Extent of Fall in Serum Potassium by Medical Therapy in End Stage Renal Disease

2021 ◽  
Vol 15 (8) ◽  
pp. 1871-1873
Author(s):  
Sadaf Sarwar ◽  
Tahir Ullah Khan ◽  
Atif Masood ◽  
Faisal Amin Baig ◽  
Arsalan Nawaz ◽  
...  
Keyword(s):  
Renal Disease ◽  
Medical Treatment ◽  
Serum Potassium ◽  
End Stage Renal Disease ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Change In Mean

Aim: To observe the mean alteration in potassium levels one-hour post-antihyperkalemic treatment in end stage renal disease patients presenting with hyperkalemia. Study design: Quazi interventional (experimental) study. Place and duration of study: Department of Medicine, Sir Ganga Ram Hospital Lahore from 28th June 2018 to 27th December 2018. Methodology: Sixty patients of both genders with age range between 14 to 70 years having stage 5 CKD (thrice-weekly dialysis dependent) for at least 6 months with raised serum potassium (>5.5 mEq/L). These patients were given medical treatment in the form of salbutamol nebulization, injectable calcium gluconate, and 100ml 25% dextrose water solution neutralized with Humulin R Insulin 12 units. Serum potassium was reassessed 1 hour after the treatment. Mean change in serum potassium was observed and was compared across various subgroups of patients. A written informed consent was taken from each patient. Results: In the current study, mean age of our studied population was 50.6±10.4 years with male-gender dominance (81.7%). Mean ESRD duration was 11.8±3.7 months while the mean BMI was 27.6±3.6Kg/m2. 15 (25.0%) patients were obese. The serum potassium level at presentation ranged from 5.6mEq/L to 6.9mEq/L with a mean of 6.25±0.39mEq/L. The serum potassium level 1 hour after medical treatment ranged from 4.8mEq/L to 6.3mEq/L with a mean of 5.58±0.43mEq/L. This change in mean serum potassium was significant (p-value<0.001) on paired sample t-test. The change in serum potassium level ranged from 0.5-0.9mEq/L with a mean of 0.676±0.123mEq/L. Similar mean change in serum potassium level was observed when stratified for age, gender, BMI and duration of ESRD. Keywords: End Stage Renal Disease, Hemodialysis, Hyperkalemia, Medical Treatment

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.

Mineralocorticoid Therapy Lowers Serum Potassium in Patients with End-Stage Renal Disease

1993 ◽  
Vol 13 (2) ◽  
pp. 138-141 ◽  
Author(s):  
Pravin C. Singhal ◽  
Lionel Desroches ◽  
Joseph Mattana ◽  
Mirel Abramovici ◽  
John D. Wagner ◽  
...  
Keyword(s):  
Renal Disease ◽  
Serum Potassium ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

The effects of cyclophosphamide and mycophenolate on end-stage renal disease and death of lupus nephritis

Lupus ◽  
2011 ◽  
Vol 20 (13) ◽  
pp. 1442-1449 ◽  
Author(s):  
HS Koo ◽  
YC Kim ◽  
SW Lee ◽  
DK Kim ◽  
K-H Oh ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Rank Test ◽  
Systemic Steroid ◽  
Diagnostic Code ◽  
Composite Outcome ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Debate continues about the optimal treatment modality of lupus nephritis (LN). We compared the efficacy and safety of intravenous cyclophosphamide (CYC) and mycophenolate mofetil (MMF) for LN treatment in Korea. After searching for systemic lupus erythematosus (SLE) patients diagnosed between 1998 and 2007 with the diagnostic code of ICD10, we selected the 71 patients who were treated with CYC or MMF without any other immunosuppressant except systemic steroid. Composite outcome was defined as progression to end-stage renal disease (ESRD) and/or all-cause mortality. The initial manifestations of the CYC group were more severe than those of the MMF group. The mean daily MMF dose was 980 ± 100 mg for 21.67 ± 18.25 months. The mean monthly dose per CYC pulse therapy was 850 ± 30 mg for 17.04 ± 13.15 months. The incidence of composite outcome was 5/20 (25%) in the MMF group and 4/51 (7.8%) in the CYC group. The relative risk (RR) for composite outcome in the CYC group was 0.249 (95% CI for RR: 0.067–0.934, p = 0.039) compared with the MMF group with Cox's hazard proportional analysis. In Kaplan–Meier analysis, the probability of composite outcome was lower in the CYC group than in the MMF group (Log rank test p-value = 0.026). The results of this retrospective study suggest that intravenous CYC therapy may be more efficacious in averting ESRD and death than MMF. These results need to be confirmed in a larger randomized controlled trial.

Differences between KT/V Measured during Dialysis and KT/V Predicted from Manufacturer Clearance Data

1992 ◽  
Vol 15 (8) ◽  
pp. 465-469 ◽  
Author(s):  
L.K. Saha ◽  
J.C. Van Stone
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Urea Clearance ◽  
Blood Flows ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

We retrospectively analyzed data from 3,863 dialysis treatments in 329 end-stage renal disease patients over a period of 33 months to evaluate the accuracy of in vitro KT/V estimated by manufacturer's urea clearance data in relation to in vivo measured KT/V. In 1,087 urea clearances measured, mean actual clearance was 87% of predicted. At all blood flows, actual clearances were significantly lower than predicted (8-16% lower than predicted). In 2,807 KT/V measurements, predicted KT/V was 1.238 ± 0.005 whereas the mean of actual measured KT/V was 16% lower or 1.024 ± 0.005 (P < 0.0001). At different blood flows and with different dialyzers, predicted KT/V overestimated actual values. With increasing numbers of reuse, actual/predicted clearance ratios and actual/predicted KT/V ratios progressively dropped. Prescribing dialysis treatments using manufacturer's in vitro generated clearance data can lead to marked underdialysis of patients.

scholarly journals Neutrophil to Lymphocyte Ratio in Patients with End Stage Renal Disease in Benue State University Teaching Hospital, Makurdi, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 250-255
Author(s):  
MO Ogiator ◽  
JE Ojobi ◽  
OO Ijachi
Keyword(s):  
Renal Disease ◽  
Systemic Inflammation ◽  
Teaching Hospital ◽  
End Stage Renal Disease ◽  
Healthy Subjects ◽  
University Teaching ◽  
State University ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Chronic Kidney Disease (CKD) leads to end-stage renal disease (ESRD) and cardiovascular events. An important determinant of progression in CKD is chronic systemic inflammation which can be evaluated using the neutrophil to lymphocyte ratio (NLR). We aimed to investigate the value of NLR in patients with ESRD compared with healthy subjects. This was a retrospective study that analyzed data from patients with end-stage renal disease and equal number of age and sex matched control (healthy subjects) seen at Benue State University Teaching Hospital Makurdi from October 1st, 2012 to 31st December 2015. Out of the 118 patients studied 70(59.3) were males while 48 (40.7) were females. The mean age of the study population was 45.9 ± 16.4. The mean NLR for patients with ESRD was 3.55± 4.01 while that of healthy subjects was 1.29± 0.25. The mean NLR for patients was 3.47±4.01 for males and 3.68±4.06 for females while for the healthy subjects the mean NLR was 1.30±0.27 for males 1.27±0.22 for females. This study revealed elevated NLR in patients with ESRD. NLR reflects systemic inflammation. The availability of this ratio (NLR) can help improve outcome of patients with CKD.

scholarly journals Survival and mortality in hemodialysis patients

KIDNEYS ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 48-52
Author(s):  
О.N. Sharapov
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Causes Of Death ◽  
Serum Potassium Level ◽  
Survival Rates ◽  
Hemodialysis Patients ◽  
Cholesterol Concentration ◽  
Cardiovascular Pathologies ◽  
Stage Renal Disease ◽  
End Stage

This article provides a review of the literature on the problem of cardiovascular mortality in patients with end-stage renal disease. The article, based on foreign literature, considers the survival and mortality of hemodialysis patients. There is a high percentage of deaths due to cardiovascular pathologies in patients with end-stage renal disease receiving renal replacement therapy. The influence of cardiovascular pathologies on survival rates is described in detail according to the data of national and international renal registries. The data are provided on the study of the structure of the causes of death in hemodialysis patients. The factors influencing the survival rate and mortality in hemodialysis patients, such as smoking, preservation of diuresis, obesity, cholesterol concentration, serum potassium level, etc, are presented in detail. The urgency and necessity of studying this problem is noted, which dictates the need for purposeful efforts to reduce mortality in dialysis patients.

scholarly journals Assessment of the 24-hour profle of blood pressure and arterial stiffness in patients with end-stage renal disease

2019 ◽  
Vol 25 (1) ◽  
pp. 66-73
Author(s):  
I. E. Minyukhina ◽  
E. A. Praskurnichiy
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Age Groups ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Design And Methods ◽  
Daily Changes

Objective. The purpose of our study was to research specifc features the daily changes of the vascular stiffness (VS) in patients with end-stage renal disease (ESRD) and to assess the feasibility of using the 24-hour vascular index Pulse Time Index of Norm (PTIN) (the percentage of the 24-hour period during which the pulse wave velocity (PWVao) does not exceed 10 m/second) in the management of arterial hypertension (HTN) in patients after renal transplantation (RT).Design and methods. We examined 158 people, divided into 4 comparable age groups: those receiving program hemodialysis (PGD), patients after RT, patients with essential HTN and healthy volunteers. All of them underwent 24-hour blood pressure (BP) monitoring with a daily evaluation of VS indices and central BP. At follow-up, 27 patients from the PG group underwent all assessments also 1 week and 6 months after transplantation.Results. Patients with ESRD compared with patients with essential HTN had elevated PWVao, night central BP and decrease PTIN. PTIN changes were the most signifcant. In 27 patients a week after the RT a decrease in the PTIN was found in most cases. After 6 months the mean PTIN in the whole group increased again. Our study demonstrates HTN persistence after kidney transplantation can be predicted. Two PTIN states could be predicted by the cutoff PTIN value that was determined in the study: a state of improvement and a state of decline/unchanged state. PTIN cutoff value at 45 % was characterized by 69 % sensitivity, 76 % specifcity and AUC of 0,65. Therefore, baseline PTIN ≥ 45 % (before RT) is associated with its further growth, and a favourable course of HTN.Conclusions. Patients receiving replacement therapy, compared to patients with essential HTN, showed a marked increase in the daily VS and the night central BP. The daily PTIN is the most accurate predictor of the changes in the VS index, the PTIN values before the RT at the PG stage allow predicting the course of HTN after the RT

scholarly journals Spontaneous changes in the rate of decline in reciprocal serum creatinine: errors in predicting the progression of renal disease from extrapolation of the slope.

1992 ◽  
Vol 2 (7) ◽  
pp. 1186-1191
Author(s):  
B V Shah ◽  
A S Levey
Keyword(s):  
Renal Disease ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Chronic Renal Disease ◽  
Linear Regression Analysis ◽  
Effect Of Therapy ◽  
The Mean ◽  
Rate Of Decline ◽  
Stage Renal Disease ◽  
End Stage

The slope of reciprocal serum creatinine (1/Pcr) versus time has been used to measure the rate of progression of chronic renal disease, predict the interval until onset of end-stage renal disease, and assess the effect of therapy. In order to determine the errors that might result from extrapolating the slope of 1/Pcr versus time beyond the interval of observation, we applied a method of linear regression analysis to search for spontaneous changes in slope in 21 patients from New England Medical Center and 56 patients in three published studies in whom the decline in 1/Pcr appeared constant (r greater than or equal to 0.84 for the correlation of 1/Pcr versus time). Significant changes in the slope (breakpoints) were identified in one third to one half of the 77 patients and appeared to be spontaneous. The second slope was less steep in 49 patients (6.1%); the mean value for serum creatinine at the time of the breakpoint was 5.3 mg/dL; the mean change in slope (absolute value) was 0.005 dL/mg/month (adults) and 0.017 dL/mg/month (children); and the mean error in prediction of the interval until the final value for serum creatinine was 27% of the actual interval. We conclude that spontaneous breakpoints in the slope of 1/Pcr versus time are very frequent, even among patients with an apparent constant rate of decline. Breakpoints may cause errors in extrapolating the slope to predict the interval until the onset of end-stage renal disease and to assess the effect of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Analysis of T Wave Nonlinear Dynamics for Serum Potassium Monitoring in End-Stage Renal Disease Patients

2020 ◽  
Author(s):  
SABARATHINAM SRINIVASAN ◽  
Syed Hassaan Ahmed Bukhari ◽  
Pablo Laguna ◽  
Carlos Sánchez ◽  
Esther Pueyo
Keyword(s):  
Nonlinear Dynamics ◽  
Renal Disease ◽  
Serum Potassium ◽  
End Stage Renal Disease ◽  
T Wave ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals MO862COVID-19 INFECTION IN HEMODIALYSIS PATIENTS:FINDINGS-EXPERIENCE-OUTCOME

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ioannis Griveas ◽  
Antonis Schinas ◽  
Anthoula Balitsari ◽  
Gerasimos Asimakopoulos ◽  
Evangelos Pratilas
Keyword(s):  
Respiratory Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Average Weight ◽  
Dialysis Unit ◽  
Spring Period ◽  
Dialysis Vintage ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Our Nephrology Department during spring period on the first wave of COVID-19 was the referral Dialysis Unit for Covid-19 positive HD patients in the district area of Athens, Greece. The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing HD and treated under our care Method This is an observational study. Our Dialysis Unit has been assigned as a referral unit for Covid-19 positive HD patients. We registered all the data regarding the clinical course of our patients population. Age, primary cause of end stage renal disease, weight, clinical presentation, HD history, outcome, days of hospitalization. Results 22 Covid-19 positive HD patients were treated under the care of our facility during the period 8 April 2020-17 June 2020. 16 patients were symptomatic at admission and 13 patients admitted with or developed during their stay pleural effusions. 12 patients (8 male) of our group died during their hospitalization. 3 out of 12 were admitted to Intensive Care Unit (ICU). 6 patients were septic, 4 had respiratory failure and 2 developed cardiovascular events. 14.5 days were the mean hospitalization days (range: 1-38 days) for the diceased ones. 2 out of 3 patients that admitted to ICU had quick deterioration, incubated and stayed in ICU for 48 hours. The third one with severe cormobidities (multiple myeloma, cancer of bladder) developed respiratory failure after 8 days of hospitalization, incubated, became septic and died after 20 days in ICU. Mean age of our patients was 74.5 years. It has to be pointed out that 13 patients were over 75 years old. Mean age was higher in those who died compared with those who were discharged with double negative Covid-19 tests (79 vs 74,5 years old respectively). Median dialysis vintage for our patients was 63 months and for the diceased ones was 89 months. Average weight of our patients was 69 kgrs. Weight of diceased patients was 63 kgrs. 11 out of 22 patients and 5 out of 12 diceased patients were diabetic. 14 patients were hypertensive and 16 had official cardiovascular backround. 10 out of total 22 patients under our care discharged after 43 days of hospitalization (range:35-56 days). Conclusion As a conclusion our data provide clues regarding out experience of caring HD patients with COVID-19. Mortality was high. It seems that despite the fact that immune response of this population has not been clearly clarified, age, cormobidities and above all end-stage renal disease by its self is a significant and unpredictable risk factor for clinical outcome of HD patients with COVID-19 infection.

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