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Chen Z, Xu N, Chen X, Zhang X, Yin S, Xiao G, Luo L, Liu Q, Su C. Dietary knowledge-attitude-practice status in hemodialysis patients: a latent profile analysis. BMC Public Health 2024; 24:836. [PMID: 38500120 PMCID: PMC10946152 DOI: 10.1186/s12889-024-18066-z] [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: 12/22/2023] [Accepted: 02/11/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Hemodialysis patients require a reasonable dietary intake to manage their disease progression effectively. However, there is limited research on these patients' overall dietary knowledge, attitude, and practice (KAP) status. This study aimed to investigate the dietary KAP status and latent profiles in hemodialysis patients and identify sociodemographic and disease-related factors associated with these profiles and dietary practice. METHODS A multicenter cross-sectional study involving 425 hemodialysis patients was conducted. A dietary KAP questionnaire in hemodialysis patients was used to evaluate the dietary KAP of the patients. A structural equation model was employed to analyze the correlations between dietary knowledge, attitude, and practice. Multiple linear regression analysis was used to identify factors associated with dietary practice scores. Latent profile analysis was conducted to determine the latent profiles of dietary KAP, and binary logistic regression was used to explore the sociodemographic and disease-related characteristics associated with each KAP profile in hemodialysis patients. RESULTS The normalized average scores for dietary knowledge, attitude, and practice in hemodialysis patients were 0.58, 0.82, and 0.58, respectively. The structural equation model revealed significant positive correlations between dietary knowledge and attitude, and attitude and practice. Attitude played an indirect effect between knowledge and practice. Gender, cerebrovascular disease, and dietary attitude scores were identified as independent influencing factors for dietary practice scores. Two dietary KAP profiles were developed: a profile with general knowledge and attitude but low practice (40.2%) and a profile with general knowledge and attitude and high practice (59.8%). Binary logistic regression analysis indicated gender and monthly income per household significantly predicted membership in each KAP profile. CONCLUSIONS The dietary practice of hemodialysis patients requires improvement. It is necessary to develop more individualized dietary interventions for these patients. Further exploration is needed to understand the motivation of patients to change their dietary behavior.
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Affiliation(s)
- Zhiqian Chen
- Department of Nursing, Peking University Third Hospital, Beijing, China
| | - Na Xu
- Department of Nephrology, Peking University Third Hospital Yanqing Hospital, Beijing, China
| | - Xinxin Chen
- Department of Nursing, Peking University Third Hospital, Beijing, China
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Xiaoyu Zhang
- Department of Nursing, Peking University Third Hospital, Beijing, China
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Shuqing Yin
- Department of Nephrology, Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China
| | - Guanghui Xiao
- Department of Nephrology, Beijing Haidian Hospital, Beijing, China
| | - Li Luo
- Department of Nephrology, Peking University International Hospital, Beijing, China
| | - Qun Liu
- Department of Nephrology, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing, China.
| | - Chunyan Su
- Department of Nursing, Peking University Third Hospital, Beijing, China.
- Department of Nephrology, Peking University Third Hospital, Beijing, China.
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Li L, Ma X, Xie C, Li Y. Resistance exercise interventions for sarcopenia and nutritional status of maintenance hemodialysis patients: a meta-analysis. PeerJ 2024; 12:e16909. [PMID: 38332806 PMCID: PMC10851873 DOI: 10.7717/peerj.16909] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Abstract
Background A previous meta-analysis showed that exercise training improves patients' physical function and health status. However, the efficacy of resistance exercise (RE) in improving patients' physical function and nutritional status is uncertain. Objective To evaluate the effect of RE on sarcopenia and nutritional indicators in maintenance hemodialysis (MHD) patients. Design A meta-analysis. Methods Randomized controlled trials up to March 28, 2023 were searched from eight databases, including PubMed, Web of Science, Embase, Cochrane, China National Knowledge Infrastructure, Wan Fang, China Science and Technology Journal Database, and CBM. The risk of bias of the literature eligible for inclusion was assessed using the Cochrane risk-of-bias tool. When a high heterogeneity was detected, a random-effects model was used. Egger's tests were used to assess publication bias. This review was conducted in accordance with the PRISMA guidelines. The reliability of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation method, and a meta-analysis of the collected data was performed using Review Manager 5.4.1 software. Results Nine studies that met the criteria were identified, and 541 patients were included in these research. Subjects The results of this review showed that RE improved patients' grip strength levels (mean difference (MD) = 4.39, 95% confidence interval (CI) [3.14-5.64]; P < 0.00001), 6 min walking distance (MD = 40.71, 95% CI [8.92-72.49]; P = 0.01), muscle mass (MD = 4.50, 95% CI [2.01-6.99]; P = 0.0004), and serum albumin level (MD = 3.16, 95% CI [1.13-5.19]; P = 0.002) compared with the controls. However, the improvement caused by RE on hemoglobin (MD = 1.69, 95% CI [-1.49 to 4.87], P = 0.30) and cholesterol (MD = 2.33, 95% CI [-5.00 to 9.65], P = 0.53) levels was not statistically significant. Conclusion RE showed a significant effect on muscle function and strength of MHD patients. This meta-analysis provides new ideas on the efficacy of RE in muscle function and strength of MHD patients. The use of consistent RE patterns and nutritional interventions should be considered in future studies for further assessment of its effects. In the future, more high-quality studies will be required to verify these results. Implications for practice This meta-analysis identified the effect of RE on muscle strength, muscle function, and walking ability of HD patients, and provided a basis for clinical formulation of the optimal timing of intervention and the optimal frequency, intensity, modality, and content of intervention. Patient or public contribution No patient or public contribution because it does not apply to my work. This review has been registered at the International Platform of Registered Systematic Review and Meta-analysis (INPLASY) (registration number: INPLASY202340078).
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Affiliation(s)
- Li Li
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaolan Ma
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chunyan Xie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Mahallawi WH, Ibrahim NA, Mumena WA. Impaired humoral immune response to hepatitis B vaccine in patients on maintenance hemodialysis. Saudi J Biol Sci 2023; 30:103788. [PMID: 37674538 PMCID: PMC10477802 DOI: 10.1016/j.sjbs.2023.103788] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a worldwide health problem. We aimed in this study to investigate the humoral immune response derived to HBV vaccine following completing the vaccine series in Madinah. Two hundred and two Saudi hemodialysis (HD) patients were included in this cross-sectional study. Mean concentration of Hepatitis B surface antibody (anti-HBs) was significantly higher among patients who received the vaccination twice compared to patients who received the vaccination only after starting hemodialysis (252 ± 489 mIU/mL vs. 144 ± 327 mIU/mL, respectively, p = 0.008). Almost half of the study sample were non-protected and showed anti-HBs concentration < 10 mlU/mL. In contrast, 20.3% (n = 41) were identified as poor responders (10-100 mlU/mL) and only 28.2% (n = 57) were identified as good responders (10-100 mlU/mL). However, the latter two groups were accounted as protected (48.5%, n = 98). Patients sex was associated with anti-HBs concentration (non-responders; poor responders; good responders), where significantly higher proportion of good responders were females compared to males (p = 0.007). In conclusion, HBV vaccine is efficient to elicit humoral immune response in hemodialysis patients.
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Affiliation(s)
- Waleed H. Mahallawi
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Nadir A. Ibrahim
- Duke Central Automated Laboratory, Duke University, Hudson Bldg, DCAL, Rm 1520, 2351, Erwin Rd, Durham, NC, USA
| | - Walaa A. Mumena
- Department of Clinical Nutrition, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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Wu Y, He L, Guo Y, Wang N. Risk Factors and Drug Efficacy for Severe Illness in Hemodialysis Patients Infected with the Omicron Variant of COVID-19. Kidney Blood Press Res 2023; 48:642-651. [PMID: 37751729 PMCID: PMC10614566 DOI: 10.1159/000534192] [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: 05/29/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION The Omicron variant of the novel coronavirus (COVID-19) has been spreading more rapidly and is more infectious, posing a higher risk of death and treatment difficulty for patients undergoing hemodialysis. This study aims to explore the severity rate and risk factors for hemodialysis patients infected with the Omicron variant and to conduct a preliminary analysis of the clinical efficacy of drugs. METHODS Clinical and biochemical indicators of 219 hemodialysis patients infected with the Omicron variant were statistically analyzed. The patients were divided into two groups based on whether they were severely ill or not, and multiple regression analysis was conducted to determine the risk factors for severe illness. The severely ill patients were then grouped based on discharge or death, and the treatment drugs were included as influencing factors for multiple regression analysis to determine the risk factors and protective factors for death of severely ill patients, and drug efficacy analysis was conducted. RESULTS Analysis showed that diabetes, low oxygen saturation, and high C-reactive protein (CRP) were independent risk factors for severe illness in hemodialysis patients infected with the Omicron variant. A history of diabetes and high C-reactive significantly increased the risk of severe illness in patients (aOR: 1.450; aOR: 1.011), while a high oxygen saturation level can reduce this risk (aOR: 0.871). In addition, respiratory distress was an independent risk factor for death in severely patients, significantly reducing the probability of discharge for patients (aOR: 0.152). The drugs thymalfasin and Tanreqing significantly increased the probability of discharge for patients (aOR: 1.472; aOR: 3.104), with the latter having a higher correlation, but with a relatively longer effective course. CONCLUSION Hemodialysis patients infected with the Omicron variant of COVID-19 should pay special attention to their history of diabetes, CRP, and oxygen saturation levels, as well as respiratory distress symptoms, to reduce the risk of severe illness and death. In addition, thymalfasin and Tanreqing may be considered in treatment.
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Affiliation(s)
- Yan Wu
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Lingling He
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongping Guo
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Niansong Wang
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Bonell V, Mongera N, Passler W, Bonincontro ML, Tabbì MG. [SARS-CoV-2 mRNA-based vaccine in hemodialysis patients: a single center-experience]. G Ital Nefrol 2023; 40:2023-vol3. [PMID: 37427909] [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] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Hemodialysis patients have an increased risk of severe complications when infected with SARS-CoV-2. The introduction of the SARS-CoV-2 vaccine represented an important progress in limiting severe forms of the disease. The focus of our study is the detection of the antibody titer in chronic hemodialysis patients vaccinated with the mRNA vaccine BNT162b2 (Comirnaty, Pfizer-BioNTech). The antibody titers were measured in 57 hemodialysis patients, vaccinated with 3 doses according to ministerial criteria, by ElectroChemiLuminescence ImmunoAssay (ECLIA). The response was defined as an antibody titer above the dosable level > 0,8 UI/ml. A good antibody response was defined as titer > 250 UI/ml. Infections with SARS-CoV-2 and adverse effects to the vaccine were recorded. Our study showed in 93% of the hemodialysis patients a dosable antibody response after the second dose of the vaccine. After the third dose of the vaccine, 100% of the hemodialysis patients reached a dosable antibody titer. The vaccine proved to be safe, no serious adverse events were observed. After the third dose, SARS-CoV-2 infections were still observed, but with reduced severity. A vaccination course against SARS-CoV-2 infection with three doses of BNT162b2 in the dialysis patient is associated with a good immune response and protects against severe infections.
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Affiliation(s)
- Vera Bonell
- Reparto di Nefrologia e Dialisi, Ospedale Centrale di Bolzano, Italia
| | - Nicola Mongera
- Reparto di Nefrologia e Dialisi, Ospedale Centrale di Bolzano, Italia
| | - Werner Passler
- Reparto di Nefrologia e Dialisi, Ospedale Centrale di Bolzano, Italia
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Ao G, Li T, Wang Y, Tran C, Gao M, Chen M. The effect of SARS-CoV-2 double vaccination on the outcomes of hemodialysis patients with COVID-19: A meta-analysis. J Infect 2023; 86:e43-e45. [PMID: 36174838 PMCID: PMC9511879 DOI: 10.1016/j.jinf.2022.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/17/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Guangyu Ao
- Department of Nephrology, Chengdu First People's Hospital, No.18 Wanxiang North Road, High-tech District, Chengdu, Sichuan 610095, China
| | - Toni Li
- School of Medicine, Queen's University, Kingston, Canada
| | - Yushu Wang
- Chengdu West China Clinical Research Center, Chengdu, Sichuan, China
| | - Carolyn Tran
- Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Ming Gao
- Department of Cardiology, Chengdu First People's Hospital, Chengdu, Sichuan, China.
| | - Min Chen
- Department of Nephrology, Chengdu First People's Hospital, No.18 Wanxiang North Road, High-tech District, Chengdu, Sichuan 610095, China.
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Desta BZ, Dadi AF, Derseh BT. Mortality in hemodialysis patients in Ethiopia: a retrospective follow-up study in three centers. BMC Nephrol 2023; 24:3. [PMID: 36600194 PMCID: PMC9811754 DOI: 10.1186/s12882-022-03053-6] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence of chronic kidney disease (CKD) is between 10 and 15% worldwide. Ethiopia is seeing a consistent increase in the number of dialysis patients. Patients on chronic hemodialysis have high mortality rates, but there is little information available in Ethiopia. Thus, this study looked into patient mortality and the factors that contributed to it at three dialysis centers in Addis Ababa for hemodialysis patients. METHOD A facility-based retrospective follow-up study was employed among End-Stage Renal Disease patients on hemodialysis from 2016 to 2020 at St. Paul Millennium Medical College (SPMMC), Zewditu Memorial Hospital (ZMH), and Menelik II Hospital. The proportional hazard assumption was checked by using the Log (-log (St)) plots and tests. Life-table analysis was fitted to estimate the one and five-year's survival probability of these patients and Cox Proportional regression analysis to model the predictors of mortality at p-value < 0.05. RESULT Over the course of 2772 person-months, 139 patients were tracked. Of these patients, 88 (63.3%) were male and the mean age (± SD) of the patients was 36.8 (± 11.9) years. During the follow-up period, 24 (17%) of the patients died, 67 (48.2%) were alive, 43 (30.9%) received a kidney transplant, and 5 (3.6%) were lost to follow-up. The mean survival time was 46.2 months (95% CI: 41.8, 50.5). According to estimates, there were 104 deaths per 1000 person-years at the end of the follow-up period. The likelihood that these patients would survive for one and 5 years was 91%% and 65%, respectively. Our analysis showed that patients with hypertension (Adjusted Hazard Rate (AHR) = 4.33; 95% CI: 1.02, 34.56), cardiovascular disease (AHR = 4.69; 95% CI: 1.32, 16.80), and infection during dialysis (AHR = 3.89; 95% CI: 1.96, 13.80) were more likely to die. CONCLUSION The hemodialysis patients' death rate in the chosen dialysis facilities was high. Preventing and treating comorbidities and complications during dialysis would probably reduce the mortality of CKD patients. Furthermore, the best way to avoid and manage chronic kidney disease is to take a complete and integrated approach to manage hypertension, diabetes, and obesity.
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Affiliation(s)
- Beza Zewdu Desta
- Ethiopian Food, Medicine Administration and Health Care Authority, Addis Ababa, Ethiopia
| | - Abel Fekadu Dadi
- grid.1043.60000 0001 2157 559XMenzies School of Health Research, Charles Darwin University, Darwin, Australia ,grid.59547.3a0000 0000 8539 4635Departments of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Ethiopia
| | - Behailu Tariku Derseh
- grid.464565.00000 0004 0455 7818School of Public Health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Ethiopia
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Agur T, Zingerman B, Ben-Dor N, Alkeesh W, Steinmetz T, Rachamimov R, Korzets A, Rozen-Zvi B, Herman-Edelstein M. Humoral Response to the Third Dose of BNT162b2 COVID-19 Vaccine among Hemodialysis Patients. Nephron Clin Pract 2022; 147:185-192. [PMID: 35896080 PMCID: PMC9747736 DOI: 10.1159/000525519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hemodialysis patients are at high risk for severe COVID-19 disease. Despite a high early seropositivity rate, dialysis patients mount a dampened immune response following two doses of an mRNA vaccine. This study aimed to evaluate the serologic response to a booster dose of BNT162b2 vaccine, 6 months after the second dose, among hemodialysis patients. METHODS This prospective study included 80 hemodialysis patients and 56 healthcare workers serving as controls. Serologic samples were evaluated before and ∼3 weeks after the third vaccine dose. The primary outcomes were the seropositivity rate and the log-transformed anti-SARS-COV-2 S1 (RBD) IgG as a continuous variable after the third dose. Secondary outcomes were the proportion of participants with "high response," defined as antibody levels >1,000 AU/mL, and "robust response," defined as antibody levels >4,160 AU/mL, according to prespecified cutoff values associated with neutralizing antibodies. Univariate and multivariate analyses were conducted to identify predictors of antibody response. RESULTS Among 80 hemodialysis patients, seropositivity rates improved from 78% (62/80) before the third dose, up to 96% (77/80) after the booster dose. The S1-RBD log-transformed antibody level increased significantly following the third dose from 2.15 ± 0.75 to 3.99 ± 0.83 compared with 2.65 ± 0.4 to 4.31 ± 0.42 in the control group. Among the hemodialysis patients, 88% (70/80) became "high responders" (>1,000 AU/mL), and of these, 79% (63/80) mounted a "robust response" (>4,160 AU/mL). Baseline antibody level, dialysis therapy, and hypoalbuminemia were independent predictors of impaired antibody response. CONCLUSIONS A third dose of BNT162b2 COVID-19 vaccine, 6 months after the standard two-dose vaccination regimen, substantially improved humoral response in hemodialysis patients.
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Affiliation(s)
- Timna Agur
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Boris Zingerman
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Ben-Dor
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Weaam Alkeesh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Internal Medicine B, Rabin Medical Center, Hasharon Hospital, Petah-Tikva, Israel
| | - Tali Steinmetz
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ruth Rachamimov
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asher Korzets
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Benaya Rozen-Zvi
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Herman-Edelstein
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Shamsdin SA, Fatahi MR, Ansari AR, Safarpour AR. Prevalence of HBV, HCV, and HIV Infections among Patients Undergoing Hemodialysis in Fasa, Iran: A Six-Year Follow-up Study. Middle East J Dig Dis 2022; 14:317-322. [PMID: 36619273 PMCID: PMC9489426 DOI: 10.34172/mejdd.2022.289] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/07/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Hemodialysis (HD) patients are at risk of viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency viruses (HIV). Current study aimed to determine the prevalence of HBV, HCV, and HIV among HD patients who attended the dialysis center in Fasa, Iran. Methods: Collectively, 2082 HD patients (1291 men, 791 women) took part in our 6-year follow-up study. Results: 2082 HD patients with a mean age of 56.2±17.8 were included in our study. One (0.09%) patient was HBsAg positive, two (0.18%) patients were anti-HCV positive, and one (0.09%) was anti-HIV positive. There was no significant correlation between the paraclinical parameters of men and women. Conclusion: The present study showed a reduction in the prevalence of HBV, HCV, and HIV infections during 6 years of follow-up in HD patients.
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Affiliation(s)
- Seyedeh Azra Shamsdin
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Reza Fatahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Ansari
- Department of Internal Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding Author: Ali Reza Safarpour, MD Assistant Professor, Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Tel:+98 716281442 Fax:+98 716281442
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Stojsavljević A, Ristić-Medić D, Krstić Đ, Rovčanin B, Radjen S, Terzić B, Manojlović D. Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients. Biol Trace Elem Res 2022; 200:3117-3125. [PMID: 34586605 PMCID: PMC8479265 DOI: 10.1007/s12011-021-02940-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/23/2021] [Indexed: 02/08/2023]
Abstract
The status of essential and toxic trace elements in patients with different stages of chronic kidney disease (CKD) is still unclear and not well characterized. The present study examined the circulatory levels of a wide panel of trace elements (Al, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Rb, Sr, Cd, Pb, and U) in hemodialysis patients (HD group) and pre-dialysis patients with stage 3 CKD (PD group). Comparisons were made between groups of patients and healthy individuals from the control group (CG). The levels of Al, Mn, Co, Ni, Cu, As, Se, Sr, and Pb were higher, while the levels of Cr, Zn, Rb, Cd, and U were lower in HD patients than in our CG. Higher levels of Al and Se, as well as lower levels of As, Sr, Zn, Rb, and U were significant and distinguished HD from PD. Among other analyzed elements, Co, Se, and U are the only trace elements that did not distinguish PD from CG at a statistically significant level. The HD group had lower serum U levels than the PD group, and this could be a result of hemodialysis. This study also revealed that the Cu/Zn ratio could be used as a marker for early and late detection of renal failure. Marked changes of essential and toxic trace element levels in sera indicate additional pathophysiological events in CKD, which could additionally contribute to the preexisting increased morbidity of HD patients. Measurement of trace elements in HD patients should be performed routinely.
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Affiliation(s)
- Aleksandar Stojsavljević
- Faculty of Chemistry, University of Belgrade, Studentski trg 12-16, Belgrade, Serbia.
- Innovation Center of the Faculty of Chemistry, University of Belgrade, Studentski trg 12-16, Belgrade, Serbia.
| | - Danijela Ristić-Medić
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, 11000, Belgrade, Serbia
| | - Đurđa Krstić
- Faculty of Chemistry, University of Belgrade, Studentski trg 12-16, Belgrade, Serbia
| | - Branislav Rovčanin
- Center for Endocrine Surgery, University Clinical Center of Serbia, Koste Todorovića 8, Belgrade, Serbia
| | - Slavica Radjen
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
- Institute of Hygiene, Military Medical Academy, Belgrade, Serbia
| | - Brankica Terzić
- Institute of Hygiene, Military Medical Academy, Belgrade, Serbia
- Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
| | - Dragan Manojlović
- Faculty of Chemistry, University of Belgrade, Studentski trg 12-16, Belgrade, Serbia
- South Ural State University, Lenin Prospect 76, Chelyabinsk, Russia
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Shahreki E, Kaykhaei MA, Mosallanezhad Z, Adineh Z, Mokhtari AM, Mohammadi M, Hosseini R, Bazi A. Effects of Selenium and/or N-Acetyl-Cysteine Supplementation on Nonthyroidal Illness Syndrome in Hemodialysis Patients: A Factorial Randomized Controlled Trial. Pharmacology 2022; 107:480-485. [PMID: 35691282 DOI: 10.1159/000525094] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/10/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nonthyroidal illness syndrome (NTIS) is common in hemodialysis patients (HPs). However, limited clinical trials have been conducted in this field. Therefore, the aim of this study was to investigate the effect of Se and/or N-acetyl-cysteine (NAC) on NTIS parameters in HPs. METHODS In this factorial randomized controlled trial, 68 HPs were divided into four groups: group A received placebo of Se and NAC, group B received 600 μg per day of NAC and placebo of Se, group C received 200 μg of Se per day and placebo of NAC and group D received 200 μg of selenium and 600 μg of NAC per day for 12 weeks. Blood samples were taken at baseline and after 12 weeks to assess free tri-iodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), and reverse T3 (rT3) concentrations. RESULTS Our finding demonstrated that rT3 levels were decreased in B, C, and D groups and increased nearly to baseline levels in the A group after 12 weeks, with a marked difference between the groups (p < 0.001) based on ANOVA. Although there were no significant differences in FT3 (p = 0.39), FT4 (p = 0.76), and TSH (p = 0.71) between the groups at the end of the trial. CONCLUSION This trial showed that Se and/or NAC exert beneficial effects on rT3 levels in HPs. However, long-term clinical trials with a larger sample size using more appropriate biomarkers are recommended to evaluate the efficacy and safety of Se and/or NAC in HPs.
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Affiliation(s)
- Elham Shahreki
- Department of Nephrology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahmoud Ali Kaykhaei
- Genetics of Noncomunicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Mosallanezhad
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Adineh
- Department of Internal Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Mohammad Mokhtari
- Department of Epidemiology and Biostatistics, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Mohammadi
- Department of Biostatistics and Epidemiology, School of Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Razieh Hosseini
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aliyeh Bazi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
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12
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Mesgar Saravi N, Mousavi T. Seroprevalence of Cytomegalovirus antibodies and primary infection among hemodialysis patients: A systematic and meta-analysis review. Transpl Immunol 2022; 72:101587. [PMID: 35339658 DOI: 10.1016/j.trim.2022.101587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients with end-stage renal failure (ESRD) require hemodialysis. According to this point that CMV infection is related to mortality in immunocompromised, and damages in hemodialysis, this study is designed to survey the seroprevalence of CMV and primary infection in hemodialysis (HD) patients. MATERIAL AND METHODS Current cross-sectional studies were found by online reviewing the national and international databases (Web of Science, Pubmed, Scopus, Science Direct, Google scholar), and suitable studies were selected. NOS checklist were used for evaluation of the qualities of all papers. Assessment of heterogeneity among the studies of primary studies was performed using Chi-squared test (Cochran's Q) and I2 index (significance level of 50%). The statistical analysis were performed using Comprehensive Meta-Analysis (CMA) V.2. For assessing publication bias, the Egger test was used by subjective judgment in each study. Also the effect of potential factor on heterogeneity of studies was performed by Meta-regression test and the impact of each study on the overall estimate was assessed by sensitivity analysis. RESULTS This meta- analysis included 23 primary studies investigating seroprevalence of Cytomegalovirus antibodies and primary infection among hemodialysis patients. Finding showed that seroprevalence of CMV IgG and IgM antibodies in hemodialysis patients at 95% confidence interval using random effect model was 88.7% (81.7-93.2%) and 10.9% (5.9-19.2%) respectively. Also the frequency of CMV infection among these studies were reported 41% (18.8-67.6%). CONCLUSION We found that frequency of CMV IgG was higher and it was detected in HD patients. The result of our study showed that most patients were exposure to CMV during dialysis may reactivate by various stimulation, including immunosuppression and inflammation, so screening of patients should be performed to prevent future consequences such as kidney transplant rejection during of dialysis.
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13
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Xi Y, Richardson DB, Kshirsagar AV, Wade TJ, Flythe JE, Whitsel EA, Peterson GC, Wyatt LH, Rappold AG. Effects of short-term ambient PM2.5 exposure on cardiovascular disease incidence and mortality among U.S. hemodialysis patients: a retrospective cohort study. Environ Health 2022; 21:33. [PMID: 35277178 PMCID: PMC8917758 DOI: 10.1186/s12940-022-00836-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/25/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND Ambient PM2.5 is a ubiquitous air pollutant with demonstrated adverse health impacts in population. Hemodialysis patients are a highly vulnerable population and may be particularly susceptible to the effects of PM2.5 exposure. This study examines associations between short-term PM2.5 exposure and cardiovascular disease (CVD) and mortality among patients receiving maintenance in-center hemodialysis. METHODS Using the United State Renal Data System (USRDS) registry, we enumerated a cohort of all US adult kidney failure patients who initiated in-center hemodialysis between 1/1/2011 and 12/31/2016. Daily ambient PM2.5 exposure estimates were assigned to cohort members based on the ZIP code of the dialysis clinic. CVD incidence and mortality were ascertained through 2016 based on USRDS records. Discrete time hazards regression was used to estimate the association between lagged PM2.5 exposure and CVD incidence, CVD-specific mortality, and all-cause mortality 1 t adjusting for temperature, humidity, day of the week, season, age at baseline, race, employment status, and geographic region. Effect measure modification was assessed for age, sex, race, and comorbidities. RESULTS Among 314,079 hemodialysis patients, a 10 µg/m3 increase in the average lag 0-1 daily PM2.5 exposure was associated with CVD incidence (HR: 1.03 (95% CI: 1.02, 1.04)), CVD mortality (1.05 (95% CI: 1.03, 1.08)), and all-cause mortality (1.04 (95% CI: 1.03, 1.06)). The association was larger for people who initiated dialysis at an older age, while minimal evidence of effect modification was observed across levels of sex, race, or baseline comorbidities. CONCLUSIONS Short-term ambient PM2.5 exposure was positively associated with incident CVD events and mortality among patients receiving in-center hemodialysis. Older patients appeared to be more susceptible to PM2.5-associated CVD events than younger hemodialysis patients.
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Affiliation(s)
- Yuzhi Xi
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Public Health and Environmental Assessment, Oak Ridge Institute for Science and Education at the United States Environmental Protection Agency, Chapel Hill, NC, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Abhijit V Kshirsagar
- Division of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, University of North Carolina Kidney Center, Chapel Hill, NC, USA
| | - Timothy J Wade
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, NC, USA
| | - Jennifer E Flythe
- Division of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, University of North Carolina Kidney Center, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Geoffrey C Peterson
- Center for Public Health and Environmental Assessment Public Health, Chemical and Pollution Assessment Division, United States Environmental Protection Agency, Washington, DC, USA
| | - Lauren H Wyatt
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, NC, USA
| | - Ana G Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, NC, USA.
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14
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Nagano N, Fukushima T, Shikata R, Ando T, Tsutsui T, Ogawa T, Ito K. Impact of phosphate binders on medication dosing frequency, timing, and number of prescribed pills in hemodialysis patients. Ther Apher Dial 2022; 26:1174-1181. [PMID: 35138029 DOI: 10.1111/1744-9987.13813] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/01/2022] [Accepted: 02/06/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Phosphate binders (PBs) account for a large proportion of the daily pill burden in hemodialysis patients. However, patients do not take them all at once but at several dosing timings. METHODS We analyzed the dosing timings of all 322 types of oral drugs prescribed to 533 hemodialysis patients. RESULTS The median daily dosing frequency for all drugs was 6 (4-7) times/day/patient. Patients prescribed PBs had a markedly higher daily dosing frequency than those not taking PBs [7 (5-8) times /day/patient versus 4 (3-5) times/day/patient, respectively (P<0.001)]. In addition, the ratio of the number of PB pills to other drugs varied greatly at each dosing timing. Furthermore, it was simulated that the daily dosing frequency could be reduced by approximately two times/day/patient by combining the dosing timings of PBs. CONCLUSION Changing PB dosing timings can reduce the daily dosing frequency, which may lead to improved medication adherence.
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Affiliation(s)
- Nobuo Nagano
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan.,Department of Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Takahiro Fukushima
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan
| | - Risa Shikata
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan
| | - Tetsuo Ando
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan
| | - Takaaki Tsutsui
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan
| | - Tetsuya Ogawa
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan.,Department of Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Kyoko Ito
- Kidney Disease and Dialysis Center, Hidaka Hospital, Hidaka-kai, Takasaki, Gunma, Japan
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15
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Ionita C, Marcelli D, Nita C, Anton C, Berca S, Vacar S, Schiller O, Gheorghiu C, Barth C. Comparison of antibody response to two different mRNA Covid-19 vaccines in patients on hemodialysis. J Nephrol 2022. [PMID: 34978050 DOI: 10.1007/s40620-021-01195-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/21/2021] [Indexed: 11/09/2022]
Abstract
Introduction In hemodialysis patients, coronavirus disease 2019 is associated with high morbidity and mortality. Aim of the study was to evaluate the antibody level against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients treated with two different mRNA-based vaccines, in a multicenter survey. Patients and methods Since April 2020, in the 5 participating Centers, periodic screening of all patients with PCR testing has been performed every 2 weeks. The study included two cohorts of patients on maintenance hemodialysis treated with the BNT162b2 or with the mRNA-1273 Covid-19 vaccine. The tests for antibodies against the receptor-binding domain was performed by the anti–SARS-CoV-2 S enzyme immunoassay (Roche Elecsys). Results Of the 398 included patients, 303 received the BNT162b2 and 95 the mRNA-1273 vaccine. In patients without previous infection, the median levels of anti-S antibodies were 297 U/mL and 1,032 U/mL for those treated with BNT162b2 or mRNA-1273, respectively (p < 0.001). In patients with previous infection, the median levels of SARS-CoV-2 anti-S antibodies were 7,516 U/mL and 17,495 U/mL for those treated with BNT162b2 or mRNA-1273, respectively (p = 0.005). The Charlson comorbidity index (CCI) was significantly associated with protective levels of anti-spike IgG, with 3.6% of low- or non-responders having a CCI of 2–4 versus 18.9% in those with a CCI of 8 or more. The adjusted OR of developing a sufficient antibody level between the two vaccines was 3.91 (p = 0.0766) in favor of mRNA-1273. Conclusions Both of the evaluated mRNA-based vaccines for SARS-CoV-2 showed good efficacy. Preliminary data may data suggest a higher antibody response to the mRNA-1273 vaccine. Graphical abstract ![]()
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16
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Yajima A, Tsuchiya K, Burr DB, Murata T, Nakamura M, Inaba M, Tominaga Y, Tanizawa T, Nakayama T, Ito A, Nitta K. Micropetrosis in hemodialysis patients. Bone Rep 2021; 15:101150. [PMID: 34926729 PMCID: PMC8649646 DOI: 10.1016/j.bonr.2021.101150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/06/2021] [Accepted: 11/15/2021] [Indexed: 01/03/2023] Open
Abstract
Micropetrosis develops as a result of stagnation of calcium, phosphorus and bone fluid, which appears as highly mineralized bone area in the osteocytic perilacunar/canalicular system regardless of bone turnover of the patients. And microcracks are predisposed to increase in these areas, which leads to increased bone fragility. However, micropetrosis of hemodialysis (HD) patients has not been discussed at all. Micropetrosis area per bone area (Mp.Ar/B·Ar) and osteocyte number per micropetrosis area (Ot.N/Mp.Ar) were measured in nine HD patients with renal hyperparathyroidism (Group I), twelve patients with hypoparathyroidism within 1 year after the treatment of renal hyperparathyroidism (Group II) and seven patients suffering from hypoparathyroidism for over two years (Group III). And bone mineral density (BMD) and tissue mineral density (TMD) were calculated using μCT to evaluate bone mineral content of iliac bone of the patients. These parameters were compared among the three groups. Only Mp.Ar/B·Ar was statistically greater in Group II and III compared to Group I in the parameters of bone mineral content and micropetrosis. However, the other parameters were not statistically different among the three groups. In long-term HD patients, BMD and TMD may be modified by the causes of renal insufficiency and the treatment of renal bone disease. We concluded that Mp.Ar/B·Ar was greater in patients with long-term hypoparathyroidism than both those with short-term hypoparathyroidism and with renal hyperparathyroidism. Special attention should be paid to avoid long-term hypoparathyroidism of the patients from the view point of increased fracture risk caused by increased micropetrosis area.
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Affiliation(s)
- Aiji Yajima
- Department of Anatomy, Cell Biology and Physiology, Indiana University, School of Medicine, Indianapolis, IN, USA.,Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan.,Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - David B Burr
- Department of Anatomy, Cell Biology and Physiology, Indiana University, School of Medicine, Indianapolis, IN, USA
| | - Taro Murata
- Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Masaki Nakamura
- Department of Nephrology and Urology, NTT East Kanto Hospital, Tokyo, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yoshihiro Tominaga
- Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | | | | | - Akemi Ito
- Ito Bone Histomorphometry Institute, Niigata, Japan
| | - Kosaku Nitta
- Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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17
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Asghari A, Sadeghipour Z, Hassanipour S, Abbasali Z, Ebrahimzadeh-Parikhani H, Hashemzaei M, Alimardani V, Hatam G. Association between Blastocystis sp. infection and immunocompromised patients: a systematic review and meta-analysis. Environ Sci Pollut Res Int 2021; 28:60308-60328. [PMID: 34528202 DOI: 10.1007/s11356-021-16187-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
The significance of opportunistic infections in immunocompromised patients and the enigmatic pathogenicity of Blastocystis directed us to conduct the first global systematic review and meta-analysis on Blastocystis prevalence, odds ratios (ORs), and subtypes distribution in various immunocompromised patients (HIV/AIDS, cancer and hemodialysis patients, as well as transplant recipients). The systematic searching procedure was done in Web of Science, PubMed, Scopus, and Google Scholar databases for relevant published literature until November 11, 2020. Random-effects model was utilized to calculate the weighted estimates and 95% confidence intervals (95% CIs). The computed pooled prevalence of Blastocystis inferred from 118 papers (128 datasets) on immunocompromised patients was 10.3% (95% CI: 8.7-12.2%), with 16.1% (95% CI: 11.3-22.2%), 12.5% (95% CI: 8.5-18%), 8.4% (95 % CI: 6.6-10.6%), and 6% (95% CI: 2.6-13.3%) for hemodialysis patients, cancer patients, HIV/AIDS patients, and transplant recipients, respectively. Based on 50 case-control studies (54 datasets), the highest ORs were associated with cancer [2.81 (95% CI: 1.24-6.38, P = 0.013)] and hemodialysis patients [2.78 (95% CI: 1.19-6.48, P = 0.018)]. The most frequent subtype being found in immunocompromised patients was ST3 [41.7% (95% CI: 31.4-52.7%)], followed by ST1 [31.7% (95% CI: 23.2-41.8%)] and ST2 [23.1% (95% CI: 14.8-34.1%)]. Also, the weighted frequency of Blastocystis in various subgroups (publication year, WHO regions, geographical distribution, continents, and country income) was analyzed separately. In total, the results of the present meta-analysis highlighted that one's immunodeficiency status is probably associated with an increased Blastocystis infection, underpinning strict preventive measures to be taken.
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Affiliation(s)
- Ali Asghari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Sadeghipour
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Abbasali
- Department of Medical Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hasan Ebrahimzadeh-Parikhani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Hashemzaei
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Alimardani
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Hatam
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Bramania PK, Ruggajo PJ, Furia FF. Prevalence and predictors of heart failure among patients on maintenance hemodialysis therapy at Muhimbili National Hospital in Tanzania: a cross-sectional study. Egypt Heart J 2021; 73:97. [PMID: 34718902 PMCID: PMC8557217 DOI: 10.1186/s43044-021-00223-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Heart failure among patients on hemodialysis therapy portends poor outcomes. Traditional risk factors like aging, hypertension and diabetes mellitus are relatively common in these patients and may not accurately predict the occurrence of heart failure. Such patients may have other factors that contribute to heart failure. This study aimed to investigate the prevalence and predictors of heart failure among patients on maintenance hemodialysis at Muhimbili National Hospital in Dar es Salaam, Tanzania.
Results Among 160 patients on maintenance hemodialysis, 49 (30.6%) were female. The mean age of patients was 52.2 ± 13.3 years. Almost all patients had hypertension and 69 (43.1%) had diabetes mellitus. Heart failure was prevalent in 17 (10.6%) patients. On multivariate analysis, presence of angina, intradialytic hypertension, and anemia were independent predictors of heart failure. Patients with heart failure had significantly higher malnutrition inflammation scores and erythropoietin resistance indexes.
Conclusions Heart failure among hemodialysis patients correlates with the presence of angina, intradialytic hypertension, and anemia. Patients with heart failure had a greater degree of malnutrition–inflammation complex, and erythropoietin resistance. Patients with these conditions require a thorough cardiac evaluation and appropriate treatment.
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Affiliation(s)
- Puneet Kishore Bramania
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, United Republic of Tanzania.
| | - Paschal Joseph Ruggajo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, United Republic of Tanzania
| | - Francis Fredrick Furia
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
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Nov T, Hyodo T, Kitajima Y, Kokubo K, Naganuma T, Wakai H, Yamashita A, Phon E, Kawanishi H. Impact of the third wave of the COVID-19 pandemic and interventions to contain the virus on society and patients with kidney disease in Cambodia. Ren Replace Ther 2021; 7:53. [PMID: 34659800 DOI: 10.1186/s41100-021-00372-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/26/2021] [Indexed: 11/23/2022] Open
Abstract
Cambodia detected its first case of COVID-19 just 3 days before WHO declared that the outbreak constituted as PHEIC. As of February 15, 2021, and after two major outbreaks, only 479 cases had been reported, 396 (83%) of which were imported. This small number of cases was largely thanks to stringent measures and policies put in place by the government to curb the spread. Despite these efforts, a third cluster outbreak was declared on February 20, 2021. It has disrupted all aspects of life in Cambodia. As in many other countries affected by the virus, economic hardship, lockdowns in cities, and food insecurity ensued. Against the backdrop of this widespread impact on the citizens of Cambodia, we conducted this review article to better understand the situation of healthcare workers in nephrology and dialysis patients and the challenge they face in providing and receiving essential medical care. Healthcare providers have continued working to serve their patients despite facing a high risk of catching SARS-CoV-2 and other challenges including difficulties in traveling to work, increased physical and mental burden, and higher stress due to measures taken to minimize the risk of transmission during patients’ care. Some healthcare workers have been discriminated against by neighbors. The most difficult mission is when having to deal with families whose loved one is denied access to a hemodialysis session due to suspected COVID-19 while waiting for PCR test results. Hemodialysis patients reported facing economic hardship and increasingly difficult circumstances. When access to food is limited, patients have eaten canned or dried salted food rather than an appropriate hemodialysis diet. Because hemodialysis centers are concentrated in a few cities, access has become even harder during the travel ban. In-center hemodialysis rules are stricter and does not allow family members or escorts to enter the unit. Only a few hemodialysis patients have been vaccinated. Before COVID-19, hemodialysis patients already faced major burdens. The pandemic appears to be decreasing their quality of life and survival even further. Through this study, we have revealed current hardships and the need to improve the situations for both healthcare workers in nephrology and hemodialysis patients in Cambodia.
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Bahramian A, Khoshnood S, Hashemi N, Moradi M, Karimi-Yazdi M, Jalallou N, Saki M. Identification of metallo-β-lactamases and AmpC production among Escherichia coli strains isolated from hemodialysis patients with urinary tract infection. Mol Biol Rep 2021; 48:7883-7892. [PMID: 34657270 PMCID: PMC8520576 DOI: 10.1007/s11033-021-06814-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/05/2021] [Indexed: 12/30/2022]
Abstract
Background This study aimed to identify metallo-β-lactamases (MBLs) and AmpC β-lactamases-producing Escherichia coli isolates obtained from hemodialysis (HD) patients with urinary tract infections (UTI). Methods and results A total of 257 HD patients with UTI were included in this study, from which 47 E. coli isolates were collected. Antibiotic susceptibility was tested by disc diffusion method. MBLs and AmpC production were phenotypically detected by imipenem-ethylenediaminetetracetate and cefoxitin/boronic acid assays, respectively. The presence of MBLs and AmpC genes was examined by polymerase chain reaction (PCR). Fosfomycin and ampicillin were the most and the least effective antibiotics against E. coli isolates, respectively. Moreover, 61.7% (29/47) of E. coli isolates were multidrug-resistant with seven different antibiotypes. Antibiotype V (AMP–CIP–IMP–MEM–CPD–CRO–CTX–GEN–LEV–SXT–TOB) was the most prevalent profile. Besides, 24 (51.1%) isolates were simultaneously resistant to imipenem and meropenem. Phenotypic assay showed MBL production in 16 (66.7%) of the 24 carbapenem-resistant E. coli isolates. The distribution of MBL genes in carbapenem-resistant E. coli was as follows: blaIMP 18 (72%), blaVIM 7 (28%), and blaNDM 1 (4%). AmpC was detected in 61.7% (29/47) of the isolates using the phenotypic method. The presence of AmpC genes was confirmed by PCR in only 26 of 29 (86.7%) AmpC producers. The frequencies of blaDHA-1, blaACC, and blaCMY-2 were 6 (20.7%), 11 (37.9%), and 21 (72.4%), respectively. Conclusions The emergence of MBL and AmpC coproducing E. coli isolates calls for an urgent surveillance program for timely diagnosis and screening of these genes in our healthcare systems.
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Affiliation(s)
- Aghil Bahramian
- Department of Medical Laboratory Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Saeed Khoshnood
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Nader Hashemi
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Melika Moradi
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Nahid Jalallou
- Department of Medical Laboratory Sciences, AJA University of Medical Sciences, Tehran, Iran.
| | - Morteza Saki
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Moldovan D, Rusu C, Potra A, Bondor C, Ticala M, Tirinescu D, Coman A, Orasan O, Moldovan I, Orasan R, Kacso I. Arterial calcifications and osteoprotegerin in chronic hemodialysis patients: impact on 6-year survival. Int Urol Nephrol 2021. [PMID: 34505226 DOI: 10.1007/s11255-021-02988-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
AIM The association between end-stage renal disease and cardiovascular mortality may be influenced through vascular alterations, in particular atherosclerosis and vascular calcification. The study goal was to assess the impact of each type of arterial intimal calcifications (AIC) and arterial medial calcifications (AMC), of osteoprotegerin (OPG), mineral metabolism markers and other features on all-cause and cardiovascular mortality in chronic hemodialysis patients. METHODS Ultrasound was performed in 87 patients on the carotid and femoral arteries, and the severity of AIC and AMC was assessed calculating a score according to the extension of calcification. We analyzed the link between AIC, AMC, OPG, mineral markers and mortality after 6 years of follow-up. RESULTS The cutoff value for OPG determined using ROC was 4.9 pmol/l for all-cause and cardiovascular mortality. Patients with higher serum OPG levels presented higher mortality rates. Our study revealed that AIC, high OPG, low ankle-arm index, presence of diabetes, smoking status, and lack of arteriovenous fistula are associated with all-cause and cardiovascular mortality in univariate regression analysis. Multivariate analysis identified AIC scoring based on the segmentation method as an independent predictor of all-cause and cardiovascular mortality, along with increased OPG levels. AMC scoring was not a predictor of mortality. CONCLUSIONS Identifying and scoring AIC on ultrasound and measuring OPG levels, as a basis of the HD patient assessment may become valuable tools in clinical work, as these have an impact on death toll.
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Nakamura-Taira N, Horikawa N, Oka F, Igarashi Y, Kobayashi S, Kato S, Enomoto T, Kimura H, Watanabe Y, Kumada T, Matsuyama K, Matsuoka N, Yoshimasu H. Quasi-cluster randomized trial of a six-month low-intensity group-based resistance exercise for hemodialysis patients on depression and cognitive function: a 12-month follow-up. Health Psychol Behav Med 2021; 9:741-760. [PMID: 34484975 PMCID: PMC8409964 DOI: 10.1080/21642850.2021.1966302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to examine the effects of a six-month group-based low-intensity resistance exercise program on depression and the cognitive function of hemodialysis patients. Method We conducted a quasi-cluster randomized, open-label controlled study from October 2017 to December 2018. Forty-two patients undergoing hemodialysis completed the trial over six months; half participated in the resistance exercise group (n = 21, mean = 74.90 years of age, SD = 2.23, 66.67% female) and the other half were in a stretching control group (n = 21, mean = 72.57 years of age, SD = 2.26, 28.57% female). Depressive symptoms and cognitive function were the primary outcome measures. Behavioral and psychological problems associated with cognitive decline (NPI-Q), subjective insomnia, and exercise self-efficacy were secondary outcomes. Outcomes were measured at baseline, three-month (mid-intervention), six-month (end of intervention), and 12-month (six months after intervention) follow-ups. Linear mixed model analyses were used to determine short-term (immediately after intervention) and long-term (six months after intervention) effects. Results In depression, cognitive function, and the NPI-Q, there were no significant effects. In subjective insomnia, a short-term group-by-time interaction in the intervention group compared to the control group was found (ES = .43). However, the effect had disappeared by the 12-month follow-up. In exercise self-efficacy, short- and long-term group-by-time interactions were found. A significant short-term increase in the resistance exercise and a significant decrease in the stretching control was observed (ES = -.83). However, the effect was weakened in the long term (ES = -.38). Conclusion The results showed that low-intensity group resistance exercise would reduce subjective insomnia and improve exercise self-efficacy, but the effect was not maintained by six months after the program. Trial registration: This study was registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029372). Trial registration:UMIN Japan identifier: UMIN000029372.
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Affiliation(s)
- Nanako Nakamura-Taira
- Department of Psychology, Faculty of Letters, Chuo University, Tokyo, Japan.,Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Naoshi Horikawa
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Fumie Oka
- Department of Psychiatry and Huntsman Mental Health Institute, University of Utah, UT, USA, UT, USA
| | - Yuri Igarashi
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan.,Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sayaka Kobayashi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shingo Kato
- Yanagihara Rehabilitation Hospital, Tokyo, Japan
| | | | | | | | | | | | | | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Prelevic V, Antunovic T, Radunovic D, Gligorovic-Barhanovic N, Gledovic B, Ratkovic M, Jukic NB. Malnutrition inflammation score (MIS) is stronger predictor of mortality in hemodialysis patients than waist-to-hip ratio (WHR)-4-year follow-up. Int Urol Nephrol 2021; 54:695-700. [PMID: 34258671 DOI: 10.1007/s11255-021-02954-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The main purpose of this study is to correlate the significance of the malnutrition inflammation score (MIS) and the waist-to-hip ratio (WHR) in the prediction of mortality in hemodialysis patients. METHODS The study was conducted from March 2016 to April 2020, covering 100 hemodialysis patients. Anthropometric measures (Waist circumference (WC), Hip circumference (HC), Waist-to-hip ratio (WHR), Caliper and BMI) and biomarkers of inflammation (IL6, hsCRP) and nutrition (Transfferin, Albumin) were determined and for the above-mentioned biomarkers, we monitored all-cause mortality for 4 years. The hemodialysis patients were divided in three groups based on their MIS score. RESULTS In this prospective, longitudinal study, we enrolled 100 patients (54 males and 46 females) with a median age of 58 (51-65) years. All patients were divided into three groups according to MIS score values. We performed univariate Cox regression survival analysis for a period of 4 years, and then included for multivariate survival Cox regression analysis well-defined nutritional markers: BMI, mid-arm circumference, WHR and MIS score. The MIS score was demonstrated to be the best independent predictor of 4-year mortality in our study (p < 0.001). CONCLUSION The results of our study have shown that there is no significance of WHR in the prediction of mortality in hemodialysis patients, but that the MIS score is a strong, independent predictor of all-cause 4-year mortality.
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Affiliation(s)
- Vladimir Prelevic
- Clinic for Nephrology, Clinical Center of Montenegro, Ljubljanska bb, 81000, Podgorica, Montenegro.
| | - Tanja Antunovic
- Center for Laboratory Diagnostics, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Danilo Radunovic
- Clinic for Nephrology, Clinical Center of Montenegro, Ljubljanska bb, 81000, Podgorica, Montenegro
| | | | - Branka Gledovic
- Center for Laboratory Diagnostics, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Marina Ratkovic
- Clinic for Nephrology, Clinical Center of Montenegro, Ljubljanska bb, 81000, Podgorica, Montenegro
| | - Nikolina Basic Jukic
- Department for Nephrology, Arterial Hypertension, Dialysis and Kidney Transplantation, Clinic for Internal Medicine, University Clinical Hospital Center, Zagreb, Croatia
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Zhou C, Zhang Y, Chen J, Mei C, Xiong F, Shi W, Zhou W, Liu X, Sun S, Tian J, Ye Z, Wu Q, Qin X, Jiang J, Hou FF. Association between serum advanced oxidation protein products and mortality risk in maintenance hemodialysis patients. J Transl Med 2021; 19:284. [PMID: 34193178 PMCID: PMC8247246 DOI: 10.1186/s12967-021-02960-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/23/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The association between serum advanced oxidation protein products (AOPP) and mortality risk remains equivocal. We aimed to assess the correlation of serum AOPP levels with the risk of all-cause mortality in hemodialysis (HD) patients. METHODS A total of 1394 maintenance HD patients with complete data on AOPP and related parameters were included from China Collaborative Study on Dialysis (CCSD), a multi-center, prospective cohort study. The primary outcome was all-cause mortality, the secondary outcome was cardiovascular disease (CVD) mortality. RESULTS During a median follow-up duration of 5.2 years (IQR, 2.1-5.4), all-cause mortality occurred in 492 (31.4%) participants. Overall, there was a reversed L-shaped association between serum AOPP and all-cause mortality in HD patients (P for nonlinearity = 0.04), with an inflection point at 87 µmol/L. Accordingly, there was no significant association between serum AOPP and all-cause mortality (per SD increment; HR, 0.94; 95%CI, 0.84, 1.05) in participants with AOPP < 87 µmol/L. However, there was a positive relationship of serum AOPP and all-cause mortality (per SD increment; HR, 1.24; 95%CI, 1.08, 1.42) in those with AOPP ≥ 87 µmol/L. Moreover, a similar trend was found for CVD mortality. CONCLUSIONS Elevated serum AOPP levels were associated with higher risk of all-cause mortality in Chinese maintenance HD patients.
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Affiliation(s)
- Chun Zhou
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China
| | - Jianghua Chen
- Kidney Disease Center, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Changlin Mei
- Division of Nephrology, Changzheng Hospital, Shanghai, China
| | - Fei Xiong
- Department of Nephrology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Zhou
- Department of Nephrology, The 8th Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Xusheng Liu
- Departmentof Nephrology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou, China
| | - Shiren Sun
- Department of Nephrology, Xijing Hospital, Xi'an, China
| | - Jianwei Tian
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China
| | - Ziliang Ye
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China
| | - Qimeng Wu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China
| | - Xianhui Qin
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China
| | - Jianping Jiang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China.
| | - Fan Fan Hou
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China.
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Karakizlis H, Thiele S, Greene B, Hoyer J. Cognitive performance in dialysis patients - "when is the right time to test?". BMC Nephrol 2021; 22:205. [PMID: 34078294 PMCID: PMC8171038 DOI: 10.1186/s12882-021-02333-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 04/02/2021] [Indexed: 11/17/2022] Open
Abstract
Background Cognitive impairment in chronic kidney disease, especially in end stage renal disease, is a public health problem. Nevertheless, the cause of chronic kidney disease still remains unclear. A prevalence of cognitive impairment in patients with end stage renal disease of up to 87% has been found. Methods The study at hand deals with the research on the – potential – effect of timing on cognitive performance when testing cognitive impairment in hemodialysis patients during the dialysis cycle. We tested cognitive performance with a neuropsychological test battery (RBANS, Repeatable Battery for the Assessment of Neuropsychological Status) on two occasions while patients were on dialysis as well as on a dialysis-free day. In addition, all participants were rated using the Geriatric Depression Scale (GDS) and several demographic and clinical variables were recorded in order to investigate their possible influence on cognitive performance. The patients were recruited in three dialysis centers in the central region of Hesse, Germany. Twenty-six participants completed the 3 testings during a period of 6 weeks. The testing was carried out in the dialysis centers. Results Looking at the total scale score, patients achieved the best cognitive performance in the RBANS during the first 2 h on dialysis with 81.1 points. When comparing the scores of the three measurement occasions (first 2 h, Timepoint 1 vs. last 2 h, Timepoint 2 vs. dialysis free day, Timepoint 3, however, no significant difference in the total scale score was detected. But patients showed significantly better cognitive performance in language in the first 2 h (p < 0.001) as well as in the last 2 h (p < 0.001) compared with the dialysis-free day. Conclusion Due to the high prevalence of cognitive impairment, there is an increasing need to assess cognitive function in dialysis patients. Our data show that the time point of testing (first 2 h on hemodialysis vs. last 2 h on hemodialysis vs. Hemodialysis free day) had no influence of cognitive function in hemodialysis patients in routine indications.
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Affiliation(s)
- Hristos Karakizlis
- Department of Nephrology, Philipps-University of Marburg, Baldingerstrasse, 35033, Marburg, Germany.,Department of Nephrology, Justus-Liebig-University of Gießen, Klinikstrasse 33, Gießen, Germany
| | - Stefanie Thiele
- Department of Nephrology, Philipps-University of Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Brandon Greene
- Institution of med. Biometrics and Epidemiology, Philipps-University Marburg, Robert-Koch-Strasse, Marburg, Germany
| | - Joachim Hoyer
- Department of Nephrology, Philipps-University of Marburg, Baldingerstrasse, 35033, Marburg, Germany.
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Ghafourifard M, Mehrizade B, Hassankhani H, Heidari M. Hemodialysis patients perceived exercise benefits and barriers: the association with health-related quality of life. BMC Nephrol 2021; 22:94. [PMID: 33726689 DOI: 10.1186/s12882-021-02292-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/02/2021] [Indexed: 12/13/2022] Open
Abstract
Background Patients on hemodialysis have less exercise capacity and lower health-related quality of life than healthy individuals without chronic kidney disease (CKD). One of the factors that may influence exercise behavior among these patients is their perception of exercise benefits and barriers. The present study aimed to assess the perception of hemodialysis patients about exercise benefits and barriers and its association with patients’ health-related quality of life. Methods In this cross-sectional study, 227 patients undergoing hemodialysis were randomly selected from two dialysis centers. Data collection was carried out using dialysis patient-perceived exercise benefits and barriers scale (DPEBBS) and kidney disease quality of life short form (KDQOL-SF). Data were analyzed using SPSS software ver. 21. Results The mean score of DPEBBS was 68.2 ± 7.4 (range: 24 to 96) and the mean KDQOL score was 48.9 ± 23.3 (range: 0 to 100). Data analysis by Pearson correlation coefficient showed a positive and significant relationship between the mean scores of DPEBBS and the total score of KDQOL (r = 0.55, p < 0.001). Moreover, there was a positive relationship between the mean scores of DPEBBS and the mean score of all domains of KDQOL. Conclusion Although most of the patients undergoing hemodialysis had a positive perception of the exercise, the majority of them do not engage in exercise; it could be contributed to the barriers of exercise such as tiredness, muscle fatigue, and fear of arteriovenous fistula injury. Providing exercise facilities, encouraging the patients by the health care provider to engage in exercise programs, and incorporation of exercise professionals into hemodialysis centers could help the patients to engage in regular exercise.
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Jiang J, Zhang Y, Chen J, Yang X, Mei C, Xiong F, Shi W, Zhou W, Liu X, Sun S, Zhang P, Zhang Y, Zhang Y, Liu S, Zhang Z, Lin Q, Yu Y, Tian J, Luo W, Qin X, Hou FF. Serum and Tissue Levels of Advanced Glycation End Products and Risk of Mortality in Patients on Maintenance Hemodialysis. Am J Nephrol 2021; 52:8-16. [PMID: 33596571 DOI: 10.1159/000512385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/01/2020] [Accepted: 10/15/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The relation of tissue and circulating advanced glycation end products (AGEs) with mortality in hemodialysis (HD) patients remains inconclusive. We aimed to investigate the association of serum AGEs (CML) and tissue AGEs estimated by skin autofluorescence (SAF) with all-cause and cardiovascular disease (CVD) mortality, and examine the possible modifiers for the association in HD patients with by far the largest sample size in any similar studies. METHODS A total of 1,634 HD patients were included from the China Cooperative Study on Dialysis (CCSD), a multicenter prospective cohort study. The primary and secondary outcomes were all-cause mortality and CVD mortality, respectively. RESULTS The median follow-up duration was 5.2 years. Overall, there was a positive relation of baseline SAF levels with the risk of all-cause mortality (per 1 AU increment, adjusted hazard ratio (HR), 1.30; 95% confidence interval (CI): 1.12, 1.50) and CVD mortality (per 1 AU increment, adjusted HR, 1.36; 95% CI: 1.14, 1.62). Moreover, a stronger positive association between baseline SAF (per 1 AU increment) and all-cause mortality was found in participants with shorter dialysis vintage, or lower C-reactive protein levels (Both p interactions <0.05). Nevertheless, there was no significant association between serum CML and the risk of mortality. CONCLUSIONS In patients undergoing long-term HD, baseline SAF, but not serum CML, was significantly associated with the risk of all-cause and CVD death.
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Affiliation(s)
- Jianping Jiang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaobing Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Changlin Mei
- Division of Nephrology, Changzheng Hospital, Shanghai, China
| | - Fei Xiong
- Department of Nephrology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Zhou
- Department of Nephrology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xusheng Liu
- Department of Nephrology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shiren Sun
- Department of Nephrology, Xijing Hospital, Xi'an, China
| | - Ping Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yixiang Zhang
- Division of Nephrology, Changzheng Hospital, Shanghai, China
| | - Yanmin Zhang
- Department of Nephrology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuangxin Liu
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhimin Zhang
- Department of Nephrology, The 8th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qizhan Lin
- Department of Nephrology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Yu
- Department of Nephrology, Xijing Hospital, Xi'an, China
| | - Jianwei Tian
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Weihong Luo
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China,
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Almeida A, Gajewska K, Duro M, Costa F, Pinto E. Trace element imbalances in patients undergoing chronic hemodialysis therapy - Report of an observational study in a cohort of Portuguese patients. J Trace Elem Med Biol 2020; 62:126580. [PMID: 32619919 DOI: 10.1016/j.jtemb.2020.126580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/19/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Patients with end-stage renal disease undergoing hemodialysis therapy are at risk of developing deficiencies of essential trace elements and/or overload of toxic trace elements, both of which may significantly affect their clinical status of. Those imbalances may result from the disease itself but also from the quality of the therapeutic process, namely the hemodialysis process, which has greatly evolved in the last decades. Thus, old observations that have been assumed as very well-proven have been recently questioned. In this case-control study we evaluate the current trace elements status in a group of Portuguese patients under hemodialysis therapy. MATERIAL AND METHODS Serum samples from patients (n = 93), collected for the routine periodic control of Al levels, were analyzed for a wide panel of trace elements (Li, Al, Mn, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Ba, Pb) using inductively coupled plasma mass spectrometry technique (hemodialysis patients' group). For comparison purposes, samples of individuals with no evidence of renal disease according to standard laboratory analytical criteria (n = 50) were also analyzed (control group). RESULTS The results showed significant differences between the two groups, with higher values in hemodialysis patients group for Al (14.6 vs. 9.5 μg/L), Co, Ni, Sr, Mo (4.5 vs. 1.4 μg/L), Cd (0.058 vs. 0.025 μg/L) and Pb (0.55 vs. 0.30 μg/L); and lower values in hemodialysis patients group for Li (4.0 vs. 75.8 μg/L), Mn, Cu (943.5 vs. 1038.5 μg/L), Zn (943.5 vs. 1038.5 μg/L), Se (71.5 vs. 103.8 μg/L), Rb (202.4 vs. 300.3 μg/L) and Ba (0.65 vs. 8.7 μg/L). CONCLUSION This study confirms that hemodialysis patients tend to present significant trace elements imbalances, which may be related to the higher morbidity and mortality observed in this specific patients' group.
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Affiliation(s)
- Agostinho Almeida
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Katarzyna Gajewska
- Chair of Chemistry, Department of Analytical Chemistry, Medical University of Lublin, Lublin, Poland
| | - Mary Duro
- Faculty of Health Sciences, University Fernando Pessoa, Praça 9 de Abril 349, 4249-004 Porto, Portugal; Laboratory Dra. Matilde Sampaio, Lda., Mogadouro, Portugal
| | - Félix Costa
- LAQV/REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Edgar Pinto
- Department of Environmental Health, School of Health, P.Porto, Rua Dr. António Bernardino de Almeida 400, 4200-072, Porto, Portugal
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Wang B, Li M, Tang F, Wang Y, Han Y, Lu W, Zhang L, Zhang L, Ni W, Zhang L, Zhang L. Event- and time-based prospective memory in hemodialysis patients. Ren Fail 2020; 42:1135-1141. [PMID: 33179540 PMCID: PMC7671658 DOI: 10.1080/0886022x.2020.1835673] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE The present study investigated whether hemodialysis (HD) patients exhibit future memory impairment (PM; the capability of remembering to perform expected future actions) and exploring relevant factors of PM task performance. METHODS Sixty HD patients and 60 healthy controls matched by age are enrolled in the Mini-Mental State Examination (MMSE), Finger Span Test (DST), Oral Fluency Test (VFT), Ray Auditory Oral Learning Test (RAVLT), Received Stroop Color Word Interference Test (SCWT), and event-based PM (EBPM) and time-based PM (TBPM). RESULTS There were no significant difference between the patients and controls in the DST-Forward digit span (9.00 ± 1.25 versus 8.97 ± 1.33, p = 0.96), the DST-Backward digit span (5.23 ± 1.98 versus. 4.60 ± 1.65, p = 0.11), the RAVLT of delayed recall (7.28 ± 2.36 versus 6.87 ± 3.33, p = 0.09) and the VFT for animals (16.70 ± 3.50 versus 17.68 ± 5.45, p = 0.56). By comparison, patients had a much worse performance than controls on the MMSE (29.10 ± 0.84 versus 28.33 ± 0.77, p < 0.001), the RAVLT of total recall (44.47 ± 5.82 versus 40.03 ± 10.46, p < 0.001) and delayed recognition (6.93 ± 1.49 versus 5.4 ± 1.33, p < 0.001), the SCWT reaction time in reading (6.47 ± 1.05 versus 7.47 ± 1.86, p < 0.001), color naming (9.07 ± 1.29 versus 11.43 ± 2.34, p < 0.001), interference (8.78 ± 1.92 versus 10.22 ± 2.91, p < 0.001) and inhibition/switching (14.53 ± 2.90 versus 19.85 ± 4.69, p < 0.001), the VFT for fruit (17.47 ± 3.18 versus 15.92 ± 4.56, p < 0.001), the EBPM task (7.85 ± 0.40 versus 7.08 ± 1.43, p = 0.01), and the TBPM task (3.30 ± 1.31 versus 2.26 ± 1.82, p < 0.001). CONCLUSIONS Our results suggest that EBPM and TBPM are impaired in HD patients and that PM may be applied to help evaluate cognitive dysfunction in HD patients.
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Affiliation(s)
- Bin Wang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Mengting Li
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Fang Tang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Yue Wang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Yuchen Han
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Wen Lu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Lan Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Ling Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Weijie Ni
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Li Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Liuping Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
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Shimoda T, Alston H, Chai A, Jassal SV. Evidence supporting the use of a subjective staff evaluation to assess the benefit of rehabilitation in hemodialysis patients undergoing inpatient rehabilitation. BMC Nephrol 2020; 21:466. [PMID: 33167863 DOI: 10.1186/s12882-020-02118-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background We questioned whether the introduction of a subjective evaluation of patient-specific goals, could be used as a valid method to assess the effectiveness of inpatient rehabilitation. Methods In this prospective cohort study, all admissions to the UHN hemodialysis rehabilitation service between April 2013 and August 2016 were included. We introduced a system of subjective assessment, performed by the team at the time of admission and discharge. We evaluated Functional Independence Measure (FIM®) score and KDQoL for objective measures of physical function and patient-reported quality of life. Results A total of 201 patients were included. The median FIM score at discharge correlated well with the subjective staff evaluation. FIM score changes for those with evaluations for Success, Partial success, and Not Successful were 28 [interquartile range (IQR) 20–34], 24 [IQR18–31], 16 [IQR 11–34] respectively. The median PCS at discharge for those deemed to have Success was 37.4 [IQR31.0, 44.7], and for those with Partial success & Not Successful 28.8 [IQR 22.4, 39.2]. There was no correlation with MCS scores (55.2 [IQR 51.2, 60.2], 58.4 [IQR 50.1, 63.1] respectively). Conclusions These results suggest the subjective staff evaluation is a brief but valid assessment of patient outcome for dialysis patients undergoing inpatient rehabilitation.
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Grammatikopoulou MG, Gkiouras K, Markaki AG, Gkouskou KK, Aivaliotis M, Stylianou K, Bogdanos DP. AMY1 diploid copy number among end-stage renal disease patients. Hormones (Athens) 2020; 19:369-376. [PMID: 32405930 DOI: 10.1007/s42000-020-00199-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 04/07/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The salivary amylase gene (AMY1) copy number variation (CNV) is increased as a human adaptation to starch-enriched nutritional patterns. The purpose of this study was to evaluate the relationship between AMY1 CNV, dietary starch consumption, and anthropometric indices among a known population with elevated cardiovascular risk, being end-stage renal disease (ESRD) patients. METHODS A total of 43 ESRD patients were recruited based on the following inclusion criteria: being (1) adults, (2) on hemodialysis for more than 3 months, (3) able to communicate effectively, and (4) willing to participate. Anthropometric measurements were performed, dietary intake was recorded via food-frequency questionnaires, and AMY1 CNV was quantified in blood samples DNA via real-time PCR. RESULTS Median AMY1 CNV was 4.0 (2.0-17.0). A total of 21 patients had an even, and 22 had an odd AMY1 copy number (CN). Independent samples t tests revealed that AMY1-odd diploid CN is associated with increased body weight, waist and hip circumferences, and fat mass compared to the respective even diploid CN carrier group. No differences were observed for BMI or nutritional intake. Multiple regression analysis revealed that AMY1-odd diploid CN was positively associated with increased hip circumference (ß = 7.87, 95% CI = 0.34 to 15.39) and absolute fat mass (ß = 6.66, 95% CI = 0.98 to 12.34); however, after applying the Bonferroni correction for multiplicity, all regression analyses lost their significance. CONCLUSIONS AMY1-odd diploid CN appears to be associated with selected adiposity variables among hemodialysis patients. However, more research is needed to verify this finding in this population with known increased cardiovascular risk.
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Affiliation(s)
- Maria G Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
| | - Konstantinos Gkiouras
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Anastasia G Markaki
- Department of Nutrition & Dietetics, Faculty of Health Sciences, Hellenic Mediterranean University, Sitia, Greece
| | - Kalliopi K Gkouskou
- Department of Medical Laboratories, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
- Embiodiagnostics, Biology Research Company, Melissinon and Damvergidon Str, Heraklion, Crete, Greece
| | - Michalis Aivaliotis
- Laboratory of Biological Chemistry, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology Hellas (FORTH), Heraklion, Crete, Greece
| | | | - Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Division of Transplantation, Immunology and Mucosal Biology, MRC Centre for Transplantation, King's College London Medical School, London, UK
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Masoudi R, Lotfizade M, Gheysarieha MR, Rabiei L. Evaluating the effect of Pender's health promotion model on self-efficacy and treatment adherence behaviors among patients undergoing hemodialysis. J Educ Health Promot 2020; 9:197. [PMID: 33062730 PMCID: PMC7530408 DOI: 10.4103/jehp.jehp_747_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Health promotion through lifestyle improvement is an important topic that has received considerable attention from the scientific community worldwide. This study aimed to determine the effect of Pender's health promotion model on self-efficacy and treatment adherence behaviors of hemodialysis patients in Shahrekord, Iran, in 2018-2019. METHODS This quasi-experimental study was performed on 70 hemodialysis patients who were attending routine hemodialysis sessions in Hajar hospital in Shahrekord. Individuals were selected by simple random sampling and randomly assigned to two groups of control and intervention. In the preintervention stage, all patients completed a questionnaire that was prepared to collect demographic information and measure health-promoting behaviors, self-efficacy, and treatment adherence. The intervention group participated in eight sessions of a health promotion model-based education program. Both groups were asked to complete the questionnaire again immediately after the intervention and also 2 months later. RESULTS The repeated measures analysis of variance (ANOVA) showed a significant difference between the two groups in terms of the extent of change in mean scores over the three measurement stages (before the intervention, after the intervention, and 2 months after the intervention) (P < 0.001). A statistically significant difference was observed between the two groups in terms of self-efficacy scores in the postintervention and follow-up stages (P < 0.05). The repeated measures ANOVA also revealed a significant difference between the two groups in terms of the extent of change in mean treatment adherence scores over the three measurement stages (P < 0.001). CONCLUSION Considering the positive effects of the program on patients undergoing hemodialysis, it is recommended to use the program to promote the well-being of these patients without time restrictions.
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Affiliation(s)
- Reza Masoudi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masood Lotfizade
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammad Reza Gheysarieha
- Department of Health Education and Health Promotion, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Leili Rabiei
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Yap YS, Chi WC, Lin CH, Liu YC, Wu YW, Yang HY. Factors affecting patency of arteriovenous fistula following first percutaneous transluminal angioplasty. Clin Exp Nephrol 2021; 25:80-6. [PMID: 32852664 DOI: 10.1007/s10157-020-01958-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Percutaneous transluminal angioplasty (PTA) has generally replaced surgical procedures to treat arteriovenous fistula (AVF) dysfunction, but the predictors of post-intervention patency are highly variable. This study aimed to determine predictors of primary patency following PTA of dysfunctional AVF. MATERIALS AND METHODS Retrospective analysis of first-time PTA of 307 AVF in 307 patients (171 males, mean age 64.3 ± 12.4 years). Demographic, clinical, anatomical and medication variables were reviewed and subjected to univariate and multivariate Cox regression analysis. RESULTS The post-intervention primary patency rates at 6, 12, 24, and 36 months were 76.3%, 58.3%, 43.2%, and 38.2%, respectively. The higher aortic arch calcification (AAC) grade patients were older, had higher incidence of comorbidities and cardiomegaly, and younger AVF age, but their dialysis vintage term was shorter and diastolic blood pressure was lower, and the maximum diameter of balloon angioplasty was mostly ≤ 6 mm, and had lower phosphorus level and less calcium-containing phosphate binder use. In multivariate Cox proportional hazard analysis, the presence of higher AAC grade [hazard ratio (95% confidence interval): (1.46 (1.02-2.09); p = 0.037)] and stenosis at upper arm [1.76 (1.16-2.67); p = 0.008] were associated with shorter post-intervention primary patency. CONCLUSION In conclusion, higher AAC grade and anatomic factor related to the location of AVF (upper arm) were the important predictors of AVF dysfunction after PTA. These results could assist in tailoring surveillance programs and performing appropriate interventions for risky AVF.
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Stergiannis P, Govari M, Jahaj E, Marvaki C, Toulia G, Marvaki K, Chasioti G, Intas G. Sleep Disorders and Restless Legs Syndrome in Hemodialysis Patients in Greece: A Cross-Sectional Study. Adv Exp Med Biol 2020; 1195:155-162. [PMID: 32468471 DOI: 10.1007/978-3-030-32633-3_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Sleep disorders, including insomnia and extreme sleep times, adversely affect the risk of developing illnesses and contribute to increased mortality rates. The aim of the study was to investigate sleep disorders experienced by hemodialysis patients in order to draw useful conclusions and to propose solutions to address this serious problem. MATERIAL AND METHOD This is a cross-sectional study, and the study sample consisted of 120 patients undergoing hemodialysis from February to April 2017 at a general hospital in Greece. The main tools of the survey were the Athens Insomnia Scale, the Berlin Questionnaire, and the RLS (Restless Legs Syndrome) Questionnaire. RESULTS Most of the patients were males (68.3%), aged 68.1 ± 14.1 years. Half of the responders suffered from insomnia. About two thirds were at low risk for sleep apnea. Most of the responders suffered from restless legs syndrome (62.5%). Insomnia was significantly associated with higher BMI (RR: 0.180; 95% CI [0.032, 1.003]), analgesics receiving (RR: 0.125; 95% CI [0.031, 0.513]), hypnotics receiving (RR: 0.072; 95% CI [0.010, 0.533]), and restless legs syndrome (RR: 2.281; 95% CI [1.179, 4.413]) after adjusting for sociodemographic variables.Sleep apnea was significantly linked to analgesics (RR: 0.309; 95% CI [0.093, 1.027]; p = 0.045). RLS was significantly tied to hypnotics (RR: 0.077; 95% CI [0.008, 0.745]; p = 0.027) and insulin (RR: 0.019; 95% CI [0.001, 0.542]; p = 0.020). CONCLUSIONS Sleep disorders are common symptoms among hemodialysis patients. The restless legs syndrome occurs at a lower frequency among hemodialysis patients but is a major problem for them.
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Affiliation(s)
| | | | | | | | - Georgia Toulia
- Faculty of Nursing, University of West Attica, Aigaleo, Greece
| | | | | | - George Intas
- General Hospital of Nikaia "AgiosPanteleimon", Nikaia, Greece.
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Hachiro K, Kinoshita T, Suzuki T, Asai T. In situ skeletonized gastroepiploic artery grafting in hemodialysis patients. Gen Thorac Cardiovasc Surg 2020; 68:1319-1324. [PMID: 32445168 DOI: 10.1007/s11748-020-01390-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES There is no firm treatment strategy of coronary artery bypass grafting in hemodialysis patients. We investigated postoperative outcomes in hemodialysis patients undergoing isolated coronary artery bypass grafting using in situ skeletonized gastroepiploic artery. METHODS From January 2002 to December 2019, 143 hemodialysis patients underwent isolated coronary artery bypass grafting in our institution. Among them, 49 consecutive patients with gastroepiploic artery grafting were retrospectively analyzed. RESULTS No patient was converted from off-pump to on-pump surgery. The mean distal anastomoses were 3.6 ± 1.0 per patients. Seven patients (14.3%) required proximal anastomosis to aorta. Thirty-day mortality was 4.1% (2 of 49). The early (3-20 days after surgery) patency rate of the gastroepiploic artery was 96.9% (63 of 65 anastomoses). The adjusted rates of survival free from overall death at 1, 5 and 10 years after surgery were 91.7%, 72.6% and 32.5%, respectively. Multivariate Cox proportional hazard regression analysis showed that age (hazard ratio 1.131, 95% confidence interval 1.055-1.212, p < 0.001) and LVEF < 40% (hazard ratio 9.411, 95% confidence interval 1.963-45.919, p = 0.005) were independent predictors of mid-term death from all causes (Table 6). CONCLUSIONS Short and mid-term outcomes were acceptable. The use of in situ skeletonized gastroepiploic artery can decrease the time of touching aorta, so gastroepiploic artery grafting may be an important option for coronary artery bypass grafting in hemodialysis patients with limited conduits.
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Affiliation(s)
- Kohei Hachiro
- Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, 520-2192, Japan
| | - Takeshi Kinoshita
- Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, 520-2192, Japan.
| | - Tomoaki Suzuki
- Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, 520-2192, Japan
| | - Tohru Asai
- Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, 520-2192, Japan
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Kanki T, Kuwabara T, Morinaga J, Fukami H, Umemoto S, Fujimoto D, Mizumoto T, Hayata M, Kakizoe Y, Izumi Y, Tajiri S, Tajiri T, Kitamura K, Mukoyama M. The predictive role of serum calprotectin on mortality in hemodialysis patients with high phosphoremia. BMC Nephrol 2020; 21:158. [PMID: 32366231 DOI: 10.1186/s12882-020-01812-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background The inflammatory mediator calprotectin (CPT, myeloid-related protein 8/14) is known as an endogenous ligand contributing to pathophysiology in inflammatory diseases. Serum CPT reportedly became a potential biomarker in these conditions, though there is no report predicting the prognosis in hemodialysis patients. The aim of this study is to investigate the predictive role of serum CPT on mortality in hemodialysis patients. Methods We conducted a multicenter, observational cohort study of 388 Japanese subjects undergoing hemodialysis. Serum CPT were measured using an ELISA. The potential associations between serum CPT and clinical variables were cross-sectionally examined. Multivariate Cox regression was used to estimate the association between serum CPT, high-sensitivity C reactive protein (hs-CRP), white blood cell (WBC) count and mortality. Median follow-up was 6.6 years. Results The median CPT level was 6108 ng/ml (median in healthy subjects, 2800) at baseline. Serum CPT positively correlated with WBC count (ρ = 0.54, P < 0.001) and hs-CRP values (ρ = 0.35, P < 0.001). In multivariate analysis, hs-CRP was an independent predictor of all-cause mortality after adjusting confounding factors (middle vs. low: hazard ratio [HR] 2.09, 95% confidence interval [CI] 1.23–3.66; high vs. low: 2.47, 1.40–4.47). In the analysis by stratum of phosphate levels, elevated CPT levels were significantly associated with all-cause mortality in the highest tertile (18.1; 3.15–345.9) among the high-phosphate group, but not among the low-phosphate group. Conclusions Serum CPT would become a potential predictive marker on mortality in hemodialysis patients with high-phosphate levels.
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Kamei D, Kamei Y, Nagano M, Mineshima M, Nitta K, Tsuchiya K. Elobixibat alleviates chronic constipation in hemodialysis patients: a questionnaire-based study. BMC Gastroenterol 2020; 20:26. [PMID: 32005162 PMCID: PMC6995167 DOI: 10.1186/s12876-020-1179-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 01/23/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hemodialysis patients are prone to constipation, which can adversely affect their quality of life (QOL). Elobixibat, a highly selective inhibitor of the ileal bile acid transporter, can increase the bile acid level in the colon and, subsequently, enhance colonic motility and secretion. In hemodialysis patients with chronic constipation, it may have a novel action mechanism. However, the effect of elobixibat on such patients' QOL had not been reported. This study aimed to evaluate the effect of elobixibat on the QOL of hemodialysis patients with chronic constipation. METHODS This was a multicenter, observational study that used the Japanese version of the Patient Assessment of Constipation-Quality of Life (PAC-QOL) questionnaire on 27 patients (18 men and nine women, age range 47-90 years), who satisfied the Rome 3 diagnostic criteria for functional constipation and were already taking other drugs for constipation. These patients were administered elobixibat 10 mg/day and were asked to respond to the PAC-QOL questionnaire at baseline and after 4 weeks. Bayesian statistics were used to confirm our results. RESULTS The number of spontaneous bowel movements per week increased significantly from 2.6 ± 1.2 to 4.1 ± 2.1 (p < 0.001), and the Bristol Stool Form Scale score significantly improved from 1.9 ± 0.8 to 3.6 ± 0.7 (p < 0.001). The Cronbach's alpha was 0.95, and the Guttman split-half reliability coefficient was 0.90. There were significant decreases in the physical discomfort scores from 1.94 ± 0.79 to 0.97 ± 0.72 (p < 0.001); psychosocial discomfort from 1.16 ± 0.93 to 0.63 ± 0.58 (p < 0.001); worries/ concerns from 1.84 ± 0.73 to 1.27 ± 0.59 (p < 0.001), and satisfaction from 2.79 ± 0.61 to 1.98 ± 0.77 (p < 0.001). The total PAC-QOL score significantly decreased from 1.83 ± 0.79 to 1.17 ± 0.56 (p < 0.001). Bayesian statistics confirmed the results' significance. CONCLUSIONS Elobixibat reduced the PAC-QOL scores for hemodialysis patients with chronic constipation and improved the patients' QOL. It may serve as a new option for treating constipation in hemodialysis patients.
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Affiliation(s)
- Daigo Kamei
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. .,Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. .,Department of Clinical Engineering, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Yuiko Kamei
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Masashi Nagano
- Nerima Sakuradai Clinic, 4-11-9 Toyotamakita, Nerima-ku, Tokyo, 176-0012, Japan
| | - Michio Mineshima
- Department of Clinical Engineering, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kosaku Nitta
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Ezzat S, Tharwat S, Abdelsalam S, Eltoraby EE. Musculoskeletal Symptoms in Hemodialysis Patients and their Effect on Health-Related Quality of Life. Blood Purif 2020; 49:289-294. [PMID: 31927539 DOI: 10.1159/000504038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/10/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Hemodialysis (HD) represents one of the most commonly used modalities as a renal replacement therapy. Health-related quality of life (HRQoL) is much lower in HD patients than general population. Musculoskeletal (MSK) symptoms are one of the most important health problems that affect patients on maintenance HD. The main purpose of this study was to investigate the association between MSK symptoms and HRQoL among HD patients. METHODS The study was carried out on 200 patients with chronic renal failure on chronic HD at different nephrology units in Egypt. They completed the Arabic version of the Kidney Disease and Quality of Life-Short Form 1.3 Questionnaire and answered the questions of MSK discomfort form based on the Nordic MSK Questionnaire. RESULTS The mean age of the patients was 50.6 years, 61% were males. Of the 200 HD patients, 180 patients (90%) had MSK manifestations. The most commonly affected part was knee joint (51.5%). Regarding HRQoL, patients with MSK symptoms had significantly lower scores than did patients without on the physical role (p = 0.035), pain domain (p = 0.003), general health (p = 0.017), quality of social interaction (p = 0.046), and sleep domain (p = 0.022). CONCLUSION MSK manifestations have a negative impact on HRQoL in HD patients. So, early identification and treatment are highly recommended.
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Affiliation(s)
- Sara Ezzat
- Nephrology Unit, Department of Internal Medicine, Nabarouh Central Hospital, Mansoura University, Mansoura, Egypt
| | - Samar Tharwat
- Rheumatology and Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University Hospital, Mansoura University, Mansoura, Egypt,
| | - Sherihan Abdelsalam
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ehab E Eltoraby
- Rheumatology and Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University Hospital, Mansoura University, Mansoura, Egypt
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Ichinose M, Sasagawa N, Chiba T, Toyama K, Kayamori Y, Kang D. Protein C and protein S deficiencies may be related to survival among hemodialysis patients. BMC Nephrol 2019; 20:191. [PMID: 31138132 PMCID: PMC6540392 DOI: 10.1186/s12882-019-1344-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/18/2019] [Indexed: 12/18/2022] Open
Abstract
Background Thrombophilia due to protein C (PC) and protein S (PS) deficiencies is highly prevalent among patients with stage 5 chronic kidney disease and is reported to arise due to extracorporeal circulation during hemodialysis (HD). This study aimed to evaluate the relationship between HD treatment and thrombophilia. Methods A total of 114 Japanese patients on maintenance HD (62 men, 52 women) were followed during 2008–2011. Their survival rates were compared against the duration of HD. Prior to each HD, coagulation/fibrinolysis parameters and PC and PS activities were measured using standard techniques. The patients were divided into two groups: Group 1, with PC and/or PS deficiencies (n = 32), and Group 2, without PC and PS deficiencies (n = 82). The influence of such deficiencies and duration of dialysis on survival was examined. Time-to-event analysis was applied using Kaplan-Meier estimates, and the log-rank test was proposed to test the equivalence of relative survival data. Hazard ratios and 95% confidence intervals (CI) were calculated. Results Of the 114 patients, 37 died (Group 1, 22; Group 2, 15). The hazard ratio (95% CI) was higher (p = 0.004) in Group 1 than Group 2. Gene analyses of PC and PS were performed in 14 patients from Group 1. No mutations in either protein were observed. We analyzed the causes of death in both groups; however, the estimated thrombophilia-related incidence of death could not be determined due to small sample size of HD patients. Conclusions Our results suggest that PC and PS deficiencies may be related to survival in HD patients. However, this finding warrants additional research.
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Affiliation(s)
- Mayuri Ichinose
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Naru Sasagawa
- Vascular Access Center, Yokohama Dai-ichi Hospital, Yokohama, Japan
| | - Tetsuo Chiba
- Vascular Access Center, Yokohama Dai-ichi Hospital, Yokohama, Japan
| | - Katsuhide Toyama
- Department of Internal Medicine, Yokohama Dai-ichi Hospital, Yokohama, Japan
| | - Yuzo Kayamori
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Dongchon Kang
- Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Chang HM, Chou YC, Jou IM, Yang JM, Ma CH, Wu PT. Clinical outcomes in distal radial fractures with ipsilateral arteriovenous fistulas. J Orthop Surg Res 2019; 14:143. [PMID: 31118080 PMCID: PMC6532144 DOI: 10.1186/s13018-019-1171-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 04/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We evaluated the effects on arteriovenous fistula (AVF) function and clinical outcomes in patients given cast fixation, external skeletal fixation [ESF], or volar locking plate fixation [VLPF] for an ipsilateral distal radial fracture (DRF). METHODS Thirteen patients were assigned to the surgery group or the cast group; follow-up was ≥12 months. One-year clinical outcomes and serial AVF function and radiographic outcomes were recorded and analyzed. RESULTS All fractures were union and all AVFs were preserved with continuous hemodialysis. The surgery group had better immediately (radial inclination and articular step-off) and 1-year post-index procedure radiographic findings (radial height, radial inclination, volar tilting, ulnar variance, and articular step-off) and better 1-year functional outcomes (Mayo and QuickDASH score) than did the cast group. The VLPF subgroup had better QuickDASH scores and radiographic outcomes (radial inclination and ulnar variance) than did the ESF subgroup. CONCLUSIONS One year after the index procedure, none of the treatment affected shunt function in DRFs ipsilateral to AVFs. ESF and VLPF yielded better functional and radiographic outcomes than did cast fixation in patients with ipsilateral DRFs and AVFs. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Hao-Ming Chang
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.,Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Chuan Chou
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.,Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Orthopedics, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - I-Ming Jou
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.,Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Jui-Ming Yang
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.,Department of Orthopedic, Tainan Sin Lau Hospital, Tainan, Taiwan
| | - Ching-Hou Ma
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan. .,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Po-Ting Wu
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan. .,Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan. .,Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan. .,Department of Orthopedics, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Dou-Liou, Taiwan.
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Ghavghani FR, Rahbarnia L, Naghili B, Dehnad A, Bazmani A, Varshochi M, Ghaffari Agdam MH. Nasal and extra nasal MRSA colonization in hemodialysis patients of north-west of Iran. BMC Res Notes 2019; 12:260. [PMID: 31077228 PMCID: PMC6509970 DOI: 10.1186/s13104-019-4298-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Methicillin resistant Staphylococcus (S.) aureus colonization is one of the main causes of serious infections in hemodialysis patients. This cross-sectional study was performed to examine prevalence of MRSA colonization and evaluation of risk factors in hemodialysis patients. A total of 560 swab samples from nasal, the skin around catheter and throat were collected from 231 hemodialysis patients in Tabriz. The standard biochemical tests were used for identification of S. aureus isolates. Antimicrobial susceptibility profile was determined against 11 antibiotics by the disk diffusion method. Phenotypic test of S. aureus was performed using novobiocin 30 μg/disc, and methicillin sensitivity test was performed by cefoxitin 30 μg/disc. RESULTS Overall, 50.65% (118/231) hemodialysis patients were positive for S. aureus which 34.93% (80/231) of patients were MRSA carriage. The MRSA colonization in patients with a catheter (44.06%) was more than individuals utilizing a fistula (24.57%, p = 0.030). Among sampling sites, the highest MRSA was related to nasal samples (30.70%, p < 0.00001). Extra nasal colonization of S. aureus was observed in 12.71% patients. The highest rates of resistance were observed against ampicillin (93.98%) and the highest sensitivity was against linezolid antibiotic (5.42%). These findings highlight the necessity of prophylaxis against S. aureus in individuals under dialysis.
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Affiliation(s)
- Fatemeh Ravanbakhsh Ghavghani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O.Box; 5163639888, Tabriz, Iran
| | - Leila Rahbarnia
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O.Box; 5163639888, Tabriz, Iran. .,Higher Education Institute of Rab-Rashid, Tabriz, Iran, Tabriz, Iran.
| | - Behrooz Naghili
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O.Box; 5163639888, Tabriz, Iran
| | - Alireza Dehnad
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O.Box; 5163639888, Tabriz, Iran.,Higher Education Institute of Rab-Rashid, Tabriz, Iran, Tabriz, Iran.,Biotechnology Department, East Azerbaijan Research and Education Canter Agricultural and Natural Resources, AREEO, Tabriz, Iran
| | - Ahad Bazmani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O.Box; 5163639888, Tabriz, Iran
| | - Mojtaba Varshochi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O.Box; 5163639888, Tabriz, Iran
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Samiei RN, Mahmoudvand S, Shokri S, Makvandi M, Shahbazian H, Pirmoradi R, Shayanpur S, Makvandi K, Nowrozi S. The frequency of Epstein-Barr virus among hemodialysis patients, Ahvaz, Iran. Iran J Microbiol 2019; 11:75-79. [PMID: 30996835 PMCID: PMC6462267] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVES Epstein-Barr virus (EBV) has infected more than 90% of adults worldwide. EBV infection is asymptomatic in healthy individuals and is controlled by a robust immune response while in individuals with weakened immunesystems including Hemodialysis (HD) patients and transplant recipients leads to serious illnesses. This study was aimed to investigate the frequency of EBV among the HD patients. MATERIALS AND METHODS The cross-sectional study was carried out on 84 HD patients. These sera were checked for anti-EBV (VCA) IgG Ab assessment using enzyme-linked immunosorbent assay (ELISA). The DNA was extracted from the sera samples and tested for EBV DNA using nested PCR. RESULTS 52/84 (61.9%) of HD were males and 32/84 (38.1%) were females. The average age of participants was varying from 18 to 85 years while the mean age was 52 ± 1.57 SD years. 81 of 84 (96.42%); including 49/52 (94.23%) male and 32/32 (100%) female, were positive for anti-EBV (VCA) IgG antibody while 3 (3.58%) were negative. No significant differences were observed between the subjects regarding gender (P=0.28). EBV DNA was detected in 7 (8.33%) individuals, including 6 (11.53%) and 1 (3.12%) in male and female, respectively (P=0.24). CONCLUSION Our study results showed that high prevalence of anti-EBV (VCA) IgG antibody (96.42%) were observed among the HD patients. Although the status of EBV latency was not performed, but it seems many of these patients are at risk of EBV-reactivation during the organ transplantation. As a result, it is recommended that the detection of EBNA-1 gene as a marker of EBV latency should be implemented for all HD patients to prevent EBV reactivation during organ transplantation.
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Affiliation(s)
- Rahil Nahid Samiei
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahab Mahmoudvand
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Somayeh Shokri
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Manoochehr Makvandi
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,Corresponding author: Prof. Manoochehr Makvandi, Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Tel: +98-9166181683, Fax: +98-6133738313,
| | - Heshmatollah Shahbazian
- Department of Nephrology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roya Pirmoradi
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shokouh Shayanpur
- Nephrology Department, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kimia Makvandi
- School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sepideh Nowrozi
- School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Boaz M, Azoulay O, Schwartz IF, Schwartz D, Assady S, Kristal B, Benshitrit S, Yanai N, Weinstein T. Malnutrition Risk in Hemodialysis Patients in Israel: Results of the Status of Nutrition In Hemodialysis Patients Survey Study. Nephron Clin Pract 2019; 141:166-176. [PMID: 30654378 DOI: 10.1159/000495150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/05/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Malnutrition is a frequently observed disorder in patients with chronic kidney disease (CKD) receiving hemodialysis (HD). While variously defined, malnutrition is a frequently observed condition among patients on HD. Prevalence estimates of malnutrition among Israeli HD patients have not been reported. OBJECTIVES To survey nutrition intake in Israeli HD patients; estimate malnutrition risk prevalence; identify risk factors, and characterize malnutrition risk in HD patients. METHODS A representative sample of 378 Israeli HD patients treated in hospital HD centers throughout the country were surveyed. Using the 24-h recall method, dietary intake was estimated and the chronologically corresponding biochemistry, anthropometric, and hemodynamic measures were recorded. Four categories of malnutrition risk were defined: "minimal": body mass index (BMI) > 23 kg/m2 and serum albumin > 3.8 g/dL; "mild": BMI < 23 kg/m2 and albumin > 3.8 g/dL; "moderate": BMI > 23 kg/m2 and albumin < 3.8 g/dL; "severe": BMI < 23 k/m2 and serum albumin < 3.8 g/dL. RESULTS Elevated malnutrition risk was identified in 175 (46.3%) study participants, who were more likely to require feeding assistance, have major comorbidities, reduced hemoglobin, and elevated C-reactive protein. Oral nutrition supplementation was prescribed to only 14.3% of patients with elevated malnutrition risk. Intradialytic parenteral nutrition was recorded for 6 patients, all of whom had moderate or severe malnutrition risk. Less than one-third of patients met the guidelines for dietary intake of energy or protein, and this did not differ across malnutrition risk groups. DISCUSSION Elevated malnutrition risk is a frequent finding in HD patients treated in hospital settings in Israel. Dietary intake does not meet guidelines but does not differ across malnutrition risk categories. Nutrition supplements are underused in HD patients with high malnutrition risk. There is a need to expand the survey to community HD centers.
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Affiliation(s)
- Mona Boaz
- Department of Nutrition Sciences, Ariel University, Holon, Israel
| | - Odile Azoulay
- Department of Nephrology, Rabin Medical Center, Petach Tikva, Israel
| | - Idit F Schwartz
- Department of Nephrology, Tel Aviv Medical Center, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Doron Schwartz
- Department of Nephrology, Tel Aviv Medical Center, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Suhair Assady
- Department of Nephrology and Hypertension, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Batya Kristal
- Department of Nephrology, Western Galilee Hospital, Bar Ilan University Medical School, Nahariya, Israel
| | - Sydney Benshitrit
- Department of Nephrology, Meir Medical Center, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Noa Yanai
- Department of Nephrology, Hillel Yaffe Hospital, Tel Aviv, Israel
| | - Talia Weinstein
- Department of Nephrology, Tel Aviv Medical Center, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel,
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Giaretta AG, Schulz M, Silveira TT, de Oliveira MV, Patrício MJ, Gonzaga LV, Fett R, da Silva EL, Wazlawik E. Apple intake improves antioxidant parameters in hemodialysis patients without affecting serum potassium levels. Nutr Res 2018; 64:56-63. [PMID: 30802723 DOI: 10.1016/j.nutres.2018.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 11/30/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022]
Abstract
Oxidative stress (OS) is associated with increased morbidity and mortality in hemodialysis (HD) patients, and the consumption of fruits seems to improve OS due to their antioxidant properties. Therefore, we hypothesized that Fuji apple intake improves OS markers in HD patients due to its polyphenolic compounds without increasing serum potassium levels. This trial was a 1-group, pre- and posttest comparison between 16 patients who had been on hemodialysis for at least 3 months without any acute illness or hyperkalemia. Each volunteer consumed 2 Fuji apples (~360 g) per day for 1 week. Blood samples were collected at the baseline period and after 8 days for the measurement of total antioxidant status, ascorbic acid, catalase, glutathione peroxidase, superoxide dismutase, reduced glutathione, total oxidant status, oxidative stress index, potassium, phosphorus, uric acid, glucose, and fructosamine. For tolerance evaluation, participants were asked about their bowel habits. Apple intake increased glutathione peroxidase (P = .006) and superoxide dismutase activities (P = .006) and ascorbic acid levels (P = .002). No significant changes were observed in uric acid, potassium, phosphorus, glucose, and fructosamine levels. Additionally, there was a decrease in the catalase activity (P = .021) and in the total antioxidant status values (P = .004). However, increased total oxidant status (P = .003) and oxidative stress index (P = .033) levels were observed after apple intake. In conclusion, the intake of 2 Fuji apples per day for 1 week was well tolerated and improved antioxidant parameters in HD patients without affecting serum potassium levels.
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Affiliation(s)
- Andréia G Giaretta
- Post-graduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Mayara Schulz
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Taís T Silveira
- Post-graduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Marina V de Oliveira
- Department of Clinical Analyses, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | | | - Luciano V Gonzaga
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Roseane Fett
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Edson L da Silva
- Post-graduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil; Department of Clinical Analyses, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Elisabeth Wazlawik
- Post-graduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Nasif WA, Mukhtar MH, El-Emshaty HM, Alwazna AH. Redox State of Human Serum Albumin and Inflammatory Biomarkers in Hemodialysis Patients with Secondary Hyperparathyroidism During Oral Calcitriol Supplementation for Vitamin D. Open Med Chem J 2018; 12:98-110. [PMID: 30450134 PMCID: PMC6198414 DOI: 10.2174/1874104501812010098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/20/2018] [Accepted: 09/23/2018] [Indexed: 12/15/2022]
Abstract
Background: Hemodialysis (HD) patients with secondary Hyperparathyroidism (s-HPT) are exposed to increased inflammation and oxidative stress. In HD patients, oxidized albumin is a reliable marker of oxidative stress and its clinical significance has been rarely studied. Objective: The objective of this study was to evaluate Cys34 Human Serum Albumin (HSA) as oxidative stress biomarker in HD patients with s-HPT and its relationship with inflammation on bone turnover markers during oral calcitriol supplementation for vitamin D. Patients and Methods: Fifteen stable hemodialysis patients with s-HPT (mean age 48.67±8.15, 11 males and 4 females) were used in the experiment to receive calcitriol treatment for 16 weeks (0.25mcg or 0.5 mcg once a day according to serum level of Ca and P for each). The changes in the serum biochemical parameters (Ca, P, ALP, and iPTH), inflammatory markers (CRP and IL-6 levels) and serum oxidative stress condition (SOD, IS and albumin ratio HNA/HMA) were evaluated before and at 8 and 16 weeks of calcitriol treatment. The correlations between those factors were studied. Results: All patients responded to oral calcitriol therapy, with a significant decrease in the serum iPTH. The results showed that calcitriol could effectively suppress iPTH secretion with a significant elevation of serum Ca and P but ALP remained unchanged during the study. It can also effectively reduce the inflammatory markers (CRP and IL-6), while increasing the oxidative markers (SOD and IS). Oxidative albumin ratio HNA/HMA showed a significant (p=0.001) reduction after 16 weeks of calcitriol treatment and the redox state of HSA showed a positive prediction for hyperparathyroidism and for inflammation. Conclusion: The redox state of HSA could be used as a predictor for monitoring hyperparathyroidism and inflammation during calcitriol treatment by retarding albumin oxidation in HD patients with secondary hyperparathyroidism.
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Affiliation(s)
- Wesam A Nasif
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia.,Molecular Biology Department, Genetic Engineering and Biotechnology Research Institute, Sadat City University, Sadat City, Egypt
| | - Mohammed H Mukhtar
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Hoda M El-Emshaty
- Research Laboratories, Gastroenterology Surgical Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed H Alwazna
- Consultant Nephrologist, Nephrology Unit, Al-Rahma Hospital, Madinah, Saudi Arabia
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Duong TV, Wong TC, Chen HH, Chen TW, Chen TH, Hsu YH, Peng SJ, Kuo KL, Liu HC, Lin ET, Wang CS, Tseng IH, Feng YW, Chang TY, Su CT, Yang SH. Inadequate dietary energy intake associates with higher prevalence of metabolic syndrome in different groups of hemodialysis patients: a clinical observational study in multiple dialysis centers. BMC Nephrol 2018; 19:236. [PMID: 30231860 PMCID: PMC6145210 DOI: 10.1186/s12882-018-1041-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 09/10/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) has been established as a risk for cardiovascular diseases and mortality in hemodialysis patients. Energy intake (EI) is an important nutritional therapy for preventing MetS. We examined the association of self-reported dietary EI with metabolic abnormalities and MetS among hemodialysis patients. METHODS A cross-sectional study design was carried out from September 2013 to April 2017 in seven hemodialysis centers. Data were collected from 228 hemodialysis patients with acceptable EI report, 20 years old and above, underwent three hemodialysis sessions a week for at least past 3 months. Dietary EI was evaluated by a three-day dietary record, and confirmed by 24-h dietary recall. Body compositions were measured by bioelectrical impedance analysis. Biochemical data were analyzed using standard laboratory tests. The cut-off values of daily EI were 30 kcal/kg, and 35 kcal/kg for age ≥ 60 years and < 60 years, respectively. MetS was defined by the American Association of Clinical Endocrinologists (AACE-MetS), and Harmonizing Metabolic Syndrome (HMetS). Logistic regression models were utilized for examining the association between EI and MetS. Age, gender, physical activity, hemodialysis vintage, Charlson comorbidity index, high sensitive C-reactive protein, and interdialytic weight gains were adjusted in the multivariate analysis. RESULTS The prevalence of inadequate EI, AACE-MetS, and HMetS were 60.5%, 63.2%, and 53.9%, respectively. Inadequate EI was related to higher proportion of metabolic abnormalities and MetS (p < 0.05). Results of the multivariate analysis shows that inadequate EI was significantly linked with higher prevalence of impaired fasting glucose (OR = 2.42, p < 0.01), overweight/obese (OR = 6.70, p < 0.001), elevated waist circumference (OR = 8.17, p < 0.001), AACE-MetS (OR = 2.26, p < 0.01), and HMetS (OR = 3.52, p < 0.01). In subgroup anslysis, inadequate EI strongly associated with AACE-MetS in groups of non-hypertension (OR = 4.09, p = 0.004), and non-cardiovascular diseases (OR = 2.59, p = 0.012), and with HMetS in all sub-groups of hypertension (OR = 2.59~ 5.33, p < 0.05), diabetic group (OR = 8.33, p = 0.003), and non-cardiovascular diseases (OR = 3.79, p < 0.001). CONCLUSIONS Inadequate EI and MetS prevalence was high. Energy intake strongly determined MetS in different groups of hemodialysis patients.
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Affiliation(s)
- Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, No. 250 Wuxing Street, Taipei, 110, Taiwan
| | - Te-Chih Wong
- Department of Nutrition and Health Sciences, Chinese Culture University, Taipei, Taiwan
| | - Hsi-Hsien Chen
- Department of Nephrology, Taipei Medical University Hospital, Taipei, Taiwan
- School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzen-Wen Chen
- School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tso-Hsiao Chen
- School of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Nephrology, Taipei Medical University- Wan Fang Hospital, Taipei, Taiwan
| | - Yung-Ho Hsu
- School of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University- Shuang Ho Hospital, Taipei, Taiwan
| | - Sheng-Jeng Peng
- Division of Nephrology, Cathay General Hospital, Taipei, Taiwan
| | - Ko-Lin Kuo
- Division of Nephrology, Taipei Tzu-Chi Hospital, Taipei, Taiwan
| | - Hsiang-Chung Liu
- Department of Nephrology, Wei Gong Memorial Hospital, Miaoli, Taiwan
| | - En-Tzu Lin
- Department of Nephrology, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Chi-Sin Wang
- School of Nutrition and Health Sciences, Taipei Medical University, No. 250 Wuxing Street, Taipei, 110, Taiwan
| | - I-Hsin Tseng
- School of Nutrition and Health Sciences, Taipei Medical University, No. 250 Wuxing Street, Taipei, 110, Taiwan
| | - Yi-Wei Feng
- School of Nutrition and Health Sciences, Taipei Medical University, No. 250 Wuxing Street, Taipei, 110, Taiwan
| | - Tai-Yue Chang
- School of Nutrition and Health Sciences, Taipei Medical University, No. 250 Wuxing Street, Taipei, 110, Taiwan
| | - Chien-Tien Su
- School of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, Taipei Medical University, No. 250 Wuxing Street, Taipei, 110, Taiwan.
- Research Center of Geriatric Nutrition, Taipei Medical University, Taipei, Taiwan.
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Roumelioti ME, Steel JL, Yabes J, Vowles KE, Vodovotz Y, Beach S, Rollman B, Weisbord SD, Unruh ML, Jhamb M. Rationale and design of technology assisted stepped collaborative care intervention to improve patient-centered outcomes in hemodialysis patients (TĀCcare trial). Contemp Clin Trials 2018; 73:81-91. [PMID: 30208343 DOI: 10.1016/j.cct.2018.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/17/2018] [Accepted: 09/07/2018] [Indexed: 01/08/2023]
Abstract
Most hemodialysis (HD) patients experience symptoms of depression, pain and fatigue that impair their health-related quality of life (HRQOL) significantly. These symptoms are associated with increased hospitalization and mortality, mediated by behavioral factors (e.g. non-adherence to medication and dialysis) and biological factors (e.g. inflammatory cytokines). Prior interventions to alleviate symptoms and improve HRQOL showed limited effectiveness in HD patients and their effect on bio-behavioral mediators is lacking evidence. It is imperative to improve patient-centered dialysis care and to address call from Kidney Disease Improving Global Outcomes (KDIGO) guidelines for integration of symptom assessment and management in routine HD-care. Technology-Assisted stepped Collaborative Care (TĀCcare) is a multi-center randomized controlled trial (RCT) of 150 diverse HD patients from Pennsylvania and New Mexico, designed to compare the effectiveness of a 12-week stepped collaborative care intervention (cognitive behavioral therapy, CBT) with an attention control arm of technology-delivered health education. Collaborative care provides an integrated multi-disciplinary structured management plan. Furthermore, a stepped approach to pharmacotherapy and/or CBT allows for individualization of treatment according to patients' clinical status, preferences and treatment response. To simplify the delivery of CBT and to minimize patient and provider burden, we will use live video-conferencing with patients in dialysis units. We will examine the effect of these interventions on patient symptoms, HRQOL, treatment adherence and inflammatory biomarkers. This RCT tests a readily implementable intervention that can be integrated in routine HD-care and will generate novel and meaningful insights on strategies to alleviate common symptoms and improve HRQOL in HD.
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Affiliation(s)
- Maria-Eleni Roumelioti
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque, NM, United States
| | - Jennifer L Steel
- Department of Surgery, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jonathan Yabes
- Center for Research on Heath Care, Division of General Internal Medicine, Department of Medicine and Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kevin E Vowles
- Department of Psychology, University of New Mexico & Division of Physical Medicine and Rehabilitation, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Yoram Vodovotz
- Department of Immunology and Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Scott Beach
- Department of Psychology, University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bruce Rollman
- Department of Medicine, Psychiatry, Biomedical Informatics, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Steven D Weisbord
- Renal and Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Mark L Unruh
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque, NM, United States
| | - Manisha Jhamb
- Renal and Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
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Tanaka K, Salunya T, Motomiya Y, Motomiya Y, Oyama Y, Yamakuchi M, Maruyama I. Decreased Expression of Thrombomodulin in Endothelial Cells by Fibroblast Growth Factor-23/α-Klotho. Ther Apher Dial 2018; 21:395-404. [PMID: 28834363 DOI: 10.1111/1744-9987.12524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/13/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022]
Abstract
Chronic kidney disease (CKD) has been known to be a state of excessive fibroblast growth factor-23 (FGF23) and α-Klotho deficiency. Patients undergoing hemodialysis have an increased mortality risk associated with cardiovascular disease and endothelial dysfunction. The mechanism responsible for the relationship of FGF23 to endothelial damage in these patients has been unclear. On the other hands, increasing evidences have demonstrated that thrombomodulin (TM) plays an important role in the endothelial barrier. Here, we report the suppression of membrane TM, in a dose-dependent manner, in human umbilical vein endothelial cells after FGF23 and FGF23/α-Klotho stimulation. In addition, the levels of soluble TM, which reflect endothelial cell injury, were much higher in cell supernatants after FGF23 and FGF23/α-Klotho stimulation than in the control supernatant. This study indicates a possible mechanism by which excessive levels of FGF23 are involved in endothelial TM disruption, which has been implicated as a potential cardiovascular risk factor in patients with CKD, especially in HD patients.
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Affiliation(s)
| | - Tancharoen Salunya
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Thailand
| | | | | | - Yoko Oyama
- Department of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Munekazu Yamakuchi
- Department of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ikuro Maruyama
- Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Foroutan M, Rostami A, Majidiani H, Riahi SM, Khazaei S, Badri M, Yousefi E. A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran. Epidemiol Health 2018; 40:e2018016. [PMID: 29748456 PMCID: PMC6060338 DOI: 10.4178/epih.e2018016] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 04/23/2018] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of Toxoplasma gondii among patients undergoing hemodialysis in Iran. METHODS We searched English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusion criteria were applied. RESULTS A total of 10 studies containing 1,865 participants (1,048 patients and 817 controls) met the eligibility criteria. Immunoglobulin G (IgG) antibodies against T. gondii were found in 58% (95% confidence interval [CI], 46 to 70) of hemodialysis patients and 40% (95% CI, 31 to 50) of healthy controls, while immunoglobulin M (IgM) antibodies were found in 2% (95% CI, 0 to 6) of hemodialysis patients and 0% (95% CI, 0 to 1) of healthy controls. The meta-analysis showed that hemodialysis patients were significantly more likely to be seropositive for IgG (odds ratio [OR], 2.04; 95% CI, 1.54 to 2.70; p<0.001) and IgM (OR, 2.53; 95% CI, 1.23 to 5.22; p<0.001) antibodies against T. gondii infection than healthy individuals. CONCLUSIONS The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that periodic screenings for T. gondii infection should be incorporated into the routine clinical care of these patients.
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Affiliation(s)
- Masoud Foroutan
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hamidreza Majidiani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyed Mohammad Riahi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Sasan Khazaei
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Milad Badri
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Elham Yousefi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Hashemi J, Joshaghani HR, Akaberi A, Hesari Z, Ghanbari R, Mohammadzadeh M, Golshan AR. Potential Correlation Between Circulating Fetuin-A and Pentraxin-3 With Biochemical Parameters of Calcification in Hemodialysis Patients. Arch Iran Med 2017; 20:752-755. [PMID: 29664315] [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] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 11/15/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND The strong correlation between vascular calcification and cardiovascular risk, which is a major cause of mortality in hemodialysis (HD) patients, has been well established. Fetuin-A is an inhibitor of vascular calcification, and pentraxin 3 (PTX3) is produced at the site of inflammation, which is associated with cardiovascular disease (CVD). The main purpose of this study was evaluating the correlation between fetuin-A and PTX3 with some biochemical parameters effective upon vascular calcification in HD patients. METHODS We included 84 HD patients and 84 healthy controls matched for age, gender, and body mass index (BMI) in this study. Blood samples were drawn from all subjects and the serum levels of creatinine, urea, albumin, calcium (Ca), phosphorus (P), lowdensity lipoprotein cholesterol (LDL-C), parathyroid hormone, fetuin-A, high sensitive C-reactive protein, and PTX3 were measured by biochemical methods. RESULTS We found that the serum levels of PTX3, C-reactive protein (CRP), parathyroid hormone (PTH), Ca, and P in the patient group were significantly higher than the control group but the serum levels of fetuin-A and albumin were significantly lower in the patient group. Also, fetuin-A had a significant correlation with high sensitive CRP (hs-CRP) as well as duration of dialysis. In addition, it was shown that the correlation between PTX3 and PTH was significant only in the patient group. CONCLUSION In this study, increased PTX3 and decreased fetuin-A levels were observed in the HD patients. According to our results, these 2 parameters may potentially serve as suitable markers for inflammation and prediction of vascular complications in these patients.
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Affiliation(s)
- Javad Hashemi
- Emam Ali's Hospital, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | - Arash Akaberi
- Biostatistician, Department of Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Zahra Hesari
- Department of Clinical Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ghanbari
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Mohammadzadeh
- Emam Ali's Hospital, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Ali-Reza Golshan
- School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
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