bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual inverse effects of lipoprotein(a) on the dementia process in Japanese late‐onset Alzheimer's disease
Authors: IWAMOTO Toshihiko , WATANABE Daisuke , UMAHARA Takahiko , SAKURAI Hirofumi , HANYU Haruo , KANAYA Kiyoshi 
Published: January 2005

AbstractBackground: The role of lipoprotein metabolism in the dementia process has attracted increasing attention. It is universally accepted that apolipoprotein E4 (ApoE) is a risk factor for late‐onset Alzheimer's disease, however, the role of lipoprotein(a) (Lp(a)) remains unclear. Therefore, we conducted the present study to clarify the association between Lp(a) and dementia.Methods: Lipoprotein(a) serum concentrations were examined in relation to ApoE phenotypes and periventricular lucency (PVL) on brain computed tomography in 150 patients with late‐onset Alzheimer's disease (AD group), compared with 46 patients with vascular dementia (VaD group) and 150 controls without dementia.Results: The incidences of hypertension, hypercholesterolaemia, and severe PVL were significantly higher in the VaD group than in the AD group. The distributions of Lp(a) concentrations showed left‐skewed deviation in each group, but we found the concentration of 40 mg/dL to be the best cut‐off point to distinguish the frequency of Alzheimer's disease from that of the controls. Compared with the frequency of high Lp(a) concentrations of 40 mg/dL or more in the controls (16.7%), that in the AD group (10.0%) was significantly lower, while that in the VaD group (45.7%) was significantly higher. Separating the AD group according to the presence or absence of ApoE4, the same findings were recognized. However, severe PVL was more frequent in the AD group with high Lp(a) concentrations (53.3%) than in the AD group without high Lp(a) concentrations (7.4%) (P < 0.01).Conclusions: These findings suggest the possibility of dual inverse effects of Lp(a) on the occurrence of Japanese late‐onset Alzheimer's disease, via suppression of Alzheimer's related processes and promotion of PVL formation presumably caused by ischemia.
Urea kinetics are not representative for the behavior of other small and water‐soluble compounds
Authors: Eloot S. , De Smet R. , Torremans A. , De Wachter D. , Marescau B. , De Deyn P.P. , Verdonck P. , Vanholder R. 
Published: January 2005

Scanty data suggests that large solutes show a kinetic behavior that is different from urea. The question investigated in this study is whether other small water‐soluble solutes such as some guanidino compounds show a kinetic behavior comparable or dissimilar to that of urea.This study included 7 stable conventional hemodialysis patients without residual diuresis undergoing low flux polysulphone dialysis (F8 and F10HPS). Blood samples were collected from the inlet and outlet blood lines before the dialysis session, after 5, 15, 30, 120 minutes, and immediately after discontinuation of the session. Plasma concentrations of urea, creatinine (CTN), creatine (CT), guanidinosuccinic acid (GSA), guanidinoacetic acid (GAA), guanidine (G), and methylguanidine (MG) were used to calculate corresponding dialyzer clearances. A two‐pool kinetic model was fitted to the measured plasma concentration profiles, resulting in the calculation of the perfused volume (V1), the total distribution volume (Vtot), and the inter‐compartmental clearance (K12); solute generation and ultrafiltration were determined independently.No significant differences were observed between V1 and K12 for urea (6.4 ± 3.3 L and 822 ± 345 mL/min) and for the guanidino compounds. However, with respect to Vtot, GSA was distributed in a smaller volume (30.6 ± 4.2 L) compared to urea (42.7 ± 6.0 L − P < 0.001), while CTN, CT, GAA, G, and MG showed significantly larger volumes (54.0 ± 5.9 L, 98.0 ± 52.3 L, 123.8 ± 66.9 L, 89.7 ± 21.4 L, and 102.6 ± 33.9 L, respectively). These differences resulted in markedly divergent effective solute removal: 67%(urea), 58%(CTN), 42%(CT), 76%(GSA), 37%(GAA), 43%(G), and 42%(MG).In conclusion, the kinetics of the guanidino compounds under study are different from that of urea; hence, urea kinetics are not representative for the removal of other uremic solutes, even if they are small and water‐soluble like urea.
Quotidian dialysis  Survival in 221 patients treated by short daily hemodialysis for 315 patient years
Authors: Kjellstrand C. , Ting G. , Traeger J. , Sibai‐Galland R. , Blagg C.R. , Young B. 
Published: January 2005

Daily hemodialysis greatly improves clinical and biochemical parameters and patient quality of life compared to conventional thrice weekly dialysis. However, mortality statistics are lacking as most centers providing daily dialysis have treated only a small number of relatively selected patients for relatively short observation times. To study patient survival we pooled experience from three sources: 51 French and 128 U.S. patients selected for daily home hemodialysis and 42 U.S. patients selected for short daily center hemodialysis because of many medical complications and cardiovascular instability. Results were compared to age‐matched patients from the USRDS 2003 data base. The age of the patients was 51 ± 16 (18–89) years; 29% were female; they had 3.3 ± 1.8 comorbidities (twice that of USRDS patients); 32% had diabetes or hypertension as cause of renal disease (USRDS patients 70%); blood access was 61% fistulae, 25% grafts, and 14% CV‐catheters. Mean duration of ESRD treatment at start of short daily hemodialysis was 6 ± 7 years.The observation period was 315 patient years. Patients had been on daily hemodialysis for a mean of 17 ± 18 (0–92) months and 11 patients were observed for more than 5 years. 35 of the 221 patients died (16%); deaths were 111 per 1,000 patient years (53% of expected) and 5‐year cumulative survival was 63% compared to 32% for USRDS patients. Five‐year survival was 0% in patients with >3 comorbidities, 75% in patients with <3 comorbidities (p < 0.0001), and in patients aged <53 years was 80% vs. 50% in patients aged >53 years (p = 0.0007). On Cox stepwise hazards analysis, comorbidity alone predicted survival when used with age. Comorbidity >3 HR = 6.00 (95% CI 2.2–16.3). Conclusions: It is difficult to do survival comparisons between patient groups. However, these daily dialysis patients were age‐matched with patients from the USRDS database. There were fewer diabetic and hypertensive patients but the comorbidity index was twice that of USRDS patients. Survival, both deaths per 1,000 patient years and cumulative count was approximately twice that reported by the USRDS and strongly suggests superior survival with short daily hemodialysis compared to thrice weekly conventional dialysis.
Infections  Recurrent empyema due to Salmonella enteritidis in a patient on hemodialysis
Authors: Hung Y.M. , Chou K.J. , Chung H.M 
Published: January 2005

Objective:
Pleural involvement of salmonella infection is very rare and we are not aware of any case of salmonella empyema in hemodialysis patients. The purpose of this study is to report our experience of recurrent empyema due to Salmonella enteritidis with bacteremia in a patient on hemodialysis. Case report: A 53‐year‐old woman with end stage renal disease, having been on hemodialysis for 10 days, was brought to the emergency department due to fever and shortness of breath for 2 days. Her initial physical examination revealed diminished breathing sound over right lung field. The chest radiographs disclosed right pleural effusion and pleural fluid analysis included a white cell count of 13800(N/L:95/5), LDH 2534 U/L, protein 2.7 g/dL, and sugar 10 mg/dL. Right side empyema was noted. Sonography revealed splenomegaly. Salmonella enteritidis was identified from the cultures of blood and pleural fluid. After antimicrobial therapy with intravenous ceftriaxone for 2 weeks and pleural pigtail drainage, fever subsided and pleural drainage tube was removed. However, thoracoscopic debridement was done later because of recurrent empyema within one week after removing the drainage tube. Computed tomography revealed pleural effusion, pericardial effusion, and splenomegaly, but there was no evidence of aortic aneurysm formation or infectious process of aorta. Overall the patient received 6 weeks of intravenous ceftriaxone treatment and 3 months of oral ciprofloxacin. The follow‐up CXR revealed minimal pleural effusion. Conclusion:  Nontyphoidal salmonella infection can present with empyema and bacteremia in patients on hemodialysis. Adequate drainage and antimicrobial therapy may be necessary to treat such patients effectively.
Early onset catheter‐associated bacteremia (CAB)
Authors: Troidle L. , Finkelstein F.O. 
Published: January 2005

Bacteremia is a common complication for hemodialysis (HD) patients (pts) with an indwelling central venous catheter (CVC). We studied our experience with CAB and noted that CAB occurred at an average of 96 ± 98 days after CVC insertion. We wondered what percentage of CAB occurred in the first 21 days after CVC insertion and the spectrum of organisms. We prospectively collected data on all HD pts from 3 centers with a CVC who developed bacteremia between 1/1/03 and 8/31/04. Pts who developed CAB with an identifiable source of bacteremia were excluded. 131 episodes of CAB were identified; 34 (25.95%) occurred in ≤21 days. The mean ± SDEV age of the pts developing CAB > 21 days and ≤21 days was 63 ± 17 and 61.5 ± 15.4 years, respectively. Table 1 outlines the spectrum of organisms. There was a significantly greater incidence of CAB with Staphylococcus aureus(SA) and a significantly lower incidence of Staphylococcus epidermidis(SE) in the pts in whom a CAB developed ≤21 days after insertion.
Table 1

<21 Days
>21 Days
P‐Value

SA
20 (58.8%)
21 (21.6%)
p < 0.01

SE
2 (5.9%)
30 (30.9%)
p < 0.05

Other GP*
7 (20.6%)
15 (15.5%)
NS

GN^
9 (26.5%)
40 (41.2%)
NS

*GP: gram‐positive; GN∧: gram‐negative

We conclude that CAB occurs in the first 21 days after CVC insertion in 25% of our CVC pts. Pts developing CAB in the first 21 days are more likely to develop CAB with SA and less likely to develop CAB with SE than pts who develop CAB after 21 days. Empiric antibiotic choice and preventative strategies need to take these data into consideration.
Morbidity and mortality: Profile of patients on renal replacement therapy in the private sector
Authors: Samaai R., , Uys H. 
Published: January 2005

Introduction:
The aim of renal replacement therapy (RRT) is to achieve a reduction in morbid events and improve quality of life (QOL). Mortality means the condition of being subject to death. Morbidity is anything that is abnormal, atypical, exceptional, and/or aberrant. Morbidity usually occurs as a result of a treatment (side effects), when treatment is inappropriate or inadequate. Predictors that may be risk factors for mortality and morbidity in dialysis patients can be divided into patient‐related and treatment‐related categories (Khan, 2000:11). Purpose of the study: The purpose of this retrospective study was to determine the morbidity and mortality profile of patients receiving RRT in the private sector. Research design and method: This study was contextual and descriptive in nature, based on case analysis of patients receiving RRT in private dialysis facilities. A checklist was used that made provisions to record all patient‐ and treatment‐ related factors that might influence mortality and morbidity profiles of the target population. The target population included all hemodialysis and peritoneal dialysis patients receiving treatment in private dialysis facilities of a specific company. Results: The results indicated the following factors have an influence on patient morbidity and mortality:

Patient related: Age, comorbid situations such as peripheral vascular, cerebrovascular, and cardiovascular disease and also diabetes mellitus.
Treatment related: Referral pattern, nutritional status, dialysis adequacy, anaemia, and blood pressure.
Severe hypercalcemia caused by Milk‐Alkali syndrome requiring urgent hemodialysis – Tums by the ton
Authors: Rai A. , Whaley‐Connell A. , Khanna R. 
Published: January 2005

An increased frequency of the Milk‐Alkali syndrome in the last several years has been noticed related to increasing use of calcium carbonate as a phosphate binder in CKD patients, as an antacid or as calcium supplementation. We present a case of severe hypercalcemia secondary to Milk‐Alkali syndrome that precipitated acute renal failure requiring urgent hemodialysis. A 59‐year‐old male with history of hypertension, diabetes mellitus, and acid reflux presented to the ER with confusion, lethargy, nausea, vomiting, and diarrhea. His family relayed a history of recent indigestion and relief with Tums. He was taking several tablets at short intervals to self‐treat the indigestion. At the time of presentation, patient was confused and noted to be dehydrated. Lab findings were significant for elevated BUN/Cr‐ 121 mg/dl/11.1 mg/dl (baseline Cr 1.1 mg/dl few months ago), bicarbonate 38 mg/dl, calcium 16.7 mg/dl, ionized Ca of 1.76 mmol/L, iPTH 10 pg/ml, PTHrP 0.7 pg/ml. Medical management with intravenous fluids and furosemide showed no improvement in renal failure, or calcium level. Patient was then started on hemodialysis with 2.0 mmol/L calcium in the dialysate the next day. There was gradual improvement in patient's mental status, calcium values, and renal failure over the ensuing 2 weeks.
Discussion and Conclusions:
The diagnosis of Milk‐Alkali syndrome is made on the basis of history. Metabolic abnormalities involved in this syndrome are hypercalcemia with low to normal PTH and Vit. D levels, renal failure, and metabolic alkalosis. Failed medical management required acute dialysis in this patient. Acute hemodialysis in such a case could be life saving. Due to increasing use of calcium carbonate for dyspepsia and osteoporosis, patients should be made aware of these severe, potentially life‐threatening adverse effects.
Experimental study on a new type citrate anticoagulant hemodialysate in dogs
Authors: Baosong G. , Ning N. , Ganglian Y. , Lin G. , Liangqi W. , Ruijun G. 
Published: January 2005

Objective:
In this study, we initiated a new hemodialysate with citrate buffer, observed the factors that influence the citrate concentration of solution in hollow fibers when using citrate hemodialysate, and observed the anticoagulant effect and safety of the citrate hemodialysate in the experiment in dogs. Methods: Ten dogs were given intermittent hemodialysis and were divided into 3 groups according to hemodialysis procedures. Group 1 was saline‐flush hemodialysed with bicarbonate hemodialysate; Group 2 was hemodialysed with citrate hemodialysis without any anticoagulant; Group 3 was hemodialysed with bicarbonate hemodialysate and heparin. ACT, Ca++, BUN, Cr, ALT, AST, TBIL, DBIL, Na+, Cl−, , and venous pressure were monitored in the animals of each group during hemodialysis. Results: During the hemodialysis in Group 1, venous pressure increased lastingly, resulting in the failure of hemodialysis for 2 hours. Hemodialysis for 2 hours in Group 2 were all finished successfully. ACT was extended and Ca++ decreased obviously in the venous end during hemodialysis. And ALT, AST, Ca++, K+, Na+, Cl−, after the hemodialysis in Group 2 were not changed (P > 0.05). Moreover, the clearance rate of the dialyzers with citrate dialysate increased significantly compared with those of saline‐flush and heparin anticoagulation. Conclusions: The anticoagulant and dialytic effects of the new type citrate hemodialysis are satisfactory and better than that of saline‐flush.
Multiple factors affect 3‐year survival of patients on chronic hemodialysis
Authors: Sugahara S. , Kanno Y. , Moriwaki K. , Ikeda N. , Takane H. , Kotaki S. , Aoki H. , Ooshima J. , Suzuki H. 
Published: January 2005

Objective:
The aim of this study is to determine the factors contributing to survival of patients on hemodialysis. Methods: Data were collected from 8 dialysis centers, and 432 patients were recruited. Among them, patients who underwent hemodialysis thrice a week for more than 3 years and received antihypertensive therapy or had systolic blood pressure of more than 160 mm Hg before dialysis secession were selected. Subsequent survival status and cause of death were ascertained for the next 3.5 years. The logistic multivariate regression analysis was used to estimate the relative risk of death. Variables used for the purpose of this analysis were patient gender, age, underlying renal disease (unknown and others (0), CGN (1), DM (2)), medication, serum albumin, history of having cerebrovascular and/or cardiovascular accidents (yes or no), the levels of serum creatinine, blood urea nitrogen, pre‐ and post‐dialysis blood pressure (systolic and diastolic), hemoglobin, serum calcium and inorganic phosphate, β2‐microglobulin, intact PTH, and other laboratory data. Results: First step logistic regression analysis indicated age, underlying renal diseases, serum creatinine, GOT, β2‐microglobulin were associated with increased relative risk (RR) of dying. According to the formula calculated in this analysis, if the levels of serum creatinine increased 1 mg/dl, the ratio of dying increased by 1.210. Also, compared to the patients aged between 50 to 64 years old, the patients aged between 65 to 90 years old had 1.521 times dying ratio. Conclusions: From this study, it is suggested that age, creatinine, underlying renal diseases, β2‐microblobulin, past history of cerebrovascular disease, serum creatinine, and GOT were important factors contributing to patients’ survival.
Vitamin D receptor BsmI and TagI gene polymorphisms in Turkish ESRD population and influences on parathyroid hormone response
Authors: Sezer S. , Özdemir F.N. , Tutal E. , Sahin F. , Akcay A. , Haberal M. 
Published: January 2005

Background/Aim:
Clinical presentation and complications of end‐stage renal disesase (ESRD) patients are under influence of many enviromental and genetic factors. In this study we aimed to define frequencies of BsmI and TagI Vitamin D receptor (VDR) gene polymorphisms and possible influences on clinical presentations in Turkish ESRD population. Methodology and Patients: 186 patients (111 male, 75 female) who are being maintained on hemodialysis were included. Genotyping was performed for the insertion/deletion BsmI (B→b, restriction site, exon VIII→IX), TagI (T→t, 352 exon IX) VDR gene polymorphisms. Last 12 months’ laboratory values (C‐reactive protein, intact parathyroid hormone, albumin, calcium, phosphorus, Ca x P product) and clinical findings (vitamin D requirement, body weight) were recorded and analysed retrospectively. Results: Mean age and follow‐up period lengths were 42.1 ± 12.6 years and 76.3 ± 43.9 months, respectively. Polymorphism percentages were as follows: BsmI; BB/Bb/bb: 28.9/65.3/5.8%, TagI; TT/Tt/tt: 36.7/60.5/2.8%, respectively. Further analysis revealed that TT variant of TagI was related with hyperparathyroidism (p < 0.05). Analysis of data after regrouping patients according to iPTH levels (0–249, 250–499, 500 + pg/mL) and hemodialysis duration (<60 vs ≥60 months) revealed that influence of TT variation on hyperparathyroidism became more frequent in case of increased hemodialysis duration and iPTH levels (p < 0.005). Conclusion: TT variation of TagI VDR gene influences the development of hyperparathyroidism in HD patients. This influence becomes more evident in patients with longer HD duration.
Central venous stenosis in chronic hemodialysis patients: The effect of percutaneous angioplasty and stenting
Authors: Yoon J.M. , Park J.A. , Jung H.A. , Kim Y.O. , Kim Y.S. , Yoon S.A. , Kim S.Y. , Chang Y.S. , Bang B.K. 
Published: January 2005

Background:
Central venous stenosis in chronic hemodialysis patients occurs in about 17% of all venous stenosis and it is associated with central vein catheterization. We evaluated the effect of percutaneous angioplasty and stenting in the treatment of central venous stenosis in hemodialysis patients. Methods: We retrospectively investigated the medical records of a total of 31 dialysis patients who had central venous stenosis. We reviewed the causes of central venous stenosis, clinical manifestations, venographic findings, and patency rate of radiological intervention. Results: Of the total 31 patients, 28 patients had past history of central vein catheterization ipsilateral to vascular access. Mean duration of the catheterization was 32 ± 14 days. Venography showed complete obstruction of central vein (n = 14) and stenosis (n = 17). The site of venous lesion was right subclavian vein (n = 11), innominate vein (n = 9), left subclavian vein (n = 7), and superior vena cava (n = 14). A total of 30 procedures of angioplasty with or without stenting were performed in 26 of 31 patients. Initial success rate was 96.1% and there was no severe complication such as rupture or bleeding. The primary patency rate at 6, 12, 24, and 48 months after the procedure was 87.3%, 75.6%, 67.9%, and 65.4%, respectively. The cumulative patency rate at the same time point was 96.0%, 90.6%, 74.0%, and 72.8%, respectively. Conclusion: Our data suggest that angioplasty with or without stenting is safe and effective in the treatment of central venous stenosis in hemodialysis patients.