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  1. Dokkyo Medical Journal
  2. 2(1) 2023

Preservation of Renal Function in Predialysis Patients before Dialysis Initiation with Nephrology Care: A Single-center Retrospective Study

https://dmu.repo.nii.ac.jp/records/2000007
https://dmu.repo.nii.ac.jp/records/2000007
fa01c1ae-081f-46fa-b2b0-378d49c090bc
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DKMJ-2-1-3.pdf DKMJ-2-1-3.pdf (113 KB)
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Item type 学術雑誌論文 / Journal Article(1)
タイトル
タイトル Preservation of Renal Function in Predialysis Patients before Dialysis Initiation with Nephrology Care: A Single-center Retrospective Study
言語 en
言語
言語 eng
キーワード
言語 en
主題Scheme Other
主題 access preparation
キーワード
言語 en
主題Scheme Other
主題 dialysis initiation
キーワード
言語 en
主題Scheme Other
主題 nephrology care
キーワード
言語 en
主題Scheme Other
主題 predialysis CKD patients
キーワード
言語 en
主題Scheme Other
主題 vitamin D
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ journal article
著者 Kawamoto, Shinya

× Kawamoto, Shinya

en Kawamoto, Shinya

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Nagahori, Katsuhiro

× Nagahori, Katsuhiro

en Nagahori, Katsuhiro

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Yasu, Takanori

× Yasu, Takanori

en Yasu, Takanori

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Takeda, Tetsuro

× Takeda, Tetsuro

en Takeda, Tetsuro

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書誌情報 Dokkyo Medical Journal

巻 2, 号 1, p. 16-22, 発行日 2023-03-25
記事種別
値 Original
内容記述
内容記述タイプ Abstract
内容記述 Background: Progressive chronic kidney disease, which necessitates dialysis, results in inability to maintain renal homeostasis. Although drugs are available, maintenance of residual renal function is challenging, and the estimated glomerular filtration rate (eGFR) declines rapidly. Age, sex, primary disease of renal failure, blood pressure, urinary protein, anemia, and access preparation for dialysis affect the decline in eGFR during this period.

Methods: We investigated 428 incident dialysis patients who received nephrology care for >6 months before dialysis initiation. We retrospectively compared age, primary disease (diabetic vs. non-diabetic kidney disease), blood pressure, serum hemoglobin levels, urinary protein levels, renin-angiotensin system (RAS) inhibitor, diuretics, vitamin D use and preparation of access at initiation to determine their association with the decline in eGFR over 6 months before dialysis initiation.

Result: The decline in eGFR was significantly associated with age (<60 years), sex (male), without access preparation, hypertension (6 months before and at initiation), renin-angiotensin system inhibitor use (6 months prior), nephrotic-range proteinuria, and vitamin D use.
We observed no significant differences in the primary disease (diabetic vs. non-diabetic kidney disease), RAS inhibitor use and hemoglobin levels at initiation. RAS inhibitors are also effective in CKDG1 to G4, whereas they are not effective in CKD with advanced G5.
Multivariate analysis showed that eGFR decline was significantly correlated with sex, vascular access preparation, and urinary protein levels.

Conclusion: Renal function preservation is challenging in patients with progressive chronic kidney disease accompanied by increased urinary protein levels. Regardless of renin-angiotensin system inhibitor use, renal function was better preserved in women with strict blood pressure control and vascular access preparation before dialysis initiation.
言語 en
出版者
出版者 Dokkyo Medical Society
ISSN
収録物識別子タイプ EISSN
収録物識別子 2436-522X
DOI
関連タイプ isIdenticalTo
識別子タイプ DOI
関連識別子 https://doi.org/10.51040/dkmj.2022-029
出版タイプ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
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