1,721,065 research outputs found
Sleep disorders in hemodialyzed patients - The role of comorbidities
No full textSleep disorders are very frequent in hemodialyzed patients, but the relationship between these disorders and water withdrawal, urea removal and comorbidities has not been sufficiently clarified. The study comprised a group of 88 patients in good nutritional condition, with target hemoglobin concentration, good control of blood pressure and optimal dry weight. After answering a questionnaire (SDQ) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) patients were assigned to one of 3 groups: those with no disturbances (no. 20), those with subclinical disorders (n. 35) and insomniacs (n. 33). Yearly fluid and urea withdrawal by dialysis and the Charlson Comorbity Index were measured. Sleep disorders were observed in 77.27% of the patients. There was no difference in body fluid and urea withdrawal between groups. In the group of patients with no sleeping disturbances, the Charlson Comorbidity Index was significantly lower (p < 0.001) than in patients with subclinical disorders or insomnia and emerged as a strongly associated with sleep disturbances. The study also attributes a predictive role to age, dialytic age, dialysis shift, antihypertensive drugs. The data indicate that, in evaluating sleeping disorders in patients on maintenance hemodialysis, comorbidities should be assessed
A systematic evaluation of bioelectrical impedance measurement after hemodialysis session.
No full textABSTRACT
BACKGROUND: There is still no definitive indication about the ideal point of time to perform bioimpedance analysis (BIA) in hemodialysis patients. Furthermore, the interpretation of data in this regard is difficult because there is still no comprehensive information about the fluctuations in BIA variables occurring in these subjects. The aim of this study was to assess BIA changes occurring in hemodialysis and specifically in the dry-weight state.
METHODS: We studied 27 anuric patients (20 males and 7 females; age 56.1 +/- 13.7 years) on chronic hemodialysis. Single-frequency BIA (R, resistance; Xc, reactance; and PhA, phase angle) was performed (1) before and at the end of hemodialysis (dialysis period); (2) 15, 30, 60, 90, and 120 minutes after hemodialysis (postdialysis period); and (3) 24, 48, and 68 hours after hemodialysis (interdialysis period).
RESULTS: Body weight decreased by 2.8 +/- 0.8 kg during hemodialysis, was unchanged during the postdialysis period, and progressively rose during the interdialysis period. At the same time, BIA variables significantly increased during hemodialysis (R, 453 +/- 74 and 542 +/- 98 ohm; Xc, 38 +/- 10 and 53 +/- 16 ohm; P < 0.05), remained stable over the 120-minute period after treatment (R, 538 +/- 94, 539 +/- 95, 538 +/- 94, 541 +/- 95, and 544 +/- 95 ohm; and Xc, 53 +/- 15, 53 +/- 15, 51 +/- 16, 52 +/- 16, and 52 +/- 16 ohm; NS), and subsequently declined [R, 471 +/- 79 (P= <0.05 vs. postdialysis), 449 +/- 71 (P= <0.05 vs. postdialysis), 424 +/- 68 (P= <0.05 vs. postdialysis) ohm; Xc, 42 +/- 13 (P= <0.05 vs. postdialysis), 37 +/- 10 (P= <0.05 vs. postdialysis), 34 +/- 13 (P= <0.05 vs. postdialysis) ohm]. The stability of BIA measures during postdialysis was confirmed by the constant relationship found between R/height and Xc/height. Also PhA increased after dialysis (4.8 +/- 1.1 degrees vs. 5.7 +/- 1.3 degrees, P < 0.05), was unchanged during the following 120 minutes and decreased in the interdialysis period (5.1 +/- 1.3 degrees, 4.8 +/- 1.0 degrees, and 4.5 +/- 1.1 degrees, P < 0.05). At the end of hemodialysis and during the postdialysis period total body water (TBW) estimated from BIA was similar on average to TBW calculated using Watson formulas (37.2 +/- 6.3 L vs. 36.2 +/- 5.7 L, NS). On the contrary, when patients were hyperhydrated BIA significantly overestimated the Watson's values.
CONCLUSION: In hemodialysis patients BIA variables fluctuate to a considerable extent (with the highest values immediately after hemodialysis), but remain constant and highly reproducible over the 120 minutes after the end of hemodialysis, that is, in a dry-weight state. Thus, taking into consideration that the point in time chosen for performing BIA is crucial to properly assess body composition, BIA can be appropriately performed at anytime during the postdialysis period, provided that hydration status does not change due to food or drink consumption
Inhibition of the Renin-Angiotensin System in HIV nephropathy
No full textIt is estimated that 1-2 % of patients starting dialysis suffers from kidney disease associated with HIV infection. HIV-associated nephropathy ( HIVAN ) develops in about 10% of people living with HIV , with different preference for Blacks and Hispanics . Since the beginning of large-scale use of antiretroviral therapy (ART), the HIVAN has been characterized by a rapid decline in renal function , with progression to ESRD ( End - Stage Renal Disease ). Aside from HIV direct damage to the nephron, numerous experimental observations support the argument that the agiotensina II contributes to the podocytes damage. Treatment with ACE - inhibitors (ACE - Is) , as well as the one with angiotensin receptor blockers ( ARBs), may attenuate the decline in renal function in HIVAN . However, clinical data on the effects of these antihypertensive agents in HIV-infected individuals are still scarce and doubts have yet to be adequately addressed. In the following, we analyze the studies that have investigated the use of ACE -Is and ARBs in the treatment of hypertension and albuminuria in patients with HIVAN
Charlson Comorbidity Index is a predictor of outcomes in incident hemodialysis patients and correlates with phase angle and hospitalization.
No full textThe prediction of single-frequency BIA variables from individual characteristics.
No full textABSTRACT
To define whether reference values for bioimpedance analysis (BIA) can be predicted in healthy individuals, individual characteristics and BIA variables resistance index=height(2)/parallel resistance and reactance index=height(2)/parallel reactance) were evaluated in non-obese healthy individuals:863 men and 769 women with an age range 20-70 years and body mass index (BMI)19.0-29.9 kg/m(2). The following predictive equations were obtained using multiple regression analysis:Resistance index (cm(2)/ohm)Males 21.06 + 0.087xage + 1.091xweight -1.801xBMI,Females 20.35 + 0.037xage + 0.878xweight - 1.343xBMIReactance index (cm(2)/ohm)Males 0.57 + 0.117xweight - 0.096xBMIFemales 1.42 + 0.078xweight - 0.075xBMI. In conclusion, reference BIA values seem to be reasonably predicted based on individual characteristics
A prospective, multicenter, randomized, controlled study: the correction of metabolic acidosis with use of bicarbonate in chronic renal insufficiency (UBI) Study. J Nephrol 2011 Aug 23.0. doi: 10.5301/jn.5000014. Epub ahead of print
No full textPrevalence and correlates of anemia and uncontrolled anemia in chronic hemodialysis patients--the Campania Dialysis Registry
No full textEpidemiologia dell'escrezione renale del calcio in età pediatrica. Dati di uno studio di popolazione a Cimitile.
No full textInflammation and oxidative stress in chronic kidney disease—potential therapeutic role of minerals, vitamins and plant-derived metabolites
No full textChronic kidney disease (CKD) is a debilitating pathology with various causal factors, culminating in end stage renal disease (ESRD) requiring dialysis or kidney transplantation. The progression of CKD is closely associated with systemic inflammation and oxidative stress, which are responsible for the manifestation of numerous complications such as malnutrition, atherosclerosis, coronary artery calcification, heart failure, anemia and mineral and bone disorders, as well as enhanced cardiovascular mortality. In addition to conventional therapy with antiinflammatory and antioxidative agents, growing evidence has indicated that certain minerals, vitamins and plant-derived metabolites exhibit beneficial effects in these disturbances. In the current work, we review the anti-inflammatory and antioxidant properties of various agents which could be of potential benefit in CKD/ESRD. However, the related studies were limited due to small sample sizes and short-term follow‐up in many trials. Therefore, studies of several anti‐inflammatory and antioxidant agents with long-term follow-ups are necessary
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