Lower-Extremity Peripheral Arterial Disease among Patients with End-Stage Renal Disease

ABSTRACT. Peripheral arterial occlusive disease (PAOD) accounts for significant morbidity and mortality among end-stage renal disease (ESRD) patients but has not been as extensively studied as other kinds of atherosclerotic disease in this population. The current epidemiology and management of PAOD in ESRD patients is here reviewed and target areas for future research are identified. The prevalence of PAOD appears to be much higher among ESRD patients than in the general population. Risk factors for disease among ESRD patients are not well understood but probably include both conventional and dialysis or uremia-associated risk factors. Standard diagnostic techniques used to identify PAOD in the general population may not be as helpful in ESRD patients because many of these tests are inaccurate in the settings of vascular calcification and small-vessel disease. Despite the fact that this is a common disease in ESRD patients, most of these patients are not screened for PAOD. Interventions that have proven effective in the prevention and treatment of PAOD in the general population, such as smoking cessation, preventive foot care, and exercise, have not been systematically applied to ESRD patients. Furthermore, the optimal management of ischemic ulceration and gangrene in ESRD patients is quite controversial, and better algorithms for the prevention and management of PAOD in ESRD patients are needed. In conclusion, PAOD is common in ESRD patients. Future research should identify risk factors for disease in this population, and efforts should be made to develop strategies for the effective prevention and management of limb ischemia in this population.

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Incidence, risk factors and distribution of syphilis in the end-stage renal disease population in the USA

Clinical Kidney Journal ◽

10.1093/ckj/sfz090 ◽

2019 ◽

Vol 13 (4) ◽

pp. 625-630

Author(s):

Erena N Weathers ◽

Jennifer L Waller ◽

N Stanley Nahman ◽

Rhonda E Colombo ◽

Mufaddal F Kheda ◽

...

Keyword(s):

Risk Factors ◽

Renal Disease ◽

End Stage Renal Disease ◽

The United States ◽

Transmitted Infection ◽

Sexually Transmitted ◽

The Usa ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background Syphilis is a sexually transmitted infection with an incidence of 14.9 cases per 100 000 persons in the USA in 2011. Untreated syphilis may remain quiescent for years but can also result in clinical sequelae, including neurosyphilis. End-stage renal disease (ESRD) patients may be at risk for syphilis due to a higher incidence of risk factors for the disease, including human immunodeficiency virus (HIV). Despite the presence of these risk factors, the incidence of syphilis in the ESRD population has not been reported. To address this issue, we investigated the incidence and risk factors for syphilis in the ESRD population using the United States Renal Data System (USRDS). Methods This study analyzed incident ESRD patients from 2004 to 2010. Based on International Classification of Diseases, Ninth Revision codes for syphilis, we determined the incidence and risk factors for syphilis following an inpatient diagnosis. Generalized linear modeling was used to examine the relative risk (RR) for the disease when controlling for demographic and other clinical risk factors. Results A total of 383 diagnoses of syphilis were identified after screening 759 066 patients. The 8-year incidence of any type of syphilis was 50.45 cases per 100 000 person-years. Other unspecified syphilis (29.77 cases per 100 000 person-years) and neurosyphilis (10.93 cases per 100 000 person-years) were the most common diagnoses. The greatest incidence was found on the East and West Coasts. Patients with the disease were younger and more likely to be black and non-Hispanic. In the final model, the adjusted RR for syphilis was significantly increased with HIV (7.61), hepatitis C (3.57), herpes simplex (2.06) and hepatitis B (1.75). Conclusions The incidence of syphilis is >3-fold greater in ESRD patients when compared with the general population and is associated with sexually transmitted viral infections. Neurosyphilis is a common occurrence and is treatable, suggesting that all assessments of confusion in dialysis patients should include screening for the disease.

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Incidence and risk factors for HPV-associated cancers in women with end-stage renal disease

Journal of Investigative Medicine ◽

10.1136/jim-2019-001262 ◽

2020 ◽

Vol 68 (5) ◽

pp. 1002-1010

Author(s):

Joan Han ◽

Jennifer L Waller ◽

Rhonda E Colombo ◽

Vanessa Spearman ◽

Lufei Young ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

General Population ◽

Renal Disease ◽

End Stage Renal Disease ◽

Dialysis Patients ◽

Herpes Infection ◽

Factors Associated ◽

Stage Renal Disease ◽

End Stage

Human papillomavirus (HPV) causes the majority of cervical, anal/rectal, and oropharyngeal cancers in women. End-stage renal disease (ESRD) is also associated with an increased risk of malignancy, but the incidence of and risk factors for HPV-associated cancers in US dialysis patients are not defined. We queried the US Renal Data System for women with HPV-associated cancers and assessed for incidence of cancer diagnosis and association of risk factors. From 2005 to 2011, a total of 1032 female patients with ESRD had 1040 HPV-associated cancer diagnoses. Patients had a mean age of 65 years, were mostly white (63%), and on hemodialysis (92%). Cervical cancer (54%) was the most common, followed by anal/rectal (34%), and oropharyngeal (12%). The incidence of HPV-associated cancers in patients with ESRD increased yearly, with up to a 16-fold increased incidence compared with the general population. Major risk factors associated with the development of any HPV-associated cancer included smoking (adjusted relative risk=1.89), alcohol use (1.87), HIV (2.21), and herpes infection (2.02). Smoking, HIV, and herpes infection were prominent risk factors for cervical cancer. The incidence of HPV-associated cancers in women with ESRD is rising annually and is overall higher than in women of the general population. Tobacco use is a universal risk factor. For cervical cancer, the presence of HIV and herpes are important comorbidities. Recognizing risk factors associated with these cancers may improve diagnosis and facilitate survival. The role of HPV vaccination in at-risk dialysis patients remains to be defined but warrants further study.

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Apoprotein(A) Isoforms Risk Factors for Atherogenesis in Esrd Patients on Haemodialysis

Macedonian Medical Review ◽

10.2478/mmr-2014-0003 ◽

2014 ◽

Vol 68 (1) ◽

pp. 16-20

Author(s):

Danica Labudovic ◽

Katerina Tosheska-Trajkovska ◽

Sonja Alabakovska

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Renal Disease ◽

Vascular Disease ◽

End Stage Renal Disease ◽

Relative Risks ◽

Increased Risk ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Introduction. End-stage renal disease (ESRD) patients undergoing hemodialysis are at an increased risk of arteriosclerotic vascular disease (ASVD). The increased risk is commonly attributed to the traditional risk factors related to ESRD. However, interest for more recent risk factors for ASVD, such as the level of lipoprotein(a) and its specific apoprotein(a) has been promoted. The aim of this paper is to determine whether apo(a) phenotype is a risk factor for arteriosclerotic vascular disease in ESRD patients who are on hemodialysis. Methods. Apo(a) phenotypisation was performed by using the Western Blot Technique of blood samples from 96 end-stage renal disease patients who were undergoing hemodialysis, and from 100 healthy individuals. Results. Frequency distribution of the basic apo(a) isoforms calculated by means of the χ2-test has shown that there was no significant statistical difference in distribution among patients on hemodialysis, and healthy carriers (χ2-0.36, p<0.548-for carriers of single apo(a) isoforms, (χ2-0.10, p<0.7545-for carriers of double apo(a) isoforms). The calculated relative risks have demonstrated that apo(a) phenotype was not a risk factor for ASVD in HD patients. Conclusion. Based on the results obtained, it can be concluded that the apo(a) phenotype is not a risk factor for arteriosclerotic vascular disease in patients undergoing hemodialysis.

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Outcomes of Dialysis in low Income Country – An Experience in a Tertiary Care Center of Bangladesh

Bangladesh Journal of Medicine ◽

10.3329/bjm.v33i1.56790 ◽

2021 ◽

Vol 33 (1) ◽

pp. 52-56

Author(s):

Ratan Das Gupta ◽

Syed Mahbub Morshed ◽

Abdullah Al Mamun ◽

HAM Nazmul Ahsan ◽

Mirzul Hasan ◽

...

Keyword(s):

Risk Factors ◽

Renal Disease ◽

Low Income ◽

End Stage Renal Disease ◽

Case Record ◽

Average Life Span ◽

Number Of Patients ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Background: The widespread use of hemodialysis to prolong life of end-stage renal disease (ESRD) patients has been a remarkable achievement, preventing death from uremia in these patients. The aim of the study was to find out the outcomes of haemodialysis patients with end-stage renal disease (ESRD) in low Income County. Methods: A hospital based prospective observational study was performed in the of Department of Nephrology, Shaheed Suhrawardy Medical College. Total 189 patients who stated dialysis during study period were included. All patients were monthly followed up and appropriate investigation done. All data recorded in a case record form. Study protocol approved by Ethical committeeof institute. Data analyzed in SPSS software version 25. Results: Among 189 ESRD patients on MHD selected with mean age 49.16 years (15-82), male was 60.3% and female 39.7%.Eighty eight 46.5% patient died and 39.15%(74) patient discontinue dialysis due to lack of financial support or helping assistant or social support. Three (1.6%) patients underwent renal transplantation and five patients (2.6%) transfer to other dialysis center. Average life span in dialysis 256 day (16-786 days). Most of the paints was on twice weekly dialysis 84%. Vascular access of stating dialysis was 73.8% by catheter and only 32.2% stated with AV fistula. Conclusion: A large group of patients leave dialysis due to financial or helping personal or social supportwithin 3-4 months of stating dialysis. A significant number of patients died due to multiple risk factors within 8-9 months. Identification of risk factors for early mortalityis essential and appropriatemeasure should take to prevent discontinuation at community and national level. Bangladesh J Medicine July 2022; 33(1) : 52-56

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A retrospective study of hemodialysis treated end-stage renal disease patients with renal osteodystrophy-associated fragility fractures

10.21203/rs.3.rs-101968/v1 ◽

2020 ◽

Author(s):

Lihua Xie ◽

Xuantao Hu ◽

Wenzhao Li ◽

Zhengxiao Ouyang

Keyword(s):

Risk Factors ◽

Alkaline Phosphatase ◽

Essential Hypertension ◽

Renal Disease ◽

Fragility Fracture ◽

End Stage Renal Disease ◽

Fragility Fractures ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background: Nephropathy associated metabolic disorder induces high incidence of fragility fracture in end-stage renal disease (ESRD) patients. As the risk factors and prognosis of fragility fracture in ESRD patients are unclear, more research is needed. This study aimed to evaluate various risk factors for ESRD-related fragility fractures, explore factors affecting the prognosis of patients with such fractures, and provide information for prevention and treatment of renal osteopathy to improve the prognosis of patients.Methods: In this retrospective case-control study, the case notes of 521 ESRD patients who received maintenance dialysis for at least 3 months were examined. Finally, 44 patients diagnosed with fragility fractures were assigned to the fragility fracture (FF) group and 192 patients were included in the control group (CG). Demographic information, underlying diseases, nutritional, bone metabolism, and renal function parameters, along with the number and causes of any deaths, were recorded for multiple statistical analysis.Results: The FF group had increased incidences of essential hypertension and diabetes mellitus and higher serum calcium, corrected calcium, alkaline phosphatase, and hemoglobin levels. Immunoreactive parathyroid hormone (iPTH), total cholesterol (TC), and low density lipoprotein (LDL) levels were higher in the CG.Conclusions: Essential hypertension and diabetes, high serum calcium and alkaline phosphatase levels, and reduced iPTH levels were risk factors for fragility fracture in ESRD patients. Maintaining iPTH and serum TC levels may protect against fragility fractures in them. Fragility fractures may yield poor prognosis and shorter lifespan. The presence of fragility fracture was an independent predictor of all-cause death in ESRD patients.

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Nurse’s Experience As Educator in Hemodialysis Care to End Stage Renal Disease Patient in Hospital X: a Phenomenology Study

KnE Life Sciences ◽

10.18502/kls.v4i13.5344 ◽

2019 ◽

Author(s):

Karolus Yosef Woitila Wangi ◽

Dessy Permata Sela ◽

Christina Evi Ambarsar

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Esrd Patient ◽

Disease Patient ◽

Lifestyle Changes ◽

Future Research ◽

Ethical Perspective ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End Stage Renal Disease (ESRD) is progressive and irreversible damage to kidney function,which can reduce the quality of life of patients and death due to accumulation of uremia toxins in the blood. Hemodialysis is a temporary therapy used to prolong the life of the patient. The uncertainty of the treatment provides a unique response which became an interesting phenomenon for researchers to conduct research Sethe qualitative strategy for explore the nurses’ experience and to describe it especially in the nurses’ role as educator in hemodialysis care to ESRD patient in Hospital X.Aim of this study to provide an overview of nurse’s experience as educator in ESRD patients during hemodialysis therapy in the Hemodialysis Unit Hospital X. this research used a qualitative method with a phenomenological approach has been conducted. The data collection technique used was using in-depth interviews. A purposive sampling was used to recruited the participant and, namely ten nurses were involded in this study with inclusion critearia as follows: (1) work as an executive nurse in HD unit, (2) have minimum Diploma III as basic education level. Data analysis using Colaizzi’s method and then using thematic analysis. Four themes were found in this study: lifestyle changes, uncooperative patients, responsive patients, and patients do not want to stop dialysis. Future research can be conduct in fourth theme concerning withdrawal dialysis in ESRD patients in various perspectives including: ethical perspective and decision making for futile treatment, health coverage policies, and palliative care.

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A Retrospective Study of Hemodialysis Treated End-stage Renal Disease Patients With Renal Osteodystrophy-associated Fragility Fractures

10.21203/rs.3.rs-53401/v1 ◽

2020 ◽

Author(s):

Lihua Xie ◽

Xuantao Hu ◽

Wenzhao Li ◽

Zhengxiao Ouyang

Keyword(s):

Risk Factors ◽

Alkaline Phosphatase ◽

Essential Hypertension ◽

Renal Disease ◽

Fragility Fracture ◽

End Stage Renal Disease ◽

Fragility Fractures ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

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Depressive symptoms and dietary non-adherence among end stage renal disease patients undergoing hemodialysis therapy: systematic review

BMC Nephrology ◽

10.1186/s12882-019-1622-5 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Mignote Hailu Gebrie ◽

Jodi Ford

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Renal Disease ◽

End Stage Renal Disease ◽

Longitudinal Design ◽

Future Research ◽

Stage Renal Disease ◽

End Stage ◽

The Relationship ◽

Esrd Patients

Abstract Background Research suggests that patients with end stage renal disease undergoing hemodialysis have a higher rate of depression and dietary non adherence leading to hospitalization and mortality. The purpose of this review was to synthesize the quantitative evidence on the relationship between depressive symptoms and dietary non adherence among end stage renal disease (ESRD) patients receiving hemodialysis. Methods A systematic review was undertaken. Three electronic databases were searched including PubMed, CINHAL and Web of Science. Only quantitative studies published between 2001 and 2016 were included in the review. Result A total of 141 publications were reviewed during the search process and 28 articles that fulfilled the inclusion criteria were included in the review. Eleven studies (39.3%) reported on the prevalence of depressive symptoms or depression and its effect on patient outcomes. Ten studies (35.7%) focused on dietary adherence/non adherence in patients with ESRD and the remaining seven (25%) articles were descriptive studies on the relationship between depressive symptoms and dietary non adherence in patients with ESRD receiving hemodialysis. The prevalence of depressive symptoms and dietary non adherence ranged as 6–83.49% and from 41.1–98.3% respectively. Decreased quality of life & increased morbidity and mortality were positively associated with depressive symptoms. Other factors including urea, hemoglobin, creatinine and serum albumin had also association with depressive symptoms. Regarding dietary non adherence, age, social support, educational status, behavioral control and positive attitudes are important factors in ESRD patients receiving hemodialysis. Having depressive symptoms is more likely to increase dietary non adherence. Conclusion Depressive symptoms and dietary non adherence were highly prevalent in patients with end stage renal disease receiving hemodialysis therapy. Nearly all of the articles that examined the relationship between depressive symptoms and dietary non adherence found a significant association. Future research using experimental or longitudinal design and gold standard measures with established cut-points is needed to further explain the relationship.

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Effects of dialysis modality choice on the survival of end-stage renal disease patients in southern China: a retrospective cohort study

10.21203/rs.3.rs-20276/v2 ◽

2020 ◽

Author(s):

Zhiren He ◽

Haijing Hou ◽

Difei Zhang ◽

Yenan Mo ◽

La Zhang ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Renal Disease ◽

Retrospective Cohort Study ◽

End Stage Renal Disease ◽

Retrospective Cohort ◽

Risk Of Death ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background: The optimal choice of treatment, with hemodialysis (HD) or peritoneal dialysis (PD), for end-stage renal disease (ESRD) patients, is yet controversial. Only a few studies comparing HD and PD have been conducted in China with the largest number of dialysis patients in the world.Methods: A retrospective cohort study was conducted on ESRD patients who began renal replacement treatment from January 1, 2012 to December 31, 2017 in Guangdong Provincial Hospital of Chinese Medicine. Propensity scoring match was applied to balance the baseline conditions and multivariate Cox regression analysis to compare the mortality between HD and PD patients, and evaluated the correlation between mortality and various baseline characteristics.Results: A total of 436 HD patients and 501 PD patients were included in this study, and PD patients had better survival than HD patients, but the difference was not statistically significant. For younger ESRD patients (≤60-years-old), the overall survival of PD was better than that of HD, but HD was associated with a lower risk of death in older patients (>70-years-old). This difference was still significant after adjustment for a variety of confounding factors. Female gender, age of dialysis initiation, cardiovascular disease, cholesterol, and HD were risk factors of all-cause mortality in the younger subgroup, while PD was risk factors in the older subgroup.Conclusion: Younger ESRD patients may be suitable for PD, and the older ESRD patients for HD.

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