Ana Maria Suarez Conejero, 2nd degree Internal Medicine Specialist and Auxiliar Professor in Faculty of Medical Sciences “Fainlay Albarran” at Mecial Sciences University of Havana.
Background: Sudden cardiac death is frequent in patients with end-stage renal disease. It seems to be ventricular arrhythmias may contribute to mortality. For that reason, would be important to estimate the frequency of significant intradialytic ventricular arrhythmias in patients with end-stage renal disease on hemodialysis and the relationship between the grade of ventricular arrhythmias and clinical, laboratory, electrocardiogram and echocardiogram parameters.\r\n\r\nMethods: Case-control study was performed. 57 patients with end-stage renal disease on maintenance hemodialysis were studied. Holter monitoring was performed the first and second days of dialysis during all hemodialysis session. 114 recordings were analyzed.\r\n\r\nResults: Ventricular arrhythmias during hemodialysis were noted in 57 recordings (50%). In 24% of them, complex ventricular arrhythmias were found. In logistic regression analysis age > 45 (OR: 19.75), male (OR: 12.34), left ventricular hypertrophy (OR: 7.46), bundle branch blocks (OR: 10.98), post-dialysis urea > 9 mmol/L (OR: 5.04) were independent predictors associated with complex ventricular arrhythmia.\r\n\r\nConclusions: Complex ventricular arrhythmias were detected in a significant proportion of patients with end-stage renal disease during hemodialysis. Age, male, left ventricular hypertrophy, bundle branch blocks and postdialysis urea were predictors of complex ventricular arrhythmia.\r\n\r\nKey words: Hemodialysis, Ventricular arrhythmias, End-Stage Renal Disease, Holter monitoring, Electrocardiography.
Keisuke Sugimoto have completed M.D at the age of 27 years, and Ph.D at the age of 34 years from Kindai University Faculty of Medicine. I worked as a research fellow at Department of Nephrology, Vanderbilt University in USA. I obtained a position as a assistant professor of Deaprtment of Pediatrics, Kindai University Faculty of Medicine. I have published more than 20 papers associated with nephrology.
Background. Nephronophthisis (NPH) is a disease characterized by renal medullary cyst formation . NPH accounts for 4 to 5% of end-stage renal disease occurring in childhood.\r\n\r\nMethod:\r\nWe investigated the clinical context and characteristics of renal and extrarenal symptoms, as well as the NPHP genes with genomic DNA extraction, PCR, and determination of NPHP gene sequence, in 35 Japanese patients with clinical and histologic features suggesting NPH.\r\n\r\nResults:\r\nNPH occurred fairly uniformly throughout Japan irrespective of region or gender. In 3 families, NPH affected siblings. Age of patients ranged from 2 to 38 years (median; 12.5. Renal abnormalities attributable to NPH discovered through mass screening, such as urine tests in school. However, NPH accounted for less than 50% of children with abnormal findings, including incidentally discovered renal dysfunction during evaluation of extrarenal symptoms or during routine check-ups. Typical extrarenal manifestations leaded to discovery including anemia and delayed physical development. The urine often showed low gravity specific density and low-molecular-weight proteinuria. Frequent renal histologic findings included cystic dilation of tubules, mainly in the medulla, and irregularity of tubular basement membranes. Genetically abnormalities of NPHP1 were not common, with large deletions frequently noted. Compound heterozygotes showing single abnormalities in each of NPHP1, NPHP3, and NPHP4 were observed.\r\n\r\nConclusions:\r\nOur findings resemble those reported in Western populations.