Effect of hyperparathyroidism on vascular stiffness in hemodialysis patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magdy Mohamed Saeed El-Sharkawy ◽  
Ahmed Hassan Mohamed El Thakaby ◽  
Ahmed Abdelmoniem Emara ◽  
Ahmed Mohamed Abdelkhalek
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Mean Value ◽  
University Hospitals ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Group B ◽  
Stage Renal Disease

Abstract Background Cardiovascular disease (CVD) is present in > 50% of patients undergoing dialysis and the relative risk of death due to CVD events in HD patients is reported to be 20 times higher than in the general population. In fact, in patients on renal replacement therapy (RRT) the prevalence of coronary heart disease and ventricular hypertrophy has been described to be 40% and 70% respectively, other CVD events include hypertention, arrhythmias, valvular calcification and arterial stiffness. Objective To detect the prevalence of arterial stiffness among end stage renal disease patients on prevalent hemodialysis with hyperparathyroidism. Patients and Methods This observational cross sectional study was conducted on 60 prevalent hemodialysis patients attending at hemodialysis unit of Ain Shams University hospitals, with convenient sampling method. The included patients are clinically stable on thrice weekly hemodialysis sessions for 4 hours per session. Results The Dual Pulse Wave Doppler (DPWD) method we proposed in this study may be considered as a useful and convenient option for clinical local Pulse Wave Velocity (PWV) measurement, this clinical practical and reproducible method had the capability to detect an increased local PWV of LCCA (which reflect arterial stiffness) in the patients with PTH > 300 more than the patients with PTH < 300 as it showed that in Group B (PTH>300), the measured carotid artery local PWV values ranged from 6.22 m/s to 8.84 m/s and the mean value was 7.81 ± 0.72 m/s, which was higher than 6.72 ± 1.06 m/s (ranging from 4.48 m/s to 8.44 m/s) of Group A (PTH<300). Conclusion Our study showed that there is a high prevalence of arterial stiffness in prevalent hemodialysis patients.

scholarly journals Telomere Length and Arterial Stiffness Reflected by Brachial–Ankle Pulse Wave Velocity: A Population-Based Cross-Sectional Study

2021 ◽  
Vol 11 (12) ◽  
pp. 1278
Author(s):  
Kyi Mar Wai ◽  
Sawada Kaori ◽  
Ken Itoh ◽  
Okuyama Shinya ◽  
Yuka Uchikawa ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Tail Length ◽  
Population Based ◽  
Cross Sectional Study ◽  
Biological Aging ◽  
Sectional Study ◽  
Cross Sectional

Telomere (TL) is a biomarker of biological aging, and its shortening is associated with major risk factors for cardiovascular diseases (CVD). This study aimed to identify whether TL is associated with arterial stiffness as reflected by brachial–ankle pulse wave velocity (baPWV). This population-based cross-sectional study involved 1065 individuals in the Iwaki area, Japan. Total TL length and TL G-tail length were measured by hybridization protection assay. The baPWV was measured on the right and left sides using a non-invasive vascular screening device. The associations between TL and baPWV were assessed by multivariate linear regression. Compared with the shortest total TL tertile, the longest total TL group showed a significant decrease in baPWV (lowest vs. highest tertile: adjusted beta: −41.24, 95% confidence interval (CI): −76.81, −5.68). The mean baPWV decreased with a longer TL (TL G-tail length: p trend < 0.001, total TL: p trend < 0.001). TL G-tail and total TL lengths were inversely associated with baPWV, implicating TL shortening in the development of CVD. This study provides evidence of the factors influencing CVD risks at a very early stage when individuals can still take necessary precautions before CVD gives rise to a symptomatic health outcome.

scholarly journals Aldosterone-to-renin ratio is related to arterial stiffness when the screening criteria of primary aldosteronism are not met

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Eeva Kokko ◽  
Pasi I. Nevalainen ◽  
Manoj Kumar Choudhary ◽  
Jenni Koskela ◽  
Antti Tikkakoski ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Primary Aldosteronism ◽  
Pulse Wave ◽  
Linear Regression Analysis ◽  
Plasma Renin ◽  
Cross Sectional Study ◽  
Whole Body ◽  
Cross Sectional ◽  
Mean Values ◽  
Aldosterone To Renin Ratio

AbstractAldosterone-to-renin ratio (ARR) is a screening tool for primary aldosteronism (PA), but the significance of ARR when the PA criteria are not met remains largely unknown. In this cross-sectional study we investigated the association of ARR with haemodynamic variables in 545 normotensive and never-medicated hypertensive subjects (267 men, 278 women, age range 19–72 years) without suspicion of PA. Supine haemodynamic data was recorded using whole-body impedance cardiography and radial tonometric pulse wave analysis. In sex-adjusted quartiles of ARR, determined as serum aldosterone to plasma renin activity ratio, the mean values were 282, 504, 744 and 1467 pmol/µg of angiotensin I/h, respectively. The only difference in haemodynamic variables between the ARR quartiles was higher pulse wave velocity (PWV) in the highest quartile versus other quartiles (p = 0.004), while no differences in blood pressure (BP), heart rate, wave reflections, cardiac output or systemic vascular resistance were observed between the quartiles. In linear regression analysis with stepwise elimination, ARR was an independent explanatory factor for PWV (β = 0.146, p < 0.001, R2 of the model 0.634). In conclusion, ARR was directly and independently associated with large arterial stiffness in individuals without clinical suspicion of PA. Therefore, ARR could serve as a clinical marker of cardiovascular risk.Trial registration: ClinicalTrails.gov: NCT01742702.

Hypomagnesemia in hemodialysis patients taking proton pump inhibitors

2020 ◽  
Vol 14 (2) ◽  
pp. 55-58
Author(s):  
Abdul Malik ◽  
Syed Mohkumuddin ◽  
Humaira Rahim ◽  
Shamima Hanif
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Serum Magnesium ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Mean Value ◽  
Female Dominance ◽  
P Value ◽  
Cross Sectional ◽  
The Mean

Background: Proton pump inhibitors (PPIs) are in routine widely prescribed to hemodialysis patients. Recent studies have reported the association of PPIs use with hypomagnesemia in patients with long term hemodialysis. This study aims to determine the frequency of hypomagnesemia in patients of hemodialysis taking proton pump inhibitors. Patients and methods: This cross-sectional study was conducted in the Department of Nephrology of Sandman Provincial Hospital Quetta from 01-6-2019 till 01-9-2019. A total of 120 patients (52 PPI users and 68 non-PPI users) who were on HD for more than 06 months were included. Data regarding age, gender, duration of hemodialysis and taking PPIs were collected. Determination of serum magnesium was made by taking 3 different samples at 2 weeks’ interval and the mean value of serum magnesium was calculated. Serum Mg2+ levels <2.0 mg/dL was taken as hypomagnesemia. A Chi-square test was applied to determine the association of PPI use with hypomagnesemia. Results: Demographic variables such as age and gender were not significantly different between the groups. There was female dominance in both groups (73% in PPI groups and 66.1% in the non-PPI group (p-value 0.65). The mean duration of dialysis was 45.3±13.8 months in PPI users versus 48.9±12.9 months in non-PPI users (p-value 0.14). There was a significantly higher frequency of hypomagnesemia in PPI users; 36 (69.3%) versus 27 (39.7%) in non-PPI users (p-value 0.001). Conclusion: The use of PPI is associated with a significant reduction in serum magnesium levels. So serum magnesium levels should be advised as routine monitoring in patients of hemodialysis taking PPIs.

scholarly journals The Fate of Patients Who Started Hemodialysis during Childhood or Adolescence: Results of an Interregional Moroccan Survey

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
F. Z. Souilmi ◽  
T. Sqalli Houssaini ◽  
G. EL Bardai ◽  
N. Kabbali ◽  
M. Arrayhani ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Pediatric Age ◽  
Sectional Study ◽  
Cross Sectional ◽  
Low Weight ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis is the most used renal replacement therapy for children in Morocco. The objective of this study was to determine the prevalence of patients who started hemodialysis in childhood and study their characteristics and specificities of their care. For this we conducted a multicentric descriptive cross-sectional study of all chronic hemodialysis patients who started dialysis in pediatric age, in hemodialysis centers in four of the sixteen regions of Morocco. We collected 2066 patients undergoing dialysis in 39 hemodialysis centers; from these, only 72 patients (3.48%) started hemodialysis in childhood. The average age of patients was 20.64 ± 6.5 years with a sex ratio of 1.9. Duration of dialysis was 78.2 ± 56 months. The cause of end stage renal disease was urological abnormalities in 18% of cases and glomerulopathy in 12.5% of cases; however, it remains unknown in half of the patients. Over 18 years, 74% of patients are without profession, it is active in 13% of cases, and pursuing studies are only in 13% of cases. Patients under 5 years and those with a low weight are rarely taken care of in chronic hemodialysis with little individualization of prescription. Greater attention should be paid to renal transplantation that is desired by the majority of these patients (92%).

scholarly journals Etiology of End-Stage Renal Disease and Arterial Stiffness among Hemodialysis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Balsam El Ghoul ◽  
Yazan Daaboul ◽  
Serge Korjian ◽  
Andrew El Alam ◽  
Anthony Mansour ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Arterial Stiffness ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Background. Prior studies have demonstrated that conventional and emerging CV risk factors are associated with worsening arterial stiffness among end-stage renal disease (ESRD) patients on hemodialysis. The present cross-sectional study evaluates the association between the etiology of ESRD and arterial stiffness among a cohort of hemodialysis patients.Methods. Etiology of ESRD was identified from patients’ medical records and classified as either vascular renal disease, diabetic nephropathy, nondiabetic glomerulopathy, tubular interstitial nephropathy, hereditary nephropathy, or ESRD of unconfirmed etiology.Results. A total of 82 subjects were enrolled. cfPWV was independently associated with the composite of either diabetic nephropathy or vascular renal disease (p=0.022), pulse pressure (p=0.001), and a history of CV events (p=0.025), but not history of hypertension or diabetes mellitus alone. The median cfPWVs in diabetic nephropathy and vascular renal disease were comparable and significantly higher than median cfPWVs in other etiologies of ESRD.Conclusion. The study suggests that the etiology of ESRD is independently associated with arterial stiffness among hemodialysis patients. Furthermore, arterial stiffness was higher among patients who developed renal sequelae of either diabetes mellitus or hypertension as compared with those who have a history of either diabetes mellitus or hypertension alone.

scholarly journals Effect of menopause on arterial stiffness and central hemodynamics: A pulse wave analysis-based cross-sectional study from Gujarat, India

2021 ◽  
Vol 12 (1) ◽  
pp. 46
Author(s):  
JayeshDalpatbhai Solanki ◽  
DevanshiNishantbhai Bhatt ◽  
RaviKanubhai Patel ◽  
HemantB Mehta ◽  
ChinmayJ Shah
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave ◽  
Cross Sectional Study ◽  
Pulse Wave Analysis ◽  
Sectional Study ◽  
Central Hemodynamics ◽  
Wave Analysis ◽  
Cross Sectional

scholarly journals The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3567
Author(s):  
Maria Fusaro ◽  
Giovanni Tripepi ◽  
Mario Plebani ◽  
Cristina Politi ◽  
Andrea Aghi ◽  
...  
Keyword(s):  
Vitamin K ◽  
Vertebral Fractures ◽  
Body Height ◽  
Fragility Fractures ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
High Morbidity ◽  
Cross Sectional ◽  
Relevant Risk Factor ◽  
Stage Renal Disease

Vascular calcification and fragility fractures are associated with high morbidity and mortality, especially in end-stage renal disease. We evaluated the relationship of iliac arteries calcifications (IACs) and abdominal aortic calcifications (AACs) with the risk for vertebral fractures (VFs) in hemodialysis patients. The VIKI study was a multicenter cross-sectional study involving 387 hemodialysis patients. The biochemical data included bone health markers, such as vitamin K levels, vitamin K-dependent proteins, vitamin 25(OH)D, alkaline phosphatase, parathormone, calcium, and phosphate. VF, IACs and AACs was determined through standardized spine radiograms. VF was defined as >20% reduction of vertebral body height, and VC were quantified by measuring the length of calcium deposits along the arteries. The prevalence of IACs and AACs were 56.1% and 80.6%, respectively. After adjusting for confounding variables, the presence of IACs was associated with 73% higher odds of VF (p = 0.028), whereas we found no association (p = 0.294) for AACs. IACs were associated with VF irrespective of calcification severity. Patients with IACs had lower levels of vitamin K2 and menaquinone 7 (0.99 vs. 1.15 ng/mL; p = 0.003), and this deficiency became greater with adjustment for triglycerides (0.57 vs. 0.87 ng/mL; p < 0.001). IACs, regardless of their extent, are a clinically relevant risk factor for VFs. The association is enhanced by adjusting for vitamin K, a main player in bone and vascular health. To our knowledge these results are the first in the literature. Prospective studies are needed to confirm these findings both in chronic kidney disease and in the general population.

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