Background: Peritoneal dialysis is used regularlly in treatment of ESRDs. Residual renal function (RRF) in these patients helps the adequacy of PD therapy very much. Objectives: 1. Study RRF of PD patients at Department of Nephro – Rheumatology, Hue Central Hospital. 2. Search the correlation between RRF and Kt/V. Patients and methods: 35 PD patients at Department of Nephro – Rheumatology, Hue Central Hospital. Measure RRF and Kt/V by formulars that depend on blood, urine and PD fluid samples. Results: Mean RRF of PD patients is 4.36 ± 13.8 ml/minute. There is a close correlation between RRF and Kt/V (r=0.79, p<0.01). Conclusion: RRF in PD patients correlates with Kt/V.

The antiphospholipid syndrome (APS) is defined by the presence of anti-phospholipid antibodies (aPLs) and venous or arterial thrombosis, recurrent pregnancy loss, or thrombocytopenia. The syndrome can be either primary or secondary to an underlying condition, most commonly systemic lupus erythematosus (SLE). Echocardiographic studies have disclosed heart valve abnormalities in about a third of patients with primary APS. SLE patients with aPLs have a higher prevalence of valvular involvement than those without these antibodies. Valvular lesions associated with aPLs occur as valve masses (nonbacterial vegetations) or thickening. These two morphological alterations can be combined and are thought to reflect the same pathological process. Both can be associated with valve dysfunction, although such association is much more common with the latter alteration. The predominant functional abnormality is regurgitation; stenosis is rare. The mitral valve is mainly affected, followed by the aortic valve. Valvular involvement usually does not cause clinical valvular heart disease. The presence of aPLs seems to further increase the risk for thromboembolic complications, mainly cerebrovascular, posed by valve lesions. Superadded bacterial endocarditis is rare but may be difficult to distinguish from pseudoinfective endocarditis. The current therapeutic guidelines are those for APS in general. Secondary antithrombotic prevention with long-term, high-intensity oral anticoagulation is advised. The efficacy of aspirin, either alone or in combination, is yet to be assessed. Corticosteroids are not beneficial and may even facilitate valve damage. Immunosuppressive agents should only be used for the treatment of an underlying condition. Current data suggest a role for aPLs in the pathogenesis of valvular lesions. aPLs may promote the formation of valve thrombi. These antibodies may also act by another mechanism, as indicated by the finding of subendothelial deposits of immunoglobulins, including anti-cardiolipin antibodies, and of colocalized complement components in deformed valves from patients with APS.

Objective: to study the Metabolic syndrome (MS) in the chronic kidney disease (CKD) patients with conservative treatment. Patients and methods: 123 CKD patients with conservative treatment at The Cantho Central General Hospital from 05/2009 to 08/2010 are investigated the component of MS basing on the NCEP-ATP III criteria for Asian. Results: - The overall prevalence of MS is 65.9% and increase significantly according to the insufficiency renal stage with 46.7% at the first stage group; 64.5% come to 67.7% at the second and the third stage group, and 83.9% at the final stage group. - The prevalence number of MS component are 99.2%, 94.3%, 65.9%, 37.4% and 10.6% respectively 1, 2, 3, 4 and 5 component of MS. - The prevalence of abdominal obesity, high triglyceride levels, low HDL-cholesterol, elevated blood pressure and high plasma glucose levels are respectively 50.4%, 54.5%, 78.9% 73.2% and 50.4%. - The prevalence of MS increase direct proportion with the level and duration of CKD significantly.

Background: By combining diffisive and convective with a large volume in the same exchange method, Online Haemodiafiltration provide the highest clearances of both small and large solutes in the end stage renal disease patients who treated by maintenance hemodialysis. Objective: To investigate the serum levels of Ure, creatinin, phosphorus, Beta2-microglobulin and Homocystein before and after one session of Online Hemodiafiltration and one session of conventional Hemodialysis in the same patient. Method: Cross – sectional study. Results: 34 patients were treated by combining one session Online Hemodiafiltration and two sessions intermittent Hemodialysis/week. The urea reduction rate: 76.61 ± 7.37% Online Hemodiafiltration compare with 69.90 ± 7.55% conventional hemodialysis; the creatinin reduction rate: 67.76 ± 6.05% Online Hemodiafiltration compare with 61.40 ± 7.82% conventional hemodialysis; the phospho reduction rate: 52.37 ± 14.47% Online Hemodiafiltration compare with 42.81 ± 21.39% conventional hemodialysis; the Beta 2-microglobulin reduction rate: 72.42 ± 7.60% Online Hemodifiltration compare with 56.91 ± 12.76% conventional hemodialysis; the Homocysteine reduction rate: 43.23 ± 15.46% Online Hemodiafiltration compare with 33.68 ± 14.72% conventional hemodialysis. A differrent in two methods was significally and the solute reduction rate was higher with Online Hemodiafiltration, p < 0.01. Conclusion: Online Haemodiafiltration provide the highest clearances of both small and large solutes and helping to improve patient’s survival and quality of life.

Background: the role of malnutrition, inflammation, atherosclerosis, and particularly the combination of these three factors were closely related to cardiovascular events, hospitalisation frequency, and death in end-stage renal disease (ESRD) patients. This study examines the relationship between malnutrition-inflammation-atherosclerosis (MIA) syndrome and mortality among these patients during an 18-month period. Subjects and methods: in this prospective observational cohort study, all cause-mortality was evaluated during an 18-month follow-up period. A total of 174 patients with ESRD (including 57 non-dialysis patients, 56 peritoneal dialysis patients, and 61 hemodialysis patients) were enrolled. M (malnutrition) was assessed by the seven-point subjective global assessment (SGA), serum albumin. I (inflammation) was assessed by serum hs-CRP, serum IL-6. A (atherosclerosis) was defined as IMT ≥0.9 mm or the presence of plaque in the carotid artery. The patients are classified into four groups by number of components (MIA0, MIA1, MIA2, MIA3). Results: 73.6% of patients had at least one component of MIA syndrome. The proportion of patients with malnutrition, inflammation, and atherosclerosis accounted for 36.8%, 21.3%, and 50.6%, respectively. The proportion of patients with 3, 2, 1 component accounted for 4.0, 27.0, and 42.5%. There was no difference between MIA groups based on age, sex, percentage suffering from dyslipidemia, anemia, or Hb levels. Relative to patients experiencing no elements of MIA syndrome, patients with three components experienced a 13.16 times higher risk of mortality. Only malnutrition was a strong predictor of mortality with HR (95% CI): 5.90 (2.46-14.14). Conclusion: clinical physicians should attend more closely to and provide early assessments of MIA syndrome in patients with ESRD. They should care for nutrition conditions and thereby provide early and effective treatments. This can contribute to enhancements in quality of life, and decrease mortality rates in patients.