scholarly journals Therapeutic efficacy of erythropoietin alfa and erythropoietin beta in hemodialysis; a randomized controlled trial

2018 ◽  
Vol 8 (1) ◽  
pp. 44-49
Author(s):  
Hamid-Reza Omrani ◽  
Sima Golmohhamadi ◽  
Amir-Hossein Hashemian ◽  
Ali-Zaman Vaysmoradi ◽  
Roya Safari-Faramani
Keyword(s):  
Controlled Trial ◽  
Hemoglobin Concentration ◽  
Control Group ◽  
Plasma Hemoglobin ◽  
Significant Difference ◽  
Erythropoietin Deficiency ◽  
Stage Renal Disease ◽  
Double Blinded ◽  
End Stage ◽  
Erythropoietin Alfa

Introduction: Anemia, as a common complication of end-stage renal disease (ESRD), usually develops due to erythropoietin deficiency. Recombinant human erythropoietins (rHEPOs) are indicated for the correction of renal anemia. Objectives: We aimed to evaluate the efficacy of a new brand of erythropoietin named CinnaPoietin (erythropoietin beta) on hemoglobin levels. Patients and Methods: This is a randomized double-blinded controlled trial. Ninety-six ESRD patients on hemodialysis recruited in the study, whose hemoglobin levels was less than 10 g/dL. They allocated to two groups. PDPoetin (erythropoietin alfa) 50-100 U/kg three times per week intravenously administrated to the control group and CinnaPoietin with exactly same regimen as like PDPoetin group administrated for the rest of the participants. The study duration was 3 months. We measured plasma hemoglobin monthly for 3 months. Results: We found, hemoglobin was increased across the time and it was statistically significant (P<0.001), while there was no statistically significant differences between the groups (P=0.712). Conclusion: According to the result of the present study there is no statistical significant difference between these two brands of exogenous rHEPO in the case of increasing the hemoglobin concentration.

Long-Term Protective Effect of N-Acetylcysteine against Amikacin-Induced Ototoxicity in End-Stage Renal Disease: A Randomized Trial

2018 ◽  
Vol 38 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Alperen Vural ◽  
İsmail Koçyiğit ◽  
Furkan Şan ◽  
Eray Eroğlu ◽  
İbrahim Ketenci ◽  
...  
Keyword(s):  
Protective Effect ◽  
Pure Tone Audiometry ◽  
The Other ◽  
Control Group ◽  
Tnf Α ◽  
Significant Difference ◽  
Hearing Test ◽  
Stage Renal Disease ◽  
End Stage

Background The aim of the study is to evaluate the long-term protective effect of N-acetylcysteine (NAC), an antioxidant agent, against aminoglycoside (AG)-induced ototoxicity. Methods A total of 40 patients receiving continuous ambulatory peritoneal dialysis (CAPD) and having their first peritonitis attacks and planned to be treated with AGs were enrolled in the study. They were randomized into 2 groups: 1 group received additional NAC and the other did not. All patients underwent hearing tests with pure tone audiometry (PTA) after the diagnosis, at 1 month and 12 months and at the same time the tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were measured. Results Patients taking NAC had better hearing test results in both ears at 1 month except 2,000 Hz for the left ear, which wasn't significantly different between the 2 groups. Although patients taking NAC had generally better PTA results at 12 months, differences between the 2 groups were not statistically significant. Baseline IL-6 level was significantly higher in the NAC group than the control group. Both TNF-α and IL-6 levels at 1 month were significantly lower in the NAC group than in the control group. On the other hand, there was no significant difference between the 2 groups in terms of TNF-α and IL-6 levels at 12 months. Conclusions The results of the current study showed that NAC, a potent anti-inflamatory drug, may be otoprotective, but that the effect is not long-lasting.

scholarly journals Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 730-737
Author(s):  
Hao-Yang Ma ◽  
Shuang Chen ◽  
Ling-Ling Lu ◽  
Wei Gong ◽  
Ai-Hua Zhang
Keyword(s):  
Lumbar Spine ◽  
Renal Disease ◽  
Postmenopausal Women ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

AbstractAs a selective estrogen receptor modulator (SERM), raloxifene is used in healthy postmenopausal women to prevent bone loss and reduce fractures. However, the benefit of raloxifene is uncertain in the treatment of osteoporosis among patients with end-stage renal disease (ESRD) or those who require maintenance dialysis. We assessed the safety and efficacy of raloxifene in this particular population. Studies were selected from PubMed, Springer, CNKI (Chinese National Knowledge Infrastructure) and Wanfang Database. Randomized controlled trials (RCTs) and prospective studies with control/placebo groups were included. Five studies were included with a total of 244 participants (121 patients in the raloxifene group and 123 patients in the placebo/control group). The median duration of treatment was 12 months. The incidence rate of side effects of raloxifene was 0/121 (0%). There was a significant improvement of lumbar spine bone mineral density (BMD) levels in the raloxifene group compared with the placebo group (MD: 33.88, 95% CI: 10.93, 56.84, p=0.004). There was no significant difference concerning the improvement of femoral neck BMD (MD: 8.42, 95% CI: –10.21, 27.04, p=0.38), intact parathyroid hormone (iPTH) (MD: –12.62, 95% CI: –35.36, 10.13, p=0.28), calcium (MD: -0.08, 95% CI: –0.61, 0.44, p=0.76), phosphorus (MD: 0.18, 95% CI: –0.12, 0.48, p=0.23) or bone alkaline phosphatase (BAP) (MD: –4.33, 95% CI: –14.44, 5.79, p=0.40). Raloxifene seems to be effective in improving the lumbar spine BMD in postmenopausal women with ESRD. More large RCTs are necessary to evaluate the long-term safety of raloxifene in uremic patients.

scholarly journals Effects of Arterial Needle Placement in Arteriovenous Fistula on Dialysis Adequacy of End-Stage Renal Disease Patients Undergoing Maintenance Hemodialysis

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Intervention Group ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Needle Placement ◽  
Dialysis Adequacy ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Objective: The arterial needle placement in arteriovenous fistula (AVF) can either be antegrade (in the direction of blood flow or pointing towards the heart) or retrograde (against the direction of blood flow) while venous needle placement should always be in the same direction as the blood flow. This study determined the effects of arterial needle placement in the arteriovenous fistula on dialysis adequacy of End-Stage Renal Disease (ESRD) patients undergoing maintenance hemodialysis in United Candelaria Doctors Hospital - Nephro Synergies Inc. (UCDHNSI) Hemodialysis Center. Methods: A randomized controlled trial design was used in the study. A total of 20 non-diabetic, non-cardiac patients on maintenance hemodialysis for more than 6 months were randomized either to the intervention group (patients’ AVF were cannulated in a retrograde manner) or the control group (patients’ AVF were cannulated in an antegrade manner). Urea reduction ratio (URR) and Kt/V as well as access recirculation percentage were used to determine dialysis adequacy. Pre-dialysis, in the first 30 minutes of dialysis initiation and post-dialysis blood samples were obtained in each patient in 6 succeeding hemodialysis considering dialyzer reuse up to fifth reuse. Means were compared by independent t-test. Results: The findings of the study revealed that the mean URR and Kt/V of the subjects cannulated in retrograde manner and antegrade manner were 69.35% and 1.45, and 74.65% and 1.70, respectively. The mean access recirculation percentage of the subjects was 4.65% in the intervention group and 3.02% in the control group. There was a significant difference on URR and Kt/V of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. There was no significant difference on access recirculation percentage of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. Conclusions: Antegrade arterial needle placement provides more adequate hemodialysis than retrograde arterial needle placement in terms of URR and Kt/V values among non-diabetic, non-cardiac patients undergoing maintenance hemodialysis in 6 succeeding hemodialysis sessions. The directions of the arterial needle either retrograde and antegrade did not have significant effects on access recirculation.

scholarly journals A comparative study on the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients; a double-blinded randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
pp. e12-e12
Author(s):  
Saeed Mardani ◽  
Faranak Sadat Filsouf
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Hemodialysis Patients ◽  
Significant Difference ◽  
Before And After ◽  
Calcium Phosphorus ◽  
Stage Renal Disease ◽  
Double Blinded ◽  
End Stage ◽  
Calcium And Phosphate Metabolism

Introduction:Chronic kidney disease (CKD) has lots of complication like calcium and phosphate metabolism disorders, hyperparathyroidism, vitamin D deficiency and metabolic acidosis. Objectives: The aim of this study was to determine and compare the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients due to end-stage renal disease (ESRD). Patients and Methods: This study was a double-blinded randomized clinical trial, which was conducted on 60 hemodialysis patients in 2017-2018. The patients were randomly assigned to two groups of 30 patients, which one group was treated with cinacalcet and the other group was treated with calcitriol. During this study, phosphorus, calcium and iPTH were measured. Results: The results showed that in the group treated with cinacalcet, the amount of calcium [t(22)=0.294, P>0.05] and the amount of phosphorus [t(22)=1.87, P>0.05] did not change significantly while iPTH values before and after the study had statistically significant difference [t(22)=4.37, P<0.05]. In group treated with calcitriol, the calcium, phosphorus and iPTH values did not change significantly (P>0.05). Calcium changes in the cinacalcet group compared to the calcitriol group [t (47) =-1.14, P>0.05] and also, the amount of phosphorus changes [t (47) =-1.022, P>0.05] was not statistically significant. The iPTH changes were not statistically significant between the two groups however iPTH in the calcitriol group was higher than the cinacalcet group [t (47) =-1.13, P>0.05]. Conclusion: In contrast to calcitriol, cinacalcet significantly reduced iPTH and did not significantly change calcium and phosphorus levels. Trial Registration: The trial was registered by Iranian Registry of Clinical Trials (IRCT) (identifier: IRCT20190702044076N1; https://en.irct.ir/trial/40547, Ethical code# IR.SKUMS.REC.1397.026).

Effects of Kidney Transplantation on Cognitive Performance in a Pediatric Population

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 273-278 ◽  
Author(s):  
Robert S. Fennell ◽  
Wiley C. Rasbury ◽  
Eileen B. Fennell ◽  
Mary K. Morris
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Cognitive Performance ◽  
End Stage Renal Disease ◽  
Pediatric Population ◽  
Control Group ◽  
Memory And Attention ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

The cognitive functioning of 20 children and adolescents with end-stage renal disease was assessed 1 to 3 weeks prior to the onset of hemodialysis, and at 1 month and 1 year after successful kidney transplantation, and results were compared with those of a matched control group. A battery of intelligence, achievement, problem solving, learning, memory, and attention tasks were administered. Both groups had significantly improved scores over time on most measures. The group with renal disease exhibited significantly greater improvement than the control group from initial testing to 1 month after transplantation on the performance IQ and full-scale IQ as well as in mathematics achievement. This significant difference was not maintained, however, at 1 year after transplantation. Cognitive performance was less impaired the later the onset of renal failure or the fewer the years in end-stage renal disease. BUN nitrogen, serum creatinine levels, and BP did not consistently correlate with any of the cognitive or academic achievement measures.

scholarly journals Effects of Heparin on Early Patency of Arteriovenous Fistula in Angioaccess Surgery of Patients with End-Stage Renal Disease

2018 ◽  
Vol 3 (1) ◽  
pp. 36
Author(s):  
Mohamamd Mozafar ◽  
Fatemeh Hoseinzadegan ◽  
Saran Lotfollahzadeh ◽  
Maryam Baikpour ◽  
Razie Amraei ◽  
...  
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Post Surgery ◽  
Significant Difference ◽  
Systemic Anticoagulation ◽  
Stage Renal Disease ◽  
End Stage

Background: Arteriovenous fistula (AVF) is now the optimal method of obtaining vascular access for dialysis. Measures such as systemic anticoagulation have been proposed as means of increasing patency rates but enough evidence does not exist to support their application. We aimed to evaluate the efficacy of preoperative heparin injection on patency of AVF during the first 24 hours after surgery and to determine whether such measure can be used to prevent early thrombosis of the vascular access.Methods: The study was carried out on 150 patients admitted to Shohada-e-Tajrish hospital for permanent vascular access placement during 2011-2012. 75 patients were randomly assigned to receive 100 units/kg of heparin intraoperatively and at 24 hours post-surgery AVF patency rate was assessed and compared to the control group. Results: All the 75 patients who had received heparin intraoperatively had a patent arteriovenous fistula 24 hours post-surgery which showed a statistically significant difference compared to the control group among which only 69 (92%) patients had a functioning AV fistula (p-value= 0.028).Conclusions: Our results show that systemic anticoagulation with heparin can be considered as an effective option in preventing vascular access failure. However, considering the contradictory data on the usefulness of heparin injection, larger trials are needed to evaluate efficacy and adverse effects of systemic intraoperative anticoagulation in End-Stage Renal Disease (ESRD) patients before qualifying it as a method of increasing AVF patency in these patients

Breathing-based leg exercises during hemodialysis improve quality of life: A randomized controlled trial

2021 ◽  
pp. 026921552110007
Author(s):  
Hsin-Yi Huang ◽  
Kuo-Sheng Hung ◽  
Mei-Ling Yeh ◽  
Hsiu-Ling Chou ◽  
Albert Lou Yeh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
End Stage Renal Disease ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Stage Renal Disease ◽  
End Stage

Objective: To evaluate the effect of a 12-week breathing-based leg exercises program on quality of life under stabilizing heart rate variability and reducing fatigue in regular hemodialysis patients. Design: Randomized controlled trial. Setting: A 94-bed hemodialysis department at a medical center in northern Taiwan. Participants: Eighty-six patients with end-stage renal disease undergoing hemodialysis were recruited and randomly assigned to the ExBr or control groups. Interventions: The breathing-based leg exercises program comprised abdominal breathing and low-intensity leg exercise, including leg lifts, quadriceps femoris contraction and knee flexion, and lasted for 15 minutes at one time, three times a week for 12 weeks. Main measure: Data was collected by using the World Health Organization quality of life assessment-brief, physiological signal recorder for heart rate variability and hemodialysis-related fatigue scale at baseline and on Week 4, Week 8, and Week 12. Results: Average (standard deviation) age was 53.70 (10.04) years in the ExBr group and 61.19 (10.19) years in the control group. The linear mixed model with adjusted age, creatinine, heart rate variability and fatigue revealed that the ExBr group had significantly higher quality of life than did the control group ( P = 0.01), especially on Week 12 ( P = 0.04). Fatigue was significantly correlated with quality of life ( P < 0.001). Conclusion: This study supported the benefits of the continued breathing-based leg exercises during hemodialysis for at least 12 weeks, which improved the quality of life of patients with end-stage renal disease and did not affect the stability of their vital signs.

scholarly journals A Randomized, Controlled Trial of Prednisone Plus Cyclophosphamide in Patients with Advanced-stage IgA Nephropathy

2021 ◽  
Author(s):  
Zhonglin Feng ◽  
Ting Zhong ◽  
Li Song ◽  
Wei Shi ◽  
Yiming Tao ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Iga Nephropathy ◽  
Controlled Trial ◽  
Oral Prednisone ◽  
Controlled Study ◽  
Advanced Stage ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Abstract BackgroundTreatments with glucocorticoids or immunosuppressants in IgA nephropathy remain controversial, especially in IgA nephropathy patients with renal insufficiency and small quantities of proteinuria. So far, no randomized controlled study has investigated whether cyclophosphamide has a protective effect on IgA nephropathy independent of glucocorticoids.MethodsWe conducted a single-center, randomized, controlled trial ((NCT01758120)). 135 IgA nephropathy patients with elevated plasma creatinine concentrations (1.3-3.0 mg/dl in males and 1.0-3.0 mg/dl in females), regardless of proteinuria level, were enrolled in and randomized 1:1 to the prednisone alone group or prednisone plus cyclophosphamide group. The daily dosage of oral prednisone was initiated at 0.5 mg/kg/d taken every morning for 2 months and then tapered by 20% each month for the next 4 months in prednisone alone group. In prednisone plus cyclophosphamide group cyclophosphamide was given in monthly pulses of 1.0 g for 6 months, while the prednisone dosage was the same as prednisone group. The two primary end points were a combination of reaching end-stage renal disease (ESRD) or doubling of serum creatinine or death and absolute changes in eGFR (estimated glomerular filtration rate) at 36 months.ResultsOverall, 135 patients were enrolled in our study. There was no significant difference between the two groups at baseline. The two groups had similar primary composite renal outcomes, which occurred in 4 participants (5.97%) in the prednisone alone group and 5 (7.35%) in the prednisone plus cyclophosphamide group (hazard ratio, 1.13 [95% CI, 0.30 to 4.19]; P = 0.861). Additionally, no significant difference in eGFR absolute change in three years was found between the two groups (0.09 (-7.42, 12.00) ml/min/1.73 m2 in the prednisone alone group vs. 3.24 (5.025, 9.59) ml/min/1.73 m2 in the prednisone plus cyclophosphamide group; P = 0.578). Proteinuria was reduced similarly in both groups. Treatment with cyclophosphamide led to more adverse events.ConclusionsOur study showed that corticosteroids plus cyclophosphamide did not increase the renal benefit of patients with advanced-stage IgA nephropathy but increased adverse effects compared with corticosteroids alone. Trial registration: ClinicalTrials.gov, NCT01758120. Registered 1 July 2012, https://clinicaltrials.gov/ct2/show/NCT01758120

The Efficacy of Omega-3 Supplement on Prevention of Retinopathy of Prematurity in Premature Infants: A Randomized Double-blinded Controlled trial

2018 ◽  
Vol 24 (17) ◽  
pp. 1845-1848 ◽  
Author(s):  
Nasrin Khalesi ◽  
Arash Bordbar ◽  
Nastaran Khosravi ◽  
Morteza Kabirian ◽  
Alireza Karimi
Keyword(s):  
Placebo Group ◽  
Birth Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Omega 3 ◽  
Significant Difference ◽  
Double Blinded

Background: The present study aimed to assess the efficacy of omega-3 in treating ROP in premature infants. Methods: This randomized double-blinded controlled trial was performed on 160 premature infants with gestational age lower than 32 weeks and birth weight < 1500 grams who were at risk of ROP development (Tehran, Iran-2013). Children were randomly assigned to two groups. The intervention group received 300 mg omega-3 daily and the control group received sterile water as the placebo. The severity of ROP was defined according to the International Classification of ROP. Results: The frequency of ROP was 7.5% in the group received omega-3 and 20.0% in the placebo group with a significant difference (p = 0.021). Regarding the severity of ROP in the intervention group, ROP grade I was found in two patients and ROP grade II in four patients; while ROP grade I, II, and III were revealed in 6, 6, and 4 patients in placebo group indicating a significant difference between the two groups (p = 0.001). Using the multivariate logistic regression modeling with the presence of gender, gestational age, and birth weight, the use of omega-3 was associated with reduced risk for ROP (p = 0.045). Conclusion: The use of omega-3 supplement can be an appropriate treatment option for the treatment of ROP in premature infants.

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