Browsing by Author "Gajić, Selena (57221714702)"

An increase in dietary protein intake (DPI) carries a risk with respect to increased sodium intake, which further leads to the development of cardiovascular morbidity in peritoneal dialysis (PD) patients. Dialytic (DSR) and urinary sodium removal (USR) are potential indicators of sodium intake. In this single-center cross-sectional study with 60 prevalent PD patients, we analyze the correlation of DPI with sodium intake and the association between residual renal function (RRF) and comorbidity grade, expressed as the Davies score with sodium removal and protein metabolism indices such as normalized protein catabolic rate (nPCR) and lean body mass (LBM). The value of RRF < 2 mL/min/1.73 m2 is significantly associated with lower USR (p = 0.000) and lower %LBM (p < 0.001). The greatest USR is detected in patients with low Davies comorbidity grade (p = 0.018). Compared to patients with DPI < 0.8 g/kg/day, patients with DPI > 0.8 g/kg/day have a greater sodium intake (3.69 ± 0.71 vs. 2.94 ± 0.86; p < 0.018) and a greater nPCR (p < 0.001). Protein intake is significantly correlated with sodium intake (p = 0.041), but not with total sodium removal (TSR). A strong correlation is observed between sodium intake and TSR (p = 0.000), although single TSR values are not the same as the corresponding sodium intake values. An increasing protein intake implies the necessity to determine both sodium intake and sodium removal. Preservation of RRF has a beneficial role not just in sodium removal, but also in the increase of LBM. © 2024 by the authors.

An increase in dietary protein intake (DPI) carries a risk with respect to increased sodium intake, which further leads to the development of cardiovascular morbidity in peritoneal dialysis (PD) patients. Dialytic (DSR) and urinary sodium removal (USR) are potential indicators of sodium intake. In this single-center cross-sectional study with 60 prevalent PD patients, we analyze the correlation of DPI with sodium intake and the association between residual renal function (RRF) and comorbidity grade, expressed as the Davies score with sodium removal and protein metabolism indices such as normalized protein catabolic rate (nPCR) and lean body mass (LBM). The value of RRF < 2 mL/min/1.73 m2 is significantly associated with lower USR (p = 0.000) and lower %LBM (p < 0.001). The greatest USR is detected in patients with low Davies comorbidity grade (p = 0.018). Compared to patients with DPI < 0.8 g/kg/day, patients with DPI > 0.8 g/kg/day have a greater sodium intake (3.69 ± 0.71 vs. 2.94 ± 0.86; p < 0.018) and a greater nPCR (p < 0.001). Protein intake is significantly correlated with sodium intake (p = 0.041), but not with total sodium removal (TSR). A strong correlation is observed between sodium intake and TSR (p = 0.000), although single TSR values are not the same as the corresponding sodium intake values. An increasing protein intake implies the necessity to determine both sodium intake and sodium removal. Preservation of RRF has a beneficial role not just in sodium removal, but also in the increase of LBM. © 2024 by the authors.

Background/Aim. Chronic kidney disease (CKD) is a global health concern associated with increased cardiovascular risks and premature mortality. Proteinuria is a key prognostic indicator for CKD outcome. Sodium-glucose cotransporter 2 (SGLT2) inhibitors show potential for reducing proteinuria and slowing CKD progression. The aim of the study was to determine the impact of SGLT2 inhibitor therapy on CKD patients by evaluating the changes in the level of serum creatinine (sCr), 24-hour (24h) urine protein (UP), estimated glomerular filtration rate (GFR), and blood pressure (BP). Methods. This prospective study monitored 79 patients with CKD on therapy with SGLT2 inhibitors, who were followed up for one year. Patients received an SGLT2 inhibitor (dapagliflozin) once daily (10 mg), and assessment of specific parameters was conducted at baseline, 6 months, and 1 year later during the therapy. The study evaluated the levels of sCr, 24h UP, GFR, systolic BP (BPs), diastolic BP (BPd), uric acid (UA), total cholesterol (TC), triglycerides (Tg), low-density lipoprotein (LDL) cholesterol, sodium (Na+), and potassium (K+). Results. Over the one-year follow-up, significant changes were seen in UA levels (5.36, 4.99, 4.94 mg/dL, respectively; p = 0.032), 24h UP (662.60, 574.11, 417.09 mg/dL, respectively; p = 0.028), as well as BPs (128.44, 125.64, 126.12 mmHg, respectively; p = 0.026). No significant variations were observed in GFR, BPd, sCr, TC, Tg, LDL, and K+ levels. Na+ levels displayed a notable decrease (148.21, 147.57, 146.41 mmol/L, respectively; p = 0.021). Conclusion. The study suggests a potential benefit of SGLT2 inhibitors in managing CKD. © 2024 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Purpose: The study was undertaken with the aim to determine gender-specific differences in incident hemodialysis (HD) patient and their changes over time. Methods: The retrospective longitudinal closed cohort study involved 441 incident patients starting HD in 2014 and followed for 1–59 (median 43, IQR 40) months. Demographic, clinical data, treatment characteristics, laboratory findings and outcome were abstracted from the patients’ medical records. Results: The relative number of males on HD was about twice that of females throughout the five years investigated. At the beginning of the study, no significant differences were found in the main demographic and clinical characteristics except that diabetes was more often the underlying disease in men than in women. Systolic blood pressure decreased over time significantly more in females than in males. Throughout the study spKt/V was significantly higher in females than in males, but it increased in patients of both genders. There were no gender differences for comorbidities, vascular access and the majority of laboratory findings except for higher serum levels of creatinine and CRP in men than in women. Relatively more females were treated with erythropoiesis stimulating agents and phosphate binders than males. Age and malignancy were selected as significant predictors of mortality for both genders, and, in addition, polycystic kidney disease, serum level of albumin and CRP for men, but spKt/V for women. Conclusion: Some significant gender differences were observed throughout, while others appeared during the study but none of them were due to gender inequalities in the applied treatment. © 2022, The Author(s), under exclusive licence to Springer Nature B.V.

Introduction. Ovarian carcinoma, being one of the most common gynecologic cancers, has the highest mortality rate. The gold standard for the treatment of patients with advanced ovarian carcinoma, along with angiogenesis inhibitors applied in certain advanced stages, is cytoreductive surgery, followed by chemotherapy (CHT). The use of chemotherapeutic agents in hemodialysis (HD) patients has some specificities and limitations, and no CHT guidelines exist for treating those patients. Case report. We present a 45-year-old female patient with end-stage renal disease undergoing HD treatment. Abdominal and pelvic magnetic resonance imaging showed a multicystic mass with a total diameter of 93 × 115 × 168 mm in the right ovary and two subcapsular lesions in the VI segment of the liver with a diameter of 22 × 14 mm and 9 mm (stage IVb ovarian cancer). The serum level of the tumor marker cancer antigen 125 (CA-125) was 93 U/mL. A total hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy was performed. Histopathological analysis of the surgical specimen confirmed high-grade serous ovarian adenocarcinoma, FIGO stage IVb. After surgery, she was treated with carboplatin and paclitaxel combination CHT, determining the dose of carboplatin according to the Calvert formula and initiating HD within 20 hrs of infusion. Two years after the diagnosis was made, the presented patient is in good condition. Conclusion. HD patients can be treated with a combination CHT regimen of carboplatin and paclitaxel, determining the dose of carboplatin according to the Calvert formula and initiating HD within 20 hrs from the end of the chemotherapeutic infusion. © 2024 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Increased peritoneal protein loss has been associated with the fast transport of small molecules, diabetes mellitus (DM), and a reduced survival in patients on peritoneal dialysis (PD), although some studies did not confirm the association with survival. In this single-center retrospective study, we investigated the relationship of baseline peritoneal albumin and protein loss with transport status, comorbidities including DM, and survival in 106 incident PD patients during the period of July 2005–June 2014. Five-year survival rate was determined using Cox-regression analysis. There were not significant differences in D/Pcr or peritoneal protein and albumin loss between diabetics and non-diabetics. In the group of 66 non-diabetics, high and high-average transporters for creatinine had higher values for both peritoneal protein (11.85 ± 6.77 vs. 7.85 ± 4.36 g/day; p = 0.002) and albumin (5.03 ± 2.32 vs. 3.72 ± 1.54 g/day; p = 0.016) loss as compared to slow transporters. However, in the group of 40 diabetics, this association was not observed. Upon multivariable regression analysis, the independent association of D/PCr with peritoneal albumin (β = 0.313; p = 0.008) and protein (β = 0.441; p = 0.001) loss was found only in non-diabetics in whom ultrafiltration also appeared as a significant predictor of peritoneal protein loss (β = 0.330; p = 0.000). A high comorbidity grade, older age, and low serum albumin were associated with mortality, but both peritoneal protein and albumin loss as well as D/Pcr were not determinants of survival. Baseline peritoneal protein and albumin loss was not associated with DM and did not predict survival. The clinical significance of the absence of association between fast peritoneal transport status and peritoneal protein flux in diabetics should be evaluated in a prospective study comprising a greater number of diabetics with evaluation of overhydration as a main inducing variable of protein leak. © 2023 by the authors.

Background: Chronic kidney disease (CKD) is a progressive, irreversible impairment of kidney function due to various etiologies. Numerous studies have shown that sodium-glucose cotransporter-2 inhibitors (SGLT2i) slow the progression of CKD, due to their pleiotropic effects. Therefore, there has been an increase in interest in their effects not only on kidney function but also on other parameters in patients with CKD. The aim of the study was to examine the effects of SGLT2i on serum lipid values and kidney function in patients with CKD undergoing SGLT2i treatment. Methods: This study was a retrospective data analysis of 75 patients with CKD on SGLT2i treatment. We compared the values of biochemical parameters, renal function outcomes, and blood pressure at two time points: baseline and 24 months after. Results: Total cholesterol (Chol) significantly decreased in all patients, while triglyceride (Tg) and low-density lipoprotein cholesterol (LDLc) levels also decreased in all patients. High-density lipoprotein cholesterol (HDLc) levels increased, but this increase was not significant. Creatinine clearance (Ccr) significantly decreased, and serum urea (Sur) significantly increased in all patients. The proteinuria (Prt) levels did not change significantly. The results showed that the diastolic blood pressure (DBP) significantly decreased in all patients. Conclusions: This study showed that the use of SGLT2i reduced total Chol in all patients with CKD during the 24-month follow-up, regardless of diabetes mellitus (DM) status. No significant differences were observed for the Tg, LDLc, and HDLc values. © 2025 by the authors.

Background: Chronic kidney disease (CKD) is a progressive, irreversible impairment of kidney function due to various etiologies. Numerous studies have shown that sodium-glucose cotransporter-2 inhibitors (SGLT2i) slow the progression of CKD, due to their pleiotropic effects. Therefore, there has been an increase in interest in their effects not only on kidney function but also on other parameters in patients with CKD. The aim of the study was to examine the effects of SGLT2i on serum lipid values and kidney function in patients with CKD undergoing SGLT2i treatment. Methods: This study was a retrospective data analysis of 75 patients with CKD on SGLT2i treatment. We compared the values of biochemical parameters, renal function outcomes, and blood pressure at two time points: baseline and 24 months after. Results: Total cholesterol (Chol) significantly decreased in all patients, while triglyceride (Tg) and low-density lipoprotein cholesterol (LDLc) levels also decreased in all patients. High-density lipoprotein cholesterol (HDLc) levels increased, but this increase was not significant. Creatinine clearance (Ccr) significantly decreased, and serum urea (Sur) significantly increased in all patients. The proteinuria (Prt) levels did not change significantly. The results showed that the diastolic blood pressure (DBP) significantly decreased in all patients. Conclusions: This study showed that the use of SGLT2i reduced total Chol in all patients with CKD during the 24-month follow-up, regardless of diabetes mellitus (DM) status. No significant differences were observed for the Tg, LDLc, and HDLc values. © 2025 by the authors.

The occurrence of anterior abdominal wall ulcer at the site of the peritoneal catheter (PC) is one of the rarest complications of peritoneal dialysis (PD). When present, it is mainly caused by staphylococci which respond well to vancomycin therapy. Despite well-conducted therapy, there is a tendency to relapse and induce peritonitis, which makes it necessary to remove the PC and change the dialysis model of treatment and/or re-insert the catheter at another place to preserve PD as a treatment method. In the present study, we discuss a case of a 53-year-old patient with end-stage kidney disease treated with PD and with decubitus changes at the PC exit site; the change occurred due to migration of the catheter middle part by protruding from the abdominal cavity to the skin, thus allowing ulcer appearance. Although the PC site was treated with antibiotics, as advised by the surgeon, the patient was finally transferred to hemodialysis as the repositioning of the catheter was not performed. This leads to the conclusion that the antibiotic treatment and catheter repositioning are mandatory to preserve peritoneal dialysis as an end-stage kidney disease (ESKD) treatment model. © 2024 by the authors.

The occurrence of anterior abdominal wall ulcer at the site of the peritoneal catheter (PC) is one of the rarest complications of peritoneal dialysis (PD). When present, it is mainly caused by staphylococci which respond well to vancomycin therapy. Despite well-conducted therapy, there is a tendency to relapse and induce peritonitis, which makes it necessary to remove the PC and change the dialysis model of treatment and/or re-insert the catheter at another place to preserve PD as a treatment method. In the present study, we discuss a case of a 53-year-old patient with end-stage kidney disease treated with PD and with decubitus changes at the PC exit site; the change occurred due to migration of the catheter middle part by protruding from the abdominal cavity to the skin, thus allowing ulcer appearance. Although the PC site was treated with antibiotics, as advised by the surgeon, the patient was finally transferred to hemodialysis as the repositioning of the catheter was not performed. This leads to the conclusion that the antibiotic treatment and catheter repositioning are mandatory to preserve peritoneal dialysis as an end-stage kidney disease (ESKD) treatment model. © 2024 by the authors.