Summary. The aim of the present research was to identify predictors of hospitalization hemodialysis (HD) patients. Materials and methods. The study involved 186 HD patients (49,38±0,94 у.) between Jan 2013 and Jan 2014. We studied the evolution of laboratory and treatment parameters, including dry body-weight, ultrafiltration, mean blood pressure, plasma albumin, Hb, absolute lymphocyte count, absolute neutrophil count, neutrophil-to-lymphocyte ratio, “hemoglobin variability ” all patients. The HD patients were divided for 2 groups: I group of outpatients (n=103), II group of hospitalized patients (n=83). Data from 83 hospitalized patients were compared with non-hospitalized patients. Laboratory and treatment parameters were assessed at least 3 months prior to admission. Results. We found that hospitalization was 45,29±4,20 days, frequency of hospitalization 1,46±0,07. The likelihood of frequency and duration a hospitalization increased with patient age (p<0,05). Hospitalizations were preceded by a decrease level albumin, a decline in Hb concentration, a decrease absolute lymphocyte count, increase in the neutrophil-to-lymphocyte ratio, a reduction ultrafiltration. The hozpitalization of patients with “stable hemoglobin ” was significantly lower than in patients with “low of hemoglobin variability”(p<0,005). Conclusions. Patients whose noted these parameters should be monitored, thus, it may be useful to identify risk factors for hospitalization.
According to opinion of European researchers the expenses, associated with in–patient treatment, constitutes the significant part of health service expenditure in population of patients on renal replacement therapy (RRT). Only in few studies the hospitalization levels were compared for population ofpatients on hemodialysis (HD) and peritoneal dialysis (PD). Aim. The aim of this study was analysis the hospital morbidity pattern in patients with CKD stage 5D on HD and PD. Materials and methods. It was performed the retrospective (for period 01 Jan to 31 Dec 2013) analysis of hospitalization structure and rate for patients, were treated by RRT. All hospitalization admissions were assessed in view of modality and duration of RRT, demographic/gender characteristics, and renal affection type. In 2013 the RRT treatment were provided to 351 patients, including the 296 on HD and 55 on PD. Results. Overall 173 cases of hospitalization were recorded, including 142 (82,08%) primary and 31 (17,92%) readmissions. Irrespective of RRT modality the three most common causes of hospitalization were cardiovascular diseases (CVD), bacterial infections, and anemia. 41 hospitalization was caused by RRT initiation (28 HD and 13 PD), the most of patients aged 45 years and older. The hospitalization rate in PD patients with was significantly higher than in patients on HD: 70,9±6,1% vs. 34,8±2,8%, respectively;p<0,0001. The duration of hospitalization was significantly higher by HD– than PD patients (30,09±17.21 vs. 21.82±10.56, respectively; p=0,0007). Conclusions. During follow–up, at least one hospitalization had more than 40%patients with CKD stage 5D. In HD patients the most common causes of hospitalization were bacterial infections, CVD and anemia. Anemia, CVD and bacterial infections were the most frequent causes hospitalization in PD patients.
The work is dedicated to the practical application of oxidant-antioxidant parameters and the possibility of using them for monitoring and optimize the treatment hemodialysis.
Abstract. The aim of our study was to evaluate the quality of life (QoL) in peritoneal dialysis (PD) patients and its relationship with nutritional disorders. Methods. 52 PD patients were included in the observational cross-sectional study. The QoL was conducted using a SF-36 quality of life assessment questionnaire. Moreover, the PD patients’ nutrition status (NS) was examined. For further analysis, the patients were divided into four groups according to the condition of the NS: the first group (n = 22) consisted of patients without nutrition disturbance, the second group (n =13) included the patients with mild nutrition disorders, the third group (n = 10) consisted the patients with an average degree of the NS, and the fourth one (n = 7) envolved the patients with a severe degree of malnutrition. A comparative evaluation of QoL among the PD patients with different nutrition disorders was performed. Results. During the analysis of indicators QoL we receive the following results: all patients were dissatisfied with the general state of health, the lowest of the indicators was the burden of the disease. The physical total component was lower than the mental. According to the analysis of NS parameters, nutritional disorders were observed in 57.6 % patients. Also according to the results, it follows that nutritional disorders negatively affect the QoL of the PD patients. Moreover, a direct strong correlation between the serum albumin level and the overall QoL score was obtained (r = 0.95; p < 0.001). In addition, the strong direct correlation between a body mass index (BMI) and overall QoL (r = 0.92; p < 0.001) and subjective global assessment (SGA) and overall QoL (r = 0.85; p < 0.001) were observed. Conclusions: According to the results of the study, it was found that PD patients' QoL is dissatisfied. It was confirmed that nutritional disorders affect bad on the QoL of patients with almost all parameters. The overall QoL was significantly associated with serum albumin levels, BMI and SGA.
Summary. The aim of the present research was to study the influence of еpoetin alfa to the level of pro- and anti-inflammatory cytokines in patients with anemia treated by hemodialysis (HD). Materials and methods: We examined 73patients with anemia treated by hemodialysis (mean age 45,85 ±1,21 years). Patients were divided into 2groups: I group - comparison (n = 32), II group - treatment by epoetin alfa (n = 41). The levels of hemoglobin, C-reactiveprotein, ferritin, albumin, pro-and anti-inflammatory cytokines were determined before and after treatment in patients of both groups. The duration of treatment was 5 months. Results: Epoetin alfa increases Hb levels in patients treated by HD. After epoetin alfa applying reduction of proinflammatory cytokines ( TNF -a, IL -ip, IL -17, IL -18) and increased levels of IL -10 were observed. Conclusions: The clinical efficacy of the epoetin alfa treatment at the moment of completion of treatment was 75.6% (level of Hb > 110 g/L ). Epoetin alfa, improving the level of Hb, reduces the activity of chronic inflammation.
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