scholarly journals P211 Short term impact of hemodialysis on right ventricular systolic function and pulmonary artery pressure in patients with end stage renal disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A M F Ali ◽  
A Salama ◽  
I Abd El Aziz ◽  
H Kamal
Keyword(s):  
Pulmonary Artery ◽  
Renal Disease ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
End Stage Renal Disease ◽  
Systolic Function ◽  
P Value ◽  
Artery Pressure ◽  
Stage Renal Disease ◽  
End Stage

Abstract Introduction Chronic kidney disease (CKD) is associated with increased morbidity and mortality. Cardiovascular disease (CVD) is the most common complication and a chief cause of death in patients with end stage renal disease (ESRD) accounting for 45% to 50% of causes of death in ESRD patient. Pulmonary hypertension (PH) occurs frequently in patients with CKD. The role of hemodialysis in reducing pulmonary artery pressure (PAP) and improving RV systolic function in not properly studied. Purpose To evaluate the effect of hemodialysis on Right ventricular (RV) systolic function and Pulmonary artery pressures using echocardiography in newly diagnosed end stage renal disease patients and after three months of regular hemodialysis. Patients and Methods 30 patients recently diagnosed to have ESRD were enrolled and were followed up after three months. Trans-thoracic echocardiography was done prior to the first dialysis session and after three months of regular hemodialysis to asses RV systolic function and PAP. Results There was a significant improvement of RV systolic function assessed by trans-annular plane systolic excursion (TAPSE)(mm)(pre dialysis 18.9 ± 3.76, post 21.56 ±3.51, p <0.01), fractional area change (FAC)(%)(pre dialysis 41.27 ± 8.9, post 47.5 ± 6.1, p < 0.01),tricuspid lateral annular systolic velocity (S’)(cm/s) (pre dialysis 12.3 ± 2.79, post 14.16 ± 2.3, p < 0.01),myocardial performance index (MPI)(pre dialysis 0.2 ± 0.1, post 0.1 ± 0.1, p < 0.01)and right ventricular outflow tract fractional shortening (RVOT-FS)(%)(pre dialysis 36.5 ± 9.5, post 39.3 ± 8.6, p < 0.01)post dialysis (P value <0.01). All parameters of assessing pulmonary artery pressures; systolic pulmonary artery pressure (PASP)(mmHg)(pre dialysis 48.03 ± 17.16, post 35.12 ± 14.73, p < 0.01), pulmonary diastolic artery pressure (PADP)(mmHg)(pre dialysis 24.05 ± 9.7, post 18.12 ± 9.64, p < 0.01), mean pulmonary artery pressure (MPAP)(mmHg) (pre dialysis 35.61 ± 15.07, post 25.8 ± 12.06, p < 0.01), pulmonary capillary wedge pressure (PCWP)((pre dialysis 23.28 ± 8.74, post 17.39 ± 5.87, p < 0.01) and pulmonary vascular resistance (PVR)(Wood unit)(pre dialysis 1.89 ± 0.57, post 1.43 ± 0.46, p < 0.01) improved significantly post dialysis (P value <0.01).There was a significant inverse correlation between the duration of renal impairment and the improvement in SPAP and PCWP after the initiation of dialysis (P values are 0.021 and 0.015, Correlation co-efficient -0.421, -0.441 respectively). The best cut-off value for weight reductionduring dialysis for prediction of improvement of SPAP is 2.75 Kg (AUC = 0.950, CI = 0.881-1.000, P value < 0.01). Conclusions The present study shows that significant improvement occurred in all RV systolic function parameters and all parameters of assessing pulmonary artery pressures post dialysis in patients recently diagnosed to have ESRD. RVOT FS is a reliable method for assessing RV function and it is significantly correlated only with TAPSE and FAC at the baseline before dialysis.

scholarly journals Pulmonary hypertension in end-stage renal disease patients on dialysis and predialysis patients

2020 ◽  
Vol 43 (3) ◽  
pp. E44-48
Author(s):  
Yifu Li ◽  
Yan Zhang ◽  
Jinjun Wang ◽  
Wenwei Chen ◽  
Yong Cai ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Pulmonary Artery ◽  
Renal Disease ◽  
Pulmonary Artery Pressure ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Purpose: Pulmonary hypertension (PH) is a frequent and serious cardiovascular complication in patients with end-stage renal disease (ESRD) on dialysis. The purpose of this study was to investigate the prevalence of PH and its associated factors in patients with ESRD on maintenance dialysis and predialysis patients. Methods: The medical records of ESRD patients who underwent kidney transplantation between January 2011 and December 2017 were retrospectively reviewed. Demographic and clinical characteristics including echocardiographic findings before joining the waiting list for transplantation were evaluated and compared among groups divided according to dialysis or not and dialysis types. The results of transthoracic Doppler echocardiography were used to determine the pulmonary artery pressure. Pulmonary hypertension was defined as a systolic pulmonary artery pressure (sPAP) greater than 35 mmHg. Univariate and multivariate analyses were used to investigate factors associated with PH. Results: Data from 35 pre-dialysis patients with ESRD, 72 maintenance hemodialysis (HD) and 34 peritoneal dialysis (PD) patients were analysed. Pulmonary hypertension was 20.69% in pre-dialysis patients, 16.7% in HD patients and 14.7% in PD patients (P=0.957). There were negative correlations between sPAP and calcium (r=-0.230, P=0.012), Ca×P(r=-0.210, P=0.021), hemoglobin (r=-0.243, P=0.008) and a positive correlation between sPAP and cardiac output (r=0.481, P=0.000). Cardiac output (CO) was an independent risk factor of sPAP (B=1.431, confidence interval [CI] 95%: 0.687 to 2.175, P=0.000). Conclusion: Incidence of PH was not statistically different in ESRD patients on dialysis and pre-dialysis patients. Uremia may play a major role in the pathogenesis of PH in patients.

scholarly journals The Problem of Pulmonary Artery Hypertension in End-Stage Renal Disease: Can Peritoneal Dialysis be the Solution

2020 ◽  
Author(s):  
Abdullah K. Alhwiesh ◽  
Ibrahim Saeed Abdul-Rahman ◽  
Abdullah M. Alshehri ◽  
Amani Alhwiesh ◽  
Mahmoud Elnokeety ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
End Stage Renal Disease ◽  
Pulmonary Artery Hypertension ◽  
Left Ventricular ◽  
Artery Pressure ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: Pulmonary artery hypertension (PAH) in the setting of end-stage renal disease (ESRD) has important prognostic and therapeutic consequences. We estimated the prevalence of PAH among patients with ESRD treated with automated peritoneal dialysis (APD), investigated the effect of different variables and compared pulmonary artery pressure and cardiac function at the beginning and end of the study. Methods: The study that started on 2015 and extended till 2020. Thirty-one ESRD patients on APD were recruited after fulfilling inclusion criteria. Blood samples were collected from all patients for the biochemical and hematological data at the beginning of the study and every month and at the study termination. Total body water (TBW) and extracellular water (ECW) were calculated using Watson’s and Bird’s calculation methods. All patients were followed-up monthly by cardiologist for an echocardiographic examination. Cox regression analysis was used to assess the relation between different variables and PAH.Results: The mean age of the study population (n=31) was 51.23±15.24 years. PAH was found in 24.2% of the patients. Mean systolic pulmonary artery pressure (sPAP) and mean pulmonary artery pressure (mPAP) were significantly higher in the APD patients at study initiation than at the end of the study (40.75 + 10.61 vs 23.55 + 9.20 and 29.66 + 11.35 vs 18.24 + 6.75 mmHg respectively, p = 0.001). The median ejection fraction was significantly lower in patients with PAH at zero point than at study termination [31% (27-34) vs 50% (46-52), p = 0.002]. Hypervolemia decreased significantly at the end of study (p <0.001) and correlated positively with the PAP (r = 0.371 and r = 0.369), p = 0.002). sPAP correlated with left ventricular mass index, hemoglobin level, and duration on APD.Conclusions: Long term PD (> 2 years) seemed to decrease pulmonary artery pressure, right atrial pressure and improve left ventricular ejection fraction (LVEF). Risk factors for PAH in ESRD were hypervolemia, abnormal ECHO findings and low hemoglobin levels. Clinical and echocardiographic abnormalities and complications are not uncommon among ESRD patients with PAH. Identification of those patients on and transthoracic echocardiography may warrant further attention to treatment with APD.

scholarly journals Association between End-Stage Renal Disease and Incident Diabetes Mellitus—A Nationwide Population-Based Cohort Study

2018 ◽  
Vol 7 (10) ◽  
pp. 343 ◽  
Author(s):  
Pin-Pin Wu ◽  
Chew-Teng Kor ◽  
Ming-Chia Hsieh ◽  
Yao-Peng Hsieh
Keyword(s):  
Diabetes Mellitus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Lower Risk ◽  
Incident Diabetes ◽  
P Value ◽  
Comparison Cohort ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Glucose is one of the constituents in hemodialysates and peritoneal dialysates. How the dialysis associates with the incident diabetes mellitus (DM) remains to be assessed. Methods: The claim data of end-stage renal disease (ESRD) patients who initiated dialysis from and a cohort of matched non-dialysis individuals from 2000 to 2013 were retrieved from the Taiwan National Health Insurance Research Database to examine the risk of incident DM among patients on hemodialysis (HD) and peritoneal dialysis (PD). Predictors of incident DM were determined for HD and PD patients using Fine and Gray models to treat death as a competing event, respectively. Results: A total of 2228 patients on dialysis (2092 HD and 136 PD) and 8912 non-dialysis individuals were the study population. The PD and HD patients had 12 and 97 new-onset of DM (incidence rates of 15.98 and 8.69 per 1000 patient-years, respectively), while the comparison cohort had 869 DM events with the incidence rate of 15.88 per 1000 patient-years. The multivariable-adjusted Cox models of Fine and Gray method showed that the dialysis cohort was associated with an adjusted hazard ratio (HR) of 0.49 (95% CI 0.39–0.61, p value < 0.0001) for incident DM compared with the comparison cohort. The adjusted HR of incident DM was 0.46 (95% CI 0.37–0.58, p value < 0.0001) for HD and 0.84 (95% CI 0.47–1.51, p value = 0.56) for PD. Conclusions: ESRD patients were associated with a lower risk of incident DM. HD was associated with a lower risk of incident DM, whereas PD was not.

KUALITAS HIDUP PASIEN GAGAL GINJAL KRONIS YANG MENJALANI HEMODIALISIS DI RSUD CHASAN BOESOIRIE TERNATE

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
FATHUL RISKY
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Short Form ◽  
Primary Data ◽  
P Value ◽  
Stage Renal Disease ◽  
End Stage

Introduction. Chronic kidney disease (CKD) as a result of structural and functional renal failure has a high progressivity leading to an end stage renal disease (ESRD), thus a therapy is needed to replace the renal function such as hemodialysis. Long term hemodialysis therapy affects many aspects of life and degrading the quality of life of the patient. Method. This cross-sectional study was conducted at Chasan Boesoirie Hospital, Ternate. Primary data, such as socio-demography were taken through history taking and medical records. Quality of life was assessed using Kidney Disease Quality of Life - Short Form (KDQOL-SF)-36 TM which has been used to measure quality of life of patients undergoing hemodialysis. Results. From this study a sample of 77 patients was obtained, of which 41 were male (53.25%) and 36 were female (46.75%). Of the three quality of life components assessed, KDCS components were 78.65 ± 13.39; the MCS component 54.67 ± 7.53; and PCS components 42.47 ± 7.76. Conclusions. From the results of the study it was found that the highest KDQOL-36TM score was obtained for the kidney disease component (KDCS), then the mental health component (MCS), and the lowest score for the physical health component (PCS). Of all the variables hypothesized to affect the quality of life of kidney failure patients undergoing hemodialis, not a single variable was found to be significantly affected (P value> 0.05).Keywords: end-stage renal disease, hemodialysis, quality of life.

Abstract 36: Diet Soda Consumption and Risk of Incident End-stage Renal Disease

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Casey M Rebholz ◽  
Morgan E Grams ◽  
Lyn M Steffen ◽  
Deidra C Crews ◽  
Cheryl A Anderson ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renal Disease ◽  
Diet Quality ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
P Value ◽  
Diet Soda ◽  
Soda Consumption ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Diet soda consumption may be associated with kidney disease, as shown in Caucasian women, due to phosphorus content, by increasing dietary acid load, or as a proxy for poor diet quality. However, less is known about the relationship between diet soda consumption and end-stage renal disease (ESRD) risk in the general population. Methods: We conducted a prospective analysis of time-varying diet soda consumption and incident ESRD in the population-based Atherosclerosis Risk in Communities study (N=15,369) using Cox regression. Usual dietary intake was assessed by a food frequency questionnaire in 1987-89 (baseline) and 1993-95. Incident ESRD was defined as initiation of renal replacement therapy (transplant, dialysis) through 2011. Results: Baseline mean age was 54 years, 55% were female, 27% were African-American, 12% had diabetes, and 35% had hypertension. Approximately a third of participants consumed <1 glass of diet soda per month; 42% of participants consumed up to 6 glasses/week; and 22% consumed more than 6 glasses/week. Over a median follow-up of 23 years, 357 incident ESRD cases were observed. Consuming up to 6 glasses of diet soda per week and more than 6 glasses of diet soda per week, respectively, was associated with 1.28-times (95% CI: 0.96, 1.70; p=0.10) and 1.95-times (95% CI: 1.43, 2.64; p<0.001) greater risk of ESRD relative to <1 glass/month after adjusting for total caloric intake, sugar-sweetened beverages, diet quality, age, sex, race-center, estimated glomerular filtration rate, diabetes, hypertension, overweight/obesity status, education level, smoking status, and physical activity (p-value for trend <0.001; Figure ). For each additional glass of diet soda consumed per day, there was a 26% higher risk of ESRD (HR: 1.26; 95% CI: 1.14, 1.40; p<0.001). Sugar-sweetened beverage consumption was not association with ESRD. Conclusion: Diet soda consumption was associated with ESRD risk and may be an important target for dietary interventions aimed at slowing kidney disease progression.

scholarly journals ASUPAN CAIRAN PADA PASIEN GGK YANG MENJALANI TERAPI HEMODIALISA

2020 ◽  
Author(s):  
Yohana Pransiska
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
P Value ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Tujuan: Penelitian ini bertujuan mengetahui hubungan dukungan keluarga dalam melakukan pembatasan asupan cairan. Metode: Penelitian ini menggunakan rancangan penelitian cross sectional. Hasil: Hasil analisis terbukti adanya hubungan antara dukungan keluarga dengan nilai (p value = 0, 000) terhadap kepatuhan klien hemodialisa dalam melakukan pembatasan asupan cairan, sedangkan variabel tingkat pendidikan (p value = 0,762) tidak ada hubungan antara kepatuhan klien yang melakukan tindakan hemodialisa dalam melakukan pembatasan asupan cairan, sementara untuk variabel usia (p value = 0,728) juga tidak ada hubungan antara kepatuhan klien yang mendapatkan tindakan hemodialisa dalam melakukan pembatasan asupan cairan. Simpulan: Dukungan keluarga adalah hal sangat penting yang perlu diperhatikan sebagai salah satu faktor yang dapat menaikan serta meningkatkan kepatuhan dalam melakukan pembatasan asupan cairan klien yang mendapatkan tindakan hemodialisa, sehingga diharapkan dukungan keluarga dapat dimaksimalkan lagi pemberianya untuk menciptakan prilaku yang patuh sehingga mampu membuat klien sadar terhadap pembatasan asupan cairan dengan cara diinformasikan kepada pihak keluarga terutama melalui tatanan klinik hemodialisa yang senantiasa melayani klien End Stage Renal Disease yang mendapatkan tindakan hemodialisa.

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