Now showing 1 - 10 of 45
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    Item type:Publication,
    COVID 19 Pneumonia and a Rare Form of Fungal Peritonitis in a Patient Survivor on Peritoneal Dialysis
    (Walter de Gruyter GmbH / Macedonian Academy of Sciences and Arts, 2021-12-30)
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    Peritoneal dialysis (PD) related peritonitis is usually caused by bacteria, but viruses and fungi could also affect the peritoneal membrane and cause cloudy effluent with negative bacterial cultures. We present a case of a PD patient who survived fungal peritonitis caused by Geotrichum klebahnii (March 2015) and COVID-19 pneumonia (April 2021) with peritonitis probably caused by the SARS-CoV-2 virus. The fungal peritonitis followed one episode of exit-site infection and two episodes of bacterial peritonitis treated with a wide-spectrum antibiotic. The patient's PD catheter was removed immediately upon the diagnosis of fungal peritonitis, and an antifungal treatment was continued for 3 weeks after catheter removal. The new peritoneal catheter was reinserted 8 weeks after complete resolution of peritonitis, and the patient continued treatment with PD. The patient developed severe Covid-19 pneumonia with a sudden appearance of cloudy peritoneal effluent. There was no bacterial or fungal growth on the effluent culture. A PCR test for SARS-CoV-2 in peritoneal effluent was not performed. The peritoneal effluent became transparent with the resolution of the severe symptoms of Covid-19 pneumonia.
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    Item type:Publication,
    Thyrotoxicosis Associated with Cholestatic Jaundice Treated with Therapeutic Plasma Exchange–Case Report
    (OMICS Publishing Group, 2017)
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    Chalovska, Viktorija
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    Avramoski, Vladimir
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    Item type:Publication,
    Effect of nephrology referral on the initiation of haemodyalisis and mortality in ESRD patients
    (Macedonian Academy of Sciences and Arts, 2007-12)
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    Polenakovic, M
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    Gelev, S
    Late nephrology referral of patients with chronic kidney disease (CKD) has been suggested as increasing mortality after the initiation of dialysis. The aim of this study was to assess the impact of nephrology referral on the initiation of haemodyalisis (HD) and mortality during HD treatment in end-stage renal disease (ESRD) patients who have died in our institution over a five-year period. We studied data from all 117 patients on HD treatment in our institution who died (after 90 days of HD treatment) in the period between 01.01. 2002 and 31.12. 2006. Early (ER) and late referral (LR) were defined by the time of follow-up by a nephrologist greater than or less than 6 months, respectively, before the initiation of haemodialysis. Out of a total of 117 patients, 37.6% (44 patients) started HD in the ER group and 62.4% (73 patients) in the LR group. At the start of HD, LR patients were older, had a higher proportion of temporary catheters and had a significantly lower levels of haemoglobin and diuresis. Creatinine clearance was less in the LR (7.67 +/- 3.86 ml/min/1.73 m2) vs. the ER group (8.70 +/- 3.62 ml/min/1.73 m2), but not significantly different. Cardiovascular disease (CVD), defined by a history of myocardial infarction, cerebral vascular disease, peripheral arteriopathy, and/or heart failure, was also significantly more common among LR patients compared to ER (56%; 27%, p = 0.002). During the haemodyalisis treatment, the LR group had significantly lower levels of haemoglobin and haematocrit. CVD accounted for about 64% of deaths observed in the LR group. According to echocardiography data, there were no significant differences in the left ventricular mass index (LVMI) between the LR and ER groups at the time of dialysis initiation, but during haemodialysis treatment the LR group had significantly greater LVMI than the ER group (232,96 +/- 92,48 g/m2 vs.184,09 +/- 51,74 g/m2; p = 0,031). The time until death in months during dialysis treatment was significantly different between the LR and ER group, (69.51 +/- 64.03 vs.113.27 +/- 89.03, p = 0.0025). LR patients experienced a greater degree of anaemia and a high prevalence of CVD at the time of dialysis initiation. Our data suggest that the anaemia, CV damage and progression of left ventricular hypertrophy (LVH) in the LR patients during haemodialysis treatment are associated with poor survival on haemodialysis.
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    Item type:Publication,
    Impact of preoperative arterial and venous diameter on achievement of the adequate blood flow in arteriovenous fistula for hemodialysis
    (Wiley, 2020-06)
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    An arteriovenous fistula (AVF) remains the best choice of vascular access (VA) for hemodialysis (HD). The aim of the study was to determine the factors associated with the achievement of adequate blood flow (BF) of AVFs at the 4th week after creation. Created AVFs in 63 patients with chronic kidney disease (CKD) stage 4/5 and CKD stage 5 on hemodialysis (CKD5D) were analyzed in a prospective study. Doppler ultrasound (DUS) was used for measuring the diameter of the radial artery, the brachial artery and the cephalic vein before AVF creation. The BF of AVF was calculated by DUS at the 4th week after creation and adequate BF was defined as ≥ 600 mL/min. The average age of patients was 61.31 ± 12.9 years. An adequate BF of AVF at the 4th week after creation was achieved in 43.54% of patients. The BF of AVF measured in male patients was significantly higher compared to the BF of AVF obtained in females (576.03 mL/min vs 375.12 mL/min, P = 0.004). The diameter of the blood vessels with achieved adequate BF was significantly larger compared to the diameter of the blood vessels without adequate BF (radial artery: 2.45 mm vs 2.03 mm, P = 0.000; brachial artery: 4.78 mm vs 4.06 mm, P = 0.001 and cephalic vein: 3.12 mm vs 2.83 mm P =  0.018). The gender and the diameter of the blood vessels before AVF creation were significantly associated with achievement of adequate BF of AVF at the 4th week of creation.
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    Item type:Publication,
    Hypomagnesemia and cause-specific mortality in hemodialysis patients: 5-year follow-up analysis
    (SAGE Publications, 2017-10-13)
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    Tozija, Liljana
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    The aim of this prospective study was to evaluate the association between serum magnesium (Mg) and mortality, in particular the cause-specific mortality of Mg and other risk factors in hemodialysis (HD) patients.
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    Item type:Publication,
    Primary Failure of the Arteriovenous Fistula in Patients with Chronic Kidney Disease Stage 4/5
    (Scientific Foundation SPIROSKI, 2019-06-15)
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    Pavleska-Kuzmanovska, Svetlana
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    Gjorgievska, Julija
    An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a "gate of life" for the patients on hemodialysis.
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    Item type:Publication,
    Trend of Kidney Replacement Therapy in North Macedonia from the Years 2015 Through 2020
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2024-11-01)
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    Simjanovska, Simona
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    Rushiti, Emine
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    Cibrev, Dragan
    Kidney replacement therapy (KRT) by dialysis or kidney transplantation represents the main treatment modalities for patients with kidney failure. Here we evaluate the trends in taking care of such patients in North Macedonia from 2015 through 2020.
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    The blood flow rate on the first day after arteriovenous fistula creation is a predictor of successful fistula maturation
    (Wiley, 2022-12-02)
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    Cibrev, Dragan
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    The determination of blood flow rate (BFR) is a useful tool for assessing the function of arteriovenous fistula (AVF).
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    Item type:Publication,
    Does hepatitis C increase the accumulation of advanced glycation end products in haemodialysis patients?
    (Oxford University Press (OUP), 2010-03)
    Arsov, Stefan
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    Graaff, Reindert
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    Morariu, Aurora M
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    van Oeveren, Wim
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    Smit, Andries J
    Hepatitis C may cause increased levels of oxidative stress that contribute to accumulation of advanced glycation end products (AGEs), which increase the risk of cardiovascular disease (CVD). The aim of this study was to determine the influence of hepatitis C on AGE accumulation in haemodialysis patients.
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    Hypercalcemia and Renal Affection: An Unusual Initial Presentation of Sarcoidosis
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2025-03-01)
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    Sarcoidosis is a chronic, multisystem, inflammatory granulomatous disease that affects multiple organs in the body, but mostly the lungs and the lymph glands. Hypercalcemia and renal affection are rarely initial presenting features, and in the absence of pulmonary symptoms, the diagnosis of sarcoidosis in those patients could be a diagnostic challenge. A case-patient with sarcoidosis presented with elevated serum calcium and creatinine levels. Renal biopsy showed nephrocalcinosis with chronic fibrosing interstitial nephritis. The extensive mediastinal, abdominal, axillar, and neck lymphadenopathy was presented on the computer tomography scan of the patient's chest and abdomen. The neck lymph node surgical biopsy showed confluent, non-caseating, epithelioid granulomas consistent with sarcoidosis. The serum angiotensin-converting enzyme level was elevated. Treatment with oral prednisolone was started, and improvement of renal function and normalization of serum calcium was noted. Sarcoidosis should be considered in the differential diagnoses in patients with renal impairment and non-parathyroid hormone (non-PTH) dependent hypercalcemia.