Long-Term Protective Effect of N-Acetylcysteine against Amikacin-Induced Ototoxicity in End-Stage Renal Disease: A Randomized Trial

2018 ◽  
Vol 38 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Alperen Vural ◽  
İsmail Koçyiğit ◽  
Furkan Şan ◽  
Eray Eroğlu ◽  
İbrahim Ketenci ◽  
...  
Keyword(s):  
Protective Effect ◽  
Pure Tone Audiometry ◽  
The Other ◽  
Control Group ◽  
Tnf Α ◽  
Significant Difference ◽  
Hearing Test ◽  
Stage Renal Disease ◽  
End Stage

Background The aim of the study is to evaluate the long-term protective effect of N-acetylcysteine (NAC), an antioxidant agent, against aminoglycoside (AG)-induced ototoxicity. Methods A total of 40 patients receiving continuous ambulatory peritoneal dialysis (CAPD) and having their first peritonitis attacks and planned to be treated with AGs were enrolled in the study. They were randomized into 2 groups: 1 group received additional NAC and the other did not. All patients underwent hearing tests with pure tone audiometry (PTA) after the diagnosis, at 1 month and 12 months and at the same time the tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were measured. Results Patients taking NAC had better hearing test results in both ears at 1 month except 2,000 Hz for the left ear, which wasn't significantly different between the 2 groups. Although patients taking NAC had generally better PTA results at 12 months, differences between the 2 groups were not statistically significant. Baseline IL-6 level was significantly higher in the NAC group than the control group. Both TNF-α and IL-6 levels at 1 month were significantly lower in the NAC group than in the control group. On the other hand, there was no significant difference between the 2 groups in terms of TNF-α and IL-6 levels at 12 months. Conclusions The results of the current study showed that NAC, a potent anti-inflamatory drug, may be otoprotective, but that the effect is not long-lasting.

Risk of and Fatality from Acute Pancreatitis in Long-Term Hemodialysis and Peritoneal Dialysis Patients

2018 ◽  
Vol 38 (1) ◽  
pp. 30-36 ◽  
Author(s):  
I-Kuan Wang ◽  
Shih-Wei Lai ◽  
Hsueh-Chou Lai ◽  
Cheng-Li Lin ◽  
Tzung-Hai Yen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Peritoneal Dialysis ◽  
Propensity Score ◽  
Dialysis Patients ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Taiwan National Health Insurance ◽  
Stage Renal Disease ◽  
End Stage

Background This study was conducted to evaluate the risk of developing acute pancreatitis (AP) and the fatality from AP in hemodialysis (HD) and peritoneal dialysis (PD) patients, using the claims data of Taiwan National Health Insurance. Methods From patients with newly diagnosed end-stage renal disease (ESRD) in 2000–2010, we identified a PD cohort ( N = 9,766), a HD cohort ( N = 18,841), and a control cohort ( N = 114,386) matched by sex, age, and the diagnosis year of the PD cohort. We also established another 2 cohorts with 9,744 PD patients and 9,744 propensity score-matched HD patients. The incident AP and fatality from AP were evaluated for all cohorts by the end of 2011. Results The adjusted hazard ratios (HRs) of acute pancreatitis were 5.68 (95% confidence interval [CI] = 5.05 – 6.39), 4.91 (95% CI = 4.32 – 5.59), and 7.47 (95% CI = 6.48 – 8.62) in the all dialysis, HD, and PD patients, compared with the controls, respectively. Peritoneal dialysis patients had an adjusted HR of 1.41 (95% CI = 1.21 – 1.65) for AP, compared with propensity score-matched HD patients. Peritoneal dialysis patients under icodextrin treatment had a lower incidence of AP than those without the treatment, with an adjusted HR of 0.59 (95% CI = 0.47 – 0.73). There was no significant difference in the 30-day mortality from AP between HD and PD patients. Conclusions Peritoneal dialysis patients were at a higher risk of developing AP than HD patients. Icodextrin solution could reduce the risk of developing AP in PD patients.

scholarly journals Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 730-737
Author(s):  
Hao-Yang Ma ◽  
Shuang Chen ◽  
Ling-Ling Lu ◽  
Wei Gong ◽  
Ai-Hua Zhang
Keyword(s):  
Lumbar Spine ◽  
Renal Disease ◽  
Postmenopausal Women ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

AbstractAs a selective estrogen receptor modulator (SERM), raloxifene is used in healthy postmenopausal women to prevent bone loss and reduce fractures. However, the benefit of raloxifene is uncertain in the treatment of osteoporosis among patients with end-stage renal disease (ESRD) or those who require maintenance dialysis. We assessed the safety and efficacy of raloxifene in this particular population. Studies were selected from PubMed, Springer, CNKI (Chinese National Knowledge Infrastructure) and Wanfang Database. Randomized controlled trials (RCTs) and prospective studies with control/placebo groups were included. Five studies were included with a total of 244 participants (121 patients in the raloxifene group and 123 patients in the placebo/control group). The median duration of treatment was 12 months. The incidence rate of side effects of raloxifene was 0/121 (0%). There was a significant improvement of lumbar spine bone mineral density (BMD) levels in the raloxifene group compared with the placebo group (MD: 33.88, 95% CI: 10.93, 56.84, p=0.004). There was no significant difference concerning the improvement of femoral neck BMD (MD: 8.42, 95% CI: –10.21, 27.04, p=0.38), intact parathyroid hormone (iPTH) (MD: –12.62, 95% CI: –35.36, 10.13, p=0.28), calcium (MD: -0.08, 95% CI: –0.61, 0.44, p=0.76), phosphorus (MD: 0.18, 95% CI: –0.12, 0.48, p=0.23) or bone alkaline phosphatase (BAP) (MD: –4.33, 95% CI: –14.44, 5.79, p=0.40). Raloxifene seems to be effective in improving the lumbar spine BMD in postmenopausal women with ESRD. More large RCTs are necessary to evaluate the long-term safety of raloxifene in uremic patients.

scholarly journals Effects of Arterial Needle Placement in Arteriovenous Fistula on Dialysis Adequacy of End-Stage Renal Disease Patients Undergoing Maintenance Hemodialysis

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Intervention Group ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Needle Placement ◽  
Dialysis Adequacy ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Objective: The arterial needle placement in arteriovenous fistula (AVF) can either be antegrade (in the direction of blood flow or pointing towards the heart) or retrograde (against the direction of blood flow) while venous needle placement should always be in the same direction as the blood flow. This study determined the effects of arterial needle placement in the arteriovenous fistula on dialysis adequacy of End-Stage Renal Disease (ESRD) patients undergoing maintenance hemodialysis in United Candelaria Doctors Hospital - Nephro Synergies Inc. (UCDHNSI) Hemodialysis Center. Methods: A randomized controlled trial design was used in the study. A total of 20 non-diabetic, non-cardiac patients on maintenance hemodialysis for more than 6 months were randomized either to the intervention group (patients’ AVF were cannulated in a retrograde manner) or the control group (patients’ AVF were cannulated in an antegrade manner). Urea reduction ratio (URR) and Kt/V as well as access recirculation percentage were used to determine dialysis adequacy. Pre-dialysis, in the first 30 minutes of dialysis initiation and post-dialysis blood samples were obtained in each patient in 6 succeeding hemodialysis considering dialyzer reuse up to fifth reuse. Means were compared by independent t-test. Results: The findings of the study revealed that the mean URR and Kt/V of the subjects cannulated in retrograde manner and antegrade manner were 69.35% and 1.45, and 74.65% and 1.70, respectively. The mean access recirculation percentage of the subjects was 4.65% in the intervention group and 3.02% in the control group. There was a significant difference on URR and Kt/V of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. There was no significant difference on access recirculation percentage of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. Conclusions: Antegrade arterial needle placement provides more adequate hemodialysis than retrograde arterial needle placement in terms of URR and Kt/V values among non-diabetic, non-cardiac patients undergoing maintenance hemodialysis in 6 succeeding hemodialysis sessions. The directions of the arterial needle either retrograde and antegrade did not have significant effects on access recirculation.

scholarly journals Patient Survival Between Hemodialysis and Peritoneal Dialysis Among End-Stage Renal Disease Patients Secondary to Myeloperoxidase-ANCA-Associated Vasculitis

2022 ◽  
Vol 8 ◽  
Author(s):  
Xueqin Wu ◽  
Yong Zhong ◽  
Ting Meng ◽  
Joshua Daniel Ooi ◽  
Peter J. Eggenhuizen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Patient Survival ◽  
Dialysis Initiation ◽  
Dialysis Modality ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

BackgroundA significant proportion of anti-neutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis eventually progresses to end-stage renal disease (ESRD) thus requiring long-term dialysis. There is no consensus about which dialysis modality is more recommended for those patients with associated vasculitis (AAV-ESRD). The primary objective of this study was to compare patient survival in patients with AAV-ESRD treated with hemodialysis (HD) or peritoneal dialysis (PD).MethodsThis double-center retrospective cohort study included dialysis-dependent patients who were treated with HD or PD. Clinical data were collected under standard format. The Birmingham vasculitis activity score (BVAS) was used to evaluate disease activity at diagnosis and organ damage was assessed using the vasculitis damage index (VDI) at dialysis initiation.ResultsIn total, 85 patients were included: 64 with hemodialysis and 21 with peritoneal dialysis. The patients with AAV-PD were much younger than the AAV-HD patients (48 vs. 62, P < 0.01) and more were female (76.2 vs. 51.6%, P = 0.05). The laboratory data were almost similar. The comorbidities, VDI score, and immuno-suppressive therapy at dialysis initiation were almost no statistical difference. Patient survival rates between HD and PD at 1 year were 65.3 vs. 90% (P = 0.062), 3 year were 59.6 vs. 90% (P < 0.001), and 5 years were 59.6 vs. 67.5% (P = 0.569). The overall survival was no significant difference between the two groups (P = 0.086) and the dialysis modality (HD or PD) was not shown to be an independent predictor for all-cause death (hazard ratio (HR) 0.73; 95% confidence interval (CI) 0.31–1.7; P = 0.473). Cardio-cerebrovascular events were the main cause of death among AAV-HD patients while infection in patients with AAV-PD.ConclusionThese results provide real-world data that the use of either hemodialysis or peritoneal dialysis modality does not affect patient survival for patients with AAV-ESRD who need long-term dialysis.

Effects of Kidney Transplantation on Cognitive Performance in a Pediatric Population

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 273-278 ◽  
Author(s):  
Robert S. Fennell ◽  
Wiley C. Rasbury ◽  
Eileen B. Fennell ◽  
Mary K. Morris
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Cognitive Performance ◽  
End Stage Renal Disease ◽  
Pediatric Population ◽  
Control Group ◽  
Memory And Attention ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

The cognitive functioning of 20 children and adolescents with end-stage renal disease was assessed 1 to 3 weeks prior to the onset of hemodialysis, and at 1 month and 1 year after successful kidney transplantation, and results were compared with those of a matched control group. A battery of intelligence, achievement, problem solving, learning, memory, and attention tasks were administered. Both groups had significantly improved scores over time on most measures. The group with renal disease exhibited significantly greater improvement than the control group from initial testing to 1 month after transplantation on the performance IQ and full-scale IQ as well as in mathematics achievement. This significant difference was not maintained, however, at 1 year after transplantation. Cognitive performance was less impaired the later the onset of renal failure or the fewer the years in end-stage renal disease. BUN nitrogen, serum creatinine levels, and BP did not consistently correlate with any of the cognitive or academic achievement measures.

scholarly journals Changes of MicroRNA-377 in Diabetic Nephropathy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Elshinnawy ◽  
C R Kamel ◽  
M H A Elkeleng
Keyword(s):  
Diabetic Nephropathy ◽  
Diabetic Patients ◽  
Ckd Stage ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Stage Renal Disease ◽  
End Stage ◽  
Stage 1

Abstract Background as one of the most important long term complications of diabetes, Diabetic nephropathy is the major cause of end stage renal disease and high mortality. Purpose to identify the pattern of microRNA-377 changes specific for diabetic nephropathy in diabetic patients and in patients with chronic kidney disease of different etiology. Patients and Methods the study was conducted from 2016 to 2018, included 50 patients for analysis of MicroRNA-377 and its control gene U18 at El Demrdash Hospital Ain shams university and Quessena Hospital El Monfia. The miRNA-U18 was analyzed for normalization of correction ratio. Results the results of our research found that the highest median IQR of miR-377 was significantly present in DN stage 1&2 and the lowest median IQR was significantly present in CKD stage 1&2, and there was significant difference between group 1 (DN stage 1&2) versus group 2 (DN stage 3&4), group 3 (Diabetics without nephropathy) and all stages of CKD. Conclusion in diabetic nephropathy stage 1&2, serum miR-377 was highly significant increased more than diabetics without nephropathy, diabetic nephropathy stage 3&4 and all satges of CKD.

scholarly journals Therapeutic efficacy of erythropoietin alfa and erythropoietin beta in hemodialysis; a randomized controlled trial

2018 ◽  
Vol 8 (1) ◽  
pp. 44-49
Author(s):  
Hamid-Reza Omrani ◽  
Sima Golmohhamadi ◽  
Amir-Hossein Hashemian ◽  
Ali-Zaman Vaysmoradi ◽  
Roya Safari-Faramani
Keyword(s):  
Controlled Trial ◽  
Hemoglobin Concentration ◽  
Control Group ◽  
Plasma Hemoglobin ◽  
Significant Difference ◽  
Erythropoietin Deficiency ◽  
Stage Renal Disease ◽  
Double Blinded ◽  
End Stage ◽  
Erythropoietin Alfa

Introduction: Anemia, as a common complication of end-stage renal disease (ESRD), usually develops due to erythropoietin deficiency. Recombinant human erythropoietins (rHEPOs) are indicated for the correction of renal anemia. Objectives: We aimed to evaluate the efficacy of a new brand of erythropoietin named CinnaPoietin (erythropoietin beta) on hemoglobin levels. Patients and Methods: This is a randomized double-blinded controlled trial. Ninety-six ESRD patients on hemodialysis recruited in the study, whose hemoglobin levels was less than 10 g/dL. They allocated to two groups. PDPoetin (erythropoietin alfa) 50-100 U/kg three times per week intravenously administrated to the control group and CinnaPoietin with exactly same regimen as like PDPoetin group administrated for the rest of the participants. The study duration was 3 months. We measured plasma hemoglobin monthly for 3 months. Results: We found, hemoglobin was increased across the time and it was statistically significant (P<0.001), while there was no statistically significant differences between the groups (P=0.712). Conclusion: According to the result of the present study there is no statistical significant difference between these two brands of exogenous rHEPO in the case of increasing the hemoglobin concentration.

scholarly journals Investigation of Astaxanthin Effect on Cisplatin Ototoxicity in Rats by Using Otoacoustic Emission, Total Antioxidant Capacity, and Histopathological Methods

2019 ◽  
pp. 014556131986682 ◽  
Author(s):  
M. Emrah Kınal ◽  
Arzu Tatlıpınar ◽  
Selami Uzun ◽  
Serhan Keskin ◽  
Emrah Tekdemir ◽  
...  
Keyword(s):  
Protective Effect ◽  
Antioxidant Capacity ◽  
Total Antioxidant Capacity ◽  
Otoacoustic Emission ◽  
The Other ◽  
Female Rats ◽  
Control Group ◽  
Hearing Level ◽  
Significant Difference ◽  
Total Antioxidant

Background: Cisplatin-induced ototoxicity is related to oxidative stress. Astaxanthin is one of the most powerful antioxidants in nature. Aims/objectives: To investigate the protective effect of astaxanthin on cisplatin-induced ototoxicity. Materials and Methods: Thirty-five Sprague Dawley female rats were divided into 5 groups: control, cisplatin, and cisplatin with 10, 20, and 40 mg/kg astaxanthin groups. Cisplatin group received a single intraperitoneal injection of 14 mg/kg cisplatin. While saline was administered in the control group, in the other 3 groups, 10, 20, and 40 mg/kg daily doses of astaxanthin were administered through orogastric cannula before administration of cisplatin. Baseline and 10th day otoacoustic emission tests were administered. An intracardiac blood sample was taken to measure total antioxidant capacity (TAC), and the cochleas of the animals were investigated histopathologically. Results: Hearing level of astaxanthin 40 mg/kg + cisplatin group was higher at 24 kHz and 32 kHz frequencies compared to the cisplatin group. The TAC value of the cisplatin group was lower than both the control and astaxanthin + cisplatin groups ( P < .05). On histopathological examination, the other groups were deformed compared to the control group, but no statistically significant difference was observed between the astaxanthin + cisplatin and cisplatin groups. Conclusions and significance: Astaxanthin showed protective effect at high frequencies when it was administered at high dose. Thus, astaxanthin may have protective effect against cisplatin-induced ototoxicity.

scholarly journals Frequency of Gastrointestinal Diseases in Patients with End-Stage Renal Disease Treated with Long Term Dialysis

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Lutfi Zylbeari ◽  
Zamira Bexheti ◽  
Gazmend Zylbeari ◽  
Ferizate Dika Haxhirexha ◽  
Kastriot Haxhirexha
Keyword(s):  
Renal Disease ◽  
Gastrointestinal Diseases ◽  
Control Group ◽  
Dialysis Patients ◽  
Gastrointestinal Complications ◽  
Increased Risk ◽  
High Incidence ◽  
Stage Renal Disease ◽  
End Stage

Background: Gastrointestinal complications are frequent in patients with renal disease and are responsible for substantial morbidity and mortality among these patients in developing countries. Many times, these patients are subjected to endoscopic evaluation and mucosal biopsies are taken for definitive diagnosis. Long before the routine uses of dialysis, patients dying of uremia were found to have a high incidence of gastrointestinal abnormalities (1).Matherials and methods: The survey included 240 persons; 120 of them were dialysis patients, while the remaining 120 were healthy individuals who served as a control group. 54 (45%) of the patients with hemodialysis were females while 66 (55%) of them were males with mean age: 58.20 ± 18.00 years. These patients had been in dialysis for more than 12 years at the Clinic for Nephrology in Skopje and the Clinical Hospital in Tetovo.Results: Gastrointestinal complications were present in 20 (37.0%) out of 54 females while 26 (39.4%) out of 66 males presented with duodenal bulbar ulcers. 84 patients [(females-38/54 (70.4%) and males-46/66 (85.2%)] of the total number of 120 examined patients were found to have chronic gastritis.In conclusion, we found that the incidence of PUD was more than 10 times higher in CKD patients than in those without CKD over a 3-year period between 2008-2010. CKD patients receiving HD, NSAID, or clopidogrel had an increased risk of PUD, compared to CKD patients not receiving these treatments.  

scholarly journals Effects of Heparin on Early Patency of Arteriovenous Fistula in Angioaccess Surgery of Patients with End-Stage Renal Disease

2018 ◽  
Vol 3 (1) ◽  
pp. 36
Author(s):  
Mohamamd Mozafar ◽  
Fatemeh Hoseinzadegan ◽  
Saran Lotfollahzadeh ◽  
Maryam Baikpour ◽  
Razie Amraei ◽  
...  
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Post Surgery ◽  
Significant Difference ◽  
Systemic Anticoagulation ◽  
Stage Renal Disease ◽  
End Stage

Background: Arteriovenous fistula (AVF) is now the optimal method of obtaining vascular access for dialysis. Measures such as systemic anticoagulation have been proposed as means of increasing patency rates but enough evidence does not exist to support their application. We aimed to evaluate the efficacy of preoperative heparin injection on patency of AVF during the first 24 hours after surgery and to determine whether such measure can be used to prevent early thrombosis of the vascular access.Methods: The study was carried out on 150 patients admitted to Shohada-e-Tajrish hospital for permanent vascular access placement during 2011-2012. 75 patients were randomly assigned to receive 100 units/kg of heparin intraoperatively and at 24 hours post-surgery AVF patency rate was assessed and compared to the control group. Results: All the 75 patients who had received heparin intraoperatively had a patent arteriovenous fistula 24 hours post-surgery which showed a statistically significant difference compared to the control group among which only 69 (92%) patients had a functioning AV fistula (p-value= 0.028).Conclusions: Our results show that systemic anticoagulation with heparin can be considered as an effective option in preventing vascular access failure. However, considering the contradictory data on the usefulness of heparin injection, larger trials are needed to evaluate efficacy and adverse effects of systemic intraoperative anticoagulation in End-Stage Renal Disease (ESRD) patients before qualifying it as a method of increasing AVF patency in these patients

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