Background Anemia is a common complication of chronic kidney disease. There are various causes of anemia in chronic kidney disease patients on hemodialysis. Secondary hyperparathyroidism is one of the less recognized causes of anemia in chronic kidney disease patients.Objectives The main objective of the study is to find the correlation between intact parathyroid hormone and hematocrit level in chronic kidney disease (CKD) patients undergoing hemodialysis.Method Verbal consent was taken from all the participants. Eighty participants between the age of 29 and 70 years with chronic kidney disease having indication of hemodialysis were included in this study. Hematocrit was measured by bioelectrical impedance method and serum intact parathyroid hormone was by using Chemi Luminescence Immuno Assay (CLIA) method.Result A weak reverse correlation was found between serum intact parathyroid level and hematocrit (r= -0.33).Conclusion In chronic kidney disease patient, there is reverse correlation between level of serum intact parathyroid and hematocrit level. This association may have clinical relevance in assessing the cause of unexplained low hemoglobin level in CKD patients.
Introduction: Dysfunction of the autonomic nervous system is common in diabetic patients. Presence of autonomic dysfunction should alert the physicians of its serious consequences that require timely preventive measures. Objectives: This study was done to fi nd out the autonomic nervous system involvement in Type 2 diabetic patients and to see its relation with the duration of diabetes. Methods: This was a hospital based cross-sectional study. All consecutive diabetic patients of both genders attending Kathmandu Medical College and a private clinic, Temple of Healing were included. A battery of six well validated and accepted autonomic nervous system evaluation tests were done to evaluate the autonomic function in 245 Type 2 diabetic patients. Results: Prevalence of autonomic dysfunction was found to be 71.02% with 58.78% patients having mild autonomic dysfunction and 12.24% having moderate dysfunction. Severe autonomic dysfunction was detected in none of the patients. Parasympathetic dysfunction was much more common than sympathetic dysfunction (68.16% vs. 17.96%). No association was found between autonomic dysfunction and duration of diabetes. Conclusions: Autonomic dysfunction is very common in diabetics and can be detected by simple tests. Timely detection of autonomic dysfunction in diabetic patients is advised so that its preventive measures can be effective.
Estimation of serum aminotransferase levels play important role in the diagnosis and monitoring of hepatic diseases. Studies suggest that in patients with chronic kidney disease, especially in those under hemodialysis, the reference ranges of the serum aminotransferases might not be reflective of hepatic function. Due to this, diagnosis and management of liver diseases in such patients becomes quite challenging. This study aims to estimate and compare serum aminotransferases levels of hemodialysis patients and healthy controls. Seventy-five patients undergoing hemodialysis in Nepal Medical College Teaching Hospital for at least three months were included in the study as cases and apparently healthy individuals with no active illness and regular medication use for the past three months and were recruited as controls. Predialysis blood samples were drawn and were analyzed for serum aminotransferases and other blood parameters. The median serum AST and ALT values for hemodialysis patients were 15 U/L and 21 U/L, while for the healthy controls, it was 30 U/L and 36 U/L and the differences were statistically significant (p < 0.001). Among the hemodialysis patients, serum AST was positively correlated with eGFR (ρ = 0.247, p = 0.033) and negatively correlated with serum creatinine levels (ρ = -0.307, p = 0.007). Hence, serum aminotransferases levels were found to be low in patients with impaired kidney function compared to those with normal kidney function.
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