scholarly journals Management of Protein and Energy Intake in Dialysis Patients

1999 ◽  
Vol 10 (10) ◽  
pp. 2244-2247
Author(s):  
MARSHA WOLFSON

Abstract. Malnutrition is not uncommon in patients with end-stage renal disease treated with maintenance dialysis. The presence of several abnormal parameters of nutritional status are reported to be predictive of poorer outcomes in these patients, compared to dialysis patients without evidence of malnutrition. This article describes methods that may be used to recognize the presence of malnutrition in end-stage renal disease patients and the management of protein and energy intake. Whether the correction of malnutrition will improve outcomes, such as morbidity and mortality, is unknown.

2019 ◽  
Vol 3 (1) ◽  
pp. 9-12
Author(s):  
Chang-Li Xu ◽  
Hui Xu ◽  
Jin-Qi Song ◽  
Ya-Nan Zhou

Introduction: The research in the past ten years shows that the incidence of malignant tumors in dialysis patients is significantly higher than that in normal people. The highest proportion of urinary tumors is one of the main causes of death in patients with end-stage renal disease, and the incidence is gradually increasing. However, the high-risk factors of urinary tract tumors in dialysis patients have not yet been fully elucidated, so exploring this issue is an important issue that the medical community needs to solve. The objectives of this study are to understand the clinical characteristics of maintenance dialysis patients with urinary tract tumors and the influence of related factors on their prognosis. Methods: The clinical data of 22 patients with urinary tract tumors in maintenance dialysis (MHD) from the Affiliated Hospital of Chengde Medical College from January 2013 to June 2018 were retrospectively analyzed. The incidence of urinary tumors and clinical diagnosis and treatment were investigated. And prognosis, analysis of the impact of various relevant factors on the overall survival of patients with dialysis and urinary tumors. Results: The 912 patients with maintenance dialysis, 22 patients had urinary tumors with an incidence of 2.41%. Among them, 13 patients were bladder tumors, 7 patients were renal or ureteral tumors, 1 patient was renal tumor, and 1 patient was prostate cancer. There were 17 cases of intermittent and painless gross hematuria, 2 cases of gross hematuria, 1 case of lumbar pain, 1 case of abdominal pain and dysuria, 1 case of frequent urination and dysuria. Ten patients underwent surgery, and 4 patients died. The postoperative survival of the patients was 12~103 months, with an average of 58.75 months. 12 patients were unable to undergo surgery because of other diseases or economic reasons; in 9 the disease was found during autopsy. The time from tumor to death was 14~38 months, with an average of 24.11 months. The causes of death in 13 death patients: 5 patients were myocardial infarction, 3 patients were heart failure, 3 patients were tumor metastasis, and severe sepsis in 2 patients. Conclusion: There is increased propensity of GU tumors in maintenance dialysis patients. The tumors are of higher grade and demonstrate poor prognosis. Therefore, attention should be paid to the monitoring of urinary tract tumors in maintenance dialysis patients, especially elderly patients without cardiovascular and cerebrovascular complications, because their life expectancy can be longer.


2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Ahad Qayyum

Pakistan has an estimated population of 212 million while the incidence of end stage renal disease in Pakistan is 100 patients per million; hence approximately 22,000 patients require maintenance dialysis to sustain life in our country. Remarkably peritoneal dialysis (PD) as a form of maintenance renal replacement is utilized in less than one per cent of these patients.  In the absence of a formal dialysis registry, we place the total number of chronic ambulatory peritoneal dialysis patients (CAPD) in Pakistan at approximately 76 excluding holiday patients who are visiting from abroad (*This figure was estimated by enquiring the total number of patients each PD units care in Pakistan. This figure was corroborated with the sole distributor of CAPD fluids in Pakistan.).


Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.


2005 ◽  
Vol 23 (5) ◽  
pp. 384-393 ◽  
Author(s):  
Yukio Maruyama ◽  
Louise Nordfors ◽  
Peter Stenvinkel ◽  
Olof Heimbürger ◽  
Peter Bárány ◽  
...  

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 113-117
Author(s):  
Salahuddin Feroz ◽  
Shah Md Zakir Hossain ◽  
Rafi Nazrul Islam ◽  
Amir Mohammad Kaiser ◽  
Miliva Mozaffor ◽  
...  

Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117


Nutrients ◽  
2018 ◽  
Vol 10 (4) ◽  
pp. 425 ◽  
Author(s):  
Dinorah Carrera-Jiménez ◽  
Paola Miranda-Alatriste ◽  
Ximena Atilano-Carsi ◽  
Ricardo Correa-Rotter ◽  
Ángeles Espinosa-Cuevas

2018 ◽  
pp. 594-614
Author(s):  
Eric K. Hoffer

Interventional radiologists developed and refined the endovascular approaches to maintenance of the permanent arteriovenous vascular accesses that are integral to the provision of hemodialysis for patients with end stage renal disease. As methods of percutaneous arteriovenous fistula creation expand the scope of IR, this chapter reviews the clinical indications and preferences pertinent to dialysis access creation with respect to National Kidney Foundation Recommendations. Accesses remain imperfect, plagued by the development of flow-limiting intimal hyperplastic stenoses, and require monitoring and maintenance to minimize complications, morbidity and mortality. The measures of dialysis access function used in the surveillance of vascular accesses that indicate potential stenosis, and the utility of pre-occlusion recanalization of these stenoses are discussed. Complications specific to dialysis access interventions are also addressed.


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