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Introduction

We performed a descriptive, retrospective study of 99 patients with stage iiib-iv chronic kidney disease (CKD) receiving calcium plus vitamin D for secondary hyperparathyroidism (SHPT).

Objectives

The main aim of this study was to evaluate reductions in microalbuminuria and proteinuria as a pleiotropic effect of treatment. A secondary aim was to analyze whether renal function, PTH values, and calcium x phosphorus product reached values recommended by guidelines.

Results

We included 99 patients with a mean age 74.8±10 years (60% women and 40% men). The most frequent cause of CKD was nephrosclerosis in 35% of the patients, unknown in 25%, chronic interstitial kidney disease in 22%, diabetes in 15%, and congenital causes in 2%. A total of 50% were receiving angiotensin converting-enzyme inhibitors, 59% were receiving angiotensin receptor blockers, and 10% direct renin inhibitors. Diabetes was present in 34% and hypertension in 92%.

The mean duration of treatment was 430.85 days. The mean changes from baseline values to those at the end of the study were as follows: creatine phosphate: from 2.151 to 2.27 (P=.005); 24-hour urinary creatinine clearance corrected for body surface area: from 33±17 ml/min/1.70 m to 32 ml/min (NS): estimated glomerular filtration rate based on the modification of diet in renal disease (MDRD) formula: from 7: 28.7 ml/min to 28.1 ml/min (NS); creatinine clearance estimated by the Cockroft-Gault formula: from 29 to 28 ml/min (NS); microalbuminuria: from 352.4 to 318.3 mg/day (NS); proteinuria: from 0.63 to 0.62 (NS); and albumin/creatinine ratio: from 651±1.3 to 615±1.1 mg/g (NS).

In diabetic patients, values were as follows: microalbuminuria: from 542 to 432 mg/day (P<.037); proteinuria: from 1 to 0,8 g/24 h (P<.044); corrected calcium: from 9.5 to 9.6 (P<.004); phosphorus levels: from 3.5±0.5 to 3.6±0.6 (NS); PTH levels: from 187 to 143 pg/ml (P<.0001). Calcium × phosphorus product was 33 34.5 mg²/dl² (NS).

Conclusion

Calcium and vitamin D supplementation in patients with stage iiib-iv CKD in addition to effective control of SHPT in diabetic patients reduced microalbuminuria and proteinuria independently of the action of antihypertensive medication and blood pressure control.

Effects of distance running on proteinuria have been evaluated in few studies. This study has been conducted to determine the influences of different distance running, with fixed exercise intensity, on proteinuria in young male football players.

Background

To access the prevalence of restless legs syndrome (RLS) in patients on chronic hemodialysis and to determine the risk factors for RLS.

Materials and methods

Fifty subjects undergoing chronic maintenance hemodialysis were included in this study after seeking informed consent. RLS was diagnosed according to International Restless Legs Syndrome study group criteria. Demographic data, clinical history and laboratory values are collected using standard interviews.

Results

RLS was reported in 14 of 50 hemodialysis patients (28%). Low hemoglobin, low serum ferritin levels and increased consumption of coffee in hemodialysis patients correlated significantly with onset of RLS. There was no difference in age, gender and duration of hemodialysis between RLS and non-RLS patients.

Conclusion

RLS is prevalent in patients on chronic hemodialysis. Further studies are needed to confirm the possible risk factors for RLS.

Inguinal hernias can be a cause of renal failure. The treatment of choice is early surgical repair. We describe the case of a patient with a giant inguinoscrotal hernia that provoked renal failure. Late repair did not allow recovery of renal function.

The Window™ Venous Needle Guide (VWNG) is a subcutaneous extravascular device designed to provide a repeatable and reliable vascular access using the single access method (eyelet or «buttonhole») for insertion of the needle with precision in hemodialysis patients. The indications for use, the non-re-use of the device, surgical implantation, and nursing care after surgery are described. As a chronic use, cannulation technique and needle removal process from the perspective of nursing care are very important.