scholarly journals ٍEvaluation of attention and memory function in hemodialysis patients; a study based on hemodialysis duration

2019 ◽  
Vol 9 (3) ◽  
pp. e28-e28
Author(s):  
Ali Alidadi ◽  
Nour-Mohammad Bakhshani ◽  
Behnoush Sabayan ◽  
Alireza Ansari-Moghadam
Keyword(s):  
Median Time ◽  
Memory Function ◽  
Score Test ◽  
Attention And Memory ◽  
Memory And Attention ◽  
Long Time ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Introduction: End-stage renal disease (ESRD) is one of the health problems in today’s world. Neuropsychological problems are more common in hemodialysis (HD) patients than in healthy individuals. Objectives: The aim of this study was to investigate the effect of long-term HD on memory function of these patients. Patients and Methods: Our study, included 80 HD patients of whom 39 were under 6 months of HD and 41 patients as another group which had a history of HD more than 6 months. Results: The population had a mean age of 51.60 years old (27.5% female). The scores of patients who have been hemodialyzed for a long-time (median time of HD was up to 4 years) had lower score in forward digit (FD), backward digit score test (BD), letter digit modality task (LDMT), letter symbol digit modality task (LSDMT) (5.49; 3.61; 21.12; 17.66) than the HD patients who underwent HD for a shorter term, with the median time of 3 to 5 months (7.38; 4.79; 39.77; 43.38) (P<0.001). Conclusion: The present study demonstrated that end-stage HD patients who were under HD for a long time had significantly lower scores in the memory and attention tests. However, additional researches are needed in this area.

scholarly journals Podocytes—The Most Vulnerable Renal Cells in Preeclampsia

2020 ◽  
Vol 21 (14) ◽  
pp. 5051
Author(s):  
Ewa Kwiatkowska ◽  
Katarzyna Stefańska ◽  
Maciej Zieliński ◽  
Justyna Sakowska ◽  
Martyna Jankowiak ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Damage Mechanism ◽  
Endothelial Damage ◽  
Main Role ◽  
Long Time ◽  
National Cohort ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function

Preeclampsia (PE) is a disorder that affects 3–5% of normal pregnancies. It was believed for a long time that the kidney, similarly to all vessels in the whole system, only sustained endothelial damage. The current knowledge gives rise to a presumption that the main role in the development of proteinuria is played by damage to the podocytes and their slit diaphragm. The podocyte damage mechanism in preeclampsia is connected to free VEGF and nitric oxide (NO) deficiency, and an increased concentration of endothelin-1 and oxidative stress. From national cohort studies, we know that women who had preeclampsia in at least one pregnancy carried five times the risk of developing end-stage renal disease (ESRD) when compared to women with physiological pregnancies. The focal segmental glomerulosclerosis (FSGS) is the dominant histopathological lesion in women with a history of PE. The kidney’s podocytes are not subject to replacement or proliferation. Podocyte depletion exceeding 20% resulted in FSGS, which is a reason for the later development of ESRD. In this review, we present the mechanism of kidney (especially podocytes) injury in preeclampsia. We try to explain how this damage affects further changes in the morphology and function of the kidneys after pregnancy.

scholarly journals Update on Recurrent Focal Segmental Glomerulosclerosis in Kidney Transplantation

Nephron ◽  
2020 ◽  
pp. 1-6
Author(s):  
Jun Shoji ◽  
Akiko Mii ◽  
Mika Terasaki ◽  
Akira Shimizu
Keyword(s):  
Kidney Transplantation ◽  
Focal Segmental Glomerulosclerosis ◽  
Rapid Progression ◽  
Segmental Glomerulosclerosis ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

<b><i>Background:</i></b> Focal segmental glomerulosclerosis (FSGS) is a clinicopathological syndrome characterized by nephrotic-range proteinuria with high incidence of progression to end-stage renal disease (ESRD). In primary FSGS, 40–60% of patients develop ESRD within 10–20 years. <b><i>Summary:</i></b> Recurrence of FSGS after kidney transplantation is frequent and is associated with poor allograft survival. The risk factors for recurrent FSGS include onset of FSGS during childhood, rapid progression of primary FSGS to ESRD, history of recurrent FSGS in previous allograft, and diffuse mesangial hypercellularity or collapsing variant of FSGS in the native kidney. The early histological findings of recurrent FSGS consist of unremarkable glomerular changes on light microscopy but significant podocyte effacement on electron microscopy; the loss of foot processes with eventual dropout of podocytes leads to the development of segmental lesions in the glomerulus. Experimental and clinical data suggest the existence of circulating permeability factors, such as soluble urokinase-type plasminogen activator receptor (suPAR), cardiotrophin-like cytokine factor-1 (CLCF-1), CD40 axis, and apolipoprotein A-Ib (ApoA-Ib), in the pathogenesis of recurrent FSGS. These biomarkers including circulating permeability factors may facilitate earlier diagnosis of FSGS posttransplant and may guide in the development of novel therapies that may be more effective and improve long-term outcomes in kidney transplantation. <b><i>Key Messages:</i></b> Several studies have suggested the possible circulating permeability factors, such as suPAR, CLCF-1, CD40 axis, and ApoA-Ib, in the pathogenesis and disease progression of FSGS and recurrent FSGS. Further studies should be performed to elucidate the true essential biomarker(s) associated with the onset and progression of FSGS as well as recurrent FSGS.

scholarly journals A case of suspected antibiotic-associated encephalopathy in a patient undergoing long-term peritoneal dialysis

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092450 ◽  
Author(s):  
Yibin Guo ◽  
Xiaojiao Shao ◽  
Liyuan Zhang ◽  
Jiayi Miao ◽  
Yiwen Zhang
Keyword(s):  
Peritoneal Dialysis ◽  
Pulmonary Infection ◽  
Auditory Hallucination ◽  
Computed Tomography Imaging ◽  
Mental Symptoms ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Slow Rhythm

A man undergoing long-term peritoneal dialysis who had no history of mental illness suffered psychosis and auditory hallucination 2 days after clindamycin was initiated at a single dose of 0.6 g per day for pulmonary infection. His mental symptoms disappeared after clindamycin was discontinued and peritoneal dialysis was strengthened. The patient’s body temperature was mildly elevated the day before he was admitted to the hospital, and no abnormalities were observed on head and chest computed tomography imaging at admission, except for a slow rhythm on electroencephalogram. Many factors were involved in this case; antibiotic-related encephalopathy caused by clindamycin may be one factor. Physicians should carefully consider the use of antibiotics, especially in patients with end-stage renal disease.

scholarly journals The Long-Term Incidence of Hospitalization for Ketoacidosis in Adults with Established T1D—A Prospective Cohort Study

2019 ◽  
Vol 105 (1) ◽  
pp. 231-241 ◽  
Author(s):  
Merlin Thomas ◽  
Valma Harjutsalo ◽  
Maija Feodoroff ◽  
Carol Forsblom ◽  
Daniel Gordin ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
General Population ◽  
Density Lipoprotein ◽  
Albumin Excretion Rate ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Incidence Of Hospitalization

Abstract Context The long-term natural history of diabetic ketoacidosis (DKA) and its risk factors are poorly understood. Objective To determine the long-term incidence and predictors of DKA in adults with longstanding type 1 diabetes (T1D). Design All hospitalizations and deaths due to DKA between 1996 and 2016 were identified in 4758 adults with T1D from the Finnish Diabetic Nephropathy Study (FinnDiane), and a cohort of 16 224 adults with T1D from the Finnish general population. Results Between 1996 and 2015, there were 1228 DKA events in the FinnDiane participants (1.4/100 person-years) and 4914 DKA events (1.8/100 person-years) in adults with T1D from the general population. The majority were hospitalized only once. There was a modest increase in the frequency of DKA in the FinnDiane over the follow-up (~2.4%/year [95% CI, 0.3–4.5%]; P = 0.03). Predictors of DKA were glucose control, CSII, smoking and alcohol consumption, and raised high-density lipoprotein cholesterol and triacylglycerides. Diabetic nephropathy and renal impairment were associated with DKA; patients with end-stage renal disease, macroalbuminuria, and microalbuminuria had 2.09-fol (95% CI, 1.40–3.12), 1.65-fold (95% CI, 1.23–2.19), and 0.87-fold (95% CI, 0.61–1.24) risk of DKA compared with patients with normal albumin excretion rate, respectively. Patients with an estimated glomerular filtration rate &lt;60 mL/min/1.73 m2 were also more likely to be hospitalized for DKA (HR 1.71 [95% CI, 1.26–2.67]). Conclusions DKA remains a common cause of hospitalization in individuals with longstanding T1D. These data suggest that the goal to use SGLT2 inhibitors for their vasculo- and renoprotective actions may be problematic, as those most likely to benefit may also have the highest risk for DKA.

scholarly journals 787 The Hidden and The Lost: A Case of a Rare Complication from A Long-Lost Surgical Technique

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M K Oo ◽  
M H Kamarul Bahrin ◽  
S Y Win ◽  
M J Perry
Keyword(s):  
Liver Transplant ◽  
Rare Complication ◽  
Biliary Tree ◽  
Biliary Colic ◽  
Stent Insertion ◽  
Long Time ◽  
History Of ◽  
End Stage

Abstract Background Various operative techniques have been developed for liver transplant since the 1960's. Waddell-Calne technique for biliary reconstruction in orthotopic liver transplant (OLT) was one of the rare and now relatively obsolete techniques. The aim of our presentation is to describe a long-term complication of this lost technique and how it posed multiple diagnosis and management challenges after 35 years post-liver transplant. Case presentation Our case is on a 50-year-old lady with a history of OLT for end-stage liver failure secondary to type-1 autoimmune hepatitis. Peri and postoperative period were completely unremarkable. 35 years later, she presented with symptoms of recurrent cholangitis. Magnetic resonance cholangio-pancreaticography demonstrated biliary tree dilatation with choledocholithiasis and possible cholecystitis. Removal of the distal stones together with pig-tail stent insertion was achieved via endoscopic retrograde cholangio-pancreaticography, however, her biliary colic persisted. The background of OLT and grossly distorted anatomy on imaging posed a challenge for further surgery. Extensive tracing of the history back from 1985 and multicentre multidisciplinary discussion revealed that the Waddell-Calne technique was carried out for her OLT where a gallbladder conduit was used for the hepaticojejunal-anastomosis. Finally, excision of the gallbladder conduit and hepaticojejunostomy with long Roux-en-Y was able to perform successfully. Conclusions Waddle-Calne technique is rarely seen globally nowadays but should be considered as a possible cause of recurrent cholangitis in patients with a history of OLT a long time ago. We demonstrated that the knowledge of such a rare procedure, together with the multidisciplinary approach could enormously benefit the management of the case.

Frequency of Gastrointestinal Diseases in Patients with End-Stage Renal Disease Treated with Long Term Dialysis

2018 ◽  
Vol 2 (2) ◽  
pp. 105-112
Author(s):  
Lutfi Zylbeari ◽  
Zamira Bexheti ◽  
Gazmend Zylbeari ◽  
Ferizate Haxhirexha ◽  
Kastriot Haxhirexha
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Gastrointestinal Diseases ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Long-term risks after kidney donation: how do we inform potential donors? A survey from DESCARTES and EKITA transplantation working groups

2021 ◽  
Author(s):  
Geir Mjøen ◽  
Umberto Maggiore ◽  
Nicos Kessaris ◽  
Diederik Kimenai ◽  
Bruno Watschinger ◽  
...  
Keyword(s):  
Evaluation Process ◽  
Kidney Donation ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Relative Risks ◽  
Written Information ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Publications from the last decade have increased knowledge regarding long-term risks after kidney donation. We wanted to perform a survey to assess how transplant professionals in Europe inform potential kidney donors regarding long-term risks. The objectives of the survey were to determine how they inform donors and to what extent, and to evaluate the degree of variation. Methods All transplant professionals involved in the evaluation process were considered eligible, regardless of the type of profession. The survey was dispatched as a link to a web-based survey. The subjects included questions on demographics, the information policy of the respondent and the use of risk calculators, including the difference of relative and absolute risks and how the respondents themselves understood these risks. Results The main finding was a large variation in how often different long-term risks were discussed with the potential donors, i.e. from always to never. Eighty percent of respondents stated that they always discuss the risk of end-stage renal disease, while 56% of respondents stated that they always discuss the risk of preeclampsia. Twenty percent of respondents answered correctly regarding the relationship between absolute and relative risks for rare outcomes. Conclusions The use of written information and checklists should be encouraged. This may improve standardization regarding the information provided to potential living kidney donors in Europe. There is a need for information and education among European transplant professionals regarding long-term risks after kidney donation and how to interpret and present these risks.

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