Browsing by Author "Mirkovic, Zlatica M. (56194136600)"

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.

Introduction: Arteriovenous fistulas (AVFs) are the preferred form vascular access for hemodialysis (HD), as they have a low rate of complications and durable function. The aim of our investigation was to analyze the factors that might influence the function of AVFs. Methods: Data were taken from the computerized patient record system in the Clinic of Urology and Nephrology, Clinical Center, Kragujevac, Serbia, for a 2-year period. We analyzed patients who had requested re-creation of AVFs as a secondary procedure. During this period 112 patients, 73 (65%) men and 39 (35%) women, had AVF thromboses. All relevant clinical and laboratory parameters that could affect the function and survival of AVF were evaluated. Findings: In univariate logistic regression analysis, statistically significant predictors influencing the duration of the fistula were magnesium (P < 0.001), triglycerides (P = 0.041), smoking (P = 0.001), antiplatelet therapy (P < 0.001), and type of HD (bicarbonate vs. hemodiafiltration) (P < 0.001). In the multiple logistic regression model, high concentrations of magnesium (B = 7434; P < 0.001) and antiplatelet therapy (B - 1.042; P = 0.04) were significantly associated with the length of AVF function. Discussion: After successful establishment of an AVF, there is a compelling need to maintain fistula patency. Factors that affect functioning of the AVFs are presently under intense scrutiny. According to our results, some clinical factors may determine long term fistula duration, such as concentration of the magnesium and antiplatelet therapy. © 2017 International Society for Hemodialysis