How to treat patients with chronic kidney disease: With special focus on IgA nephropathy

Tomino, Yasuhiko

doi:10.1111/nep.13471

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…Tomino found that glomerular disease and metabolic disease can cause different degrees of infection in CGD patients, which were caused by primary glomerular disease (such as glomerular minimal disease, focal segmental glomerulosclerosis, membranous nephropathy, and proliferative glomerulonephritis), glomerular disease caused by systemic diseases (such as lupus nephritis, allergic purpura nephritis, and systemic infections), and vascular disease (Tomino, 2018). In addition, Floege suggested that glomerular disease can be caused by drug damage and infection, especially acute glomerulonephritis and cross‐immunity caused by infections from the respiratory tract, leading to kidney damage (Wang & Fey, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…(A: the patient's age and course of disease; B: the patient's systolic and diastolic blood pressure) F I G U R E 6 Patient's infection types. (A: a, b, c, d, and e indicated lupus nephritis, primary nephritis, immunoglobulin nephropathy, mesangial proliferative glomerulonephritis, and minimal changes, respectively; B: a, b, c, d, and e indicated diabetic nephropathy, rapidly progressive glomerulonephritis, glomerulosclerosis, purpuric nephritis, membranous proliferative glomerulonephritis, respectively)glomerulonephritis), glomerular disease caused by systemic diseases (such as lupus nephritis, allergic purpura nephritis, and systemic infections), and vascular disease(Tomino, 2018). In addition, Floege suggested that glomerular disease can be caused by drug damage and infection, especially acute glomerulonephritis and cross-immunity caused by infections from the respiratory tract, leading to kidney damage(Wang & Fey, 2018).In this study, patients with CGD were diagnosed with symptoms and signs observation diagnosis, combined diagnosis of blood test and urine test, and health information data diagnosis based on CNN deep learning, respectively, to study the infection factors in CGD patients based on diagnosis by health information data of deep learning.…”

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confidence: 99%

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Diagnosis of infectious factors in patients with chronic glomerular disease using deep learning‐based health information data

Zhou¹,

Chen

et al. 2021

Expert Systems

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The study was aimed to explore the effect of information health data based on deep learning of neural network to diagnose the infectious factors of patients with chronic glomerular disease (CGD) and evaluate its diagnostic effect. Ninety patients with CGD were selected and randomly rolled into control group A, control group B, and observation group, with 30 cases in each group. Big data scientific research analysis platform was used for data integration, convolutional neural network (CNN) was employed for feature analysis, correlation analysis, and screening of disease-related biomarkers. The patients were diagnosed by observation of symptoms and signs, combined diagnosis of blood test and urine test, and information health data diagnosis based on deep learning CNN. As a result, the specificity, sensitivity, and accuracy of information health data diagnosis based on deep learning CNN were 78.9%, 87.6%, and 92.1%, respectively.The main sources of infections in patients were lung infections, bloodstream infections, urinary system infections, skin and soft tissue infections, and upper respiratory tract infections. Amongst them, lung infection accounted for the highest proportion, reaching 65.4%, followed by blood infection (11.2%) and skin tissue infection (9.6%).The pathogens of infection were mainly bacteria, viruses, fungi, tuberculosis, and pneumocystis pneumonia (PCP), amongst which bacterial infections accounted for the highest proportion (31.5%), followed by PCP (25.6%). In short, the information health data based on deep learning CNN had high specificity, sensitivity, and accuracy for the diagnosis of CGD. The main infectious factors of CGD were pulmonary infection and blood infection, and the pathogens were mainly bacteria and viruses.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Diagnosis of infectious factors in patients with chronic glomerular disease using deep learning‐based health information data

Zhou¹,

Chen

et al. 2021

Expert Systems

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“…In a discussion on periodontal therapy in patients with CKD, we must also take into consideration the influence of immunosuppressive agents. In short, a variety of CKD, such as lupus nephritis and IgA nephropathy, is commonly treated with immunosuppressive agents [76,77]. Undoubtedly, the immune response is closely associated with infection control in almost organs and tissues including oral and periodontal tissues.…”

Section: Periodontal Disease and Chronic Kidney Diseasementioning

confidence: 99%

Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation

Kitamura

Mochizuki

Miyata

et al. 2019

IJMS

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Chronic kidney disease (CKD) is recognized as an irreversible reduction of functional nephrons and leads to an increased risk of various pathological conditions, including cardiovascular disease and neurological disorders, such as coronary artery calcification, hypertension, and stroke. In addition, CKD patients have impaired immunity against bacteria and viruses. Conversely, kidney transplantation (KT) is performed for patients with end-stage renal disease as a renal replacement therapy. Although kidney function is almost normalized by KT, immunosuppressive therapy is essential to maintain kidney allograft function and to prevent rejection. However, these patients are more susceptible to infection due to the immunosuppressive therapy required to maintain kidney allograft function. Thus, both CKD and KT present disadvantages in terms of suppression of immune function. Periodontal disease is defined as a chronic infection and inflammation of oral and periodontal tissues. Periodontal disease is characterized by the destruction of connective tissues of the periodontium and alveolar bone, which may lead to not only local symptoms but also systemic diseases, such as cardiovascular diseases, diabetes, liver disease, chronic obstructive pulmonary disease, and several types of cancer. In addition, the prevalence and severity of periodontal disease are significantly associated with mortality. Many researchers pay special attention to the pathological roles and clinical impact of periodontal disease in patients with CKD or KT. In this review, we provide information regarding important modulators of periodontal disease to better understand the relationship between periodontal disease and CKD and/or KT. Furthermore; we evaluate the impact of periodontal disease on various pathological conditions in patients with CKD and KT. Moreover, pathogens of periodontal disease common to CKD and KT are also discussed. Finally, we examine the importance of periodontal care in these patients. Thus, this review provides a comprehensive overview of the pathological roles and clinical significance of periodontal disease in patients with CKD and KT.

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“…Secondary adrenal insufficiency (AI) due to long-term glucocorticoid medication in patients on hemodialysis (HD) is a diagnostic challenge, as many kidney diseases are treated with corticosteroids, and immunosuppressive therapy after renal transplantation often includes prednisolone [1][2][3][4][5][6]. This is further complicated, as AI and renal replacement treatment may both lead to the same unspecific symptoms like fatigue and orthostatic hypotonia [1,3,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Adrenal function testing in dialysis patients – a review of the literature

et al. 2021

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Background Secondary adrenal insufficiency is a frequent issue in patients with renal replacement therapy. There are concerns about metabolism and clearance for adrenocorticotropic hormone (ACTH) and cortisol in addition to hemoconcentration as confounding factors during hemodialysis (HD). Therefore, ACTH testing is currently performed before or in between HD sessions. This review of the literature aims to evaluate the current evidence for validity of testing for adrenal insufficiency in patients on chronic renal replacement therapy. Methods A literature search of PubMed database for interventional and observational clinical trials was performed. Case reports and reviews were excluded. The search included all articles published until July 2020. Results Of 218 potentially eligible articles, 16 studies involving 381 participants were included. Seven studies performed an ACTH test before HD or in between HD sessions. There was no data available regarding ACTH testing during HD. But there was evidence of decreased cortisol levels during HD as compared to afterwards. All included 16 studies measured basal cortisol, and seven studies performed an ACTH test. Seven trials had comparable data of baseline cortisol for a quantitative analysis. Standardized mean difference of overall cortisol was 0.18 nmol/l (95%CI − 0.08 to 0.44) in the case group. Conclusions In patients undergoing renal replacement therapy, basal serum cortisol values are comparable to healthy volunteers. There is limited data on the validity of stimulated cortisol in these patients, especially during HD. Trial registration Registration no. CRD42020199245.

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How to treat patients with chronic kidney disease: With special focus on IgA nephropathy

Cited by 3 publications

References 17 publications

Diagnosis of infectious factors in patients with chronic glomerular disease using deep learning‐based health information data

Diagnosis of infectious factors in patients with chronic glomerular disease using deep learning‐based health information data

Pathological Characteristics of Periodontal Disease in Patients with Chronic Kidney Disease and Kidney Transplantation

Adrenal function testing in dialysis patients – a review of the literature

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