Citrate 4% lock solution is equally effective as heparin in maintaining catheter patency in dialysis patients. It may have a favorable effect on prevention of catheter-related infection due to its additional antiseptic properties as compared to heparin. Citrate-based locking solutions are a promising alternative to unfractionated heparin as a locking solution for dialysis catheters.
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Background Obesity is associated with an increased risk of sudden death that may be due to abnormal cardiac vagal modulation reflected by reduced Heart rate variability (HRV). Weight loss after diet or gastroplasty in morbidly obese patients has been shown to reverse the deleterious impacts of obesity on cardiac autonomic nervous system modulation, with subjects showing enhanced HRV after reduction in body mass index (BMI), through increased cardiac vagal modulation Objective The aim of this study is to assess weight loss effect after bariatric surgery on Heart rate variability (HRV) by 24-hour Holter monitoring. Methods This is an observational cross section study was done on thirty morbidly obese patients (twenty female and ten males) undergoing bariatric surgery (Roux-en-Y gastric bypass) were enrolled in the study from Ain Shams University Hospitals within the period 1/7/2019 till 1/3/2020. Results Our study results proved that weight loss after bariatric surgery (Roux-en-Y gastric bypass) improves the heart rate variability and hence cardiac autonomic modulation. This is of importance because higher heart rate is associated with increased mortality, and decreased the heart rate variability is associated with increased cardiac mortality independent of ejection fraction. Weight loss after bariatric surgery (Roux-en-Y gastric bypass) achieved better glycemic control of the diabetic patients. Even more, a complete resolution of diabetes occurred in a large number of the diabetic patients (50% of total diabetic patients). Conclusion The Significant weight loss after bariatric surgery (Roux-en-Y gastric bypass) improves the heart rate variability and hence cardiac autonomic modulation.

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