scholarly journals Carnitine Concentrations in Dialysed and Undialysed Patients with Chronic Renal Insufficiency

1986 ◽  
Vol 23 (6) ◽  
pp. 671-675 ◽  
Author(s):  
S Rodriguez-Segade ◽  
C Alonso De La Peña ◽  
M Paz ◽  
D Novoa ◽  
R Romero ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Control Group ◽  
Serum Concentrations ◽  
Total Carnitine ◽  
Haemodialysis Treatment ◽  
Endogenous Synthesis

Free carnitine, acylcarnitine and total carnitine serum concentrations have been measured in chronic renal insufficiency patients under conservative treatment, in patients under regular haemodialysis treatment and in healthy controls. In the undialysed patients the levels of free carnitine, acylcarnitine and total carnitine were all clearly higher than those of the control group. The free carnitine and total carnitine levels of undialysed subjects were also higher than in regularly haemodialysed patients, showing that dialysis produces plasma carnitine losses that are not compensated for by endogenous synthesis of carnitine (this finding supports published reports of tissue carnitine deficiency in patients undergoing regular haemodialysis). The acylcarnitine levels of dialysed and undialysed patients were not significantly different, however; both were very much higher than that of control group. The hypercarnitinaemia of the patients under conservative treatment suggests that the impairment of renal function causes a reduction in the elimination of carnitine via the kidney.

scholarly journals Effects of l-Carnitine Supplementation in Patients Receiving Hemodialysis or Peritoneal Dialysis

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3371 ◽  
Author(s):  
Masako Kuwasawa-Iwasaki ◽  
Hiroaki Io ◽  
Masahiro Muto ◽  
Saki Ichikawa ◽  
Keiichi Wakabayashi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiac Function ◽  
Acid Metabolism ◽  
Carnitine Deficiency ◽  
Muscle Spasm ◽  
Free Carnitine ◽  
Carnitine Supplementation ◽  
Dialysis Patients ◽  
Muscle Spasms ◽  
Total Carnitine

l-carnitine is an important factor in fatty acid metabolism, and carnitine deficiency is common in dialysis patients. This study evaluated whether l-carnitine supplementation improved muscle spasm, cardiac function, and renal anemia in dialysis patients. Eighty Japanese outpatients (62 hemodialysis (HD) patients and 18 peritoneal dialysis (PD) patients) received oral l-carnitine (600 mg/day) for 12 months; the HD patients further received intravenous l-carnitine injections (1000 mg three times/week) for 12 months, amounting to 24 months of treatment. Muscle spasm incidence was assessed using a questionnaire, and cardiac function was assessed using echocardiography. Baseline free carnitine concentrations were relatively low in patients who underwent dialysis for >4 years. Total carnitine serum concentration, free carnitine, and acylcarnitine significantly increased after oral l-carnitine treatment for 12 months, and after intravenous l-carnitine injection. There was no significant improvement in muscle spasms, although decreased muscle cramping after l-carnitine treatment was reported by 31% of patients who had undergone HD for >4 years. Hemoglobin concentrations increased significantly at 12 and 24 months in the HD group. Therefore, l-carnitine may be effective for reducing muscle cramping and improving hemoglobin levels in dialysis patients, especially those who have been undergoing dialysis for >4 years.

scholarly journals Infection by Cryptosporidium parvum in renal patients submitted to renal transplant or hemodialysis

1998 ◽  
Vol 31 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Pedro Paulo Chieffi ◽  
Yvoty A.S. Sens ◽  
Maria Aparecida Paschoalotti ◽  
Luiz Antonio Miorin ◽  
Hélio Gomes C. Silva ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Renal Transplant ◽  
Renal Insufficiency ◽  
Arterial Hypertension ◽  
Cryptosporidium Parvum ◽  
Chronic Renal Insufficiency ◽  
The Other ◽  
Control Group ◽  
Faecal Examination ◽  
Systemic Arterial Hypertension

The frequency of infection by Cryptosporidium parvum was determined in two groups of renal patients submitted to immunosuppression. One group consisted of 23 renal transplanted individuals, and the other consisted of 32 patients with chronic renal insufficiency, periodically submitted to hemodialysis. A third group of 27 patients with systemic arterial hypertension, not immunosuppressed, was used as control. During a period of 18 months all the patients were submitted to faecal examination to detect C. parvum oocysts, for a total of 1 to 6 tests per patient. The results showed frequencies of C. parvum infection of 34.8%, 25% and 17.4%, respectively, for the renal transplanted group, the patients submitted to hemodialysis and the control group. Statistical analysis showed no significant differences among the three groups even though the frequency of C. parvum infection was higher in the transplanted group. However, when the number of fecal samples containing C. parvum oocysts was taken in account, a significantly higher frequency was found in the renal transplanted group.

scholarly journals Apparent Treatment-Resistant Hypertension Assessed by Office and Ambulatory Blood Pressure in Chronic Kidney Disease—A Report from the Chronic Renal Insufficiency Cohort Study

Kidney360 ◽  
2020 ◽  
Vol 1 (8) ◽  
pp. 810-818
Author(s):  
George Thomas ◽  
Jesse Felts ◽  
Carolyn S. Brecklin ◽  
Jing Chen ◽  
Paul E. Drawz ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Renal Insufficiency ◽  
Clinical Outcomes ◽  
Resistant Hypertension ◽  
Chronic Renal Insufficiency ◽  
Hazard Ratio ◽  
Control Group ◽  
Treatment Resistant ◽  
Ambulatory Bp Monitoring

BackgroundApparent treatment-resistant hypertension is common in patients with CKD. Whether measurement of 24-hour ambulatory BP monitoring is valuable for risk-stratifying patients with resistant hypertension and CKD is unclear.MethodsWe analyzed data from the Chronic Renal Insufficiency Cohort study, a prospective study of participants (n=1186) with CKD. Office BP was measured using standardized protocols; ambulatory BP was measured using Spacelabs monitors. Apparent treatment-resistant hypertension was defined on the basis of office BP, ambulatory BP monitoring, and use of more than three antihypertensive medications. Outcomes were composite cardiovascular disease, kidney outcomes, and mortality. Groups were compared using Cox regression analyses with a control group of participants without apparent treatment-resistant hypertension.ResultsOf 475 participants with apparent treatment-resistant hypertension on the basis of office BP, 91.6% had apparent treatment-resistant hypertension confirmed by ambulatory BP monitoring. Unadjusted event rates of composite cardiovascular disease, kidney outcomes, and mortality were higher in participants with ambulatory BP monitoring–defined apparent treatment-resistant hypertension compared with participants without apparent treatment-resistant hypertension. In adjusted analyses, the risks of composite cardiovascular disease (hazard ratio, 1.27; 95% confidence interval [95% CI], 0.59 to 2.7), kidney outcomes (hazard ratio, 1.68; 95% CI, 0.88 to 3.21), and mortality (hazard ratio, 1.27; 95% CI, 0.5 to 3.25) were not statistically significantly higher in participants with ambulatory BP monitoring–defined apparent treatment-resistant hypertension compared with participants without apparent treatment-resistant hypertension.ConclusionsIn our study population with CKD, most patients with apparent treatment-resistant hypertension defined on the basis of office BP have apparent treatment-resistant hypertension confirmed by ambulatory BP monitoring. Although ABPM-defined apparent treatment-resistant hypertension was not independently associated with clinical outcomes, it identified participants at high risk for adverse clinical outcomes.

scholarly journals Serum Cystatin C in Estimating Glomerular Filtration Rate

2008 ◽  
Vol 27 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Velibor Čabarkapa ◽  
Zoran Stošić ◽  
Mirjana Đerić ◽  
Ljiljana Vučurević-Ristić ◽  
Radmila Žeravica ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Renal Insufficiency ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Chronic Renal Insufficiency ◽  
Filtration Rate ◽  
Control Group ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Subgroup Ii

Serum Cystatin C in Estimating Glomerular Filtration RateUsing serum cystatin C in estimating glomerular filtration rate (GFR) has in recent times been recommended. A number of simple formulas for calculating GFR have been derived specifically from serum cystatin C concentrations. The purpose of this study was to assess the significance of cystatin C and of the two most frequently applied of these formulas in estimating glomerular filtration rate compared to serum creatinine and its derived formulas for estimating glomerular filtration rate from creatinine concentrations. The study included 74 patients: 59 were in various stages of chronic renal insufficiency (divided into two subgroups: I with GFR ≥ 60 mL/min/1.73m2and II with GFR<60 mL/min/1.73m2) and 15 on hemodialysis. A control group of 30 healthy participants was also included in the study. Serum values of cystatin C ranged from: 0.86 ± 0.16 mg/L in subgroup I, and 1.77 ± 0.79 mg/L in subgroup II, to 6.9 ± 1.83 mg/L in patients on hemodialysis. The correlation between the two formulas derived from cystatin C and the clearance of creatinine, as well as the Cockcroft and Gault's formula, was significant, while one of the formulas derived from cystatin C did not show a significant correlation with MDRD. It was concluded that serum cystatin C is a significant marker in estimating glomerular filtration rate, especially in the advanced stages of chronic renal insufficiency.

scholarly journals Lipoprotein Metabolism Abnormalities in Patients with Chronic Renal Insufficiency

2011 ◽  
Vol 30 (1) ◽  
pp. 38-44
Author(s):  
Abdellah Ali ◽  
Phalisteen Sultan ◽  
Mohamed El-Napoli ◽  
Mohamed Fahmy
Keyword(s):  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Lipoprotein Metabolism ◽  
Hdl Cholesterol ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Increased Risk ◽  
Significant Difference ◽  
Peripheral Cells ◽  
Lipid Parameters

Lipoprotein Metabolism Abnormalities in Patients with Chronic Renal InsufficiencyPatients with chronic renal insufficiency (CRI) on hemodialysis develop lipoprotein abnormalities that may contribute to increased risk for atherosclerosis. The objective of this study was to assess the atherogenic risk of chronic renal insufficiency patients and dialysis treated patients (DTP) by measuring total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and calculating the risk factor ratio: TC/HDL-C and LDL-C/HDL-C. The examined group consisted of 18 chronic renal insufficiency patients and 60 patients on hemodialysis. The results were compared to a control group of 85 voluntary blood donors. Serum lipid parameters were examined by standard methods. All lipid parameters in hemodialysis patients were statistically different as compared to the control group (p<0.05) while chronic renal insufficiency patients showed significant difference only in triglycerides and HDL-cholesterol. Hypertriglyceridemia was present in both examined groups of patients and HDL-cholesterol was lower within both groups. All calculated atherogenic ratios were higher for patients than the control group. Lipid parameters were compared between chronic renal insufficiency and hemodialysis patients, but statistically significant difference was obtained only for HDL-cholesterol (p<0.05). The increased values of triglycerides and lower HDL-cholesterol in chronic renal insufficiency patients contribute to high incidence of cardiovascular disease. Chronic renal insufficiency patients have impaired reverse cholesterol transport from peripheral cells to lipoproteins, decreased levels of HDL-cholesterol, hypertriglyceridemia prevalence of small, dense LDL and increased levels of potentially atherogenic remnant particles.

scholarly journals Prevalence of Carnitine Deficiency and Decreased Carnitine Levels in Patients on Peritoneal Dialysis

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2645 ◽  
Author(s):  
Satoshi Shimizu ◽  
Hiroyuki Takashima ◽  
Ritsukou Tei ◽  
Tetsuya Furukawa ◽  
Makiyo Okamura ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
High Risk ◽  
Carnitine Deficiency ◽  
Free Carnitine ◽  
Serum Concentrations ◽  
Clinical Factors ◽  
Carnitine Level ◽  
Serum Free ◽  
Factors Associated ◽  
Carnitine Concentration

Background: Carnitine deficiency is common in patients on dialysis. Serum free carnitine concentration is significantly lower in patients on hemodialysis (HD) than in healthy individuals. However, there are few reports on serum free carnitine concentration in patients on peritoneal dialysis (PD). Methods: We examined serum concentrations of total, free, and acylcarnitine and the acylcarnitine/free carnitine ratio in 34 PD and 34 age-, sex-, and dialysis duration-matched HD patients. We investigated the prevalence of carnitine deficiency and clinical factors associated with carnitine deficiency in the PD group. Results: Prevalence of carnitine deficiency was 8.8% in the PD group and 17.7% in the HD group (p = 0.283). High risk of carnitine deficiency was found in 73.5% of the PD group and 76.4% of the HD group (p = 0.604). Carnitine insufficiency was found in 82.3% of the PD group and 88.2% of HD group (p = 0.733). Multivariate analysis revealed that duration of dialysis and age were independent predictors of serum free carnitine level in the PD group. Conclusions: The prevalence of carnitine deficiency, high risk of carnitine deficiency, and carnitine insufficiency in PD patients was 8.8%, 73.5%, and 82.3%, respectively. These rates were comparable to those in patients on HD.

scholarly journals Improved Growth in Young Children with Severe Chronic Renal Insufficiency Who Use Specified Nutritional Therapy

2001 ◽  
Vol 12 (11) ◽  
pp. 2418-2426 ◽  
Author(s):  
RULAN S. PAREKH ◽  
JOSEPH T. FLYNN ◽  
WILLIAM E. SMOYER ◽  
JOAN L. MILNE ◽  
DAVID B. KERSHAW ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Renal Replacement Therapy ◽  
Treatment Group ◽  
Renal Insufficiency ◽  
Creatinine Clearance ◽  
Replacement Therapy ◽  
Chronic Renal Insufficiency ◽  
Population Control ◽  
Control Group ◽  
Salt Wasting

Abstract. Growth in children with chronic renal failure caused by polyuric, salt-wasting diseases may be hampered if ongoing sodium and water losses are not corrected. Twenty-four children were treated with polyuric chronic renal insufficiency (CRI; creatinine clearance <65 ml/min per 1.73 m2) with low-caloric-density, high-volume, sodium-supplemented feedings. Subsequent growth was compared with that of children in two control groups: a national historic population control from the US Renal Data System database (n = 42), and a literature control (n = 12). Members of the three groups were 81 to 96% white, and 58 to 70% were boys. Obstructive uropathy and dysplasia were the cause of CRI in 92% of the treatment group, 75% of the literature control group, and 30% of the population control group. Treatment effect was assessed in a multivariate, retrospective analysis of the height standard deviation score (SDS), simultaneously controlling for the severity of disease by renal replacement therapy, primary cause of CRI, and initial height SDS. The change in SDS (ΔSDS) for height by regression analysis at 1 yr was significantly greater by +1.37 in the treatment group versus the population control (P = 0.017). The 2-yr height ΔSDS by regression analysis adjusted for creatinine clearance was significantly greater by +1.83 in the treatment group versus the literature control (P = 0.003). Nutritional support with sodium and water supplementation can maintain or improve the growth of children with polyuric, salt-wasting CRI. This inexpensive intervention may delay the need for renal replacement therapy, growth hormone treatment, or both in many of these children and may be used in any clinical setting.

Anxiety Forms of Patients with Balcans Endemic Nephropaty

2011 ◽  
Vol 26 (S2) ◽  
pp. 1124-1124
Author(s):  
M.P. Novakovic ◽  
D. Mitrovic ◽  
Z. Maksimovic ◽  
Z. Naskovic ◽  
R. Novakovic
Keyword(s):  
Renal Insufficiency ◽  
Comparative Study ◽  
Chronic Renal Insufficiency ◽  
Clinical Observation ◽  
Group Differences ◽  
Renal Diseases ◽  
Control Group ◽  
Cognitive Differences ◽  
Significant Group ◽  
The Family

AimsTo analyze the forms of anxiety with BEN of the dialyzed patients with sub-hypothesis: socio-demographical, psychopathological, and biological influences.MethodIn B&H dialyzed in 2009. 2879 patients because of chronic renal insufficiency. Dialysis started in B&H on patients with BEN (n = 348) were in the first group, and other the N18 group was formed of patients with other diseases (n = 405). Controls group consists of the patients with other nephrology diseases. Clinical observation lasted from 01.01.2000. to 31.12.2009. when the study was done. Research is a comparative study cut, and the patients are questioned: Renal Registry of B&H, BAI, HDRS, and MMSE.ResultsPatients of the Cases group are the age of: 64.77 ± 8.86, and Controls 53.85 ± 13.6. High socio-demographic significations are the places of living of the Cases group (c2 = 23. 970), P < 0.01; renal diseases in the place of residence (c2 = 23. 970), P < 0.01; in the family (c2 = 23,970); P < =0.001 and the migration (c2 = 4,874); P < 0. 01. BAI scale has very significant group differences P < 0.001 and the level differences at the emerging of the fear, HDRS scale has group signification P < 0.001 and the variables point out depressive and anxiety differences and MMSE cognitive differences.ConclusionAll patients which are interrogated at the dialysis in B&H from 2000. to 2009 have anxiety. Anxiety is more expressed in Cases group due to Control group, and comorbidity gives endemic factors for presuicidal risk for both groups.

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