The present study indicates that H. pylori plays a role in the development of RAS, but periodontal diseases have no effect on it. Eradicating H. pylori might be useful to prevent RAS.
There are two types of malnutrition in patients with chronic renal failure (CRF); type 1 and type 2. The aim of this study was to investigate the relationship between malnutrition and inflammation and also the relationship between malnutrition and volume status. Ninety-four pre-dialysis CRF patients were included in the study. Nutritional status of the patients was calculated using the subjective global assessment. Scores of 1-5 were given according to the severity of the symptoms and physical examination findings. Serum inflammation markers [high-sensitive C-reactive protein (hs-CRP), interleukin-1β, interleukin-6 and tumor necrosis factor-alfa] and nutrition parameters (albumin, pre-albumin, transferrin, fetuin-A, insulin like growth factor-1 and insulin-like growth factor-binding protein-3)] were measured in all the patients. Serum N-terminal pro-brain natriuretic peptide levels and echocardiography were performed to evaluate the volume status of the patients. The mean age of the patients was 59.6±13.3 years, the mean malnutrition score was 17.2±6.01, the mean and the median of hs-CRP levels were 18.5±40.7 and 5.6 mg/L, respectively, the mean albumin level was 3.46±0.48 and the mean creatinine clearance was 23.7±13.5 mL/min. A positive correlation between malnutrition scores with inflammation and volume parameters was found in the bivariate and multivariate analysis. In the multiple regression analysis, volume parameters proved to be the most important factors influencing malnutrition scores. Thus, the elimination of volume excess would ameliorate both inflammation and malnutrition. This hypothesis needs to be supported or proved with prospective studies.
Background: Malnutrition is very common in chronic kidney disease patients and it starts from predialytic stage. The purpose of our project is to investigate the relationship between volume and malnutrition. Materials and method: A total of 109 chronic kidney disease patients were included in the study. Three groups have been created in patients according to their subjective global assessment (SGA) and malnutrition situation; SGA A: well feed group, SGA B: mild to moderate malnutrition, SGA C: severe malnutrition. Anthropometric measurements of all patients have been made (Body mass index, mid arm circumference, mid arm muscle circumference, triceps skinfold thickness, biceps skinfold thickness). Albumin, total chlosterol, triglyceride, serum amino acid leves have evaluated in blood samples of all patients. 24 hour ambulatory blood pressure monitoring was made for all patients. Results: According to results average age of patients was 59.92 year and average GFR was 23.56 mL/min. 22.01 percent of patients was evaluated as SGA A and 77.98 percent of patients was evaluated as SGA B and C. We found negative correlation between albumin, body mass index, mid arm circumference, mid arm muscle circumference, triceps skinfold thickness measurements and SGA scores. At the same time a positive correlation was found between NTSBP (Night time systolic blood pressure) and SGA scores. Discussion: Malnutrition and hypervolemia are significant cardiovascular risk factors for chronic kidney disease patients. In this study we examine the relationship between malnutrition and hypervolemia in predialysis patients. This study was cross sectional and only ambulatory blood pressure measuring used as a volume parameter so cause and effect relationship between hypervolemia-malnutrition should not be inferred. This study should be taken into consideration because it's the first study that examines the relationship between ambulatory blood pressure and malnutrition in prediyalisis patients. Also our data shows statistically significant relationship between amino acid levels and blood pressure parameters and this study is the first reported data in this topic.
Introduction: Heart failure (HF) is a disease associated with poor quality of life. Peritoneal dialysis (PD) can be an alternative in the treatment of these patients to overcome fluid overload. The objective of this study is to observe the effects of PD in refractory HF patients. Methods: We conducted an observational study including 10 patients with refractory congestive HF. PD started solely for fluid overload. Patients' baseline parameters were compared with follow-up parameters. Results: Median age was 57.5 (44.8-64.3) years. Median left ventricular ejection fraction was 20% (18.8-31.3), and all patients had right ventricular dysfunction. Median estimated glomerular filtration rate was 51.2 (43.8-101.3) ml/min/1.73 m 2 .Two patients (20%) died during the follow-up period. New York Heart Association (NYHA) functional class decreased significantly from a median of 4 to 2,1 and 1 in the 3rd, 6th, and 12th months, respectively (p ≤ 0.01 for all from baseline). Number and length of hospitalization decreased significantly after treatment (number from a median of 3 to 0, p = 0.013; days from 50.5 to 0, p = 0.028). Conclusion:PD significantly reduced NYHA functional class, number and days of hospitalization for HF. It could be a reasonable option in chronic treatment of patients with refractory HF.
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