scholarly journals Comment to the Article „Mid-Term Outcomes of Primary Hip Replacement in Patients with End-Stage Chronic Renal Disease“

2019 ◽  
Vol 25 (2) ◽  
pp. 55-58
Author(s):  
V. Yu. Murylev ◽  
G. L. Sorokina
Keyword(s):  
Renal Disease ◽  
Hip Replacement ◽  
Chronic Renal Disease ◽  
End Stage ◽  
Primary Hip Replacement

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scholarly journals Mid-Term Outcomes of Primary Hip Replacement in Patients with End-Stage Chronic Renal Disease

2019 ◽  
Vol 25 (2) ◽  
pp. 44-54
Author(s):  
A. N. Tsed ◽  
A. K. Dulaev ◽  
N. E. Mushtin ◽  
K. G. Iliushchenko ◽  
A. V. Shmelev
Keyword(s):  
Parathyroid Hormone ◽  
Renal Disease ◽  
Hip Replacement ◽  
Chronic Renal Disease ◽  
Group Iii ◽  
Dihydroxyvitamin D ◽  
Group I ◽  
Group Ii ◽  
End Stage ◽  
Primary Hip Replacement

Purpose — to evaluate mid-term outcomes of primary hip replacement in patients with end-stage chronic renal disease and to develop an algorithm for selection of surgical tactics and perioperative treatment.Materials and Methods. The authors evaluated outcomes of primary hip replacement in 45 patients receiving renal substitution therapy and 47 patients without chronic renal disease. Patients with end-stage chronic renal disease (CRD) were divided into two groups: group I included 30 (66.6%) patients receiving chronic hemodialysis (CH) and group II included 15 (33.4%) patients after renal transplantation (RT). Group III of 47 (51.1%) patients without any signs of CRD who underwent hip arthroplasty within relevant period of time was established to evaluate the effectiveness of primary hip replacement. Blood serum Ca2+ and P5+ levels as well as levels of parathyroid hormone (PTH) and 1.25-dihydroxyvitamin D were measured to determine the rate of calcium- phosphoric metabolism disturbance. Multi-spiral CT scans of hip joint were performed to identify bone mineral density and the mean Hounsfield (Hu) value was calculated for which the data was obtained from five various points on the proximal femur and acetabulum. Beta-2 microglobulin (B2M) blood test was performed to confirm amyloid bone disease.Results. The authors did not observe statistically significant differences for arthroplasty outcomes in patients of group II and III. Patients receiving long-term hemodialysis demonstrated significantly lower parameters of Harris score and Barthel’s index of social adaptation after hip replacement as compared to groups II and III: patients of group I demonstrated outcomes improvement at 19.55%, in group II — at 13.03%, in group III — at 10.15% as compared to preoperative status. Decrease of 1.25-dihydroxyvitamin D below 20,0 mcg results in resorption of cancellous bone in proximal femur and acetabulum along with myopathy of gluteus muscles. Sharp increase of parathyroid hormone level (over 600 pcg/ml) was accompanied by inhibition of osteoblasts proliferation and differentiation resulting in substantial impairment of mineralization.Conclusion. According to the algorithm suggested by the authors the key parameters that need to be evaluated in preoperative period are parathyroid hormone (PTH) and 1.25-dihydroxyvitamin D. Five-fold increase of PTH (>600 pcg/ml) demands parathyroidectomy as the first stage of treatment to decrease risk of early aseptic loosening of hip prosthesis and development of periprosthetic fracture.

scholarly journals The Pathogenesis of End-Stage Renal Disease from the Standpoint of the Theory of General Pathological Processes of Inflammation

2021 ◽  
Vol 22 (21) ◽  
pp. 11453
Author(s):  
Evgenii Gusev ◽  
Liliya Solomatina ◽  
Yulia Zhuravleva ◽  
Alexey Sarapultsev
Keyword(s):  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Classical Type ◽  
Low Grade ◽  
Systemic Complications ◽  
Life Threatening ◽  
Microcirculatory Disorders ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease can progress to end-stage chronic renal disease (ESRD), which requires the use of replacement therapy (dialysis or kidney transplant) in life-threatening conditions. In ESRD, irreversible changes in the kidneys are associated with systemic changes of proinflammatory nature and dysfunctions of internal organs, skeletal muscles, and integumentary tissues. The common components of ESRD pathogenesis, regardless of the initial nosology, are (1) local (in the kidneys) and systemic chronic low-grade inflammation (ChLGI) as a risk factor for diabetic kidney disease and its progression to ESRD, (2) inflammation of the classical type characteristic of primary and secondary autoimmune glomerulonephritis and infectious recurrent pyelonephritis, as well as immune reactions in kidney allograft rejection, and (3) chronic systemic inflammation (ChSI), pathogenetically characterized by latent microcirculatory disorders and manifestations of paracoagulation. The development of ChSI is closely associated with programmed hemodialysis in ESRD, as well as with the systemic autoimmune process. Consideration of ESRD pathogenesis from the standpoint of the theory of general pathological processes opens up the scope not only for particular but also for universal approaches to conducting pathogenetic therapies and diagnosing and predicting systemic complications in severe nephropathies.

Undertreatment of Cardiac Risk Factors in Adolescents with Renal Failure

2001 ◽  
Vol 21 (3_suppl) ◽  
pp. 285-289 ◽  
Author(s):  
Uwe Querfeld
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Normal Population ◽  
Cardiac Risk ◽  
Uremic Cardiomyopathy ◽  
Degree Modification ◽  
Stage Renal Disease ◽  
End Stage ◽  
Lower Morbidity

Cardiovascular disease (CVD) is the most common cause of death in adults with end-stage renal disease and after renal transplantation, and the relative excess of mortality is greatest in the young. The most likely explanation is the dramatic accumulation of both classical and uremic risk factors leading to atherosclerosis, uremic vasculopathy, and uremic cardiomyopathy. Prospective studies have established the significance of classical and uremic risk factors for the occurrence of CVD in the normal population and in the population with chronic renal disease alike. However, whether and to what degree modification of risk factors by therapeutic intervention can lower morbidity and mortality rates is as yet unknown.

scholarly journals Chronic Renal Failure, Cachexia, and Ghrelin

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
A. Laviano ◽  
Z. Krznaric ◽  
K. Sanchez-Lara ◽  
I. Preziosa ◽  
A. Cascino ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Food Intake ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Contributing Factors ◽  
Protein Energy Wasting ◽  
Protein Energy ◽  
Stage Renal Disease ◽  
End Stage

Protein energy wasting is frequently observed in patients with advanced chronic renal failure and end-stage renal disease. Anorexia and reduced food intake are critical contributing factors and negatively impact on patients' survival. Ghrelin is a prophagic peptide produced by the stomach and acting at the hypothalamic level to increase the activity of orexigenic neurons. In patients with chronic renal disease, plasma levels are increased as a likely effect of reduced renal clearance. Nevertheless, patients' food intake is significantly reduced, suggesting inflammation-mediated resistance of hypothalamic nuclei to peripheral signals. A number of forms of evidence show that ghrelin resistance could be overcome by the administration of exogenous ghrelin. Therefore, ghrelin has been proposed as a potential strategy to improve food intake in chronic renal failure patients with protein energy wasting. Preliminary data are encouraging although larger prospective clinical trials are needed to confirm the results and to identify those patients who are likely to benefit most from the administration of exogenous ghrelin.

scholarly journals Incidence, mortality, and prevalence of end-stage chronic renal disease in the Bajo Lempa region of El Salvador: A ten-year community registry

2016 ◽  
Vol 36 (5) ◽  
pp. 517-522
Author(s):  
Ramón García-Trabanino ◽  
Carolina Hernández ◽  
Adrián Rosa ◽  
Jesús Domínguez Alonso
Keyword(s):  
Renal Disease ◽  
El Salvador ◽  
Chronic Renal Disease ◽  
End Stage

COVID-19 related hospitalization costs; assessment of influencing factors

2021 ◽  
Author(s):  
Mohammad Haji Aghajani ◽  
Mohammad Sistanizad ◽  
Amirmohammad Toloui ◽  
Arian Madani Neishaboori ◽  
Asma Pourhoseingholi ◽  
...  
Keyword(s):  
Renal Disease ◽  
Teaching Hospital ◽  
Chronic Renal Disease ◽  
Renal Diseases ◽  
Loss Of Consciousness ◽  
Factors Affecting ◽  
Hospitalization Costs ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Objective: Our aim is to assess the effective factors on hospitalization costs of COVID-19 patients. Methods: Data related to clinical characteristics and cost of hospitalized COVID-19 patients from February 2020 until July 2020, in a public teaching hospital in Tehran, Iran was gathered in a retrospective cohort study. The corresponding factors influencing the diagnostic and therapeutic costs were evaluated, using a generalized linear model. Results: The median COVID-19 related diagnostic and therapeutic costs in a public teaching hospital in Iran, for one hospitalized COVID-19 patient was equal to 271.1 US dollars (USD). In patients who were discharged alive from the hospital, the costs increased with patients’ pregnancy (P<0.001), loss of consciousness during hospitalization (P<0.001), a history of drug abuse (P=0.006), history of chronic renal disease (P<0.001), end stage renal disease (P=0.002), history of brain surgery (P=0.001), history of migraine (P=0.001), cardiomegaly (P=0.033) and occurrence of myocardial infarction during hospitalization (P<0.001). In deceased patients, low age P<0.001), history of congenital disease (P=0.024) and development of cardiac dysrhythmias during hospitalization (P=0.044) were related to increase in therapeutic costs. Conclusion: Median diagnostic and therapeutic costs in COVID-19 patients, hospitalized in a public teaching hospital in Iran were 271.1 USD. Hoteling and medications made up most of the costs. History of cardiovascular disease and new onset episodes of such complications during hospitalization were the most important factors contributing to the increase of therapeutic costs. Moreover, pregnancy, loss of consciousness, and renal diseases are of other independent factors affecting hospitalization costs in COVID-19 patients.

scholarly journals Assessment of thyroid dysfunction, dyslipidemia and oxidative stress in hypertensive end stage chronic renal disease patients in a teaching hospital in Western Uttar Pradesh

2019 ◽  
Vol 10 (5) ◽  
pp. 13-18
Author(s):  
Poonam Kachhawa ◽  
Vivek Sinha
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Disease ◽  
Superoxide Dismutase ◽  
Renal Disease ◽  
Lipid Profile ◽  
Thyroid Dysfunction ◽  
Chronic Renal Disease ◽  
Economic Output ◽  
End Stage ◽  
And Oxidative Stress

Background: CKD is a serious health problem in worldwide. In developing nation, CKD has severe implication on health and economic output. The rapid increase of common risk factors such as hypertension (HTN), obesity and type 2 diabetes will result in greater and more burdens to developing country. There are many complications associated with CKD including thyroid dysfunction, dyslipidemia,hypertension and cardiovascular disease (CVD).It is generally seen that patients suffering from CKD are at high risk of cardiovascular disease. Aims and Objectives: The purpose of the study was to evaluate the diagnostic screening of thyroid dysfunction, dyslipidemia and oxidative stress in hypertensive end stage chronic renal disease patients. Materials and Methods: Thyroid status, Lipid profile, serum Urea, serum Creatinine, serum Uric acid, serum electrolyte, Catalase,Malondialdehyde (MDA) and Superoxide dismutase (SOD) were assayed in 160 subjects in which 80 patients of CKD were having hypertension and 80 healthy controls. Results: In our study, we found statistical significantly increased level of (p<0.001) of malondialdehyde (MDA) and significantly decreased level (p<0.001) of Catalase and Superoxide dismutase (SOD).There was found significantly increased level (p<0.001) of TSH in CKD associated with hypertension patients.We also found deranged lipid profile and renal functions in CKD associated with hypertension patients as compared to controls. Conclusion: In the present study, we arrived at conclusion that dyslipidemia and thyroid dysfunction is very common in CKD patients. Our study revealed that there was significant association between thyroid dysfunction and CKD progression and dyslipidemia. The antioxidant status is assessed through changes in antioxidant enzymatic activity in patients of CKD with hypertensive and data provide evidence of blood pressure modulation by measurable oxidative stress–related parameters.

scholarly journals Comprehensive and Personalized Care of the Hemodialysis Patient in Tassin, France: A Model for the Patient-Centered Medical Home for Subspecialty Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Eva Anvari ◽  
Hoda Mojazi Amiri ◽  
Patricia Aristimuno ◽  
Charles Chazot ◽  
Kenneth Nugent
Keyword(s):  
United States ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
The United States ◽  
Care Needs ◽  
Antihypertensive Medications ◽  
Patient Centered ◽  
Personalized Care ◽  
Stage Renal Disease ◽  
End Stage

The Centre de Rein Artificiel in Tassin, France, provides comprehensive care to patients with chronic renal disease similar to the model proposed for Patient Center Medical Homes; patients with end-stage renal disease in the Tassin Hemodialysis Center appear to have better outcomes than patients in the United States. These differences likely reflect this center’s approach to patient-centered care, the use of longer dialysis times, and focused vascular access care. Longer dialysis times provide better clearance of small and middle toxic molecules, salt, and water; 85% of patients at the Tassin center have a normal blood pressure without the use of antihypertensive medications. The observed mortality rate in patients at the Tassin Center is approximately 50% of that predicted based on the United States Renal Data system standard mortality tables. Patient outcomes at the Tassin center suggest that longer dialysis times and the use of multidiscipline teams led by nephrologists directing all health care needs probably explain the outcomes in these patients. These approaches can be imported into the U.S healthcare system and form the framework for patient-centered medical practice for ESRD patients.

scholarly journals The Relationship between IL-1β, IL-17, IL-33 and Bcl-2 and the Development of Diabetic Nephropathy

2021 ◽  
Author(s):  
Ahmed Nabil ◽  
Basant Mahmoud ◽  
Adel Abdel-Moneim ◽  
Zinab Negeem
Keyword(s):  
Diabetic Nephropathy ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cell Lymphoma ◽  
Chronic Renal Disease ◽  
Sodium Concentration ◽  
Positive Correlations ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Abstract Background: Diabetic nephropathy (DN) is among the main complications of diabetes mellitus, and it has been the major factor of renal failure. The current investigation aims to address the association between beta-cell lymphoma-2 (Bcl-2), interleukin (IL)-1β, IL-17, and IL-33 with the development of DN. Methods: In this study, twenty healthy volunteers plus hundred patients have been signed up. According to their biochemical markers, patients were categorized into 5 groups; diabetic, chronic renal disease, diabetic chronic renal disease, end-stage renal disease, and diabetic end-stage renal disease. Results: Our results showed a noticeable elevation in IL-1β and IL-17 levels and a reduce in IL-33 and Bcl-2 levels in all investigated groups relative to the healthy group. Positive correlations were reported between IL-1β with FBS and creatinine levels, IL-17, with HbA1c% and sodium levels. However, negative correlations were exerted between IL-33 with urea and sodium concentration, Bcl2 with HbA1c%, and creatinine levels.Conclusion: The present data revealed a marked relationship between Bcl-2, IL-1β, IL-17, and IL-33 levels and the progression of DN. Therefore, understanding the molecular pathways of inflammatory and apoptotic activities-related DN could be translated into the development of therapeutic strategies.

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