Document Detail


Seasonal variations in clinical and laboratory variables among chronic hemodialysis patients.
MedLine Citation:
PMID:  12191979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seasonal variations in BP among chronic hemodialysis patients have been reported. It was hypothesized that other characteristics of these patients might also vary with the seasons. Twenty-one clinical and laboratory variables were examined for seasonal variations among 1445 patients enrolled in the Hemodialysis Study, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases. Mixed-effects models were applied to longitudinal changes (up to 45 mo) for individual patients for 19 of the 21 variables, which were measured at least twice each year, to determine the seasonal component of each variable. Seasonal variations in the other two variables, i.e., protein and energy intakes determined from annual dietary records, were assessed in cross-sectional comparisons of intakes of patients entering the study at different time points. Thirteen of the 21 variables examined demonstrated statistically significant (P < 0.01) seasonal components in their longitudinal variations. Predialysis blood urea nitrogen concentrations peaked in March, which coincided approximately with the peak protein catabolic rates, as well as protein and energy intakes (determined by dietary recall). Predialysis systolic and diastolic BP values were highest in winter and lowest in summer, corroborating previous reports. In addition, the lower predialysis BP values in summer were associated with higher outdoor temperatures and less interdialytic fluid gain. The mean predialysis hematocrit values were highest in July, which could not be attributed solely to the estimated changes in plasma volume. Seasonal variations in clinical and laboratory variables occur commonly among chronic hemodialysis patients. The reasons for most of these variations are not apparent and require further investigation. Nonetheless, failure to consider these variations might lead to biases in the interpretation of clinical studies. In addition, awareness of these variations might facilitate the interpretation of laboratory results and the clinical treatment of these patients.
Authors:
Alfred K Cheung; Guofen Yan; Tom Greene; John T Daugirdas; Johanna T Dwyer; Nathan W Levin; Daniel B Ornt; Gerald Schulman; Garabed Eknoyan;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  13     ISSN:  1046-6673     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-22     Completed Date:  2003-02-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2345-52     Citation Subset:  IM    
Affiliation:
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA. alfred.cheung@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bicarbonates / blood
Blood Pressure
Blood Urea Nitrogen
Body Temperature
Body Weight
Cohort Studies
Cross-Sectional Studies
Dietary Proteins / pharmacokinetics
Female
Humans
Kidney Failure, Chronic / blood*,  therapy*
Longitudinal Studies
Male
Middle Aged
Renal Dialysis / methods*
Seasons*
Sodium / blood
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Dietary Proteins; 7440-23-5/Sodium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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