MO436PLASMA OXALATE VALUES IN PATIENTS WITH END-STAGE KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ella Metry ◽  
Sander Garrelfs ◽  
Michiel Oosterveld ◽  
Aegida Neradova ◽  
Joost Bijlsma ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Plasma Concentrations ◽  
Maintenance Hemodialysis ◽  
Healthy Individuals ◽  
End Stage Kidney Disease ◽  
Waste Products ◽  
Therapeutic Work ◽  
Reference Limit ◽  
End Stage ◽  
Work Up

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) are known to have higher plasma concentrations of metabolic waste products than healthy individuals. Patients with Primary Hyperoxaluria (PH), a rare congenital cause of ESKD, suffer from hepatic overproduction of the metabolic end product oxalate. Plasma oxalate (POx) levels are determined in the diagnostic and therapeutic work-up for PH. Remarkably, correct interpretation of these values is hampered by the absence of knowledge concerning POx levels in patients with ESKD due to common causes. Method In this observational study, we obtained POx values in patients with ESKD due to another cause than PH, to establish reference values in this patient group. We collected blood samples from 120 adults with eGFR < 15 mL/min/1.73 m2 who required maintenance hemodialysis or peritoneal dialysis at the Amsterdam UMC. Results While there was a wide variation in POx levels in patients with ESKD, the median was 50 umol/L and lowest values were twice the upper reference limit that applies to healthy individuals (6.7 umol/L). Conclusion This study shows that POx levels of 50 umol/L are not necessarily suggestive for PH which contradicts the current literature. This study could lead to a paradigm shift in the diagnostic and therapeutic work-up for patients with ESKD.

scholarly journals Protection of Residual Renal Function and Nutritional Treatment: First Step Strategy for Reduction of Uremic Toxins in End-Stage Kidney Disease Patients

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 289
Author(s):  
Adamasco Cupisti ◽  
Piergiorgio Bolasco ◽  
Claudia D’Alessandro ◽  
Domenico Giannese ◽  
Alice Sabatino ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Residual Renal Function ◽  
The Body ◽  
Uremic Toxins ◽  
End Stage Kidney Disease ◽  
Waste Products ◽  
Hemodialysis Treatment ◽  
Life Saving ◽  
Kidney Replacement Therapy ◽  
End Stage

The retention of uremic toxins and their pathological effects occurs in the advanced phases of chronic kidney disease (CKD), mainly in stage 5, when the implementation of conventional thrice-weekly hemodialysis is the prevalent and life-saving treatment. However, the start of hemodialysis is associated with both an acceleration of the loss of residual kidney function (RKF) and the shift to an increased intake of proteins, which are precursors of uremic toxins. In this phase, hemodialysis treatment is the only way to remove toxins from the body, but it can be largely inefficient in the case of high molecular weight and/or protein-bound molecules. Instead, even very low levels of RKF are crucial for uremic toxins excretion, which in most cases are protein-derived waste products generated by the intestinal microbiota. Protection of RKF can be obtained even in patients with end-stage kidney disease (ESKD) by a gradual and soft shift to kidney replacement therapy (KRT), for example by combining a once-a-week hemodialysis program with a low or very low-protein diet on the extra-dialysis days. This approach could represent a tailored strategy aimed at limiting the retention of both inorganic and organic toxins. In this paper, we discuss the combination of upstream (i.e., reduced production) and downstream (i.e., increased removal) strategies to reduce the concentration of uremic toxins in patients with ESKD during the transition phase from pure conservative management to full hemodialysis treatment.

scholarly journals The Serum Concentration of Anti-Aging Proteins, Sirtuin1 and αKlotho in Patients with End-Stage Kidney Disease on Maintenance Hemodialysis

2020 ◽  
Vol Volume 15 ◽  
pp. 387-393 ◽  
Author(s):  
Edyta Zbroch ◽  
Angelika Bielach - Bazyluk ◽  
Jolanta Malyszko ◽  
Ewa Koc-Zorawska ◽  
Alicja Rydzewska-Rosolowska ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Serum Concentration ◽  
Maintenance Hemodialysis ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals ASSESSMENT OF NUTRITIONAL STATUS IN END STAGE KIDNEY DISEASE PATIENTS ON MAINTENANCE HEMODIALYSIS.

2020 ◽  
pp. 1-3
Author(s):  
P. C Sandhya ◽  
Himanshu Sharma ◽  
M. Gupta
Keyword(s):  
Kidney Disease ◽  
Nutritional Status ◽  
Dietary Protein ◽  
Calorie Intake ◽  
Maintenance Hemodialysis ◽  
Study Cohort ◽  
End Stage Kidney Disease ◽  
Nutritional Counselling ◽  
End Stage ◽  
The Impact

ABSTRACT Background: Malnutrition is a common problem in patients with end-stage-kidney-disease (ESKD) and is a strong risk factor for morbidity and mortality. ESKDis a maladaptive metabolic state and patients need to increase their dietary protein and calorie intake especially when on maintenance dialysis. In a developing country like India, the economic and knowledge barrier affects the diet of the patient. In this study we assessed the prevalence of malnutrition and the impact of dietary counselling on improvement in nutritional status of the patient. Method: This study enrolled patients undergoing maintenance hemodialysis in our centre between June 2017 and June 2019. The prevalence of malnutrition was assessed by Subjective Global Assessment (SGA). Dietary history was recorded with a 24-hour dietary recall method. The patient was then periodically counselled regarding adequate dietary protein and calorie requirement and was re-assessed for the prevalence of malnutrition at the end of 6 months. Results: The mean age of study cohort was 38.76±10.85 years and 64 % were male.Hypertension (38.89%) and Diabetes (11.11%) were the most common co-morbid illnesses.The prevalence of PEW was 92% at baseline and 86% at the end of 6 months of follow up. There was a significant increase in BMI from 19.97 to 20.38 (p=0.022). Most of the study patients were from very low socioeconomic status (78% Class V modified Prasad's scale). Conclusions: There is a very high prevalence of protein-energy malnutrition among ESKD patients on maintenance haemodialysis. Nutritional counselling resulted in statistically significant improvement in the prevalence of malnutrition. Hence,nutritional counselling must be given regularly to patients with kidney disease.

scholarly journals Study of Cutaneous Manifestations in End Stage Kidney Disease Undergoing Hemodialysis

2020 ◽  
Vol 18 (1) ◽  
pp. 37-43
Author(s):  
Abhishek Maskey ◽  
Ajay Kumar ◽  
Roshan Shrestha
Keyword(s):  
Kidney Disease ◽  
Maintenance Hemodialysis ◽  
Cholestatic Liver Disease ◽  
End Stage Kidney Disease ◽  
Major Step ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Cutaneous Manifestations ◽  
The Mean ◽  
End Stage

Introduction: The prevalence of cutaneous manifestations in hemodialysis patients is increasing. Objectives: The aim of this study was to determine the prevalence and pattern of various cutaneous manifestations in patients undergoing maintenance hemodialysis. Material and Methods: A hospital based cross sectional study was conducted in patient undergoing maintenance hemodialysis at least for three months in dialysis unit of Manipal Teaching Hospital Pokhara, Nepal during the period from August 2018 to January 2019. A demographic questionnaire and a checklist about cutaneous disorders were used for data collection. Patients with cholestatic liver disease or acute hepatitis, active infection, active malignancy, patient with acute kidney injury, patient undergoing peritoneal dialysis and renal transplant recipient were excluded from study. Results: Total 80 patients undergoing maintenance hemodialysis were included. Among them, 52 (65%) patients were male. The mean age of study population was 51.95±14.96 years. The mean duration of dialysis was 40.28±11.09 months. The most common cause of end stage kidney disease was diabetic nephropathy. The most common cutaneous manifestations were pigmentation (82.5%), nail changes (75%), xerosis (70%) and pruritis (50%). Conclusions: The results of this study revealed that patients on hemodialysis were associated with multiple cutaneous symptoms, the most prevalent of which were pigmentation and nail disorders. Therefore, early diagnosis of these problems is a major step in improving the quality of life in these patients.

PULMONARY HYPERTENSION IN END STAGE KIDNEY DISEASE (ESKD) PATIENTS ON MAINTENANCE HEMODIALYSIS (MHD) VIA SURGICALLY CREATED ARTERIOVENOUS FISTULA.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Hamad Jeelani ◽  
Manjuri Sharma ◽  
Manzoor A. Parry ◽  
Prodip.K. Doley ◽  
Gayatri Pegu
Keyword(s):  
Pulmonary Hypertension ◽  
Kidney Disease ◽  
Pulmonary Artery ◽  
Arteriovenous Fistula ◽  
Pulmonary Artery Pressure ◽  
Maintenance Hemodialysis ◽  
Systolic Pulmonary Artery Pressure ◽  
End Stage Kidney Disease ◽  
Venous Fistula ◽  
End Stage

Background Pulmonary hypertension is a disorder which worsens systemic diseases. One of the important underlying pathology is end stage chronic kidney disease The aim of this study was to assess the incidence of unexplained PHT, and to relate this to the cardiovascular status and arteriovenous fistula characteristics in ESKD patients on maintenance hemodialysis Methods: 159 patients with end stage kidney disease on maintenance hemodialysis were evaluated, 103 were excluded. Clinical, laboratory parameters were recorded. Systolic Pulmonary artery pressure and cardiac functions were evaluated by echocardiography. Flow across arteriovenous fistula was assessed by Doppler sonography. Patients were divided between the group with and without pulmonary hypertension. It was a cross sectional study. Result: Out of 159 patients, 56 patients who fulfilled inclusion criteria were evaluated, 36% had systolic pulmonary artery pressure of 35 mm Hg, mean age was 52.42 ± 9.12 years, 71.4% were males, and mean duration of end stage kidney disease was 33.66 ±11.56 months. Pulmonary hypertension patients were exposed to longer duration of hemodialysis therapy (p=0.0001) as compared to the patients with no pulmonary hypertension group, they also had a longer duration of functional Arterio venous fistula (p=0.0001), and flow across Arterio venous fistula was significantly more in pulmonary hypertension group (p=0.022), and these also had higher cardiac output (p=0.0001).  Patients with Pulmonary hypertension were significantly more anemic, had more hypoalbuminemia and more interdialytic weight gain. Conclusions:  Pulmonary hypertension is frequent in end-stage kidney disease patients on maintenance hemodialysis. It appears to be a late complication of hemodialysis with surgically created AVF with implications on cardiovascular status. Keywords: Arterio venous fistula (AVF), End-stage kidney disease (ESKD), Maintenance hemodialysis (MHD), pulmonary hypertension (PHT).Systolic pulmonary artery pressure (sPAP)

Androgen Deficiency and Endothelial Dysfunction in Men with End-Stage Kidney Disease Receiving Maintenance Hemodialysis

2006 ◽  
Vol 26 (6) ◽  
pp. 536-543 ◽  
Author(s):  
Dimitrios Karakitsos ◽  
Alexandros P. Patrianakos ◽  
Eric De Groot ◽  
John Boletis ◽  
Andreas Karabinis ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Kidney Disease ◽  
Maintenance Hemodialysis ◽  
Androgen Deficiency ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Hepatitis-C and it’s seroconversion in end stage kidney disease patients on maintenance hemodialysis and factors affecting it

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Yasir Hussain ◽  
Anjum Shahzad ◽  
Sidra Azam ◽  
Nazish Munawar
Keyword(s):  
Hepatitis C ◽  
Kidney Disease ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
End Stage Kidney Disease ◽  
Factors Affecting ◽  
Creative Commons ◽  
Group I ◽  
Acute Kidney Disease ◽  
End Stage

Objective: To determine frequency of hepatitis-C in dialysis patients at start of hemodialysis, seroconversion from HCV negative to HCV positive over study duration and factors affecting seroconversion. Methods: This descriptive prospective observational study done in dialysis center of DHQ hospital Sheikhupura, Punjab, Pakistan. The study was conducted from October 2016 to October 2017. Data was collected on Performa and later followed prospectively in same cohort of patients. All the patients on maintenance hemodialysis for more than one month were included in the study. Patients with acute kidney disease and on dialysis less than one month were excluded. Patients were analyzed by dividing them in three groups, group-I patients who were HCV positive at start of dialysis, Group-II who were negative and seroconvert to HCV positive, Group-III who were negative and remained negative. All seronegative patients were followed at one, three, six and twelfth months on being hemodialysis for seroconversion. Results: Out of 230 surveyed patients 52 were HCV positive at start of dialysis and 19 were loss of follow up. Out of remaining 159 HCV negative patients 95 became HCV positive, only 64 patients remained HCV negative by end of study. Conclusion: Frequency of HCV seroconversion among chronic hemodialysis patient is found to be 53.37%. Arteriovenous access, number of dialysis, reuse of dialyzer and blood transfusions are important risk factors. How to cite this:Hussain Y, Shahzad A, Azam S, Munawar N. Hepatitis-C and it’s seroconversion in end stage kidney disease patients on maintenance hemodialysis and factors affecting it. Pak J Med Sci. 2019;35(1):66-70. doi: https://doi.org/10.12669/pjms.35.1.366 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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