FP681THE ASSOCIATION BETWEEN SERUM ALKALINE PHOSPHATASE LEVELS AND BACTEREMIA IN MAINTENANCE HEMODIALYSIS IN AN OUTPATIENT SETTING: A MULTI-CENTRE CROSS-SECTIONAL STUDY

AbstractObjectivesPhosphate is essential for skeletal mineralization, which is regulated by parathyroid hormone, calcitriol and fibroblast growth factor 23 (FGF23). Serum phosphate is physiologically higher in younger children, but factors that contribute to this physiological state are poorly understood. This study aimed to evaluate phosphate and its regulators in children compared with adults.Materials and methodsThe participants were children aged 3–11 years and adults older than 20 years of age. Biochemical parameters including calcium, phosphorus, alkaline phosphatase, FGF23, and vitamin D were measured. Fractional excretion of phosphate was calculated, using serum and urine phosphate and creatinine.ResultsThis cross-sectional study was conducted on 45 children (mean age: 9.0 ± 2.1) and 44 adults (mean age: 38.9 ± 11.1). The children had higher serum calcium, phosphate, alkaline phosphatase, and FGF23 (p < 0.001), but fractional excretion of phosphate was greater in adults (14.1 ± 5.7, 11.4 ± 4.4, p = 0.019, 95% confidence interval [CI]: −0.7 to −0.2). Of all individuals, 61.8% had vitamin D deficiency. By multiple regression analysis, entering age, calcium, phosphate, and vitamin D level, the only independent predictor of FGF23 was 1, 25 dihydroxy-vitamin D3 (β: 0.78, p < 0.001, 95% CI: 0.5–1.1, R2: 0.59 for children, and β: 0.59, p < 0.001, 95% CI: 0.5–1.4, R2: 0.45 for adults).ConclusionAs far as we know, there is little information regarding the role of FGF23 in physiologic state. In this cross-sectional study no association was found between FGF23 and urinary phosphate excretion in growing children. Further studies with more detail are essential to evaluate phosphate homeostasis during childhood.

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A retrospective cross-sectional study for predicting 72-h mortality in patients with serum aspartate aminotransferase levels ≥ 3000 U/L

Scientific Reports ◽

10.1038/s41598-020-79435-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kai Saito ◽

Hitoshi Sugawara ◽

Tamami Watanabe ◽

Akira Ishii ◽

Takahiko Fukuchi

Keyword(s):

Risk Factors ◽

Alkaline Phosphatase ◽

Creatine Kinase ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Sodium Potassium ◽

Factors Associated ◽

C Statistic ◽

Serum Aspartate Aminotransferase

AbstractRisk factors associated with 72-h mortality in patients with extremely high serum aspartate aminotransferase levels (AST; ≥ 3000 U/L) are unknown. This single-centre, retrospective, case-controlled, cross-sectional study obtained data from medical records of adult patients treated at Saitama Medical Center, Japan, from 2005 to 2019. We conducted a multivariate logistic after adjusting for age, sex, height, weight, body mass index, Brinkman Index, vital signs, biochemical values, updated Charlson Comorbidity Index (CCI) score, CCI components, and underlying causes. A logistic regression model with selected validity risks and higher C-statistic for predicting 72-h mortality was established. During the 15-year period, 428 patients (133 non-survivors and 295 survivors [cases and controls by survival < 72 and ≥ 72 h, respectively]) with AST levels ≥ 3000 U/L were identified. The 72-h mortality rate was 133/428 (31.1%). The model used for predicting 72-h mortality through the assessment of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus levels had a C-statistic value of 0.852 (sensitivity and specificity, 76.6%). The main independent risk factors associated with 72-h mortality among patients with AST levels ≥ 3000 U/L included higher serum values of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus.

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Relationship between Dream Anxiety in Recurrent Nightmare and Indefinite Complaints in Patients Undergoing Maintenance Hemodialysis: A Cross-sectional Study

International Journal of Affective Engineering ◽

10.5057/ijae.ijae-d-18-00004 ◽

2018 ◽

Vol 17 (3) ◽

pp. 213-220

Author(s):

Yoshihiro TSUJI ◽

Naoki SUZUKI ◽

Yasumasa HITOMI ◽

Yusuke SAKAI ◽

Toshiko TOKORO ◽

...

Keyword(s):

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Sectional Study ◽

Cross Sectional

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Blood Pressure of Maintenance Hemodialysis Patients in the Dalmatian Region of Croatia: Differences between Hospital and Out-of-Hospital Dialysis Centers

Blood Purification ◽

10.1159/000474931 ◽

2017 ◽

Vol 44 (2) ◽

pp. 110-121

Author(s):

Marijana Gulin ◽

Dragan Klarić ◽

Mario Ilić ◽

Josipa Radić ◽

Vedran Kovačić ◽

...

Keyword(s):

Blood Pressure ◽

Weight Gain ◽

Beta Blockers ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Sectional Study ◽

Cross Sectional ◽

Interdialytic Weight Gain ◽

Maintenance Hemodialysis Patients

Aims: This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. Methods: A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-dialysis BP values were collected for 3 consecutive HD sessions per patient. Results: Of the 399 subjects, 73.9% were hypertensives, who showed higher interdialytic weight gain compared to the normotensives (2.58 vs. 2.40). Hospital and out-of-hospital HD patients received identical antihypertensive therapies, except that beta blockers were more frequently administered to out-of-hospital HD patients. Higher pre-, intra-, and post-dialysis BP values were recorded in patients at out-of-hospital HD centers. Conclusion: The differences in BP variability and antihypertensive therapies administered to hospital HD patients as compared to out-of-hospital HD patients may reflect differing approaches by the nephrologists at these centers.

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Association between fluoroquinolone resistance and resistance to other antimicrobial agents among Escherichia coli urinary isolates in the outpatient setting: a national cross-sectional study

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dku029 ◽

2014 ◽

Vol 69 (6) ◽

pp. 1720-1722 ◽

Cited By ~ 6

Author(s):

Thomas J. Hwang ◽

David C. Hooper

Keyword(s):

Escherichia Coli ◽

Antimicrobial Agents ◽

Cross Sectional Study ◽

Outpatient Setting ◽

Fluoroquinolone Resistance ◽

Sectional Study ◽

Cross Sectional ◽

Urinary Isolates

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Determinants of the intensity of uremic pruritus in patients receiving maintenance hemodialysis: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0245370 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245370

Author(s):

Jian-Hui Zhao ◽

Qiu-Shuang Zhu ◽

Yi-Wen Li ◽

Li-Li Wang

Keyword(s):

Logistic Regression ◽

Multiple Logistic Regression Analysis ◽

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Multiple Logistic Regression ◽

Sectional Study ◽

Cross Sectional ◽

Urea Nitrogen ◽

Uremic Pruritus ◽

Hs Crp

Background Uremic pruritus (UP) is a common and frustrating symptom in patients receiving hemodialysis (HD). The majority of patients have mild to moderate itching of the skin, and a small percentage have severe itching, which seriously affects their quality of life and survival rate. However, little is known about factors that influence the intensity of itching in patients. Methods A cross-sectional study on uremic pruritus in male and female patients receiving HD was conducted in September 2019. This study included 148 eligible patients who received HD at the Blood Purification Center of Xinchang County People’s Hospital, Zhejiang Province, China from March 2019 to June 2019. We collected general data consisted of age, sex, body mass index (BMI), place of residence, educational level, diabetes mellitus status and duration of HD; as well as clinical, biochemical indicators, including serum calcium (Ca), serum phosphorus (P), serum albumin (ALB), haemoglobin (Hb), serum intact parathyroid hormone (iPTH), pre-dialysis serum urea nitrogen (BUN), normalized protein catabolic rate (nPCR), urea nitrogen clearance index (KT/V), ferritin (FER) and pre-dialysis serum creatinine (sCR). We also assayed the inflammatory cytokine serum high sensitivity C-reactive protein (hs-CRP). The Five-Dimensional Itching Scale (5DIS) was used to evaluate the degree of skin itching (none, mild, moderate, or severe). We used multiple logistic regression to analyze influencing factors on the degree of skin itching in patients with UP. Results Of the 148 patients, 60 had uremic pruritus (incidence rate, 40.54%). These included 22 cases of mild skin itching (14.86%), 30 of moderate skin itching (20.27%), and 8 of severe skin itching (5.41%). Compared with uremia patients without skin pruritus, patients with UP had higher levels of iPTH, Hb, BUN, nPCR, and hs-CRP. The composition ratio showed significant differences between urban and rural patients with different degrees of skin itching (P = 0.017); moreover, the difference of iPTH and hs-CRP levels were statistically significant (P = 0.009 and < 0.001, respectively). Using no itching as a reference, multiple logistic regression analysis showed that as hs-CRP level increased, the patient’s risks of mild skin itching (odds ratio [OR] = 1.740; 95% confidence interval [CI], 1.061–2.854; P = 0.028), moderate skin itching (OR = 2.8838 95% CI, 1.744–4.718; P < 0.001), and severe skin itching (OR = 9.440; 95% CI, 3.547–25.124; P < 0.001) all increased as well. Compared with urban residents, rural residents have a higher risk of moderate itching (OR = 3.869; 95% CI, 1.099–13.622; P = 0.035). Conclusion Levels of hs-CRP were associated with the intensity of skin itching in patients with UP. Higher hs-CRP levels were closely related to severe skin itching. The relationship between the intensity of skin itching and the environment in maintenance hemodialysis patients needs further clarification.

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Comparison of Body Mass Index with Modified Subjective Global Assessment for Detection of Malnutrition Among Patients Under Maintenance Hemodialysis: A Multi-Center Cross-Sectional Study

Journal of Preventive and Social Medicine ◽

10.3329/jopsom.v40i1.56686 ◽

2022 ◽

Vol 40 (1) ◽

pp. 14-21

Author(s):

Mohammad Syfur Rahman ◽

Mohammad Farhadul Haque ◽

Tayeba Sultana ◽

Tahera Sultana ◽

Syed Asif Ul Alam

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Subjective Global Assessment ◽

Sectional Study ◽

Cross Sectional ◽

Cutoff Value ◽

Best Fitting ◽

Study Population

Background: Patients under maintenance hemodialysis are at increased risk of malnutrition, causing from multitude of factors. Present study aims to assess the prevalence of malnutrition among maintenance hemodialysis patients using both modified subjective global assessment score and body mass index, compare them and assess the sensitivity and specificity of body mass index for detecting malnutrition, along with determining a new cutoff value for BMI that better represent the maintenance hemodialysis patient’s nutritional status. Methods: This was a cross-sectional study conducted in the hemodialysis unit of Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College Mitford Hospital, BIRDEM General Hospital and National Institute of Kidney Diseases & Urology; among 80 adult CKD patients who were on regular (≥2 sessions per week) maintenance hemodialysis for more than 3 months without any acute infection, during the period of July 2016 to June 2017. Nutritional assessment was done for each patient using modified SGA score along with BMI. Sensitivity analysis of WHO recommended cutoff value for BMI was done among the study population using modified SGA score as gold standard test for detection of malnutrition among the respondents. ROC curve was used to estimate the best fitting cutoff value of BMI that showed highest sensitivity, specificity and accuracy for detracting malnutrition among maintenance hemodialysis patients. Results: The study participants were predominantly male (66.3%) and from age group 45 to 59 years (36.3%). Modified SGA score detected 90.0% of the study population as malnourished. WHO recommended 18.5 kg/m2 cutoff value was also used to detect malnutrition among study population and 13.8% were found to be malnourished, with a sensitivity and specificity of 12.5% and 75.0% respectively. Accuracy was found to be 18.8%. Using ROC curve, 23.1 kg/m2 was found to be the best fitting cutoff value of BMI for the study population to detect malnutrition. With a sensitivity of 47.2%, specificity of 37.5% and accuracy of 46.3%. Conclusion: BMI showed low sensitivity for detecting malnutrition among patients under maintenance hemodialysis, compared to modified SGA score and should be avoided as a screening tool, but 23.1 kg/m2 cutoff value for BMI showed potential to be used as an easy to use and quick tool for detecting malnutrition among such patients. Further study with larger sample size could shed more light on this. JOPSOM 2021; 40(1): 14-21

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