Journal of nephrology
-
Journal of nephrology · May 2009
ReviewSleep disturbances and sleep apnea in patients on chronic peritoneal dialysis.
Sleep disturbances in chronic peritoneal dialysis (PD) patients are increasingly widely recognized. These include changes in sleep architecture, sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder and excessive daytime sleepiness. Some of these entities will be addressed in this review. ⋯ The exact underlying pathophysiology, however, is complex and likely involves a combination of multiple factors. There are preliminary data that nocturnal PD may be advantageous over conventional continuous ambulatory peritoneal dialysis in correcting sleep apnea associated with PD. Randomized studies are needed for confirmation.
-
Journal of nephrology · May 2009
Case ReportsSpontaneous coronary artery dissection: One more extrarenal manifestation of autosomal dominant polycystic kidney disease?
Autosomal dominant polycystic kidney disease (ADPKD) may present with a variety of extrarenal manifestations. Only 1 case of spontaneous coronary artery dissection has been reported so far in ADPKD. Here we report a case of coronary artery dissection occurring in a 38-year-old woman with ADPKD and an unremarkable medical history. ⋯ In conclusion, spontaneous coronary artery dissection is a rare cause of myocardial ischemia and infarction. Myocardial infarction in patients without any risk factors for coronary atherosclerosis or in young patients should prompt a diligent search for a possible spontaneous coronary artery dissection. It is suggested that ADPKD may be a predisposing factor for spontaneous coronary artery dissection.
-
Journal of nephrology · Jan 2009
Randomized Controlled TrialRosuvastatin in hemodialysis: short-term effects on lipids and C-reactive protein.
Patients on regular hemodialysis present high cardiovascular mortality. Uremic dyslipidemia and inflammation take part in the etiology of atherosclerosis. Rosuvastatin calcium has not been studied in patients on dialysis to date. We sought to evaluate the results of rosuvastatin therapy regarding lipids, lipoproteins and a marker of inflammation in hemodialysis patients. ⋯ Rosuvastatin calcium at 10 mg/day was effective in lowering total cholesterol, LDL cholesterol, non-HDL cholesterol and hs-CRP in hemodialysis patients.
-
Journal of nephrology · Nov 2008
Comparative StudyPrognostic factors in critically ill surgical patients requiring continuous renal replacement therapy.
Acute mortality of unselected critically ill patients has improved during the last 15 years. Whether these benefits also affect long-term survival of critically ill surgical patients with severe acute renal failure is unclear, as are the prognostic factors relevant for survival time or mortality. ⋯ Six-month prognosis of critically ill surgical patients with severe acute renal failure is poor and mostly determined by the disease severity at ICU admission and by the frequency of surgical complications. Outcome had not improved over the study period, but after successful surgical and intensive care therapy, long-term survival appears to be reasonably good.