scholarly journals Evaluation of acute intradialytic complications, management & outcome in end-stage renal disease patients

2013 ◽  
Vol 2 (2) ◽  
pp. 35-40
Author(s):  
MJ Hasan ◽  
A Muqueet ◽  
M Asadujjaman ◽  
A Sharmeen ◽  
S Kabir ◽  
...  
Keyword(s):  
Chest Pain ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hypertensive Crisis ◽  
Electrolyte Imbalance ◽  
Loss Of Consciousness ◽  
Female Ratio ◽  
Muscular Cramps ◽  
Stage Renal Disease ◽  
End Stage

Little is known about the challenges of routine renal replacement therapy in Bangladesh. We investigated the fatal and nonfatal acute hemodialysis complications in patients with end stage renal disease (ESRD) in dialysis centers in Mymensingh. 500 consecutive hemodialysis sessions incurred over a 4-month period by 50 patients with ESRD, receiving two weekly hemodialysis sessions of 4 hours each were considered. Personal and clinical profiles before, during, and within 24 hours after hemodialysis sessions were used to diagnose complications. The mean age of the patients was 45.5 ± 16.8 years and the lowest and highest ages were 17 and 82 years respectively. Male was predominant of the patients and male to female ratio was 2:1. Hypotension, muscular cramps, pruritus, nausea and vomiting were the common complications in end-stage renal disease patients. Twenty eight percent of patients presented with hypertensive crisis, 34% fever, 18% bleeding, 44% headache, 32% vomiting, 16% lumber pain, 16% palpitations, 22% disequilibrium syndrome, 36% dyspnea, 28% chest pain, 20% syncope, 32% abdominal problem, 44% neurological problem, 46% electrolyte imbalance, 34% articular & musculoskeletal problems, 48% cramps, 38% convulsions and 20% loss of consciousness. The vascular access was the main bleeding site of the patients (44.5%), followed by 33.3% through nose and 22.2% digestive tract bleeding. Most of patients experienced muscular cramps, hypertensive crisis, pruritus, vomiting, palpitations, disequilibrium syndrome, dyspnea, chest pain, neurologic problem, electrolyte disorders, nausea, vomiting, convulsions and loss of consciousness in shorter duration of dialysis than those in longer duration of dialysis sessions. Bleeding, disequilibrium syndrome and cardiovascular disease were leading cause of death in end-stage renal disease patients. Those complications occurred mostly during understaffed periods. Urgent strategies are needed to quickly solve the human capital crisis in the health care sector. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16696 Community Based Medical Journal 2013 July: Vol.02 No 02: 35-40

scholarly journals Real-world evidence and optimization of vocal dysfunction in end-stage renal disease patients with secondary hyperparathyroidism

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geng-He Chang ◽  
Fong-Fu Chou ◽  
Ming-Shao Tsai ◽  
Yao-Te Tsai ◽  
Ming-Yu Yang ◽  
...  
Keyword(s):  
Renal Disease ◽  
Secondary Hyperparathyroidism ◽  
Real World ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Electrolyte Imbalance ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Stage Renal Disease ◽  
End Stage

AbstractPatients with end-stage renal disease (ESRD) may demonstrate secondary hyperparathyroidism (SHPT), characterized by parathyroid hormone oversecretion in response to electrolyte imbalance (e.g., hypocalcemia and hyperphosphatemia). Moreover, this electrolyte imbalance may affect vocal cord muscle contraction and lead to voice change. Here, we explored the effects of SHPT on the voices of patients with ESRD. We used data of 147,026 patients with ESRD from the registry for catastrophic illness patients, a sub-database of Taiwan National Health Insurance Research Database. We divided these patients into 2 groups based on whether they had hyperparathyroidism (HPT) and compared vocal dysfunction (VD) incidence among them. We also prospectively included 60 ESRD patients with SHPT; 45 of them underwent parathyroidectomy. Preoperatively and postoperatively, voice analysis was used to investigate changes in vocal parameters. In the real-world database analysis, the presence of HPT significantly increased VD incidence in patients with ESRD (p = 0.003): Cox regression analysis results indicated that patients with ESRD had an approximately 1.6-fold increased VD risk (p = 0.003). In the clinical analysis, the “jitter” and “shimmer” factors improved significantly after operation, whereas the aerodynamic factors remained unchanged. In conclusion, SHPT was an independent risk factor for VD in patients with ESRD, mainly affecting their acoustic factors.

scholarly journals Machine learning algorithm for early detection of end-stage renal disease

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zvi Segal ◽  
Dan Kalifa ◽  
Kira Radinsky ◽  
Bar Ehrenberg ◽  
Guy Elad ◽  
...  
Keyword(s):  
Machine Learning ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Predictive Value ◽  
Hypertensive Crisis ◽  
Machine Learning Algorithms ◽  
Gradient Boosting ◽  
Severe Stage ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background End stage renal disease (ESRD) describes the most severe stage of chronic kidney disease (CKD), when patients need dialysis or renal transplant. There is often a delay in recognizing, diagnosing, and treating the various etiologies of CKD. The objective of the present study was to employ machine learning algorithms to develop a prediction model for progression to ESRD based on a large-scale multidimensional database. Methods This study analyzed 10,000,000 medical insurance claims from 550,000 patient records using a commercial health insurance database. Inclusion criteria were patients over the age of 18 diagnosed with CKD Stages 1–4. We compiled 240 predictor candidates, divided into six feature groups: demographics, chronic conditions, diagnosis and procedure features, medication features, medical costs, and episode counts. We used a feature embedding method based on implementation of the Word2Vec algorithm to further capture temporal information for the three main components of the data: diagnosis, procedures, and medications. For the analysis, we used the gradient boosting tree algorithm (XGBoost implementation). Results The C-statistic for the model was 0.93 [(0.916–0.943) 95% confidence interval], with a sensitivity of 0.715 and specificity of 0.958. Positive Predictive Value (PPV) was 0.517, and Negative Predictive Value (NPV) was 0.981. For the top 1 percentile of patients identified by our model, the PPV was 1.0. In addition, for the top 5 percentile of patients identified by our model, the PPV was 0.71. All the results above were tested on the test data only, and the threshold used to obtain these results was 0.1. Notable features contributing to the model were chronic heart and ischemic heart disease as a comorbidity, patient age, and number of hypertensive crisis events. Conclusions When a patient is approaching the threshold of ESRD risk, a warning message can be sent electronically to the physician, who will initiate a referral for a nephrology consultation to ensure an investigation to hasten the establishment of a diagnosis and initiate management and therapy when appropriate.

scholarly journals Pilot Experience in Senegal with Peritoneal Dialysis for End-Stage Renal Disease

2014 ◽  
Vol 34 (5) ◽  
pp. 539-543 ◽  
Author(s):  
Abdou Niang ◽  
Mouhamadou Moustapha Cisse ◽  
Sidi Mohamed Ould M. Mahmoud ◽  
Ahmed Tall Ould Lemrabott ◽  
El Hadji Fary Ka ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Health Care Providers ◽  
End Stage Renal Disease ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Female Ratio ◽  
Sub Saharan ◽  
Stage Renal Disease ◽  
End Stage

IntroductionPeritoneal dialysis (PD) is occasionally used in western sub-Saharan Africa to treat patients with end-stage renal disease (ESRD). The present study is a retrospective review of the initial six years’ experience with PD for ESRD therapy in Senegal, a West African country with a population of over 12 million.Material and MethodsSingle-center retrospective cohort study of patients treated with PD between March 2004 and December 2010. Basic demographic data were collected on all patients. Peritonitis rates, causes of death and reasons for transfer to hemodialysis (HD) were determined in all patients.ResultsSixty-two patients were included in the study. The median age was 47 ± 13 years with a male/female ratio of 1.21. Nephrosclerosis and diabetic nephropathy were the main causes of ESRD. The mean Charlson score was 3 ± 1 with a range of 2 to 7. Forty five peritonitis episodes were diagnosed in 36 patients (58%) for a peritonitis rate of 1 episode/20 patient-months (0.60 episodes per year). Staphylococcus aureus and Pseudomonas aeruginosa were the most commonly identified organisms. Touch contamination has been implicated in 26 cases (57.7%). In 23 episodes (51%), bacterial cultures were negative. Catheter removal was necessary in 12 cases (26.6%) due to mechanical dysfunction, fungal or refractory infection. Sixteen patients died during the study.ConclusionPeritoneal dialysis is a suitable therapy which may be widely used for ESRD treatment in western sub-Saharan Africa. A good peritonitis rate can be achieved despite the difficult living conditions of patients. Challenges to the development of PD programs include training health care providers, developing an infrastructure to support the program, and developing a cost structure which permits expansion of the PD program.

scholarly journals Incidence of end stage renal disease on renal replacement therapy in Nepal

1970 ◽  
Vol 7 (3) ◽  
pp. 301-305 ◽  
Author(s):  
R Hada ◽  
S Khakurel ◽  
RK Agrawal ◽  
RK Kafle ◽  
SB Bajracharya ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Female Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country. Objectives: The objective of this study is to find out the incidence of ESRD on renal replacement therapy and their out come. Materials and methods: It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients file, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profile, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis. Results: Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 ± 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT. Conclusion: The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to find out of cause of ESRD and to institute preventive measures.Key words: End stage renal disease; Renal replacement therapy; Haemodialysis; Intermittent peritoneal dialysis; Incidence of end stage renal disease; Nepal. DOI: 10.3126/kumj.v7i3.2742 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 302-305

Cutaneous manifestations of end-stage renal disease

2015 ◽  
Author(s):  
Timur A. Galperin ◽  
Kieron S. Leslie ◽  
Antonia J. Cronin
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Skin Diseases ◽  
Treatment Options ◽  
Electrolyte Imbalance ◽  
Cutaneous Manifestations ◽  
Metastatic Calcification ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage

A broad range of skin diseases occur in patients with end-stage renal disease. Some of these conditions are benign, and make little impact on patients’ lives. Others, however, have a greater impact on quality of life, may be physically disabling, and even life-threatening. Mostly, they result from a combination of factors, such as electrolyte imbalance and co-morbid disease. Uraemic pruritus is the most commonly troublesome and an approach to it is presented. Other non-specific skin manifestations of CKD include skin-colour changes, xerosis, half-and-half nails Specific manifestations include acquired perforating dermatosis, bullous dermatoses, metastatic calcification, and nephrogenic systemic fibrosis. Pathophysiology, clinical presentation, diagnosis, and treatment options are discussed.

scholarly journals Management of Resistant Pericarditis in an End Stage Renal Disease Patient - Case Presentation

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Chest Pain ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Disease Patient ◽  
Abdominal Ultrasound ◽  
Liver Cyst ◽  
Surgical Department ◽  
Stage Renal Disease ◽  
End Stage ◽  
Serum Crp

A 75 year old female receiving dialysis 3 times weekly due to end-stage renal disease (ESRD), secondary to polycystic kidney disease, presented to the emergency room. She complained of right upper quadrant pain together with pleuritic chest pain. The chest pain worsened on deep inspiration and on lying down flat, but improved on sitting up and bending forwards. An abdominal ultrasound, performed due to a known liver cyst, revealed a solid dense lesion, which was not indicative of a cyst. There was the suspicion that the lesion may have been infectious or hemorrhagic in nature. As a result the patient was admitted to the surgical department for further evaluation. Due to her failure to respond to antibiotic treatment a PET-CT with F-18-FDG was ordered. The studies revealed increased mediastinal absorption between her large vessels and pericardium as well as a small pericardial effusion. Her serum CRP peak was 236.83 mg/l, the troponin was negative and her blood urea was 42 mg/dl (15-45 mg/dl). The ECG did not show any typical changes of pericarditis.

scholarly journals Pattern of End Stage Renal Disease in a Tertiary Care Center

2009 ◽  
Vol 48 (174) ◽  
pp. 126-30 ◽  
Author(s):  
Sudha Khakurel ◽  
Rajendra Kumar Agrawal ◽  
Rajani Hada
Keyword(s):  
Diabetic Nephropathy ◽  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Female Ratio ◽  
Stage Renal Disease ◽  
End Stage

Introduction: End Stage renal disease (ESRD) is a major public health problem across the world and it is rising. The incidence prevalence and causes of ESRD is not known in Nepal. With a population of 27 million people the estimated incidence of ESRD is around 2700/year if we take 100/million population at par with India and Pakistan. However majority of patients do not reach hospitals with dialysis facilities. The aim of the present study was to analyze the clinico-epidemiological profile of ESRD in the Nepalese context. Methods: A retrospective, cross sectional study was conducted on newly diagnosed ESRD patients within fi ve years in a tertiary care center. Their demographic profi le, etiology and follow up were studied.Results: The mean age of the patients was 42 years, male to female ratio being 1.7:1. Chronic glomerulonephritis (41%) was the leading cause of ESRD, followed by diabetic nephropathy (16.8%) and hypertensive nephrosclerosis (13.7%). Unexplained renal failure constituted 18% of our cases. Intermittent peritoneal dialysis (IPD) remained the initial mode of therapy due to easy accessibility. Most of the patients dropped out after having single session of IPD. Others went for repeat sessions of IPD or haemodialysis. Out of the 23.6% who went for haemodialysis only 13% could continue dialysis for more than three months and 3.8% could go to neighboring country for renal transplantation.Conclusions: CGN is the leading cause of ESRD followed by diabetic nephropathy and hypertension. It affected younger age group people. ESRD treatment is costly and unaffordable by most Nepalese people. Stress should be given to the health education and screening programme for prevention and early detection of CKD.Key Words: end stage renal disease, intermittent peritoneal dialysis, Nepal

scholarly journals Acquired cystic renal disease in hemodialysis patients.

2020 ◽  
Vol 27 (11) ◽  
pp. 2403-2406
Author(s):  
Suhail Iqbal Malik ◽  
Raheel Khan ◽  
Muhammad Yousuf ◽  
Muhammad Imran ◽  
Yusra Saeed ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Age Groups ◽  
Stone Disease ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Female Ratio ◽  
Cystic Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

Objectives: Acquired cystic renal disease is known complication of End stage renal disease and hemodialysis and is also a precursor to renal cell carcinoma in patients who are on long term maintenance hemodialysis. Study Design: Cross Sectional study. Setting: Bahawal Victoria Hospital, Bahawalpur-Pakistan. Period: Jan 2019 to June 2019. Material & Methods: Patients on maintenance hemodialysis were evaluated using ultrasound for acquired cystic renal disease. Results: The study included 220 patients who were on maintenance hemodialysis. The male to female ratio was 2.01:1. Most common causes of renal failure were Diabetes Mellitus and Renal stone Disease (22.3%) each. Acquired cystic renal disease was found in 45 (20.5%). The difference of frequency of acquired cystic renal disease was statistically significant in age groups & anemia. Conclusions: Acquired cystic renal disease is common complication of End stage renal disease and maintenance hemodialysis. Regular monitoring with ultrasound needs to be done for those patients who are on maintenance hemodialysis for more than 3 years.

scholarly journals Clinical profile of end stage renal disease in patients on maintenance haemodialysis in a tertiary hospital

2020 ◽  
Vol 13 (2) ◽  
pp. 169-172
Author(s):  
Durga Dhungana ◽  
Chandra Bahadur Pun ◽  
Bidhya Banstola
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Hospital ◽  
Clinical Profile ◽  
Female Ratio ◽  
Maintenance Haemodialysis ◽  
Stage Renal Disease ◽  
End Stage

Introduction and Objectives: Chronic kidney disease is an increasing health problem worldwide and the burden of such patients is increasing in developing countries like Nepal as well. The final treatment for End Stage Renal Disease is only renal replacement therapy. The objective was to study the demographic and clinical profile of patients with End Stage Renal Disease undergoing haemodialysis. Methods: This was a prospective, observational study carried out in a tertiary hospital after obtaining ethical consent from the Institutional Review Board. The study period was from June 1st to August 31st, 2019. Thirty seven patients, older than 15 years who were on maintenance haemodialysis on regular basis in the hospital for at least 3 months were selected for the study. Patient’s records were used for the data collection as well as direct questionnaire to the patients on follow up for routine haemodialysis. Data were entered into Statistical Package for the Social Sciences 21 and descriptive analysis was done. Results: Twenty-six patients were under 50 years with male: female ratio of 1.64:1. Mean duration of haemodialysis of patients was 3.82 years. Most common cause for end stage renal disease was hypertension followed by idiopathic cause. Anaemia and hypocalcaemia were found to be the common complications associated with the patients. Conclusions: Prevention and early treatment may be the key to decrease the incidence of chronic kidney disease patients and also halt the progression to End stage renal disease.  

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