Subject(s)
Carcinoid Tumor , Granulomatosis with Polyangiitis , Lung Neoplasms , Humans , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/diagnosis , Lung Neoplasms/diagnosis , Lung Neoplasms/diagnostic imaging , Lung/pathology , Carcinoid Tumor/complications , Carcinoid Tumor/diagnostic imaging , Carcinoid Tumor/surgeryABSTRACT
Background and Objectives: Hypertension affects at least 80% of hemodialysis patients. Inappropriate control of blood pressure is mentioned as one of the essential cardiovascular risk factors associated with development of cardiovascular events in dialysis populations. The aim of the cross-sectional, retrospective study was the evaluation of the antihypertensive treatment schedule and control of blood pressure in relation to the guidelines in the group of hemodialysis patients. Additionally, we assessed the level of decrease in blood pressure by each group of hypotensive agents. Materials and Methods: 222 patients hemodialyzed in a single Dialysis Unit in three distinct periods of time-2006, 2011, and 2016-with a diagnosis of hypertension were enrolled in the study. The analysis of the antihypertensive treatment was based on the medical files and it consisted of a comparison of the mean blood pressure results reported during the six consecutive hemodialysis sessions. Results: The mean values of blood pressure before hemodialysis were as follows: 134/77, 130/74, and 140/76 mmHg, after hemodialysis 124/74, 126/73, and 139/77 mmHg in 2006, 2011, and 2016 respectively. The goal of predialysis blood pressure control (<140/90) was achieved by up to 64.3% of participants in 2006 as compared to 49.4% in 2016. Additionally, the postdialysis goal (<130/90) reached 57.1% of the study population in 2006 as compared to 27.1% of patients in 2016. The differences in percentage of patients using single, double, triple, and multidrug therapy during observation were not statistically significant. The most often used drugs were ß-blockers, diuretics, and calcium channel blockers in all points of the study. Blockades of the renin-angiotensin-aldosterone system in 2006 and calcium channel blockers in 2011 and 2016 were the drugs with highest impact on lowering blood pressure. Conclusions: The goal of predialysis or postdialysis blood pressure control was achieved in a lower percentage of patients during the period of the study. Blockade of renin-angiotensin-aldosterone system and calcium channel blockers decrease the blood pressure significantly. It is necessary to achieve better control of blood pressure in prevention of cardiovascular incidents.
Subject(s)
Antihypertensive Agents , Hypertension , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Blood Pressure , Calcium Channel Blockers/therapeutic use , Cross-Sectional Studies , Drug Therapy, Combination , Humans , Hypertension/drug therapy , Hypertension/epidemiology , Leprostatic Agents/pharmacology , Leprostatic Agents/therapeutic use , Renal Dialysis , Retrospective StudiesSubject(s)
COVID-19 , Coinfection , Kidney Transplantation , Pneumonia, Pneumocystis , Humans , SARS-CoV-2Subject(s)
Aneurysm/complications , Aneurysm/therapy , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/mortality , Granulomatosis with Polyangiitis/therapy , Hematoma/therapy , Hemorrhage/etiology , Kidney Neoplasms/therapy , Aneurysm/physiopathology , Anti-Infective Agents/therapeutic use , Embolization, Therapeutic/methods , Granulomatosis with Polyangiitis/physiopathology , Hematoma/diagnosis , Hematoma/etiology , Hematoma/physiopathology , Hemorrhage/therapy , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/etiology , Kidney Neoplasms/physiopathology , Male , Middle Aged , Rare Diseases , Renal Artery/physiopathologyABSTRACT
BACKGROUND: Dietary supplements (DS) are available over the counter, but patients with impaired renal function are specifically at risk for toxicity when consuming certain DS. The aim of this study was to evaluate the prevalence and characteristics of DS use in patients with chronic kidney disease (CKD). MATERIAL AND METHODS: A cross-sectional, controlled DS use survey (22 questions) was conducted among 180 CKD patients (stage 1-5, dialysis, kidney transplant), with 60 patients without CKD serving as controls. RESULTS: DS use did not differ significantly between subjects with and without CKD, unless the CKD patients were on dialysis. In the CKD group, 20% admitted to use DS regularly and 22% did not take the mat all. In the controls, DS consumption was 17% and 13%, respectively (NS). The DS use was higher among women ascompared to men (89% vs. 70%; p < 0.005), and people living in cities versus those living in the country side (81% vs. 63%; p < 0.05). DS most commonly used were: vitamins, minerals, and herbs. Major indications for DS use included: musculoskeletal issues, general health improvement and prevention of urinary tract infections. Subgroup analyses revealed that dialysis patients were characterized by a significantly higher DS use in comparison to CKD stage 1-5 subjects and renal transplant recipients. The decision to introduce DS was made by the physician in 54% of cases; by a pharmacist in 9% of cases, and by the patients themselves in 37%. Only 21% of patients with CKD, and 27% of subjects without CKD, declared knowledge of any possible side-effects associated with DS (NS). CONCLUSIONS: The use of DS among patients with CKD is similar to patients without CKD, with the exception of those on dialysis. Vitamins and minerals were the most commonly reported DS consumed. The knowledge on potential side-effectof DS was limited to approximately one-fourth of those surveyed.
