scholarly journals The relationship between anemia and Kt/V index in patients undergoing continuous ambulatory peritoneal dialysis and hemodialysis

2019 ◽  
Vol 9 (1) ◽  
pp. 06-06
Author(s):  
Boshra Hasanzamani ◽  
Mahin Ghorban Sabbagh
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Hemoglobin Concentration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Introduction: Anemia in end-stage renal disease (ESRD) can cause serious problems for patients. Objectives: The present study was conducted to investigate whether the type or adequacy of dialysis can affect the incidence of anemia in these patients. Patients and Methods: This cross-sectional study was conducted on 57 patients with ESRD, who were referred to Qaem and Imam Reza hospitals, Mashhad, Iran. The patients were divided into two groups of continuous ambulatory peritoneal dialysis (CAPD) (n=37 patients) and hemodialysis (n=20 patients). Patients had no laboratory evidence of iron deficiency or hyperparathyroidism. Enrolled patients were received vitamin B12 and folic acid too. Hemoglobin concentration of under 11 mg/dL was considered as anemia. Adequacy of dialysis was evaluated by Kt/V index (>1.2 for hemodialysis and >1.7 per week for peritoneal dialysis). We compared different factors in these two groups, including anemia and Kt/V, and evaluated their relationship. Results: Around 27% and 65% of the patients on CAPD and hemodialysis were anemic respectively (P=0.005). Adequacy of dialysis in CAPD was acceptable in 81.1% of the cases, while target Kt/V was achieved in 50% of the patients on hemodialysis. Dialysis adequacy was significantly higher in patients receiving CAPD (P=0.014). No significant correlation between the incidence of anemia and Kt/V in both types of dialysis was found (P>0.05). Conclusion: Anemia was mostly observed in patients receiving hemodialysis as compared to CAPD. Regardless of the type of dialysis, adequacy of dialysis did not affect the incidence of anemia in any of the groups.

scholarly journals Shortened red blood cell age in patients with end-stage renal disease who were receiving haemodialysis: a cross-sectional study

2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Cell ◽  
Renal Disease ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: The causes of anaemia in patients with end-stage renal disease include a relative deficiency in erythropoietin production and complex clinical conditions. We aimed to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease who were undergoing maintenance dialysis by measuring erythrocyte creatine levels.Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease who were receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine level, a quantitative marker of mean red blood cell (RBC) age, was measured.Results: The mean RBC age was significantly shorter in the haemodialysis group than in the peritoneal dialysis group (47.7 days vs. 59.8 days, p<0.0001), although the haemoglobin levels were comparable between the groups. A Spearman correlation coefficient analysis revealed that shortened RBC age positively correlated with transferrin saturation (r = 0.54), ferritin level (r= 0.47), and haptoglobin level (r = 0.39) but inversely related with reticulocyte (r = −0.36), weekly doses of erythropoiesis-stimulating agents (ESAs; r = −0.62), erythropoietin resistance index (r = −0.64), and intradialytic ultrafiltration rate (r = −0.32).Conclusions: Shortened RBC age was observed in patients who were receiving maintenance haemodialysis and was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness, as well as with greater intradialytic fluid extraction.

scholarly journals Shortened red blood cell age in patients with end-stage renal disease who were receiving haemodialysis: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Cell ◽  
Renal Disease ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background The causes of anaemia in patients with end-stage renal disease include a relative deficiency in erythropoietin production and complex clinical conditions. We aimed to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease who were undergoing maintenance dialysis by measuring erythrocyte creatine levels. Methods In a cross-sectional study, we evaluated 69 patients with end-stage renal disease who were receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine level, a quantitative marker of mean red blood cell (RBC) age, was measured. Results The mean RBC age was significantly shorter in the haemodialysis group than in the peritoneal dialysis group (47.7 days vs. 59.8 days, p < 0.0001), although the haemoglobin levels were comparable between the groups. A Spearman correlation coefficient analysis revealed that shortened RBC age positively correlated with transferrin saturation (r = 0.54), ferritin level (r = 0.47), and haptoglobin level (r = 0.39) but inversely related with reticulocyte (r = − 0.36), weekly doses of erythropoiesis-stimulating agents (ESAs; r = − 0.62), erythropoietin resistance index (r = − 0.64), and intradialytic ultrafiltration rate (r = − 0.32). Conclusions Shortened RBC age was observed in patients who were receiving maintenance haemodialysis and was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness, as well as with greater intradialytic fluid extraction.

scholarly journals Haemolysis in Patients with End-Stage Renal Disease Receiving Haemodialysis: A Cross-Sectional Study

2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Resistance Index ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maintenance Haemodialysis ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Haemolysis due to mechanical stress on red blood cells (RBCs) during extracorporeal circulation has been reported in patients receiving haemodialysis. However, little is known about the incidence of, and the mechanisms underlying haemolysis in patients receiving maintenance haemodialysis. We sought to investigate the incidence and underlying mechanisms of haemolysis in patients with end-stage renal disease undergoing maintenance dialysis by measuring erythrocyte creatine.Method: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine, a quantitative marker of mean RBC age, was measured with other haemolytic markers including haptoglobin, reticulocyte count and lactate dehydrogenase.Results: RBC age was significantly shorter [47.7 (43.2–52.8) days vs. 59.8 (56.0–66.2) days, p<0.0001], and haptoglobin was significantly lower in haemodialysis patients than in those with peritoneal dialysis, although haemoglobin levels were comparable in the two groups. When haemodialysis patients were stratified by median RBC age (47.7 days), patients with shortened RBC age had higher intradialytic ultrafiltration rates, larger erythropoiesis-stimulating agent doses, and a higher erythropoietin resistance index compared to that of those with preserved RBC age.Conclusions: Haemolysis exists in patients receiving maintenance haemodialysis, especially in those with greater intradialytic fluid extraction.

scholarly journals Shortened red blood cell age in patients with end-stage renal disease who were receiving haemodialysis: a cross-sectional study

2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Cell ◽  
Renal Disease ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: The causes of anaemia in patients with end-stage renal disease include a relative deficiency in erythropoietin production and complex clinical conditions. We aimed to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease who were undergoing maintenance dialysis by measuring erythrocyte creatine levels.Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease who were receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine level, a quantitative marker of mean red blood cell (RBC) age, was measured.Results: The mean RBC age was significantly shorter in the haemodialysis group than in the peritoneal dialysis group (47.7 days vs. 59.8 days, p<0.0001), although the haemoglobin levels were comparable between the groups. A Spearman correlation coefficient analysis revealed that shortened RBC age positively correlated with transferrin saturation (r = 0.54), ferritin level (r= 0.47), and haptoglobin level (r = 0.39) but inversely related with reticulocyte (r = −0.36), weekly doses of erythropoiesis-stimulating agents (ESAs; r = −0.62), erythropoietin resistance index (r = −0.64), and intradialytic ultrafiltration rate (r = −0.32).Conclusions: Shortened RBC age was observed in patients who were receiving maintenance haemodialysis and was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness, as well as with greater intradialytic fluid extraction.

scholarly journals Shortened red blood cell age in patients with end-stage renal disease receiving haemodialysis: a cross-sectional study

2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Cell ◽  
Renal Disease ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Cause of anaemia in end-stage renal disease is not only due to relative deficiency in erythropoietin production, but also to the complex clinical conditions. We sought to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease undergoing maintenance dialysis by measuring erythrocyte creatine.Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine, a quantitative marker of mean red blood cell (RBC) age, was measured.Results: Mean RBC age was significantly shorter in haemodialysis patients than in those with peritoneal dialysis (47.7 days vs. 59.8 days, p<0.0001), although haemoglobin levels were comparable between the groups. Spearman correlation coefficient analysis revealed that transferrin saturation (r = 0.54), ferritin (r= 0.47), and haptoglobin (r = 0.39) were positively, whereas reticulocyte (r = -0.36), weekly dose of erythropoiesis-stimulating agent (r = -0.62), erythropoietin resistance index (r = -0.64), and intradialytic ultrafiltration rate (r = -0.32) were inversely related to shortened RBC age.Conclusions: Shortened RBC age was observed in patients receiving maintenance haemodialysis. Shortened RBC age was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness as well as greater intradialytic fluid extraction.

scholarly journals Peritoneal Microbiome in End-Stage Renal Disease Patients and the Impact of Peritoneal Dialysis Therapy

2020 ◽  
Vol 8 (2) ◽  
pp. 173
Author(s):  
Liliana Simões-Silva ◽  
Ricardo Araujo ◽  
Manuel Pestana ◽  
Isabel Soares-Silva ◽  
Benedita Sampaio-Maia
Keyword(s):  
Peritoneal Dialysis ◽  
Human Microbiome ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peritoneal Tissue ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Factors influencing the occurrence of peritoneal dialysis (PD)-related infections are still far from fully understood. Recent studies described the existence of specific microbiomes in body sites previously considered microbiome-free, unravelling new microbial pathways in the human body. In the present study, we analyzed the peritoneum of end-stage kidney disease (ESKD) patients to determine if they harbored a specific microbiome and if it is altered in patients on PD therapy. We conducted a cross-sectional study where the peritoneal microbiomes from ESKD patients with intact peritoneal cavities (ESKD non-PD, n = 11) and ESKD patients undergoing PD therapy (ESKD PD, n = 9) were analyzed with a 16S rRNA approach. Peritoneal tissue of ESKD patients contained characteristically low-abundance microbiomes dominated by Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. Patients undergoing PD therapy presented lower species richness, with dominance by the Pseudomonadaceae and Prevotelaceae families. This study provides the first characterization of the peritoneal microbiome in ESKD patients, bringing new insight to the human microbiome. Additionally, PD therapy may induce changes in this unique microbiome. The clinical relevance of these observations should be further explored to uncover the role of the peritoneal microbiome as a key element in the onset or aggravation of infection in ESKD patients, especially those undergoing PD.

Clinical Utility of Potassium-Sparing Diuretics to Maintain Normal Serum Potassium in Peritoneal Dialysis Patients

2017 ◽  
Vol 37 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Tibor Fülöp ◽  
Lajos Zsom ◽  
Betzaida Rodríguez ◽  
Sabahat Afshan ◽  
Jamie V. Davidson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Potassium ◽  
Residual Renal Function ◽  
Normal Serum ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Laboratory Variables ◽  
Stage Renal Disease ◽  
End Stage ◽  
Vexing Problem

BackgroundHypokalemia is a vexing problem in end-stage renal disease patients on peritoneal dialysis (PD), and oral potassium supplements (OPS) have limited palatability. Potassium-sparing diuretics (KSD) (spironolactone, amiloride) may be effective in these patients.MethodsWe performed a cross-sectional review of 75 current or past (vintage > 6 months) PD patients with regard to serum potassium (K+), OPS, and KSD utilization. We reviewed charts for multiple clinical and laboratory variables, including dialysis adequacy, residual renal function, nutritional status and co-existing medical therapy.ResultsThe cohort was middle-aged with a mean age of 49.2 years (standard deviation [SD] = 14.7) and overweight with a body mass index of 29.5 (6.7) kg/m2. Of all the participants, 57.3% were female, 73.3% African-American, and 48% diabetic with an overall PD vintage of 28.2 (24.3) months at the time of enrollment. Weekly Kt/V was 2.12 (0.43), creatinine clearance was 73.5 (33.6) L/week/1.73 m2with total daily exchange volume of 10.8 (2.7) L. Residual urine output (RUO) measured at 440 (494) mL (anuric 30.6%). Three-month averaged serum K+measured at 4 (0.5) mmol/L with 36% of the participants receiving K+supplements (median: 20 [0;20] mmol/day) and 41.3% KSD (spironolactone dose: 25 – 200 mg/day; amiloride dose: 5 – 10 mg/day). Serum K+correlated positively with weekly Kt/V (r = 0.239; p = 0.039), PD vintage (r = 0.272; p = 0.018) but not with PD modality, daily exchange volume, RUO, or KSD use. However, KSD use was associated with decreased use of OPS (r = -0.646; p < 0.0001).ConclusionsPotassium-sparing diuretics were effective in this cohort of PD patients and decreased the need for OPS utilization.

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