ABSTRACT
Doppler ultrasonography is the main modality for imaging of hemodialysis AV ?stula as it is safe and non-invasive. This study is to measure the Arterio-venous (AV) ?stula blood ?ow during early postoperative period (0–7days) and assess its role in AV ?stula failure prediction. Doppler ultrasonography was used to estimate the blood ?ow in the AV ?stula of 50 patients at (0–7days) after the ?stula was made. The blood ?ow in ?stula during early postoperative period for ?stula failure was evaluated, and long term failure was predicted. Blood ?ow rates Method measured in arteriovenous ?stula created in upper extremity were measured in ?rst week and sixth week post-operative. Results After follow up evaluation out of 50 patients, 40 ?stulas considered to be matured; 10 considered failed. 30% failure were males and 70% were female. In early post operative period, cut off was set at 182 ml/min and the sensitivity of blood ?ow for prediction of ?stula failure is 98%, speci?city 90 %, PPV 95% and NPV 90%. Measurements of the AV ?stula blood Conclusion ?ow in proximal artery and draining vein with its diameter of lumen were noted in the early postoperative period has a role predicting AV ?stula failure. There is risk of failure if the blood ?ow less than 182 ml/min (day 0–7)
ABSTRACT
Background: Chronic kidney disease is a major public health problem worldwide with continuously increasing incidence and prevalence. Diabetes and hypertension are the leading causes of chronic kidney disease worldwide, whereas hypertension is a cause as well as effect of chronic kidney disease. Objectives: To evaluate and analyze the echocardiographic changes in the end stage renal disease patients on maintenance haemodialysis by the help of 2-D echocardiography. Materials and methods: End stage renal disease (ESRD) patients who were on maintenance haemodialysis for at least 3 months, in MG hospital were included in the study. We performed 2- Dechocardiography in 50 ESRD patients during inter-dialytic period. Patients with clinical evidence of coronary artery disease, previous history of hypertension, valvular heart disease, congenital heart disease and pericardial effusion were excluded from this study. Results: out of 50 chronic kidney disease patients, echocardiography revealed LVH in 29 (58%) patients, LVDD in 25(50%) patients, pericardial effusion in 10 (20%) patients, pulmonary hypertension in 23(46%) patients, dilated left atrium in 14(28%) patients, dilated left ventricle in 4 (8%) patients and regional wall motion abnormalities in 3 (6%) patients. Hypertension was present in Saxena N, Dhamija JP, Saxena S. Role of 2-D echocardiography in detecting cardiovascular abnormalities in chronic kidney disease patients: Case series of 50 chronic kidney disease patients. IAIM, 2017; 4(1): 122-126. Page 123 46 (92%) out of 50 CKD patients out of which LVH was in 29 patients. Severe Anaemia was present in 10 (20%) patients. Conclusion: LV diastolic dysfunction and left ventricular hypertrophy were the most common and significant echocardiographic findings among 50 CKD patients. There was statistically significant correlation between anaemia and the presence of left ventricular hypertrophy and positive correlation between presence of hypertension and left ventricular hypertrophy.
ABSTRACT
Background: Chronic kidney disease (CKD) is a major public health problem worldwide with increase in incidence and prevalence. Diabetes and hypertension are the leading cause of CKD worldwide, whereas hypertension is a cause as well as effect of CKD. Objectives: To evaluate and analyze the echocardiographic changes in the end stage renal disease patients on maintenance hemodialysis. Materials and methods: End stage renal disease (ESRD) patients who were on maintenance Haemodialysis for at least 3 months, in MG hospital were included in the study. We performed 2D echocardiography in 35 ESRD patients during inter-dialytic period. Patients with clinical evidence of coronary artery disease, valvular heart disease, congenital heart disease and pericardial effusion were excluded from the study. Results: Out of 35 ESRD patients, echocardiography revealed LV dilatation and diastolic dysfunction in 18 patients (51.2%) , LV hypertrophy in 17 patients (48%), systolic dysfunction and pericardial effusion in 10 patients (28.57%) and 6 patients (17.14%) respectively. RWMA was present in 3 patients (8.5%) and no valvular calcification was seen in any patient. In a sub group of 21 patients with Hb <10g%, LVH was present in 15 patients (71.42%) vs 2 out of 14 patients (14.28%) in patients group with Hb >10 g%. Hypertensive patients were 27 of 35 ESRD patients, 13 out of 27 had Dhamija JP, Saxena N, Saxena S. Evaluation of 2-D echo findings in chronic kidney disease: Case study of 35 end stage renal disease patients. IAIM, 2016; 3(9): 61-65. Page 62 higher prevalence of LVH (51.85%). Systolic dysfunction and RWMA was absent in normotensive group. Conclusion: LV diastolic dysfunction and hypertrophy were most common echocardiographic findings. There was statistically significant correlation between anaemia and presence of LVH and positive correlation between presence of hypertension and LVH.
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Purpose: Aim of this study is to review the simultaneous pancreas and kidney transplantation (SPK) cases performed in Seoul National University Hospital for DM nephropathy patients. Methods: Medical records of the SPK recipients from April 2002 to February 2006 were reviewed and analyzed retrospectively. Results: There were 10 cases of SPK transplantation in SNUH from April 2002 to February 2006, which were composed of 8 type II DM patients and 2 type I DM patients. We experienced 1 operative mortality case and 3 acute rejection cases. All the acute rejection cases were recovered by steroid pulse therapy. We performed two graft pancreatectomy operations due to CMV infection followed by duodenal perforation and severe graft pancreatitis with pancreatic leakage. With the exception of 1 mortality case and 2 graft loss cases, all 7 patients stopped insulin and oral hypoglycemic agent and are keeping blood glucose level within normal range. Conclusion: Although patient follow-up is limited up to four years, SPK recipients are free from insulin use and show good graft functions. SPK could be a good treatment modality for insulin dependent type II DM nephropathy patients.