scholarly journals Prevalence of Cardiovascular Risk Factors among Chronic Kidney Disease Patients Undergoing Hemodialysis in a Tertiary Care Center, Kathmandu, Nepal

2019 ◽  
Vol 21 (4) ◽  
pp. 313-318
Author(s):  
A Pokhrel ◽  
P. Gyawali ◽  
BR Pokhrel ◽  
M P Khanal ◽  
D N Manandhar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Maintenance Hemodialysis ◽  
Tertiary Care Center ◽  
Phosphate Product

The risk of cardiovascular disease is higher in chronic kidney disease patients compared to the general population and its impact is higher in developing countries compared to the developed countries. With this background in mind, we aimed to evaluate the prevalence of different cardiovascular risk factors in patients on maintenance hemodialysis in a tertiary care center. Chronic kidney disease patients aged 18 years and above who were under maintenance hemodialysis in the hemodialysis unit of Nepal Medical College were included in the study. Pre-dialysis venous blood samples from the participants were collected and analyzed for serum calcium, phosphorus, total protein, albumin and hemoglobin. Calcium phosphate product was calculated. Out of 100 study participants, 52% were male and 48% were female. Age-wise distribution showed 38% of the participants were below 40 years. The mean age of the participants was 45.86 ± 14.4 years. Ninety-three percent had hypertension and 29% had diabetes mellitus. Hypocalcemia was present in 80%, hyperphosphatemia was seen among 81% and high calcium phosphate product was present in 33% of the participants. Low hemoglobin (< 10gm/dL) was found in 86%. The cardiovascular risk trend in the Nepalese chronic kidney disease population is fairly different compared to the western population. Participants were younger. Prevalence of hypertension and diabetes was high. The high prevalence of anemia might be due to unaffordability of the participants for regular erythropoietin therapy. Inadequately managed hyperphosphatemia despite the widespread use of phosphorus binders, is still a major clinical challenge in patients on hemodialysis.

scholarly journals Depression among patients undergoing maintenance hemodialysis at a tertiary care center in Kathmandu, Nepal

2018 ◽  
Vol 5 (2) ◽  
pp. 4-11
Author(s):  
Nora Ranjitkar Manandhar ◽  
Rabi Shakya ◽  
Bimal Pandey ◽  
Pratik Wagley
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Alcohol Intake ◽  
Care Center ◽  
Tertiary Care ◽  
Maintenance Hemodialysis ◽  
Tertiary Care Center ◽  
Housing Status ◽  
Co Morbidity ◽  
Prevalence Of Depression

Introductions:Patients with chronic kidney disease have a high burden of somatic symptoms which may be due to depression. This study analyses occurrence of depression in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) at a tertiary care center in Kathmandu, Nepal.  Methods: This is a retrospective study done at Patan Hospital, a tertiary care teaching hospital of Patan Academy of Health sciences, Lalitpur, Nepal. Translated in Nepali language and validated Beck Depression Inventory (BDI) was used. A cut-off of 16/17 was used to define depression.   Results: Altogether 56 patients were included, mean age 54.375±17.87 years, time on HD 25.06±21.58 months, BDI score 19.18±10.16. The prevalence of depression was 51.8%. There was no significant differences of BDI score and rate of depression in genders, housing status, education level, alcohol intake, presence of co-morbidity and shift of HD. However, there was a significant association of BDI score and the employment status, p=0.026 and the affordability of erythropoiesis stimulating agent, p=0.033.  Conclusions: Depression was common in patients undergoing hemodialysis treatment and the rate of depression was significantly lower in the patients who were employed and used of erythropoiesis stimulating agent.

Cardiac risk factors and events in patients with prostate cancer commencing androgen deprivation therapy: Analysis from a tertiary care center in the Middle East.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 73-73
Author(s):  
Mona Hassan ◽  
Talar Telvizian ◽  
Mostafa Abohelwa ◽  
Hadi Skouri ◽  
Deborah Mukherji
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Middle East ◽  
Cardiovascular Events ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Cardiac Events ◽  
Artery Disease

73 Background: Androgen deprivation therapy (ADT) is the mainstay of treatment for advanced prostate cancer, improving symptoms and prolonging survival. There is an association between ADT use and cardiovascular events, particularly in men with pre-existing risk factors. There are no definite guidelines to stratify patients based on cardiovascular risk prior to ADT initiation. This is the first study on cardiac risks and events in patients on ADT from Lebanon and the Middle East region, a population known to have a high prevalence of cardiovascular risk factors. Methods: A retrospective chart review of 236 patients with prostate cancer who received ADT therapy at a tertiary care center in Lebanon was performed. 167 had a full set of data and were included in analysis. Cardiovascular risk factors at baseline and cardiovascular events on ADT were reviewed. Results: The median age of our cohort was 68, range 48-92 years. The majority of patients had stage 4 diseases at diagnosis (49.8%) with a median duration of 12 months on ADT. In our cohort 24.4% had body mass index > 30, 52.1% had smoking history, 27.4% were diabetic, 28.8 % had history of coronary artery disease, 10.6% had heart failure history and 54.6% had hypertension. Less than half of the patients had a documented lipid profile at baseline. Twenty two patients (9.5%) had documented cardiac events following ADT initiation. Conclusions: In this cohort of patients from the Middle East we found that one third of the population had established coronary artery disease at baseline and 9.5% had documented cardiac events on ADT initiation. Our study highlights the gaps in cardiovascular risk assessment for this high risk group of patients with prostate cancer. Risk and resource-stratified algorithms are needed before starting ADT therapy for optimal cardiovascular health. Increased awareness, collaboration and referral mechanisms between oncologists, urologist and cardiologists are also needed.

scholarly journals Chronic kidney disease in children: A report from a tertiary care center over 11 years.

2012 ◽  
Vol 1 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Alaleh Gheissari ◽  
Saeedeh Hemmatzadeh ◽  
Alireza Merrikhi ◽  
Sharareh Fadaei Tehrani ◽  
Yahya Madihi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center
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