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Functional evaluation of patients undergoing hemodialysis with chronic kidney disease

Novo, André; Teixeira, Fernanda; Múrua, Aldo; Azevedo, José; Alves, Maria José; Paz Fernández, José António de
Fonte: Austrian Society of Physical Medicine and Rehabilitation Publicador: Austrian Society of Physical Medicine and Rehabilitation
Tipo: Conferência ou Objeto de Conferência
Português
Relevância na Pesquisa
37.09%
The chronic kidney disease (CKD) is characterized by the loss of the kidney’s ability to eliminate toxic substances, concentrate urine and conserve electrolytes, with subsequent alteration of the remaining kidney function. The severe loss of kidney function is a first-order threat to life and requires the removal of toxic waste that cannot be debugged with sufficient effectiveness for other organ systems, as well as the restoration of an adequate volume and composition of body fluids - dialysis. If the loss of renal function is irreversible patients have two options: kidney transplant or chronic dialysis. Since 1977, with the pioneering study by Jette et al., it is well documented that patients with CKD on hemodialysis are limited in their overall physical capacity between 60 and 70% of that expected for their age, compared with healthy patients [1] and most CKD patients are sedentary [2], [1]. With this study, our main objective is to evaluate the functional status of hemodialysis patients with CKD. León University, León, Spain The study was carried out by the NorDial Clinic (Mirandela city – Portugal) in a total population of 123 patients. We met the exclusion criteria defined by the American College of Sports Medicine. Tests: anthropometric measurements...

Obstructive Sleep Apnea in Patients on Conventional and Short Daily Hemodialysis

ELIAS, Rosilene Motta; CASTRO, Manuel Carlos Martins; QUEIROZ, Eduardo Lyra de; ABENSUR, Hugo; ROMAO-JUNIOR, Joao Egidio; LORENZI-FILHO, Geraldo
Fonte: KARGER Publicador: KARGER
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.09%
Obstructive sleep apnea (OSA) is common among patients on maintenance hemodialysis. However, the factors associated with the origin of OSA as well as the cardiovascular consequences in this population are not completely understood. We evaluated, by standard overnight polysomnography, 24-hour ambulatory blood pressure (BP) monitoring and echocardiography in 30 patients (14 males, age 34 +/- 11 years, BMI 23.2 +/- 5.2) - 15 on short daily hemodialysis (SDH) and 15 matched patients on conventional hemodialysis (CHD). The hemodialysis dose (standard Kt/V) was higher in patients on SDH than on CHD (p = 0.001). OSA (apnea-hypopnea index 1 5 events/h) was present in 13 patients (43%). Patients with OSA were predominantly males (77 vs. 44%), presented a higher BMI (25.5 +/- 6.2 vs. 21.5 +/- 3.6), a larger neck circumference (38 +/- 1 vs. 34 +/- 1 cm) and a lower Kt/V (2.6 +/- 0.3 vs. 2.2 +/- 0.1) than patients with no OSA (p < 0.05). Neck circumference and lower Kt/V were independently associated with OSA on multivariate analysis. No patient with Kt/V > 2.5 (n = 10) presented OSA. On the other hand, hypertensive patients with OSA needed more BP control pills (p = 0.03). Despite similar BP control, patients with OSA presented a higher interventricular septum thickness (11.5 +/- 0.5 vs. 9.9 +/- 0.3 mm; p = 0.011). In conclusion...

Functional matrix metalloproteinase (MMP)-9 genetic variants modify the effects of hemodialysis on circulating MMP-9 levels

Marson, Bernardo P.; Lacchini, Riccardo; Belo, Vanessa; Mattos, Silvia G.; da Costa, Bartira P.; Poli-de-Figueiredo, Carlos E.; Tanus-Santos, Jose E.
Fonte: ELSEVIER SCIENCE BV; AMSTERDAM Publicador: ELSEVIER SCIENCE BV; AMSTERDAM
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.09%
Background: Altered levels of matrix metalloproteinases (MMPs) and their inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), are involved in cardiovascular alterations associated with end stage kidney disease (ESKD). Genetic polymorphisms in MMP-9 gene affect MMP-9 levels. We examined how MMP-9 polymorphisms and haplotypes affect the changes in plasma MMP-9 and TIMP-1 levels found in patients with ESKD undergoing hemodialysis. Methods: We studied 94 ESKD patients undergoing hemodialysis for at least 3 months. MMP-9 and TIMP-1 were measured by ELISA in plasma from blood samples collected before and after a session of hemodialysis. Genotypes for three MMP-9 polymorphisms (C-1562T, rs3918242; -90 (CA)(14-24), rs2234681; and Q279R, rs17576) were determined by Taqman (R) Allele Discrimination Assay and real-time polymerase chain reaction. Haplotype frequencies were determined with the software program PHASE 2.1. Results: Hemodialysis increased MMP-9 and TIMP-1 levels (P<0.05). Genotypes had no effects on baseline MMP-9 and TIMP-1 levels (P>0.05). Hemodialysis increased MMP-9 and TIMP-1 levels in subjects with the CC (but not CT or TT) genotype for the C-1562T polymorphism (P<0.05), and increased MMP-9 levels in subjects with the QQ (but not QR or RR) genotype for the Q279R polymorphism (P<0.05)...

"Avaliação da qualidade de vida relacionada à saúde de pacientes em hemodiálise" ; Evaluation of Health-Related Quality of Life in hemodialysis patients.

Kusumota, Luciana
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/12/2005 Português
Relevância na Pesquisa
37.06%
A Insuficiência Renal Crônica Terminal (IRCT) é uma doença crônica não transmissível e uma das principais causas de morbimortalidade e incapacidades mundiais, o que requer a intervenção dos profissionais da saúde para o seu tratamento e manutenção da vida. A IRCT e o tratamento por meio da hemodiálise podem ocasionar impacto na Qualidade de Vida Relacionada à Saúde (QVRS) dos pacientes, afetando potencialmente o estado de saúde física, mental, funcional, bem-estar geral, interação social e satisfação do paciente. Objetivos: caracterizar a população de pacientes em tratamento por hemodiálise residentes em um município do estado de São Paulo, quanto aos aspectos sociodemográficos, econômicos e clínicos; avaliar e descrever a QVRS desses pacientes e identificar as relações entre a QVRS e os fatores sociodemográficos, econômicos e clínicos, para adultos e idosos. Material e Método: Foi realizado um estudo seccional e populacional nos quatro serviços de diálise do município de Ribeirão Preto-SP, nos quais foram entrevistados os pacientes com 18 anos e mais de idade, residentes nesse município, em tratamento por hemodiálise por seis meses ou mais e que aceitaram participar da pesquisa. Foram excluídos os pacientes idosos (60 anos e mais) que tiveram resultado no Miniexame do Estado Mental (MEEM) insatisfatório...

Infecções hospitalares em pacientes cardiopatas sob procedimento hemodialítico em unidade de terapia intensiva; Nosocomial infections in cardiac patients under hemodialysis procedure in an intensive care unit

Cais, Daiane Patricia
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 06/07/2009 Português
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37.13%
Introdução: Os procedimentos hemodialíticos para a correção da lesão renal têm a infecção como principal complicação. Em pacientes com lesão renal crônica (LRC), submetidos à hemodiálise em centros especializados, a infecção da corrente sanguínea (ICS) comprovadamente é a mais importante. Para pacientes críticos, com lesão renal aguda (LRA), internados em unidades de terapia intensiva (UTI), a literatura é escassa. Nesta população, as infecções relacionadas ao procedimento são de difícil avaliação devido à gravidade do paciente e aos inúmeros procedimentos invasivos a que são submetidos. Objetivos: analisar as infecções hospitalares em cardiopatas com LRA ou LRC agudizada submetidos a procedimento hemodialítico, em uma UTI, verificar se a ICS é a principal topografia infecciosa e identificar fatores de risco para o desenvolvimento de ICS associados ao procedimento hemodialítico. Métodos: Estudo de coorte prospectivo (12 meses), envolvendo 101 pacientes internados em uma UTI do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, submetidos a procedimento hemodialítico por meio do cateter temporário, sem cuff, para hemodiálise. Utilizou-se o critério proposto pelos Centers for Disease Control and Prevention para definição de ICS e das demais infecções hospitalares. Os dados coletados foram digitados no programa Statistical Package for Social Sciences e o nível de significância adotado para os testes estatísticos foi de 5%. Aplicou-se o teste de Mann-Whitney para comparar os pacientes com e sem ICS...

Influence of fluid volume variations on the calculated value of the left ventricular mass measured by echocardiogram in patients submitted to hemodialysis

Martin, L. C.; Barretti, Pasqual; Cornejo, IV; Felipe, M. J.; Forti, A. H.; Matsubara, B. B.; Okoshi, K.; Padovani, C. R.; Teixeira-Caramori, J.; Tucci, PJF; Franco, RJD
Fonte: Marcel Dekker Inc Publicador: Marcel Dekker Inc
Tipo: Artigo de Revista Científica Formato: 43-53
Português
Relevância na Pesquisa
37.09%
The left ventricular mass (LVM) measurement is of major importance for renal patients, as ventricular hypertrophy is an important prognostic index. The echo-cardiogram of the ventricular mass is larger before than it is after hemodialysis, which can confuse data interpretation. The aim of this work is to study the influence of alterations in fluid volume on the variations in measurements of ventricular mass observed during the course of a hemodialysis. Sixteen patients with chronic renal insufficiency in hemodialysis were evaluated at the Dialysis Unit of the University Hospital-UNESP, Botucatu, São Paulo State. The left ventricular mass was calculated from echocardiograms taken before and after hemodialysis and simultaneous ultra-filtration (12 patients: UF GROUP) and before and after hemodialysis isovolemic phase with sequential ultra-filtration (10 patients: ISO GROUP). Six of these patients were submitted to measurements of left ventricular mass before and after hemodialysis in both isovolemic and simultaneous ultra-filtration procedures. In the UF group, there was significant reduction in the following parameters before and after dialysis: diastolic diameter from 54.0 +/- 6.0 mm to 45.6 +/- 7.6 mm; left ventricular mass from 342 +/- 114 g to 265 +/- 117 g; and its respective index (IMVE) from 214 +/- 68 g/m(2) to 168 +/- 71 g/m(2). The ISO group showed no statistically significant variation. The behavior of the variables of six patients submitted to both observations confirm these results. In conclusion...

Avaliação das pressões respiratorias maximas em pacientes renais cronicos submetidos a hemodialise; Evaluation of maximum respiratory pressures in chronic renal patients undergoing hemodialysis

Carmelia Bomfim Jaco Rocha
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 16/12/2008 Português
Relevância na Pesquisa
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JUSTIFICATIVA E OBJETIVOS: As medidas das pressões inspiratória e expiratória máximas (PImáx e PEmáx) são utilizadas para avaliar a integridade da musculatura respiratória medindo sua força. Em pacientes renais crônicos, o efeito da hemodiálise sobre essas variáveis ainda não se encontra bem estabelecido na literatura. O objetivo do estudo foi avaliar a influência da hemodiálise nos valores de PImáx e PEmáx. MÉTODO: Foi realizado um estudo prospectivo, transversal, em uma amostra de conveniência, em que foram avaliados 35 indivíduos renais crônicos (26 homens e 9 mulheres), com idade entre 21 e 81 anos, no serviço de hemodiálise do Hospital Universitário Alzira Vellano, em Alfenas-MG. Os pacientes realizaram as medidas das PImáx e PEmáx, na posição sentada (90º), utilizando um manovacuômetro digital (MVD 300®) acoplado a um microcomputador para a leitura e armazenamento dos dados obtidos, antes e após a hemodiálise. RESULTADOS: Tanto a PImáx como a PEmáx foram menores que as preditas nos momentos pré- e pós-hemodiálise (p<0,0001). Quando foram comparados os valores pré- e pós-hemodiálise, a PImáx apresentou discreta melhora (p=0,0420), sendo evidente apenas naqueles pacientes com valores pré-hemodiálise menores que 60 cmH2O (Wilcoxon; p=0...

Functional matrix metalloproteinase (MMP)-9 genetic variants modify the effects of hemodialysis on circulating MMP-9 levels

Marson, Bernardo P.; Lacchini, Riccardo; Belo, Vanessa; Mattos, Silvia G.; da Costa, Bartira P.; Poli-de-Figueiredo, Carlos E.; Tanus-Santos, Jose E.
Fonte: Elsevier; Amsterdam Publicador: Elsevier; Amsterdam
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.09%
Background: Altered levels of matrix metalloproteinases (MMPs) and their inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), are involved in cardiovascular alterations associated with end stage kidney disease (ESKD). Genetic polymorphisms in MMP-9 gene affect MMP-9 levels. We examined how MMP-9 polymorphisms and haplotypes affect the changes in plasma MMP-9 and TIMP-1 levels found in patients with ESKD undergoing hemodialysis. Methods: We studied 94 ESKD patients undergoing hemodialysis for at least 3 months. MMP-9 and TIMP-1 were measured by ELISA in plasma from blood samples collected before and after a session of hemodialysis. Genotypes for three MMP-9 polymorphisms (C-1562T, rs3918242; -90 (CA)(14-24), rs2234681; and Q279R, rs17576) were determined by Taqman (R) Allele Discrimination Assay and real-time polymerase chain reaction. Haplotype frequencies were determined with the software program PHASE 2.1. Results: Hemodialysis increased MMP-9 and TIMP-1 levels (P<0.05). Genotypes had no effects on baseline MMP-9 and TIMP-1 levels (P>0.05). Hemodialysis increased MMP-9 and TIMP-1 levels in subjects with the CC (but not CT or TT) genotype for the C-1562T polymorphism (P<0.05), and increased MMP-9 levels in subjects with the QQ (but not QR or RR) genotype for the Q279R polymorphism (P<0.05)...

Hemodialysis improves endothelial venous function in end-stage renal disease

Silva,A.M.V.; Signori,L.U.; Plentz,R.D.M.; Moreno Jr.,H.; Barros,E.; Belló-Klein,A.; Schaan,B.D.; Irigoyen,M.C.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2008 Português
Relevância na Pesquisa
37.09%
The objective of the present study was to determine the acute effect of hemodialysis on endothelial venous function and oxidative stress. We studied 9 patients with end-stage renal disease (ESRD), 36.8 ± 3.0 years old, arterial pressure 133.8 ± 6.8/80.0 ± 5.0 mmHg, time on dialysis 55.0 ± 16.6 months, immediately before and after a hemodialysis session, and 10 healthy controls matched for age and gender. Endothelial function was assessed by the dorsal hand vein technique using graded local infusion of acetylcholine (endothelium-dependent venodilation, EDV) and sodium nitroprusside (endothelium-independent venodilation). Oxidative stress was evaluated by measuring protein oxidative damage (carbonyls) and antioxidant defense (total radical trapping antioxidant potential - TRAP) in blood samples. All patients were receiving recombinant human erythropoietin for at least 3 months and were not taking nitrates or a-receptor antagonists. EDV was significantly lower in ESRD patients before hemodialysis (65.6 ± 10.5) vs controls (109.6 ± 10.8; P = 0.010) and after hemodialysis (106.6 ± 15.7; P = 0.045). Endothelium-independent venodilation was similar in all comparisons performed. The hemodialysis session significantly decreased TRAP (402.0 ± 53.5 vs 157.1 ± 28.3 U Trolox/µL plasma; P = 0.001). There was no difference in protein damage comparing ESRD patients before and after hemodialysis. The magnitude of change in the EDV was correlated negatively with the magnitude of change in TRAP (r = -0.70; P = 0.037). These results suggest that a hemodialysis session improves endothelial venous function...

Effects of in-center daily hemodialysis upon mineral metabolism and bone disease in end-stage renal disease patients

Lugon,Jocemir Ronaldo; André,Mauro Barros; Duarte,Maria Eugênia Leite; Rembold,Simone Martins; Cruz,Elisa de Albuquerque Sampaio da
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2001 Português
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37.18%
CONTEXT: Alternative hemodialysis schedules have been proposed to improve the quality of the dialysis. Nonetheless, their influence upon mineral and bone disorders is unknown. OBJECTIVE: To report the impact of a daily hemodialysis schedule upon the lesions of renal osteodystrophy. TYPE OF STUDY: Prospective non-controlled study. SETTING: Public University Hospital. PARTICIPANTS: Five patients treated by daily hemodialysis for at least 24 months. INTERVENTION: Daily dialysis sessions were accomplished with non-proportional dialysis machines without an ultrafiltration control device, with blood flow of 300 ml/min, bicarbonate dialysate ([Ca]=3.5 mEq/L) at 500 ml/min, and low-flux membrane dialyzers. Sessions were started at 6:00 p.m. (except Sundays) and lasted 2 hours. MAIN MEASUREMENTS: Serum levels of Ca and P from the last 6 months on conventional hemodialysis for the same patients were used for comparison with each semester of daily hemodialysis. Bone biopsies and PTH levels were obtained at the end of the conventional hemodialysis period and then again after 2 years of daily hemodialysis. RESULTS: Mean serum calcium was significantly higher during the second and third semesters of daily dialysis [10.0 mg% (SD 0.6), and 10.0 mg% (SD 0.8)...

Serum alanine aminotransferase levels, hematocrit rate and body weight correlations before and after hemodialysis session

Lopes,Edmundo Pessoa; Sette,Luis Henrique B. C.; Sette,Jorge Bezerra C.; Luna,Carlos F.; Andrade,Amaro M.; Moraes,Maviael; Sette,Paulo C. A.; Menezes,Roberto; Cavalcanti,Rui L.; Conceição,Sergio C.
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2009 Português
Relevância na Pesquisa
37.17%
PURPOSE: To evaluate alanine aminotransferase levels before and after a hemodialysis session and to correlate these values with the hematocrit rate and weight loss during hemodialysis. PATIENTS AND METHODS: The serum alanine aminotransferase levels, hematocrit rate and body weight were measured and correlated before and after a single hemodialysis session for 146 patients with chronic renal failure. An receiver operating characteristic (ROC) curve for the serum alanine aminotransferase levels collected before and after hemodialysis was plotted to identify hepatitis C virus-infected patients. RESULTS: The mean weight loss of the 146 patients during hemodialysis was 5.3% (p < 0.001). The mean alanine aminotransferase levels before and after hemodialysis were 18.8 and 23.9 IU/, respectively, denoting a significant 28.1% increase. An equally significant increase of 16.4% in the hematocrit rate also occurred after hemodialysis. The weight loss was inversely correlated with the rise in both the alanine aminotransferase level (r = 0.3; p < 0.001) and hematocrit rate (r = 0.5; p < 0.001). A direct correlation was found between the rise in alanine aminotransferase levels and the hematocrit during the hemodialysis session (r = 0.4; p < 0.001). Based on the ROC curve...

Effect of maintenance hemodialysis on diastolic left ventricular function in end-stage renal disease

Duran,Mustafa; Unal,Aydin; Inanc,Mehmet Tugrul; Esin,Fatma; Yilmaz,Yucel; Ornek,Ender
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2010 Português
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37.15%
PURPOSE: To analyze the effect of maintenance hemodialysis on left ventricular diastolic function in patients with end-stage renal disease. METHODS: Study population consisted of 42 patients with end-stage renal disease. Before an arteriovenous fistula was surgically created, the patients were evaluated by conventional and Doppler echocardiography and Doppler tissue imaging. Then, the patients undergoing hemodialysis treatment when the arteriovenous fistula was compleated. After the first hemodialysis session (mean 76.14 ± 11.37 days) the second echocardiographic evaluations were performed. RESULTS: Mean age was 58 ± 13 years and 21 (%50) of the patients were female. After maintenance hemodialysis treatment; peak early (E) and peak late (A) diastolic mitral inflow velocities and E/A ratio were not significantly change however the deceleration time of E wave and left atrial diameter were significantly increased. Also there was no change in the early (Em) and late (Am) diastolic myocardial velocities and Em/Am ratios of lateral and septal walls of left ventricular. E/Em ratio was decreased insignificantly. Pulmonary vein velocities and right ventricular functions are remained almost unchanged after hemodialysis treatment. DISCUSSION: The acute and long-term effect of hemodialysis on left ventricular diastolic function is unclearly. Patients with end-stage renal disease treatment with hemodialysis via arteriovenous fistula experience a variety of hemodynamic and metabolic abnormalities that predispose to alterations in left and right ventricular functions. The present study showed that left ventricular diastolic function except left atrial diameter and right ventricular functions were not significantly change...

Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis

Liberato,Isabella Ramos de Oliveira; Lopes,Edmundo Pessoa de Almeida; Cavalcante,Maria Alina Gomes de Mattos; Pinto,Tiago Costa; Moura,Izolda Fernades; Loureiro Júnior,Luiz
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
Relevância na Pesquisa
37.19%
OBJECTIVE: The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis. PATIENTS AND METHODS: Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis) to measure the enzymes and the hematocrit. RESULTS: In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session)...

Segurança do paciente em uma unidade de hemodiálise: análise de eventos adversos; Patient safety in a hemodialysis unit: analysis of adverse events

Sousa, Maiana Regina Gomes de
Fonte: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG) Publicador: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Enfermagem (FEN); Faculdade de Enfermagem - FEN (RG)
Tipo: Dissertação Formato: application/pdf
Português
Relevância na Pesquisa
37.11%
INTRODUCTION: Health care comes accompanied with potential to cause adverse events (AE) and compromising patient safety. In hemodialysis units there are numerous risk factors that increase the potential of occurrence of these events, suggesting that the supply of safe care to this population presents some exclusive challenges, beyond generic questions of patient safety common to all health establishments. OBJECTIVES: To analyze the occurrence of AE related to hemodialysis treatment. METHODOLOGY: Sectional study, conducted in a hemodialysis unit of a teaching hospital of Goiás. Data collection occurred between March and September 2013, by analyzing the records of the evolution of the hemodialysis sessions, from medical records of patients attended between January and December, 2012 in the unit. Was used an instrument in which were transcribed information related to the patient, treatment and possible AE. Participated in the study 117 patients, all obeyed the inclusion criteria. The analysis of the records was conducted by one researcher and two external reviewers, independently. Statistical analysis was performed using SPSS version 19.0 for Windows. The study was approved by the Research Ethics Committee and obeyed regulatory standards of Resolution 466/2012. RESULTS: Among the 117 patients who participated of the study...

Urämische Kardiomyopathie und der Einfluss der Hämodialyse; Uremic Cardiomyopathy and the effect of hemodialysis

Valina, Ulrike Katrin
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
Relevância na Pesquisa
37.19%
ZIEL: Analyse von Risikofaktoren und Entstehungsmechanismen der urämischen Kardiomyopathie bei Hämodialysepatienten und Vergleich von Diagnostiken zur frühen Detektion kardialer Funktionstörungen zur Optimierung der Therapie bei terminaler Niereninsuffizienz und Senkung der hohen Mortalitätsrate. METHODEN: Einschluss von 32 Hämodialysepatienten. Messungen mittels Blutentnahme (Entzündungs-, Atherosklerose-, Anämieparameter, EPO, PTH und RAAS) und MRT (Herzfunktion, Herzmorphologie und Herzklappendiagnostik) erfolgten vor und nach Dialyse, die Impedanzkardiographie (Volumetrie und Herzfunktion) während Hämodialyse. ERGEBNISSE: Alle Patienten litten an einer renalen Anämie, EPO war nach Hämodialyse um 110 % erhöht (p= 0,0133), ohne signifikanten Zusammenhang zwischen Herzmasse und EPO (p= 0,6631). 6 Patienten zeigten starke Erhöhungen von EPO, diese wiesen eine geringere Herzmasse auf. EPO i.v.-Gabe während Hämodialyse wirkte sich nicht auf die Herzmassewerte aus (p= 0,0765). Fibrinogen und Triglyceride waren erhöht, HDL, LDL, Lipoprotein A, Cholesterin und BMI lagen im Normbereich. Korrelationen von Ischämiebefunden im MRT und Homocystein 1 (p= 0,9735), 2 (p= 0,3785), Fibrinogen (p= 0,9742) und Triglyceride (p= 0...

Hemodialysis improves endothelial venous function in end-stage renal disease

Silva, Antônio Marcos Vargas da; Signori, Luis Ulisses; Plentz, Rodrigo Della Méa; Barros, Elvino José Guardão; Belló-Klein, Adriane; Schaan, Beatriz D'Agord; Irigoyen, Maria Claudia Costa
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
Relevância na Pesquisa
37.09%
The objective of the present study was to determine the acute effect of hemodialysis on endothelial venous function and oxidative stress. We studied 9 patients with end-stage renal disease (ESRD), 36.8 ± 3.0 years old, arterial pressure 133.8 ± 6.8/80.0 ± 5.0 mmHg, time on dialysis 55.0 ± 16.6 months, immediately before and after a hemodialysis session, and 10 healthy controls matched for age and gender. Endothelial function was assessed by the dorsal hand vein technique using graded local infusion of acetylcholine (endothelium-dependent venodilation, EDV) and sodium nitroprusside (endothelium-independent venodilation). Oxidative stress was evaluated by measuring protein oxidative damage (carbonyls) and antioxidant defense (total radical trapping antioxidant potential - TRAP) in blood samples. All patients were receiving recombinant human erythropoietin for at least 3 months and were not taking nitrates or α-receptor antagonists. EDV was significantly lower in ESRD patients before hemodialysis (65.6 ± 10.5) vs controls (109.6 ± 10.8; P = 0.010) and after hemodialysis (106.6 ± 15.7; P = 0.045). Endotheliumindependent venodilation was similar in all comparisons performed. The hemodialysis session significantly decreased TRAP (402.0 ± 53.5 vs 157.1 ± 28.3 U Trolox/μL plasma; P = 0.001). There was no difference in protein damage comparing ESRD patients before and after hemodialysis. The magnitude of change in the EDV was correlated negatively with the magnitude of change in TRAP (r = -0.70; P = 0.037). These results suggest that a hemodialysis session improves endothelial venous function...

Hemodialysis improves endothelial venous function in end-stage renal disease

Silva, Antônio Marcos Vargas da; Signori, Luis Ulisses; Plentz, Rodrigo Della Méa; Moreno Junior, Heitor; Barros, Ernesto; Belló Klein, Adriane; Schaan, Beatriz D'Agord; Irigoyen, Maria Claudia Costa
Fonte: Universidade Federal do Rio Grande Publicador: Universidade Federal do Rio Grande
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.09%
The objective of the present study was to determine the acute effect of hemodialysis on endothelial venous function and oxidative stress. We studied 9 patients with end-stage renal disease (ESRD), 36.8 ± 3.0 years old, arterial pressure 133.8 ± 6.8/80.0 ± 5.0 mmHg, time on dialysis 55.0 ± 16.6 months, immediately before and after a hemodialysis session, and 10 healthy controls matched for age and gender. Endothelial function was assessed by the dorsal hand vein technique using graded local infusion of acetylcholine (endothelium-dependent venodilation, EDV) and sodium nitroprusside (endothelium-independent venodilation). Oxidative stress was evaluated by measuring protein oxidative damage (carbonyls) and antioxidant defense (total radical trapping antioxidant potential - TRAP) in blood samples. All patients were receiving recombinant human erythropoietin for at least 3 months and were not taking nitrates or α-receptor antagonists. EDV was significantly lower in ESRD patients before hemodialysis (65.6 ± 10.5) vs controls (109.6 ± 10.8; P = 0.010) and after hemodialysis (106.6 ± 15.7; P = 0.045). Endotheliumindependent venodilation was similar in all comparisons performed. The hemodialysis session significantly decreased TRAP(402.0 ± 53.5 vs 157.1 ± 28.3 U Trolox/μL plasma; P = 0.001). There was no difference in protein damage comparing ESRD patients before and after hemodialysis. The magnitude of change in the EDV was correlated negatively with the magnitude of change in TRAP (r = -0.70; P = 0.037). These results suggest that a hemodialysis session improves endothelial venous function...

Effect of maintenance hemodialysis on diastolic left ventricular function in end-stage renal disease

Duran, Mustafa; Unal, Aydin; Inanc, Mehmet Tugrul; Esin, Fatma; Yilmaz, Yucel; Ornek, Ender
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2010 Português
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37.15%
PURPOSE: To analyze the effect of maintenance hemodialysis on left ventricular diastolic function in patients with end-stage renal disease. METHODS: Study population consisted of 42 patients with end-stage renal disease. Before an arteriovenous fistula was surgically created, the patients were evaluated by conventional and Doppler echocardiography and Doppler tissue imaging. Then, the patients undergoing hemodialysis treatment when the arteriovenous fistula was compleated. After the first hemodialysis session (mean 76.14 ± 11.37 days) the second echocardiographic evaluations were performed. RESULTS: Mean age was 58 ± 13 years and 21 (%50) of the patients were female. After maintenance hemodialysis treatment; peak early (E) and peak late (A) diastolic mitral inflow velocities and E/A ratio were not significantly change however the deceleration time of E wave and left atrial diameter were significantly increased. Also there was no change in the early (Em) and late (Am) diastolic myocardial velocities and Em/Am ratios of lateral and septal walls of left ventricular. E/Em ratio was decreased insignificantly. Pulmonary vein velocities and right ventricular functions are remained almost unchanged after hemodialysis treatment. DISCUSSION: The acute and long-term effect of hemodialysis on left ventricular diastolic function is unclearly. Patients with end-stage renal disease treatment with hemodialysis via arteriovenous fistula experience a variety of hemodynamic and metabolic abnormalities that predispose to alterations in left and right ventricular functions. The present study showed that left ventricular diastolic function except left atrial diameter and right ventricular functions were not significantly change...

Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis

Liberato, Isabella Ramos de Oliveira; Lopes, Edmundo Pessoa de Almeida; Cavalcante, Maria Alina Gomes de Mattos; Pinto, Tiago Costa; Moura, Izolda Fernades; Loureiro Júnior, Luiz
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2012 Português
Relevância na Pesquisa
37.19%
OBJECTIVE: The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis. PATIENTS AND METHODS: Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis) to measure the enzymes and the hematocrit. RESULTS: In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session)...

Serum alanine aminotransferase levels, hematocrit rate and body weight correlations before and after hemodialysis session

Lopes, Edmundo Pessoa; Sette, Luis Henrique B. C.; Sette, Jorge Bezerra C.; Luna, Carlos F.; Andrade, Amaro M.; Moraes, Maviael; Sette, Paulo C. A.; Menezes, Roberto; Cavalcanti, Rui L.; Conceição, Sergio C.
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2009 Português
Relevância na Pesquisa
37.17%
PURPOSE: To evaluate alanine aminotransferase levels before and after a hemodialysis session and to correlate these values with the hematocrit rate and weight loss during hemodialysis. PATIENTS AND METHODS: The serum alanine aminotransferase levels, hematocrit rate and body weight were measured and correlated before and after a single hemodialysis session for 146 patients with chronic renal failure. An receiver operating characteristic (ROC) curve for the serum alanine aminotransferase levels collected before and after hemodialysis was plotted to identify hepatitis C virus-infected patients. RESULTS: The mean weight loss of the 146 patients during hemodialysis was 5.3% (p < 0.001). The mean alanine aminotransferase levels before and after hemodialysis were 18.8 and 23.9 IU/, respectively, denoting a significant 28.1% increase. An equally significant increase of 16.4% in the hematocrit rate also occurred after hemodialysis. The weight loss was inversely correlated with the rise in both the alanine aminotransferase level (r = 0.3; p < 0.001) and hematocrit rate (r = 0.5; p < 0.001). A direct correlation was found between the rise in alanine aminotransferase levels and the hematocrit during the hemodialysis session (r = 0.4; p < 0.001). Based on the ROC curve...