Dataset Information

A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD.

ABSTRACT: OBJECTIVES:Although many secondary effects of high levels of vanadium (V) and chromium (Cr) overlap with symptoms seen in paediatric patients with chronic kidney disease (CKD), their plasma V and Cr levels are understudied. DESIGN:Ancillary cross-sectional study to a prospective, longitudinal, randomised controlled trial. SETTING:Children's Hospital of Western Ontario, London Health Sciences Centre, London, Ontario, Canada. PARTICIPANTS:36 children and adolescents 4-18 years of age with CKD. INTERVENTIONS:1-6 trace element measurements per patient. Cystatin C (CysC) estimated glomerular filtration rate (eGFR) was calculated using the Filler formula. Plasma V and Cr levels were measured using high-resolution sector field inductively coupled mass spectrometry. Anthropomorphic data and blood parameters were collected from our electronic chart programme. Water Cr and V data were obtained from the Ontario Water (Stream) Quality Monitoring Network. PRIMARY AND SECONDARY OUTCOME MEASURES:Primary outcomes: plasma Cr and V. SECONDARY OUTCOMES:age, season, CysC, CysC eGFR, and Cr and V levels in environmental water. RESULTS:The median (IQR) eGFR was 51?mL/min/1.73?m2 (35, 75). The median V level was 0.12?µg/L (0.09, 0.18), which was significantly greater than the 97.5th percentile of the reference interval of 0.088?µg/L; 32 patients had at least one set of V levels above the published reference interval. The median Cr level was 0.43?µg/L (0.36, 0.54), which was also significantly greater than the established reference interval; 34 had at least one set of Cr levels above the published reference interval. V and Cr levels were moderately correlated. Only some patients had high environmental exposure. CONCLUSIONS:Our study suggests that paediatric patients with CKD have elevated plasma levels of V and Cr. This may be the result of both environmental exposure and a low eGFR. It may be necessary to monitor V and Cr levels in patients with an eGFR <30?mL/min/1.73?m2. TRIAL REGISTRATION NUMBER:NCT02126293; HC#172241.

SUBMITTER: Filler G

PROVIDER: S-EPMC5734203 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

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A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD.

Filler Guido G Kobrzynski Marta M Sidhu Hargun Kaur HK Belostotsky Vladimir V Huang Shih-Han S SS McIntyre Chris C Yang Liju L

BMJ open 20170606 5

<h4>Objectives</h4>Although many secondary effects of high levels of vanadium (V) and chromium (Cr) overlap with symptoms seen in paediatric patients with chronic kidney disease (CKD), their plasma V and Cr levels are understudied.<h4>Design</h4>Ancillary cross-sectional study to a prospective, longitudinal, randomised controlled trial.<h4>Setting</h4>Children's Hospital of Western Ontario, London Health Sciences Centre, London, Ontario, Canada.<h4>Participants</h4>36 children and adolescents 4- ...[more]

PMID: 28592575

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Project description:Background and objectivesTo assess the association between self-reported sleep duration and quality and odds of having CKD in Chinese adults on the basis of a community study.Design, setting, participants, & measurementsIn this cross-sectional study, we included 11,040 Chinese adults who participated in an ongoing prospective study, the Kailuan cohort. Survey questionnaire items addressed insomnia, daytime sleepiness, snoring, and sleep duration during their 2012 interview. Overall sleep quality was evaluated by summarizing these four sleep parameters. Fasting blood samples and single random midstream morning urine samples were collected in 2012 and analyzed for serum creatinine and proteinuria. CKD was defined by eGFR<60 ml/min per 1.73 m2 or proteinuria >300 mg/dl. We also examined those at high or very high risk of having CKD, on the basis of the Kidney Disease Improving Global Outcomes recommendations. The association between sleep quality and CKD was assessed using logistic regression model.ResultsWorse overall sleep quality was associated with higher likelihood of being high or very high risk for CKD (multiadjusted odds ratio, 2.69; 95% confidence interval, 1.30 to 5.59 comparing two extreme categories; P trend <0.01), but not overall CKD (multiadjusted odds ratio, 1.58; 95% confidence interval, 0.89 to 2.80 comparing two extreme categories; P trend =0.46), after adjusting for potential confounders. Specifically, individuals with worse sleep quality were more likely to have proteinuria (multiadjusted odds ratio, 1.95; 95% confidence interval, 1.03 to 3.67 comparing two extreme categories; P trend =0.02), rather than lower eGFR level (multiadjusted mean eGFR levels were 96.4 and 93.6 ml/min per 1.73 m2 in the two extreme sleep categories, respectively; P trend =0.13). However, there was no statistically significant association between individual sleep parameters and CKD status.ConclusionsWorse overall sleep quality was associated with higher odds of being high or very high risk for CKD and proteinuria in Chinese adults.

Project description:BACKGROUND:The quality of patient-physician discussions about chronic kidney disease (CKD) in primary care has not been studied previously. STUDY DESIGN:Cross-sectional study. SETTINGS & PARTICIPANTS:We audiotaped encounters between 236 patients with hypertension and their primary care physicians (n = 40). PREDICTORS:Patient, physician, and encounter characteristics. OUTCOMES & MEASUREMENTS:We described the occurrence and characteristics (content, use of technical terms, and physician assessment of patient comprehension of new concepts) of CKD discussions. We assessed patient and physician characteristics associated with CKD discussion occurrence. RESULTS:Many patients (mean age, 59 years) had uncontrolled hypertension (51%), diabetes (44%), and/or 3 or more comorbid conditions (51%). Most primary care physicians practiced (52%) fewer than 10 years. CKD discussions occurred in few (26%; n = 61) encounters, with content focused on laboratory assessment (89%), risk-factor treatment (28%), and causes (26%) of CKD. In encounters that included a CKD discussion, physicians used technical terms (28%; n = 17) and rarely assessed patients' comprehension (2%; n = 1). CKD discussions were statistically significantly less common in visits of patients with some (vs no) college education (OR, 0.23; 95% CI, 0.09-0.56), with 3 or more (vs fewer) comorbid conditions (OR, 0.49; 95% CI, 0.25-0.96), and who saw physicians with more (vs fewer) than 10 years of practice experience (OR, 0.41; 95% CI, 0.21-0.80). CKD discussions were more common during longer encounters (OR, 1.31; 95% CI, 1.04-1.65) and encounters in which diabetes was (vs was not) discussed (OR, 2.87; 95% CI, 1.22-6.77). LIMITATIONS:Generalizability of our findings may be limited. CONCLUSIONS:Patient-physician discussions about CKD in high-risk primary care patients were infrequent. Physicians used technical terms and infrequently assessed patients' understanding of new CKD concepts. Efforts to improve the frequency and content of patient-physician CKD discussions in primary care could improve patients' clinical outcomes.

Dataset Information

A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD.

Publications

A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD.

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