losartan-potassium and calcium-acetate

Interdialytic weight gain is an important prognostic factor in dialysis patients. Different eating patterns may affect interdialytic weight gain. The goal was to assess the effect of the Mediterranean type of diet on interdialytic weight gain of chronic hemodialysis patients.. This study had a cross-sectional design.. Four hospital-based satellite hemodialysis units in different cities in Turkey.. A total of 702 patients (279 women, 423 men; mean age, 47.8 +/- 15.5 years) were included in the study. They were grouped according to the hemodialysis centers: Alanya-Izmir (group 1, n = 194) and Ankara-Adana (group 2, n = 508).. Group 1 patients were consuming a Mediterranean type of diet, whereas group 2 patients had a diet rich in protein and carbohydrates. All of the patients were under the same dialysis and treatment protocols. The demographic data, the medications, interdialytic weight gains, and laboratory data such as serum albumin, C-reactive protein, hemoglobin, hematocrit, serum iron binding capacity, ferritin, and parathyroid hormone during the last 3 months for each patient were recorded.. The interdialytic weight gain differences between the groups were compared using the Student t-test and the Mann-Whitney U test.. When the two groups were compared according to age, sex, blood pressure, serum albumin, hematocrit, and parathyroid hormone levels, there was no statistically significant difference. Mean interdialytic weight gain for group 1 and group 2 was 2.47 +/- 0.94 kg and 3.08 +/- 0.94 kg, respectively (P < .001). When the two groups were compared according to their iron requirements, group 1 showed an increased requirement for doses of iron and erythropoietin (P < .001 and P < .001, respectively).. A Mediterranean-type diet, rich in seafood and vegetables, was associated with less interdialytic weight gain compared with a diet rich in protein and carbohydrates. Although all of our patients had the same diet education and treatment protocols, the geographic region and culture influenced their compliance to diet and their therapeutic outcomes.

Topics: Acetates; Adult; Aged; Blood Pressure; Calcium Compounds; Cross-Sectional Studies; Diet, Mediterranean; Erythropoietin; Female; Ferritins; Hematocrit; Humans; Iron; Male; Middle Aged; Renal Dialysis; Seafood; Vegetables; Weight Gain

A multicenter collaborative study was performed to investigate the prevalence of abnormal blood contents of 6 trace metals, copper (Cu), zinc (Zn), aluminum (Al), lead (Pb), cadmium (Cd), and mercury (Hg), in hemodialysis (HD) patients and to analyze their relationship with the medications, such as CaCO3, Ca acetate, Al containing phosphate-binding agents, 1,25-dihydroxy vitD3, 1-hydroxy vitD3, and erythropoietin (EPO), as well as hematocrit level, by chi-square statistics. From 6 medical centers in Taiwan, we included 456 patients in maintenance HD for more than 4 months for this study, and they had continued the previously mentioned medications for at least 3 months. Blood samples were collected before initiating HD, and atomic absorption spectrophotometry was used to measure plasma levels of Cu, Zn, and Al as well as whole blood levels of Pb, Cd, and Hg. Three hundred seventy-five (78%) of the HD patients had low plasma Zn levels, that is, <800 microg/L, and the mean (+/-SD) concentration was 705.8 (+/-128.23) microg/L in all subjects. One hundred forty-one (31%) of the HD patients had high plasma Al, that is, >50 microg/L, and the mean (+/-SD) was 44.30 (+/-28.28) microg/L in all subjects. Three hundred thirty-three (73%) of the dialysis patients had high Cd levels, that is, >2.5 microg/L, and the mean (+/-SD) was 3.32 (+/-1.49) microg/L in all subjects. The majority of HD patients had normal blood levels of Cu, PB, and Hg. Only 21 (4. 6%), 5 (1.1%), and 3 (0.06%) patients had elevated blood levels of Cu, Pb, and Hg, respectively. Their mean (+/-SD) blood concentration of Cu, Pb, and Hg were 1,049.78 (+/-233.25) microg/L, 7.45 (+/-3.95) microg/dL, and 3.17 (+/-25.56) microg/L, respectively. Three patients had elevated plasma Hg concentrations, that is, 546, 12.6, and 24.0 microg/L, respectively. In the 152 normal healthy age and sex matched control group, the blood levels of Al, Cd, and Pb were all significantly lower than the HD patients. However, the levels of Cu and Zn were higher in the control group. The Hg level was not significantly different in both groups. There was no statistical difference between patients with normal and abnormal blood levels of trace metals in various medications except Al containing phosphate binder. The Al containing phosphate binder users had significantly higher plasma Al levels (54.71 +/- 26.70 versus 41.15 +/- 28.03 microg/L, p < 0.001) and hematocrit levels (29.61 +/- 4.61 versus 27. 81 +/- 3.91, p < 0.0005). There

Topics: Acetates; Aluminum; Aluminum Hydroxide; Cadmium; Calcitriol; Calcium; Calcium Carbonate; Calcium Compounds; Case-Control Studies; Chelating Agents; Chi-Square Distribution; Copper; Cross-Sectional Studies; Erythropoietin; Female; Hematocrit; Humans; Hydroxycholecalciferols; Kidney Failure, Chronic; Lead; Male; Mercury; Metals; Middle Aged; Phosphates; Renal Dialysis; Spectrophotometry, Atomic; Sucralfate; Trace Elements; Zinc