METABOLIC SYNDROME IN DIALYSIS PATIENTS

2016 ◽  
pp. 7-11
Author(s):  
Vinh Phu Hoang ◽  
Tam Vo ◽  
Van Tien Le ◽  
Thi Hoai Huong Vo

Objective: To review disorders elements of the metabolic syndrome in patients with end-stage chronic renal failure on dialysis cycle. Materials and methods: A cross sectional descriptive study of 85 patients including end-stage chronic renal failure in dialysis cycle from 5/2015 - 9/2016 at the Department of Artificial Kidney, Hue Central Hospital. Results: The prevalence of metabolic syndrome in dialysis patients was 37.65%. The prevalence of abdominal obesity was 30.6%; The prevalence of hypertension was 72.9%, the average value systolic blood pressure and diastolic blood pressure were 142.24 ± 27.53, 80.35 ± 12.48 mmHg; The prevalence of hyperglycemia was 28%, the average value blood glucose was 4.9 ± 1.19 mmol/l; The prevalence of triglyceride increase was 34.1%, the average value triglyceride was 1.59 ± 0.84 mmol/l. The prevalence of HDL-C increase was 47.1%, the average value HDL-C was 1.24 ± 0.33 mmol/l. Conclusion: The prevalence of metabolic syndrome in dialysis patients is very high, in which hypertension and HDL disturbances are the highest. Key words: chronic renal failure, dialysis, metabolic syndrome

2016 ◽  
Vol 50 (suppl 1) ◽  
Author(s):  
Maria Cristina C Kuschnir ◽  
Katia Vergetti Bloch ◽  
Moyses Szklo ◽  
Carlos Henrique Klein ◽  
Laura Augusta Barufaldi ◽  
...  

ABSTRACT OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.


2008 ◽  
Vol 93 (3) ◽  
pp. 832-836 ◽  
Author(s):  
Gang Hu ◽  
Jaana Lindström ◽  
Pekka Jousilahti ◽  
Markku Peltonen ◽  
Lena Sjöberg ◽  
...  

Abstract Objective: Our objective was to assess a 10-yr change in the prevalence of the metabolic syndrome defined by the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) among Finnish men and women. Design and Subjects: Two cross-sectional population surveys were performed in Finland in 1992 and 2002. A total of 3495 participants aged 45–64 yr were included in the analysis. Results: In both years the metabolic syndrome was more common among men than women. In men the prevalence of the metabolic syndrome tended to increase slightly between 1992 and 2002, from 48.8–52.6% (P = 0.139) based on the NCEP definition, and from 51.4–55.6% based on the IDF definition (P = 0.102). In women the prevalence of the metabolic syndrome increased significantly from 32.2–39.1% based on the NCEP definition (P = 0.003), and from 38.0–45.3% based on the IDF definition (P = 0.002). In both sexes the prevalence of high blood pressure decreased, but the abnormalities in glucose metabolism increased between 1992 and 2002. The prevalence of central obesity increased in women between 1992 and 2002. Conclusions: In Finland the prevalence of the metabolic syndrome, based both on the NCEP and IDF definitions, is higher in men than women. However, the increase in the prevalence of the metabolic syndrome, from 1992–2002, was significant only among women.


Author(s):  
Aina M. Galmes-Panades ◽  
Veronica Varela-Mato ◽  
Jadwiga Konieczna ◽  
Julia Wärnberg ◽  
Miguel Ángel Martínez-González ◽  
...  

Abstract Background This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55–75 years, BMI 27–40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). Conclusions Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health. Trial registration The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.


Author(s):  
Do Thi Hoa ◽  
Nguyen Thi Tuyet Trinh ◽  
Nguyen Thi Lien Huong ◽  
Phan Tung Linh

Treatment and control of anemia plays an important role in improving the quality and effectiveness of artificial kidney. The study was conducted on 61 patients who met the selection and were not included in the excluded criteria group. Collecting data from medical records using retrospective, descriptive, vertical follow-up method for 6 months. Data were processed using Microsoft Excel Office 2010 and R. The results showed that patients used both EPO alpha and EPO beta simultaneously. Rate of usage’s EPO beta accounted for 23%, alpha EPO was 77%. Lyophilized form (EPO alpha) is most commonly used. Starting from T3, Hb. averages treat. There were no abnormalities in blood pressure, white blood cell, platelets, and electrolytes. Keywords Hanoi Kidney Hospital, EPO (erythropoietin), Hb, efficacy and safety. References [1] L.A. Szczech, W. Harmon, T.H. Hostetter et al, World Kidney Day 2009: Problem and Challenges in the Emering Epidemic of Kidney Disease, J Am Soc Nephrol 20 (2009) 453-455. https://doi.org/10.1681/ASN.2009010041.[2] D.T. Gilbertson, J. Liu et al, Projecting the Number of Patient with End Stage Renal Disease in the United States to the Year 2015, J Am Soc Nephrol 16 (2005) 3736-3741. https://doi.org/10.1681/ASN.2005010112.[3] A.E. Gaweda, G.R. Aronoff et al, Individualized anemia management reduces hemoglobin variability in hemodialysis patients, J Am Soc Nephrol 25(1) (2014) 159-66. https://doi.org/10.1681/ASN.2013010089.[4] Do Thi Thu Hien, Evaluation of the usage of erythropoietin in the treatment of anemia in patients with chronic renal failure on dialysis at Thai Binh Provincial General Hospital, Master of Pharmacy thesis, Hanoi University of Pharmacy, 2015 (in Vietnamese).[5] Trieu Thi Tuyet Van, Evaluation of the usage of erythropoietin in the treatment of anemia in patients with chronic renal failure on dialysis at the artificial kidney department - Bach Mai Hospital, Master of Pharmacy thesis, Hanoi University of Pharmacy, 2009 (in Vietnamese).[6] Nguyen Thi Uyen, Investigating the effectiveness and safety of Erythropoietin use in dialysis patients at artificial kidney monotherapy Sanit Paul Hospital, Graduation thesis of Pharmacist, Hanoi University of Pharmacy, 2016 (in Vietnamese).[7] Bui Thi Tam, Evaluation the effectiveness of anemia treatment with Erythropoietin in patients with chronic renal failure receiving dialysis at Dien Bien Provincial General Hospital, Graduation thesis of Pharmacist Specialist 2, Hanoi University of Pharmacy, 2011 (in Vietnamese).[8] Drug Administration of Vietnam - Ministry of health, Official dispatch number 4764/QLD-ĐK, 2014 (in Vietnamese).[9] The Vietnam Urology & Nephrology Association, Guidelines for treatment of anemia in chronic kidney disease, The Vietnam Urology & Nephrology Association, 2013 (in Vietnamese).[10] KDIGO, KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease, Kidney International Supplement, 2013, pp.1-150.[11] Lam Thanh Vung, Study on the characteristics of anemia and the effectiveness of Erythropoietin β combination with intravenous iron in patients with chronic renal dialysis by dialysis, Thesis Specialized level 2 Medical and Pharmaceutical University, Hue University, 2013.  


2019 ◽  
Vol 33 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Masoumeh Akhlaghi

AbstractThe metabolic syndrome is a cluster of disorders dominated by abdominal obesity, hypertriacylglycerolaemia, low HDL-cholesterol, high blood pressure and high fasting glucose. Diet modification is a safe and effective way to treat the metabolic syndrome. Dietary Approaches to Stop Hypertension (DASH) is a dietary pattern rich in fruits, vegetables and low-fat dairy products, and low in meats and sweets. DASH provides good amounts of fibre, K, Ca and Mg, and limited quantities of total fat, saturated fat, cholesterol and Na. Although DASH was initially designed for the prevention or control of hypertension, using a DASH diet has other metabolic benefits. In the present review, the effect of each dietary component of DASH on the risk factors of the metabolic syndrome is discussed. Due to limited fat and high fibre and Ca content, individuals on the DASH diet are less prone to overweight and obesity and possess lower concentrations of total and LDL-cholesterol although changes in TAG and HDL-cholesterol have been less significant and available evidence in this regard is still inconclusive. Moreover, high amounts of fruit and vegetables in DASH provide great quantities of K, Mg and fibre, all of which have been shown to reduce blood pressure. K, Mg, fibre and antioxidants have also been effective in correcting glucose and insulin abnormalities. Evidence is provided from cross-sectional investigations, cohort studies and randomised controlled trials, and, where available, from published meta-analyses. Mechanisms are described according to human studies and, in the case of a lack of evidence, from animal and cell culture investigations.


2020 ◽  
pp. 1-8

Abstract In 1923, Georg Ganter at the University of Würzburg performed the first peritoneal dialysis for patients with chronic kidney disease. During the period from 1924 to 1938, intermittent peritoneal dialysis was used in the USA and Germany as a short-term replacement for the renal functions. In 1946, Fine and colleagues described the use of peritoneal irrigation in a patient with severe anuria, who survived after four days of continuous peritoneal lavage. In 1943, a Dutch physician named Willem Kolff developed the first dialyzer which was called “Artificial kidney” with aim of cleaning the blood of patients with acute renal failure. Kolff moved to the USA and improved the early design of the dialyzer and was manufactured in the early 1950s. During the 1980s and 1990s, experimental studies on animals suggested that dietary fibers including acacia gum have a urea lowering effect (Yatzidis et al., 1980; Rampton et al., 1984; Tetens et al., 1996). In 1996, in 1996, Bliss et al. reported that the use of acacia gum supplementation in adult patients with asymptomatic early chronic renal failure on low protein diet was associated with urea lowering effect. The use of Intestinal dialysis in symptomatic chronic renal failure patients was first described by Aamir Jalal Al-Mosawi in 2002. The achievement of six-year dialysis freedom with the use of intestinal dialysis in patients with end-stage renal failure was described by Aamir Jalal Al-Mosawi in 2009. Late during the 2000s, “Only medical talks” web site included Aamir Jalal Al-Mosawi in the list of famous physicians of all time for describing intestinal dialysis [9]. During the previous two decades there have been a plethora of publications describing the concepts, principles and use of intestinal dialysis including journal articles, conference papers and books. Some of these publications have been translated to eight languages confirming that intestinal dialysis has become an established medical therapeutic technology. The aim of this paper is to review the milestones associated with intestinal dialysis which was considered by many experts as a Nobel Prize winning technology.


Author(s):  
M Saraei ◽  
A Najafi ◽  
E Heidarbagi ◽  
A Rahimi-Golkhandan

Introduction: Screening of risk factors for metabolic syndrome among commercial and train drivers that are considered safety sensitive jobs, is an important issue in safety of transportation system. Metabolic syndrome is consisted of disturbed lipid profile, high blood pressure, and high waist circumference. It can lead to decrease the quality of life and higher health associated costs for these patients. This study aimed to assess risk factors for metabolic syndrome among train drivers. Methods: This cross-sectional study was conducted on 281 train drivers referred to their annual health examinations to Occupational Medicine Clinic of Baharloo Hospital, Tehran University of Medical Sciences. Demographic characteristics of participants were recorded. Blood pressure, body mass index and waist circumference of drivers were measured. Participants’ blood sample for fasting blood sugar, triglyceride, high and low density lipoproteins were collected. Metabolic syndrome was defined according to the NCEP ATP III criteria. Results: All of the participants were males.  Their mean age and BMI was 43±10 year and 26.60±3.67 Kg/m2, respectively. Fifty three (21%) of the participants were diagnosed with metabolic syndrome. The more frequent risk factor for metabolic syndrome was triglyceride more than 150mg/dl. Conclusion: Findings of the present study revealed high prevalence of metabolic syndrome among train drivers. Further studies are needed for screening the metabolic syndrome in this occupational group as it is a sensitive occupation.


1980 ◽  
Vol 3 (6) ◽  
pp. 322-325 ◽  
Author(s):  
N.D. Vaziri ◽  
R. Skowsky ◽  
A. Warner

The effect of isoosmolar volume reduction on plasma ADH level was studied in 8 patients with chronic renal failure utilizing hemofiltration technique. Plasma ADH fell significantly (P < 0.001) after one hour of hemofiltration despite volume reduction which was expected to elevate the ADH level. After two hours of hemofiltration, ADH remained low in 5 patients and increased in 3. Posthemofiltration mean blood pressure was generally lower in patients whose ADH rose than those whose ADH remained low. The two groups were otherwise comparable with respect to total fluid loss, hemofiltration rate, and fluid removed expressed as percent body weight. It can thus be suggested that in these patients a rise in plasma ADH in response to fluid reduction may require a fall in the arterial blood pressure below a critical level. While the rise in plasma ADH observed with continued fluid removal in some patients can be readily explained, we have no clear explanation for the paradoxical initial fall of ADH in all patients and subsequent maintenance of low levels observed in the majority of patients. This unusual ADH response to isoosmolar volume reduction may represent some unidentified mechanism of ADH regulation in patients with end-stage renal disease.


2018 ◽  
Vol 21 (02) ◽  
pp. 280-289
Author(s):  
Nisar Khan Sajid ◽  
Shakil Ahmad ◽  
Imran Sarwar

Introduction: Chronic renal failure is defined as progressive and irreversible lossof renal functions that gradually progress to end-stage renal disease. The etiology of chronicrenal failure in childhood correlates closely with the age of patient at the time when the renalfailure is first detected. Objectives: The aim was to assess the underlying causes and risk factorsof chronic renal failure and to identify the clinical presentation of chronic renal failure in childrenreporting at Allied Hospital Faisalabad. Study design: It was a cross sectional study. Duration ofth study: The study was done in a period of one year starting from March 20th, 2007 to March 20 ,2008. Setting: The study was done in the Department of Pediatrics medicine Allied HospitalFaisalabad. Subjects and methods: CRF was defined as glomerular filtration rate less than 25%of the normal for that age and sex. Patients of either sex ranging from 6 months to 15 yearsfulfilling the inclusion criteria were included in this study. Sampling technique was non-probabilityconvenience sampling. In addition to clinical evaluation, they were investigated to find out theunderline causes. Results: Out of 40 patients of CRF males were (n-28), females were (n-12), withmale to female ratio of 2.3:1. Mean age of males was 7.36+ 3.98 and females was 8.96+ 2.65.Etiological factors found in 34(85%) patients included congenital malformations (9-22.5%)urolithiasis (8-20%) reflux nephropathy (6-15%) glomerulopathies (3-7.5%) neurogenic bladder(2-5%) strictures (1-2.5%) and miscellaneous (5-20.5%) Etiology was unknown in 6 patients(15%). Failure to thrive 77%, Respiratory distress 75%, Pallor 75%, Fever 75%, Headache 67%,Vomiting 63%, Edema 50%, & Anorexia 42% were the most common clinical features atpresentation.


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