scholarly journals A comparative study on the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients; a double-blinded randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
pp. e12-e12
Author(s):  
Saeed Mardani ◽  
Faranak Sadat Filsouf
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Hemodialysis Patients ◽  
Significant Difference ◽  
Before And After ◽  
Calcium Phosphorus ◽  
Stage Renal Disease ◽  
Double Blinded ◽  
End Stage ◽  
Calcium And Phosphate Metabolism

Introduction:Chronic kidney disease (CKD) has lots of complication like calcium and phosphate metabolism disorders, hyperparathyroidism, vitamin D deficiency and metabolic acidosis. Objectives: The aim of this study was to determine and compare the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients due to end-stage renal disease (ESRD). Patients and Methods: This study was a double-blinded randomized clinical trial, which was conducted on 60 hemodialysis patients in 2017-2018. The patients were randomly assigned to two groups of 30 patients, which one group was treated with cinacalcet and the other group was treated with calcitriol. During this study, phosphorus, calcium and iPTH were measured. Results: The results showed that in the group treated with cinacalcet, the amount of calcium [t(22)=0.294, P>0.05] and the amount of phosphorus [t(22)=1.87, P>0.05] did not change significantly while iPTH values before and after the study had statistically significant difference [t(22)=4.37, P<0.05]. In group treated with calcitriol, the calcium, phosphorus and iPTH values did not change significantly (P>0.05). Calcium changes in the cinacalcet group compared to the calcitriol group [t (47) =-1.14, P>0.05] and also, the amount of phosphorus changes [t (47) =-1.022, P>0.05] was not statistically significant. The iPTH changes were not statistically significant between the two groups however iPTH in the calcitriol group was higher than the cinacalcet group [t (47) =-1.13, P>0.05]. Conclusion: In contrast to calcitriol, cinacalcet significantly reduced iPTH and did not significantly change calcium and phosphorus levels. Trial Registration: The trial was registered by Iranian Registry of Clinical Trials (IRCT) (identifier: IRCT20190702044076N1; https://en.irct.ir/trial/40547, Ethical code# IR.SKUMS.REC.1397.026).

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.

Role of vitamin D in oxidative stress modulation in end‐stage renal disease patients: A double‐blind randomized clinical trial

2020 ◽  
Vol 24 (3) ◽  
pp. 367-373
Author(s):  
Leila Malekmakan ◽  
Zeinab Karimi ◽  
Afshin Mansourian ◽  
Maryam Pakfetrat ◽  
Jamshid Roozbeh ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Clinical Trial ◽  
Vitamin D ◽  
Renal Disease ◽  
Randomized Clinical Trial ◽  
End Stage Renal Disease ◽  
Double Blind ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Effects of Liberal Versus Restrictive Fluid Therapy on Renal Function Indices in Laparoscopic Bariatric Surgery

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Mahzad Alimian ◽  
Masood Mohseni ◽  
Omid Moradi Moghadam ◽  
Seyed Alireza Seyed Siamdoust ◽  
Javad Moazzami
Keyword(s):  
Bariatric Surgery ◽  
Clinical Trial ◽  
Fluid Therapy ◽  
Gastric Bypass Surgery ◽  
Kidney Injury ◽  
Laparoscopic Bariatric Surgery ◽  
Significant Difference ◽  
Conflicting Objectives ◽  
Before And After ◽  
Double Blinded

Background: Earlier studies have suggested the liberal administration of fluids in favor of reducing the risk of rhabdomyolysis in obese patients, but the results are conflicting. Objectives: The present study aimed at comparing the effects of liberal and restrictive fluid therapy on renal indices in laparoscopic gastric bypass surgery. Methods: In a double-blinded randomized clinical trial, 72 candidates of bariatric surgery were randomly assigned into two groups of restrictive and liberal fluid therapy. Indices, including BUN, creatinine, creatine kinase, GFR, and urine output were measured before and 24 hours after the surgery. The clinical trial was registered at IRCT.ir under code IRCT20170109031852N3. Results: There was no significant difference in BUN, creatinine, creatinine kinase, and GFR indices between the two groups of liberal and restrictive fluid therapy both before and 24 hours after surgery (P > 0.05). Intragroup comparisons before and after surgery revealed that BUN decreased in both groups after the surgery (P < 0.05). Also, creatinine and GFR values improved in patients who received a liberal fluid regimen, whereas these indices remained statistically unchanged in the restrictive group before and 24 hours after the surgery (P > 0.05). Conclusions: Two methods of liberal and restrictive fluid therapy have comparable effects on traditional renal functional indices in laparoscopic bariatric surgery. The clinical significance of observed differences in outcomes should be investigated in further studies. The use of early biomarkers of acute kidney injury is warranted.

scholarly journals Effect of dietary combinations on plaque pH recovery after the intake of pediatric liquid analgesics

2015 ◽  
Vol 09 (03) ◽  
pp. 340-345 ◽  
Author(s):  
Shaam Saeed ◽  
Nada Bshara ◽  
Juliana Trak ◽  
Ghiath Mahmoud
Keyword(s):  
Clinical Trial ◽  
Statistical Analysis ◽  
Randomized Clinical Trial ◽  
Sampling Method ◽  
Chewing Gum ◽  
P Value ◽  
Plaque Ph ◽  
Significant Difference ◽  
Before And After ◽  
Difference Test

ABSTRACT Objectives: To study the effect of water, halloumi cheese and sugar-free (SF) chewing gum on plaque pH recovery after the intake of sweetened PLAs. Settings and Design: A randomized clinical trial was conducted on 17 children (10 females, 7 males) aged 11–12 years with DFT/dft of more than 3. Materials and Methods: Each volunteer tested paracetamol and ibuprofen suspension alone or followed with water, halloumi cheese or SF gum, as well as 10% sucrose and 10% sorbitol as controls. Plaque pH was measured using the sampling method before and after 5, 10, 15, 20, 30 min of ingestion. Statistical Analysis: Statistical analysis was performed using analysis of variance followed by least significant difference test to assess minimum pH (min pH), maximum pH drop (ΔpH), and the area under baseline pH, and P value was set as 0.05. Results: Both ibuprofen and paracetamol were not significantly different from 10% sucrose in terms of min pH, ΔpH, and area under baseline pH except for min pH of ibuprofen (P = 0.034). Water and halloumi cheese did not have a significant effect on plaque pH recovery after the intake of both analgesics as min pH, ΔpH, and area under baseline pH were similar to 10% sucrose except for min pH of ibuprofen + water (P = 0.048). However, plaque pH variables after chewing SF gum for 20 min were similar to 10% sorbitol. Conclusion: Chewing SF gum immediately after the intake of sweetened PLAs for 20 min restores plaque pH and could be recommended as a complementary aid in caries prevention.

Potassium dynamics are attenuated in hyperkalemia and a determinant of QT adaptation in exercising hemodialysis patients

2013 ◽  
Vol 115 (4) ◽  
pp. 498-504 ◽  
Author(s):  
Cao Thach Tran ◽  
Henning Bundgaard ◽  
Søren Daustrand Ladefoged ◽  
Stig Haunsø ◽  
Keld Kjeldsen
Keyword(s):  
Qt Interval ◽  
Potassium Concentration ◽  
Plasma Potassium ◽  
Work Load ◽  
Hemodialysis Patients ◽  
Cycle Ergometer ◽  
Potassium Dynamics ◽  
Before And After ◽  
Stage Renal Disease ◽  
End Stage

Disturbances in plasma potassium concentration (pK) are well known risk factors for the development of cardiac arrhythmia. The aims of the present study were to evaluate the effect of hemodialysis on exercise pK dynamics and QT hysteresis, and whether QT hysteresis is associated with the pK decrease following exercise. Twenty-two end-stage renal disease patients exercised on a cycle ergometer with incremental work load before and after hemodialysis. ECG was recorded and pK was measured during exercise and recovery. During exercise, pK increased from 5.1 ± 0.2 to 6.1 ± 0.2 mM (mean ± SE; P < 0.0001) before hemodialysis and from 3.8 ± 0.1 to 5.1 ± 0.1 mM ( P < 0.0001) after hemodialysis. After 2 min of recovery, pK had decreased to 5.0 ± 0.2 mM and 4.1 ± 0.1 mM ( P < 0.0001) before and after hemodialysis, respectively. pK increase during exercise was accentuated after hemodialysis. The pK increase was negatively linearly correlated with pK before exercise (β = −0.21, R2 = 0.23, P = 0.001). QT hysteresis was negatively linearly correlated with the decrease in pK during recovery (β = −28 ms/mM, R2 = 0.36, P = 0.006). Thus, during recovery, low pK was associated with relatively longer QT interval. In conclusion, new major findings are an accentuated increase in pK during exercise after hemodialysis, an attenuated increase in pK in hyperkalemia, and an association between pK and QT interval adaptation during recovery. The acute pK shift after exercise may modulate QT interval adaptation and trigger cardiac arrhythmias.

P1588CAN L-CARNITINE SUPPLEMENTATION IMPROVE CARDIOPULMONARY FUNCTION? A RANDOMIZED CONTROLLED TRIAL IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Fatemeh Yassari ◽  
Alireza Eslaminejad ◽  
Mehran Marashian ◽  
Farzaneh Dastan ◽  
Farzaneh Maleki Kazeri
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Controlled Trial ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Carnitine Supplementation ◽  
Carnitine Level ◽  
Cardiopulmonary Function ◽  
Significant Difference ◽  
Spss Software

Abstract Background and Aims It is well known that L-Carnitine is a cardioprotective agent, which balances cardiac energy metabolism, by promoting mitochondrial β-oxidation and facilitating transport of long chain fatty acids into the mitochondrial matrix. It has been shown that L-Carnitine level in plasma and tissue is lower in hemodialysis patients and they may lose the benefits of this substance. As far as our knowledge, the effect of L-Carnitine on cardiopulmonary function has not been evaluated by ergospirometry up to now. The aim of this randomized clinical trial was to assess the effects of L-carnitine supplementation on cardiopulmonary Function in hemodialysis patients through ergospirometry. Method This randomized clinical trial was conducted on 46 chronic hemodialysis patients. The patients were divided into two groups. In both groups ergospirometry parameters (VE Max, VO2-Max, VCO2 Max, AT, VE/VCO2 Slope) were recorded for a 3-month period. During this period, one group received L-Carnitine at doses of 2 gr/day orally and the other group received only placebo. After three months, all of the mentioned parameters were rechecked and statistical analysis performed by SPSS software. Results Only CRP was different between the two groups increasing in placebo group significantly after 3 months (P = 0.018). No significant difference was detected in Cardiopulmonary factors. In terms of ergospirometry factors, PET-CO2 was the only parameter significantly increased in the treatment group (P = 0.026). Conclusion The present results indicate that L-Carnitine can improve cardiopulmonary function among hemodialysis patients.

Longevity, Esthetic Perception, and Psychosocial Impact of Teeth Bleaching by Low (6%) Hydrogen Peroxide Concentration for In-office Treatment: A Randomized Clinical Trial

2017 ◽  
Vol 42 (1) ◽  
pp. 41-52 ◽  
Author(s):  
E Fernández ◽  
C Bersezio ◽  
J Bottner ◽  
F Avalos ◽  
I Godoy ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hydrogen Peroxide ◽  
Randomized Clinical Trial ◽  
Positive Impact ◽  
Color Difference ◽  
Psychosocial Impact ◽  
Bleaching Procedure ◽  
Significant Difference ◽  
Before And After ◽  
Shade Guide

SUMMARY Objective: The aim was to evaluate the color longevity after nine months of in-office bleaching with gel (6% hydrogen peroxide), to compare this to a control concentration of 35% in a split-mouth study model, and to assess the dental confidence and psychosocial impact on patients. Methods and Materials: Twenty-seven patients were assessed at the nine-month recall. The bleaching procedure with 6% or 35% hydrogen peroxide gel was performed randomly in the upper hemi-arch of each patient. The color was measured at baseline and at one week, one month, and nine months after the procedure, using the Vita Easyshade spectrophotometer, the Vita classical shade guide organized by value, and Vita Bleach Guide 3DMaster. Moreover, two surveys, OHIP-Esthetics and PIDAQ, were used to assess the esthetic self-perception and psychosocial impact of the bleaching procedure. During the nine-month recall, the color was assessed before and after dental prophylaxis. Results: Twenty-seven patients participated in the nine-month recall. There was a significant difference in ΔE between the two groups at all times assessed (p&lt;0.011). The ΔL, Δa, and Δb showed a difference between the two groups at all times assessed (p&lt;0.038), except for ΔL from the baseline vs nine-month after prophylaxis value (p&gt;0.20). There was no significant difference in ΔSGU at all times (p&gt;0.05). There was a significant difference in OHIP-Esthetics and PIDAQ sums compared with baseline scores (p&lt;0.03). Conclusion: The two compounds remained effective at nine months, with a slight rebound of color, and maintained their objective color difference but not the subjective color difference. Patients were satisfied with the bleaching procedure, and this had a positive impact on esthetic perception and a positive psychosocial impact at the nine-month recall.

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