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Seminars in Dialysis

journal
https://www.readbyqxmd.com/read/29105839/hemodialysis-in-neonates-and-infants-a-systematic-review
#1
REVIEW
Rupesh Raina, Prashanth Vijayaraghavan, Gaurav Kapur, Sidharth Kumar Sethi, Vinod Krishnappa, Deepak Kumar, Timothy E Bunchman, Shari D Bolen, Deepa Chand
Hemodialysis (HD) in neonates and infants poses unique challenges due to high risks of mortality attributable to obligatory small blood flow volumes. Although HD is often necessary in neonates, its effectiveness and feasibility are poorly understood. The aim of this review is to describe in detail the few studies reporting on HD in neonates and infants (<12 months old) and then dissertate more broadly on the subject with an emphasis on recent innovations with potential to overcome traditional barriers for effective HD in this population...
November 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29098724/improving-wellbeing-in-patients-undergoing-dialysis-can-meditation-help
#2
REVIEW
Paul N Bennett, Trey Ngo, Christine Kalife, Brigitte Schiller
Coping with the stress and anxiety caused by end stage kidney disease (ESKD) symptoms, treatment, restrictions, and social, financial and family stressors, consumes many afflicted with kidney disease. Meditation has been shown to decrease anxiety and stress, and improve wellbeing and quality of life of people with chronic disease. However, the clinical uptake of meditation is low in the ESKD dialysis population. This review describes what meditation and mindful meditation are and how they have been used for people with ESKD...
November 2, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29098715/central-venous-catheters-for-chronic-hemodialysis-is-last-choice-never-the-right-choice
#3
EDITORIAL
Chance S Dumaine, Robert S Brown, Jennifer M MacRae, Matthew J Oliver, Pietro Ravani, Robert R Quinn
Since the publication of the first vascular access clinical practice guidelines in 1997, the global nephrology community has dedicated significant time and resources toward increasing the prevalence of arteriovenous fistulas and decreasing the prevalence of central venous catheters for hemodialysis. These efforts have been bolstered by observational studies showing an association between catheter use and increased patient morbidity and mortality. To date, however, no randomized comparisons of the outcomes of different forms of vascular access have been conducted...
November 2, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29063671/magnesium-supplementation-a-consideration-in-dialysis-patients
#4
EDITORIAL
Mugurel Apetrii, Adrian Covic, Ziad A Massy
Even though disorders of magnesium (Mg) balance are common in dialyzed patients, this cation is often neglected. Many factors interfere with serum magnesium including diet, medications (eg, antacids or phosphate binders), and the dialysis prescription. Mg supplementation may help reduce serum phosphate concentration, PTH, and interfere with vascular calcification and bone mineralization. It could also decrease the all-cause and cardiovascular mortalities, although the results of current studies are conflicting...
October 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28990213/the-complex-relationship-among-arteriovenous-access-heart-and-circulation
#5
EDITORIAL
Carlo Basile, Carlo Lomonte
There are currently near 400 000 patients on hemodialysis in the United States. More than 50% of those treated by chronic hemodialysis die because of a cardiovascular (CV) event. The majority of these patients have functional arteriovenous fistulas (AVFs). AVFs have an adverse effect on cardiac function, but their exact contribution to CV morbidity is not clear. It has long been known that a vascular access with an inappropriately high-flow rate may cause high-output heart failure. Paradoxically, there may be hemodynamic and cardiopulmonary benefits conferred by AVF particularly in severe chronic obstructive pulmonary disease...
October 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28983956/transitional-dialysis-care-units-a-new-approach-to-increase-home-dialysis-modality-uptake-and-patient-outcomes
#6
REVIEW
José A Morfín, Alex Yang, Elizabeth Wang, Brigitte Schiller
Home hemodialysis (HHD) and peritoneal dialysis (PD) are associated with better clinical outcomes, lower hospitalization rates, and improved quality of life compared with conventional in-center hemodialysis. However, <12% of patients requiring dialysis therapy use HHD or PD in the United States, even though over 90% of nephrologists would choose home-based dialysis modalities for themselves. Inadequate patient education and decision-making support are key barriers to patients choosing home-based therapy...
October 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28967233/overhydration-underhydration-and-total-body-sodium-a-tricky-m%C3%A3-nage-a-trois-in-dialysis-patients
#7
EDITORIAL
Luminita Voroneanu, Cristina Gavrilovici, Adrian Covic
Overhydration is a frequent complication in dialysis patients. It has been linked with hypertension, left ventricular hypertrophy, arterial stiffness, atherosclerosis uremic cardiomyopathy, and all-cause mortality or cardiovascular morbidity. In addition, predialysis underhydration is also associated with increased risk of death in ESRD patients. In this context, the optimal evaluation of hydration status is a must. However, this mission is not easy or accurate. In the last 10 years, several new methods have been tested in dialysis patients, particularly bioimpedance and lung ultrasonography...
October 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28925068/when-and-how-can-nephrologists-treat-hepatitis-c-virus-infection-in-dialysis-patients
#8
REVIEW
Maya I Davis, Donald F Chute, Raymond T Chung, Meghan E Sise
Hepatitis C virus (HCV) infection, a major cause of end-stage liver disease, is a common comorbidity in patients on dialysis and causes increased morbidity and mortality. Historically HCV has been extremely difficult to cure with interferon and ribavirin-based therapies, which are also associated with significant side effects, and few dialysis patients ever received HCV treatment. However, in the last 4 years, interferon-free direct-acting antiviral therapies have been approved, and several combinations have been studied in dialysis patients...
September 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28833520/introduction-to-intradialytic-hypotension-perspectives-in-contemporary-practice
#9
EDITORIAL
Steven Brunelli
No abstract text is available yet for this article.
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28707302/dialysate-sodium-and-intradialytic-hypotension
#10
Wael F Hussein, Brigitte Schiller
Intradialytic hypotension (IDH) is a common complication in hemodialysis, particularly with the time and frequency constraints of standard session delivery in contemporary practice. High intradialytic weight gain (IDWG), high ultrafiltration rates (UFR), and frequent IDH are highly interlinked, and separately or together contribute to the high cardiovascular morbidity and mortality observed in the hemodialysis population. Using a lower concentration of sodium in the dialysate (D-Na) reduces sodium delivery to the patient during dialysis, and several studies reported the beneficial effect in controlling IDWG, UFR, and hypertension...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28691195/definitions-of-intradialytic-hypotension
#11
Magdalene M Assimon, Jennifer E Flythe
Intradialytic hypotension (IDH) is a common and often distressful complication of hemodialysis. However, despite its clinical significance, there is no consensus, evidence-based medical definition for the condition. Over the years, numerous definitions have been implemented in both the clinical and research settings. Definition inconsistencies have hindered data synthesis and the development of evidence-based guidelines for the prevention and treatment of IDH, as well as prevented accurate estimation of the population burden of IDH and patient risk assessment...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28681510/impact-of-drugs-on-intradialytic-hypotension-antihypertensives-and-vasoconstrictors
#12
Tara I Chang
Intradialytic hypotension (IDH) is a common complication of hemodialysis and is associated with numerous adverse outcomes including cardiovascular events, inadequate dialysis, loss of vascular access, and death. It is estimated that approximately 20%-30% of all dialysis sessions are affected by IDH. In seeking ways to reduce the occurrence of IDH, dialysis providers often turn to pharmacological approaches: withholding antihypertensive medications prior to hemodialysis or administering vasoconstrictor medications...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28666075/the-effect-of-treatment-time-dialysis-frequency-and-ultrafiltration-rate-on-intradialytic-hypotension
#13
George R Aronoff
Dialysis treatment time, the frequency of dialysis treatments, and the rate of fluid ultrafiltration-each impacts the incidence of intradialytic hypotension. These factors influence blood pressure independently and together. The strongest evidence supports that rapid ultrafiltration increases the likelihood of intradialytic hypotension and that combined strategies leading to a reduction in ultrafiltration rate have the greatest impact on reducing intradialytic hypotension. A practical approach to avoiding the effects of ultrafiltration on systemic hemodynamics would be to set a maximum ultrafiltration rate needed to achieve the desired fluid removal and vary the duration of the treatment to achieve that target volume...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28666072/special-situations-intradialytic-hypertension-chronic-hypertension-and-intradialytic-hypotension
#14
Peter Noel Van Buren, Jula K Inrig
Hypertension is a comorbidity that is present in the majority of end-stage renal disease patients on maintenance hemodialysis. This population is particularly unique because of the dynamic nature of blood pressure (BP) during dialysis. Modest BP decreases are expected in most hemodialysis patients, but intradialytic hypotension and intradialytic hypertension are two special situations that deviate from this as either an exaggerated or paradoxical response to the dialysis procedure. Both of these phenomena are particularly important because they are associated with increased mortality risk compared to patients with modest decreases in BP during dialysis...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28666069/setting-the-dry-weight-and-its-cardiovascular-implications
#15
Arjun D Sinha, Rajiv Agarwal
Volume overload is common and associated with adverse outcomes in the hemodialysis population including systemic hypertension, pulmonary hypertension, left ventricular hypertrophy, and mortality. Since the beginning of the era of maintenance dialysis, prescribing and maintaining a dry weight remains the standard of care for managing volume overload on hemodialysis. Reducing dry weight even by relatively small amounts has been shown to improve blood pressure and has been associated with reductions in left ventricular hypertrophy...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28786139/should-all-dialysis-patients-with-hepatitis-c-be-treated-if-so-before-or-after-kidney-transplantation
#16
EDITORIAL
Michel Jadoul, Paul Martin
HCV infection by genotype 1 and 4 can now be cured in close to 100% of patients with stage 4 or 5 CKD, including dialysis patients. Several regimens are available, all interferon-free and given for only 12 weeks. Thus unless life expectancy is short, HCV infection should be treated. The optimal timing of antiviral treatment will be dependent on several parameters: the possibility of being transplanted rapidly (either with a HCV+ graft or from a living donor) calls for treatment after transplantation. On the contrary, severe liver fibrosis, especially with portal hypertension calls for immediate treatment of HCV...
September 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28677243/parathyroidectomy-a-last-resort-for-hyperparathyroidism-in-dialysis-patients
#17
EDITORIAL
Amr El-Husseini, Kevin Wang, Adeleye Annick Edon, B Peter Sawaya
Despite advancements in the medical management of secondary hyperparathyroidism, parathyroidectomy is still necessarily in some patients. However, patients' selection, optimal surgical intervention and long-term outcome are still not well-defined and very challenging for the practicing nephrologists. In this manuscript we will attempt to answer several questions related to parathyroidectomy in dialysis patients. We will discuss the indications, the appropriate parathyroidectomy surgical techniques and current guidelines for parathyroidectomy...
September 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28628255/still-a-reasonable-goal-targeting-cholesterol-in-dialysis-and-advanced-chronic-kidney-disease-patients
#18
EDITORIAL
Gunnar H Heine, Kyrill S Rogacev, Oliver Weingärtner, Gunther Marsche
Chronic kidney disease (CKD) patients have a high burden of cardiovascular disease. In the general population, lipid metabolism disorders, which cause the initiation and progression of atherosclerotic vascular changes, are major targets for preventive and therapeutic strategies in cardiovascular medicine. However, data from large cohort studies and from clinical trials suggest that the treatment guidelines on cardiovascular disease prevention and therapy cannot uncritically be transferred from individuals with intact renal function to CKD patients...
September 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28609017/clinical-aspects-of-magnesium-physiology-in-patients-on-dialysis
#19
REVIEW
Paraish S Misra, Sharon J Nessim
Magnesium balance is infrequently discussed in the dialysis population, and the clinical consequences of derangements in magnesium homeostasis are incompletely understood. There is an association between hypomagnesemia and adverse outcomes including increases in cardiovascular disease and mortality, while elevated magnesium levels have also been linked with complications such as osteomalacia. In this review, we discuss the features of magnesium physiology relevant to dialysis patients and provide an updated summary of the literature linking magnesium derangements with bone disease, cardiovascular disease, sudden cardiac death, and mortality...
September 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608984/dialysis-in-the-undocumented-the-past-the-present-and-what-lies-ahead
#20
EDITORIAL
Shruti Gupta, Andrew Z Fenves
In many states undocumented immigrants with end stage renal disease (ESRD) do not have access to regular, thrice weekly dialysis. The term "compassionate dialysis" is used to describe dialysis that is provided on an emergent basis, when patients are in extremis from symptoms of volume overload or suffer from life-threatening electrolyte abnormalities. In this editorial, one particularly poignant anecdote is presented from the experience of one of the authors (AZF) as a nephrologist in Texas, a state where undocumented immigrants have faced difficulties in accessing regular dialysis...
September 2017: Seminars in Dialysis
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