The objective of this study was to examine the prevalence and the levels of awareness, control, and treatment of hypertension in workers, technicians and clerks of factories of the city of Naoussa. A total of 1976 employees in 19 units were examined. From those, 1937 (1045 men and 892 women), 15-73 years of age, were included in the analysis. Every employee was examined twice with 1 week's interval between the two examinations. Analysis was performed using the 140/90 mmHg hypertension threshold. In every visit, three blood pressure (BP) measurements were taken with at least 1-min interval between them. In the analysis only the average BP of the second clinic visit was used. In total, hypertension prevalence was 30.5% (32.1% for men and 28.7% for women respectively, P ¼ 0.10). The levels of awareness, treatment, and control of hypertension in hypertensive patients were 18.6%, 11.8%, and 2.2%, respectively. The levels of awareness and treatment differed significantly between men and women (13.4 vs 25.4%, Po0.001 and 9.6 vs 14.8%, Po0.05), but there was no difference in the levels of control (1.5 vs 3.1%, P ¼ 0.18). Hypertension prevalence, awareness, and treatment differed also between patients o45 and X45 years of age (22.0 vs 53.2%, Po0.001, 9.7 vs 28.4%, Po0.001 and 6.5 vs 17.7%, Po0.001, respectively). In conclusion, the prevalence of hypertension in our study's population is high, while the levels of awareness, treatment, and control are disappointing and should be significantly improved. There is also a difference in awareness and treatment in favour of women compared to men and in favour of patients X45 years of age compared to those o45 years of age.

Introduction Management of the Primary Membranous Nephropathy (PMN) usually involves administration of immunosuppressives. Cyclophosphamide (Cyclo) and Calcineurin Inhibitors (CNIs) are both widely used but only limited data exist to compare their efficacy in long term follow-up. Aim The aim of the present study was to estimate and compare long term effects of Cyclo and CNIs in patients with PMN. Patients-methods Clinical data, histologic findings and long term outcome were retrospectively studied. The response to treatment and rate of relapse was compared between patients treated with CNIs or Cyclo based immunosuppressive regimens. Results Twenty three centers participated in the study, with 752 PMN patients (Mean age 53.4(14–87) yrs, M/F 467/285), followed for 10.1±5.7 years. All patients were initially treated with Renin Angiotensin Aldosterone System inhibitors (RAASi) for at least 6 months. Based on their response and tolerance to initial treatment, patients were divided into 3 groups, group I with spontaneous remission, who had no further treatment, group II, continued on RAASi only, and group III on RAASi+immunosuppression. Immunosuppressive regimes were mainly based on CNIs or Cyclo. Frequent relapses and failure to treatment were more common between patients who had started on CNIs (n = 381) compared to those initially treated with Cyclo (n = 110), relapse rate: 25.2% vs. 6.4%, p<0.0001, and no response rate: 22.5% vs. 13.6%, p = 0.04, respectively. Conclusions Long term follow up showed that administration of Cyclo in PMN is followed by better preservation of renal function, increased response rate and less frequent relapses, compared to CNIs.

Background End‐stage kidney disease (ESKD) patients require specific and continuous care, which affects caregivers' quality of life (QOL). It is necessary to define the basic problems and restrictions upon family caregivers of renal patients affecting their physical and psychological status. Objectives The main objectives of this narrative review were to examine the literature over the past 10 years, to describe factors associated with QOL of caregivers of patients with ESKD, and to identify the level of subjective burden reported by caregivers. Methods A literature search was carried out using the following electronic databases: PubMed, Medscape, Science Direct, Scopus, PsychINFO and other scientific sources. Keywords included 'quality of life', 'caregivers', 'end stage kidney or renal disease patients', 'burden' and a combination of these terms. Only studies from January 2010 to December 2020 were included in this study. Results The results found that there was significant burden and distress experienced by caregivers that affected their QOL. Patients' QOL is associated with caregivers' QOL. The hours of caring per day and the long‐term replacement therapy are associated with great burden. Conclusions More awareness to caregivers' QOL is required to meet their needs, reduce anxiety and to improve patients' QOL. Caregiver support could empower and prepare them for initiation of replacement therapy. This can potentially enhance their diseased family members' QOL and could also restrict the use of health care system resources. Given how difficult it is to conceptualize QOL, a holistic approach to patients and caregivers require QOL assessment in each stage of the kidney disease.

Erythrocytosis occurs in 10-15% of renal transplant recipients and there is evidence that the production of erythropoietin is modulated by adenosine. We prospectively evaluated the effects of theophylline, a nonselective adenosine antagonist, in 8 patients with erythrocytosis after renal transplantation. All patients were given triple-drug immunosuppressive therapy with methylprednisolone (8 mg/daily), azathioprine (2 mg/kg b.w. daily) and cyclosporin A (4 mg/kg b.w. daily). After an 8-week course of theophylline treatment (Theodur 300 mg × 2 daily), the mean serum erythropoietin levels were significantly reduced (from 61 mlU/ml before to 16.5 mlU/ml after treatment, p < 0.05). Also the hematocrit was reduced from 0.58 before to 0.50 after treatment (p < 0.05). The previous requirement of monthly phlebotomy was eliminated in all transplant recipients. The above effects were reproducible when the patients were rechallenged with theophylline after a recovery period. It is suggested that theophylline modulates the production of erythropoietin as well as the hematocrit levels in patients with erythrocytosis after renal transplantation and may be useful in the treatment of this condition.

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Background and Aims Chronic kidney disease (CKD) is considered a high-stress disease because of its chronicity, co-morbidity, and lifelong treatment. Family members are often the main caregivers of end stage kidney disease (ESKD) patients and they are involved in various roles. Caregivers of ESKD patients experience emotional stress, anxiety and depression as they support their family members throughout the disease and treatment. This cross-sectional study aimed to assess depression and anxiety in caregivers of ESKD patients and to compare these disorders between caregivers of hemodialysis (HD) patients’ and kidney transplant recipients (KTR), as well as to investigate potential social-demographic parameters associated with caregivers’ depression and anxiety. Method A total of 342 participants (171 couples of patients and caregivers) were recruited. Structured interviews and self-completed questionnaires were obtained from HD patients, KTR (138 HD patients and 33 KTR) and their caregivers. The Beck Depression Inventory and the Generalized Anxiety Disorder-2 scales were used as screening tools. Depression scores were classified into four levels based on the level of severity (low, mild, moderate, severe). The collected data were encoded and analyzed using ΙΒΜ SPSS version 25 and R Statistical Software. Results Mean age of caregivers was 58 years and the majority were females (67.2%). Total anxiety score was high (Mdn = 3) with a mildly increased score of depression (Mdn = 9.5). Caregivers’ anxiety and depressive symptoms were significantly associated with gender, duration of caregiving, educational level, financial status, and caregivers’ age (p&lt;0.01 for all). Caregivers’ depression and anxiety were also, related to the type of patients’ treatment (Table 1). HD caregivers reported significantly higher anxiety scores (Mdn = 3(2-5)) in comparison to KTR caregivers (Mdn = 2(2-4)) (p = 0.048) (Table 2). Moreover, HD caregivers revealed higher (Mdn = 11(0-46)) levels of depression than the KTR group (Mdn = 6 (0-25)) (p = 0.049) (Table 3). Conclusion Based on the findings of this study, the type of ESKD treatment displayed an important role in caregivers’ anxiety and depression symptoms, with KTR caregivers having the best scores. In particular, KTR caregivers appeared to have lower levels of depression and anxiety than caregivers of HD patients.