Purpose: End-stage renal disease (ESRD) patients exhibit silent white-matter alterations after long-term hemodialysis, which may be due to ESRD itself or the hemodialysis. The purpose of this study was to investigate the longitudinal white-matter alterations in the ESRD patients under 3-year long-term hemodialysis using voxel-wise analysis of diffusion tensor imaging (DTI).
Materials And Methods: 15 ESRD patients and 15 age-matched healthy controls participated in this study. Due to the development of abnormal brain lesions in some cases, 13 ESRD patients and 13 age-matched healthy controls were enrolled and underwent cognitive function assessment and DTI acquisition at two-time points separated by 3 years. Voxel-based analysis was performed to globally detect white-matter alterations between the two groups as well as between the two scans within the two groups.
Results: In the ESRD patients, diffusivity indices were significantly increased and the fractional anisotropy was significantly decreased in both scans, as compared with healthy controls. Longitudinal comparisons showed significant white-matter alterations in healthy controls in three years, but little or no significant alterations were noted in the ESRD patients after additional 3-year hemodialysis.
Conclusion: Poorer white matter integrity and cognitive function are noted in ESRD patients and the toxic effect of ESRD may be the major factor of white matter alterations.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490894 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215942 | PLOS |
Introduction: Patients with end-stage renal disease usually undergo hemodialysis as a way of renal function replacement therapy which comes with a wide array of systemic and cutaneous complications. The aim of this study was to evaluate the most frequent dermatological manifestations including xerosis, pruritis and other nail, hair and oral conditions, as these are a very important aspect to be considered while managing the patients psychological and physical needs to improve their outcomes and quality of life.
Methods: This retrospective cross-sectional study was performed by selecting 77 patients on hemodialysis based on a certain criteria and data was then collected on a sheet using patients database on Hakeem National E-Health Program, in addition to information from interviews with patients during their hemodialysis sessions after taking an oral informed consent and insuring patients' privacy.
Am J Obstet Gynecol MFM
January 2025
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, Ohio 45267, USA. Electronic address:
Background: Chronic kidney disease is a significant cause of adverse obstetric outcomes. However, there are few studies assessing the risk of severe maternal morbidity and mortality among patients with chronic kidney disease and no studies assessing the association between individual indicators of severe maternal morbidity and chronic kidney disease.
Objective: To evaluate the risk of severe maternal morbidity and mortality among pregnant patients with chronic kidney disease.
Cardiovasc Drugs Ther
January 2025
Department of Cardiovascular Science, Ascension St, Thomas Hospital, University of Tennessee Health Science Center, Nashville, TN, USA.
Purpose: Heart failure (HF) management is well-defined for reduced ejection fraction (HFrEF) but less so for mildly reduced (HFmrEF) or preserved ejection fraction (HFpEF). This meta-analysis evaluates the impact of Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, on cardiovascular and renal outcomes in these patient populations.
Methods: A systematic search in PubMed and Embase identified randomized controlled trials (RCTs) on Finerenone's cardiovascular and renal effects.
BMJ Open
January 2025
Bio Heart Cardiovascular Diseases Research Group, Bellvitge Institute for Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain.
Introduction: Chronic hand ischaemia may affect some haemodialysis patients with an arteriovenous fistula (AVF) or graft (AVG), a condition known as haemodialysis access-induced distal ischaemia (HAIDI). Duplex ultrasonography (DUS) can provide comprehensive insights into anatomical and perfusion properties, and measuring the hand acceleration time (HAT) has been demonstrated to be sensitive within the framework of chronic upper limb ischaemia.
Methods And Analysis: This single-centre, prospective cohort study will involve adult end-stage renal disease (ESRD) patients requiring either AVF or AVG for haemodialysis.
Background: Choline alfoscerate, a cholinergic precursor, is widely used in Korea for dementia-related symptoms and is covered by national health insurance (NHI). This study investigates the utilization trends and factors influencing choline alfoscerate prescription in newly diagnosed Alzheimer's disease (AD) patients using real-world data.
Methods: We analyzed data from the Health Insurance Review and Assessment Service (HIRA) for patients aged 60 years and older who were newly diagnosed with AD between 2012 and 2019.
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