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Wen-Hung Huang, Ching-Wei Hsu, Cheng-Hao Weng, Dan-Tzu Lin-Tan, Tzung-Hai Yen
The adverse effects of increased blood lead levels have been well discussed. Several antioxidant agents have been reported to offer protection from lead toxicity and to reduce blood lead levels (BLL). Given that erythropoietin (EPO) also has antioxidant properties, the aim of this cross-sectional study was to assess the role of EPO and other clinical variables on BLL in hemodialysis (HD) patients. We recruited 931 maintenance hemodialysis (MHD) patients who had undergone HD for at least 6 months and who had ever received blood lead level (BLL) study...
September 29, 2016: Scientific Reports
Vaidas Vicka, Laurynas Rimsevicius, Alvita Gincaite, Diana Sukackiene, Marius Miglinas
OBJECTIVE: Water balance and blood pressure (BP) alterations are strongly associated in haemodialysis (HD) patients. Aim of this study was to determine whether bioelectrical impedance analysis (BIA) parameters can be used as predictors of intradialytic hypotension (IDH). DESIGN AND METHOD: We conducted an observational study of chronic HD patients. BIA was measured before the HD procedure using InBody S10 (Biospace, Seoul, Korea) body composition analyzer. Intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/TBW ratio and phase angle (PhA) were selected as markers of hydration state and thus possible predictors of IDH...
September 2016: Journal of Hypertension
Kevin Damman, Serge Masson, Donata Lucci, Marco Gorini, Renato Urso, Aldo P Maggioni, Luigi Tavazzi, Luigi Tarantini, Gianni Tognoni, Adriaan Voors, Roberto Latini
BACKGROUND: Data on the natural change in renal function in patients with chronic heart failure (HF) is limited. METHODS AND RESULTS: Estimated glomerular filtration rate (eGFR) was assessed over 36 months in 6934 patients included in the GISSI-HF study. Association between baseline, changes in renal function and occurrence of Cardiovascular Death or HF hospitalization was assessed. Mean age was 67 years, mainly males (78%) and mean eGFR was 68 mL/min/1.73m(2). Change in eGFR in the first year was -1...
September 13, 2016: Journal of Cardiac Failure
V A Batrashov, É N Manafov
A native arteriovenous fistula is the most preferred type of a permanent vascular access (PVA) amongst the patients on programmed haemodialysis. Complications of vascular accesses leading to their lost with time would eventually and unavoidably result in exhaustion of the vascular recourses of the patient thus creating posing a problem while forming yet another PVA. Taking into consideration vitally important necessity of carrying out haemodialysis procedures for these patients, vascular surgeons have to search for alternative variants of access to the vascular bed...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Ariadna Pérez-Ricart, Maria Galicia-Basart, Maria Alcalde-Rodrigo, Alfons Segarra-Medrano, Josep-Maria Suñé-Negre, José-Bruno Montoro-Ronsano
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). METHODS: A retrospective observational study was conducted...
2016: PloS One
Agam D Patel, Mohammed Ibrahim, Rajesh V Swaminathan, Irfan U Minhas, Luke K Kim, Prashanth Venkatesh, Dmitriy N Feldman, Robert M Minutello, Geoffrey W Bergman, S Chiu Wong, Harsimran S Singh
OBJECTIVE: To examine peri-procedural and long-term outcomes in patients with chronic kidney disease (CKD) undergoing percutaneous coronary interventions (PCI). BACKGROUND: Patients with advanced CKD are considered high risk when undergoing PCI. Limited published data exist on quantifying risk and assessment of long-term outcomes after PCI in this group. METHODS: Examining the Cornell Coronary Registry, we prospectively collected data of 6,478 consecutive patients who underwent elective or urgent PCI between 2009 and 2013...
August 13, 2016: Catheterization and Cardiovascular Interventions
F Wei, N E A Drummen, A E Schutte, L Thijs, L Jacobs, T Petit, W Y Yang, W Smith, Z Y Zhang, Y M Gu, T Kuznetsova, P Verhamme, K Allegaert, R Schutte, E Lerut, P Evenepoel, C Vermeer, J A Staessen
OBJECTIVE: Vitamin K (VK) dependent carboxylation of matrix Gla protein (MGP) protects the macrocirculation against calcification. Whether glomerular filtration (GFR), a renal microvascular trait, is related to circulating desphospho-uncarboxylated MGP (dp-ucMGP) has not been explored before. We therefore investigated our hypothesis in our Flemish Study on Environment, Genes and Health Outcomes (FLEMENGHO) and sought replication in the South African Study Regarding the Influence of Sex, Age and Ethnicity on Insulin Sensitivity and Cardiovascular Function (SAfrEIC)...
September 2016: Journal of Hypertension
Holly Kramer, Jerry Yee, Daniel E Weiner, Vinod Bansal, Michael J Choi, Laura Brereton, Jeffrey S Berns, Milagros Samaniego-Picota, Paul Scheel, Michael Rocco
High hemodialysis ultrafiltration rate (UFR) is increasingly recognized as an important and modifiable risk factor for mortality among patients receiving maintenance hemodialysis. Recently, the Kidney Care Quality Alliance (KCQA) developed a UFR measure to assess dialysis unit care quality. The UFR measure was defined as UFR≥13mL/kg/h for patients with dialysis session length less than 240 minutes and was endorsed by the National Quality Forum as a quality measure in December 2015. Despite this, implementation of a UFR threshold remains controversial...
October 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Tuncay Sahutoglu, Ekrem Kara, Elbis Ahbap, Tamer Sakaci, Yener Koc, Taner Basturk, Mustafa Sevinc, Cuneyt Akgol, Zuhal Atan Ucar, Arzu Ozdemir Kayalar, Feyza Bayraktar Caglayan, Abdulkadir Unsal
BACKGROUND: The optimal delivered dialysis dose has been of a great interest for the last three decades, though a clear cut point has not been reached yet. We aimed to evaluate the relationship between one-year mortality and the delivered dialysis dose, which was recommended by Kidney Disease Outcomes Quality Initiative (KDOQI), in our maintenance hemodialysis (MHD) patients. METHODS: This was a single center, prospective observational study with one year of follow-up...
September 2016: Renal Failure
Sanjay Vikrant, Anupam Parashar
BACKGROUND: Disordered mineral metabolism is common complications of chronic kidney disease (CKD). However, there are limited data on the pattern of these disturbances in Indian CKD population. MATERIALS AND METHODS: This was a prospective observational study of CKD-mineral and bone disorder (CKD-MBD) over a period of 3 years. The biochemical markers of CKD-MBD, namely, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH), and 25-hydoxyvitamin Vitamin D3 (25OHD), were measured in newly diagnosed CKD Stage 3-5 and prevalent CKD Stage 5D adult patients...
July 2016: Indian Journal of Endocrinology and Metabolism
Chava L Ramspek, Hakan Nacak, Merel van Diepen, Marjolijn van Buren, Raymond T Krediet, Joris I Rotmans, Friedo W Dekker
BACKGROUND: Monitoring of renal function is important in patients with chronic kidney disease progressing towards end-stage renal failure, both for timing the start of renal replacement therapy and for determining the prognosis on dialysis. Thus far, studies on associations between estimated glomerular filtration rate (eGFR) measurements in the pre-dialysis stage and mortality on dialysis have shown no or even inverse relations, which may result from the poor validity of serum creatinine-based estimation equations for renal function in pre-dialysis patients...
June 16, 2016: Nephrology, Dialysis, Transplantation
Dayong Hu, Changbin Li, Liping Sun, Chunyu Zhou, Xinhua Li, Zisheng Ai, Jie Tang, Ai Peng
OBJECTIVE: With the growing need for reliable and durable upper arm hemodialysis access, we sought to compare the performance of a novel modified nontransposed brachiobasilic arteriovenous fistula (mNT-BBAVF) with that of the more traditional brachiocephalic arteriovenous fistula (BCAVF). METHODS: Briefly, to construct an mNT-BBAVF, an incision is made on the ulnar side of the elbow. The brachial artery and basilic vein are then isolated, and a side-to-side anastomosis is performed without transposition of the basilic vein...
October 2016: Journal of Vascular Surgery
José Luis Lepe-Zúñiga, Pedro Morales-Molina, Gabriela Alejandra García-Nandayapa
BACKGROUND: Patients with End Stage Renal Disease (ESRD), defined as those in Stage 5 of the Kidney Disease Outcome Quality Initiative (KDOQI) classification, have a number of acquired immune deficiencies secondary to the uremic stage, among them lymphopenia. In the present report, we retrospectively characterized the peripheral blood lymphocyte counts in a group of patients with ESRD and we related lymphopenia to their biochemical parameters and to the presence or absence of infections...
July 2016: Revista Médica del Instituto Mexicano del Seguro Social
Giovanni Montini, Alberto Edefonti, Yajaira Silva Galán, Mabel Sandoval Díaz, Marta Medina Manzanarez, Giuseppina Marra, Fabio Robusto, Gianni Tognoni, Fabio Sereni
BACKGROUND: The widely recognized clinical and epidemiological relevance of the socioeconomic determinants of health-disease conditions is expected to be specifically critical in terms of chronic diseases in fragile populations in low-income countries. However, in the literature, there is a substantial gap between the attention directed towards the medical components of these problems and the actual adoption of strategies aimed at providing solutions for the associated socioeconomic determinants, especially in pediatric populations...
2016: PloS One
Kaifeng Guo, Lei Zhang, Fangya Zhao, Junxi Lu, Pan Pan, Haoyong Yu, Yuqian Bao, Haibing Chen, Weiping Jia
AIMS: This cross-sectional study aimed to determine the prevalence and associated risk factors of chronic kidney disease (CKD) in Chinese type 2 diabetic patients. METHODS: A total of 3301 patients with type 2 diabetes were included in this study. Anthropometric parameters and biochemical indices were measured. The main outcome measures were detection of CKD, albuminuria and estimated glomerular filtration rate (eGFR). RESULTS: The prevalence of CKD and albuminuria in Shanghai Chinese type 2 diabetic patients was 27...
July 2016: Journal of Diabetes and its Complications
Somasundram Pillay, Colleen Aldous, Fazleh Mahomed
BACKGROUND: The combination of HIV infection and diabetes mellitus (DM) represents a collision of two chronic conditions. Both HIV and DM increase the risk of developing tuberculosis (TB). Health resources in developing countries are already under strain as a result of the TB epidemic and poor diabetic control would further worsen this epidemic. Optimal diabetic control provides one avenue of curbing the TB epidemic in developing countries. OBJECTIVES: To establish if there is a difference in blood pressure, lipid and glycaemic control and complications between HIV-infected and uninfected diabetic patients; and to compare characteristics among HIV-infected diabetic patients between those with optimal and sub- optimal glycaemic control...
April 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Fang-Fei Wei, Nadja E A Drummen, Aletta E Schutte, Lutgarde Thijs, Lotte Jacobs, Thibaut Petit, Wen-Yi Yang, Wayne Smith, Zhen-Yu Zhang, Yu-Mei Gu, Tatiana Kuznetsova, Peter Verhamme, Karel Allegaert, Rudolph Schutte, Evelyne Lerut, Pieter Evenepoel, Cees Vermeer, Jan A Staessen
BACKGROUND: Following activation by vitamin K (VK), matrix Gla protein (MGP) inhibits arterial calcification, but its role in preserving renal function remains unknown. METHODS: In 1166 white Flemish (mean age, 38.2 years) and 714 South Africans (49.2% black; 40.6 years), we correlated estimated glomerular filtration (eGFR [CKD-EPI formula]) and stage of chronic kidney disease (CKD [KDOQI stages 2-3]) with inactive desphospho-uncarboxylated MGP (dp-ucMGP), using multivariable linear and logistic regression...
February 2016: EBioMedicine
Jerry J Kim, Matthew Koopmann, Ezinne Ihenachor, Annie Zeng, Timothy Ryan, Christian deVirgilio
BACKGROUND: Routine upper extremity vein mapping by ultrasound (Ven-US) is recommended by current National Kidney Foundation/Kidney Disease Outcomes Quality Initiative guidelines before arteriovenous fistula (AVF) creation. However, the impact of concomitant arterial US (Art-US) examination is not clear. METHODS: The Ven-US protocol at our institution was modified to include Art-US starting January 2013. Therefore, retrospective review of patients who received Ven-US with Art-US between January 2013 and July 2014 was performed...
May 2016: Annals of Vascular Surgery
Jonathan Wong, Sivakumar Sridharan, Jocelyn Berdeprado, Enric Vilar, Adie Viljoen, David Wellsted, Ken Farrington
Residual kidney function (RKF) contributes significant solute clearance in hemodialysis patients. Kidney Diseases Outcomes Quality Initiative (KDOQI) guidelines suggest that hemodialysis dose can be safely reduced in those with residual urea clearance (KRU) of 2 ml/min/1.73 m(2) or more. However, serial measurement of RKF is cumbersome and requires regular interdialytic urine collections. Simpler methods for assessing RKF are needed. β-trace protein (βTP) and β2-microglobulin (β2M) have been proposed as alternative markers of RKF...
May 2016: Kidney International
Ljubica Djukanović, Nada Dimković, Jelena Marinković, Živka Djurić, Violeta Knežević, Tatjana Lazarević, Stanimir Ljubenović, Rodoljub Marković, Violeta Rabrenović
BACKGROUND: Increased mortality of hemodialysis (HD) patients is associated with chronic kidney disease-mineral and bone disorders (CKD-MBD), and therefore, their correction may improve patient survival. Differences in targets recommended by KDOQI and KDIGO CKD-MBD guidelines directed us to compare the relative numbers of patients achieving these targets and to examine possible associations between compliance with the targets and patient outcome. METHODS: A total of 1,744 patients (61...
2016: Nephron
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