RESUMEN
UNLABELLED: The prevalence of treated patients with end-stage renal disease (ESRD) has considerably increased in the last decade mainly in the elderly age groups. The type of optimal mode of dialysis therapy in elderly is difficult to establish and most studies comparing hemodialysis and peritoneal dialysis in elderly failed to demonstrate the superiority of one therapy versus the other. The present article uses Charlson Co morbidity Index to compare evolution of an elderly population in HD versus PD. MATERIAL AND METHODS: Nondiabetic patients (> 65 years) who initiated dialysis therapy for ESRD during January 2006-December 2007. RESULTS: In HD group, the median CCI calculated 6 month before initiating dialysis therapy was 5.87, with limits between 3 and 11. At the time of initiating dialysis, the median CCI was 6.55 (limits 3-11). In peritoneal dialysis group, CCI evaluated 6 months before initiating dialysis had a median value of 7.38, with limits between 3 and 11. At the time of initiating dialysis procedure, the median CCI was 7.72. CONCLUSIONS: This study demonstrates that PD is, in the majority of situations, a better option for dialysis in elderly.
Asunto(s)
Fallo Renal Crónico/terapia , Diálisis Renal , Anciano , Anciano de 80 o más Años , Humanos , Fallo Renal Crónico/epidemiología , Diálisis Peritoneal/métodos , Prevalencia , Diálisis Renal/métodos , Rumanía/epidemiología , Resultado del TratamientoRESUMEN
Chronic kidney disease (CKD) patients could present various types of calcifications causing different pathological conditions that would contribute to the renal disease progression and high risk of mortality. Extra-skeletal calcifications represent a common consequence of mineral bone disorders in CKD patients. Vascular calcifications represent a complex systemic manifestation caused by phospho-calcium homeostasis disorders, by imbalance among promoters and inhibitors of calcification and the presence of various arterial diseases and other risk factors. Consequently, vascular calcification can be considered an active pathological process that resembles osteogenesis. Therefore, before starting a suitable therapy for the prevention or delay of vascular calcifications, our recommendations are: to perform lateral abdominal radiography or CT-based techniques in CKD stages 3-5 patients for an early vascular calcification detection, to assess thoroughly patients presenting hyperphosphatemia, hyperparathyroidism, vitamin D deficiency and to understand clearly the pathophysiology of arterial calcification and calciphylaxis.
Asunto(s)
Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/fisiopatología , Calcificación Vascular/complicaciones , Calcificación Vascular/fisiopatología , Cardiología/métodos , Progresión de la Enfermedad , Humanos , Hiperparatiroidismo/diagnóstico , Hiperfosfatemia/diagnóstico , Factores de Riesgo , Tomografía Computarizada por Rayos X/métodos , Deficiencia de Vitamina DRESUMEN
UNLABELLED: As the renal function progressive decline is often correlated to diuresis impairment, potassium level changes represent a major pathophysiological factor in monitoring chronic kidney disease. Even more, potassium level imbalance could lead to life-threatening situations with the risk of severe rhythm disorders appearance. The aim of the study was to determine in which degree the serum potassium changes are implicated in arrhythmias development in CKD patients. PATIENTS AND METHODS: We included 678 CKD patients (predialysis and dialysed patients) to whom we recorded biohumoral and clinical features in correlations with the possibility of arrhythmias genesis. RESULTS: we noticed, in our predialysis group, an important correlation between hyper-/hypokalemia and arrhythmias appearance, more frequent during hypokalemia episodes (OR=4.04, respectively OR=7.5). The same situation was observed in chronic dialysis group. CONCLUSIONS: Hypokalemia is a stronger risk factor than hyperkalemia, but all together, any minimal changes in serum potassium levels could determine arrhythmia in CKD patients.