Effects of N-acetylcysteine on arterial neo-intimal hyperplasia in rat model of arteriovenous fistula

2018 ◽  
Vol 20 (2) ◽  
pp. 190-194
Author(s):  
Amirmohsen Jalaeefar ◽  
Arash Mohammadi Tofigh ◽  
Atoosa Gharib ◽  
Mohsen Khandaghy ◽  
Mohammad Reza Rahimi

Introduction: Arteriovenous fistula is the best choice for vascular access in hemodialysis patients. However, arteriovenous fistula dysfunction is a major clinical issue. The most common cause of arteriovenous fistula failure is intimal hyperplasia. In this study, we have investigated the effect of N-acetylcysteine on neo-intimal hyperplasia after arteriovenous fistula creation in rats. Methods: This study was conducted in 24 rats which were randomly divided into two groups: control and N-acetylcysteine groups. An end-to-side anastomosis was made between the femoral artery and vein. The control group received distilled water intraperitoneally while the animals in N-acetylcysteine group received 300 mg/kg/day of N-acetylcysteine via the same route. After 28 days, the thickness of intima and media was measured using hematoxylin and eosin. Results: There was no significant difference between the two groups regarding age ( p = 0.6) and weight ( p = 0.1). The mean intima thickness in N-acetylcysteine group was significantly less than control group (17 ± 20 and 119 ± 46 µm, respectively; p < 0.001). The mean intima/media thickness in the N-acetylcysteine group was significantly less than control group (0.5 ± 0.63 vs 2.05 ± 1.17 µm; p < 0.001). Conclusion: N-acetylcysteine is effective in inhibiting neo-intimal hyperplasia in a rat model of arteriovenous fistula.

2021 ◽  
Vol 10 (4) ◽  
pp. 354-367
Author(s):  
Tahereh Baloochi Beydokhti ◽  

Objective: Hemodialysis is one of the most common treatment methods in kidney patients. To do this, repeated insertion of the needle into the vessel is necessary. Patients treated with hemodialysis are exposed to stress and pain caused by perforation of their arteriovenous fistula about 300 times a year. More than 1/5 of hemodialysis patients express this pain as unbearable. This study aims to evaluate the effect of acupressure at SP6 and ST36 acupoints on the pain caused by fistula needle placement in hemodialysis patients. Methods: This study is a double-blind randomized clinical trial conducted in 2016 on 90 hemodialysis patients with arteriovenous fistula in Mashhad, Iran. They were randomly divided into three groups of SP6, ST36, and control. Data were collected after obtaining a written informed consent by a demographic form and the Visual Analog Scale (VAS). Data analysis was performed in SPSS v.16 software by using Kolmogorov-Smirnov test, Kruskal-Wallis test, one-way ANOVA, paired t-test, and Chi-square test. Results: There was a statistically significant difference between VAS scores after the intervention in all three group (P<0.001). The Mean±SD VAS scores before the intervention in SP6, ST36, control groups were 54.47±18.93, 51.5±22.83, 46.6±17.73, respectively which changed to 45.63±20.53, 40.2±20.01, and 51.87±19.05 after the intervention, indicating that acupressure at SP6 and ST36 acupoints reduced pain in patients, while the pain increased in the control group. Conclusion: Acupressure at SP6 and ST36 acupoints is an effective method in relieving pain caused by the insertion of a needle into the arteriovenous fistula in hemodialysis patients.


2020 ◽  
Author(s):  
Sherif Salah Azab ◽  
Mohamed Abdelfatah Farag

Abstract Background: investigate the prevalence and The related factors between the two types of premature ejaculation (lifelong PE[LPE], acquired PE [APE] in men and atherosclerosis. Methods: One hundred patients complaining of PE and 100 control subjects were enrolled in this prospective study.All cases underwent a full medical history and Clinical examination.Blood pressure,serum lipid profile, testosterone,and Body mass index (BMI) were measured.The Arabic index of premature ejaculation (AIPE) and self-estimated (IELT) Intravaginal latency time was used for PE evaluation. Atherosclerosis was diagnosed by measuring the Carotid artery intima-media thickness (CIMT). Patients were divided into two major groups, (Group 1) [PE group] and (Group 2) [Control group]. Results: The mean age of cases in (group1) and (group 2) were 44.5 ± 11.7 versus 42.3 ± 10.8 yrs. The Systolic BP, diastolic (BP), Serum Triglycerides, serum LDL (BMI), the prevalence of atherosclerosis and smoking rate showed higher results in (group1) compared to group2, with significant difference (p<0.001). The IELT was significantly lower in group1 (2.67± 1.25) compared to group2 (3.77±1.52), (p<0.001). The prevalence of APE (74%) was significantly higher than LPE (26%) in group1(p<0.001). regression analysis revealed that patients with APE showed more comorbidities than LPE patients concerning the prevalence of atherosclerosis, hypertension, and hyperlipidemia (p<0.001 for all items).Both of APE and LPE were significantly related to age>35y, BMI ≥ 25 kg/m2, smoking, Bl pressure and hyperlipidemia (p<0.001 for all factors).Conclusions: Both types of PE,predominately the APE type,are associated with atherosclerosis, hypertension, and hyperlipidemia. The APE type reported more prevalence than the LPE.


Author(s):  
Ziba Ghoreyshi ◽  
Monireh Amerian ◽  
Farzaneh Amanpour ◽  
Reza Mohammadpourhodki ◽  
Hossein Ebrahimi

AbstractBackgroundThe vital signs reflect the physiological state of patients in various clinical conditions. The purpose of this study was to compare the effects of cold compress and Xyla-P cream on hemodynamical changes during venipuncture in hemodialysis patients.Methods and MaterialIn this clinical trial study, 50 patients under hemodialysis were selected by simple random sampling. The patients were then randomly assigned to either Xyla-P cream, cold compress or placebo groups. The vital signs (blood pressure and pulse) were measured upon two intermittent hemodialysis sessions before and after venipuncture. Data were analyzed using repeated measures analysis of variance.ResultsThe mean alternation in systolic blood pressure was significantly different comparing the placebo and cold compress groups before and after intervention (p<0.001). However, the difference was not significant between the Xyla-P cream group and either placebo (p=0.402) or ice compress (p=0.698) groups. The difference of the mean diastolic blood pressure was significant comparing the placebo group with either the Xyla-P cream group (p=0.003) or cold compress group (p<0.001) before and after intervention. In addition, there was a significant difference in the mean number of heartbeats comparing the control group with either the Xyla-P cream group (p<0.001) or cold compress group (p<0.001) before and after the intervention.ConclusionsConsidering the beneficial effects of ice compress and the Xyla-P cream on reduction of cardiovascular parameters, it is recommended to use these methods in hemodialysis patients during venipuncture.


Author(s):  
Wanjun Ren ◽  
Yuejuan Du ◽  
Huili Jiang ◽  
Dongmei Xu

Background Chronic kidney disease has become a serious public health problem in China. Our study is to explore effect of hydraulic expansion on arteriovenous fistula (AVF) of hemodialysis patients. Methods A total of 190 patients with end-stage renal disease (ESRD) were randomly divided into hydraulic expansion group (n = 117) and conventional surgery group (n = 73). Age, sex, the cause of ESRD, height, weight, body mass index (BMI), blood pressure, and diameter of artery and vein from ultrasonography before surgery from patients were recorded. Doppler ultrasonography of vessel was performed with a 12-MHz scanning probe for vascular measurements. The time of first cannulation was recorded. Primary and secondary patency rates were compared between the two groups. Results The mean arterial pressure for this cohort of patients was around 98.12 mm Hg. The mean diameters of artery and vein ready for anastomoses measured by ultrasonography before surgery were 1.96 and 2.04 mm, respectively. Age, weight, BMI, sex ratio, the cause of renal failure, history of catheter insertion, mean arterial pressure, frequency of hemodialysis, blood flow of hemodialysis, and the mode of anastomoses of AVF in conventional surgery group were similar to hydraulic expansion group. There were no differences in stroke volume of radius arterial and venous pressure before dilation between the two groups. The stroke volume of radius artery increased significantly after hydraulic expansion than before dilation and control group. The primary patency rates of AVF in patients with hydraulic expansion were higher significantly than conventional surgery group. The secondary patency rates in conventional surgery group were not different from hydraulic expansion group. Conclusion Hydraulic expansion showed no difference from conventional surgery in complication after operation, and could decrease the time reliance on catheters and the risk of catheter-related infection, thrombosis, and decrease the related medical care costs.


Author(s):  
Masoumeh Bagheri Nesami ◽  
Seyed Afshin Shorofi ◽  
Attieh Nikkhah ◽  
Hossein Roohi Moghaddam ◽  
Ali Mahdavi

  In spite of the improvement of dialysis techniques, hemodialysis patients still experience debilitation. Impaired functioning, well-being, and quality of life are among the factors that are of a great concern in these patients. The current study aimed to examine the effects of lavender essential oil on well-being among hemodialysis patients. This randomized clinical trial was conducted on 30 hemodialysis patients. For each patient in the experimental group, five cotton balls were prepared using two drops of lavender essence diluted with sweet almond oil. Lavender was used at five concentrations of 10%, 20%, 30%, 40%, and 50%, administered through pinning the soaked cotton ball on the patients' collar on the first, second, third, fourth, and fifth weeks of the intervention, respectively. The patients were asked to breathe normally for 20 min. On the other hand, the control group received only routine nursing care. The perceived sense of well-being was measured in both groups at the end of each week using a visual analog scale. The mean ages of patients were obtained as 58.9 ± 14.31 and 53.03 ± 15.84 years for the experimental and control groups, respectively. Hypertension was reported to be the most common underlying disease in both groups. The results showed a significant difference in the mean level of well-being in the experimental group in the fourth and fifth weeks of the intervention, compared to that before the intervention. Inhalation aromatherapy with 40% and 50% lavender essence had a positive effect on the perceived sense of well-being in hemodialysis patients. However, lower concentrations of 10%, 20%, and 30% did not exert a comparable effect.


2021 ◽  
Vol 24 (1) ◽  
pp. 39-46
Author(s):  
Ida Rosdiana ◽  
Yanti Cahyati

disorder in hemodialysis patients, which will cause a decrease in quality of life. Aromatherapy combined with progressive muscle relaxation are expected to increase the effects of relaxation on the patient so that the patient's sleep quality can improve optimally.Objective: The study aimed to investigate the effect of the progressive muscle relaxation combined with lavender aromatherapy on insomnia among patients undergoing hemodialysis. Material and Methods: The design of this study included a quasi-experiment with a pretest-posttest control group approach. The sample selection was performed using a consecutive sampling technique and involved 50 respondents, divided into two equal control and study group. Patients in study group recommended to do progressive muscle relaxation at least four times per week for three weeks and were told to drop two – three drops lavender aromatherapy on a pillow 30 minutes before bedtime at least 4 nights per week for three weeks. The control group recommended to do muscle relaxation and daily routine care at least four times per week for three weeks. Results: The results showed that both study and control groups were equal in terms of demographics, and scores of insomnia at the baseline. There no significant difference between the mean insomnia scores of two group before intervention, while the difference was statistically significant after the intervention. The mean insomnia scores were lower in study group than in the control group.Conclusion: Progressive muscle relaxation and lavender aromatherapy were effective in decreasing insomnia scores among patients undergoing hemodialysis.


Author(s):  
Seyyed Ali Mousavi Kiasari ◽  
Monir Nobahar ◽  
Raheb Ghorbani ◽  
Mohammad Reza Tamaddon

Background & Aim: Anemia is one of the most common complications of chronic renal failure, which is associated with increased fatigue, dyspnea, depression, malaise, prolonged hospitalization and mortality. Some patients are resistant to erythropoietin therapy. Therefore, the purpose of this study was to determine the effect of thyme honey on anemia in hemodialysis patients. Methods & Materials: The present clinical trial was conducted in 2018 at Kowsar Hospital of Semnan on hemodialysis patients randomly selected with convenience sampling method within two groups of case (n=28) and control (n=27). The case group received thyme honey (33 g) daily for one month. The control group did not consume thyme honey. Blood samples were taken from the patients before and after the intervention with 10-hour fasting and then blood parameters were assessed. Results: The mean ±SD reduction rate in hemoglobin level was 0.46±0.96 in the case group and 0.23±3.15 g/dl in the control group, but no significant difference using independent t-test (P=0.758). The mean±SD reduction rate in hematocrit percentages was 1.20±2.78 in the case group and 0.11±8.53 in the control group, but there is no significant difference between the two groups using independent t-test (P=0.590). Conclusion: Results showed that daily administration of 33 grams of thyme honey had no effect on anemia in hemodialysis patients. Further studies are recommended with modification of the methodology regarding the type, dose, duration and instructions of honey consumption for better results.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
JAE WAN JEON ◽  
Young Rok Ham ◽  
Haeri Kim ◽  
Wonjung Choi ◽  
Ki Ryang Na ◽  
...  

Abstract Background and Aims Permanent vascular access is important in patients requiring hemodialysis. However, among patients requiring hemodialysis, even if arteriovenous fistula surgery is performed, many are unable to undergo hemodialysis with vascular access due to maturation failure. Method Using 194 patients who underwent arteriovenous fistula surgery, a cilostazol group (n = 107) and a control group (n = 87) were compared and analyzed for the occurrence of vascular complications. Results In the cilostazol group, there were less vascular complications (36.4% vs. 52.9%; p = 0.022), especially maturation failure (2.8% vs. 11.5%; p = 0.016). However, there was no significant difference between the cilostazol group and control group regarding percutaneous transluminal angioplasty (PTA) requirement nor frequency and interval to PTA after vascular surgery. The frequency of reoperations due to vascular injury after the start of hemodialysis after maturation was also significantly lower in the cilostazol group. Conclusion These results suggest that vascular access patients may benefit from postoperative cilostazol therapy.


2018 ◽  
Vol 19 (3) ◽  
pp. 303-310
Author(s):  
Can Huzmeli ◽  
Gokhan Bagci ◽  
Ferhan Candan ◽  
Binnur Bagci ◽  
Lale Akkaya ◽  
...  

Purpose: We investigated the influence of the vitamin D receptor gene TaqI (rs731236), ApaI (rs7975232), and FokI (rs2228570) polymorphisms in arteriovenous fistula failure in hemodialysis patients. Methods: This study was carried out with 54 patients who experienced two or more fistula failures in the late period after arteriovenous fistula operation and 58 control patients with no history of arteriovenous fistula failure in 3 years or longer. The polymerase chain reaction–restriction fragment length polymorphism method was used to determine the vitamin D receptor TaqI, FokI, and ApaI polymorphisms. Results: For vitamin D receptor gene TaqI and Fok1 polymorphisms, no significant association was found between the two groups ( p > 0.05). However, a statistically significant association was determined for ApaI polymorphism between the two groups ( p = 0.02). In patients, ApaI AA, AC, and CC genotype frequencies were found as 21 (38.9%), 32 (59.3%), and 1 (1.8%), respectively. However, genotype frequencies of AA, AC, and CC in the control group were 29 (50%), 22 (37.9%), and 7 (12.1%), respectively. In all three polymorphisms, no significant difference was found between the two groups in terms of allele frequencies ( p > 0.05). Conclusion: Vitamin D receptor ApaI AC genotype may be a possible cardiovascular risk factor for the development of arteriovenous fistula failure.


2020 ◽  
Vol 10 (2) ◽  
pp. 174-183
Author(s):  
Ahmadreza Siasari ◽  
◽  
Mansour Zamani Afshar ◽  
Fatemeh Sargolzaie ◽  
Najmeh Saberi ◽  
...  

Objective: Anxiety and depression are the most common psychological problems and effective on treatment process in hemodialysis patients. Acupressure is inexpensive, effective, and available method for reducing anxiety and depression. Therefore, this study was conducted to determine the effect of acupressure on anxiety and depression in hemodialysis patients. Methods: This study was a clinical trial, conducted on 40 patient’s referral to Imam Khomeini medical center in Zabul at 2017. Patient-based census method selected and randomly divided in two groups (intervention group: 20, control group: 20). For data collection we used demographic, Spielberger Anxiety and Beck Depression Questionnaire. The intervention group received acupressure in p6 point in three days a week for four weeks. Data were collected before and one month after the intervention then data analyzed by SPSS v. 16 with paired t-test and independent statistical test.   Results: The Mean±SD depression and anxiety score after intervention were 25.41±5.67 and 37.15±5.13, respectively. Evaluation of depression and anxiety scores after intervention showed a significant difference (P<0.05). Conclusion: The results of this study indicated that acupressure is effective in reducing anxiety and depression in patients. Therefore, it is recommended as a simple, inexpensive, and workable method by the patient himself.


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