Background and Objectives: Chronic Kidney Disease (CKD) affects 6,7% of the adult population in Romania and is associated with high morbidity. About one out of three adults with diabetes has kidney disease. According to current literature data, the prevalence of diabetes is very high, up to 11,6%, of whom 2,4% had undiagnosed diabetes, and is the leading cause of kidney damage and the need for renal replacement therapy (RRT). COVID-19 has brought with it a lot of unanswered questions, regarding the risk factors, the disease evolution, and the treatment possibilities. It became clear that diabetic kidney disease (DKD) is among the independent risk factors that predict unfavorable outcomes upon SARS-CoV-2 infection, so we aimed to evaluate the characteristics of diabetic and non-diabetic dialyzed patients, COVID-19 positive. Materials and Methods: It is an observational, single-center study that analyzed type 2 diabetes mellitus and non–diabetic patients in maintenance hemodialysis hospitalized for SARS CoV-2 infection. Results: A total of 101 adult dialyzed patients were admitted with a SARS-CoV-2 RT-PCR positive test, out of which 42 had a long history of diabetes mellitus type 2 and 59 of them have been known with other etiologies of CKD. Hypertension and heart disease were the most commonly associated comorbidities. Inflammatory markers and anemia were significantly increased in diabetic patients compared to non-diabetic. Conclusions: We found that anemia was more severe in patients COVID-19-positive MHD T2DM patients.
The recent increase in life expectancy is the main argument for a better understanding of the pathophysiological mechanisms underlying aging. These, once known, can provide possible links to therapies to prevent aging or slow down the process. Normal aging is associated with a progressive decrease in the glomerular filtration rate. Accurate estimation of GFR in the elderly is under the suspicion of multiple errors mainly due to sarcopenia and decreased protein intake. Differentiation between chronic kidney disease and the physiological decline of GFR might be a challenge in clinical practice and this has consequences on the evolution and treatment of the numerous comorbidities of the elderly. The current trend to use non-invasive diagnostic techniques explains the need to identify a serological marker to help differentiate between decreased GFR secondary to kidney aging or the development of chronic kidney disease.
(1) Background: The aim of this retrospective observational study was to evaluate the effects of sodium–glucose cotransporter-2 inhibitors (SGLT2i) therapy in patients with chronic kidney disease (CKD) who had been receiving renin–angiotensin– aldosterone system (RAAS) inhibitor (RAASi) treatment for at least one year. (2) Methods: The medical records of 73 patients with CKD, staged according to the KDIGO 2012 guidelines, were reviewed at the start of combined therapy (RAASi and SGLT2i), marked as T0, and again after six months (T1). Biochemical parameters assessed at both time points included urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), urinary albumin, urinary proteinuria, serum creatinine, and hemoglobin. (3) Results: A significant reduction in UACR (p < 0.001) and 24-hour urine albumin excretion (p = 0.050) was observed. Urine protein/24h (p = 0.074) and serum creatinine (p = 0.391) showed decreasing trends, while eGFR increased (p = 0.154), although these changes did not reach statistical significance. Regarding UACR category migration, 25% of patients improved, 74% remained stable, and only 1% worsened. (4) Conclusions: After six months of combined SGLT2i and RAASi therapy, most patients showed stable or improved renal status, suggesting a nephroprotective effect of dual therapy in CKD.
