Transient Elastography in End-Stage Renal Disease Patients on Hemodialysis: The Effect of Net Fluid Withdrawal

2015 ◽  
Vol 40 (3) ◽  
pp. 256-259 ◽  
Author(s):  
Narongrit Khunpakdee ◽  
Kullapong Jayanama ◽  
Piyaporn Kaewdoung ◽  
Kwannapa Promson ◽  
Sasivimol Rattanasiri ◽  
...  

Background/Aims: The impact of volume status on liver stiffness measurement (LSM) as measured by transient elastography (TE) as in end-stage renal disease (ESRD) was unclear. We evaluated LSM before and after hemodialysis (HD) and identified the associated factors if the difference of LSM existed. Methods: A cross-sectional study was conducted in ESRD patients on regular HD. Subjects underwent TE and bioelectrical impedance before and after HD. Results: Thirty-six patients were enrolled. Mean (SD) net fluid withdrawal volume (NFWV) per session was 2.55 (0.9) l. Median (range) pre- and post-HD LSMs were 5.38 (2.8-25.7) and 5.4 (2.8-26) kPa, respectively (p = 0.712). Mean differences of pre- and post-HD LSMs correlated with NFWV (r = 0.49, 95% CI 0.19-0.71, p = 0.002). Conclusion: In ESRD on regular HD, LSM is not affected by HD. TE can be done before or after HD with similar results. However, fluid excess at pre-HD can cause inaccurately high LSM.

Author(s):  
Izzat AlAwwa ◽  
Sarah Ibrahim ◽  
Ahmad Obeid ◽  
Nadeen Alfraihat ◽  
Reham Al-Hindi ◽  
...  

Objectives An overlap between the somatic symptoms of depression and those of uremia seen in end-stage renal disease (ESRD) patients may affect the diagnosis of depression. This study aims to evaluate the effect of hemodialysis on the diagnosis of depression among patients on maintenance hemodialysis as dialysis diminishes the uremic symptoms, and to compare depression scores before and after dialysis. Methods This was a cross-sectional analytic study conducted from November 2018 through April 2019, in three tertiary hospitals. Consenting participants aged 18 years or older, who had received hemodialysis for at least three months were included. The Patient Health Questionnaire (PHQ-9) tool was used to collect patients’ data and to identify symptoms of depression Pre- and post-hemodialysis. Depression scores were compared using the paired sample Wilcoxon rank test or the McNemar test, where appropriate. Results Overall, 163 participants were enrolled in the study. The average age of the participants was 56.5 years old, whereas 44.8% were females. The prevalence of depressive symptoms before hemodialysis was 48.5%, with prevalence of mild, moderate and moderately severe of 34.4%, 11.7% and 2.5%, respectively. On the other hand, the prevalence of depressive symptoms after hemodialysis was 46.6% with 36.8%, 9.2% and 0.6% of the participants reporting mild, moderate and moderately severe symptoms, respectively. We found no significant difference in depression scores before and after dialysis (p-values > 0.05). Conclusion Our study supports the fact that the prevalence of depression is high among patients with ESRD on maintenance hemodialysis. We didn’t find a significant difference in depression scores among hemodialysis patients before and after dialysis, with negligible effect of uremic symptoms on the diagnosis of depression. We suggest adopting routine screening of depression among this high-risk group of patients.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Samah W. Al-Jabi ◽  
Ansam Sous ◽  
Fatimah Jorf ◽  
Mahmoud Taqatqa ◽  
Mahdi Allan ◽  
...  

Abstract Background The impact of end-stage renal disease on the patient’s psychological status necessitates the value of increasing depression awareness. The current study aimed to assess the depression prevalence among Palestinian hemodialyzed patients and its association with patients’ characteristics. Methods A convenience clustered sampling technique was followed. Sample was collected from ten hemodialysis centers in the West Bank, Palestine, during 3 months in 2015. We used the Beck Depression Inventory-II scale (BDI-II) to evaluate depression among participants. All data were analyzed using Statistical Package for the Social Sciences version 16.0. Results Two hundred and eighty-six hemodialyzed patients were interviewed. The mean age (± standard deviation) of the patients was 52.0 ± 14.3 years, and most participants were males 172 (60.1%). Regarding the dialysis characteristics, the median of years of dialysis was 2 years (1–4). The prevalence of depression was 73.1%. Elderly patients (p = 0.001), female (p = 0.036), living in rural areas or camp (p = 0.032), low income (p = 0.041), unemployment (p = 0.001), not doing regular exercise (p = 0.001), and having multi comorbidities (p = 0.001) were significantly associated with more depression scores. The results of binary logistic regression showed that only patients who were living in camps, patients who were previously employed, and patients who were not practicing exercise remained significantly associated with a higher depression score. Conclusions This study is the first one confirmed about depression and its prevalence among hemodialyzed patients in the West Bank, Palestine. Compared to other communities, the study found a higher depression prevalence rate. There is a need to offer psychological interviews and non-pharmacological and pharmacological interventions.


2018 ◽  
Vol 30 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Sarah M Michienzi ◽  
Christopher A Schriever ◽  
Melissa E Badowski

No single-tablet antiretroviral (ARV) regimens (STRs) are approved for patients with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) on hemodialysis (HD). Based on known pharmacokinetic (PK) properties, abacavir (ABC)/lamivudine (3TC)/dolutegravir (DTG) STR may represent a promising option. This case series presents the safety and efficacy of ABC/3TC/DTG STR in patients with HIV and ESRD on HD. Patients were included if they were HIV-positive, maintained on intermittent HD for ESRD, switched to an ARV regimen containing ABC/3TC/DTG, and had at least one set of virologic data before and after the switch. Average age (±standard deviation) was 59 (±8) years. The majority of patients were cis-gender male and non-Hispanic Black. Only one demonstrated clinically significant resistance at baseline. All were on multiple-tablet regimens prior to the switch. Five patients (83%) achieved undetectable HIV-RNA after the switch while only four patients (46%) were undetectable immediately prior. No decline in immune function was noted. ABC/3TC/DTG STR was well tolerated. Only one patient self-reported an adverse event (nausea), which resolved without drug discontinuation. Based on these data, it appears that ABC/3TC/DTG may be a safe and effective ARV-STR option for patients with HIV and ESRD on HD. A larger trial including a PK analysis is needed to confirm these findings.


1997 ◽  
Vol 29 (4) ◽  
pp. 608-614 ◽  
Author(s):  
Greg A. Knoll ◽  
Martha R. Tankersley ◽  
Jeannette Y. Lee ◽  
Bruce A. Julian ◽  
John J. Curtis

Author(s):  
Kareem Mohsin Yousif ◽  
Hamid Obaid Khadhim Al Jaaed

Background: End stage renal disease (ESRD) is irreversible loss of renal function which is physiologically defined by a GFR of less than 15 ml / minute. ESRD is associated with a higher incidence of coronary artery disease and serious arrhythmia especially ventricular arrhythmia. The goal of study is to determine whether ESRD and haemodialysis (HD)are associated with occurrence of significant electrocardiogram (ECG) changes or not.Methods: This is a cross-sectional study design which involved 22 patients with ESRD on regular HD in Al Sadre teaching hospital / Al Najaf. Both sexes was included in this study. All patients underwent full medical history and examination which included the following aspects: Age, Sex, Occupation, BP, HR, RBS, B.urea, S.creatinine , Serum electrolyte (Na+, K+, Cl-, Ca++), Lipid profile (Cholesterol , Triglyceride, HDL, LDL), Duration of CRF, Duration of dialysis, Social history including (smoking, alcohol) and Drug used by the patient. Resting EGC and Hotler ECG.Results: Eighteen patients exhibited emergence of simple ectopic activity premature atrial complex (PAC) and premature ventricular complex (PVC) events and four patients exhibited (ST,T changes). Potentially lethal arrhythmias and other serious ECG changes are not detected in our patient’s sample.Conclusion: In this study, neither ESRD nor haemodialysis were associated with development of serious ECG changes or emergence of significant arrhythmia.


Author(s):  
Suryani Jamal ◽  
Uleng Bahrun ◽  
Ibrahim Abdul Samad ◽  
Fitriani Mangarengi ◽  
Hasyim Kasim ◽  
...  

This study aimed to analyze endocan levels as a marker of endothelial dysfunction in the control group, patients withstage I hypertension, stage II hypertension, and patients with end-stage renal disease. Endocan levels were measured withESM-1 (endocan) kit by Enzyme-Linked Immunosorbent Assay (ELISA) method. This study used a cross-sectional methodand was conducted in Dr. Wahidin Sudirohusodo Hospital, Makassar and Hasanuddin University Hospital from Septemberto October 2017. There were 83 samples in this study, consisting of 12 samples in the control group, 22 samples of stage Ihypertension, 28 samples of stage II hypertension, and 21 samples of end-stage renal disease aged 20-90 years old. Thisstudy showed significantly higher endocan levels in patients with stage II hypertension and end-stage renal disease(p< 0.05). Endocan levels were significantly higher (p<0.05) in patients with end-stage renal disease compared with thecontrol group and patients with stage I hypertension; but not significantly higher (p > 0.05) compared to patients with stageII hypertension. Also, the median of endocan levels in patients with the end-stage renal disease was higher (309,850 ng/L)compared to patients with stage II hypertension (273,050 ng/L).


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