Drugs in Renal Failure: Dosing Guidelines for Frequently Used Drugs in End-Stage Renal Disease and Dialysis Patients

1985 ◽  
Vol 3 (1-3) ◽  
pp. 140-168 ◽  
Author(s):  
G. Seyffart
1981 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Thomas G Murray ◽  
Carol Eisen ◽  
Morris Grabie ◽  
Ellen Buerklin ◽  
Barry R Walker ◽  
...  

Patients with end stage renal disease who are maintained on haemodialysis have elevated levels of many hormones, some of which may play a role in the pathogenesis of the complications of uraemia. The infusion of synthetic somatostatin reduces the circulating level of many of these same hormones in patients with normal renal function. If the elevated hormone levels in dialysis patients could be similarly lowered, study of the pathogenitic significance of the various hormonal abnormalities would be facilitated. With this in mind, the effect of synthetic somatostatin on the circulating level of growth hormone, glucagon, insulin, gastrin, parathyroid hormone, and thyroid stimulating hormone in dialysis patients was investigated. In pilot protocol, a dose of 2 mg of somatostatin infused over 24, 18, or 12 hours (two patients each) was found to have no effect on any hormonal level. Infusion of 2 mg of somatostatin over 4 hours, however, was associated with consistent fall in the level of growth hormone (13.6 ± 6.2 to 6.53 ± 2.9, p = 0.15) and glucagon (595.0 ± 73 to 441 ± 28, p < 0.05) in each of four patients. The percentage change in the level of growth hormone and glucagon during the 4-hour somatostatin infusion was significantly different from the change occurring during a 4-hour timed control period (growth hormone —45 ± 18% vs +9 ± 7%, [p < 0.05]), (glucagon −27% ± 2% vs + 8 ± 2%, [p < 0.01]). There was no change in the level of any other hormone during the 4-hour infusion. No significant adverse effects were seen. This study suggests that the intravenous infusion of somatostatin can, at least on an acute basis, lower the level of growth hormone and glucagon in patients with end stage renal failure; and, therefore, it may be useful in further study and possibly the treatment of the hormonal abnormalities of end stage renal disease.


1997 ◽  
Vol 8 (12) ◽  
pp. 1942-1945 ◽  
Author(s):  
B I Freedman ◽  
J M Soucie ◽  
W M McClellan

As part of a larger study of genetic risk factors for the occurrence of renal failure, the prevalence of a family history of end-stage renal disease (ESRD) in first- and second-degree relatives of all incident dialysis patients treated in Georgia, North Carolina, and South Carolina (ESRD Network 6) in 1994 was ascertained. Family histories were obtained from 4365 dialysis patients (83% of those eligible), and 856 (20%) reported having a family history of ESRD. Among race-sex groups, 14.1% of Caucasian men, 14.6% of Caucasian women, 22.9% of African-American men, and 23.9% of African-American women reported a first- or second-degree relative with ESRD (P = 0.001). The prevalence of relatives with ESRD varied by the reported etiology: 22.2% in diabetes mellitus; 18.9% in hypertension, 22.7% in glomerulonephritis; and 13.0% of other etiologies (P = 0.001). Patient characteristics independently associated with family history of ESRD included race, younger age, higher levels of education, and etiology of ESRD. In this report, it is concluded that a large proportion of incident ESRD cases have close relatives with ESRD in whom preventive actions might be directed. Genetic analyses in multiply affected families may identify the inherited factors contributing to progressive renal failure.


Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.


Author(s):  
Aysun Karabay Bayazit ◽  
Bahriye Atmi&scedil; ◽  
Engin Melek ◽  
Abdulsamet Ala ◽  
Merve Sapmaz ◽  
...  

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 113-117
Author(s):  
Salahuddin Feroz ◽  
Shah Md Zakir Hossain ◽  
Rafi Nazrul Islam ◽  
Amir Mohammad Kaiser ◽  
Miliva Mozaffor ◽  
...  

Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117


2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.


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