Hypothyroidism Induced Severe Rhabdomyolysis in a Hemodialysis Patient

Hypothyroidism occurs relatively common and is a significant cause of morbidity and mortality during the course of chronic kidney disease. Rhabdomyolysis is a potentially life-threatening condition characterised by necrosis of muscular tissue and rarely associates with hypothyroidism. Here we describe a case of rhabdomyolysis due to severe hypothyroidism in a 56-year-old female hemodialysis patient

The Impact of Strict Volume Control Strategy on Patient Survival and Technique Failure in Peritoneal Dialysis Patients

WOS: 000291539400005PubMed ID: 21293119Strict volume control strategy provides better cardiac functions and control of hypertension in dialysis patients. We investigated the effect of this strategy on mortality and technique failure in peritoneal dialysis patients over a 10-year period. 243 patients were enrolled. Strict volume control by dietary salt restriction and ultrafiltration was applied. Mean systolic and diastolic blood pressures decreased from 138.4 +/- 29.9 and 86.3 +/- 16.8 to 114.9 +/- 32.3 and 74.7 +/- 18.3 mm Hg, respectively. Overall and cardiovascular mortality rates were 48.4 and 29.6 per 1,000 patient-years, respectively. In multivariate analysis, age, diabetes and baseline serum albumin level were independent predictors of overall mortality, and age, diabetes and baseline serum calcium of cardiovascular mortality. Residual diuresis and peritoneal equilibration test values were not related to mortality. Strict volume control leads to lower mortality than comparable series in the literature. Technique survival is better during the first 3 years, but not after 5 years. Copyright (C) 2011 S. Karger AG, Base

Association of insulin resistance with arterial stiffness in nondiabetic peritoneal dialysis patients

WOS: 000299080500034PubMed ID: 21643643Insulin resistance is a risk factor for cardiovascular morbidity and mortality in the general and end-stage renal disease populations. In this study, we investigated the association between insulin resistance and arterial stiffness in nondiabetic peritoneal dialysis (PD) patients. Fifty-three patients were enrolled. Patients were divided into 2 groups as homeostasis model assessment of insulin resistance (HOMA-IR) a parts per thousand currency sign2.97 (low) and > 2.97 (high). Carotid-femoral pulse wave velocity (c-f PWV) analysis and intima-media thickness of the carotid artery were measured. Mean age was 46 +/- A 12 years and HOMA-IR was 2.97 +/- A 1.77 (0.77-8.88). Mean c-f PWV was 7.6 +/- A 1.7 m/s. HOMA-IR was positively correlated with age, body mass index, and c-f PWV and negatively with serum HDL cholesterol and parathormone. In linear regression analysis, age and mean arterial pressure were predictors for c-f PWV. When patients were divided into 2 groups according to median age as a parts per thousand currency sign49 and > 50, mean arterial pressure, male gender, and age were predictors for c-f PWV in patients aged a parts per thousand currency sign49, whereas HOMA-IR was the only predictor for c-f PWV in patients aged > 50 years. Insulin resistance is an independent risk factor for arterial stiffness in PD patients older than 50 years. IR is not associated with carotid intima-media thickness.ISPDThe authors would like to thank Dr. Evert Dorhout Mees for his critical review of the manuscript. This study was presented as a free communication in 13th Congress of International Society of Peritoneal Dialysis, 2010, Mexico City and received the ISPD travel grant award

THE RELATIONSHIP BETWEEN RENAL OSTEODYSTROPHY AND FIBROBLAST GROWTH FACTOR-23 IN HEMODIALYSIS PATIENTS

50th European-Renal-Association - European-Dialysis-and-Transplant-Association Congress -- MAY 18-21, 2013 -- Istanbul, TURKEYWOS: 000319498200063European Renal Assoc (ERA), European Dialysis & Transplant Assoc (EDTA

Neither oxidized nor anti-oxidized low-density lipoprotein level is associated with atherosclerosis or mortality in hemodialysis patients

It is anticipated that oxidized low-density lipoprotein (oxLDL) and anti-oxLDL are associated with atherosclerosis and mortality. However, data on this issue are controversial and limited. We aimed to investigate the effect of these two markers on the extent and progression of atherosclerosis and mortality in a group of hemodialysis patients. In this prospective observational study with a follow-up of 36 months, 124 hemodialysis patients were studied. Ninety-five patients underwent carotid intima media thickness (CA-IMT) measurement by B-Mode ultrasonography both at baseline and at the end of the study. oxLDL and anti-oxLDL were measured by enzyme-linked immunosorbent assay. The extent and progression of CA-IMT, along with overall and cardiovascular mortality, were assessed. The mean age at baseline was 54.0 +/- 14.8 years, 57.3% male and 20% diabetic. The mean oxLDL and anti-oxLDL levels were 8.11 +/- 3.16?mU/L and 1.30 +/- 0.31, respectively. Baseline mean CA-IMT was 0.82 +/- 0.20?mm. Fifteen patients died during a follow-up period of 28.5 +/- 6.6 months, 11 from cardiovascular causes. Only oxLDL, not anti-oxLDL, was correlated with the extent of atherosclerosis at baseline. However, both had no role in the progression of atherosclerosis. Also, in unadjusted and adjusted models, both parameters were not associated with overall or cardiovascular mortality. Neither oxLDL nor anti-oxLDL level is associated with the progression of atherosclerosis or mortality in hemodialysis patients

THE INFLUENCE OF DIALYSATE CALCIUM ON PROGRESSION OF ARTERIAL STIFFNESS IN PERITONEAL DIALYSIS PATIENTS

12th Congress of the International-Society-for-Peritoneal-Dialysis -- JUN 20-24, 2008 -- Istanbul, TURKEYWOS: 000263937100002PubMed ID: 19270206Background: One of the origins of cardiovascular disease in dialysis patients is arterial stiffness. The aim of our study was to assess the relationship between the calcium content of peritoneal dialysis (PD) solution and arterial stiffness. Patients and Methods: We enrolled into the study 49 PD patients who had been treated with the same PD solution for the preceding 6 months. The calcium content of the PD solution was 1.25 mmol/L in 34 patients (low-Ca group) and 1.75 mmol/L in 15 patients (high-Ca group). Study patients were followed for 6 months on the same PD prescription. Arterial stiffness was assessed by measurement of augmentation index (AI) and brachial pulse wave velocity (PWV) at baseline and at month 6 (SphygmoCor: Atcor Medical, West Ryde, NSW, Australia). Demographic data were recorded from patient charts. Results: Mean age of the whole group was 51 +/- 11 years, prevalence of diabetes was 14%, duration of PD was 43 +/- 30 months, percentage of women was 45%, and percentage of patients using a cycler was 33%. We observed no differences between groups with regard to those variables or creatinine clearance, residual renal function, Ca, phosphorus, parathormone, C-reactive protein, lipid parameters, and use of phosphate binder with or without Ca content. Mean arterial pressure was higher in the high-Ca group, but the difference was not statistically significant (100 +/- 22 mmHg vs 88 +/- 18 mmHg, p = 0.06). At baseline, AI was significantly higher in the high-Ca group than in the low-Ca group (27% +/- 10% vs 21% +/- 9%, p < 0.05). Measurements of PWV were not different between the groups (8.4 +/- 1.1 m/s vs 8.5 +/- 1.7 m/s). Measurement of arterial stiffness parameters at month 6 revealed that PWV had increased in the high- Ca group (to 9.6 +/- 2.3 m/s from 8.4 +/- 1.1 m/s, p < 0.05), but had not changed in the low-Ca group (to 8.2 +/- 1.9 m/s from 8.5 +/- 1.7 m/s). The AI did not change in either group. Conclusions: These data suggest that Ca exposure through PD solution plays a role in the progression of arterial stiffness, which may be related to increased vascular calcification.Int Soc Peritoneal Dialysi