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Objective: To determine the frequency of Arteriovenous Fistula (AVF) Stenosis and Access Recirculation (AR) among Hemodialysis patients. Study Design: Cross-Sectional Study. Setting: Dialysis Unit, Nephrology Department, Fatima Jinnah Medical University, Sir Ganga Ram Hospital, Lahore. Period: July 2017, to December 2017. Material & Methods: Eighty-four patients on maintenance hemodialysis fulfilling selection criteria were enrolled in the study. All the patients underwent Doppler ultrasonography for AVF stenosis detection and Peak systolic velocity (PSV) of more than 500 ml/sec predicted 50% or greater stenosis of AVF. A two-needle urea-based method was used for the calculation of AR and the AR value of more than 10% was considered significant. Data were analyzed in Statistical Package for Social Science (SPSS) v23.0. Data were stratified according to age, sex, BMI, hypertension, smoking, and duration of dialysis. Post-stratification, Chi-square was used. P-value ≤0.05 was taken significantly. Results: Among ESRD patients, 60(71.4%) were males and 24(28.6%) were females. 65(77.4%) had hypertension and 21(25.0%) were smokers. Among these patients, 6(8.3%) had AV fistula stenosis, and 10(11.9%) had access re-circulation. Statistically, a significant correlation was only present between AVF stenosis and AR (p-value 0.003) Conclusion: The periodic measurement of AVF stenosis and AR have diagnostic implications in maintenance hemodialysis patients because these are important causes of inadequate dialysis. [ABSTRACT FROM AUTHOR]

Background The skin is an external reflection of many renal pathologies and hence serves as an important tool for the clinician. Mucocutaneous manifestations are commonly observed among patients with chronic kidney disease undergoing hemodialysis. Objective To estimate the frequency of dermatoses in patients undergoing hemdialysis. Study design Descriptive study. Place and duration of study Dialysis Centre, Shaikh Zayed Hospital, Lahore from 01.06.18 to 30.11.18. Materials and Methods One hundred and seventy seven patients of chronic kidney disease undergoing hemodialysis of both genders irrespective of dialysis duration were observed for various dermatoses. Results There were 109 (61.6%) males and 68 (38.4%) females and male to female ratio was 1.6:1. The age of patients ranged from 11-75 years with the mean age being 45.80±14.30 years. One hundred and twenty patients were found to have skin problems. Xerosis was most common (37.9%) followed by pruritus (30.5%) while diffuse hyperpigmentation was seen in 20.3% of patients. Among the nail findings were onychomycosis (2.8%), Beau’s lines (3.4%). Hair changes such as sparse scalp hair and dry lusterless hair were seen in 10.2% and 1.7% of cases respectively. Other cutaneous findings observed were pallor 5.1%, ichthyosis vulgaris 2.3%, cellulitis 0.6%, bullous eruption at site of AV fistula 0.6%, seborrheic dermatitis 0.6%, scabies 1.1%, Schambergs’ disease 0.6%, calcinosis cutis 1.1%, paronychia 1.1%, angular cheilitis 0.6% and keratosis pilaris 0.6%. Conclusion A broad range of dermatoses occur in patients with chronic kidney disease on hemodialysis. Many of them negatively impact on quality of life. Their early recognition and treatment are essential in reducing morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objective: To measure recirculation by Urea based Method in double lumen catheters in patients undergoing hemodialysis. Design: Cross sectional study. Place and duration of study: Hemodialysis unit of Nephrology department of Shaikh Zayed Hospital, Lahore, and Quaid- i-Azam Medical College Bahawalpur for period of eight months from October 2007 to May 2008. Patients and methods: Total 125 adult patients selected with Non probability purposive sampling technique in which hemodialysis were done through double lumen catheter, were studied for recirculation. Access recirculation by urea based method with three sample technique was calculated from following formula; Percentage Recirculation= Systemic (S) - Arterial (A)/ systemic - Venous (V) x 100. Results: Out of 125 patients 53 (42%) were males, whereas 72 (58%) were females. Their mean age was 43.4 ± 15.7 years. Percentage recirculation by urea based method was 10.3± 6.64 with range from 3.6 to 24.8. Conclusions: Our results have shown the upper limit of acceptable recirculation (10.3± 6.6) through double lumen catheter. Central venous catheter remains an important temporary access and in some cases the only achievable access for the patients. This recirculation should be considered when measuring adequacy level in these patients. [ABSTRACT FROM AUTHOR]