共查询到20条相似文献，搜索用时 15 毫秒
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Krzysztof Letachowicz Katarzyna Madziarska Waldemar Letachowicz Magdalena Krajewska Józef Penar Mariusz Kusztal Tomasz Gołębiowski Wacław Weyde Marian Klinger 《Hemodialysis international. International Symposium on Home Hemodialysis》2016,20(2):E12-E14
Chronic hemodialysis is implemented when irreversible loss of kidney function occurs. Sometimes renal recovery is overlooked. From January 2005 to December 2014, we identified 28 patients hemodialyzed for more than 3 months who had renal replacement therapy discontinued. The group consisted of 17 (57.7%) males and 11 (42.3%) females. Patients were 18–87 years old. Time of hemodialysis ranged from 3 to 97 months. Of note, 14 (50%) patients were referred from local dialysis units for solution of vascular access problems. In 13 (46.2%) patients dialysis was abandoned within the first 6 months, in 5 (17.8%) patients between 6 and 12 months, and in 10 (35.7%) patients beyond 12 months. Estimated dialysis‐free survival was 94.4% (SE 0.054) and 82% (SE 0.095) at 12 and 24 months, respectively. All physicians must be aware of possible kidney function improvement. In patients with preserved diuresis fall in periodical urea or creatinine measurements might be a sign of renal recovery. 相似文献
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Shinichiro Morishita Atsuhiro Tsubaki Nobuyuki Shirai 《Hemodialysis international. International Symposium on Home Hemodialysis》2017,21(4):483-489
Previous studies have shown that exercise improves aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health‐related quality of life (QOL) in patients with chronic kidney disease (CKD) and dialysis. Recently, additional studies have shown that higher physical activity contributes to survival and decreased mortality as well as physical function and QOL in patients with CKD and dialysis. Herein, we review the evidence that physical function and physical activity play an important role in mortality for patients with CKD and dialysis. During November 2016, Medline and Web of Science databases were searched for published English medical reports (without a time limit) using the terms “CKD” or “dialysis” and “mortality” in conjunction with “exercise capacity,” “muscle strength,” “activities of daily living (ADL),” “physical activity,” and “exercise.” Numerous studies suggest that higher exercise capacity, muscle strength, ADL, and physical activity contribute to lower mortality in patients with CKD and dialysis. Physical function is associated with mortality in patients with CKD and dialysis. Increasing physical function may decrease the mortality rate of patients with CKD and dialysis. Physicians and medical staff should recognize the importance of physical function in CKD and dialysis. In addition, exercise is associated with reduced mortality among patients with CKD and dialysis. 相似文献
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Adalbert Schiller Mugurel Apetrii Mihai Onofriescu Dimitrie Siriopol Gabriel Veisa Oana Schiller Flaviu Bob Romulus Timar Adelina Mihaescu Mehmet Kanbay Adrian Covic 《Hemodialysis international. International Symposium on Home Hemodialysis》2015,19(2):249-255
Vitamin D deficiency is still a common problem particularly in the elderly and in individuals with various degrees of renal impairment. The present study aimed to evaluate the association between plasma concentrations of 25(OH)D and death in a large cohort of prevalent patients on hemodialysis (HD) from south‐east Romania, a typical Balkan region. This is an observational prospective study that included a total of 570 patients on maintenance HD. Study patients were classified into three groups by baseline 25(OH)D levels: (1) sufficient 25(OH)D—i.e., >30 ng/mL; (2) insufficient 25(OH)D—i.e., between 10 and 29 ng/mL; and (3) deficient 25(OH)D—i.e., <10 ng/mL. During the follow‐up period of 14 months, 68 patients (11.9%) died, the Kaplan–Meier analysis showing significant differences in all‐cause mortality for chronic kidney disease patients in different 25(OH)D groups (P = 0.002). Unadjusted Cox regression analysis also showed significant differences in survival. The multivariate Cox regression model showed no significant differences in survival according to vitamin D levels. Hazard ratio for death in the “<10 ng/mL” group was 1.619 (P = 0.190) and in the “10–30 ng/mL” group was 0.837 (P = 0.609). In our dialysis population with a high comorbidity burden, low 25(OH)D concentration was not associated with mortality in the adjusted Cox model, suggesting that vitamin D deficiency could represent only a non‐specific marker for a poor health status, with less impact on mortality. 相似文献
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Tatsuhiko Furuhashi Masao Moroi Nobuhiko Joki Hiroki Hase Megumi Minakawa Hirofumi Masai Taeko Kunimasa Hiroshi Fukuda Kaoru Sugi 《Hemodialysis international. International Symposium on Home Hemodialysis》2013,17(4):568-575
Cardiovascular prognosis in patients under normal stress myocardial perfusion images (MPI) is generally excellent. However, this is not true for patients with chronic kidney disease (CKD) treated by hemodialysis. This study evaluated prognostic factors of adverse cardiovascular events in hemodialysis patients in whom stress MPI was performed. Pharmacological stress MPI was performed in 88 hemodialysis patients, and we retrospectively followed‐up for 26 months. Cardiovascular events included cardiac death, nonfatal myocardial infarction, and unstable angina. Cardiovascular events occurred in 16 patients (18%). Univariate Cox regression analysis revealed that peripheral artery disease (PAD) and parameters of stress MPI were significant predictors of cardiovascular events. Multivariate Cox regression analysis revealed that only PAD (hazard ratio = 6.54; P = 0.002), and abnormal stress MPI (hazard ratio = 8.26; P = 0.008) were independent and significant predictors of cardiovascular events. Kaplan–Meier analysis showed better prognosis in patients with normal stress MPI than in patients with abnormal stress MPI (P < 0.001, log–rank test). However, in patients with normal stress MPI, cardiovascular events occurred in 10 of the 76 patients (13%). Among patients with normal stress MPI, Kaplan–Meier analysis showed that patients with no PAD had better prognosis than patients with PAD (P = 0.001, log–rank test). In hemodialysis patients, both PAD and stress MPI were powerful cardiovascular predictors. Normal stress MPI alone cannot guarantee good prognosis in terms of cardiovascular events. Consideration of PAD may improve the predictive value of stress MPI in some patients. 相似文献
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Yeo‐Jin Kang Eun Jin Bae Jong Woo Seo Dae‐Hong Jeon Hyun Seop Cho Hyun‐Jung Kim Se‐Ho Chang Dong Jun Park 《Hemodialysis international. International Symposium on Home Hemodialysis》2013,17(1):111-115
We report on two additional cases of metformin‐associated encephalopathy in patients with end‐stage renal disease (ESRD) undergoing hemodialysis. Two patients were seen at our hospital with abnormal neurological signs and symptoms. Magnetic resonance imaging (MRI) revealed the same pattern of high signal intensity in both basal ganglia in T2‐weighted images in the two patients. The two patients had started taking metformin 5 and 6 weeks earlier at the same dose of 1000 mg per day. Metformin was immediately stopped, and regular hemodialysis was conducted. Their signs and symptoms resolved completely after these measures. The high signal intensity in both ganglia in T2‐weighted MRI also disappeared. We should suspect metformin‐induced encephalopathy and withdraw the drug when presented with diabetic patients with chronic kidney disease and neurological signs and symptoms of unknown cause. 相似文献
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Vanitha Gnanasoundran Edwin Fernando M Senthil Kumar Raj Kumar Thiruma Valavan Chandra Mohan Noor Mohammed Srinivasa Prasad 《Hemodialysis international. International Symposium on Home Hemodialysis》2014,18(4):835-838
Chryseobacterium meningosepticum is an uncommon human pathogen, which is an inhabitant of soil and water. It should be included in the list of suspected nosocomial infections, especially in patients with immunocompromised status. C. meningosepticum infections are not common but are clinically important because the organism is naturally resistant to multiple antibiotics. We report a case where the bacterium was isolated from the pleural fluid from a chronic kidney disease patient on hemodialysis, who developed pneumonia with complicated parapneumonic effusion. To the best of our knowedge, this is the first case where C. meningosepticum is isolated from the pleural effusion, from India. 相似文献
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Shaji Sajmi Kamalakannan Goutham Venkatesh Arumugam Natarajan Gopalakrishnan Tanuj Moses Lamech Dhanapalan Aiswarya Ravindran Krishna Paulpandian Vathsalyan Badri Srinivasan Kannan Dolphin Solomon Govindasamy Nithya Bhagavatula V. R. H. Sastry Ramanathan Sakthirajan 《Hemodialysis international. International Symposium on Home Hemodialysis》2021,25(4):515-522
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Yuki Tsuruta Kan Kikuchi Yukio Tsuruta Yuko Sasaki Takahito Moriyama Mitsuyo Itabashi Takashi Takei Keiko Uchida Takashi Akiba Ken Tsuchiya Kosaku Nitta 《Hemodialysis international. International Symposium on Home Hemodialysis》2015,19(4):514-520
Endothelial dysfunction is often found in both hyperuricemia and hemodialysis patients. Recent studies have shown that treating hyperuricemia with allopurinol improves endothelial dysfunction. This study is performed to assess the effect of febuxostat on endothelial dysfunction in hemodialysis patients with hyperuricemia. We randomly assigned 53 hemodialysis patients with hyperuricemia to a febuxostat (10 mg daily) group and a control group and measured flow‐mediated dilation, serum uric acid (UA) levels, systolic and diastolic blood pressure, malondialdehyde‐modified low‐density lipoprotein (MDA‐LDL), and highly sensitive C‐reactive protein (hsCRP) at baseline and at the end of a 4‐week study period. Flow‐mediated dilation increased from 5.3% ± 2.4% to 8.9% ± 3.6% in the febuxostat group but did not change significantly in the control group. Treatment with febuxostat resulted in a significant decrease in serum UA level and a significant decrease in MDA‐LDL compared with baseline, but no significant difference was observed in hsCRP level or blood pressure. No significant differences were observed in the control group. Febuxostat improved endothelial dysfunction and reduced serum UA levels and oxidative stress in hemodialysis patients with hyperuricemia. 相似文献
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Periklis Dousdampanis Konstantina Trigka Costas Fourtounas 《Hemodialysis international. International Symposium on Home Hemodialysis》2014,18(4):730-739
Magnesium is as an essential metal implicated in numerous physiological functions of human cells. The kidney plays a crucial role in magnesium homeostasis. In advanced chronic kidney disease, serum magnesium levels are increased. Data from experimental and observational studies suggest that low levels of magnesium are associated with several factors, such as insulin resistance, diabetes, oxidative stress, hypertension, atherosclerosis, and inflammation which are implicated in the progression of chronic kidney disease. Moreover, low levels of magnesium have been correlated with cardiovascular disease and all‐cause mortality in end‐stage renal disease patients. Hypomagnesemia has also been associated with poorer renal allograft and transplant recipients' outcomes. The causality of these relationships has not been completely elucidated. A thorough review of the current literature indicates that low magnesium levels in dialysis patients may reflect a poorer nutritional status and/or are the result of systemic inflammation. Further studies in chronic kidney disease and dialysis patients are needed in order to clarify the causality of these associations. 相似文献
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Ashish K. Sharma Nigel D. Toussaint Janice Pickering Tony Beeston Edward R. Smith Stephen G. Holt 《Hemodialysis international. International Symposium on Home Hemodialysis》2015,19(2):256-262
Plasma aluminum (Al) is routinely tested in many dialysis patients. Aluminum exposure may lead to acute toxicity and levels in excess of ∼2.2 μmol/L (60 μg/L) should be avoided. Historically, toxicity has been caused by excessive dialyzate Al but modern reverse osmosis (RO) water should be Al free. Nevertheless, many units continue to perform routine Al levels on dialysis patients. This single‐center study retrospectively analyzed Al levels in plasma, raw water feed, and RO product between 2010 and 2013 using our database (Nephworks 6) with the aim of determining the utility of these measurements. Two thousand fifty‐eight plasma Al tests in 755 patients (61.9% male, mean age 64.7 years) were reviewed showing mean ± SD of 0.41 ± 0.30 μmol/L. One hundred eleven (5.4%) tests from 61 patients had Al levels >0.74 μmol/L and 45 (73.8%) of these patients were or had been prescribed Al hydroxide (Al(OH)3) as a phosphate binder. Seven patients had Al concentrations >2.2 μmol/L with no source of Al identified in 1 patient. One hundred sixty‐six patients taking Al(OH)3 (78.7% of all patients on Al(OH)3) had levels ≤0.74 μmol/L, the odds ratio of plasma Al > 0.74 μmol/L on Al(OH)3 was 9. The cost of plasma Al assay is $A30.60; thus, costs were $A62,974.80 over the study period. Despite RO feed water Al levels as high as 48 μmol/L, Al output from the RO was almost always undetectable (<0.1 μmol/L) with dialyzate Al levels > 2.2 μmol/L only 3 times since 2010, and never in the last 3 years. Routine unselected testing of plasma Al appears unnecessary and expensive and more selective testing in dialysis patients should be considered. 相似文献
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Rui‐Xin Wu Chun‐Chi Chen Chih‐Hung Wang Hsin‐Chien Chen 《Hemodialysis international. International Symposium on Home Hemodialysis》2014,18(1):195-199
Sudden sensorineural hearing loss (SSNHL) is being described with increasing incidence among patients with end‐stage renal disease (ESRD) undergoing hemodialysis (HD). There are no widely accepted guidelines in the medical literature for the appropriate management of this medical emergency. Administration of systemic steroids remains the mainstay of the management of SSNHL in conjunction with the supportive treatment, in this vulnerable group of patients, as well. However, encouraged by the evolving evidence on the efficacy of the intratympanic steroid injections (ITSI) in the treatment of SSNHL among patients without renal disease—we successfully treated SSNHL in an elderly diabetic with sepsis due to bilateral pneumonitis undergoing regular HD treatment with multiple ITSI and antibiotics resulting in complete recovery of hearing function within 3 months of onset of the first symptoms. 相似文献
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Tian Xie Ziliang Yang Guanyu Dai Kaixiao Yan Yuan Tian Dan Zhao Huawei Zou Fei Deng Xiaolei Chen Quan Yuan 《Hemodialysis international. International Symposium on Home Hemodialysis》2014,18(3):668-673
Chronic kidney disease has become a worldwide public health problem, and it negatively affects oral health. However, the data of the hemodialysis (HD) patients in Chinese population is unknown. This study was aimed to evaluate the dental health status and oral hygiene behavior of the HD patients in China. Patients undergoing HD therapy at two hospitals were asked to finish a questionnaire and receive dental examination (DMF‐T). A total of 306 patients, aged 24–88 (58.09 ± 14.06), took part in this study. Although majority of the patients (77.78%) brushed their teeth at least twice a day, few (less than 5%) had ever used dental floss or mouthwash. More than half of the patients have not visited a dentist since the commencement of HD therapy. The dental examination showed that DMF‐T was 9.63 ± 7.54, and the number of filled teeth (F‐T) was only 0.70 ± 1.48. Moreover, the average caries restoration ratio and replacement index were 17.57% and 32.59%, respectively. HD therapy seems to prevent patients from visiting a dentist, and there is a great need for dental treatment for Chinese HD patients. 相似文献
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Julie Ann Kemp Marta Esgalhado Renata Azevedo Macedo Bruna Regis Ngila Raquel Teixeira Damasceno Elizabeth Aparecida Ferraz da Silva Torres Gustavo Henrique Ferreira Gonalinho Natlia Alvarenga Borges Lia Sumie Nakao Denis Fouque Denise Mafra 《Hemodialysis international. International Symposium on Home Hemodialysis》2019,23(2):189-197
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Hyperphosphatemia among end‐stage renal disease patients in developing countries: A forgotten issue?
Afifi A El-Sayed H El-Setouhi M Ahmed H Khalifa N 《Hemodialysis international. International Symposium on Home Hemodialysis》2005,9(4):409-415
The prevalence of hyperphosphatemia and increased calcium-phosphorus product has never been evaluated in a large multicenter study in a developing country. Our aim is to study the prevalence of hyperphosphatemia in 38 HD centers in Egypt (as an example of a developing country) and to correlate it with different co-morbid conditions and the patient's demographic data. This is a cross-sectional study conducted on 1005 chronic kidney disease stage 5 patients (CKD-stage 5) on HD for a period of more than 1 year in 38 dialysis centers in Egypt. All patients were receiving calcium-based salts as a phosphate binder. Hyperphosphatemia and increased calcium-phosphorus product were evaluated and correlated with different parameters including age, sex, knowledge by diet parameters, HD session duration, the frequency of HD per week, the type of dialysis membrane, the surface area of the dialyzer, dialyzer phosphorus clearance (phosphorus KoA), and the type of dialysate. Other co-morbid medical conditions and evidence of IHD were also investigated. Hyperphosphatemia was present in 69.1% of cases and a high calcium-phosphorus product was present in 30.2%. A higher calcium-phosphorus product was found among males. 83.2% of those with a poor knowledge by diet parameters had hyperphosphatemia compared with 67.6% in patients with a satisfactory knowledge by diet parameters. 72.3% of patients using a membrane with low-to-medium clearance had hyperphosphatemia, compared with 67.2% using a membrane with a high clearance. Seventy-two percent of patients with IHD were hyperphosphatemic compared with 67.6% of the non-ischemic patients. Hyperphosphatemia is a major problem in dialysis patients in developing countries, reflecting differences from developed countries regarding dietary habits, ethnic factors, dialysis quality, types of dialysis membranes, as well as economic factors hampering the use of the more expensive phosphate binders. Extended dialysis hours may be a good alternative solution in developing countries. 相似文献
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Beatriz B. M. Bambini Rosa M. A. Moyss Luci C. D. Batista Brunelle B. S. S. Coelho Sergio Tufik Rosilene M. Elias Fernando M. Coelho 《Hemodialysis international. International Symposium on Home Hemodialysis》2019,23(4):445-448
Introduction: Restless legs syndrome (RLS) is a highly prevalent sleep movement disorder usually accompanied by periodic limb movements of sleep (PLMS). The incidence of RLS and PLMS in patients with end‐stage renal disease (ESRD) on dialysis is much higher. Clinically, RLS and PLMS can co‐occur. We hypothesized that patients with ESRD on dialysis would have a distinct presentation of RLS, with a higher prevalence of PLMS. Methods: We examined clinical, demographic, biochemical, and polysomnographic characteristics of RLS in patients on dialysis matched to control subjects with normal renal function based on age, sex, body mass index, and frequency of apneas and hypopneas per hour of sleep, defined by the apnea and hypopnea index (AHI), in a proportion of 3:1. Patients with ESRD were on hemodialysis three times per week. Polysomnography was performed overnight in the sleep laboratory. Findings: Patients on dialysis compared to control subjects had a lower amount of N3 sleep (77.6 ± 39.9 minutes vs. 94.8 ± 33.7 minutes, p = 0.037) and REM sleep (55.6 ± 27.5 minutes vs. 74.1 ± 28.4 minutes, p = 0.006), regardless of the presence of RLS. Among the patients on dialysis, those with RLS had higher PLMS. In the control group, patients with RLS had a lower ferritin level, which was not observed in the dialysis group. There was a significant interaction between PLMS and ESRD (p = 0.001), with a higher prevalence of PLMS in patients with ESRD on dialysis in a model adjusted for AHI, sex, arousals, and age. Factors that were associated with PLMS were RLS (p = 0.003), ESRD (p = 0.0001), and AHI (p = 0.041), with an adjusted R2 of 0.321. Conclusion: RLS in patients with ESRD on dialysis is independently associated with PLMS, regardless of the severity of sleep apnea, arousals, and age. 相似文献