People living with kidney disease are among the most vulnerable groups at the time of natural or man-made disasters. In addition to their unpredictable course, armed-conflicts impose a major threat given disruption of infrastructure, sanitation, access to food, water, and medical care. The ongoing war in Ukraine has once more demonstrated the importance of preparedness, organization, coordination and solidarity during disasters. People living with kidney disease face serious challenges given their dependence on life-saving treatment, irrespective of whether they remain in the war zone, or are displaced internally or externally. This affects especially those requiring kidney replacement therapy (KRT), dialysis or transplantation, but also patients with other kidney diseases and the medical staff who take care of them. The European Renal Association (ERA) assigned a Renal Disaster Relief Task Force (RDRTF) dedicated to support the people living with kidney disease and the nephrology community in Ukraine, soon after the war started. This report summarizes the major challenges faced, actions taken, and lessons learnt by this Task Force. We anticipate that the experience will help to increase preparedness and to mitigate the devastating effects of armed conflicts on the kidney community in the future and propose to establish an international collaboration to extend this effort to other parts of the world facing similar challenges.
The aim of our study was to determine the relationship of processes of atherogenesis and indicators of endothelial dysfunction with the processes of activation of lipid peroxidation (LPO) and chronic inflammation in patients with CKD stages II-IV. Material and methods. Levels of proinflammatory and anti-inflammatory cytokines, indicators of lipid peroxidation, the thickness of the intima-media (IMT) of the carotid artery, ankle-brachial index (ABI) were measured in 90 patients with CKD stage II-IV (30 - CKD st. II, 31 patients with CKD st. III and 29 st. IV CKD patients) and 30 healthy subjects (control group). The correlation analysis was performed to identify the possible association between the obtained parameters of atherosclerotic vascular lesions and endothelial dysfunction and indices of lipid peroxidation and pro- and anti-inflammatory cytokines. Results. The average levels of interferon-y, interleukin (IL) -1p and IL-10 in patients with CKD II-IV Art. were significantly increased compared with the corresponding values in the control group. The average levels of malondialde- hyde (MDA) of serum and MDA of erythrocyte in CKD patients was significantly increased compared with the corresponding values in the control group, and the antioxidant system indices - total peroxidase activity of erythrocytes and serum levels of the sulfhydrylgroups was significantly reduced relative to the corresponding values in the group control. 39 (43%) patients with CKD st. II-IV were recorded carotid atherosclerotic changes. The IMT (from 0.91 to 1.29 mm) defined in 22 (56%) patients and atherosclerotic plaques (IMT > 1,3 mm) defined in 17 (44%) patients. Bilateral carotid atherosclerotic lesions was observed in 14 (36%) patients with CKD st. II-IV. Endothelial dysfunction was observed in 71 (79%) patients with CKD st. II-IV. There was a statistically significant association between indicators of chronic inflammation, lipid peroxidation and indicators of atherosclerotic vascular lesions and endothelial dysfunction. Conclusion. Pathological processes ofLPO activation, chronic inflammation are closely linked between themselves and progression of atherosclerotic vascular lesions in CKD.
The purpose of the work was to determine the effect of continuous erythropoietin receptor activator (CERA) on the autonomic regulation of cardiac activity and cardiovascular events in patients treated with online hemodiafiltration (HDF). Materials and methods. A total of 105 stable chronic HDF patients were included in this prospective observational multicenter study. According to the CERA treatment, the patients were assigned to one of two groups: the 1st group (n = 73) received CERA
Abstract. The present study aimed to evaluate the efficacy and safety of EMAVAIL (epoetin alfa) in the correction of anemia in hemodialysis patients. Methods. A total of 36 patients undergoing regular hemodialysis were enrolled in this prospective study. Among the patients were 19 (53%) men and 17 (47%) women with severe anemia (hemoglobin (Hb) level ≤ 90 g/L). The mean patients' age was 48.41±1.82 years, an average dialysis vintage consisted of 42.38±10.41 months. All the patients had thrice-weekly hemodialysis sessions, with a mean duration of 12.6 ± 0.51 hours per week and Kt/V 1.27 ± 0.08. All the patients were treated with biosimilar of epoetin alfa EMAVAIL intravenously three times a week in adjustable doses. The follow-up period was 56 days. Results. At the study entry, the mean Hb level in hemodialysis patients was 81.7±0,93 g/L. In 56 days of anemia treatment, the concentration of Hb increased to 109.17±1.75 g/L. Eventually, 32 (89%) patients achieved the target Hb level (110 g/L); 6 (17%) patients had adverse events (mild hypertension). There were no serious adverse events. Conclusions. EMAVAIL is an effective and safe epoetin alfa biosimilar for anemia management in hemodialysis patients.
Abstract. The occurrence of an emergency situation (ES) forced international (ISN, EDTA/ERA) and national (Turkey) nephrological associations to establish the Renal Disaster Relief Task Force, which is primarily concerned with the treatment of patients with acute kidney injury and end-stage renal disease requiring dialysis. The war started by the RF is putting the Ukrainian state, Ukrainian society, and the healthcare system in the catastrophic ES. Under these circumstances, all nephrological patients became one of the most vulnerable categories of patients. To provide immediate support in solving problems within the Ukrainian Association of Nephrologists and Kidney Transplant Specialists (UAN&KTS), the Ukrainian Renal Disaster Relief Committee (URDRC) has been established. One of the most important tasks was to form a group of experts to develop recommendations for specialized medical care for kidney patients in wartime. According to the experts, the key person for this type of medical care is the leading nephrologist in the region or city. He/she establishes a local Renal Disaster Relief Committee (LRDRC) and decides through horizontal (with other LRDRC) or vertical (with UAN &KTS) collaboration, using available communication tools, on the problems that arise; the most appropriate tool is the Viber platform "Nephrology. Dialysis. Transplantation". In this way, a network without administrative subordination and a non-hierarchical functional system was created, which, on the one hand, functions according to similar working principles, but, on the other hand, may differ in terms of LRDRC composition, communication methods, and more. The LRDRC divides all patients into three groups and provides work preparation measures before, during and after the cancellation of ES.
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.