ABSTRACT
Cuffed central venous catheters [CCVC]. as preferred types of vascular access for hemodialysis have several complications [e.g. infection, thrombosis, embolism, bleeding and fractures]. This study aimed to describe the complications of CCVC. In this cross-sectional study, the incidence of complications associated with CCVC in patients referred to Kashan Akhavan dialysis center was evaluated during a six-month period between June 2013 to December 2013. The census sampling method was used and patients in each dialysis session were evaluated for all catheter-related complications using the checklist. Finally, a nephrologist approved the complications. From a total of 183 patients admitted to the Kashan Akhavan dialysis center during the six months, 43 patients were enrolled with permanent hemodialysis catheters. Catheter-related infection and thrombosis were common complications. The incidence rates of catheter-related infection and thrombosis were 1.87 and 1.5 per 1,000 daily catheter use, respectively. Catheter-related infection and thrombosis are two common complications among hemodialysis patients used a CCVC. Therefore, the necessary measures should be taken to reduce these complications
ABSTRACT
In dialysis patients, insufficient exertion of amyloid particles can cause beta-2-microglobulin [beta 2M] to deposit in periarticular structures and consequently complications like carpal tunnel syndrome. This study was conducted to evaluate the plasma beta 2M level in hemodialysis patients with carpal tunnel syndrome in Kashan. This cross-sectional study was performed on 60 hemodialysis patients, with more than 10 years history of hemodialysis with low flux membrane through an AV fistula, referred to dialysis center in Kashan. Samples of venous blood [5cc] were taken from each patient to measure the beta 2M level using the ELISA method. The carpal tunnel syndrome establishment was made through EMG/NCV under the supervision of a neurologist. The mean age of participants was 59.3 +/- 13.2 years. A total of 44 subjects [73.3%] had been diagnosed with carpal tunnel syndrome. There was a significant difference in plasma beta 2M level in hemodialysis patients with and without carpal tunnel syndrome [52.2 +/- 6.2 and 44.8 +/- 6.1, respectively; P=0.002]. There is a significant relation between beta 2M level and the incidence of carpal tunnel syndrome in hemodialysis patients. Thus, performing serial beta-2 microglobulin measurement is recommended in these patients
ABSTRACT
Rapidly progressive glomerulonephritis [RPGN] is a rare but important renal disease that can rapidly cause irreparable renal failure. The disease has various causes and hence our attempt to study on prognostic factors of renal failure in these patients. The aim of this study is to find some prognostic factors of progress to end-stage renal failure in patients. In this study, the patients with proved RPGN, on the basis of renal biopsy results, who had come to the hospital from July 2002 to July 2004, were identified and studied. Some factors including creatinine were measured and kept in records of each patient referred for this study. They were followed-up for 9 months looking for occurrence of end stage renal disease [ESRD]. Patients who reached ESRD in less than 9 months were not followed-up further. Those who were followed-up for less than 9 months or died before that were also excluded. Thus, only 22 patients were included. Incidence of ESRD during the nine months period of followed-up in patients with creatinine level of more than 5.7 mg% was higher that in patients with levels equal to or lower than 5.7 mg%. [91.7% VS 40%, P=0.015]. Also, average of creatinine levels upon referral in patients who developed ESRD in the following 9 months were significantly higher that those who did not [6.59 mg% VS 2.75 mg%, P=0.008], which confirms the value of creatinine as a prognostic factor in RPGN patients, as mentioned in previous similar studies. Other prognostic factors did not show any meaningful difference in this study. The above results show that creatinine levels higher that 5.7 mg% upon referral in patients with RPGN can be used as a helpful prognostic factor in prediction of development of ESRD, even despite treatment, in these patients