<strong>Objective:</strong> To evaluate the correlation between residual renal function and hypertension in regular haemodialysis patients. <strong>Background:</strong> Initiating chronic dialy...<strong>Objective:</strong> To evaluate the correlation between residual renal function and hypertension in regular haemodialysis patients. <strong>Background:</strong> Initiating chronic dialysis treatment gives end-stage renal disease patients a new lease on life. However, the annual mortality rate in dialysis patients is ~20% and quality of life is substantially reduced. <strong>Patients and Methods:</strong> This study was carried out on a reasonable number of subjects on regular haemodialysis divided into two groups. All were given informed consent and, the study was approved by the ethics committee of Menoufia University. <strong>Results:</strong> There was significant relation between presence of residual renal function and hypertension in patients with ESRD on regular haemodialysis, but the relation between residual renal function and control of hypertension is not statistically significant. 40% of group 1 were hypertensive, 66.7% of group 2 patients were hypertensive, the interdialytic weight gain mean was 1.42 in group 1 and 2.37 in group 2. Control of hypertension was achieved in 63.6% of group 1 patients by one drug, 27.3% patients by 2 drugs;however 9.1% of patients need 3 drugs to control their blood pressure, while in group 2 40% of patients were controlled by one drug, 45% with 2 drugs and 15% need 3 drugs to control blood pressure. <strong>Conclusion:</strong> There is significant relation between presence of residual renal function and hypertension in patients with ESRD on regular haemodialysis, but the relation between residual renal function and control of hypertension is not statistically significant.展开更多
<strong>Objectives:</strong> To elucidate the role of lung ultrasound in assessment of subclinical fluid overload in hemodialysis (HD) patients. <strong>Background:</strong> Volume overload has...<strong>Objectives:</strong> To elucidate the role of lung ultrasound in assessment of subclinical fluid overload in hemodialysis (HD) patients. <strong>Background:</strong> Volume overload has a significant role in HD patients with difficult blood pressure control. The clinical evaluation of fluid status is challenging and has poor diagnostic accuracy. Extravascular lung water (ELW) represents an important element of body fluid volume. Lung ultrasound (LUS) is increasingly used for ELW assessment through the analysis of B-lines artifacts. <strong>Methods:</strong> Eighty-eight HD patients were followed up prospectively. Patients were divided into 3 groups according to the changes of systolic blood pressure (SBP) during HD sessions. Group (1): patients with intra-dialytic hypertension (n = 12), group (2): patients with intra-dialytic hypotension (n = 28) and group (3): patients with no significant blood pressure variabilities (n = 48). Numbers of B-lines were measured by LUS and IVC diameters were measured pre and post-dialysis. In addition, Endothelin-1 (ET-1) and other routine laboratory tests were done. <strong>Results:</strong> There were significant increases in the number of B-lines and IVC diameter pre and post-dialysis in group (1) compared to the other two groups. There was significant decrease in post dialysis IVC diameter but not the number of B-lines in group (2) compared with the other two groups. ET-1 level was significantly increased in group 1 compared to the other two groups. There was a statistically significant positive correlation between the pre-dialysis number of B-lines and ET-1. <strong>Conclusion:</strong> Lung ultrasound can be considered a sensitive and specific modality for volume assessment in HD patients especially with intra-dialytic hypertension. We recommend serial LUS as a part of management in this group of patients.展开更多
<strong>Introduction:</strong> Nx stage one machine results can help to enhance the clinical efficiency and shortage concerning the use of home hemodialysis. Therefore, the study investigates effectiveness...<strong>Introduction:</strong> Nx stage one machine results can help to enhance the clinical efficiency and shortage concerning the use of home hemodialysis. Therefore, the study investigates effectiveness of Nx stage machine for intermittent conventional hemodialysis in hospital for inpatients and outpatients to replace conventional hemodialysis in stable chronic hemodialysis patients. <strong>Methods:</strong> Prospective observatory study was conducted in Nephrology Division, King Fahd General Hospital from April 1 to June 1 2018. Patients with ESRD, who were dependent on dialysis and maintained on regular hemodialysis were recruited. Fifty-two sessions of hemodialysis were performed. The patients were given intermittent dialysis using Nx stage one machine. Pre and Post dialysis investigations and body weight were taken, and patients were observed for any complications during or post-dialysis. <strong>Findings:</strong> The primary endpoint ultrafiltration with a goal to remove 1 - 4 kg was achieved without any technical difficulty. Secondary endpoint for potassium reduction levels was achieved with mean SD post-dialysis 3.53 ± 0.3, and the tertiary endpoint was achieved in a patient less than 50 kg weight with spKt/V above 1.2. It was difficult to achieve spKt/V in patients with weight more than 60 kg due to limitations in the duration of sessions or dialysate volume. Target spkT/V was achieved for patients with body weight less than 50 kg;however, it was not achieved among the patients with body weight more than 60 kg. <strong>Discussion:</strong> Nx stage one machine can replace conventional intermittent dialysis in terms of ultrafiltration and Potassium correction;however, further investigation is needed for urea clearance.展开更多
<strong>Background:</strong> Chronic kidney disease (CKD) is a worldwide public health alarming problem. Although both heart and kidneys are separated by a quite distance within the body and they perform v...<strong>Background:</strong> Chronic kidney disease (CKD) is a worldwide public health alarming problem. Although both heart and kidneys are separated by a quite distance within the body and they perform varied functions, there is a close physiological relationship between them. The diseases in the kidneys can trigger a disease in the heart and vice versa. High blood pressure is the most significant risk factor for the development and progression of chronic kidney disease (CKD). Lowering blood pressure is a goal to prevent CKD progress. Chronic abnormalities in cardiac function (e.g., chronic congestive heart failure) causing, chronic kidney disease and anemia appear to act together in a vicious circle in which each condition causes or exacerbates the other progressive chronic kidney disease. <strong>Objective:</strong> To assess the prevalence of chronic kidney disease in patients with cardiovascular disease at Shebin El-Kom Teaching Hospital and Menoufia University Hospital Cardiology Outpatient Clinic, Menoufia Governorate, Egypt. <strong>Methods:</strong> This is a cross-sectional study that was conducted in Shebin El-Kom Teaching Hospital Cardiology Outpatient Clinic, Menoufia University Cardiology Outpatient Clinic from April 2019 to July 2019. This study included 200 patients with cardiovascular disease or hypertension for more than 6 months. All patients were subjected to detailed history taking, clinical examination, laboratory investigation, echo and abdominal ultrasound. <strong>Results:</strong> This study included 200 patients with cardiovascular disease or hypertension for more than 6 months, which showed that: 63 (31.5%) were diagnosed as chronic kidney disease, 24 (38%) known to be CKD, 39 (62%) not known diagnosed in our study. Uncontrolled hypertension, congestive heart failure, diuretics and ACEI or ARBS with diuretics together are significant risk factors for renal impairment;uncontrolled hypertension and diuretics are the most predictors for renal impairment. <strong>Conclusion:</strong> Unco展开更多
Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian p...Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, <i>p</i> < 0.001), of increasing age (OR = 0.12 CI 95%: 0.07_0.19, <i>p</i> < 0.001), low education (OR = 1.08, CI 95%: 1.04_1.11, <i>p</i> < 0.001) and the patient did not undergo kidney transplant (OR = 4.19 CI 95%: 1.12_15.62, <i>p</i> = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.展开更多
<strong>Introduction:</strong> Haemodialysis is the most well-established form of treatment for ESRD. <strong>Method:</strong> To evaluate the implementation of standard criteria in heamodialys...<strong>Introduction:</strong> Haemodialysis is the most well-established form of treatment for ESRD. <strong>Method:</strong> To evaluate the implementation of standard criteria in heamodialysis water treatment units in Sharkia governorate and to determine the weak points in application of standard criteria, and reach the optimal standards to improve pt. outcomes, across the sectional study was conducted at 30 heamodialysis units of Sharkia governorate, using a modified questionnaire was developed based on MOH protocol and international guidelines such as CARI guidelines, AAMI guidelines and others by the researchers. All data were collected, tabulated and statistically analyzed using SPSS 22.0 for windows (SPSS Inc., Chicago, IL, USA). <strong>Results:</strong> Of the 30 units, the majority more than 80% of the units achieved the infrastructure and schematic structure, contain water purification devices, good infection control policies, proper chemical disinfection, good monitoring and quality control, accepted maintenance technician evaluation and collected processed water samples results matched decree of 63 for 1996. <strong>Conclusion:</strong> Most of the studied units nearly fulfilled the standard specifications of both MOH and AAMI. Ensuring that water quality meets AAMI standards and recommendations will minimize patient exposure to potential contaminants such as chemical hazards and endotoxemia associated with the use of the treated water for HD.展开更多
<strong>Objectives:</strong> To estimate the prevalence of chronic kidney disease (CKD) in first and second degree relatives of Hemodialysis patients. <strong>Background:</strong> Early detecti...<strong>Objectives:</strong> To estimate the prevalence of chronic kidney disease (CKD) in first and second degree relatives of Hemodialysis patients. <strong>Background:</strong> Early detection and intervention of chronic kidney disease (CKD) may prevent or delay the progression and achieve improved patient outcomes. Family members of end-stage renal disease (ESRD) patients are considered as a high-risk population for CKD. The aim of this work is to screen and estimate the prevalence of chronic kidney disease in first and second degree relatives of hemodialysis patients. <strong>Methods:</strong> This is an observational prospective study carried out in Nephrology Unit, Internal Medicine Department, Menoufia University Hospital during January 2019 to January 2020. First and second degree relatives of ESRD were included. Relatives with known CKD risk factors or relative to ESRD with known hereditary disease were excluded. Serum creatinine and estimated eGFR, albumin creatinine ratio (ACR) and abdominal ultrasound were done twice with 3 months apart to screen for CKD. <strong>Results:</strong> 321 persons from first and second degree relatives of chronic hemodialysis patients were included. CKD prevalence was 5.6% Comparison between CKD group and non CKD showed no statistically significant difference as regard age, Gender, Smoking, BMI, and degree of relatives. There were highly significant difference between the studied groups as regard serum creatinine, bloodurea, eGFR and ACR. Relatives of ESRD patients of unknown etiology showed highly significant difference to develop CKD (44.4%) compared to non CKD group 11.5% with P value < 0.0001. <strong>Conclusions:</strong> Prevalence of CKD in relatives—without any CKD risk factors—to ESRD was 5.6%. Family members of ESRD should be screened for CKD, especially relatives to ESRD of unknown etiology.展开更多
<strong>Background:</strong> The prevalence of both cardiovascular mortality and vascular calcification is much higher in patients with chronic kidney disease (CKD) than in the general population so early ...<strong>Background:</strong> The prevalence of both cardiovascular mortality and vascular calcification is much higher in patients with chronic kidney disease (CKD) than in the general population so early detection and intervention of VC may prevent or delay the progression and achieve improved patient outcomes. <strong>Objectives:</strong> To detect different predictors of vascular calcification in haemodialysis patients. <strong>Methods:</strong> This was a cross sectional observational study that included 85 patients with end stage renal disease (ESRD) on regular dialysis 47 males and 38 females ranged between 18 and 80 years old selected from Nephrology Unit, Internal Medicine Department, Menoufia University Hospital from April 2019 to May 2020. Serum calcium, phosphorus, alkhaline phosphatase, intact PTH, serum Matrix GLA protein, vitamin D and non-contrast CT for calcium scoring of femoral arteries were performed. <strong>Results:</strong> There was a significant correlation between age of the patient by years (p value 0.0001), serum calcium (p value 0.0001), phosphate (0.0001), calcium phosphate products (p value 0.0001) and alkhaline phosphatase (0.0001), and vascular calcification score detected by non-contrast CT on femoral arteries and negative correlation between serum Matrix GLA protein p value 0.0001) and the detected calcification score;the lower the MGP level the higher calcification score while there was no correlation between body mass index (BMI) (p value 0.021) intact PTH (p value 0.117), serum vitamin D level (p value 0.643), serum albumin (p value 0.643), serum haemoglobin (p value 0.257) and duration of dialysis (p value 0.260) and the detected score. Serum phosphate and calcium phosphorus product are independent risk factors for vascular calcification severity in haemodialysis patients. <strong>Conclusions:</strong> serum phosphate, calcium phosphate products are risk factors for vascular calcification while intact PTH vitamin D has no significant role in developing vascular calcification 展开更多
<b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The aim of the work is to study the relationship between Red blood cell ...<b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The aim of the work is to study the relationship between Red blood cell osmotic fragility and level of parathyroid hormone in patients with different stages of Chronic Kidney Disease including End Stage Renal Disease. </span><b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Anaemia is one of the common complications associated with Chronic Kidney Disease (CKD) responsible for the increase in the morbidity and mortality in such patients. Several factors have been attributed to caus</span><span style="font-family:Verdana;">ing</span><span style="font-family:Verdana;"> renal anaemia, amongst which hyperparathyroidism is one of the less recognised reasons. The level of PTH in early stages of chronic kidney disease has not been much studied. The excess amount of Parathyroid Hormone (PTH) secondary to CKD has been suggested to be a causative factor for anaemia. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">A</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">number of chronic kidney disease patients were studied for the relationship between Red cell osmotic fragility and level of parathyroid hormone.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> This study was conducted on a number of 111 patients with chronic kidney disease classified into three groups. The study revealed a significant fall in Hb%, along with a rise in Median Osmotic Fragility (MOF) and PTH in the CKD patients. iPTH and MOF were significantly lower in group 3 as compared with cases in group 1. Also, iPTH and MOF were significantly lower in cases in group 2 as compared with cases in group 1. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> 展开更多
文摘<strong>Objective:</strong> To evaluate the correlation between residual renal function and hypertension in regular haemodialysis patients. <strong>Background:</strong> Initiating chronic dialysis treatment gives end-stage renal disease patients a new lease on life. However, the annual mortality rate in dialysis patients is ~20% and quality of life is substantially reduced. <strong>Patients and Methods:</strong> This study was carried out on a reasonable number of subjects on regular haemodialysis divided into two groups. All were given informed consent and, the study was approved by the ethics committee of Menoufia University. <strong>Results:</strong> There was significant relation between presence of residual renal function and hypertension in patients with ESRD on regular haemodialysis, but the relation between residual renal function and control of hypertension is not statistically significant. 40% of group 1 were hypertensive, 66.7% of group 2 patients were hypertensive, the interdialytic weight gain mean was 1.42 in group 1 and 2.37 in group 2. Control of hypertension was achieved in 63.6% of group 1 patients by one drug, 27.3% patients by 2 drugs;however 9.1% of patients need 3 drugs to control their blood pressure, while in group 2 40% of patients were controlled by one drug, 45% with 2 drugs and 15% need 3 drugs to control blood pressure. <strong>Conclusion:</strong> There is significant relation between presence of residual renal function and hypertension in patients with ESRD on regular haemodialysis, but the relation between residual renal function and control of hypertension is not statistically significant.
文摘<strong>Objectives:</strong> To elucidate the role of lung ultrasound in assessment of subclinical fluid overload in hemodialysis (HD) patients. <strong>Background:</strong> Volume overload has a significant role in HD patients with difficult blood pressure control. The clinical evaluation of fluid status is challenging and has poor diagnostic accuracy. Extravascular lung water (ELW) represents an important element of body fluid volume. Lung ultrasound (LUS) is increasingly used for ELW assessment through the analysis of B-lines artifacts. <strong>Methods:</strong> Eighty-eight HD patients were followed up prospectively. Patients were divided into 3 groups according to the changes of systolic blood pressure (SBP) during HD sessions. Group (1): patients with intra-dialytic hypertension (n = 12), group (2): patients with intra-dialytic hypotension (n = 28) and group (3): patients with no significant blood pressure variabilities (n = 48). Numbers of B-lines were measured by LUS and IVC diameters were measured pre and post-dialysis. In addition, Endothelin-1 (ET-1) and other routine laboratory tests were done. <strong>Results:</strong> There were significant increases in the number of B-lines and IVC diameter pre and post-dialysis in group (1) compared to the other two groups. There was significant decrease in post dialysis IVC diameter but not the number of B-lines in group (2) compared with the other two groups. ET-1 level was significantly increased in group 1 compared to the other two groups. There was a statistically significant positive correlation between the pre-dialysis number of B-lines and ET-1. <strong>Conclusion:</strong> Lung ultrasound can be considered a sensitive and specific modality for volume assessment in HD patients especially with intra-dialytic hypertension. We recommend serial LUS as a part of management in this group of patients.
文摘<strong>Introduction:</strong> Nx stage one machine results can help to enhance the clinical efficiency and shortage concerning the use of home hemodialysis. Therefore, the study investigates effectiveness of Nx stage machine for intermittent conventional hemodialysis in hospital for inpatients and outpatients to replace conventional hemodialysis in stable chronic hemodialysis patients. <strong>Methods:</strong> Prospective observatory study was conducted in Nephrology Division, King Fahd General Hospital from April 1 to June 1 2018. Patients with ESRD, who were dependent on dialysis and maintained on regular hemodialysis were recruited. Fifty-two sessions of hemodialysis were performed. The patients were given intermittent dialysis using Nx stage one machine. Pre and Post dialysis investigations and body weight were taken, and patients were observed for any complications during or post-dialysis. <strong>Findings:</strong> The primary endpoint ultrafiltration with a goal to remove 1 - 4 kg was achieved without any technical difficulty. Secondary endpoint for potassium reduction levels was achieved with mean SD post-dialysis 3.53 ± 0.3, and the tertiary endpoint was achieved in a patient less than 50 kg weight with spKt/V above 1.2. It was difficult to achieve spKt/V in patients with weight more than 60 kg due to limitations in the duration of sessions or dialysate volume. Target spkT/V was achieved for patients with body weight less than 50 kg;however, it was not achieved among the patients with body weight more than 60 kg. <strong>Discussion:</strong> Nx stage one machine can replace conventional intermittent dialysis in terms of ultrafiltration and Potassium correction;however, further investigation is needed for urea clearance.
文摘<strong>Background:</strong> Chronic kidney disease (CKD) is a worldwide public health alarming problem. Although both heart and kidneys are separated by a quite distance within the body and they perform varied functions, there is a close physiological relationship between them. The diseases in the kidneys can trigger a disease in the heart and vice versa. High blood pressure is the most significant risk factor for the development and progression of chronic kidney disease (CKD). Lowering blood pressure is a goal to prevent CKD progress. Chronic abnormalities in cardiac function (e.g., chronic congestive heart failure) causing, chronic kidney disease and anemia appear to act together in a vicious circle in which each condition causes or exacerbates the other progressive chronic kidney disease. <strong>Objective:</strong> To assess the prevalence of chronic kidney disease in patients with cardiovascular disease at Shebin El-Kom Teaching Hospital and Menoufia University Hospital Cardiology Outpatient Clinic, Menoufia Governorate, Egypt. <strong>Methods:</strong> This is a cross-sectional study that was conducted in Shebin El-Kom Teaching Hospital Cardiology Outpatient Clinic, Menoufia University Cardiology Outpatient Clinic from April 2019 to July 2019. This study included 200 patients with cardiovascular disease or hypertension for more than 6 months. All patients were subjected to detailed history taking, clinical examination, laboratory investigation, echo and abdominal ultrasound. <strong>Results:</strong> This study included 200 patients with cardiovascular disease or hypertension for more than 6 months, which showed that: 63 (31.5%) were diagnosed as chronic kidney disease, 24 (38%) known to be CKD, 39 (62%) not known diagnosed in our study. Uncontrolled hypertension, congestive heart failure, diuretics and ACEI or ARBS with diuretics together are significant risk factors for renal impairment;uncontrolled hypertension and diuretics are the most predictors for renal impairment. <strong>Conclusion:</strong> Unco
文摘Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, <i>p</i> < 0.001), of increasing age (OR = 0.12 CI 95%: 0.07_0.19, <i>p</i> < 0.001), low education (OR = 1.08, CI 95%: 1.04_1.11, <i>p</i> < 0.001) and the patient did not undergo kidney transplant (OR = 4.19 CI 95%: 1.12_15.62, <i>p</i> = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.
文摘<strong>Introduction:</strong> Haemodialysis is the most well-established form of treatment for ESRD. <strong>Method:</strong> To evaluate the implementation of standard criteria in heamodialysis water treatment units in Sharkia governorate and to determine the weak points in application of standard criteria, and reach the optimal standards to improve pt. outcomes, across the sectional study was conducted at 30 heamodialysis units of Sharkia governorate, using a modified questionnaire was developed based on MOH protocol and international guidelines such as CARI guidelines, AAMI guidelines and others by the researchers. All data were collected, tabulated and statistically analyzed using SPSS 22.0 for windows (SPSS Inc., Chicago, IL, USA). <strong>Results:</strong> Of the 30 units, the majority more than 80% of the units achieved the infrastructure and schematic structure, contain water purification devices, good infection control policies, proper chemical disinfection, good monitoring and quality control, accepted maintenance technician evaluation and collected processed water samples results matched decree of 63 for 1996. <strong>Conclusion:</strong> Most of the studied units nearly fulfilled the standard specifications of both MOH and AAMI. Ensuring that water quality meets AAMI standards and recommendations will minimize patient exposure to potential contaminants such as chemical hazards and endotoxemia associated with the use of the treated water for HD.
文摘<strong>Objectives:</strong> To estimate the prevalence of chronic kidney disease (CKD) in first and second degree relatives of Hemodialysis patients. <strong>Background:</strong> Early detection and intervention of chronic kidney disease (CKD) may prevent or delay the progression and achieve improved patient outcomes. Family members of end-stage renal disease (ESRD) patients are considered as a high-risk population for CKD. The aim of this work is to screen and estimate the prevalence of chronic kidney disease in first and second degree relatives of hemodialysis patients. <strong>Methods:</strong> This is an observational prospective study carried out in Nephrology Unit, Internal Medicine Department, Menoufia University Hospital during January 2019 to January 2020. First and second degree relatives of ESRD were included. Relatives with known CKD risk factors or relative to ESRD with known hereditary disease were excluded. Serum creatinine and estimated eGFR, albumin creatinine ratio (ACR) and abdominal ultrasound were done twice with 3 months apart to screen for CKD. <strong>Results:</strong> 321 persons from first and second degree relatives of chronic hemodialysis patients were included. CKD prevalence was 5.6% Comparison between CKD group and non CKD showed no statistically significant difference as regard age, Gender, Smoking, BMI, and degree of relatives. There were highly significant difference between the studied groups as regard serum creatinine, bloodurea, eGFR and ACR. Relatives of ESRD patients of unknown etiology showed highly significant difference to develop CKD (44.4%) compared to non CKD group 11.5% with P value < 0.0001. <strong>Conclusions:</strong> Prevalence of CKD in relatives—without any CKD risk factors—to ESRD was 5.6%. Family members of ESRD should be screened for CKD, especially relatives to ESRD of unknown etiology.
文摘<strong>Background:</strong> The prevalence of both cardiovascular mortality and vascular calcification is much higher in patients with chronic kidney disease (CKD) than in the general population so early detection and intervention of VC may prevent or delay the progression and achieve improved patient outcomes. <strong>Objectives:</strong> To detect different predictors of vascular calcification in haemodialysis patients. <strong>Methods:</strong> This was a cross sectional observational study that included 85 patients with end stage renal disease (ESRD) on regular dialysis 47 males and 38 females ranged between 18 and 80 years old selected from Nephrology Unit, Internal Medicine Department, Menoufia University Hospital from April 2019 to May 2020. Serum calcium, phosphorus, alkhaline phosphatase, intact PTH, serum Matrix GLA protein, vitamin D and non-contrast CT for calcium scoring of femoral arteries were performed. <strong>Results:</strong> There was a significant correlation between age of the patient by years (p value 0.0001), serum calcium (p value 0.0001), phosphate (0.0001), calcium phosphate products (p value 0.0001) and alkhaline phosphatase (0.0001), and vascular calcification score detected by non-contrast CT on femoral arteries and negative correlation between serum Matrix GLA protein p value 0.0001) and the detected calcification score;the lower the MGP level the higher calcification score while there was no correlation between body mass index (BMI) (p value 0.021) intact PTH (p value 0.117), serum vitamin D level (p value 0.643), serum albumin (p value 0.643), serum haemoglobin (p value 0.257) and duration of dialysis (p value 0.260) and the detected score. Serum phosphate and calcium phosphorus product are independent risk factors for vascular calcification severity in haemodialysis patients. <strong>Conclusions:</strong> serum phosphate, calcium phosphate products are risk factors for vascular calcification while intact PTH vitamin D has no significant role in developing vascular calcification
文摘<b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The aim of the work is to study the relationship between Red blood cell osmotic fragility and level of parathyroid hormone in patients with different stages of Chronic Kidney Disease including End Stage Renal Disease. </span><b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Anaemia is one of the common complications associated with Chronic Kidney Disease (CKD) responsible for the increase in the morbidity and mortality in such patients. Several factors have been attributed to caus</span><span style="font-family:Verdana;">ing</span><span style="font-family:Verdana;"> renal anaemia, amongst which hyperparathyroidism is one of the less recognised reasons. The level of PTH in early stages of chronic kidney disease has not been much studied. The excess amount of Parathyroid Hormone (PTH) secondary to CKD has been suggested to be a causative factor for anaemia. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">A</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">number of chronic kidney disease patients were studied for the relationship between Red cell osmotic fragility and level of parathyroid hormone.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> This study was conducted on a number of 111 patients with chronic kidney disease classified into three groups. The study revealed a significant fall in Hb%, along with a rise in Median Osmotic Fragility (MOF) and PTH in the CKD patients. iPTH and MOF were significantly lower in group 3 as compared with cases in group 1. Also, iPTH and MOF were significantly lower in cases in group 2 as compared with cases in group 1. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;">
