Documento de consenso para la detección y manejo de la enfermedad renal crónica

Martínez‐Castelao, Alberto; Górriz, José Luis; Bover, Jordi; Segura, Julián; Cebollada, J.; Escalada, Javier; Esmatjes, Enric; Fácila, Lorenzo; Gamarra, Javier; Gràcia, S.; Hernández-Moreno, J.; Llisterri-Caro, J.L.; Mazón, Pilar; Montañés, Rosario; Morales‐Olivas, Francisco J.; Muñóz-Torres, Manuel; Pablos-Velasco, Pedro de; Santiago, Ana de; Sánchez-Celaya, Marta; Suárez, Carmen; Tranche, Salvador

doi:10.1016/j.semerg.2014.09.001

Cited by 18 publications

(13 citation statements)

References 56 publications

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“…Chronic kidney disease (CKD) is a major public health problem that has received increasing attention because of its association with the high rate of end stage renal disease (ESRD) (Eknoyan et al 2004 ; Liu et al 2015 ; Martinez-Castelao et al 2014 ). Proteinuria is often observed in patients with CKD, and it is reportedly a vital risk factor for the progression and prognosis of CKD (Sandsmark et al 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Altered gut microbiome promotes proteinuria in mice induced by Adriamycin

Jiang

Zou

et al. 2018

AMB Expr

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Inflammation has recently been attributed to dysbiosis of the gut microbiome, which has been linked to proteinuria in chronic kidney disease. Since Adriamycin® (ADR) is widely used to induce proteinuria in mouse models, the aim of this study was to explore the potential effect of gut microbiome on this process. Both ADR resistant (C57BL/6) and susceptible (BALB/C) strains were part of the induced nephropathy with ADR injection. BALB/C mice significantly presented increased urinary albumin/creatinine ratio (UACR) with renal lesions in pathology, but C57BL/6 mice were absent from kidney damage. Species and genus level resolution analysis showed a shift in gut microbial profile between BALB/C and C57BL/6 mice. ADR further altered the stool microbiome in BALB/C mice, particularly with enrichment of Odoribacter and depletion of Turicibacter, Marvinbryantia and Rikenella. Moreover, the level of UACR in BALB/C mice was marked related to the abundance of Marvinbryantia, Odoribacter and Turicibacter in stool. Meanwhile, ADR remarkably increased the serum levels of interleukin (IL)-2 in BALB/C mice, but not in C57BL/6 mice. It is suggested that the favorably altered stools as shown in the microbiome might promote the inflammation and proteinuria in ADR-sensitive mice, which provides a new insight on the pathogenicity of chronic kidney disease.

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Section: Introductionmentioning

confidence: 99%

Altered gut microbiome promotes proteinuria in mice induced by Adriamycin

Jiang

Zou

et al. 2018

AMB Expr

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“…Although cardiologists and endocrinologists evaluated in our study require periodic laboratory tests for hypertensive and diabetic patients, it is still necessary to include albuminuria and GFR exams in their routines. Other studies carried out in Senegal (13), Spain (14) and the United States (15) show that hypertension and DM are the main diseases that pose a risk of developing kidney damage, and that these diseases require preventive screening through laboratory tests, not only in adults but also in children in order to avoid developing CKD (16,17).…”

Section: Discussionmentioning

confidence: 99%

“…The guidelines recommend that in order to maintain good cardiovascular health and quality of life, every adult should perform physical exercise three to five times a week, with 30 minutes of light to moderate physical activity (18). In the case of established kidney disease, Martinez-Castelao et al reported that exercise should be adapted to the individual's physical capacity (14).…”

Section: Discussionmentioning

confidence: 99%

Knowledge regarding the prevention of chronic kidney disease in hypertensive and diabetic patients: a cross-sectional study

2017

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Introduction: Hypertension (HT) and diabetes mellitus (DM) lead to functional and structural changes in target organs such as the kidneys, characterizing the need for preventive actions to avoid Chronic Kidney Disease (CKD). Objective: To verify cardiologists’ and endocrinologists’ knowledge, indications and practices regarding prevention of CKD in patients with HT and DM. Methods: A cross-sectional study with 14 cardiologists and 5 endocrinologists applying a questionnaire about the conduct of these professionals regarding the prevention of CKD in hypertensive and diabetic patients. Results: One hundred percent of the cardiologists and endocrinologists did not request specific tests for CKD screening (albuminuria and glomerular filtration rate (GFR), although 92.9% of the cardiologists and 60.0% of the endocrinologists report referring hypertensive and diabetic patients with impaired renal function to nephrologists. One hundred percent of the interviewees recognize the importance of physical exercise for their patients; however, only 68.6% of cardiologists and 60% of endocrinologists indicated a physiotherapist and/or physical trainer to implement these exercises. Conclusion: The professionals evaluated in this study do not request microalbuminuria and GFR examinations for hypertensive and diabetic patients as a follow-up routine, despite having found cases of renal function impairment in these patients; in contrast to what is proposed in the guidelines for hypertension and diabetes mellitus. They recognize the importance of physical exercise and report indicating their patients to a physiotherapist and/or physical trainer. We suggest continuing the study in order to ascertain the reasons for their not complying with the respective guidelines.

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“…Several wake-up calls should alarm diabetic patients regarding their kidneys' health, and patients should be referred to a nephrologist earlier if they present rapid renal reduction, resistant hypertension, hyperkalemia, UACR exceeding 300 mg/g, or other urinary abnormalities [56].…”

Section: Management Of Diabetes Mellitus In the Transition From Dkd To Esrdmentioning

confidence: 99%

Kidney Disease in Diabetic Patients: From Pathophysiology to Pharmacological Aspects with a Focus on Therapeutic Inertia

Gembillo

Ingrasciotta

Crisafulli

et al. 2021

IJMS

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Diabetes mellitus represents a growing concern, both for public economy and global health. In fact, it can lead to insidious macrovascular and microvascular complications, impacting negatively on patients’ quality of life. Diabetic patients often present diabetic kidney disease (DKD), a burdensome complication that can be silent for years. The average time of onset of kidney impairment in diabetic patients is about 7–10 years. The clinical impact of DKD is dangerous not only for the risk of progression to end-stage renal disease and therefore to renal replacement therapies, but also because of the associated increase in cardiovascular events. An early recognition of risk factors for DKD progression can be decisive in decreasing morbidity and mortality. DKD presents patient-related, clinician-related, and system-related issues. All these problems are translated into therapeutic inertia, which is defined as the failure to initiate or intensify therapy on time according to evidence-based clinical guidelines. Therapeutic inertia can be resolved by a multidisciplinary pool of healthcare experts. The timing of intensification of treatment, the transition to the best therapy, and dietetic strategies must be provided by a multidisciplinary team, driving the patients to the glycemic target and delaying or overcoming DKD-related complications. A timely nephrological evaluation can also guarantee adequate information to choose the right renal replacement therapy at the right time in case of renal impairment progression.

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Documento de consenso para la detección y manejo de la enfermedad renal crónica

Cited by 18 publications

References 56 publications

Altered gut microbiome promotes proteinuria in mice induced by Adriamycin

Altered gut microbiome promotes proteinuria in mice induced by Adriamycin

Knowledge regarding the prevention of chronic kidney disease in hypertensive and diabetic patients: a cross-sectional study

Kidney Disease in Diabetic Patients: From Pathophysiology to Pharmacological Aspects with a Focus on Therapeutic Inertia

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