Serum magnesium and its association with vascular calcification in chronic kidney disease patients on haemodialysis

Background: Cardiovascular disease is one of the leading causes of death in chronic kidney disease (CKD). It has been observed that haemodialysis patients have a high prevalence of cardiac risk factors with further risk due to abnormal mineral metabolism. A study has demonstrated that a higher serum magnesium significantly decreased the mortality risk in haemodialysis patients and lower serum Mg level has been found to be associated with increased mortality in them. The aim of the study was to characterize the relationship between Mg level and vascular calcification in CKD patients.Methods: It was a cross sectional study conducted in 100 CKD patients attending outpatient and inpatient ward of Tagore Medical College and Hospital, Chennai, Tamil Nadu, India. Serum magnesium levels will be measured using Xylidyl blue method. Carotid intimal medial thickness will be measured using Doppler.Results: In the study 10 patients did not show the sign of any calcification. Among the remaining 90 patients, 42 patients showed calcification and 48 patients showed stenosis. The statistical analysis showed a spearman correlation coefficient value of 0.201 thus showing only a weak association.Conclusion: The present study showed that only a weak relationship exists between the magnesium level and vascular calcification.

Cardiovascular Parameters in Chronic Haemodialysis Patients in Tobago / Parámetros cardiovasculares en pacientes con hemodiálisis crónica en Tobago

ABSTRACT Objective: To identify cardiac risk factors that contribute to sudden cardiac death in a haemodialysis population and thus optimize them, in an effort to minimize death in this population. Methods: This was a retrospective study and audit. The medical records of the patients receiving chronic haemodialysis were reviewed for the period January to December 2014. Data collected included age, gender, comorbidities, types of access, length of time on haemodialysis, laboratory indices, and main electrocardiographic and echocardiographic findings. Results: All patients had elevated intact parathyroid hormone. Some patients had hypocalcaemia, hyperphosphataemia and mild anaemia. Prominent echocardiographic findings were left ventricular hypertrophy and pulmonary hypertension. Conclusion: Sudden cardiac death in end-stage renal disease patients on haemodialysis may be predicted by certain abnormal laboratory findings and echocardiographic findings which may all be positively correlated.

RESUMEN Objetivo: Identificar los factores de riesgo cardíaco que contribuyen a la muerte cardíaca súbita en una población de hemodiálisis, y de este modo optimizarlos, en un esfuerzo por minimizar los fallecimientos por tal motivo en esta población. Métodos: Se trata de un estudio retrospectivo y auditoría. Se revisaron las historias clínicas de los pacientes que recibían hemodiálisis crónica, correspondientes al período de enero a diciembre de 2014. Los datos recogidos incluyeron edad, sexo, comorbilidades, tipos de acceso, tiempo de hemodiálisis, índices de laboratorio, y los principales hallazgos electrocardiográficos y ecocardiográficos. Resultados: Todos los pacientes tenían hormona paratiroides intacta elevada. Algunos pacientes tenían hipocalcemia, hiperfosfatemia y anemia leve. Los resultados ecocardiográficos más sobresalientes fueron la hipertrofia ventricular izquierda y la hipertensión pulmonar. Conclusión: La muerte cardíaca repentina en pacientes con la enfermedad renal en fase terminal sujetos a hemodiálisis, puede predecirse por ciertos resultados de laboratorio anormales y los resultados de la ecocardiografía, todos los cuales se pueden correlacionar positivamente.

The high prevalence of Torque teno virus DNA in blood donors and haemodialysis patients in southern Brazil

This study investigates the frequency of Torque teno virus (TTV) infection in 150 blood donors and 77 patients requiring haemodialysis in southern Brazil. Plasma samples were screened for TTV DNA using polymerase chain reaction (PCR). The prevalences of TTV among blood donors and patients requiring haemodialysis were 73.3% and 68.8%, respectively. The presence of TTV was correlated with age in the blood donors (p = 0.024). In haemodialysis patients, no association was found between TTV infection and the demographic parameters (age, sex and education), the duration of haemodialysis or a history of blood transfusion. This study is the first to evaluate the prevalence of TTV infection in Brazilian patients requiring haemodialysis.

Estilos de afrontamiento y calidad de vida en pacientes con insuficiencia renal crónica (IRC) en tratamiento de hemodiálisis / Coping styles and quality of life in patients with chronic kidney disease (CKD) in treatment with haemodialysis

El propósito de este estudio fue observar si los estilos de afrontamiento asumidos por un grupo de 41 pacientes con IRC guardan relación con su calidad de vida. Para ello, se utilizaron los instrumentos SF-36 y CAE. Se observó un deterioro importante en la calidad de vida de estos pacientes; no obstante, su funcionamiento social se encontró preservado. De acuerdo con los resultados, el afrontamiento focalizado en la solución de problemas correlacionó positivamente con salud mental, mientras que la auto-focalización negativa se asoció inversamente con la mayoría de las dimensiones de calidad de vida evaluadas. La evitación y la religiosidad, como estilos de atontamiento, presentaron resultados distintos a los hallados por otros autores. Se discuten las implicaciones de estos hallazgos.

The purpose of this study was to observe if the coping styles of 41 patients with chronic kidney disease were related to their quality of life. The SF-36 and CAE questionnaires were the instruments used. Significant decline in quality of life was evidenced in these patients. Nevertheless, their social functioning was preserved. Results showed that the coping style focused on problem solving was positively correlated with mental health whereas the negative self-focused coping style was inversely related to most dimensions of quality of life that were evaluated. Different results were found about avoidance and religiosity as coping styles. The implications of these results are discussed.

Clinical and electrophysiological investigation of uremic neuropathy in haemodialysis patients

Uremic neuropathy is a distal sensorimotor polyneuropathy caused by uremic toxins. The severity of neuropathy is correlated strongly with the severity of the renal insufficiency. The electrophysiological study is a sensitive test for diagnosis of neuropathy in patients with uremia. Objectives: (1) To assess the clinical characteristics and (2) to describe the electrodiagnostic abnormalities of neuropathy during the haemodialysis. Patients and method: Clinical examination, motor and sensory nerve conduction measurements and an H reflex study (via the Nicolet EMG machine) were performed in 32 non-diabetic uremic patients (16 men and 16 women, mean age 43.5+2.29), who were all treated with chronic maintenance haemodialysis. Results: The incidence of neuropathy in haemodialysis patients was 68.8% on clinical examination and was 96.9% on electrophysiological study. The abnormalities in clinical findings were altered motor-sensory function in 62.8%, predominantly impaired sensibility in 50%, loss of tendon reflexes in 37.5%, symptom of restless legs in 46.9% and carpal tunel syndrome in 9.4% of patients. In the electrophysiological parameters, compared with Vietnamese healthy index, the nerve conduction velocity of all tested nerves was decreased significantly (p<0.05), the highest abnormal rates was the sural nerve (75%), the tibial nerve (71%) and the peroneal nerve (69.4%); H-reflex was also significantly prolonged in 42.9%. Conclusion: The most haemodialysis patients showed clinical and electrophysiological evidence of uremic neuropathy. Electrophysiological findings showed more abnormalities than clinical examination for neuropathy showed on hemodialysis patients.