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Hemodialysis International

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https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#1
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28509350/high-sodium-continuous-veno-venous-hemodialysis-with-regional-citrate-anticoagulation-and-online-dialysate-generation-in-patients-with-acute-liver-failure-and-cerebral-edema
#2
Tamim Hamdi, Lenar Yessayan, Jerry Yee, Balazs Szamosfalvi
INTRODUCTION: Acute liver failure is associated with a high mortality rate. Induction of plasma hypertonicity with mannitol or hypertonic saline remains the cornerstone in the management of resultant cerebral edema. Significant disadvantages of this approach include poor or unpredictable control of serum sodium concentration and volume expansion, among others. METHODS: We used high sodium continuous veno-venous hemodialysis with regional citrate anticoagulation and online dialysate generation to accurately control the serum sodium in eleven patients with acute liver failure, renal failure, and cerebral edema...
May 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28485119/case-of-mycobacterium-mucogenicum-in-home-hemodialysis-patient
#3
Miten J Dhruve, Paul E Bunce, Celine D'Gama, Christopher T Chan
We present a case of a patient on home hemodialysis who developed Mycobacterium mucogenicum bacteremia. While infections with this particular organism are rare, disseminated infections have been reported and have been associated with significant morbidity and mortality. Diagnosis required appropriate cultures, understanding of natural habitat of organism and complete environmental analysis including blood, dialysis sample port, reverse osmosis and incoming water supply cultures. The patient was treated successfully with systemic antibiotics, removal of central venous catheter, patient education and complete exchange of the hemodialysis circuit...
May 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28474859/the-deterioration-in-physical-function-of-hemodialysis-patients
#4
Brianna K Sutcliffe, Paul N Bennett, Steve F Fraser, Mohammadreza Mohebbi
INTRODUCTION: Physical function in people on hemodialysis deteriorates significantly, however quantification of the rate of deterioration has not been well established. The aim of this study was to examine the rate of deterioration in objective physical function among end-stage kidney disease patients receiving hemodialysis. METHODS: One hundred and ninety-three participants (mean age 67.5 ±13.2 years, 60.6% males) receiving hemodialysis in Australia. Objective physical function was assessed via the 30-second sit-to-stand and eight-foot timed up-and-go at baseline, 12 and 24 weeks...
May 5, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28425583/sleep-apnea-syndrome-inflammation-and-oxidative-stress-in-hemodialysis-patients
#5
Olga Nikitidou, Euphemia Daskalopoulou, Aikaterini Papagianni, Vassilios Liakopoulos, Aikaterini Michalaki, Foteini Christidou, Paraskevi Argyropoulou, Dimitrios Kirmizis, Georgios Efstratiadis, Pavlos Nikolaidis, Michail Daniilidis, Nicholas Dombros
INTRODUCTION: Sleep apnea syndrome (SAS) is an established cardiovascular risk factor in the general population related to inflammation and oxidative stress and is very common among hemodialysis patients. Cardiovascular disease and its complications is the main cause of death among hemodialysis patients. The aim of the present study was to investigate the role of SAS in the promotion of inflammation and oxidative stress and thus in the augmentation of cardiovascular risk in hemodialysis patients...
April 20, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28425578/survival-comparisons-of-intensive-vs-conventional-hemodialysis-pitfalls-and-lessons
#6
REVIEW
Amanda J Miller, Jeff Perl, Karthik K Tennankore
The optimal dose of hemodialysis (HD) has not yet been established. As a means of better approximating the physiology of native kidney function, there has been a growing interest in intensive HD (an increase in dialysis frequency and/or duration). Although many studies have demonstrated a survival benefit with intensive dialysis, results have been conflicting. This controversy stems from the challenges of randomizing patients to conventional vs. intensive HD modalities and, therefore, the reliance on observational comparisons that have been limited by varying definitions for intensive dialysis, differences in dialysis location and prescription, unavoidable treatment selection bias, and a potential lack of generalizability...
April 20, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28418628/catheter-related-fungal-endocarditis-caused-by-candida-parapsilosis-in-a-hemodialysis-patient
#7
Ying Shu, Shaobin Yu, Ling Zha, Ping Fu, Tianlei Cui
Fungal endocarditis (FE) is commonly regarded as a rare but fatal disease. The incidence of infective endocarditis (IE) in hemodialysis (HD) patients is thought to be obviously higher than that in the general population. Moreover, IE occurs more likely in HD patients with catheters. With the increase of HD population and extensive use of catheters in HD patients, FE, as a special form of IE, may increase and bring new challenges to clinicians. We reported a case of FE associated with catheter infection in a 44-year-old woman on HD...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28418625/physical-function-was-related-to-mortality-in-patients-with-chronic-kidney-disease-and-dialysis
#8
REVIEW
Shinichiro Morishita, Atsuhiro Tsubaki, Nobuyuki Shirai
Previous studies have shown that exercise improves aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health-related quality of life (QOL) in patients with chronic kidney disease (CKD) and dialysis. Recently, additional studies have shown that higher physical activity contributes to survival and decreased mortality as well as physical function and QOL in patients with CKD and dialysis. Herein, we review the evidence that physical function and physical activity play an important role in mortality for patients with CKD and dialysis...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28418614/efficacy-and-safety-of-low-dose-heparin-in-hemodialysis
#9
Mariana Murea, Gregory B Russell, Pirouz Daeihagh, Anita M Saran, Karan Pandya, Mark Cabrera, John M Burkart, Barry I Freedman
INTRODUCTION: The dose of unfractionated heparin (UFH) administered during hemodialysis (HD) varies widely. This prospective study evaluated the safety and efficacy of UFH dose de-escalation. METHODS: Sixty-six prevalent patients on HD receiving UFH per standard-dose protocol (load dose [LD] 50-75 units/kg, maintenance dose [MD] 500-1000 units/hour) had heparin prescription converted to low-dose protocol (start LD 15 units/kg and MD 500 units/hour; dose adjusted in small increments based on assessments of extracorporeal blood circuit)...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28403540/monocyte-lymphocyte-ratio-as-a-better-predictor-of-cardiovascular-and-all-cause-mortality-in-hemodialysis-patients-a-prospective-cohort-study
#10
Fangfang Xiang, Rongyi Chen, Xuesen Cao, Bo Shen, Zhonghua Liu, Xiao Tan, Xiaoqiang Ding, Jianzhou Zou
INTRODUCTION: Patients with chronic kidney disease, especially those with end-stage renal disease, have an increased risk of death. Previous studies have suggested neutrophil/lymphocyte ratio (NLR) was related to worse outcome in patients undergoing hemodialysis (HD). However, monocyte/lymphocyte ratio (MLR) has not been evaluated in HD patients. In this study, we prospectively studied the predictive value of MLR for all-cause and cardiovascular mortality in HD patients and compared it with NLR...
April 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28370973/a-single-center-open-label-randomized-parallel-group-study-assessing-the-relationship-between-asymptomatic-bacteriuria-and-inflammation-in-maintenance-hemodialysis-patients
#11
Ilia Beberashvili, Evgeni Golovko, Liat Golinsky, Nedal Garra, Inna Sinuani, Leonid Feldman, Oleg Gorelik, Shai Efrati, Kobi Stav
INTRODUCTION: The significance of asymptomatic bacteriuria in maintenance hemodialysis (MHD) patients remains controversial. We hypothesized that the presence of asymptomatic bacteriuria as a sole clinical manifestation of urinary tract infection (UTI) in asymptomatic MHD patient may contribute to the chronic inflammatory response. Our aim was to explore the relationship between asymptomatic bacteriuria and elevated levels of inflammatory markers in MHD patients. METHODS: A randomized open-label single center study of 114 MHD patients was conducted...
April 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28332336/association-between-afebrile-status-and-in-hospital-mortality-among-adult-chronic-hemodialysis-patients-with-bacteremia
#12
Wonhak Kim, So Mi Kim, Hoon Yu, Mun Jang, Seung Don Baek, Soon Bae Kim
AIM: We aimed to compare the in-hospital mortality between febrile and afebrile chronic hemodialysis (HD) patients with bacteremia and analyze the blood culture positive rate according to the C-reactive protein (CRP) level. METHODS: We collected data from 2006 to 2014. One hundred ninety bacteremic events were assigned to the "febrile group" (n = 162) and "afebrile group" (n = 28) based on the presence of fever. Fever was defined as a tympanic temperature >37...
March 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28332280/hfe-gene-mutations-are-not-risk-factors-for-iron-overload-in-european-hemodialysis-patients
#13
LETTER
Guy Rostoker, Mireille Griuncelli, Yves Cohen
No abstract text is available yet for this article.
March 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28301073/thyroid-function-in-end-stage-renal-disease-and-effects-of-frequent-hemodialysis
#14
Joan C Lo, Gerald J Beck, George A Kaysen, Christopher T Chan, Alan S Kliger, Michael V Rocco, Minwei Li, Glenn M Chertow
INTRODUCTION: End-stage renal disease (ESRD) is associated with perturbations in thyroid hormone concentrations and an increased prevalence of hypothyroidism. Few studies have examined the effects of hemodialysis dose or frequency on endogenous thyroid function. METHODS: Within the Frequent Hemodialysis Network (FHN) trials, we examined the prevalence of hypothyroidism in patients with ESRD. Among those with endogenous thyroid function (without overt hyper/hypothyroidism or thyroid hormone supplementation), we examined the association of thyroid hormone concentration with multiple parameters of self-reported health status, and physical and cognitive performance, and the effects of hemodialysis frequency on serum thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) levels...
March 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28296033/predictors-of-post-hospitalization-recovery-of-renal-function-among-patients-with-acute-kidney-injury-requiring-dialysis
#15
Russell Pajewski, Patrick Gipson, Michael Heung
INTRODUCTION: Acute kidney injury (AKI) requiring dialysis complicates 1% of all hospital admissions, and up to 30% of survivors will still require dialysis at hospital discharge. There is a paucity of data to describe the postdischarge outcomes or to guide evidence-based dialysis management of this vulnerable population. METHODS: Single-center, retrospective analysis of 100 consecutive patients with AKI who survived to hospital discharge and required outpatient dialysis...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28295984/safety-of-arteriovenous-fistulae-and-grafts-for-continuous-renal-replacement-therapy-the-michigan-experience
#16
Anas Al Rifai, Nidhi Sukul, Robert Wonnacott, Michael Heung
INTRODUCTION: Arteriovenous fistula or graft (AVF/AVG) use is widely considered contraindicated for continuous renal replacement therapy (CRRT), yet insertion of hemodialysis (HD) catheters can carry high complication risk in critically ill end-stage renal disease (ESRD) patients. METHODS: Single-center analysis of 48 consecutive hospitalized ESRD patients on maintenance HD who underwent CRRT using AVF/AVG from 2012 to 2013. Primary outcome was access-related complications...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28272776/iatrogenic-hypernatremia-in-hemodialysis-patients-a-result-erroneous-online-conductivity-monitor-and-conductivity-meter-reading
#17
Chamberlain I Obialo, Smitha John, Khalid Bashir
Hyponatremia is common in chronic kidney disease and in end stage kidney disease (ESKD) but hypernatremia is infrequent in ESKD. The incidence of hypernatremia is higher in ambulatory peritoneal dialysis (PD) than in hemodialysis (HD) patients. In PD patients it is often a result of excessive ultrafiltration but in HD it is often a result of dialysate composition errors. Dialysate composition errors can inadvertently cause either hyponatremia or hypernatremia. We present two cases of symptomatic hypernatremia which manifested as increased thirst, excessive weight gain and worsening hypertension in HD patients...
March 8, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28272770/sex-differences-in-vascular-dysfunction-and-cardiovascular-outcomes-the-cardiac-endothelial-function-and-arterial-stiffness-in-esrd-ceres-study
#18
Isabella Guajardo, Amrita Ayer, Alexander D Johnson, Peter Ganz, Claire Mills, Catherine Donovan, Rebecca Scherzer, Sanjiv J Shah, Carmen A Peralta, Ruth F Dubin
INTRODUCTION: Recent studies suggest that women with end-stage renal disease (ESRD) may have higher rates of mortality than men, but it is unknown whether sex differences in vascular function explain this disparity. The cardiac, endothelial function, and arterial stiffness in ESRD (CERES) study is an ongoing, prospective observational study designed to investigate vascular function, myocardial injury, and cardiovascular outcomes in ESRD. METHODS: Among 200 CERES participants (34% women), we evaluated arterial wave reflections as augmentation index normalized to a heart rate of 75 (AIx75), arterial stiffness as pulse wave velocity, and macro- and microvascular endothelial dysfunction as flow-mediated dilation and velocity time integral (VTI)...
March 8, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28263039/sertraline-can-reduce-the-uremic-pruritus-in-hemodialysis-patient-a-double-blind-randomized-clinical-trial-from-southern-iran
#19
Maryam Pakfetrat, Leila Malekmakan, Noushin Hashemi, Taraneh Tadayon
INTRODUCTION: Uremic pruritus is an undesirable complication of end stage renal disease (ESRD). In spite of introduction of many treatments for this complication, it has no certain cure. The aim of this study was to assess sertraline effect on uremic pruritus. METHODS: In the present clinical trial study, we randomly divided our patients into two groups; trial group that received sertraline and control group that consumed placebo. We measured the severity of pruritus by two scoring systems (visual analogue scale and DUO) at the beginning and during the study with a-2-week interval...
March 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28263032/impact-of-arteriovenous-fistula-cannulation-on-the-quality-of-dialysis
#20
Michelle Elias, Erika Nnang-Obada, Bernard Charpentier, Antoine Durrbach, Severine Beaudreuil
INTRODUCTION: Adequate hemodialysis directly improves health. Puncturing an arteriovenous fistula (AVF) and the amount of blood recirculation greatly affect the quality of dialysis. Few studies have assessed the method to cannulate a fistula and its influence on efficiency of hemodialysis. METHODS: This prospective pilot study included 14 patients with end-stage renal failure receiving regular intermittent hemodialysis. Patients received three consecutive treatments with both needles directed upstream then three consecutive treatments with the venous needle directed upstream and the arterial needle directed downstream...
March 6, 2017: Hemodialysis International
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