Introduction: Dermatologic involvement in hemodialysis patients is characterized by a multitude o... more Introduction: Dermatologic involvement in hemodialysis patients is characterized by a multitude of different aspects; pruritus, xerosis cutis, hyperpigmentation, actinic elastosis, scalp hair loss and skin infections could occur . Alterations in the cutaneous pigmentation is mainly hyperpigmentation on sun-exposed areas and yellowish tinge to the skin. Hypopigmentation is quite rare . Hair changes are mainly diffuse hair loss of scalp which may be related to telogen effluvium associated with severity of illness, xerosis, pruritus or due to drugs (heparin, anti-hypertensives, lipid-lowering). Sparse body hair, discoloration and dryness of hair, dry and lusterless hair are seen also . A case of lightening of hair in a dialysis patient under Heptaminol was reported . We report here the same finding with lightening of hair of scalp, eyebrows, eyelashes and total body hair in 3 patients on Hemodialysis and treated by Heptaminol for hypotension.
Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complication... more Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complications after a heart transplant. The aim of this study is to compare survival in heart transplant (HT) vs non-heart transplant (non-HT) patients starting dialysis. Methods. Survival was studied among the 539 newly dialysed patients between 1 January 1995 and 31 December 2005 in our Department. All patients were prospectively followed from the date of first dialysis up to death or 31 December 2005. Multivariate survival analysis adjusted on baseline characteristics was performed with the Cox model. Results. There were 21 HT patients and they were younger than non-HT patients at first dialysis: 58.6 AE 11.6 vs 63.0 AE 16.2 years (P ¼ 0.09). Calcineurin inhibitor nephrotoxicity was the main cause of ESRF in HT patients (47.6%). Crude 1, 3 and 5-year survival rates in HT and in non-HT patients were as follows: 76.2%, 57.1%, 28.6% and 79.1%, 58.7%, 46.7% (P ¼ 0.2). The adjusted hazard ratio of death in HT vs non-HT patients was 2.27 [1.33-3.87], P ¼ 0.003. Sudden death was the main cause of death in HT patients, in 33.3% vs 10.4% in non-HT patients (P ¼ 0.01). Five HT patients benefited from renal transplant. They were all alive at the end of the study period, while one patient among the 16 remaining on dialysis survived. Conclusion. HT patients with CKD who reached ESRF have a poor outcome after starting dialysis in comparison with other ESRF patients. Improvement in renal function management in the case of CKD is needed in these patients and non-nephrotoxic immunosuppressive regimens have to be evaluated. Renal transplant should be the ESRF treatment of choice in HT patients.
Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complication... more Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complications after a heart transplant. The aim of this study is to compare survival in heart transplant (HT) vs non-heart transplant (non-HT) patients starting dialysis. Methods. Survival was studied among the 539 newly dialysed patients between 1 January 1995 and 31 December 2005 in our Department. All patients were prospectively followed from the date of first dialysis up to death or 31 December 2005. Multivariate survival analysis adjusted on baseline characteristics was performed with the Cox model. Results. There were 21 HT patients and they were younger than non-HT patients at first dialysis: 58.6 AE 11.6 vs 63.0 AE 16.2 years (P ¼ 0.09). Calcineurin inhibitor nephrotoxicity was the main cause of ESRF in HT patients (47.6%). Crude 1, 3 and 5-year survival rates in HT and in non-HT patients were as follows: 76.2%, 57.1%, 28.6% and 79.1%, 58.7%, 46.7% (P ¼ 0.2). The adjusted hazard ratio of death in HT vs non-HT patients was 2.27 [1.33-3.87], P ¼ 0.003. Sudden death was the main cause of death in HT patients, in 33.3% vs 10.4% in non-HT patients (P ¼ 0.01). Five HT patients benefited from renal transplant. They were all alive at the end of the study period, while one patient among the 16 remaining on dialysis survived. Conclusion. HT patients with CKD who reached ESRF have a poor outcome after starting dialysis in comparison with other ESRF patients. Improvement in renal function management in the case of CKD is needed in these patients and non-nephrotoxic immunosuppressive regimens have to be evaluated. Renal transplant should be the ESRF treatment of choice in HT patients.
Introduction: Dermatologic involvement in hemodialysis patients is characterized by a multitude o... more Introduction: Dermatologic involvement in hemodialysis patients is characterized by a multitude of different aspects; pruritus, xerosis cutis, hyperpigmentation, actinic elastosis, scalp hair loss and skin infections could occur . Alterations in the cutaneous pigmentation is mainly hyperpigmentation on sun-exposed areas and yellowish tinge to the skin. Hypopigmentation is quite rare . Hair changes are mainly diffuse hair loss of scalp which may be related to telogen effluvium associated with severity of illness, xerosis, pruritus or due to drugs (heparin, anti-hypertensives, lipid-lowering). Sparse body hair, discoloration and dryness of hair, dry and lusterless hair are seen also . A case of lightening of hair in a dialysis patient under Heptaminol was reported . We report here the same finding with lightening of hair of scalp, eyebrows, eyelashes and total body hair in 3 patients on Hemodialysis and treated by Heptaminol for hypotension.
Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complication... more Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complications after a heart transplant. The aim of this study is to compare survival in heart transplant (HT) vs non-heart transplant (non-HT) patients starting dialysis. Methods. Survival was studied among the 539 newly dialysed patients between 1 January 1995 and 31 December 2005 in our Department. All patients were prospectively followed from the date of first dialysis up to death or 31 December 2005. Multivariate survival analysis adjusted on baseline characteristics was performed with the Cox model. Results. There were 21 HT patients and they were younger than non-HT patients at first dialysis: 58.6 AE 11.6 vs 63.0 AE 16.2 years (P ¼ 0.09). Calcineurin inhibitor nephrotoxicity was the main cause of ESRF in HT patients (47.6%). Crude 1, 3 and 5-year survival rates in HT and in non-HT patients were as follows: 76.2%, 57.1%, 28.6% and 79.1%, 58.7%, 46.7% (P ¼ 0.2). The adjusted hazard ratio of death in HT vs non-HT patients was 2.27 [1.33-3.87], P ¼ 0.003. Sudden death was the main cause of death in HT patients, in 33.3% vs 10.4% in non-HT patients (P ¼ 0.01). Five HT patients benefited from renal transplant. They were all alive at the end of the study period, while one patient among the 16 remaining on dialysis survived. Conclusion. HT patients with CKD who reached ESRF have a poor outcome after starting dialysis in comparison with other ESRF patients. Improvement in renal function management in the case of CKD is needed in these patients and non-nephrotoxic immunosuppressive regimens have to be evaluated. Renal transplant should be the ESRF treatment of choice in HT patients.
Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complication... more Background. Chronic kidney disease (CKD) and endstage renal failure (ESRF) are major complications after a heart transplant. The aim of this study is to compare survival in heart transplant (HT) vs non-heart transplant (non-HT) patients starting dialysis. Methods. Survival was studied among the 539 newly dialysed patients between 1 January 1995 and 31 December 2005 in our Department. All patients were prospectively followed from the date of first dialysis up to death or 31 December 2005. Multivariate survival analysis adjusted on baseline characteristics was performed with the Cox model. Results. There were 21 HT patients and they were younger than non-HT patients at first dialysis: 58.6 AE 11.6 vs 63.0 AE 16.2 years (P ¼ 0.09). Calcineurin inhibitor nephrotoxicity was the main cause of ESRF in HT patients (47.6%). Crude 1, 3 and 5-year survival rates in HT and in non-HT patients were as follows: 76.2%, 57.1%, 28.6% and 79.1%, 58.7%, 46.7% (P ¼ 0.2). The adjusted hazard ratio of death in HT vs non-HT patients was 2.27 [1.33-3.87], P ¼ 0.003. Sudden death was the main cause of death in HT patients, in 33.3% vs 10.4% in non-HT patients (P ¼ 0.01). Five HT patients benefited from renal transplant. They were all alive at the end of the study period, while one patient among the 16 remaining on dialysis survived. Conclusion. HT patients with CKD who reached ESRF have a poor outcome after starting dialysis in comparison with other ESRF patients. Improvement in renal function management in the case of CKD is needed in these patients and non-nephrotoxic immunosuppressive regimens have to be evaluated. Renal transplant should be the ESRF treatment of choice in HT patients.
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