Frequency of Hepatitis C Virus in Chronic Kidney Disease Patients on Regular Hemodialysis at Tertiary Care Hospital
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Introduction: Chronic kidney disease is the most important public health issue affecting about 10% of the world adult population. Objective: To assess the frequency of Hepatitis C Virus in chronic kidney disease patients on regular hemodialysis at tertiary care hospital, Peshawar Methodology: This was descriptive cross sectional study, carried out at the Medicine department, Hayatabad Medical Complex, Peshawar for one year duration from December 2020 to December 2021. A total of 211 patients were observed in our study. All the data was statistically analyzed by using SPSS 23. Results: In our study, there were 140 (66.4%) male patients while female patients were 71(33.6%). Based on duration of illness, 149(70.6%) patients were in illness duration of 1-2 years while 62(29.4%) patients were observed in illness duration of more than 2 years (Table 1). The overall frequency of Hepatitis C virus was 68(32.2%) in patients with chronic kidney disease on regular hemodialysis Conclusion: In hospitalized CKD patients, the occurrence of hepatitis C ELISA antibody is considerably higher. To avoid hepatitis C infection spread, rigorous global infection control strategies must be applied in nephrology units. More research is required to evaluate whether detecting and treating hepatitis C in CKD patients reduces death rates or delays advancement to end-stage renal disease. Key words Hepatitis C Virus; Chronic kidney disease; HemodialysisKeywords:
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<i>Background:</i> Some patients who reach end-stage renal disease refuse to start dialysis at the time suggested by their nephrologist and delay it. Whether this delay may affect health-related quality of life (HRQoL), clinical and biological parameters at dialysis onset, and then survival and hospitalization during dialysis is unknown. <i>Methods:</i> We considered all adult patients who began dialysis in Lorraine (France) in 2005–2006 having previously been followed by a nephrologist. Clinical and biological characteristics at dialysis onset were collected from medical records, and nephrologists were interviewed about compliance with the recommended starting date. HRQoL was measured using the French version of the ‘Kidney Disease Quality of Life’ V36 questionnaire. Mortality and total duration of hospitalization during the first year of dialysis were recorded as part of the end-stage renal disease French registry. The effects of delaying dialysis on survival and on duration of hospitalization were determined using log-rank test and polychotomous logistic regression, respectively. <i>Results:</i> Of 541 patients, 88 (16.3%) declined to initiate dialysis at the time recommended by the nephrologist and delayed it. Compared with patients who were compliant with the advice, noncompliers had more comorbidities, poorer clinical and biological profiles at dialysis start, and a higher risk of beginning dialysis in emergency circumstances with greater decline in the ‘burden of kidney disease’ dimension of HRQoL. However, there were no differences in survival or duration of hospitalization during dialysis. <i>Conclusion:</i> Despite a negative effect on clinical and biological parameters at initiation, delaying dialysis did not impact on survival during treatment.
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The prevalence of chronic kidney disease (CKD), especially the early stages, is still not exactly known. This is also true for CKD stage 3, when cardiovascular and other major complications generally appear. The NANHES data have shown a steady increase in the prevalence of CKD 3 up to 7.7% in 2004. Chronic kidney disease and renal failure are underdiagnosed all over the world. In Italy, prevalence estimates for stage 3 to 5 CKD are around 4 million yet, less than 30% of these subjects are believed to be followed at nephrology clinics. This means that in Italy for every dialyzed patient there are about 85 individuals with possibly progressive kidney disease, while fewer than five (mainly stage 4 and 5 patients) are actually followed by a nephrologist.
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The National Kidney Foundation developed and oversees the Kidney Disease Outcomes Quality Initiative, a process that develops clinical practice guidelines in nephrology. Recent guidelines address the evaluation, classification, and stratification of chronic kidney disease (CKD). These guidelines provide, for the first time, a standard definition of CKD, classification of its stages, and suggestions for appropriate laboratory measurements for the assessment of kidney function. Also discussed are the association of level of kidney function with systemic complications that develop during CKD, and the risk of loss of kidney function and development of cardiovascular disease in CKD.
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Objective:To evaluate the effects of individualized hemodialysis on lowering the hemodialysis complications.Methods:All together312times of hemodialysis in20chronic renal failure patients were investiˉgated.The clinical effects of two different dialysis methods which included routine dialysis and individualized dialysis were compared.Results:There were a few influences on plasma osmotic pressure and serum natrium in individualized hemodialysis group with good effects and fewer complications.Conclusion:Individualized dialysis could effectively prevent the dialysis complications,promote the dialysis quality together with ensuring the dialysis effects.
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STARRT recently demonstrated that many patients experience suboptimal dialysis starts (defined as initiation as an inpatient and/or with a central venous catheter), even when followed by a nephrologist for >12 months (NDT 2011). However, STARRT did not identify the factors associated with suboptimal initiation of dialysis. The objectives of this study were to extend the results of STARRT by ascertaining the factors leading to suboptimal initiation of dialysis in patients who were referred at least 12 months prior to commencement of dialysis. At each of the three Toronto centers, charts of consecutive incident RRT patients were identified from 1 January 2009 to 31 December 2010, with predetermined data extracted. A total of 436 incident RRT patients were studied; 52.4% were followed by a nephrologist for >12 months prior to the initiation of dialysis. Suboptimal starts occurred in 56.4% of these patients. No attempt at arteriovenous fistula (AVF) or arteriovenous graft (AVG) prior to initiation was made in 65% of these starts. Factors contributing to suboptimal starts despite early referral included patient-related delays (31.25%), acute-on-chronic kidney disease (31.25%), surgical delays (16.41%), late decision-making (8.59%) and others (12.50%). The percentage of optimal starts with early referral among 14 nephrologists ranged from 33 to 72%. Most patients started dialysis in a suboptimal manner, despite an extended period of pre-dialysis care. Nephrologists should take responsibility for suboptimal initiation of dialysis despite early referral and test methods that attempt to prevent this.
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Abstract Chronic kidney disease (CKD) represents a public health burden worldwide and is associated with significant morbidity and mortality. Most patients with CKD are managed by primary care practitioners and this educational series hope to improve knowledge and delivery of care to this high-risk patient population with CKD.
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Prime time
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The prevalence of chronic kidney disease (CKD), especially the early stages, is still not exactly known. This is also true for CKD stage 3, when cardiovascular and other major complications generally appear. The NANHES data have shown a steady increase in the prevalence of CKD 3 up to 7.7% in 2004. Chronic kidney disease and renal failure are underdiagnosed all over the world. In Italy, prevalence estimates for stage 3 to 5 CKD are around 4 million yet, less than 30% of these subjects are believed to be followed at nephrology clinics. This means that in Italy for every dialyzed patient there are about 85 individuals with possibly progressive kidney disease, while fewer than five (mainly stage 4 and 5 patients) are actually followed by a nephrologist.
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Chronic renal failure
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