scholarly journals Prevalence of glycemic variability and factors associated with the glycemic arrays among end-stage kidney disease patients on chronic hemodialysis

Medicine ◽  
2021 ◽  
Vol 100 (30) ◽  
pp. e26729
Author(s):  
Abdul Hanif Khan Yusof Khan ◽  
Nor Fadhlina Zakaria ◽  
Muhammad Adil Zainal Abidin ◽  
Nor Azmi Kamaruddin
2009 ◽  
Vol 21 (12) ◽  
pp. 1395-1399 ◽  
Author(s):  
Vitória R. Becker ◽  
Rosilene G. Badiani ◽  
Lara B. Lemos ◽  
Renata M. Perez ◽  
José O. Medina-Pestana ◽  
...  

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Seki A. Balogun ◽  
Natalie B. May ◽  
Meagan Briley ◽  
Allison Bosch ◽  
Isabelle Duerr ◽  
...  

BackgroundLittle is known about the perceptions of older adults with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) even though this could potentially influence how treatment is received. This study explores the perceptions of older adults with ESKD on HD, specifically their decision to initiate HD, preconceptions and expectations of HD, perceived difficulties with HD, and coping strategies.Design: Cross–sectionalSetting: Outpatient chronic dialysis units Participants: Older adults with ESKD on HD Intervention: Open-ended interviews were conducted with 15 participants. Inclusion criteria were age 60 years and older, HD duration of at least three months, and ability to consent and participate in the interview process.Results: We report on four identified domains: decision to initiate HD; preconceptions and expectations of HD; drawback of HD; and coping strategies. All participants were reluctant to initiate HD, but made the decision on advice from their physicians for varying reasons. Trust in physicians’ opinions also played a role for some. Some participants had positive preconceptions of HD, while a few had negative preconceptions or unrealistic expectations. Even though the majority of participants identified several difficulties with being on HD, they also had positive coping strategies, and the majority indicated that they would make the same decision to initiate HD.Conclusion: As clinicians are turning more to patient-centered medicine, understanding patients’ perceptions of HD is of crucial importance. Our study highlights the importance of improving pre-hemodialysis education to ensure that patients’ expectations are realistic, as well as identifying individualized coping strategies by patients. 


2018 ◽  
Vol 37 (3) ◽  
pp. 475-483 ◽  
Author(s):  
Hye Eun Yoon ◽  
Yaeni Kim ◽  
Seok Joon Shin ◽  
Yeon Sik Hong ◽  
Kwi Young Kang

2020 ◽  
Author(s):  
Abdul Hanif Khan Yusof Khan ◽  
Nor Fadhlina Zakaria ◽  
Muhammad Adil Zainal Abidin ◽  
Nor Azmi Kamaruddin

Abstract Introduction: Glycaemic variability (GV) or glycaemic fluctuations carries a significant higher risk of diabetic-related complications, especially cardiovascular. Extensive researches have been reported, but study on the end-stage-kidney-disease (ESKD) patients on chronic haemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs non-diabetic) patients and its associated factors during haemodialysis day (HDD) and non-haemodialysis day (NHDD). Methods: We recruited 150 patients on haemodialysis, 93 patients had diabetic (DM-ESKD), and 57 non-diabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage co-efficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles during haemodialysis and non-haemodialysis day. The GV indices and its associated factors were analysed comparing between both groups during the HDD and NHDD. Results: Mean blood glucose during HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared to 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (p =<0.01). The DM-ESKD group experienced significantly higher GV indices compared to NDM-ESKD; both during haemodialysis and non-haemodialysis day, particularly in the group with HbA1c 8-10% (p= <0.01). Presence of diabetes, older age group, hyperlipidaemia, HbA1c, ferritin levels, and albumin were recognised as factors associated with GV. Conclusion: DM-ESKD patients has high glycaemic variability, especially during the haemodialysis day, therefore increasing their chance to develop future devastating complications. We identified high HbA1c, older age group, presence of hyperlipidaemia, ferritin levels, and albumin as factors associated with GV. Since these groups of patients are vulnerable to CVD mortality, urgent attention is needed to rectify it.


Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1212
Author(s):  
Bushra Alshammari ◽  
Helen Noble ◽  
Helen McAneney ◽  
Farhan Alshammari ◽  
Peter O’Halloran

Background: Caring for a patient with end-stage kidney disease (ESKD) is highly stressful and can impact negatively on the physical and psychological well-being of caregivers. To accurately assess caregiver burden (CB), health care providers (HCPs) need to identify characteristics associated with an increase in CB. Aim: The aim of this review is to explore CB in caregivers of adult patients with ESKD and to identify characteristics associated with any increase in CB. Method: A comprehensive literature search was completed using five electronic databases. Medline, Embase, CINHAL, PsycINFO, and Scopus. The Joanna Briggs Institute checklist (JBI) was used to quality appraise full text papers included in the review. No time limit for the date of publication of studies was employed, to enable the inclusion of more extensive literature. Results: A total of 38 relevant studies from 18 countries were identified and included in the review. A variety of patient and caregiver factors can impact positively or negatively on CB, including socio-demographic factors of patients and caregivers, disease-related factors, situational and relational factors, environmental factors, and psychological factors. Conclusion: This review provides awareness to HCPs of the important factors associated with CB, when assessing or targeting interventions for caregivers experiencing burden.


2015 ◽  
Vol 40 (4) ◽  
pp. 332-336 ◽  
Author(s):  
Yuri Tanaka ◽  
Nobuhiko Joki ◽  
Hiroki Hase

Background: It was recently reported that the severity of coronary and carotid atherosclerosis in patients with end-stage kidney disease (ESKD) has improved over the last two decades. However, the frequency of coronary artery events observed at the initiation of dialysis remains high. Summary: Recently, 5 different clinical types of acute myocardial infarction (MI) were introduced in the third universal definition of MI. Type 2 MI, known as secondary MI, is a more heterogeneous entity, where a condition other than coronary artery narrowing contributes to an acute imbalance in oxygen supply and demand. In patients with chronic kidney disease, it has been demonstrated that type 2 MI is more common than type 1 MI, which is associated with coronary occlusive disease. It is suspected that patients with ESKD also often have type 2 MI. Factors associated with incremental increases in oxygen demand may cause myocardial ischemia in ESKD. Key Messages: Significant epicardial coronary narrowing might not be a necessary precursor of myocardial ischemia in ESKD. To prevent ischemic heart disease and improve prognosis in patients with ESKD, we need to pay attention not only to coronary stenotic lesions, but also to the factors associated with the induction of an imbalance in myocardial oxygen supply and demand.


2020 ◽  
Author(s):  
Abdul Hanif Khan Yusof Khan ◽  
Nor Fadhlina Zakaria ◽  
Muhammad Adil Zainal Abidin ◽  
Nor Azmi Kamaruddin

Abstract Introduction: Glycaemic variability (GV) confers a significantly higher risk of diabetic-related complications, especially cardiovascular. Despite extensive research in this area, data on end-stage-kidney-disease (ESKD) patients on chronic haemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs non-diabetic) patients and its associated factors on haemodialysis days (HDD) and non-haemodialysis days (NHDD).Methods: We recruited 150 patients on haemodialysis, 93 patients with diabetic (DM-ESKD), and 57 with non-diabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage co-efficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles on HDD and NHDD. The GV indices and its associated factors of both DM-ESKD and NDM-ESKD were analysed to compare HDD vs. NHDD.Results: Mean blood glucose on HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared to 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (p =<0.01). The DM-ESKD group experienced significantly higher GV indices compared to NDM-ESKD on both HDD and NHDD, particularly in the subgroup with HbA1c 8-10% (p= <0.01). Presence of diabetes, older age, hyperlipidaemia, HbA1c, ferritin levels, and albumin were identified as factors associated with GV.Conclusion: DM-ESKD patients have high GV, especially on HDD, therefore increasing their risk of developing future complications. We identified high HbA1c, older age group, presence of hyperlipidaemia, ferritin levels, and albumin as factors associated with GV. Since these groups of patients are vulnerable to CVD mortality, urgent attention is needed to rectify it.


2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Vieux Momeme Mokoli ◽  
Ernest Kiswaya Sumaili ◽  
François Bompeka Lepira ◽  
Fiston Ikwa Ndol Mbutiwi ◽  
Jean Robert Rissassy Makulo ◽  
...  

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Yasir Hussain ◽  
Anjum Shahzad ◽  
Sidra Azam ◽  
Nazish Munawar

Objective: To determine frequency of hepatitis-C in dialysis patients at start of hemodialysis, seroconversion from HCV negative to HCV positive over study duration and factors affecting seroconversion. Methods: This descriptive prospective observational study done in dialysis center of DHQ hospital Sheikhupura, Punjab, Pakistan. The study was conducted from October 2016 to October 2017. Data was collected on Performa and later followed prospectively in same cohort of patients. All the patients on maintenance hemodialysis for more than one month were included in the study. Patients with acute kidney disease and on dialysis less than one month were excluded. Patients were analyzed by dividing them in three groups, group-I patients who were HCV positive at start of dialysis, Group-II who were negative and seroconvert to HCV positive, Group-III who were negative and remained negative. All seronegative patients were followed at one, three, six and twelfth months on being hemodialysis for seroconversion. Results: Out of 230 surveyed patients 52 were HCV positive at start of dialysis and 19 were loss of follow up. Out of remaining 159 HCV negative patients 95 became HCV positive, only 64 patients remained HCV negative by end of study. Conclusion: Frequency of HCV seroconversion among chronic hemodialysis patient is found to be 53.37%. Arteriovenous access, number of dialysis, reuse of dialyzer and blood transfusions are important risk factors. How to cite this:Hussain Y, Shahzad A, Azam S, Munawar N. Hepatitis-C and it’s seroconversion in end stage kidney disease patients on maintenance hemodialysis and factors affecting it. Pak J Med Sci. 2019;35(1):66-70. doi: https://doi.org/10.12669/pjms.35.1.366 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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