Residual Renal Function Affects Lipid Profile in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

1997 ◽  
Vol 17 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Alexander Kagan ◽  
Eti Elimalech ◽  
Zvi Lerner ◽  
Aaron Fink ◽  
Yaacov Bar-Khayim

Objective To determine whether lipoprotein abnormalities associated with continuous ambulatory peritoneal dialysis (CAPD) are influenced by residual renal function (RRF). Design Open, non randomized prospective and com -parative study. Setting Single university teaching hospital dialysis unit and outpatient clinic. Patients Twenty adult patients on standard CAPD (1 -38 months) were divided into two groups: group A (RRF ≤ 0.8 mL/min, n = 10) and group B (RRF ≥ 1.1 mL/ min, n = 10). Patients in the two groups were matched for age, time on dialysis, body weight, body mass index, serum urea and albumin levels, peritoneal and urinary albumin losses, and peritoneal transport characteristics such as overnight 8hour peritoneal creatinine and β2-microglobulin clearances and overnight 8-hour effluent glucose concentrations. Results The degree of uremia in patients with preserved RRF (group B) was obviously lower than in patients with negligible RRF (group A), that is, patients in group B had significantly lower serum creatinine and β2-microglobulin levels and significantly higher weekly KTN than group A patients. Despite the prevalence of allele 4 of apolipoprotein E genotype in group A patients, their levels of serum total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a) [Lp(a)], apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1) were significantly lower than those of patients with preserved RRF (group B). The two groups did not differ significantly in the serum levels of triglyceride or high-density lipoprotein cholesterol. Serum concentrations of Lp(a) and ApoA1, as well as ratios of ApoA1 to ApoB, were correlated significantly with RRF (r = 0.63, r = 0.51, and r = 0.61, respectively). Conclusions The findings suggest that RRF affects the lipid profile of CAPD patients, especially serum levels of cholesterol-rich lipoproteins.

Author(s):  
Sheena Chopra ◽  
Sangeeta Pahwa

Background: Preeclampsia is associated with adverse pregnancy outcome and is a major cause of the fetomaternal morbidity and mortality. This study aimed at finding the role of lipid profile and uterine artery Doppler as a reliable predictor of risk of preeclampsia in early second trimester.Methods: This study is conducted in the obstetrics and gynecology department of a tertiary care teaching hospital, Amritsar. Lipid profile and Uterine artery doppler is estimated in 100 antenatal women from 14-20 weeks of period of gestation who met the inclusion criteria and are followed up till delivery or till preeclampsia sets in.Results: Out of 100 subjects 74 remained normotensive (Group A) and 26 developed preeclampsia (Group B). The mean serum level of total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL) and very low-density lipoprotein cholesterol (VLDL) was significantly higher in Group B as compared to group A women. The Preeclamptic women showed significant fall in high density lipoprotein cholesterol (HDL) level as compared to normal pregnant women. The mean S/D ratio, PI and RI values of uterine artery Doppler were higher for group B and were statistically significant.Conclusions: The combined predictive value of lipid profile and uterine artery Doppler for estimating risk of preeclampsia was more reliable than of any of the test individually.


Author(s):  
S. K. Tripathy ◽  
N. Dhal ◽  
M. Kanungo ◽  
S. Das ◽  
S. K. Mishra ◽  
...  

Background: Though there are many studies on thyroid dysfunction and dyslipidemia in Chronic Kidney Disease (CKD), no study is conclusive. Aim of this study was to correlate abnormalities in thyroid function and lipid profile with the severity of renal failure and also to observe the difference of these abnormalities between patients on conservative management verses hemodialysis.Methods: Hundred consecutive CKD cases admitted to Medicine Department were taken up for the study. They were divided into two groups as Group-A [on conservative management] and Group-B [on regular Hemodialysis (HD)]. Hundred healthy persons were taken as control in Group-C. After evaluation of thyroid function and lipid profile statistical analysis was done by students t-test, chi-square and regression analysis.Results: Hundred CKD cases with 74% male (n=74) and 26% female (n=26) in a M: F ratio of 2.9:1 were found to be in different stages CKD (0, 2, 20, 28 and 50 in stage-1 to stage-5 respectively). In 50 cases of stage-5 CKD, 30 were on HD and 20 on conservative management. Diabetes Mellitus (DM) (40%) was the commonest etiology of CKD followed by Hypertension (HTN), obstructive uropathy, chronic glomerulonephritis (CGN) and polycystic kidney disease (PKD). Thyromegaly was not found in a single case. In all CKD cases (Group-A+B) TT3 (TT3) was significantly low (P =0.0011) when compared with control (Group-C) and no difference was found between Group-A and Group-B. Fall in TT3 worsened with increasing severity of CKD. Lipid profile study revealed Decreased High-Density Lipoprotein Cholesterol (HDLc) and increased Triglyceride (TG), Total Cholesterol (TC), Low Density Lipoprotein Cholesterol (LDLc), TC/HDLc and LDLc/HDLc in Group-A than Group-B but only TG and TC increase was statistically significant. The levels of TG and TC and TC/HDLc increased as the stage of CKD progressed and was statistically significant (P= 0.035).Conclusions: There occurs a state of biochemical hypothyroidism without overt clinical hypothyroid state in CKD, the extent of which correlates with the severity of CKD. Increased cardiovascular complications occur due to accelerated atherosclerosis in CKD. This study confirmed that atherogenic lipid profile and thyroid dysfunction worsen with the progression of disease. Difference between patients on conservative management and HD was not found.


2005 ◽  
Vol 25 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Josep Teixidó–Planas ◽  
Alberto Ortíz ◽  
Francisco Coronel ◽  
Jesús Montenegro ◽  
Ramón López-Menchero ◽  
...  

Background Protein-energy malnutrition is prevalent in peritoneal dialysis (PD) patients and is associated with increased morbidity and mortality. Objective To evaluate the impact of prophylactic treatment with an oral protein-energy supplement (Protenplus; Fresenius AG, Bad Homburg, Germany) on nutritional parameters in patients starting PD. Design Prospective, multicenter, randomized study of group A patients (Protenplus, n = 35) and group B (controls, n = 30), with evaluations at baseline and at 6 and 12 months. Statistical Methods: Efficacy of factors by linear mixed model analysis for repeated measurements, chi-square, t-test, and Mann–Whitney test. Outcome Parameters Patient compliance, serum albumin, and other nutritional parameters. Results No significant differences were found at baseline evaluation. During follow-up, a significant number of group A patients abandoned intake of the supplement due to noncompliance ( n = 7) or side effects ( n = 8) (χ2 p < 0.01). Patients with lower residual renal function were less likely to comply. The mixed model in the “intention to treat” analysis showed a significant increase related to supplement intake only in total lymphocyte count in group A. The “as treated” analysis of the 29 patients who fulfilled the study (9 in group A, 20 in group B) disclosed that belonging to group A constituted an independent factor for increased lymphocyte count ( p < 0.001), body weight ( p < 0.03), tricipital skinfold thickness ( p < 0.01), middle-arm muscle circumference ( p < 0.025), lean body mass (LBM) ( p < 0.002), creatinine LBM related to body surface area ( p < 0.001), and creatinine generation rate ( p < 0.002). However, these data may have been biased by the high rate of noncompliance in group A. Conclusions Protenplus proved to be unsuitable as a long term, oral protein-energy supplement in PD patients due to a high rate of noncompliance and intolerance, primarily among patients with lower residual renal function. The question of whether other products, better-tolerated as nutritional supplements, could compensate for daily protein peritoneal losses in long-term PD remains open.


1997 ◽  
Vol 17 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Madhukar Misra ◽  
David A. Reaveley ◽  
Jacqueline Ashworth ◽  
Bruce Muller ◽  
Mary Seed ◽  
...  

Objective To evaluate the effect of 1.1% amino acid dialysate (A AD) (Nutrineal, Baxter, Castlebar, Ireland) on lipid metabolism in hyperlipidemic patients on continuous ambulatory peritoneal dialysis (CAPD). Design Patients were alternately assigned to receive AAD in the first (group A), or the second (group B), 6 months of a prospective cross-over study. Setting University teaching hospital. Patients Eighteen stable CAPD patients with a serum cholesterol 5.5 mmol/L or greater. Interventions One post prandial exchange of AAD during a 24-hour period for 6 months. Main Outcome Measures A significant change in serum lipid levels. Results Patients in group A (n = 10) received a single daily exchange of AAD in place of their post prandial dextrose exchange for the first 6 months, and then crossed over to the dextrose phase. Patients in group B (n = 8) continued their usual dextrose dialysis for the first 6 months and then crossed over to receive AAD in the latter 6 months. Measurements of serum lipids and lipoproteins along with other biochemical parameters were made at regular intervals. Although a downward trend in mean serum total cholesterol was seen on AAD in group A, no significant change in total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol was observed in any group. Mean serum triglycerides fell on AAD in both groups, but were not statistically significant. Serum lipoprotein(a) [Lp(a)] and apolipoprotein B were elevated in both groups but did not change on AAD or with time. No change was observed in serum apoprotein A1 levels. Serum Lp(a) was not correlated to dialysate protein excretion. No change in mean serum albumin was observed, in either group, on AAD. KT/V urea, total weekly creatinine clearance, net ultrafiltration, and dialysate protein excretion remained unchanged on AAD. Conclusions The use of A AD, although clinically safe and without side effects, had no effect on the dyslipidem ia in our group of CAPD patients.


2006 ◽  
Vol 134 (11-12) ◽  
pp. 503-508
Author(s):  
Natasa Jovanovic ◽  
Mirjana Lausevic ◽  
Biljana Stojimirovic

Introduction:Most of patients with chronic renal failure are affected by normochromic, normocytic anemia caused by different etiological factors. Anemia causes a series of symptoms in chronic renal failure, which can hardly be recognized from the uremic signs. Anemia adds to morbidity and mortality rates in patients affected by advanced chronic renal failure. Blood count partially improves during the first months after starting the chronic renal replacement therapy, in correlation with the quality of depuration program, with extension of erythrocyte lifetime and with hemoconcentration due to reduction of plasma volume. Recent trials found that higher residual renal function (RRF) significantly reduced co-morbidity, the rate and duration of hospitalization and risk of treatment failure. Objective: The aim of the study was to follow blood count parameters in 32 patients on chronic continuous ambulatory peritoneal dialysis (CAPD) during the first six months of treatment, to evaluate the influence of demographic and clinical factors on blood count and RRF, and to examine the correlation between RRF and blood count parameters. Method: A total of 32 patients affected by end-stage renal disease of different major cause during the first six months of CADP treatment were studied. RRF and blood count were evaluated as well as their relationship during the follow-up. Results: Blood count significantly improved in our patients during the first six months of CAPD treatment even if Hb and HTC failed to reach normal values. Iron serum level slightly decreased because of more abundant erythropoiesis and iron utilization during the first six months of treatment. RRF slightly decreased. After six months of CAPD treatment, the patients with higher RRF had significantly higher Hb, HTC and erythrocyte number and a lot of positive correlations between RRF and anemia markers were observed. Conclusion: After 6-month follow-up period, the patients with higher RRF had significantly higher blood count parameters, and several positive correlations between RRF and blood count markers were confirmed.


2015 ◽  
Vol 1 (2) ◽  
pp. 235-243
Author(s):  
Most Sumona Akter ◽  
Md Abu Yousuf ◽  
Md Yousuf Ali ◽  
Most Mahfuja Khatun ◽  
Sukumar Saha ◽  
...  

Ground nut is one of the commonly used decorative nutritious relish seed around the world. Ground nut have hypocholesterolamic, hypoglycemic, hypolipidemic, anti-atherosclerotic, immune-modulatory and bacterial counting effects. In Bangladesh, limited research has so far been performed on the action of ground nut in biological system and its comparative efficacy with commercialized drugs that reduce blood cholesterol. The aim of this study was carried on the effects of PUFA on blood total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG) and against artificial inoculation (I/N) Staphylococcus aureus infection of experimental rat by feeding of ground nut. A total of fifteen long Evans rats (Rattus norvegicus) were used for this study. The rats were randomly divided into three equal groups (n=5) and numbered as A, B and C. Group A (control), Group B (50gm ground nut/ day/group), group C (100 gm ground nut/day/group). All groups were supplied with standard broiler pellet and fresh drinking water throughout the experimental period (January to June /2012). The blood samples were collected directly from the heart at the 1st and 60th day for biochemical test (TC, LDL, HDL and TG) and test was performed as per Memorial Diagnostic Centre, Charpara, Mymensingh. Staphylococcus aureus was cultured in nutrient broth and 100 µl of their culture was inoculated into the rats through intranasal route. Among all the treated groups, the rats of group C exhibited the lowest TC value, TG and LDL and reduced blood cholesterol significantly than (control group A) followed by group B. In bacteriological examinations, it was found that the number of bacterial colony lowest in group C in comparison with the group of A and B. From the present experiment, it can be assumed that PUFA has significant effect on blood lipid profile and against bacterial infection.Asian J. Med. Biol. Res. June 2015, 1(2): 235-243


1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 242-244 ◽  
Author(s):  
Sophia Spaia ◽  
Fotini Christidou ◽  
Panayotis Pangidis ◽  
Thomas Tsoulkas ◽  
Michalis Pazarloglou ◽  
...  

In order to evaluate the Influence of diabetes mellitus on peritoneal membrane permeability, we studied the peritoneal protein loss In two groups of patients. Group A consisted of 16 patients (9 nondlabetics and 7 diabetics) who were In the first month of treatment on continuous ambulatory peritoneal dialysis (CAPO). Group B consisted of 13 patients (7 nondlabetics and 6 diabetics) who had been on CAPO for approximately 15 months. In both groups we measured the body weight, serum total protein, albumin, and total protein, urea, and glucose In the peritoneal fluid. We did not find any difference In groups A and B between diabetics and nondlabetics as far as the estimated parameters were concerned. Age, body weight, serum biochemistry, and protein and urea content In peritoneal fluid were similar, when group A was compared to group B. Patients of group B hed on average higher protein losses than those who had been on the method for a short period (mean 7.9 g/dL, vs 6.09 g/dL). Six patients were followed for over 15 months and were found to have significantly Increased protein losses (p=0.02). Glucose levels In peritoneal fluid were significantly lower In patients In group B, p<0.05 (mean 51.8 g/dL vs 37.1 g/dL). Peritoneal protein loss does not seem to differ between diabetic and nondiabetic patients with end-stage renal disease treated with CAPO, at any given time of the treatment. We observed an Increase In protein loss In some patients and a tendency to Increase the protein loss In others. This, along with the fall In glucose levels, might reflect progressive alterations In structure and permeability of the elements Involved In peritoneal transport, and It should receive further evaluation.


Author(s):  
Hymavathi K. Reddy ◽  
Vineela P. ◽  
Bhargavi M. Chowdary

Background: A comparative study of serum lipid profile and magnesium levels in normal pregnancy versus preeclampsia (PE).Methods: A prospective study done for 2 years (October 2014 to October 2016) in the Department of Obstetrics and Gynecology, Narayana medical college and hospital, a tertiary care centre, Nellore, Andhra Pradesh, India. A sample size of 200 pregnant women, recruited and divided into group A and B. group A being women with PE and group B is normal pregnant women.A10ml of venous blood was collected in the fasting state and serum collected from clotted blood to measure lipid profile, magnesium, Apo lipoprotein A-I and Apo lipoprotein B 100.Serum Lipid profile  measured by enzymatic method using commercially available kit Human (GmbH Germany) using humastar 600 chemistry analyzer (Human GmbH Germany). Serum magnesium measured by dye binding method using commercially available kit Human (GmbH Germany) using Humastar 600 chemistry analyzer (Human GmbH Germany). Serum ApoA-I and ApoB were measured by immune-turbidometry using commercial kits from Spinreact Spain. Urine albumin done by dipstick method.Results: Serum total cholesterol (TC), Triglyceride (TG), low density lipoprotein (LDL), very low-density lipoprotein (VLDL), Apo lipoprotein B 100 (Apo B100) were high and serum Magnesium, high density lipoprotein (HDL) and Apo lipoprotein A1(Apo A1) were low in the study group (group A) compared to controls (group B).Conclusions: Abnormal lipid profile (low HDL and increased TG concentration) and serum hypomagnesaemia may be contributing etiologies of preeclampsia, having good predictive value as a screening procedure for PE in high risk pregnant population.


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