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Chronic Haemodialysis Patients (chronic + haemodialysis_patient)
Selected AbstractsATYPICAL REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME IN A CHRONIC HAEMODIALYSIS PATIENT WITH SEVERE HYPERTENSIONNEPHROLOGY, Issue 6 2008JONGHA PARK [source] Anticardiolipin antibody and Taiwanese chronic haemodialysis patients with recurrent vascular access thrombosisINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2005F-R Chuang Summary Vascular access failure is a major cause of morbidity in chronic haemodialysis (HD) patients. However, some factors (such as homocysteine levels) are known regarding the risk factors predisposing certain HD patients to vascular access thrombosis (VAT). Immunoglobulin-G anticardiolipin antibody (IgG-ACA) is strongly associated with venous and arterial thrombosis in patients with normal renal function. Previous investigations have reported the characteristics of patients with raised IgG-ACA titre and recurrent VAT of HD in Western countries, but few equivalent studies exist for Taiwan. This retrospective study attempts to determine whether raised IgG-ACA titres are associated with an increased risk of recurrent VAT in chronic HD patients. This study enrolled 483 patients undergoing HD. IgG-ACA titre and hepatitis B&C marker were measured for all patients. A history of recurrent (VAT more than one) and/or VAT was elicited by using information from the patient questionnaires and was verified by means of careful inpatient and outpatient chart review. Raised IgG-ACA titres were present in 21.7% (105/483) of patients. In both groups (raised IgG-ACA and normal IgG-ACA), the type of shunt differed significantly (p = 0.029). In predicting for more or one episodes of VAT by using multiple logistic regression with all significant factors, synthetic graft was also a significant factor (p < 0.0001). The 105 raised IgG-ACA titres and 378 normal IgG-ACA titres were associated between chronic HD patients and recurrent VAT (p = 0.034). In predicting for more or one episode of VAT by using multiple logistic regression with all significant factors, raised IgG-ACA titre was a non-significant factor (p = 0.336). The presence of hepatitis C had a higher percentage in group with raised IgG-ACA titres of HD patients (p = 0.042). In predicting for more or one episode of VAT by using multiple logistic regression with all significant factors, the presence of hepatitis C was also a significant factor (p = 0.022). In conclusion, the prevalence of raised IgG-ACA titres was 21.7% among HD patients. There was a weak association between raised IgG-ACA titre and recurrent VAT and this finding may be the consequence of pathogenetic role of raised IgG-ACA titres in the development of VAT status for chronic HD patients. The presence of hepatitis C was a cofactor. [source] Neutrophil gelatinase-associated lipocalin levels in chronic haemodialysis patientsNEPHROLOGY, Issue 1 2010DAVIDE BOLIGNANO ABSTRACT: Neutrophil gelatinase-associated lipocalin (NGAL), a small 25 kDa protein strongly induced in injured renal tubular cells, represents an interesting emerging biomarker in the field of clinical nephrology. The aim of the present pilot study was to analyze circulating NGAL levels in a small cohort of 30 patients on chronic haemodialysis (HD), in order to assess any relationships with different laboratory and clinical parameters. Pre- and post-HD levels were higher in patients than in healthy subjects (485.2 ± 49.7 vs 51.2 ± 4.6 ng/mL; P < 0.001; and 167.4 ± 48.0 vs 51.2 ± 4.6 ng/mL; P = 0.01). Furthermore, a single HD session decreased NGAL levels by approximately fourfold (485.2 ± 49.7 vs 167.4 ± 48.0 ng/mL; p:0.01), with a reduction ratio of 73 ± 14%. At baseline, direct and independent correlations were found between NGAL and, respectively, high-sensitivity C-reactive protein (, = 0.34; P = 0.03) and spKt/V (, = 0.35; P = 0.02). The findings showed that HD patients have chronically increased levels of circulating NGAL. However, with a single HD session, a marked reduction was achieved in circulating NGAL values, probably as a result of an important dialytic removal, similar to that observed for other cytokines. Finally, the direct independent correlation found between NGAL and spKt/V raises the question of whether, in the future, NGAL may also become a useful tool in predicting the adequacy of dialysis and in guiding the management of dialysis prescriptions. [source] Ultrasound assessment of large joint amyloidosis in haemodialysisNEPHROLOGY, Issue 1-2 2000Marc Lanteri SUMMARY: Dialysis-related amyloidosis (DRA), associated with beta-2 microglobulin deposition, is a common cause of morbidity in patients with renal failure undergoing chronic dialysis. The non-invasive diagnosis of DRA in its early stages is difficult. High resolution ultrasound (US) was used to examine the shoulder, hip and knee joints of 25 chronic haemodialysis patients, and features distinctive of DRA were determined. Distinctive US features were associated with increased total duration of dialysis (15 ± 5 vs 4 ± 2 years), carpal tunnel syndrome (9/10 cases) and shoulder joint discomfort (19 vs three joints). These features include altered rotator cuff echogenicity (hyperechoic and hypoechoic areas; 20/48 joints), hypoechoic material in the biceps sheath (16/48), erosions of bone (15/48) and reduced biceps tendon fibril echogenicity (12/48). These changes are unique in the experience of the current authors, but histological proof that they are definitely the result of DRA has not yet been possible. Tears of the rotator cuff tendons (14/50) were not consistently associated with symptoms (7/14). Tendon thickness was also increased (as has been described previously). The hip capsule thickness was increased in patients with signs of DRA in the shoulder, but no specific changes in texture were seen. Asymptomatic knee joint effusions were present in 40/50 joints (80%). These features detectable on high resolution US allow the non-invasive early detection of DRA and are useful in the diagnosis and management of this condition. [source] | ||||||||||