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Eliasson J, Antonsen LB, Molsted S, Liem YS, Eidemak I, Sille L, Sjøgren P, Kurita GP, Jeppesen PB. A comparison of health-related quality of life in chronic intestinal failure and end-stage kidney disease: A cross-sectional study. JPEN J Parenter Enteral Nutr 2024; 48:184-191. [PMID: 38035855 DOI: 10.1002/jpen.2584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND There is inequal access to treatment and scarce evidence on how the disease burden in chronic intestinal failure (CIF) compares to other chronic nonmalignant types of organ failure. Therefore, we compared the health-related quality of life (HRQOL) of people with CIF with that of people with end-stage kidney disease (ESKD) receiving hemodialysis (HD). These groups were selected for comparison as they have similar treatment characteristics. We hypothesized that people treated with HD and people with CIF had similarly poor HRQOL. METHODS HRQOL was evaluated and compared in a cross-sectional study of adult people with CIF and people with ESKD HD at a tertiary hospital in Denmark, using the Short-Form 36 (SF-36). RESULTS One hundred forty-one people with CIF and 131 people with ESKD receiving HD were included in the analysis. Both groups reported low scores (<50) for HRQOL on general health, vitality, and role limitation-physical. People with ESKD receiving HD had significantly lower scores than people with CIF regarding physical functioning, general health, and vitality when adjusted for sex and age. No significant difference was found for any other SF-36 domain. CONCLUSION HRQOL was similarly and significantly reduced in people with CIF and in people with ESKD receiving HD. People with ESKD receiving HD had significantly poorer HRQOL than people with CIF in some aspects of physical and mental health. Access to home parenteral support treatment varies among countries that typically provide HD, suggesting an inequality in healthcare based on the type of organ failure.
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Affiliation(s)
- Johanna Eliasson
- Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise B Antonsen
- Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, Hillerød, Denmark
| | - Ylian S Liem
- Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Larsen Sille
- Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Sjøgren
- Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Geana P Kurita
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Anaesthesiology, Pain and Respiratory Support, Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Palle B Jeppesen
- Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Lykke C, Sørensen J, Liem YS, Eidemak I, Larsen S, Sjøgren P, Molsted S, Laursen L, Kurita GP. Co-Occurrence of Prevalent Symptoms in Patients Receiving Hemodialysis - A Cross-Sectional Survey. Nephrol Nurs J 2023; 50:497-504. [PMID: 38112678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Patients with chronic kidney disease undergoing hemodialysis generally have a significant symptom burden, which may interfere with their quality of life. The aim of this study was to identify the prevalence of fatigue, pain, anxiety, and depression in patients on hemodialysis and analyze their co-occurrence. A cross-sectional study used self-reported measures. A total of 242 patients aged 18 years or older were initially screened; 141 were included in the study; 129 answered the questionnaires (response rate 91%). Preva lences were 24.8% had moderate to severe fatigue, 38.0% had pain, 32.6% had anxiety, and 29.5% had depression. The prevalence of coexistent moderate to severe symptoms ranged from 15.5% to 25.6%. Further research is needed to better understand the symptom burden and their co-occurrence in patients receiving hemodialysis.
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Affiliation(s)
- Camilla Lykke
- Postdoc, the Section of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, and the Department of Oncology and Palliative Care, North Zealand Hospital, Hillerød, Denmark
| | - Jonas Sørensen
- PhD Student, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Ylian S Liem
- Physician, the Department of Nephrology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Physician, the Section of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Sille Larsen
- Project Nurse, the Section of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Sjøgren
- Consultant, the Section of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Stig Molsted
- Senior Researcher, Research Unit, North Zealand Hospital, Hillerød, Denmark
| | - Louise Laursen
- Project Nurse, the Section of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Geana P Kurita
- Professor at the Section of Palliative Medicine, Department of Oncology, and the Pain and Palliative Care Research Group, Multidisciplinary Pain Centre, Department of Anesthesiology, Pain and Respiratory Support, Rigshospitalet Copenhagen University Hospital, and the Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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3
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Kurita GP, Eidemak I, Larsen S, Jeppesen PB, Antonsen LB, Molsted S, Liem YS, Pressler T, Sjøgren P. The impact of caring on caregivers of patients with life-threatening organ failure. Palliat Support Care 2023:1-7. [PMID: 37185060 DOI: 10.1017/s1478951523000469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES This study aimed at characterizing 3 populations of family/friend caregivers of patients with different life-threatening organ failure regarding health-related quality of life, caregiver burden, and dyadic coping. METHODS Three cross-sectional (population) studies were conducted at a tertiary hospital in Denmark (2019-2020). Patients with renal failure (RF), cystic fibrosis (CF), and intestinal failure (IF) were asked to designate the closest person with ≥18 years old involved in the care (caregiver) to participate in this study. Number of caregivers included were RF = 78, CF = 104, and IF = 73. Electronic questionnaires were filled in by caregivers to assess health-related quality of life and caregiver burden and by caregivers and respective patients to assess dyadic coping. RESULTS The 3 caregiver groups had self-perception of poor health and energy; however, caregivers of CF patients perceived their physical role functioning better than those caregiving for RF and IF patients (p = 0.002). The level of caregiver burden was reported as not high, but caregivers used in average 13 hours/day for caring. Moreover, cleaning tasks (p = 0.005) and personal care (p = 0.009) were more demanding in RF and IF patients. Caregivers also did not differ regarding dyadic coping. When comparing patients and caregivers, stress communication by oneself and the partner differed (p < 0.001). SIGNIFICANCE OF RESULTS Caregivers spent many hours in the care role, they reported poor health, and dyadic coping may be improved. Interventions in caregivers of patients with life-threatening organ failure could help to improve care management at home, caregiver's health, and dyadic coping between caregiver and patient and consequently reduce caregiver burden.
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Affiliation(s)
- Geana Paula Kurita
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Palliative Research Group, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
- Multidisciplinary Pain Centre, Department of Anaesthesia, Pain and Respiratory Support, Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark
| | - Inge Eidemak
- Section of Palliative Medicine, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Sille Larsen
- Section of Palliative Medicine, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Palle Bekker Jeppesen
- Department of Intestinal Failure and Liver Diseases, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Louise Bangsgaard Antonsen
- Department of Intestinal Failure and Liver Diseases, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Ylian Serina Liem
- Department of Nephrology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Tania Pressler
- Cystic Fibrosis Centre, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Palliative Research Group, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
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Buur LE, Madsen JK, Eidemak I, Krarup E, Lauridsen TG, Taasti LH, Finderup J. Correction: Does conservative kidney management offer a quantity or quality of life benefit compared to dialysis? a systematic review. BMC Nephrol 2022; 23:352. [PMID: 36324071 PMCID: PMC9632121 DOI: 10.1186/s12882-022-02963-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Louise Engelbrecht Buur
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jens Kristian Madsen
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
| | - Inge Eidemak
- Department of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Elizabeth Krarup
- Department of Renal Medicine, Herlev and Gentofte Hospital, Herlev, Denmark
| | | | | | - Jeanette Finderup
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark. .,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Sørensen J, Sjøgren P, Stine C, Sørensen TV, Heinecke K, Larsen H, Eidemak I, Kurita GP. Patient-reported outcome measures (PROMs) and palliative-care clinician reported outcomes (ClinROs) mutually improve pain and other symptoms assessment of hospitalized cancer-patients. Scand J Pain 2022; 22:569-577. [PMID: 35179007 DOI: 10.1515/sjpain-2021-0162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/25/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Patients with malignant diseases are known to have a high symptom burden including pain, and insufficient treatment of pain in this population has been frequently documented. To promote the integration of specialized palliative care and hematology and oncology, this study investigated disease, treatment, and comorbidity related symptoms as well as functional capacity and health-related quality of life (HQoL) by patient-reported outcome measures (PROMs) and clinician-reported outcome measures (ClinROs) among inpatients in a comprehensive cancer center. METHODS This cross-sectional study was carried out in a large comprehensive cancer centre of both oncological and hematological inpatients. It combined the use of PROMs and ClinROs. RESULTS A high symptom burden was reported with fatigue and appetite loss as the most frequent symptoms, and role function being the most impaired function. Further, a low HQoL score was associated with a high number of symptoms/impairments. More than half of all patients reported pain in the last 24 h. Out of 95 patients with average pain >0 in the last 24 h, 71% were treated with opioids and 24% were treated with adjuvant analgesic (AA) defined as antiepileptics, antidepressants and prednisolone. Out of 57 patients with average pain >0 in the last 24 h and possible neuropathic pain, 33% were treated with AAs. A high odds ratio for moderate/severe pain in patients with possible neuropathic pain mechanisms was observed. CONCLUSIONS AND IMPLICATIONS This study did not only emphasize the need for systematic use of PROMs to identify symptoms and needs for inpatients, but also displayed why PROMs supported by ClinROs are a prerequisite to deliver truly individualized and high-quality patient-centered care. This study calls for continuous training of health care professionals to deliver high-quality treatment of pain. Further, it contributes to the growing recognition, that palliative care and standard care must be integrated to strengthen patient-centered care.
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Affiliation(s)
- Jonas Sørensen
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Clemmensen Stine
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tanja Vibeke Sørensen
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Katja Heinecke
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Henrik Larsen
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Geana Paula Kurita
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Oncology and Multidisciplinary Pain Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Molsted S, Wendelboe S, Flege MM, Eidemak I. The impact of marital and socioeconomic status on quality of life and physical activity in patients with chronic kidney disease. Int Urol Nephrol 2021; 53:2577-2582. [PMID: 33674948 DOI: 10.1007/s11255-021-02826-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/24/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Quality of life (QOL) and physical activity (PA) is reduced in patients with chronic kidney disease (CKD). The aim was to investigate the impact of marital status and educational level on QOL and PA in patients with CKD including dialysis treatment. METHODS This cross-sectional study included ambulatory adult patients undergoing dialysis or CKD stage 4-5. Data for marital status, educational level and PA were obtained using the Danish health and Morbidity Survey. QOL was assessed using the Physical Component Scale and the Mental Component Scale scores from the Kidney Disease Quality of Life Instrument. RESULTS Five hundred twelve participants were included: 316 (62%) were married/had a permanent partner, 119 (23%) had a low level of education, 327 (67%) were physically active. After confounder adjustments (age, sex, treatment), having a permanent partner was associated with greater scores in Mental Component Scale, β 2.88 [CI 95% 0.99; 4.77], p = 0.003, and being physically active in women OR 2.237 [1.231; 4.066], p = 0.008. A high vs low educational level was associated with greater scores in Physical Component Scale (3.79 [1.01; 6.58], p = 0.008) and in Mental Component Scale (3.55 [0.82; 6.28], p = 0.011). CONCLUSION In ambulatory patients with CKD stage 4-5, being married or having a permanent partner and a high educational level had positive impacts on mental QOL. Higher educational level was also associated with better physical QOL. The presented inequality in QOL should be considered in communications, care and treatments in clinical practice.
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Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark.
| | - Sofie Wendelboe
- Department of Medicine, Zealand University Hospital Roskilde, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| | - Marius M Flege
- Department of Medicine, Amager Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark
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Høgdal N, Eidemak I, Sjøgren P, Larsen H, Sørensen J, Christensen J. Occupational therapy and physiotherapy interventions in palliative care: a cross-sectional study of patient-reported needs. BMJ Support Palliat Care 2020:bmjspcare-2020-002337. [PMID: 32788277 DOI: 10.1136/bmjspcare-2020-002337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/22/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION An interdisciplinary team approach to patients in specialised palliative care is recommended; however, the composition of the professionals tends to vary, and the roles of physiotherapists and occupational therapists may be underestimated. We aimed to investigate patient-reported unmet needs, which potentially could benefit from physiotherapy and occupational therapy interventions in a specialised palliative care team. METHODS Adult patients with chronic advanced diseases referred to the Specialised Palliative Care Team at Copenhagen University Hospital, Rigshospitalet were enrolled in the study. The Three-Levels-of-Needs Questionnaire was used as primary outcome to assess symptom/problem intensity, symptom/problem burden and felt needs for 12 commonly reported symptoms/problems for patients referred to a specialised palliative care team. Furthermore, participants' level of distress, fatigue and physical activity, symptoms of anxiety and depression, and barriers towards the rehabilitation programme were registered with other measures. RESULTS In total, 43 of 67 (64%) patients participated. The majority of participants reported severe symptoms/problems concerning fatigue (81%), impaired physical activities (77%), carrying out work and daily activities (77%), pain (72%), and worries (58%). Furthermore, need for help was expressed concerning physical activities (79%), work and daily activities (77%), fatigue (70%), pain (65%), concentration (58%) and worries (51%). On average the patients characterised 6 (out of 12) symptoms/problems as severe. CONCLUSION Patients referred to a specialised palliative care team reported extensive unmet needs concerning physical activities, work and daily activities, fatigue, pain, concentration and worries. Unmet needs that potentially could be alleviated by physiotherapists or occupational therapists implemented in the interdisciplinary team.
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Affiliation(s)
- Nina Høgdal
- Section of Occupational Therapy and Physiotherapy, Rigshospitalet HovedOrtoCentret, Copenhagen, Denmark
| | - Inge Eidemak
- Section of Palliative Medicine, Rigshospitalet Department of Oncology, Copenhagen, Denmark
| | - Per Sjøgren
- Section of Palliative Medicine, Rigshospitalet Department of Oncology, Copenhagen, Denmark
| | - Henrik Larsen
- Section of Palliative Medicine, Rigshospitalet Department of Oncology, Copenhagen, Denmark
| | - Jonas Sørensen
- Section of Palliative Medicine, Rigshospitalet Department of Oncology, Copenhagen, Denmark
| | - Jan Christensen
- Section of Occupational Therapy and Physiotherapy, Rigshospitalet HovedOrtoCentret, Copenhagen, Denmark
- REHPA - The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark
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8
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Kesmez Ö, Frøjk MJ, Eidemak I, Jensen SB, Kragelund C. Oral symptoms and pathologies in Danish patients with chronic kidney disease- a pilot study. APMIS 2020; 128:401-405. [PMID: 32202674 DOI: 10.1111/apm.13042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/04/2020] [Indexed: 01/07/2023]
Abstract
The aim was to investigate oral health in randomly selected patients with chronic kidney disease (CKD). Data obtained by structured interview (self-reported lifestyle, oral symptoms and regularity of dental visits) and oral examination of patients with CKD from the Copenhagen University Hospital. Fourteen patients with CKD were screened. Only half of the patients reported regular dental visits and poor dental status was registered in half of the patients. Oral mucosal changes were registered in thirteen patients (93%). Eleven patients (79%) had gingival inflammatory disease. Twelve patients (86%) were carriers of Candida, and three (21%) had oral candidosis. Six patients (43%) had low whole saliva flow rate. Twelve patients (86%) reported at least one oral symptom. Overall, there was no differences in oral symptoms or findings related to kidney transplanted or not transplanted patients. The small sample size most likely influences the results. However, the vast majority of patients with CKD reported oral symptoms and only half consulted a dentist regularly. Poor dental status, oral mucosal changes and gingival disease were prevalent findings. Patients with CKD need focus on daily oral healthcare and regular dental visits. Interdisciplinary cooperation could encourage patients with CKD to focus on oral health.
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Affiliation(s)
- Özlem Kesmez
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Metha Juhl Frøjk
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Siri Beier Jensen
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Camilla Kragelund
- Oral Pathology and Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Molsted S, Eidemak I. Musculoskeletal pain reported by mobile patients with chronic kidney disease. Clin Kidney J 2020; 13:813-820. [PMID: 33123357 PMCID: PMC7577771 DOI: 10.1093/ckj/sfz196] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background Musculoskeletal pain has been reported as a clinical problem in patients with chronic kidney disease (CKD). The purpose of this study was to compare the frequency of musculoskeletal pain in patients with CKD and no mobility problems with a general population and to investigate the impact of pain on quality of life (QOL), physical activity and physical function. Methods Patients with CKD Stages 4 and 5 with or without a dialysis treatment and no mobility problems were included. Musculoskeletal pain in the shoulder/neck, back/low back and limbs and level of physical activity were measured using the Danish Health and Morbidity Survey and coded into dichotomous answers. QOL and physical function were measured using the kidney disease QOL questionnaire and the 30-s chair stand test, respectively. Data for the general population were collected in national registers and adjusted for age, gender and region. Results The patients (n = 539) had a mean age of 66 [95% confidence interval (CI) 65–67] years, 62% were men and they were treated with haemodialysis (HD) (n = 281), peritoneal dialysis (n = 62) or without dialysis (n = 196). The frequency of reported musculoskeletal pain in the patients did not exceed pain reported by the general population [e.g. pain in the limbs in patients undergoing HD versus a matched general population, 61% versus 63% (P = 0.533), respectively]. Pain in all measured body sites was associated with reduced QOL [e.g. pain in the limbs associated with a physical component scale β of −8.2 (95% CI −10.3 to −6.0), P < 0.001]. Pain in the limbs was associated with a reduced number of repetitions in the 30-s chair stand test [mean −1.7 (95% CI −3.0 to −0.4), P = 0.009]. Pain in the shoulder/neck was associated with reduced odds of being physically active [odds ratio 0.6 (95% CI 0.4 to 0.9); P = 0.022]. Conclusions Musculoskeletal pain was not more frequently reported by patients with CKD and no mobility problems compared with the general population. However, as musculoskeletal pain was reported by up to two-thirds of the patient sample, healthcare professionals should remember to focus on this issue. The patients’ pain was associated with negative impacts on QOL, level of physical activity and physical function.
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Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Inge Eidemak
- Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Denmark
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10
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Molsted S, Brauner C, Eidemak I. SP408IS PHYSICAL ACTIVITY ASSOCIATED WITH LOW BACK PAIN AND PHYSICAL FUNCTION IN PATIENTS UNDERGOING DIALYSIS? Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Cecilie Brauner
- Emergency Department, Nordsjællands Hospital, Hillerød, Denmark
| | - Inge Eidemak
- Department of Nephrology P, Rigshospitalet, Copenhagen, Denmark
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11
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Abstract
Health related quality of life (HRQOL) has become a recognized outcome in studies of the treatment of patients undergoing hemodialysis (HD). The aim of this study was to assess changes in HRQOL reported by two different samples of patients undergoing HD in the same dialysis center in 2002 and 2015. Two samples of patients from the same Danish dialysis center completed the HRQOL questionnaire Kidney Disease Quality of Life version 1.3 in 2002 (n = 71) and 2015 (n = 81), respectively. The associations between KDQOL summery scores and the time frame were analyzed in multivariable regression analyses. The 2015 sample of patients were older compared to the 2002 sample (66 ± 13 vs. 59 ± 16 years, p = 0.003, respectively), they comprised more obese patients (20.6 vs. 3.2%, p = 0.002) and more patients with hypoalbuminemia (66.7 vs. 42.9%, p = 0.006). After confounder adjustment the time period 2015 versus 2002 was not associated with changes in the generic summery scales Physical Component Scale (β 3.9, 95% CI <-0.1; 7.9, p = 0.051) and Mental Component Scale (β -2.5, 95% CI -7.6; 2.5, p = 0.322) or the disease specific summery scale Kidney Disease Component Scale (β 1.0, 95% CI -5.1; 7.1, p = 0.746). This study indicated an unchanged HRQOL when recent data were compared with data collected 13 years earlier in patients undergoing HD from a Danish dialysis center. We suggest that the included dialysis center monitor HRQOL and pay attention on interventions that may be associated with improvements of HRQOL and reduce the elevated frequency of patients with obesity or hypoalbuminemia.
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Affiliation(s)
- Signe de Place Knudsen
- a Department of Clinical Research , Nordsjællands Hospital , Hillerød , Denmark ;,b Department of Public Health , University of Southern Denmark , Odense M , Denmark
| | - Inge Eidemak
- c Department of Nephrology P , Rigshospitalet, Copenhagen University Hospital Copenhagen Ø , Denmark
| | - Stig Molsted
- a Department of Clinical Research , Nordsjællands Hospital , Hillerød , Denmark
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12
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Molsted S, Andersen JL, Harrison AP, Eidemak I, Mackey AL. Fiber type-specific response of skeletal muscle satellite cells to high-intensity resistance training in dialysis patients. Muscle Nerve 2015; 52:736-45. [PMID: 25736589 DOI: 10.1002/mus.24633] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The aim of this study was to assess the effect of high-intensity resistance training on satellite cell (SC) and myonuclear number in the muscle of patients undergoing dialysis. METHODS Patients (n = 21) underwent a 16-week control period, followed by 16 weeks of resistance training 3 times weekly. SC and myonuclear number were determined by immunohistochemistry of vastus lateralis muscle biopsy cross-sections. Knee extension torque was tested in a dynamometer. RESULTS During training, SCs/type I fibers increased by 15%, whereas SCs/type II fibers remained unchanged. Myonuclear content of type II, but not type I, fibers increased with training. Before the control period, the SC content of type II fibers was lower than that of type I fibers, whereas contents were comparable when normalized to fiber area. Torque increased after training. CONCLUSIONS Increased myonuclear content of type II muscle fibers of dialysis patients who perform resistance training suggests that SC dysfunction is not the limiting factor for muscle growth.
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Affiliation(s)
- Stig Molsted
- Department of Cardiology, Nephrology & Endocrinology, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Løvind Andersen
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Adrian Paul Harrison
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Inge Eidemak
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Abigail Louise Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Molsted S, Eiken P, Andersen JL, Eidemak I, Harrison AP. Interleukin-6 and vitamin D status during high-intensity resistance training in patients with chronic kidney disease. Biomed Res Int 2014; 2014:176190. [PMID: 24800209 PMCID: PMC3996980 DOI: 10.1155/2014/176190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 12/20/2022]
Abstract
Background. The aim of this study was to investigate IL-6 and 25-hydroxyvitamin D (25-OH D) associations with muscle size and muscle function in dialysis patients. Methods. Patients were included in a 16-week control period followed by 16 weeks of high-intensity resistance training thrice weekly. IL-6 and 25-OH D were analysed after an over-night fast. Muscle fibre size was analysed in biopsies from m. vastus lateralis. Muscle power was tested using a Leg Extensor Power Rig. Results. Patients (n = 36) with IL-6 ≥ 6.49 pg/ml (median) were older and had decreased muscle power and a reduced protein intake (P < 0.05) compared with patients with IL-6 < 6.49 pg/ml. IL-6 was not associated with muscle fibre size. Vitamin D deficiency (25-OH D < 50 nmol/l) was present in 51% of the patients and not associated with muscle power. IL-6 remained unchanged during the training period, whilst muscle power increased by 20-23% (P < 0.001). Conclusion. Elevated IL-6 values were associated with decreased muscle power but not with decreased muscle fibre size. Half of the patients were suffering from vitamin D deficiency, which was not associated with muscle power. IL-6 was unchanged by high-intensity resistance training in dialysis patients in this study.
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Affiliation(s)
- Stig Molsted
- Department of Cardiology, Nephrology & Endocrinology, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Pia Eiken
- Department of Cardiology, Nephrology & Endocrinology, Nordsjællands University Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3, 2200 Copenhagen N, Denmark
| | - Jesper L. Andersen
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
| | - Inge Eidemak
- Department of Nephrology P, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Adrian P. Harrison
- Department of Basic Animal and Veterinary Sciences, Faculty of Health and Medical Sciences, Copenhagen University, Grønnegårdsvej 15, 1870 Frederiksberg C, Denmark
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Molsted S, Andersen JL, Eidemak I, Harrison AP. Increased rate of force development and neuromuscular activity after high-load resistance training in patients undergoing dialysis. Nephrology (Carlton) 2013; 18:770-6. [DOI: 10.1111/nep.12145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Stig Molsted
- Department of Cardiology, Nephrology and Endocrinology; Nordsjaellands Hospital; Hillerød Denmark
| | - Jesper L Andersen
- Institute of Sports Medicine Copenhagen; Bispebjerg University Hospital; Copenhagen Denmark
| | - Inge Eidemak
- Department of Nephrology P; Rigshospitalet, Copenhagen University Hospital; Copenhagen Denmark
| | - Adrian P Harrison
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences; Copenhagen University; Copenhagen Denmark
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Molsted S, Harrison AP, Eidemak I, Dela F, Andersen JL. Improved glucose tolerance after high-load strength training in patients undergoing dialysis. Nephron Clin Pract 2013; 123:134-41. [PMID: 23887226 DOI: 10.1159/000353231] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 05/23/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The aim of this controlled study was to investigate the effect of high-load strength training on glucose tolerance in patients undergoing dialysis. METHODS 23 patients treated by dialysis underwent a 16-week control period followed by 16 weeks of strength training three times a week. Muscle fiber size, composition and capillary density were analyzed in biopsies obtained in the vastus lateralis muscle. Glucose tolerance and the insulin response were measured by a 2-hour oral glucose tolerance test. RESULTS All outcome measures remained unchanged during the control period. After strength training the relative area of type 2X fibers was decreased. Muscle fiber size and capillary density remained unchanged. After the strength training, insulin concentrations were significantly lower in patients with impaired glucose tolerance or type 2 diabetes (n = 14) (fasting insulin from 68 ± 12 (46-96) to 54 ± 10 (37-77) pmol/l, p < 0.05, 2-hour insulin from 533 ± 104 (356-776) to 344 ± 68 (226-510) pmol/l, p < 0.05, total insulin area under the curve from 1,868 ± 334 (1,268-2,536) to 1,465 ± 222 (1,094-1,913), p < 0.05). Insulin concentrations were unchanged in patients with normal glucose tolerance (n = 9). CONCLUSION The conducted strength training was associated with a significant improvement in glucose tolerance in patients with impaired glucose tolerance or type 2 diabetes undergoing dialysis. The effect was apparently not associated with muscle hypertrophy, whereas the muscle fiber type composition was changed.
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Affiliation(s)
- Stig Molsted
- Department of Basic Animal and Veterinary Sciences, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
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Malhotra R, Usyvat L, Raimann J, Thijssen S, Levin N, Kotanko P, Hilderman M, Qureshi AR, Al-Abed Y, Anderstam B, Bruchfeld A, Minco M, Argentino G, Grumetto L, Postiglione L, Memoli B, Riccio E, Striker G, Yubero-Serrano E, Uribarri J, Vlassara H, do Sameiro-Faria M, Ribeiro S, Kohlova M, Rocha-Pereira P, Fernandes J, Nascimento H, Reis F, Miranda V, Bronze-da-Rocha E, Quintanilha A, Costa E, Belo L, Santos-Silva A, Modilca M, Margineanu M, Gluhovschi G, Vernic C, Velciov S, Petrica L, Barzuca E, Gluhovschi C, Balgradean C, Kaycsa A, Stockler-Pinto M, Dornelles S, Cozzolino S, Malm O, Mafra D, Cobo G, Rodriguez I, Oliet A, Hinostroza J, Vigil A, Di Gioia M, Gallar P, Drechsler C, Wanner C, Blouin K, Pilz S, Tomaschitz A, Krane V, Marz W, Ritz E, van der Harst P, de Boer R, Carrero JJ, Cabezas-Rodriguez I, Zoccali C, Qureshi A, Ketteler M, Gorriz J, Rutkowski B, Teplan V, Kramar R, Pavlovic D, Goldsmith D, Benedik M, Fernandez-Martin J, Cannata-Andia J, Guido G, Loiacono E, Serriello I, Camilla R, Coppo R, Amore A, Schiller A, Munteanu M, Schiller O, Mihaescu A, Olariu N, Andrei C, Anton C, Ivacson Z, Roman V, Berca S, Bansal V, Marcelli D, Grassmann A, Bayh I, Scatizzi L, Marelli C, Etter M, Usvyat L, Kooman J, Sande F, Levin N, Kotanko P, Canaud B, Quiroga B, Villaverde M, Abad S, Vega A, Reque J, Yuste C, Barraca D, Perez de Jose A, Lopez-Gomez JM, Castellano Gasch S, Palomares I, Dominguez J, Ramos R, Schmidt J, Hafer C, Clajus C, Hadem J, Schmidt B, Haller H, Kielstein J, Katagiri M, Kamada Y, Kobayashi N, Moriguchi I, Ito Y, Kamekawa D, Akiyama A, Ishii H, Tanaka S, Kamiya K, Hamazaki N, Kato M, Shimizu R, Hotta K, Masuda T, Veronesi M, Mancini E, Valente F, Righetti F, Brunori G, Santoro A, Bal Z, Tutal E, Erkmen Uyar M, Guliyev O, Sayin B, Sezer S, Mikami S, Hamano T, Tanaka T, Iba O, Toki M, Mikami H, Takamitsu Y, Inoue T, Fujii M, Hirayama A, Ueda A, Watanabe R, Matsui H, Nagano Y, Nagase S, Aoyagi K, Owada S, Tutal E, Bal Z, Erkmen Uyar M, Sayin B, Tot U, Sezer S, Onec K, Erten Y, Pasaoglu O, Ebinc F, Uludag K, Okyay G, Inal S, Pasaoglu H, Deger S, Arinsoy T, Arias-Guillen M, Masso E, Perez E, Herrera P, Romano B, Perez N, Maduell F, Jung YS, Kim YN, Shin HS, Rim H, Al Ismaili Z, Hassan M, Dastoor H, Bernieh B, Ismael A, Marcelli D, Richards N, Khil M, Sheiman B, Dudar I, Gonchar Y, Khil V, Kim HL, Ryu HH, Kim SH, Bosch Benitez-Parodi E, Baamonde Laborda E, Perez Suarez G, Ramirez JI, Garcia Canton C, Guerra R, Ramirez Puga A, Toledo A, Lago Alonso MM, Checa Andres MD, Hwang WM, Yun SR, Molsted S, Andersen JL, Eidemak I, Harrison AP, Kose E, Turgutalp K, Kiykim A, Celik F, Gok Oguz E. Protein-energy wasting. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gatti G, Lanzani C, Messaggio E, Casamassima N, Hamlyn J, Simonini M, Manunta P, Perri A, Vizza D, Lofaro D, Gigliotti P, Leone F, Papalia T, Bonofiglio R, Gawrys O, Gawarecka K, Swiezewska E, Masnyk M, Chmielewski M, Kompanowska-Jezierska E, Apponi F, Sinibaldi V, Giuliani A, Baldinelli M, Luciani R, Giordano F, Panzieri G, Punzo G, Mene P, Pirozzi N, Dusilova Sulkova S, Horacek J, Safranek R, Kalousova M, Malirova E, Dlabalova B, Kubisova M, Zak P, Sirotina N, Fidchenko Y, Smirnova O, Moraes CF, Marinho SM, Stockler-Pinto MB, Barros AF, Mafra D, Inoue M, Saito T, Ueno K, Yoshimura A, Yamamoto H, Saito O, Kusano E, Moraes CF, Leal VO, Marinho SM, Barroso SG, Rocha GS, Boaventura GT, Mafra D, Molsted S, Andersen JL, Eidemak I, Harrison A, Jorgensen N. Hormones. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Molsted S, Harrison AP, Eidemak I, Andersen JL. The effects of high-load strength training with protein- or nonprotein-containing nutritional supplementation in patients undergoing dialysis. J Ren Nutr 2012; 23:132-40. [PMID: 22959782 DOI: 10.1053/j.jrn.2012.06.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 06/21/2012] [Accepted: 06/27/2012] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the effects of high-load strength training and protein intake in patients undergoing dialysis with a focus on muscle strength, physical performance, and muscle morphology. DESIGN This was a randomized controlled study conducted in three dialysis centers. SUBJECTS Subjects for the study included 29 patients undergoing dialysis. INTERVENTION The participants went through a control period of 16 weeks before completing 16 weeks of strength training. Before the training period, the participants were randomly assigned to receive a protein or a nonprotein drink after every training session. MAIN OUTCOME MEASURE Muscle strength and power were tested using the good strength equipment and the leg extensor power rig. Physical performance and function were assessed using a chair stand test and the Short Form 36 questionnaire. Muscle fiber type size and composition were analyzed in biopsies obtained from the m. vastus lateralis. RESULTS All variables remained unchanged during the control period. After training, muscle strength and power, physical performance, and physical function increased significantly. Muscle fiber composition was changed by a relative decrease in type 2x muscle fiber number whereas muscle size at the fiber level was unchanged. There were no effects of combining the training with protein intake. CONCLUSIONS High-load strength training is associated with improvements in muscle strength and power, physical performance, and quality of life. The effects were surprisingly not associated with muscle hypertrophy, and the results did not reveal any additional benefit of combining the training with protein intake. The positive results in muscle strength and physical performance have clinically relevant implications in the treatment of patients undergoing dialysis.
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Affiliation(s)
- Stig Molsted
- Department of Animal and Veterinary Basic Sciences, LIFE, Copenhagen University, Copenhagen, Denmark.
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Bilgic A, Sezer S, Ozdemir N, Kurita N, Hosokawa N, Nomura S, Maeda Y, Uchihara H, Fukuhara S, Gascon LD, Karohl C, Smith AL, Wilson RO, Raggi P, Ignace S, Loignon RC, Couture V, Marquis K, Utescu M, Lariviere R, Agharazii M, Zahalkova J, Marsova M, Nikorjakova I, vestak M, amboch K, Bellasi A, Gamboa C, Ferramosca E, Ratti C, Block G, Muntner P, Raggi P, Makino J, Makino K, Ito T, Kato S, Yuzawa Y, Yasuda Y, Tsuruta Y, Itoh A, Maruyama S, Karasavvidou D, Kalaitzidis R, Spanos G, Pappas K, Pappas E, Kountouris S, Tatsioni A, Siamopoulos K, Staffolani E, Galli D, Nicolais R, Magliano G, Forleo GB, Santini L, Romano V, Sgueglia M, Romeo F, Di Daniele N, Freercks R, Swanepoel C, Carrara H, Raggi P, Rayner B, Freercks R, Swanepoel C, Carrara H, Raggi P, Rayner B, Fedak D, Kuzniewski M, Galicka-Latala D, Kusnierz-Cabala B, Dumnicka P, Pasowicz M, Solnica B, Sulowicz W, Kuzniewski M, Fedak D, Kapusta M, Kusnierz-Cabala B, Janda K, Pasowicz M, Solnica B, Sulowicz W, Ozcan M, Calayoglu R, Sengul S, Ensari A, Hazinedaroglu S, Tuzuner A, Nergizoglu G, Erbay B, Keven K, Gross T, Floege J, Leon S, Markus K, Vincent B, Ulrich G, Zitt E, Koenig M, Vychytil A, Auinger M, Wallner M, Lingenhel G, Schilcher G, Lhotta K, Csiky B, Toth G, Sulyok E, Melegh B, Vas T, Wittmann I, Martens-Lobenhoffer J, Awiszus F, Bode-Boger SM, Staffolani E, Nicolais R, Miani N, Galli D, Borzacchi MS, Cipriani S, Sturniolo A, Di Daniele N, Abouseif K, Bichari W, Elewa U, Buimistriuc LD, Badarau S, Stefan A, Leanca E, Covic A, Kimura H, Mukai H, Miura S, Maeda A, Takeda K, Sikole A, Trajceska L, Selim G, Amitov V, Dzekova P, Gelev S, Severova G, Trajceski T, Abe Y, Watanabe M, Ito K, Ogahara S, Nakashima H, Saito T, Oleniuc M, Secara IF, Nistor I, Onofriescu M, Covic A, Papagianni A, Kasimatis E, Stavrinou E, Pliakos K, Spartalis M, Dimitriadis C, Belechri AM, Giamalis P, Economidou D, Efstratiadis G, Memmos D, Chen R, Xing C, Bi G, Ito S, Oyake N, Tanabe K, Shimada T, Capurro F, De Mauri A, Brustia M, Navino C, David P, De Leo M, Usvyat L, Bayh I, Etter M, Lam M, Levin NW, Marcelli D, Raimann JG, Schuh E, Thijssen S, Kotanko P, Sipahioglu M, Unal A, Kocyigit I, Karakurt M, Oguzhan N, Cilan H, Kavuncu F, Tokgoz B, Oymak O, Utas C, Canas L, Galan A, Ferrer E, Filella A, Fernandez M, Bayes B, Bonet J, Bonal J, Romero R, Amore A, Puccinelli MP, Petrillo G, Albiani R, Bonaudo R, Camilla R, Steckiph D, Grandi F, Bracco G, Coppo R, Chen X, Zhu P, Chen Y, Xu Y, Chen N, Tatar E, Kircelli F, Asci G, Carrero JJ, Gungor O, Demirci MS, Ozkahya M, Toz H, Ok E, Buzdugan E, Condor A, Crisan S, Radulescu D, Lucaciu D, Hakemi MS, Nassiri AA, Asadzadeh R, Faizei AM, Molsted S, Andersen JL, Eidemak I, Harrison AP, Rodriguez Gomez MA, Fernandez-Reyes Luis MJ, Molina Ordas A, Heras Benito M, Sanchez Hernandez R, Mortazavi Najafabadi M, Moinzadeh F, Saadatnia SM, Shahidi S, Davarpanah A, Farajzadegan Z, Rodriguez-Reimundes E, Rognant N, Jolivot A, Abdeljaouad A, Pelletier S, Juillard L, Laville M, Fouque D, Santoro A, Zuccala A, Cagnoli L, Bolasco PG, Panzetta O, Mercadal L, Fessy H, London G, Severi S, Domini R, Grandi F, Corsi C. Cardiovascular complications in CKD 5D (2). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Heaf J, Molsted S, Harrison A, Eiken P, Prescott L, Eidemak I. Vitamin D, Surface Electromyography and Physical Function in Uraemic Patients. ACTA ACUST UNITED AC 2010; 115:c244-50. [DOI: 10.1159/000313482] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 09/18/2009] [Indexed: 11/19/2022]
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Abstract
OBJECTIVE The questionnaire Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SF) is valuable for assessing the health-related quality of life in patients treated with chronic dialysis. The aim of this study was to translate and test the reliability of the KDQOL-SF for use in Denmark. MATERIAL AND METHODS Translation into Danish and back-translation into English were performed. Pilot, field and internal consistency reliability tests were performed. RESULTS Cronbach's alpha coefficients for the internal reliability test ranged from 0.77 to 0.93 for the eight generic scales. In a test involving all patients, two of the disease-specific scales had Cronbach's alpha coefficients of <0.70 ("social support" = 0.67; and "quality of social interaction" = 0.43). After removing one item from the scale "quality of social interaction", Cronbach's alpha reached 0.63. A test of the scores of peritoneal dialysis (PD) patients discovered low reliability for three disease-specific scales. The KDQOL-SF manual and the Danish manual for the Short Form 36 (SF36) differed in the scoring of four generic scales: "role limitation-physical", "bodily pain", "general health" and "social function". CONCLUSIONS With the exception of the scale "quality of social interaction" the Danish translation of the KDQOL-SF achieved values in the internal consistency reliability test of the same level as the original U.S. version. When data were stratified according to dialysis treatment, the reliability of PD patients scores was lower. Generic data from the questionnaire SF36 should be scored according to the Danish SF36 manual.
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Affiliation(s)
- Stig Molsted
- Department of Nephrology, Herlev Hospital, Herlev, Denmark.
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Abstract
OBJECTIVE Along with survival and other types of clinical outcome, physical, mental and social well-being are important indicators of the effectiveness of the medical care that haemodialysis (HD) patients receive. The present cross-sectional study was designed to assess self-rated health in HD patients from a large Danish HD centre compared to a Danish general population sample with similar sex and age distributions. Furthermore, employment status and associations between self-rated health and clinical, social and demographic factors were investigated. MATERIAL AND METHODS A total of 150 patients were included. They were asked to complete the Short Form 36 (SF-36) questionnaire and additional questions concerning education and employment status. The SF-36 consists of eight scales representing physical, social, mental and general health. Clinical, biochemical and dialysis adequacy data were obtained from hospital records. RESULTS A total of 112 patients completed the questionnaire, giving a response rate of 75%. Compared to the general population sample, HD patients scored significantly lower on all eight SF-36 scales (p < 0.01), with the greatest difference being observed for items concerning physical functioning. No correlation was found between any of the eight scales and estimates of dialysis adequacy. Of patients aged 18-60 years, 22% were in employment. CONCLUSION In a large group of Danish HD patients, self-rated health (and especially physical function) was found to be substantially impaired compared to the general population and only a small proportion of patients were employed. We believe that results obtained using the SF-36 questionnaire represent an independent marker of health status in HD patients and should be considered, together with common clinical outcome measures, when monitoring patients. Furthermore, we believe that self-rated health questionnaires are a useful tool for evaluating the need for and the effects of physical activity programmes in a dialysis unit.
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Affiliation(s)
- Stig Molsted
- Department of Medical Orthopaedic and Rehabilitation, University Hospital in Copenhagen, Rigshospitalet, Denmark.
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Molsted S, Eidemak I, Sorensen HT, Kristensen JH, Harrison A, Andersen JL. Myosin heavy-chain isoform distribution, fibre-type composition and fibre size in skeletal muscle of patients on haemodialysis. ACTA ACUST UNITED AC 2008; 41:539-45. [PMID: 17853024 DOI: 10.1080/00365590701421330] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Chronic uraemia is associated with abnormalities in skeletal muscles, which can affect their working capacity. It is also well known that the fibre-type composition of skeletal muscles influences endurance, muscle strength and power. In this study we therefore determined the size and distribution of muscle fibres and the myosin heavy-chain (MHC) isoform composition in patients on haemodialysis (HD) in order to establish any differences with values for untrained control subjects. MATERIAL AND METHODS Muscle biopsies were obtained from the vastus lateralis muscle of 14 non-diabetic patients on HD. The size and distribution of muscle fibres were evaluated using adenosine triphosphate synthase (ATPase) histochemistry, whilst MHC isoform composition was determined in muscle homogenates using sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Values were compared to those for a group of age-, gender- and BMI-matched untrained control subjects. The aerobic work capacity of the patients was also determined. RESULTS The MHC composition for I, IIA and IIX isoforms was found to be 35.3% +/- 18.2%, 35.9% +/- 7.1% and 28.9% +/- 15.6%, respectively, findings supported by the ATPase histochemically determined fibre-type composition of the vastus lateralis muscle. The mean fibre area of type 1 and 2 fibres was 3283 +/- 873 and 3594 +/- 1483 MICROm2, respectively. The MHC composition and the size of the type 1 fibres of the patients on HD were significantly different from those of the control subjects. CONCLUSIONS The data demonstrate relatively fewer type 1 and consequently more type 2x fibres, with a corresponding change in MHC isoforms (MHC I and MHC IIX) in the skeletal muscle of patients on HD. Several patients on HD were found to have <15% type 1 (or relative percentage of MHC I) fibres. Such a low percentage of type 1 fibres is very rarely observed in normal untrained subjects. Chronic uraemia more severely affects the composition than the size of fibres.
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Affiliation(s)
- Stig Molsted
- Department of Medical Orthopaedics and Rehabilitation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Molsted S, Prescott L, Heaf J, Eidemak I. Assessment and clinical aspects of health-related quality of life in dialysis patients and patients with chronic kidney disease. Nephron Clin Pract 2007; 106:c24-33. [PMID: 17409766 DOI: 10.1159/000101481] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND/AIMS It is relevant to investigate health-related quality of life (HRQOL) in dialysis and chronic kidney disease (CKD) patients in order to optimise treatment. The aim of this study was to investigate HRQOL in dialysis and CKD patients, to compare results from patients treated with hemodialysis (HD) and peritoneal dialysis (PD) and to investigate the prediction of dialysis quality control parameters (blood hemoglobin, plasma albumin, and Kt/V) and tobacco smoking in disease-specific HRQOL. METHODS Seventy-one HD, 59 PD, and 63 CKD patients participated in the study. Dialysis quality control parameters were measured and the patients completed the questionnaire Kidney Disease Quality Of Life. RESULTS PD patients rated Dialysis Staff Encouragement and Patient Satisfaction better than HD patients (p< or = 0.05). Dialysis patients scored significant lower than the general population in all generic HRQOL scales (p < or = 0.01), whereas CKD patients scored lower than the general population in 5 of 8 scales (p < or = 0.05). The dialysis quality parameters did not predict dialysis patients' disease specific HRQOL, but tobacco consumption was independently associated with low scores on a number of HRQOL scales. CONCLUSION Based on the results, it is suggested to include elements of HRQOL as a supplement to standard quality control parameters. It is also suggested routinely to include information of the beneficial effects of physical activity already in the predialysis program, and to focus on smoking as a very important risk factor.
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Affiliation(s)
- Stig Molsted
- Department of Nephrology, Hilleroed Hospital, Hilleroed, Denmark.
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Clausen P, Feldt-Rasmussen B, Iversen J, Lange M, Eidemak I, Strandgaard S. Flow-associated dilatory capacity of the brachial artery is intact in early autosomal dominant polycystic kidney disease. Am J Nephrol 2006; 26:335-9. [PMID: 16825759 DOI: 10.1159/000094402] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Accepted: 06/05/2006] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS Autosomal dominant polycystic kidney disease is associated with endothelial dysfunction of resistance arteries. This study tested whether endothelial dysfunction is also present in the conduit arteries in patients with preserved renal function. METHODS Twenty-seven patients (9 females and 18 males, age 36 +/- 10 years) with polycystic kidney disease and normal renal function were compared to 27 healthy controls. The dilatory responses of the brachial artery to postischemic increased blood flow [endothelium-dependent flow-associated dilatation (FAD)] and to nitroglycerin [endothelium-independent nitroglycerin-induced dilatation (NID)] were measured by external ultrasound. Plasma concentrations of the stable end products of nitric oxide nitrate/nitrite (NOx) and of the endothelial markers vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1, E-selectin and von Willebrand factor antigen were also measured. RESULTS No differences in FAD or NID were found between patients and controls (104.6 +/- 4.2 vs. 105.3 +/- 3.9%, mean +/- SD, p = 0.55, and 117.0 +/- 8.4 vs. 117.5 +/- 7.6%, p = 0.75). However, the plasma concentration of VCAM-1 was elevated and the plasma concentration of NOx was reduced in patients with polycystic kidney disease. CONCLUSION Biochemical markers confirm an association between polycystic kidney disease and endothelial dysfunction. However, a normal FAD of the brachial artery suggests that the endothelial dysfunction does not involve the conduit arteries.
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Affiliation(s)
- Peter Clausen
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark.
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26
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Harrison AP, Nielsen AH, Eidemak I, Molsted S, Bartels EM. The Uremic Environment and Muscle Dysfunction in Man and Rat. ACTA ACUST UNITED AC 2006; 103:p33-42. [PMID: 16352915 DOI: 10.1159/000090221] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Accepted: 09/14/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients reaching end-stage renal disease experience debilitating fatigue, with progression of this disease, rendering patients dysfunctional in their everyday lives. METHODS In vivo measurements of muscle function, assessed using surface electromyography (EMG), were made on 25 patients prior to and after a session of hemodialysis (HD) treatment, along side in vitro measurements of muscle function in isolated rat muscles incubated in normal or uremic conditions approximating to those found in uremic rats (rat uremic: RU) or uremic humans (human uremic: HU). RESULTS HD significantly affected plasma values, e.g. reducing urea (69%), creatinine (62%), potassium (23%) and phosphate (48%) concentrations in patients (all p < 0.01). Treatment also improved the EMG frequency of 2nd dorsal interosseous (fast-twitch) (p < 0.01), although no change was noted for vastus lateralis (slow-twitch). In isolated rat muscles, a uremic environment had no significant effect on slow-twitch soleus during field stimulation, however, in fast-twitch extensor digitorum longus, a significant 23% (RU) and 22% (HU) faster rate of decline in force was measured, compared to controls (p < 0.001 and p < 0.01, respectively). CONCLUSION It is concluded that (1) muscle weakness and its electrophysiological correlates may be rapidly induced by uremic solutes and rapidly reversed when the solutes are removed by dialysis, and (2) fast-twitch muscles are more readily affected by uremic conditions than slow-twitch muscles.
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Affiliation(s)
- A P Harrison
- Institute of Anatomy and Physiology, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark.
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27
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Molsted S, Eidemak I, Sorensen HT, Kristensen JH. Five Months of Physical Exercise in Hemodialysis Patients: Effects on Aerobic Capacity, Physical Function and Self-Rated Health. ACTA ACUST UNITED AC 2004; 96:c76-81. [PMID: 15056989 DOI: 10.1159/000076744] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2003] [Accepted: 10/20/2003] [Indexed: 11/19/2022]
Abstract
BACKGROUND The number of chronic renal failure patients treated by hemodialysis (HD) is continuously increasing. Most patients have reduced physical capacity and have a high risk of cardiac and vascular diseases. The aim of this study was to determine the effects of 5 months physical exercise of HD patients' physical capacity, self-rated health and risk factors for cardiovascular disease. METHODS 33 HD patients were included in the study. INCLUSION CRITERIA HD for more than 3 months, age >18 years. EXCLUSION CRITERIA Diabetes mellitus, symptomatic cardiovascular disease, musculoskeletal limitations, severe peripheral polyneuropathy, inability to speak Danish or English, dementia or other mental disorders. The patients were randomly assigned to an exercise group (EG, n = 22) or a control group (CG, n = 11). Prior to randomization, baseline testing was performed. The effects were measured by aerobic capacity, '2-min stair climbing', 'squat test', self-rated health (SF36), blood pressure and lipids. All tests were carried out by blinded testers. The intervention consisted of 1 h of physical exercise twice a week for 5 months. RESULTS 20 patients completed the intervention. Attendance was 74% of all sessions. There were no dropouts caused by complications related to the intervention. The EG had a significant increase in aerobic capacity, 'squat test' and Physical Function and Physical Component Scale (SF36). No significant changes were observed in any of the parameters in the CG. CONCLUSION Physical exercise twice a week for 5 months increases physical function and aerobic capacity in HD patients. An exercise program with only two exercise sessions per week seems easy to implement in clinical practice with high attendance among participants. Further investigation is needed to determine the effects on blood pressure and lipids. There were no medical complications related to the exercise program.
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Affiliation(s)
- Stig Molsted
- Department of Medical Orthopaedic and Rehabilitation, Copenhagen University Hospital, Rigshospitalet, Denmark.
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28
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Eidemak I, Haaber AB, Feldt-Rasmussen B, Kanstrup IL, Strandgaard S. Exercise training and the progression of chronic renal failure. Nephron Clin Pract 1997; 75:36-40. [PMID: 9031268 DOI: 10.1159/000189497] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The possible beneficial effect of regular exercise training on the progression of chronic renal failure was studied in a prospective randomized controlled study. Thirty patients with a median glomerular filtration rate (GFR) of 25 ml/(min.1.73 m2) (range 10-43) were randomized to physical training (30 min of bicycling daily or an equal amount of other physical activities) or to maintenance of the usual lifestyle. The median maximal work capacity increased significantly in the exercise group and remained unchanged in the control group during a median observation time of 20 months whereas the rate of progression judged by the slope of GFR versus time plot was equal in the two groups. Hence, the beneficial effect of exercise training, earlier observed in rat studies, could not be reproduced in our patients. Physical exercise had no untoward effect on progression of renal disease.
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Affiliation(s)
- I Eidemak
- Department of Medicine, Herlev Hospital, Denmark
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29
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Eidemak I, Feldt-Rasmussen B, Kanstrup IL, Nielsen SL, Schmitz O, Strandgaard S. Insulin resistance and hyperinsulinaemia in mild to moderate progressive chronic renal failure and its association with aerobic work capacity. Diabetologia 1995; 38:565-72. [PMID: 7489839 DOI: 10.1007/bf00400725] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Tissue sensitivity to insulin and aerobic work capacity was measured in patients with mild to moderate progressive chronic renal failure. Twenty-nine non-diabetic patients with a glomerular filtration rate of 25 ml.min-1.1.73 m-2 (11-43) (median, range) and 15 sex, age, and body mass index matched control subjects with normal renal function were studied. Fasting blood glucose was comparable and in the non-diabetic range in the two groups as was the oral glucose tolerance test. Patients demonstrated hyperinsulinaemia both during fasting (p < 0.01) and during the test (p < 0.02). The tissue sensitivity to insulin, expressed by the amount of glucose infused during the last 60 min of a 120-min hyperinsulinaemia euglycaemic clamp (M-value) and the M/I ratio, was significantly lower in the patients than in the control subjects (M-value 404 +/- 118 vs 494 +/- 85 mg glucose/kg body weight, p < 0.02) (M/I ratio 1.77 +/- 0.71 vs 2.57 +/- 0.70 (mg/(kgBW.min) per pmol/l.100, p < 0.001). The maximal aerobic work capacity was significantly lower in the patients than in the control subjects (24 +/- 8 vs 32 +/- 11 ml O2/(kg body weight.min), p < 0.02) and positively correlated to the M-value and the M/I ratio in both groups. In conclusion, not only patients with end-stage chronic renal failure but also those with mild to moderate progressive chronic renal failure are insulin resistant and hyperinsulinaemic. The tissue sensitivity to insulin is correlated to the maximal aerobic work capacity suggesting that these patients might benefit from physical training programmes.
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Affiliation(s)
- I Eidemak
- Department of Nephrology, Herlev University Hospital, Copenhagen, Denmark
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30
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Haaber AB, Eidemak I, Jensen T, Feldt-Rasmussen B, Strandgaard S. Vascular endothelial cell function and cardiovascular risk factors in patients with chronic renal failure. J Am Soc Nephrol 1995; 5:1581-4. [PMID: 7756591 DOI: 10.1681/asn.v581581] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Cardiovascular risk factors and markers of endothelial cell function were studied in nondiabetic patients with mild to moderate chronic renal failure. The transcapillary escape rate of albumin and the plasma concentrations of von Willebrand factor, fibrinogen, and plasma lipids were measured in 29 nondiabetic patients (GFR of 25 (11-44) mL/min x 1.73 m2 (median and range)) and 14 normal subjects. The proportion of smokers was similar between the groups. In the patients, the plasma concentration of von Willebrand factor was elevated by 61% (1.27 +/- 0.44 versus 0.79 +/- 0.28 U/mL; P < 0.01) (mean +/- SD) and that of fibrinogen was elevated by 72% (10.18 +/- 4.14 versus 5.92 +/- 2.01 mumol/L; P < 0.01). The plasma concentrations of lipoproteins showed an atherogenic pattern in the patients with increased levels of very low-density lipoprotein cholesterol (0.57 +/- 0.31 versus 0.33 +/- 0.13 mmol/L; P < 0.01) and triglycerides (1.26 +/- 0.25 versus 0.71 +/- 0.28 mmol/L; P < 0.01), but a decreased level of high-density lipoprotein cholesterol (1.23 +/- 0.33 versus 1.46 +/- 0.35 mmol/L; P < 0.05). Total cholesterol and low-density lipoprotein cholesterol were similar in the groups. The observed differences were further aggravated among smoking patients, particularly with respect to von Willebrand factor and triglycerides. The transcapillary escape rate of albumin was similar in the patients and the controls and was not correlated to the level of albuminuria.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A B Haaber
- Department of Nephrology, Herlev County Hospital, Denmark
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31
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Fogh-Andersen N, Eidemak I, Løkkegaard H, Levin Nielsen S. Changes in blood and plasma volume during treatment with recombinant human erythropoietin. Scand J Clin Lab Invest Suppl 1993; 214:61-5. [PMID: 8332853 DOI: 10.3109/00365519309090680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
18 chronic dialysis patients with renal anemia were examined before and after three months of regular treatment with recombinant human erythropoietin (EPO). All patients responded with an increase in hemoglobin concentration (cHb). The target cHb of 7.0 mmol/L was subsequently maintained by one subcutaneous injection a week, obviating the need of blood transfusions. The amount of circulating hemoglobin and the volume of erythrocytes increased, but the plasma volume simultaneously decreased, maintaining a constant blood volume. Although some of the individual blood volumes varied, the relation between circulating hemoglobin and the hemoglobin concentration still existed. We conclude that the hemoglobin concentration gives an accurate measure of the degree of anemia, and measurement of circulating hemoglobin is unnecessary during routine treatment of dialysis patients with EPO.
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Høegholm A, Eidemak I, Kristensen KS, Bang LE, Madsen NH. Clinical evaluation of the Takeda Medical (A & D) TM 2420 ambulatory blood pressure monitor. Practical experience and comparison with direct and indirect measurements. Scand J Clin Lab Invest 1992; 52:261-8. [PMID: 1439512 DOI: 10.3109/00365519209088357] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Takeda Medical (A & D) TM 2420 is an automatic ambulatory blood pressure monitoring system employing the auscultatory technique. The device was used under stable conditions and compared to readings from the Hawksley random-zero sphygmomanometer using a double headset stethoscope and a Y-connection. We tested 85 subjects (aged 13-89 years, systolic blood pressure 85-212 mmHg, diastolic blood pressure 40-116 mmHg) and found a difference amounting to 1.6 +/- 6.7 mmHg (mean +/- SD) for systolic and 2.1 +/- 4.5 mmHg for diastolic readings (Hawksley-TM 2420). In 62 subjects a comparison with simultaneous measurement on the opposite arm with the Hawksley manometer showed similar results. When comparing intra-arterial readings from 10 subjects, a difference (intra-arterial-TM 2420) of -1.9 +/- 12.1 mmHg was found for systolic pressures, while the diastolic difference was -10.7 +/- 8.7 mmHg. Twenty-four hour monitoring was performed on 80 subjects; 70 of these yielded usable tracings. The proportion of successful recordings was acceptable, but the device was not suitable for bicycle stress testing. The quality of the accessories provided with the equipment could be improved, but in spite of this the monitoring system was found to be recommendable for clinical use.
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Affiliation(s)
- A Høegholm
- Department of Internal Medicine, County Central Hospital, Naestved, Denmark
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33
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Eidemak I, Høegholm A, Kristensen KS, Madsen NH, Nielsen HS. [The new ambulatory non-invasive 24-hour blood pressure monitoring system, Takeda Medical TM 2420. Reliability and practical experiences]. Ugeskr Laeger 1991; 153:335-8. [PMID: 1994554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Takeda TM 2420 is an automatic ambulant device for measuring blood pressure which functions by auscultation of the Korokoff sounds. During static conditions, the apparatus was investigated by means of a double stetoscope and a connecting branch with the Hawksley random zero manometer. Where 69 persons were concerned (ages 13-89 years, systolic blood pressures 85-212 mmHg, diastolic blood pressure 44-110 mmHg) a difference in the systolic blood pressure of 1.5 +/- 9.2 mm Hg were found (average +/- standard deviation) and where the diastolic blood pressure was concerned 2.8 +/- 6.3 mm Hg. Statistical comparison with the Hawksley manometer on the contralateral arm in 51 volunteers produced corresponding results. In 24-hour monitoring of 80 persons, useful results were obtained in 74. The proportion of erroneous measurements was acceptable but the apparatus was unsuitable for exercise testing on an ergometer bicycle. The quality of the cuff, the connecting tubing, the carrying strap and computer programmel should be improved but the apparatus was otherwise found to be useful for daily clinical use.
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Affiliation(s)
- I Eidemak
- Centralsygehuset i Naestved, Medicinsk Afdeling
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34
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Høegholm A, Eidemak I, Kristensen KS. [The time interval before hospitalization in acute myocardial infarction]. Ugeskr Laeger 1989; 151:1861-4. [PMID: 2773096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The prehospital time interval in 103 patients with acute myocardial infarction was investigated. Twenty patients were admitted with cardiac arrest. In the remaining patients the average total delay was found to be 3.3 hours and the patient delay 1.5 hours. The total delay was significantly prolonged in patients who were admitted during working hours, patients who were unaffected on admission, patients transported for long distances, patients who had been visited by their doctors prior to admission and patients who contacted their own doctors. The authors find that attempts should be made to reduce these delays by means of information both to the public and to doctors.
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35
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Kristensen KS, Mortensen SA, Høegholm A, Eidemak I, Hindberg J. [Heart-lung transplantation]. Ugeskr Laeger 1989; 151:1382-6. [PMID: 2499970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To date, more than 200 human heart-lung transplantations (HLT) have been performed in USA and Europe. The main indications are still primary pulmonary hypertension and Eisenmenger's syndrome but the intervention has also been employed in cases of parenchymatous pulmonary disease. At operation, the thoracic organ is replaced. The recipient's heart can frequently be donated. Recent reviews suggest acceptable two-year survival following HLT of approximately 60%. The direct economical costs of transplantation have been stated to be approximately 17,000 pounds but to this must be added the expenses for life-long immunosuppressive treatment and follow up control together with hospitalization during the time waiting for a suitable donor. The annual requirement for transplantation in Denmark is estimated at present to be approximately ten patients. The immediate requirement for transplantation will probably be covered by referral to the European centres via national or provincial hospitals and with the permission of the Danish Board of Health. The case reports of the first two Danes (both with emphysema secondary to alpha-1-antitrypsin deficiency) who underwent successful heart-lung transplantations in England are presented. In the long run, it will prove necessary to utilize Danish donors which necessitates alterations in the criteria of death.
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