Objective: Current guidelines for initiating dialysis therapy are based on level of kidney function and clinical evidence of uremia. In several stu dies, early dialysis showed no benefit in mortality and complication rate. Thus we examined whether the timing of initiation of dialysis influenced mortality and complication rate with renal failure. Methods: We retrospectively studied the clinical outcomes in 290 patients with renal failure who underwent dialysis therapy from 2001 to 2009. The early and late dialysis group defined as values more than and less than 10 mL/min/1.73 m 2. The primary outcome was death from any cause and the secondary outcome was complication event. Results: The survival rates and complication events were compared based on the estimated glomerular filtration rate, the survival rate in late dialysis group is better than in early dialysis group and the significant prognostic factors determined by multivariate analysis were age and residual renal function at time of initiation of dialysis. No difference in complication events were observed. Subgroup analysis in hemodialysis group shows no significant difference in survival rate. Conclusion: The survival rate in late dialysis group is better than in early dialysis group. And the complication rate were not different in two groups.
Objective: Metabolic syndrome (MS) is associated with increased left ventricular (LV) mass and diastolic dysfunction. This study uses relatively load-independent Doppler tissue echocardiography to examine whether MS is associated with decreased longitudinal contractile reserve during dynamic exercise. Methods: A total of 112 patients with relatively well-controlled, treated hypertension who complained of exertional dyspnea were enrolled (average age, 56.7± 10.5 years). Fifty-six were non-diabetic patients with MS (group 1), and 56 were age-sex matched hypertensive patients without MS (group 2). Exercise stress echo was performed using a symptom-limited, multistage, supine bicycle exercise test. Multiple Doppler parameters were obtained at baseline, at each stage of exercise. Results: There was no significant difference between the two groups in terms of age, gender, and hemodynamic variables. E/E' , an index of LV filling pressure, was significantly higher in the MS group at rest and during exercise. The longitudinal contractile reserve, the change in S' (longitudinal tissue velocity) from baseline to peak exercise, was significantly lower in the MS group (2.00± 1.65 vs. 2.90± 1.66, P= 0.015). Multiple regression analysis showed independent association of MS with longitudinal contractile reserve when controlled for confounding factors, such as LV mass index, gender, blood pressure, and age (β= -0.235, P= 0.035). Conclusion: Longitudinal contractile reserve was reduced in MS patients compared to others, although both groups demonstrated similar longitudinal contractile function at rest. We present the first demonstration that metabolic syndrome is independently associated with LV systolic dysfunction during exercise in hypertensive patients.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.