Incidence of Atrial Fibrillation in Haemodialysis Patients

Abstract Background Chronic kidney disease patients usually experience several comorbid conditions including cardiovascular disorders and at final end-stage renal disease (ESRD) stage, cardiovascular mortality accounts for about 50% of total mortality. End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. Aim of the Work To detect the incidence of AF in hemodialysis patients during six months. Patients and Methods The study was a prospective cohort study for six months included 250 adult patients with end stage renal diseases on regular hemodialysis sessions in National Institute of Urology and Nephrology in CAIRO, EGYPT for at least six months with no past history suggestive of any arrhythmias and normal holter ECG at the start of the study. Results The study includes 250 patients from whom 37 patients refuse follow up after 6 months and 18 patients was died before our follow up holter ECG so mortality rate 14.4% .1n our study population there were 102 male patients (52.3%) and 93 female patients (47.7%) with mean age 54.39 ± 9.98 (19:73) and BMI 29.01±1.28 (24.5:34). In study population 96 patients were diabetic (49.2%), 84 patients were hypertensive (43.1%), 100patients were with ischemic heart diseases (51.3%) with median renal replacement duration 4 (3 — 6) with range (1 — 13). The main etiological causes of dialysis were diabetes mellitus, hypertension and analgesic nephropathy and other different causes of dialysis 35 patients (45%).The study showed association between incidence of AF in hemodialysis patients and different factors as increased BMI (0.006), prolonged duration of renal replacement therapy (0.017), diabetes mellitus (0.005), hypertension (0.000), ischemic heart diseases (0.02) and left atrium dilation (0.000). Conclusion The incidence of AF in patients with ESRD is 16.4%. The risk factors for increased incidence of AF in hemodialysis are; increased BMI, increased duration of renal replacement therapy, hypertension, diabetes mellitus, ischemic heart diseases and left atrium dilation by echocardiography.

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Diabetic nephropathy: what should cardiologist remember

Consilium Medicum ◽

10.26442/20751753.2021.1.200712 ◽

2021 ◽

Vol 23 (1) ◽

pp. 20-24

Author(s):

Natalia P. Trubitsyna ◽

◽

Natalia V. Zaitseva ◽

Anastasia S. Severinа ◽

◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Renal Replacement Therapy ◽

Renal Disease ◽

Replacement Therapy ◽

End Stage Renal Disease ◽

Kidney Diseases ◽

Renin Angiotensin Aldosterone System ◽

Stage Renal Disease ◽

End Stage

Prevalence of diabetes mellitus (DM) progressively increases around the world. Diabetic nephropathy (DN) is significant reason of end-stage renal disease and it is associated with high risk of cardiovascular disease and mortality. Necessity of expensive renal replacement therapy for patients with prominent vascular diabetic complications and end-stage renal disease has significant socio-economic impact. DM, as a one of leading causes of kidney diseases, competes for stricted resources of public health. Renal replacement therapy in patients with DM does not solve the whole problem, because survival of such patients is low, comparing with another kidney diseases, first of all because of cardiovascular diseases. Good control of glycaemia, blood pressure and cholesterol level and prescription of renin-angiotensin-aldosterone system inhibitors and statins decrease cardiovascular risk and slow down DN progression, as it was shown in many clinical trials. So patients with DM and DN should receive complex therapy for risk reduction of kidney disease and cardiovascular disorders progression. Keywords: diabetes mellitus type 2, diabetic nephropathy, nephroprotection, cardioprotection, SGLT-2 inhibitors, GLP-1 agonists, renin-angiotensin-aldosterone system For citation: Trubitsyna NP, Zaitseva NV, Severinа AS. Diabetic nephropathy: what should cardiologist remember. Consilium Medicum. 2021; 23 (1): 20–24. DOI: 10.26442/20751753.2021.1.200712

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Quantification and Dosing of Renal Replacement Therapy in Acute Kidney Injury: A Reappraisal

Blood Purification ◽

10.1159/000475457 ◽

2017 ◽

Vol 44 (2) ◽

pp. 140-155 ◽

Cited By ~ 6

Author(s):

William R. Clark ◽

Martine Leblanc ◽

Zaccaria Ricci ◽

Claudio Ronco

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Journal Club ◽

Kidney Injury ◽

Accurate Estimation ◽

Stage Renal Disease ◽

End Stage ◽

Dose Assessments ◽

Solute Clearance

Background/Aims: Delivered dialysis therapy is routinely measured in the management of patients with end-stage renal disease; yet, the quantification of renal replacement prescription and delivery in acute kidney injury (AKI) is less established. While continuous renal replacement therapy (CRRT) is widely understood to have greater solute clearance capabilities relative to intermittent therapies, neither urea nor any other solute is specifically employed for CRRT dose assessments in clinical practice at present. Instead, the normalized effluent rate is the gold standard for CRRT dosing, although this parameter does not provide an accurate estimation of actual solute clearance for different modalities. Methods: Because this situation has created confusion among clinicians, we reappraise dose prescription and delivery for CRRT. Results: A critical review of RRT quantification in AKI is provided. Conclusion: We propose an adaptation of a maintenance dialysis parameter (standard Kt/V) as a benchmark to supplement effluent-based dosing of CRRT. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=475457

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Survival During Renal Replacement Therapy for Diabetic End-Stage Renal Disease in Pima Indians

Diabetes Care ◽

10.2337/diacare.19.12.1333 ◽

1996 ◽

Vol 19 (12) ◽

pp. 1333-1337 ◽

Cited By ~ 11

Author(s):

R. G. Nelson ◽

R. L. Hanson ◽

D. J. Pettitt ◽

W. C. Knowler ◽

P. H. Bennett

Keyword(s):

Renal Replacement Therapy ◽

Renal Disease ◽

Replacement Therapy ◽

End Stage Renal Disease ◽

Pima Indians ◽

Stage Renal Disease ◽

End Stage

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Letermovir exposure in transplant patients with end-stage renal disease on renal replacement therapy

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkab316 ◽

2021 ◽

Author(s):

Nora Isberner ◽

Ruth Van Daele ◽

Hartwig Klinker ◽

Sabrina Kraus ◽

Fatemeh Aghai ◽

...

Keyword(s):

Renal Replacement Therapy ◽

Renal Disease ◽

Replacement Therapy ◽

End Stage Renal Disease ◽

Transplant Patients ◽

Stage Renal Disease ◽

End Stage

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Acute Kidney Injury and Renal Replacement Therapy

10.2310/anes.18367 ◽

2020 ◽

Author(s):

Karen L. Krechmery ◽

Diego Casali

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

End Stage Renal Disease ◽

Kidney Injury ◽

Treatment Modalities ◽

Optimal Timing ◽

Timing Of Initiation ◽

Stage Renal Disease ◽

End Stage

Acute kidney injury (AKI) is a common syndrome encountered in critical illness and is associated with significant morbidity and increased mortality. Despite attempts to prevent the development of AKI, its incidence continues to rise, probably due to increased recognition in the setting of clearer definitions of the stages of AKI. Despite advances in the field of Nephrology, the treatment of AKI and its complications remains difficult in clinical practice. Critical care clinicians must have an understanding of the current definitions, pathophysiology, and treatment modalities. Renal replacement therapy (RRT) is a mainstay of treatment, but a lack of consensus regarding the optimal timing for initiation remains. There is a need for further research regarding both the timing of initiation of RRT and biomarkers that might allow earlier detection, differentiation of etiologies and monitoring of interventions. This review contains 3 figures, 4 tables, and 31 references Key Words: acute kidney injury (AKI), KDIGO, renal replacement therapy (RRT), risk, injury, failure, loss of kidney function, end stage renal disease (RIFLE), nephrology

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Periodontal Disease in Patients Receiving Dialysis

International Journal of Molecular Sciences ◽

10.3390/ijms20153805 ◽

2019 ◽

Vol 20 (15) ◽

pp. 3805

Author(s):

Yasuyoshi Miyata ◽

Yoko Obata ◽

Yasushi Mochizuki ◽

Mineaki Kitamura ◽

Kensuke Mitsunari ◽

...

Keyword(s):

Renal Replacement Therapy ◽

Periodontal Disease ◽

Replacement Therapy ◽

Healthy Individuals ◽

Progressive Loss ◽

Medical Instruments ◽

Stage Renal Disease ◽

End Stage ◽

The Impact

Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.

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