No abstract

Vascular access intervention therapy (VAIVT) is necessary to maintain vascular access in patients undergoing hemodialysis. VAIVT‐associated vasodilatation is painful. However, few reports have focused on effective pain relief at the time of VAIVT. The present study was performed to determine whether lidocaine‐propitocain cream, a eutectic mixture of local anesthetics (EMLA), effectively reduces VAIVT‐associated pain in patients undergoing hemodialysis. This placebo‐controlled, double‐blind, crossover study was conducted in a single center. Among 210 patients who underwent a total of 437 VAIVT procedures from August 2017 to June 2018, 30 patients were randomly allocated to either the EMLA–placebo arm or placebo–EMLA arm at the time of VAIVT. EMLA application significantly reduced the visual analog scale score compared with placebo (47.0 ± 21.1 vs. 68.6 ± 20.7 mm, respectively; P < 0.05). EMLA is a safe and effective treatment for relief of VAIVT‐associated pain in patients undergoing hemodialysis.

No abstract

Introduction and Aims: Growth differentiation factor-15 (GDF-15), a member of TGF-beta family, has been implicated in several pathological conditions, which include inflammation, cancer, cardiovascular, pulmonary and renal diseases. Recently it is reported that serum GDF-15 may be a marker for chronic kidney disease (CKD) and CKD progression. In present study, we evaluated whether serum GDF-15 is associated with renal vascular resistance evaluated by resistive index (RI) measured in Ultrasound, which is the marker of renal injury. Methods: Eighty patients with essential hypertension were enrolled in this study. They were evaluated on serum GDF-15 and renal RI as well as for conventional atherosclerotic risk factors. Results: Mean age of all patients was 66 ± 12 years (35 males and 45 females). Mean eGFR and renal RI was 68.9 ± 23.0ml / min / 1.73m2 and 0.71 ± 0.07 respectively. Mean serum GDF-15 was 1492 ± 1319 pg/ml. RI correlated with GDF-15 (r=0.47, P<0.001), age (r=0.40, p<0.001), eGFR (r=-0.34, p=0.002) and diastolic BP (r=-0.56, p<0.001) in simple regression analysis. Multiple regression analysis showed GDF-15 (beta=0.31, P=0.005) and systolic BP (beta=0.35, P<0.001) and diastolic BP (beta=-0.74, P<0.001) were the independent determinants of renal RI. Conclusions: GDF-15 is associated with renal vascular resistance and may become a nephropathic marker in patients with hypertension.

No abstract