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Timofte D, Dragos D, Balcangiu-Stroescu AE, Tanasescu MD, Gabriela Balan D, Raducu L, Jecan CR, Stiru O, Medrihan L, Ionescu D. Characteristics of patients at initiation of renal replacement therapy - experience of a hemodialysis center. Exp Ther Med 2020; 20:103-108. [PMID: 32509001 PMCID: PMC7271700 DOI: 10.3892/etm.2020.8608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/03/2020] [Indexed: 01/25/2023] Open
Abstract
The monitoring and care of patients with chronic kidney disease (CKD) before the dialysis initiation contribute to a better survival rate and an improvement in quality of life. The patients who do not benefit from a good predialysis management have a worse short and long-term prognosis. A retrospective, unicentric study was performed to evaluate the status of patients with stage 5 CKD at the time of initiation of renal replacement treatment. A total of 109 patients were included in the study. The evaluation of the patients included the clinical manifestations leading to hemodialysis initiation, the clinical and laboratory data of the patients when the hemodialysis was started. Based on the obtained data, a statistical analysis was performed using the Chi-square test, Fisher's exact test, ANOVA, and Kruskal-Wallis H test. The mean age of the patients was 64.61±13.59 years. Of the patients 51.38% were women. Vascular nephropathies and diabetes mellitus dominated the etiology of CKD. The comorbidities were high blood pressure, ischemic heart disease, history of myocardial infarction, heart failure, history of stroke, peripheral artery disease or atrial fibrillation. Only 43 (39.45%) of our patients were monitored before the hemodialysis initiation. Hemodialysis was initiated on central venous catheter (in most cases non-tunneled) in 78.90% of the patients. Most of the patients had an altered general status, fatigue/tiredness with poor exercise capacity when hemodialysis was initiated. Most of the patients (98.17%) had anemia, the average level of hemoglobin being 8.69±1.85 g/dl. In conclusion, careful monitoring of patients in the early stages of CKD would result in lower morbidity and mortality. These objectives can be achieved by implementing screening programs and early interventions.
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Affiliation(s)
- Delia Timofte
- Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania
| | - Dorin Dragos
- Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Nephrology, Emergency University Hospital, 050098 Bucharest, Romania
| | - Andra-Elena Balcangiu-Stroescu
- Department of Dialysis, Emergency University Hospital, 050098 Bucharest, Romania
- Discipline of Physiology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Maria-Daniela Tanasescu
- Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Nephrology, Emergency University Hospital, 050098 Bucharest, Romania
| | - Daniela Gabriela Balan
- Discipline of Physiology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Laura Raducu
- Discipline of Plastic and Reconstructive Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic and Reconstructive Surgery, Clinical Emergency Hospital ‘Prof. Dr. Agrippa Ionescu’, 011356 Bucharest, Romania
| | - Cristian-Radu Jecan
- Discipline of Plastic and Reconstructive Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic and Reconstructive Surgery, Clinical Emergency Hospital ‘Prof. Dr. Agrippa Ionescu’, 011356 Bucharest, Romania
| | - Ovidiu Stiru
- Department of Cardiovascular Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Cardiovascular Surgery, ‘Prof. Dr. C. C. Iliescu’ Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Lavinia Medrihan
- Department of Diabetology-Endocrinology-Nutrition, Lille University, 59019 Lille, France
| | - Dorin Ionescu
- Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Nephrology, Emergency University Hospital, 050098 Bucharest, Romania
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Stepanova N, Burdeyna O. Association between Dyslipidemia and Peritoneal Dialysis Technique Survival. Open Access Maced J Med Sci 2019; 7:2467-2473. [PMID: 31666849 PMCID: PMC6814482 DOI: 10.3889/oamjms.2019.664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND: A large body of research has investigated the effects of pro-atherogenic lipid profile on cardiovascular diseases (CVD) in peritoneal dialysis (PD) patients. However, there is a general lack of research on the association between atherogenic dyslipidemia and PD technique survival. AIM: The study aimed to define the association between dyslipidemia and PD technique survival. METHODS: It was a prospective single-centre observational study involving 40 outpatients on continuous ambulatory PD treatment for more than 3 months between 2010 and 2016 in a single centre in Ukraine. There were 27 males and 13 females. The mean age of the participants was 49.3 ± 12.2 years. The primary outcome measures were all-cause technique failure. RESULTS: Atherogenic dyslipidemia was identified in 28/40 (70 %) patients and correlated with PD adequacy parameters. During the 36-month- follow-up period technique failure occurred in 2/12 (16.6 %) patients with atherogenic dyslipidemia compared with 12 / 28 (42.9 %) patients without atherogenic dyslipidemia (χ2 = 2.5; p = 0.12). In the univariate Cox regression model, atherogenic dyslipidemia at baseline was significantly associated with a higher risk of all-cause PD technique failure (HR 4.5; 95% CI 1.6 to 12.9; χ2 = 5.5, p = 0.019). CONCLUSION: The presence of atherogenic dyslipidemia was significantly associated with a higher risk of technique failure in PD patients. This is an important issue for future research. Further well-designed clinical trials are needed to determine the impact of dyslipidemia on PD adequacy and technique survival.
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Affiliation(s)
- Natalia Stepanova
- Department of Nephrology and Dialysis, State Institution "Institute of Nephrology of the National Academy of Medical Sciences of Ukraine"Kiev, Ukraine
| | - Olena Burdeyna
- Department of Nephrology and Dialysis, State Institution "Institute of Nephrology of the National Academy of Medical Sciences of Ukraine"Kiev, Ukraine
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