ABSTRACT
Background: The aim of this study was to determine the disturbances in Calcium and other mineral levels in patients on hemodialysis at Tabba Kidney Institute, Karachi, Sindh, Pakistan.Methods: A cross sectional observational study through convenient sampling technique was conducted from January 2017 to August 2017 at Tabba Kidney Institute, Karachi after obtaining ethical approval. 255 patients, all above 18 years of age and on hemodialysis were included in the study. Multi-organ failure patients on dialysis, other systemic diseased patients on hemodialysis were excluded. Demographic variables, mineral levels, symptoms and supplementations were recorded. SPSS version 20.0 was used for data analysis.Results: A total of 255 patients on hemodialysis were selected and divided into groups depending upon median years of hemodialysis below and above 5 years of hemodialysis. Median and IQR of calcium were 8.8 and 8.2-9.1 mg/dl for below 5 years, 8.6 and 8.1-9.1 mg/dl for above 5 years (P value=0.44). Median and IQR of phosphate were 4.9 and 3.9-5.7 mg/dl for below 5 years and 4.6 and 3.7-5.5 mg/dl for above 5 years (P value=0.21). Median and IQR of parathyroid hormone were 393 and 212-699 pg/ml for below 5 years and 329 and 128-657 pg/ml for above 5 years. (P value=0.13) Median and IQR of albumin were 4.0 and 3.6-4.2 mg/dl for below 5 years and 4.0 and 3.8-4.3 for above 5 years (P value=0.30). Total of 18 (10.9%) had para thyroidectomy.Conclusions: Present study showed that significant difference in mineral levels did not exist in patients on hemodialysis as regards to the duration of dialysis. However clinical features had a tendency to decrease as duration of dialysis increased to above 5 years. Para thyroidectomy and itching were two main significant findings in this study.
ABSTRACT
Background: Hypertension is estimated to affect about 40% of adults above 25 years of age globally. While many of the risk factors of hypertension are well known, such is not the case with smoking. Pertinent published literature is heterogeneous, with a dearth of relevant local data. Objectives was to study the relationship between smoking and blood pressure levels in hypertensive patients and to assess the effects of gender, age and hypertension duration on such a relationship.Methods: A cross-sectional study was carried out on a total of 298 conveniently sampled patients, aged 18 or above, from the medical outpatient department of a secondary care hospital of Karachi. The relevant data were collected by means of a structured questionnaire whereas the blood pressure level was checked using sphygmomanometer with stethoscope. Mann Whitney U test was used for inferential analysis whereas the significance level was set at 0.05.Results: Overall, both the systolic and diastolic blood pressure levels were significantly associated with smoking history (p<0.05 for both) where they were found to be higher in smokers than in non-smokers. Furthermore, after gender, age and hypertension duration based stratifications; both the systolic and diastolic blood pressure levels were still significantly associated with smoking history in patients who were male, were ≥35 years old and had <5 years hypertension duration (p<0.05 for both) where they were again found to be higher in smokers than in non-smokers.Conclusions: The study results showed a significant association of positive smoking history with higher mean systolic and diastolic blood pressure levels, though after stratifying for gender, age and hypertension duration, this relationship persisted only in patients who were male, were ≥35 years old and had <5 years hypertension duration.