Online ISSN: 2515-8260

Keywords : dialysis


A SYSTEMIC REVIEW OF PREVALENCE OF DEPRESSION IN PATIENT TAKING LONG TERM DIALYSIS

Mihirkumar P. Parmar, Mankirat Kaur, Gunjan Kochhar, K. Shashi Vardhan Reddy, Rajagopal, E R, Umesh Batura, Sweta Sahu, Jitendra Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2376-2390

Background: People living with chronic kidney disease are at high risk of depression, anxiety, frailty, high depression in chronic kidney disease patients is associated with decreased selfcare behaviour, and aim of this review is to check the association between depressions with chronic kidney disease patients. High depression prevalence is there in long term dialysis patients and affect the person life quality so our main objective of this study is to check the depression associated with the long term dialysis.
Materials and Methods: Observational, qualatative, cross sectional, longitudinal, retrospective, cohart, prospective analysis and study is hospital and renal therapy unit, dialysis center based. This study took place in between year 2018- jan to 2022- jun, involving 3235 participants. following instruments is used: sociodemographic, economic and health condition characterization and the subjective frailty assessment (SFA) and patient health questionnaire-9 (PHQ-9), depression subscale of the hospital anxiety and depression scale and HQRoL was assesed using the kidney disease of life 36 short form, cross lagged pathway analysis, univariate analysis followed by multiple regression analysis was performed for demographical parameters, clinical conditions and laboratory test, QoL (36-Item Short-Form Health Survey [SF-36]), cognitive impairment (Mini-Mental State Examination [MMSE]), depressive state (Center for Epidemiologic Studies Depression Scale [CES-D]), grip strength, and 24-h urine volume, Depressive symptoms measured using BDI-II, Quality of Life measured using the 12-item short-form health Survey (SF-12), Hospitalizations, Mortality, Beck Anxiety Inventory, the state-trait anxiety inventory (STAI), the beck depression inventory (BDI) and the hospital anxiety and depression scale (HADS).
Results: Depression is associated with the presence of frailty among patients with CKD on hemodialysis by the finding there was occurrence of physical frailty (73.8%) and depression (93.7%), patients with poor HRQoL were at risk of more symptoms of depression, Biochemical abnormalities like abnormal serum phophate, parathyroid hormone level are related to depression, there is high Qol and recovery by peritoneal dialysis from cognitive failure than patient on hemodialysis. Anxiety symptoms are independently associated with increased risk for mortality and 1-year hospitalization, fitting factorial structure for the Beck-Depression Inventory-II (BDI), in dialysis patients and to assess the relation of these structure dimensions with quality of life (QoL), hospitalization, and mortality by the results median follow-up time was 3.0-3.5 years, during that time 25% deaths occurred. 22% of patients had anxiety symptoms and 42% had depressive symptoms, A higher prevalence of depressive symptoms was found in immigrant compared to native patients (49% vs. 36%), Depression and anxiety were significantly associated with females, low level of education, increased patients' age, retirement, poor financial situation, marital status and co-morbidity by the result 29.4% had depression and 35.9% had anxiety, also Patients with high levels of anxiety had higher levels of depression and those with high depression scores had higher anxiety scores.
Conclusion: The evidence from eight studies gives idea about the depression related to chronic kidney disease patient on dialysis; our review gives idea about the relation depression, anxiety, frailty with the ckd patients on dialysis. High quality studies required to examine depression in dialysis patient.

Acute kidney injury in obstetrics: Varied pathologies and outcomes

Somashekhar HK, Chandrashekhar Shrivastava, Pragyan Paramita Pradhan, Pavan Bhargava Chandramohan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1848-1851

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Acute kidney injury in obstetrics: Varied pathologies and outcomes.

Somashekhar HK, Chandrashekhar Shrivastava, Pragyan Paramita Pradhan, Pavan Bhargava Chandramohan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1984-1987

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Prevalence of Hepatitis B and C in Thi-Qar Province - Iraq from 2015-2019

Rana A. Othman; Yahya A. Abbas

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 43-48

Background: Hepatitis B virus and hepatitis C virus are two of the most commonly
transmitted infectious agents by Blood transmitting so it is still remains a considerable
global health problem, this prospective cross-sectional study was conducted
between 2015 and 2019 at the directorate of main Blood Bank, dialysis center,
thalassemia center and public health laboratory in Thi-Qar Province -Iraq, during that
period a total of 1323 patients, 948 (71.7%) males and 375 (28.3%) females, they
suffering from signs and symptoms of liver diseases.
The aim of study: There were no adequate epidemiological studies on the prevalence
of viral hepatitis, especially in last years and there were no national solutions to limit
it’s, we conduct this study to determine the prevalence of both types at Thi-qar
province.
Sampling and methods: This study was conducted in January 2015 to December 2019,
on main blood bank, patients referred to the thalassemic center, renal dialysis unit and
public health laboratory at Thi-Qar province, the study was conducted on 176848
individuals, from those (1323) cases, (515) blood donors, (45) thalassemic patients, (91)
renal failure patients and public health laboratory (672), the following data were
recorded: Age, sex, date, resident, type of infection, data were collected by from
statistical units. Data were analyzed using SPSS for windows (version 23.0, SPSS lnc,
Chicago, III), for comparison between groups as appropriate; P ≤ 0.01 was considered
statistically significant.
The results: The results of infection were found 1323(0.7%), its distributed as :672
(50.8%) were public health laboratory patients, 515 (38.9%) blood donors, 91 (6.9%)
renal dialysis patients and 45(3.4%) thalassemic patients, the results was showed
higher infection in males more than females, with high prevalence in age groups (31-
40) and (41-50) years, with significant difference (P<0.01) .
Conclusions: despite the findings revealed that Thi-Qar is acceptable percentage rate
of prevalence of infection, but may be increased the infection by Immigration from
endemic areas, especially for business , transfusion of blood, a major roots of
infections by renal dialysis, thalassemic patients were a risk groups because
administration of blood.

The Dynamics of C-reactive Protein Associated with Nutritional Status Changes in Kidney Failure Patients at Initiation and After 3 Months of Dialysis

Trina Primalia Irawanti; Haerani Rasyid; Syakib Bakri; Hasyim Kasim; Andi Makbul Aman; Fabiola Maureen Shinta Adam; Nur Ahmad Tabri; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 152-159

Among kidney failure patients, especially those on dialysis, malnutrition is associated with poor outcomes. Malnutrition is a multifactorial process, including inflammation, which can be measured by C-reactive protein (CRP). The objective is to evaluate the dynamics of CRP associated with nutritional status changes in kidney failure patients at initiation and after 3 months of dialysis. A prospective cohort study using a consecutive sampling method consisting of 40 kidney failure patients who received initial dialysis at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January-March 2020. Nutritional status was evaluated with Subjective Global Assessment (SGA), and CRP was measured at the initial dialysis and after 3 months. All subjects received nutritional education at the beginning. Nutritional status was defined as well-nourished (WN, SGA A) and malnourished (MN, SGA B and C), then classified into 4 groups denoting nutritional changes: Group 1 (WN to WN), Group 2 (MN to WN), Group 3 (WN to MN), and Group 4 (MN to MN). ANOVA, paired t-test, and chi-square test (significance p<0.05) were used for statistical analyses. Subject’s mean age was 50.5±14.8 years old; 52.5% were male. Diabetes and obstructive nephropathy were the most frequent underlying diseases, both had a prevalence of 35%. At initiation, the prevalence of malnutrition was 77.5%; after 3 months, it was 70%. The highest proportion of Group 4 were female (62.5%) and those with diabetes (45.9%). Among all subjects, mean CRP decreased (9.4±32.3 mg/dL) after 3 months. While mean CRP based on nutritional changes, Group 2 had the highest reduction (18.8±26.8 mg/dL), and Group 3, CRP increased (17.5±17.0 mg/dL). C-reactive protein is negatively associated with nutritional status changes in kidney failure patients after 3 months of dialysis. Malnutrition was higher in female subjects and those with diabetes.