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14. Mineral and bone disease - CKD 5D

Author

Hecking, M., primary, Kainz, A., additional, Bielesz, B., additional, Plischke, M., additional, Beilhack, G., additional, Hoerl, W. H., additional, Sunder-Plassmann, G., additional, Bieglmayer, C., additional, Benchetrit, S., additional, Green, J., additional, Bernheim, J., additional, Golan, E., additional, Oyake, N., additional, Suzuki, K., additional, Itoh, S., additional, Tanabe, K., additional, Fujimori, A., additional, Okada, S., additional, Yamamoto, K., additional, Sakai, M., additional, Kamiura, N., additional, Solenne, P., additional, Guebre-Egziabher, F., additional, Bacchetta, J., additional, Drai, J., additional, Richard, M., additional, Chapurlat, R., additional, Fouque, D., additional, Nowak, Z., additional, Grzegorz, K., additional, Maria, K., additional, Zofia, W., additional, Zamboch, K., additional, Zahalkova, J., additional, Kosatikova, Z., additional, Skypalova, P., additional, Skarda, J., additional, Cunha, J., additional, Boim, M., additional, Ferreira, V., additional, Naves, M., additional, Kikuchi, H., additional, Shimada, H., additional, Takimoto, Y., additional, Karasawa, R., additional, Shimotori, M., additional, Ikarashi, K., additional, Saito, N., additional, Miyazaki, S., additional, Sakai, S., additional, Suzuki, M., additional, Ogata, H., additional, Takeshima, A., additional, Yamamoto, M., additional, Asakura, K., additional, Kato, T., additional, Shishido, K., additional, Koiwa, F., additional, Mizobuchi, M., additional, Kinugasa, E., additional, Akizawa, T., additional, Londrino, F., additional, Corbani, V., additional, Ardini, M., additional, Falqui, V., additional, Zattera, T., additional, Rombola', G., additional, Takeshige, Y., additional, Matsuzaka, K., additional, Ciceri, P., additional, Volpi, E., additional, Brenna, I., additional, Elli, F., additional, Borghi, E., additional, Brancaccio, D., additional, Cozzolino, M., additional, Farrand, K., additional, Copley, J. B., additional, Heise, J., additional, Fridman, M., additional, Keith, M., additional, Silverberg, A., additional, Wilson, R., additional, Poole, L., additional, Jean, G., additional, Bresson, E., additional, Chazot, C., additional, Maduell, F., additional, Arias, M., additional, Sentis, A., additional, Rodriguez, N., additional, Jimenez, S., additional, Alemany, B., additional, Perez, N., additional, Vera, M., additional, Fontsere, N., additional, Carrera, M., additional, Cases, A., additional, Sonikian, M., additional, Miha, T., additional, Skarakis, I., additional, Karatzas, I., additional, Karaitianou, A., additional, Tomanoski, V., additional, Petkovic, D., additional, Curic, I., additional, Hrvacevic, R., additional, Kaperonis, N., additional, Kourvelou, C., additional, Sgantzos, A., additional, Nastou, D., additional, Ntatsis, G., additional, Ziakka, S., additional, Karakasis, F., additional, Nikolopoulos, V., additional, Zoubaniotou, D., additional, Koutsovasili, A., additional, Zagorianakos, A., additional, Kolovos, V., additional, Papagalanis, N., additional, Forni, V., additional, Pruijm, M., additional, Tousset, E., additional, Zweiacker, C., additional, Menetrey, I., additional, Berwert, L., additional, Bullani, R., additional, Cherpillod, A., additional, Gabutti, L., additional, Gauthier, T., additional, Halabi, G., additional, Mathieu, C., additional, Meier, P., additional, Phan, O., additional, Pianca, S., additional, Schoenholzer, C., additional, Teta, D., additional, Von Albertini, B., additional, Vrijens, B., additional, Burnier, M., additional, Kurita, N., additional, Fukagawa, M., additional, Onishi, Y., additional, Yamaguchi, T., additional, Hasegawa, T., additional, Fukuma, S., additional, Kurokawa, K., additional, Fukuhara, S., additional, Urena, P., additional, Bridges, I., additional, Christiano, C., additional, Cournoyer, S., additional, Cooper, K., additional, Farouk, M., additional, Kopyt, N., additional, Rodriguez, M., additional, Zehnder, D., additional, Covic, A., additional, Tominaga, Y., additional, Hiramitsu, T., additional, Yamamoto, T., additional, Nanmoku, K., additional, Matsuda, Y., additional, Tsuzuki, T., additional, Lang, C.-L., additional, Lu, K.-C., additional, Wang, M.-H., additional, Liu, S.-Y., additional, Huang, J.-W., additional, Chiang, C.-K., additional, Hung, K.-Y., additional, Bantis, C., additional, Kouri, N.-M., additional, Tsandekidou, E., additional, Frangidis, S., additional, Tsiandoulas, A., additional, Liakou, E., additional, Bamichas, G., additional, Stangou, M., additional, Papagianni, A., additional, Efstratiadis, G., additional, Natse, T., additional, Memmos, D., additional, Messa, P., additional, Cannella, G., additional, Mazzaferro, S., additional, Yu, X., additional, Bieber, B., additional, Guidinger, M., additional, Yang, X., additional, Tentori, F., additional, Pisoni, R., additional, Qian, J., additional, Chen, N., additional, Yan, Y., additional, Wang, M., additional, Zuo, L., additional, Wang, H., additional, Albert, J., additional, Ramirez, S., additional, Caccetta, F., additional, Caroppo, M., additional, Musio, F., additional, Mudoni, A., additional, Accogli, A., additional, Zacheo, M. D., additional, Nuzzo, V., additional, Selim, G., additional, Stojceva-Taneva, O., additional, Tozija, L., additional, Gelev, S., additional, Pusevski, V., additional, Dzekova-Vidimliski, P., additional, Rambabova-Busletic, I., additional, Sikole, A., additional, Esposito, P., additional, Coppo, R., additional, Malberti, F., additional, Dal Canton, A., additional, Moriwaki, K., additional, Komaba, H., additional, Kakuta, T., additional, Cernaro, V., additional, Lupica, R., additional, Donato, V., additional, Lacquaniti, A., additional, Fazio, M. R., additional, Lucisano, S., additional, Buemi, M., additional, Okuno, S., additional, Ishimura, E., additional, Tsuboniwa, N., additional, Norimine, K., additional, Yamakawa, K., additional, Yamakawa, T., additional, Shoji, S., additional, Mori, K., additional, Nishizawa, Y., additional, Inaba, M., additional, Dahaba, M., additional, Seck, S., additional, Cisse, M., additional, Jotoku, Y., additional, Sato, Y., additional, Dimkovic, N., additional, Asicioglu, E., additional, Kahveci, A., additional, Arikan, H., additional, Koc, M., additional, Tuglular, S., additional, Ozener, C., additional, Kido, R., additional, Yamaguch, T., additional, Krasniak, A., additional, Drozdz, M., additional, Chmiel, G., additional, Podolec, P., additional, Pasowicz, M., additional, Kowalczyk-Michalek, M., additional, Sulowicz, W., additional, Perez-Suarez, G., additional, Baamonde, E., additional, Bosch, E., additional, Ramirez, J. I., additional, El Hayek, B., additional, Lago, M. D. M., additional, Garcia, C., additional, Checa, M. D., additional, Hiramatsu, R., additional, Ubara, Y., additional, Salas, K., additional, Vicent, E. S., additional, Gonzalez Oliva, J. C., additional, Fulquet, M., additional, Duarte, V., additional, Pou, M., additional, Saurina, A., additional, Macias, J., additional, Ramirez de Arellano, M., additional, Matias, P., additional, Jorge, C., additional, Mendes, M., additional, Amaral, T., additional, Ferreira, C., additional, Aires, I., additional, Gil, C., additional, Ferreira, A., additional, Arcal, C., additional, Campistol, J. M., additional, Seferi, S., additional, Rroji, M., additional, Likaj, E., additional, Petrela, E., additional, Barbullushi, M., additional, Zeneli, N., additional, Mumajesi, S., additional, Thereska, N., additional, Vulpio, C., additional, Bossola, M., additional, Stigliano, E., additional, Fadda, G., additional, Gueiros, A. P. S., additional, Borba Junior, J. O., additional, Lordsllen, A. B. d. M. D. S., additional, Gueiros, J. E. d. B., additional, Itami, N., additional, Tuneyama, K., additional, Uemura, S., additional, Hamada, H., additional, Takada, J., additional, Takahashi, K., additional, Adamidis, K., additional, Apostolou, T., additional, Pleros, C., additional, Oikonomaki, T., additional, Kyratzi, E., additional, Exarchos, D., additional, Metaxatos, G., additional, Dracopoulos, S., additional, Nikolopoulou, N., additional, Delanaye, P., additional, Dubois, B., additional, Krzesinski, J.-M., additional, Cavalier, E., additional, De la Fuente, V., additional, Gil, M. T., additional, Gutierrez, P., additional, Delgado, P., additional, Ribero, J., additional, Arenas, L., additional, Sezer, S., additional, Tutal, E., additional, Bal, Z., additional, Erkmen Uyar, M., additional, Ozdemir Acar, F. N., additional, Azevedo de Oliveira, R., additional, Carvalho Barreto, F., additional, Dos Reis, L., additional, Cunha Ferreira, J., additional, Maria Leme Britto, Z., additional, Maria Moyses, R., additional, Jorgetti, V., additional, Ozelsancak, R., additional, Gurlek Demirci, B., additional, Torun, D., additional, Veljancic, L., additional, Radojevic, M., additional, Paunic, Z., additional, Vavic, N., additional, Obrencevic, K., additional, Kovacevic, Z., additional, and Pejovic, J., additional

Published
2012
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17. Glucose Levels During Dialysis with Glucose-Free Versus Glucose-Rich Dialysate Fluid.

Author

Bushljetik IR, Trajceska L, Pusevski V, and Spasovski G

Subjects
Biomarkers blood, Blood Glucose metabolism, Blood Pressure, Cross-Over Studies, Female, Humans, Kidney Failure, Chronic blood, Kidney Failure, Chronic physiopathology, Male, Middle Aged, Treatment Outcome, Dialysis Solutions pharmacology, Glucose pharmacology, Kidney Failure, Chronic therapy, Renal Dialysis methods
Abstract

Introduction: Asymptomatic hypoglycaemia has been reported in both diabetic and non-diabetic patients on haemodialysis. Uremic symptoms as inadequate appetite, nausea and vomiting worsen the risk of hypoglycaemia at dialysis initiation. As a standard therapeutic approach for decreasing this risk and dis-equilibrium syndrome at our dialysis unit, a continuous venous 5% glucose solution is applied during the glucose-free dialysate (GFD) dialysis. In this interventional study we sought to assess the glycaemic control during standard initiating dialysis protocol versus novel approach with glucose-rich dialysis fluid (GRD)., Material and Methods: Twenty-one dialysis patients with chronic renal failure were dialyzed alternatively using GRD (5.6 mmol/l) and GFD fluid. They were not taking any hypoglycaemic medication prior and food during dialysis session. Blood was sampled at regular intervals during dialysis. The dialysis prescription consisted of ultrafiltration (UF) of up to 1 L, membrane surface (MS) up to 1.4 square meters and duration time of 2-2.5 hours. Intra-patient glycaemic variability was defined by Coefficient of variation (CV). In paired analysis t-test was used to determine the glucose control differences in both therapeutic approaches in each patient. For the whole group t-test was used to assess the glucose variability as CV., Results: The mean age of study participants was 62.95±11.73 years; 7 (33%) had diabetes. The two dialysis approaches did not differ in respect of initial blood pressure, UF and MS. Only two episodes of hypoglycaemia occurred in both types of dialysis. The mean glucose level was higher during GRD (8.15±1.89 vs. 6.29±1.33, p=0.001), respectively. The glucose CV was lower in GRD dialysis when pared t-test was applied, without significant difference (16.97± 8.86 vs. 21.05±11.99, p=0.151). When only diabetic patients were analysed, there was no significant glucose CV difference as well (p=0.151). For the whole cohort glucose variability was significantly higher in glucose-free dialysate dialysis (p=0.0001)., Conclusion: The GRD approach for initiating dialysis sessions is non-inferior to standard GFD care. Dialysate rich in glucose obtains better glucose control during dialysis compared to glucose-free dialysate.

Published
2019
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18. Hypomagnesemia and cause-specific mortality in hemodialysis patients: 5-year follow-up analysis.

Author

Selim GN, Spasovski G, Tozija L, Georgievska-Ismail L, Zafirova-Ivanovska B, Masin-Spasovska J, Rambabova-Busletic I, Petronijevic Z, Dzekova-Vidimliski P, Ristovska V, Pusevski V, and Stojceva-Taneva O

Subjects
Aged, C-Reactive Protein metabolism, Cardiovascular Diseases blood, Cardiovascular Diseases mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Multivariate Analysis, Natriuretic Peptide, Brain blood, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic therapy, Risk Factors, Magnesium blood, Renal Dialysis, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic mortality
Abstract

Introduction: The aim of this prospective study was to evaluate the association between serum magnesium (Mg) and mortality, in particular the cause-specific mortality of Mg and other risk factors in hemodialysis (HD) patients., Methods: We studied a cohort of 185 HD patients receiving thrice-weekly HD treatment, on a dialysate Mg concentration of 0.5 mmol/L. We stratified 3 patient groups according to the level of Mg: lower (<1.1 mmol/L), intermediate-reference (1.1 to <1.3 mmol/L), and higher (Mg >1.3 mm/L)., Results: During the 5-year follow-up, 60 patients died, with cardiovascular (CV) disease as the predominant cause (73.3%). Hazard ratio (HR) for all-cause and CV mortality were 2.55 and 2.67 in the lower versus intermediate Mg group, but there was no significant association between the higher and intermediate Mg group. Univariate Cox regression analysis showed that Mg <1.1 versus 1.1-1.30 mml/L with HR 2.34, was a significant univariate predictor for increased mortality in addition to the Hb <110 g/L, Alb <40 g/L, C-reactive protein (CRP) ≥10 mg/L and brain natriuretic peptide >1,200 pg/mL. However, in the multivariate analysis only CRP ≥10 mg/L with HR 3.89 was a significant predictor of mortality. Subgroup analyses showed that among patients with CRP >10 mg/L, HR for all-cause and CV mortality of the lower versus intermediate Mg group were 1.96 and 2.39, respectively, not reaching significance for the higher versus intermediate Mg group. Conversely, there was no association between Mg level and all-cause and CV mortality within these 3 groups among patients with CRP <10 mg/L., Conclusions: Lower serum Mg level was significantly associated with an increased all-cause and cardiovascular mortality in HD patients, especially in inflamed patients.

Published
2017
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19. Protocol for performing nephrological activity in the Republic of Macedonia.

Author

Polenakovic M, Bogdanovska S, Cakalaroski K, Dzikova S, Masin G, Masin-Spasovska J, Oncevski A, Gerasimovska V, Spasovski G, Grozdanovski R, Stojceva-Taneva O, Grcevska L, Sikole A, Dejanov P, Tozija L, Zafirovska K, Ivanovski N, Lozance L, and Pusevski V

Subjects
Humans, Republic of North Macedonia, Kidney Diseases therapy, Nephrology methods
Abstract

The fast development of nephrology in the world, especially in the second half of the 20 th century demanded protocol (guidelines) for nephrological activity for all levels of medical care, of doctors and specialists. The International Society of Nephrology, the European Renal Association and other national associations created their own protocol (guidelines) for nephrological activity. The Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) proclaimed the First Protocol for Performing Nephrological Activity in the Republic of Macedonia at the First Congress of the MSNDTAO, held in Ohrid 1993, and it was published in the Macedonian Medical Review, 1994; Supplement 14: 397-406 [1]. The update of the Protocol for Performing Nephrological Activity in the Republic of Macedonia was proclaimed at the Fourth Congress of MSNDTAO, held in Ohrid 2012 and it presented in this text.

Published
2014
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20. Aminotransferase activity as a poor predictor of liver disease progression in dialysis patients with chronic hepatitis C.

Author

Dzekova-Vidimliski P, Severova-Andreevska G, Trajceska L, Pusevski V, Selim G, Gelev S, Amitov V, Dzikova S, and Sikole A

Subjects
Disease Progression, Female, Genotype, Hepacivirus genetics, Hepatitis C, Chronic blood, Hepatitis C, Chronic diagnostic imaging, Hepatitis C, Chronic virology, Humans, Liver diagnostic imaging, Male, Middle Aged, Ultrasonography, Alanine Transaminase blood, Hepatitis C, Chronic therapy, Renal Dialysis
Abstract

Lower aminotransferase activity in dialysis patients makes the assessment of the natural history of hepatitis C virus (HCV) infection difficult. The aim of the study was to determine the risk factors associated with the aminotransferase activity in dialysis patients with chronic hepatitis C. According to the serum levels of alanine aminotransferase (ALT) during the follow-up, the patients were divided in the two groups. The first group consisted of 34 chronically HCV infected patients with persistently normal levels of ALT. The second group included 46 chronically HCV infected patients with elevated levels of ALT. Genotype 1 was the dominant genotype in both groups (78 patients, 97.5%). Patients with the elevated ALT levels were characterized with a significantly shorter dialysis duration (p = 0.048) and a significantly shorter duration of HCV infection (p = 0.005) compared to the patients with persistently normal levels of ALT. The values of measured ultrasound parameters were not significantly different between the two groups. The univariate analysis identified a higher serum level of direct bilirubin (p = 0.044), shorter duration of dialysis (p=0.048), and shorter duration of HCV infection (p = 0.005) as potential predictors of elevated serum ALT levels in dialysis patients. After a stepwise logistic regression, none of the potential predictors was independently associated with the elevated ALT levels. Serum aminotransferase levels are poor predictors of liver disease progression in dialysis patients with chronic hepatitis C. Further studies should be conducted in order to identify non-invasive indicators of the disease progression in uremic patients with hepatitis C (Tab. 3, Ref. 22).

Published
2011

21. The outcome of commercial kidney transplant tourism in Pakistan.

Author

Ivanovski N, Masin J, Rambabova-Busljetic I, Pusevski V, Dohcev S, Ivanovski O, and Popov Z

Subjects
Adolescent, Adult, Developing Countries, Female, Follow-Up Studies, Graft Survival, Hepacivirus isolation & purification, Hepatitis B surgery, Hepatitis B virus isolation & purification, Hepatitis C surgery, Humans, Male, Middle Aged, Pakistan, Survival Rate, Young Adult, Hepatitis B complications, Hepatitis C complications, Kidney Diseases surgery, Kidney Transplantation mortality, Medical Tourism, Outcome Assessment, Health Care, Postoperative Complications
Abstract

The lack of cadaver organs for transplantation motivates some Balkan patients to go to developing countries to buy a kidney. We have followed 36 patients who received kidney transplants in Lahore and Rawalpindi, Pakistan. The patients had not been cleared for transplantation with a standard pre-transplant work-up: 80% were hepatitis-C virus (HCV) or HBsAg positive. During follow-up, seven patients died. Sixteen patients experienced wound infections with post-operative hernias, and three patients developed peri-renal hematomas. Six abscesses and four lymphoceles occurred, and four urinary fistulas were surgically treated. Nephrectomy was performed in three patients because of renal artery thrombosis. Nine patients developed active hepatitis C, and four patients manifested cytomegalovirus disease. Three patients developed steroid diabetes, and three patients experienced acute myocardial infarction. Nine patients had one or more rejection episodes. Urinary tract infection with Pseudomonas or Escherichia occurred frequently. The one-yr patient and graft survival rates were 80% and 68%, respectively. Paid unregulated renal transplantation is not recommended for both ethical reasons and because of an association with excessive morbidity and mortality., (© 2010 John Wiley & Sons A/S.)

Published
2011
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