Keywords : hemodialysis


Lipid Profile in Children with Chronic Renal Failure Undergoing Hemodialysis

Nariman F. Ahmed Azat; Qahtan M. Ali

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 2, Pages 222-228

ABSTRACT:
BACKGROUND:
Dyslipidemia is common in Patients with chronic renal failure undergoing intermittent haemodialysis and is considered a risk factor of cardiovascular disease in these patients.
OBJECTIVE:
To highlight the lipid profile abnormalities in children with end stage renal disease undergoing maintenance hemodialysis and know whether the hemodialysis duration and frequency of sessions per week has any impact on lipid profile in these patients.
PATIENTS AND METHOD:
A case-control study which was collected in the dialysis unit of (Al Karama Teaching Hospital, Child's Central Teaching Hospital , Al Kadhumia Teaching Hospital and Ibn Al Balady Hospital) for six months started on 1st June 2013 till the 1st of December 2013. Blood samples were obtained from 40 patients with end stage renal disease undergoing maintenance haemodialysis (2-3 sessions per week) and 40 matched healthy controls and analyzed for serum total cholesterol, low density lipoproteins, high density lipoprotein and serum triglyceride.
RESULTS:
A statistically significant decrease was found in serum high density lipoprotein level (Mean= 46.40mg/dl ,p < 0.025) in Hemodialysis patients when compared with healthy controls. A significant increase in serum triglyceride content of patients (p < 0.000) was also observed. It was found that improvements in lipid profile results were achieved with the use of more frequent (more than 2sessions of haemodialysis per week). There is no any impact of the duration being on HD on the lipid profile in the study.
CONCLUSION:
This study found that normal lipid profile is better maintained in patients undergoing adequate haemodialysis, and the frequency of haemodialysis sessions can affect the atherogenic states of the lipid profile which is probably the responsible for high incidence of atherosclerotic heart diseases among these patients.
KEYWORDS :lipid profile, chronic kidney disease, hemodialysis .

Assessment of Dialysis Adequacy Using Urea Reduction Ratio and KT/V in four Pediatric Hemodialysis Centers in Baghdad

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 4, Pages 522-529

ABSTRACT:
BACKGROUND:
The 21st century has been set to enhance dialysis adequacy. Numerous studies have confirmed the association between the delivered dose of hemodialysis and patients outcomes. There is thus some evidence regarding the relationship between dialysis dose and quality of life.
OBJECTIVE:
To assess dialysis adequacy using (Urea Reduction Rate and KT/V), and to determine the association between dialysis dose and different Hemodialysis characteristics in children with End Stage Renal Failure undergoing Hemodialysis.
METHOD:
This was an observational cross-sectional study that was conducted for three months, from (November 2014 till January 2015); we enrolled 50 children with End Stage Renal Failure in four hemodialysis centers in Baghdad. Samples for blood urea (predialysis and postdialysis) were drown to calculate the adequacy dose.
RESULTS:
Thirty two (64%) of patients were male and 18(36%) were females; with male to female ratio was (1.7:1).The mean urea reduction ratio and Kt/V were 59.63 ± 7.345% and 1.29 ± 0.275, respectively, with fair dialysis adequacy .A Kt/V less than 1.2 and a urea reduction ratio less than 65% were found in 42%, and 38% of the hemodialysis patients, respectively. There was a significant correlation between dialysis dose and (Blood flow rate, Dialysis hours, Dialysis frequency /week and Effective surface area), while there was insignificance correlation with (gender, age, volume of ultrafiltration.
CONCLUSION:
Our results were better than neighbor countries with fair dialysis adequacy. It is important to regularly measure the parameters of dialysis adequacy in order to assess whether targets are achieved in accordance with K/DOQI guidelines.

Lipid Profile in Children with Chronic Renal Failure Undergoing Hemodialysis

Nariman F. Ahmed Azat; Qahtan M. Ali

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 2, Pages 222-228

ABSTRACT:
BACKGROUND:
Dyslipidemia is common in Patients with chronic renal failure undergoing intermittent haemodialysis and is considered a risk factor of cardiovascular disease in these patients.
OBJECTIVE:
To highlight the lipid profile abnormalities in children with end stage renal disease undergoing maintenance hemodialysis and know whether the hemodialysis duration and frequency of sessions per week has any impact on lipid profile in these patients.
PATIENTS AND METHOD:
A case-control study which was collected in the dialysis unit of (Al Karama Teaching Hospital, Child's Central Teaching Hospital , Al Kadhumia Teaching Hospital and Ibn Al Balady Hospital) for six months started on 1st June 2013 till the 1st of December 2013. Blood samples were obtained from 40 patients with end stage renal disease undergoing maintenance haemodialysis (2-3 sessions per week) and 40 matched healthy controls and analyzed for serum total cholesterol, low density lipoproteins, high density lipoprotein and serum triglyceride.
RESULTS:
A statistically significant decrease was found in serum high density lipoprotein level (Mean= 46.40mg/dl ,p < 0.025) in Hemodialysis patients when compared with healthy controls. A significant increase in serum triglyceride content of patients (p < 0.000) was also observed. It was found that improvements in lipid profile results were achieved with the use of more frequent (more than 2sessions of haemodialysis per week). There is no any impact of the duration being on HD on the lipid profile in the study.
CONCLUSION:
This study found that normal lipid profile is better maintained in patients undergoing adequate haemodialysis, and the frequency of haemodialysis sessions can affect the atherogenic states of the lipid profile which is probably the responsible for high incidence of atherosclerotic heart diseases among these patients.

Brachial Arteriovenous Fistula Flow and post Fistula Venous Diameter in HemoDialysis Patients

Nidham A. Jaleel; Mohamad Atea; Saadon Ubaydi; asem ali mutasher

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 2, Pages 246-252

ABSTRACT: BACKGROUND: An arteriovenous fistula must be able to sustain the flow demands of the hemodialysis machine; the flow rate in the fistula only has to be marginally greater than the demands of the blood pump. So fistula flow should be in the range of 600 to 700 mL/min. Overflow occurs when flow rate exceeds 20% of cardiac output. OBJECTIVE: Evaluation of arteriovenous fistula flow rate and post fistula venous diameter in patients on regular hemodialysis to highlight the prevalence of overflow fistula and its relation to gender, co-morbidities, signs and symptoms. PATIENTS AND METHODS: The measurements of fistula flow rate and post fistula venous diameter in a randomly selected sample of 43 hemodialysis patients (all are bracheocephalic AV-fistula) in the department of dialysis in al-Yarmouk Teaching Hospital in the period from the 1st of August 2010 till the 28th of February 2011. Statistical analysis using Chi-square test and Pearson correlation has been done via SPSS software version 17. RESULTS: From the 43 patients enrolled in the study, 31(72%) patients have a fistula flow rate over 1300 mL/min, overflow group; 12 (28%) patients have a flow rates within 1000 ± 300 mL/min, optimal flow group and none has a fistula flow rate less than 700 mL/min. There is a significant association between overflow fistula with (hypertension, the presence of peripheral cyanosis in the fistula corresponding hand, the occurrence of numbness in the fistula corresponding hand and the occurrence of dizziness during hemodialysis) and a strong linear correlation between the measurements of post fistula venous diameter and corresponding fistula flow rates, Pearson correlation coefficient (r) of +0.8005. CONCLUSION: Our study shows a high prevalence of overflow fistula in the patient sample, and this high flow rate is associated with significant complications

Hepatitis C Virus Infection Assessment Among Chronic Hemodialysis Patients in AL-Kadhmiya Teaching Hospital

Jawad K. Mnuti; Fadhil A. AL- Abbudi

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 4, Pages 460-464

ABSTRACT:
BACKGROUND:
Hepatitis C virus (HCV) has been recognized as an emerging problem in dialysis patients, and viral hepatitis remains a major hazard for both patients and medical staff of hemodialysis (HD) units.
The reported yearly incidence of anti-HCV antibody worldwide between HD patients ranges from 10.5% to 24%, while the prevalence of anti-HCV antibody among dialysis patients varies in different countries (5-85%) worldwide, and may exceed 95% in the Middle East
OBJECTIVE:
To asses the prevalence of anti-hepatitis C virus (HCV) among the hemodialysis unit in AL-Kadhmiya Teaching Hospital and to identify the risk factors of infection in relation to age, sex, blood transfusions and duration of dialysis
PATIENTS AND METHODS:
Across-sectional study was conducted in AL-Nahrain College of Medicine in AL-Kadhmiya Teaching Hospital in dialysis unit during the period from April 2008 to December 2010. 100 patients(58 male and 42 female their ages ranged from (15—75). are known cases of end stage renal failure on regular haemodialysis. All patients underwent a history and physical examination at baseline and investigations include blood urea nitrogen, creatinine, serum calcium, phosphorus, liver function test and screen for hepatitis C virus antibodies were tested by using Murex anti-HCV ELISA , Positive cases were confirmed by polymerase chain reaction
RESULTS:
The prevalence of HCV infection in patients in the dialysis unit was 41%. This study showed that there was an association between the history of blood transfusions, duration of the dialysis and kidney transplantation and the prevalence of HCV infection,( P.value <0.001.)
Although the levels of AST and ALT were higher in the positive HCV marker group, there was no statistically significant difference between them.
CONCLUSION:
HCV infection is high in hemodialysis unit in alkadhmiya teaching hospital, HCV-related liver disease in patients on long-term dialysis often appears clinically mild, with only modest elevations in AST and ALT levels but most of them asymptomatic. Observation of appropriate preventive measures in the hemodialysis center is highly recommended

Correlation of Angiographic Findings and Clinical Presentations in Unstable Angina

Ali Abdulamir Mohammad AL.Mossawi; Kasim Abbas Ismail; Azher Sabih Zubaidy; Adil Siwan Aqabi; Majid Hameed AL Maini; Jawad K. Mnuti; Fadhil A. AL- Abbudi; Amira H. Shubbar; Layth Rafea Taqa; Sawsan Sati; Abbas; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali; Nassir Enssief Mohsun; Raji H AL-Hadithi; Suhaila Saadallah; Darya Akram Faqe Mahmood; Ari R. Qader; Kurdo A. Mohmmad; Dawood Salman Hameed Alazzawi; s Central Teaching Hospital in Baghdad; a Descreptive Study; Autism Among Children Attending Pediatric Psychiatric Department in Child; Jaafar Muhamed Hassan; AL- Ghabban; Haider Abdul Muhsin; Huda Adnan Habib; Maysaloun Muhammed Abdulla; Selwa Elias Yacoub; Abdulrazak H. Alnakash; Shaema Jafar; Yousef Abdul-Raheem; Alaa Hussein Ali; Montadhar Hameed Nima; Rasha Abbas Azeez; Jassim Mohammad Alkhazraji; Hussein Mahmood Gazi; Mohammed Shafik Tawfeek; Nabeel Ghazi Hashim; Hayder Hadi Lazim; Maysoon Mohammad Najeeb Mohammad Saleem; Arieg Abdul Wahab Mohammad; Majid Syki Jabir; Kareem Al-Tameemi; Malak A. Al-Yawer; Adel Rabea Alsaadawi; Mohammed S. Saeed; Thukaa T. Yahya; Osama E. Hudder; Issraa A. Hussein

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 4, Pages 449-455

ABSTRACT: BACKGROUND: Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. The highest; level of Braunwald classification of unstable angina can be used to assess the severity of clinical presentation. However the highest classes have not been directly correlated with thrombotic and complex lesions. OBJECTIVE: The study was done to clarify the correlation between angiographic findings and the most acute and / or severe clinical presentation in unstable angina. PATIENTS AND METHOD: We conducted a prospective study of 110 patients of unstable angina at Ibn-Albitar Center for Cardiac Surgery. All of these patients underwent cardiac catheterization, culprit lesion was identified in 80 patients and in 30 patients there was no an identifiable culprit lesion .Complex lesions including complex morphology, intracoronary thrombus, or total occlusion were also quantitatively analyzed and Thrombolysis in Myocardial Infarction (TIMI) flow grade was assessed. Patients were classified according to Braunwald classification in instable angina .We compared patients with and those with no culprit lesions in regarding Braunwald classification. We sequentially compared the highest Braunwald classes II, C, 3 with classes

Keywords

braunwald classification
---
unstable angina

Hepatitis C Virus Infection Assessment Among Chronic Hemodialysis Patients in AL-Kadhmiya Teaching Hospital

Jawad K. mnuti; Fadhil A. AL- Abbudi

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 4, Pages 460-464

ABSTRACT:
BACKGROUND:
Hepatitis C virus (HCV) has been recognized as an emerging problem in dialysis patients, and viral
hepatitis remains a major hazard for both patients and medical staff of hemodialysis (HD) units.
The reported yearly incidence of anti-HCV antibody worldwide between HD patients ranges from
10.5% to 24%, while the prevalence of anti-HCV antibody among dialysis patients varies in
different countries (5-85%) worldwide, and may exceed 95% in the Middle East
OBJECTIVE:
To asses the prevalence of anti-hepatitis C virus (HCV) among the hemodialysis unit in ALKadhmiya
Teaching Hospital and to identify the risk factors of infection in relation to age, sex, blood
transfusions and duration of dialysis
PATIENTS AND METHODS:
Across-sectional study was conducted in AL-Nahrain College of Medicine in AL-Kadhmiya
Teaching Hospital in dialysis unit during the period from April 2008 to December 2010. 100
patients(58 male and 42 female their ages ranged from (15—75). are known cases of end stage renal
failure on regular haemodialysis. All patients underwent a history and physical examination at
baseline and investigations include blood urea nitrogen, creatinine, serum calcium, phosphorus, liver
function test and screen for hepatitis C virus antibodies were tested by using Murex anti-HCV
ELISA , Positive cases were confirmed by polymerase chain reaction
RESULTS:
The prevalence of HCV infection in patients in the dialysis unit was 41%. This study showed that
there was an association between the history of blood transfusions, duration of the dialysis and
kidney transplantation and the prevalence of HCV infection,( P.value <0.001.)
Although the levels of AST and ALT were higher in the positive HCV marker group, there was no
statistically significant difference between them.
CONCLUSION:
HCV infection is high in hemodialysis unit in alkadhmiya teaching hospital, HCV-related liver
disease in patients on long-term dialysis often appears clinically mild, with only modest elevations in
AST and ALT levels but most of them asymptomatic. Observation of appropriate preventive
measures in the hemodialysis center is highly recommended.

Correlation of Angiographic Findings and Clinical Presentations in Unstable Angina

Ali Abdulamir Mohammad AL.Mossawi; Kasim Abbas Ismail; Majid Hameed AL Maini; Adil Siwan Aqabi; Azher Sabih Zubaidy; Jawad K. mnuti; Fadhil A. AL- Abbudi; Amira H. Shubbar; DEFINITION GERD is described as any symptomatic or histopathological alteration resulting from episodes of gastroesophageal reflux; Layth Rafea Taqa; INTRODUCTION; Reflux esophagitis describes the subset of GERD patient with histopathological changes of; Sawsan Sati; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali; Suhaila Saadallah; Raji H AL-Hadithi; Darya Akram Faqe Mahmood; Ari R. Qader; Kurdo A. Mohmmad; Dawood Salman Hameed Alazzawi; Entissar Hadi AL- Shimery; Jaafar Muhamed Hassan; AL- Ghabban; Haider Abdul Muhsin; Huda Adnan Habib; Maysaloun Muhammed Abdulla; Selwa Elias Yacoub; Abdulrazak H. Alnakash; Shaema Jafar; Yousef Abdul-Raheem; Alaa Hussein Ali; Montadhar Hameed Nima; Rasha Abbas Azeez; Jassim Mohammad Alkhazraji; Hussein Mahmood Gazi; Mohammed Shafik Tawfeek; Nabeel Ghazi Hashim; Hayder Hadi Lazim; Maysoon Mohammad Najeeb Mohammad Saleem; Arieg Abdul Wahab Mohammad; Majid Syki Jabir; Kareem Al-Tameemi; Malak A. Al-Yawer; Adel Rabea Alsaadawi; ABSTRACT; Issraa A. Hussein; Osama E. Hudder; Thukaa T. Yahya

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 4, Pages 449-455

ABSTRACT:
BACKGROUND:
Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. The highest;
level of Braunwald classification of unstable angina can be used to assess the severity of clinical
presentation. However the highest classes have not been directly correlated with thrombotic and complex
lesions.
OBJECTIVE:
The study was done to clarify the correlation between angiographic findings and the most acute and / or
severe clinical presentation in unstable angina.
PATIENTS AND METHOD:
We conducted a prospective study of 110 patients of unstable angina at Ibn-Albitar Center for Cardiac
Surgery. All of these patients underwent cardiac catheterization, culprit lesion was identified in 80
patients and in 30 patients there was no an identifiable culprit lesion .Complex lesions including complex
morphology, intracoronary thrombus, or total occlusion were also quantitatively analyzed and
Thrombolysis in Myocardial Infarction (TIMI) flow grade was assessed. Patients were classified
according to Braunwald classification in instable angina .We compared patients with and those with no
culprit lesions in regarding Braunwald classification. We sequentially compared the highest Braunwald
classes II, C, 3 with classes

Keywords

braunwald classification
---
unstable angina

How to Decrease the Prevalence of Hepatitis C in Iraqi Hemodialysis Patients

Omar Salem Khattab

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 1, Pages 31-35

ABSTRACT:
BACKGROUND :
Hepatitis C virus infection has been recognized as an emerging problem in dialysis patients, its prevalence varies considerably among different areas of the world. The prevalence of HCV infection in hemodialysis patients and its associated risk factors is not well documented in our country. We performed this study aiming to discuss prevention of further transmission of HCV infection among our patients.
OBJECTIVE:
We performed this study aiming to discuss prevention of further transmission of HCV infection among our patients.
PATIENTS AND METHODS:
A cross sectional study done between September 2003 – December 2008 in the Renal Transplant Center, Medical City Teaching Hospital, Baghdad. Including 244 patients with end stage renal failure and had been on hemodialysis for more than 3 months. focusing on the prevalence of anti-HCV positive patients, and the associated risk factors.
RESULTS:
153(62.7%) were males, and 91(37.3%) were females, with age range 14-67 years. The prevalence of anti-HCV positive patients was 12(4.9%), dialysis in different centers, female sex, ≥ 60 years age, ≤ 6 months on dialysis, blood transfusion, and < 9 hours per week haemodialysis were significant predictors of anti-HCV positivity.
CONCLUSION:
We conclude that adherence to universal infection precautions; HCV screening of transfusions and of patients on hemodialysis; and the use of separate machines in separate rooms for those who are anti-HCV positive, was important factors, To further reduce the prevalence in our patients, erythropoietin should replace blood transfusions, also to test for HCV RNA using polymerase chain reaction before starting hemodialysis.

Physiological Problems Which Confront Renal Transplant Recipients

Batool Amin Jaddoue Al-Ani; Suhban S. AL-Mallah

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 3, Pages 270-276

ABSTRACT:
BACKGROUND:
The study objectives are to identify the problems which confront renal transplant recipients ( RTRS).
OBJECTIVE:
Identify the physiological problems which confront renal transplant recipients ( RTRS).
METHODS:
A descriptive study was carried out at two Teaching Hospitals with kidney transplant centers. Surgical specialties and Al-Karama outpatients, clinics for ( RTRS) , and three Teaching Hospitals; Medical city, Al-Karama and Al-Yermok which were responsible for immunosuppressive drugs distribution .Starting from October ,1st 2006 to the end of July 2007.To achieve the objectives of study, a non-probability (purposive) sample of 150 ( RTRS) who were attending to the outpatient clinic of the above listed hospital were selected according to the criteria of the study sample .
The finalized questionnaire contained (42) items. The content validity of the instrument was established through penal of (14) experts. Reliability of the problems scales was determined by test-retest method which was estimated as average (r=0.76).
Data was gathered by interview technique using the questionnaire format and data was analyzed by application of descriptive and inferential statistical methods.
RESULT:
The results of the study indicated that the ( RTRS) confront (83 ) problems and affected by these problems with different severity level, high, moderate, and low.
CONCLUSION:
according to the results of this study, the researcher recommended that the provision of the necessary post transplant medicines should be easily acquired from easy to reach centers

The Significance of Helicobacter Pylori Infection in Uraemic Patients

Jenan Eiyas; Arif Sami; Tariq AL-Hadithi

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 2, Pages 111-113

ABSTRACT: BACKGROUND: Helicobacter Pylori play an important role in pathogenesis of gastritis and peptic ulcer disease in uraemic patients OBJECTIVE: To assess the prevalence of helicobacter pylori infection in uraemic , and to find the relationship endoscopic findings and the H. pylori infection PATIENTS AND METHODS : Forty patient with chronic renal failure were studied and compared with 38 patients with dyspepsia with out any known history of renal disease. All underwent upper gastrointestinal endoscopy and antral biopsies were taken for detection of H.pylori infection using the rapid uraease test as agoldstandard for confirmation of the infection RESULT: The prevalence of H.pylori infection was 32.5% in uraemic patient and abnormal endoscopic finding were detected in 70% of the patients with abnormal endoscpic findings CONCLUSION: The prevalence of H.pylori in uraemic patients is lower than in patients with the normal renal function , but the difference is not significant statistically