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Dialysis. Hypertension

Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Tahereh Sabaghian, Bahareh Hajibaratali, Shiva Samavat
AIM: Bio-impedance analysis (BIA) is a preferred method for estimating the volume status. However, it cannot be utilized in daily practice. Since the assessment of the volume status is important and challenging for hemodialysis (HD) patients, the aim of study was to determine the volume status in chronic HD patients using echocardiographic parameters and assess its correlation with BIA. METHODS: In this cross-sectional analysis, echocardiography and BIA were performed on 30 chronic HD patients 30 min before and 30 min after dialysis...
October 20, 2016: Renal Failure
Naro Ohashi, Shinsuke Isobe, Sayaka Ishigaki, Takahisa Suzuki, Masafumi Ono, Tomoyuki Fujikura, Takayuki Tsuji, Akihiko Kato, Seiichiro Ozono, Hideo Yasuda
Circulating renin-angiotensin system (RAS) activation is maintained after renal function has deteriorated. The activation of the intrarenal RAS plays a critical role in the pathophysiology of chronic kidney disease (CKD), independently of the circulating RAS. However, the activation of intrarenal RAS and the chymase-dependent pathway after initiation of dialysis has not been clarified. We recruited 19 CKD patients (10 without dialysis and 9 with dialysis) who underwent a heminephrectomy. Circulating RAS was investigated before nephrectomy...
October 20, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Masato Nishimura, Toshiko Tokoro, Satoru Yamazaki, Tetsuya Hashimoto, Hiroyuki Kobayashi, Toshihiko Ono
BACKGROUND: We examined the prevalence, prognosis, and effect of endothelin receptor antagonists on survival in end-stage kidney disease patients with idiopathic pre-capillary pulmonary hypertension. METHODS: We investigated 1988 end-stage kidney disease patients in Toujinkai Hospital from January 1, 2001 to December 31, 2014. Pulmonary hypertension was screened by symptoms (dyspnea, hypotension, or near syncope) and echocardiography, and diagnosed by computed tomography with enhancement, pulmonary flow scintigraphy, and right heart catheterization...
October 19, 2016: Clinical and Experimental Nephrology
Joo Hoon Lee, Jae Suk Baek, Jeong Jin Yu, Young-Hwue Kim, Jae-Kon Ko, Young Seo Park
OBJECTIVE: To evaluate the relationship between B-type natriuretic peptide (BNP) and cardiac parameters on echocardiography. DESIGN AND METHOD: Echocardiography was checked at 6 months ∼ 1 year interval in children with end-stage renal disease on peritoneal dialysis, which was more frequently done in patients with hypertension or any heart problems. We reviewed blood pressure (BP) and echocardiographic findings of those children (since February 2005). Data were presented as mean ± standard deviation (median, minimum ∼ maximum)...
September 2016: Journal of Hypertension
George Bakris
Resistant hypertension is defined as a blood pressure above 140/90 mmHg despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease (CKD) is one of the more common patient comorbidities associated with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. CKD is associated with premature vascular ageing, characterized by accelerated arteriosclerosis or atherosclerosis and endothelial dysfunction...
September 2016: Journal of Hypertension
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
Effiong Ekong Akpan, Udeme Ekpenyong Ekrikpo, Aniema Isaac Assam Udo
The prevalence of chronic kidney disease (CKD) is increasing the world over, and it is now regarded as a public health problem. The prevalence of CKD in Nigeria remained largely unknown with hospital-based data of 2-8%. However, emerging community studies show a prevalence of 10-26.8%. This study was conducted during the 2013 world kidney day activities in Uyo, Akwa Ibom, State of Nigeria, with an estimated population of 554,906 people. Sensitizations of members of the public were ensured through the media...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Shatha Hussain Ali, Salman Hussain Assi, Fadhil S Hussien
Hypertension (HTN) is one of the most common sequelae of chronic kidney disease (CKD) in children. Dialysis-related HTN is predominantly caused by chronic volume overload, and as such the blood pressure (BP) can be reduced and/or brought down to normal in a sizable number of patients with improved salt and fluid balance. This study was conducted to assess the prevalence of HTN among children on hemodialysis (HD) and to evaluate the correlation of HTN with some demographic data. This is a prospective study performed on forty pediatric patients with CKD receiving maintenance HD in three centers in Baghdad...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
J C Araújo, R W D S Barbosa, M F Machado, P S Furtado, C M D Pugas, J S D A Filho, C F Lopes, R J C Mattoso, C L Neves
BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment...
September 2016: Transplantation Proceedings
Dorota Sikorska, Krzysztof Pawlaczyk, Anna Olewicz-Gawlik, Natasza Czepulis, Bartlomiej Posnik, Ewa Baum, Maria Wanic-Kossowska, Bengt Lindholm, Andrzej Oko
BACKGROUND: Peritoneal dialysis (PD) patients with preserved residual diuresis have a lower risk of death and complications. Here we analyzed associations between residual diuresis and presence of fluid overload and biomarkers of cardiac strain and nutrition in PD patients. METHODS: Among 44 PD patients placed into three subgroups, depending on volume of residual diuresis (group A ≤ 500; group B 600-1900; and group C ≥ 2000 mL/day), we examined: overhydration (OH) assessed by bioimpedance analysis (BIA; yielding OH index OHBIA) and by clinical criteria (edema and hypertension); nutritional status (by subjective global assessment, SGA); metabolic status (electrolytes, serum lipid profile, CRP, and albumin); biomarkers of fluid overload and cardiac strain (N-terminal probrain natriuretic peptide, NT-proBNP, and troponin T, TnT); and, echocardiography and chest X-ray...
October 12, 2016: International Urology and Nephrology
Cheng Wang, Zengchun Ye, Yan Li, Jun Zhang, Qunzi Zhang, Xinxin Ma, Hui Peng, Tanqi Lou
The "reverse dipping" blood pressure (BP) pattern has been studied among the general population and in individuals suffering from hypertension. However, the prognosis of this pattern in chronic kidney disease (CKD) patients is not known. We monitored BP throughout the day and followed health outcomes in 588 CKD patients admitted to our hospital. Time to all-cause mortality, cardiovascular mortality, renal events and cardiovascular events was recorded. Multivariate-adjusted Cox regression analyses were carried out to detect the prognostic value of a reverse dipping BP pattern...
October 7, 2016: Scientific Reports
Narges Sadat Zahed, Omid Gharooi, Latif Gachkar, Hajar Nikbakht
INTRODUCTION: Hypertension is one of the traditional risk factors of cardiovascular disease (CVD). Extra cellular volume expansion and Na retention remain the main cause of hypertension. OBJECTIVES: The aim of this study was to investigate the relation between concentration of Na dialysate and blood pressure (BP) in chronic hemodialysis (HD) patient. PATIENTS AND METHODS: This cross-sectional study was performed on 266 adult patients undergoing HD for at least three months...
2016: Journal of Renal Injury Prevention
Khalil Ghoussoub, Bernard Ghanem, Dania Nehme Chelala, Serge Finianos, Hiba Azar, Zakhia Naoum, Kassem Bdeiri
OBJECTIVE: The purpose of the study is to identify factors that may influence the functional limitations of hemodialysis patients and analyze their level of physical activity. MATERIAL/PATIENTS AND METHODS: Cross-sectional descriptive study, for adult patients on chronic hemodialysis in the Hôtel-Dieu de France Hospital. A 32-item questionnaire explores the personal data, etiology of renal failure, associated defects, technical data of hemodialysis and seniority, the current seat and pain...
September 2016: Annals of Physical and Rehabilitation Medicine
Hannelore Sprenger-Mähr, Emanuel Zitt, Karl Lhotta
INTRODUCTION: The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. METHODS: We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015...
2016: PloS One
M S Rita de Cássia Mattos, Helton P Lemes, Sebastião R Ferreira-Filho
PURPOSE: To determine the association between arterial systolic blood pressure values at the beginning and at the end of a hemodialysis (HD) session in intradialytic hypertension patients. METHODS: This study evaluated the arterial systolic blood pressure patterns in 154 chronic kidney failure patients; among these patients, 18 were identified as having intradialytic hypertension. In the patients with intradialytic hypertension, four consecutive HD sessions were analyzed in which the systolic, diastolic, mean, and pulse blood pressures were automatically determined every 30 min...
September 26, 2016: International Urology and Nephrology
Panagiotis I Georgianos, Rajiv Agarwal
Contrary to the direct, graded, and causal relationship of hypertension with cardiovascular outcomes in the general population, among dialysis patients, blood pressure (BP) recorded either predialysis or postdialysis displays a U-shaped curve with mortality. This paradoxical phenomenon of lower BP or a decline in BP over time being associated with increased mortality and higher BP being associated with a lower mortality is described as "reverse" epidemiology of hypertension, raising substantial controversy on whether BP lowering causes harms or benefits among dialysis patients...
September 22, 2016: American Journal of Hypertension
Ramez R Hanna, Nicholas Kolanko, Carlos Torres
History A 70-year-old woman presented to a peripheral hospital with signs and symptoms of acute chronic obstructive pulmonary disease (COPD) exacerbation. The patient also reported acute on chronic onset of thoracolumbar back pain over a period of 24 hours. She denied any history of recent trauma or intravenous drug use. She did not have any long-term indwelling catheters. The patient's medical history was also complicated by stage 4 renal failure from long-standing type II diabetes, hypertension, iron deficiency anemia, aortic stenosis, and prior bariatric surgery...
October 2016: Radiology
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
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