scholarly journals A Respective Observational Study of Patients on Maintenance Hemodialysis Receiving Parathyroidectomy By Ultrasonic Scalpel

2021 ◽  
Author(s):  
Dan Gao ◽  
Fengqi Hu ◽  
Zhao Gao ◽  
Hai Yuan
Keyword(s):  
Kidney Disease ◽  
Hospital Stay ◽  
Statistical Significance ◽  
Chronic Kidney Disease Stage ◽  
Univariate Analysis ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Disease Stage ◽  
Maintenance Hemodialysis ◽  
Ultrasonic Scalpel

Abstract Background Secondary hyperparathyroidism (SHPT) remains a common complication in many patients on maintenance hemodialysis. Kidney Disease Improve Global Outcomes (KDIGO) 2017 guidelines suggest that parathyroidectomy (PTX) should be performed in severe SHPT patients with chronic kidney disease stage 3a-stage 5D. In the present study, we observed the efficacy of ultrasonic scalpel for PTX in SHPT patients on maintenance hemodialysis. Methods A total of 74 patients on maintenance hemodialysis who underwent PTX (34 with traditional electrocautery and 40 with an ultrasonic scalpel) were observed between August 2020 and August 2021 at Xiangyang Central Hospital (Hubei University of Arts and Science). Baseline demographic and clinic characteristics were collected pre- and post-PTX. Moreover, the postoperative complications and operation time were assessed between the two groups. Results The univariate analysis showed that there was no statistical significance in weight, dialysis duration, serum potassium, serum calcium, alkaline phosphate, triglyceride, and intact parathyroid hormone (iPTH) before and after PTX between the two groups (P>0.05). The operation time in the ultrasonic scalpel group was significantly decreased compared with the traditional electrocautery group (P<0.05). Compared with the traditional electrocautery group, the drainage amount was significantly reduced in the ultrasonic scalpel group, and the number of days with drain and postoperative hospital stay were also remarkably decreased (P<0.05). In addition, a higher incidence of recurrent laryngeal nerve injury occurred in the traditional electrocautery group, while the difference was not significant (P>0.05). Conclusions The use of ultrasonic scalpel significantly reduced the operation time and postoperative hospital stay in patients on maintenance hemodialysis undergoing PTX.

scholarly journals Distribution of Pruritus and Its Association With Serum Parathormone Level in Chronic Kidney Disease (Stage-5) Patients On Maintenance Hemodialysis

2020 ◽  
Vol 28 (1) ◽  
pp. 54-59
Author(s):  
Rafiqul Hasan ◽  
Md Nizamuddin Chowdhury ◽  
Md Nazrul Islam ◽  
Parvez Iftekher Ahmed ◽  
ASM Tanim Anwar ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Normal Serum ◽  
Disease Stage ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Maintenance Haemodialysis

Background: Pruritus is a common manifestation in patients on hemodialysis. The aim of this study is to determine the distribution of pruritus and evaluate the association between pruritus and serum parathormone levels in chronic kidney disease patients on maintenance haemodialysis. Methods:This analytic, descriptive, cross-sectional study was performed over 191 patients of maintenance haemodialysis in 2014. Information related to the patients including age, gender, residence, pruritus was extracted from questionnaires. Serum levels of intact parathormone were measured & data were analyzed. Results: 68% of the patients had pruritus. The Mean ± SD of serum parathormone was 53.25±7.96 pg/ml in patients with pruritus and 81.91±9.34 pg/ml in patients without pruritus. Our study showed that most patients with pruritus had normal serum parathormone levels and no significant association was found between pruritus and serum parathormone levels. Conclusion: serum parathormone level may not play a role in uraemic pruritus in these patients. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 54-59

scholarly journals Osteopontin Levels in Patients With Chronic Kidney Disease Stage 5 on Hemodialysis Directly Correlate With Intact Parathyroid Hormone and Alkaline Phosphatase

2019 ◽  
Vol 25 ◽  
pp. 107602961989662
Author(s):  
Aleksander Druck ◽  
Dimpi Patel ◽  
Vinod Bansal ◽  
Debra Hoppensteadt ◽  
Jawed Fareed
Keyword(s):  
Chronic Kidney Disease ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Mineral Metabolism ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Maintenance Hemodialysis ◽  
Intact Parathyroid Hormone

Chronic kidney disease stage 5 (CKD5) marks the fifth stage of renal failure, frequently causing dysregulation of bone and mineral metabolism. Challenges exist in evaluating and managing chronic kidney disease–mineral bone disorder (CKD-MBD) with the standard panel of biomarkers. Our objective was to profile osteopontin (OPN) in patients with CKD5 on maintenance hemodialysis (CKD5-HD) and elucidate its relationship to phosphorus (P), calcium (Ca2+), alkaline phosphatase (AP), and intact parathyroid hormone (iPTH) to improve understanding of the present model of CKD-MBD. Elevation of plasma OPN was seen in the CKD5-HD cohort (n = 92; median: 240.25 ng/mL, interquartile range [IQR]: 169.85 ng/mL) compared to a normal group (n = 49; median: 63.30 ng/mL, IQR: 19.20 ng/mL; p < .0001). Spearman correlation tests revealed significant positive correlations of OPN with iPTH ( p < .0001; r = 0.561, 95% confidence interval = 0.397-0.690) and OPN with AP ( p < .0001; r = 0.444, 95% confidence interval = 0.245-0.590) in CKD5-HD patients. Ultimately, OPN may play an integral role in the MBD axis, suggesting that it may be important to actively monitor OPN when managing CKD5-HD.

Ligation-free single scrotal incision orchiectomy with ultrasonic scalpel: Xinhua Zhang Procedure

2021 ◽  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Postoperative Complication ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Ultrasonic Scalpel ◽  
Surgery Group ◽  
Significant Difference

Background: To explore the efficacy and safety of a new type of testicular excision with ultrasonic dissector. Methods: A retrospective analysis was performed on 69 patients with advanced prostate cancer undergoing orchiectomy in our hospital between June 2017 and June 2019. All patients were divided into a traditional surgery group (n = 27) and an ultrasonic scalpel surgery group (n = 42). The operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rates were compared. Results: The ultrasonic scalpel surgery group had significantly shorter operation times and less intraoperative blood loss than the traditional surgery group (each P < 0.01). Moreover, the incidence of postoperative complication differed significantly between the traditional surgery group (18.52%) and the ultrasonic scalpel surgery group (0%) (P < 0.01). However, there was no significant difference in postoperative hospital stay between the two groups (P > 0.05). Conclusions: The surgery time for testicular excision using the ultrasonic knife is short, the operation is simple and the complications are few and thus it may become a form of replacement for traditional testicular excision.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

1049-P: Preexisting Chronic Kidney Disease Stage 3 Does Not Reduce Glycemic Efficacy of Metformin in U.S. Veterans with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1049-P
Author(s):  
ELVIRA GOSMANOVA ◽  
DARREN E. GEMOETS ◽  
LAURENCE S. KAMINSKY ◽  
CSABA P. KOVESDY ◽  
AIDAR R. GOSMANOV
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage

Sarcopenia is an actual problem in chronic kidney disease of the 5d stage

2020 ◽  
Vol 24 (1) ◽  
pp. 60-66
Author(s):  
I. V. Lavrishcheva ◽  
A. Sh. Rumyantsev ◽  
M. V. Zakharov ◽  
N. N. Kulaeva ◽  
V. M. Somova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Chronic Kidney Disease Stage ◽  
Age Groups ◽  
Disease Stage ◽  
Actual Problem ◽  
European Working ◽  
Low Performance ◽  
6 Minute Walk Test

BACKGROUND. The lack of data on the epidemiology of presarcopenia/sarcopenia leads to an underestimation of the role of this condition in the structure of morbidity and mortality of haemodialysis patients in theRussian Federation. THE AIM: to study the epidemiological aspects of presarcopenia /sarcopenia in patients with chronic kidney disease stage 5d. PATIENTS AND METHODS. This study comprised 317 patients receiving programmed bicarbonate haemodialysis for 8.2 ± 5.1 years, among them 171 women and 146 men, the average age was 57.1 ± 11.3 years. The assessment of the presence of sarcopenia was performed using the method recommended by the European Working Group on Sarcopenia in Older People. RESULTS. The prevalence of presarcopenia was 0.7 % and sarcopenia 29.6 %. The incidence of skeletal muscle mass deficiency according to muscle mass index (IMM) was 30.3 %, 48.7 % showed a decrease in muscle strength according to dynamometry, and low performance of skeletal muscles according to 6 minute walk test was determined in 42.8 %. Sarcopenia patients were significantly characterized by lower body mass index, as well as higher body fat mass values. The duration of haemodialysis (χ2 = 22.376, p = 0.0001) and the patient's age (χ2 = 10.545 p = 0.014) were an independent risk factors for the development of sarcopenia. CONCLUSION. Sarcopenia is recorded more frequently in hemodialysis patients than presarcopenia. Its prevalence increases among patients of older age groups and with a hemodialysis duration of more than 5 years. The age and experience of dialysis make their independent contribution to the development of this syndrome.

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