Inflammation and Extracellular Volume Expansion are Related to Sodium and Water Removal in Patients on Peritoneal Dialysis

2006 ◽  
Vol 26 (5) ◽  
pp. 574-580 ◽  
Author(s):  
Marcela Ávila-Díaz ◽  
María-de-Jesús Ventura ◽  
Delfilia Valle ◽  
Marlén Vicenté-Martínez ◽  
Zuzel García-González ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Extracellular Volume ◽  
Extracellular Fluid ◽  
Cross Sectional Study ◽  
Serum Glucose ◽  
Cross Sectional ◽  
Fluid Removal ◽  
Sodium Removal ◽  
Extracellular Volume Expansion ◽  
Total Body

Background Inflammation is an important risk for mortality in dialysis patients. Extracellular fluid volume (ECFv) expansion, a condition commonly seen in peritoneal dialysis (PD) patients, may be associated with inflammation. However, published support for this relationship is scarce. Objectives To quantify the proportion of patients on PD with inflammation and to analyze the role of ECFv expansion and the factors related to these conditions. Design A prospective, multicenter cross-sectional study in six hospitals with a PD program. Patients and Methods Adult patients on PD were studied. Clinical data, body composition, and sodium and fluid intake were recorded. Biochemical analysis, C-reactive protein (CRP), and peritoneal and urinary fluid and sodium removal were also measured. Results CRP values positive (≥ 3.0 mg/L) for inflammation were found in 147 (80.3%) and negative in 36 patients. Patients with positive CRP had higher ECFv/total body water (TBW) ratio (women 47.69 ± 0.69 vs 47.36 ± 0.65, men 43.15 ± 1.14 vs 42.84 ± 0.65; p < 0.05), higher serum glucose (125.09 ± 81.90 vs 103.28 ± 43.30 mg/dL, p < 0.03), and lower serum albumin (2.86 ± 0.54 vs 3.17 ± 0.38 g/dL, p < 0.001) levels. They also had lower ultrafiltration (1003 ± 645 vs 1323 ± 413 mL/day, p < 0.005) and total fluid removal (1260 ± 648 vs 1648 ± 496 mL/day, p < 0.001), and less peritoneal (15.59 ± 162.14 vs 78.11 ± 110.70 mEq/day, p < 0.01) and total sodium removal (42.06 ± 142.49 vs 118.60 ± 69.73 mEq/day, p < 0.001). In the multivariate analysis, only ECFv/TBW was significantly ( p < 0.04) and independently associated with inflammation. ECFv/TBW was correlated with fluid removal ( r = 0.16, p < 0.03) and renal sodium removal ( r = 0.2, p < 0.01). Conclusion The data suggest that ECFv expansion may have a significant role as an inflammatory stimulus. The results disclose a relationship between the two variables, ECFv expansion and inflammation, identified as independent risk factors for mortality in PD patients.

The Role of Dexa Bone Densitometry in Evaluating Renal Osteodystrophy in Continuous Ambulatory Peritoneal Dialysis Patients

1996 ◽  
Vol 16 (1) ◽  
pp. 34-40 ◽  
Author(s):  
David w. Johnson ◽  
H. David Mclntyre ◽  
Alison Brown ◽  
Judy Freeman ◽  
Russell J. Rigby
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Bone Densitometry ◽  
Previous History ◽  
Population Data ◽  
Reference Population ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Z Scores ◽  
Total Body

Objective The aims of this study were to assess the clinical utility of total and regional bone densitometry in a large continuous ambulatory peritoneal dialysis (CAPD) population and to determine the clinical, biochemical, and radiographic variables that best identified osteopenic CAPD patients. Design and Patients A cross-sectional study was performed on 45 CAPD patients (19 males, 26 females), comprising the total CAPD population at the Princess Alexandra Hospital. Main Outcome Measures Total body (TB), anteroposterior lumbar spine (APL), femoral neck (FN), Ward's triangle (WT), and skull bone mineral densities (BMDs) were measured using dual-energy x-ray absorptiometry (DEXA) and then correlated with clinical, biochemical, and radiographic indices of uremic osteodystrophy. Results BMDs were not significantly different from age and sex-matched reference population data. Considerable regional variation of BMD Z scores were noted between FN (-0.11 ± 0.23), WT (-0.11 ± 0.22), and APL (1.22 ± 0.04) (p = 0.003). APLZ scores were significantly reduced in patients with a previous history of fracture (-1.36 ± 1.07vs0.89 ± 0.31), bonepain(-0.72 ± 1.08vs 1.01 ± 0.31), or steroid treatment (-0.62 ± 0.39 vs 1.16 ± 0.35). Increased BMDZ scores for APL (1.82 ± 0.57 vs0.38 ± 0.29, p < 0.05), FN (0.32 ± 0.36vs-0.38 ± 0.29, p =0.014), and WT (0.45 ± 0.38vs-0.45 ± 0.26, p <0.05) were found in patients with radiographic hyperparathyroid bone disease. Both APL BMD Z scores and skull BMDs were weakly correlated with PTH (r = -0.33, p < 0.05 and r = -0.33, p < 0.05, respectively) and with CAPD duration (r = 0.30, p < 0.05 and r = -0.30, p < 0.05). Generally, however, total body and regional BMDs were poorly related to age, renal disease type, dialysis duration, renal failure duration, serum aluminum, calcium, phosphate, alkaline phosphatase, osteocalcin, and parathyroid hormone. Conclusions We conclude that the prevalence of osteopenia is not increased in CAPD patients. Clinical and biochemical parameters do not reliably predict BMD measurements, but prior steroids and bone symptoms are major risk factors for important bone loss. Although DEXA can reliably detect osteopenia in different skeletal regions, its usefulness in detecting osteodystrophy is limited by the confounding effects of superimposed hyperparathyroid osteosclerosis, which increases BMD.

scholarly journals Associations between exposure to perfluoroalkyl substances and body fat evaluated by DXA and MRI in 109 adolescent boys

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mathilde Lolk Thomsen ◽  
Louise Scheutz Henriksen ◽  
Jeanette Tinggaard ◽  
Flemming Nielsen ◽  
Tina Kold Jensen ◽  
...  
Keyword(s):  
Body Fat ◽  
Study Design ◽  
Sulfonic Acid ◽  
Standard Deviation Score ◽  
Cross Sectional Study ◽  
Mass Spectrometry Data ◽  
Perfluoroalkyl Substances ◽  
Sectional Study ◽  
Cross Sectional ◽  
Total Body

Abstract Background Exposure to perfluoroalkyl substances (PFASs) has been associated with changes in body mass index and adiposity, but evidence is inconsistent as study design, population age, follow-up periods and exposure levels vary between studies. We investigated associations between PFAS exposure and body fat in a cross-sectional study of healthy boys. Methods In 109 boys (10–14 years old), magnetic resonance imaging and dual-energy X-ray absorptiometry were performed to evaluate abdominal, visceral fat, total body, android, gynoid, android/gynoid ratio, and total fat percentage standard deviation score. Serum was analysed for perfluorooctanoic acid, perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid, perfluorononanoic acid, and perfluorodecanoic acid using liquid chromatography and triple quadrupole mass spectrometry. Data were analysed by multivariate linear regression. Results Serum concentrations of PFASs were low. Generally, no clear associations between PFAS exposure and body fat measures were found; however, PFOS was negatively associated with abdominal fat (β = -0.18, P = 0.046), android fat (β = -0.34, P = 0.022), android/gynoid ratio (β = -0.21, P = 0.004), as well as total body fat (β = -0.21, P = 0.079) when adjusting for Tanner stage. Conclusions Overall, we found no consistent associations between PFAS exposure and body fat. This could be due to our cross-sectional study design. Furthermore, we assessed PFAS exposure in adolescence and not in utero, which is considered a more vulnerable time window of exposure.

Time to Positivity of Bacteria Cultures in Peritoneal Dialysis Fluid: Evaluation of Different Laboratory Techniques

2017 ◽  
Vol 37 (3) ◽  
pp. 342-344
Author(s):  
Roberta M. Katzap ◽  
Vany Elisa Pagnussatti ◽  
Ana Elizabeth Figueiredo ◽  
Julia Gabriela Motta ◽  
Domingos O. d'Avila ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Fluid ◽  
Antibiotic Sensitivity ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Essential Elements ◽  
Coagulase Negative Staphylococcus ◽  
Cross Sectional ◽  
Peritoneal Dialysis Fluid

Patients with chronic kidney disease on peritoneal dialysis (PD) are susceptible to infections, with peritonitis being the primary cause of dropout. Peritoneal fluid culture is one of the essential elements for proper diagnosis and peritonitis treatment. The aim of this study was to compare the time required to obtain a positive culture using different laboratory methods. An in vitro cross-sectional study was conducted comparing different techniques for preparation and culture of bacteria in peritoneal fluid. The research was carried out with 21 sterile dialysis bags and 21 PD bags containing peritoneal fluid drained from patients without peritonitis. Fluids from the 42 PD bags were contaminated by injecting a coagulase-negative Staphylococcus suspension and then prepared for culture using 4 distinct techniques: A - direct culture; B - post-centrifugation culture; C - direct culture after 4 h sedimentation; and D - culture after 4 h sedimentation and centrifugation. This was followed by seeding. In the 21 contaminated sterile bags, mean times to obtain a positive culture with techniques D (19.6 h ± 2.6) and C (19.1 h ± 2.3) were longer than with technique A (15.8 h ± 3.0; p < 0.01), but not statistically different from group B (19.0 h ± 3.2). The same occurred in the 21 bags drained from patients, with mean times for techniques D (14.0 h ± 1.9) and C (14.5 h ± 1.7) being longer than technique A (12.22 h ± 1.94; p < 0.05) but not statistically different from technique B (13.2 h ± 1.3). The sedimentation and centrifugation steps seem to be unnecessary and may delay antibiotic sensitivity test results by approximately 8 hours.

Development of a prediction rule for diagnosing postoperative meningitis: a cross-sectional study

2018 ◽  
Vol 128 (1) ◽  
pp. 262-271 ◽  
Author(s):  
Olga Helena Hernández Ortiz ◽  
Héctor Iván García García ◽  
Fabián Muñoz Ramírez ◽  
Juan Sebastián Cardona Flórez ◽  
Bladimir Alejandro Gil Valencia ◽  
...  
Keyword(s):  
Prediction Rule ◽  
Cross Sectional Study ◽  
Serum Glucose ◽  
Csf Leak ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Glucose Ratio ◽  
Neurosurgical Patients ◽  
Csf Lactate ◽  
Postoperative Meningitis

OBJECTIVEDiagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection.METHODSA cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants. Their CSF was studied for suspicion of infection and a bivariate analysis was performed between the dependent variable (confirmed/probable NM) and the identified independent variables. Those variables with a p value ≤ 0.2 were fitted in a multiple logistic regression analysis with the same dependent variable. After determining the best model according to its discrimination and calibration, the β coefficient for each selected dichotomized variable obtained from the logistic regression model was used to construct the score for the prediction rule.RESULTSAmong 320 patients recruited for the study, 154 had confirmed or probable NM. Using bivariate analysis, 15 variables had statistical associations with the outcome: aneurysmal subarachnoid hemorrhage (aSAH), traumatic brain injury, CSF leak, positioning of external ventricular drains (EVDs), daily CSF draining via EVDs, intraventricular hemorrhage, neurological deterioration, age ≥ 50 years, surgical duration ≥ 220 minutes, blood loss during surgery ≥ 200 ml, C-reactive protein (CRP) ≥ 6 mg/dl, CSF/serum glucose ratio ≤ 0.4 mmol/L, CSF lactate ≥ 4 mmol/L, CSF leukocytes ≥ 250 cells, and CSF polymorphonuclear (PMN) neutrophils ≥ 50%. The multivariate analysis fitted a final model with 6 variables for the prediction rule (aSAH diagnosis: 1 point; CRP ≥ 6 mg/dl: 1 point; CSF/serum glucose ratio ≤ 0.4 mmol/L: 1 point; CSF leak: 1.5 points; CSF PMN neutrophils ≥ 50%: 1.5 points; and CSF lactate ≥ 4 mmol/L: 4 points) with good calibration (Hosmer-Lemeshow goodness of fit = 0.71) and discrimination (area under the receiver operating characteristic curve = 0.94).CONCLUSIONSThe prediction rule for diagnosing NM improves the diagnostic accuracy in neurosurgical patients with suspicion of infection. A score ≥ 6 points suggests a high probability of neuroinfection, for which antibiotic treatment should be considered. An independent validation of the rule in a different group of patients is warranted.

scholarly journals Total body bone measurements: A cross-sectional study in children with acute lymphoblastic leukemia during and following completion of therapy

2009 ◽  
Vol 52 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Kara M. Kelly ◽  
John C. Thornton ◽  
Deborah Hughes ◽  
Ifeyinwa Osunkwo ◽  
Michael Weiner ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Total Body ◽  
Body Bone

scholarly journals Predictors of quality of life among patients on dialysis in southern Brazil

2008 ◽  
Vol 126 (5) ◽  
pp. 252-256 ◽  
Author(s):  
Maristela Bohlke ◽  
Diego Leite Nunes ◽  
Stela Scaglioni Marini ◽  
Cleison Kitamura ◽  
Marcia Andrade ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Short Form ◽  
Outcome Measurement ◽  
Cross Sectional Study ◽  
Southern Brazil ◽  
Cross Sectional ◽  
Sf 36 ◽  
Dialysis Facilities

CONTEXT AND OBJECTIVE: Quality of life (QoL) is considered important as an outcome measurement, especially for long-term diseases such as chronic renal failure. The present study searched for predictors of QoL in a sample of patients undergoing dialysis in southern Brazil. DESIGN AND SETTING: This was a cross-sectional study developed in three southern Brazilian dialysis facilities. METHODS: Health-related QoL of patients on hemodialysis or peritoneal dialysis was measured using the generic Short Form-36 (SF-36) health survey questionnaire. The results were correlated with sociodemographic, clinical and laboratory variables. The analysis was adjusted through multiple linear regression. RESULTS: A total of 140 patients were assessed: 94 on hemodialysis and 46 on peritoneal dialysis. The mean age was 54.2 ± 15.4 years, 48% were men and 76% were white. The predictors of higher (better) physical component summary in SF-36 were: younger age (β-0.16; 95% confidence interval, CI: -0.27 to -0.05), shorter time on dialysis (β-0.06; 95% CI: -0.09 to -0.02) and lower Khan comorbidity-age index (β 5.16; 95% CI: 1.7-8.6). The predictors of higher mental component summary were: being employed (β 8.4; 95% CI: 1.7-15.1), being married or having a marriage-like relationship (β 4.56; 95% CI: 0.9-8.2), being on peritoneal dialysis (β 4.9; 95% CI: 0.9-8.8) and not having high blood pressure (β 3.9; 95% CI: 0.3-7.6). CONCLUSIONS: Age, comorbidity and length of time on dialysis were the main predictors of physical QoL, whereas socioeconomic issues especially determined mental QoL.

scholarly journals The Association Between Self-Management Ability and Malnutrition-Inflammation-Atherosclerosis Syndrome in Peritoneal Dialysis Patients: A Cross-Sectional Study

2020 ◽  
Author(s):  
Zehui Huang ◽  
Junyang Fang ◽  
Ahui Song ◽  
Yan Tong ◽  
Hai Deng ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cross Sectional Study ◽  
Self Management ◽  
Spearman Correlation ◽  
Effect Evaluation ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Management Ability ◽  
Evaluation And Monitoring ◽  
The Relationship

Abstract BackgroundThe relationship between malnutrition-inflammation-atherosclerosis syndrome (MIAS) and self-management ability has not been previously revealed even though both play an important role in the management of peritoneal dialysis (PD) patients.Materials and methodsIn total, 93 patients were enrolled in this study. A self-management questionnaire was used for the evaluation of self-management ability. The identification of MIAS was based on one or more of the following three conditions: C-reactive protein (CRP) ≥10 mg/L, malnutrition–inflammation score (MIS) > 7, and the presence of atherosclerosis related medical records. The possible association between different self-management abilities and MIAS was analyzed with a Spearman correlation analysis.ResultsThere were 40 (43.0%) patients in the atherosclerosis group, and 38 (40.9%), 38 (40.9%), 10 (10.8%), and 7 (7.5%) patients in the MIAS0, MIAS1, MIAS2, and MIAS3 groups, respectively. The group with a score above the mean score of the Dialysis Effect Evaluation and Monitoring dimension had a fewer number of hospitalizations, higher albumin levels, lower MIS scores, lower level of IL-6, and a lower number of MIAS factors. The Pearson and Spearman correlation analyses also revealed that this dimension was negatively correlated with the MIAS, MIS, IL-6, BNP, number of hospitalizations, and age and positively associated with albumin and prealbumin. ConclusionThe Dialysis Effect Evaluation and Monitoring dimension of the self-management scale for PD patients is closely linked to the MIAS, and the better the dialysis effect evaluation and monitoring capacity, the lower the chance of exposure to malnutrition and inflammation.Trial registrationChina Clinical Trials Register: SH9H-2020-T20-2, retrospectively registered 15 January 2020.

scholarly journals Tear electrolyte assessment of diabetic patients in Southern Nigeria

1970 ◽  
Vol 19 (4) ◽  
pp. 2839-2845
Author(s):  
Juno Okukpon ◽  
Oziegbe Okukpon
Keyword(s):  
Extracellular Fluid ◽  
Chemical Properties ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Glass Capillary ◽  
Cross Sectional ◽  
Increased Risk ◽  
Calcium Phosphorus ◽  
Calcium Magnesium ◽  
The University

Background: Tears are a critical body extracellular fluid coating the surface epithelial cells of the cornea and conjunctiva, and providing the optically smooth surface necessary for refraction of light onto the retina. The biological and chemical properties of tears change in response to systemic disease.Objectives: This study assessed the concentration of calcium, magnesium and phosphate levels in tears of diabetics.Methods: A comparative cross-sectional study involving twenty diabetics visiting Department for Health Services, University of Benin and forty non-diabetics within the University between 35 to 65 years participated in the study. Calcium, magnesium and phosphorous were analysed in tears sample collected with 75mm glass capillary tubes.Results: The fasting blood sugar (FBS) and age of diabetic patients was 7.48±1.88mmol/l and 56.75±5.82years and non-diabetics was 4.83±0.52mmol/l and 53.58±6.16years respectively. Magnesium showed no differences (P<0.05) between diabetics (0.76±0.45mmol/l) and non-diabetics (0.93±0.59mmol/l). Calcium was elevated (P=0.041) and phosphate (P=0.044) was decreased in diabetics (3.14±1.65mmol/l and 0.074±0.058mmol/l) than non-diabetics (2.41±1.05mmol/l and 0.11±0.081mmol/l).Conclusion: This study concluded that being diabetic can affect the levels of some tear electrolytes in the tear fluid which may lead to an increased risk of diabetic ocular complications.Keywords: Tears, diabetics, mag nesium, calcium, phosphorus.

scholarly journals Are Vaspin and Omentin-1 Related to Insulin Resistance, Blood Pressure and Inflammation in NAFLD Patients?

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Fereshteh Aliasghari ◽  
Azimeh Izadi ◽  
Masoumeh Jabbari ◽  
Bahareh Imani ◽  
Bahram Pourghassem Gargari ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Cross Sectional Study ◽  
Serum Glucose ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Glucose Levels ◽  
Partial Correlations ◽  
Hs Crp

Summary Background: Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of insulin resistance, is the most common cause of chronic liver. The present study aimed to investigate the roles of Vaspin and omentin-1 in the NAFLD-related pathology including IR, inflammation and elevated blood pressure. Methods: This cross-sectional study was conducted among 83 NAFLD patients in Jahrom, Iran. Plasma levels of omentin-1, Vaspin, hs-CRP and IL-6 were measured. Anthropometric indices, lipid profiles, liver enzymes as well as abdominal ultrasonography were assessed. Results: Partial correlations controlling for age and sex showed significant positive correlation between Vaspin and fasting blood sugar (FBS), insulin, HOMA-IR, and hs-CRP. It has been observed that omentin negatively correlated with glucose levels. Moreover, a marginally significant association has been found between Omentin levels and systolic blood pressure (SBP). Conclusions: This study shows that Vaspin and Omentin-1 are associated with inflammation, insulin resistance and serum glucose levels in patients with NAFLD.

scholarly journals Association between Blood Pressure and Obesity Indices in Medical Students

2020 ◽  
Author(s):  
Shalini Gandhi ◽  
Jitender Sorout ◽  
Rohit Raina ◽  
Abhay Raina ◽  
Urvashi Miglani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Students ◽  
Cross Sectional Study ◽  
Whole Body ◽  
Poor Correlation ◽  
Cross Sectional ◽  
Study Results ◽  
Measuring Tape ◽  
Total Body ◽  
Obesity Indices

Introduction: Obesity is strongly associated with other metabolic disorders including Hypertension (HTN), diabetes and Cardiovascular Diseases (CVD). High Blood Pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in South Asia. Aim: The aim of present was to study the association between BP and obesity indices in medical student’s population. Materials and Methods: A cross sectional study was conducted on a group of 100 healthy young medical students. BP, pulse and Hb O2% was measured by using sphygmomanometer, pulse oximeter. Obesity indices were measured by using weighing machine, stadiometer, measuring tape and impedance based Body Composition Analyser (BCA). Results: There was poor correlation of Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) with Total Body Fat (TF) and the association was not significant. SBP and DBP were mildly correlated with BMI. Whole body Visceral Fat (VF) correlation of SBP was moderate and significant. DBP was correlated with whole body VF and correlation was significant. But the whole body, trunk, leg Skin Fat (SF) and Muscle Fat (MF) were not having significant correlation with SBP and DBP. Finger to heart distance was positively correlated with SBP (p<0.05). Also, O2%, chest and hip size were positively correlated with SBP (p<0.05). Only whole body VF and Waist Hip Ratio (WHR) were significantly (p<0.05) affected SBP. None of the other parameters affected DBP. Conclusion: The present study results found that Body Mass Index (BMI), VF and WHR had significant correlation with systolic and SBP and DBP. VF and WHR were significant predictors of SBP.

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