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Hemodialysis International

Konomi Togo, Masahito Yamamoto, Takahisa Ono, Motoyuki Imai, Keiichi Akiyama, Kunio Ebine, Akihiro C Yamashita
INTRODUCTION: Polysulfone (PSf) membrane has been widely used for hemodialysis. A few studies have been reported in which a method of sterilization may affect biocompatibility. In this study, the comparison was made between two PSf membranes in order to evaluate the effect of sterilization from the biocompatibility point of view. METHODS: We investigated the biocompatibility of the following two dialyzers, that is, APS-11SA (Asahi Kasei medical Co., Tokyo, Japan), sterilized by gamma-ray irradiation, and RENAK PS-1...
November 8, 2018: Hemodialysis International
Ladan Golestaneh, Michele H Mokrzycki
Tunneled central venous catheters used for the provision of hemodialysis are associated with excess morbidity and mortality. Catheter related exit site and blood stream infections are major risks of their use. Although catheter-avoidance is the best strategy to reduce infections and mortality in the hemodialysis population, the use of catheters remains unacceptably high. In this review, the existing clinical practice guidelines for the prevention of hemodialysis catheter associated infections are outlined, and a comprehensive evidenced-based summary of interventions is provided...
November 8, 2018: Hemodialysis International
Sarju Panchal, Christine Schneider, Kunal Malhotra
Chronic kidney disease and dialysis brings with it a plethora of complications, including malnutrition. Strict dietary restrictions in hemodialysis (HD) patients further complicate the picture as it increases the risk of deficiency of micronutrients, specifically water-soluble vitamins. Today, there is a lack of concrete guidelines concerning recommendations on vitamin supplementation in HD patients. This lack of data is partly due to our incomplete understanding of handling of vitamins in a uremic state. There is a dire need for more data on the impact of dialysis and uremic state on water-soluble vitamins to facilitate appropriate preventative supplementation...
November 8, 2018: Hemodialysis International
Andrew Davenport
Dialyzers were initially developed for diffusive clearance of uraemic toxins. Diffusion most effectively clears small uncharged solutes from plasma water, such as urea. Sessional urea clearance targets have been shown to be important for short-term patient survival, but over the longer term, although low-flux dialysis can prolong patient survival, accumulation of middle-sized uraemic toxins, such as β2 microglobulin can lead to disabling arthropathy. Although the introduction of high-flux dialyzers, designed to increase β2 microglobulin clearance, has reduced the prevalence of arthropathy; this has not been translated into a demonstrable significant improvement in patient survival...
November 8, 2018: Hemodialysis International
Deepa Amberker, Ting Ting Li, Ritesh Rampure
Hemodialysis (HD) is not the preferred approach for dialysis in patients with hemophilia. HD in such patients can possess a high risk of bleeding from arterio-venous cannulation and hence peritoneal dialysis is the first choice in patients with hemophilia. The bleeding risk can be overcome by the prophylactic administration of factor VIII, which is a very costly solution. Here, we present a case of hemophilia with successful HD using an arterio-venous graft averting the need for factor VIII. We review the literature on epidemiology and risk factors for chronic kidney disease in patients with hemophilia...
November 1, 2018: Hemodialysis International
Alba Santos García, Nicolás Macías Carmona, Almudena Vega Martínez, Soraya Abad Estébanez, Tania Linares Grávalos, Inés Aragoncillo Sauco, Ursula Verdalles Guzmán, Nayara Panizo González, Leonidas Cruzado Vega, Juan Manuel López Gómez
INTRODUCTION: The aim of this study is to compare molecule removal and albumin leakage in postdilution online hemodiafiltration with different high-flux dialyzers. METHODS: We studied seven high-flux dialyzers (Polyflux 210H®, Evodial 2.2®, FxCordiax1000®, Elisio21H®, TS-2.1SL®, XevontaHi20®, VitaPES 210-HF®) in 6 patients. The reduction ratio (RR) of small- and middle-sized molecules was calculated. Dialysate samples were collected to estimate the albumin leakage...
October 27, 2018: Hemodialysis International
Takeshi Okamoto, Tsutomu Sakurada, Kenichiro Koitabashi, Yugo Shibagaki
INTRODUCTION: As the number of elderly end-stage renal disease patients lacking suitable vessels for arteriovenous fistula (AVF) is increasing, indications for tunnel cuffed catheters (TCCs) may be expanding. This study aimed to clarify changes over time in the number of patients with TCC and indications for TCCs. METHODS: This single-center retrospective study analyzed 143 catheters for 95 patients who inserted TCCs between July 2005 and July 2017. Patients were divided into two groups (early- and late-phase groups) based on the median observational period...
October 26, 2018: Hemodialysis International
Shehryar Khan, Lauren Wake, Kristina Glover, Pedro Bauza, Deepak Prabhakar, Esther Akinyemi
No abstract text is available yet for this article.
October 25, 2018: Hemodialysis International
Madhukar Misra, Harold Moore
No abstract text is available yet for this article.
October 25, 2018: Hemodialysis International
Sabrina Haroon, Andrew Davenport
The objectives of hemodialysis have moved from the diffusive clearance of small molecular weight uremic toxins and achieving dialyzer urea adequacy targets to emphasis on improving clinical outcomes in end stage renal failure patients by increasing larger sized uremic toxin clearance. Clinical emphasis in the last few decades has focused on increasing middle molecule weight toxin clearance by hemodiafiltration. Although long-term data is still lacking, short-term outcomes appear promising. Advancements in nanotechnology have now introduction a new generation of medium cut-off membrane dialyzers which allow diffusive clearance of similar middle molecular weight uremia toxin clearance as hemodiafiltration, without increased albumin losses...
October 8, 2018: Hemodialysis International
Sanjay Vikrant
INTRODUCTION: Tuberculosis (TB) is a significant health problem in developing countries. There are limited data on TB among end stage renal disease (ESRD) patients on maintenance dialysis in India. Clinical profile and outcome of TB in dialysis were studied. METHODS: Retrospective study of ESRD patients who were on maintenance dialysis (either peritoneal dialysis [PD] or hemodialysis (HD]) and diagnosed to have TB over a period of 11 years. FINDINGS: Thirty-two patients had a diagnosis of TB...
October 5, 2018: Hemodialysis International
Frances Reintjes, Nim Herian, Nikhil Shah, Robert P Pauly
INTRODUCTION: Increasing renal care providers offer home hemodialysis (HD) as a modality choice. There is considerable variation in the provision of after-hours on-call support for self-dialyzing patients and no literature describing the utility of this service. In this prospective, observational study we sought to monitor and classify the number and nature of interactions between home patients and our on-call nurses and technologists, and enumerate the number of adverse events averted by the availability of on-call staff...
October 5, 2018: Hemodialysis International
Sami Deniz, Yusuf Aydemir, Aysun Şengül, Jülide Çeldir Emre, Mehmet Tanrisev, Mustafa Hikmet Özhan, İbrahim Güney
INTRODUCTION: The risk of TB is increased in patients with chronic kidney disease (CKD) when compared with individuals with normal renal function. We aimed to determine tuberculin skin test (TST) response and the factors which might affect the response in patients with CKD undergoing dialysis in this study. METHODS: The purified protein derivative solution was administered to the patients and the diameter of induration was measured. Additionally, the age, gender and smoking status of the patients were interrogated...
October 5, 2018: Hemodialysis International
Cibele Puato de Almeida, Daniela Ponce, André Luís Balbi
INTRODUCTION: Hemodialysis (HD) is one treatment for acute kidney injury (AKI) patients. Studies have shown that this dialysis modality may lead to changes in pulmonary function with an impact on prognosis. The aim of our study was to evaluate changes in respiratory mechanics and oxygenation of AKI patients admitted to an intensive care unit who were undergoing intermittent mechanical ventilation (IMV) and daily HD. METHODS: This prospective cohort study evaluated 94 AKI patients and 234 HD sessions...
October 5, 2018: Hemodialysis International
Margaret K Yu, Susan P Y Wong, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare
INTRODUCTION: Clinical practice guidelines increasingly favor a more symptom-driven approach to maintenance dialysis initiation. But, little is known about the clinical presentation at dialysis initiation, such as the different kinds of signs and symptoms present at dialysis initiation, illness acuity at dialysis initiation, and how these aspects of the clinical presentation relate to subsequent survival. METHODS: This is a retrospective cohort study of a random sample of veterans who initiated dialysis between 2000 and 2009 at Veterans Affairs (VA) medical centers across the country (N = 1,691)...
October 4, 2018: Hemodialysis International
Najia Idrees, Mohammad Almeqdadi, Vaidyanathapuram S Balakrishnan, Bertrand L Jaber
Levofloxacin, a third-generation fluoroquinolone antibiotic, is rarely associated with neurotoxicity. Patients with advanced kidney disease are particularly vulnerable to this adverse effect. We present two elderly patients with kidney failure who developed levofloxacin-induced neurotoxicity, which was successfully treated with frequent hemodialysis, resulting in the full resolution of their symptoms. Neurotoxicity is a well-known side effect of fluoroquinolone antibiotics. Postulated mechanisms include inhibition of the gamma-aminobutyric acid A receptors and activation of the excitatory N-methyl-D-aspartate receptors...
September 25, 2018: Hemodialysis International
John K Leypoldt, Eric D Weinhandl, Allan J Collins
With dialysis delivery systems that operate at low dialysate flow rates, prescriptions for more frequent hemodialysis (HD) employ dialysate volume as the primary parameter for small solute removal rather than blood-side urea dialyzer clearance (K). Such delivery systems, however, yield dialysate concentrations that almost completely saturate with blood (water), suggesting that the volume of urea cleared (the product of K and treatment time or Kt) can be readily estimated from the prescribed dialysate volume to target small solute removal...
September 25, 2018: Hemodialysis International
George Joseph Kavalam, Siddiqua Safreen, Georgi Abraham, Saravanan Sundararajan, Milly Mathew, Senthil Murugan, Deepu S George
We report a 28-year-old female with no history of allergies and recent onset of Goodpasture syndrome who developed life-threatening bleeding immediately after placement of a polytetrafluoroethylene (PTFE) graft as an access for hemodialysis in the left upper limb by an experienced vascular surgeon. In spite of transfusing fresh frozen plasma, packed cells and cryoprecipitate, her prothrombin time (PT), activated partial thromboplastin time and international normalized ratio became progressively worse which were normal at the beginning of the surgery...
September 25, 2018: Hemodialysis International
Ilhan Nahit Mutlu, Burak Kocak, Melis Baykara Ulusan, Kivilcim Ulusan, Mehmet Semih Cakir, Ozgur Kilickesmez
INTRODUCTION: Pericatheter bleeding (PB) following tunneled hemodialysis catheter (THC) placement is a common phenomenon. In addition to complicating securement of the THC, the PB may loosen the adhesive catheter dressing and delay wound healing. The primary aim of this study was to determine whether epinephrine-containing local anesthetics rather than plain ones reduce superficial PB after THC placement. METHODS: The study was based on the retrospective analysis of the prospectively gathered data...
September 21, 2018: Hemodialysis International
Fumitaka Nakajima, Yoshiyuki Furumatsu, Takatomi Yurugi, Yoshifumi Amari, Takeshi Iida, Takayuki Fukui, Takanori Kuramoto
INTRODUCTION: Although gastrointestinal hemorrhage is an important complication for dialysis patients, the details of many points remain unclear with regard to small intestinal lesions. METHODS: Capsule endoscopy was performed in fecal occult blood-positive dialysis (n =16) and non-dialysis (n = 20) patients after upper and lower gastrointestinal endoscopies failed to reveal hemorrhagic lesions. FINDINGS: Erosive lesions were observed in 50...
September 20, 2018: Hemodialysis International
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