scholarly journals SARS-CoV-2 Antibodies in Hemodialysis Patients Six Months after Infection Compared to Healthcare Workers

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Henri Boulanger ◽  
Salima Ahriz Saksi ◽  
Jedjiga Achiche ◽  
Florence Batusanski ◽  
Nicolas Stawiarski ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Severe Disease ◽  
Humoral Response ◽  
Pulmonary Involvement ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Neutrophil Lymphocyte Ratio ◽  
Oxygen Requirements ◽  
Circulating Levels

Background. The humoral response to SARS-CoV-2 infection in hemodialysis patients needs to be clarified. Methods. In this retrospective study performed in two dialysis facilities, we measured the circulating levels of SARS-CoV-2 antibodies in patients who were on maintenance hemodialysis during the first wave of the epidemic in March and April 2020 and were still alive 6 months later. We also investigated associations between the patients diagnosed as infected during the first wave and several clinical, biological, and radiological parameters of COVID-19. Finally, we compared these circulating levels of SARS-CoV-2 antibodies with those of a control group of healthcare workers infected during the same period. Results. Of the 299 hemodialysis patients who recovered from the first wave of the epidemic 6 months before, 59 had a positive SARS-CoV-2 antibody whereas only 45 patients were diagnosed as infected during the first wave of the epidemic. All infected hemodialysis patients developed circulating antibodies. Using a clustering method, a significant correlation was identified between the cluster with the lowest circulating levels of SARS-CoV-2 antibodies and the severity of COVID-19 based on several parameters including CRP, BNP, lymphocyte count, neutrophil-lymphocyte ratio, and oxygen requirements, as well as pulmonary involvement on chest scan. Moreover, the circulating levels of the SARS-CoV-2 antibodies in surviving hemodialysis patients (n = 59) were similar to those of the control group (n = 17). Conclusion. The main finding of this study is that all of the surviving hemodialysis patients who were diagnosed with SARS-CoV-2 infection from March to April 2020 developed a persistent humoral response with significant circulating levels of SARS-CoV-2 antibodies, 6 months later. Another important finding is that surviving hemodialysis patients who had more severe disease had lower circulating levels of SARS-CoV-2 antibodies. Finally, circulating levels of SARS-CoV-2 antibodies were similar in surviving hemodialysis patients and healthcare workers without kidney disease.

MO894EVALUATIONS OF TOXIC HEAVY METALS LEAD AND MERCURY IN REGULAR HEMODIALYSIS SMOKER AND NONSMOKER PATIENTS BY COMPARISON WITH OTHER HEALTHY CONTROL SUBJECTS IN EGYPTIAN POPULATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ezzeldin Shalaby ◽  
Hisham Abdelmawgoud
Keyword(s):  
Heavy Metals ◽  
Kidney Diseases ◽  
Mercury Level ◽  
Lead Level ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Toxic Heavy Metals ◽  
Ckd Stage ◽  
Regular Hemodialysis

Abstract Background and Aims Around worldwide population, 10% are affected by chronic kidney diseases (CKD); hemodialysis is the common choice of renal replacement therapy. Cigarette smokers have higher Lead level than non-smoker population. As Tobacco leaves are grown on polluted soil, it is proven that Mercury poisoning depends on dose and duration of exposure. Aim of the study was to determine two important toxic heavy metals elements Lead and Mercury concentrations in regular hemodialysis patients smoker and non-smoker by comparison with normal subjects and its correlation to anemia. Method Blood samples were collected from CKD patients on maintenance hemodialysis for more than 6 months divided into non-smoker and smoker to be compared with samples from a control group of non-CKD, non-smoker persons. This study was conducted in September 2019 in Al Mokattam Insurance Hospital – Cairo and involved 60 persons of both sex. They were divided into 3 groups: CKD stage 5 patients on hemodialysis 40 patients and sub-divided into 2 groups; (smoker) 20 patients and (non-smoker) 20 patients and the history of eating fish and seafood was taken. The third group was a control group included 20 healthy non-smoker participants. Lead and Mercury were analyzed by electro thermal atomic absorption spectrophotometer in Al Borg central Laboratory. The complete blood count (CBC), kidney function tests and Iron parameters were also detected. Results duration on hemodialysis did not raise Lead or Mercury level in blood, while smoking raises Lead level in blood, and eating fish and sea food more than once per week increased Mercury level in blood. There was a relation between raised Lead level and anaemia in hemodialysis patients. Conclusion Lead Prolonged and Mercury measurement is important in hemodialysis patients with possible symptoms of heavy metal toxicity. Lead level monitoring is recommended in resistant anemia in hemodialysis patients.

Variations in the Circulating Heparin Levels During Maintenance Hemodialysis in End Stage Renal Disease Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3412-3412
Author(s):  
Vinod Bansal ◽  
Kristiyana Kaneva ◽  
Debra Hoppensteadt ◽  
Josephine Cunanan ◽  
Jawed Fareed
Keyword(s):  
Thrombin Generation ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Functional Assay ◽  
Dialysis Unit ◽  
Blood Samples ◽  
Patient Consent ◽  
Significant Difference ◽  
Circulating Levels ◽  
Maintenance Hemodialysis Patients

Abstract Abstract 3412 Introduction: Unfractionated heparin has remained the anticoagulant of choice for hemodialysis patients. The anticoagulation facilitates blood flow through the dialysis circuit and assures the patency of the dialysis membrane. Wide variations in the heparinization responses have been observed in patients undergoing this procedure. The purpose of this investigation was to measure circulating heparin levels in patients prior to and after hemodialysis. Methods: This study included 119 ESRD patients undergoing maintenance hemodialysis after appropriate IRB approval and patient consent. For the 3–4 hour hemodialysis duration, a heparin loading dose of 1000 Units followed by two additional dosages of 500 Units/hour were administered. Citrated blood samples were collected prior to and immediately after the dialysis session. The blood samples were centrifuged for 15 minutes at 3000 g at 4°C and platelet poor plasma (PPP) was extracted. Citrated plasma was frozen at −70°C and analyzed utilizing such clot based methods as Activated Partial Thromboplastin Time (APTT), Heptest and Prothrombinase Induced Clotting Time (PiCT). Circulating Anti-Xa levels were measured using a chromogenic substrate method. Thromboplastin induced thrombin generation was also measured using a fluorogenic substrate method, Thrombin Generation Assay (TGA). The Antithrombin (AT) levels in each of these patients were also measured using a functional assay. The circulating levels of heparin were determined using a calibration curve constructed from the heparin used in the dialysis unit. Results were computed for the individual tests and heparin concentrations were obtained using the assay based calibration procedures. Results: In the clot based assays such as APTT and Heptest, no significant differences between pre and post plasma samples were noted. The circulating levels of heparin were from 0 to 1.08 U/ml with a mean of 0.07 ± 0.11 for the APTT and a range of 0 to 1.98 for the Heptest with a mean of 0.09 ± 0.26 U/ml. In the PiCT test the range was from 14.0 to 300 seconds for the pre dialysis samples with a mean of 32.0 ± 38.2, whereas for the post samples the range was from 15.2 to 110 with a mean of 29.6 ± 14.0. For the Anti-Xa levels the % inhibition for the two groups was similar. The circulating Anti-Xa levels in the pre dialysis samples ranged from 0 to 0.77 with a mean of 0.10 ± 0.14, whereas the post level ranged from 0 to 0.51 with a mean of 0.13 ± 0.11. For the thrombin generation, the % inhibition levels ranged from 0 to 100% pre dialysis with a mean of 34.2 ± 34% and ranged 0 to 100% post dialysis with a mean of 44.5 ± 34.4%. The Antithrombin levels ranged from 28 to 130% with a mean of 86.6 ± 19.5% in the pre dialysis samples. There was no significant difference between pre and post dialysis samples using APTT, Heptest and PiCT, whereas the Thrombin generation and Anti-Xa resulted in a statistically significant p value < 0.05 when comparing the two groups. Conclusion: Wide variations in circulating heparin levels are noted in maintenance hemodialysis patients at pre dialysis and post dialysis time periods. Some patients exhibit higher levels of heparin due to a vascular access flush. These results also suggest that the use of heparin in maintenance hemodialysis patients in repeated regimen results in a steady state hypocoagulation as evidenced by the inhibition of thrombin generation, circulating Anti-Xa level and the prolongation of various clotting times. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Clinical Characteristics and degree of severity of COVID-19 in Hemodialysis Patients in Armed Forces Institute of Urology.

2021 ◽  
Vol 5 (4) ◽  
pp. PP1-6
Author(s):  
Saba Umar ◽  
Sohail Sabir ◽  
Khalid Raja ◽  
Khurram Mansoor ◽  
Tanveer Sajid ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Armed Forces ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Mild Disease ◽  
Spread Of Infection ◽  
Degree Of Severity

Introduction  This study was conducted to evaluate the clinical characteristics and severity of COVID -19 in hemodialysis patients at  from 1st March 2020 to 15th August 2020. Methodology It was a prospective and Cross Sectional Observational Study. We collected data prospectively that includes all patients on maintenance hemodialysis and reviewed clinical characteristics  of those with laboratory-confirmed COVID-19 between March 1and August 15, 2020. Results  39 out of 268 dialysis dependent patients had  COVID-19. Mean age of patients was 55.9yrs. Only 35.8% patients were symptomatic. 15 out of 39 were having mild  disease,12  had moderate and 12  had severe disease. Females (54.5%)  were found to be  more affected  than males(45.5%). Dry cough was the commonest symptom (53.8%) followed by fever (46.1%) and abdominal pain(18.1%).  Patients with multiple comorbidities were found to have severe disease. Conclusion We concluded that patients receiving maintenance hemodialysis are susceptible to COVID-19 and that hemodialysis centers are  high risk for spread of infection. Isolating  patients with COVID-19  can help in preventing the spread of COVID-19.

scholarly journals Risk of Hepatitis B and Hepatitis C Among Whole Blood Transfused Chronic Hemodialysed Chronic Kidney Disease (CKD) Patients

2019 ◽  
Vol 30 (2) ◽  
pp. 78-82
Author(s):  
Md Abdul Quader ◽  
Khan Anisul Islam ◽  
Tashmim Farhana Dipta ◽  
Md Ashadul Islam
Keyword(s):  
Hepatitis C ◽  
Blood Transfusion ◽  
Hepatitis B ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Transmitted Infection ◽  
Transfusion Transmitted Infection ◽  
Healthy Donors ◽  
Significant Difference

Background: Patients with chronic renal failure on maintenance hemodialysis (MHD) have high risks of viral infections and the prevalence of transfusion transmissible viral infection is common among them. The aim of our study was to detect hepatitis B and hepatitis C virus in hemodialysis patients and healthy donors and to explore if there was a relationship between duration of hemodialysis and hepatitis B and hepatitis C in our patients. Methodology: A cross sectional study was conducted in a private hemodialysis clinic in Dhaka city with end stage renal disease on maintenance hemodialysis and an age matched healthy donors as comparable group from July 2015 to June 2016. Serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), HBsAg and anti HCV were determined along with duration and units of blood transfusion needed by them. Results: Our study showed the mean age of 126 MHD patients were 42.2±11.7 years along with 132 healthy donors as control group had mean age 39.2±9.7 years. Among the hemodialysis patients 34 (26.98%) showed transfusion transmitted infection positivity and in control group 11 (8.33%) showed transfusion transmitted infection positivity with the difference between two study group showed statistical significance (p<o.oo1). History of blood transfusion showed the significant predictor of occurrence of TTV infection in hemodialysis patients (p<0.01). Duration of hemodialysis and seropositivity of TTI was not significant (p>0.05). The number of units of blood transfusion and the TTI positivity also showed no significant difference (p>0.05) with HBsAg (17.46%) and anti HCV (9.52%). Conclusions: The prevalence of TTI in hemodialysis patients is significantly higher than that in healthy individuals. So, the regular screening of HBV and HCV among patients and healthy donors are strictly provided to monitor the communicable disease. Bangladesh J Medicine July 2019; 30(2) : 78-82

scholarly journals Influence of hemoglobin level and dose of administered recombinant human beta erythropoietin on survival of hemodialysis patients

2011 ◽  
Vol 68 (9) ◽  
pp. 749-755
Author(s):  
Violeta Knezevic ◽  
Aleksandra Milosevic ◽  
Slavenka Vodopivec ◽  
Dusan Bozic ◽  
Ivana Budosan ◽  
...  
Keyword(s):  
Function Analysis ◽  
Underlying Disease ◽  
Hemodialysis Patients ◽  
Hemoglobin Level ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Dialysis Duration ◽  
Significant Difference ◽  
The Difference ◽  
Stage Renal Disease

Background/Aim. In patients with end-stage renal disease, treatment with erythropoietin lowers cardiovascular morbidity, improves quality of life and patient survival. The aim of this study was to determine the difference in survival of hemodialysis patients treated with recombinant human beta erythropoietin and patients without this treatment, and to determine the influence of hemoglobin level and erythropoietin dose on the survival of these patients. Method. The study included 291 patients undergoing maintenance hemodialysis, 122 were on erythropoietin therapy, 169 patients formed control group. The study was performed at the Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, during a 69-month period. We analyzed basic demographic parameters, dialysis duration, underlying disease, comorbidities, death causes, bloodwork parameters and erythropoietin dosage. Descriptive statistics, Anova, Manova, discriminant function analysis, Cox regressional model and Kaplan Meier survival curves were used as statistical methods. Results. Average age and dialysis duration in the experimental group were 47.88 ? 13.32 years, and 45.76 ? 46.73 months, respectively and in the control group 58.73 ? 12.67 years and 62.80 ? 55.23 months, respectively. Average level of hemoglobin and hematocrit in the group in which erythropoietin had been administered was 11.40 ? 8.39 g/dL and 0.35 ? 0.04/L, while the control group these values were 8.52 ? 7.73 g/dL and 0.26 ? 0.04/L, respectively. Average monthly dosage of erythropoietin was 21 587 ? 10 183.36 IJ/month. Significant difference in survival was determined (p < 0,05) between the stated patient groups. A significant difference (p < 0,05) was found in survival of the patients in which erythropoietin was administered regarding hemoglobin level (< 100 g/L/100-110 g/L/110-120 g/L/ > 120 g/L), as well as in regard of erythropoietin dose applied (< 20 000 IJ/20 000-40 000 IJ/ > 40 000 IJ/month). Conclusion. Best survival was noted in patients with hemoglobin > 120 g/L and erythropoietin dose < 20 000 IJ/month.

scholarly journals Levocarnitine Injections Decrease the Need for Erythropoiesis-Stimulating Agents in Hemodialysis Patients with Renal Anemia

2017 ◽  
Vol 7 (3) ◽  
pp. 188-197 ◽  
Author(s):  
Takashi Maruyama ◽  
Terumi Higuchi ◽  
Toshio Yamazaki ◽  
Erina Okawa ◽  
Hideyuki Ando ◽  
...  
Keyword(s):  
Hemodialysis Patients ◽  
Renal Anemia ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Human Erythropoietin ◽  
Significant Difference ◽  
Group 2 ◽  
To Receive ◽  
Esa Therapy

Aims: The aim of this study was to evaluate the efficacy of levocarnitine injection for renal anemia in hemodialysis patients. Methods: In this randomized controlled clinical trial, we randomly assigned patients on maintenance hemodialysis at our hospital to receive levocarnitine injections (n = 30) or no injection (n = 30) and monitored the patients during 12 months of treatment. In the treatment group, patients received an injection of levocarnitine 1,000 mg 3 times weekly after hemodialysis sessions. All patients received recombinant human erythropoietin as an erythropoiesis-stimulating agent (ESA). Response to ESA therapy was determined by calculating the erythropoietin responsiveness index (ERI; ESA dose·kg-1·g-1· dL-1·week-1). Results: (1) The target levels of hemoglobin and hematocrit were maintained during the study period in both the levocarnitine group and the control group. (2) The dose of ESAs required to maintain these levels decreased gradually in the levocarnitine group and was significantly lower at 6 and 12 months than at study initiation. Furthermore, the dose of ESAs was significantly lower than that in the control group at 12 months. (3) The ERI showed a significant decrease at 6 and 12 months in the levocarnitine group, with a significant difference between the 2 groups at 12 months. Conclusion: Our results suggest that levocarnitine administration can reduce the dose of ESAs required in patients with renal anemia on hemodialysis and improve the response to ESA therapy.

scholarly journals Risk Factors for Low Humoral Response to BNT-162b2 In Hemodialysis Patients

2021 ◽  
Author(s):  
Rui Duarte ◽  
Cátia Figueiredo ◽  
Ivan Luz ◽  
Francisco Ferrer ◽  
Hernâni Gonçalves ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Humoral Response ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Older Age ◽  
Maintenance Hemodialysis ◽  
List Type ◽  
Central Venous ◽  
Dialysis Vintage

AbstractIntroductionMaintenance Hemodialysis (HD) patients are at higher risk of both infection and mortality associated with the new coronavirus 2. Immunization through large-scale vaccination is the cornerstone of infection prevention in this population. This study aims to identify risk factors for low response to the BNT-162b2 (Pfizer BioNTech) vaccine in a HD cohort.Materials and MethodsObservational prospective study of a HD group followed in a Portuguese Public Founded Hemodialysis Center who received BNT-162b2 vaccination. Specific anti-Spike IgG was evaluated as arbitrary units per milliliter (AU/mL) on two separate occasions: 3 weeks after the first dose and 3 weeks after the second. IgG titers, Non-Responders (NR), and Weak-Responders (WR) after each dose were evaluated against risk factors that included demographic, clinical and analytical variables.ResultsHumoral response evaluated by IgG anti-Spike levels showed a strong correlation with Charlson comorbidity index (CCI) and intact parathormone (iPTH) after each inoculation (1st dose: ρ=−0.64/0.54; 2nd dose: ρ=−0.66/0.63, respectively; p<0.01 throughout). After completing both doses: 1) NR were associated with female sex (p<0.01), lower albumin and iPTH (p=0.01); 2) WR showed higher CCI, older age, lower iPTH and lower albumin (p=<0.01, p=0.03, p<0.01, p=0.05, respectively) and, consistently, associated with CCI over 8, age over 75, iPTH under 150 ng/L, female sex, dialysis vintage under 24 months and central venous catheter (CVC) over arteriovenous fistula (p=0.01, p=0.03, p<0.01, p=0.01, p=0.01, p<0.01, respectively). A binary regression model using CCI, sex (male) and CVC was statistically significant in prediction of WR after the 2nd dose with OR (95% CI): 1.81 (1.06-3.08); 0.05 (0.01-0.65); 13.55 (1.06-174.18), respectively (p=0.01).ConclusionOlder age, higher CCI, lower iPTH and albumin, CVC as vascular access and recent hemodialysis initiation (less than 2 years) associate with lower response to vaccination in our study. A higher comorbidity burden is suggested as a more significant surrogate marker for low immunogenicity rather than age alone. Identifying HD patients as a population at high-risk for low response to vaccination is essential for proper policy-making, facilitating the implementation of adequate and individualized contingency protocols.What is already known about this subjectMaintenance hemodialysis patients have lower humoral response to BNT-162b2 COVID-19 vaccine when compared to the general population.Maintenance dialysis patients are at high risk of exposure to coronavirus 2 in addition to a more severe disease course.What this study addsWe suggest Charlson commorbidity index, older age, intact parathormone, central venous catheter as vascular access and lower dialysis vintage as possible surrogate markers of immunogenicity in HD patients.There is a low humoral response after a single dose of the vaccine (50%) that can be increased after the second (86%).What impact this may have on practice or policyStrict Protocols for follow-up measures in HD patients, including closer humoral titers assessment, risk stratification, adequate isolation, and surveillance of symptoms might be necessary in order to improve this population survival/life expectancy.Screening HD patients, seroconversion rates may be improved by giving extra inoculations for patients at risk for low response.

scholarly journals Correlation between blood lead level and anemia in hemodialysis patients

2020 ◽  
Vol 10 (1) ◽  
pp. e06-e06
Author(s):  
Parisa Mohammadi ◽  
Farid Azizi Jalilian ◽  
Hassan Ahmadinia ◽  
vida Sheikh
Keyword(s):  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Case Group ◽  
Iron Level ◽  
Serum Iron Level ◽  
Hemoglobin C

Introduction: Studies show that blood lead level (BLL) is higher in hemodialysis patients than in healthy people. Lead can disrupt iron metabolism and hemoglobin synthesis and therefore it is regarded as a cause of anemia. Objectives: This study investigated the relationship between BLL and anemia in end-stage renal disease (ESRD) undergoing maintenance hemodialysis Patients and Methods: This case-control study was conducted on 70 patients who had received hemodialysis at least for three months. The participants were selected randomly among eligible patients considering the inclusion and exclusion criteria. Based on their hemoglobin levels, the participants were divided into two groups, namely patients with anemia (case) and those without anemia (control). Results: The mean age of the participants in the case and control groups were 63.8±11.02 and 55.4±13.34 years, respectively. There were significant differences between two groups regarding hemoglobin, C-reactive protein (CRP) and erythropoietin (EPo) levels (P < 0.05). There was a significant correlation between hemoglobin and ferritin levels in the case group and between the length of dialysis and serum iron level in the control group without anemia (P < 0.001). Conclusion: Our results showed no correlation between BLL and anemia, however the BLL was higher in those undergoing long-term maintenance hemodialysis. Our findings require further investigation with larger studies.

scholarly journals Relationship of Neutrophil Lymphocyte Ratio (NLR) with Parathyroid Hormone (PTH) in Maintenance Hemodialysis Patients

2021 ◽  
Vol 7 (1) ◽  
pp. 17-25
Author(s):  
Dr. Asmita Hazra ◽  
◽  
Dr. Saptarshi Mandal ◽  
Dr. Jayati Chakraborty ◽  
◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Pearson Correlation ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Maintenance Hemodialysis Patients

Background: Neutrophil-Lymphocyte-Ratio (NLR), a simple derived parameter of routine CompleteBlood Counts (CBC), has been shown to be better than WBC count as a marker for inflammation inmany contexts. Inflammation is associated with adverse outcomes in hemodialysis patients.Methods: A cross sectional study was designed on 100 maintenance hemodialysis Patients in atertiary care hospital in Eastern India after IRB permission and informed consent. 88 completeresults became available. Complete blood count (CBC), routine PTH and biochemistry analysis wereperformed. KDIGO 2009 cut offs were used to classify patients by PTH levels (PTH<2ULN, PTH 2-9ULN & PTH>9 ULN). NLR was calculated and NLR of 3.5 was used as high inflammation cut off.Results: In Analysis of 88 samples, significant Pearson Correlation with NLR was shown by Albumin,Hemoglobin, PTH, Gender, Age, and Sugar, but involved collinearities. Multiple Linear Regressionwith Robust estimation of Standard Errors retained only PTH as a significant predictor (Beta=-0.273, P=0.033) of NLR and Albumin as a borderline significant predictor (Beta= -0.501, P=0.061). The population was partitioned into 3 sets based on PTH as per KDIGO guideline.Conclusion: Our study suggests that PTH is a significant predictor of inflammation as measured byNLR, independent of the other parameters, and it has an overall weak negative association withinflammation especially in the mid-range (PTH 2-9 ULN) subgroup, which largely corroborates withavailable but scant literature.

Autonomic Neuropathy in Hemodialysis Patients Treated with Recombinant Human Erythropoietin

1996 ◽  
Vol 19 (10) ◽  
pp. 574-577 ◽  
Author(s):  
O.O. Stojcheva-Taneva ◽  
M.H. Polenakovic
Keyword(s):  
Blood Pressure ◽  
Autonomic Dysfunction ◽  
Recombinant Human Erythropoietin ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Exercise Heart Rate ◽  
Control Group ◽  
Human Erythropoietin ◽  
Group I ◽  
Before And After

Autonomic nervous system (ANS) function was evaluated in hemodialysis patients treated with recombinant human erythropoietin (rHu-EPO) before and after therapy, in an effort to evaluate the role of anemia in the genesis of autonomic dysfunction in chronic renal failure (CRF). Studies were conducted using a battery of five cardiovascular reflex tests: Valsalva maneuver, handgrip exercise, heart rate response to standing (30:15 index), post-Valsalva rise in blood pressure and postural drop in blood pressure. The patients were divided into two groups: group I consisted of 14 patients on maintenance hemodialysis treated with rHu-EPO for one year, and group II - 13 hemodialysis patients treated with rHu-EPO for two years. The results of the tests were compared before and after the correction of anemia by rHu-EPO in each group, as well as with the control group of ten healthy subjects. Data show that renal anemia is not implicated in the genesis of ANS dysfunction in hemodialysis patients, since correction of same by rHu-EPO does not improve the autonomic dysfunction.

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