Risk of Abdominal Aortic Calcifications among End Stage Renal Disease Patients under Maintenance Haemodialysis.

Calcification of soft tissue and blood vessel wall occurs more frequently in dialyzed patients. The purpose of the present study was to estimate the risk of abdominal aortic calcification among end stage renal disease patients under maintenance haemodialysis. This case-control study was carried out in the Department of Nephrology at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka and National Institute of Cardiovascular Disease and Hospital (NICVD), Dhaka, Bangladesh from January 2013 to December 2014 for a period of two (02) years. Chronic kidney disease in stage 5 {CKD-5(D)} patients older than 18 years on maintenance haemodialysis (MHD) for more than 3 months were selected as case group. And same age and sex non CKD patients were considered as control group. Serum calcium, serum albumin, serum phosphate and iPTH were estimated by semi-automated biochemistry analyzer from the Department of Biochemistry of NIKDU, Dhaka and NICVD, Dhaka. Plain X-ray abdomen in lateral view was performed for all patients. Total 100 patients were enrolled for this study of which 50 patients were in end stage renal disease (ESRD) group and the rest 50 patients were in non-CKD group. Abdominal aortic calcification on X ray was present in 22(44%) patients of ESRD group and 6(12%) patients of non CKD group of population. Mean±SD serum calcium (corrected) level was significantly high (p<0.001) in ESRD patients (9.79±0.87) compared to non CKD group of population (9.13±0.70). Mean±SD of serum phosphate level was significantly higher (p<0.001) in ESRD patients (5.71±0.96) compared to non CKD group of population (4.20±0.59). However, mean±SD iPTH level showed no significant difference between ESRD (25.33±51.98) and non CKD group of population (38.53±19.52), though iPTH level remain below the target level in ESRD group. Abdominal aortic calcification is significantly higher among ESRD subjects.

Frequency and risk factors for posttransplant diabetes mellitus in Iranian renal transplant patients.

Posttransplant diabetes mellitus (PTDM) is a frequent complication of renal transplantation. This study was performed to determine the prevalence of and risk factors for PTDM among Iranian renal transplant recipients. In this cross-sectional study, 300 patients were studied in 2007. It included questionnaires with clinical data and blood samples. PTDM was defined as DM without a pretransplant history. The 184 (61.3%) male and 116 (38.7%) female patients of overall mean age of 41.2 +/- 13.5 years were 67.4 +/- 48.6 months after the procedure. PTDM was observed in 24 patients (8%). The mean interval to develop PTDM was 19.9 +/- 31.5 months. The mean age of PTDM patients was significantly higher than non-PTDM patients: 49.4 +/- 13.4 vs 40.6 +/- 13.4 years (P < .005). The mean serum high-density lipoprotein (HDL) was higher among PTDM compared with non-PTDM patients: 71.4 +/- 21 vs 58.6 +/- 14.6 (P < .005). There was a trend toward higher serum low-density lipoprotein (LDL) among PTDM patients: 109.2 +/- 29.5 vs 96.2 +/- 25.2 (P = .06). A recent admission was more frequent among PTDM patients (58.3% vs 28.7%; P < .005), as was history of hepatitis C virus (HCV) infection (6% vs 1%; P < .01). There was no significant difference in doses of immunosuppressive drugs and doses atenolol, mean body mass index, DM family history, rejection, cytomegalovirus (CMV) infection, or frequency of positive anti-HCV antibody between the 2 groups. Our study showed an 8% prevalence of PTDM. Mean age, history of recent admissions and HCV infection, as well as mean plasma HDL and LDL levels were higher among PTDM patients.