scholarly journals CHANGES OF NONESSENTIAL TRACE ELEMENTS LEVELS IN WHOLE BLOOD OF END STAGE RENAL DISEASE ADULT PATIENTS

Author(s):  
O. O. Makarov ◽  
E. O. Pisarev ◽  
B. S. Sheiman ◽  
M. V. Kulizkiy ◽  
D. V. Peretyatko ◽  
...  

Aims: Accumulation of trace elements occurs in conditions of decreased or termination of kidneys functions. In some conditions increased trace elements can obtain toxic features. On other hand, researches are showing that concentration of some trace elements could be decreased in ERSD patients, too. The most important factor affecting trace element concentration in ERSD patient is the degree of renal failure and using of replacement therapy. Materials and methods: We determined the concentration of microelements (beryllium, boron, aluminum, vanadium, chromium, nickel, arsenic, rubidium, strontium, cadmium, cesium, barium, thallium and lead) in whole blood of 41 ESRD patients with chronic kidney disease stage VD, who were treated with hemodialysis / hemodiafiltration and in 61 conditionally healthy donors. Determination of whole bloods trace elements content was conducted using inductive coupled plasma mass- spectrometry (ICPMS).  Results: It is determinate that levels of beryllium, boron, aluminum, vanadium, chromium, strontium, cadmium, barium, thallium and lead is reliable increased in ESRD patients. Decreased levels are observed for nickel, arsenic, cesium and rubidium. Conclusions: ESRD is accompanied with substantial and multidirectional changes of trace elements blood levels. During researches has shown that in ESRD patients processes of trace elements accumulation are prevailing over elimination ones.

Author(s):  
M. G. Prodanchuk ◽  
O. O. Makarov ◽  
B. S. Sheiman ◽  
O. G. Vasileva ◽  
G. B. Bodnar

Homeostasis disorders in kidneys damage is accompanied by the accumulation or reduction of trace elements as a component of Chronic Kidney Disease (CKD) progression. The degree of trace elements misbalanced depends on the stage of CKD. The deep disorders are most common during renal replacement therapy (RRT), especially in children due to anatomic and physiological immaturity. Materials and methods: We investigated the 20 trace elements blood concentrations in 42 children with CKD V D depending on RRT duration used the technique of inductive coupled plasma mass-spectrometry (ICPMS). Results: There is detected significant increase of cobalt (in 3,80 times), cadmium (2,66), lead (2,44) and nickel (7,19) in patients with statistically weighty decrease in vanadium (1,49), chromium (1,62), arsenic (9,45), strontium (2,02), barium (5,29), rubidium (2,69 and zinc (1,46). It was found the increasing levels of aluminum, chromium and zinc in RRT duration enlargement (p<0,05). Conclusions: The course of CKD V D in children is accompanied with substantial and multidirectional changes in trace elements blood levels that characterized by a predominance of accumulation processes versus elimination depending the RRT duration.


2018 ◽  
Vol 1 (1) ◽  
pp. 53-55
Author(s):  
Sarju Raj Singh ◽  
Manisha Dhakal ◽  
Santosh Thapa ◽  
Sudha Khakurel

The toxicity of Baclofen is extremely unusual. However, its predominant renal clearance makes its vulnerable in patients with impaired renal function. Clinical manifestations may begin as early as 2-3 days after starting the drug, even with a smaller dosage.A 73-year-old man with end-stage renal disease on maintenance hemodialysis was admitted to our emergency department with progressive confusion, hallucination and a generalized decrease in muscular tone. There was no significant metabolic or infectious etiology that could have clarified his condition. A thorough laboratory and imaging workup was negative too. A detailed history of his medication revealed that he had recently been prescribed baclofen for neck muscular spasm (10mg twice daily). He was then diagnosed with baclofen toxicity and was treated with intensive hemodialysis. During his admission, few sessions of hemodialysis on consecutive days, eventually produced expected clinical improvement and a complete return to his previous baseline mental status.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 54-56


2012 ◽  
Vol 11 (2) ◽  
pp. 154-157
Author(s):  
Marcus Vinícius Martins Cury ◽  
Marcelo Fernando Matielo ◽  
Ana Carolina Calixtro ◽  
Giuliano de Almeida Sandri ◽  
Marcos Roberto Godoy ◽  
...  

Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentially performed via an arteriovenous fistula (AVF). We report the case of a 58-year-old male patient with diabetes mellitus, hypertension and end-stage renal disease in whom hemodialysis was conducted via a long-term catheter. His medical record described numerous central venous cannulations and several AVF creations. The patient developed subclinical subclavian stenosis that required creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.


2011 ◽  
Vol 68 (7) ◽  
pp. 556-560
Author(s):  
Jasna Trbojevic-Stankovic ◽  
Miljana Obradovic ◽  
Vesna Cemerikic-Martinovic ◽  
Dusan Trpinac ◽  
Zeljko Lausevic ◽  
...  

Background/Aim. During peritoneal dialysis (PD) an exchange of substances between blood and dialysate takes place through specific histological structures of peritoneum. Peritoneal double-layered serous membrane has, so far, mostly been studied with electron microscopy on experimental animals. The aim of this study was to assess integrity of peritoneal tissue in end-stage renal disease (ESRD) and PD patients using standard light microscopy and immunohistochemical methods. Methods. Peritoneal tissue biopsies were performed on 25 persons: 8 healthy donors during nephrectomy, 9 ESRD patients upon insertion of PD catheter, and 8 PD patients upon removal of the catheter for medical indications. The samples were fixed and prepared routinely for immunocytochemical staining by standardized streptavidin biotin AEC method using a LSAB2? HRP kit (Dako?, Denmark) for collagen IV and analyzed by light microscopy. Results. We observed mesothelial detachment from lamina propria, duplicated basement membrane and much thicker blood vessel walls in ESRD and PD patients, compared to healthy subjects. Differences in histological structure, emphasized with immunostaining, indicated pathological alterations of peritoneal tissue in the renal patients. Conclusions. Imunohistochemistry can be used in studying histological alterations of peritoneal tissue in ESRD and PD patients. This method may indicate possible problems in filtration and secretion processes in this tissue.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Arjan M. Van Alphen ◽  
Tessa M. Bosch ◽  
Ralph W. Kupka ◽  
Rocco Hoekstra

Abstract Background Lithium-induced nephropathy is a known long-term complication, sometimes limiting the use of lithium as mood stabilizer. The aim of this study is to establish the incidence of chronic kidney disease and the rate of decline of renal function in patients using lithium and to identify risk factors. Methods We selected 1012 patients treated with lithium from the laboratory database of the Antes Centre for Mental Health Care spanning a period from 2000 to 2015. Serum lithium and creatinine concentrations were retrieved and eGFR was calculated using the 4-variable CKD-EPI formula. We calculated the incidence of renal insufficiency and the rate of decline. We compared patients with and without chronic kidney disease (CKD) stage 3 regarding duration of lithium exposure. Results Incidence of chronic kidney disease was 0.012 cases per exposed patient-year. Average decline of eGFR was 1.8 ml/min/year in patients who developed chronic kidney disease stage 3. Incidence of chronic kidney disease stage 4 was only 0.0004 per patient year. No cases of end stage renal disease were found in this cohort. Odds of reaching chronic kidney disease stage 3 were increased with longer duration of lithium exposure. Conclusions The use of lithium seems to be related to a higher incidence of chronic kidney disease. Longer duration of lithium exposure significantly increased the risk of renal failure.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
G. De Vlieger ◽  
B. Bammens ◽  
F. Claus ◽  
R. Vos ◽  
K. Claes

Diabetic muscle infarction is a rare microangiopathic complication occurring in patients with advanced diabetes mellitus. Diabetic patients with chronic kidney disease stage Vd are prone to develop this complication. The presenting symptom is a localized painful swelling of the affected limb. Symptoms usually resolve spontaneously during the following weeks, but frequent relapse can occur and in some cases swelling may lead to compartment syndrome. Biochemical blood analyses show an elevated C-reactive protein, but creatine kinase is often normal. Diagnosis can be made on clinical presentation and imaging, with magnetic resonance imaging as the gold standard. Histology is often not contributive. Treatment consists of rest, analgesics, rigorous glycemic control and low-dose aspirin. Severe cases of compartment syndrome require fasciotomy. In the current paper, we present two diabetic patients with cystic fibrosis, who are treated with automated peritoneal dialysis and suffered from episodic lower limb infarction. We subsequently review 48 episodes of diabetic muscle infarction previously reported in the literature in patients with end-stage renal disease.


2020 ◽  
Vol 7 (1) ◽  
pp. e09-e09
Author(s):  
Mouna Jerbi ◽  
Hiba Ghabi ◽  
Hanene Gaied ◽  
Fathi Ben Hmida ◽  
Raja Aoudia ◽  
...  

Introduction: Vitamin D deficiency is frequently observed among dialysis patients. Previous studies suggested that 50 to 90% of end-stage renal disease patients are deficient in vitamin D. In Tunisia, studies regarding hypovitaminosis D in patients on dialysis are not numerous. Actually, many data support the use of native vitamin D in hemodialysis (HD) patients. In Tunisia, using native vitamin D is not part of therapeutic habits of all dialysis centers. Objectives: The aim of this study was to determine the prevalence of vitamin D deficiency in patients with chronic kidney disease stage 5 undergoing HD and to evaluate the effect of oral cholecalciferol supplementation, in intact parathormone (iPTH), serum calcium and serum phosphorus. Patients and Methods: We conducted a pre-experimental study among HD patients. Monthly oral supplementation with Cholecalciferol, was instituted for six months. Results: Forty-three participants were included. The mean 25-hydroxy vitamin D concentration was 17.89 ng/mL. Vitamin D deficiency was observed in 83.7% of our patients. We observed a significant increase in 25-hydroxy vitamin D and calcium levels and a significant decline in iPTH levels. No evidence of toxicity, nor severe hypercalcemia or hyperphosphatemia was noted. Conclusion: The supplementation with cholecalciferol seems reasonable and well tolerated in HD patients if reasonable doses are used with regular monitoring.


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