scholarly journals The Acute Effect of Hemodialysis on Choroidal Thickness

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Osman Çelikay ◽  
Sinan Çalışkan ◽  
Tolga Biçer ◽  
Naciye Kabataş ◽  
Canan Gürdal

Objective. To determine the effect of hemodialysis (HD) on choroidal thickness (CT).Methods. The right eyes of 41 patients with end-stage renal disease (ESRD) undergoing HD were included. All patients underwent an ophthalmic examination, including CT measurement via optical coherence tomography, intraocular pressure (IOP), blood pressure, and body weight measurement immediately before and after a HD session.Results. Mean subfoveal choroidal thickness (SFCT) after HD decreased significantly from 254.59 ± 84.66 µm to 229.34 ± 77.79 µm(p<0.001). CT at the temporal and nasal regions also decreased significantly after HD (bothp<0.001). IOP changes after HD were insignificant(p=0.958). CT difference was insignificant in patients with diabetes mellitus (DM) and without DM before and after HD, respectively (p=0.285andp=0.707). Stepwise multivariate linear regression analysis showed that diastolic blood pressure was the best fitted factor to explain the changes in CT (r=0.327andp=0.040).  Conclusion. CT was decreased in the patients with ESRD following a HD session. This study suggested that the changes in CT may be related to the changes in systemic blood pressure.

1987 ◽  
Vol 67 (3) ◽  
pp. 387-393 ◽  
Author(s):  
Mark N. Hadley ◽  
Robert F. Spetzler ◽  
Mary S. Fifield ◽  
William D. Bichard ◽  
John A. Hodak

✓ Nimodipine was administered by intravenous infusion to six male baboons before, during, and after 6 hours of middle cerebral artery occlusion. Intracranial pressure (ICP) and systemic blood pressure were monitored continuously. An epidural balloon was inflated at regular intervals at three levels of arterial CO2 tension (25, 35, and 50 mm Hg) before and after the administration of nimodipine, and volume-pressure curves were generated. In every case, curves generated after intravenous nimodipine infusion were lower and shifted more to the right than the same set of curves generated before nimodipine administration, regardless of the baseline ICP. The reduction in ICP following nimodipine infusion was not due to a reduction in mean arterial blood pressure and was statistically significant at all three levels of pCO2 (p < 0.01). These results suggest that, in the presence of elevated ICP due to cerebral infarction, there is no increased risk of exacerbating intracranial hypertension with the addition of nimodipine.


Author(s):  
Natércia Neves Marques de Queiroz ◽  
Franciane Trindade Cunha de Melo ◽  
Fabrício de Souza Resende ◽  
Luísa Corrêa Janaú ◽  
Norberto Jorge Kzan de Souza Neto ◽  
...  

Background: Vitamin D (VD) deficiency has been related to several endocrine metabolic and cardiovascular diseases. Effect of VD supplementation on blood pressure (BP) in patients with diabetes is controversial. Objective: The aim of this study was to evaluate high-dose vitamin D supplementation effects on blood pressure of normotensive type 1 diabetes mellitus (T1DM) patients by 24-hour ambulatory blood pressure monitoring (ABPM). Methods: We performed a clinical trial including 35 T1DM normotensive patients, who received doses of 4,000 or 10,000 IU/day of cholecalciferol for 12 weeks according to previous VD levels. They underwent 24-hour ABPM, along with glycated hemoglobin, creatine, lipids profile and PCRus dosage before and after VD supplementation. Results and discussion: We found an expressive reduction of systolic and diastolic morning blood pressures (117±14 vs 112±14, p<0,05; 74±9 vs 70±10 mmHg, p<0,05, respectively) with no changes in other pressoric markers. Besides, we noticed a relation between levels of VD after supplementation and diastolic morning blood pressure (r= -0,4; p<0.05). Conclusion: Our study suggests an association between supplementation of high doses of vitamin D and the reduction of morning blood pressure in normotensive T1DM patients.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Alex R Chang ◽  
J E Hartle ◽  
Lawrence Appel ◽  
Morgan Grams

Background: JAMA 2014 blood pressure (BP) guidelines raised BP goals for adults older than 60 years (from <140/90 to <150/90) and adults with chronic kidney disease (CKD) or diabetes (from < 130/80 to <140/90). It is unknown whether there were changes in BP control at the health system level after guideline publication. Methods: Using data from 288,962 adults receiving primary care in the Geisinger Health System, we compared blood pressure control over 1-year time periods before and after the February 2014 publication of the JAMA 2014 BP guidelines (i.e. Aug 2012-July 2013 vs Aug 2014-July 2015). Mixed effects models were used, allowing intercepts to vary by individual, adjusted for age, gender, and race. Results: Mean age was 49.2 ± 18.3 y, 56.7% were female, and 2.5% were black. Prevalence of diagnoses for hypertension, diabetes, and CKD were 40.0%, 15.1%, and 11.4%, respectively. Overall, distributions of systolic BP were similar before and after JAMA 2014 BP guidelines (Figure). BP control <140/90 was also similar between the two periods for adults 18-59 y (90.9% vs. 90.3%; OR 1.01, 95% CI: 0.99-1.02; p=0.3), adults ≥ 60 y (81.8% vs 82.2%; OR 1.01, 95% CI: 1.00-1.03; p=0.05), and adults with diabetes (83.2% vs. 82.7%; OR 1.00, 95% CI: 0.99-1.02; p=0.7) whereas BP control <140/90 improved slightly for adults with CKD (81.7% vs. 82.1%; OR 1.06, 95% CI: 1.04-1.08; p<0.001). BP control <130/80 was marginally worse after JAMA 2014 BP guidelines in patients with diabetes (53.5% vs. 51.8%; OR 0.98, 95% CI: 0.96-0.99; p=0.01). Trends were similar in analyses only including patients with hypertension diagnoses (overall 78.6% vs. 78.2%, OR 1.00, 95% CI: 0.99-1.02; p=0.5), and when using a goal of < 130/80 for patients with CKD (53.3% vs. 53.5%; OR 1.06, 95% CI: 1.04-1.08; p<0.001). Conclusion: There was little change in blood pressure control in a large integrated health system after publication of the JAMA 2014 BP guidelines. These findings are reassuring given recent findings from the SPRINT trial supporting lower BP goals.


2021 ◽  
Vol 1 (4) ◽  
pp. 50-56
Author(s):  
Ana Luísa Freitas Siqueira ◽  
Gabriela Souza Faria ◽  
Pedro De Oliveira Neto ◽  
Maria Paula Fabrício de Andrade ◽  
Bruna Pereira Molina Cruz ◽  
...  

Physical training is used in the control of arterial hypertension (AH), especially in patients with higher levels of blood pressure (BP). However, there are still few studies on the effects of physical training on AH in less advanced stages of the disease. The aim of the present study was to assess the immediate and late acute effects of continuous moderate physical training (CMT) and high intensity interval training (HIIT) in patients with mild AH, and to assess which training method induces a greater hypotensive effect. A female patient, 43 years old, sedentary, diagnosed with mild AH (stage 1), taking Losartana 50 mg twice a day was studied. She underwent one CMT and one HIIT session, one week apart. BP measurements were taken before and after each session, as well as 24 hours before and after the sessions. After the physical training sessions, we observed a drop in the patient's BP that lasted up to 60 minutes, and a reduction in blood pressure levels on the day after the training. We conclude that both training modalities were efficient in reducing the BP of the patient with mild acute immediate and delayed hypertension.


2017 ◽  
Vol 20 (2) ◽  
pp. 24-34
Author(s):  
Sagar Koirala ◽  
Pawan Raj Chalise ◽  
Prem Gyawali

Introduction: End stage renal disease has a high rate of mortality and morbidity. Kidney transplantation remains the best treatment option in comparison to other forms of renal replacement therapy. Live related donor renal transplantation was started at TUTH in 2008. Compared to other established centers, the outcome of transplantation was comparable. Though there is considerable evidence showing that donors are able to return to their healthy life, quality of life (QOL) assessment using standardized questionnaires has not yet been done in our centre. This study was carried out in order to compare QOL before and after donor nephrectomy. Methods: Short Form 36 version 2 (SF36v2) was used to assess the quality of life of kidney donors. Interview was conducted just before and three months after donor nephrectomy. Eight domains of quality of life score were compared using SPSS 17.0. Kolmogorov Smirnov test was used to check normal distribution of data. Mean scores before and after donation was compared with paired t test. Multivariate linear regression analysis was done to find out variables predicting poorer outcome. Results: Out of eight domains of quality of life, bodily pain, physical functioning and physical role limitation were decreased 3 months after donation. However, this did not have any impact on overall quality of life of donors. Increasing age was found to an independent predicter of poorer quality of life. However gender and donation status had no significance. Conclusion: Quality of life of renal transplant donors was not affected by donor nephrectomy. Long term follow up and quality of study is required in order to assess the changes in physical health component with time.


1977 ◽  
Vol 232 (5) ◽  
pp. H485-H494 ◽  
Author(s):  
J. E. Norris ◽  
W. C. Randall

The thoracic cardiac nerves were stimulated in each of 21 dogs anesthetized with alpha chloralose. Recordings were made of heart rate, blood pressure, and contractile force from all four cardiac chambers. Walton-Brodie strain-gauge arches were sutured to both atria, and to three locations of each ventricle, representing both anterior and posterior surfaces. The functional autonomic components of each nerve were summarized and classified into four basic types. Types I and II were both located medial to the thoracic vagi. These were shown to contain both sympathetic and parasympathetic components traveling to all four chambers of the heart. The sympathetic componnent of the type II nerves produced reflex changes in force of contraction and systemic blood pressure. Nerves classified as types III and IV produced no parasympathetic effect on the heart. These were all located lateral to the thoracic vagi. While the type III nerves carried sympathetic efferent fibers to all four chambers, the type IV nerve carried sympathetic fibers predominantly to the right atrium.


1975 ◽  
Vol 53 (5) ◽  
pp. 763-776 ◽  
Author(s):  
Pierre Gauthier ◽  
Réginald A. Nadeau ◽  
Jacques de Champlain

The present study in dogs indicates that the peripheral sympathetic fibers develop mostly after birth and reach a full maturity at about 2 months of life. The norepinephrine content of the heart, spleen, intestine, salivary glands, and adrenal glands increased from birth to 56 days of age. In contrast, the content of the stellate ganglia decreased during this period. In most of the organs studied, the uptake of [3H] norepinephrine developed in parallel with the norepinephrine content, except in the right atrium and salivary glands where it was fully developed soon after birth. During development, the systemic blood pressure increased from 40 to 100 mm Hg. Bilateral adrenal vessel clamping failed to induce a fall in blood pressure in growing dogs which indicates that the adrenal medulla or the baroreceptors did not fully compensate for the lack of peripheral sympathetic fibers and for the lower blood pressure in newborn animals. Although cardiac norepinephrine content was still very low in 10-day-old animals, cardiovascular responses to direct and reflex sympathetic stimulation were similar to those observed in 56-day-old animals. These results indicate that the sympathetic nervous system becomes functional before the fibers reach their full maturity.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Nur Azem ◽  
Oriel Spierer ◽  
Meital Shaked ◽  
Meira Neudorfer

Background.Effects of hemodialysis (HD) treatment on retinal thickness and macular edema are unclear.Objective.To evaluate changes in retinal thickness using optical coherence tomography (OCT) in end stage renal disease (ESRD) patients with diabetic retinopathy (DR), with and without diabetic macular edema (DME), undergoing HD.Methods.Nonrandomized prospective study. Forty eyes of DR patients with ESRD treated with HD were divided into two groups: patients with macular edema and patients without macular edema. Both eyes were analyzed. Patients underwent an ophthalmic examination including OCT measurements of retinal thickness, blood albumin and hemoglobin A1C levels, blood pressure, and body weight, 30 minutes before and after HD.Results.We found no significant effects of HD on retinal thickness among patients both with and without DME. The former showed a trend towards reduction in retinal thickness in foveal area following HD, while the latter showed an increase. There was no correlation between retinal thickness and mean blood pressure, weight, kinetic model value—Kt/V, glycemic hemoglobin, or albumin levels before and after HD.Conclusions.HD has no significant effect on retinal thickness among patients with or without DME. Further studies on larger cohorts and repeated OCT examinations are needed to confirm the preliminary findings in this study.


2020 ◽  
Vol 8 (2) ◽  
pp. 99-105
Author(s):  
Sholy K Vareed ◽  
Don Paul Mathew ◽  
P Suresh

Background: Increase in intimal medial thickness (IMT) of the carotid arteries is contemplated as a guide to atherosclerotic vascular disease and subclinical organ damage and foretell cardiovascular disease. The study aimed to analyse IMT in non-diabetic and diabetic subjects. Subjects and Methods: There were 105 diabetic and 95 non-diabetic subjects in this study. Common carotid artery (CCA) IMT was calculated using a linear probe of a high-resolution ultrasound medical system. Results: Diabetic subjects (0.95 mm) showed significantly higher mean intimal medial thickness (IMT) when compared non-diabetic subjects (0.85 mm) (p <0.05). Correlation of IMT was seen with age, total cholesterol, triglycerides, HDL & LDL cholesterol and systolic blood pressure (SBP) in diabetic subjects. Total cholesterol, SBP and diastolic blood pressure (DBP) showed a correlation with IMT in the non-diabetic subjects. Age, total cholesterol, SBP, and diabetes were independent risk factors for intimal medial thickness in multivariate linear regression analysis. Conclusion: Higher intimal medial thickness was seen in diabetic subjects when compared to non-diabetic subjects. We conclude that age, total cholesterol, SBP and duration of diabetes showed a significant correlation with IMT. IMT can be considered as a screening tool in diabetic patients for the early detection of atherosclerosis.


2011 ◽  
Vol 70 (3) ◽  
Author(s):  
J. A. Ebeigbe ◽  
P. N. Ebeigbe ◽  
A. D. A Ighoroje

Background: Mean intraocular pressure (IOP) in postmenopausal women has been reported higher than that in menstruating women. Also, intraocular pressure is said to be positively correlated with systemic blood pressure. No previous study in Nigeria has compared intraocular pressure in postmenopausal women with and without systemic hypertension. Purpose: To investigate the effects of menopause on intraocular pressure in subjects with and without high blood pressure. Methods: Normotensive and hypertensive premenopausal and postmenopausal subjects in the   same agerange of 45 to 55 years were studied. Intraocular pressure was measured with the hand-held Kowa applanation tonometer.  Blood pressure was taken in the sitting position at the right upper arm using a manual mercury sphygmomanometer with the right cuff size. The average of two readings was recorded. Results: Mean IOP for premenopausal normotensive women was 14.58 ± 2.56 mmHg whilethat of postmenopausal normotensive women was16.15 ± 1.80 mmHg (p<0.05).  Also, the difference in mean IOP between premenopausal hypertensive (16.58 ± 3.23 mmHg) and postmenopausal hypertensive women (18.24 ± 3.89 mmHg)was statistically significant (p<0.05). A statistically significant and positive correlation was observed between IOP and systemic blood pressure in postmenopausal hypertensive women, p<0.05.Conclusion: Menopause significantly increases intraocular pressure. Mean intraocular pressure of hypertensive postmenopausal women was significantly higher than that of normotensive post-menopausal women, (p<0.05). Knowledge of the normal level of intraocular pressure during various stages of the female reproductive cycle may help during glaucoma screening. (S Afr Optom 2011 70(3) 117-122)


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