EFFECT OF DIETARY FACTORS AND NUTRITIONAL STATUS ON SERUM CALCIUM AND PHOSPHORUS LEVELS IN CKD PATIENTS ON TREATMENT IN A TERTIARY CARE SETTING IN NORTH INDIA

Objective: The control of phosphorus and calcium metabolism is one of the objectives in treatment protocol for CKD patients. The levels of these minerals in serum are affected by dietary patterns and nutritional status of the patients. India being a large country, diet patterns vary from one state to another. Thus, we suspect a close association between dietary intake and alterations in homeostasis of calcium and phosphorus in CKD patients. Therefore, we conduct this study to describe the effect of dietary factors and nutritional status on serum calcium and phosphorus levels in CKD patients on treatment in a tertiary care setting in North India. Methods: In the present study 330 CKD patients coming to dialysis unit, were recorded with detailed Medical history as well as baseline demographic data. Also, biochemical analysis of serum albumin corrected, calcium, phosphorus, and serum albumin of all cases were done using fully automated equipment. All statistical analyses were performed using SPSS statistical software. Results: Majority (58.2 %) of the study patients were vegetarians with a mean value of BMI (Mean±SD=23.75±4.70 kg/m2). A negative but significant correlation was found between corrected calcium and phosphorus with 0.05 level of confidence interval (r=-0.149, p= 0.007). Conclusion: It was found that the well-nourished patients were more likely to be hyperphosphatemic as compared to poorly nourished patients, but statistically the values were found to be nonsignificant (Statistically p-value was not less than 0.05).                  Peer Review History: Received 23 November 2019;   Revised 12 December 2019; Accepted 1 January, Available online 15 January 2020 Academic Editor: Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Dina Abd Elfattah Eldakhs, Pharos university (PUA), Egypt, [email protected] Dr. Mohammad Tauseef, Department of Pharmaceutical Sciences, College of Pharmacy, Chicago State University, [email protected]  Similar Articles: NEW ERA OF MEDICINE: ROLE OF NUTRACEUTICALS IN TREATMENT AND PREVENTION OF VARIOUS DISEASE

Impact of menstrual cycle phases on C-reactive protein concentrations

Background: C-reactive protein (CRP) is one of the most commonly employed indicator of acute phase reaction and predictors of cardiovascular disease in healthy women; although, only a sparse information on its variations during a regular menstrual cycle is currently available. Our objective was to see whether CRP levels are affected during different phases of menstrual cycle.Methods: Females aged 15-45 years with regular menstrual cycle in terms of length, flow and variation from cycle to cycle were followed for one menstrual cycle. Serum levels of C-reactive protein were measured in the Follicular (10th day) and in the Luteal (22nd day) phase of the menstrual cycle.Results: C-reactive protein levels were observed to vary in response to the phases of menstrual cycle. The concentrations of C-reactive protein levels tend to be highest during the Follicular phase and it declined significantly in the Luteal phase.Conclusions: Identifying the fluctuations in C-reactive protein levels during the menstrual cycle is essential as there may be clinical implication of the suitable timing of assessment while framing and concluding studies in women of reproductive age

ALTERATIONS IN PARATHORMONE, CALCIUM AND PHOSPHORUS LEVELS IN CKD PATIENTS ON MAINTENANCE HAEMODIALYSIS IN A HOSPITAL SETTING IN PUNJAB.â€

Objective: Many people who have severe chronic kidney disease (CKD) will eventually develop kidney failure and will require dialysis. The controlof parathormone (PTH), phosphorus, and calcium metabolism is one of the objectives in an adequate dialysis protocol. Therefore, we conductedthis study to describe alterations in PTH, calcium, and phosphorous homeostasis in patients with CKD on hemodialysis in our center. Our study alsoaimed to find an association between hormonal and biochemical abnormalities in CKD patients, who have been on hemodialysis for ≥5 months andcomparing the results obtained with that recommended by Kidney Disease Improving Global Outcomes (KDIGO) guidelines.Methods: This was a hospital-based cross-sectional observational study. The study population of 330 patients (>18 years) on maintenancehemodialysis coming to dialysis Unit of Department of Medicine of Gian Sagar Hospital, Ramnagar (Patiala), over a period of 3 years (2012-2015),were enrolled in the study. Each patient was considered only once for the study. In addition, biochemical analysis of serum intact PTH (iPTH), correctedcalcium, phosphorus, total alkaline phosphatase (tALP), serum creatinine, blood urea, serum albumin, and hemoglobin of all cases was done usingfully automated equipment. All statistical analyses were performed using SPSS statistical software, version 17.Results: The study population of 330 patients comprised adults, mainly illiterate (54.5%) predominantly belonging to the rural (66.4%) strata witha mean age of 52.67±15.05 (range: 25-98 years). The abnormality in the laboratory profile of the patients was found to be hyperparathyroidism in40.3% as compared to hypoparathyroidism in 33.5% and normal iPTH levels in 26.2%. Hypocalcaemia was detected in 50.6% and hyperphosphatemiain 62.1% of the patients. There was statistically significant association of serum iPTH, with corrected calcium and phosphorus (P=0.032 and P=0.035,respectively). Corrected calcium was also significantly associated with phosphorus (P=0.001) and tALP (P=0.007).Conclusion: We showed in the present study that disorders of mineral metabolism are common in hemodialysis patients and that only a smallproportion adheres to the targets as advised in the KDIGO guidelines for bone metabolism and disease in CKD. We demonstrated that these disordersare associated with important negative clinical outcomes, such as increased all-cause lack survival, more muscle and bone problems. Our findings,therefore, support a strict control of mineral metabolism in dialysis patients. Further research and progress in this area are required to establish amore rational approach with a view toward improving patient outcomes.Keywords: Parathormone, Calcium, Phosphorus, Hemodialysis.Â

A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study

ABSTRACT BACKGROUND: The aim here was to study acute effects of hemodialysis among end-stage renal disease (ESRD) patients. DESIGN AND SETTING: Prospective study in tertiary-level care center. METHODS: Fifty ESRD patients undergoing hemodialysis were studied. Spirometric pulmonary function tests were performed before and after four-hour hemodialysis sessions. RESULTS: The patients’ average age was 45.8 ± 10.0 years; 64% were males and 64% had normal body mass index. Anemia (94%) and hypoalbuminemia (72%) were common. Diabetes mellitus (68%), hypertension (34%) and coronary artery disease (18%) were major comorbidities. Forty-five patients (90%) had been on hemodialysis for six months to three years. The patients’ pre-dialysis mean forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were below normal: 45.8 ± 24.9% and 43.5 ± 25.9% of predicted, respectively. After hemodialysis, these increased significantly, to 51.1 ± 23.4% and 49.3 ± 25.5% of predicted, respectively (P 0.05). The pre-dialysis mean forced expiratory flow 25-75% was 50.1 ± 31% and increased significantly, to 56.3 ± 31.6% of predicted (P < 0.05). The mean peak expiratory flow was below normal (43.8 ± 30.7%) and increased significantly, to 49.1 ± 29.9% of predicted (P < 0.05). Males and females showed similar directions of change after hemodialysis. CONCLUSIONS: Pulmonary function abnormalities are common among ESRD patients. Comparison of pre and post-hemodialysis parameters showed significant improvements, but normal predicted values were still not achieved

A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study

<div><p>ABSTRACT BACKGROUND: The aim here was to study acute effects of hemodialysis among end-stage renal disease (ESRD) patients. DESIGN AND SETTING: Prospective study in tertiary-level care center. METHODS: Fifty ESRD patients undergoing hemodialysis were studied. Spirometric pulmonary function tests were performed before and after four-hour hemodialysis sessions. RESULTS: The patients’ average age was 45.8 ± 10.0 years; 64% were males and 64% had normal body mass index. Anemia (94%) and hypoalbuminemia (72%) were common. Diabetes mellitus (68%), hypertension (34%) and coronary artery disease (18%) were major comorbidities. Forty-five patients (90%) had been on hemodialysis for six months to three years. The patients’ pre-dialysis mean forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were below normal: 45.8 ± 24.9% and 43.5 ± 25.9% of predicted, respectively. After hemodialysis, these increased significantly, to 51.1 ± 23.4% and 49.3 ± 25.5% of predicted, respectively (P < 0.01). The increase in mean FEV1/FVC, from 97.8 ± 20.8% to 99.3 ± 20.1% of predicted, was not significant (P > 0.05). The pre-dialysis mean forced expiratory flow 25-75% was 50.1 ± 31% and increased significantly, to 56.3 ± 31.6% of predicted (P < 0.05). The mean peak expiratory flow was below normal (43.8 ± 30.7%) and increased significantly, to 49.1 ± 29.9% of predicted (P < 0.05). Males and females showed similar directions of change after hemodialysis. CONCLUSIONS: Pulmonary function abnormalities are common among ESRD patients. Comparison of pre and post-hemodialysis parameters showed significant improvements, but normal predicted values were still not achieved.</p></div