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Background and Objectives: This study aimed to evaluate the association between QoL, self-assessed physical activity, and the presence and severity of muscle spasms in chronic hemodialysis patients. Patients undergoing regular in-center hemodialysis (HD) have much lower quality of life (QoL) than healthy individuals. However, there is limited knowledge about the impact of specific common complications of hemodialysis, particularly muscle spasms on the overall well-being of patients. Materials and Methods: In this prospective, single-center study, 67 chronic HD patients were surveyed regarding the prevalence of muscle spasms using a validated 9-multiple-choice-question survey, alongside the Physical Activity Questionnaire (IPAQ) and The Short Form (36) Health Survey (SF-36). Based on the muscle spasms survey answers, patients were divided into two subgroups: with (n = 39) and without muscle spasms (n = 28). Results: The findings revealed that patients with muscle spasms had a higher body mass index (BMI) (p = 0.005), a shorter dialysis vintage (p = 0.063), and significantly longer sitting times (p = 0.017). Multivariate analysis identified BMI (p = 0.034), sitting time (p = 0.009), physical functioning scores (p = 0.032), and dialysis vintage (p = 0.040) as significant predictors of muscle spasms. Conclusions: This study concluded that muscle spasms are associated with lower QoL among HD patients. The contributing factors to this dependance are BMI, dialysis vintage, physical functioning, and sitting time. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nephrology & Dialyzotherapy / Nefrologia i Dializoterapia Polska is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Polish Nephrology & Dialyzotherapy / Nefrologia i Dializoterapia Polska is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Dyslipidemia is common in chronic hemodialysis patients and its underlying mechanism is complex. Hemodialysis causes an imbalance between antioxidants and production of reactive oxygen species, which induces the oxidative stress and thereby may lead to accelerated atherosclerosis. Statins have been found to be little effective in end-stage kidney disease and other lipid-lowering therapies have been only scarcely studied. The study aimed to assess the effect of low-dose fenofibrate therapy on plasma lipids and redox status in long-term hemodialysis patients with mild hypertriglyceridemia. Twenty seven chronic hemodialysis patients without any lipid-lowering therapy were included in a double-blind crossover, placebo-controlled study. The patients were randomized into two groups and were given a sequence of either 100 mg of fenofibrate per each hemodialysis day for 4 weeks or placebo with a week-long wash-out period between treatment periods. Plasma lipids, high sensitive C-reactive protein (CRP), urea, creatinine, electrolytes, phosphocreatine kinase (CK), GOT, GPT and plasma thiols (total and free glutathione, homocysteine, cysteine and cysteinylglycine) were measured at baseline and after each of the study periods. Plasma aminothiols were measured by reversed phase HPLC with thiol derivatization with 2-chloro-1-methylquinolinium tetrafluoroborate. Fenofibrate therapy caused a significant decrease of total serum cholesterol, LDL cholesterol and triglycerides and an increase of HDL cholesterol. The treatment was well tolerated with no side-effects but there was a small but significant increase of CK not exceeding the upper limit of normal range. There were no changes of serum CRP, potassium, urea, and creatinine and liver enzymes during the treatment. Neither total nor total free cysteinylglycine and cysteine changed during the study but both total and free glutathione increased during the therapy with fenofibrate and the same was observed in case of plasma homocysteine. The study shows that a treatment with reduced fenofibrate dose is safe and effective in reducing serum triglycerides and cholesterol in chronic dialysis patients and may shift plasma aminothiol balance towards a more antioxidative pattern.

Most hypertensive dialysis patients are currently treated with angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). Aliskiren, the direct renin inhibitor, has not been specifically studied in peritoneal dialysis patients. The aim of the study was to compare hypotensive effects of aliskiren and ramipril and their influence on serum potassium and inflammatory parameters in hypertensive peritoneal dialysis patients. Eighteen hypertensive patients on chronic peritoneal dialysis were enrolled in an open-label comparative fixed-order study. The patients had been off RAAS blocking drugs for ≥4 weeks prior to an inclusion. At each of 3 study visits (baseline and after each of the treatment periods) blood pressure, serum lipids, potassium, renin, aldosterone, C-reactive protein (CRP) and monocyte chemotactic protein-1 (MCP-1) were measured. After the baseline visit aliskiren was started (150 mg/d) and after 12 weeks replaced with ramipril (5 mg/d) for the next 12 weeks. Blood pressure was 142/88±15/11 mmHg at baseline, 137/84±10/8 mmHg after aliskiren (ns) and 126/81±11/7 mmHg after ramipril (p<0.05 vs baseline and aliskiren). No incidents of hyperkalemia were observed. Plasma renin concentration increased significantly during aliskiren treatment compared to ramipril (227,6±844 vs 58,3±765 pg/mL). CRP was similar after both therapies (8,8±34 vs 8,4±32 μg/mL) but MCP-1 concentration was significantly lower after aliskiren than after ramipril (294,0±172,6 vs 358,9±183,3 pg/mL). Aliskiren 150 mg/day decreases blood pressure less effectively than ramipril 5 mg/day in peritoneal dialysis patients. It does not influence serum potassium. The decrease of MCP-1 concentration after aliskiren treatment may provide an indirect evidence for its blood pressure independent cardioprotective and anti-inflammatory effects. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

According to recent definitions the person enters a senile age after 65. Each person starts ageing after the completion of maturation. The phenomenon of ageing is highly individual and differs among people with respect to its rate and affected systems and organs. This may be responsible for a frequent inequality of metrical and biological age. Ageing is a multisystem process which also leads to alterations in symptomatology of many diseases. The process of ageing has been very well described, especially in the cardiovascular system. In contrast, ageing of the respiratory tract is far less recognised and still remains a subject of debates. The elderly are affected by the same diseases as younger individuals. The most common diseases at this age are respiratory tract infections, tuberculosis, chronic obstructive pulmonary diseases and bronchial asthma. Their course may be, however, different in the elderly not only due to the physiologic process of ageing but also frequent comorbidities. This fact should be taken into account when establishing a diagnosis and treatment regimens. A therapy of the older person usually requires a highly individualized approach.