Day 2 :
B.R.A.M. Hospital Raipur
Punit Gupta, was Profossser in Government medical college hospital (consider to be the tribal of india), raipur, India. He have done bachelor degree in 2000 I.e MBBS, than master degree in General Medicine in 2003 I.e MD, than Superspeciality in Nephrology I.e DM , With PHD DEGREE . He also awarded the prestigious ISPD SCHOLARSHIP and ASN fellowship. He have awarded with APCN developmental award in Malaysia. And also awarded with many oral n poster presentation National and International. He have presented highest number of papers I.e 31 abstract in single conference under his name till date around 175 paper and abstract is presented by him in different conferences.
Objectives: Hyperphosphatemia is highly prevalent in dialysis patients and may be associated with immune dysfunction. The association of serum phosphate level with infection remains largely unexamined.
Material and method: A study group contain total of 100 patients, out of which 25 patients blood culture and central venous catheter tip culture was positive. All Patients were underwent investigation in form of renal function test, C Reactive Protein level, serum phosphorus, blood culture, urine culture, central line tip culture.
Results: Out of 25 patients of renal failure on hemodialysis with sepsis none had serum phosphate level less than 3.5 mg /dl, 4 (26.67%) had serum phosphorus level between 3.5 – 5.5 mg/dl and 11 (73.33%) patients had serum phosphorus level > 5.5 mg/dl. Infections of any type were more frequent among patients with high phosphate levels at baseline, relative to normal. Male sex, advanced age, diabetes, anemia, hypoalbuminemia were found to be risk factors for infections. Gram positive cocci (Staphylococcus aureus) was the most common organism found in blood of 80% patients of renal failure on haemodialysis with sepsis. Incidence of sepsis was high with femoral vein (66.67%) usage and prolonged hemodialysis (more than 21 days). Serum Phosphorus level was high in 73.33% patients and CRP was raised in all 25 patients with sepsis. Most of the patients were euthyroid and their lipid profile was normal.
Conclusions: High phosphate levels may be associated with increased risk for infection, contributing further to the rationale for aggressive management of hyperphosphatemia in dialysis patients.