Introduction: Patients’ high levels of health literacy and positive perception of health are effective in their compliance with the treatment. Objectives: The aim of this study was to examine the relationship between health literacy and the perception of health of hemodialysis patients. Patients and Methods: In the study, the sampling method was not performed, but it was performed with patients who received hemodialysis treatment and fulfilled the research criteria within the 3-month period. The descriptive study was conducted with a total of 110 patients in two dialysis centers Sivas province of Turkey. Results: Data were collected using the patient information form, Health Literacy Index (HLI) and perception of health scale (PHS) to determine demographic characteristics. Around 56.4% of the patients had been receiving hemodialysis treatment for 0-4 years. The mean score of patients’ health literacy was 77.40±12.94, and they received the highest score from the appraisal of the subscales. Perception of health mean score was 47.56±4.10. When sociodemographic characteristics were examined, health literacy levels were found to be high in males between the ages of 36-45 years, those with a long duration of chronic kidney disease (CKD) and those with higher education level. Conclusion: According to results patients’ health literacy and disease perception were found to be slightly above the middle level. We found a positive relationship between health literacy level and perception of health, and patients’ health literacy since the perception of health should be increased in order for the hemodialysis treatment process to be effective.
{"title":"Examination of the relationship between health literacy and health perceptions in hemodialysis patients","authors":"M. Mollaoğlu, Esra Başer, F. Candan","doi":"10.34172/jre.2021.11","DOIUrl":"https://doi.org/10.34172/jre.2021.11","url":null,"abstract":"Introduction: Patients’ high levels of health literacy and positive perception of health are effective in their compliance with the treatment. Objectives: The aim of this study was to examine the relationship between health literacy and the perception of health of hemodialysis patients. Patients and Methods: In the study, the sampling method was not performed, but it was performed with patients who received hemodialysis treatment and fulfilled the research criteria within the 3-month period. The descriptive study was conducted with a total of 110 patients in two dialysis centers Sivas province of Turkey. Results: Data were collected using the patient information form, Health Literacy Index (HLI) and perception of health scale (PHS) to determine demographic characteristics. Around 56.4% of the patients had been receiving hemodialysis treatment for 0-4 years. The mean score of patients’ health literacy was 77.40±12.94, and they received the highest score from the appraisal of the subscales. Perception of health mean score was 47.56±4.10. When sociodemographic characteristics were examined, health literacy levels were found to be high in males between the ages of 36-45 years, those with a long duration of chronic kidney disease (CKD) and those with higher education level. Conclusion: According to results patients’ health literacy and disease perception were found to be slightly above the middle level. We found a positive relationship between health literacy level and perception of health, and patients’ health literacy since the perception of health should be increased in order for the hemodialysis treatment process to be effective.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80244809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Type 2 diabetes is a progressive disease with a significant risk for developing late complications. Objectives: This study aimed to determine if the discharge NPH and regular insulin doses of conventional insulin therapy protocol in which optimal glycemic control can be achieved are similar to NPH and regular insulin doses at beginning of the insulin protocol or not. In other words, we aimed to compare two insulin injection methods on the control of type 2 diabetes. Patients and Methods: This cross-sectional study was performed on hospital records of type II diabetic patients admitted for insulin therapy with the conventional protocol from 2008-2013. Treatment was initiated with the following proportions; morning NPH: 44%, morning regular dosage: 22%, evening NPH dosage: 17% and evening regular dosage: 17%. Insulin doses of the discharge day in which optimal glycemic control has been achieved were recorded and based on their mean, a protocol was made. Finally, two groups were categorized. Group 1 consisted of patients whose discharge insulin dose was in the range of the mean data of the study (±2 IU/mL) and patients whose discharge insulin dose was in accordance with the conventional protocol (±2 IU/mL) participated in group 2. Results: At discharge day, the mean morning NPH dose was 34.2±6.69, morning regular: 23.8±6.36, evening NPH: 21.26±6.75 and evening regular: 20.74±5.51. The discharge insulin ratios of the conventional protocol were similar to that of the admission ratios in only 17.7% of the patients. Only 34.5% of the patients could include in the new protocol and 50% of them didn’t fit any protocol. Conclusion: It is suggested to inject one-third of the total daily insulin need as NPH in the morning and divide the remained two-thirds between morning regular, evening NPH and evening regular equally. This may decrease the length of hospital stay and decrease the time to reach the desired glycemic control.
{"title":"Comparison of two insulin injection methods on control of type 2 diabetes; is the new protocol effective or not?","authors":"M. Bayani, Hojjat Ghorbani, R. Akbari","doi":"10.34172/jre.2021.10","DOIUrl":"https://doi.org/10.34172/jre.2021.10","url":null,"abstract":"Introduction: Type 2 diabetes is a progressive disease with a significant risk for developing late complications. Objectives: This study aimed to determine if the discharge NPH and regular insulin doses of conventional insulin therapy protocol in which optimal glycemic control can be achieved are similar to NPH and regular insulin doses at beginning of the insulin protocol or not. In other words, we aimed to compare two insulin injection methods on the control of type 2 diabetes. Patients and Methods: This cross-sectional study was performed on hospital records of type II diabetic patients admitted for insulin therapy with the conventional protocol from 2008-2013. Treatment was initiated with the following proportions; morning NPH: 44%, morning regular dosage: 22%, evening NPH dosage: 17% and evening regular dosage: 17%. Insulin doses of the discharge day in which optimal glycemic control has been achieved were recorded and based on their mean, a protocol was made. Finally, two groups were categorized. Group 1 consisted of patients whose discharge insulin dose was in the range of the mean data of the study (±2 IU/mL) and patients whose discharge insulin dose was in accordance with the conventional protocol (±2 IU/mL) participated in group 2. Results: At discharge day, the mean morning NPH dose was 34.2±6.69, morning regular: 23.8±6.36, evening NPH: 21.26±6.75 and evening regular: 20.74±5.51. The discharge insulin ratios of the conventional protocol were similar to that of the admission ratios in only 17.7% of the patients. Only 34.5% of the patients could include in the new protocol and 50% of them didn’t fit any protocol. Conclusion: It is suggested to inject one-third of the total daily insulin need as NPH in the morning and divide the remained two-thirds between morning regular, evening NPH and evening regular equally. This may decrease the length of hospital stay and decrease the time to reach the desired glycemic control.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80171269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Patel, Nitin A. Patel, Shruti P. Gandhi, H. Trivedi
Fungal infection represents 5% of the infections of post renal transplant recipients. The frequency of invasive Aspergillus ranges from 0.5% to 2.2% with a mortality rate of 88%. In renal transplantation, Aspergillus infection usually affects primarily the lungs with occasional dissemination and the central nervous system. Involvement of a renal allograft in the isolated form is rare. A-35-year-old male post-renal transplant patient presented in our institute for routine follow up examination. Ultrasound and computed tomography (CT) were conducted in our radiology department, suggestive of abscess formation in mid pole of transplanted kidney. The patient did not have any clinical symptoms. His serum creatinine level was also within normal limit. Diagnosis of Aspergillus fumigates was made by aspiration of pus. Treatment started according to culture and sensitivity report. Ultimately graft nephrectomy was performed to control infection. Aspergillus infection of a renal allograft remains a key issue for nephrologists and infection specialists. For diagnosis of fungal infection, a high index of suspicious is necessary. In the present case, the infected allograft nephrectomy and the elimination of immune-compromised state and the prompt administration of antifungal therapy, made recovery possible. However, early diagnosis remains difficult.
{"title":"Incidentally detected isolated Aspergillus fumigates infection of the renal allograft","authors":"K. Patel, Nitin A. Patel, Shruti P. Gandhi, H. Trivedi","doi":"10.34172/jre.2021.08","DOIUrl":"https://doi.org/10.34172/jre.2021.08","url":null,"abstract":"Fungal infection represents 5% of the infections of post renal transplant recipients. The frequency of invasive Aspergillus ranges from 0.5% to 2.2% with a mortality rate of 88%. In renal transplantation, Aspergillus infection usually affects primarily the lungs with occasional dissemination and the central nervous system. Involvement of a renal allograft in the isolated form is rare. A-35-year-old male post-renal transplant patient presented in our institute for routine follow up examination. Ultrasound and computed tomography (CT) were conducted in our radiology department, suggestive of abscess formation in mid pole of transplanted kidney. The patient did not have any clinical symptoms. His serum creatinine level was also within normal limit. Diagnosis of Aspergillus fumigates was made by aspiration of pus. Treatment started according to culture and sensitivity report. Ultimately graft nephrectomy was performed to control infection. Aspergillus infection of a renal allograft remains a key issue for nephrologists and infection specialists. For diagnosis of fungal infection, a high index of suspicious is necessary. In the present case, the infected allograft nephrectomy and the elimination of immune-compromised state and the prompt administration of antifungal therapy, made recovery possible. However, early diagnosis remains difficult.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88342138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Jerbi, H. Ghabi, H. Gaied, F. Ben Hmida, R. Aoudia, R. Goucha, T. Ben Abdallah
Introduction: Vitamin D deficiency is frequently observed among dialysis patients. Previous studies suggested that 50 to 90% of end-stage renal disease patients are deficient in vitamin D. In Tunisia, studies regarding hypovitaminosis D in patients on dialysis are not numerous. Actually, many data support the use of native vitamin D in hemodialysis (HD) patients. In Tunisia, using native vitamin D is not part of therapeutic habits of all dialysis centers. Objectives: The aim of this study was to determine the prevalence of vitamin D deficiency in patients with chronic kidney disease stage 5 undergoing HD and to evaluate the effect of oral cholecalciferol supplementation, in intact parathormone (iPTH), serum calcium and serum phosphorus. Patients and Methods: We conducted a pre-experimental study among HD patients. Monthly oral supplementation with Cholecalciferol, was instituted for six months. Results: Forty-three participants were included. The mean 25-hydroxy vitamin D concentration was 17.89 ng/mL. Vitamin D deficiency was observed in 83.7% of our patients. We observed a significant increase in 25-hydroxy vitamin D and calcium levels and a significant decline in iPTH levels. No evidence of toxicity, nor severe hypercalcemia or hyperphosphatemia was noted. Conclusion: The supplementation with cholecalciferol seems reasonable and well tolerated in HD patients if reasonable doses are used with regular monitoring.
{"title":"Cholecalciferol therapy; is it the gold standard for vitamin D deficiency and mineral disorders in hemodialysis?","authors":"M. Jerbi, H. Ghabi, H. Gaied, F. Ben Hmida, R. Aoudia, R. Goucha, T. Ben Abdallah","doi":"10.34172/jre.2021.09","DOIUrl":"https://doi.org/10.34172/jre.2021.09","url":null,"abstract":"Introduction: Vitamin D deficiency is frequently observed among dialysis patients. Previous studies suggested that 50 to 90% of end-stage renal disease patients are deficient in vitamin D. In Tunisia, studies regarding hypovitaminosis D in patients on dialysis are not numerous. Actually, many data support the use of native vitamin D in hemodialysis (HD) patients. In Tunisia, using native vitamin D is not part of therapeutic habits of all dialysis centers. Objectives: The aim of this study was to determine the prevalence of vitamin D deficiency in patients with chronic kidney disease stage 5 undergoing HD and to evaluate the effect of oral cholecalciferol supplementation, in intact parathormone (iPTH), serum calcium and serum phosphorus. Patients and Methods: We conducted a pre-experimental study among HD patients. Monthly oral supplementation with Cholecalciferol, was instituted for six months. Results: Forty-three participants were included. The mean 25-hydroxy vitamin D concentration was 17.89 ng/mL. Vitamin D deficiency was observed in 83.7% of our patients. We observed a significant increase in 25-hydroxy vitamin D and calcium levels and a significant decline in iPTH levels. No evidence of toxicity, nor severe hypercalcemia or hyperphosphatemia was noted. Conclusion: The supplementation with cholecalciferol seems reasonable and well tolerated in HD patients if reasonable doses are used with regular monitoring.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86542427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reginaldo Passoni dos Santos, Letícia Giroldo Vieira, Danielle Fernanda Miner de Oliveira, Raissa Fritz Schmitt, Vinicius Ferreira de Barros, Ariana Rodrigues da Silva Carvalho, Luis Alberto Batista Peres
Introduction: In Brazil, primary studies on this issue are still limited and the ideal timing of initiation of dialysis in severe acute kidney injury (AKI) still generates disagreements among experts. Objectives: To assess if the timing of initiation of dialysis is associated with the mortality of patients with AKI in intensive care unit (ICU). Patients and Methods: We retrospectively analyzed medical records of patients that developed severe AKI in the ICU. Bivariate analysis was carried out to compare data between groups of patients who underwent early dialysis (ED - initiated up to two days after the AKI diagnosis) and late dialysis (LD – initiated more than two days after the AKI diagnosis), while multivariate logistic regression was applied to identify factors associated with mortality. Results: Of the 76 patients included in the study, 27 (35.5%) were allocated in the ED group and 49 (64.5%) in the LD group. LD group had a higher frequency of sepsis [26 (53%) vs. 12 (44%); P = 0.472], while the ED group had a higher median number of dialysis sessions (6 vs. 3; P = 0.477) and higher total median time on dialysis (17.5 h vs. 13 h; P = 0.629). The overall mortality rate was 61.8% (n = 47) and of 76% (n = 22) in the ED group. The patients’ serum creatinine level at admission in the ICU was the only statistically significant risk factor for death [OR= 0.453 (95% CI= 0.257–0.801); P = 0.006]. Conclusion: The overall and in the ED group mortality rate was elevated, however, the timing of initiation of dialysis did not show statistically significant association with death. The serum creatinine at ICU admission seems to be an important mortality predictor.
{"title":"Impact of timing of initiation of dialysis on mortality of patients with acute kidney injury","authors":"Reginaldo Passoni dos Santos, Letícia Giroldo Vieira, Danielle Fernanda Miner de Oliveira, Raissa Fritz Schmitt, Vinicius Ferreira de Barros, Ariana Rodrigues da Silva Carvalho, Luis Alberto Batista Peres","doi":"10.34172/jre.2021.07","DOIUrl":"https://doi.org/10.34172/jre.2021.07","url":null,"abstract":"Introduction: In Brazil, primary studies on this issue are still limited and the ideal timing of initiation of dialysis in severe acute kidney injury (AKI) still generates disagreements among experts. Objectives: To assess if the timing of initiation of dialysis is associated with the mortality of patients with AKI in intensive care unit (ICU). Patients and Methods: We retrospectively analyzed medical records of patients that developed severe AKI in the ICU. Bivariate analysis was carried out to compare data between groups of patients who underwent early dialysis (ED - initiated up to two days after the AKI diagnosis) and late dialysis (LD – initiated more than two days after the AKI diagnosis), while multivariate logistic regression was applied to identify factors associated with mortality. Results: Of the 76 patients included in the study, 27 (35.5%) were allocated in the ED group and 49 (64.5%) in the LD group. LD group had a higher frequency of sepsis [26 (53%) vs. 12 (44%); P = 0.472], while the ED group had a higher median number of dialysis sessions (6 vs. 3; P = 0.477) and higher total median time on dialysis (17.5 h vs. 13 h; P = 0.629). The overall mortality rate was 61.8% (n = 47) and of 76% (n = 22) in the ED group. The patients’ serum creatinine level at admission in the ICU was the only statistically significant risk factor for death [OR= 0.453 (95% CI= 0.257–0.801); P = 0.006]. Conclusion: The overall and in the ED group mortality rate was elevated, however, the timing of initiation of dialysis did not show statistically significant association with death. The serum creatinine at ICU admission seems to be an important mortality predictor.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78298502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert Ikechukwu Uroko, F. Adamude, S. Egba, C. Nwuke, C. L. Asadu, Peter Anyaorah
Introduction: Benign prostatic hyperplasia (BPH) is a prostate disorder in ageing males that negatively affects the quality of life and requires multidimensional approaches to ameliorate its adverse health effects. Objectives: This study evaluated the effects of combined ethanol extract of Funtumia africana and Abutilon mauritianum leaves on the prostate biomarkers, serum mineral levels and prostate histomorphology of BPH induced rats. Materials and Methods: Thirty-six male Wistar albino rats randomly distributed into 5 groups containing 6 rats each was used for this study. Group 1 served as the normal control rats without BPH induction while groups 2–5 were BPH induced rats that served as BPH control (untreated), finasteride control, and BPH induced treated with 200 and 600 mg/kg/d of the combined ethanol extract of F. africana and A. mauritianum leaves respectively. BPH was induced in the rats by subcutaneous injection of 5 mg/kg/d of testosterone propionate injection and treatment followed 1h after the induction for 28 consecutive days. All the biochemical analyses and prostate histological examinations were carried out using standard methods. Results: BPH induction significantly elevated serum prostatic acid phosphatase activities and serum prostate-specific antigen (PSA) concentrations in the BPH control rats relative to the normal control. The BPH induction caused significant (P<0.05) reductions in the serum levels of calcium and selenium levels and significantly increased the serum inorganic phosphate concentration in the BPH control when compared with the normal control. Treatment with the combined extract significantly (P<0.05) increased the serum zinc, calcium, copper, iron and inorganic phosphate and significantly reduced serum selenium level when compared with the BPH control. The combined extract further significant (P<0.0) reduced the serum prostatic acid phosphatase activities and PSA level relative to the BPH control. The BPH control showed severe prostate histomorphological alterations consistent with BPH which were largely reduced to mild alterations in combined extract-treated BPH induced rats. Conclusion: This study revealed that the combined ethanol extract of F. africana and A. mauritianum leaves positively regulate the serum mineral levels, serum prostatic acid phosphatase activities, PSA levels and improves prostate histomorphology BPH induced rats.
{"title":"Effects of combined ethanol extract of Funtumia africana and Abutilon mauritianum leaves on prostate biomarkers and serum mineral levels in prostatic hyperplasia induced male rats","authors":"Robert Ikechukwu Uroko, F. Adamude, S. Egba, C. Nwuke, C. L. Asadu, Peter Anyaorah","doi":"10.34172/jre.2021.06","DOIUrl":"https://doi.org/10.34172/jre.2021.06","url":null,"abstract":"Introduction: Benign prostatic hyperplasia (BPH) is a prostate disorder in ageing males that negatively affects the quality of life and requires multidimensional approaches to ameliorate its adverse health effects. Objectives: This study evaluated the effects of combined ethanol extract of Funtumia africana and Abutilon mauritianum leaves on the prostate biomarkers, serum mineral levels and prostate histomorphology of BPH induced rats. Materials and Methods: Thirty-six male Wistar albino rats randomly distributed into 5 groups containing 6 rats each was used for this study. Group 1 served as the normal control rats without BPH induction while groups 2–5 were BPH induced rats that served as BPH control (untreated), finasteride control, and BPH induced treated with 200 and 600 mg/kg/d of the combined ethanol extract of F. africana and A. mauritianum leaves respectively. BPH was induced in the rats by subcutaneous injection of 5 mg/kg/d of testosterone propionate injection and treatment followed 1h after the induction for 28 consecutive days. All the biochemical analyses and prostate histological examinations were carried out using standard methods. Results: BPH induction significantly elevated serum prostatic acid phosphatase activities and serum prostate-specific antigen (PSA) concentrations in the BPH control rats relative to the normal control. The BPH induction caused significant (P<0.05) reductions in the serum levels of calcium and selenium levels and significantly increased the serum inorganic phosphate concentration in the BPH control when compared with the normal control. Treatment with the combined extract significantly (P<0.05) increased the serum zinc, calcium, copper, iron and inorganic phosphate and significantly reduced serum selenium level when compared with the BPH control. The combined extract further significant (P<0.0) reduced the serum prostatic acid phosphatase activities and PSA level relative to the BPH control. The BPH control showed severe prostate histomorphological alterations consistent with BPH which were largely reduced to mild alterations in combined extract-treated BPH induced rats. Conclusion: This study revealed that the combined ethanol extract of F. africana and A. mauritianum leaves positively regulate the serum mineral levels, serum prostatic acid phosphatase activities, PSA levels and improves prostate histomorphology BPH induced rats.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86440974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Abdo-Cuza, R. Castellanos-Gutiérrez, Janete Treto-Ramirez, Sandra Arencibia-Larin, Thalía Gómez-Pariente, Tania González-Fernández, J. C. Hernández-Perera, Katia Arocha-Stalella, Niurka Verdecia-Gorrita, Lisy Vento-Buigues, Yanet Cordero-Vasallo, Yusmel Rivero-Yi, Odalys González-Dias, H. Nodarse-Cuní, R. Machado-Martínez, M. Blanco-González, Julio Valdivia-Arencibia, Daymiris Mendez-Felipe, Ernesto Delgado-Almora, C. Gutiérrez-Gutiérrez, J. Suárez-López, Jorge L. Leiva-Torres, Alicia Rodríguez-Sotolongo, Nilda Bejerano-Gil
Introduction: Patients diagnosed with end-stage chronic kidney disease on a hemodialysis program (HDP) represent a risk group for COVID-19. Scientific societies have developed guidelines for the prevention of contagion, but there is no prophylactic medicine in them. Objectives: To describe the safety and efficacy of recombinant intranasal human Interferon alfa 2b as prophylaxis for COVID-19 in patients in an HDP. Patients and Methods: Intervention description through the monitoring of 15 patients in outpatient HDP. Prior to the administration of the drug, clinical, radiological evaluation and hematology and blood chemistry studies were performed. Daily contact was made with each study patient in person or by telephone, asking about the occurrence of adverse events or symptoms of disease. Results: In 47% of the patients, there was leukopenia, lymphopenia in 67% and anemia and thrombocytopenia in 33% respectively, prior to the use of the drug. There was no clinical suspicion of COVID-19 in any of them. Adverse events occurred in 3 patients (20%), all were mild and non-severe. All patients were negative for SARS-CoV-2 real-time polymerase chain reaction (rtPCR) and antibody studies 45 days after the study started. Conclusion: the use of intranasal recombinant human interferon alfa 2b as prophylaxis of COVID-19 in patients in a HDP at a dose of 1 MIU daily for ten days, as part of a prevention protocol, has an adequate safety profile. None of the patients in the series was infected with SARS-CoV-2 during the surveillance period.
{"title":"Safety and efficacy of intranasal recombinant human interferon alfa 2b as prophylaxis for COVID-19 in patients on a hemodialysis program","authors":"A. Abdo-Cuza, R. Castellanos-Gutiérrez, Janete Treto-Ramirez, Sandra Arencibia-Larin, Thalía Gómez-Pariente, Tania González-Fernández, J. C. Hernández-Perera, Katia Arocha-Stalella, Niurka Verdecia-Gorrita, Lisy Vento-Buigues, Yanet Cordero-Vasallo, Yusmel Rivero-Yi, Odalys González-Dias, H. Nodarse-Cuní, R. Machado-Martínez, M. Blanco-González, Julio Valdivia-Arencibia, Daymiris Mendez-Felipe, Ernesto Delgado-Almora, C. Gutiérrez-Gutiérrez, J. Suárez-López, Jorge L. Leiva-Torres, Alicia Rodríguez-Sotolongo, Nilda Bejerano-Gil","doi":"10.34172/jre.2021.05","DOIUrl":"https://doi.org/10.34172/jre.2021.05","url":null,"abstract":"Introduction: Patients diagnosed with end-stage chronic kidney disease on a hemodialysis program (HDP) represent a risk group for COVID-19. Scientific societies have developed guidelines for the prevention of contagion, but there is no prophylactic medicine in them. Objectives: To describe the safety and efficacy of recombinant intranasal human Interferon alfa 2b as prophylaxis for COVID-19 in patients in an HDP. Patients and Methods: Intervention description through the monitoring of 15 patients in outpatient HDP. Prior to the administration of the drug, clinical, radiological evaluation and hematology and blood chemistry studies were performed. Daily contact was made with each study patient in person or by telephone, asking about the occurrence of adverse events or symptoms of disease. Results: In 47% of the patients, there was leukopenia, lymphopenia in 67% and anemia and thrombocytopenia in 33% respectively, prior to the use of the drug. There was no clinical suspicion of COVID-19 in any of them. Adverse events occurred in 3 patients (20%), all were mild and non-severe. All patients were negative for SARS-CoV-2 real-time polymerase chain reaction (rtPCR) and antibody studies 45 days after the study started. Conclusion: the use of intranasal recombinant human interferon alfa 2b as prophylaxis of COVID-19 in patients in a HDP at a dose of 1 MIU daily for ten days, as part of a prevention protocol, has an adequate safety profile. None of the patients in the series was infected with SARS-CoV-2 during the surveillance period.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"363 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80302007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Osman, Nada Awad Alkareem, Baha eldin Elawad, O. Dawod, Mohammed Elshiekh
Introduction: Anemia is caused by a variety of mechanisms in chronic kidney disease (CKD), including erythropoietin (EPO) deficiency, resistance to erythropoiesis-stimulating agents (ESAs), impaired iron metabolism and its clinical management remains challenging. Objectives: The aim of the current study was to evaluate the impact of CRP, BMI, gender and duration of hemodialysis. Patients and Methods: A total of 94 maintenance HD patients participated in this study. Laboratory investigation included CBC, renal function test and qualitatively C-reactive protein was performed. Erythropoietin resistance index (ERI) was calculated as weekly EPO dose/ body weight in kg/hemoglobin level. Results: Female gender had significantly higher ERI (11.36 ± 1.52) compared to male HD patients (10.68 ± 1.56) (P ˃ 0.05). Patients with low BMI had significant higher ERI (12.08 ± 1.09) compared to HD patients with overweight (10.62 ± 0.79) and obese (9.62 ± 1.68) (P ˃ 0.05). The highest ERI were found in the positive CPR group (P ˃ 0.05) compared to negative CRP group. There is no significant difference between duration of hemodialysis. Conclusion: Our data exposed that female gender; low BMI and inflammation (positive CRP) contributed to EPO hyporesponsiveness. In addition, there is no significant difference between lengths on hemodialysis.
{"title":"Impact of gender, C-reactive protein and body mass index on erythropoietin resistance index in maintenance hemodialysis patients","authors":"A. Osman, Nada Awad Alkareem, Baha eldin Elawad, O. Dawod, Mohammed Elshiekh","doi":"10.34172/jre.2021.04","DOIUrl":"https://doi.org/10.34172/jre.2021.04","url":null,"abstract":"Introduction: Anemia is caused by a variety of mechanisms in chronic kidney disease (CKD), including erythropoietin (EPO) deficiency, resistance to erythropoiesis-stimulating agents (ESAs), impaired iron metabolism and its clinical management remains challenging. Objectives: The aim of the current study was to evaluate the impact of CRP, BMI, gender and duration of hemodialysis. Patients and Methods: A total of 94 maintenance HD patients participated in this study. Laboratory investigation included CBC, renal function test and qualitatively C-reactive protein was performed. Erythropoietin resistance index (ERI) was calculated as weekly EPO dose/ body weight in kg/hemoglobin level. Results: Female gender had significantly higher ERI (11.36 ± 1.52) compared to male HD patients (10.68 ± 1.56) (P ˃ 0.05). Patients with low BMI had significant higher ERI (12.08 ± 1.09) compared to HD patients with overweight (10.62 ± 0.79) and obese (9.62 ± 1.68) (P ˃ 0.05). The highest ERI were found in the positive CPR group (P ˃ 0.05) compared to negative CRP group. There is no significant difference between duration of hemodialysis. Conclusion: Our data exposed that female gender; low BMI and inflammation (positive CRP) contributed to EPO hyporesponsiveness. In addition, there is no significant difference between lengths on hemodialysis.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86000271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Presentation A 58-year-old woman was referred with the complaints of nausea, vomiting and left flank pain since last night. She had a history of renal colic during previous years and in this presentation, she received medication for relieving the pain. She was discharged from the clinic with analgesic drugs and intravenous (IV) line therapy with normal saline. Urine analysis revealed, +1 blood and 4-5 red blood cells (RBCs) in microscopic urine sediment. When she presented to us, she was anuric and had severe pain in the left flank. She had a history of favism after exposure to beans a few years ago. She had consumed some food containing beans 2 days ago. On admission, she had severe left flank pain and anuria of 12 hours duration. She had dyspnea and on physical examination had end-expiratory crackles in the base of both lungs. The relevant laboratory tests on the day of admission and several days thereafter are summarized in Table 1. Her peripheral blood film showed polychromasia, anisocytosis, poikilocytosis and blister cells. The viral and autoimmune serology was negative. On abdominal ultrasonography, the size of the right kidney was 105 mm and that of the left, 128 mm. No stone or hydronephrosis was seen. Doppler ultrasonography of renal vessels (arterial and venous) was done and normal finding was reported. The patient’s renal functions continued to deteriorate and hemodialysis was started for ameliorating her Open Access Photoclinic
{"title":"Reversible acute renal failure in a middle aged woman secondary to intravascular hemolysis caused by favism","authors":"M. Mubarak, F. Moeinzadeh, H. Nasri","doi":"10.34172/jre.2021.03","DOIUrl":"https://doi.org/10.34172/jre.2021.03","url":null,"abstract":"Case Presentation A 58-year-old woman was referred with the complaints of nausea, vomiting and left flank pain since last night. She had a history of renal colic during previous years and in this presentation, she received medication for relieving the pain. She was discharged from the clinic with analgesic drugs and intravenous (IV) line therapy with normal saline. Urine analysis revealed, +1 blood and 4-5 red blood cells (RBCs) in microscopic urine sediment. When she presented to us, she was anuric and had severe pain in the left flank. She had a history of favism after exposure to beans a few years ago. She had consumed some food containing beans 2 days ago. On admission, she had severe left flank pain and anuria of 12 hours duration. She had dyspnea and on physical examination had end-expiratory crackles in the base of both lungs. The relevant laboratory tests on the day of admission and several days thereafter are summarized in Table 1. Her peripheral blood film showed polychromasia, anisocytosis, poikilocytosis and blister cells. The viral and autoimmune serology was negative. On abdominal ultrasonography, the size of the right kidney was 105 mm and that of the left, 128 mm. No stone or hydronephrosis was seen. Doppler ultrasonography of renal vessels (arterial and venous) was done and normal finding was reported. The patient’s renal functions continued to deteriorate and hemodialysis was started for ameliorating her Open Access Photoclinic","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86888269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Al-Helal, E. Abdallah, Altayyeb Yousef, Reem Asad, M. Reda
Introduction: Cerebral salt wasting or renal salt wasting (RSW) syndrome, may be more common than syndrome of inappropriate antidiuretic hormone secretion (SIADH) and may even occur in the absence of cerebral disease. We report a case of RSW in a Bangladeshi patient positive for COVID-19 without clinical cerebral disease. Case Presentation: A 53 years-old Bangladeshi patient presented with history of chest pain and acute MI. On examination, the patient was conscious, alert, vitally stable, chest with fine bilateral basal crepitation and heart with additional S3 sound and abdomen was lax with no organomegaly. There was no lower limbs oedema. His serum creatinine; 68 umol/L, urea; 3.4 mmol/L, K; 4.7 mmol/L, sodium; 135 mmol/L, uric acid; 141 mmol/L and phosphate was 1.3 mmol./L. Echocardiography (ECG) revealed anterior lateral wall STEMI. PCI was done for LAD. ECG revealed ejection fraction (EF) 10-15 %. Nasopharyngeal swab for COVID-19 was positive. Serum sodium decreased from 135 to 108 with signs of hypovolemia. Work up for hyponatremia revealed serum osmolality of 237 mOsm/kg, urine NA; 109 mmol/L, urine osmolality; 295 mOsm/kg, urine uric acid; 685 umol/L, and urine phosphate; 6.5 mmol/L. Additionally serum T3, T4, TSH and serum basal cortisol were normal. The patient received normal saline infusion and fludrocortisone and serum sodium increased to 134 mmol/L. Our patient had all the important clinical and laboratory characteristics of RSW in the absence of cerebral disease which include hyponatremia associated with hypovolemia, high urinary sodium excretion, increased fraction excretion of phosphate and persistent hypouricemia with increased fractional excretion of urate after correction of hyponatremia and with normal renal, adrenal and thyroid functions. Furthermore, there was a prompt response to saline replacement and fludrocortisone and steady improvement in serum sodium with negativity and improvement of COVID-19. Our diagnosis was RSW in the absence of cerebral disease and to our knowledge; this is the first case of RSW in a patient with COVID-19 in the literature. Conclusion: RSW should be considered in patients with COVID-19 with hyponatremia and absence of cerebral disease. We suggest changing cerebral salt wasting to the more appropriate term RSW.
{"title":"Renal salt wasting syndrome in a patient with COVID-19; a case report and review of the literature","authors":"B. Al-Helal, E. Abdallah, Altayyeb Yousef, Reem Asad, M. Reda","doi":"10.34172/jre.2021.02","DOIUrl":"https://doi.org/10.34172/jre.2021.02","url":null,"abstract":"Introduction: Cerebral salt wasting or renal salt wasting (RSW) syndrome, may be more common than syndrome of inappropriate antidiuretic hormone secretion (SIADH) and may even occur in the absence of cerebral disease. We report a case of RSW in a Bangladeshi patient positive for COVID-19 without clinical cerebral disease. Case Presentation: A 53 years-old Bangladeshi patient presented with history of chest pain and acute MI. On examination, the patient was conscious, alert, vitally stable, chest with fine bilateral basal crepitation and heart with additional S3 sound and abdomen was lax with no organomegaly. There was no lower limbs oedema. His serum creatinine; 68 umol/L, urea; 3.4 mmol/L, K; 4.7 mmol/L, sodium; 135 mmol/L, uric acid; 141 mmol/L and phosphate was 1.3 mmol./L. Echocardiography (ECG) revealed anterior lateral wall STEMI. PCI was done for LAD. ECG revealed ejection fraction (EF) 10-15 %. Nasopharyngeal swab for COVID-19 was positive. Serum sodium decreased from 135 to 108 with signs of hypovolemia. Work up for hyponatremia revealed serum osmolality of 237 mOsm/kg, urine NA; 109 mmol/L, urine osmolality; 295 mOsm/kg, urine uric acid; 685 umol/L, and urine phosphate; 6.5 mmol/L. Additionally serum T3, T4, TSH and serum basal cortisol were normal. The patient received normal saline infusion and fludrocortisone and serum sodium increased to 134 mmol/L. Our patient had all the important clinical and laboratory characteristics of RSW in the absence of cerebral disease which include hyponatremia associated with hypovolemia, high urinary sodium excretion, increased fraction excretion of phosphate and persistent hypouricemia with increased fractional excretion of urate after correction of hyponatremia and with normal renal, adrenal and thyroid functions. Furthermore, there was a prompt response to saline replacement and fludrocortisone and steady improvement in serum sodium with negativity and improvement of COVID-19. Our diagnosis was RSW in the absence of cerebral disease and to our knowledge; this is the first case of RSW in a patient with COVID-19 in the literature. Conclusion: RSW should be considered in patients with COVID-19 with hyponatremia and absence of cerebral disease. We suggest changing cerebral salt wasting to the more appropriate term RSW.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89512243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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