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Mr Alireza Shariati, Dr Mohammad Mojerloo, Mr Einolah Molaei, Mr Moslem Hesam, Mr Hamid Asayesh, Mr Hossein Nasiri, Dr Gholamreza Mahmodi,
Volume 7, Issue 2 (11-2010)
Abstract

  Background and Objective : Anemia is one of the most common complications of end stage renal diseases. Inadequate production of erythropoietin is the main cause of anemia in these patients, and iron deficiency is the other important factor. We designed this study to survey the prevalence of iron deficiency anemia in hemodialysis patients referred to hemodialysis ward of Panje Azar hospital in Gorgan, Iran.

  Material and Methods: The subjects of this descriptive and cross-sectional study were all 97 patients undergone permanent hemodialysis. Hemoglobin, Serum Iron, Ferritin, Transferrin saturation and Hemoglobin index were measured to assess iron deficiency anemia. We did data analysis by using chi square, fisher exact test and independent T test in spss 13 environment.

  Results: The prevalence of anemia and iron deficiency anemia were 57.6 and 31.1 percent, respectively. Tranferrin saturation in 29.16 percent of the patients is less than 20%. There was no significant correlation between signs of anemia and variables such as, duration of dialysis, causes of the disease and iron- deficiency anemia (p=0.06). But signs of anemia were significantly correlated (p<0.0001) with erythropoietin. In comparison with patients consumed iron orally, those who used injectable iron had higher serum iron, Hemoglobin and Transferrin saturation (p<0.001).

  Conclusion: Because of high frequency of iron- deficiency that may results in resistance to erythropoietin therapy and leads to inappropriate treatment of iron deficiency. We recommend first treating of ID to prevent from useless administering of erythropoietin.


Saied Ghari, Einollah Molaie, Dr Mohammad Mojerloo, Naser Behnampour, Alireza Shariati, Mohammad Jafar Aghakhani, Maryam Khari, Robabeh Salehi,
Volume 9, Issue 2 (1-2013)
Abstract

  Background and objective : Low blood pressure and Muscle cramps are common complications of Hemodialysis. One approach that has recently been proposed to prevent this complication is the combination of sodium and ultrafiltration. The purpose of this study was to investigate the effect of of sodium and ultrafiltration profile on some of the common complications during Hemodialysis.

  Material and Methods: In this crossover clinical trial study, 22 Hemodialysis patients referred to Panje-­Azar Hospital in 2012 were divided randomly into two groups. For each group, two treatment protocols were conducted, six hemodialysis sessions. The intervention protocol was a linear sodium dialysate and linear ultrafiltration. In routine Protocol, both sodium dialysate and ultrafiltration were considered constant. Using chi-square test and relative risk, the data was analyzed (P<0.05).

  Results: The mean age is 54.73 ± 11.21 year and 59.1% of them are females. The incidence of hypotension and muscle cramps in the experimental protocol procedure is significantly decreased compared with that of control group (P<0.05), but the incidence of headache and vomiting is not significant (P<0.05).

  Conclusion: Because sodium and ultrafiltration profile is simple and cost-free and reduces the incidence of complications during dialysis, we recommend using sodium and UF profile instead of routine one.


Dr Mohammad Mojerloo, Alireza Shariati, Hamid Asayesh, Dr Hamid Reza Joshaghani, Moslem Hesam, Hossein Nasiri, Mahdis Shariati, Maryam Safarian,
Volume 10, Issue 0 (Supplementary 2013)
Abstract

  Background and Objective: anemia is one of the main problems of chronic renal failure patients undergone Hemodialysis and erythropoietin is not effective for these patients. Since Vitamin C deficiency in Hemodialysis patients is common, this study was performed to compare the effect of intravenous and oral ascorbic acid consumption on anemia in Hemodialysis patients.

  Material and Methods: this clinical trial was conducted on 75 patients, selected via convenience sampling and including criteria (hemoglobin, 11mg/dl ferritin, 100ug/L transferring saturation, < 20%). The subjects were randomly assigned to three equal groups of control , oral ascorbic acid (POAA) and intravenous ascorbic acid (IVAA) After each every-other-day dialysis performed for eight weeks, the patients of IVAA group were given 300mg intravenous vitamin C and the ones of POAA group given 500mg vitamin C orally. The Plasma iron with chemical method, total iron-binding capacity (TIBC) and ferritin level with indirect method, hemoglobin with cell counter and transferring saturation (TSAT) with related formula were measured. Using a checklist, the data of demographic, laboratory results and side effects were recorded and analyzed by SPSS-13, using ANOVA and scheffe post-hoc test (p≤ 0.05).

  

  Results: the baseline hemoglobin, serum iron, ferritin, TIBC and TSAT in three groups were not different significantly. After intervention, the hemoglobin level of IVAA group( 20.1g/dl ) and in POAA group (0.99g/dl) were increased compared to control group(P>0.001). the mean of hemoglobin in IVAA was significantly more than POAA (P>0.05).

  

  Conclusion: based on the results, the use of oral and intravenous vitamin C can be effective in the anemia caused by iron deficiency, especially vitamin C injection that is more beneficial.

 


Einollah Mollaie, Saied Ghari, Dr Mohammad Mojerloo, Naser Behnampour, Alireza Shariati, Mohammad Jafar Aghakhani, Seyyed Yaghoob Jafari, Maryam Khari, Robabeh Salehi,
Volume 10, Issue 2 (10-2013)
Abstract

Background and objective: Hypotension and Muscle cramp are the common complications of Hemodialysis. One approach that has recently been proposed to prevent this complication is the change in the concentration of sodium and ultrafiltration. The purpose of this study was to investigate the influence of sodium dialysate variation and ultrafiltration in preventing hypotension and muscle cramp during hemodialysis process.
Material and Methods: In this clinical trial study, 44 Hemodialysis patients were divided randomly into four groups. For each group, four treatment protocols (six-session Hemodialysis) were conducted. Protocol A: Sodium dialysate and ultrafiltration were constant. Protocol II: sodium was linear and ultrafiltration was constant. Protocol III: Sodium and ultrafiltration were linear. Protocol IV (routine): Sodium and ultrafiltration were constant. Using Chi-Square and relative risk, the data was analyzed (P<0.05).
Results: The incidence of hypotension, at the end of the fourth hour of dialysis in Protocol 3, was significantly decreased compared to that of routine method (P<0.05), while at the end of first, second and third hour, this difference was not significant. Muscle cramp in the routine method was more than other protocols (P=0.034). The relative risk of muscle cramp in the routine method was 2.08 times of protocol I, 1.09 of Protocol II, 2.08 of protocol III.
Conclusion: Sodium and ultrafiltration profile is simple and cost-free, and it reduces the incidence of hypotension and muscle cramp during dialysis. Thus, we recommend using sodium and UF profile instead of routine protocol to reduce these effects.


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