Denver peritoneovenous shunt in the management of refractory ascites due to chronic liver diseases: impact of patients selection on its outcome

Forty four patients with refractory ascites due to chronic liver diseases that fulfilling the inclusion criteria of selection were divided into 2 groups. The first group [G1, n=24] was subdivided into 2 subgroups according to degree of liver condition; GIa [n=11] with Child-Pugh class B and GIb [n=13] with early class C. The patients were subjected to P-V shunt [Denver group]. Similarly, patients in the second group [GII, n=20] were divided into 2 subgroups GIIa [n=10] and GIIb [n=10] respectively and treated by the repeated tapping and albumin infusion [control group]. Postoperative results revealed a significant increase in urine output [P

Independent, non-traditional risk factors for cardiovascular events and atherothrombosis in chronic kidney disease and in hemodialysis-dependent patients

This study aimed at evaluating the role of the emerging non-traditional risk factors, their impact on Cardiovascular Disease [CVD] prediction-together with traditional RFs-in Chronic Kidney Disease [CKD] and end-stage renal disease [ESRD] patients. Total homocysteine [tHcy], plasma fibrinogen [Fbg], plasma factor VII activity [FVIIc], anaemia [HCT] and C-reactive protein [CRP], were studied in 37 Egyptian patients classified into chronic kidney disease group [10 cases] and hemodialysis [HD] group [27 cases] in addition to 10 healthy age and sex-matched controls. This study showed that tHcy, fbg CRP and FVIIc demonstrated highly significant increase in the total patient group and in the HD group compared to the normal controls. These values showed a progressive increase with the disease approaching hemodialysis dependence. Among the 37 patients, 21 showed evidence of ischemic heart disease [IHD]. A statistically significant elevation of the previous factors was found in IHD when compared to non-ischemic group of patients. Multivariante analysis showed CRP as the most predictive risk factor for CVE in CKD and ESRD patients. Therefore, it was concluded that the emerging non-traditional factors studied could explain to a great extent-together with traditional RFs- the high rate of CVD in these patients and that CRP is the most fulfilling for being recommended in clinical practice. Alterations of these factors will aid prevention of coronary heart disease [CHD], thus benefiting the patient from risk factor modification