Correlation between Residual Renal Function and Hypertension in Regular Haemodialysis Patients

Objective: To evaluate the correlation between residual renal function and hypertension in regular haemodialysis patients. Background: Initiating chronic dialysis treatment gives end-stage renal disease patients a new lease on life. However, the annual mortality rate in dialysis patients is ~20% and quality of life is substantially reduced. Patients and Methods: This study was carried out on a reasonable number of subjects on regular haemodialysis divided into two groups. All were given informed consent and, the study was approved by the ethics committee of Menoufia University. Results: There was significant relation between presence of residual renal function and hypertension in patients with ESRD on regular haemodialysis, but the relation between residual renal function and control of hypertension is not statistically significant. 40% of group 1 were hypertensive, 66.7% of group 2 patients were hypertensive, the interdialytic weight gain mean was 1.42 in group 1 and 2.37 in group 2. Control of hypertension was achieved in 63.6% of group 1 patients by one drug, 27.3% patients by 2 drugs;however 9.1% of patients need 3 drugs to control their blood pressure, while in group 2 40% of patients were controlled by one drug, 45% with 2 drugs and 15% need 3 drugs to control blood pressure. Conclusion: There is significant relation between presence of residual renal function and hypertension in patients with ESRD on regular haemodialysis, but the relation between residual renal function and control of hypertension is not statistically significant.

Gastrointestinal symptoms in patients undergoing peritoneal dialysis: Multivariate analysis of correlated factors

AIM: To investigate gastrointestinal (GI) symptoms in peritoneal dialysis (PD) patients and to explore related factors contributing to GI symptoms. METHODS: One hundred and twelve patients undergoing PD participated in the study. The gastrointestinal symptom rating scale was used for measuring GI symptoms. Information on age, height, weight, body mass index, disease leading to chronic renal failure, history of corticosteroid therapy, presence of predialytic GI symptoms, daily dosage of pills, and duration, type and daily dialysate volume of PD was obtained by interviewing patients and/or reviewing the medical records. Hemoglobin, albumin and Kt/V data were obtained from follow-up database. We used multiple regression analysis with stepwise backward variable selection to test for factors predicting GSRS scores with significance level of selection entry at 0.05 and selection of stay at 0.10. RESULTS: The prevalence of eating dysfunction, reflux and indigestion in the PD patients was 44.2%, 32.7%,32.7%, respectively. A history of corticosteroid therapy (b = 8.93, P < 0.001) and all pills daily intake (b = 0.16, P = 0.007) were positively correlated to GI symptoms, while residual renal Kt/V (b =-3.47, P = 0.009) was negatively correlated to GI symptoms. Other factors were proven to be not associated with GI symptoms, with P > 0.05. CONCLUSION: Eating dysfunction, reflux and indigestion were common in PD patients. Daily dosage of pills and corticosteroid history predicted GI symptoms, while residual renal function prevented them.

Increasing the use of biocompatible,glucose-free peritoneal dialysis solutions

A major concern inhibiting some clinicians from embracing peritoneal dialysis(PD) as the preferred first modality of dialysis is the effects of PD solutions on the peritoneal membrane. These anatomical and functional changes predispose to complications like peritonitis,encapsulating peritoneal sclerosis and ultrafiltration failure. In recent years, "biocompatible" and glucosesparing PD regimens have been developed to minimize damage to the peritoneal membrane. Can the use of these more expensive solutions be justified on current evidence? In this review of the literature, we explore how we may individualize the prescription of biocompatible PD fluid.

Clinical Study on Zhengan xifeng（镇肝熄风）Decoction in Preventing and Treating Hypertensive Nephropathy

Seventeen cases of hypertensive nephropathy with azotemia (test group) treated with Zhen-gan Xifeng Decoction (ZGXFD) and a routine regimen of Western Medicine were observed. The result wascompared with that of 15 cases treated with routine regimen alone(control. group) . After 3 months of treat-ment, the blood pressure, sodium excretion, blood urea nitrogen and creatinine were all reduced, while cre-atinine clearance rate (CCr) and residual renal function index(RRFI) were improved significantly in bothgroups. Compared with the control group, the treatment on the test group showed a more prominent effect onlowering of diastolic blood pressure, elevating the hemoglobin, reducing the blood level of triglyceride andcreatinine as well as improving on CCr and RRFI , suggesting the deterioration of residual renal function couldbe restrained by ZGXFD , through improving the disorder of lipid metabolism, osmolality gradient and creati-nine kinetics.