Cardiac arrhythmia during early-week and mid-week dialysis in hemodialysis patients.

Data on cardiac arrhythmia and electrolyte changes during the dialysis cycle have been limited. Fifty-two hemodialysis (HD) patients underwent 48-h Holter monitoring during early-week and mid-week HD sessions. Pre-HD and post-HD blood samples were collected in both HD sessions.

Prevalence and Factors Associated with Left Ventricular Systolic Dysfunction in End-Stage Renal Disease Patients on Dialysis.

Background: Heart failure is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Previous studies reported various factors associated with left ventricular systolic dysfunction (LVSD) in patients with ESRD.

Objective: To investigate the prevalence and factors associated with LVSD in patients with ESRD on dialysis.

Glomerular macrophage is an indicator of early treatment response in diffuse proliferative lupus nephritis.

Background: Patients with diffuse proliferative lupus nephritis (class IV) who responded to treatment within 6 months had better renal outcome than those who did not. Glomerular macrophage is known to be associated with poor renal outcome in glomerular diseases.

Objective: To evaluate association between glomerular macrophage number and early treatment response in lupus nephritis class IV patients.

Late onset lupus nephritis: analysis of clinical manifestations and renal pathological features in Siriraj Hospital.

Background: Lupus nephritis (LN) is uncommon after the age of 50 years and studies of elderly patients with LN are rare. The authors conducted the current study to determine the clinical manifestations, pathological features and prognosis of 30 Thai patients with late onset LN in Siriraj hospital in Bangkok from 1989 to 2006.

Material And Method: Thirty LN patients with a disease onset beyond the age of 50 years from 1989 to 2006 were enrolled in this retrospective study.

Buttonhole technique better than area puncture technique on hemostasis and pain associated with needle cannulation.

Background: The buttonhole (constant site) arteriovenous fistulae cannulation technique, in which the inserted needle utilizes exactly the same site and the same angle every dialysis session, offers the advantage of an easier cannulation procedure, less pain associated with cannulation, and fewer complications when compared with the traditional method.

Objective: To compare buttonhole arteriovenous fistula (AVF) cannulation technique with area puncture method on the effect of hemostasis after needle withdrawal and pain during needle puncture.

Material And Method: The duration of hemostasis after needle withdrawal and pain during needle puncture of AVF were prospectively recorded in 21 chronic hemodialysis patients at Siriraj Hospital.

Acute kidney injury in primary nephrotic syndrome: report of nine cases in Siriraj Hospital.

Acute kidney injury is a rare but important complication of nephrotic syndrome. We demonstrated here nine patients with nephrotic syndrome and oliguric renal failure in Siriraj Hospital during 2007-2009. Renal biopsy was done in every patient.

Evaluation of atherosclerosis, arterial stiffness and related risk factors in chronic hemodialysis patients in Siriraj Hospital.

Background: Additional to traditional risk factors for cardiovascular disease (CVD), recent evidence demonstrates that nontraditional risk factors such as high-sensitive C-reactive protein (hsCRP), hyperhomocysteinemia and vascular calcification may cause progressive atherosclerosis in hemodialysis patients.

Objective: We aim to determine the prevalence of atherosclerosis and assess the arterial stiffness and related risk factors.

Material And Method: Common carotid artery intima-media thicknesses (CIMT), atherosclerotic plaque occurrence were determined by B-mode ultrasonography in 105 hemodialysis patients (mean age, 53 +/- 15.

Nephrotic syndrome in elderly patients: three years experience at Siriraj Hospital.

Background: The population age is being high and nephotic syndrome is a common renal disease.

Objective: To find the etiology and clinical manifestations of nephrotic syndrome in the elderly patients who underwent renal biopsy at Siriraj hospital including management and outcome.

Material And Method: Retrospective study in 76 nephrotic patients whose age > or =50 years and underwent renal biopsy between 2005-2007.

Malnutrition-inflammation score associated with atherosclerosis, inflammation and short-term outcome in hemodialysis patients.

Background: Malnutrition-Inflammation Score (MIS) has been proposed as a new quantitative system for assessment of malnutrition and inflammation, which are common important risk factors for increased morbidity and mortality in maintenance hemodialysis (MHD) patients.

Objective: To determine the MIS and related it to the presence of atherosclerosis, and the morbidity and mortality rate.

Material And Method: The inflammatory and nutritional status in 100 MHD patients was evaluated by serum high-sensitivity C-reactive protein (hs-CRP), Subjective Global Assessment (SGA), and MIS.

Arterial occlusion in nephrotic syndrome: report of four cases in Siriraj Hospital.

Venous thrombosis is commonly found in nephrotic syndrome, but arterial occlusion is never report in Thailand. Four cases with cerebral and femoral arteries occlusion were demonstrated. The early diagnosis and appropriate intervention can improve outcomes, reduce mortality and morbidity significantly.

Effect of short-term folate and vitamin B supplementation on blood homocysteine level and carotid artery wall thickness in chronic hemodialysis patients.

Objective: Hyperhomocysteinemia is an independent risk factor for atherosclerotic vascular disease in chronic hemodialysis patients. This stratified randomized controlled trial was designed to measure the effect of high dose oral vitamin B6, vitamin B12, and folic acid on homocysteine levels, and to evaluate the effect on atherosclerosis as measured by Intima-Media Thickness (IMT) of carotid arteries.

Material And Method: Fifty-four chronic hemodialysis patients with hyperhomocysteinemia were randomized to receive oral 15 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12 daily (treatment group) or oral 5 mg folic acid alone (control group) for 6 months.

An analysis of 3,555 cases of renal biopsy in Thailand.

Background: The knowledge of the epidemiology of biopsied renal diseases provides useful information in clinical practice. There are several epidemiologic population-based studies of biopsy-proven nephropathies with detailed clinicopathologic correlations that could be different according to the country analyzed.

Objective: To identify the prevalence of primary and secondary glomerular diseases and to study the trend of the pattern changes of the glomerulopathy in Thailand.

Efficacy of intradermal hepatitis B vaccination compared to intramuscular vaccination in hemodialysis patients.

Background: Hepatitis B virus infection remains an important problem in hemodialysis patients. Only 50 to 60% of the patients develop seroconversion (anti-HBs Ab titer > 10 IU/L) after intramuscular hepatitis B vaccination. Small dose intradermal inoculation method of hepatitis B vaccine has been reported to be effective as well as economical, and could provide rapid seroconvesion of immunity.

Relationship between hyperhomocysteinemia and atherosclerosis in chronic hemodialysis patients.

Background: Hyperhomocysteinemia is an independent risk factor of coronary artery heart disease (CAHD) and atherosclerosis in a normal population. However, it is still controversial in end-stage kidney disease patients who underwent long-term dialysis. Carotid intima-media thickness (IMT) is the standard non-invasive measurement of atherosclerosis.

Prednisone metabolism in recipients of kidney or liver transplants and in lung recipients receiving ketoconazole.

Background: Actual prednisone exposure in low-dose prednisone regimens, in part determined by cytochrome P450 metabolism, has been shown to be important for allograft survival.

Methods: Prednisolone (the principal active metabolite of prednisone) metabolism was determined in eight nontransplant patients and in transplant recipients receiving oral prednisone maintenance therapy (20 kidney and 6 liver recipients receiving cyclosporine [CsA] and eight lung recipients receiving ketoconazole and CsA or tacrolimus [FK506]).

Results: Prednisolone area under the curve (AUC)-dose-normalized (PNAUCn) to 1 mg/kg was 8,288+/-1,513 ng.

Proteinuria in "normal" cadaver kidney donors.

Background: More information is needed about cadaver organ donor pathophysiology.

Methods: We quantitated preprocurement, timed urine protein excretion in 23 "normal" cadaver kidney donors, and correlated results with urine protein dipstick readings and multiple other parameters. We also attempted to measure microalbuminia in 10 subjects.