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Mahmoudi M, Moeinzadeh F, Atapour A, Seirafian S, Azhir Z. Serum zinc levels in hemodialysis and peritoneal dialysis patients: A retrospective observational study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2024; 29:13. [PMID: 38808217 PMCID: PMC11132417 DOI: 10.4103/jrms.jrms_167_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 10/27/2023] [Accepted: 11/08/2023] [Indexed: 05/30/2024]
Abstract
Background Zinc is vital for cellular functions, but kidney failure increases zinc deficiency risk. We compared zinc levels in hemodialysis (HD) and peritoneal dialysis (PD) patients in Isfahan, Iran. Materials and Methods A retrospective study included 150 patients (75 PD and 75 HD). Serum zinc levels were assessed through photometry. Statistical analysis employed Chi-square, independent t-test, and correlation. Results Serum zinc was below normal in both groups (P < 0.01). HD patients had lower zinc levels (70.85 ± 7.68 mg/dL) compared to PD (75.04 ± 13.55 mg/dL, P = 0.021), remaining significant after adjusting for confounders (P = 0.011). Conclusion Zinc levels in PD and HD patients are lower than in the general population, with HD patients having lower levels than PD patients.
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Affiliation(s)
- Masoud Mahmoudi
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firouzeh Moeinzadeh
- Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Seirafian
- Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zhina Azhir
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Huang YJ, Jiang ZP, Zhou JF, Zhang X, Xiong LP, Liang MJ, Shi HR, Su N, Zhang R. Hypertriglyceridemia is a risk factor for treatment failure in patients with peritoneal dialysis-related peritonitis. Int Urol Nephrol 2021; 54:1583-1589. [PMID: 34689313 DOI: 10.1007/s11255-021-03027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/08/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Disorders of triglycerides (TG) are common in patients with peritoneal dialysis (PD). Hypertriglyceridemia has been demonstrated in various infections. The association between triglycerides and the outcomes of peritoneal dialysis-related peritonitis (PDRP) was investigated in this study. METHODS We retrospectively investigated patients with PDRP from January 1, 2013 to October 31, 2020. Hypertriglyceridemia was defined as triglycerides ≥ 1.7 mmol/L. PDRP episodes were divided into two groups: hypertriglyceridemia and normal levels of triglycerides. The clinical and laboratory baseline data of the two groups were collected and compared. The association between triglycerides and treatment failure was analyzed by logistic regression analysis. RESULTS Ninety episodes in 66 patients were recorded in our center. Hypertriglyceridemia occurred in 38% (34/90) of episodes. Twenty-five episodes were not cured in 90 episodes (27.8%, 25/90). The levels of thrombocytes, high-sensitivity C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL-C) and glycated hemoglobin, were higher in hypertriglyceridemia episodes of PDRP at baseline. The bacterial classification was different between elevated triglyceride group and normal triglyceride group. Adjusted for age, duration of dialysis, residual renal function, diabetes, thrombocytes, hs-CRP, serum albumin, cholesterol, HDL-C, LDL-C, intact parathyroid hormone (iPTH), glycated hemoglobin and spectrum of bacteria, hypertriglyceridemia were associated significantly with treatment failure of PDRP in our study (OR 3.416, 95% CI 1.223-9.540 p < 0.05). CONCLUSION Hypertriglyceridemia at baseline was an independent risk factor for treatment failure of PDRP.
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Affiliation(s)
- Ya-Juan Huang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Zong-Pei Jiang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Ja-Fan Zhou
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Xing Zhang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Li-Ping Xiong
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Meng-Jun Liang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Hong-Rui Shi
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Ning Su
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
| | - Rui Zhang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
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Schellartz I, Ohnhaeuser T, Mettang T, Scholten N. Information about different treatment options and shared decision making in dialysis care - a retrospective survey among hemodialysis patients. BMC Health Serv Res 2021; 21:673. [PMID: 34238295 PMCID: PMC8268609 DOI: 10.1186/s12913-021-06599-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/31/2021] [Indexed: 11/25/2022] Open
Abstract
Background Hemodialysis (HD) and peritoneal dialysis (PD) are equivalent treatment alternatives for patients with end stage renal disease. In Germany, there is a legal obligation to inform every patient about all treatment alternatives and their possible harms and benefits. However, there is a low utilization of PD. Therefore, the question arises, whether HD patients perceive that they were informed about different dialysis options. We further investigate, if personal characteristics of informed and non-informed patients vary, and if both groups experienced the decision for their dialysis treatment as shared decision making (SDM). Methods The database was a nationwide postal survey of 590 HD patients from two statutory health insurers in Germany. Participants were asked whether they have been informed about both dialysis options. A logistic regression model examines impact factors on this information. We investigate differences in the German version of the 9-item SDM Questionnaire (SDM-Q-9) between informed and non-informed patients with a multivariate linear regression model. Results 56 % of the respondents reported they had been informed about different dialysis treatment options. Patients older than 65 had a 61 % lower chance than patients ≤ 65 for this information (p < 0.001). High educated patients had a 47 % higher chance for this information than patients with low education level (p = 0.030). Informed patients rated a higher SDM-Q-9 scores than non-informed patients (76.9 vs. 44.2; p < 0.001). Non-informed patients showed high values in those SDM-Q-9 items which had no regard to different treatment options. Conclusions A great proportion of HD patients – mostly elderly patients and patients with a low education level – did not perceive that they were informed about different dialysis options before dialysis was initiated. The current obligation to provide information about all treatment alternatives in Germany is a first step to assure the unselected access to different treatment options. But it has not reached routine application in health care yet. Information about different treatment options can pave the way for SDM. While SDM is considered to be a valuable tool in clinical medicine, there is still room for improvement for its successful implementation when it comes to decision making on different dialysis treatment options. Trial registration The MAU-PD study (Multidimensional analysis of causes for the low prevalence of ambulatory peritoneal dialysis in Germany) is registered at the German Clinical Trials Register.
DRKS-ID: DRKS00012555 Link: https://www.drks.de/drks_web/setLocale_EN.do. Date of Registration in DRKS: 2018/01/04.
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Affiliation(s)
- Isabell Schellartz
- Faculty of Human Sciences, Faculty of Medicine, Institute of Medical Sociology, University of Cologne, Health Services Research and Rehabilitation Science (IMVR), Eupener Str. 129, 50933, Cologne, Germany.
| | - Tim Ohnhaeuser
- Faculty of Human Sciences, Faculty of Medicine, Institute of Medical Sociology, University of Cologne, Health Services Research and Rehabilitation Science (IMVR), Eupener Str. 129, 50933, Cologne, Germany
| | | | - Nadine Scholten
- Faculty of Human Sciences, Faculty of Medicine, Institute of Medical Sociology, University of Cologne, Health Services Research and Rehabilitation Science (IMVR), Eupener Str. 129, 50933, Cologne, Germany
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Xie D, Zhou J, Cao X, Zhang Q, Sun Y, Tang L, Huang J, Zheng J, Lin L, Li Z, Cai G, Chen X. Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI. BMC Nephrol 2020; 21:199. [PMID: 32450790 PMCID: PMC7249625 DOI: 10.1186/s12882-020-01850-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 05/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion, although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. METHODS One hundred eighty seven consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI > 28 or ≤ 28. The outcomes included catheter related complications and catheter survival. RESULTS Total infectious complication rates were significantly lower in group P than in group S. There were no significant differences in peritonitis rate between group P and group S (1.20% vs. 3.16% with P = 0.71 in early stage, and 4.82% vs. 11.58% with P = 0.11 in late stage). All other measured complications were similar between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infection-free catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI > 28, which was confirmed by Kaplan-Meier analysis. CONCLUSIONS Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique seems to be a safe and effective approach to placing a peritoneal dialysis catheter.
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Affiliation(s)
| | - Jianhui Zhou
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China.
| | - Xueying Cao
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Qingtao Zhang
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Yanli Sun
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Li Tang
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Jing Huang
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Juanli Zheng
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Li Lin
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Zhenzhen Li
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Guangyan Cai
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Xiangmei Chen
- Department of Nephrology, the First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center for Kidney Diseases, Fuxing Road 28, Beijing, 100853, People's Republic of China.
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