Displaying publications 21 - 40 of 89 in total

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  1. Fulltext Patients with end stage renal disease: a registry at Sultanah Aminah Hospital, Johor Bahru, Malaysia
    Liu WJ, Hooi LS
    Med J Malaysia, 2007 Aug;62(3):197-200.
    PMID: 18246906 MyJurnal
    The epidemiology of new patients presenting to Sultanah Aminah Hospital Johor Bahru (HSAJB) with end-stage renal disease (ESRD) in 2003 and 2004 was analysed. Patients with ESRD were prospectively registered in the renal replacement therapy (RRT) database in the nephrology unit. The incidence of ESRD and the RRT provision rate in the district of Johor Bahru were calculated according to gender and race. There were 306 new patients in 2003 and 299 in 2004. Diabetic nephropathy contributed 56.8% new patients in 2003 and 57.9% in 2004. The mean age was 50.8 + 15.1 years in 2003 and 51.3 + 14.2 years in 2004. Males accounted for 53.3% in 2003 and 47.8% in 2004. Haemodialysis was the commonest form of RRT (60.5% in 2003, 69.9% in 2004), followed by continuous ambulatory peritoneal dialysis (30.1% in 2003, 19.4% in 2004) and renal transplantation (5.5% in 2003, 2.3% in 2004). Ninety-one percent of patients in 2003 and 90% in 2004 were alive at the end of the year they presented. The incidence of ESRD in the district of Johor Bahru was estimated as 136 per million population (p.m.p.) in 2003 and 151 p.m.p. in 2004. In the two year period the incidence of ESRD was higher among females (154 p.m.p.) than males (134 p.m.p.). Malays (194 p.m.p.) had higher ESRD incidence compared to Chinese (126 p.m.p.) and Indians (134 p.m.p.). RRT provision in Johor Bahru (92.7%) did not differ significantly with gender or race. The increasing number of patients presenting to HSAJB with ESRD especially those with diabetic nephropathy is a major concern. Prevention strategies at the primary care level may curb the burden of this chronic disease.
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  2. Optimization of peritoneal dialysis services through research activities
    Tan SY
    Perit Dial Int, 2008 Jun;28 Suppl 3:S49-52.
    PMID: 18552263
    Although peritoneal dialysis (PD) is an effective alternative to hemodialysis (HD) and indeed, in terms of survival, superior to HD in first year of dialysis, the utilization rate for PD remains low. Although the utilization rate of PD varies considerably, the worldwide penetration rate appears to be falling. Still, in rapidly developing countries such as China, the PD penetration rate is rising-an encouraging sign. Clearly, considerable room for improvement remains, particularly with the take-on rate of PD, and one of the potentially influential factors is the role of research activities in improving both the quantity and quality of life of patients on PD.
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  3. Fulltext Total parathyroidectomy under local anaesthesia for renal hyperparathyroidism
    Cheong YT, Taib NA, Normayah K, Hisham AN
    Asian J Surg, 2009 Jan;32(1):51-4.
    PMID: 19321403 DOI: 10.1016/S1015-9584(09)60009-9
    Renal hyperparathyroidism with attendant osteodystrophy is a frequent and severe morbidity affecting the quality of life of end stage renal failure patients surviving on long-term renal replacement therapy. A small subgroup of these patients with severe cardiorespiratory dysfunction was deemed at very high risk for general anaesthesia (GA). We report on a series of total parathyroidectomy under local anaesthesia (LA) for these patients.
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  4. Fulltext Frequencies of hepatitis B and C infections among haemodialysis and peritoneal dialysis patients in Asia-Pacific countries: analysis of registry data
    Johnson DW, Dent H, Yao Q, Tranaeus A, Huang CC, Han DS, et al.
    Nephrol Dial Transplant, 2009 May;24(5):1598-603.
    PMID: 19096083 DOI: 10.1093/ndt/gfn684
    The impact of dialysis modality on the rates and types of infectious complications has not been well studied. The aim of the present investigation was to evaluate the rates of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in peritoneal dialysis (PD) and haemodialysis (HD) patients in the Asia-Pacific region.
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  5. Establishing learning curve for Tenckhoff catheter insertion by interventional nephrologist using CUSUM analysis: how many procedures and in which situation?
    Goh BL, Ganeshadeva Yudisthra M, Lim TO
    Semin Dial, 2009 Mar-Apr;22(2):199-203.
    PMID: 19426429 DOI: 10.1111/j.1525-139X.2008.00536.x
    Peritoneal dialysis (PD) catheter insertion success rate is known to vary among different operators, and peritoneoscope PD catheter insertion demands mastery of a steep learning curve. Defining a learning curve using a continuous monitoring tool such as a Cumulative Summation (CUSUM) chart is useful for planning training programs. We aimed to analyze the learning curve of a trainee nephrologist in performing peritoneoscope PD catheter implantation with CUSUM chart. This was a descriptive single-center study using collected data from all PD patients who underwent peritoneoscope PD catheter insertion in our hospital. CUSUM model was used to evaluate the learning curve for peritoneoscope PD catheter insertion. Unacceptable primary failure rate (i.e., catheter malfunction within 1 month of insertion) was defined at >40% and acceptable performance was defined at <25%. CUSUM chart showed the learning curve of a trainee in acquiring new skill. As the trainee became more skillful with training, the CUSUM curve flattened. Technical proficiency of the trainee nephrologist in performing peritoneoscope Tenckhoff catheter insertion (<25% primary catheter malfunction) was attained after 23 procedures. We also noted earlier in our program that Tenckhoff catheters directed to the right iliac fossae had poorer survival as compared to catheters directed to the left iliac fossae. Survival of catheters directed to the left iliac fossae was 94.6% while the survival for catheters directed to the right iliac fossae was 48.6% (p < 0.01). We advocate that quality control of Tenckhoff catheter insertion is performed using CUSUM charting as described to monitor primary catheter dysfunction (i.e., failure of catheter function within 1 month of insertion), primary leak (i.e., within 1 month of catheter insertion), and primary peritonitis (i.e., within 2 weeks of catheter insertion).
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  6. Alkaline phosphatase predicts calcium requirements after total parathyroidectomy in patients receiving dialysis
    Goh BL, Yudisthra MG, Hisham AN
    Br J Surg, 2010 Feb;97(2):185-8.
    PMID: 20035536 DOI: 10.1002/bjs.6818
    : It can be difficult to achieve a stable serum calcium level after parathyroidectomy for renal hyperparathyroidism. This study examined the impact of a calcium replacement protocol guided by predicted need in reducing hospital stay.
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  7. Complications after tenckhoff catheter insertion: a single-centre experience using multiple operators over four years
    Liu WJ, Hooi LS
    Perit Dial Int, 2010 03 12;30(5):509-12.
    PMID: 20228175 DOI: 10.3747/pdi.2009.00083
    OBJECTIVE: To analyze the complications after Tenckhoff catheter insertion among patients with renal failure needing dialysis. ♢

    PATIENTS AND METHODS: The open, paramedian approach is the commonest technique to insert the 62-cm coiled double-cuffed Tenckhoff peritoneal catheter. All patients with catheters inserted between January 2004 and November 2007 were retrospectively analyzed for demographics and followed for up to 1 month for complications. We excluded patients whose catheters had been anchored to the bladder wall and who underwent concurrent omentectomy or readjustment without removal of a malfunctioning catheter (n = 7). Intravenous cloxacillin was the standard preoperative antibiotic prophylaxis. ♢

    RESULTS: Over the 4-year study period, 384 catheters were inserted under local anesthetic into 319 patients [201 women (62.8%); mean age: 49.4 ± 16.7 years (range: 13 - 89 years); 167 (52.2%) with diabetes; 303 (95%) with end-stage renal disease] by 22 different operators. All Tenckhoff catheters were inserted by the general surgical (n = 223) or urology (n = 161) team. There were 29 cases (7.6%) of catheter migration, 22 (5.7%) of catheter obstruction without migration, 24 (6.3%) of exit-site infection, 12 (3.1%) of leak from the main incision, 14 (3.6%) of culture-proven wound infection, 11 (2.9%) post-insertion peritonitis, and 1 (0.3%) hemoperitoneum. No deaths were attributed to surgical mishap. ♢

    CONCLUSIONS: The most common complication was catheter migration. The paramedian insertion technique was safe, with low complication rates.

    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  8. Normalized bioimpedance indices are better predictors of outcome in peritoneal dialysis patients
    Koh KH, Wong HS, Go KW, Morad Z
    Perit Dial Int, 2010 06 30;31(5):574-82.
    PMID: 20592100 DOI: 10.3747/pdi.2009.00140
    BACKGROUND: While phase angle of bioimpedance analysis (BIA) has great survival-predicting value in dialysis populations, it is known to be higher in male than in female subjects. In this study, we aimed to explore the factors influencing the predictive value of phase angle and to identify the appropriate physics terms for normalizing capacitance (C) and resistance (R).

    METHODS: We formulated body capacitive index (BCI), C(BMI) (capacitance × height(2)/weight), body resistive index (BRI), R(BMI) (resistance × weight/height(2)), and CH(2) (capacitance × height(2)). We also studied H(2)/R, R/H, and reactance of a capacitor/height (X(C) /H). There are 3 components in this study design: (1) establishment of normal values in a control Malaysian population, (2) comparison of these with a CAPD population, and (3) prediction of survival within a CAPD population. We initially performed a BIA study in 206 female and 116 male healthy volunteers, followed by a prospective study in a cohort of 128 CAPD patients [47 with diabetes mellitus (DM), 81 non-DM; 59 males, 69 females] for at least 2 years. All the parameters during enrolment, including BIA, serum albumin, peritoneal equilibrium test, age, and DM status, were analyzed. Outcome measurement was survival.

    RESULTS: In healthy volunteers, both genders had the same BCI (2.0 nF kg/m(2)). On the contrary, female normal subjects had higher BRI than male normal subjects (median 15 642 vs 13242 Ω kg/m(2), p < 0.001) due to higher fat percentage (35.4% ± 0.4% vs 28.0% ± 0.6%, p < 0.001), resulting in a lower phase angle (mean 5.82 ± 0.04 vs 6.86 ± 0.07 degrees, p < 0.001). Logistic regression showed that BCI was the best risk indicator in 128 CAPD patients versus 322 normal subjects. In age- and body mass index (BMI)-matched head-to-head comparison, BCI had the highest χ(2) value (χ(2) = 102.63), followed by CH(2) (or H(2)/X(C); χ(2) = 81.00), BRI (χ(2) = 20.54), and X(C)/H (χ(2) = 20.48), with p value < 0.001 for these parameters. In comparison, phase angle (χ(2) = 11.42), R/H (χ(2) = 7.19), and H(2)/R (χ(2) = 5.69) had lower χ(2) values. 35 (27.3%) patients died during the study period. Univariate analysis adjusted for DM status and serum albumin level demonstrated that non-surviving patients had significantly higher CH(2) (245 vs 169 nF m(2), p < 0.001) and BCI (4.0 vs 2.9 nF m(2)/kg, p = 0.005) than patients that survived. CH(2) was the best predictor for all-cause mortality in Cox regression analysis, followed by BCI, phase angle, and X(C)/H.

    CONCLUSION: Measures that normalize, such as BCI and CH(2), have higher risk discrimination and survival prediction ability than measures that do not normalize, such as phase angle. Unlike phase angle, measurement of BCI overcomes the gender effect. In this study, the best risk indicator for CAPD patients versus the general population is BCI, reflecting deficit in nutritional concentration, while CH(2) reflects total nutritional deficit and thus is the major risk indicator for survival of CAPD patients.

    Matched MeSH terms: Kidney Failure, Chronic/therapy
  9. Impact of interventional nephrology on outcome and penetration rate of a CAPD program
    Wong CM, Ng KP, Keng TC, Lim SK, Tan SY
    Perit Dial Int, 2011 3 24;31(2):194-6.
    PMID: 21427247 DOI: 10.3747/pdi.2009.00237
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  10. Fulltext In-centre intermittent peritoneal dialysis: a viable interim option to an eventual definitive renal replacement therapy?
    Ng EK, Goh BL, Hamdiah P
    Med J Malaysia, 2012 Apr;67(2):151-4.
    PMID: 22822633 MyJurnal
    In-centre intermittent peritoneal dialysis (IPD), a decade-old modality commonly associated with acute (stab) PD, continues to play an undeniably important role of providing "temporary" renal replacement therapy (RRT) in Malaysia. In our center, IPD is commenced after insertion of Tenckhoff catheter by interventional nephrologists as an interim option until a definitive RRT is established. This study aims to describe our experience and evaluate the viability of this modality as a bridging therapy. We retrospectively analyzed 39 IPD patients from January 2007 to December 2009; looking at demographics, cause of end-stage renal disease, duration on the program, length of hospitalization, PD-related infection profile, biochemical parameters and clinical outcomes. We accumulated a total experience of 169 patient-months, the average age of patients was 54.6 +/- 11.6 years, 84.6% of them diabetics. The median duration of a patient in the program was 88 days with accumulated in-hospital stay of 45 days. Eventually 48.7% of the patients secured placement for long-term haemodialysis while 20.5% were converted to CAPD. The mortality rate was 7.7% while the peritonitis rate was at 1 per 18.8 patient months. Our study shows that IPD is a viable interim option with a low infection rate and good clinical outcome.
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  11. Fulltext A retrospective review of diabetic nephropathy patients during referral to the sub-urban nephrology clinic
    Menon R, Mohd Noor FS, Draman CR, Seman MR, Ghani AS
    Saudi J Kidney Dis Transpl, 2012 Sep;23(5):1109-14.
    PMID: 22982937 DOI: 10.4103/1319-2442.100972
    Diabetic nephropathy (DN) has become the most common cause of end-stage renal failure. Early referral and specific nephrology treatment could delay the disease progression and should reduce the treatment cost, mortality and morbidity rate in these patients. This is a single-center, retrospective review of all DN patients referred to the nephrology clinic in Hospital Sultan Ahmad Shah, Temerloh, from 2000 to 2009, to study and define the clinical characteristics of DN patients at the time of the referral to the nephrology clinic. A total of 75 patient case records were reviewed. Forty-three (57.3%) of them were males, with a median age of 64.3 ± 8.5 years at the time of referral. Only 14.7% of them had blood pressure lower than 125/75 mmHg. Co-morbid and disease-related complications were also commonly diagnosed and 28.4% (n = 21) had ischemic heart disease, 23% (n = 17) had diabetic retinopathy and 20.3% (n = 15) had diabetic neuropathy. The mean serum creatinine at the time of referral was 339.8 ± 2.3 μmol/L, gylcated hemoglobin A 1c (HbA1C) was 8.1 ± 2.0 %, serum fasting glucose was 9.6 ± 4.7 mmol/L, serum cholesterol was 5.4 ± 1.2 mmol/L and hemoglobin level was 10.6 ± 2.9 g/dL. Although female patients were less frequently seen in the early stages of chronic kidney disease (CKD), they comprised at least 72.7% of CKD stage 5 (male:female; 6:16, P <0.05). Twenty-nine percent (n=22) of them were referred at CKD stage 5, 48% (n=36) were at CKD stage 4, 17.3% (n=13) were at CKD stage 3, 4% (n=3) were at CKD stage 2 and 1.3% (n=1) was at CKD stage 1. Advanced CKD patients were frequently prescribed with more antihypertensives. CKD stage 5 patients were prescribed with two-and-half types of antihypertensive as compared to two types of anti-hypertensive in CKD stage 2 and stage 3. Furthermore, ACE-inhibitors (ACE-I) were less frequently prescribed to them. Only 22.7% (n=5) of CKD stage 5 patients received ACE-I and 30% (n=11) in CKD stage 4 patients as compared to 53.4% (n=7) in CKD patients stage 3. This review shows that DN patients were referred late to the nephrologists and the overall disease management was suboptimal. Antihypertensive requirement was also increased and ACEIs were less frequently prescribed in the advanced diabetic nephropathy patients.
    Study site: Nephrology Clinic, Hospital Sultan Ahmad Shah, Temerloh, Pahang, Malaysia
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  12. Multicenter analysis on the impact of nephrologist-initiated catheter insertion program on peritoneal dialysis penetration
    Ng EK, Goh BL, Chew SE, Tan CC, Ching CH, Sha'ariah MY, et al.
    Semin Dial, 2012 Sep-Oct;25(5):569-73.
    PMID: 22353629 DOI: 10.1111/j.1525-139X.2012.01051.x
    The demands for timely catheter insertion have spurred the growth of peritoneoscopic catheter insertion program by nephrologists in Malaysia. We performed a multicenter analysis to study its impact on the growth of peritoneal dialysis (PD) population. Data were collected retrospectively from five centers at the point of program initiation until December 2009. In Center 1, with this program, PD population continued to grow from 25 patients in 2006 to 120 in 2009. In center 2, the program began in 2005, but comprised only 28.6% of total insertions. From 2007 onwards, nephrologists had overtaken the surgeon, inserting from 85% to 97% of the total insertions. In center 3, with the program at its infancy, a modest growth in its PD population was shown. In center 4, nephrologists maintained an annual average of 41.8% of total catheter insertions, and thus maintaining a stable PD population. In center 5, surgeon-assisted PD catheter insertions helped to maintain the growth of its PD, seeing lesser impact from this program. Subanalysis showed that 1-year catheter survival in Center 1 was 85.4%. This study on PD catheter insertion program by nephrologists showed the greatest impact on new center and center experiencing suboptimal catheter insertions by traditional providers.
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  13. Randomized controlled trial to compare the efficacy and safety of oral paricalcitol with oral calcitriol in dialysis patients with secondary hyperparathyroidism
    Ong LM, Narayanan P, Goh HK, Manocha AB, Ghazali A, Omar M, et al.
    Nephrology (Carlton), 2013 Mar;18(3):194-200.
    PMID: 23311404 DOI: 10.1111/nep.12029
    The objective of the study was to compare the efficacy and safety of oral paricalcitol with oral calcitriol for treating secondary hyperparathyroidism.
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  14. Depression and coping in adults undergoing dialysis for end-stage renal disease
    Ibrahim N, Kong NCT, Desa A, Razali R
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:35-40.
    PMID: 23857835 DOI: 10.1111/appy.12042
    Introduction: Research on depression in local patients with end-stage renal disease (ESRD) is sparse. Thus, this study aims to examine the frequency and severity of depression among ESRD patients and relate depression with their coping skills.
    Methods: A cross-sectional study using universal sampling method was conducted at several dialysis centers in Kuala Lumpur, Selangor and Johor, Malaysia. The Beck Depression Inventory II (BDI-II) and the Brief COPE scale were used to measure depression and coping skill, respectively.
    Results: The study involved 274 ESRD patients, comprising of 183 hemodialysis and 91 continuous ambulatory peritoneal dialysis patients. The result showed that 21.1% of the patients experienced moderate to severe depression. Several components of coping skill were associated with depression. However, only two components in the Brief COPE (behavioral disengagement and self-blame) were identified as predictors.
    Discussion: This study showed that depression is common in ESRD patients and is related to the types of coping skills adopted by patients. Hence, this study provides some insight into ESRD patients with depression. Appropriate counseling should be given to these patients to empower them to cope with the illness so as to enhance their quality of life.
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  15. Fulltext Melioidosis and peritoneal dialysis related peritonitis
    Wong KW
    Med J Malaysia, 2013 Apr;68(2):179-80.
    PMID: 23629573 MyJurnal
    We report a case of melioidosis presenting as peritonitis in a patient on continuous ambulatory peritoneal dialysis (CAPD). A 47-year-old man, a lorry driver, with end-stage renal disease due to diabetes mellitus on CAPD presented in PD-related peritonitis. He was started on intraperitoneal cloxacillin and ceftazidime, and changed to intraperitoneal vancomycin and meropenam after day 5 due to nonresponse. Burkholderia pseudomallei was identified from the dialysate culture. He was treated with intraperitoneal meropenam for two weeks, and IV ceftazidime for 4 weeks. He responded, and the Tenckhoff catheter was not removed. He was discharged well and continued on oral sulfamethoxazole/trimethoprim for six months. This patient had done his PD exchanges in a lorry.
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  16. Fulltext Factors associated with quality of life among hemodialysis patients in Malaysia
    Md Yusop NB, Yoke Mun C, Shariff ZM, Beng Huat C
    PLoS One, 2013;8(12):e84152.
    PMID: 24358336 DOI: 10.1371/journal.pone.0084152
    Although hemodialysis treatment has greatly increased the life expectancy of end stage renal disease patients, low quality of life among hemodialysis patients is frequently reported. This cross-sectional study aimed to determine the relationship between medical history, hemodialysis treatment and nutritional status with the mental and physical components of quality of life in hemodialysis patients. Respondents (n=90) were recruited from Hospital Kuala Lumpur and dialysis centres of the National Kidney Foundation of Malaysia. Data obtained included socio-demography, medical history, hemodialysis treatment and nutritional status. Mental and physical quality of life were measured using the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) of the Short-Form Health Survey 36-items, a generic core of the Kidney Disease Quality of Life Short Form. Two summary measures and total SF-36 was scored as 0-100, with a higher score indicating better quality of life. Approximately 26 (30%) of respondents achieved the body mass index (24 kg/m(2)) and more than 80% (n=77) achieved serum albumin level (>35.0 mg/dL) recommended for hemodialysis patients. The majority of respondents did not meet the energy (n=72, 80%) and protein (n=68,75%) recommendations. The total score of SF-36 was 54.1 ± 19.2, while the score for the mental and physical components were 45.0 ± 8.6 and 39.6 ± 8.6, respectively. Factors associated with a higher MCS score were absence of diabetes mellitus (p=0.000) and lower serum calcium (p=0.004), while higher blood flow (p=0.000), higher serum creatinine (p=0.000) and lower protein intake (p=0.006) were associated with a higher PCS score. To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality of life are warranted to reduce further health complications and to improve quality of life.
    Matched MeSH terms: Kidney Failure, Chronic/therapy
  17. Perception of quality of life amongst end stage renal failure patients undergoing haemodialysis
    Ho SE, Ho CC, Norshazwani N, Teoh KH, Ismail MS, Jaafar MZ, et al.
    Clin Ter, 2013;164(6):499-505.
    PMID: 24424213 DOI: 10.7417/CT.2013.1627
    AIMS: The objective of the study was to examine the quality of life amongst the end stage renal disease (ESRD) haemodialysis patients in Malaysia.

    MATERIALS AND METHODS: A cross sectional descriptive study was conducted on 72 ESRD patients at a Dialysis Centre in Malaysia. The modified KDQOL-SF™ subscales, kidney disease-targeted scale and 36 item health survey scale questionnaires were used.

    RESULTS: The overall health rating was 66.73 ± 11.670 indicating good quality of life. There was no significant difference between quality of life for the different domains according to gender (p >0.05). However, there were significant differences between quality of life in the domain of burden of kidney disease. Physical functioning deteriorated significantly with age (p=0.012) while social functioning was lowest in the 50-65 years age group (p=0.037). Those who had no morbidities had significantly better scores on the effects of kidney (p=0.036), burden of kidney disease (p=0.011) and physical functioning (p=0.025).

    CONCLUSIONS: Patients undergoing haemodialysis have been found to have good quality of life despite having ESRD. It is therefore of paramount importance to constantly monitor the standard of care for these patients to enable them to live their life to the fullest.

    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  18. Pantoea agglomerans as a rare cause of catheter-related infection in hemodialysis patients
    Wong KW
    J Vasc Access, 2013 Jul-Sep;14(3):306.
    PMID: 23599132 DOI: 10.5301/jva.5000139
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  19. Renal replacement therapy in Brunei Darussalam: comparing standards with international renal registries
    Tan J
    Nephrology (Carlton), 2014 May;19(5):288-95.
    PMID: 24641721 DOI: 10.1111/nep.12228
    Brunei Darussalam is a small South East Asian country with a high prevalence and incidence of end stage kidney disease (ESRD). This study aims to compare key performance indicators recorded in the Brunei Dialysis and Transplant Registry and department records against international practice. Registries from the USA (USRDS), UK (UK Renal Registry), Australasia (ANZDATA), Europe (ERA-EDTA Registry) and Malaysia (MDTR) were used for comparisons.
    Matched MeSH terms: Kidney Failure, Chronic/therapy*
  20. Left ventricular hypertrophy and chronic fluid overload in peritoneal dialysis patients
    Cader RA, Ibrahim OA, Paul S, Gafor HA, Mohd R
    Int Urol Nephrol, 2014 Jun;46(6):1209-15.
    PMID: 24307428 DOI: 10.1007/s11255-013-0615-8
    PURPOSE: Cardiovascular disease is the leading cause of mortality in dialysis patients with left ventricular hypertrophy (LVH) being an important predictor of mortality. We wanted to determine the prevalence of LVH in peritoneal dialysis (PD) patients and factors contributing to it.

    METHODS: This is a cross-sectional study assessing LVH using echocardiogram in PD patients. Left ventricular mass index (LVMI) was calculated to determine LVH. Chronic fluid overload (overhydration) was assessed using the body composition monitor, and blood pressure (BP) was measured using 24-h ambulatory BP monitoring.

    RESULTS: Thirty-one patients (21 females:10 males, 48.97 ± 14.50 years and dialysis vintage 40.0 ± 28.9 months) were studied. More than two-thirds (77.4 %) were hypertensive, and a third (35.5 %) were diabetic. Baseline data included mean serum albumin (37.34 ± 4.43 g/l), weekly Kt/V (2.02 ± 0.23), residual renal function of 68 (0-880) ml and ultrafiltration of 1,606.9 ± 548.6 ml. Majority of patients (80.6 %) had LVH on echocardiogram with LVMI of 136.5 ± 37.8 g/m(2) and overhydration of 2.23 ± 1.77 l. Average systolic BP, diastolic BP and mean arterial pressure were 141.2 ± 23.3, 90.8 ± 19.7 and 107.6 ± 19.6 mmHg, respectively. Patients with LVH had a lower serum albumin (p = 0.003), were more overhydrated (p = 0.010) and were on higher number of anti-hypertensive agents (p ≤ 0.001). Predictors of LVMI were overhydration (p = 0.002), the presence of diabetes (p = 0.008) and the number of anti-hypertensive agents used (p = 0.026). However, overhydration (p = 0.007) was the main predictor of LVH on multivariate analysis.

    CONCLUSION: Overhydration is strongly associated with LVH in PD patients.

    Matched MeSH terms: Kidney Failure, Chronic/therapy*
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