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Hemodialysis has improved the morbidity and mortality associated with end stage renal disease. In India, hemodialysis prescription is empiric, which leads to complications related to under-dialysis. Hence, adequacy of hemodialysis in Indian setting was analyzed in this study. A total of 50 patients on twice per week hemodialysis were assessed for 1 month. The number of sessions meeting standards laid out by Kidney Diseases Outcome Quality Initiatives (KDOQI) guidelines were calculated. They were divided into two groups: one in whom dialysis was monitored and session length enhanced to meet the minimum standard Kt/V of 2 and second control group; where Kt/V was not monitored. Hemoglobin (Hb) levels, albumin levels, mean arterial pressure and World Health Organization (WHO) quality of life (QoL) score were compared in the two groups after 6 months. Only 28% of hemodialysis sessions were adequate as per KDOQI guidelines. There was significant improvement in Hb levels (1.47 vs. 0.15 g/dl), mean arterial pressure levels (15.2 vs. 3.16 mm Hg), serum albumin levels (0.82 vs. 0.11 g/dl) and WHO QoL score (17.2 vs. 2.24) in study group as compared to control group. Standard Kt/V can be used as an important tool to modify twice weekly dialysis sessions to provide better QoL to the patients. However, studies with larger sample size are required to conclusively prove our results. [ABSTRACT FROM AUTHOR]

We evaluated whether polymorphisms in interleukin (IL‑1) gene cluster (IL‑1 alpha [IL‑1A], IL‑1 beta [IL‑1B], and IL‑1 receptor antagonist [IL‑1RN]) are associated with end stage renal disease (ESRD). A total of 258 ESRD patients and 569 ethnicity matched controls were examined for IL‑1 gene cluster. These were genotyped for five single‑nucleotide gene polymorphisms in the IL‑1A, IL‑1B and IL‑1RN genes and a variable number of tandem repeats (VNTR) in the IL‑1RN. The IL‑1B − 3953 and IL‑1RN + 8006 polymorphism frequencies were significantly different between the two groups. At IL‑1B, the T allele of − 3953C/T was increased among ESRD (P = 0.0001). A logistic regression model demonstrated that two repeat (240 base pair [bp]) of the IL‑1Ra VNTR polymorphism was associated with ESRD (P = 0.0001). The C/C/C/C/C/1 haplotype was more prevalent in ESRD = 0.007). No linkage disequilibrium (LD) was observed between six loci of IL‑1 gene. We further conducted a meta‑analysis of existing studies and found that there is a strong association of IL‑1 RN VNTR 86 bp repeat polymorphism with susceptibility to ESRD (odds ratio = 2.04, 95% confidence interval = 1.48-2.82; P = 0.000). IL‑1B − 5887, +8006 and the IL‑1RN VNTR polymorphisms have been implicated as potential risk factors for ESRD. The meta‑analysis showed a strong association of IL‑1RN 86 bp VNTR polymorphism with susceptibility to ESRD. [ABSTRACT FROM AUTHOR]