scholarly journals Hemodialysis Membranes: Interleukins, Biocompatibility, and Middle Molecules

2002 ◽  
Vol 13 (suppl 1) ◽  
pp. S62-S71
Author(s):  
Walter H. Hörl
Keyword(s):  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Necrosis Factor Alpha ◽  
Middle Molecules ◽  
End Products ◽  
Factor Alpha ◽  
Stage Renal Disease ◽  
End Stage ◽  
Necrosis Factor

ABSTRACT. Maintenance hemodialysis patients display evidence of elevated interleukin-1 (IL-1) and tumor necrosis factor alpha release after stimulation either by contaminated dialysate, bioincompatible membrane material, or both. This release is followed by the stimulated secretion of a large number of other interleukins, particularly IL-6, the cytokine principally responsible for acute-phase protein synthesis. It has been shown that high levels of the circulating proinflammatory cytokines IL-1, tumor necrosis factor alpha, IL-6, and IL-13 are associated with mortality in hemodialysis patients. Essential functions of polymorphonuclear leukocytes—that is, phagocytosis, oxygen species production, upregulation of specific cell surface receptor proteins, or apoptosis—are disturbed in patients with end-stage renal disease. These are further altered as a result of complement activation by the hemodialysis procedure, particularly if bioincompatible dialyzers are used. Polymorphonuclear leukocyte degranulation occurring during extracorporeal circulation does not depend on complement activation but rather on intracellular calcium and the presence or absence of the degranulation inhibitory proteins angiogenin and complement factor D. Clinical signs and symptoms of end-stage renal disease patients are at least in part related to the accumulation of middle molecules such as β2-microglobulin, parathyroid hormone, advanced glycation end products, advanced lipoxidation end products, advanced oxidation protein products (formed as a result of oxidative stress, carbonyl stress, or both), granulocyte inhibitory proteins, or leptin. Currently available membrane materials do not provide long-lasting, effective reduction of middle molecules in patients who require maintenance hemodialysis.

scholarly journals IMPACT OF DURATION OF HEMODIALYSIS ON LIPID PROFILE IN END STAGE RENAL DISEASE PATIENTS RECEIVING HEMODIALYSIS.

2020 ◽  
Vol 27 (06) ◽  
pp. 1230-1236
Author(s):  
Sadia Rehman ◽  
Santosh Kumar ◽  
Fatima Mehboob ◽  
Fatima Rehman ◽  
Syed Hidayat Ali ◽  
...  
Keyword(s):  
Renal Disease ◽  
Lipid Profile ◽  
End Stage Renal Disease ◽  
Serum Triglyceride ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Healthy Controls ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End Stage Renal Disease (ESRD) patients receiving hemodialysis are at a higher risk of developing dyslipidemia which is undoubtedly a predisposing factor of cardiac related disease in these patients. Objectives: To assess serum lipid profile in subjects having end stage renal disease and receiving maintenance hemodialysis and to compare it with normal healthy controls and also to assess the effects of duration of hemodialysis on the lipid profile. Study Design: A case-control study. Setting: Executed in the Nephrology Department of JPMC. Period: January 2018 to January 2019. Material and Methods: Blood samples were obtained from a total of 90 subjects. Subjects were stratified into 3 groups including cases of ESRD receiving maintenance hemodialysis and matched healthy controls. Analysis for serum triglyceride, serum VLDL, total cholesterol, LDL and HDL was done. Results: A significant rise in serum triglyceride content and total serum cholesterol of hemodialysis patients (p < 0.01) was detected as compared to healthy controls. A statistically significant decrease was found in serum HDL level (p < 0.01) in hemodialysis patients in comparison to healthy controls. The impact of the hemodialysis duration was found to deteriorate the lipid profile of patients having longer duration of hemodialysis. Conclusion: Dyslipidemia was found to be evident in hemodialysis patients. The duration of hemodialysis sessions was found to affect the lipid profile of ESRD patients, which may play a role in higher incidence of atherosclerotic related cardiac events among these patients.

scholarly journals Clinicodemographic Profile and Outcome of Maintenance Hemodialysis Patients in a Tertiary Hospital of Central Nepal, Chitwan

2020 ◽  
Vol 18 (1) ◽  
pp. 9-14
Author(s):  
M. Ghimire ◽  
S. Vaidya ◽  
H.P. Upadhyay
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Volume Overload ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
P Value ◽  
Stage Renal Disease ◽  
End Stage ◽  
Maintenance Hemodialysis Patients

Background Maintenance hemodialysis is a popular treatment modality of renal replacement therapy for end stage renal disease patients; however their mortality seemed to be rising in our centre. There were no previous studies regarding the clinicodemographic profile and outcome of maintenance hemodialysis patients from this region. Objective This study was carried out with an objective to know the clinicodemographic profile and outcome of maintenance hemodialysis patients in our centre. Method This study was a hospital based prospective observational study carried out over a period of three year, from May 2016 to April 2019, in the hemodialysis unit of the department of nephrology. All the consecutive end stage renal disease patients on maintenance hemodialysis were included in the study. The patient’s demographic profile and outcome were studied and analysed using appropriate statistical tools. Result A total of 156 patients were enrolled in the study. Males were 96(61.5%) and females were 60(38.5%). The mean age of the patient was 52.2±15.6 years. The commonest causes of end stage renal disease and reasons for admission were Type 2 diabetes mellitus 68(43.6%) and volume overload with heart failure 101(64.7%) respectively. At the end of three years, 39(25%) were expired, 14(8.9%) were transferred to other centre and four (2.6%) underwent kidney transplantation. The average duration of hemodialysis was 20.3± 17.5 months. Majority of the patients 154(98.7%) had repeat admission ranging from 1 time 21(13.5%) to 10 times two (1.3%). There was a significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively). Conclusion The commonest cause of end stage renal disease and the reason of admission were Type 2 diabetes mellitus 68 (43.6%) and volume overload with heart failure 101 (64.7%) respectively. The overall mortality was 39 (25%) and the commonest cause of mortality was sepsis/health care associated pneumonia 30 (76.9%). There was significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively).

P1379PLATELET/LYMPHOCYTE RATIO AS A MARKER OF ERYTHROPOIETIN RESPONSIVENESS IN END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sonja Golubović ◽  
Tijana Azasevac ◽  
Siniša Živković ◽  
Bojana Ljubiäiä‡ ◽  
Violeta Knezevic ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Laboratory Data ◽  
Moderate Intensity ◽  
Maintenance Hemodialysis ◽  
Weekly Dose ◽  
Lymphocyte Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esa Therapy

Abstract Background and Aims Neutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) are closely associated with increased inflammation in end-stage renal disease, which often contributes to the severity of anemia in these patients. Erythropoiesis stimulating agents (ESA) have become a standard treatment of anemia in hemodialysis patients. Since some patients do not respond well to erythropoietin therapy (EPO) the aim of this study is to investigate if NLR and PLR as markers of increased inflammation, could be associated with resistance to EPO therapy. Method A total of 90 patients (36 females, 54 males; mean age 60,45 ±11,58) undergoing maintenance hemodialysis and who received recombinant human EPO therapy were examined. Patients' clinical characteristics, laboratory data, dialysis adequacy and the applied doses os EPO were examined in a period of 3 months. EPO hyporesponsiveness index (EHRI) was calculated as the weekly dose of EPO divided by kilograms of body weight divided by the hemoglobin level. Results Obtained results show a statistically significant correlation of moderate-intensity between EHRI and NLR ( r = 0.497, p &lt; 0.01) as well as a negative correlation of moderate-intensity between EHRI and hemoglobin levels (Hgb) (r = -0.403, p &lt; 0.01). When it comes to the connection of NLR and PLR with logarithmically converted EHRI values, the results show that there is no statistically significant correlation between NLR and EHRI. Comparison of PLR among 25th, 50th and 75th percentile of EHRI showed that PLR levels increased going from the 25th towards the 75th percentile (p &lt; 0.01). Post hoc analysis indicated that there is also a statistically strong connection for the 25th i 50th percentile (&lt;0 .05) and furthermore for the 50th and 75th percentile (&lt; 0.05). Conclusion PLR was found to be superior to NLR in terms of evaluating ESA therapy resistance. PLR could be used as a predictor of ESA therapy response.

Depression in end-stage renal disease hemodialysis patients

2006 ◽  
Vol 2 (12) ◽  
pp. 678-687 ◽  
Author(s):  
Daniel Cukor ◽  
Rolf A Peterson ◽  
Scott D Cohen ◽  
Paul L Kimmel
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Age Group ◽  
Calcium Phosphorus ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

scholarly journals Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

scholarly journals Frequency of Intradialytic Complications in Patients of End-Stage Renal Disease on Maintenance Hemodialysis

Cureus ◽  
2021 ◽  
Author(s):  
Muhammad Ali ◽  
Ayesha Ejaz ◽  
Hina Iram ◽  
Shafique A Solangi ◽  
Abdul Manan Junejo ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Maintenance Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage

Aiming for the optimal bicarbonate prescription for maintenance hemodialysis therapy in end‐stage renal disease

2019 ◽  
Vol 23 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Andreas Bozikas ◽  
Iliana Kiriakoutzik ◽  
Ioannis Petrou ◽  
Theodoros Touroutzis ◽  
Eleni Kitoukidi ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Maintenance Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage
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