scholarly journals Antihypertensive treatment in patients with end-stage renal disease

2005 ◽  
Vol 5 (4) ◽  
pp. 22-25
Author(s):  
Mensura Aščerić ◽  
Nedžad Mulabegović ◽  
Sabina Nuhbegović ◽  
Alma Nadarević ◽  
Muamera Mujčinagić-Vrabac
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
Systolic Blood Pressure ◽  
End Stage Renal Disease ◽  
Antihypertensive Treatment ◽  
Control Group ◽  
Chronic Haemodialysis ◽  
Ultra Filtration ◽  
Stage Renal Disease ◽  
End Stage

Arterial hypertension is a common finding in patients with end stage renal disease (80% patients are hypertensive). Cardiovascular diseases are the main cause of death in haemodialysis. The present study was performed to asses' successful treatment in hypertensive chronic haemodialysis patients by ultra filtration only and ultra filtration combined with medics. We studied 80 hypertensive adult patients who had been on regular haemodialysis treatment for at least 12 months (average duration of 41 months). All subjects were divided in two different antihypertensive treatment groups including 40 subjects each. The first group of patients were treated with trandolapril and ultra filtration, and the second group of patients were only treated with ultra filtration (control group). Blood pressure measurements before and after HD sessions were performed for each patient. Blood pressure control was defined using World Health Organizationcriteria 140/90 mm Hg. Average systolic blood pressure levels, after haemodialysis, were in the first group of patients 146.33 +/- 9.7 mm Hg, and in the control group 157,86 +/- 10.33 mm Hg. Average diastolic blood pressure was 87.83 +/- 8.11 mm Hg in the first group of patients and, in the control group it was 91.03 +/- 10.67 mm Hg. There were significant differences between systolic blood pressure level in the first group of patients and the control group of patients as well as in diastolic blood pressure (p < 0.05). We conclude that an antihypertensive therapy by trandolapril is more effective than ultra filtration alone in hypertensive patients on chronic haemodialysis.

scholarly journals Dynamical interaction between heart rate and blood pressure of end-stage renal disease patients evaluated by cross recurrence plot diagonal analysis

2020 ◽  
Vol 128 (1) ◽  
pp. 189-196 ◽  
Author(s):  
G. Hortensia González ◽  
Oscar Infante ◽  
Paola Martínez-García ◽  
Héctor Pérez-Grovas ◽  
Nadia Saavedra ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Renal Disease ◽  
Systolic Blood Pressure ◽  
End Stage Renal Disease ◽  
Recurrence Plots ◽  
Interbeat Interval ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The assessment of spontaneous variability of blood pressure and heart rate is based on specific physiological hypotheses about dynamic features, for example, the baroreflex modulation of heart rate over time in daily life. Usually, arterial baroreflex control of heart rate is explored without delays between blood pressure and heart rate data points, within a narrow range of values, excluding the analysis of saturation regions or low-threshold changes. In this work, we examine the dynamic interactions between systolic blood pressure (SBP) and interbeat interval (IBI), in 15-min length time series and for the first time using the analysis of diagonals derived from a cross-recurrence plots in healthy persons and end-stage renal disease (ESRD) patients. We found that ESRD patients have stronger intermittent dynamical interactions between IBI and SBP, but they lose most of the dynamical interactions. Although healthy subjects exhibit a continuously changing order of precedence between IBI and SBP at different lags, ESRD patients preserve this changing order of precedence only for lags >0 beats. NEW & NOTEWORTHY This study is the first to compare the time-variant pattern of systolic blood pressure (SBP) and interbeat interval (IBI) coupling between ESRD patients and healthy volunteers through the analysis of diagonal in cross-recurrence plots, and in the face of an orthostatic challenge. Our results demonstrated alternant interactions on the order of precedence (IBI → SBP or SBP→ IBI) at different time delays. This pattern is different in resting position and during active standing for the two groups studied, and interestingly, some association patterns are lost in ESRD patients. These patterns of alternant interactions on the order of precedence could be related to autonomic neural activities and cardiovascular synchronization at different scales both in time and space. This could reflect physiological adaptive flexibility of cardiovascular regulation. Losing some association patterns in ESRD may be the result of chronic adjustments of many physiological mechanisms (including chronic sympathetic hyperactivity), which could increase cardiovascular vulnerability to hemodynamic challenges.

scholarly journals Determinants of Premature Atherosclerosis in Children With End-Stage Renal Disease

2012 ◽  
pp. 53-61 ◽  
Author(s):  
H. M. DVOŘÁKOVÁ ◽  
P. SZITÁNYI ◽  
P. DVOŘÁK ◽  
J. JANDA ◽  
T. SEEMAN ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Oxidative Capacity ◽  
Atherogenic Index ◽  
Control Group ◽  
Healthy Children ◽  
Stage Renal Disease ◽  
End Stage

Cardiovascular disease is a major cause of morbidity and mortality in young adults with end-stage renal disease (ESRD), but its basis is still not well understood. We therefore evaluated the determinants of atherosclerosis in children with ESRD. A total of 37 children with ESRD (with 31 who had undergone transplantation) were examined and compared to a control group comprising 22 healthy children. The common carotid intima-media thickness (CIMT) was measured by ultrasound as a marker of preclinical atherosclerosis. The association of CIMT with anthropometrical data, blood pressure, plasma lipid levels, and other biochemical parameters potentially related to cardiovascular disease was evaluated. Children with ESRD had significantly higher CIMT, blood pressure, and levels of lipoprotein (a), urea, creatinine, ferritin, homocysteine, and serum uric acid as well as significantly lower values of apolipoprotein A. The atherogenic index of plasma (log(triglycerides/HDL cholesterol)) was also higher in patients with ESRD; however, this difference reached only borderline significance. In addition, a negative correlation was found between CIMT and serum albumin and bilirubin in the ESRD group, and this correlation was independent of age and body mass index. In the control group, a significant positive correlation was observed between CIMT and ferritin levels. Factors other than traditional cardiovascular properties, such as the anti-oxidative capacity of circulating blood, may be of importance during the early stages of atherosclerosis in children with end-stage renal disease.

The role of VEGF rs699947 polymorphism in End-Stage Renal Disease: A preliminary study

2021 ◽  
pp. 19-23
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Protective Factor ◽  
Public Health Problem ◽  
Turkish Population ◽  
Control Group ◽  
Case Group ◽  
Important Public Health Problem ◽  
Stage Renal Disease ◽  
End Stage

Aim: End-Stage Renal Disease (ESRD) is an important public health problem worldwide with an increasing incidence and prevalence. There are many environmental and genetic factors which contribute to the development of ESRD. Vascular endothelial growth factor (VEGF) has been suggested to play an important role in renal pathophysiology. The aim of this study was to determine the probable relation between ESRD and VEGF gene rs699947 polymorphism in Turkish population. Material and Method: Genotyping of rs699947 was carried out in 50 ESRD patients on dialysis treatment and 30 healthy controls, using a Kompetitive Allelic-Specific PCR (KASP) method following DNA isolation. Demographic and clinical characteristics of the patients were recorded. Results: The prevalance of rs699947 AA genotype was found to be higher in the control group, but it was not statistically significant (p>0.05) . Conclusion: Although statistically insignificant, the frequency of AA genotype was higher in the control group compared to the case group, therefore we concluded that AA genotype may be a protective factor for ESRD in Turkish population. However, this conclusion needs to be further verified by future studies performed in larger study groups.

scholarly journals Effects of Variability in Blood Pressure, Glucose, and Cholesterol Concentrations, and Body Mass Index on End-Stage Renal Disease in the General Population of Korea

2019 ◽  
Vol 8 (5) ◽  
pp. 755 ◽  
Author(s):  
Mee Kyoung Kim ◽  
Kyungdo Han ◽  
Hun-Sung Kim ◽  
Yong-Moon Park ◽  
Hyuk-Sang Kwon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
General Population ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
High Variability ◽  
Metabolic Parameters ◽  
Metabolic Parameter ◽  
Stage Renal Disease ◽  
End Stage

Aim: Metabolic parameters, such as blood pressure, glucose, lipid levels, and body weight, can interact with each other, and this clustering of metabolic risk factors is related to the progression to end-stage renal disease (ESRD). The effect of variability in metabolic parameters on the risk of ESRD has not been studied previously. Methods: Using nationally representative data from the Korean National Health Insurance System, 8,199,135 participants who had undergone three or more health examinations between 2005 and 2012 were included in this analysis. Intraindividual variability in systolic blood pressure (SBP), fasting blood glucose (FBG), total cholesterol (TC), and body mass index (BMI) was assessed by examining the coefficient of variation, variability independent of the mean, and average real variability. High variability was defined as the highest quartile of variability and low variability was defined as the lower three quartiles of variability. Results: Over a median (5–95%) of 7.1 (6.5–7.5) years of follow-up after the variability assessment period, 13,600 (1.7/1000 person-years) participants developed ESRD. For each metabolic parameter, an incrementally higher risk of ESRD was observed for higher variability quartiles compared with the lowest quartile. The risk of ESRD was 46% higher in the highest quartile of SBP variability, 47% higher in the highest quartile of FBG variability, 56% higher in the highest quartile of BMI variability, and 108% higher in the highest quartile of TC variability. Compared with the group with low variability for all four parameters, the group with high variability for all four parameters had a significantly higher risk for incident ESRD (hazard ratio (HR) 4.12; 95% CI 3.72–4.57). Conclusions: Variability in each metabolic parameter was an independent predictor of the development of ESRD among the general population. There was a composite effect of the variability in additional metabolic parameters on the risk of ESRD.

scholarly journals Electrocardiogram changes in patients with end stage renal disease on chronic haemodialysis

2019 ◽  
Vol 7 (11) ◽  
pp. 4020
Author(s):  
Kareem Mohsin Yousif ◽  
Hamid Obaid Khadhim Al Jaaed
Keyword(s):  
Renal Disease ◽  
Social History ◽  
End Stage Renal Disease ◽  
Cross Sectional Study ◽  
Premature Ventricular Complex ◽  
Chronic Haemodialysis ◽  
Ecg Changes ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Background: End stage renal disease (ESRD) is irreversible loss of renal function which is physiologically defined by a GFR of less than 15 ml / minute. ESRD is associated with a higher incidence of coronary artery disease and serious arrhythmia especially ventricular arrhythmia. The goal of study is to determine whether ESRD and haemodialysis (HD)are associated with occurrence of significant electrocardiogram (ECG) changes or not.Methods: This is a cross-sectional study design which involved 22 patients with ESRD on regular HD in Al Sadre teaching hospital / Al Najaf. Both sexes was included in this study. All patients underwent full medical history and examination which included the following aspects: Age, Sex, Occupation, BP, HR, RBS, B.urea, S.creatinine , Serum electrolyte (Na+, K+, Cl-, Ca++), Lipid profile (Cholesterol , Triglyceride, HDL, LDL), Duration of CRF, Duration of dialysis, Social history including (smoking, alcohol) and Drug used by the patient. Resting EGC and Hotler ECG.Results: Eighteen patients exhibited emergence of simple ectopic activity premature atrial complex (PAC) and premature ventricular complex (PVC) events and four patients exhibited (ST,T changes). Potentially lethal arrhythmias and other serious ECG changes are not detected in our patient’s sample.Conclusion: In this study, neither ESRD nor haemodialysis were associated with development of serious ECG changes or emergence of significant arrhythmia.

scholarly journals Analysis of Endocan Levels in Hypertensive Patients as Risk Factors of Chronic Kidney Disease

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Suryani Jamal ◽  
Uleng Bahrun ◽  
Ibrahim Abdul Samad ◽  
Fitriani Mangarengi ◽  
Hasyim Kasim ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Ii ◽  
University Hospital ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Elisa Method ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

This study aimed to analyze endocan levels as a marker of endothelial dysfunction in the control group, patients withstage I hypertension, stage II hypertension, and patients with end-stage renal disease. Endocan levels were measured withESM-1 (endocan) kit by Enzyme-Linked Immunosorbent Assay (ELISA) method. This study used a cross-sectional methodand was conducted in Dr. Wahidin Sudirohusodo Hospital, Makassar and Hasanuddin University Hospital from Septemberto October 2017. There were 83 samples in this study, consisting of 12 samples in the control group, 22 samples of stage Ihypertension, 28 samples of stage II hypertension, and 21 samples of end-stage renal disease aged 20-90 years old. Thisstudy showed significantly higher endocan levels in patients with stage II hypertension and end-stage renal disease(p< 0.05). Endocan levels were significantly higher (p<0.05) in patients with end-stage renal disease compared with thecontrol group and patients with stage I hypertension; but not significantly higher (p > 0.05) compared to patients with stageII hypertension. Also, the median of endocan levels in patients with the end-stage renal disease was higher (309,850 ng/L)compared to patients with stage II hypertension (273,050 ng/L).

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