Underlying diseases, nutritional assessment, viral incidence and HBV immunity status in patients undergoing hemodialysis

M. Musavi, A. Rasoolzadeh, M. Salehi, Hadi Fazel
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Abstract

Introduction: Underlying kidney diseases and their progression cease the function of kidney and raise the need for regular maintenance dialysis. Furthermore, nutritional requirements and blood born viral infections affect their quality of life. Objectives: This study aims to investigate viral incidence, underlying kidney diseases, nutritional status; and hepatitis B virus (HBV) immunity status in hemodialysis (HD) patients. Patients and Methods: A total of 330 end-stage renal disease (ESRD) patients were assessed for human immunodeficiency virus (HIV), HBV, hepatitis C virus (HCV) viruses using Enzyme-linked immunosorbent assay (ELISA) assay. The underlying kidney diseases were confirmed by a physician. Eighty-two subjects with diabetic nephropathy are referred to dietitian for nutritional assessments and body mass index (BMI) measurement. Hepatitis B surface antibody (Anti-HBs) tests were done at two different times of year for 94 qualified subjects. Results: Out of 330 patients 82 (24.8%) had diabetic mellitus (DM), 5 (1.5%) myocardial infarction (MI), 3 (0.9%) systemic lupus erythematosus (SLE), 55 (16.7%) hypertensive nephrosclerosis (HN), 3 (0.9%) obstructive nephropathy, 5 (1.5%) autosomal dominant polycystic kidney disease (ADPKD), and 4 (1.2%) glomerulonephritis. 45 cases (13.6%) had DM and HTN simultaneously. Eleven percent of diabetic nephropathy (DN) patients had severe malnutrition. Only five men (1.51%) were positive for HBV. No incidence of HCV and HIV was seen. Findings showed a dramatic change for anti-HBs after 6 months. Conclusion: Despite the advances in medicine, malnutrition and viral diseases still threaten dialysis patients. DM was the most common underlying disease. The safety of dialysis patients for HBV is compromised after regular dialysis, underscoring the importance of strict adherence to vaccination program.
血液透析患者的基础疾病、营养评估、病毒发病率和HBV免疫状况
潜在的肾脏疾病及其进展使肾脏功能停止,并增加了定期维护性透析的需要。此外,营养需求和血源性病毒感染影响他们的生活质量。目的:本研究旨在了解病毒发病率、潜在肾脏疾病、营养状况;血液透析(HD)患者乙型肝炎病毒(HBV)免疫状况。患者和方法:采用酶联免疫吸附试验(ELISA)对330例终末期肾病(ESRD)患者进行人类免疫缺陷病毒(HIV)、HBV、丙型肝炎病毒(HCV)检测。医生证实了潜在的肾脏疾病。82例糖尿病肾病患者被转介给营养师进行营养评估和体重指数(BMI)测量。在一年的两个不同时间对94名合格受试者进行乙型肝炎表面抗体(Anti-HBs)检测。结果:330例患者中,糖尿病(DM) 82例(24.8%),心肌梗死(MI) 5例(1.5%),系统性红斑狼疮(SLE) 3例(0.9%),高血压肾硬化(HN) 55例(16.7%),阻塞性肾病3例(0.9%),常染色体显性多囊肾病(ADPKD) 5例(1.5%),肾小球肾炎4例(1.2%)。DM合并HTN 45例(13.6%)。11%的糖尿病肾病(DN)患者有严重的营养不良。只有5名男性(1.51%)HBV阳性。未见HCV和HIV的发病率。结果显示,6个月后,抗hbs发生了巨大变化。结论:尽管医学进步,但营养不良和病毒性疾病仍然威胁着透析患者。糖尿病是最常见的基础疾病。透析患者在定期透析后HBV的安全性受到损害,这强调了严格遵守疫苗接种计划的重要性。
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