Browsing by Author "Lazic, Snezana (57140141800)"

Purpose: The number of elderly patients with end-stage kidney disease is on the rise. Nonalcoholic fatty liver disease (NAFLD) is characterized by parenchymal fat accumulation in patients without information about alcohol abuse. The aim of our study was to determine correlation between NAFLD and cardiovascular diseases in elderly hemodialysis patients. Methods: The examination was organized as observational and cross-sectional study in elderly patients on hemodialysis. An abdominal ultrasound examination was made in order to define NAFLD. Intima-media thickness of the carotid arteries was quantified by Doppler ultrasound. Biochemical parameters, gender, anthropometric characteristics, duration, adequacy of hemodialysis, blood pressure, smoking and cardiovascular disease were determined. Respondents were divided into a group with NAFLD (37/72 patients, 51 %) and group without NAFLD (35/72 patients, 49 %). Results: Patients with NAFLD have significantly more cardiovascular disease (p = 0.017) as well as significantly higher values of intima-media thickness of the carotid arteries (p = 0.03) in correlation with patients without NAFLD. Patients without NAFLD have a statistically lower triglyceride (p = 0.04), aspartate aminotransferase (p = 0.006), alanine aminotransferase (p = 0.013) and gamma-glutamyl transpeptidase (p = 0.029) compared to patients with NAFLD. Patients with cardiovascular disease have a higher risk of NAFLD; likewise, patients with NAFLD have a three times higher chance for developing cardiovascular diseases (OR 3.01). Conclusion: Elderly patients on hemodialysis with cardiovascular disease have a higher risk of NAFLD; likewise, patients with NAFLD have a three times higher chance for developing cardiovascular diseases. © 2016, Springer Science+Business Media Dordrecht.

Introduction: Metabolic syndrome is considered as one at the most important public health problems and in hemodialysis patients it is one of the main factors of mortality. The aim of the study was to determine the predictive parameters of the mortality of patients with metabolic syndrome. Materials and methods: In a nine-year study, the outcome of the clinical treatment of 108 hemodialysis patients was analyzed, divided into a group of patients with metabolic syndrome and group of patients without metabolic syndrome. The demographic, anthropometric, clinical and laboratory characteristics of the examinees were evaluated. Results: Mortality of patients with metabolic syndrome was 28.1% and in the group of patients without metabolic syndrome 13.2%. Statistically significant difference was found between the group of patients with and without metabolic syndrome in comparison with body mass index (p <0.001), age (p = 0.027), diabetic nephropathy (p <0.001), number of comorbidities (p <0.001), the number of leukocytes (p = 0.043), total proteins (p = 0.044), albumin (p = 0.001), calcium (p = 0.016), glycemia (p = 0.002) and creatinine (p = 0.032). Predictive parameters of survival in patients on hemodialysis with metabolic syndrome are the body mass index (B - 0.056; SE 0.008; p <0.001) and diabetic nephropathy (B 0.397; SE 0.098; p <0.001). Conclusion: Lower body mass index and diabetic nephropathy are, in our study, the predictive parameters of mortality of patients on hemodialysis. © 2019 A. CARBONE Editore. All rights reserved.

Introduction: Data on management of atrial fibrillation (AF) in the Balkan Region are scarce. To capture the patterns in AF management in contemporary clinical practice in the Balkan countries a prospective survey was conducted between December 2014 and February 2015, and we report results pertinent to the use of non-vitamin K antagonist oral anticoagulants (NOACs). Methods: A 14-week prospective, multicenter survey of consecutive AF patients seen by cardiologists or internal medicine specialists was conducted in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Romania, and Serbia (a total of about 50 million inhabitants). Results: Of 2712 enrolled patients, 2663 (98.2%) had complete data relevant to oral anticoagulant (OAC) use (mean age 69.1 ± 10.9 years, female 44.6%). Overall, OAC was used in 1960 patients (73.6%) of whom 338 (17.2%) received NOACs. Malignancy [odds ratio (OR), 95% confidence interval (CI) 2.06, 1.20–3.56], rhythm control (OR 1.64, 1.25–2.16), and treatment by cardiologists were independent predictors of NOAC use (OR 2.32, 1.51–3.54) [all p < 0.01)], whilst heart failure and valvular disease were negatively associated with NOAC use (both p < 0.01). Individual stroke and bleeding risk were not significantly associated with NOAC use on multivariate analysis. Conclusions: NOACs are increasingly used in AF patients in the Balkan Region, but NOAC use is predominantly guided by factors other than evidence-based decision-making (e.g., drug availability on the market or reimbursement policy). Efforts are needed to establish an evidence-based approach to OAC selection and to facilitate the optimal use of OAC, thus improving the outcomes in AF patients in this large region. © 2017, The Author(s).