Piotr Skonieczny

In patients suffering from end-stage kidney disease, the vast majority of renal replacement therapy is performed using haemodialysis. Peritoneal dialysis is less frequently chosen because, particularly in older patients, it is associated with challenges related to fluid exchange. An alternative approach might be assisted peritoneal dialysis, wherein trained relatives perform fluid exchange. The objective was to present a case report of a patient diagnosed with hypersensitivity to dialysis membranes, which necessitated a transition to an alternative method of renal replacement therapy. Assisted peritoneal dialysis emerges as a promising option, particularly among elderly patients burdened with multiple comorbidities and frailty syndrome, offering the potential for improved quality of life. Keywords: haemodialysis assisted peritoneal dialysis allergy to dialyser

DOI: 10.20452/pamw.16385, Published online: December 15, 2022, Authors: Piotr Skonieczny, Anna Wojteczek, Zbigniew Zdrojewski, Alicja Dębska-Ślizień

Background and Objectives: Hypertension affects at least 80% of hemodialysis patients. Inappropriate control of blood pressure is mentioned as one of the essential cardiovascular risk factors associated with development of cardiovascular events in dialysis populations. The aim of the cross-sectional, retrospective study was the evaluation of the antihypertensive treatment schedule and control of blood pressure in relation to the guidelines in the group of hemodialysis patients. Additionally, we assessed the level of decrease in blood pressure by each group of hypotensive agents. Materials and Methods: 222 patients hemodialyzed in a single Dialysis Unit in three distinct periods of time—2006, 2011, and 2016—with a diagnosis of hypertension were enrolled in the study. The analysis of the antihypertensive treatment was based on the medical files and it consisted of a comparison of the mean blood pressure results reported during the six consecutive hemodialysis sessions. Results: The mean values of blood pressure before hemodialysis were as follows: 134/77, 130/74, and 140/76 mmHg, after hemodialysis 124/74, 126/73, and 139/77 mmHg in 2006, 2011, and 2016 respectively. The goal of predialysis blood pressure control (Conclusions: The goal of predialysis or postdialysis blood pressure control was achieved in a lower percentage of patients during the period of the study. Blockade of renin–angiotensin–aldosterone system and calcium channel blockers decrease the blood pressure significantly. It is necessary to achieve better control of blood pressure in prevention of cardiovascular incidents.

DOI: 10.20452/pamw.15996, Published online: May 11, 2021, Authors: Piotr Skonieczny, Zbigniew Heleniak, Maria Szostakiewicz, Krzysztof Kuziemski, Alicja Dębska-Ślizień

Background: Dietary supplements (DS) are available over the counter, and no detailed data on their use is available. Patients with impaired renal function are at risk of toxicity associated with DS. The aim of the study was to evaluate the prevalence and characteristics of DS use in patients with chronic kidney disease (CKD).Material and methods: A cross-sectional controlled survey study in 180 CKD patients (stage 1-5, dialysis, kidney transplant), 60 patients without CKD served as controls.Results: Self-medication with DS did not differ between subjects with and without CKD. In the CKD group, 20% admitted to use DS regularly, 22% did not take them at all. In the controls, this was 17% and 13%, respectively (NS). The DS use was higher among women as compared to men (89% vs. 70%; p<0.005), and people living in cities in comparison to patients living in villages (81% vs. 63%; p<0.05). DS agents most commonly used were: vitamins, mineral substances and herbs. Major indications for self-medication with DS included: musculoskeletal issues, general health improvement and prevention of urinary tract infections. Subgroup analyses revealed that dialysis patients were characterized by a significantly higher DS use in comparison to CKD stage 1-5 subjects and renal transplant recipients. The decision on introducing DS was made by the physician in 54% of cases; by a pharmacist in 9% of cases, and by the patients themselves in 37%. Only 21% of patients with CKD, and 27% of subjects without CKD declared knowledge of any possible side-effects associated with DS (NS).Conclusions: The use of DS among patients with CKD is similar to patients without CKD, and is most prevalent among patients on dialysis. Vitamins and minerals are the most commonly used DS. The knowledge on the side-effects of DS is very limited.

The use of over-the-counter analgesics in patients with chronic kidney disease. Background: Analgesics can be sold following medical prescription, but also as over-the-counter (OTC) medications. In patients with chronic kidney ...