Clinical Characteristics and degree of severity of COVID-19 in Hemodialysis Patients in Armed Forces Institute of Urology.

Introduction This study was conducted to evaluate the clinical characteristics and severity of COVID -19 in hemodialysis patients at from 1st March 2020 to 15th August 2020. Methodology It was a prospective and Cross Sectional Observational Study. We collected data prospectively that includes all patients on maintenance hemodialysis and reviewed clinical characteristics of those with laboratory-confirmed COVID-19 between March 1and August 15, 2020. Results 39 out of 268 dialysis dependent patients had COVID-19. Mean age of patients was 55.9yrs. Only 35.8% patients were symptomatic. 15 out of 39 were having mild disease,12 had moderate and 12 had severe disease. Females (54.5%) were found to be more affected than males(45.5%). Dry cough was the commonest symptom (53.8%) followed by fever (46.1%) and abdominal pain(18.1%). Patients with multiple comorbidities were found to have severe disease. Conclusion We concluded that patients receiving maintenance hemodialysis are susceptible to COVID-19 and that hemodialysis centers are high risk for spread of infection. Isolating patients with COVID-19 can help in preventing the spread of COVID-19.

Download Full-text

Assessment of nutritional status of hemodialysis patients by subjective global assessment score: a single centre study from Karachi, Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1935 ◽

2022 ◽

Vol 71 (12) ◽

pp. 2761-2765

Author(s):

Lubna Ghazi ◽

Murtaza Dhrolia ◽

Aamna Hamid ◽

Ruqaya Qureshi ◽

Kiran Nasir ◽

...

Keyword(s):

Nutritional Status ◽

Global Assessment ◽

Practical Method ◽

Hemodialysis Patients ◽

Normal Weight ◽

Maintenance Hemodialysis ◽

P Value ◽

Binary Logistic Regression Analysis ◽

Subjective Global Assessment ◽

Cross Sectional

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment. Continuous...

Download Full-text

Associations of cardiovascular disease and blood pressure with cognition in hemodialysis patients: The Osaka Dialysis Complication Study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab247 ◽

2021 ◽

Author(s):

Tetsuo Shoji ◽

Hisako Fujii ◽

Katsuhito Mori ◽

Shinya Nakatani ◽

Yuki Nagata ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Diastolic Pressure ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Cross Sectional ◽

Diabetic Kidney ◽

Prior Stroke

Abstract Background Previous studies reported mixed results regarding the contributions of cardiovascular disease (CVD) and blood pressure to cognitive impairment in chronic kidney disease. Methods This was a cross-sectional study in 1213 patients on maintenance hemodialysis from 17 dialysis units in Japan. The main exposures were prior CVD and blood pressure components including systolic (SBP) and diastolic pressure (DBP). The outcome was low cognitive function evaluated with the Modified Mini-Mental State examination (3MS) with a cut-off level of 3MS < 80. Results The median age was 67 years, median duration of dialysis was 71 months, 37% were women, 39% had diabetic kidney disease, and 36% had any pre-existing CVD. Median (interquartile range) of 3MS score was 91 (82 to 97), and 240 patients (20%) had 3MS < 80. Logistic regression analysis showed that 3MS < 80 was associated with the presence of any prior CVD, particularly prior stroke. 3MS < 80 was associated with lower DBP but not with SBP. When patients were stratified by the presence of prior stroke, lower DBP, higher age, and lower education level were factors associated with 3MS < 80 in both subgroups. In the subgroup of patients without prior stroke, diabetic kidney disease was an additional factor associated with 3MS < 80. CVDs other than stroke were not associated with 3MS in either subgroup. Conclusions Prior stroke and lower DBP were associated with 3MS < 80 in hemodialysis patients. These findings support the hypothesis that these vascular factors contribute to low cognitive performance in patients undergoing hemodialysis.

Download Full-text

P070 TRENDS AND CHARACTERISTICS OF CLINICAL TRIALS PARTICIPATION IN THE IBD PARTNERS COHORT

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.027 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S11-S12

Author(s):

Cole Johnson ◽

Edward Barnes ◽

Xian Zhang ◽

Millie Long

Keyword(s):

Clinical Trials ◽

Controlled Trial ◽

Severe Disease ◽

Drug Approval ◽

Cross Sectional Study ◽

Participation Rates ◽

Cross Sectional ◽

Mild Disease ◽

Randomized Controlled ◽

Study Results

Abstract Background and Aims There are currently several recruitment challenges in randomized controlled trials (RCT) for inflammatory bowel disease (IBD) which prolong the drug approval process and affect the generalizability of study results. The purpose of this study is to characterize individuals who participate in IBD RCTs and identify factors which could influence future recruitment strategies. Methods We performed a cross-sectional study within the IBD Partners cohort comparing patients with current or prior participation in an interventional randomized controlled trial (RCT) of a medical therapy for IBD to those without any RCT participation. Bivariate statistics were used to compare RCT participation by IBD subtype and by other demographic and disease characteristics, and predictive modeling was used to identify factors predictive of RCT participation. We calculated the percent of the cohort that participated an in RCT during each calendar year from 2011–2018 and Clinicaltrials.gov was accessed to determine the number of active RCTs for IBD therapies per year during that same period. Results A total of 14,747 patients with IBD were included in the analysis and 1,116 (7.6%) reported RCT participation at any time. Demographic factors predictive of RCT participation (Table 1) included following at an academic institution (OR=1.8; 95%CI: 1.51–2.04) and age 36–75 (OR=1.6; 95%CI: 1.43–1.87). Patients with Crohn’s disease (CD) were more likely to participate than those with ulcerative colitis (UC) (OR=1.5; 95%CI: 1.35–1.77). Patients with more severe disease were more likely to participate, including those with prior IBD-related hospitalization (OR=2.6; 95%CI: 2.19–2.99), IBD-related surgery (OR=2.5; 95%CI: 2.24–2.87), biologic exposure (OR=3.2; 95%CI: 2.76–3.65), and “Poor” or worse quality of life (OR=1.7; 95%CI: 1.45–1.93). Steroid-free remission was associated with lower likelihood of RCT participation (OR=0.6; 95%CI: 0.53–0.70). While the number of active RCTs for IBD more than doubled between 2011 and 2018, RCT participation rates during that same time period decreased from 1.1% to 0.7% of the cohort (Figure 1). Conclusions RCT participation rates declined within this cohort between 2011–2018. Groups underrepresented in RCTs for IBD included younger patients, patients followed in community settings, and patients with more mild disease. The non-RCT group had mean sCDAI and SCCAI scores that did not meet remission thresholds, demonstrating populations in need of alternate therapies for whom clinical trials could be an option. Given anti-TNF exposure rates in this national cohort, studies should focus on anti-TNF failure populations. Investigators should make every effort to offer RCTs to all patients and network with community providers to increase awareness of RCTs.

Download Full-text

Arteriosclerosis in Dialysis Patients

The International Journal of Artificial Organs ◽

10.1177/039139889601901104 ◽

1996 ◽

Vol 19 (11) ◽

pp. 638-644 ◽

Cited By ~ 25

Author(s):

J. Bommer ◽

E. Strohbeck ◽

J. Goerich ◽

M. Bahner ◽

I. Zuna

Keyword(s):

Calcium Phosphate ◽

Hdl Cholesterol ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Maintenance Hemodialysis ◽

Time Interval ◽

Dialysis Patients ◽

Cross Sectional ◽

Vldl Cholesterol

Arteriosclerosis is a constant problem in long-term hemodialysis patients. Computer tomography of the abdominal aorta allows a well-defined and reproducible evaluation of aortosclerosis. In the cross-sectional study, aortosclerosis was significantly accelerated in 84 chronic hemodialysis patients and was comparable to the results found in 20-year older control patients without renal disease. The increase of aortosclerosis correlated significantly with age of the patient, smoking, and duration of dialysis therapy. Furthermore, increased VLDL cholesterol and decreased HDL cholesterol seem to enhance aortosclerosis in our dialysis patients. In the longitudinal study (two CT scans with a time interval of 87 ± 62.7 months) in 36 dialysis patients, progressed aortosclerosis correlated significantly with the long duration of hypertriglyceridemia, VLDL cholesterol, uric acid, and calcium phosphate products. Progression of aortosclerosis was reduced in parathyroidectomized patients. The study suggests that premature aortosclerosis is found in dialysis patients. In addition to the common risk factor of aortosclerosis, disturbed calcium phosphate and parathyroid hormone metabolism seem to enhance aortosclerosis in patients under maintenance hemodialysis.

Download Full-text

Asymmetry indicates more severe and active disease in Graves’ orbitopathy: results from a prospective cross-sectional multicentre study

Journal of Endocrinological Investigation ◽

10.1007/s40618-020-01258-w ◽

2020 ◽

Vol 43 (12) ◽

pp. 1717-1722 ◽

Cited By ~ 4

Author(s):

P. Perros ◽

◽

M. P. Žarković ◽

G. C. Panagiotou ◽

C. Azzolini ◽

...

Keyword(s):

Clinical Characteristics ◽

Severe Disease ◽

Clinical Parameter ◽

Cross Sectional ◽

Multi Centre Study ◽

Patient Demographics ◽

Male Ratio ◽

Included Patient ◽

Graves Orbitopathy ◽

Active Disease

Abstract Purpose Patients with Graves’ orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves’ orbitopathy. Methods This was a multi-centre study of new referrals to 13 European Group on Graves’ Orbitopathy (EUGOGO) tertiary centres. New patients presenting over a 4 month period with a diagnosis of Graves’ orbitopathy were included. Patient demographics were collected and a clinical examination was performed based on a previously published protocol. Patients were categorized as having asymmetric, symmetric, and unilateral Graves’ orbitopathy. The distribution of clinical characteristics among the three groups was documented. Results The asymmetric group (n = 83), was older than the symmetric (n = 157) group [mean age 50.9 years (SD 13.9) vs 45.8 (SD 13.5), p = 0.019], had a lower female to male ratio than the symmetric and unilateral (n = 29) groups (1.6 vs 5.0 vs 8.7, p < 0.001), had more active disease than the symmetric and unilateral groups [mean linical Activity Score 3.0 (SD 1.6) vs 1.7 (SD 1.7), p < 0.001 vs 1.3 (SD 1.4), p < 0.001] and significantly more severe disease than the symmetric and unilateral groups, as measured by the Total Eye Score [mean 8.8 (SD 6.6) vs 5.3 (SD 4.4), p < 0.001, vs 2.7 (SD 2.1), p < 0.001]. Conclusion Older age, lower female to male ratio, more severe, and more active disease cluster around asymmetric Graves’ orbitopathy. Asymmetry appears to be a marker of more severe and more active disease than other presentations. This simple clinical parameter present at first presentation to tertiary centres may be valuable to clinicians who manage such patients.

Download Full-text

Evaluation of Body Composition in Hemodialysis Thai Patients: Comparison between Two Models of Bioelectrical Impedance Analyzer and Dual-Energy X-Ray Absorptiometry

Journal of Nutrition and Metabolism ◽

10.1155/2018/4537623 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Kulapong Jayanama ◽

Supanee Putadechakun ◽

Praopilad Srisuwarn ◽

Sakda Arj-Ong Vallibhakara ◽

Prapimporn Chattranukulchai Shantavasinkul ◽

...

Keyword(s):

Body Composition ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Hemodialysis Patients ◽

Dual Energy ◽

Fat Free Mass ◽

Maintenance Hemodialysis ◽

Cross Sectional ◽

X Ray ◽

Inbody 720

Background. Body composition measurement is very important for early nutritional care in hemodialysis patients. Dual-energy X-ray absorptiometry (DXA) is a gold standard test, but clinically limited. Bioelectrical impedance analysis (BIA) with multifrequency technique is a practical and reliable tool. Objective. This cross-sectional study was aimed to compare the agreement of BIA with DXA in measurement of body composition in hemodialysis patients and to evaluate their associated factors. Methods. Body composition was measured by 2 BIA methods (InBody S10 and InBody 720) and DXA after a hemodialysis session. A total of 69 measurements were included. Pearson’s correlation and Bland and Altman analysis were used to determine the correlation of body composition between methods and to compare the methods agreement, respectively. Results. The correlation coefficients of body compositions were strong between DXA and InBody S10 (fat mass index (FMI): r=0.95, fat-free mass index (FFMI): r=0.78) and also between DXA and InBody 720 (FMI: r=0.96, FFMI: r=0.81). Comparing to DXA, the means of each body composition measured by InBody S10 method were not significantly different in each gender, but differences were found in FM, %FM, and FMI measured by InBody 720. Conclusions. In maintenance hemodialysis patients, the measurement of body composition with DXA and both BIA methods had highly significant correlations; practically, BIA method could be used as an instrument to follow FM and FFM and to measure the edematous stage. Further studies with large populations are warranted.

Download Full-text

Blood Pressure of Maintenance Hemodialysis Patients in the Dalmatian Region of Croatia: Differences between Hospital and Out-of-Hospital Dialysis Centers

Blood Purification ◽

10.1159/000474931 ◽

2017 ◽

Vol 44 (2) ◽

pp. 110-121

Author(s):

Marijana Gulin ◽

Dragan Klarić ◽

Mario Ilić ◽

Josipa Radić ◽

Vedran Kovačić ◽

...

Keyword(s):

Blood Pressure ◽

Weight Gain ◽

Beta Blockers ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Sectional Study ◽

Cross Sectional ◽

Interdialytic Weight Gain ◽

Maintenance Hemodialysis Patients

Aims: This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. Methods: A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-dialysis BP values were collected for 3 consecutive HD sessions per patient. Results: Of the 399 subjects, 73.9% were hypertensives, who showed higher interdialytic weight gain compared to the normotensives (2.58 vs. 2.40). Hospital and out-of-hospital HD patients received identical antihypertensive therapies, except that beta blockers were more frequently administered to out-of-hospital HD patients. Higher pre-, intra-, and post-dialysis BP values were recorded in patients at out-of-hospital HD centers. Conclusion: The differences in BP variability and antihypertensive therapies administered to hospital HD patients as compared to out-of-hospital HD patients may reflect differing approaches by the nephrologists at these centers.

Download Full-text

Cross-sectional small intestinal surveillance of maintenance hemodialysis patients using video capsule endoscopy: SCHEMA study

Endoscopy International Open ◽

10.1055/s-0042-105203 ◽

2016 ◽

Vol 04 (05) ◽

pp. E589-E596 ◽

Cited By ~ 4

Author(s):

Naoki Hosoe ◽

Shigeaki Matsukawa ◽

Yoshihiko Kanno ◽

Makoto Naganuma ◽

Hiroyuki Imaeda ◽

...

Keyword(s):

Capsule Endoscopy ◽

Hemodialysis Patients ◽

Video Capsule Endoscopy ◽

Maintenance Hemodialysis ◽

Cross Sectional ◽

Small Intestinal ◽

Maintenance Hemodialysis Patients

Download Full-text

ERECTILE DYSFUNCTION

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.03.1471 ◽

2016 ◽

Vol 23 (03) ◽

pp. 268-273

Author(s):

Ansari Muhammad Rafique ◽

Pooran Mal ◽

Jairamani Bhagwan Das ◽

Shafique-Ur-Rehman Memon ◽

Syed M Tahir ◽

...

Keyword(s):

Diabetes Mellitus ◽

Erectile Dysfunction ◽

Rural Areas ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Diabetic Patients ◽

Cross Sectional ◽

Male Patients

Objectives: Erectile dysfunction (ED) is a very common and distressing healthproblem in chronic maintenance hemodialysis patients. There is no such data available fromSind province of Pakistan on this issue; we want to highlight the factors and prevalence oferectile dysfunction among hemodialysis patients in this part of our country. Study Design:This hospital based observational, cross-sectional study Setting: It was conducted at 04hemodialysis centers of Hyderabad city Perod: In 2014 Methods: The Study was conductedby using International Index of Erectile Dysfunction (IIEF-5) for determination of prevalence& severity of ED among these patients. Comparative analysis for frequency of ED was alsodone between urban & rural patients. Adapted Urdu version of IIEF-5 was used for those whocannot understand English pro forma. Results: There were total 62 male patients; all of themwere on maintenance hemodialysis for more than 6 months. Their ages were between 20 to59 years with mean 36±11. In this series of patients 80% (n=50) were < 50 years of age whilethe diabetic patients were 58% (n=36). The overall prevalence of ED observed in patients was88.7% (n=55) in our study. Severe ED was seen in 30 (48.4%) patients. The prevalence &severity of ED was significantly higher in diabetes mellitus and over 50 years of age. There washigher incidence of ED 94% observed in patients who are living in rural areas as compared tourban areas patients 82%. Conclusions: It has been concluded in this study that majority ofmale hemodialysis patients were suffering from ED problem. Diabetes mellitus and & > 50 yearsof age has the highest prevalence of ED. Erectile dysfunction is very common and distressinghealth related issue among hemodialysis patients and this should be addressed with routine

Download Full-text