scholarly journals Interrelation Between Disorder of Melatonin-forming Function of Epiphysis and Dyslipidemia in Patients with Chronic Kidney Disease of V Stage Treated by Hemodialysis

2020 ◽  
Vol 0 (1-2) ◽  
pp. 112-120
Author(s):  
В. Є. Кондратюк ◽  
А. С. Петрова ◽  
О. В. Карпенко ◽  
Т. Г. Осташевська ◽  
Е. К. Красюк

The results of a number of studies have proved the relationship between the functional state of the pineal gland and renal function. However, violations of the melatonin-forming function of the epiphysis (MFE) in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) and its relationship with dyslipidemia in this patient population is a poorly understood issue. The objective: to analyze disorders of MFE and blood lipid spectrum in patients with CKD of 5 stage treated with HD and to determine the relationship of epiphysis dysfunction with dyslipidemia. Materials and methods. 130 people (50% of men) aged 58.5 were surveyed [43; 66] which are on permanent hemodialysis treatment. Control passed 20 healthy individuals. The determination of day and night level of melatonin (MT) in saliva was conducted, based on the level of which patients (treated with HD) were divided into two groups: group I – 110 patients with impaired MFE, group II – 20 patients with normal MFE. Clinical and laboratory researches were carried out for all patients: general and biochemical analyzes of blood with determination of cholesterol level and its fractions, measurements of office blood pressure (BP) were made. Results. Significant prevalence of MFE disorders in patients with CKD of 5 stage treated with hemodialysis and its relationship with blood lipid spectrum were found. The level of total cholesterol (TC), triglycerides (TG) and low density lipoproteins (LDL) in patients with impaired MFE was higher by 26.4 % (p<0.05), 16.7 % (p<0.05) and 22,6 % (p= 0.03) according to the outcome of the comparison group patients. The level of high-density lipoprotein (HDL) of the main group is lower by 11.8 % compared to the group with preserved MFE. The data obtained indicate the relationship of MFE disorders with the duration of RRT treatment, the duration of arterial hypertension, the age of patients, and their effect on the lipid spectrum of patients with CKD of 5 stage treated with hemodialysis. Night feedback correlation of MT with TC level was established (r=–0.256; p<0.05). Correlation analysis confirms that a decrease in MT at night is combined with an increase of TG level (r=–0.272; p<0.05) in the blood of patients. The feedback correlation of night (r=–0.347; p=0.03) and daytime level (r=–0.198; p<0.05) of MT with LDL level and positive relationships between MT in daytime (r=0.27; p=0.03) and the night period (r=0.331; p=0.02) with HDL levels. Conclusion. For patients with CKD of 5 stage undergoing hemodialysis, there is a frequent violation of MFE (84.6%) and significant disorders of lipid metabolism (58%). Analysis of the lipid metabolism study revealed more profound abnormalities in the form of an increased concentration of TC and all its fractions in patients with impaired MFE, which may indicate a connection between epiphysis dysfunction and lipid metabolism in patients with RRT. In patients with hemodialysis, melatonin-forming dysfunction and disorders of lipid metabolism are age-dependent and are determined by the duration of RRT, the duration of hypertension, the level of hemoglobin. We have identified a relationship between the deterioration of lipid metabolism on the background of deeper disturbance of MFE by daytime and nighttime MT.

2021 ◽  
Vol 1 (29) ◽  
pp. 21-27
Author(s):  
S. A. Smakotina ◽  
Yu. A. Bokhanov

Objective. Patients with stage 5 chronic kidney disease.Study objective. Determination of factors affecting cognitive function in patients with CKD-5.Design and methods. The study included young and middle-aged patients (18 to 60 years old) (n = 40), there is a terminal stage of chronic kidney disease (CKD). Exclusion criteria: history of diseases of the central nervous system, brain injury, episodes of cerebrovascular accident with severity, coronary artery disease, chronic heart failure, pregnancy, abuse of alcohol, refusal to participate in the study. In a previous work, patient examination data were obtained on the Status PF hardware complex. Neurodynamic indicators were estimated, including the determination of the time of a simple visual-motor reaction (MTCM) and a complex visual-motor reaction (MPSM), reaction to a moving object (RDO), memory and attention. Using Spearman’s correlation analysis, we evaluated the impact on cognitive functions of a number of factors, presumably related to neurodynamics. The following factors were selected: age, creatinine level, NSE and S100 proteins, hemoglobin level, Beck’s depression points, indicators of personal and situational anxiety.Results. All patients examined on the Status PF software package had mild cognitive impairment in terms of neurodynamics, attention, and memory. The average positive relationship between the level of depression and various indicators of RDO was established: with RDO_average (ρ = 0.405; p = 0.018), with RDO_total delay (ρ = 0.540; p < 0.001), with RDO_average delay (ρ = 0.421; p = 0.007), as well as weak positive – with CEMR average exposure (ρ = 0.358; p = 0.023). An average positive relationship of creatinine level with RDO_O (ρ = 0.438; p = 0.005) is noted. A weak positive relationship between the level of personal anxiety and RDO_total delay (ρ = 0.334; p = 0.035) was revealed. The average negative relationship between hemoglobin level and RDO_total delay (ρ = –0.535; p < 0.001) was revealed. A weak positive relationship between situational anxiety and SEMR is determined by the number of errors (ρ = 0.364; p = 0.021), as well as a weak negative one with the attention volume (ρ = –0.357; p = 0.024). A weak negative relationship of age with visual memory per word was revealed (ρ = –0.362; p = 0.022).Domain of usage. Outpatient and hospital treatment stages of patients with chronic kidney disease case management


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
S. O. Oguntola ◽  
M. O. Hassan ◽  
R. Duarte ◽  
A. Vachiat ◽  
P. Manga ◽  
...  

Abstract Background Occurrence of cardiovascular disease (CVD) in the setting of chronic kidney disease (CKD) can be described as a “cruel alliance”, with CVD responsible for about half of all deaths among CKD patients. Chronic kidney disease patients are more likely to die from CVD than progress to end stage kidney disease (ESKD). Dyslipidaemia, a known traditional risk factor for CVD, is highly prevalent among CKD patients and with an even higher frequency among ESKD patients on dialytic therapies. Prolonged exposure of continuous ambulatory peritoneal dialysis (CAPD) patients to high glucose concentrations in CAPD fluid have been associated with increased risk of cardiovascular events. In this study, we investigated the relationship of atherosclerotic vascular disease (AsVD) to clinical and echocardiographic parameters among black South Africans with CKD (stage 3) and ESKD on CAPD and haemodialysis (HD). Methods This was a cross-sectional study of 40 adult (18–65 years) non-diabetic CKD patients (kidney disease outcome quality initiative [KDOQI] stage 3), 40 ESKD patients on CAPD, 40 ESKD patients on HD and 41 age and sex-matched healthy controls. An interviewer-administered questionnaire was used to obtain information on participants’ sociodemographic and cardiovascular risk factors. Anthropometric parameters were measured. Serum blood samples were analysed for creatinine, albumin and lipid profile; lipoprotein ratios, Framingham’s risk score and the 10-year risk of developing coronary heart disease (CHD) were calculated. Echocardiography was performed on all patients and carotid intima media thickness (CIMT) was measured in both right and left carotid arteries at 1 cm proximal to the carotid bulb. Spearman’s rank correlation and binary logistic regression were conducted to determine the relationship of AsVD to clinical and echocardiographic parameters. Results Atherosclerotic vascular disease was most prevalent among ESKD patients on CAPD (70%, n = 28/40). Chronic kidney disease and HD patients exhibited a similar prevalence (47.5%, n = 19/40), while the prevalence in controls was 17.1% (n = 7/41). Presence of AsVD was associated with significantly older age, higher waist hip ratio (WHR), left ventricular mass index (LVMI) and Framingham’s 10-year risk of developing CHD. Significant differences in clinical and echocardiographic parameters were observed when the study groups were compared. Age and LVH independently predicted AsVD. Conclusion Atherosclerotic vascular disease was more prevalent among CAPD patients compared to pre-dialysis CKD and HD patients. Among all lipoprotein ratios assessed, non-HDL-C showed the most consistent significant difference between the groups. Age (> 40 years) and presence of LVH were independent predictors of AsVD.


Author(s):  
Olga Kompaniets

The article is devoted to a review of the literature on the impact of hyperuricemia on the development and progression of chronic kidney disease (CKD). The tendency of changes of views on the role of uric acid in the pathogenesis of CKD is demonstrated. An analysis of experimental, epidemiological and clinical studies on the effects of uric acid on the physiology of the nephron and endothelial tissues, the relationship of hyperuricemia with metabolic and cardiorenal syndromes.


Kardiologiia ◽  
2019 ◽  
Vol 59 (6S) ◽  
pp. 17-23
Author(s):  
E. D. Kosmacheva ◽  
A. E. Babich

Background. In patients after liver transplantation cardiovascular complications is the third main reason of death afer allograf failure and infections. The most important factors in the development of cardiovascular diseases are dyslipidemia and impaired renal function. The aim of the study was to investigate the lipid spectrum and renal function in liver recipients in real clinical practice and the correspondence of their correction to current clinical recommendations for the diagnosis and treatment of dyslipidemia and chronic kidney disease (CKD). Methods. A retrospective analysis of lipid spectrum and renal function in patients who underwent OLT in Research Institute – Regional Clinical Hospital №1, Krasnodar was performed. The level of creatinine, GFR and lipid spectrum was studied before and 36 months after liver transplantation. The GFR was calculated using the formula CKD‑EPI (Chronic Kidney Disease Epidemiology Collaboration). Statistical analysis of the study results was made using the program Statistica 10. Results. Liver recipients have a significantly higher total cholesterol by 31.0% (p<0.01) in comparison with the baseline before surgery. Total cholesterol was increased in 13.7% (p<0.01), triglycerides in 12.3% (p<0.01) before transplantation. Tree years after transplantation, the increasion in cholesterol was registered in 42.6% (p<0.01) and triglycerides in 37.9% (p <0.01), respectively. 3 years after transplantation reduction of GFR was observed in comparison with the baseline by 22.6% (p=0.00006). Verification of chronic kidney disease and statin administration in patients were carried out in some cases. The levels of total cholesterol and triglycerides had a reliable inverse correlation with GFR (r = ‑0.42; p<0.01 and r = ‑0.36; p<0.05). Conclusions. In the long‑term postoperative period there was an impaired lipid metabolism and decreased level of GFR. Dyslipidemia was closely related to the progression of renal dysfunction in liver recipients, an inverse correlation was established between the glomerular filtration rate and the increasion in cholesterol and triglyceride levels. It is necessary to increase the attention of physicians with regard to timely correction of lipid metabolism disorders and detection of initial manifestations of renal dysfunction.


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