Prevalence of Renal Osteodystrophy and its Related Factors among Patients with End-Stage Renal Disease Undergoing Hemodialysis: Single Center Experience from Kermanshah, Iran

Objectives: The current study aimed to determine the prevalence of Renal Osteodystrophy (ROD) and its related factors in a group consisting of End-Stage Renal Disease (ESRD) patients undergoing maintenance hemodialysis. Methods: One hundred twenty –eight ESRD patients (52 men & 76 women) with a mean age of 59.3 years old undergoing maintenance hemodialysis at Imam Reza Referral Hospital, were included in this cross-sectional study. Thereafter, serum parathyroid hormone (PTH) levels were measured, and the range of 150 to 300 pg/mL was determined as the desirable range for the values. Values lower or higher than this range were used to determine ROD. Furthermore, this study investigated the association of ROD with clinical and laboratory variables (age at the onset of renal failure, hemodialysis sessions per week, clinical symptoms associated with renal osteodystrophy, and serum calcium and phosphate levels). Results: ROD was diagnosed in 93 patients (72.7%) out of 128 patients studied. Of them, 53 (41.4%) patients had PTH levels above 300 pg/mL (high bone turnover, HTO group) and 40 patients (31.3%) had PTH levels below 150 pg/mL (low bone turnover, LTO group). No statistically significant difference was detected in terms of ROD-related clinical findings (P=0.11), age at the time of ESRD diagnosis (P=0.2), and number of hemodialysis sessions per week (P=0.2). Hyperphosphatemia (52 patients, 57.1%) was more prevalent in ROD group compared with 11 patients (31.4%) included in the group without ROD (P=0.004). Conclusion: The prevalence rate of ROD in this study was found to be significant, and it was largely consistent with the rate reported in the research previously performed in some Asian countries. Hyperphosphatemia were laboratory variables closely related to ROD.

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Clinical Manifestations of Cardiac Disease in Patients with End Stage Renal Disease Under Maintenance Hemodialysis in a Tertiary Level Hospital of Nepal

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v15i1.15017 ◽

2016 ◽

Vol 15 (1) ◽

pp. 61-65

Author(s):

Kumar Roka ◽

Pratibha Bista Roka

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Low Voltage ◽

Clinical Manifestations ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Maintenance Hemodialysis ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Introduction: End stage renal disease presents with multiple clinical and systemic manifestations. The aim of the present study was to identify the early cardiac and other morbidities in end stage renal disease (ESRD) patients who were under maintenance hemodialysis.Methods: This was an observational, prospective study conducted in fifty established ESRD patients of 20 to 74 years under maintenance hemodialysis in Nephrology unit of Shree Birendra Hospital. Clinical examination, laboratory parameters, electrocardiogram and echocardiography findings were used to identify the morbidities. Results: Among all patients enrolled in the study 88.7% had anemia, 64.2 % systolic murmurs, 62.26 % pedal edema, 73.6 % fatiguability, 71.7 % angina, 24.4 % palpitations and 13.2 % had breathlessness on exertion. 62.26% of the patients had hypertension and 13.20 % had diabetes. In the electrocardiogram, prolonged QTc was observed in 10.4%, followed by T wave inversion in 9.4 % and finally low voltage complex comprised 7.6 %. The echocardiogram showed left ventricular diastolic dysfunction in 58.5 %, left ventricular hypertrophy (overall type) 49 % and valvular lesion like mitral regurgitation and tricuspid regurgitation 83 % and 58.5 % respectively. Conclusion: Cardiac co-morbidities are common in patients diagnosed with ESRD on maintenance hemodialysis.

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Redox Balance Correlates with Nutritional Status among Patients with End-Stage Renal Disease Treated with Maintenance Hemodialysis

Oxidative Medicine and Cellular Longevity ◽

10.1155/2019/6309465 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Małgorzata Maraj ◽

Beata Kuśnierz-Cabala ◽

Paulina Dumnicka ◽

Katarzyna Gawlik ◽

Dorota Pawlica-Gosiewska ◽

...

Keyword(s):

Nutritional Status ◽

Renal Disease ◽

Antioxidant Capacity ◽

End Stage Renal Disease ◽

Maintenance Hemodialysis ◽

Sod Activity ◽

Antioxidant Power ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Over 50% of end-stage renal disease (ESRD) patients die of cardiovascular disease. ESRD patients treated with maintenance hemodialysis are repeatedly exposed to oxidative stress. The aim of the study was to find the relationship between lifestyle factors, nutritional status, calcium-phosphate metabolism, and selected redox parameters such as glutathione peroxidase (GPx), glutathione reductase (GR), superoxide dismutase (SOD), uric acid (UA), and total antioxidant capacity expressed as ferric reducing antioxidant power (FRAP). The study included 97 ESRD hemodialysis patients and 42 controls with no renal disease. Patients were asked to complete a questionnaire which gathered information on their physical activity, hours of sleep, smoking, and frequency of fruit and vegetable intake; the blood samples were then drawn before the midweek dialysis session. The ESRD patients had lower levels of GR, GPx, and SOD activity, a lower level of FRAP, and a higher UA concentration than the control group. The FRAP value decreased with age (ρ=−0.32, p=0.001); smokers had a significantly lower SOD activity in comparison to nonsmokers (p=0.03). In the ESRD patients, FRAP and UA correlated with both albumin (ρ=0.26, p=0.011; ρ=0.41, p=0.006, respectively) and prealbumin (ρ=0.34, p≤0.001; ρ=0.28, p=0.006, respectively), whereas UA, GR, GPx, and SOD correlated with calcium, UA, GR, and GPx with phosphate level. Based on the findings, there are weak associations between nutritional status and selected redox parameters in hemodialyzed patients. Further studies are needed to establish if diet modifications and adequate nutritional status can positively impact the antioxidant capacity in this group of patients.

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Abnormal rich club organization in end-stage renal disease patients before dialysis initiation and undergoing maintenance hemodialysis

10.21203/rs.3.rs-38717/v1 ◽

2020 ◽

Author(s):

Shaohui Ma ◽

Ming Zhang ◽

Yang Liu ◽

Dun Ding ◽

Peng Li ◽

...

Keyword(s):

Cognitive Function ◽

Renal Disease ◽

Cystatin C ◽

End Stage Renal Disease ◽

Neuropsychological Tests ◽

Maintenance Hemodialysis ◽

Rich Club ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background End-stage renal disease (ESRD) patients are at substantially higher risk for developing cognitive impairment compared with the healthy population. Dialysis is an essential way to maintain the life of ESRD patients. Based on previous research, there did not provide an uncontested result whether cognition was improved or worsened during dialysis. Methods To explore the impact of dialysis treatment on cognitive performance, we recruited healthy controls (HCs), ESRD patients before dialysis initiation (bESRD) and those undergoing maintenance hemodialysis (mESRD). All ESRD patients performed a serious of blood biochemistry tests (hemoglobin, urea, cystatin C, Na+, K + and parathyroid hormone). Neuropsychological tests were used to measure cognitive function. By using diffusion tensor imaging and graph-theory approaches, the topological organization of the whole-brain structural network was investigated. Generalized linear models (GLMs) were performed to investigate blood biochemistry predictors of the neuropsychological tests and the results of graph analyses in mESRD and bESRD groups. Results Neuropsychological analysis showed mESRD exhibited greater cognitive function than bESRD, but both were worse than HCs. Whole-brain graph analyses revealed that increased global efficiency and normalized shortest path length remained in the bESRD and mESRD than the HCs. Besides, lower normalized clustering coefficient was in bESRD relative to the HCs and mESRD. For the GLMs analysis, only the Cystatin C level was significantly associated with the average fiber length of rich club connections in bESRD. Conclusions Our study revealed that dialysis had a limited effect on cognitive improvement. Cystatin C may be a risk feature of cognitive decline of bESRD.

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Abnormal rich club organization in end-stage renal disease patients before dialysis initiation and undergoing maintenance hemodialysis

10.21203/rs.3.rs-38717/v2 ◽

2020 ◽

Author(s):

Shaohui Ma ◽

Ming Zhang ◽

Yang Liu ◽

Dun Ding ◽

Peng Li ◽

...

Keyword(s):

Cognitive Function ◽

Renal Disease ◽

Cystatin C ◽

End Stage Renal Disease ◽

Neuropsychological Tests ◽

Maintenance Hemodialysis ◽

Rich Club ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background: End-stage renal disease (ESRD) patients are at a substantially higher risk for developing cognitive impairment compared with the healthy population. Dialysis is an essential way to maintain the life of ESRD patients. Based on previous research, there isn’t an uncontested result whether cognition was improved or worsened during dialysis.Methods: To explore the impact of dialysis treatment on cognitive performance, we recruited healthy controls (HCs), predialysis ESRD patients (predialysis group), and maintenance hemodialysis ESRD patients (HD group). All ESRD patients performed six blood biochemistry tests (hemoglobin, urea, cystatin C, Na+, K+, and parathyroid hormone). Neuropsychological tests were used to measure cognitive function. By using diffusion tensor imaging and graph-theory approaches, the topological organization of the whole-brain structural network was investigated. Generalized linear models (GLMs) were performed to investigate blood biochemistry predictors of the neuropsychological tests and the results of graph analyses in the HD group and predialysis group.Results: Neuropsychological analysis showed the HD group exhibited better cognitive function than the predialysis group, but both were worse than HCs. Whole-brain graph analyses revealed that increased global efficiency and normalized shortest path length remained in the predialysis group and HD group than the HCs. Besides, a lower normalized clustering coefficient was found in the predialysis group relative to the HCs and HD group. For the GLM analysis, only the Cystatin C level was significantly associated with the average fiber length of rich club connections in the predialysis group.Conclusions: Our study revealed that dialysis had a limited effect on cognitive improvement.

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Factors Affecting Carpal Tunnel Syndrome in End Stage Renal Disease with Maintenance Hemodialysis: A Systematic Review

World Journal of Current Medical and Pharmaceutical Research ◽

10.37022/wjcmpr.vi.164 ◽

2021 ◽

pp. 05-12

Author(s):

Dary Gunawan ◽

Theodore Dharma Tedjamartono

Keyword(s):

Carpal Tunnel Syndrome ◽

Renal Disease ◽

Carpal Tunnel ◽

End Stage Renal Disease ◽

Maintenance Hemodialysis ◽

Number Of Patients ◽

Tunnel Syndrome ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Introduction: The number of patients with End Stage Renal Disease (ESRD) is increasing every year, as well as those who have to undergo hemodialysis. Most hemodialysis must be undertaken in a long time. Long term hemodialysis is known to be associated with the incidence of Carpal Tunnel Syndrome (CTS). Method: This study aimed to systematically review factors contributing in the mentioned problem. Literature research was done using three search engines, consist of Google Scholar, Pubmed and ProQuest. Journals used are limited to the last 5 years or those deemed to be relevant. The studies obtained were further read and and appraised critically. Result and Discussion: From a total of 423 journals, 4 articles were selected based on inclusion and exclusion criteria. The prevalence of CTS was found to be higher in ESRD patients undergoing maintenance hemodialysis (MHD). Age, Gender, MHD Duration, β2-Microglobulin are factors that have long been known to play a role. Several other factors such as serum prealbumin, serum albumin, Blood Lead Levels, hepatitis infection, wrist injury, predialytic urea serum and BMI have been implicated in the incidence of CTS in ESRD patients undergoing MHD in some literatures. Conclusion: The factors mentioned earlier were found to have different roles and it is interesting for further reviewed. However, unfortunately there is still very little research that discuss these matters and more research needs to be done related to the factors above.

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Factors Affecting Non-Adherence to Treatment in End Stage Renal Disease (ESRD) Patients Undergoing Hemodialysis in Indonesia

The Open Psychology Journal ◽

10.2174/1874350101912010141 ◽

2019 ◽

Vol 12 (1) ◽

pp. 141-146

Author(s):

Kustimah Kustimah ◽

Ahmad Gimmy Prathama Siswadi ◽

Achmad Djunaidi ◽

Aulia Iskandarsyah

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Adherence To Treatment ◽

Structured Interviews ◽

Related Factors ◽

Factors Affecting ◽

Treatment Regimens ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Background: Non-adherence to treatment regimens is a widespread problem of great clinical relevance among hemodialysis patients. However, only few studies have addressed the factors of non-adherence in End Stage Renal Disease (ESRD) patients, and none conducted in the Indonesia. Objective: The present study explores the reasons of non-adherence in end stage renal disease patients undergoing hemodialysis in Indonesia seen from perspectives of patients, caregivers and health professionals. Methods: The study is conducted using qualitative methods and is set in the hemodialysis unit in a private hospital in Bandung. A total of 23 respondents were recruited in this study. All participants were selected through purposive sampling and invited to participate in semi-structured interviews with open-ended questions. The data obtained were written in verbatim and analyzed using thematic analysis. Results: The six main themes related to non-adherence emerged. These themes were categorized into two clusters namely: (1) factors related to patient (patient related factors) (negative perception and treatment belief, denial, lack of awareness and knowledge and negative feelings) and (2) factors related to the treatment (treatment burden and financial problems). Conclusion: The findings showed determinants of non-adherence in ESRD patients from perspective of patients, caregivers and health professional. The finding from this study can be used as a base for designing an intervention, aimed to increase the adherence to treatment in ESRD patients who are undergoing hemodialysis.

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α1-Acid Glycoprotein and Dietary Intake in End-Stage Renal Disease Patients

Nutrients ◽

10.3390/nu13113671 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3671

Author(s):

Małgorzata Maraj ◽

Paulina Hetwer ◽

Beata Kuśnierz-Cabala ◽

Barbara Maziarz ◽

Paulina Dumnicka ◽

...

Keyword(s):

Vitamin D ◽

Renal Disease ◽

Dietary Intake ◽

End Stage Renal Disease ◽

Plant Protein ◽

Maintenance Hemodialysis ◽

Acid Glycoprotein ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Management of end-stage renal disease (ESRD) patients requires monitoring each of the components of malnutrition–inflammation–atherosclerosis (MIA) syndrome. Restrictive diet can negatively affect nutritional status and inflammation. An acute-phase protein—α1-acid glycoprotein (AGP), has been associated with energy metabolism in animal and human studies. The aim of our study was to look for a relationship between serum AGP concentrations, laboratory parameters, and nutrient intake in ESRD patients. The study included 59 patients treated with maintenance hemodialysis. A 24 h recall assessed dietary intake during four non-consecutive days—two days in the post-summer period, and two post-winter. Selected laboratory tests were performed: complete blood count, serum iron, total iron biding capacity (TIBC) and unsaturated iron biding capacity (UIBC), vitamin D, AGP, C-reactive protein (CRP), albumin, prealbumin, and phosphate–calcium metabolism markers (intact parathyroid hormone, calcium, phosphate). Recorded dietary intake was highly deficient. A majority of patients did not meet recommended daily requirements for energy, protein, fiber, iron, magnesium, folate, and vitamin D. AGP correlated positively with CRP (R = 0.66), platelets (R = 0.29), and negatively with iron (R = −0.27) and TIBC (R = −0.30). AGP correlated negatively with the dietary intake of plant protein (R = −0.40), potassium (R = −0.27), copper (R = −0.30), vitamin B6 (R = −0.27), and folates (R = −0.27), p < 0.05. However, in multiple regression adjusted for confounders, only CRP was significantly associated with AGP. Our results indicate that in hemodialyzed patients, serum AGP is weakly associated with dietary intake of several nutrients, including plant protein.

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IMPACT OF DURATION OF HEMODIALYSIS ON LIPID PROFILE IN END STAGE RENAL DISEASE PATIENTS RECEIVING HEMODIALYSIS.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.4188 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1230-1236

Author(s):

Sadia Rehman ◽

Santosh Kumar ◽

Fatima Mehboob ◽

Fatima Rehman ◽

Syed Hidayat Ali ◽

...

Keyword(s):

Renal Disease ◽

Lipid Profile ◽

End Stage Renal Disease ◽

Serum Triglyceride ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Healthy Controls ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End Stage Renal Disease (ESRD) patients receiving hemodialysis are at a higher risk of developing dyslipidemia which is undoubtedly a predisposing factor of cardiac related disease in these patients. Objectives: To assess serum lipid profile in subjects having end stage renal disease and receiving maintenance hemodialysis and to compare it with normal healthy controls and also to assess the effects of duration of hemodialysis on the lipid profile. Study Design: A case-control study. Setting: Executed in the Nephrology Department of JPMC. Period: January 2018 to January 2019. Material and Methods: Blood samples were obtained from a total of 90 subjects. Subjects were stratified into 3 groups including cases of ESRD receiving maintenance hemodialysis and matched healthy controls. Analysis for serum triglyceride, serum VLDL, total cholesterol, LDL and HDL was done. Results: A significant rise in serum triglyceride content and total serum cholesterol of hemodialysis patients (p < 0.01) was detected as compared to healthy controls. A statistically significant decrease was found in serum HDL level (p < 0.01) in hemodialysis patients in comparison to healthy controls. The impact of the hemodialysis duration was found to deteriorate the lipid profile of patients having longer duration of hemodialysis. Conclusion: Dyslipidemia was found to be evident in hemodialysis patients. The duration of hemodialysis sessions was found to affect the lipid profile of ESRD patients, which may play a role in higher incidence of atherosclerotic related cardiac events among these patients.

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Increased Levels of Anaphylatoxin (C5a) and Bradykinin in End-Stage Renal Disease Patients on Maintenance Hemodialysis. Potential Relevance to Heparin Mediated Hemodynamic Responses

Blood ◽

10.1182/blood.v112.11.4079.4079 ◽

2008 ◽

Vol 112 (11) ◽

pp. 4079-4079

Author(s):

Cafer Adiguzel ◽

Vinod Bansal ◽

Josephine Cunanan ◽

Evangelos Litinas ◽

Debra Hoppensteadt ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Sandwich Elisa ◽

Maintenance Hemodialysis ◽

Control Group ◽

Contact Activation ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Besides the upregulation of inflammatory mediators, end stage renal disease (ESRD) patients maintained on hemodialysis are subjected to periodic exposure to heparin and contact activation due to procedural settings. Recently the presence of a heparin contaminant, namely hypersulfated chondroitin sulfate was linked with the adverse reactions and deaths observed in these patients (Kishmoto, et al. N J Med 2008). To validate this report we measured both the C5a anaphlatoxin and bradykinin levels in ESRD patients prior to and after maintenance hemodialysis. The control group comprised of 40 normal healthy individuals were included to establish the normal level of these mediators. A sandwich ELISA method utilizing a monoclonal antibody which is specific for human C5a and bradykinin were used in these studies. Both the C5a and bradykinin were elevated in pre-dialysis samples from ESRD patients (C5a: 3.2±0.6 ng/ml vs 14.2± 4.6 ng/ml, bradykinin: 6.4±1.8 ng/ml vs 9.3±2.4 ng/ml). Moreover, dialysis itself produced an increase in both the C5a and bradykinin levels. Moreover, the postdialysis samples were further increased, suggesting that dialysis and heparinization itself result in the up-regulation of these mediators. Supplementation of heparin to the plasma also resulted in the generation of both C5a and bradykinin. The plasma samples included in these studies represents patients who were not treateded with the contaminant heparin. Additional studies on in-vitro generation of these markers with contaminated heparin and the isolated contaminant showed that both of these triggered the generation of C5a and bradyknin. These results suggest that both C5a and bradykinin are up-regulated in ESRD patients and this level can be further augmented by dialysis and heparinization. Therefore, additional factors may have contributed to the complex adverse reaction profiles and deaths in patients administrated with contaminated heparin.

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Abnormal rich club organization in end-stage renal disease patients before dialysis initiation and undergoing maintenance hemodialysis

BMC Nephrology ◽

10.1186/s12882-020-02176-y ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Shaohui Ma ◽

Ming Zhang ◽

Yang Liu ◽

Dun Ding ◽

Peng Li ◽

...

Keyword(s):

Cognitive Function ◽

Renal Disease ◽

Cystatin C ◽

End Stage Renal Disease ◽

Neuropsychological Tests ◽

Maintenance Hemodialysis ◽

Rich Club ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background End-stage renal disease (ESRD) patients are at a substantially higher risk for developing cognitive impairment compared with the healthy population. Dialysis is an essential way to maintain the life of ESRD patients. Based on previous research, there isn’t an uncontested result whether cognition was improved or worsened during dialysis. Methods To explore the impact of dialysis treatment on cognitive performance, we recruited healthy controls (HCs), predialysis ESRD patients (predialysis group), and maintenance hemodialysis ESRD patients (HD group). All ESRD patients performed six blood biochemistry tests (hemoglobin, urea, cystatin C, Na+, K+, and parathyroid hormone). Neuropsychological tests were used to measure cognitive function. By using diffusion tensor imaging and graph-theory approaches, the topological organization of the whole-brain structural network was investigated. Generalized linear models (GLMs) were performed to investigate blood biochemistry predictors of the neuropsychological tests and the results of graph analyses in the HD group and predialysis group. Results Neuropsychological analysis showed the HD group exhibited better cognitive function than the predialysis group, but both were worse than HCs. Whole-brain graph analyses revealed that increased global efficiency and normalized shortest path length remained in the predialysis group and HD group than the HCs. Besides, a lower normalized clustering coefficient was found in the predialysis group relative to the HCs and HD group. For the GLM analysis, only the Cystatin C level was significantly associated with the average fiber length of rich club connections in the predialysis group. Conclusions Our study revealed that dialysis had a limited effect on cognitive improvement.

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