Browsing by Author "Jaksic, Masa D. (57196713448)"

Background: Physical rehabilitation is an important segment in the treatment of hemodialysis patients as they often have numerous comorbidities, functional constraints and severe disabilities resulting from physical inactivity. Aim: To determine the effect of strength training program on muscle mass in patients on hemodialysis. Methodology: The study was organized in the Center for Hemodialysis, Kosovska Mitrovica, Serbia for the duration of 8 weeks. It involved 25 patients, 18 (72%) men and 7 (28%) women, of average age 52.9 ± 14 years, who had received chronic hemodialysis for 3 x 3-4 hours for at least 3 months using commercially available dialysers. During the first two hemodialyses, twice a week for 15-20 minutes, exercises were performed with a load to increase muscle mass of the upper and lower extremities together with isometric muscle contractions to strengthen the quadriceps, as well as a lateral flexion of the spinal column. Measurements were made before and after exercise. Routine laboratory analyses, oxygen saturation, demographic, anthropometric and clinical characteristics of the subjects were also evaluated. Results: After exercise oxygen saturation (p = 0.04) and venous pressure (p = 0.009) were significantly lower than pre-exercise values. Muscle strength of the fist (p = 0.001), the upper arm (p = 0.005) and forearms (p <0.001) also differed significantly before and after exercise. After exercise lower extremity muscles were significantly stronger, both in relation to the left and right muscles of the shin and thighs. Left side (p = 0.002) and right-side (p = 0.017) spinal column flexion was significantly higher after exercise. Conclusion: The study confirmed the positive effect of strength training program on the size of the exercising muscles, lateral flexion of the spinal column and venous pressure. © 2018 A. CARBONE Editore. All rights reserved.

Elderly patients with end stage kidney disease represent a challenge for surgeons to create a vascular access. Determine predictive parameters functionality of the arteriovenous fistulas for hemodialysis in the elderly. The study was organized as a retrospective study at the Center for Dialysis, Clinic for Urology and Nephrology, Clinical Center Kragujevac. The study included patients older than 65 years with arteriovenous fistula thrombosis, in the period of four years, in which there is information on the length of the functioning fistula. The study included 48 patients, mean age 71.3±5.2 years, 29 (60%) men and 19 (40%) women. The data were analyzed according to gender and demographic structure, type of anastomosis, positioning, length of functioning fistulas, and the lumen diameter of the arteries and veins that are used to create a fistula. The median length of functioning arteriovenous fistula, based on Kaplan-Meier model, is 16 months (95% CI 6.9- 25.1). Median functioning for proximaly located fistulas was 24 months (range, 1-259), while median functioning in patient with distally located fistulas was 8 months (range, 1-96). The difference in relation to the positioning of the fistula was statistically significant (p=0.006). In univariate Cox regression model, a statistically significant predictor of the functioning of arteriovenous fistulae is fistula positioning (B=0.700; p=0.022). The predictive parameter of survival of arteriovenous fistulas in elderly is proximally located fistula. © 2019, University of Kragujevac, Faculty of Science. All rights reserved.