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Niacin hemodialysis

Giacomo Bovio, Ciro Esposito, Giovanni Montagna, Silvia Brazzo, Vittoria Esposito, Massimo Torreggiani, Luca Semeraro, Hellas Cena
BACKGROUND/AIMS: It is very important to assess the nutritional intake in patients on dialysis given the high prevalence of poor nutritional status of those in this population. The aim of this study was to assess nutrient intakes in hemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS: A clinical cross-sectional study was conducted over 7 days on 14 dialysis patients (98 days) who were trained to keep a weighed food record and a 7-day food diary. Nutrient intake adequacy was compared with specific guidelines for Italians and dialysis patients...
2016: Nephron
Sanae Fukuda, Hidenori Koyama, Kazuhiro Kondo, Hisako Fujii, Yoshinobu Hirayama, Tsutomu Tabata, Mikio Okamura, Tomoyuki Yamakawa, Shigeki Okada, Sumio Hirata, Hiroshi Kiyama, Osami Kajimoto, Yasuyoshi Watanabe, Masaaki Inaba, Yoshiki Nishizawa
BACKGROUND: Fatigue is a predictor of cardiovascular events in patients with end-stage renal disease (ESRD) undergoing hemodialysis treatment. We hypothesized that multinutritional support would improve quality of life, fatigue symptoms, and potential quantitative measures including endocrine, immune and autonomic functions in patients with ESRD undergoing hemodialysis. METHODS: Two hundred and two hemodialysis patients were randomly assigned to receive active treatment (containing vitamin B1, vitamin B2, niacin, vitamin B6, vitamin B12, folic acid, vitamin C, carnitine, coenzyme Q10, naïve galacto-oligosaccharide, and zinc) or placebo after each dialysis session for 12 weeks...
2015: PloS One
Ishir Bhan
PURPOSE OF REVIEW: The review focuses on the rationale and evidence behind management strategies for hyperphosphatemia in patients with chronic kidney disease (CKD). RECENT FINDINGS: Optimal management of phosphate in CKD remains an area of uncertainty, but multiple studies now point to a clinical benefit from the use of phosphate binders. Evidence of improved survival is particularly strong with sevelamer, though it remains unclear whether the absence of calcium or other properties of sevelamer are responsible for this relationship...
March 2014: Current Opinion in Nephrology and Hypertension
Amanda Rennick, Rabih Kalakeche, Lindsey Seel, Brian Shepler
Phosphate binders have traditionally been used to treat hyperphosphatemia, a common complication in patients with end stage renal disease (ESRD). New evidence suggests that nicotinic acid and its metabolites may effectively decrease phosphorus absorption in the gastrointestinal tract, thereby reducing serum phosphorus concentrations. We conducted a literature search to identify studies of patients with ESRD on dialysis that evaluated the role of niacin and related compounds in decreasing serum phosphorus levels...
June 2013: Pharmacotherapy
M Edalat-Nejad, F Zameni, A Talaiei
Hyperphosphatemia is common in patients with end-stage renal disease. Recent studies have shown that niacinamide and niacin achieve clinically significant reductions in serum phosphate in patients undergoing dialysis. The aim of the present study was to evaluate the serum phosphorus lowering effect of niacin in long-term hemodialysis patients. In this 8-week randomized, double-blind clinical trial, 37 patients were assigned to niacin or placebo with titration from 400 to 1000 mg daily. A 2-week washout preceded the switch from niacin to placebo or vice versa...
May 2012: Indian Journal of Nephrology
Farrokhlagha Ahmadi, Fatemeh Shamekhi, Mahbob Lessan-Pezeshki, Mohammad Reza Khatami
Hyperphosphatemia is a significant risk factor for the development of ectopic calcification and coronary artery diseases in patients on hemodialysis (HD), and must be controlled with the use of phosphate binders. Studies comparing the effects of sevelamer and nicotinic acid, both similar non-calcium and non-aluminum phosphate binders, are not available. In this study, 40 patients on HD with a serum phosphorus level of more than 6 mg/dL were enrolled. After a two week washout period without phosphate binders, the patients were randomly divided into two equal groups (n = 20) and were started on nicotinic acid or sevelamer for a period of four weeks...
September 2012: Saudi Journal of Kidney Diseases and Transplantation
Pornanong Aramwit, Rachanon Srisawadwong, Ouppatham Supasyndh
BACKGROUND: Hyperphosphatemia is commonly found in dialysis patients, which can lead to fatal cardiovascular diseases. The objective of this study was to evaluate the effectiveness and safety of extended-release nicotinic acid for reducing serum phosphorus in hemodialysis patients. METHODS: A randomized placebo-controlled trial was conducted, and 28 hemodialysis patients with hyperphosphatemia after 4 weeks of diet control were randomized to receive extended-release nicotinic acid (treatment group) once daily for 12 weeks...
May 2012: Journal of Nephrology
Marcia Machado Cunha Ribeiro, Melissa Luciana de Araújo, Michele Pereira Netto, Lucas Maciel Cunha
INTRODUCTION: To assess the effects of the habit of having evening dinner on the dietary macro- and micronutrient profile of chronic kidney failure patients on hemodialysis. METHODS: Cross-sectional study carried out at a dialysis clinic at the city of Belo Horizonte, state of Minas Gerais. The study comprised 90 patients undergoing hemodialysis. Personal, clinical, and dietary (three-day food record) data were collected. The habit of having dinner was considered as having a complete evening meal, and the lack of that habit was considered as not having it or replacing it by a fast meal...
March 2011: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Anders G Olsson
Advances in clinical lipidology during the last 18 months include the establishment of high-sensitivity C-reactive protein (hsCRP) as an important risk marker for cardiovascular disease. Determining hsCRP levels should help the clinician single out patients at particularly high risk. However, more research needs to be done in this area. Furthermore, statins do not seem to be of benefit in patients with severe congestive heart failure, on chronic hemodialysis, or with aortic stenosis. Next, plasma triglyceride levels are now considered an important risk marker for cardiovascular disease, but the therapeutic benefits related to lowering triglyceride levels remain difficult to achieve...
2010: F1000 Medicine Reports
Anne M Daul, Michael C Beuhler
BACKGROUND: Niacin, a well-established agent for treating dyslipidemia, has been promoted on the Internet as a method for passing urine drug screening, although there are no data to support its use for this purpose. In a handful of cases, this practice has resulted in serious niacin toxicity. OBJECTIVES: The aim of this article is to describe a unique clinical presentation of niacin toxicity. CASE REPORT: A 23-year-old previously healthy man presented to an Emergency Department with altered mental status, fever, acute renal failure, microangiopathic hemolytic anemia, thrombocytopenia, and coagulopathy...
September 2011: Journal of Emergency Medicine
Charles R Harper, Terry A Jacobson
The incidence of chronic kidney disease (CKD) in the U.S. continues to increase, and now over 10% of the U.S. population has some form of CKD. Although some patients with CKD will ultimately develop renal failure, most patients with CKD will die of cardiovascular disease before dialysis becomes necessary. Patients with CKD have major proatherogenic lipid abnormalities that are treatable with readily available therapies. The severe derangements seen in lipoprotein metabolism in patients with CKD typically results in high triglycerides and low high-density lipoprotein (HDL) cholesterol...
June 24, 2008: Journal of the American College of Cardiology
C A Restrepo Valencia, J Cruz
OBJECTIVE: To establish if the nicotinic acid in patients with chronic renal disease reduce significantly and with security the levels of lipids and serum phosphate in refractory patients to the classical management. DESIGN: Observational study Place: Renal Unity RTS Ltda Caldas Santa Sofìa Hospital. PATIENTS: All the patients with chronic renal disease in dialysis therapy to whom the classical treatment for their hyperlipidaemia and hyperphosphatemia didn't manage a satisfactory reduce of their serum levels...
2008: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Krishnaswamy Sampathkumar, Manickam Selvam, Yesudas Santhakumari Sooraj, Sankaran Gowthaman, Rajappan Nair Prabha Ajeshkumar
BACKGROUND: Hyperphosphatemia is common in hemodialysis patients. Recent animal studies show that nicotinamide inhibits the sodium dependent phosphate co-transport in the small intestine and thereby reduces serum phosphorus levels. Nicotinic acid which is the prodrug of nicotinamide is widely used as antihyperlipidemic agent. We examined in a prospective study whether it reduces serum phosphorus levels in hemodialysis patients. METHODS: Patients who were on maintenance hemodialysis were enrolled in to the study if their predialysis serum phosphorus was more than 6 mg/dl...
2006: International Urology and Nephrology
Angela Yee-Moon Wang, Mandy Man-Mei Sea, Ricky Ip, Man Ching Law, Kai Ming Chow, Siu Fai Lui, Philip Kam-Tao Li, Jean Woo
BACKGROUND: Dialysis patients are at risk of vitamin and mineral deficiencies, not only because of losses during chronic hemodialysis or peritoneal dialysis but also because of low intakes. OBJECTIVE: The objective was to determine the importance of urea clearance (calculated as K(t)/V) and residual renal function (RRF) in predicting micronutrient intakes in a large cohort of patients receiving continuous ambulatory peritoneal dialysis (CAPD). DESIGN: We conducted a survey of dietary intakes in 242 CAPD patients and divided them into 3 groups according to their weekly urea clearance and RRF: WD group (n = 84), a urea clearance >/= 1...
September 2002: American Journal of Clinical Nutrition
V Mikalunas, K Fitzgerald, H Rubin, R McCarthy, R M Craig
The administration of multivitamins to patients receiving home parenteral nutrition (HPN) was decreased from once daily to three times weekly during the parenteral multivitamin shortage in 1997. Blood vitamin levels were measured to examine whether the decrement in the infused vitamins affected the levels. Six patients with normal renal and liver function, receiving HPN for 6 months to 10 years, were studied 6 months after the institution of 10 mL of multivitamins thrice weekly. Two patients with renal insufficiency who required hemodialysis and HPN were also studied...
November 2001: Journal of Clinical Gastroenterology
Y Saika, N Kodama, K Kimura, R Fujii, H Ohtani, M Mune, K Mimura, T Maeda, S Yukawa
Lp(a) has recently begun to attract attention as a risk factor of atherosclerotic disease, especially of ischemic heart disease. The Lp(a) concentration in the serum was shown to be important for chronic hemodialysis patients who have high mortality due to cardiovascular disease. Nicotinic acid derivatives, which are recognized for their capacity to lower the serum Lp(a) concentration, are effective against a high Lp(a) concentration in hemodialysis patients. In this study, niceritrol which is a nicotinic acid derivative was tested on hemodialysis patients and healthy controls by investigating the serum nicotinic acid level...
June 1999: Nihon Jinzo Gakkai Shi
M P Kelly, M A Kight, S Castillo
In the absence of biochemically determined nutrient status, renal nutrition specialists have been left to assume that hemodialysis (HD) patients with a stable body weight and acceptable macronutrient intakes had adequate micronutrient stores. However, at the University of California Renal Center, using physical examination and laboratory studies, approximately one in three HD patients were found to have micronutrient imbalance. The Nutrition Physical Examination (NPE), an advanced practice, nutrition-focused, physical examination, can be a timely, cost-effective strategy in assessing nutrient status...
July 1998: Advances in Renal Replacement Therapy
G Ramirez, M Chen, H W Boyce, S M Fuller, D E Butcher, C D Brueggemeyer, J L Newton
Plasma B12, folate, B6 and thiamine, and red blood cell folate, thiamine and niacin levels were monitored for a period of 6 months in 15 clinically stable, chronic hemodialysis patients who were not supplemented with the water-soluble vitamins. Microbiological assays were used to determine the blood levels of the water-soluble vitamins. Over the period of 6 months, none of the patients had plasma or red cell vitamin levels below the normal range. No appreciable changes were observed in the plasma and red blood cell vitamin levels before and after dialysis in 5 patients...
1986: Nephron
G Ramirez, M Chen, H W Boyce, S M Fuller, R Ganguly, C D Brueggemeyer, D E Butcher
Vitamin supplementation for dialysis patients is still controversial. In our study, we followed longitudinally over a period of a year, 15 patients on chronic hemodialysis who were deprived of vitamin supplementation. Microbiological assays were used to determine the levels of five vitamins of the B group (folate, niacin, B12, B6, and thiamine). Vitamin C was measured chemically. During the observation period when vitamins were not supplemented, a marked drop of many of these vitamins in blood levels were encountered...
July 1986: Kidney International
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