Coronary risk factors in maintenance hemodialysis patients: Who is the culprit - hemodialysis or chronic renal failure?

Propranolol is widely employed in hemodialysis patients for the control of renin-dependent hypertension. Infrequent reports have linked hypoglycemia and propranolol, especially in complex situations such as malnutrition, anesthesia, and excessive insulin use. Three patients on maintenance hemodialysis taking propranolol developed severe hypoglycemia resulting in cardiac arrest. The life-threatening hypoglycemia occurred without apparent precipitating cause and unaccompanied by the classical signs and symptoms of hypoglycemia. These three cases suggest that propranolol in a setting of chronic renal failure and dialysis may bring about severe hypoglycemia, a complication previously unsuspected.

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Risk factors for herpes zoster reactivation in maintenance hemodialysis patients

European Journal of Internal Medicine ◽

10.1016/j.ejim.2012.08.005 ◽

2012 ◽

Vol 23 (8) ◽

pp. 711-715 ◽

Cited By ~ 13

Author(s):

Chia-Ter Chao ◽

Chun-Fu Lai ◽

Jenq-Wen Huang

Keyword(s):

Risk Factors ◽

Herpes Zoster ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Maintenance Hemodialysis Patients

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Comparison of cardiovascular risk factors in maintenance hemodialysis patients based on phase angle of bioimpedance analysis

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/125/1/012115 ◽

2018 ◽

Vol 125 ◽

pp. 012115

Author(s):

R A Muzasti ◽

H R Lubis

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Phase Angle ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Bioimpedance Analysis ◽

Maintenance Hemodialysis Patients

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The Clinical Significance and Risk Factors of Anti-Platelet Factor 4/heparin Antibody on Maintenance Hemodialysis Patients: A Two-Year Prospective Follow-up

PLoS ONE ◽

10.1371/journal.pone.0062239 ◽

2013 ◽

Vol 8 (4) ◽

pp. e62239 ◽

Cited By ~ 10

Author(s):

Delong Zhao ◽

Xuefeng Sun ◽

Li Yao ◽

Hongli Lin ◽

Jijun Li ◽

...

Keyword(s):

Risk Factors ◽

Clinical Significance ◽

Hemodialysis Patients ◽

Platelet Factor 4 ◽

Maintenance Hemodialysis ◽

Platelet Factor ◽

Maintenance Hemodialysis Patients

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The Effect of Discontinuation of Angiotensin-II Receptor Blocker on Therapeutic Effect of Synthetic Erythropoietin on Anemia Modification in Hemodialysis Patients

Quarterly of Horizon of Medical Sciences ◽

10.32598/hms.25.3.230 ◽

2019 ◽

Vol 25 (3) ◽

pp. 230-254

Author(s):

Farid Reza Ejlali ◽

◽

Mahmood Reza Khazaei ◽

Zahra Mostafavian ◽

Jalil Moshari ◽

...

Keyword(s):

Clinical Trial ◽

Renal Failure ◽

Chronic Renal Failure ◽

Hemodialysis Patients ◽

Hemoglobin Level ◽

Maintenance Hemodialysis ◽

Angiotensin Ii Receptor Blocker ◽

Angiotensin Ii Receptor ◽

Before And After ◽

In The Beginning

Aims The aim of this study was to evaluate the effect of discontinuation of losartan in response to synthetic erythropoietin therapy on hemoglobin level in patients on maintenance hemodialysis. Methods & Materials This study was a pre-and post-interventional clinical trial. The population of the study was hemodialysis patients with chronic renal failure. In the beginning of the study, and three months after removal of losartan, the patients’ hemoglobin changes were compared. Findings Hemoglobin was significantly increased at the end of the study in all patients (from 10.90±1.66 at the beginning of the study to 11.37±1.42g/dl at the end of 3 months, P=0.046). No significant changes were seen in the hemoglobin level before and after intervention between patients according age, sex, and duration of the disease. Conclusion There was a significant increase in hemoglobin level at the end of study after losartan discontinuation. But this increase did not have a significant relationship with patient’s age, sex as well as the duration of the disease.

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Risk factors and antihypertensive medications for mortality in elderly hospitalized hemodialysis patients: a multicenter retrospective study in China

10.21203/rs.2.13665/v1 ◽

2019 ◽

Author(s):

Yu-Huan SONG ◽

Guang-Yan Cai ◽

Yue-Fei Xiao ◽

Jie-qiong Liu ◽

Shuang Liang ◽

...

Keyword(s):

Risk Factors ◽

Uric Acid ◽

Enzyme Inhibitor ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Angiotensin Ii Receptor Blocker ◽

Central Venous ◽

Antihypertensive Medications ◽

Blood Calcium ◽

Maintenance Hemodialysis Patients

Abstract Background Elderly Hemodialysis patients are increasing yearly. Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity andmortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens with outcomes and analyze the risk factors in elderly hemodialysis patients.Methods This study was a retrospective cohort study based on data from adult hemodialysis patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of elderly hemodialysis patients (≥60 years old) were analyzed. Antihypertensive drugs into the following regimens: β-blockers, calcium channel blockers, renin–angiotensin system (RAS) blocking drugs and α-blockers. Logistic regression analysis was used to explore the risk factors for death adjusting for clinical and laboratory values and antihypertensive medications.Results A total of 7135 patients on maintenance hemodialysis including 2738 elderly patients were enrolled in this study. The mean levels of hemoglobin, albumin, blood calcium, phosphorus and parathyroid hormone (PTH) in elderly group were lower than the younger group. We compared the characteristics of 2492 survived elderly maintenance hemodialysis patients and 246 patients who died.Aging (OR = 1.59, 95% CI: 1.13-2.24), central venous catheter (OR = 1.62, 95% CI: 1.53-1.72) and Charlson comorbidities index>3(OR=1.97,95% CI: 1.49-2.60)were independently risk factors of mortality in elderly maintenance hemodialysis patients. High levels of hemoglobin (OR=0.76, 95%CI: 0.73-0.79), albumin (OR=0.87, 95%CI: 0.77-0.98), uric acid(OR=0.90,95%CI: 0.84-0.96)and those taking angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB) (OR=0.77, 95%CI: 0.58-0.90) had a lower risk of mortality.Conclusions Age, Charlson Comorbidities index >3, anemia and malnutrition, the use of central venous catheters and low serum uric acid level are risk factors for mortality in elderly maintenance hemodialysis patients. Taking ACEI/ARB can reduce the mortality of elderly maintenance hemodialysis patients.

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The Prevalence and Independent Risk Factors of Significant Tricuspid Regurgitation Jets in Maintenance Hemodialysis Patients With ESRD

Frontiers in Physiology ◽

10.3389/fphys.2020.568812 ◽

2020 ◽

Vol 11 ◽

Author(s):

Ying Zhang ◽

Xiao-Han Ding ◽

Fang Pang ◽

Laiping Zhang ◽

Yiqin Wang ◽

...

Keyword(s):

Risk Factors ◽

Tricuspid Regurgitation ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Maintenance Hemodialysis ◽

Dialysis Patients ◽

Ventricular Ejection Fraction ◽

Maintenance Dialysis ◽

Maintenance Hemodialysis Patients

Background and AimTricuspid regurgitation (TR) is a frequent complication in various cardiovascular diseases. However, few studies have reported the prevalence of TR especially the moderate to severe or significant TR (ms-TR) maintenance dialysis patients. Thus, we aimed to identify the prevalence of ms-TR and its associated factors.MethodsA total of 491 maintenance dialysis patients underwent echocardiographic examinations, while a subgroup (n = 283) also received routine blood tests, renal function examinations, and electrolyte analysis. We first compared the differences in abovementioned parameters among groups with various TR areas (TRAs). Finally, univariate and adjusted regression were also used to identify factors that were independently associated with ms-TR.ResultsThe incidence of TR jets was 62.6%, which included a mildly increased TRA (47.8%), moderately increased TRA (10.4%), and severely increased TRA (3.5%). Most of the cardiac structures and functional parameters, such as the end-diastolic internal diameters of the left atrium (LA), left ventricle (LVDD), right atrium (RA), right ventricle (RV), left ventricular ejection fraction (LVEF), and fractional shortening (FS), were significantly associated with ms-TR. Among serum ions, only total CO2 (TCO2; r = −0.141, p = 0.047) was negatively correlated with TRA. After adjusted, only Na+ [odds ratio (OR): 0.871 0.888, p = 0.048], RA (OR: 1.370, p < 0.001), and FS (OR: 0.887, p < 0.001) were independently associated with ms-TR.ConclusionTricuspid regurgitation occurs in maintenance hemodialysis patients with ESRD. Na+ FS and RA were independently associated with ms-TR, and these parameters may be potential risk factors/predictors for ms-TR.

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