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- Winitzki, D., et al.
(author)
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Educational Attainment Is Associated With Kidney and Cardiovascular Outcomes in the German CKD (GCKD) Cohort
- 2022
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In: Kidney International Reports. - : Elsevier BV. - 2468-0249. ; 7:5, s. 1004-1015
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Journal article (peer-reviewed)abstract
- Introduction: Prospective data on impact of educational attainment on prognosis in patients with chronic kidney disease (CKD) are scarce. We investigated the association between educational attainment and all-cause mortality, major adverse cardiovascular (CV) events (MACEs), kidney failure requiring dialysis, and CKD etiology. Methods: Participants (N = 5095, aged 18–74 years) of the ongoing multicenter German Chronic Kidney Disease (GCKD) cohort, enrolled on the basis of an estimated glomerular filtration rate (eGFR) of 30 to 60 ml/min (stages G3, A1–A3) or overt proteinuria (stages G1–G2, A3), were divided into 3 categories according to their educational attainment and were followed for 6.5 years. Results: Participants with low educational attainment (vs. high) had a higher risk for mortality (hazard ratio [HR] 1.48, 95% CI: 1.16–1.90), MACE (HR 1.37, 95% CI: 1.02–1.83), and kidney failure (HR 1.54, 95% CI: 1.15–2.05). Mediators between low educational attainment and mortality were smoking, CV disease (CVD) at baseline, low income, higher body mass index, and higher serum levels of CRP, high-density lipoprotein cholesterol, uric acid, NGAL, BAP, NT-proBNP, OPN, H-FABP, and urea. Low educational attainment was positively associated with diabetic nephropathy (odds ratio [OR] 1.65, 95% CI: 1.36–2.0) and CKD subsequent to acute kidney injury (OR 1.56, 95% CI: 1.03–2.35), but negatively associated with IgA nephropathy (OR 0.68, 95% CI: 0.52–0.90). Conclusion: Low educational attainment is associated with adverse outcomes and CKD etiology. Lifestyle habits and biomarkers mediate associations between low educational attainment and mortality. Recognition of the role of educational attainment and the associated health-relevant risk factors is important to optimize the care of patients with CKD and improve prognosis. © 2022 International Society of Nephrology
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| 2. |
- Heindel, J., et al.
(author)
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Association Between Dietary Patterns and Kidney Function in Patients With Chronic Kidney Disease: A Cross-Sectional Analysis of the German Chronic Kidney Disease Study
- 2020
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In: Journal of renal nutrition. - : Elsevier BV. - 1051-2276. ; 30:4, s. 296-304
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Journal article (peer-reviewed)abstract
- Objective In the general population, “healthy” dietary patterns are associated with improved health outcomes, but data on associations between observance of specific dietary patterns and kidney function in patients with chronic kidney disease (CKD) are sparse. Methods Dietary intake was evaluated using food frequency questionnaires in patients with moderately severe CKD under nephrology care enrolled into the observational multicenter German CKD study. The Dietary Approaches to Stop Hypertension (DASH) diet score, Mediterranean diet score, and German Food Pyramid Index (GFPI) were calculated and their association with estimated glomerular filtration rate (eGFR) and albuminuria was assessed by multivariable linear regression analysis, adjusted for gender, age, body mass index, energy intake, smoking status, alcohol intake, education, high-density lipoprotein-cholesterol (HDL- cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), hypertension, and diabetes mellitus. Results A total of 2,813 patients (41% women; age 60.1 ± 11.6 years) were included in the analysis. High DASH diet score and GFPI were associated with lower systolic blood pressure and lower intake of antihypertensive medication, higher HDL, and lower uric acid levels. Mediterranean-style diet was associated with lower prevalence of diabetes mellitus. Higher DASH and Mediterranean diet scores were associated with higher eGFR (β-coefficient = 1.226, P < .001; β-coefficient = 0.932, P = .007, respectively). In contrast, GFPI was not associated with eGFR. For the individual components of the dietary patterns, higher intake of nuts and legumes, cereals, fish, and polyunsaturated fats was associated with higher eGFR and higher intake of dairy, composed of low- and whole-fat dairy, was associated with lower eGFR. No association was found between dietary patterns and albuminuria. Conclusion Higher observance of the DASH or Mediterranean diet, but not German food pyramid recommendations, was associated with higher eGFR among patients with CKD. Improving dietary habits may offer an opportunity to better control comorbidities and kidney function decline in patients with CKD.
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| 3. |
- Movaghar, Amirreza, 1987, et al.
(author)
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Numerical investigation of turbulent-jet primary breakup using one-dimensional turbulence
- 2017
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In: International Journal of Multiphase Flow. - : Elsevier BV. - 0301-9322. ; 89, s. 241-254
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Journal article (peer-reviewed)abstract
- Primary breakup to form droplets at liquid surfaces is an important fundamental process to study as it determines the initial properties of the dispersed phase, which affect mixing rates, secondary breakup, droplet collisions, and flow separation within the dispersed flow region. Primary breakup can be regarded as one of the least developed model components for simulating and predicting liquid jet breakup. However, it is of paramount importance in many technical applications, e.g. fuel injection in engines and spray painting. This paper presents a numerical investigation of primary breakup of a turbulent liquid jet in still air at standard conditions using the one-dimensional turbulence (ODT) modeling framework. ODT is a stochastic model that simulates turbulent flow evolution along a notional 1D line of sight by applying instantaneous maps to represent the effect of individual turbulent eddies on property profiles. An important feature of ODT is the resolution of all relevant scales, both temporal and spatial. The restriction to one spatial dimension in ODT permits affordable high resolution of interfacial and single-phase property gradients, which is key to capturing the local behavior of the breakup process and allows simulations at high Reynolds and Weber numbers that are currently not accessible to direct numerical simulations (DNS). This paper summarizes our extensions of the ODT model to simulate geometrically simple jet breakup problems, including representations of Rayleigh wave breakup, turbulent breakup, and shear-driven breakup. Each jet breakup simulation consists of a short temporal channel section to initialize a turbulent velocity profile at the nozzle exit followed by an adjacent jet section. The simulations are carried out for jet exit Reynolds number of 11,500, 23,000, 46,000 and 92,000 while the Weber number is varied within the range 102–107. We present results on breakup statistics including spatial locations of droplet release, droplet sizes and liquid core length. The results on primary breakup are compared to experimental results and models.
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