scholarly journals Clinical and paraclinical characteristics of patients undergoing hemodialysis

2021 ◽  
Vol 6 (1) ◽  
pp. e12-e12
Author(s):  
Sanaz Jamshidi ◽  
Sepideh Hajian ◽  
Nafiseh Rastgoo
Keyword(s):  
Vascular Access ◽  
Binding Capacity ◽  
Hemodialysis Patients ◽  
Total Iron ◽  
Dialysis Solution ◽  
Catheter Site ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Iron Binding Capacity

Introduction: End-stage renal disease (ESRD) is an irreversible decrease in kidney function with severe consequences. Objectives: The aim of this study was to investigate clinical and paraclinical characteristics of hemodialysis patients. Patients and Methods: This study was a descriptive-analytical performed on 105 patients undergoing hemodialysis referred to Bou Ali and Velayat hospitals in Qazvin. The data were included age, gender, duration of dialysis, kind of vascular access, kind of catheter, site of catheters, weight, height, systolic and diastolic blood pressure, kind of flux, use of midodrine, kind of dialysis solution, number of dialysis per week, calcium (Ca), iron, total iron binding capacity (TIBC), ferritin, parathyroid hormone (PTH), Kt/V, blood urea nitrogen (BUN) and creatinine (Cr). The data were analyzed using SPSS version 21. Results: The mean age of the patients was 60.97±15.13 years and 44.8% of the patients were females. The mean number of dialysis per week was 2.84 times with a mean duration of 3.90 years. The mean Cr level was 8.89±3.14 mg/dL. Males had higher level of BUN (55.91±16.06 mg/dL versus 65.24±17.53 mg/ dL, P=0.006) and Cr (8.09±2.43 mg/dL versus 9.59±3.47 mg/dL, P=0.010). Arteriovenous fistula/AVF was the most common vascular access (76.2% of cases). With increasing BUN, number of dialysis per week and weight, the level of Cr increases significantly (P<0.05). In the younger patients, Cr showed low level compared to the older patients. Conclusion: The number of dialysis per week, weight and BUN level is factors to predict the level of Cr and with increasing these factors, the level of Cr increases. The mean Cr level was high which showed inadequacy of hemodialysis in these patients. The level of Cr and BUN is higher in men.

scholarly journals Gambaran status besi pada pasien penyakit ginjal kronik stadium 5 dengan anemia yang menjalani hemodialisis reguler

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Bryan J. Silaban ◽  
Cerelia Sugeng ◽  
Bradley J. Waleleng
Keyword(s):  
End Stage Renal Disease ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Binding ◽  
Total Iron Binding Capacity ◽  
Stage Renal Disease ◽  
End Stage ◽  
Iron Binding Capacity

Abstract: Chronic kidney disease (CKD) is a pathological condition with a variety of etiology, resulting in progressively decreased renal function which is often ended with kidney failure. Chronic kidney disease has a global prevalence of 800 per million of population and the incidence of end-stage renal disease ranges from 150 to 200 per million of population. Complications often occur at the end-stage renal disease inter alia anemia with a rate of 80-90%. This study was aimed to obtain the profile of stage-5 CKD patients with anemia and regular hemodialysis was performed on them. This was a descriptive-retrospective study using data of medical records at Prof. Dr. R. D. Kandou General Hospital from January 2015 to October 2016. There were six observed variables as follows: age, gender, serum iron (SI), total iron binding capacity (TIBC), transferrin saturation, and ferritin. The results showed that of the 48 CKD patients with anemia, there were 24 males and 24 females. The majority were aged 60-69 years (33%) and had normal SI level in 30 patients (67%); decreased TIBC in 35 patients (75%); normal transferrin saturation in 26 patients (54%); and increased ferritin level in 38 patients (81%). Conclusion: Majority of the patients were 60-69 years old and had normal level of SI, decreased TIBC, normal transferrin saturation, and increased levels of ferritin. There was no difference in case number of both sexes.Keywords: serum iron, total iron binding capacity, transferrin saturation, ferritin Abstrak: Penyakit Ginjal Kronik (PGK) adalah suatu keadaan patologis dengan etiologi yang beragam, terjadi penurunan fungsi ginjal secara progresif, dan biasanya berakhir dengan gagal ginjal. Penyakit ginjal kronik merupakan salah satu masalah kesehatan di dunia dengan prevalensi 800 per juta populasi dan insidensi end-stage renal disease (ESRD) 150-200 per juta populasi di dunia. Komplikasi sering terjadi pada PGK stadium akhir antara lain anemia dengan persentase mencapai 80-90%. Penelitian ini bertujuan untuk mendapatkan profil pasien PGK stadium 5 dengan anemia dan menjalani hemodialisis reglular. Jenis penelitian ialah deskriptif-retrospektif menggunakan data sekunder dari catatan rekam medik periode Januari 2015 – Oktober 2016 di RSUP Prof. Dr. R. D. Kandou Manado dengan enam variabel penelitian, yaitu usia, jenis kelamin, serum iron (SI), total iron binding capacity (TIBC), saturasi transferin, dan feritin. Dari 48 data rekam medik pasien yang memenuhi kriteria inklusi ditemukan bahwa mayoritas pasien berumur 60-69 tahun (33%), laki-laki maupun perempuan berjumlah sama, mayoritas pasien memiliki kadar SI normal berjumlah 30 pasien (67%), kadar TIBC menurun berjumlah 35 pasien (75%), saturasi transferin normal berjumlah 26 pasien (54%), dan kadar feritin meningkat berjumlah 38 pasien (81%). Simpulan: Mayoritas pasien PGK stadium 5 yang menjalani hemodialisis reguler berusia 60-69 tahun, laki-laki dan perempuan berjumlah sama, serta memiliki kadar SI normal, penurunan TIBC, saturasi transferin normal, dan peningkatan kadar feritin. Kata kunci: serum iron, total iron binding capacity, saturasi transferin, feritin

scholarly journals Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Age Group ◽  
Calcium Phosphorus ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

scholarly journals Provision of Kidney Disease Education Service is Associated with Improved Vascular Access Outcomes among the US Incident Hemodialysis Patients

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0004502021
Author(s):  
Rupam Ruchi ◽  
Shahab Bozorgmehri ◽  
Gajapathiraju Chamarthi ◽  
Tatiana Orozco ◽  
Rajesh Mohandas ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Vascular Access ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
The Us ◽  
Nephrology Care ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Encompassing Model

Background: Pre-end stage renal disease (ESRD) Kidney Disease Education (KDE) has been shown to improve multiple chronic kidney disease (CKD) outcomes but, its impact on vascular access outcomes is not well-studied. In 2010, Medicare launched KDE reimbursements policy for patients with advanced CKD. Methods: In this retrospective USRDS analysis, we identified all adult incident hemodialysis patients with a minimum of 6-months of pre-ESRD Medicare coverage during the first five-years of CMS-KDE policy and divided them into CMS-KDE services recipients (KDE-cohort) and non-recipients (non-KDE cohort). The primary outcome was incident arteriovenous fistula (AVF) and the composite of incident AVF or arteriovenous graft (AVG) utilization. Secondary outcomes were central venous catheter (CVC) with maturing AVF/AVG and pure CVC utilizations. Step-wise multivariate analyses were performed in four progressive models (model 1: KDE alone, model 2: multivariate model encompassing model 1 with socio-demographics, model 3: model 2 with comorbidity and functional status, and model 4: model 3 with pre-ESRD nephrology care). Results: Of the 211,990 qualifying incident hemodialysis patients during the study period, 2,887(1.4%) received KDE services before dialysis initiation. The rates of incident AVF and composite AVF/AVG were more than double (29.7% and 34.9% respectively, compared to 14.2% and 17.2%) and pure catheter use about a third lower (40.4% compared to 64.5%) in the KDE cohort compared to the non-KDE cohort. Maximally adjusted odds ratio(99% confidence interval) in model 4 for study outcomes were: incident AVF use: 1.78 (1.55-2.05), incident AVF/AVG use: 1.78 (1.56-2.03), incident CVC with maturing AVF/AVG: 1.69 (1.44-1.97)and pure CVC without any AVF/AVG: 0.51 (0.45-0.58). The benefits of KDE service were maintained even after accounting for the presence, duration and facility of ESRD care. Conclusion: Occurrence of pre-ESRD KDE service is associated with significantly improved incident vascular access outcomes. Targeted studies are needed to examine the impact of KDE on patient engagement and self-efficacy as a cause for improvement in vascular access outcomes.

Vascular Calcification Markers and Hemodialysis Vascular Access Complications

2018 ◽  
Vol 48 (5) ◽  
pp. 330-338 ◽  
Author(s):  
Beini Lyu ◽  
Tanushree Banerjee ◽  
Julia J. Scialla ◽  
Tariq Shafi ◽  
Alexander S. Yevzlin ◽  
...  
Keyword(s):  
Vascular Calcification ◽  
Vascular Access ◽  
Hemodialysis Patients ◽  
Fetuin A ◽  
Av Fistula ◽  
Morphogenetic Protein ◽  
Disease Study ◽  
Stage Renal Disease ◽  
End Stage ◽  
Access Complications

Background: Arteriovenous (AV) access dysfunction is a common complication in hemodialysis patients. Markers of vascular calcification are associated with cardiovascular outcomes and mortality in this population, but their association with vascular access outcomes is unknown. In this study, we aimed to evaluate the association between selected vascular calcification makers and vascular access complications in a cohort of hemodialysis patients. Method: Fetuin-A, osteopontin (OPN), osteoprotegerin (OPG), and bone morphogenetic protein-7 (BMP-7) were measured in blood samples from 219 dialysis patients in the Choice for Healthy Outcomes in Caring for end-stage renal disease study; these patients were using a permanent vascular access. Participants were followed for up to 1 year or until the occurrence of a vascular access intervention or replacement. Associations with AV fistula (AVF) and AV graft (AVG) intervention-free survival were assessed in models adjusted for demographic characteristics, comorbidities, and inflammation. Results: A total of 24 out 103 participants with an AVF and 43 out of 116 participants with an AVG had an intervention during follow-up. Lower fetuin-A, higher OPN, and higher BMP-7 were associated with a higher risk of AVF intervention (adjusted hazard ratios [aHR] for highest versus lowest tertile = 0.30 [95% CI 0.10–0.94]) for fetuin-A, 3.84 (95% CI 1.16–12.74) for OPN, and 3.49 (95% CI 1.16–10.52) for BMP-7. OPG was not significantly associated with the risk of AVF intervention. The associations of OPN and BMP-7 with AVF intervention appeared stronger among participants without diabetes (aHR 8.06; 95% CI 1.11–58.57 for OPN and aHR 2.55; 95% CI 1.08–6.08 for BMP-7, respectively) than among their counterparts with diabetes (p interaction = 0.06). None of the markers studied were significantly associated with AVG interventions. Conclusion: Lower fetuin-A and higher OPN and BMP-7 are associated with complications in AVF but not in AVG, suggesting a role for calcification in the pathogenesis AVF failure.

scholarly journals Study of effectiveness, tolerability and safety of intravenous iron sucrose in iron deficiency anaemia in postnatal women

2018 ◽  
Vol 7 (11) ◽  
pp. 4366
Author(s):  
R. Niranjana ◽  
K. S. Raja Rajeswari
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Binding Capacity ◽  
Intravenous Iron ◽  
Total Iron ◽  
Iron Sucrose ◽  
Deficiency Anaemia ◽  
Postnatal Women ◽  
The Mean ◽  
Iron Binding Capacity

Background: Iron deficiency anaemia is the most common type of reversible anemia encountered during pregnancy and postpartum period. The present study was done with the objective to find out the efficacy and safety of intravenous iron sucrose in the treatment of iron deficiency anaemia in the postpartum period.Methods: Fifty (50) postnatal patients both after vaginal and caesarean section with iron deficiency anaemia within the first 48 hours with haemoglobin percentage between 6 g/dl and 8g/dl were studied prospectively at the Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai. The patients were given 100 mg of elemental iron diluted in 100 ml of 0.9% normal saline and infused over 15 minutes every alternate day (not more than 3 days in a week) until the required dosage is infused. The blood samples of all the patients were collected and analyzed for haemoglobin (g/dl), hematocrit, mean corpuscular volume (MCV), serum iron, total iron binding capacity (TIBC) and compared before and after therapy.Results: The mean age group of the patients was 24.94 years. Majority of the patients were multipara (68%) and belongs to the class V socio economic status (84%). All the blood parameters were increased significantly (p=0.000) when compared from baseline values to end of the treatment. Mean raise in haemoglobin% after 30 days of treatment was 3.60. Average raise in the mean hematocrit was 8.73. The mean difference in the mean corpuscular volume, total iron binding capacity and the percent saturation was 129.77, 13.55, was 22.26 respectively.Conclusions: Our data confirm that the intravenous iron sucrose was very effective, well tolerated and safe than other forms of iron preparations for treating iron deficiency anaemia in postnatal women.

scholarly journals The identification of ketotifen as a novel cardioprotective agent in patients undergoing anthracyclines chemotherapy

2021 ◽  
Author(s):  
hosny elewa ◽  
Naser elberay ◽  
Walaa Keshk ◽  
Hamada Abulkhair
Keyword(s):  
Breast Cancer ◽  
Binding Capacity ◽  
Serum Levels ◽  
Total Iron ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Iron Binding ◽  
Total Iron Binding Capacity ◽  
The Mean ◽  
Iron Binding Capacity

Objective: The present study aimed to investigate the possible cardioprotective effects of ketotifen and to assess its activity as an iron-chelating agent in patients receiving anthracyclines for the treatment of breast cancer. Patients & Methods: This was a randomized, prospective, controlled clinical trial. One hundred eleven eligible patients with breast cancer (age range, 30-60 years) were scheduled to receive anthracyclines chemotherapy. The patients were divided into two groups: Patients (n = 56) assigned to the ketotifen group received ketotifen 1 mg three times daily for six consecutive cycles of treatment, and patients assigned to the control group (n = 55) without ketotifen treatment. The echocardiogram for each patient was recorded two times at baseline and the end of the study. As well, blood samples were collected from all patients. Results: The findings showed a statistically significant reduction in the mean serum levels of common cardiotoxicity accompanied biomarkers in the ketotifen group compared with the control group (P ≤ 0.05). The mean serum levels of total iron-binding capacity were significantly elevated in the ketotifen group (P ≤ 0.001). There was a direct correlation between the mean serum levels of iron and that of lactate dehydrogenase (LDH) (r = + 0.79). On the other hand, there were indirect correlations between mean serum levels of LDH and both the percentage of ejection fraction and the total iron-binding capacity (r = - 0.69 and -0.697, respectively). Conclusion: Oral administration of ketotifen appears to be efficient and safe as a novel cardioprotective agent for the prevention of anthracyclines induced cardiotoxicity. Additionally, ketotifen suggested a beneficial effect in iron overload inducing diseases such as COVID-19.

scholarly journals Novel use of Ketotifen as a cardio-protective agent in patients undergoing anthracycline chemotherapy

2021 ◽  
Author(s):  
hosny elewa ◽  
Naser elberay ◽  
amany elsharif ◽  
Walaa Keshk ◽  
zeinab zalat
Keyword(s):  
Breast Cancer ◽  
Binding Capacity ◽  
Serum Levels ◽  
Total Iron ◽  
Control Group ◽  
Iron Binding ◽  
Total Iron Binding Capacity ◽  
The Mean ◽  
Iron Binding Capacity ◽  
Anthracycline Chemotherapy

Objective: The present study aimed to investigate the possible cardioprotective effects of ketotifen and to assess its activity as an iron-chelating agent in patients receiving anthracyclines for the treatment of breast cancer. Patients & Methods: This was a randomized, prospective, controlled clinical trial. 111 eligible patients with breast cancer (age range, 30-60 year) were scheduled to receive anthracycline chemotherapy. The patients divided into two groups: Patients (n=56) assigned to The ketotifen group received ketotifen 1 mg three times daily for six consecutive cycles of treatment, and patients assigned to The control group (n= 55) without ketotifen treatment. The echocardiogram for each patient was recorded two times at baseline and at the end of the study. As well, blood samples were collected from all patients. Results: The findings showed a statistically significant reduction in the mean serum levels of common cardiotoxicity accompanied biomarkers in The ketotifen group compared with The control group (P ≤ 0.05). The mean serum levels of total iron-binding capacity was significantly elevated in The ketotifen group (P ≤ 0.001). There was a direct correlation between the mean serum levels of iron and that of lactate dehydrogenase (LDH) (r = + 0.79). On the other hand, there were indirect correlations between mean serum levels of LDH and both the percentage of ejection fraction and the total iron-binding capacity (r = - 0.69 and -0.697, respectively). Conclusion: Oral administration of ketotifen appears to be efficient and safe as a novel cardioprotective agent for the prevention of anthracyclines induced cardiotoxicity. Additionally, ketotifen suggested a beneficial effect in iron overload inducing diseases such as COVID-19.

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