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Renal CKD


Chronic kidney disease is diagnosed when there is a gradual loss of kidney function over time, this is a debilitating disorder because the main duty of the kidneys is to remove wastes and excess water from the body. The main problem there is in the health industry is having a way to monitor severity or stage of this disease as time goes on without highly invasive and costly measures that usually involve a myriad of tests from blood and extraction of other fluids from the patient, these procedures may be necessary quite often especially at the latter stages.

The study used for this research involves a subject group from the Subjective Global Assessment or SGA of patients experiencing Protein- Energy Waste otherwise PEW for those that are not at the stage of CKD where dialysis is necessary; whereas this group has been “scarcely investigated” up to now.

The study directs attention to those not dependent on dialysis (NDD) according to their stage of CKD. This population consists of 922 individuals that meet that basic criteria from 2001 to 2012, where 58.6% were men, mean age 63.8 plus or minus 13.6 years from the average, Body Mass Index (BMI) 27.7 plus or minus 5.3 kg/m squared.

The actual study puts the state of the subject group according to the disease up against an alternative method of measuring critical criteria associated with CKD. This put to the test traditional anthropometric parameters that employ physical metrics to find a correlation to identify critical data. These measurements include BMI, mid arm circumference, mid arm muscle circumference, and triceps skinfold thickness. In this way the researchers would be able to see if a far less invasive method of measurement is applicable and reliable to monitor this disease and limit the onslaught of medical intrusion that is currently unavoidable for these types of patients.

What the experiment revealed is that majority of patients were in CKD stages 3 (48.9%) or 4 (40.3%), so that according to the SGA that showed less than or equal to stage 5 these generally correlate. PEW was present in 11% of the section below stage 6, and 32% showed signs of PEW that were in stage 6 according to SGA. The analysis led to the discernment that “worse renal function were independently associated with high levels of PEW. The study showed a moderately good agreement between the anthropometric parameters with the presence of PEW that was discovered by the SGA.

Though encouraging for those going through this chronic illness, the limitations of this study that need to be weighed are that only a fraction, 494 of the patients studied by the SGA, had available the physical metrics for the study compared to the full 922 subjects evaluated. With no specific reasoning for the selection whom were able to be measured, this can in some way skew results. That, however is the only avenue for inconsistencies that are seen in this experiment, the study question itself is fairly unsearched and only more studies will create a clearer solution to the problem.

The problem for these patients and the studies surrounding their condition is the necessity for such invasive modes of determining severity and action needed. Symptoms may not arise until much later where evidence of this disease can be deduced from a range of tests for: Albumin, Calcium, Cholesterol, Complete blood count, Electrolytes, Magnesium, Phosphorous, Potassium, and Sodium. Because of the similar findings to SGA studies that simple anthropometric parameters were able to produce, there is a way to estimate PEW or the phase at which the kidneys are unable to process out waste. As these tests can be necessary every couple weeks through the progression of CKD for the sake of the patient and insight to the therapy warranted to promote quality of life, this is a major find in the health society and a step into being able to study and understand further the dynamic nature of this illness.