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Seminars in Dialysis

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https://www.readbyqxmd.com/read/28628255/still-a-reasonable-goal-targeting-cholesterol-in-dialysis-and-advanced-chronic-kidney-disease-patients
#1
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...
June 19, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28628236/blastomyces-dermatitidis-peritonitis-complicating-peritoneal-dialysis
#2
Yogesh Sanghvi, Douglas Somers
Fungal peritonitis is an uncommon complication in peritoneal dialysis patients. We report a case of blastomyces dermatitis peritonitis in a nonimmunocompromised peritoneal dialysis patient, who initially presented with symptoms of lower extremity weakness and altered mental status. Peritoneal blastomycosis is rare condition and not previously reported in end stage renal disease patients on peritoneal dialysis. Fungal peritonitis can present with subtle clinical findings so a high index of suspicion is needed as early detection and treatment may decrease mortality and morbidity...
June 19, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28609017/clinical-aspects-of-magnesium-physiology-in-patients-on-dialysis
#3
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...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608994/hiv-in-the-dialysis-population-current-issues-and-future-directions
#4
REVIEW
Suzanne M Boyle, Dong H Lee, Christina M Wyatt
Antiretroviral therapy has significantly reduced mortality due to HIV infection, but the aging HIV-positive patient population now faces a growing burden of comorbidity. This review describes the changing epidemiology of chronic kidney disease and end-stage renal disease in this population, and highlights recent advances in antiretroviral therapy and kidney transplantation that directly impact the care of patients with HIV infection and end-stage renal disease.
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608984/dialysis-in-the-undocumented-the-past-the-present-and-what-lies-ahead
#5
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...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608981/health-related-quality-of-life-of-patients-on-chronic-dialysis-the-need-for-a-focused-effort
#6
EDITORIAL
Maurizio Bossola, Gilda Pepe, Emanuele Marzetti
Health-related quality of life (HRQOL) in patients on chronic hemodialysis has not improved significantly in the last 20 years. This is largely due to their substantial symptom burden which is rarely assessed and treated in routine clinical practice. It also is a consequence of the lack of an appropriate armamentarium for the treatments of such symptoms. Adequate studies on the causes and pathogenesis of the symptoms of hemodialysis patients are needed followed by high quality studies on possible therapeutic pharmacological and nonpharmacological interventions...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608938/when-the-hero-becomes-the-villain
#7
Patrick Onkka, Roger Rodby
No abstract text is available yet for this article.
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608937/sleep-disturbance-and-sleep-disordered-breathing-in-hemodialysis-patients
#8
REVIEW
Ginger Chu, Peter Choi, Vanessa M McDonald
Sleep disturbance is one of the most common dialysis-related symptoms reported by hemodialysis patients. Poor sleep confers significant physical and psychological burden on patients with kidney disease and is associated with reduced quality of life and survival. More recent evidence also indicates that sleep-disordered breathing may be a risk factor for kidney injury.
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608933/ultrapure-versus-standard-dialysate-a-cost-benefit-analysis
#9
EDITORIAL
Ashish Upadhyay, Paweena Susantitaphong, Bertrand L Jaber
Low-level bacterial and endotoxin contamination of water used to generate dialysate propagates chronic inflammation in patients with a wide-range of potential adverse consequences, including erythropoietin hyporesponsiveness. Advancements in hemodialysis systems now allow for the generation of ultrapure dialysate that has lower bacterial and endotoxin levels than the standard dialysate. The cost associated with ultrapure dialysate is thought to be a major barrier to its widespread adoption. In this report, we conduct a cost-benefit analysis examining the excess cost of generating ultrapure dialysate and the potential cost saving from a lower erythropoietin dose requirement...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608932/hormonal-changes-in-hemodialysis-patients-novel-risk-factors-for-mortality
#10
REVIEW
Ozkan Gungor, Ismail Kocyigit, Juan Jesus Carrero, Mahmut Ilker Yılmaz
Patients with end-stage renal disease undergoing dialysis commonly experience derangements in the hypothalamic-pituitary-gonadal axis together with alterations at the level of synthesis and clearance of many hormones. This hormonal imbalance, even if asymptomatic, has recently been associated with increased mortality in these patients. In this review, we summarize observational and mechanistic evidence linking hormonal alterations at the level of the thyroid and sex-hormone systems with this mortality risks...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28608927/role-of-vascular-calcification-inhibitors-in-preventing-vascular-dysfunction-and-mortality-in-hemodialysis-patients
#11
REVIEW
Ozkan Gungor, Ismail Kocyigit, Mahmut Ilker Yilmaz, Siren Sezer
Cardiovascular events make up the primary cause of death in hemodialysis patients, and the risk for cardiovascular mortality is significantly increased by vascular calcification, a condition observed frequently in this patient population. The mechanisms underlying the pathogenesis of vascular calcification are complex, and many factors facilitate or hinder the development of calcification. In this review, we first summarize the main factors contributing to the pathogenesis of vascular calcification in patients with end-stage renal disease...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28581689/the-physical-deterioration-of-dialysis-patients-ignored-ill-reported-and-ill-treated
#12
EDITORIAL
Paul N Bennett, Nicole Capdarest-Arest, Kristen Parker
The progressive physical deterioration of dialysis patients is apparent to all who are involved in their care. Exercise can help stem this decline, yet exercise uptake in chronic and end-stage kidney disease is low. The involvement of exercise professionals has been shown to significantly increase patients' physical function and improve their quality of life. However, exercise professionals are scarce in renal programs, far less than dietetic and social work services. A review of 10 years of renal exercise publications in the physical therapy and rehabilitation literature found that only 0...
June 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28581677/interplay-of-volume-blood-pressure-organ-ischemia-residual-renal-function-and-diet-certainties-and-uncertainties-with-dialytic-management
#13
REVIEW
Ercan Ok, Nathan W Levin, Gulay Asci, Charles Chazot, Huseyin Toz, Mehmet Ozkahya
Extracellular fluid volume overload and its inevitable consequence, hypertension, increases cardiovascular mortality in the long term by leading to left ventricular hypertrophy, heart failure, and ischemic heart disease in dialysis patients. Unlike antihypertensive medications, a strict volume control strategy provides optimal blood pressure control without need for antihypertensive drugs. However, utilization of this strategy has remained limited because of several factors, including the absence of a gold standard method to assess volume status, difficulties in reducing extracellular fluid volume, and safety concerns associated with reduction of extracellular volume...
June 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28558417/imaging-of-parathyroid-glands-in-end-stage-renal-disease
#14
Jyotirmay Sharma, Raghuveer Halkar, Collin J Weber
Secondary hyperparathyroidism from chronic renal failure often requires a parathyroidectomy for correction. A successful parathyroidectomy often relies upon localization of all parathyroid tumors. Although most of the tumors are localized during a neck exploration, preoperative localization studies can help identify ectopic and supernumerary tumors. Three of the most common localization studies are radionuclide imaging, ultrasound, and CT scanning. Utility of these studies is strongly dependent on local institutional practice...
May 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28558415/obstacles-to-reducing-plasma-levels-of-uremic-solutes-by-hemodialysis
#15
EDITORIAL
Tammy L Sirich
More intensive hemodialysis has provided limited clinical benefit. The lack of benefit may be due in part to the failure of intensive dialysis to reduce uremic solute levels in plasma. Two well-described factors limiting the reduction in these levels are the intermittency of dialysis treatment and the distribution of solutes in multiple body compartments. Efforts to increase the clearance of large solutes and protein-bound solutes have revealed two other considerations-the presence of nonrenal clearance and increases in solute generation...
May 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28547810/introduction-to-imaging-in-dialysis-patients
#16
W Charles O'Neill
No abstract text is available yet for this article.
May 25, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28543535/diagnosis-and-management-of-acquired-cystic-kidney-disease-and-renal-tumors-in-esrd-patients
#17
Frederic Rahbari-Oskoui, William Charles O'Neill
The incidence of renal malignancies is markedly increased in end-stage renal disease and appears to be related to the development of acquired cystic kidney disease. Identification and evaluation of simple cysts, complex cysts, and solid masses in these patients rely on imaging studies, including ultrasonography, computed tomography, and magnetic resonance imaging, each of which has advantages and disadvantages. While there are no published data to support screening of ESRD patients, this seems appropriate in at least some patients, based on patient characteristics and the presence or absence of acquired cystic kidney disease...
May 21, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28523699/imaging-and-peritoneal-dialysis-catheters
#18
Stephen Ash, Adrian Sequeira, Rajeev Narayan
The placement of a peritoneal dialysis (PD) catheter by interventionalists demands not only procedural skill but also an ability to decipher real-time ultrasonographic and fluoroscopic images. In this article, we discuss how imaging assists in PD placement and recognition of complications. To aid this endeavor, we have provided images and video clips that should assist interventionalists. Compared with the fluoroscopic technique, peritoneoscopic PD catheter placement provides direct visual imaging to also aid placement of the initial trocar and the peritoneal catheter...
May 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28486776/ultrasound-guided-cannulation-of-the-hemodialysis-arteriovenous-access
#19
Frank Ward, Rose Faratro, Rory F McQuillan
Successful cannulation of the arteriovenous access for patients with end-stage kidney failure to allow catheter-free hemodialysis is associated with superior patient outcomes. With an increasing rate of arteriovenous access creation, coupled with increasing dialysis patient age, the "difficult-to-cannulate" access is becoming more commonplace. Ultrasound-guided cannulation aims to improve first-time successful cannulations and minimize cannulation-associated complications such as infiltration and hematoma formation, minimizing delays in access use and reducing catheter dependency...
May 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28393400/sonography-of-arteriovenous-fistulas-and-grafts
#20
Jason A Pietryga, Mark D Little, Michelle L Robbin
Arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) are the vascular accesses of choice for long-term hemodialysis. Strategies to establish and maintain functioning AVFs and AVGs are essential. In addition to clinical evaluation, ultrasound plays a critical role in the evaluation and maintenance of AVFs and AVGs. AVFs have a high rate of failure to mature which can be reliably diagnosed with ultrasound. Treatable etiologies of the failure to mature can often be diagnosed with ultrasound. Causes of secondary AVG failure can also be diagnosed with ultrasound and treated...
April 10, 2017: Seminars in Dialysis
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