Assessment of Magnesium level Among Hemodialysis Patients and Its Relation to Vascular Stiffness

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Zaki ◽  
Abdel Rahman Khedr ◽  
Ashraf Hassan ◽  
Nouran Abdel Fattah
Keyword(s):  
Vascular Calcification ◽  
Cardiovascular Complications ◽  
Hemodialysis Patients ◽  
Pulse Velocity ◽  
Magnesium Level ◽  
Vascular Stiffness ◽  
Valve Calcification ◽  
Media Thickness ◽  
Group I ◽  
Significant Difference

Abstract Background The pathogenesis of vascular calcification in Chronic kidney disease (CKD) patients is multifactorial and complicated. It has been proposed that Magnesium (Mg) may be implicated in the process of vascular calcification on various levels. Aim This study aims to assess the level of magnesium in hemodialysis patients and its relation to the vascular stiffness. Patients and methods 100 prevalent hemodialysis patients were included in the study and they were clinically stable with absence of cardiovascular complications, all patients underwent the following laboratory investigation including complete blood picture, median of magnesium level over 3 months, electrolytes, ipth, lipid profile and radiological investigations including transthoracic echocardiography and carotid duplex. Results The studied population was divided into two groups, group I included 68 patients with normal mg level and group II included 32 patients with low mg level. There was statistically significant difference between the two groups as regard hemoglobin level (pvalue=0.033), otherwise there was no statistically significant difference as regard other laboratory and radiological investigations. Then they were divided into another two groups according to the presence of mitral valve calcification (MVC), group III involved 85 patients without MVC and group IV involved 15 patients with MVC. There was statistically significant difference between 2 groups as regard aortic wave pulse velocity (aPWV) with (pvalue=0.002), presence of plaques with (pvalue <0.001) and intimal media thickness with (pvalue<0.001). Another group was divided according to presence of aortic valve calcification (AVC) into two groups, first group V included 39 patients without AVC and second group VI included 61 patients with AVC. There was statistically significant difference between two groups as regard age with (pvalue<0.001), ipth with (pvalue=0.033), presence of plaques with (pvalue=0.048) and intimal media thickness with (pvalue<0.001). Conclusion There was high prevalence of vascular calcification among hemodialysis patients which may be related to age and hyperparathyroidism but without statistically significant correlation to Mg level.

Outcome of Patients Hospitalized with Acute Coronary Syndrome Fulfilling the Criteria of Metabolic Syndrome

2014 ◽  
Vol 15 (1) ◽  
pp. 31-35
Author(s):  
Mohammed Shahadat Hossain ◽  
Khan Abul Kalam Azad ◽  
Prodip Kumar Biswas ◽  
Md. Amir Hossain ◽  
Jayanta Kumar Saha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Acute Coronary Syndrome ◽  
Heart Block ◽  
Cardiovascular Complications ◽  
Coronary Syndrome ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

The aim of the study was to assess the association of metabolic syndrome in patients with acute coronary syndrome and the impact of metabolic syndrome on clinical outcome. Total 210 ACS patients were included in this study and divided in group I & II on the basis of presence or absence of MS respectively. Among the study patients mean age in group I and group II was 52.99 ± 11.49 years and 53.34 ± 12.54 years respectively. Among the risk factors, hypertension (70%vs 15%), dyslipidemia (100 vs. 97%), diabetes mellitus (36.4% vs. 6%) were significant between two groups. Mean waist circumference recorded was 103.12 ± 4.15 in group I and 96.50 ± 6.43 in group II which was significant. Present study showed, in hospital outcome was worse in group I in comparison to group II and was significant, like cardiogenic shock (11% vs. 1%), LVF (28.2% vs. 16%), and CVD (5.45 vs. 0%). But there were no significant difference in heart block, tachyarrhythmia, cardiac arrest, reinfarction and death. Complications were far more in group I than in group II (14.5% vs. 52.0%) which was also highly significant. So, we conclude that the presence of MS in patients suffered from ACS was associated with a greater incidence of in-hospital cardiovascular complications and mortality.DOI: http://dx.doi.org/10.3329/jom.v15i1.19857 J Medicine 2014; 15: 31-35

scholarly journals P1098THE CHANGE OF PLASMA SCLEROSTIN AND OTHER BIOMARKERS IN HEMODIALYTIC PATIENTS USING DIALYZER WITH MEDIUM CUT-OFF MEMBRANE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Jong Hwan Jung ◽  
Seon-Ho Ahn ◽  
Ju Hung Song
Keyword(s):  
Molecular Weight ◽  
Vascular Calcification ◽  
Plasma Levels ◽  
Cardiovascular Complications ◽  
Uremic Toxins ◽  
Control Group ◽  
High Flux ◽  
Middle Molecules ◽  
Significant Difference ◽  
Fgf 23

Abstract Background and Aims Protein-bound toxins and uremic toxins with middle molecular weight usually develop uremic symptoms in patients with advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD). Although the effect on uremic toxicity of the molecules is not proven yet, middle molecules or larger middle molecules is regarded with important substance concerning of development of uremic symptoms and cardiovascular complication, particularly in CKD patients. Hemodialysis (HD) or hemodiafiltration (HDF) using dialyzer with high flux membrane provided improved clearance for uremic toxins with middle molecular weights. However, uremic toxins with larger middle molecular weight could not be easily removed through above methods. Medium cut-off (MCO) membrane can remove larger middle molecules which can be not removed through high flux membrane and HDF. From this perspective, chronic use of MCO membrane lowering the plasma concentration of larger middle molecules associated with cardiovascular complications including vascular calcification may give beneficial effect, particularly in patients with ESRD. Method Twenty-five patients undergoing chronic hemodialysis were prospectively analyzed for 6 months. We randomly divided enrolled patients into two groups: control group and MCO group. Patients in the control group used dialyzer with high flux membrane and patients in MCO group used dialyzer with MCO membrane. The enrolled patients performed hemodialysis thrice a week during 6 months. We measured plasma levels of several biomarkers at baseline and 3-month and 6-month through the multiplexing using Luminex® technology. In this prospective study, we performed comparative analysis with larger middle molecules, such as CXCL16, sclerostin, and FGF-23, in both groups. Results The plasma levels of all biomarkers at baseline did not show significant difference between two groups (CXCL16: p =0.904, Sclerostin: p =0.322, FGF-23: p =0.065, respectively). However, plasma sclerostin levels at 3-month and 6-month were significantly lower in MCO group (p = 0.060, p <0.005, respectively). In addition, even after analysis of covariance through ANCOVA analysis, plasma sclerostin levels at 3-month and 6-month were significantly lower in MCO group compared with the control group (p = 0.042, p =0.001, respectively). But, there was no a significant decrease of plasma sclerostin levels according to time, particularly in MCO group (p = 0.157, p =0.412, respectively) (Figure 1). Conclusion This study showed the 6-month outcome for changes of the plasma levels of larger middle molecules, including CXCL16, sclerostin, and FGF-23, particularly in dialytic patients using dialyzer with MCO membrane. Plasma sclerostin associated with vascular calcification showed decreasing tendency during 6 months after application of MCO membrane, but, there was no statistical significance. However, plasma levels of sclerostin were significantly lower in dialytic patients using MCO membrane than those using high flux membrane at 3 and 6 months, respectively. Therefore, hemodialysis using dialyzer with MCO membrane may be an option to attenuate cardiovascular complications in ESRD patients.

Association between Plasma Dehydroepiandrosterone Sulfate and Carotid Intima-Media Thickness among Male and Female Patients with End-Stage Renal Disease on Hemodialysis

2019 ◽  
Vol 10 (1) ◽  
pp. 61-68
Author(s):  
Rasha Samir Shemies ◽  
Tamer Zaki Gaber ◽  
Samar Tharwat Radwan ◽  
Mostafa Mansour ◽  
Mohamed Mofreh ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Dehydroepiandrosterone Sulfate ◽  
Cross Sectional ◽  
Female Patients ◽  
Male Group ◽  
Media Thickness ◽  
Group I ◽  
Significant Difference

Background and Aim: Serum dehydroepiandrosterone sulfate (DHEA-S) is known to be lower in chronic kidney disease (CKD) patients and in those with cardiac disease, and correlates with a poor cardiovascular outcome. This study aimed to assess the correlation between DHEA-S and carotid intima-media thickness (CIMT) as a predictor of cardiovascular disease in hemodialysis (HD) patients. Methods: A total of 88 HD patients were included in this cross-sectional study. They included 53 male (group I) and 35 female patients (group II). In addition to conventional history taking, clinical examination, and routine laboratory investigations, serum DHEA-S and CIMT were measured for all patients. CIMT was measured using B-mode ultrasonography, and the mean of maximum CIMT was recorded. The 2 patient groups were further classified according to the level of DHEA-S. The correlation between serum DHEA-S and CIMT was studied. Results: In male patients, CIMT and age were significantly higher in the group with low DHEA-S level (p = 0.003 and 0.001, respectively), while there was no significant difference in both parameters in females. A higher percentage of HCV-positive patients is present in the male group with low DHEA-S level (p = 0.009). Serum DHEA-S is significantly negatively correlated with CIMT in males (p = 0.003) but not in females, and has a significant negative correlation to age in both genders (p = 0.001 and 0.04, respectively). Conclusion: Endocrinal disturbance representing as lower serum DHEA-S is associated with increased CIMT, which is considered a predictor of cardiovascular disease in male HD patients, although it is largely explained by advancing age.

scholarly journals Non-traditional Risk Factors of Cardiovascular Disease and Coenzyme Q10 Therapy in Hemodialysis Patients

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Elham Shahraki ◽  
Batool Shahraki ◽  
AliReza Dashipour
Keyword(s):  
Serum Albumin ◽  
Coenzyme Q10 ◽  
Antioxidant Properties ◽  
Serum Levels ◽  
Cardiovascular Complications ◽  
Hemodialysis Patients ◽  
Diabetic Patients ◽  
Beneficial Effects ◽  
Significant Difference ◽  
Coq10 Supplementation

Background: Inflammatory markers increase in end-stage renal disease (ESRD), especially in diabetic patients, and are positively correlated with cardiovascular mortality. Coenzyme Q10 (CoQ10), an agent with antioxidant properties, may be effective in reducing cardiovascular complications in hemodialysis patients. This study aimed to investigate the effects of CoQ10 supplementation on plasma C-reactive protein (CRP), homocysteine, and albumin in hemodialysis patients. Methods: Forty diabetic ESRD patients on hemodialysis for at least six months were evaluated in a double-blinded randomized clinical trial. The patients were randomly assigned to one of the two groups to receive either CoQ10 100 mg daily or placebo. In all patients, the serum levels of homocysteine, albumin, and CRP were measured before and after six months. Results: The mean age of the patients was 60.3 ± 9.1 years, and 57.5% of the participants were female. There was no statistical difference between the two groups at baseline. Furthermore, no significant difference was observed in serum albumin (P = 0.843), CRP (P = 0.214), and homocysteine (P = 0.21) at the end of the intervention between the groups. Conclusions: This study showed that in patients with ESRD, using CoQ10 supplementation has minimal beneficial effects on serum albumin, CRP, and homocysteine levels.

scholarly journals A study on the correlation of serum magnesium with intima-media thickness of carotid in hemodialysis patients

2021 ◽  
Vol 10 (2) ◽  
pp. e21-e21
Author(s):  
Taraneh Esmaili ◽  
Zahra Aghaalitafreshi ◽  
Mohammad Hadi Gharib ◽  
Maryam Montazeri
Keyword(s):  
Medical Center ◽  
Normal Population ◽  
Serum Magnesium ◽  
Intima Media Thickness ◽  
Hemodialysis Patients ◽  
Magnesium Level ◽  
Serum Magnesium Level ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Media Thickness

Introduction: Atherosclerosis progression in the patients suffering from end-stage renal disease (ESRD) is more than normal population. Magnesium levels are also associated with an increase in atherosclerosis in the common carotid artery. Intima-media carotid calcification is either directly or indirectly related to cardiovascular disease and a higher rate of death among patients with chronic renal failure. Objectives: The purpose of the present study was to evaluate the protective role of serum magnesium levels in vascular calcification and the improvement of the carotid intima-media thickness (CIMT). Patients and Methods: In this cross-sectional research, the participants were selected from all patients with ESRD in Five Azar Medical Center of Gorgan, Iran. Blood samples collected from research units were tested for serum magnesium level in three times. Patients were referred to a radiologist to measure CIMT. Data collected in all patients were evaluated based on Spearman’s correlation test. Results: The correlation between serum magnesium level and CIMT was not statistically significant (P = 0.66 r= 0.04), however a positive correlation between CIMT and the dialysis adequacy (KT/V) was detected (r = 0.306, P = 0.006). Conclusion: This study demonstrated no correlation between the serum magnesium level and the CIMT in hemodialysis patients.

scholarly journals Serum fetuin-A levels and its relationship with biochemical parameters in hemodialysis patients

2021 ◽  
Vol 11 (1) ◽  
pp. e6-e6
Author(s):  
Behzad Abbasi Jamaati ◽  
Raheb Ghorbani ◽  
Mehrdad Zahmatkesh ◽  
Mohammad Reza Tamadon
Keyword(s):  
Biochemical Markers ◽  
Heart Diseases ◽  
Statistical Significance ◽  
Serum Triglyceride ◽  
Cardiovascular Complications ◽  
Hemodialysis Patients ◽  
Fetuin A ◽  
Blood Hemoglobin ◽  
Significant Difference ◽  
Calcium Phosphorus

Introduction: Cardiovascular events are the most important complications of end-stage renal disease (ESRD). The role of fetuin-A and vascular calcification inhibitors in cardiovascular complications, dysregulated biochemical markers, and mortality is uncertain in patients under hemodialysis. Objectives: The aim of this study was to investigate the relationship of fetuin-A with cardiovascular complications and biochemical markers in hemodialysis patients. Patients and Methods: In this cross-sectional study, 65 patients undergoing hemodialysis were enrolled. Blood samples were taken at pre-dialysis to determine serum fetuin-A, calcium, phosphorus, intact parathyroid hormone (iPTH), C-reactive protein (CRP), albumin, triglyceride, total cholesterol, as well as blood hemoglobin, and hematocrit. The data was analyzed considering the statistical significance level of 0.05. Results: Out of 65 patients, seven patients died during the study, and 58 patients were finally evaluated. Mean (±SD) serum fetuin-A level was 1268.71 ± 1229.4 μg/mL. There was no significant difference in the mean fetuin-A level between genders (P=0.904). There were no significant correlations between the serum level of fetuin-A and age, duration of dialysis, heart diseases, serum levels of calcium, phosphorus, PTH, albumin, CRP, cholesterol and finally blood hemoglobin. However, significant relationships were found between fetuin-A level and serum triglyceride (TG) level (P=0.019) and body mass index (BMI) (P=0.024). Conclusion: Fetuin-A level was significantly associated with serum TG level and BMI. Regarding the links of obesity and hypertriglyceridemia with cardiovascular diseases (CVDs), controlling serum TG level and body weight can reduce the risk of vascular atherosclerosis in patients undergoing dialysis.

scholarly journals Evaluation of Serum Magnesium Level Among Patients with Essential Hypertension in Erbil-Iraq

2021 ◽  
Vol 20 (2) ◽  
pp. 23-30
Author(s):  
Salam Naser Zangana ◽  
◽  
Suhad Ali Khazaal
Keyword(s):  
Essential Hypertension ◽  
Serum Magnesium ◽  
Critical Role ◽  
Study Groups ◽  
Magnesium Level ◽  
Serum Magnesium Level ◽  
Hypertensive Patients ◽  
Established Risk Factor ◽  
Group I ◽  
Significant Difference

Background: Hypertension is a well-established risk factor for cardiovascular diseases with an ongoing global increase in incidence. Low Magnesium may play a critical role in cardiovascular physiology. Although many reports have mentioned the correlation between low serum magnesium levels and hypertension, the results were conflicting. Objective: To measure the levels of serum magnesium in hypertensive patients, and to evaluate the prevalence of hypomagnesemia among them. Patients and Methods: A case-control study from June 2019 to December 2019 was carried out in Rizgary Teaching Hospital and Nawroz Health Center involving 100 adult patients with essential hypertension (group I ) and 100 normotensive age and gender-matched controls ( group II). The serum magnesium level was measured in all participants. Results: Females constitute 64 % of both study groups. The means of the age of both study groups show no significant difference (p=0.82). Although the means of Mg level in hypertensive and control groups were within the normal range, it was significantly lower in hypertensive patients (p=0.004). Besides, 4 hypertensive patients (4%) had hypomagnesemia compared with zero in controls (p=0.043). Conclusion: There was a significantly lower mean magnesium level in hypertensives compared to controls. A relationship was assumed between serum magnesium level and hypertension. However; hypomagnesemia was not common in hypertensive patients.

Correlation of Serum Sclerostin Levels with Carotid Intima Media Thickness in Chronic Kidney Disease Hemodialysis

2020 ◽  
Vol 6 (1) ◽  
pp. 18-26
Author(s):  
Adhi Permana ◽  
Ian Effendi ◽  
Taufik Indrajaya
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Ultrasound Examination ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
The Mean ◽  
Sclerostin Level ◽  
Hemodialysis Duration

Chronic kidney disease is associated with a high mortality rate, especially cardiovascular disease associated with mineral and bone disorders. Sclerostin is an inhibitor of Wnt signaling which has the effect of increasing the occurrence of vascular calcification in patients with chronic kidney disease. There are several studies that show different results. Carotid intima media thickness ultrasound examination is a tool to identify atherosclerosis which is part of vascular calcification. The aim of this study is to look at the correlation of sclerostin with carotid intima media thickness (CIMT) in patients with chronic kidney disease undergoing hemodialysis. In this cross section, the concentration of sclerostin was measured by examination of enzymed linked immunosorbent assay. CIMT measurement by ultrasound mode B examination. There were 40 patients in this study. The mean sclerostin level was 256.68 ± 127.76 pg / ml. Sclerostin levels are declared high if above 162 pg / ml there are 30 people. CIMT thickening was present in 11 patients. There was no significant correlation of serum sclerostin with CIMT in patients with chronic kidney disease undergoing hemodialysis (r-0.32 p0,847). In multivariate linear regression, hemodialysis duration is an independent factor that is significantly significant with CIMT. There was no significant correlation of serum sclerostin with CIMT in patients with chronic kidney disease undergoing hemodialysis.

scholarly journals Comparative Evaluation of Immediate Bond Strength to Bleached Enamel Following Application of Various Antioxidant Solutions

2017 ◽  
Vol 05 (02) ◽  
pp. 084-089
Author(s):  
Alisha Dhingra ◽  
Ashu Gupta ◽  
Anshu Minocha ◽  
Nayantara Sen
Keyword(s):  
Bond Strength ◽  
Shear Bond Strength ◽  
Grape Seed Extract ◽  
Grape Seed ◽  
Seed Extract ◽  
The Other ◽  
Sodium Ascorbate ◽  
Group V ◽  
Group I ◽  
Significant Difference

Abstract Aim: The aim of this study was to compare the reversal of shear bond strength of composite to bleached enamel immediately after bleaching followed by application of various antioxidant solutions. Material and Methods: Seventy central incisors were divided into seven groups. Groups I and II served as unbleached and bleached controls respectively. Groups III, IV, V, VI and VII served as the experimental groups and were subjected to 37.5% hydrogen peroxide bleaching followed by 10 min application of 10% sodium ascorbate, 25% alpha-tocopherol, 6.5% grape seed extract, 5% lycopene and 5% green tea extract respectively. Following composite bonding, shear bond strength was determined and the results were analyzed using ANOVA followed by Post Hoc Multiple Comparisons test. Results: The bond strength values for Group I (positive control) were maximum and significantly different than all the other groups except Grape seed extract group (Group V). When compared to Group II (bleached control), all the groups showed significantly higher bond strength. Significant difference in the bond strength values were seen between Group III (10% sodium ascorbate) and Group V. Also values for Group V were significantly different from Group VI (5% lycopene). All the other values showed insignificantly different results. Conclusion: All the antioxidant solutions improved the shear bond strength values after bleaching but only Grape seed extract application reversed the values to the non bleached levels. Lycopene was least effective. Other antioxidants showed comparable results.

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