Association of high-sensitive C-reactive protein and dialysis adequacy with uremic pruritus

Malekmakan, Leila; Malekmakan, Alireza; Sayadi, Mehrab; Pakfetrat, Maryam; Sepaskhah, Mozhdeh; Roozbeh, Jamshid

doi:10.4103/1319-2442.164565

Cited by 29 publications

(19 citation statements)

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“…The result of our study showed, dialysis adequacy was less than international targets (9), which is consistent with the results of different studies (6,8). The results of this study indicated, dialysis inadequacy in routine dialysis using conventional filters, blood flow and dialysate flow rate.…”

Section: Discussionsupporting

confidence: 81%

“…Some studies suggested that increased rate of blood flow in hemodialysis device increases dialysis adequacy without increasing duration and cost of dialysis (7). Different studies showed that high blood flow is a convenient tool to increase dialysis adequacy (8,9). However, increasing blood flow can also decrease dialysis adequacy due to vascular access type, hypotension and muscular cramps.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of two interventions of increased blood flow rate and high-flux filters on hemodialysis adequacy and complications; a quasi-experimental study

Shahdadi¹,

Balouchi²,

Haghighi³

2017

J Renal Inj Prev

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Dialysis should be a safe procedure with less complications. It should improve physical state of the patients. High dialysis adequacy should also be taken into account in dialysis procedure. Thereby, the present study recommended dialysis with increased blood flow rate with higher adequacy and less complications compared to routine dialysis despite insignificant difference in dialysis adequacy and complications between increased blood flow intervention and high-flux hemodialysis. Nevertheless, increased blood flow intervention increased dialysis adequacy. For this purpose, this intervention was preferred over high-flux hemodialysis. Introduction: Various parameters such as increased blood flow and high flux filter increase dialysis adequacy. Each parameter is associated with specific complications. Objective: The aim of this study was comparison of two interventions of increased blood flow rate and high-flux filter on hemodialysis adequacy and complications. Please cite this paper as: Patients and Methods:This was a single-group quasi-experimental before-and-after intervention study. Twenty-two patients undergoing dialysis three times a week in the last 6 months consented to participate in the study. The participants were selected using random sampling method. They were reevaluated prior to dialysis and every 30 minutes until the end of each hemodialysis session using dialysis complication checklist. Dialysis adequacy was measured at the end of the fourth session for each patient. Results: The paired t test results showed a significant increase in dialysis adequacy in dialysis with increased blood flow and dialysis with high flux filter (high-flux hemodialysis) compared to routine dialysis (P = 0.01). A significant increase was found in incidence of muscular cramp in dialysis with increased blood flow compared to routine dialysis based on McNemar's statistical test (P = 0.02). Conclusion: Dialysis adequacy improved in both increased blood flow intervention and highflux hemodialysis compared to routine dialysis. On the other hand, increased blood flow intervention was associated with less complications than high-flux hemodialysis. In addition, increased blood flow intervention was more efficient and safer than high-flux hemodialysis.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Comparison of two interventions of increased blood flow rate and high-flux filters on hemodialysis adequacy and complications; a quasi-experimental study

Shahdadi¹,

Balouchi²,

Haghighi³

2017

J Renal Inj Prev

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“…Recent studies [29–33] have revealed that a variety of inflammation factors participate in the pathogenesis of UP. A study [34] has revealed that the complex microenvironment network formed by inflammatory factors and the persistent inflammation state play important roles in the pathogenesis of the repeat attacks of pruritus. A study [35] has suggested that in UP patients, stem cell factors were significantly increased, and the elevation of stem cell factors could recruit chemokines and stimulate mastocyte proliferation and activation.…”

Section: Discussionmentioning

confidence: 99%

Curative effect of neutral macroporous resin hemoperfusion on treating hemodialysis patients with refractory uremic pruritus

Yin

Chen

et al. 2017

Medicine

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This study aims to investigate the efficacy and safety of neutral macroporous resin hemoperfusion in treating maintenance hemodialysis (MHD) patients with refractory uremic pruritus (RUP).Ninety patients were enrolled and were randomly divided into 3 groups: control group, experiment 1 group, and experiment 2 group. Clinical symptom scores of skin itching were recorded before and at 4 and 8 weeks after the treatment. In addition, serum parathyroid hormone (PTH), calcium (Ca2+), phosphorus (P3+), and C-reactive protein (CRP) were detected; and the calcium–phosphorus product ([Ca] × [P]) was calculated to compare the curative effect.VSA score, modified Duo pruritus score, and CRP: these indices decreased to some extent at 4 and 8 weeks after treatment in the 2 experiment groups, compared with pretreatment (P < 0.05); and differences among these 3 groups were statistically significant (P < 0.05). PTH, P3+, and [Ca] × [P]: these indices decreased to some extent at 4 and 8 weeks after treatment in the 2 experiment groups, compared with pretreatment (P < 0.05); and differences between the control and experiment 1 groups, as well as between the control and experiment 2 groups, were statistically significant (P < 0.05). However, the difference between the experiment 1 and experiment 2 groups were not statistically significant (P < 0.05).The effects of HA330 and HA130 resin hemoperfusion apparatus on secondary hyperparathyroidism and the disorder of calcium and phosphorus metabolism are similar. The mechanism may be related to its strong adsorption effect, and its capacity to widely remove inflammatory mediators, immune mediators, and endotoxins.

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“… 7 – 10 Besides, we and others found that the adequacy of dialysis and the clearance of pruritogenic substances could influence the severity of pruritus. 11 – 13 …”

Section: Introductionmentioning

confidence: 99%

A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis

Peng

Chen

et al. 2016

Medicine

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Uremic pruritus is common and bothersome in patients receiving either peritoneal dialysis (PD) or hemodialysis (HD). To date, the preferred dialysis modality regarding the alleviation of uremic pruritus remains controversial. We conducted this cross-sectional study to compare the prevalence, intensity, and characteristics of uremic pruritus between PD and HD patients.Patients receiving maintenance dialysis at a referral medical center in Taiwan were recruited. Dialysis modality, patient demographic, clinical characteristics, and laboratory data were recorded. The intensity of uremic pruritus was measured using visual analogue scale (VAS) scores. Multivariate linear regression analysis was conducted to compare the severity of uremic pruritus between PD and HD patients. Generalized additive models were applied to detect nonlinear effects between pruritus intensity and continuous covariates.A total of 380 patients completed this study, with a mean age of 60.3 years and 49.2% being female. Uremic pruritus was presented in 24 (28.6%) of the 84 PD patients and 113 (38.2%) of the 296 HD patients (P = .12). The VAS score of pruritus intensity was significantly lower among the PD patients than the HD patients (1.32 ± 2.46 vs 2.26 ± 3.30, P = .04). Multivariate linear regression analysis showed that PD was an independent predictor for lower VAS scores of pruritus intensity compared with HD (β-value −0.88, 95% confidence interval −1.62 to −0.13). The use of active vitamin D was also an independent predictor for a lower intensity of uremic pruritus, whereas hyperphosphatemia and higher serum levels of triglyceride and aspartate transaminase were significantly associated with higher pruritus intensity. There was a trend toward a less affected body surface area of uremic pruritus in the PD patients than in the HD patients, but the difference did not reach statistical significance (P = .13).In conclusion, the severity of uremic pruritus was lower among PD patients than HD patients, and PD may provide better alleviation of pruritus symptoms. The result provides a valuable reference for clinicians and patients when choosing a dialysis modality.

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Association of high-sensitive C-reactive protein and dialysis adequacy with uremic pruritus

Cited by 29 publications

References 0 publications

Comparison of two interventions of increased blood flow rate and high-flux filters on hemodialysis adequacy and complications; a quasi-experimental study

Comparison of two interventions of increased blood flow rate and high-flux filters on hemodialysis adequacy and complications; a quasi-experimental study

Curative effect of neutral macroporous resin hemoperfusion on treating hemodialysis patients with refractory uremic pruritus

A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis

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