & p<0.001), TG (r = -0.24 & p<0.001), LDL (r = -0.25 & p<0.001) and only ACR had positive correlation with TG (r = 0.17 & p = 0.012). The nTDL wasn't associated with altered eGFR or ACR. Conclusion In this study it was observed that traditional lipid components were altered in 81% whereas non-traditional lipids were altered in 50% rural subjects. Only the traditional dyslipidemia was associated with lower eGFR and higher ACR.