Yue J.,General Hospital of Jinan Military Area Command |
Jiao S.,General Hospital of Jinan Military Area Command |
Xiao Y.,Shandong University of Traditional Chinese Medicine |
Ren W.,The Fifteenth Hospital of the Peoples Liberation Army |
And 2 more authors.
International Urology and Nephrology | Year: 2015
Methods: In this 12-week prospective, randomized, and double-blind trial, we assessed the efficacy and side effects in UP patients undergoing dialysis. Patients were randomly assigned to receive 12 weeks of 75 mg twice-weekly pregabalin or 8 mg/day ondansetron or a placebo. Visits were scheduled at 0, 2, 4, 6, 8, and 12 weeks after treatment. The severity of pruritus was evaluated using Visual Analogue Scale and modified Duo’s VAG Scale. Quality of sleep was evaluated using the Pittsburgh sleep quality index. The effect of UP on health-related quality of life was assessed using the Chinese version of the 12-item short-form (SF-12) general health survey. Baseline laboratory data and demographic characteristics were recorded from patient charts.Results: Finally, 179 (108 males, 71 females, aged 54.7 ± 11.3 years old) out of the 188 patients completed the 12-week study. Of five patients who stopped pregabalin treatment due to side effects, two patients reported an improvement in nausea and vomiting among those receiving ondansetron. Two patients dropped out for renal transplantation. The 179 patients included 62 cases from the pregabalin group, 60 from the ondansetron group, and 57 from the placebo group. Over the 12 weeks, only pregabalin improved UP significantly. The severity of pruritus was reduced significantly in the pregabalin group compared with the ondansetron and the placebo groups. The final pruritus scores were not different between the ondansetron and the placebo groups. Pruritus absolutely disappeared in two patients following renal transplantation.Conclusions: Pregabalin is an effective alternative for treatment of uraemic pruritus. Ondansetron has negligible effect on uremic pruritus and is expensive. A larger sample size may be needed to demonstrate the effect of ondansetron in uraemic pruritus.Aim: Pruritus is common among patients with end-stage renal disease undergoing dialysis, and the pathogenesis can be explained by several mechanisms. However, there is no definite evidence supporting them, which limits the relative efficacy of any individual treatment option. In this paper, we aimed to compare pregabalin with ondansetron in treatment of uraemic pruritus (UP) in dialysis patients. © 2014, Springer Science+Business Media Dordrecht.
Shibahara H.,Blood Purification Center |
Shibahara N.,Hashimoto Minami Internal Medicine Clinic
Journal of Nephrology | Year: 2010
Background: The detailed mechanisms and treatment methods of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) are not fully understood. We conducted a prospective study in CHF patients manifesting CKD to examine if AST-120 (Kremezin) improves cardiac and renal functions. Methods: Twenty outpatients with CHF manifesting moderate CKD (serum creatinine 1.3-2.0 mg/dL) were studied. The patients had received AST-120 at a dosage of 6 g/day in combination with existing medications for 24 months. Some parameters of kidney and heart function were monitored. Also the cumulative length of hospital stay and number of admissions for the 2-year periods before and after initiation of AST-120 treatment were calculated. Results: Results of renal function tests, atrial natriuretic peptide, edema, cardiothoracic ratio and hospital stay indicated significant improvements in patients treated with AST-120. The length of hospital stay and number of admissions both decreased significantly during the 2 years of AST-120 treatment compared with the 2 years before treatment, from 39.7 ± 12.9 days to 4.14 ± 2.5 days, and from 0.79 ± 0.21 admissions to 0.21 ± 0.11 admissions, respectively. Conclusions: AST-120 contributes to the improvement of cardiac and renal functions, and consequently improves the quality of life of patients. © 2010 Società Italiana di Nefrologia.
Xiao C.G.,Blood Purification Center
Zhonghua nei ke za zhi | Year: 2013
To explore the incidence and possible risk factors of restless legs syndrome (RLS) in the maintenance hemodialysis patients. A total of 375 maintenance hemodialysis patients were enrolled in this study from September 1 to 30 in 2012. The diagnosis and assessment of severity were based on the International Restless Leg Syndrome Study Group (IRLSSG) standard. The relevant laboratory parameters and dialysis indicators were collected, such as hemoglobin, serum ferritin, parathyroid hormone, blood flow and dialysis mode. The clinical data were analyzed by multivariate logistic regression method. The incidence of RLS was 13.3% with the severity score of 18.69 ± 0.95. The logistic regression analysis showed that anuria (OR 0.292, 95%CI 0.114-0.750) and β2 microglobulin (OR 1.023, 95%CI 1.003-1.044) were the risk factors for RLS in the maintenance hemodialysis patients, while hemoglobin, serum iron and parathyroid hormone were not correlated with RLS. The incidence of RLS is high in the maintenance hemodialysis patients. The risk factors of RLS are anuria and β2 microglobulin. Therefore, the preservation of residual renal function and the improvement of dialysis adequacy, especially the removal of the middle molecular weight toxins, may reduce the occurrence of RLS and improve the quality of life in the hemodialysis patients.
Lou Y.-J.,Blood Purification Center
World Chinese Journal of Digestology | Year: 2015
AIM: To assess the clinical efficacy of omeprazole to prevent upper gastrointestinal bleeding in uremia patients with hemofiltration and determine appropriate nursing measures.METHODS: One hundred and twelve patients with uremia treated at our hospital were divided into either a control group or a treatment group, both of which received hemofiltration and targeted nursing. The treatment group was additionally given omeprazole treatment. Clinical efficacy was observed and compared for the two groups.RESULTS: The gastric pH, incidence rate of upper gastrointestinal bleeding and mortality rate of the control group were 5.22 ± 1.43, 12.5% and 7.1%, respectively; the corresponding values in the treatment group were 6.54 ± 1.54, 1.8% and 0.0%. The gastric pH was significantly higher in the treatment group that in the control group (P < 0.05), while the incidence rate of upper gastrointestinal bleeding and mortality rate were significantly lower in the treatment group (P < 0.05). The rates of nausea and vomiting, headache, anemia and diarrhea did not differ significantly between the control group and treatment group (5.4% vs 3.6%, 3.6% vs 1.8%, 0.0% vs 0.0%, 3.6% vs 0.0%, P > 0.05).CONCLUSION: Using omeprazole to prevent upper gastrointestinal bleeding in uremia patients with hemofiltration is effective. © 2015 Baishideng Publishing Group Inc. All rights reserved.
Xu L.,Shandong University |
Liu Z.-C.,First Peoples Hospital of Taian |
Guan G.-J.,Shandong University |
Lv X.-A.,Taian Central Hospital |
Luo Q.,Blood Purification Center
Kaohsiung Journal of Medical Sciences | Year: 2014
The aim of the present study was to evaluate the efficacy of cyclosporine A (CsA) combined with medium/low dose prednisone in the treatment of progressive immunoglobulin A nephropathy (IgAN). Ninety-six patients who satisfied the inclusion criteria were enrolled in a prospective controlled clinical study. They were assigned into two groups and initially given either 0.6-0.8 mg/kg/day prednisone (maximum 40 mg/day) plus 3 mg/kg/day CsA (CsA group), or 1 mg/kg/day prednisone (maximum 60 mg/day) alone (steroid group). During therapy, the dose of prednisone was reduced in both groups and the dose of CsA was gradually tailed off over the first 3 months and maintained at 2 mg/kg/day in the CsA group. Urinary protein excretion, serum biochemical indexes, clinical efficacy and side effects of CsA were assayed. A significant decline in mean 24-hour urinary protein excretion (p < 0.05) was observed 1 month after treatment in patients in the CsA group, which was observed 2 months after treatment in the steroid group. The decline in mean 24-hour urinary protein excretion in the CsA group was more significant than in the steroid group. Serum albumin level increased significantly in the CsA group 2 months after therapy (p < 0.05). Moreover, at the end of the course, a higher remission rate was observed in patients with Lee's Grade III IgAN after combined treatment with prednisone and CsA (p < 0.05). No significant difference in clinical efficacy was observed in patients with Lee's Grade IV and Grade V IgAN between the two groups (p > 0.05). CsA at a dose of 2-3 mg/kg/day in combination with medium/low dose prednisone was effective in inducing remission of IgAN, especially for patients with Lee's Grade III IgAN, and is a safe and effective choice for short-term treatment of patients with progressive IgAN. © 2014, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.