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Although several investigators have reported the relationship between bone mineral density (BMD) and mortality in patients on hemodialysis, it is unclear BMD of which site is most strongly associated with mortality.

We examined the factors related to fractures in patients on hemodialysis in 2009. Based on these data, we investigated the influence of BMD of different sites on mortality in this cohort of 81 patients on hemodialysis. BMD was measured at the distal third of the radius (1/3 Rad), lumbar spine, and total hip. Fifteen patients had prevalent vertebral fractures and seven had prevalent hip fractures. The influences of age, body mass index (BMI), serum creatinine (Cr), serum albumin (Alb), dialysis vintage, and parathyroid hormone (PTH, measured as whole PTH) on mortality were also studied.

Fifty-two patients died by August 31, 2018. BMD was significantly higher in the survival group than in the deceased group only for the 1/3 Rad group (P < .001). Although patients with prevalent hip or vertebral fractures showed a higher mortality rate than those without fractures, no significant difference was observed. In the deceased group, age was significantly higher, and BMI and Cr levels were significantly lower than those in the survival group (P < .001, P < .05, and P < .01; respectively). After adjustment for these parameters, BMD of the 1/3 Rad remained a significant prognostic factor.

Although this was a study with a limited number of patients, BMD of the 1/3 Rad appears to be associated with mortality in patients on hemodialysis.

Although this was a study with a limited number of patients, BMD of the 1/3 Rad appears to be associated with mortality in patients on hemodialysis.

Pulmonary artery hypertension (PAH) is common in end stage renal disease (ESRD) patients undergoing hemodialysis. Fibroblast growth factor-23 (FGF-23) increases in hemodialysis but its relationship with PAH is not completely understood. The aim of this study was to evaluate the relation between FGF-23 level and development of PAH in ESRD patients undergoing hemodialysis.

Patients undergoing hemodialysis for more than 6 months were enrolled in this cross-sectional study. Transthoracic echocardiography was performed to measure ejection fraction and pulmonary artery pressure (PAP) in all patients. Patients were grouped into normal PAP (PAP < 25 mmHg), elevated PAP (25 < PAP < 35 mmHg) and PAH (PAP > 35 mmHg). Parathormone hormone, calcium, phosphorus, vitamin D, and hemoglobin levels were also evaluated.

Eighty-five patients (48 male, 56.47%) enrolled in this study. The mean age of the patients was 51.05 ± 16.45 years. Most of the patients (49, 57.65%) had normal PAP, 20 (23.53%) had elevated PAP and 16 (18.82%) had PAH. Serum biochemical markers and demographic characteristics were not significantly related to different PAP values (P > .05). Most of the patients (42, 49.41%) had normal FGF-23 levels. There was a significant relationship between PAP groups and FGF-23 and parathormone levels, P < .001, and P < .05; respectively. FGF-23 was significantly higher in PAH and elevated PAP groups compared with normal PAP group (P < .05). Only a significant positive correlation was observed between FGF-23 levels and PAP (P < .001).

This finding highlights the possible role of FGF-23 in the development of vascular complications in ESRD patients.

This finding highlights the possible role of FGF-23 in the development of vascular complications in ESRD patients.

Angiotensin receptor neprilysin inhibitor (ARNI) has been recommended by major guidelines as the leading therapy for heart failure with reduced ejection fraction (HFrEF). But little is known about its safety and effectiveness among maintenance hemodialysis patients with HFrEF in real-word practice.

An observational study was conducted among maintenance hemodialysis patients who received ARNI at our dialysis center. Enrollment commenced on June 1, 2018; and follow-up was completed on May 31, 2019.

A total of 110 patients included in the study (age 54.2 ± 14.8 y, 59% males). After 12 months of treatment, the average ARNI daily dose increased from 135 mg to 308 mg. The mean NT-pro- BNP concentration at baseline was 14455 pg/mL and 6435 pg/ mL after 12 months of treatment (P < .001). The left ventricular ejection fraction improved (35.1 vs. 49.8%, P < .001) over the 12 months, while left ventricular end-diastolic diameter, left ventricular mass index, left ventricular end-systolic diameter, and left atrial diameter also changed significantly (167.8 vs. 154.9 g/m, P < .001; 52.2 vs. 51.5 mm, P < .05; 35.9 vs. 36.9 mm, P < .001; 42.2 vs. 40.3 mm, P < .001). Furthermore, we found the quality of life and the NYHA symptom severity class improved significantly (P < .001). Kaplan-Meier analysis indicated that higher dose of ARNI and less vintage of HD were associated with best survival.

In our study, ARNI appeared to be safe, relieved heart failure symptoms, and improved the scores of KCCQ physical and social activities in hemodialysis patients in real-world practice.

In our study, ARNI appeared to be safe, relieved heart failure symptoms, and improved the scores of KCCQ physical and social activities in hemodialysis patients in real-world practice.

Coronavirus disease 19 (COVID-19), has recently emerged as a great health challenge. check details The novel corona virus may affect the kidneys mainly as acute kidney injury (AKI). Also, the outcome of COVID-19 may be different in patients with underlying kidney disease. The aim of this study was to compare the outcome of COVID-19 in patients with and without underlying kidney disease.

This was a retrospective study on 659 hospitalized COVID-19 patients in six centers of Iran. Patients were classified into kidney (chronic kidney disease (CKD), end-stage kidney disease (ESKD) or kidney transplantation) and non-kidney groups. The clinical conditions and laboratory data were extracted from the charts. Outcome was defined as death during hospitalization or within 30 days of discharge.

Among 659 COVID-19 patients (mean age 60.7 ± 16.4, 56% male), 208 were in the kidney group (86 ESKD, 35 kidney transplants, and 87 CKD patients). AKI occurred in 41.8%. Incidence of AKI was 34.7% in non-kidney, 74.7% in CKD, and 51.4% in kidney transplant patients (P < .