The global population is progressively aging, to the extent that over 1.5 billion people worldwide will be aged 65 years or more by 2050, and the prevalence of end-stage renal disease in the elderly will remain high in forthcoming years. Since older patients typically suffer from several comorbidities, the above issue poses a hefty financial burden on healthcare systems. Although current guidelines might be useful for older individuals with fewer comorbidities and no significant disability, a tailored therapeutic approach is often essential in individuals with severe comorbidities, short life expectancy or poor treatment compliance. In such patients, rather than aggressively pursuing different therapeutic targets, physicians should strive to enhance quality of life by treating comorbidity-related symptoms and addressing common geriatric syndromes, including cognitive impairment, depression, incontinence, falls and polypharmacy, and the decision about starting dialysis should be guided not only by medical reasons, but also by patients‘ personal beliefs and preferences.
Introduction: Hepatitis C virus (HCV) infection is associated with increased morbidity and mortality among patients on dialysis (HD). The aims of this study were to estimate the presence of HCV and other comorbidities in the dialysis population of Elbasan city, and to compare the survival outcomes of those patients who started dialysis with haemodialysis and peritoneal dialysis. Methods: In the present study, we have used a socio-demographic questionnaire to collect data from HD patients. We studied 108 dialysis patients in dialysis Centre for 1 year. Software SPSS version 20.0, were used to analyzed and evaluate the data. P < 0.05 was considered statistically significant. Results: Over of all 108 patients with dialysis, HCV infection was present in 15.7% of them. Male patients were 74% and female 26%. Age groups 50-59 and 60-69 were the most frequent among dialysis patients with 35.1% and 34.25% cases respectively. There are a significant association for age of dialysis patients and the presence of HCV for p < 0.001. Regarding the co-morbidities in dialysis patients our findings suggest that diabetes mellitus tip 2 (16/108 patients), Hypertension arterial HTA (56/108), Coronary artery disease (16/108), and Arrhythmia (12/108) were more prevalent diseases in our patients. A significant association we found for cardiovascular disease in dialysis patients and the presence of HCV p = 0.0001. Based to Kaplan-Meier and univariate Cox regression performed to estimate risk factor in haemodialysis patients, adjusted survival rates HD vs. PD patients was significantly different (hazard ratio 14.75, CI 95% [8.92-44.76]) p value < 0.0001). Conclusion: In this study we have observed a significant association of HCV infection with some socio-demographic data of dialysis patients, and also with cardiovascular disease. We suggest that prospective studies should be performed to evaluate the role of HCV infection and other comorbidities in dialysis patients.
Ellis van Creveld syndrome (EVC) is a rare chrondro-ectodermal dysplasia. Renal abnormalities are found in few EVC cases with agenesis, dysplasia, megaureter and nephrocalcinosis. Rarely EVC syndrome is complicated with kidney failure and only one child required renal transplantation.We report a patient who was diagnosed with EVC syndrome at birth. He developed hypertension at age 15 and gradually progressed to chronic kidney disease stage 5 requiring hemodialysis and renal transplantation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.