Owen, Paul Body composition and function in chronic kidney disease.
For some, their renal dysfunction is a consequence of their cardiac failure or general vascular disease; for others it develops and progresses over the course of their renal disease.
Uraemic Cardiomyopathy is a group of particular cardiac abnormalities that are found in renal failure; left ventricular hypertrophy, ventricular dilatation and left ventricular systolic dysfunction.
Pathological examination of these hearts reveals prominent cardiac fibrosis and expansion of the ventricular muscular wall. Therefore it has been proposed that factors other than uraemia and uraemic toxins probably contribute to this pathological process.
The renin-angiotensin-aldosterone system is one of the possible contributing factors. Animal studies and more recently clinical studies have added weight to this theory.
Brilla and Weber published a set of landmark papers indemonstrating an increase in cardiac fibrosis in rats treated with an aldosterone infusion. However, these finding were only present in rats fed a high sodium diet.
They also appear to be independent of hypertension; another known cause of left ventricular hypertrophy.
Evidence in humans is more difficult to prove and remains varied in outcome. A recent study in a hypertensive population found a positive correlation between aldosterone serum levels and left ventricular mass. Evidence in renal failure is even more limited and it is this situation that we have focused on in our study.
However this is not the only signalling pathway that is under investigation and at present the evidence is equivocal. This Thesis incorporates three separate but related studies. The West of Scotland Kidney Disease Study was a 10 year follow-up analysis of patients initially enrolled inwith a range of renal failure from mild to end-stage, those on dialysis and transplanted patients.
As expected survival decreased as renal function declined and survival rates were better in the transplanted group than those on dialysis. However, survival rates in this group of patients were not determined by aldosterone, total renin, aldosterone: The Aldosterone Study, aimed to identify factors affecting left ventricular mass and aldosterone levels in a renal failure population.
Unfortunately no link was identified between aldosterone and left ventricular mass, or surrogate markers of cardiac disease. Also no significant factors affecting the aldosterone levels of these patients were identified. The Rat Slice Study was an experimental model developed in an attempt to replicate ventricular cell interactions and structure that occurs within the body.
Rat ventricle tissue slices were used and incubated in media for 48hours. Viability of the slices was evident at 48hours although at a much lower level than at the start of the experiment.
This was true of both the uraemic and non-uraemic states.of chronic kidney disease and its progression to end-stage renal disease, the current state of knowledge about nutritional status in chronic dialysis patients, and how the chapters in this thesis may contribute to our understanding.
Abstract: Chronic Kidney Disease is a worldwide health problem with an increasing incidence and prevalence. Abnormalities in the structure and function of the thyroid gland and in the metabolism and plasma concentration of thyroid hormones are common in .
Korle-Bu Teaching Hospital (Ghana) recorded cases of chronic kidney disease between January and July in the country (All Africa, ) and this may represent less than 30% of the total disease burden as . Jul 17, · Chronic kidney disease (CKD)—or chronic renal failure (CRF), as it was historically termed—is a term that encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure.
CKD is a worldwide public health problem. Chronic kidney disease (CKD) includes conditions that affect the kidney with the potential to cause either progressive loss of kidney function or complications resulting from decreased kidney function (Levey et al., ). Harris et al.
() also defined CKD as the presence of kidney damage or decreased level of kidney function for three months or more, irrespective of diagnosis which generally results in death of . Chronic kidney disease is a worldwide public health problem.
In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. There is an even higher prevalence of earlier stages of chronic kidney disease. Increasing evidence, accrued in the past.