Analysis of clinical characteristics of dialysis patients at the University Hospital.

OBJECTIVES: The incidence and prevalence of Chronic Kidney Disease (CKD) patients treated with dialysis has continued to increase worldwide. These patients are at the highest risk of developing cardiovascular complications which contribute to their demise. The objective of this study was to describe the clinical and demographic characteristics of the patients on maintenance hemodialysis at the University Hospital, in San Juan Puerto Rico. METHODS: We reviewed a total of 55 active patients. Data was collected to identify the demographic and clinical characteristics. Co-morbid conditions such as diabetes mellitus, hypertension, and coronary artery disease (CAD) were noted as well as age, dialysis vintage and social and educational profiles. RESULTS: Patients were divided into two groups according to age (group 1 were less than 60 years and group 2 were more than 60 years). Average age was 42 years in group 1 with 17 females and 24 males and 78 years in group 2 with 6 females and 8 males. Diabetes mellitus was present in 17 (41%) of group 1 and 5 patients (35%) of group 2. Likewise hypertension was present in 26 (63%) of group 1 patients and 11(78%) of group 2 patients. CAD was present in 15 (36%) of group 1 patients and 7 (50%) of group 2 patients. There was an association between low annual income in both groups but not in the level of education. CONCLUSION: A relatively young population was identified in our descriptive analysis of hemodialysis patients at the University Hospital. The expected high incidence of diabetes mellitus observed in the general population of hemodialysis patients in our country was not present. Hypertension and CAD were major risk factors in these patients. In view of these findings we recommend better control of blood pressure, prevention and early detection of CAD in CKD patients before initiating dialysis.

Kidney biopsy findings as prognostic factors of renal outcome in a case of ANCA-associated glomerulonephritis.

We present the case of a 29-year-old woman with twelve-years history of Wegener's granulomatosis and multiple relapses resulting in chronic kidney disease. The patient was referred to our center for kidney biopsy, after presenting with a relapse of Wegener's disease mainly manifested by rapid progressive glomerulonephritis. Kidney biopsy was obtained and she was treated with intravenous methylprednisolone and oral cyclophosphamide as initial therapy. Histopatological findings are described, followed by a discussion on how it can be used as a tool to established renal prognosis.