scholarly journals Skor APRI pada subyek penyakit ginjal stadium 5 hemodialisis dengan hepatitis B dan hepatitis C

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria E. Jarut ◽  
Emma Sy. Moeis ◽  
Bradley J. Waleleng
Keyword(s):  
Platelet Count ◽  
Hepatitis C ◽  
Renal Replacement Therapy ◽  
Hepatitis B ◽  
Replacement Therapy ◽  
High Risk Group ◽  
Hemodialysis Unit ◽  
Apri Score ◽  
Age Range ◽  
Observational Descriptive Study

Abstract: Chronic kidney disease (CKD) is a process with various etiology, resulting in a progressive descent in kidney function and generally end up with kidney failure that requires renal replacement therapy. One of the renal replacement therapy is hemodialysis. Subjects undergoing hemodialysis belong to the high-risk group for hepatitis B and hepatitis C. This study aimed to obtain the APRI scores in subjects CKD 5 HD with hepatitis B and hepatitis C. This was a retrospective observational descriptive study. This study was conducted from October to December 2014 in the medical record of Hemodialysis Unit Prof. Dr. R. D. Kandou Hospital Manado. The results showed that there were 64 subjects who met the inclusion criteria, consisted of 29 (45%) subjects with CKD 5 HD and hepatitis B and 35 (55%) subjects with CKD 5 HD and hepatitis C. Among subjects of CKD 5 HD with hepatitis B, there were 24 (37.50%) males and 5 (7.81%) females. Among subjects with CKD 5 HD and hepatitis C, there were 15 (23.43%) males and 20 (31.25%) females. Age range in subjects with CKD 5 HD and hepatitis B was 37-69 years, while in subjects with CKD 5 HD and hepatitis C was 33-65 years. The SGOT of the CKD 5 HD subjects with hepatitis B was 14-58 U/L while of the CKD 5 HD subjects with hepatitis C was 21-38 U/L. The platelet count in subjects with CKD 5 HD and hepatitis B was 78.103 /mm3 – 357.103/ mm3 while in CKD 5 HD subjects with hepatitis C was 54.103/mm3 – 417.103/mm3. Based on the SGOT and the platelet count, the final APRI scores for subjects with CKD 5 HD and hepatitis B was 0.004- 0.056 while the of CKD 5 HD subjects with hepatitis C was 0.005-0.177. The APRI scores in subjects with CKD 5 HD and hepatitis B and CKD 5 HD subjects with hepatitis C was < 0.5 which meant there was no fibrosis of the liver or fibrosis without septa. Conclusion: APRI scores were not significant to the degree of fibrosis in the early stages of either hepatitis B or hepatitis C. Keywords: CKD 5 HD, hepatitis B, hepatitis C, APRI score Abstrak: Penyakit ginjal kronik adalah suatu proses dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif dan umumnya berakhir dengan gagal ginjal yang memerlukan terapi pengganti ginjal. Salah satu terapi pengganti ginjal yaitu hemodialisis. Subyek yang menjalani hemodialisis merupakan kelompok risiko tinggi untuk virus hepatitis B dan hepatitis C. Penelitian ini bertujuan untuk mengetahui skor APRI pada subyek PGK 5 HD dengan hepatitis B dan hepatitis C. Jenis penelitian ini ialah observasional dengan rancangan deskriptif retrospektif. Penelitian ini dilaksanakan mulai Oktober sampai Desember 2014 di Bagian rekam medik Ilmu Penyakit Dalam Unit Hemodialisis RSUP Prof Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan dari 64 subyek yang memenuhi kriteria inklusi terdapat 29 (45%) subyek PGK 5 HD dengan hepatitis B dan 35 (55%) subyek PGK 5 HD dengan hepatitis C. Pada subyek PGK stadium 5 HD dengan hepatitis B, terdapat 24 laki-laki (37,50%) dan 5 perempuan (7,81%). Pada subyek PGK 5 HD dengan hepatitis C, terdapat 15 laki-laki (23,43%) dan 20 perempuan (31,25%). Rentang umur pada subyek PGK 5 HD dengan hepatitis B 37-69 tahun sedangkan rentang umur pada subyek PGK 5 HD dengan hepatitis C 33-65 tahun. Nilai SGOT subyek PGK 5 HD dengan hepatitis B 14-58 U/L sedangkan subyek PGK 5 HD dengan hepatitis C 21-38 U/L. Jumlah trombosit pada subyek PGK 5 HD dengan hepatitis B 78.103/mm3– 357.103/mm3sedangkan subyek PGK 5 HD dengan hepatitis C 54.103/mm3– 417.103/mm3. Berdasarkan nilai SGOT dan jumlah trombosit yang diperoleh maka hasil perhitungan skor APRI untuk subyek PGK 5 HD dengan hepatitis B 0,004-0,056 sedangkan pada subyek PGK 5 HD dengan hepatitis C 0,005-0,177. Skor APRI pada subyek PGK 5 HD dengan hepatitis B dan subyek PGK 5 HD dengan hepatitis C <0,5, yang menunjukkan tidak terdapat fibrosis pada hati atau terdapat fibrosis tanpa septa. Simpulan: Skor APRI tidak bermakna terhadap derajat fibrosis stadium awal baik pada hepatitis B ataupun heptitis C.Kata kunci: PGK 5 HD, hepatitis B, hepatitis C, skor APRI

scholarly journals A Deleterious Combination of Intravenous Drug Usage with HIV and Chronic Hepatitis Infection; How Renal Replacement Therapy Emanated?

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Renal Failure ◽  
Hepatitis C ◽  
Renal Replacement Therapy ◽  
Hepatitis B ◽  
Replacement Therapy ◽  
Intravenous Drug ◽  
Drug Usage ◽  
Intravenous Drug Usage

Intravenous drug usage of substances like cocaine and heroin; encompasses a spectrum of generalized state of illness. A continuum insult which predispose patients to chronic viral illnesses, bacterial infections and subsequently end organ damage due to multiple factors. The renal structure is one of the target organs involved in this process, by which a majority of them will lately developed end stage renal disease and as a result renal replacement therapy. However, the spectrum of complications of this population is enormous starting with acquire infections like HIV, Hepatitis C, Hepatitis B, severe skin infections, pneumonias, cardiovascular diseases, endovascular complications as the well-known Lemierre’s syndrome, central nervous system infections, systemic complications like renal failure ending up in hemodialysis and most of them with a low expectancy of life. In our population 69 patients were randomly with a mean age of 44 years assign for investigation all of them known to have a poor social support in conjunction with intravenous drug usage of cocaine and heroin. All these patients were study using the electronic medical record system, several conditions were measure like HIV, Hepatitis B, Hepatitis C, Hypertension and Diabetes mellitus. Of the patients been study the admission diagnosis that lead to renal replacement therapy was recorded, and later in the process compared. Our population of 69 patients, 16 of them ended up in hemodialysis 23% (16/69), of this patients that had renal replacement therapy 4 of them had Hepatitis C 25% (4/16), Hepatitis B 19% (3/16), HIV 13% (2/16), Hypertension 6% (1/16) and Diabetes mellitus 6% (1/16) respectively. There were several precise findings that lead to hemodialysis in the population, with the majority been infected ulcers 25% (17/69), pneumonia 20% (14/69), upper gastrointestinal bleeding in 10 %(7/69) and symptomatic anemia 10% (7/69) respectively. All of this patient did not have good social support, none of them knew about the long-term consequences of renal failure and most of them did not had positive approach of stopping intravenous drug usage. As a whole, illicit intravenous drug usage is associated with a broad spectrum of diseases, all of them creating a rapid deleterious clinical picture; mostly debuting to medical assistance with infectious etiologies.

Evaluating the Risk of Developing Thrombocytopenia Within Five Days of Continuous Renal Replacement Therapy Initiation in Septic Patients

2020 ◽  
pp. 089719002095917
Author(s):  
Lauren Fay ◽  
Georgeanna Rechner-Neven ◽  
Drayton A. Hammond ◽  
Joshua M. DeMott ◽  
Mary Jane Sullivan
Keyword(s):  
Differential Diagnosis ◽  
Platelet Count ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Primary Outcome ◽  
Control Group ◽  
Chi Square ◽  
Time Zero ◽  
Renal Replacement Therapy Initiation

Background: The differential diagnosis for thrombocytopenia in critical illness is often extensive. This study was performed to determine the incidence of thrombocytopenia in septic patients undergoing continuous renal replacement therapy (CRRT) versus those not undergoing CRRT. Objective: The primary outcome of this study was to compare the development of thrombocytopenia, defined as a platelet count ≤ 100 × 103/mm3, in septic patients within 5 days of time zero. Time zero was defined as the baseline platelet count upon hospital admission or CRRT initiation. Methods: An IRB approved, retrospective cohort study was conducted evaluating thrombocytopenia development in critically ill, septic patients who were initiated on CRRT versus those whom were not. Baseline and clinical characteristics were displayed using descriptive statistics. The primary outcome was evaluated overall and in subgroups of CRRT using Chi-square tests. Results: One hundred sixty patients, 80 per arm, were included in the study. Thrombocytopenia development within 5 days occurred more frequently in the renal replacement therapy (RRT) group compared to the control group (67.5% vs. 6.3%, p < 0.001). In the subgroup analysis of the RRT cohort, thrombocytopenia development within 5 days occurred more frequently in the continuous veno-venous hemofiltration (CVVH) group compared to the accelerated veno-venous hemofiltration (AVVH) group (76% vs. 53.3%, p = 0.049). Conclusion: There is a high likelihood that septic patients initiated on CRRT will develop thrombocytopenia during their hospital stay. Patients receiving CVVH may develop thrombocytopenia more frequently than those receiving AVVH. Overall, CRRT should remain a differential diagnosis for thrombocytopenia development in this patient population.

scholarly journals Hepatitis C virus genotypes in patients on renal replacement therapy

1998 ◽  
Vol 13 (3) ◽  
pp. 731-734 ◽  
Author(s):  
T. Chan ◽  
J. Lau ◽  
P. Wu ◽  
C. Lai ◽  
A. Lok ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Virus Genotypes ◽  
Hepatitis C Virus Genotypes

Transfusion Transmitted Infections in Patients With Hemophilia of Karachi, Pakistan

2011 ◽  
Vol 17 (6) ◽  
pp. 651-655 ◽  
Author(s):  
Munira Borhany ◽  
Tahir Shamsi ◽  
Samsan Boota ◽  
Hazrat Ali ◽  
Naeem Tahir ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
Replacement Therapy ◽  
Blood Donors ◽  
Hemophilia A ◽  
Hiv Infections ◽  
Downward Trend ◽  
Positive Case ◽  
Hiv Positive ◽  
Anti Hiv

The aim of the study was to assess the prevalence of HCV, HBV, and HIV infections among the patients with hemophilia. Patients with Hemophilia A and B were evaluated who visited hospital for factor replacement therapy. The viral markers tested in these patients included anti-HCV-Ab, HBsAg, and anti-HIV-Ab. Seroprevalence was compared from 5717 exchange healthy blood donors for same markers. A total of 173 multitransfused male hemophiliacs showed prevalence of 51.4% for HCV, 1.73% for HBV, and nil for HIV. In blood donors seroprevalence was 1.9% for HCV, 1.81% for HBV, while no HIV-positive case was detected. Prevalence of anti-HCV-Ab was significantly high in patients with hemophilia than normal donors ( P = .0005). This study showed that HCV infection was more frequently identified than HBV and HIV infections in multitransfused hemophiliacs. The frequency of hepatitis C among blood donors is also higher than that of hepatitis B which is showing downward trend.

Seroprevalance of the Hepatitis B and C in Patients with Chronic Kidney Disease without History of Renal Replacement Therapy

2013 ◽  
Vol 22 (02) ◽  
pp. 171-176 ◽  
Author(s):  
Serhan Piskinpasa ◽  
Hadim Akoglu ◽  
Nihal Ozkayar ◽  
Didem Turgut ◽  
Fatma Akyel ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Hepatitis B ◽  
Replacement Therapy ◽  
History Of

Antibodies to Core Antigen of Hepatitis B Virus in Patients on Renal Replacement Therapy: Association with Demographic, Clinical and Laboratory Data

2010 ◽  
Vol 114 (3) ◽  
pp. c194-c203 ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Danuta Kurzawska-Firlej ◽  
Włodzimierz Ratajewski ◽  
Dorota Frankiewicz ◽  
Leszek Niepolski ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Renal Replacement Therapy ◽  
Hepatitis B ◽  
Replacement Therapy ◽  
Laboratory Data ◽  
Core Antigen ◽  
B Virus

Predictors of Liver Fibrosis in HCV+ Hemophilic Men.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 319-319 ◽  
Author(s):  
Kakra Soadwa ◽  
Michael Nalesnik ◽  
Qianyu Dang ◽  
Margaret Ragni
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Laboratory Tests ◽  
Surrogate Markers ◽  
Apri Score ◽  
Receiver Operating

Abstract Hepatitis C is a major cause of chronic liver disease in hemophilia. Liver biopsy is typically not performed in this population because of potential bleeding risk, and, thus, the proportion with liver fibrosis is not known. A number of laboratory tests, including AST, ALT, ALT/AST ratio, PT, platelet count and AST/platelet ratio (APRI) have been evaluated as surrogate tests for liver fibrosis in other HCV risk groups, but not in individuals with hemophilia. If laboratory tests could be validated as surrogate markers of fibrosis in the hemophilic population, it might be possible to predict the extent of their HCV liver disease. We, therefore, evaluated the above laboratory tests as potential surrogate markers of fibrosis in HCV (+) hemophilic men undergoing liver biopsy and enrolled in an ongoing prospective, cross-sectional multi-center NHLBI-funded study of hepatitis C in hemophilia (HHH Study). Liver biopsies were evaluated by independent, central review for fibrosis using the Ishak, Metavir, and Knodell classification systems. Statistical analyses were performed by Spearman rank correlation, logistic regression, and area under receiver operating characteristic curves (AUROC). Only significant predictors in univariate models were used in the final multivariate model. Of 301 enrolled subjects, 75 (24.9%) had undergone liver biopsy, of whom 53 (17.6%) with slides/blocks/tissue available for pathologic review, were analyzed. Of the 53, 24 (45.3%) had biopsy evidence of fibrosis by Ishak score ≥ 3 (F3–F6). Those with fibrosis (F3–F6) did not differ in proportion HIV (+) or in proportion treated with interferon/ribavirin, from those without fibrosis (F0–F2). As compared with the HIV(–) group (n= 26), the HIV(+) group (n=27) was older, 40 vs. 33 yr, and had higher AST, 64 vs. 40 IU/ml, higher APRI scores, 0.48 vs. 0.21, and lower platelet counts, 180,000/μl vs. 235,000/μl, all p &lt; 0.05. The HIV (+) men also tended to use alcohol more frequently, ≥ twice monthly vs. ≤ once monthly, and tended to use analgesics more frequently, at least weekly vs. monthly or less, both p = 0.03; but did not differ in hemoglobin level, 14.7 gm% vs. 15.4 gm%, or in the proportion treated with interferon/ribavirin, 24% vs. 28%, both p &gt; 0.1. Although all three fibrosis scoring systems, Ishak, Metavir, Knodell showed good correlation with all lab markers studied, the Ishak system showed the best correlation. In the logistic regression model, the best predictor of Ishak fibrosis (F3–F6), was the AST/platelet ratio (APRI), p = 0.008. The APRI score was a better predictor of fibrosis (F3 –F6) in HIV (−) than among HIV (+) men, area under the receiver operating characteristics curve (AUROC), 88.9% vs. 66.1%, respectively. In the HIV (+) group, only the Knodell system showed good correlation with lab markers. In conclusion, APRI score is a potentially useful surrogate marker for fibrosis on liver biopsy in HIV (−) hemophilic men with hepatitis C, but less so in HIV (+) hemophilic men with hepatitis C. The reason for differences in the APRI score as a predictor of fibrosis between HIV(−) and HIV(+) is not known, but may suggest that AST and/or platelet count may be affected by HIV infection, rendering these parameters less specific and/or predictive for HCV liver fibrosis. It will be important to test this hypothesis in a large number of patients.

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