A. Al-Hwiesh, I. Abdul-Rahman, N. Al-Audah, Amani Alhwiesh, A. Taha, N. Ma, Abdalla Abdelrahman, A. Harbi, A. Mm, D. Mousa, H. Al-Ramadan, Khalid M. Al-Otaibi, S. Skhiri, D. AlKhaldi, Scapuzzi Ja
Background: This study aimed at evaluation of the visibility of instant-start, life-saving peritoneal dialysis in dialysis patients with End Stage Vascular Access Failure (ESVAF) in addition to complications and outcome of this dialysis modality. Methods: This is a prospective observational study from June 2015 throughout July 2018. Urgent two-cuff curled Tenckhoff PD catheters were inserted percutaneously within few hours by expert nephrology team. Twenty-three dialysis ESVAF patients who presented acutely to our hospital were included in the study. Results: Dialysis was initiated within 2 hours (range: 1-3 h) from presentation in all patients. Adequate metabolic and volume control was achieved after 4 sessions of PD. Mechanical complications occurred in 25.1%. The main mechanical complications were minor peri-catheter leakage (13%) and catheter tip migration (8.7%). One patient had omental wrap which necessitated catheter replacement. Exit-Site Infection (ESI) occurred in 13%, tunnel infection in 0% and peritonitis in 13% of patients. Peritonitis rate was 0.142 episode/patient-year. After 6 months, catheter and patient survival rates were 87.0% and 91.3% respectively. Conclusion: The instant-start PD modality was a life-saving, feasible and safe alternative to hemodialysis in patients with ESVAF.
{"title":"Success of Instant-Start Life-Saving Peritoneal Dialysis in Patients with EndStage Vascular Access Failure: Time to Rescue Patients","authors":"A. Al-Hwiesh, I. Abdul-Rahman, N. Al-Audah, Amani Alhwiesh, A. Taha, N. Ma, Abdalla Abdelrahman, A. Harbi, A. Mm, D. Mousa, H. Al-Ramadan, Khalid M. Al-Otaibi, S. Skhiri, D. AlKhaldi, Scapuzzi Ja","doi":"10.16966/2380-5498.182","DOIUrl":"https://doi.org/10.16966/2380-5498.182","url":null,"abstract":"Background: This study aimed at evaluation of the visibility of instant-start, life-saving peritoneal dialysis in dialysis patients with End Stage Vascular Access Failure (ESVAF) in addition to complications and outcome of this dialysis modality. Methods: This is a prospective observational study from June 2015 throughout July 2018. Urgent two-cuff curled Tenckhoff PD catheters were inserted percutaneously within few hours by expert nephrology team. Twenty-three dialysis ESVAF patients who presented acutely to our hospital were included in the study. Results: Dialysis was initiated within 2 hours (range: 1-3 h) from presentation in all patients. Adequate metabolic and volume control was achieved after 4 sessions of PD. Mechanical complications occurred in 25.1%. The main mechanical complications were minor peri-catheter leakage (13%) and catheter tip migration (8.7%). One patient had omental wrap which necessitated catheter replacement. Exit-Site Infection (ESI) occurred in 13%, tunnel infection in 0% and peritonitis in 13% of patients. Peritonitis rate was 0.142 episode/patient-year. After 6 months, catheter and patient survival rates were 87.0% and 91.3% respectively. Conclusion: The instant-start PD modality was a life-saving, feasible and safe alternative to hemodialysis in patients with ESVAF.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67391100","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}
With the increasing morbidity and mortality of renal ischemia/reperfusion, whether epoxyeicosatrienoic acids could protect against it and the relative mechanism needs further exploration. Aim: To investigate the effect of epoxyeicosatrienoic acids on renal ischemia/reperfusion injury. Methods: Thirty mice were randomly divided into sham group, ischemia/reperfusion group, ischemia/reperfusion with epoxyeicosatrienoic acids group, ischemia/reperfusion with toll-like receptor 4 inhibitor group, ischemia/reperfusion with epoxyeicosatrienoic acids and toll-like receptor 4 inhibitor group. Kidney function and pathology changes were observed 24 h after surgery. ELISA was used to exam the level of serum interleukin1β, tumor necrosis factor α and nod-like receptor 3. The protein expression of nod-like receptor 3, cleaved cysteinyl aspartate specific proteinase 1, pro-interleukin-1β, interleukin-1β, toll-like receptor 4 and nuclear factor kappa-light-chain-enhancer of activated B cells p65 were evaluated by western blot. Result: Compared with the sham group, the ischemia/reperfusion group showed severe renal tubular epithelial cell necrosis (P<0.05). BUN, Scr and interleukin-1β, tumor necrosis factor α, nod-like receptor 3, toll-like receptor 4, cleaved cysteinyl aspartate specific proteinase 1 were obviously higher than those in the sham group (P<0.05). Furthermore, epoxyeicosatrienoic acids were alleviated in the ischemia/reperfusion-induced kidney function damage and expression of above protein (P<0.05), the level of each proteins was significantly reduced after the co-administration of toll-like receptor 4 inhibitor and epoxyeicosatrienoic acids (P<0.05). Conclusion: Epoxyeicosatrienoic acids can reduce renal ischemia/reperfusion injury, and its mechanism may be related to the regulation of nod-like receptor 3 production and pyroptosis through the toll-like receptor 4 pathway.
{"title":"The Protective Effect of EET on Renal I/R through NLRP3 and Pyroptosis","authors":"Y. Zhu, A. Ding, H. Yang, Chen Bh, Guo Jl","doi":"10.16966/2380-5498.186","DOIUrl":"https://doi.org/10.16966/2380-5498.186","url":null,"abstract":"With the increasing morbidity and mortality of renal ischemia/reperfusion, whether epoxyeicosatrienoic acids could protect against it and the relative mechanism needs further exploration. Aim: To investigate the effect of epoxyeicosatrienoic acids on renal ischemia/reperfusion injury. Methods: Thirty mice were randomly divided into sham group, ischemia/reperfusion group, ischemia/reperfusion with epoxyeicosatrienoic acids group, ischemia/reperfusion with toll-like receptor 4 inhibitor group, ischemia/reperfusion with epoxyeicosatrienoic acids and toll-like receptor 4 inhibitor group. Kidney function and pathology changes were observed 24 h after surgery. ELISA was used to exam the level of serum interleukin1β, tumor necrosis factor α and nod-like receptor 3. The protein expression of nod-like receptor 3, cleaved cysteinyl aspartate specific proteinase 1, pro-interleukin-1β, interleukin-1β, toll-like receptor 4 and nuclear factor kappa-light-chain-enhancer of activated B cells p65 were evaluated by western blot. Result: Compared with the sham group, the ischemia/reperfusion group showed severe renal tubular epithelial cell necrosis (P<0.05). BUN, Scr and interleukin-1β, tumor necrosis factor α, nod-like receptor 3, toll-like receptor 4, cleaved cysteinyl aspartate specific proteinase 1 were obviously higher than those in the sham group (P<0.05). Furthermore, epoxyeicosatrienoic acids were alleviated in the ischemia/reperfusion-induced kidney function damage and expression of above protein (P<0.05), the level of each proteins was significantly reduced after the co-administration of toll-like receptor 4 inhibitor and epoxyeicosatrienoic acids (P<0.05). Conclusion: Epoxyeicosatrienoic acids can reduce renal ischemia/reperfusion injury, and its mechanism may be related to the regulation of nod-like receptor 3 production and pyroptosis through the toll-like receptor 4 pathway.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67391184","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}
Depaynos Tch, Alayon Ra, Cabanayan-Casasola Cb, Danguilan Ra
Background: The Philippine national health insurance’s second highest pay-out goes towards dialysis treatment. The increasing number of patients developing End Stage Renal Disease (ESRD) requiring dialysis each year will result in an increasing subsidy by the government. Considering the huge expense of the government to support dialysis treatment, it is important to show that it results in a good Quality of Life (QOL). Objectives: To determine the QOL of Hemodialysis (HD) and Peritoneal Dialysis (PD) patients using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Materials and Methods: A cross-sectional study using the self-administered WHOQOL-BREF questionnaire evaluated randomly selected Filipino adult ESRD patients at the National Kidney and Transplant Institute’s (NKTI) Chronic Hemodialysis (HD) Center and from the Chronic Ambulatory Peritoneal Dialysis (CAPD) clinic. Results: There were185 patients on HD and 225 patients on PD with mean age of 47 and male preponderance. Majority of HD patients were privately paying, while those on PD patients were all financially-subsidized by the Institute. Primary renal disease was due to hypertension. Most were on dialysis for more than 2 years (44.6%). PD patients had higher transformed scores in 3 domains compared with HD patients. Conclusion: PD patients had a higher QOL in the psychological, social relationship and environmental domains; whereas physical domain was higher among HD patients.
{"title":"Quality of Life among End Stage Renal Disease Patients on Hemodialysis and Peritoneal Dialysis in the National Kidney and Transplant Institute","authors":"Depaynos Tch, Alayon Ra, Cabanayan-Casasola Cb, Danguilan Ra","doi":"10.16966/2380-5498.183","DOIUrl":"https://doi.org/10.16966/2380-5498.183","url":null,"abstract":"Background: The Philippine national health insurance’s second highest pay-out goes towards dialysis treatment. The increasing number of patients developing End Stage Renal Disease (ESRD) requiring dialysis each year will result in an increasing subsidy by the government. Considering the huge expense of the government to support dialysis treatment, it is important to show that it results in a good Quality of Life (QOL). Objectives: To determine the QOL of Hemodialysis (HD) and Peritoneal Dialysis (PD) patients using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Materials and Methods: A cross-sectional study using the self-administered WHOQOL-BREF questionnaire evaluated randomly selected Filipino adult ESRD patients at the National Kidney and Transplant Institute’s (NKTI) Chronic Hemodialysis (HD) Center and from the Chronic Ambulatory Peritoneal Dialysis (CAPD) clinic. Results: There were185 patients on HD and 225 patients on PD with mean age of 47 and male preponderance. Majority of HD patients were privately paying, while those on PD patients were all financially-subsidized by the Institute. Primary renal disease was due to hypertension. Most were on dialysis for more than 2 years (44.6%). PD patients had higher transformed scores in 3 domains compared with HD patients. Conclusion: PD patients had a higher QOL in the psychological, social relationship and environmental domains; whereas physical domain was higher among HD patients.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67391160","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}
Dakhin Ad, J. Malheiro, M. Almeida, L. Martins, L. Dias, S. Pedroso, A. Henriques, A. Cabrita
Posttransplant Anemia (PTA) is a common finding, often multifactorial. Some atypical etiologies can be masked by the usual causes, resulting in non-solving anemia and compromising graft viability and host recovery. An immune-mediated hemolysis can develop in solid or bone marrow graft recipients in the presence of ABO-minor mismatch or, more rarely, other blood groups mismatches, like Rhesus (Rh) system. This condition, known by Passenger Lymphocyte Syndrome (PLS), occurs after the transfer of donor’s viable B-lymphocytes with the transplanted organ, which leads to the production of antibodies (Ab) against recipient red blood cells (RBC) antigens (Ag). PLS should be considered even when the PTA etiology seems obvious or when there are no apparent reasons for suspecting it. We review a case of PLS after kidney transplantation, caused by an Rh(D) mismatch.
{"title":"Post-Kidney Transplant Anemia as a Result of Passenger Lymphocyte Syndrome by Rhesus Antibodies - A Rare Etiology for a Common Finding","authors":"Dakhin Ad, J. Malheiro, M. Almeida, L. Martins, L. Dias, S. Pedroso, A. Henriques, A. Cabrita","doi":"10.16966/2380-5498.179","DOIUrl":"https://doi.org/10.16966/2380-5498.179","url":null,"abstract":"Posttransplant Anemia (PTA) is a common finding, often multifactorial. Some atypical etiologies can be masked by the usual causes, resulting in non-solving anemia and compromising graft viability and host recovery. An immune-mediated hemolysis can develop in solid or bone marrow graft recipients in the presence of ABO-minor mismatch or, more rarely, other blood groups mismatches, like Rhesus (Rh) system. This condition, known by Passenger Lymphocyte Syndrome (PLS), occurs after the transfer of donor’s viable B-lymphocytes with the transplanted organ, which leads to the production of antibodies (Ab) against recipient red blood cells (RBC) antigens (Ag). PLS should be considered even when the PTA etiology seems obvious or when there are no apparent reasons for suspecting it. We review a case of PLS after kidney transplantation, caused by an Rh(D) mismatch.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67391067","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}
Most of bladder calculi are mobile, though stones formed on a suture or retained stent or on the intravesical portion of a papillary tumor are fixed. Generally, most of urinary calculi are calcium oxalate dehydrate monohydrate stones with a regular, homogeneous appearance and smooth margin. During endoscopic examinations they appear black, whereas Jackstone calculi are irregular and yellow [2]. Calcium oxalate dehydrate monohydrate stones are less susceptible to fragmentation through lithotripsy.
{"title":"Jackstone Calculus: A Rare Subtype of Urinary Stone with a Sea-Urchin Appearance","authors":"B. Brogna, F. Flammia, Flammia Fc, U Flammia","doi":"10.16966/2380-5498.166","DOIUrl":"https://doi.org/10.16966/2380-5498.166","url":null,"abstract":"Most of bladder calculi are mobile, though stones formed on a suture or retained stent or on the intravesical portion of a papillary tumor are fixed. Generally, most of urinary calculi are calcium oxalate dehydrate monohydrate stones with a regular, homogeneous appearance and smooth margin. During endoscopic examinations they appear black, whereas Jackstone calculi are irregular and yellow [2]. Calcium oxalate dehydrate monohydrate stones are less susceptible to fragmentation through lithotripsy.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67390826","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}
Ruggajo P, M. S, J. I., M. J., Fredrick F, C. P, Kamuhabwa A
{"title":"Anaemia in Patients on Haemodialysis Therapy in Dar es Salaam, Tanzania","authors":"Ruggajo P, M. S, J. I., M. J., Fredrick F, C. P, Kamuhabwa A","doi":"10.16966/2380-5498.181","DOIUrl":"https://doi.org/10.16966/2380-5498.181","url":null,"abstract":"","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67391086","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}
Pregnancy in the End Stage Renal Disease (ESRD) population is one of the most complex clinical challenges for healthcare providers. Current guidelines, peer-reviewed publications, and textbook chapters were utilized in this review to determine the best practices for dialysis during pregnancy, extending to immediate post-partum period. The purpose of this review is to impart healthcare providers with current practice recommendations for the best health outcomes for the mother and fetus.
{"title":"Dialysis and Pregnancy-A Review","authors":"M. Kothari, Hampton Td, M. Singh","doi":"10.16966/2380-5498.175","DOIUrl":"https://doi.org/10.16966/2380-5498.175","url":null,"abstract":"Pregnancy in the End Stage Renal Disease (ESRD) population is one of the most complex clinical challenges for healthcare providers. Current guidelines, peer-reviewed publications, and textbook chapters were utilized in this review to determine the best practices for dialysis during pregnancy, extending to immediate post-partum period. The purpose of this review is to impart healthcare providers with current practice recommendations for the best health outcomes for the mother and fetus.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67390961","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}
Ghalia Khellaf, M. Saidani, S. Missoum, T. Rayane, L. Kaci, Gubler M-C, M. Benabadji
Background: Toni Debré Fanconi syndrome is characterized by a generalized dysfunction of the proximal tube. The isolated, familial syndrome is rare. It is transmitted according to the autosomal dominant mode. Niemann-Pick disease (NP) is an equally rare autosomal recessive disorder characterized by lysosomal accumulation of sphingomyelin in body cells. The disease is caused by mutations in the SMPD1 gene that cause lysosomal acid sphingomyelinase deficiency. Case Report: We report a case of a 28-years-old patient from first-degree consanguineous marriage, family history of polydipsia and polyuria, staff hospitalized for moderate renal impairment and asthenia, the finding of tubular proteinuria associated with hypouricemia, hyperphosphaturia and hypercalciuria, leads to the diagnosis of Toni Debré Fanconi syndrome. On the other hand, the particular face of the patient, the existence of hepatosplenomegaly, hypertriglyceridemia and thrombocytopenia lead to the diagnosis of Niemann Pick type B syndrome, diagnosis confirmed by the biochemical assay and the genetic study. Conclusion: We report the rare association, in a Maghrebian family, of an autosomal dominant Toni Debré Fanconi syndrome, and an autosomal recessive disorder, Niemann Pick B syndrome.
{"title":"A Syndrome Hides Another, About an Algerian Family","authors":"Ghalia Khellaf, M. Saidani, S. Missoum, T. Rayane, L. Kaci, Gubler M-C, M. Benabadji","doi":"10.16966/2380-5498.170","DOIUrl":"https://doi.org/10.16966/2380-5498.170","url":null,"abstract":"Background: Toni Debré Fanconi syndrome is characterized by a generalized dysfunction of the proximal tube. The isolated, familial syndrome is rare. It is transmitted according to the autosomal dominant mode. Niemann-Pick disease (NP) is an equally rare autosomal recessive disorder characterized by lysosomal accumulation of sphingomyelin in body cells. The disease is caused by mutations in the SMPD1 gene that cause lysosomal acid sphingomyelinase deficiency. Case Report: We report a case of a 28-years-old patient from first-degree consanguineous marriage, family history of polydipsia and polyuria, staff hospitalized for moderate renal impairment and asthenia, the finding of tubular proteinuria associated with hypouricemia, hyperphosphaturia and hypercalciuria, leads to the diagnosis of Toni Debré Fanconi syndrome. On the other hand, the particular face of the patient, the existence of hepatosplenomegaly, hypertriglyceridemia and thrombocytopenia lead to the diagnosis of Niemann Pick type B syndrome, diagnosis confirmed by the biochemical assay and the genetic study. Conclusion: We report the rare association, in a Maghrebian family, of an autosomal dominant Toni Debré Fanconi syndrome, and an autosomal recessive disorder, Niemann Pick B syndrome.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46925043","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}
Pub Date : 2017-08-01Epub Date: 2017-04-06DOI: 10.16966/2380-5498.141
Mary Hammes, Rita McGill, Promila Dhar, Rama S Madhurapantula
Background: Vascular access for hemodialysis is best provided by an arteriovenous fistula (AVF). AVF fail primarily because of neointimal hyperplasia. Asymmetric dimethlyarginine (ADMA) is a naturally occurring analogue of L-arginine, which is elevated in renal failure and impairs endothelial cell function. ADMA inhibits nitric oxide synthetase, leading to impaired nitric oxide production and contributing to the development of neointimal hyperplasia. ADMA was measured at the time of AVF placement to evaluate associations with access failure.
Methods: ADMA was measured at the time of brachiocephalic access placement. Patients were followed for up to 12 months with end-points of access thrombosis or venous stenosis.
Results: Sixty patients with primary brachiocephalic fistulas were included in the study cohort. The median value for ADMA drawn at the time of AVF creation was 3.1 µmol/L. ADMA was not significantly associated with early thrombosis or venous stenosis events (P>0.05).
Conclusion: Preoperative ADMA levels, as a surrogate for endothelial cell dysfunction and predictor of adverse access event (thrombosis or stenosis), were not associated with subsequent access events Future studies that identify markers of endothelial cell dysfunction are warranted.
{"title":"Asymmetric Dimethylarginine does not Predict Early Access Events in Hemodialysis Patients with Brachiocephalic Fistula Access.","authors":"Mary Hammes, Rita McGill, Promila Dhar, Rama S Madhurapantula","doi":"10.16966/2380-5498.141","DOIUrl":"https://doi.org/10.16966/2380-5498.141","url":null,"abstract":"<p><strong>Background: </strong>Vascular access for hemodialysis is best provided by an arteriovenous fistula (AVF). AVF fail primarily because of neointimal hyperplasia. Asymmetric dimethlyarginine (ADMA) is a naturally occurring analogue of L-arginine, which is elevated in renal failure and impairs endothelial cell function. ADMA inhibits nitric oxide synthetase, leading to impaired nitric oxide production and contributing to the development of neointimal hyperplasia. ADMA was measured at the time of AVF placement to evaluate associations with access failure.</p><p><strong>Methods: </strong>ADMA was measured at the time of brachiocephalic access placement. Patients were followed for up to 12 months with end-points of access thrombosis or venous stenosis.</p><p><strong>Results: </strong>Sixty patients with primary brachiocephalic fistulas were included in the study cohort. The median value for ADMA drawn at the time of AVF creation was 3.1 µmol/L. ADMA was not significantly associated with early thrombosis or venous stenosis events (<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Preoperative ADMA levels, as a surrogate for endothelial cell dysfunction and predictor of adverse access event (thrombosis or stenosis), were not associated with subsequent access events Future studies that identify markers of endothelial cell dysfunction are warranted.</p>","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35576953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The relationship between trace elements and Oxidative Stress (OS) in Chronic Kidney Disease (CKD) patients is still not completely elucidated. The aim of this work is to determine the serum levels of OS and the trace elements in CKD patients.
{"title":"Effects of Chronic Kidney Disease on levels of Oxidative Stress and Trace Elements","authors":"Z. X, Z. Y., H. J, Xiao D, Zhu D, Óùøôùø Ý ý","doi":"10.16966/2380-5498.221","DOIUrl":"https://doi.org/10.16966/2380-5498.221","url":null,"abstract":"Introduction: The relationship between trace elements and Oxidative Stress (OS) in Chronic Kidney Disease (CKD) patients is still not completely elucidated. The aim of this work is to determine the serum levels of OS and the trace elements in CKD patients.","PeriodicalId":92052,"journal":{"name":"International journal of nephrology and kidney failure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67391172","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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