scholarly journals Bone mineral density in Palestinian patients with end-stage renal disease and the related clinical and biochemical factors: Cross-sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241201
Author(s):  
Zaher Nazzal ◽  
Shahd Khader ◽  
Hiba Zawyani ◽  
Mazen Abdallah ◽  
Osama Sawalmeh ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction End-Stage Renal Disease (ESRD) is the ultimate result of chronic kidney disease (CKD). In Palestine, the prevalence of ESRD was 240.3 PMP which is comparable with the nearby countries. Accelerated bone loss among ESRD patients is attributed to abnormal bone turn over that leads to osteoporosis and osteopenia. The risk of fractures is increased four-fold in men and women on hemodialysis, which explains the importance of assessing the bone mineral density among these population. The goals of this study were to find the prevalence of osteoporosis in ESRD patients as determined by bone mineral density (BMD) at different sites and to determine whether BMD correlates with many other clinical parameters. Methods A cross-sectional study of 194 ESRD patients were recruited from the dialysis unit in An-Najah National University Hospital, Nablus, Palestine. The patients were on regular hemodialysis or peritoneal dialysis. BMD was measured at the lumbar spine and the hip using the dual-energy X-Ray absorptiometry (DEXA) and the value is expressed as T-score. The data were analyzed using SPSS, version 26. The relationship between BMD and the clinical and biochemical parameters among the ESRD patients was assessed. Results We found that 42.8% of ESRD patient had osteoporosis and 40.2% had osteopenia. There were significantly higher proportions of osteoporosis and osteopenia among patients >60 years of age (p<0.005). Patients with osteoporosis and osteopenia had significantly higher serum levels of PTH (792.9 and 469.7) (p<0.05). BMD decreases as the duration of dialysis (39.0 months Vs. 56.8 months), (p<0.05). We found no significant difference between patients on hemodialysis or peritoneal dialysis. Conclusion This study showed that Palestinian patients with ESRD have low BMD at the hip and spine. The observed high serum level of PTH was associated with low BMD. Those patients should be closely monitored especially those with more than one risk factor. Moreover, more attention should be paid for these category of patients to decrease the incidence of falling down and the resulting fractures that might lead to mortality and morbidity.

scholarly journals Bone mineral density and mortality in end-stage renal disease patients

2020 ◽  
Vol 13 (3) ◽  
pp. 307-321 ◽  
Author(s):  
Ken Iseri ◽  
Lu Dai ◽  
Zhimin Chen ◽  
Abdul Rashid Qureshi ◽  
Torkel B Brismar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Renal Disease ◽  
Cortical Bone ◽  
Vascular Calcification ◽  
Bone Mineral ◽  
End Stage Renal Disease ◽  
Mineral Density ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Osteoporosis characterized by low bone mineral density (BMD) as assessed by dual-energy X-ray absorptiometry (DXA) is common among end-stage renal disease (ESRD) patients and associates with high fracture incidence and high all-cause mortality. This is because chronic kidney disease-mineral bone disorders (CKD-MBDs) promote not only bone disease (osteoporosis and renal dystrophy) but also vascular calcification and cardiovascular disease. The disturbed bone metabolism in ESRD leads to ‘loss of cortical bone’ with increased cortical porosity and thinning of cortical bone rather than to loss of trabecular bone. Low BMD, especially at cortical-rich bone sites, is closely linked to CKD-MBD, vascular calcification and poor cardiovascular outcomes. These effects appear to be largely mediated by shared mechanistic pathways via the ‘bone–vascular axis’ through which impaired bone status associates with changes in the vascular wall. Thus, bone is more than just the scaffolding that holds the body together and protects organs from external forces but is—in addition to its physical supportive function—also an active endocrine organ that interacts with the vasculature by paracrine and endocrine factors through pathways including Wnt signalling, osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand system and the Galectin-3/receptor of advanced glycation end products axis. The insight that osteogenesis and vascular calcification share many similarities—and the knowledge that vascular calcification is a cell-mediated active rather than a passive mineralization process—suggest that low BMD and vascular calcification (‘vascular ossification’) to a large extent represent two sides of the same coin. Here, we briefly review changes of BMD in ESRD as observed using different DXA methods (central and whole-body DXA) at different bone sites for BMD measurements, and summarize recent knowledge regarding the relationships between ‘low BMD’ and ‘fracture incidence, vascular calcification and increased mortality’ in ESRD patients, as well as potential ‘molecular mechanisms’ underlying these associations.

scholarly journals Patient and provider factors associated with enrolment in the pre-end-stage renal disease pay-for-performance programme in Taiwan: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031354
Author(s):  
Hsiao-Yun Hu ◽  
Feng-Xuan Jian ◽  
Yun-ju Lai ◽  
Yung-Feng Yen ◽  
Nicole Huang ◽  
...  
Keyword(s):  
Health Insurance ◽  
End Stage Renal Disease ◽  
Pay For Performance ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

ObjectiveThe incidence and prevalence of end-stage renal disease (ESRD) in Taiwan have been ranked the highest worldwide. Therefore, the National Health Insurance Administration has implemented the pre-ESRD pay-for-performance (P4P) programme since November 2006, which had significantly reduced the incidence of dialysis and all-cause mortality. This study aimed to identify the factors associated with the enrolment in the pre-ESRD P4P programme.DesignCross-sectional study.SettingThe National Health Insurance research database 2007–2012 in Taiwan.ParticipantsPatients with prevalent pre-ESRD aged more than 18 years between January 2007 and December 2012 were enrolled. Patient demographics and hospital characteristics between P4P and non-P4P groups were compared. A logistic regression model was used to analyse the factors associated with P4P enrolment, and a generalised estimating equation was used to verify the results.Primary outcome measureEnrolment in the pre-ESRD P4P programme.ResultsIn total, 82 991 patients were enrolled in the programme, with a 45.6% participation rate. Patients who were males (adjusted OR (AOR)=0.89, 95% CI=0.86 to 0.91) and employed (AOR=0.95, 95% CI=0.92 to 0.97) had a significantly lower probability to be enrolled in the programme. Older patients (66–75 years old, AOR=1.23, 95% CI=1.14 to 1.33) and those with higher Charlson Comorbidities Index (CCI 5+, AOR=4.01, 95% CI=3.55 to 4.53) tended to be enrolled in the programme, while those in the 76+ years age group were not (AOR=1.03, 95% CI=0.95 to 1.13). Hospitals located in the central (AOR=1.48, 95% CI=1.05 to 2.08) and Kao-Ping regions (AOR=1.62, 95% CI=1.18 to 2.22) also tended to enrol patients in the pre-ESRD P4P programme. Enrolment rates increased over time.ConclusionPre-ESRD patients of the female gender, greater age and more comorbidities were more likely to be enrolled in the pre-ESRD P4P programme. Healthcare providers and health authorities should focus attention on patients who are male, younger and with less comorbidities to improve the healthcare quality and equality for all pre-ESRD patients.

scholarly journals Quality of Life in Patients With End-Stage Renal Disease on Hemodialysis: A Cross-Sectional Study in Sudan

2020 ◽  
Author(s):  
Marwah Mohamed
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease (CKD) when renal replacement therapy (RRT) is necessary for sustaining life. Assessment of QoL of ESRD patients has become an essential tool to measure how the disease affects patients’ lives, and to develop better plans of care. Little is known about QoL in patients with CKD before RRT. This study aims to examine the various socio-demographic and other factors that affect the daily QoL of ESRD patients on haemodialysis (HD).Methods: A cross-sectional study was conducted at Dr Selma Dialysis Center, Khartoum, Sudan from September to December 2018. A total of 138 adult patients on chronic dialysis were recruited in this observational study. The QoL was assessed using the Kidney Disease Quality of Life-Short Form questionnaire (KDQoL-SF™).Results: Out of 138 enrolled patients, there were 105 patients (76.1%) had a good QoL and 33 patients (23.9%) had a poor QoL.Patients with a poor QoL had an average age of 42.8 ± 12.9 years. The good-QoL group had an average age of 46.9 ± 14.9 years. The total score of KDQoL-SF was 61.6%, while the scores for the physical and mental components were 39.3 ± 9.6 and 50.0 ± 10.6 respectively.Conclusion: This study indicated that the main factors that have a significant impact on the QoL were social status, origin, employment status, duration of the CKD, family history of kidney disease, time on HD, and Hypertension.

scholarly journals Somatic maturation and the relationship between bone mineral variables and types of sports among adolescents: cross-sectional study

2017 ◽  
Vol 135 (3) ◽  
pp. 253-259 ◽  
Author(s):  
Ricardo Ribeiro Agostinete ◽  
Igor Hideki Ito ◽  
Han Kemper ◽  
Carlos Marcelo Pastre ◽  
Mário Antônio Rodrigues-Júnior ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Peak Height ◽  
Cross Sectional Study ◽  
Height Velocity ◽  
Whole Body ◽  
Sectional Study ◽  
Peak Height Velocity ◽  
Mineral Density ◽  
Cross Sectional

ABSTRACT CONTEXT AND OBJECTIVE: Peak height velocity (PHV) is an important maturational event during adolescence that affects skeleton size. The objective here was to compare bone variables in adolescents who practiced different types of sports, and to identify whether differences in bone variables attributed to sports practice were dependent on somatic maturation status. DESIGN AND SETTING: Cross-sectional study, São Paulo State University (UNESP). METHODS: The study was composed of 93 adolescents (12 to 16.5 years old), divided into three groups: no-sport group (n = 42), soccer/basketball group (n = 26) and swimming group (n = 25). Bone mineral density and content were measured using dual-energy x-ray absorptiometry and somatic maturation was estimated through using peak height velocity. Data on training load were provided by the coaches. RESULTS: Adolescents whose PHV occurred at an older age presented higher bone mineral density in their upper limbs (P = 0.018). After adjustments for confounders, such as somatic maturation, the swimmers presented lower values for bone mineral density in their lower limbs, spine and whole body. Only the bone mineral density in the upper limbs was similar between the groups. There was a negative relationship between whole-body bone mineral content and the weekly training hours (β: -1563.967; 95% confidence interval, CI: -2916.484 to -211.450). CONCLUSION: The differences in bone variables attributed to sport practice occurred independently of maturation, while high training load in situations of hypogravity seemed to be related to lower bone mass in swimmers.

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