scholarly journals Estimation of Serum Vitamin D2, Growth Hormone, Alkaline Phosphatase and Calcium Phosphate Product in Patients with End Stage Renal Disease

2021 ◽  
Vol 9 (01) ◽  
pp. 61-65
Author(s):  
Santosh Chaudhary ◽  
Narayan Gautam ◽  
Manoj Karki ◽  
Sunkeshari Deshar ◽  
Archana Jayan ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
End Stage Renal Disease ◽  
Hypovitaminosis D ◽  
Vitamin D2 ◽  
Hypertension Status ◽  
Significant Difference ◽  
Phosphate Product ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

INTRODUCTION The chronic kidney disease (CKD) patient's calcium phosphate product, alkaline phosphatase (ALP), vitamin-D2  and human growth hormone (hGH) are altered under haemodialysis. This study aimed to evaluate these biochemical variables in conjunction with haemoglobin and blood pressure to find out their association in End Stage Renal Disease (ESRD) patients. MATERIAL AND METHODS This cross-sectional study comprised of 104 patients with ESRD undergoing haemodialysis. The estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault (CG) equation and calcium, phosphorus, ALP were measured by fully automated analyzer whereas vitamin-D2  and hGH were measured by sandwich and competitive enzyme linked immune sorbent assay (ELISA) techniques. RESULTS The mean age of patients was 53.12 ±16.37 years comprising 68% male. The hypovitaminosis D was 57.7% deficiency and 23.1% insufficiency states whereas hGH insufficiency was 22.1%. The calcium phosphate product was found to be increased in only 39.9% cases. The increased ALP level was observed in 64.4% cases. There was statistically significant association between hGH and Hb status (p=0.03). The significant difference in mean sodium and Ca×P of ESRD cases was observed with hypertension status (p=0.03 and p=0.01) respectively. Moreover, the significant difference in mean eGFR and hGH was observed with haemoglobin status (p=0.0001and p=0.01) respectively. CONCLUSION Increased level of ALP and hypovitaminosis-D was very common in ESRD patients undergoing dialysis with less prevalence of hGH insufficiency and calcium phosphate product increment. The anaemia and hypertension status can be pre-existing condition with ESRD which are cumbersome to control if not monitor in these patients.

scholarly journals Parathyroid Hormone Status in Patients with End Stage Renal Disease on Maintenance Haemodialysis

2014 ◽  
Vol 4 (1) ◽  
pp. 13-17
Author(s):  
SM Sajjad ◽  
YA Zaman ◽  
MA Rahim ◽  
A Mahmuda ◽  
WMM Haque ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Calcium Phosphate ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Maintenance Haemodialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Pth Level

Objective: To evaluate parathyroid hormone (PTH) status among end stage renal disease (ESRD) patients on maintenance haemodialysis (MHD). Methodology: This descriptive cross-sectional study was done in the Department of Nephrology, BIRDEM General Hospital, Dhaka, from April to September 2011. Results: A total of 50 patients were included in this study with a 3:2 male predominance. Mean age was 54.6 (range 34-76) years. Mean duration of ESRD was 3.73 years. All the patients were diabetic and other common co-morbidities were hypertension (76%), dyslipidaemia (56%), ischaemic heart disease (48%) and stroke (12%). They were receiving calcium (72%), vitamin D (40%), both calcium and vitamin D (38%) supplementation and 20% were not on any medication for treatment of chronic kidney disease mineral bone disorder (CKD-MBD). Mean pre-dialysis values of urea and creatinine were 30.28 mg/dl and 8.67 mg/dl respectively. Mean (± SD) serum level of calcium, phosphate and PTH were 8.32 (±1.26) mg/dl, 4.42 (±1.54) mg/dl and 125.45±117.71 pg/ml respectively. In 76% of the study subjects, PTH level was above normal. Significant difference (P=<0.05) in PTH levels was observed among patients with and without any medication for prevention of CKD-MBD but the levels were within the acceptable range. Serum calcium level in the study subjects had significant positive relationship with serum PTH level. It was also observed that PTH level had significant negative relationship with phosphate level. Conclusion: PTH level was higher in ESRD patients on MHD specially those who were not on any medication than those who took calcium, vitamin D or both but it was still within the acceptable reference range. In such patients, serum calcium, phosphate and PTH levels should be monitored periodically. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18547 Birdem Med J 2014; 4(1): 13-17

scholarly journals Epidemiological Characteristics and Causes of End-stage Renal Disease in Hemodialysis Patients

2020 ◽  
Vol 7 (2) ◽  
pp. 53-57
Author(s):  
Mehdi Khazaei ◽  
Zainab Eslami Hasan Abadi ◽  
Mohammad Keshvari Delavar ◽  
Morteza Shamsizadeh
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Prevalence Rate ◽  
Significant Difference ◽  
Common Causes ◽  
The Common ◽  
Stage Renal Disease ◽  
End Stage ◽  
Epidemiological Characteristics ◽  
Esrd Patients

Background and aims: Hemodialysis (HD) is considered as the main method of renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients in many countries including Iran. Given the limited number of epidemiological studies in this regard at the provincial level across the country, the present study aimed to describe the demographic and clinical characteristics of ESRD patients and determine the most important causes of ESRD in Hamadan Province. Methods: This cross-sectional study was conducted on 508 HD patients in Hamadan province in January 2017. The checklist used to gather information comprised of the patient’s demographic and clinical information. The analysis was carried out using descriptive analysis including frequency tables and charts and the chi-square statistic test was used to compare the groups using Stata software, version 12. Results: The prevalence rate of HD treatment was 288.9 per million population (PMP). Further, most under HD patients were married, illiterate, and urban residents. The mean age of patients at the diagnosis was 47.64 ± 15.17 years. Hypertension (37.4%), diabetes (28.74%), and glomerulonephritis (10.63%) were the common causes of ESRD. Eventually, there was a significant difference between ESRD causes according to gender and residency (P<0.05). Conclusion: In general, the prevalence rate of HD in Hamadan was relatively similar to that of developing countries although it was lower than the national average. Furthermore, hypertension and diabetes were the common causes of ESRD in Hamadan Province. Therefore, preventive strategies should be taken to modify their risk factors.

scholarly journals Sexual Dysfunction Among Patients with End-Stage Renal Disease Undergoing Hemodialysis: Prevalence and Associated Factors

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Mansour Shakiba ◽  
Nour-Mohammad Bakhshani ◽  
Zohre Soorgi ◽  
Shahab Lotfinia
Keyword(s):  
Sexual Dysfunction ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Pearson Correlation ◽  
Educational Status ◽  
Number Of Patients ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Chronic renal disease is a worldwide concern. The number of patients on hemodialysis increases every year. These patients have several physiological and psychological problems like sexual dysfunction that can affect their mental health and treatment course. Objectives: This study first aimed to assess the prevalence of sexual dysfunction in end-stage renal disease (ESRD) patients on hemodialysis compared to healthy people. Then, it evaluated factors associated with sexual dysfunction in both groups. Methods: This cross-sectional study recruited a total of 142 participants in two groups selected by a convenience sampling method. Group one included 71 ESRD patients from two hemodialysis centers in Zahedan, Southeast of Iran, recruited between September 2018 and September 2019. Group two included 71 healthy individuals matched for age, weight, and educational status. The two groups were assessed based on psychiatric interviews, the International Index of Erectile Function (IIEF), and the index of female sexual function (IFSF). The SPSS 24 software was used for data analysis. The bivariate Pearson correlation test, Cramer V, and independent-t-test were used to analyze the data. Results: All female patients and 90% of healthy females had various levels of sexual dysfunction, and there was no significant difference between them (P = 0.21). However, 84.6% of male patients and 33.3% of healthy males had various levels of sexual dysfunction and there was a significant difference between the two groups (P < 0.001). The duration of hemodialysis was not correlated with sexual dysfunction. Age, weight, educational status, and marriage duration showed the most correlations with sexual dysfunction, especially in females. Conclusions: As the findings showed, sexual dysfunction had a high prevalence among hemodialysis patients. As many of these patients must be on hemodialysis for long periods, we need to pay attention to sexual dysfunction when assessing and planning for their treatment.

scholarly journals The risk factors associated with COVID-19-Related death among patients with end‐stage renal disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hadith Rastad ◽  
Hanieh-Sadat Ejtahed ◽  
Gita Shafiee ◽  
Anis Safari ◽  
Ehsan Shahrestanaki ◽  
...  
Keyword(s):  
Renal Disease ◽  
Hospital Mortality ◽  
Medical History ◽  
End Stage Renal Disease ◽  
Demographic Factors ◽  
Increased Risk ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background The extent to which patients with End-stage renal disease (ESRD) are at a higher risk of COVID-19-related death is still unclear. Therefore, the aim of this study was to identify the ESRD patients at increased risk of COVID-19 -related death and its associated factors. Methods This retrospective cohort study was conducted on 74 patients with ESRD and 446 patients without ESRD hospitalized for COVID-19 in Alborz province, Iran, from Feb 20 2020 to Apr 26 2020. Data on demographic factors, medical history, Covid-19- related symptoms, and blood tests were obtained from the medical records of patients with confirmed COVID-19. We fitted univariable and multivariable Cox regression models to assess the association of underlying condition ESRD with the COVID-19 in-hospital mortality. Results were presented as crude and adjusted Hazard Ratios (HRs) and 95% confidence intervals (CIs). In the ESRD subgroup, demographic factors, medical history, symptoms, and blood parameters on the admission of survivors were compared with non-survivors to identify factors that might predict a high risk of mortality. Results COVID-19 patients with ESRD had in-hospital mortality of 37.8% compared to 11.9% for those without ESRD (P value < 0.001). After adjusting for confounding factors, age, sex, and comorbidities, ESRD patients were more likely to experience in-hospital mortality compared to non-ESRD patients (Adjusted HR (95% CI): 2.59 (1.55–4.32)). The Log-rank test revealed that there was a significant difference between the ESRD and non-ESRD groups in terms of the survival distribution (χ2 (1) = 21.18, P-value < 0.001). In the ESRD subgroup, compared to survivors, non-survivors were older, and more likely to present with lack of consciousness or O2 saturation less than 93%; they also had lower lymphocyte but higher neutrophil counts and AST concentration at the presentation (all p –values < 0.05). Conclusions Our findings suggested that the presence of ESRD would be regarded as an important risk factor for mortality in COVID-19 patients, especially in those who are older than age 65 years and presented with a lack of consciousness or O2 saturation less than 93%.

scholarly journals VARIATION IN ADVANCE DIRECTIVES TIMING BETWEEN END-STAGE RENAL DISEASE PATIENTS AND CANCER PATIENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S275-S275
Author(s):  
Yu-Hsuan Wang ◽  
Susan Enguidanos
Keyword(s):  
Renal Disease ◽  
End Of Life ◽  
Cancer Patients ◽  
End Stage Renal Disease ◽  
The United States ◽  
Completion Rates ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract The United States has the third highest prevalence and the second highest incidence of End-Stage Renal Disease (ESRD). ESRD is associated with high mortality and lower quality of end-of-life experiences. Having an advance directive (AD) is associated with better care at the end of life. Although past ACP completion rates in ESRD patients has been studied, little is known about its timing differences between ESRD and cancer patients. This study investigates the timing difference of AD completion between ESRD and cancer patients We conducted logistic regression to analyze data from the Health and Retirement Study, a nationally representative longitudinal survey of older adults. The analytic sample included exit interviews from 2012 to 2016 among 971 proxies of deceased with ESRD or cancer. Among the sample, 47% of decedents completed an AD; 44% of cancer patients and 48% of ESRD patients. Being a racial minority (OR=0.38, p&lt;0.001), and lower education (OR= 0.63, p=0.001) were associated with lower AD completion rates. No significant differences in AD completion rates were found between cancer patients and ESRD patients. Compared to cancer patients, ESRD patients were more likely to complete ADs more than one year before death (OR=3.15, p=0.001). However, there were no significant difference between cancer patients and ESRD patients in AD completion rates in the three months before death. Although both samples had comparable rates of AD completion, compared to cancer patients, ESRD patients tend to document care preferences earlier. Further studies are needed to investigate factors related to early documentation of ADs.

scholarly journals MON-368 A Case of Uremic Tumoral Calcinosis with Secondary Hyperparathyroidism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Justin Mathew ◽  
Preeti Kishore
Keyword(s):  
Calcium Phosphate ◽  
Soft Tissue ◽  
Secondary Hyperparathyroidism ◽  
End Stage Renal Disease ◽  
Tumoral Calcinosis ◽  
Intact Pth ◽  
Phosphate Product ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Uremic tumoral calcinosis is an uncommon clinical entity that can be seen in patients with end-stage renal disease, characterized by development of calcific deposits in the soft tissue. This condition can cause significant pain and impairment of mobility for patients. While it appears that elevation in calcium-phosphate product and hyperparathyroidism may each play a role in the development of these deposits, these conditions are neither necessary nor sufficient for this process to occur. As a result, the optimal treatment of this condition is not well-established. Case: A 50-year-old man with history of ESRD since 2015 secondary to autosomal dominant polycystic kidney disease on peritoneal dialysis, HTN, and secondary hyperparathyroidism presented to the emergency room with progressive right lateral hip pain, reaching the point where the patient could no longer ambulate. Exam demonstrated a thin man whose right hip was tender to palpation with limited range of motion, as well as a palpable, deep right upper leg mass. Laboratory findings were significant for a creatinine of 14.83mg/dL (n &lt;1.5mg/dL), calcium of 9.1 mg/dL (n 8.5-10.5mg/dL), phosphate of 7.9mg/dL (n 2.5-4.5mg/dL), intact PTH of 1129pg/mL (n 15-65pg/mL), and 25-OH Vit D of 20.4ng/mL (n&gt;30ng/mL). X-ray of the right femur demonstrated a 9cm calcified soft tissue lesion, which was not present on imaging 7 months earlier. Subsequent CT of the pelvis showed a cystic, multilobulated calcified mass in the right gluteus, measuring 6.1 x 3.5 x 7.5cm, consistent with tumoral calcinosis. Attempts to normalize his serum phosphorous level using treatment with phosphate binders or changes to his dialysate had failed previously, and the patient declined transitioning to hemodialysis. Nuclear medicine parathyroid scan demonstrated four-gland hyperplasia, and the decision was made to perform 3.5 gland parathyroidectomy. Two days post-operatively calcium had dropped to 7.7 mg/dL, phosphate to 6.8mg/dL, and intact PTH to 29pg/mL. Conclusions: Uremic tumoral calcinosis is a very rare but potentially debilitating consequence of end-stage renal disease that can be significantly detrimental to quality of life in patients with ESRD. Elevated calcium-phosphate product is frequently implicated in its development, and evidence exists that lowering these levels can lead to complete resolution of these lesions. However, in patients for whom medical therapy is not effective and who have concomitant secondary hyperparathyroidism, subtotal parathyroidectomy is a reasonable treatment option.

scholarly journals Cutaneous manifestations of end-stage renal disease

2020 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Navya Vanaja Sahadevan ◽  
Lissy Skaria ◽  
Kunjumani Sobhanakumari
Keyword(s):  
Calcium Phosphate ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Small Sample ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Treatment Comparison ◽  
Phosphate Product ◽  
Stage Renal Disease ◽  
End Stage

Objectives: (1) To study the dermatological manifestations in patients with end-stage renal disease (ESRD) of diverse etiology and (2) to compare the dermatological manifestations in patients on conservative treatment and those receiving hemodialysis. Materials and Methods: One hundred patients with ESRD who attended the nephrology/dermatology department of a tertiary care center were examined for dermatological manifestations. Results: All the 100 patients evaluated had at least one cutaneous manifestation. Pallor was the most common cutaneous finding in our study (64%). Xerosis was observed in 61% and pruritus in 46%. Other common findings included diffuse hyperpigmentation (22%) and cutaneous infections (20%). Specific changes noted were acquired perforating dermatoses (7%) and nephrogenic systemic fibrosis (2%). Nail, oral mucosa, and hair were affected in 61%, 54%, and 29% cases, respectively. No significant association was noted between dermatological manifestations and modality of treatment. Comparison of serum calcium, serum phosphorus, and calcium-phosphate product was done with pruritus and a significant association was noted between pruritus and the serum levels of phosphate and calcium-phosphate product. Limitations: Small sample size and the single center study design were the major limitations. Conclusion: Dermatological manifestations are common among patients with ESRD. Early diagnosis and prompt management of the dermatological diseases may improve the quality of life of the affected.

Iron Chelation Therapy in CAPD: A New and Effective Treatment of Iron Overload Disease in Esrd Patients

1983 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Glen H Stanbaugh ◽  
A. W, Holmes Diane Gillit ◽  
George W. Reichel ◽  
Mark Stranz
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Overload ◽  
End Stage Renal Disease ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelation Therapy ◽  
Peritoneal Dialysate ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.

Adipokines and Gut Hormones in End-Stage Renal Disease

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peptide Yy ◽  
Gut Hormones ◽  
Poor Quality ◽  
Mortality And Morbidity ◽  
Novel Therapeutic Strategies ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.

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