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.

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.

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

Fibrin clot structure in patients with end-stage renal disease

2007 ◽  
Vol 98 (08) ◽  
pp. 339-345 ◽  
Author(s):  
Johannes Sidelmann ◽  
Mikkel Brabrand ◽  
Robert Pedersen ◽  
Jørgen Pedersen ◽  
Kim Esbensen ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Healthy Controls ◽  
Structure Characteristics ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Fibrin Structure ◽  
Plasma Markers ◽  
Fibrin Clots

SummaryFibrin clots with reduced permeability, increased clot stiffness and reduced fibrinolysis susceptibility may predispose to cardiovascular disease (CVD). Little is known, however, about the structure of fibrin clots in patients with end-stage renal disease (ESRD).These patients suffer from a high risk of CVD in addition to their chronic low-grade inflammation. Using permeability, compaction and turbidity studies in 22 ESRD patients and 24 healthy controls, fibrin clots made from patient plasma were found to be less permeable (p<0.001), less compactable (p<0.001), and less susceptible to fibrinolysis (p<0.001) than clots from controls.The maximum rate of turbidity increase was also higher for the patients than controls (p<0.001), and scan-ning electron microscopy revealed higher clot density of fibrin fibers in clots from patients than clots from controls (p<0.001). Patients had higher plasma concentrations of fibrinogen, C-reative protein and interleukin 6 than controls.These plasma markers of inflammation correlated significantly with most of the fibrin structure characteristics observed in the patients. In contrast, plasma markers of azothemia showed no such correlations. The results suggest that in ESRD patients fibrin clots are significantly different from healthy controls, and that the fibrin structure characteristics in the patients are associated primarily with the inflammatory plasma milieu rather than with level of azothemia.

scholarly journals The Profile of Timing Dialysis Initiation in Patients with End-stage Renal Disease in China: A Cohort Study

2020 ◽  
Vol 45 (2) ◽  
pp. 180-193
Author(s):  
Ying Liu ◽  
Luping Wang ◽  
Xianfeng Han ◽  
Yang Wang ◽  
Xuefeng Sun ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Mainland China ◽  
Dialysis Initiation ◽  
Significant Difference ◽  
Initiation Of Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship

Background: Hemodialysis is the main approach for renal replacement therapy in patients with end-stage renal disease (ESRD) in China. The timing of dialysis initiation is one of the key factors influencing patient survival and prognosis. Over the past decade, the relationship between the timing of dialysis initiation and mortality has remained unclear in patients with ESRD in China. Methods: Patients who commenced maintenance hemodialysis from 2009 to 2014 from 24 hemodialysis centers in Mainland China were enrolled in the study (n = 1,674). Patients were divided into 2 groups based on the year they started hemodialysis (patients who started hemodialysis from 2009 to 2011, and patients who started hemodialysis from 2012 to 2014). Analysis of the yearly change in the estimated glomerular filtration rate (eGFR) at the initiation of dialysis was performed for the 2 groups. Meanwhile, the patients were divided into 3 groups based on their eGFR at the initiation of dialysis (<4, 4–8, and >8 mL/min/1.73 m2). For these 3 groups, the relationship between the eGFR at the start of dialysis and mortality were analyzed. Results: The average eGFRs were 5.68 and 5.94 mL/min/1.73 m2 for 2009–2011 and 2012–2014, respectively. Compared with the 2009–2011 group, the proportion of patients with diabetes in 2012–2014 increased from 26.7 to 37.7%. The prognosis of patients with different eGFRs at the start of dialysis was analyzed using Kaplan-Meier survival curves. After adjusting for confounding factors through a Cox regression model, no significant difference was demonstrated among the 3 groups (<4 mL/min/1.73 m2 was used as the reference, in comparison with 4–8 mL/min/1.73 m2 [p = 0.681] and >8 mL/min/1.73 m2 [p = 0.403]). Conclusion: In Mainland China, the eGFR at the start of dialysis did not change significantly over time from 2008 to 2014 and had no association with the mortality of patients with ESRD.

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