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Showing 5 results for Renal Failure
Etiology of end stage renal disease in dialysis patient in Gilan province
M. Khosravi, M. Ghaheryfar, A. Monfared,
Volume 64, Issue 4 (7-2006)
Abstract

Background: The etiology of End Stage Renal Disease (ESRD) in every community differ according to genetic, nutrition, and public health status. ESRD,the terminal stage of chronic renal failure,needs replacement therapy otherwise could lead to death. The aim of the study is to determine the relative frequency of ESRD etiology in hemodialysis patients of Gilan province.

Methods:This descriptive study was performed on 407 patients who were being hemodialysis in all hemodialysis centers of the Gilan province from September 2002 to September 2003. The original data was collected from the medical records of patients.

Results: The most prevalent causes were: hypertension 35.4% unknown etiology 16.2% diabetes melitus 13.8% , glomerulopathies 9.6% , urologic causes 9.1%, cystic kidney diseases 7.6 % other causes 5.9 % congenital 2.5%.

Conclusion: In our study hypertension was the first etiology of ESRD, followed by unknown causes, however nephrology textbooks indicate diabetes melitus as the primary and hypertension as the secondary etiology of ESRD,.


Patients with massive honeybee stings: report of four cases
Shahidi Sh, Ashrafi F, Izadi N, Adilipour H,
Volume 66, Issue 8 (11-2008)
Abstract

Background: Insect stings can cause local or systemic reactions that range from mild to fatal, and are among the most common causes of anaphylaxis. The major allergens of honeybee venom are phospholipase A2, hyaluronidase, acid phosphatase, allergen C and melitin. Phospholipase and melitin induce hemolysis, rhabdomyolysis and liver damage due to cell membrane breakdown, damage of the vascular endothelium and activation of the inflammatory response. Rhabdomyolysis has been implicated as the cause of acute renal failure in approximately 5-7% of cases. However, bee stings are a rare cause of rhabdomyolysis, and are usually associated with 50 or more stings. It has been reported that more than 250 bee stings are capable of causing death in humans.

Case report: We report two cases of massive honeybee stings (>2000) with rhabdomyolysis, hemolysis and acute renal failure who survived with full recovery, and two cases of >500 honeybee stings who survived without significant complications.


Atherosclerotic changes and hemodynamic parameters of carotid artery in hemodialysis patients
Rohani Zohre , Sanadgol Hooshang , Khajehnasiri Samaneh ,
Volume 69, Issue 12 (3-2012)
Abstract

Background: Atherosclerotic vascular disease is a major cause of morbidity and mortality in patients with end-stage renal diseases on maintenance hemodialysis. Early atherosclerotic changes of the arterial wall can be evaluated by measuring intima-media thickness (IMT), and looking for the presence and structure of plaques and parameters of vascular resistance. In this study we investigated the relationship between carotid IMT and pulsatility index (PI) or resistive index (RI) values in hemodialysis patients.

Methods: Sixty hemodialysis patients (27 females and 33 males median age 41.7 years) and 60 healthy volunteers (32 females and 28 males, median age 37.8 years) underwent ultrasonography of common carotid artery for the determination of IMT, PI and RI.

Results: Bilateral IMT was significantly higher in hemodialysis patients than in control group (P<0.001). Left carotid artery RI and PI were found to be significantly higher in hemodialysis patients than in the controls (P<0.001). Right carotid artery RI and PI had no significant statistical differences between the two groups (P=0.18 and P=0.78, respectively). There was a moderately significant negative correlation between the left carotid IMT and left RI and PI in the controls (r= -0.42, P=0.001 and r=- 0.43, P<0.001, respectively).

Conclusion: PI and RI values of the left coronary artery increased as did IMT in hemodialysis patients. Therefore, measurement of RI and PI values together with IMT are recommended for early diagnosis of atherosclerosis in hemodialysis patient.


Spinal anesthesia in renal transplantation
Atabak Najafi , Mohammad Reza Khajavi , Pejman Pourfakhr , Farhad Etezadi ,
Volume 71, Issue 6 (9-2013)
Abstract
Background: Renal transplantation is the preferred therapeutic method for patients with end-stage renal disease. Patients with renal failure have significant associated medical conditions, such as cardiovascular disease. The suitable anesthesia for renal transplantation requires minimal toxicity for the transplanted organ, as well as sufficient pain relief and maintenance of optimal blood pressure and intravascular volume to keep renal functions. The aim of this study was to improve our experience of spinal anesthesia in patients undergoing renal transplantation.
Methods: Sixty consecutive patients scheduled for elective renal transplantation over a period of two years who consented for spinal anesthesia were enrolled in the study. Intraoperative hemodynamic, intravenous fluids and infused blood products, duration of surgery, urine output and arterial blood gas and intensity of pain score in the recovery room were monitored. We also noted intraoperative and postoperative complications.
Results: Spinal anesthesia was satisfactory in all, but in five patients they required supplementation with general anesthesia for excessively prolonged surgery. There were no significant intraoperative hemodynamic changes. The total intravenous fluid used during surgery was 65.15±7.2 mL/kg, the mean surgical time was 170±22 min. The mean of mean arterial pressure (MAP) during the operation was 98±12 mmhg. There was no significant acidosis at the end of the operation (PH=38±0.03). Also the mean intensity of pain was 4±2 in recovery and a few of patients suffered from bladder catheter bladder discomfort in the recovery room (8 patients).
Conclusion: Spinal anesthesia is a successful regional anesthetic technique in well selected patients for renal transplantation. A successful outcome in this technique is dependent on close intra-operative monitoring, optimization of intravascular fluid volume and keep the hemodynamic status in optimal range.

Effect of hydroxyzine on pruritus of hemodialysis patients
Mohsen Soleimani , Rahimeh Nabavi , Nadia Karimi , Abbasali Ebrahimian ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Uremic pruritus is one of the important problems in patients undergoing hemodialysis. Causing the mechanism of uremic pruritus in hemodialysis patients is complex and multifactorial. Almost 60 percent of hemodialysis patients suffer from uremic pruritus. Oral hydroxyzine is a common treatment for uremic pruritus of this patients. This study aimed to survey effect of hydroxyzine on uremic pruritus of hemodialysis patients.
Methods: This quasi-experimental study (pre and post design) performed on 40 patients with eligible criteria. All of the hemodialysis patients who suffer from pruritus received a tablet of hydroxyzine 25 mg daily for 6 weeks. In this time, drugs and the plan of hemodialysis were constant. Pruritus score of patients, evaluated with 5-D pruritus scale that had 8 items with 5-score Likert scale and evaluate duration, direction, disability, and distribution of pruritus. Severity scores of pruritus before and after treatment with tablet of hydroxyzine were compared. This study was conducted on hemodialysis patients in the Soodeh Center of Hemodialysis in the south of Tehran, Iran, from September 2016 to February 2017.
Results: The findings of this study showed that most of the patients in this study were male (55%) with mean age of 55.97±11.59 years. The most cause of chronic renal failure in these patients was diabetes (37.5%). This study showed that 32.5% of the hemodialysis patients had moderate to severe uremic pruritus. The mean score of pruritus before the treatment with hydroxyzine was 16.73±3.4 and the most effect of this drug was in the social activity item (2.47±0.6). After treatment with hydroxyzine, the mean score of pruritus in the patients was 9.65±2.15 that was decreased significantly (P<0.001). The findings showed that there was no significant relationship between decrease of pruritus and characteristics of patients.    
Conclusion: This study showed that uremic pruritus is still a challenge in hemodialysis patients. According to this study use of hydroxyzine, regardless of uremic pruritus mechanism, could be decreased uremic pruritus of hemodialysis patients.

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