Hemodialysis For Chronic Renal Failure Research Articles

Blood purification therapy in chronic renal failure and its impact on renal index, serological index, and inflammatory factors.

This study aimed to explore the clinical effects of blood purification therapy in patients with chronic renal disease, measured by renal function index and inflammation. Data were collected from a tertiary care hospital in Pakistan between June 2022 and September 2023. Eighty-four patients undergoing maintenance hemodialysis for chronic renal failure were retrospectively included in this cohort. Age, sex, BMI, course of disease, primary disease, and educational level were not related to the response to blood purification treatment. Blood purification therapy positively affected renal function, serological indices, and inflammatory factors (P<0.05). Blood purification therapy can improve toxin clearance and renal function and reduce inflammation. Therefore, the authors can conclude that this is an effective therapy for our population.

Detection of ABH Antigen in Sudanese Patients with Chronic Renal Failure in Shendi Town, Sudan

Background: Patients suffering from chronic renal failure have significant challenges in their social and economic lives. In Sudan, the annual incidence of chronic renal failure is between 70 and 140 cases per million, and until more is done to address this illness, the problem is likely to persist. Blood group types appear to be associated with secretor status and certain disorders, in addition to the main therapeutic significance of the ABO blood group to organ transplantation and blood transfusions. Objective: To determine the prevalence of ABO and secretor status, a descriptive cross-sectional study was carried out among Sudanese patients receiving hemodialysis for chronic renal failure disease at the kidney treatment and surgical center in Shendi City between August and December 2021. Materials and Methods: Fifty samples total from patients with chronic renal failure were taken; of these, 42% were female and 58% were male. Two milliliters of venous blood and three milliliters of saliva were collected in sterile containers and EDTA anticoagulant containers, respectively. Slides were used to do ABO grouping, and absorption inhibition was used to determine secretor status. Results: 44% of patients with CKD were blood group O, 38% were blood group A, 16% were blood group B, and 2% were blood group AB. The data also revealed that 68% of patients with CKD were non-secretors and 32% were secretors. According to the study, there was a decrease in the frequency of the Se gene compared to the Se gene. The homozygous genotype SeSe was found to be 3%, the heterozygous genotype Sese to be 29%, and the recessive genotype Sese to be 68%. Additionally, the blood groups O and A have a higher risk of renal failure. Conclusions: Blood group O was the highest frequency among patients receiving hemodialysis for chronic renal failure, followed by blood groups A and B, while blood group AB was the least prevalent. The non-secretors had a higher genotype frequency. Renal failure is more common among non-secretors.

Arteriovenous Fistula about 400 Cases

Objective: Native arteriovenous fistula is the choice vascular acces for chronic hemodialysis due to its longevity, low complication rate and mortality compared to arteriovenous bypasses and catheters. The aim of our study is to present our surgical experience, to evaluate our results and show the main complications. Methods: We report our experience of 604 arteriovenous fistulas created in 400 patients undergroing hemodialysis for chronic renal failure. The mean fellow up period varied one day to eight years. Results: We have observed 25% of primary thrombosis and 16% of secondary thrombosis, there were two cases of local sepsis. Conclusion: We conclude that the Cimino-Brescia fistula is superior to any other type of vascular access in patients with renal failure.

Effect of Music Therapy On Pain Perception, Fatigue Level, And Physiological Variables in Patients Undergoing Hemodialysis- A Prospective Randomized Interventional Trial

Chronic renal failure (CRF) is a severe and chronic illness that can significantly impact a person's quality of life. It is caused by various pathologies and can lead to multiple complications, including fatigue and chronic pain. Hemodialysis is a standard and lifesaving treatment for patients with CRF, but the prolonged immobilization required during this procedure can exacerbate fatigue and pain. Music therapy is a non-invasive treatment that has positively impacted patients undergoing hemodialysis. In the study we have done, the therapy consisted of passive listening and active participation in the form of deep breathing for eight weeks. To provide music therapy based on client preference to patients undergoing hemodialysis for chronic renal failure. To observe the fatigue and subjective pain perception level after eight weeks of musical intervention.The sessions began with a warm-up session of OM chanting, which was used to set the atmosphere and bring attention to the subject. Then, devotional songs were played for 10 minutes based on the patient's preferences, followed by 20 minutes of Indian classical Veena music. The therapy sessions were administered every third day, twice a week when the patients underwent hemodialysis. Each session lasted around 3 hours. Subjective parameters of fatigue and pain perception were assessed before the intervention, after four weeks, and after eight weeks of musical intervention. The results indicated that music therapy lowered these patients' fatigue and pain perception. The fatigue level, estimated by the CIS (Checklist Individual Strength) score, was reduced by 30%, and the pain perception score dropped from 8 to 6.5. The findings of this study suggest that music therapy can be an effective complementary treatment for patients undergoing hemodialysis, as it can help to reduce fatigue and pain perception. It is essential because these symptoms can significantly impact patients' quality of life and may impact adherence to treatment regimens. However, it's also worth noting that this study only assesses the effect in a small sample size. For a short period, more research is needed in a larger population with a longer duration. Exploring different music or other therapeutic techniques is also beneficial to find the most effective approach for individual patients.

Olfactory function in patients undergoing hemodialysis as assessed by Sniffin' Sticks testing.

This study evaluated olfactory function in patients undergoing hemodialysis. The evaluation utilized the Sniffin' Sticks test. The study enrolled 56 individuals undergoing hemodialysis for chronic renal failure alongside 54 healthy controls. The Sniffin' Sticks battery was used to assess olfactory function in all subjects. The battery included 12 separately identifiable odors. A score below 6 was considered anosmia, whilst scores ranging from 7 to 10 were classed as hyposmia. A score of at least 11 indicated normal olfaction. There was a statistically significant difference in scores between the two groups. The hemodialysis patients scored 9.12±2.77 compared to 10.72±1.94 in the controls. In the hemodialysis patients, scores for males and females did not differ significantly. Furthermore, there was no correlation between score and age, sex or length of renal failure. Some 12.5% of hemodialysis patients were anosmic, whilst 50% were hyposmic. The corresponding rates in the control group were 7.4% and 20.4%. Undergoing hemodialysis is associated with a decreased total score on the Sniffin' Sticks battery, with anosmia in 12.5% of patients and hyposmia in 50.0%. Thus, olfactory impairment is present in 62.5% of hemodialysis patients. According to previous research, renal transplantation results in an improved ability to smell, depending on how plastic the neurons involved in olfaction are.

Gangrenous ischemic colitis localized to the cecum: a case report

BackgroundIschemic colitis affects the left colon in elderly individuals and localization on the right side, especially in the cecum, is rare. We report a case of gangrenous ischemic colitis localized in the cecum of a patient undergoing hemodialysis.Case presentationA 73-year-old man had been undergoing hemodialysis for chronic renal failure caused by diabetic nephropathy. He experienced frequent vomiting, diarrhea, and abdominal pain. Contrast-enhanced computed tomography revealed thickening of the cecal wall, poor enhancement, dilation of the cecum, and intrahepatic portal emphysema. No obvious abnormal findings were observed in the appendix. The patient was diagnosed with cecal necrosis and ileocecal resection was performed. Histopathological examination revealed gangrenous ischemic colitis of the cecum. He was discharged 12 days after surgery without postoperative complications.ConclusionIt is important to consider the possibility of ischemic colitis of the right colon in the event of renal failure requiring dialysis, to ensure that opportunities for surgical intervention are not missed.

Frequency and type of arrhythmia in Holter electrocardiogram in patients undergoing hemodialysis

Background/Aim: It is known that approximately 40% of chronic hemodialysis patients die due to cardiac arrhythmia and cardiovascular reasons. Determining whether the hemodialysis procedure poses a risk for arrhythmia is important in terms of prognostic follow-up of the patients. Therefore, we aimed to determine the underlying arrhythmia frequency and types with 24-hour Holter electrocardiogram (ECG) in patients receiving hemodialysis with normal baseline electrocardiography between the hemodialysis periods. Methods: Between January 2018 and January 2022, 91 consecutive patients who received hemodialysis for chronic renal failure (CRF) and applied to the cardiology outpatient clinic with complaints of palpitation and sinus rhythm on ECG and evaluated with 24-hour rhythm Holter ECG were included in the study. Our study was designed as a retrospective cohort study. Results: The mean age of the patient population was 65.78 (11.92) years, the mean systolic blood pressure was 143.71 (24.88) mmHg, and the mean heart rate was 83.43 (15.85) beats/min. Hypertension (HT) (n=44, 48%) and coronary artery disease (n=34, 37%) were the most common comorbid diseases. The most common arrhythmias detected on Holter ECG were ventricular extrasystole (VES) (n=18, 19.8%) and paroxysmal AF (n=8, 8.8%). Non-sustained ventricular tachycardia was detected in two patients. Conclusion: Detecting arrhythmia in the interdialytic periods in patients receiving hemodialysis due to CRF is important for follow-up and treatment. Even if the baseline ECG is normal in hemodialysis patients with CRF, the frequency of the underlying arrhythmia that needs to be treated is high.

“Effects of Different Measurements of Foot Angle on Vital Activities of Hemodialysis Patients”

Abstract Background Individuals who receive hemodialysis treatment due to chronic renal failure have limitations in their daily life and a decrease in physical activity and walking speed. In this study, we have investigated the effectiveness of various measurements of ankle angles of hemodialysis performed on patients on balance, falling risk, and daily life activities. Materials and Methods 114 volunteer hemodialysis patients with a mean age of 30-94 have measured at the position of plantar flexion, inversion, and eversion by a 1-degree sensitivity manual goniometer. The Time Up and Go test (TUG), Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and Barthel Index (BI) were applied to the patients. Statistical analyzes were made with the SPSS25 program. Results 55 male and 59 female participants were accompanied in the study. The average age was 62,8 ± 15,29, and the average hemodialysis performed duration was 5,59 ± 3,92, the average body mass indexes were 25,08 ± 5,17, the average number of falls was 5,59 ± 3,92. A low positive significant correlation was observed between plantar flexion and inversion foot angle measurements with The Lawton and Brody IADL scale (p&lt;0,05). A low-level significant positive correlation was observed between the BI score and the plantar flexion angle measurements (p&lt;0.05). A highly significant positive correlation was observed between plantar flexion angle measurement and inversion angle measurement. In contrast, a moderately significant positive correlation was observed between plantar flexion angle measurement and eversion angle measurement (p&lt;0.05). Conclusion We observed a decrease in daily life activities and a walking speed increase in falling risk in the diagnosis of chronic renal failure hemodialysis patients.

Effect of Anticoagulant and Antiplatelet Drugs on Outcome of Arterio-Venous Fistula Created for Hemodialysis Access

Background: Arteriovenous fistula (AVF) creation is the primary mode of achieving vascular access for hemodialysis in chronic renal failure (CRF). Because of high complication rates like thrombosis, maintenance of the fistula is a major challenge. Although antiplatelet and anticoagulant drugs are emerging rapidly for improving the outcome of AVF but fear of bleeding, hematoma, subsequent compression of AV fistula and blockade restrict their use in many dialysis centers. Objective: To see the effect of anticoagulant &amp; antiplatelet drugs in improving primary patency rate and reducing early thrombus formation of AVF. Methods: This clinical trial was conducted in the Department of Urology Bangabandhu Sheikh Mujib Medical University, Dhaka from November, 2018 to October, 2019. Ninety six ESRD patients who underwent AV fistula with immediate postoperative had thrill and murmur were included as study population as per selection criteria. Informed written consent was taken from all the patients. Patients were divided into two groups using computer generated random number (group I and group II). In group I, patients anticoagulation and antiplatelet drugs were used and in group II, patients anticoagulation and antiplatelet drugs were not used after creation of AVF. Patients were followed up on 3rd POD, at 2 weeks and at 4 weeks after the operation and re-evaluated with clinical examinations and investigations. The outcome were evaluated and compared between two groups. Results: In this study maximum patients were more than 40 years old in both groups. Mean age was 47.89 ± 12.54 years in group I and 46.29 ± 14.78 in group II. Males were predominant in both groups. Male to female ratio was 3.36:1 and 5.8:1 in group I and group II respectively in this study. In this study 35.4% in Group I and 45.8% in Group II patients had hypertension. 47.9% in Group I and 60.4% in Group II patients had DM. Thrombosis was significantly lower in study group (group I) than control group (group II). Primary patency was significantly higher at 4th week after treatment in group I than group II. Bleeding was observed in one (2.1%) patients at 1rd POD in group I who came with emergency &amp; managed conservatively. Haematoma was observed in 1 (2.1%) patients at 3rd POD in group I. Conclusion: Use of antiplatelet and anticoagulant agents prevented the loss of AV patency. But it still needs to be determined whether the potential benefits of anticoagulant &amp; antiplatelet therapy outweights the risk of adverse events. Bangladesh J. Urol. 2021; 24(1): 90-98

Effectiveness of Comprehensive Nursing in Hemodialysis of Patients with Chronic Renal Failure and the Impact on Their Quality of Life.

Objective To assess the effectiveness of comprehensive nursing in patients with chronic renal failure undergoing hemodialysis and the impact on their quality of life. Methods The present study included 86 patients undergoing hemodialysis for chronic renal failure from January 2020 to October 2021 and randomly assigned them to receive either normal nursing or comprehensive nursing, with 43 cases in each group. Outcome measures included psychological status, treatment compliance, quality of life, and complications of the eligible patients. Results After the intervention, comprehensive nursing resulted in lower Self-Rating Anxiety Scale (SAS) scores and Self-Rating Depression Scale (SDS) scores and higher quality of life scores for patients versus routine nursing (P < 0.05). Comprehensive nursing was associated with a significantly higher overall patient compliance rate versus routine nursing (P < 0.05). Patients receiving comprehensive nursing had a lower risk of developing complications versus those given routine nursing (P < 0.05). Conclusion Comprehensive care increases treatment compliance and self-care capacity of patients undergoing hemodialysis for chronic renal failure, improves their quality of life, and lowers the risk of complications, indicating a high potential for clinical advancement.

First Reported Cases of COVID-19-Associated Mucormycosis in Tunisia

COVID-19 infection is associated with several complications such as mucormycosis. We report, to the best of our knowledge, the first published cases of mucormycosis associated with severe COVID-19 infection in Tunisia. The first case was a diabetic, 68-year-old man, who presented a rhino-orbito-cerebral mucromycosis. The second case was a 37-year-old woman with a chronic renal failure hemodialysis stage and liver disease and who presented a rhino-sinuso-orbital mucormycosis. The diagnosis of mucormycosis was retained in both cases seven days after COVID-19 infection. Antifungal treatment was prescriped. Surgical treatment was not possible. Both cases died. We should think about mucormycosis in patients with COVID-19 infection and emergency medical and surgical treatment must be started to reduce mortality.

Severe Intraocular Pressure Fluctuation following Hemodialysis after Cataract Surgery in a Patient with Chronic Renal Failure

Purpose: To report a case of severe intraocular pressure fluctuation following hemodialysis after cataract surgery in a patient with chronic renal failure.Case summary: A 51-year-old female patient on hemodialysis for chronic renal failure, who was seen regularly by our retina clinic for proliferative diabetic retinopathy and right eye cataract, presented with decreased visual acuity in her right eye. During phacoemulsification under the diagnosis of right eye cataract, zonular dialysis and posterior capsule rupture occurred and intraocular lens ciliary sulcus insertion was performed. Following hemodialysis 3 days after the surgery, the patient complained of headache and right eye pain. The intraocular pressure of the right eye had increased to 44 mmHg. Mild inflammation in the anterior chamber was found with remnant lens material present at the inferior anterior angle. The use of glaucoma eye drops, anterior chamber paracentesis, and anterior chamber irrigation reduced the intraocular pressure and improved the patient’s symptoms. However, a severe increase in intraocular pressure recurred with the above symptoms, again following hemodialysis. Intraocular pressure fluctuation was repetitively present after serial hemodialysis treatments for 1 month, at which point cataract and glaucoma surgeries were considered. However, the intraocular pressure stabilized afterwards; thus, the patient remained under observation and was treated with glaucoma eye drops.Conclusions: Inflammation and a decrease in the aqueous outflow facility due to remnant lens material and the use of an ophthalmic viscoelastic device in cataract surgery may cause severe intraocular pressure fluctuations in patients undergoing hemodialysis for chronic renal failure.

Evaluation of Serum Gonadotropin and Prolactin Level among Sudanese Patients with Chronic Renal Failure

Background: Generally, patients on hemodialysis for chronic renal failure also have endocrine defects and sexual function disorders. In this study, we aimed to assess the serum prolactin (PRL), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in patients with chronic renal failure.&#x0D; Methods: This hospital-based case–control study was conducted at Jabal Aulia Teaching Hospital, Khartoum, Sudan. The study was carried out between August 2019 and February 2020. A total of 100 subjects were enrolled – 50 chronic renal failure patients and 50 as controls. The serum hormones were estimated using Tosoh 360. SPSS version 25 was used to analyze the results.&#x0D; Results: The serum PRL, LH, and FSH were significantly increased among chronic renal failure patients than their healthy counterparts (p-value = 0.000). The age of patients was positive correlated with plasma hormones, PRL (r = 0.332, p = 0.001), LH (r = 0.387, p = 0.000), and FSH (r = 0.320, p = 0.001). No correlation was found between the duration of the disease and serum hormones.&#x0D; Conclusion: Patients with chronic renal failure had a highly significant increase of serum PRL, LH, and FSH and also the age of the patients was positively correlated with serum hormones.&#x0D; Keywords: chronic renal failure, prolactin, gonadotropin, hemodialysis

Salivary and Serum Biochemical Analysis from Patients with Chronic Renal Failure in Hemodialysis: A Cross-Sectional Study

Objective: To compare salivary and serum biochemical levels in patients with chronic renal failure undergoing hemodialysis. Material and Methods: The sample was composed of 57 patients treated in Hemodialysis Reference Centers, from a state of Northeastern Brazilian, with age ≥21 years old with at least 3 months of hemodialysis treatment time. Serum data were obtained from records. Unstimulated and stimulated saliva were collected. Flow rate (mL/min) was measured. Spectrophotometry was performed for the measurement of salivary levels of calcium (570 nm), urea (340 nm), and creatinine (510 nm). Statistical analysis used Mann Whitney and Kruskal-Wallis tests (p<0.05). Results: Unstimulated and stimulated salivary flow rates were 0.43 mL/min and 1.69 mL/min, respectively. There was significant difference (p<0.001) of levels of calcium (5.41 mg/dL and 9.70 mg/dL), urea (118.03 mg/dL and 183.22 mg/dL) and creatinine (0.59 mg/dL and 9.20 mg/dL) between saliva and serum, respectively. Concerning the time of hemodialysis, salivary and serum calcium not exhibited significant association; however, serum urea (p=0.012) and serum creatinine (p=0.025) showed significant association to the time of hemodialysis. Conclusion: Salivary biochemical levels of urea, creatinine and calcium can indicate the presence of a possible chronic renal failure and the saliva demonstrated to be a potential auxiliary biofluid for clinical monitoring renal alterations.

A rare cause of steal phenomenon and ischemic pain: A radial artery pseudoaneurysm

Catheter insertion and forearm arteriovenous shunts are the main reasons for pseudoaneurysms in the practice of cardiovascular surgery. Radial artery pseudoaneurysm from arterial wall disruption is an extremely rare complication of arterial approach. Herein, we report a case of radial pseudoaneurysm repair leading to steal phenomenon and ischemic pain which occurred following the closure of the arteriovenous fistula located between the radial artery and cephalic vein in the medial aspect of the right forearm in a 37-year-old male receiving regular hemodialysis for chronic renal failure.

Natural history of upper and lower gastrointestinal bleeding in hemodialysis patients: A dual‐center long‐term cohort study

Knowledge on the risk of gastrointestinal (GI) bleeding in hemodialysis patients is limited. We evaluated the risk of GI bleeding in hemodialysis patients compared with non-hemodialysis patients. We performed a retrospective cohort study from 1996 to 2017 at the Graduate School of Medicine, University of Tokyo, and Horinouchi Hospital. We analyzed patients on hemodialysis for chronic renal failure and controls not on hemodialysis. The primary endpoint was GI bleeding. A survival analysis was performed to estimate the cumulative incidence and hazard ratio of GI bleeding. A total of 14451 patients were analyzed (417 hemodialysis and 14034 non-hemodialysis patients). In total, 524 GI bleeding events occurred. Upper and lower GI bleeding occurred in 432 and 92 patients in the hemodialysis and non-hemodialysis groups, respectively. The most frequent source of upper and lower GI bleeding was gastric ulcer and colonic diverticular bleeding, respectively. The cumulative incidence of GI bleeding was 4.44% at 1year, 7.15% at 3years, and 10.40% at 5years in hemodialysis patients; the respective rates were 2.35%, 2.98%, and 3.79% in non-hemodialysis patients during a mean follow-up period of 3.5years. Hemodialysis was significantly associated with an increased risk of GI bleeding after adjustment (hazard ratio 1.67, P=0.01, 95% confidence interval 1.13-2.50). Hemodialysis patients had a GI bleeding rate of 10% over 5years, and hemodialysis was a risk factor for GI bleeding.

V11-06 RENAL GRAFT IN A PATIENT WITH ILIAC DACRON PROSTHESIS

You have accessJournal of UrologyTransplant, Misc GU Cancers & Bladder Reconstruction (non-cancer) (V11)1 Apr 2020V11-06 RENAL GRAFT IN A PATIENT WITH ILIAC DACRON PROSTHESIS Anna Colomer, Oscar Buisan Rueda*, Mario Alves Oliveira, and Joan Areal Calama Anna ColomerAnna Colomer More articles by this author , Oscar Buisan Rueda*Oscar Buisan Rueda* More articles by this author , Mario Alves OliveiraMario Alves Oliveira More articles by this author , and Joan Areal CalamaJoan Areal Calama More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000945.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nowadays approximately more than 1% of the patients with aortoiliac prosthesis are candidates of renal transplantation in their life time. We present a case of kidney transplantation with renal graft artery anastomosis directly to a iliac Dacron prosthesis. METHODS: In this video we present a case of a 76 years old male undergoing kidney transplantation with renal graft artery anastomosis directly to a iliac Dacron prosthesis. Patient medical history includes arterial hypertension, auricular fibrillation, aortobifemoral bypass in 2002 due to abdominal aorta aneurism, chronic renal failure in hemodialysis since 2013. A previous kidney transplantation was performed in 2018 with early graft dysfunction. The steps of the surgical technique are described. RESULTS: Renal graft was placed in left iliac fossa. Arterial anastomosis to iliac Dacron bypass. Cold ischemia time was 20h and 20'. Postoperative recovery was with no vascular events, but delay in graft function was observed. Postoperative doppler ultrasound reveled good arterial and venous flow. Patient was discharged home on post-operative day 25. After 2 months follow-up the transplanted kidney is working well with a creatinine of 1,99. The patient presents good urinary diuresis and does not require dialysis. CONCLUSIONS: Renal transplantation can be a good option and safely performed in patient with iliac disease, presenting a good short-term outcome. Source of Funding: No source of funding. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1016-e1016 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anna Colomer More articles by this author Oscar Buisan Rueda* More articles by this author Mario Alves Oliveira More articles by this author Joan Areal Calama More articles by this author Expand All Advertisement PDF downloadLoading ...

A study on understanding the blood lipid profile of the hemodialysis patients in Al-Diwaniyah Province, Iraq

One of the most frequently worldwide recorded health conditions, is a chronic renal failure (CRF), especially in elderly individuals induced due to renal damage. Kidney damage and therefore, dialysis have several detrimental effects on the body organs and their functions. According to those effects, this study was conducted to recognize the blood lipid profile of the hemodialysis patients in Al-Diwaniyah Province, Iraq. Such determination gives assurance for overall functions of the body organs in order to place proper medical management of those levels if disturbed. From Al-Diwaniyah General Teaching Hospital, Diwaniyah City, Iraq, 68 (50, 33 males and 17 females, hemodialysis CRF (H-CRF) patients and 18, 11 males and 7 females, healthy individuals) samples of blood were collected. For revealing the levels of serum blood lipids of the participants, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were tested using a cholesterol oxidase method for TC and HDL-C, a glycerol kinase method for TG, and the Friedewald formula for LDL-C. The results unveiled significant (p˂0.01) higher TG levels in H-CRF patients than those in healthy individuals. In addition, HDL-C revealed significant (p˂0.01) lower levels in the H-CRF patients than those in healthy people. No significant (p˃0.01) data were observed from the TC and the LDL-C levels in both groups. This work demonstrates the level changes of the TGs and the HDL-C in the serum of the hemodialysis patients which need proper medical intervention for the correction of those levels.

Intractable hyperkalemia caused by hepatic infarction developed during laparoscopic gastrectomy in a patient with end-stage renal failure: a case report

BackgroundPatients with renal failure are susceptible to electrolyte disturbances including life-threatening hyperkalemia, and intraoperative hepatic damage exacerbates it. We report a case on hemodialysis who developed intraoperative remarkable hyperkalemia caused by hepatic damage during laparoscopic gastrectomy.Case presentationA 48-year-old man underwent laparoscopic gastrectomy for gastric cancer. He had been on hemodialysis for chronic renal failure. Serum K+ continued to increase to a maximum level of 7.4 mEq/L, despite the infusion of glucose with insulin during surgery. Postoperative computed tomography revealed hepatic infarction. Combined with increased hepatic enzymes, hepatic infarction caused by intraoperative mechanical traction would have exacerbated hyperkalemia.ConclusionsWe report a case on hemodialysis who developed intraoperative hyperkalemia due to hepatic damage. Our case highlights hepatic damage during laparoscopic gastrectomy as a potential cause of hyperkalemia.

Case of early-stage gastric cancer identified in the gastric mucosa with lanthanum phosphate deposition

Background and study aims A 78-year-old man with Helicobacter pylori infection had been undergoing hemodialysis for chronic renal failure and receiving lanthanum carbonate preparations for 3 years. Endoscopy revealed fine white granular discoloration throughout the stomach, a moderately reddish depression on the lesser curvature of the gastric angle, and white granular discoloration in the surrounding area. A magnified image using narrow-band imaging showed that the depressed part had irregular vascular and pit structures. We established a diagnosis of intramucosal gastric cancer and performed endoscopic submucosal dissection. Histopathological examination revealed a well-differentiated adenocarcinoma that was confined to the mucosa of the depressed area. Moreover, using an electron probe microanalyzer-equipped electron microscope, we found that the degree of lanthanum deposition was lower in the tumor region than in the non-tumor region. Thus, the current case can help in understanding the relationship between lanthanum deposition and early-stage gastric cancer. Because gastric cancers can occur in lanthanum deposit-containing mucosa, esophagogastroduodenoscopy should be used carefully after understanding the characteristics of early- stage gastric cancer in such cases.