Not Residual Kidney Removal but Peritoneal Clearance Dominates in Uric Acid Control in Peritoneal Dialysis

Abstract Background: There’s a paucity of systematic study focusing on clearance of uric acid (UA) in peritoneal dialysis (PD). The aim of this study was to investigate peritoneal UA removal and its influencing factors in PD patients. Methods: This was a cross-sectional study. Patients who performed peritoneal equilibration test (PET) and Kt/V from April 1, 2018 to August 31, 2019 were enrolled. The demographic data, clinical and laboratory parameters including the UA levels in the dialysate, blood and urine samples were collected. Results: Finally, there were 180 prevalent PD patients (52.8% male). Compared with normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1±6.2 vs. 42.0±8.0 L/week/1.73m2, P=0.008). Peritoneal UA clearance but not residual kidney removal was revealed to be independently associated with continuous [standardized coefficients (β) -0.21, 95% confidence interval (CI) -0.07, -0.006] and categorical SUA level [odds ratio (OR) 0.91, 95% CI 0.84,0.98]. Furthermore, the higher (high or high-average) transporters showed greater peritoneal UA clearance than the lower (low or low-average) transporters (42.0±7.0 vs. 36.4±5.6 L/week/1.73 m2, P<0.001). Among the widely used solute removal indicators, peritoneal creatinine clearance (CCL) performed best to predict higher peritoneal UA clearance in ROC analysis [area under curve (AUC) 0.96, 95% CI 0.93-0.99]. In multiple linear regression, lower albumin level (β -0.06, 95%CI -2.09, -0.19), higher transporters (β 0.06, 95%CI 0.05, 1.69) and greater peritoneal CCL (β 0.95, 95%CI 0.81, 0.93) were independently associated with higher peritoneal UA clearance. Conclusions: It was peritoneal removal but not residual kidney function that dominated in SUA balance of PD patients. Albumin level, peritoneal transport type and peritoneal CCL were identified as independent determinants of peritoneal UA clearance.

Download Full-text

Roles of Peritoneal Clearance and Residual Kidney Removal in Control of Uric Acid in Patients on Peritoneal Dialysis

10.21203/rs.2.18171/v2 ◽

2020 ◽

Author(s):

Xi Xiao ◽

Hongjian Ye ◽

Chunyan Yi ◽

Jianxiong Lin ◽

Yuan Peng ◽

...

Keyword(s):

Body Mass Index ◽

Uric Acid ◽

Peritoneal Dialysis ◽

Body Mass ◽

Glucose Concentration ◽

Demographic Data ◽

Albumin Level ◽

Dialysis Dose ◽

Average Glucose Concentration ◽

Average Glucose

Abstract Background: There have been few systematic studies regarding clearance of uric acid (UA) in patients undergoing peritoneal dialysis (PD). This study investigated peritoneal UA removal and its influencing factors in patients undergoing PD. Methods: This cross-sectional study enrolled patients who underwent peritoneal equilibration test and assessment of Kt/V from April 1, 2018 to August 31, 2019. Demographic data and clinical and laboratory parameters were collected, including UA levels in dialysate, blood, and urine. Results: In total, 180 prevalent patients undergoing PD (52.8% men) were included. Compared with the normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1±6.2 vs. 42.0±8.0 L/week/1.73m2; P=0.008). Furthermore, higher transporters (high or high-average) exhibited greater peritoneal UA clearance, compared with lower transporters (low or low-average) (42.0±7.0 vs. 36.4±5.6 L/week/1.73 m2; P<0.001). Among widely used solute removal indicators, peritoneal creatinine clearance showed the best performance for prediction of higher peritoneal UA clearance in receiver operating characteristic curve analysis [area under curve (AUC) 0.96; 95% confidence interval [CI], 0.93-0.99]. Peritoneal UA clearance was independently associated with continuous SUA [standardized coefficient (β), -0.32; 95% CI, -6.42 to -0.75] and hyperuricemia [odds ratio (OR), 0.86; 95% CI, 0.76–0.98] status, only in patients with lower (≤2.74 mL/min/1.73 m2) measured glomerular filtration rate (mGFR). In those patients with lower mGFR, lower albumin level (β -0.24; 95%CI -7.26 to -0.99), lower body mass index (β -0.29; 95%CI -0.98 to -0.24), higher transporter status (β 0.24; 95%CI 0.72-5.88) and greater dialysis dose (β 0.24; 95%CI 0.26-3.12) were independently associated with continuous peritoneal UA clearance. Furthermore, each 1kg/m2 decrease in body mass index (OR 0.79; 95% CI 0.63-0.99), each 1g/dL decrease in albumin level (OR 0.08; 95%CI 0.01-0.47), and each 0.1% increase in average glucose concentration in dialysate (OR 1.56; 95%CI 1.11-2.19) were associated with greater peritoneal UA clearance (>39.8 L/week/1.73m2). Conclusions: For patients undergoing PD who exhibited worse residual kidney function, peritoneal clearance dominated in SUA balance. Increasing dialysis dose or average glucose concentration may aid in controlling hyperuricemia in lower transporters.

Download Full-text

Roles of Peritoneal Clearance and Residual Kidney Removal in Control of Uric Acid in Patients on Peritoneal Dialysis

10.21203/rs.2.18171/v3 ◽

2020 ◽

Author(s):

Xi Xiao ◽

Hongjian Ye ◽

Chunyan Yi ◽

Jianxiong Lin ◽

Yuan Peng ◽

...

Keyword(s):

Body Mass Index ◽

Uric Acid ◽

Peritoneal Dialysis ◽

Body Mass ◽

Glucose Concentration ◽

Demographic Data ◽

Albumin Level ◽

Dialysis Dose ◽

Average Glucose Concentration ◽

Average Glucose

Abstract Background: There have been few systematic studies regarding clearance of uric acid (UA) in patients undergoing peritoneal dialysis (PD). This study investigated peritoneal UA removal and its influencing factors in patients undergoing PD. Methods: This cross-sectional study enrolled patients who underwent peritoneal equilibration test and assessment of Kt/V from April 1, 2018 to August 31, 2019. Demographic data and clinical and laboratory parameters were collected, including UA levels in dialysate, blood, and urine. Results: In total, 180 prevalent patients undergoing PD (52.8% men) were included. Compared with the normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1±6.2 vs. 42.0±8.0 L/week/1.73m 2 ; P =0.008). Furthermore, higher transporters (high or high-average) exhibited greater peritoneal UA clearance, compared with lower transporters (low or low-average) (42.0±7.0 vs. 36.4±5.6 L/week/1.73 m 2 ; P <0.001). Among widely used solute removal indicators, peritoneal creatinine clearance showed the best performance for prediction of higher peritoneal UA clearance in receiver operating characteristic curve analysis [area under curve (AUC) 0.96; 95% confidence interval [CI], 0.93-0.99]. Peritoneal UA clearance was independently associated with continuous SUA [standardized coefficient (β), -0.32; 95% CI, -6.42 to -0.75] and hyperuricemia [odds ratio (OR), 0.86; 95% CI, 0.76–0.98] status, only in patients with lower (≤2.74 mL/min/1.73 m 2 ) measured glomerular filtration rate (mGFR). In those patients with lower mGFR, lower albumin level (β -0.24; 95%CI -7.26 to -0.99), lower body mass index (β -0.29; 95%CI -0.98 to -0.24), higher transporter status (β 0.24; 95%CI 0.72-5.88) and greater dialysis dose (β 0.24; 95%CI 0.26-3.12) were independently associated with continuous peritoneal UA clearance. Furthermore, each 1kg/m 2 decrease in body mass index (OR 0.79; 95% CI 0.63-0.99), each 1g/dL decrease in albumin level (OR 0.08; 95%CI 0.01-0.47), and each 0.1% increase in average glucose concentration in dialysate (OR 1.56; 95%CI 1.11-2.19) were associated with greater peritoneal UA clearance (>39.8 L/week/1.73m 2 ). Conclusions: For patients undergoing PD who exhibited worse residual kidney function, peritoneal clearance dominated in SUA balance. Increasing dialysis dose or average glucose concentration may aid in controlling hyperuricemia in lower transporters.

Download Full-text

Quality of life in peritoneal dialysis patients and its relationship with nutrition disorders

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.1(61).2019.06 ◽

2019 ◽

pp. 45-52

Author(s):

I. Dudar ◽

A. Shymova ◽

Y. Gonchar ◽

O. Loboda ◽

E. Krasiuk

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Serum Albumin ◽

Cross Sectional Study ◽

Albumin Level ◽

Life Assessment ◽

Nutrition Status ◽

Cross Sectional ◽

Nutrition Disorders

Abstract. The aim of our study was to evaluate the quality of life (QoL) in peritoneal dialysis (PD) patients and its relationship with nutritional disorders. Methods. 52 PD patients were included in the observational cross-sectional study. The QoL was conducted using a SF-36 quality of life assessment questionnaire. Moreover, the PD patients’ nutrition status (NS) was examined. For further analysis, the patients were divided into four groups according to the condition of the NS: the first group (n = 22) consisted of patients without nutrition disturbance, the second group (n =13) included the patients with mild nutrition disorders, the third group (n = 10) consisted the patients with an average degree of the NS, and the fourth one (n = 7) envolved the patients with a severe degree of malnutrition. A comparative evaluation of QoL among the PD patients with different nutrition disorders was performed. Results. During the analysis of indicators QoL we receive the following results: all patients were dissatisfied with the general state of health, the lowest of the indicators was the burden of the disease. The physical total component was lower than the mental. According to the analysis of NS parameters, nutritional disorders were observed in 57.6 % patients. Also according to the results, it follows that nutritional disorders negatively affect the QoL of the PD patients. Moreover, a direct strong correlation between the serum albumin level and the overall QoL score was obtained (r = 0.95; p < 0.001). In addition, the strong direct correlation between a body mass index (BMI) and overall QoL (r = 0.92; p < 0.001) and subjective global assessment (SGA) and overall QoL (r = 0.85; p < 0.001) were observed. Conclusions: According to the results of the study, it was found that PD patients' QoL is dissatisfied. It was confirmed that nutritional disorders affect bad on the QoL of patients with almost all parameters. The overall QoL was significantly associated with serum albumin levels, BMI and SGA.

Download Full-text

Prevalence of Clinical and Subclinical Thyroid Disease in a Peritoneal Dialysis Population

Peritoneal Dialysis International ◽

10.3747/pdi.2010.00202 ◽

2012 ◽

Vol 32 (1) ◽

pp. 86-93 ◽

Cited By ~ 16

Author(s):

Yee Yung Ng ◽

Shiao Chi Wu ◽

Hong Da Lin ◽

Fen Hsiang Hu ◽

Chun Cheng Hou ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Subclinical Hypothyroidism ◽

Demographic Data ◽

Clinical Manifestations ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Subclinical Hyperthyroidism ◽

Cross Sectional ◽

Dialysis Duration ◽

Total Thyroxine

AimsWe investigated dialysis duration, dose of erythropoietin (EPO), and clinical manifestations in peritoneal dialysis (PD) patients with subclinical hypothyroidism.MethodsThis cross-sectional study, performed in 3 centers, assessed 122 adult patients on PD for more than 6 months with regard to demographic data, dialysis duration, thyroid function, biochemical data, EPO dose, and clinical manifestations. Thyroid dysfunction was determined by serum thyroid-stimulating hormone, free thyroxine, total thyroxine, total triiodothyronine, antithyroid peroxidase antibodies, and auto-antibodies against thyroglobulin.ResultsOf the 122 study patients, 98 (80.3%) were assessed as having euthyroidism; 19 (15.6%), subclinical hypothyroidism; and 5 (4.1%), subclinical hyperthyroidism. The proportion of women (74.2% vs. 57.1%, p = 0.038), the mean duration of PD (58.1 months vs. 37.9 months, p = 0.032), and the weighted mean monthly EPO dose (1.22 μg/kg vs. 1.64 μg/kg, p = 0.009) were significantly higher in the subclinical hypothyroidism group than in the euthyroidism group, but the prevalences of coronary artery disease and cerebrovascular disease were not. From the multivariate model, PD duration was more significant than sex as a risk factor for subclinical hypothyroidism ( p = 0.0132).ConclusionsSubclinical hypothyroidism is frequent in PD patients, especially female patients and patients with a longer PD duration. Compared with euthyroid patients, patients with subclinical hyperthyroidism need a higher dose of EPO to maintain a stable hemoglobin level.

Download Full-text

Roles of Peritoneal Clearance and Residual Kidney Removal in Control of Uric Acid in Patients on Peritoneal Dialysis

10.21203/rs.2.18171/v4 ◽

2020 ◽

Author(s):

Xi Xiao ◽

Hongjian Ye ◽

Chunyan Yi ◽

Jianxiong Lin ◽

Yuan Peng ◽

...

Keyword(s):

Body Mass Index ◽

Uric Acid ◽

Peritoneal Dialysis ◽

Body Mass ◽

Glucose Concentration ◽

Demographic Data ◽

Albumin Level ◽

Dialysis Dose ◽

Average Glucose Concentration ◽

Average Glucose

Abstract Background: There have been few systematic studies regarding clearance of uric acid (UA) in patients undergoing peritoneal dialysis (PD). This study investigated peritoneal UA removal and its influencing factors in patients undergoing PD.Methods: This cross-sectional study enrolled patients who underwent peritoneal equilibration test and assessment of Kt/V from April 1, 2018 to August 31, 2019. Demographic data and clinical and laboratory parameters were collected, including UA levels in dialysate, blood, and urine.Results: In total, 180 prevalent patients undergoing PD (52.8% men) were included. Compared with the normal serum UA (SUA) group, the hyperuricemia group showed significantly lower peritoneal UA clearance (39.1±6.2 vs. 42.0±8.0 L/week/1.73m2; P=0.008). Furthermore, higher transporters (high or high-average) exhibited greater peritoneal UA clearance, compared with lower transporters (low or low-average) (42.0±7.0 vs. 36.4±5.6 L/week/1.73 m2; P<0.001). Among widely used solute removal indicators, peritoneal creatinine clearance showed the best performance for prediction of higher peritoneal UA clearance in receiver operating characteristic curve analysis [area under curve (AUC) 0.96; 95% confidence interval [CI], 0.93-0.99]. Peritoneal UA clearance was independently associated with continuous SUA [standardized coefficient (β), -0.32; 95% CI, -6.42 to -0.75] and hyperuricemia [odds ratio (OR), 0.86; 95% CI, 0.76–0.98] status, only in patients with lower (≤2.74 mL/min/1.73 m2) measured glomerular filtration rate (mGFR). In those patients with lower mGFR, lower albumin level (β -0.24; 95%CI -7.26 to -0.99), lower body mass index (β -0.29; 95%CI -0.98 to -0.24), higher transporter status (β 0.24; 95%CI 0.72-5.88) and greater dialysis dose (β 0.24; 95%CI 0.26-3.12) were independently associated with continuous peritoneal UA clearance. Furthermore, each 1kg/m2 decrease in body mass index (OR 0.79; 95% CI 0.63-0.99), each 1g/dL decrease in albumin level (OR 0.08; 95%CI 0.01-0.47), and each 0.1% increase in average glucose concentration in dialysate (OR 1.56; 95%CI 1.11-2.19) were associated with greater peritoneal UA clearance (>39.8 L/week/1.73m2).Conclusions: For patients undergoing PD who exhibited worse residual kidney function, peritoneal clearance dominated in SUA balance. Increasing dialysis dose or average glucose concentration may aid in controlling hyperuricemia in lower transporters.

Download Full-text

Breakfast Skipping Is an Independent Predictor of Obesity but not Overweight Among Children in a Southeastern European Population

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000272 ◽

2016 ◽

Vol 86 (5-6) ◽

pp. 242-248 ◽

Cited By ~ 2

Author(s):

Genc Burazeri ◽

Jolanda Hyska ◽

Iris Mone ◽

Enver Roshi

Keyword(s):

Task Force ◽

Demographic Data ◽

Cross Sectional Study ◽

European Population ◽

Overweight And Obesity ◽

World Health ◽

Communist Country ◽

Western Balkans ◽

Cross Sectional ◽

Breakfast Skipping

Abstract.Aim: To assess the association of breakfast skipping with overweight and obesity among children in Albania, a post-communist country in the Western Balkans, which is undergoing a long and difficult political and socioeconomic transition towards a market-oriented economy. Methods: A nationwide cross-sectional study was carried out in Albania in 2013 including a representative sample of 5810 children aged 7.0 – 9.9 years (49.5% girls aged 8.4 ± 0.6 years and 51.5% boys aged 8.5 ± 0.6 years; overall response rate: 97%). Children were measured for height and weight, and body mass index (BMI) calculated. Cut-off BMI values of the World Health Organization (WHO) and the International Obesity Task Force (IOTF) were used to define overweight and obesity in children. Demographic data were also collected. Results: Upon adjustment for age, sex, and place of residence, breakfast skipping was positively related to obesity (WHO criteria: OR = 1.5, 95% CI = 1.3–1.9; IOTF criteria: OR = 1.9, 95% CI = 1.4–2.5), but not overweight (OR = 1.1, 95% CI = 0.9–1.3 and OR = 1.1, 95% CI = 0.9–1.4, respectively). Furthermore, breakfast skipping was associated with a higher BMI (multivariable-adjusted OR = 1.05, 95% CI = 1.02–1.07). Conclusions: Our findings point to a strong and consistent positive relationship between breakfast skipping and obesity, but not overweight, among children in this transitional southeastern European population. Future studies in Albania and other transitional settings should prospectively examine the causal role of breakfast skipping in the development of overweight and obesity.

Download Full-text

Health-related quality of life in different trimesters during pregnancy

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01811-y ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Huailiang Wu ◽

Weiwei Sun ◽

Hanqing Chen ◽

Yanxin Wu ◽

Wenjing Ding ◽

...

Keyword(s):

Quality Of Life ◽

Pregnant Women ◽

Demographic Data ◽

Cross Sectional Study ◽

University Hospital ◽

Health Related Quality ◽

Cross Sectional ◽

Related Quality ◽

Health Related

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.

Download Full-text

POS0548 OPTIMAL ASSESSMENT OF THE RHEUMATOID ARTHRITIS ANKLE AND HINDFOOT: A COMPARATIVE STUDY BETWEEN CLINICAL EXAMINATION AND ULTRASONOGRAPHY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2720 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 508.2-509

Author(s):

K. Maatallah ◽

H. Boussaa ◽

H. Riahi ◽

H. Ferjani ◽

M. Habechi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Examination ◽

Demographic Data ◽

Power Doppler ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Therapeutic Decisions ◽

The Mean ◽

Foot Disease

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared

Download Full-text

Assessment of Inorganic Phosphate Intake by the Measurement of the Phosphate/Urea Nitrogen Ratio in Urine

Nutrients ◽

10.3390/nu13020292 ◽

2021 ◽

Vol 13 (2) ◽

pp. 292

Author(s):

María Victoria Pendón-Ruiz de Mier ◽

Noemí Vergara ◽

Cristian Rodelo-Haad ◽

María Dolores López-Zamorano ◽

Cristina Membrives-González ◽

...

Keyword(s):

Inorganic Phosphate ◽

Daily Intake ◽

Cross Sectional Study ◽

Normal Serum ◽

Dietary Recommendations ◽

Clinical Practices ◽

Cross Sectional ◽

Urea Nitrogen ◽

Inorganic P ◽

Nitrogen Ratio

In chronic kidney disease (CKD) patients, it would be desirable to reduce the intake of inorganic phosphate (P) rather than limit the intake of P contained in proteins. Urinary excretion of P should reflect intestinal absorption of P(inorganic plus protein-derived). The aim of the present study is to determine whether the ratio of urinary P to urinary urea nitrogen (P/UUN ratio) helps identify patients with a high intake of inorganic P.A cross-sectional study was performed in 71 patients affected by metabolic syndrome with CKD (stages 2–3) with normal serum P concentration. A 3-day dietary survey was performed to estimate the average daily amount and the source of P ingested. The daily intake of P was 1086.5 ± 361.3 mg/day; 64% contained in animal proteins, 22% in vegetable proteins, and 14% as inorganic P. The total amount of P ingested did not correlate with daily phosphaturia, but it did correlate with the P/UUN ratio (p < 0.018). Patients with the highest tertile of the P/UUN ratio >71.1 mg/g presented more abundant inorganic P intake (p < 0.038).The P/UUN ratio is suggested to be a marker of inorganic P intake. This finding might be useful in clinical practices to identify the source of dietary P and to make personalized dietary recommendations directed to reduce inorganic P intake.

Download Full-text

Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet’s Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020673 ◽

2021 ◽

Vol 18 (2) ◽

pp. 673

Author(s):

Hashim A. Mahdi ◽

Hamza M. Assaggaf ◽

Mohammad Alfelali ◽

Omar B. Ahmed ◽

Radi Alsafi ◽

...

Keyword(s):

Hand Hygiene ◽

Graduate Education ◽

Formal Education ◽

Demographic Data ◽

Knowledge Score ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet’s Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants’ demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18–65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors’ mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.

Download Full-text