Aluminum Toxicity in Dialysis Patients

2015 ◽  
pp. 198-220 ◽  
Author(s):  
F. L. Van de Vyver ◽  
F. J. E. Silva ◽  
P. C. D�Haese ◽  
A. H. Verbueken ◽  
M. E. De Broe
Keyword(s):  
Aluminum Toxicity ◽  
Dialysis Patients

Microcytic Anemia in Dialysis Patients: Reversible Marker of Aluminum Toxicity

1987 ◽  
Vol 9 (3) ◽  
pp. 217-223 ◽  
Author(s):  
Richard Swartz ◽  
Janet Dombrouski ◽  
Maria Burnatowska-Hledin ◽  
Gilbert Mayor
Keyword(s):  
Aluminum Toxicity ◽  
Microcytic Anemia ◽  
Dialysis Patients

scholarly journals Aluminum Toxicity: Evaluation of 16-Year Trend Among 14 919 Patients and 45 480 Results

2018 ◽  
Vol 142 (6) ◽  
pp. 742-746 ◽  
Author(s):  
Ron B. Schifman ◽  
Daniel R. Luevano
Keyword(s):  
Chronic Toxicity ◽  
Aluminum Toxicity ◽  
Serum Levels ◽  
Veterans Affairs ◽  
Repeated Measurements ◽  
Dialysis Fluid ◽  
Dialysis Patients ◽  
Toxicity Evaluation ◽  
Long Term Trends

Context.— Annual monitoring with serum aluminum measurements is recommended for dialysis patients who are susceptible to toxic accumulation from contaminated dialysis fluid or from ingestion of aluminum-containing medications. Objective.— To evaluate long-term trends in serum aluminum concentrations and frequency of chronic toxicity. Design.— A retrospective observational study was conducted by analyzing serum aluminum results obtained from the Veterans Affairs corporate data warehouse. Serum aluminum concentrations of 60 μg/L or greater were considered false positives and not indicative of chronic toxicity if another specimen retested within 45 days had a concentration below 20 μg/L. Results.— A total of 45 480 serum aluminum results involving 14 919 patients and 119 Veteran Affairs facilities during a 16-year period ending in October 2016 were evaluated. The percentage of elevated (≥20 μg/L) serum aluminum results declined from 31.5% in 2000 to 2.0% in 2015. Average testing intervals changed from every 159 days in 2000 to every 238 days in 2015. Of 529 patients with serum aluminum concentrations of 60 μg/L or greater, 216 (40.8%) were retested within 45 days (average = 21 days); of these, 83 (38.4%) had concentrations below 20 μg/L after repeated measurements. Retesting rates increased with higher initial serum aluminum concentrations. Conclusions.— Aluminum toxicity, as assessed by serum levels, has substantially declined over time and is now rare. Many serum aluminum concentrations in the toxic range were not confirmed after retesting. Patients with toxic serum aluminum concentrations should be retested with another specimen before undergoing treatment or investigating sources of exposure to verify abnormal results.

Relationship between intact 1–84 parathyroid hormone and bone histomorphometric parameters in dialysis patients without aluminum toxicity

1995 ◽  
Vol 26 (5) ◽  
pp. 836-844 ◽  
Author(s):  
Mei Wang ◽  
Gavril Hercz ◽  
Donald J. Sherrard ◽  
Norma A. Maloney ◽  
Gino V. Segre ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Aluminum Toxicity ◽  
Dialysis Patients

Serum Thiamine Values in End-Stage Renal Disease Patients under Maintenance Hemodialysis

2015 ◽  
Vol 85 (5-6) ◽  
pp. 348-355 ◽  
Author(s):  
Masamitsu Ubukata ◽  
Nobuyuki Amemiya ◽  
Kosaku Nitta ◽  
Takashi Takei
Keyword(s):  
Thiamine Deficiency ◽  
Risk Index ◽  
Nutritional Risk ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Significant Difference ◽  
Nutritional Risk Index ◽  
Serum Aspartate Aminotransferase ◽  
Stage Renal Disease ◽  
End Stage

Abstract. Objective: Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients. Methods: To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis. Results: Average thiamine levels were not low in both pre-hemodialysis (50.1 ± 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 ± 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (Δthiamine/pre thiamine < 0; - 0.13 ± 0.11) group (n = 18) and the increase (Δthiamine/pre thiamine> 0; 0.32 ± 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group (≥ 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 ± 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group (≥ 35.4 ng/ml; 73.5 ± 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate. Conclusion: In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.

Impact of an educative program on dialysis patients’ knowledge and mental health: controlled before and after program

2018 ◽  
Vol 10 (2) ◽  
pp. 20204
Author(s):  
Laetitia Idier ◽  
Aurélie Untas ◽  
Nicole Rascle ◽  
Michèle Koleck ◽  
Maider Aguirrezabal ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Vascular Access ◽  
Educational Program ◽  
Psychological State ◽  
Control Group ◽  
Dialysis Patients ◽  
Emotional Change ◽  
The Impact ◽  
Experimental Group

Introduction:Psychological impact of Therapeutic Patient Education (TPE) for dialysis patients is rarely evaluated since the focus of many studies is on medical variables (i.e., adherence).Objectives:The aims of this study were: 1) to estimate the impact of a TPE program on knowledge, depression and anxiety, 2) to examine change in knowledge as a mediator of the effects of a TPE program on mental health.Method:This study was conducted in three hemodialysis units and comprised two groups: an experimental group with education and a control group with routine care. The program was based of 5 educative sessions. Knowledge, depressive and anxious symptoms were assessed with self-reported outcomes measured before and 3 months after the program.Results:The sample comprised 125 patients. Knowledge about vascular access and nutrition (p < 0.01) and depressive symptoms increased in the experimental group (p < 0.01). Analysis of mediation showed that changes in knowledge about vascular access were a significant mediator of the effects of the program on depressive symptoms (F = 4.90;p = 0.01).Discussion:Knowledge acquired during an educational program could lead to an emotional change. Improving knowledge often leads to an awareness of the risks that can modify the psychological state of patients by reminding them of their vulnerability. This study shows that it is required to be attentive to the way of transmitting knowledge. It’s necessary adapting this transmission to the needs of patients and promoting the acquisition of psychosocial competence too.Conclusion:This study shows that knowledge acquired during an educational program can lead to an emotional change in the short term. A long-term follow-up of the population should be interesting to observe these emotional effects.

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