Louisa M. Nerl studies medicine in Munich. The first two years, she studied at the ´Ludwig-Maximilian- Universität´(LMU) afterwards at the ´Technische Universität München´ (TUM). In 2015, she studied one semester abroad at the University of Bern in Switzerland. In October 2017, she completed 2. State exam with grade ´good´. In September 2016, she joined PD Dr. Schmaderer´s research team; in the context of the TUM Graduate School. In October 2017, Louisa continued her research on a full-time basis.
Background: Arterial stiffness is a known cardiovascular risk factor in end-stage-renal-disease (ESRD) patients. ESRD patients in need of dialysis are generally of an advanced age, which combined with disease factors lead to a high mortality rate. Arterial stiffness, as assessed by pulse wave velocity (PWV), has been found to be linked to arterial hypertension. Here, we propose that PWV can be used to predict all-cause mortality in ESRD patients. Methods: In this prospective study, 235 patients from 8 dialysis centers in Munich were placed under observation. As a baseline, data concerning age, sex and comorbidities were recorded. 164 patients underwent 24hours monitoring of PWV with Mobil-O-Graphs. At the 6-year-follow-up, 108 were deceased, 47 were loss-to-follow-up (LTFU) and 80 were still alive and on active dialysis. The LTFU group included patients who received a kidney transplantation or who underwent a change of dialysis center. Results: Statistical analysis showed that patients with a PWV >10 m/s had a median survival (as defined by half of the included patients in a group being deceased) of 1362 days (standard deviation = 281). The median survival for patients with a PWV <10 m/s could not be assessed to-date as ~51% of these patients were still alive after 72 months. Conclusion: PWV was found to represent an effective measure to predict all-cause mortality in ESRD. Measurements with Mobil-O-Graph are easily performed and reproducible, therefore monitoring PWV instead of arterial hypertension to determine efficacy of treatment could be an important aspect in future treatment of ESRD patients.
I completed my MBBS from Army Medical college Rawalpindi (National University of Sciences & Technology) in 2009. Currently Iam undergoing my FCPS part II training in Chemical Pathology in Armed Forces Institute of Pathology,Rawalpindi.I am actively involved in Reasearch projects and two more projects are in the pipeline.
The study was a cross sectional study conducted at the Department of Chemical Pathology & Endocrinology Armed Forces Institute of Pathology (AFIP) Rawalpindi from Jan 2016 to Dec 2016. One hundred and sixty-five young hypertensive subjects, aged 17-40 years, of either gender presenting in the outpatient department (OPD) were recruited from local population of Rawalpindi. All subjects were having blood pressure more than 140/90 mm of Hg and were not on any anti-hypertensive medicine. Patients with renal dysfunction, heart failure, pregnancy and secondary hypertension were excluded from the study. Blood sample was taken from each patient to analyze arterial blood gases, plasma renin, serum aldosterone and electrolytes. Sandwich chemiluminescence immunoassay and ELISA techniques were used to analyze plasma renin and serum aldosterone level. Arterial blood gases and electrolytes like sodium and potassium were measured by potentiometry, while bicarbonate was calculated. Normally distributed continuous variables were presented as mean+SD and others as median. Multiple regression analysis was performed to compute association of age, electrolytes, systolic and diastolic blood pressure in OPD and Endocrine Clinic AFIP with Essential hypertension and Primary hyperaldosteronism. P<0.05 was considered statistically significant. Out of 80 subjects, 72 were diagnosed with Essential hypertension and 08 with Primary hyperaldosteronism. None of the patients had Liddle syndrome, apparent mineralocorticoid excess or Gordon syndrome. Mean age of patients having Essential hypertension was 30.97+7.13 years, whereas those with Primary hyperaldosteronism was 29.25 + 7.1 years. Mean serum sodium was 137.8 + 6.5 mmol/l and potassium was 4.23 + 0.6 mmol/l. Mean systolic blood pressure of patients measured in OPD was 172.7+19.2 mm of Hg whereas diastolic blood pressure was 100.0+8.3 mm of Hg. Mean systolic blood pressure measured in Endocrine Clinic AFIP was 142.7 + 10.5 mm of Hg and diastolic blood pressure was 90.3+6.5 mm of Hg. Diastolic blood pressure was significantly higher (p = 0.001) among all the patients reported in OPD. No statistically significant association was found between age, systolic and diastolic blood pressure (p < 0.05) in either OPD or Endocrine Clinic¬¬ic.Therefore, it was concluded that hypertension is not uncommon in young population of Pakistan. Primary hyperaldosteronism as compared to other RAAS disorders, remains the leading cause of hypertension in young population.