Refusal of hemodialysis by hospitalized chronic kidney disease patients in Pakistan.

Refusal of hemodialysis by hospitalized chronic kidney disease patients in Pakistan. Saudi J Kidney Dis Transpl. 2018 Mar-Apr;29(2):401-408 Authors: Shafi ST, Saleem M, Anjum R, Abdullah W, Shafi T Abstract In Pakistan, patients with chronic kidney disease (CKD) are commonly diagnosed at a late stage. There is little information about the refusal of hemodialysis by hospitalized CKD patients who need hemodialysis (HD) and reasons for acceptance and refusal among these patients. All patients with Stage V CKD who had medical indications to undergo HD and were hospitalized at a tertiary care facility over a six-month period were invited to participate in this study. Patients were surveyed regarding acceptance or refusing of HD and reasons for their decisions. Demographic, socioeconomic, and clinical characteristics of patients were compared between patients who accepted or refused HD. A total of 125 patients were included in the study. The mean age of the patients was 47.9 ±12.1 years. The mean duration of diagnosis of CKD was 2.5 ± 0.6 months. Of all patients, 72 (57.6%) agreed to do HD and 53 (42.4%) refused HD. Patients with arteriovenous fistula in place (27.1 vs. 9.1%, P 0.02) and those in the middle- or higher-income group (64.4% vs. 38.6%, p = 0.03) were more willing to undergo HD. Trust in doctor's advice (86.1%) was the most common reason for acceptance of HD. Frequency of HD per week (52.8%), lifelong and permanent nature of HD (50.9%...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research

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AbstractIntroductionChronic kidney disease (CKD) is a systemic disease affecting many organs. Progression of renal failure aggravates ongoing inflammation and increases oxidative stress. In the final stage of CKD, it is necessary to use renal replacement therapy. A side effect of dialysis therapy is the synthesis of proinflammatory factors and increased oxidative stress, which activates platelets and immune cells.Aim of the studyTo determine the regenerative potential of platelets in patients with CKD based on the analysis of the relationships between substances with potential regenerative action, as well as analysis of th...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
CONCLUSION: Therapeutic patient education (TPE) has become a need in the care of CKD patients, even at early stages of the disease. TPE allows to prepare the patients, favoring autonomy and shared decision making about his disease, in collaboration with healthcare workers and patient's relatives. PMID: 31126878 [PubMed - as supplied by publisher]
Source: Nephrologie and Therapeutique - Category: Urology & Nephrology Authors: Tags: Nephrol Ther Source Type: research
ve; P Abstract INTRODUCTION: Increased levels of cardiac troponins (cTn) are a hallmark of acute myocardial infarction (AMI), along with symptoms and electrocardiographic (ECG) changes. Stably elevated cTn concentrations are frequently observed in asymptomatic patients with chronic kidney disease (CKD) and/or on hemodialysis (HD); the meaning of this elevation, as assessed by conventional techniques, remains unclear. Aim of our study was to evaluate the clinical significance of cTnI levels in asymptomatic HD patients by employing a newer high-sensitive cTnI (hs-cTnI) assay. METHODS: We enrolled 49 patients un...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Publication date: Available online 19 April 2019Source: Canadian Journal of CardiologyAuthor(s): Pierluigi Costanzo, Vladimír DžavíkAbstractPatients with chronic kidney disease (CKD) have an increased risk of obstructive coronary artery disease (CAD), while patients with end stage renal disease (ESRD) on hemodialysis represent a population at particularly high risk of developing cardiac ischemic events. Patients with CKD and acute coronary syndromes (ACS) should be treated the same way as ACS patients without kidney dysfunction. The benefit of revascularization in patients with advanced kidney failure and CA...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
CONCLUSION: The absolute number of patients and rates of incidence and prevalence on dialysis continued to increase; the mortality rate tended to rise. There were obvious regional and state discrepancies in these rates. PMID: 30968930 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
ConclusionDespite the measures of state hospitals to provide CKD management, barriers to management of CKD still exist amongst the CKD population. Hence, there is need to develop specific tailored interventions to reduce such obstacles thus promoting effective management of CKD patients.
Source: International Journal of Africa Nursing Sciences - Category: African Health Source Type: research
We report a case of systemic oxalosis involving the eyes and joints due to long-term use of high-dose vitamin C in a patient receiving maintenance peritoneal dialysis (PD). This 76-year-old woman with autosomal dominant polycystic kidney disease underwent living unrelated kidney transplantation 10 years earlier. The transplant failed 6 months before presentation, and she initiated hemodialysis therapy before transitioning to PD therapy 4 months later. During the month before presentation, the patient noted worsening arthralgias and decreased vision. Ophthalmologic examination revealed proliferative retinopathy and calcium ...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Discussion: Incomplete septal cirrhosis is an uncommon cause of non-cirrhotic portal hypertension. Its definition is not well known, morphological and pathophysiological. We have not found published cases of post-RT ascites secondary to this pathology, described as possibly associated with drugs, immune alterations, infections, hypercoagulability and genetic predisposition. PMID: 30897191 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
Kidney transplantation is the best treatment for patients with end-stage renal disease (ESRD) because of a significant survival benefit conferred compared to patients who remain on haemodialysis.1 Although the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with ESRD has significantly declined over time, it remains at least 4-times higher than in the general population.2,3 Chronic HCV or HBV infection can result in chronic liver disease, cirrhosis, and hepatocellular carcinoma4 –6 and increase the risk of chronic kidney disease (CKD).
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Research Article Source Type: research
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