scholarly journals Determinants of the intensity of uremic pruritus in patients receiving maintenance hemodialysis: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245370
Author(s):  
Jian-Hui Zhao ◽  
Qiu-Shuang Zhu ◽  
Yi-Wen Li ◽  
Li-Li Wang

Background Uremic pruritus (UP) is a common and frustrating symptom in patients receiving hemodialysis (HD). The majority of patients have mild to moderate itching of the skin, and a small percentage have severe itching, which seriously affects their quality of life and survival rate. However, little is known about factors that influence the intensity of itching in patients. Methods A cross-sectional study on uremic pruritus in male and female patients receiving HD was conducted in September 2019. This study included 148 eligible patients who received HD at the Blood Purification Center of Xinchang County People’s Hospital, Zhejiang Province, China from March 2019 to June 2019. We collected general data consisted of age, sex, body mass index (BMI), place of residence, educational level, diabetes mellitus status and duration of HD; as well as clinical, biochemical indicators, including serum calcium (Ca), serum phosphorus (P), serum albumin (ALB), haemoglobin (Hb), serum intact parathyroid hormone (iPTH), pre-dialysis serum urea nitrogen (BUN), normalized protein catabolic rate (nPCR), urea nitrogen clearance index (KT/V), ferritin (FER) and pre-dialysis serum creatinine (sCR). We also assayed the inflammatory cytokine serum high sensitivity C-reactive protein (hs-CRP). The Five-Dimensional Itching Scale (5DIS) was used to evaluate the degree of skin itching (none, mild, moderate, or severe). We used multiple logistic regression to analyze influencing factors on the degree of skin itching in patients with UP. Results Of the 148 patients, 60 had uremic pruritus (incidence rate, 40.54%). These included 22 cases of mild skin itching (14.86%), 30 of moderate skin itching (20.27%), and 8 of severe skin itching (5.41%). Compared with uremia patients without skin pruritus, patients with UP had higher levels of iPTH, Hb, BUN, nPCR, and hs-CRP. The composition ratio showed significant differences between urban and rural patients with different degrees of skin itching (P = 0.017); moreover, the difference of iPTH and hs-CRP levels were statistically significant (P = 0.009 and < 0.001, respectively). Using no itching as a reference, multiple logistic regression analysis showed that as hs-CRP level increased, the patient’s risks of mild skin itching (odds ratio [OR] = 1.740; 95% confidence interval [CI], 1.061–2.854; P = 0.028), moderate skin itching (OR = 2.8838 95% CI, 1.744–4.718; P < 0.001), and severe skin itching (OR = 9.440; 95% CI, 3.547–25.124; P < 0.001) all increased as well. Compared with urban residents, rural residents have a higher risk of moderate itching (OR = 3.869; 95% CI, 1.099–13.622; P = 0.035). Conclusion Levels of hs-CRP were associated with the intensity of skin itching in patients with UP. Higher hs-CRP levels were closely related to severe skin itching. The relationship between the intensity of skin itching and the environment in maintenance hemodialysis patients needs further clarification.

Children ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 6
Author(s):  
Jie Xu ◽  
Lingxiao Tong ◽  
Jianhua Mao

Background: Hyperuricemia is increasingly recognized as a risk factor for chronic kidney disease (CKD) just in adults. The purpose of this study was to investigate the clinical characteristics of hyperuricemia and its associated factors in Chinese children with CKD at a single center. Methods: A cross-sectional study of 170 CKD children collected from the Department of Nephrology, The Zhejiang University Children’s Hospital was conducted. The clinical data, including anthropometric data, blood pressure measurements, and biochemical parameters, were recorded and analyzed retrospectively. The factors associated with hyperuricemia in CKD children were evaluated by Pearson and Spearman correlation analysis and multiple logistic regression analysis. Results: The mean age was 9.79 ± 4.10 years, and 72 (42.35%) were girls. Higher blood urea nitrogen (BUN), serum creatinine, cystatin C, D-dimer, lower hemoglobin, albumin, and estimated glomerular filtration rate (eGFR) were significantly associated with higher serum uric acid (SUA). In multiple logistic regression analysis, anemia and higher BUN were both positively associated factors, whereas eGFR ≥ 90 mL/min/1.73 m2 was a negatively associated factor for subjects with SUA ≥ 390 µmol/L (6.5 mg/dL). Conclusions: SUA was significantly associated with kidney risk factors in CKD children. Monitoring and controlling SUA, Hb, BUN, and Scr levels in CKD children may help to prevent the progression of CKD.


2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva Olga Melin ◽  
Magnus Hillman ◽  
Maria Thunander ◽  
Mona Landin-Olsson

Abstract Background Abdominal obesity is a risk factor for cardiovascular disease. The aim was to explore the influence of midnight salivary cortisol (MSC), antidepressants and sex on abdominal obesity in type 1 diabetes (T1D). We controlled for physical inactivity, smoking, depression and alexithymia. Methods Cross sectional study of 190 T1D patients (86 women/104 men, 18–59 years, diabetes duration 1–55 years), consecutively recruited from one specialist diabetes outpatient clinic. Anthropometrics, blood pressure, saliva and blood samples were collected, supplemented with data from electronic medical records. Depression and alexithymia were assessed by self-report instruments. MSC (nmol/l) was categorised into 3 levels: high MSC: (≥ 6.7) (n = 64); intermediate MSC: ≥ 3.7− < 6.7) (n = 64); low MSC (< 3.7) (n = 62). Abdominal obesity was defined as waist circumference (meters) ≥ 0.88 for women and as ≥ 1.02 for men. Multiple logistic regression analyses (Backward: Wald) were performed. The Hosmer and Lemeshow test for goodness-of-fit and Nagelkerke R2 were used to evaluate each multiple logistic regression analysis model. Results The prevalence of abdominal obesity was three times higher in the women than in the men (24% versus 8%) (p = 0.002). Antidepressants were used by 10% of the women and by 4% of the men (p = 0.09). The prevalence of high MSC was 1.7 times higher in the women (43% versus 26%); the prevalence of both intermediate MSC (28% versus 38%) and low MSC (29% versus 36%) were lower in the women (p = 0.048). Significant associations with abdominal obesity were for all 190 patients: female sex (adjusted odds ratio (AOR) 3.4 (confidence interval (CI) 1.4–8.2)) and the use of antidepressants (AOR 4.3 (CI 1.2–14.8)); for the 86 women: high MSC (AOR 18.4 (CI 1.9–181)) and use of antidepressants (AOR 12.2 (CI 2.0–73.6)); and for the 104 men: alexithymia (AOR 5.2 (CI 1.1–24.9)). Conclusions Clear sex differences were demonstrated with a distinct higher prevalence of abdominal obesity, as well as a distinct higher prevalence of high midnight salivary cortisol in the women with type 1 diabetes. High midnight salivary cortisol secretion and the use of antidepressants were independent risk factors for abdominal obesity in the women.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031660 ◽  
Author(s):  
Yen-An Lin ◽  
Ying-Jen Chen ◽  
Yu-Chung Tsao ◽  
Wei-Chung Yeh ◽  
Wen-Cheng Li ◽  
...  

ObjectiveObesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan.DesignCross-sectional observational study.SettingCommunity-based investigation in Guishan Township of northern Taiwan.ParticipantsA total of 396 people were recruited from a northern Taiwan community for a cross-sectional study. Anthropometrics and blood pressure were measured at the annual health exam. The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).Outcome measuresStatistical analyses, including Pearson’s correlation, multiple logistic regression and the area under ROC curves (AUCs) between HTN and anthropometric measurements, were used in this study.ResultsOf the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.ConclusionsWC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount.


2020 ◽  
Author(s):  
Guangming Dai ◽  
Yajuan Ran ◽  
Jiajia Wang ◽  
Xingru Chen ◽  
Junnan Peng ◽  
...  

Abstract Background AECOPD is highly heterogeneous with respect to etiology and inflammation. COPD with higher blood eosinophils is associated with increased readmission rates and better corticosteroid response. However, the clinical features of eosinophilic AECOPD aren’t well explored. Then, the aim of this study was to investigate the clinical differences between eosinophilic and non-eosinophilic AECOPD. Methods A total of 643 AECOPD patients were enrolled in this multicenter cross-sectional study. Finally, 455 were included, 214 in normal eosinophils AECOPD (NEOS-AECOPD) group, 63 in mild increased eosinophils AECOPD (MEOS-AECOPD) group, and 138 in severe increased eosinophils AECOPD (SEOS-AECOPD) group. Then, demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistic regression was performed to identify the independent factors associated with blood EOS. Correlations between blood EOS and its associated independent factors were evaluated. Results The significant differences in 19 factors, including underlying disease, clinical symptom, and laboratory parameters, were identified by univariate analysis. Subsequently, multiple logistic regression revealed that lymphocytes%, neutrophils% (NS%), procalcitonin (PCT), and anion gap (AG) were associated with blood EOS in AECOPD. Both blood EOS counts and EOS% significantly correlated with lymphocytes%, NS%, PCT, and AG. Conclusions The blood EOS was independently associated with lymphocytes%, NS%, PCT, and AG in AECOPD patients. Lymphocytes% was lower, and, NS%, PCT, and AG were higher in eosinophilic AECOPD. Our results indicate that viral dominant infections probably were the major etiology of eosinophilic AECOPD. Non-eosinophilic AECOPD was more likely associated with bacterial dominant infections. The systemic inflammation in non-eosinophilic AECOPD was more severe.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Guangming Dai ◽  
Yajuan Ran ◽  
Jiajia Wang ◽  
Xingru Chen ◽  
Junnan Peng ◽  
...  

Rationale. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is highly heterogeneous with a plethora of different etiologic factors and inflammatory presentations. COPD with higher blood eosinophil count is associated with increased readmission rates and better corticosteroid responses. However, the clinical features of eosinophilic AECOPD are not well explored. Thus, this study was aimed at exploring the clinical differences between eosinophilic and noneosinophilic AECOPD. Methods. A total of 643 AECOPD patients were enrolled in this multicenter cross-sectional study. Finally, 455 were included, 214 in the normal-eosinophil AECOPD (NEOS-AECOPD) group, 63 in the mild increased-eosinophil AECOPD (MEOS-AECOPD) group, and 138 in the severe increased-eosinophil AECOPD (SEOS-AECOPD) group. Demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistic regression analysis was performed to identify the independent factors associated with blood eosinophils (EOS). Correlations between blood EOS and its associated independent factors were evaluated. Results. The significant differences in 19 factors, including underlying diseases, clinical symptoms, and laboratory parameters, were identified by univariate analysis. Subsequently, multiple logistic regression analysis revealed that lymphocyte%, neutrophil% (NS%), procalcitonin (PCT), and anion gap (AG) were independently associated with blood EOS in AECOPD. Both blood EOS counts and EOS% were significantly correlated with lymphocyte%, NS%, PCT, and AG. Conclusions. Collectively, blood EOS was independently associated with lymphocyte%, NS%, PCT, and AG in AECOPD patients. Lymphocyte% was lower, and NS%, PCT, and AG were higher in eosinophilic AECOPD. Our results indicate that viral-dominant infections are the probable major etiologies of eosinophilic AECOPD. Noneosinophilic AECOPD is more likely associated with bacterial-dominant infections. The systemic inflammation in noneosinophilic AECOPD was more severe.


2008 ◽  
Vol 21 (4) ◽  
pp. 393-399 ◽  
Author(s):  
Rita de Cássia Ribeiro Silva ◽  
Ana Marlucia Oliveira Assis

OBJECTIVE: This study aims to assess the association between geohelminth infections and the physical growth of schoolchildren. METHODS: This is a cross-sectional study with the participation of 1861 children aging from 7 to 14 years who live in a municipality in the Southern region (Recôncavo) of the State of Bahia. The participants were submitted to anthropometric assessment and stool tests. Multiple logistic regression analysis was used as the statistical means to determine the association of interest. RESULTS: The risks of stunting were greater among boys with Ascaris lumbricoides (Odds ratio=1.79; confidence interval 95%: 1.07-3.01), Trichuris trichiura (Odds ratio=2.26; confidence interval 95%: 1.33-3.84) and ancylostomiasis (Odds ratio=2.18; confidence interval 95%: 1.28-3.73) when compared with non-infected children. These results remained unchanged after adjustments for the location of the school, children's ages and other geohelminth infections. CONCLUSION: These infections did not compromise girls´ growth. These results emphasize the association between geohelminth infection and linear physical growth, indicating the need to implement preventive and curative measures that allow the quality of life of the children to improve since the repercussion that these parasites have on the nutritional status and health of this population is severe.


2020 ◽  
Vol 19 (2) ◽  
Author(s):  
Said AH ◽  
Yusof MZ ◽  
Mohd FN ◽  
Azmi MANH ◽  
Mohd Hanapiah H ◽  
...  

INTRODUCTION: Poor sleep quality is a common problem experienced by medical students worldwide. Therefore, this study aimed to measure the prevalence of poor sleep quality among medical students in International Islamic University Malaysia (IIUM) and its association with mental health and other factors. MATERIALS AND METHODS: A cross-sectional study using convenience sampling was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire including sociodemographic, socioeconomic, lifestyle, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Score 21 was distributed from 15th July to 31st August 2019. Descriptive statistics were used to measure the prevalence of poor sleep quality. Chi- square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to measure the association between risk factors and sleep quality. RESULT: The response rate was 91.2%. The prevalence of poor sleep quality was 59.6%. Multiple logistic regression analysis revealed level of study (clinical year (AOR=0.44, 95% CI: 0.29 - 0.66) and depression (yes (AOR: 1.71, 95% CI 1.03-2.83) contributed independently on poor sleep quality among medical students. There was no significant relationship between tahajjud practice and poor sleep quality. CONCLUSION: More than half of IIUM medical students have poor sleep quality. Those students who were in the pre-clinical year and had depression were independently associated with the occurrence of poor sleep quality. Early intervention is compulsory to overcome this problem among medical students in IIUM.  


2014 ◽  
Vol 12 (2) ◽  
pp. 179-183 ◽  
Author(s):  
MAH Mondal ◽  
MS Parvin ◽  
SC Sarker ◽  
AKMA Rahman ◽  
MT Islam

Bovine tuberculosis (bTB) is a disease of zoonotic importance as well as high priority all over the world. Risk factors for bovine tuberculosis in cattle are not well investigated in Bangladesh. Therefore, the objective of this study was to identify the associated risk factors for bTB along with determination of prevalence in cattle of Mymensingh Sadar. A cross-sectional study was carried out to elucidate on 101 cattle from 56 households during January to May 2012. The direct interview using a questionnaire and physical examination of cattle was performed to collect farm and animal level data. Besides data collection, blood samples were collected from study cattle and subjected to immunochromatographic assay (ICGA) by using Anigen Rapid Bovine TB Ab test kit for the diagnosis of bTB. Risk factors analysis was done using bivariable followed by multiple logistic regression with stepwise backward elimination method. The results of the study revealed an overall tuberculosis prevalence of 5.9%. Multiple logistic regression analysis revealed significant association of bovine tuberculosis with herd size (more than 4) (Odds Ratio, OR = 5.9, p = 0.03) and history of coughing (OR = 8.9, p = 0.005). The effect of herd size (more than 4) could be minimized by maintaining the cattle in a herd with adequate floor space and better ventilation facilities as it would not be practicable to keep the herd size minimum. Further study should be done to find out more associated risk factors for the occurrence of bTB.DOI: http://dx.doi.org/10.3329/bjvm.v12i2.21283 Bangl. J. Vet. Med. (2014). 12 (2): 179-183 


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Cheng-Yu Wei ◽  
Chia-Cheng Sun ◽  
James Cheng-Chung Wei ◽  
Hsu-Chih Tai ◽  
Chien-An Sun ◽  
...  

The increasing prevalence of metabolic syndrome (MetS) has become an important issue worldwide. Metabolic comorbidities of hypertension, obesity, and hyperlipidemia are shown as important risk factors for incident gout. The purpose of this study was to investigate the relationship between hyperuricemia and MetS. This is a cross-sectional study. The effective sample included 21,544 individuals who received worker health examinations at a local teaching hospital in Changhua County from 2008~2012. We used multiple logistic regression analysis to investigate the influences of hyperuricemia on MetS. The results showed that individuals with MetS had significantly higher blood pressure, fasting plasma glucose, triglycerides, waist circumference, and high-density lipoprotein cholesterol than those without MetS(P<0.001). Multiple logistic regression analysis revealed hyperuricemia to be an important factor of MetS. The risk of developing MetS is higher with high levels of serum uric acid (SUA) and the odds ratio (OR) of having MetS is 4.98 times higher for Tertile 3 than for Tertile 1 (95% CI = 4.16–5.97) and 4 times higher for Quartile 4 than for Quartile 1 (95% CI = 3.59–4.46). In conclusion, males are more likely to develop MetS than females, and the risk of having MetS increases with age and SUA concentration.


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