Introduction
Mortality in patients with chronic renal failure is high compared to the general population. The objective of our study is to evaluate the predictive factors related to mortality in hemodialysis.
Methods
This is a retrospective study involving 126 hemodialysis patients in the Nephrology Department of Ibn Rochd Hospital, Casablanca. Data were collected between January 2012 and January 2016. For each of our patients, we analyzed demographic, clinical, biological and anthropometric data. The Kaplan-Meier method and the log-rank test were used to evaluate and compare survival curves. To evaluate the effect of predictors of mortality, we used the proportional Cox hazard model.
Results
The analysis of the results showed that the surviving patients were younger than the deceased patients (43.07±13.52 years versus 53.09±13.56 years, p=0.001). Also, the latter has a significantly lower albumin and prealbumin levels (p=0.01 and p=0.04 respectively). Overall survival was 80.2%. Cox regression analysis at age (HR=1.26, p<0.0002), inflammation (HR=1.15, p<0.03), AIP> 0.24 (HR=2.1, p<0.002) and cardiovascular disease (RR=2.91, p<0.001) were associated with global and cardiovascular mortality.
Conclusion
Our study showed that the mortality rate is high in our cohort. In addition, cardiovascular diseases, under nutrition and inflammation are predictive factors for mortality. Treatment and early management of these factors are essential for reducing morbidity and mortality.
Several studies had revealed that following the Mediterranean diet (MD) contributes to beneficial health status and a decreased risk of many chronic diseases. The aim of our study was to assess adherence to MD in Casablanca City and to identify the relationship between MD adherence and sociodemographic and lifestyle parameters. This cross-sectional study concerned 719 subjects with complete dietary data. Data collection was performed using a questionnaire including sociodemographic and lifestyle factors. The dietary intake was assessed with the use of a food-frequency questionnaire. The compliance with MD was evaluated with a simplified MD score. Our study showed that high adherence to the MD was characterized by high intakes of vegetables, fruits, pulses, fish, cereals, olive oil, and low meat and dairy consumption according to the Simplified MD score. As regard to the multivariate logistic, being a man, being married, persons with a level of education >6 years, luxurious housing, and consumption of alcohol were associated with a higher adherence to MD, while, the overweight was negatively associated with a higher adherence to MD. Maintaining the traditional MD pattern is crucial for public health; in this way, more research is needed in this area in order to precisely measure these associations.
Objective:
Helicobacter pylori (H. pylori)
induces the production of tumor necrosis factor-alpha (TNF-α), which is closely related to a gastric epithelial injury.
TNF-α
gene polymorphism and
TNF-α
serum levels are associated with various malignant conditions. Identification of the ideal marker for gastric cancer (GC) is still the leading aim of several trials. Physio-pathological considerations of GC led us to investigate the association of two
TNF-α
promoter polymorphisms (-308G>A and -238G>A), and TNF-α serum levels with the susceptibility to gastric precancerous (PL) and GC.
Methods:
Patients suffering from gastric lesions (65 chronic gastritis, 50 PL, 40 GC) related to
H. pylori
infection , and 63 healthy controls (HC) were involved in this study. Individuals are genotyped by
TNF-α
gene promoter sequencing and TNF-α serum levels are measured by ELISA quantitative method.
Results:
Regarding TNF-α-308 G/A locus, we noticed higher risk for GC (OR=4.3, CI 1.5-11.9, p-value=0.005) and PL (OR=3.4, CI 1.2-9.2, p-value=0.01) for individuals with AA/GA genotypes compared to GG genotype. Concerning TNF-α-238 G/A locus, we noticed higher risk for GC (OR=5.9, CI 1.2-27.5, p-value=0.01) and PL (OR=4.8, CI 1.3-18, p-value=0.01) for individuals with GG genotype compared to AA/GA genotypes. We noticed that TNF-α serum levels have been increased together with gastric lesions severity. Moreover, TNF-α-308 and TNF-α-238 A alleles seemed to, respectively, upregulate and downregulate TNF-α serum levels.
Conclusion:
The TNF-α -308 A allele has a promotive effect for GC progression, whereas the TNF-α -238 A allele has a protective function against GC progression. High levels of TNF-α seemed to be associated with the aggressiveness of gastric lesions.
TNF-α
gene polymorphisms and TNF-α serum levels might be helpful to select those patients who are at high risk for GC.
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