scholarly journals MO857HEMOPERFUSION IN HEMODIALYSIS PATIENTS WITH COVID-19 INFECTION:  IMPACT ON CLINICAL COURSE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ioannis Griveas ◽  
Antonis Schinas ◽  
Anthoula Balitsari ◽  
Gerasimos Asimakopoulos ◽  
Evangelos Pratilas
Keyword(s):  
Clinical Course ◽  
Therapeutic Option ◽  
Alternative Therapy ◽  
Purification Method ◽  
Dialysis Unit ◽  
Extracorporeal Blood Purification ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Abstract Background and Aims Our Nephrology Department during spring period on the first wave of COVID-19 was the referral Dialysis Unit for Covid-19 positive hemodialysis (HD) patients in the district area of Athens, Greece. We used hemoperfusion (HP) as a therapeutic option in our patients. The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing HD and were treated under our care focusing on the impact of HP on them. Method This is an observational study. Our Dialysis Unit has been assigned as a referral unit for Covid-19 positive HD patients. Patients divided to 2 groups: first group of patients underwent HD sessions with Hemoperfusion (A) and the second one received HD sessions without any other extracorporeal blood purification method (B). We used resin-directed hemoadsorption cartridges (HA-330 and HA-130) manufactured by the Jafron Biomedical Company, China. We registered all the data regarding the clinical course of our patients population. Age, primary cause of end stage renal disease, weight, clinical presentation, HD history, outcome, days of hospitalization. Results Group A 13 patients (4 males) have been enrolled in this group with mean age of 74 years old. 5 of them were presented asymptomatic at admission and 7 of them admitted with or developed during their stay pleural effusions. 4 of them were asymptomatic without effusions during the whole hospital stay. 12 patients received HP for 3 hours in our Dialysis Unit during the planned HD session and one patient received Hemoperfusion in ICU during CRRT. 6 patients had one session of Hemoperfusion (with HA130, 4 patients and with HA 330, 2 patients). 6 patients had 2 sessions (7 days interval) either with HA 130 both sessions (3 patients) or with HA 330 followed 7 days after with HA 130 (3 patients). The patients that admitted in ICU started HP the third day of her admission. The pattern was as follows: We used HA330 in 3 consecutive days during CRRT. In Day 10 we used HA130 and in Day 13 HA330. HP was performed for 3 hours. 24 days was the average hospitalization stay before starting HP for the 12 patients in boards. 9 patients discharged from the hospital after 43 days of hospitalization (range: 35-56 days). 30 days were the mean hospitalization stay for the diceased ones. We did not observe any side effects with HP cartridges (hypotension, reduction of platelets, bleeding). Group B 9 patients (7 males) with mean age of 75 years old did not receive HP during their hospitalization. All of them were presented symptomatic. 8 out of 9 patients died after 6 days of hospitalization (range: 1-14 days), 2 of them in ICU. Conclusion To sum up, HP seems to be a helpful, safe an quite efficient tool in the battle against Covid-19 in HD patients. Despite the method is unspecific, our lack of strong evidence, our views are with the opinion that is an reliable alternative therapy. However, the real impact of HP on the patient’s clinical course (time of initiation, therapeutic protocols, tools to evaluate response) has yet to be determined. The above notice does not minimize the great interest for the method that renal community should give.

scholarly journals P1356PACLITAXEL-COATED BALLOON ANGIOPLASTY FOR STENOSIS OF ARTERIOVENOUS FISTULA IN PATIENTS UNDER HEMODIALYSIS: 18TH MONTH FOLLOW-UP

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
IOANNIS GRIVEAS ◽  
GEORGIOS VOURLIOTAKIS ◽  
IOANNIS KANDOUNAKIS
Keyword(s):  
Clinical Course ◽  
Therapeutic Option ◽  
Minimal Invasive ◽  
Arteriovenous Fistulas ◽  
Day Clinic ◽  
Before And After ◽  
Vascular Stenosis ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims The recording of the experience of the use of paclitaxel-coated balloons in patients with End Stage Renal Disease under hemodialysis (HD) exhibiting narrowing in arteriovenous fistulas (AVF). Method 20 patients with ultrasonographically confirmed AVF dysfunction were subjected after angiographic screening to prosthesis with a simple angioplasty balloon, and then a balloon drug gradually released the drug paclitaxel. After the damage was restored (one-day clinic), arteriovenous communication was used immediately. The degree of vascular stenosis, blood flow to it and kt / V before and after recovery were assessed by ultrasound. At the same time, the clinical course of the patient and the vestibule of the vessel were monitored for 18 months. Results In the 20 patients of the study, since the damage was recovered, AVF was immediately treated without any problems. After angioplasty the degree of stenosis of the responsible vessel was statistically significantly reduced from 69.85% to 27.38% (p <0.05). Flow volume increased statistically significantly from 690.47 mils / min to 942.67 mils / min (p <0.05). The kt / v of patients improved from 1.25 to 1.6. During the 18th -month follow-up, the clinical course of the patients was stable, no problems related to vascular access appeared. Restenosis occurred to two patients, one of each received another successful angioplasty. Conclusion Drug-releasing balloons can be a useful therapeutic option for patients with AVF stenosis due to accelerated endothelial hyperplasia. The use of paclitaxel-coated balloons helps reduce the risk of restenosis of arteriovenous anastomoses and is a safe, time consuming, minimal invasive and immediate solution to AVF management.

scholarly journals The Impact of Histologic Variants on FSGS Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Kristin Meliambro ◽  
Monica Schwartzman ◽  
Paolo Cravedi ◽  
Kirk N. Campbell
Keyword(s):  
Kidney Transplantation ◽  
End Stage Renal Disease ◽  
Clinical Course ◽  
Steroid Resistance ◽  
Favorable Prognosis ◽  
Interpretation Errors ◽  
Risk Of Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Focal segmental glomerulosclerosis (FSGS) is the most common glomerular disease leading to end-stage renal disease. The clinical course is highly variable with disparate responses to therapeutic intervention and rates of progression. Histologic variant subtype has been commonly used as a prognostic and therapeutic guide in the clinical management of FSGS. The tip lesion is widely considered to portend the most favorable prognosis and to be the most responsive to steroid therapy. Conversely, the collapsing lesion, more prevalent in patients of African descent, is associated with steroid resistance and higher risk of disease progression. In the 10 years since the Columbia classification system for FSGS was published, some retrospective and one prospective study explored the impact of histologic variants at the time of biopsy on FSGS outcomes. The results largely validate its clinical predictive value with respect to treatment response, though its utility in cases recurring after kidney transplantation is still unknown. Sampling and interpretation errors are additional sources of caution. More research is needed to fully define reproducible prognostic and therapeutic markers for this polymorphic disorder.

scholarly journals Depression among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study from Palestine

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Samah W. Al-Jabi ◽  
Ansam Sous ◽  
Fatimah Jorf ◽  
Mahmoud Taqatqa ◽  
Mahdi Allan ◽  
...  
Keyword(s):  
Renal Disease ◽  
Low Income ◽  
End Stage Renal Disease ◽  
West Bank ◽  
Psychological Status ◽  
The West ◽  
Depression Prevalence ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Abstract Background The impact of end-stage renal disease on the patient’s psychological status necessitates the value of increasing depression awareness. The current study aimed to assess the depression prevalence among Palestinian hemodialyzed patients and its association with patients’ characteristics. Methods A convenience clustered sampling technique was followed. Sample was collected from ten hemodialysis centers in the West Bank, Palestine, during 3 months in 2015. We used the Beck Depression Inventory-II scale (BDI-II) to evaluate depression among participants. All data were analyzed using Statistical Package for the Social Sciences version 16.0. Results Two hundred and eighty-six hemodialyzed patients were interviewed. The mean age (± standard deviation) of the patients was 52.0 ± 14.3 years, and most participants were males 172 (60.1%). Regarding the dialysis characteristics, the median of years of dialysis was 2 years (1–4). The prevalence of depression was 73.1%. Elderly patients (p = 0.001), female (p = 0.036), living in rural areas or camp (p = 0.032), low income (p = 0.041), unemployment (p = 0.001), not doing regular exercise (p = 0.001), and having multi comorbidities (p = 0.001) were significantly associated with more depression scores. The results of binary logistic regression showed that only patients who were living in camps, patients who were previously employed, and patients who were not practicing exercise remained significantly associated with a higher depression score. Conclusions This study is the first one confirmed about depression and its prevalence among hemodialyzed patients in the West Bank, Palestine. Compared to other communities, the study found a higher depression prevalence rate. There is a need to offer psychological interviews and non-pharmacological and pharmacological interventions.

The impact of renal transplantation on survival in hepatitis C-positive end-stage renal disease patients

1997 ◽  
Vol 29 (4) ◽  
pp. 608-614 ◽  
Author(s):  
Greg A. Knoll ◽  
Martha R. Tankersley ◽  
Jeannette Y. Lee ◽  
Bruce A. Julian ◽  
John J. Curtis
Keyword(s):  
Renal Transplantation ◽  
Hepatitis C ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

scholarly journals Dyslipidemia in End Stage Renal Disease: A Study on Dialysis Patients in Bangabandhu Sheikh Mujib Medical University Bangladesh

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 113-117
Author(s):  
Salahuddin Feroz ◽  
Shah Md Zakir Hossain ◽  
Rafi Nazrul Islam ◽  
Amir Mohammad Kaiser ◽  
Miliva Mozaffor ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hdl Cholesterol ◽  
Dialysis Patients ◽  
Ckd Stage ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage ◽  
Medical University

Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117

scholarly journals CHILDRENONHEMODIALYSIS: A RETROSPECTIVESTUDYIN BENGHAZI PEDIATRIC HOSPITAL

2020 ◽  
Vol 8 (12) ◽  
pp. 827-832
Author(s):  
Narges M. Kablan ◽  
◽  
Khadija A. Ali ◽  
Kamlah J. Said ◽  
Mabroka A. Ali ◽  
...  
Keyword(s):  
Body Weight ◽  
White Blood Cells ◽  
Life Quality ◽  
Pediatric Hospital ◽  
Dialysis Unit ◽  
Major Health Problem ◽  
Drug History ◽  
Male Patients ◽  
Stage Renal Disease ◽  
End Stage

End stage renal disease (ESRD) is a major health problem worldwide. In Libya, limited studies are available on children with ESRD.Regular assessment of laboratory parameters is the only way to reduce their risk of mortality.This study aimed to determinethe demographic characteristics and evaluate the hematological profile of children on hemodialysis (HD) admitted to the dialysis unit in Benghazi Pediatric hospital, Benghazi, Libya during the period 3rd of December, 2017 to 15th of January 2018.A structured form was used to record data collected from patients files. Data includedage, gender, body weight, treatment history, drug history, duration and frequency of HD and laboratory tests results, specifically white blood cells (WBC), hemoglobin (HB), blood urea, glucose, Albumin, uric acid, serum creatinine, serum iron, calcium, phosphate, sodium and potassium.Number of patients on HD includedin this study was seven with average age of 11years,the majority (71%)were males.Average body weight of female patients was24.2kg,while male patients averagebody weight was25.52kg. Most of the patients(57%)hadhigh BP.71%of patientsstarted dialysis sincemore than one year.Patients underwentdialysisthree times a week represented(86%),while the rest of patients underwent dialysis four times a weekrepresented(14%).All patients had anemia and highcreatininelevel.Providing an appropriate care for children on maintenance dialysis in Libya is quitedifficult. Increasing the awareness ofparents about ESRD is necessary to improve the life quality of children with ESRD.

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