Abstract Background Hemoglobin A1c (HbA1c) is a widely used test for glycemic control. It is done for chronic kidney disease (CKD) patients. Renal disease is accompanied by thyroid abnormalities, which affect HbA1c, especially in those taking erythropoiesis-stimulating agents (ESAs). We aimed to find the effect of thyroid dysfunction on HbA1c in hemodialysis patients taking ESAs and those who do not. Materials and Method Fifty six patients were included in this study, which was done between September 2017 and June 2018, in Baghdad Teaching Hospital. Thyroid stimulating hormone, free T3, free T4 and HbA1c measurements were done. The patients were divided into 2 groups; those who took ESAs and those who did not, then they were subdivided into those with hypothyroidism and hyperthyroidism according to the Body mass index (BMI). Results Comparing HbA1c levels in hemodialysis patients taking ESAs and those who did not, showed no significant difference (5.79 ± 1.91 vs. 6.19 ± 1.64, P=0.09). The difference was also not significant in both hypothyroid and hyperthyroid patients in both high and low BMI patients. The only significant difference in HbA1c was between hyperthyroid and hypothyroid patients in those not taking ESAs, and having low BMI (4.97 ± 1.36 and 7.51 ± 0.87 respectively, P=0.02). Conclusion There is no significant influence of thyroid hormone changes on HbA1c levels in hemodialysis patients taking and not taking ESAs. Keywords Hemoglobin A1c, Chronic kidney disease, Thyroid dysfunction, Hemodialysis, Erythropoiesisstimulating agents.
Background: Hemoglobin A1c (HbA1c) is a widely used test for glycemic control. It is done for chronic kidney disease (CKD) patients. Renal disease is accompanied by thyroid abnormalities, which affect HbA1c, especially in those taking erythropoiesis-stimulating agents (ESAs). We aimed to find the effect of thyroid dysfunction on HbA1c in hemodialysis patients taking ESAs and those who do not. Materials and Method: Fifty six patients were included in this study, which was done between September 2017 and June 2018, in Baghdad Teaching Hospital. Thyroid stimulating hormone, free T3, free T4 and HbA1c measurements were done. The patients were divided into 2 groups; those who took ESAs and those who did not, then they were subdivided into those
... Show MoreBackground: Anemia is a common finding in patients with renal failure disease and it is, primarily, due to reduced production of iron and erythropoietin. Therefore, the aim of current study was to evaluate the relationship between serum level of hepcidin 25, on the one hand, and levels of serum iron, total iron-binding capacity, serum erythropoietin and transferrin saturation% in Iraqi male patients undrgoning haemodialysis.. Methods: Serum from75 males in the end stage of hemodialysis, as group one, and 25 Iraqi healthy malecontrols, as group two, were recruited in this study. Results: Data from current study showed significant increase in hepcidin 25 and significant decrease in serum iron, total iron-binding capacity, transferrin saturati
... Show MoreToxoplasma gondii is an obligate intracellular protozoan parasite; it spreads via the circulatory system during infection and causes chronic infection in various organs. Toxoplasmosis affects nearly one third of people worldwide, especially immunocompromised people. This study aimed to determine the effect of toxoplasmosis on renal function in hemodialysis patients. Overall 300 patients referred to the Medical City, Al-Karama General Hospital, Baghdad, Iraq were enrolled from 2021 to 2022. All serum samples were tested for T. gondii immunoglobulins (IgG and IgM) antibodies, urea and creatinine levels. In patients undergoing hemodialysis, the results revealed a high positivity percentage for anti-Toxoplasma IgG. In hemodialysis patients infe
... Show MoreFibroblast growth factor-23, play an important role in atherosclerosis, endothelial dysfunction and vascular calcification. Sevelamer can improve vascular calcification, serum uric acid, low-density lipoprotein-cholesterol and Fibroblast growth factor-23. Aim of study Assessment the effect of sevelamer as phosphate binder against calcium carbonate on Fibroblast growth factor-23. Methods A prospective open-labelled study that included patients on hemodialysis. A total of 72 patients were screened, only 53 patients completed the 10 week period. Adults patients with serum phosphate as> 5.5 mg/dl were included. There were Group1: Includes 28 patients (19 males and 9 females receiving sevelamer carbonate (Renvela) tablet. Group 2: Include 25pati
... Show MoreThyroid hormones, triiodothyronine (T3) and thyroxin (T4) play an important role in growth, development, and physiology of the kidney. The kidney has a central role in metabolism and clearance of these hormones as well as thyroid – stimulating hormone (TSH). Chronic renal failure (CRF) is a state of irreversible deceleration in renal function results in alterations in internal milieu, which affects the synthesis and secretory rate of hormones. To evaluate the thyroid hormone levels in non-dialyzed patients with chronic renal failure (CRF); 24 patients with CRF aged 30-70 years, mean±S.d. (48.458 ± 13.569) and 48 healthy volunteers who served as controls aged 30-70 years (43.104 ± 12.387) were studied for their thyroid function status u
... Show MoreEnd Stage Renal Disease is a well-known global public health problem. Maintenance hemodialysis is considered a life-saving treatment for patients with such disease. This treatment method that requires patients to be adherent to hemodialysis attendance, dietary and fluid recommendations as well as adherence to prescribed medications to ensure success. The aim of the current study was to assess adherence, perception, and counseling among hemodialysis patients to different modalities of treatment (fluid restriction, dietary recommendations, medications, and hemodialysis schedules). A cross-sectional study carried out on hemodialysis patients who attended to the dialysis centers at al- Karama teachi
... Show MoreHypothyroidism has been associated with disorders of glucose and insulin metabolism..The present study was designed to evaluate the possible change in some hormones (free testosterone, estradiol, prolactin, insulin), glucose and homeostasis model assessment of insulin resistance (HOMA-IR) in women with primary hypothyroidism under thyroid hormone replacement therapy .This cross-sectional study was carried on 62 hypothyroid patients׳ women and 22 healthy women as control group at the specialized center for endocrinology and diabetes, AL-Rasafa Directorate of Health Baghdad, with age range(15-60 years), diagnosed as having primary hypothyroidism on thyroxine replacement therapy with duration not less than four months.
... Show MoreType 2 diabetes mellitus (T2DM) is the most frequent endocrinal disease commonly associated with thyroid disorders .The study is conducted at the Specialized Center for Endocrinology and Diabetes in Baghdad ,during December 2014 up to October 2015.This study was done to investigate the prevalence of anti- thyroid peroxidase (Anti-TPO) antibody in patients suffered from type 2 diabetes with thyroid disorders .The study groups included a total number of 80 subjects consisting of 60 type 2 diabetic patients divided into 20 hyperthyroidism subjects (group 1) ,20 hypothyroidism subjects (group 2), 20 euthyroidism subjects (group 3) and 20 healthy controls (group 4) . The fasting blood samples were analyzed for (T3,T4,TSH) by using Vitek Immuno d
... Show MoreBackground: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled i
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