Chronic Renal Failure Patients Research Articles

Exosomal miRNA-200b-3p regulated autogenous arteriovenous fistula thrombosis in maintenance hemodialysis patients.

Autogenous arteriovenous fistula (AVF) is the best vascular hemodialysis access for terminal chronic renal failure patients but is prone to thrombosis. Pathogenic mechanisms of AVF thrombus are thus largely explored. As exosomes carry genetic content from cell of origin. We hypothesized that miRNAs in serum exosomes are promising regulators of AVF thrombosis. Serum exosomes were isolated from maintenance hemodialysis (MHD) patient, miRNAs profile of the exosomes was obtained by high throughput sequencing, six miRNAs (miR-144-5p, miR-18a-5p, miR-200a-3p, miR-200b-3p, miR-141-3p, and miR-429) were determined as candidates examined by RT-PCR, cells transfected with miR-200b-3p mimics demonstrated significantly increased mRNA levels of VEGF and Ang-II, the relationship between miR-200b-3p and VEGF or Ang-II was performed by adual luciferase reporter assay. There are 43 miRNA down-regulation and 15 miRNA up-regulation between MHD group and MHD+Thrombus group, the expression levels of miR-200b-3p and miR-429 in MHD with thrombus were significantly increased (p < 0.001, p < 0.05). Inhibited miR-200b-3p expression level can increase VEGF mRNA and protein expression levels and decrease Ang-II mRNA and protein expression levels. Furthermore, we also identified that miR-200b-3p targets VEGF and Ang-II. Our study indicates that serum exosome-derived miR-200b-3p regulate VEGF and Ang-II to increase intimal hyperplasia to induce AVF thrombosis. Besides miR-200b-3p, miR-200 family may also play a regulatory role in AVF thrombosis.

Comparison of SARS-CoV-2 vaccine induced antibody response among healthy individuals and chronic renal failure patients

AZD1222 (Covishield) COVID-19 vaccination response among healthy adults and chronic renal disease patients has been compared in this analysis. Compared to healthy individuals, vaccine induced immune response seems to be suboptimal after two doses of the vaccine in patients with chronic renal disease on hemodialysis. Infection following full course of vaccination can boost the vaccine induced antibody levels in both healthy individuals and patients with chronic renal disease. It is necessary to conduct comprehensive prospective research to further evaluate these conclusions made based on this preliminary data evaluation, and to find out its overall impact for future SARS-CoV-2 infection and its disease outcome.

Pengaruh Edukasi Terhadap Mekanisme Koping Pasien Gagal Ginjal Kronik Dengan Pre Hemodialisa di RSUD Dr. M. Haulussy Kota Ambon

Coping mechanism is an active process which uses internal resources and develops new behaviors that aim to grow strength in the individual, reduce the impact of anxiety and even stress in life. The purpose of this study was to determine the effect of education on the coping mechanisms of chronic renal failure patients with pre hemodialysis. This research method is a quasi-experimental design with one group pretest-posttest. The sampling technique used was the accidental sampling method, as many as 60 respondents. The results of the Wilcoxon test showed that the P value = 0.004 &lt; = 0.05, which means that there is an effect of education on the coping mechanisms of patients with chronic kidney failure before and after being given education. Suggestions for patients are to continue to increase knowledge and be active in health education activities. Suggestions for health agencies are to provide optimal counseling so that patients are able to use adaptive coping mechanisms.Keywords: Education; Chronic renal failure; Hemodialysis; Coping mechanism

Analisis Biaya dan Nilai Utilitas pada Pasien Hemodialisis yang Diberikan Terapi Erythropoiesis di Rumah Sakit

Chronic kidney failure is a condition where there is a gradual decline in kidney function. Chronic kidney disease is often followed by complications of anemia. The use of erythropoietin therapy in chronic renal failure patients undergoing hemodialysis requires no small amount of money. This affects the quality of life (utility). The purpose of this study is to measure costs and utility values using the EQ-5D-5L (EuroQol-Five Dimensions) instrument, VAS (Visual Analog Scale), and costs based on the patient's perspective at Prof.Aloei Saboe Hospital. This study is a prospective cross-sectional approach. Data was collected using the EQ-5D-5L and EQ-VAS questionnaires. The subjects of the study were hemodialysis patients as many as 45 met the inclusion criteria. The results showed that the most widely used Erythropoietin therapy was single Hemapo. The results of the calculation of the estimated cost of each hemodialysis patient from the perspective of a patient for one month of therapy are Rp. 7,112,000. The average expenditure of patient transportation costs is Rp. 50,111. The average cost of food for the patient is Rp. 25,000.Utility value based on average Indonesian set value 0.673 (sufficiently feeling well)and VAS score 71.4 (health status is quite healthy).

The Effects of Resistance Exercise in End Stage Renal Disease Patients Undergoing Hemodialysis: A Systematic Meta-Analysis

End-stage renal disease (ESRD) is a global public health problem as same as in Thailand the number of patients undergoing hemodialysis treatment is getting higher every year. In frequently cases has many impacts and affect the reduction of functional conditions. The objective of this study is to conduct a systematic review and meta-analysis of research into the effects of resistance exercise on end stage renal disease patients undergoing hemodialysis and to analyze the effect size of resistance exercise on patients. A systematic literature search was conducted using the database of Science direct, Wiley Online Library, Scopus, PubMed, EBSSCO host and the Thai-Journal Citation Index Center, looking for randomized controlled trials between 2009 and 2020. Combined effect sizes were calculated using Review Manager Version 5.3. Eight articles met the inclusion criteria and in the effect size analysis. Results showed that resistance exercise improved the ability to function and increased muscle strength, improved body composition and quality of life in chronic renal failure patients undergoing hemodialysis treatment.&#x0D; HIGHLIGHTS&#x0D; &#x0D; The effectiveness of resistance exercise interventions improves physical performance, quality of life (QOL), muscle strength and body composition&#x0D; The characteristic of exercise has shown to be high beneficial for many health aspects and easily modifiable lifestyle factor with virtually no negative side effects&#x0D; This meta-analysis might help to develop early intervention strategies for physical and psychological outcome both of patients with chronic diseases&#x0D; &#x0D; GRAPHICAL ABSTRACT

TO STUDY THE BIOCHEMICAL PARAMETER IN HYPERTENSION AND RENAL FAILURE

Background: In both economically developing and non-developing countries, hypertension is a major public health issue. India has been reported to have lower hypertension prevalence rates. The blood pressure of city dwellers is higher than that of rural dwellers. India is a populous and typical developing country with a vast population. Renal failure is defined as the retention of nitrogenous waste products due to impairment of renal function. Acute renal failure and chronic renal failure are the two types of renal failure. Acute renal failure is described as kidney failure that occurs in a matter of days or weeks. Acute renal failure is most common in older persons and is linked with considerable mortality and morbidity, with death rates ranging from 25 to more than 70% among hospitalized patients.&#x0D; Aim: To establish the above biochemical parameters for diagnosis and management of hypertension and renal failure.&#x0D; Material and Method: The clinical materials for present study entitled “To Study the Biochemical Parameter in Hypertension and Renal Failure” comprised 52 male hypertensive patients. 39 female hypertensive patients, 50 male chronic renal failure patients, 43 female chronic renal failure patients, 42 male chronic renal failure with hypertension, 40 female chronic renal failure with hypertension, 36 male acute renal failure, 48 female acute renal failure were admitted in Hospital.&#x0D; Results: Results revealed that highly significant decreased level of protein (Total), creatinine, and P-MDA were observed respectively. Serum sodium was found to be significant. Significant increased potassium was observed. Highly significant level of glucose, glutathione reductase, glutathione peroxidase, and catalase were observed respectively. Focus on acute renal failure patients were analyzed in both male and female. Highly significant decreased level of protein (Total), superoxide dismutase and P-MDA were observed respectively, glutathione reductase, glutathione peroxidase, and catalase were observed respectively. Significant increased serum glucose was observed, and highly significant increased level of glutathione reductase, glutathione peroxidase, and catalase were observed respectively.&#x0D; Conclusion: The study's key finding is that oxidative stress causes hypertension and can signal the onset of chronic renal failure. Oxidative stress in older people became more severe, especially if they had renal difficulties, especially in middle age.&#x0D; Keywords: P-MDA, Glutathione reductase, glutathione peroxidase, SOD, DBP

Study of Autonomic Neuropathy in Cardiovascular System in Chronic Renal Failure Patients on Maintenance Hemodialysis

Autonomic nervous system abnormalities are major causes of morbidity and mortality in patients with chronic renal failure (CRF) on hemodialysis and are generally considered a part of polyneuropathy. Postural hypotension, impotency, gastrointestinal disturbance, gastrointestinal motility, and sweating abnormalities are common symptoms. The most frequent complication in patients with CRF on hemodialysis is intradialytic hypotension, and it has been suggested that intradialytic hypotension is mostly related to autonomic neuropathy. The pathogenesis of autonomic neuropathy is unclear, but a reduced response to norepinephrine by the end organ and the toxic effect of metabolic toxins are considered to be some of the causes. Five cardiovascular reflex tests are generally used to determine autonomic neuropathy: the heart rate reaction to the Valsalva Maneuver, the heart rate variability during deep breathing, the heart rate response to standing up, the blood pressure response to standing up, and the blood pressure response to hand grip exercise.

Prevalence of Hepatitis C in Dialysis Patients in Khyber Teaching Hospital Peshawar

Introduction: The hepatitis C virus (HCV) is a Flaviviridae-related virus that causes a systemic illness that can be transmitted. HCV is a blood-borne infection that primarily affects the liver. HCV diagnosis that is accurate and timely is critical in significantly reducing the risk of morbidity and mortality. The goal of this study was to find out the Hepatitis C in chronic renal failure patients who are on hemodialysis. Method: This descriptive cross-sectional study was carried out in the Dialysis Unit of the Khyber Teaching Hospital (KTH) Peshawar's Department of Nephrology. From September to December 2017, this study took place over four months. The study included a total of 114 patients, regardless of their age or gender. Hepatitis C was detected in whole blood samples collected from 114 healthy people using an immunochromatography method. The data was analyzed using SPSS v.22. Result: The Immunochromatography technique for HCV was used to analyze 114 blood samples from recruited individuals. Male patients were 52.6% of the total, while female patients made up 47.4%. The study found that 24.56% of male patients were positive, while 28.07% of female patients were positive. Overall, the technique's sensitivity and specificity were 83.1% and 72.7%, respectively. Conclusion: It is concluded that the HCV rapid testing is still sensitive and specific for detecting hepatitis C virus, it should be used in routine clinical settings for early hepatitis C virus diagnosis when advanced diagnostic options are restricted. Keywords: HCV, Hepatitis C virus, Nephrology, Dialysis

Detection of Anti-Erythropoietin Antibodies in Patients with Chronic Renal Failure Undergoing Hemodialysis

Background: Erythropoietin, a hormone produced by the kidney, activates the bone marrow upon demand. Recombinant erythropoietin can be subcutaneously injected to maintain red blood cell counts in chronic renal failure patients. Some time being recognized as foreign antigens, the patient occasionally produces antibodies against erythropoietin. Objective of current study was to investigate the existence of Anti-Erythropoietin Antibodies in Chronic Renal Failure (CRF) affected individuals during hemodialysis. Methods: The current study was performed at the Pathology Department, Khyber Teaching Hospital, Peshawar, Pakistan. After the assent of ethical committee, data collection was initiated to carry out the study. All the patients filled the informed consent proforma. The blood sample was collected in two EDTA and Gel tubes for complete blood count and for anti-EPO-antibodies respectively. ELISA tests for anti-EPO antibodies were performed on all patients who were classified into two groups based on whether antibodies were present or not. The data was analyzed using SPSS version 25.0. Results: In this study, 150 patients suffering from Chronic Kidney Disease on dialysis were included in which 79 (52.7%) were males. Moreover, age-wise group 41-60 years (n=93, 62%) were more suffering as compared to age group 21-40 years (n=24, 16%). In our study, hypertension was found to be a leading cause of death for 65(43.3%), diabetes 32(21.3%), hypertension and diabetes mellitus 10(6.7%), and miscellaneous accounted for 28.7%. There were 56(37.3%) patients who received dialysis twice a week, and 94 patients (62.6%) received it three times a week. Patients had transfusion history were 136(90.7%), while 92 (61.3%) patients were found to have anti-EPO antibodies. Conclusion: Anti-EPO antibodies are frequently demonstrated in patients with CKD undergoing hemodialysis. Due to the lack of correlation between antibody levels and Hb or reticulocyte counts, these antibodies might not be neutralizing antibodies. Keywords: Anti-EPO antibodies, Chronic Renal Failure, Hypertension, Peshawar.

Studies on the pharmacokinetics of piperacillin/tazobactam in renal replacement therapy in patients with chronic renal failure

&#x0D; &#x0D; &#x0D; &#x0D; Purpose: To study the pharmacokinetics of piperacillin/tazobactam in renal replacement therapy (CRRT) in patients with chronic renal failure (CRF).&#x0D; Methods: Six CRF patients treated with CRRT in the First Affiliated Hospital of Hebei North University from April 2020 to July 2020 were selected and administered 4 g of piperacillin and 0.5 g of tazobactam within 30 min after, and at 5, 30, 45, 60, 90, 120, 180, 240, 360 and 480 min after CRRT. The DAS software was used to calculate pharmacokinetic parameters while linear regression was used to analyze the relationship among patient characteristics, CRRT parameters, and pharmacokinetics.&#x0D; Results: The Cmax of piperacillin and tazobactam was 118.46 (96.12 - 161.12) mg/L and 27.45 (14.75 - 28.45) mg/L, while the volume of distribution (Vd) was 1.16 (0.72 - 1.59) L/h and 0.72 (0.57 -0.82) L/kg, respectively. The value for elimination half-life (t1/2) was 4.66 (3.19 -8.45) h and 4.25 (3.42 - 5.96) h, while total clearance (CL) was 7.28 (5.58 - 9.73) L/h and 6.37 (4.28 - 10.04) L/h, respectively. Multivariate linear regression showed that piperacillin Cmax was negatively correlated with the flow velocity of the substitution fluid (β = -0.679, 95 % CI = -0.278 - 0.943, p &lt; 0.001). Piperacillin CL was positively correlated with the flow velocity of the waste liquid (β = 0.956, 95 % CI = 1.267 - 4.796, p &lt; 0.001).&#x0D; Conclusion: When used in CRF patients receiving CRRT, piperacillin and tazobactam show decrease in Cmax and CL, but increase in t1/2. This finding should provide useful guidance for clinicians concerned.&#x0D; &#x0D; &#x0D; &#x0D;

Serum Cystatin, Chemokine, and Gastrin-Releasing Peptide Precursors and Their Clinical Value in Patients with Chronic Renal Failure.

Objective To investigate the serum cystatin (CysC), Chemerin, and gastrin-releasing peptide precursor (ProGRP) levels in patients with chronic renal failure (CRF). Methods CRF patients admitted to our hospital from February 2019 to July 2019 were selected as the observation group, and 50 healthy patients were selected as the control group. The serum levels of CysC, Chemerin, ProGRP, and Scr of all subjects were detected. Patients with CRF were admitted for peritoneal dialysis (PD) treatment for 1 week, and continued treatment was performed. The survival rate of patients with CRF in nearly 1 year after continuous treatment was observed. Multivariate analysis of factors affecting survival time of CRF patients undergoing peritoneal dialysis was performed. The results were compared with those in the health group. The expression levels of CysC, Chemerin, ProGRP, and Scr in the observation group were all decreased, and the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that Scr expression in CRF patients is positively correlated with CysC, Chemerin, and ProGRP (P < 0.001). The survival rate of 98 patients with CRF was 80.61% (79/98), and the mortality rate was 19.39% (19/98). Serum levels of CysC, Chemerin, ProGRP, and Scr in the death group are all higher than those in the survival group, and the differences are statistically significant (P < 0.05). CysC, Chemerin, ProGRP, and Scr are independent risk factors affecting survival time (P < 0.05). The AUC aspects of serum CysC, Chemerin, ProGRP, and Scr in predicting the survival rate of CRF patients in the treatment phase are 0.840, 0.775, 0.782, and 0.725, respectively. Conclusion The serum levels of CysC, Chemerin, and ProGRP of CRF patients are abnormally elevated and are positively correlated with serum Scr of patients, which can be used as a reliable indicator of pathogenesis and prognosis assessment of CRF patients.

Possible effect of dialysis membrane in polymethylmethacrylate on clinical variables associated with atherosclerosis development in chronic renal failure patients

Background: Chronic hemodialysis patients have higher cardiovascular morbidity compared to the general population. A number of studies have suggested that patients undergoing hemodialysis with polymethylmethacrylate (PMMA) membranes have a better outcome compared to other membranes. Methods: We performed a retrospective, multicenter study to evaluate the impact of PMMA membranes compared to other types of membranes on clinical parameters considered important risk factors for the development of cardiovascular disease in chronic kidney disease patients. Results: The study included 104 patients (52 patients on PMMA and 52 patients on other membranes) from ten dialysis centers, monitored for 24 months. HDL cholesterol (mg/dL) increased significantly in the PMMA group (41.4 ± 10.8 to 44.1 ± 13.5, p = 0.0467), but not in the control group (41.8 ± 13.8 to 39.4 ± 9.6, p = 0.8628). At 24 months total cholesterol and triglycerides (mg/dl) were significantly lower in the PMMA group than in the control group (142.4 ± 43.8 vs. 166.1 ± 43.4, p = 0.0321 and 106 (76.5-176) vs. 170 (118-254), p = 0.014), respectively. Serum creatinine (mg/dL) increased significantly from baseline to 24months in the PMMA group (9.20 ± 2.5 to 9.47 ± 2.3, p = 0.0291), but not in the patients treated with other membranes (8.39 ± 2.6 to 8.37 ± 2.3, p = 0.2743). In addition creatinine was significantly higher in the PMMA group compared to the other group (9.47 ± 2.3 vs. 8.37 ± 2.3, p = 0.0493). WBCs (109/L) increased significantly in the control group (6151 ± 1846 to 6672 ± 1872, p = 0.0457) but not in the PMMA group (6326 ± 2113 to 6152 ± 1832, p = 0.8981). At 24 months platelets (109/L) and CRP (ng/dL) were significantly lower in the PMMA group compared to the control group (185 (144-222) vs. 210 (173-259), p = 0.0498 and 0.70 (0.30-1.59) vs. 3.76 (0.46-10.2), p = 0.023, respectively). Iron and transferrin (μ g/dL) decreased signifi cantly in the patients treated with other membrane (62.5 ± 30.4 to 52.6 ±19.0, p = 0.0113 and 178 (157-218) to 170 (124-203), p = 0.0019, respectively), but not in the PMMA group. Conclusion: This retrospective study of data from 104 patients shows a favorable effect of PMMA on clinical variables considered relevant for the development of atherosclerosis in hemodialysis patients.

Nail Changes in the Chronic Kidney Failure – A Cross-Sectional Study

Background: Nail manifestations observed in chronic renal failure (CRF) patients are multifarious and heterogeneous in nature. The prime objective of the study is to evaluate the prevalence and features of various kinds of nail manifestations in the patients of CRF. CRF causes heterogeneous pathology of nail which may be or may not be associated with renal condition itself, complications related to it and its therapy. Objective: To study nail changes in the patients of CRF whether managing conservatively or on maintenance hemodialysis (HD). Patients and Methods: The study consists of 100 patients suffering from CRF. Nails of these 100 patients suffering from CRF were examined and different kinds of nails were appreciated and frequencies of the same type of nails in different patients were noted. Results: Nail changes found in chronic kidney disease are longitudinal ridges, half and half nails, leukonychia, pitting nails, onychomycosis, absence of lunula, splinter hemorrhage, and onycholysis as decreasing trend they observed. Conclusions: Nail changes that are seen on examination of patients with CRF managing on HD are very frequent and nail changes if found earlier can be an indicator for early diagnosis of systemic diseases.

The Possibilities of Chronic Renal Failure Patients Contracting Occult Hepatitis B Virus Infection, Sudan

Introduction: Chronic kidney disease (CKD) is a major cause of death in sub-Saharan Africa. The effects of the CKD on the host and the continuous therapeutic measures increase the hypothesis of blood-borne diseases transmission. Objective: This study aimed to find the frequency of occult hepatitis B virus (OBI) in patients of chronic renal failure (CRF) and to study the possibilities of infection acquisition. Methods: During 2017 and 2019, two hundred CRF patients under regular haemodialysis and attending Gezira Hospital for Renal Diseases and Surgery were recruited. Plasma specimens were collected and used for detection of hepatitis B surface antigens (HbsAg), total hepatitis B core antibodies (anti-HBc) and hepatitis B virus DNA isolation. Nested PCR reaction was followed to identify HBV. Socio-clinical data for each participant was obtained. Results: Male patients represented 64% (128/200), most frequent age group was from 41 to 60 years with percentage of 56.5% (113/200), 86% (172/200) of CRF patients were received blood while 42% (84/200) get HBV vaccination. Hepatitis B core antibodies were found in 54% (108/200) of studied cases, and 22% (42/188) of tested DNA were positively amplified for target gene. Detection of Hepatitis B core antibodies was significantly associated with marital status while absence of vaccination significantly associated with the detection of both hepatitis B core antibodies and HBV DNA. Conclusion: This study found high frequency of OBI in CRF patients, to reduce the transmission of the disease, possible hypotheses should be studied, including blood transfusion, haemodialysis process and HBV vaccination status.

Estimation of Renin enzyme activity and some biochemical parameters among chronic renal failure patients in Tikrit city.

Chronic renal failure is a deficiency and failure in the excretory function of the kidneys, which causes a general imbalance in the body by retaining and accumulating nitrogenous waste and harmful substances as a result of metabolic reactions. Other functions of the kidneys, such as the regulation of fluids and electrolytes, may also be affected. This study's primary purpose is to estimate some parameters in the serum of chronic renal failure patients. Data and blood samples were obtained from 90 patients with chronic renal failure and 50 healthy volunteers for this cross-sectional study, conducted between 11 April and 26 July 2022. The results of this study show a considerable rise in the level of renin enzyme in patients (4.824±0.045) compared to the control (2.86±0.39), a high level of ALT in patients (19.56±8.13) compared to the control (11.24±0.98), high level of ALP in patients (95.34±67.71) compared to the control (38.81±5.14), high level of AST in patients (25.33±8.63) compared to the control (11.58±0.94), low level of albumin in patients with chronic renal failure (3.12±0.44) compared to the control (3.90±0.49), high level of globulin in patients with chronic renal failure (8.34±0.68) compared to the control (3.01±0.41), low level of calcium in patients with chronic renal failure (1.731±0.053) compared to the control (2.510±0.063), high level of potassium in the serum of patients with chronic renal failure (6.256±0.068) compared to the control (4.513±0.22), low level of sodium in patients with chronic renal failure (119.82±2.15) compared to the control group (143.76±2.11). According to this study, all physiological systems are significantly impacted by chronic renal failure. According to the results, chronic renal failure affects several electrolytes and liver function tests and causes a considerable increase in renin levels.

Short-term Postoperative Outcomes of Colorectal Cancer Patients With Chronic Renal Failure on Dialysis.

Surgery for dialysis patients requires special attention because of their physical characteristics. This study aimed to investigate the short-term postoperative outcomes of colorectal cancer patients with chronic renal failure (CRF) on dialysis and aimed to investigate safer treatment options for these patients. A total of 1,504 colorectal cancer patients who underwent primary resection between January 2008 and December 2018 were included. A retrospective analysis of clinical data, preoperative tumor markers (carcinoembryonic antigen and carbohydrate antigen 19-9), and the Clavien-Dindo (CD) classification was performed. Patients were stratified into Groups A and B based on their need for dialysis or not, respectively. There were 20 and 1,484 patients in Groups A and B, respectively. No differences were observed regarding age, body mass index, and preoperative tumor markers. The rate of laparoscopic surgery was significantly lower in Group A than in Group B. There was one mortality in Group A due to pulmonary disease. Group A had a significantly higher rate of complications. CRF patients on dialysis who underwent colorectal cancer surgery tended to be ruled out of laparoscopic surgery, and their rates of postoperative complications were higher.

The effect of hemodialysis on macular thickness

Introduction/Objective. During hemodialysis (HD) treatment great fluctuations were recorded in the systemic hemodynamic parameters and in the volume and composition of ocular fluid. There are only a few studies that analyzed the effect of HD on retinal and macular thickness with conflicting results. Objective of this study was to determine macular thickness, marked as central foveal thickness, average macular thickness and macular volume, shortly before and after HD. Methods. This prospective study included 30 chronic renal failure (CRF) patients of HD treatment. Thorough ophthalmologic examinations were performed including evaluation of best corrected visual acuity, intraocular pressure and slit-lamp examination of all eye segments. Macular thickness was determined by optical coherence tomography shortly before and after HD. The next parameters were evaluated: central foveal thickness, average macular thickness and macular volume. The correlation between systemic parameters and macular thickness changes during HD was tested. Results. There were significant changes in body weight and blood pressure pre- and post-HD. Results showed macular thickness (central foveal thickness, average macular thickness and macular volume) decreased, but the change was not significant. There was no significant correlation between systemic hemodynamic parameters and macular thickness changes. Conclusion. Results of this study showed there was no statistically significant changes in macular thickness CRF patient undergoing HD. Further research on a larger group of patients and a longer follow-up time are required to confirm these findings.

Seroprevalence and risk factors for Hepatitis C virus among maintenance hemodialysis patients at a Tertiary Care Hospital in Puducherry, India

Background: Hepatitis C virus (HCV) infection is a serious public health problem and the most significant cause of liver disease in patient receiving dialysis for a long term. The prevalence of HCV infections among dialysis patients varies markedly from country to country. Tight infection control measures implemented in developed countries have minimized the transmission rate, while the prevalence still remains high in the developing world. The aim of this study is to estimate the prevalence rate of HCV infection in hemodialysis patients, to describe demographic characteristics of individuals infected with HCV and to determine whether HCV-polymerase chain reaction (PCR) testing identifies HCV infections not detected by anti-HCV testing. Methods: This retrospective record-based study was carried in Aarupadai Veedu Medical College and Hospital, a Tertiary Care Center in Puducherry, A total of 258 chronic renal failure patients on hemodialysis were studied and tested for anti-HCV antibodies by 4th generation HCV TRIDOT ELISA and real time-PCR. Results: Anti-HCV antibodies were positive in 34 (13.2%) patients, comprising 27 (79.4%) males and 7 (20.6%) females. The majority of patients were found to be positive; between 41 and 60 age 24 (70.5%). HCV RNA was detected in 38 (14.72%) patients. The mean age of patients undergoing dialysis was 45 years. 12 (35%) had raised aspartate transaminase (AST) levels and 14 (41%) had raised alanine transaminase (ALT) levels. Gamma-glutamyl transferase was found to be raised in 25 (73.5%) of the subjects. All the 34 HCV seropositive patients were hypertensive and 33% had diabetes mellitus. 23 (67.6%) patients had undergone dialysis in more than one center. Conclusions: Regular screening of patients for HCV is absolute necessity for early detection of HCV infection that could result in better management of patients and also stresses on the importance of HCV RNA detection by PCR. Strict adherence to universal precautions, the use of dedicated machines along with regular surveillance for HCV in HD units will dramatically decrease the risk of transmission of HCV.

Intradialytic Exercise on Changes in Blood Pressure in Chronic Kidney Failure Patients during Hemodialysis Therapy

Abstract&#x0D; BACKGROUND: Chronic renal failure (CRF) is a reduction in chronic renal function that leads to non-reversible and progressive kidney tissue damage. Blood pressure is a major risk factor that can increase the mortality rate by up to 20 times in patients with chronic renal failure who are undergoing hemodialysis therapy. Intradialytic exercise is an intervention that can be used to control systolic blood pressure.&#x0D; AIM: This study was to analyze the effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital.&#x0D; METHODS: The research method is quasi-experimental design pre-post with control group design. The study population was 97 dialysis patients. The sampling technique used a purposive sampling of 30 people. Data analysis using Paired t-Test.&#x0D; RESULTS: The research results showed that the sex characteristics of most respondents were male as many as 17 people (56.7%), the average age of the respondents was 51.03 years, the pre-intervention in the control group obtained an average systolic blood pressure of 168.93 mmHg and 106 diastole, 120 mmHg, while the blood pressure in the control group post was 173.13 mmHg systole and 107 mmHg diastoles. In the treatment group, the average blood pressure in the pre-intradialytic exercise showed 162.20 mmHg systole and 104.27 mmHg diastole, while the post-intradialytic exercise system blood pressure was 153.13 mmHg and diastole 94.33 mmHg.&#x0D; CONCLUSION: There is an effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital with a p-value of 0.025. Intradialytic exercise can be recommended as structured physical exercise therapy for hemodialysis therapy patients.&#x0D; &#x0D; KEYWORDS: intradialytic exercise, chronic renal failure, patients, changes in blood pressure, hemodialysis

Analysis of the Efficacy of Alprostadil in Combination with Reduced Glutathione on the Chronic Renal Failure

To observe the clinical efficacy and safety of alprostadil in combination with the reduced glutathione for the treatment of chronic renal failure patients is the main objective. A total of 98 chronic heart failure patients in this hospital were selected as the subjects and divided into the control group and the observation group, with 49 patients in each group. Patients in the control group received the regular therapy, while those in the observation group received the combined medication of alprostadil and reduced glutathione. Following the treatment, we compared the clinical efficacy, incidence of adverse events and the indicators of renal functions, including the hemoglobin, serum creatinine, 24 h urinary protein and blood urea nitrogen. After treatment, patients in two groups had improvement in the health status, social function, emotional function and mental status, and the improvement in the observation group was superior to that in the control group (all p<0.05). In the observation group, incidence rate of adverse events was 5.4 %, significantly lower than 24.3 % in the control group (p<0.05). Besides, following the treatment, significant improvement was also seen in the indicators of renal functions in two groups and similarly, the improvement in the observation group was more obvious than that in the control group (p<0.05). Alprostadil in combination with reduced glutathione, in treatment of chronic renal failure, can improve the indicators of renal functions, with fewer adverse events, so it is worthy of being promoted in clinical practice.