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Djukanović L, Ležaić V, Dimković N, Marinković J, Aksić Milićević B, Arsenijević S, Arsenović A, Ceković B, Ćelić D, Djordjević V, Djurin M, Filipović N, Gajić S, Haviža-Lilić B, Jandrić M, Jovanović N, Knežević V, Krsmanović S, Marković D, Maksić D, Maslovarić J, Milanović S, Mitić B, Ostojić A, Petković D, Pilipović D, Sokolović M, Stanković D, Stojanović M, Stojšić Vuksanović T, Tirmenštajn B, Uzelac J, Vesić N, Vojinović G, Vukša V. Gender-specific differences in hemodialysis patients: a multicenter longitudinal study from Serbia. Int Urol Nephrol 2022; 54:3233-3242. [PMID: 35780280 DOI: 10.1007/s11255-022-03247-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 06/07/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The study was undertaken with the aim to determine gender-specific differences in incident hemodialysis (HD) patient and their changes over time. METHODS The retrospective longitudinal closed cohort study involved 441 incident patients starting HD in 2014 and followed for 1-59 (median 43, IQR 40) months. Demographic, clinical data, treatment characteristics, laboratory findings and outcome were abstracted from the patients' medical records. RESULTS The relative number of males on HD was about twice that of females throughout the five years investigated. At the beginning of the study, no significant differences were found in the main demographic and clinical characteristics except that diabetes was more often the underlying disease in men than in women. Systolic blood pressure decreased over time significantly more in females than in males. Throughout the study spKt/V was significantly higher in females than in males, but it increased in patients of both genders. There were no gender differences for comorbidities, vascular access and the majority of laboratory findings except for higher serum levels of creatinine and CRP in men than in women. Relatively more females were treated with erythropoiesis stimulating agents and phosphate binders than males. Age and malignancy were selected as significant predictors of mortality for both genders, and, in addition, polycystic kidney disease, serum level of albumin and CRP for men, but spKt/V for women. CONCLUSION Some significant gender differences were observed throughout, while others appeared during the study but none of them were due to gender inequalities in the applied treatment.
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Affiliation(s)
- Ljubica Djukanović
- Academy of Medical Sciences of Serbian Medical Society, Belgrade, Serbia.
- School of Medicine, University of Belgrade, Dr Subotica 8, 11 000, Belgrade, Serbia.
| | - Višnja Ležaić
- Academy of Medical Sciences of Serbian Medical Society, Belgrade, Serbia
- School of Medicine, University of Belgrade, Dr Subotica 8, 11 000, Belgrade, Serbia
| | - Nada Dimković
- Academy of Medical Sciences of Serbian Medical Society, Belgrade, Serbia
- School of Medicine, University of Belgrade, Dr Subotica 8, 11 000, Belgrade, Serbia
| | - Jelena Marinković
- School of Medicine, University of Belgrade, Dr Subotica 8, 11 000, Belgrade, Serbia
| | | | | | | | | | - Dejan Ćelić
- Clinic of Nephrology and Clinical Immunology, Univeristy Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Miloš Djurin
- Nephrology Ward, General Hospital, Kikinda, Serbia
| | | | - Selena Gajić
- Department of Nephrology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | | | | | - Violeta Knežević
- Clinic of Nephrology and Clinical Immunology, Univeristy Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Dragana Marković
- Department of Nephrology, Zvezdara Clinical Hospital Center, Belgrade, Serbia
| | - Djoko Maksić
- Department of Nephrology, Military Medical Academy, Belgrade, Serbia
| | | | | | - Branka Mitić
- Department of Nephrology, University Clinical Center, Niš, Serbia
| | - Ana Ostojić
- Nephrology Department, Zemun Clinical Hospital Center, Zemun-Belgrade, Serbia
| | | | | | | | | | | | | | | | | | - Nataša Vesić
- Nephrology Ward, General Hospital, Valjevo, Serbia
| | | | - Vanja Vukša
- Medicon Special Hemodialysis Hospital, Belgrade, Serbia
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Bukvić D, Marić I, Arsenović A, Janković S, Djukanović L. Prevalence of Balkan endemic nephropathy has not changed since 1971 in the Kolubara region in Serbia. Kidney Blood Press Res 2007; 30:117-23. [PMID: 17396036 DOI: 10.1159/000101447] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Accepted: 01/12/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Thirty-one years after the first cross-sectional study, the population of Vreoci, a Balkan endemic nephropathy (BEN) village, was reinvestigated in order to determine the current prevalence of BEN and the clinical and laboratory characteristics of BEN family members with detected signs of kidney disease. METHODS A total of 2,009 inhabitants (82% of the adult population) of the village were examined. Danilovic's criteria were used for diagnosis and classification of BEN. RESULTS The prevalence of BEN (1.70%) was similar to that in 1971 (1.67%). Diagnosis of BEN was established in 19 BEN family members, suspected BEN in 23, proteinuria in 29, while 16 healthy members were examined as controls. Urine protein, alpha1-microglobulin levels and frequency of glucosuria were significantly higher and kidney length significantly smaller in the three patient groups than in healthy persons. Serum urea and creatinine levels were significantly higher, but creatinine clearance was lower in BEN and BEN suspected patients than in the other two groups. CONCLUSION The prevalence of BEN remains stable over time in Vreoci village. Manifested disease was found in both BEN and BEN suspected patients. In persons with proteinuria but not enough criteria for BEN, tubular disorders and hypertension were frequently found.
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Arsenović A, Bukvić D, Trbojević S, Marić I, Djukanović L. Detection of renal dysfunctions in family members of patients with Balkan endemic nephropathy. Am J Nephrol 2005; 25:50-4. [PMID: 15731549 DOI: 10.1159/000084105] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2004] [Accepted: 01/12/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Recent studies have questioned whether new cases of Balkan endemic nephropathy (BEN) are occurring. The aim of the present study was to find out whether new members with renal dysfunctions can be identified among family members of BEN patients from the Kolubara region. METHODS The study included 47 family members of 5 BEN patients on hemodialysis (HD) and 17 members of 3 non-BEN patients on HD. Their medical and epidemiological histories were taken, an objective survey made, and all persons were examined for global and tubular kidney function. RESULTS Seven BEN family members (2 with previously known BEN) had creatinine clearance (Ccr) below the 75th percentile rank according to sex and age. All non-BEN family members had normal Ccr and no evidence of previous renal disorders. Hypertension was found in 20 (43%) BEN and 6 (35%) non-BEN family members. No significant differences in the frequency of renal function disorders (proteinuria, alpha1-microglobulinuria, urine specific gravity, osmolality, functional excretion of sodium, tubular phosphate resorption) or anemia were found between the groups. Renal disorders were detected in 18 BEN family members without previously detected disease, 3 of whom fulfilled criteria for a diagnosis of BEN and another 2 for BEN-suspected persons. CONCLUSION New cases of BEN are still arising among the affected families in the Kolubara region.
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