Patients with chronic renal failure (CRF) experience a significant decrease in their living quality, due to the limitations imposed by the disease as well as the demands of the treatment that they receive. Some side effects contribute to the morbidity of these patients. Among them, erectile dysfunction (ED) is notable. This article reviews recent advances in etiological factor study and treatment of ED in CRF patients, which may guide the clinic practices in a considerable scale.
Erectile Dysfunction ; etiology ; therapy ; Humans ; Kidney Failure, Chronic ; complications ; Male

Host factors such as systemic diseases, genetic polymorphism or drug usage play a major role in the pathogenesis of periodontal disease by modifying the host response to periodontal infection or altering the susceptibility to infection by periodontal organisms. This study was designed to evaluate the clinical response of patients receiving hemodialysis to existing microbial dental plaque. Gingival Index (GI) and Plaque Index (PI) scores and probing depths (PD) were recorded for the entire dentition on 36 chronic renal failure patients receiving hemodialysis (H) and 36 systemically healthy individuals (C), matched with the patient group, based on age and extent of plaque accumulation. No statistically significant difference was observed in the clinical parameters between the two groups (PI: t=1.69 p= 0.096; GI: t=1.057 p=0.294; PD: t=0.01 p=0.99). In the present study, H patients revealed a similar response to existing bacterial plaque and their periodontal status was comparable to that of the control group. Although patients receiving hemodialysis have been suggested to present a certain degree of immunosuppression, based on the findings of the present study chronic renal failure does not seem to be an additional risk factor for more severe periodontal destruction.
Adult ; Aged ; Female ; Human ; Kidney Failure, Chronic/*complications/*therapy ; Middle Aged ; Periodontal Diseases/*etiology ; *Renal Dialysis

Sexual dysfunction is a highly prevalent problem among patients with chronic renal failure, which affects patients in the quality of life. However, it has not received enough attention. The genesis of sexual dysfunction is multifactorial, including physiological, psychological and organic factors. This review summarized the incidence, main manifestation, evaluation, risk factors and treatments associated with sexual dysfunction in patient of the chronic renal failure.
Female ; Humans ; Kidney Failure, Chronic ; complications ; physiopathology ; psychology ; Male ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Sexual Dysfunctions, Psychological ; etiology ; therapy

OBJECTIVE: To analyze the etiology and the relevant factors such as age, sex, blood pressure, outcomes and causes of death in end stage renal disease (ESRD) with hemodialysis (HD) in some hospitals in Hunan province. METHODS: The retrospective analysis included 1,622 ESRD with HD patients. Data on the etiology, demographic and epidemiologic aspects of these patients were examined, and life expectancy and mortality rate were calculated. RESULTS: In 1,622 ESRD with HD patients, the average age at the start of HD was 46.91 +/- 15.41, and the male/female ratio was 1.45/1. As the leading cause, chronic glomerulonephritis accounted for 56.43%, followed by hypertensive nephropathy (12.58%), obstructive nephropathy (9.13%) and diabetic nephropathy (8.85%). In recent years, the constituent ratio of diabetic nephropathy rose. The number of ESRD maintenance HD (MHD) patients was 581. Among them, 43.7% remained MHD, 13.0% received renal transplantation, 19.9% were transferred to other hospitals for HD, 7.2% became peritoneal dialysis, 14.8% died, and 1.4% ceased treament for economic reasons. The longest MHD was 13 years. The 1st-year, 3rd-year and 5th-year survial rate of MHD patients was 93.53%, 68.92% and 62.51%, respectively. The leading cause of death was cardiovascular incidence. In this group of ESRD with (53.6%), and then cerebrovascular disorder (21.0%). CONCLUSION HD patients, the age of starting dialysis was 30 approximately 70. The first cause was chronic glomerulonephritis. As the age increased, the constituent ratio of diabetic nephropathy rose. In MHD patients, the 1st-year, 3rd-year and 5th-year survial rate of maintenance hemodialysis patients was 93.53%, 68.92% and 62.51%, respectively. The first cause of death was cardiovascular accidence, and then cerebrovascular disorder.
Adult ; Aged ; China ; Diabetic Nephropathies ; complications ; therapy ; Female ; Glomerulonephritis ; complications ; therapy ; Humans ; Hypertension, Renal ; complications ; Kidney Failure, Chronic ; etiology ; therapy ; Male ; Middle Aged ; Renal Dialysis ; Retrospective Studies

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glomerulonephritis ; complications ; Humans ; Kidney Failure, Chronic ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Powders

The study of cancer in patients treated with dialysis in Korea has not been reported. The aim of this study was to investigate the incidence and mortality of cancer among patients on dialysis in Korea. The study subjects were 106 cancer patients (2.3%) out of 4,562 end-stage renal disease (ESRD) patients maintained on hemodialysis (HD) or peritoneal dialysis (PD) at Yonsei University Health System from 1996 to 2005. We excluded patients in whom the diagnosis of cancer preceded dialysis or those who received renal allograft or started dialysis after renal allograft. Seventy- three (69%) of our subjects were male and 33 (31%) were female. The mean age at the time of cancer diagnosis was 57.9+/-11.7 yr. The mean time from the start of dialysis to the diagnosis of cancer was 75.2+/-63.9 months. The most common cancer site was gastrointestinal tract (GIT) (51%) followed by urinary tract (20%), lung (8%), and thyroid (7%). Sixty nine percent of the total mortality was due to cancer. The mean time from diagnosis to death was 2.9+/-2.5 yr. In ESRD patients with cancer, there were no significant differences in mortality rates by dialysis modality. In ESRD patients, the most common cancer was GIT cancer followed by urinary tract cancer. Therefore, careful surveillance of these cancers in ESRD patients is highly recommended.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney Failure, Chronic/*complications/epidemiology/*therapy ; Korea ; Male ; Middle Aged ; Neoplasms/*complications/epidemiology ; *Peritoneal Dialysis ; Registries ; *Renal Dialysis ; Time Factors

We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.
Adolescent ; Adult ; Antigens, Viral/*blood ; *Bone Marrow Transplantation ; Case Report ; Cytomegalovirus/*immunology ; Cytomegalovirus Infections/complications/*diagnosis ; Fatal Outcome ; Graft vs Host Disease/complications ; Human ; Immunocompromised Host ; In Situ Hybridization ; Kidney Failure, Chronic/complications ; Kidney Transplantation ; Leukemia/*complications/therapy ; Leukemia, Lymphocytic, Acute, L2/complications/therapy ; Leukemia, Myelocytic, Acute/complications/therapy ; Leukemia, Myeloid, Chronic/complications/therapy ; Male ; Viremia/*diagnosis

BACKGROUND/AIMS: Many studies have compared patients with systemic lupus erythematosus (SLE) on renal replacement therapy (RRT) with non-lupus patients. However, few data are available on the long-term outcome of patients with end-stage renal disease (ESRD) secondary to SLE who are managed by different types of RRTs. METHODS: We conducted a retrospective multicenter study on 59 patients with ESRD who underwent maintenance RRT between 1990 and 2007 for SLE. Of these patients, 28 underwent hemodialysis (HD), 14 underwent peritoneal dialysis (PD), and 17 patients received kidney transplantation (KT). We analyzed the clinical outcomes in these patients to determine the best treatment modality. RESULTS: The mean follow-up period was 5 +/- 3 years in the HD group, 5 +/- 3 years in the PD group, and 10 +/- 5 years in the KT group (p = 0.005). Disease flare-up was more common in the HD group than in the KT group (p = 0.012). Infection was more common in the PD and HD groups than in the KT group (HD vs. KT, p = 0.027; PD vs. KT, p = 0.033). Cardiovascular complications were more common in the HD group than in the other groups (p = 0.049). Orthopedic complications were more common in the PD group than in the other groups (p = 0.028). Bleeding was more common in the HD group than in the other groups (p = 0.026). Patient survival was greater in the KT group than in the HD group (p = 0.029). Technique survival was lower in the PD group than in the HD group (p = 0.019). CONCLUSIONS: Among patients with ESRD secondary to SLE, KT had better patient survival and lower complication rates than HD and lower complication rates than PD. The prognosis between the HD and PD groups was similar. We conclude that if KT is not a viable treatment option, any alternative treatment should take into account the patient's general condition and preference.
Adult ; Female ; Humans ; Kidney Failure, Chronic/etiology/mortality/*therapy ; Lupus Nephritis/*complications ; Male ; Middle Aged ; *Renal Replacement Therapy ; Retrospective Studies ; Treatment Outcome

Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Glomerulonephritis, IGA ; complications ; diagnosis ; drug therapy ; Humans ; Kidney Failure, Chronic ; drug therapy ; etiology ; Medicine, Chinese Traditional ; Phytotherapy

INTRODUCTIONA complex relationship exists between chronic kidney disease-mineral and bone disorder (CKD-MBD) and adverse outcomes among dialysis patients. This study aimed to report the prevalence of CKD-MBD and examine the impact of achieving target CKD-MBD parameters on morbidity and mortality one year after peritoneal dialysis (PD) initiation.

METHODSIn this retrospective cohort study, patients electively initiated on PD were followed up for one year. Laboratory parameters were collected and the prevalence of CKD-MBD 4-6 months after PD initiation was determined based on the Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Linear regression and Cox proportional hazards model were used to evaluate the effects of achieving CKD-MBD targets 4-6 months after PD initiation on hospitalisation, the incidence of peritonitis or exit-site infections (ESIs), and mortality at one year.

RESULTSThe prevalence of CKD-MBD among the 86 patients in this study was 86.0% (KDOQI) and 54.7% (KDIGO). There was no significant difference in hospitalisation duration between patients who achieved targets and those who did not. Patients who failed to meet all the KDIGO CKD-MBD or calcium serum targets had a higher incidence of peritonitis or ESI. A trend toward shorter time to death was observed among patients who failed to meet the KDIGO phosphorus serum targets.

CONCLUSIONThere was moderate (KDIGO) to high prevalence (KDOQI) of CKD-MBD among the patients. Achievement of all the KDIGO CKD-MBD or calcium serum targets was associated with reduced peritonitis or ESI, while achievement of the KDIGO phosphorus serum targets was associated with improved survival.

Adult ; Aged ; Aged, 80 and over ; Chronic Kidney Disease-Mineral and Bone Disorder ; complications ; epidemiology ; Female ; Humans ; Kidney Failure, Chronic ; complications ; therapy ; Linear Models ; Male ; Middle Aged ; Peritoneal Dialysis ; Prevalence ; Proportional Hazards Models ; Quality Control ; Retrospective Studies ; Treatment Outcome