Stojanoska, Ana
Preferred name
Stojanoska, Ana
Official Name
Stojanoska, Ana
Main Affiliation
Email
ana@mactheatre.edu.mk
10 results
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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); ; ; ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Permanent Vascular Access for Hemodialysis in Elderly Patients - Single Center Experience(2019); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FACTORS AFFECTING THE ATTAINMENT OF ADEQUATE BLOOD FLOW OF ARTERIOVENOUS FISTULA FOR HEMODIALYSIS(Oxford University Press, 2020-06-01); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Membranous Nephropathy as a Paranepoplastic Syndrome in a Patient with Ovarian Serous Cystadenofibroma- Case report(Macedonian Society of Nephrology, Dialysis, Transplantation and Artifical Organs, Department of Nephrology, 2019); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COLLAPSING GLOMERULOPATHY-RARE VARIANT OF FOCAL SEGMENTAL GLOMERULOSCLEROSIS-CASE REPORT(Македонско лекарско друштво = Macedonian medical association, 2021); ; ; ; Focal segmental glomerulosclerosis (FSGS) is classified into five variants, with the collapsing variant being the most rare one. However, the number of idiopathic cases is increasing and the presentation becoming more routine. We report the case of a 77-year-old female patient, with nephrotic syndrome and histopathologic features of glomerular capillary collapse. She presented with chronic renal failure with serum creatinine-126…154…174 μmol/L. Nephrotic syndrome with feet and ankles edema, progressively extended, at first failed to respond to diuretic therapy. The level of total serum protein fraction was 54g/l, albumin-29…24…28g/L. Urinalysis demonstrated proteinuria 7.8 g/l… 6.15g/L and 12.3 g/24 h. Presence of 25-30 erythrocytes and 2-3 leukocytes in urine sediment was also noticed. Renal biopsy was performed to determinate the presence of glomerular disease. The histopathological analysis showed fibrously thickened Bowman’s membrane, with discretely thickened glomerular basal membrane and collapsed vascular lumen on TEM analysis. The treatment of the patient included corticosteroids, angiotensin-converting enzyme inhibitor and lipid lowering agents, which resulted in lowering of the proteinuria, followed by withdrawal of the edema. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Peritoneal Dialysis-Related Peritonitis: Rate, Clinical Outcomes and Patient Survival(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2021-12-01); ; ; ; Peritoneal dialysis-related peritonitis remains the major complication and primary challenge to the long-term success of peritoneal dialysis (PD). The study aimed to analyze the peritonitis rate, the cause, the outcomes, and the association of peritonitis with the survival of patients on peritoneal dialysis. Patient data were collected retrospectively from medical charts. A total of 96 patients received peritoneal dialysis in the PD center from 1 January 1999 to 31 December 2018. Episodes of peritonitis (n=159) were registered in 54 (56.3%) patients. The study population was divided into two groups, a group of patients (n=54) who experienced peritonitis and a group of patients free of peritonitis (n=42). The peritonitis rate was 0.47 episodes per patient year. The majority of causative microorganisms were gram-positive bacteria (53.5%). Outcomes of the episodes of peritonitis were resolved infection in 84.9% of episodes, catheter removal in 11.3% of episodes, and death in 3.8% of the episodes of peritonitis. A Kaplan–Meier analysis and log-rank test revealed that the group with peritonitis tended to survive significantly longer than the peritonitis-free group. A 67% reduction rate in the risk of patient mortality was observed for the peritonitis group compared with the peritonitis-free group (hazard ratio: 0.33, 95% CI 0.19-0.57, P=0.000). The prevention and management of PD-related infections, resulted in their worldwide reduction, supporting the use of PD as a first-line dialysis modality.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, P0316 RELATION OF RENAL ULTRASONOGRAPHIC MEASUREMENTS WITH BODY HEIGHT(Oxford University Press (OUP), 2020-06-01); ; Kabova, AngelaKidney size has been found to be correlated with anthropometric features and is different among different ethnicities. In this study, we used ultrasonography for measurement of kidney volumes in healthy individuals and evaluated the relationships with body height, age and gender.We conducted a cross-sectional observational study and evaluated 108 healthy individuals whose serum creatinine level was within reference range. Patients’ medical clinical and laboratory records were reviewed. Age, gender and height were recorded. Pearson correlation coefficients were used to evaluate the strength of association between ultrasonographic parameters with each other and with other parameters, and were expressed as r2. Variations in left and right renal dimensions between various age groups were compared using a one-way analysis of variance, followed by a post-hoc Tukey's testSubjects’ age ranged from 16 to 84 years and the mean age was over 50 years. There was an equal distribution among genders. Strong and positive correlations were seen for the measured length, parenchyma thickness and also for both total and parenchymal volumes with subjects’ height for both kidneys. The strongest correlations were observed for the left and right kidney length and also for the right kidney parenchymal volume (r=0.536, p=0.001; r=0.469, p=0.001; r=0.44, p=0.001). On the opposite, most of the relations with age were negative, but week and insignificant. When we divided the study subjects into three age groups and compared them for the height, there was no significant difference among them. Regarding the parenchymal and total kidney volumes of both kidneys, the different age groups showed similar findings in the ultrasonographic measurements. The mean calculated volumes were slightly declining with age and showed the largest values in the first group of patients under 30 years and lowest values in patients over 70 years old. Ultrasonographic measurements were also compared among the two genders. Both (men and women) showed similar age (53.55 ± 18.22 vs. 50.79 ± 18.13 p= 0.430, respectively). As for the height, men were significantly taller than women (1.734 ± 0.007 vs.1.637 ± 0.005, p= 0.001). The kidney length, volume and parenchymal volumes of both kidneys were significantly larger in men. Conclusion: Renal length and volume are strongly correlated with body height. This relation must be considered in clinical decisions on further investigations regarding kidney disease progression. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, No difference of arteriovenous fistula successful creation and maturation between diabetic and non-diabetic patients after three months of surgery: The beneficial role of preoperative doppler ultrasound.(2019); ; ; INTRODUCTION: The arteriovenous fistula (AVF) has become a symbol of hemodyalisis (HD) which guarantees the successful treatment and allows a multidecade survival of patients. However the AVF creation and maturation is still a significant medical challenge especially in diabetic patients (DP). Due to the peripheral diabetic vasculopathy the rate of fistula failure of DP is still higher than the nondiabetic patients (NDP). The aim of the study was to compare the outcomes of DP and NDP with chronic kidney disease ( CKD) stage 5 undergoing creation of a new upper limb AVF using a preoperative vessels mapping by Doppler ultrasound. METHODS: Medical records for creation of AVF in the patients with CKD stage 5 for year 2018 were analyzed in a single center. Preoperative Doppler ultrasound for assessing the adequacy of blood vessels and to determine the location of AVF creation, were performed in all patients, a vein diameter > 2mmand an artery diameter _ 1.6 mmare considered adequate. Three different types of AVF were created: the distal (radial-cephalic), middle-arm (radial-cephalic) and proximal (brachial-cephalic). Primary thrombosis of AVF was defined as an immediate failure of fistula within 24 hours of creation and primary failure was defined as thrombosis of fistula within 3 mounts. The demographic variables, location of the AVF creation, and HDtime were included as parameters for determination of the successful maturation of AVF. RESULTS: We analyzed 367 created AVF in 238 men (64,85%) and 129 female (35,15%). The average age of patients was 61.4614.2 years and mean HD vintage was 14 months. Successful AVF was created in 301 patients (82%) while primary thrombosis occurred in 66 patients (18%) of created fistulas. AVF maturation within 3 months was successful in 272 patients (74,15%), while the primary failure occurred in 95 patients (25,85%) of created fistulas. The distal AVF was dominant location in 168 (47,78%), followed by middle-arm location in 136 (37,06%) and proximal in 63 (17,16%) of created fistulas. AVF was created in 104 (28,3%) DP and 263 (71,7%) NDP. The DP were significantly older than NDP (64,12 vs. 60,40 years, p=0.000), and with shorter HD vintage in DP compared to NDP (7,06 vs. 16,49 months, p=0.004). There was no association between successful AVF creation and diabetes mellitus (OR=1,0, 95%CI 0,91-1,08, p=0,010). The AVF maturation was also not associated with diabetes mellitus (OR=1,0, 95%CI 0,93-1,14, p=0,413). CONCLUSIONS: Using a preoperative Doppler ultrasound in the creation and maturation of AVF in DP are comparable with NDP regarding primary thrombosis and fistula failure for a period of three months of follow up. Further analysis are needed for the assessment of long term AVF functional capacity in both groups of patients - Some of the metrics are blocked by yourconsent settings
Item type:Publication, New approach in creating an arteriovenous fistula: First year of experience implementing the new method in R. N. Macedonia(2019-12); ; ;