Parathyroid ultrasonography and bone metabolic profile of patients on dialysis with hyperparathyroidism

Influence of the Workload and Years of Experience of Nurses on Hemodialysis Quality Using Korean National Hemodialysis Adequacy Evaluation Data

The aim of this study is to examine the influence of nurses’ workload and years of experience on the rate of patients with normal calcium–phosphorus products levels and the adequacy evaluation grade of hemodialysis (HD) facilities using 2015 and 2018 national HD adequacy evaluation data. The data of 616 hospital-level outpatient HD facilities were analyzed using multiple linear regression and ordinal logistic regression. A higher rate of nurses with ≥2 years of HD experience was correlated with a higher rate of patients with normal calcium–phosphorus levels. As the average daily number of HD cases per nurse increased, the probability of HD facilities’ receiving the higher adequacy evaluation grade decreased by 83% (odds ratio (OR)=.17, 95% confidence interval (CI)=.14–.22), whereas it increased by 4% as the rate of nurses with ≥2 years of HD experience increased by 1%p (OR=1.04, 95% CI=1.03–1.05). Reducing the nursing workload by maintaining sufficient nurses and increasing the rate of nurses with ≥2 years of HD experience would improve the quality of HD and patient outcomes.

Treatment with Cinacalcet in Hemodialysis Patients with Severe Secondary Hyperparathyroidism, Influences Bone Mineral Metabolism and Anemia Parameters

Background:

Due to the premium rate of Chronic Kidney Disease, we have increased our knowledge with respect to diagnosis and treatment of Bone Mineral Disease (BMD) in End- Stage Renal Disease (ESRD). Currently, various treatment options are available. The medication used for Secondary Hyper-Parathyroidism gives promising results in the regulation of Ca, P and Parathormone levels, improving the quality of life. The aim of the present study was to investigate the relation of cinacalcet administration to not only parathormone, Ca and P but also to anemia parameters such as hematocrit and hemoglobin.

Materials and Methods:

retrospective observational study was conducted in a Chronic Hemodialysis Unit. One-hundred ESRD patients were recruited for twenty-four months and were evaluated on a monthly rate. Biochemical parameters were related to medication prescribed and the prognostic value was estimated. Cinacalcet was administered to 43 out of 100 patients in a dose of 30-120 mg.

Results:

Significant differences were observed in PTH, Ca and P levels with respect to Cinacalcet administration. Ca levels appeared to be higher at 30mg as compared to 60mg cinacalcet. Furthermore, a decreasing age-dependent pattern was observed with respect to cinacalcet dosage. A positive correlation was observed between Dry Weight (DW) and cinacalcet dose. Finally, a positive correlation between Hematocrit and Hemoglobin and cinacalcet was manifested.

Conclusions:

Cinacalcet, is a potential cardiovascular and bone protective agent, which is approved for use in ESRD patients to assist SHPT. A novel information was obtained from this study, regarding the improvement of the control of anemia.