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Hemodialysis International

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https://www.readbyqxmd.com/read/28799704/the-nature-consequences-and-management-of-neurological-disorders-in-chronic-kidney-disease
#1
REVIEW
Bahman Jabbari, Nosratola D Vaziri
Perhaps no other organ in the body is affected as often and in as many ways as the brain is in patients with chronic kidney disease (CKD). Several factors contribute to the neurological disorders in CKD including accumulation of uremic toxins, metabolic and hemodynamic disorders, oxidative stress, inflammation, and impaired blood brain barrier among others. The neurological disorders in CKD involve both peripheral and central nervous system. The peripheral neurological symptoms of CKD are due to somatic and cranial peripheral neuropathies as well as a myopathy...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28799694/patient-with-a-total-artificial-heart-maintained-on-outpatient-dialysis-while-listed-for-combined-organ-transplant-a-single-center-experience
#2
Ramy M Hanna, Huma Hasnain, Mohammad Kamgar, Mina Hanna, Raffi Minasian, James Wilson
Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28796431/acute-kidney-injury-in-a-postpartum-woman-with-paroxysmal-nocturnal-hemoglobinuria-a-case-report-and-literature-review
#3
Masatoshi Nishimoto, Masaru Matsui, Hideo Tsushima, Kaori Tanabe, Miho Tagawa, Ken-Ich Samejima, Yasuhiro Akai, Yoshihiko Saito
Paroxysmal nocturnal hemoglobinuria is a rare clonal hematopoietic stem cell disorder characterized by intravascular hemolysis, hemoglobinuria, and inflammatory thrombotic state. Intravascular hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) can lead to acute and chronic renal injury through hemoglobin-mediated toxicity. A 32-year-old pregnant woman with myelodysplastic syndrome was admitted to our hospital with severe preeclampsia. Shortly after an urgent caesarean section, she became obtunded and showed signs of acute kidney injury (AKI) with anuria, severe intravascular hemolysis, and hypermagnesemia...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28796425/comparison-of-stroke-volume-measurements-during-hemodialysis-using-bioimpedance-cardiography-and-echocardiography
#4
Michael J Germain, Jyovani Joubert, Daniel O'Grady, Brian H Nathanson, Yossi Chait, Nathan W Levin
BACKGROUND: Fluid management remains a major challenge of hemodialysis (HD) care, with serious implications for morbidity and mortality. Intradialytic fluid management is typically guided by blood pressure, an indirect resultant of hemodynamics status. Direct measurements of hemodynamic parameters may improve cardiovascular outcomes by providing rational bases for intervention. We compare stroke volume (SV) measurements using a noninvasive, regional biompedance cardiography device (NiCaS) with Doppler echocardiography (Echo) in HD setting...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28796408/use-of-the-anion-gap-and-intermittent-hemodialysis-following-continuous-hemodiafiltration-in-extremely-high-dose-acute-on-chronic-lithium-poisoning-a-case-report
#5
Yohei Komaru, Ryota Inokuchi, Yoshihiro Ueda, Masaomi Nangaku, Kent Doi
A 35-year-old woman intentionally took 40,000 mg of lithium carbonate, and she was transferred to our hospital with nausea, vomiting, and diarrhea. She was diagnosed as having bipolar disorder 10 years ago and was receiving oral lithium therapy. Blood test results on arrival were remarkable for a negative anion gap of -2.1 and later, the serum lithium level turned out to be as high as 15.4 mEq/L. Intubation was required because of disrupted consciousness, and continuous hemodiafiltration (CHDF) was immediately started in the intensive care unit to obtain constant removal of lithium...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28762659/timing-of-surgical-intervention-for-fungal-infective-endocarditis
#6
LETTER
Chang-Hua Chen
No abstract text is available yet for this article.
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#7
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28762633/platelet-activation-and-clotting-cascade-activation-by-dialyzers-designed-for-high-volume-online-hemodiafiltration
#8
Kamonwan Tangvoraphonkchai, Anne Riddell, Andrew Davenport
INTRODUCTION: Hemodialysis patients are pro-thrombotic. Higher volume online postdilutional hemodiafiltration (OL-HDF), with increasing hematocrit increases the risk of clotting in the extracorporeal circuit (ECC). We wished to determine whether OL-HDF increased platelet activation and ECC clotting. METHODS: Coagulation parameters, platelet, white cell, and endothelial activation markers were measured at the start and end of dialysis sessions in 10 patients and also pre- and post-dialyzer after 15 minutes using two different dialyzers designed for high volume OL-HDF; cellulose triacetate (TAGP) and polysulphone (PS), and polyvinylpyrrolidone (PVP)...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28762626/adjustment-of-target-weight-based-on-absolute-blood-volume-reduces-the-frequency-of-intradialytic-morbid-events
#9
Susanne Kron, Daniel Schneditz, Jutta Czerny, Til Leimbach, Klemens Budde, Joachim Kron
INTRODUCTION: Adequate volume management removing excess volume and at the same time avoiding intradialytic morbid events (IME) remains a core problem in current hemodialysis (HD) therapy. Recently, we developed a feasible method to determine absolute blood volume (Vs, in mL/kg) in patients on HD. The aim of this study was to investigate the suitability of Vs measurements for volume management. METHODS: Following a 4 week baseline phase to quantify the frequency of IME, volume status was determined in a single specified HD session during which Vs was measured using dialysate dilution, volume overload (Vo, L) was measured using bioimpedance spectroscopy, and the occurrence of IME was recorded...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28762615/plasma-cell-neoplasm-as-a-risk-factor-for-early-thrombosis-of-arteriovenous-fistula
#10
Yoshitaka Kinoshita, Akira Ishikawa, Konan Hara, Toru Sugihara, Yoshitaka Ishibashi, Yukio Homma
INTRODUCTION: We hypothesized that presence of plasma cell neoplasms might be a risk for thrombosis of arteriovenous fistulas (AVFs) as well as other well-known factors including age, sex, race, and presence of diabetes mellitus or certain vascular disorders. METHODS: In this single-center, retrospective study based on medical record data, we investigated the influence of plasma cell neoplasms and the above-mentioned factors on the occurrence of complete occlusive thrombosis of the AVF within 30 days after surgery for creation of the AVF...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28762611/pregnancy-on-short-daily-home-hemodialysis-using-low-dialysate-flow-rate-a-new-hope-for-the-end-stage-renal-disease-patients
#11
Vincent Leduc, Maxence Ficheux, Clémence Bechade, Michel Dreyfus, Thierry Lobbedez, Patrick Henri
INTRODUCTION: In France in 2014, there were approximately 1500 patients of reproductive age treated by dialysis. Pregnancy in these patients remains rare, however, the incidence has increased since the 2000s, with a parallel increase in the fetal survival rate. We report 2 cases of pregnancy in short-daily home hemodialysis using low dialysate flow rate. METHODS: Short-daily hemodialysis was continued at the request of the patients. The treatment consisted in an increase of frequency and duration of hemodialysis sessions, an independent blood pressure and dry weight control supervised by nephrological monitoring twice a month and a regular obstetrics follow-up...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28662308/gender-disparity-in-fistula-use-at-initiation-of-hemodialysis-varies-markedly-across-esrd-networks-analysis-of-usrds-data
#12
Mariana Markell, Amarpali Brar, Dimitre G Stefanov, Moro O Salifu
BACKGROUND: Gender disparities had been noted in the care of women with end stage renal disease (ESRD) in the early 2000's, including less frequent initiation of hemodialysis utilizing a fistula but more recent data have not been examined and underlying factors have not been extensively studied. STUDY DESIGN: Data from the United States Renal Data System (USRDS) were examined, including 202,999 hemodialysis patients. Only those who had received prior nephrology care were included...
June 29, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28643860/subcutaneous-defibrillators-for-dialysis-patients
#13
REVIEW
Tushar J Vachharajani, Loay Salman, Eric J Costanzo, Sushil K Mehandru, Mayurkumar Patel, Dawn M Calderon, Roy O Mathew, Mandeep S Sidhu, Arif Asif
Defibrillation can be successfully provided by the subcutaneous implantable cardioverter defibrillator (ICD) without the leads. In contrast, traditional ICDs require leads that can cause central venous stenosis, lead-induced endocarditis, and carry the risk of tricuspid regurgitation by valve adhesion, perforation, coaptation interference, or entanglement. Central venous stenosis, infection, and tricuspid regurgitation are all critically important considerations in hemodialysis patients. Recent reports are supporting the use of subcutaneous ICDs in renal patients maintained on long-term hemodialysis...
June 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28643378/effects-of-weight-based-ultrafiltration-rate-limits-on-intradialytic-hypotension-in-hemodialysis
#14
James L Pirkle, Mary E Comeau, Carl D Langefeld, Gregory B Russell, Somer S Balderston, Barry I Freedman, John M Burkart
INTRODUCTION: High ultrafiltration (UF) rates can result in intradialytic hypotension and are associated with increased mortality. The effects of a weight-based UF rate limit on intradialytic hypotension and the potential for unwanted fluid weight gain and hospitalizations for volume overload are unknown. METHODS: This retrospective cohort study examined 123 in-center hemodialysis patients at one facility who transitioned to 13 mL/kg/h maximum UF rates. Patients were studied for an 8 week UF rate limit exposure period and compared to the 8-week period immediately prior, during which the cohort served as its own historical control...
June 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28627747/spontaneous-intercostal-artery-bleeding-in-a-hemodialysis-patient
#15
Areum Durey, Young Sam Kim, Ah Jin Kim
Spontaneous rupture of an intercostal artery (ICA) is a rare but could be a life-threatening emergency requiring prompt diagnosis and intervention for optimal outcome. We report a patient presented with swelling in his right-side back which started immediately after scheduled hemodialysis and continued to increase in size. Contrast computed tomography scan revealed soft tissue attenuated lesion with internal enhancing dots which suggested expanding hematoma with active bleeding. Arteriography detected focal contrast extravasation from seventh ICA, and transcatheter arterial embolization was successfully done...
June 19, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/27804233/quality-of-life-development-during-initial-hemodialysis-therapy-and-association-with-loss-of-residual-renal-function
#16
Christina G Poulsen, Krista D Kjaergaard, Christian D Peters, Bente Jespersen, Jens D Jensen
INTRODUCTION: Health related quality of life (HRQOL) is markedly reduced in hemodialysis patients compared to the general population. We investigated the course of self-reported HRQOL over time and the association with selected factors, focusing on changes in glomerular filtration rate (GFR). METHODS: Eighty-two newly started hemodialysis patients from the SAFIR cohort filled out the Kidney Disease Quality of Life Short Form Version 1.3 (KDQOL-SF(TM) ) questionnaire at baseline, 6 and 12 months...
July 2017: Hemodialysis International
https://www.readbyqxmd.com/read/27766736/re-evaluation-of-re-hospitalization-and-rehabilitation-in-renal-research
#17
Eugene Lin, Manjula Kurella Tamura, Maria E Montez-Rath, Glenn M Chertow
INTRODUCTION: The use of administrative data to capture 30-day readmission rates in end-stage renal disease is challenging since Medicare combines claims from acute care, inpatient rehabilitation (IRF), and long-term care hospital stays into a single "Inpatient" file. For data prior to 2012, the United States Renal Data System does not contain the variables necessary to easily identify different facility types, making it likely that prior studies have inaccurately estimated 30-day readmission rates...
July 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28449418/hif-prolyl-hydroxylases-as-therapeutic-targets-in-erythropoiesis-and-iron-metabolism
#18
REVIEW
Volker H Haase
A classic response to systemic hypoxia is the increase in red blood cell production. This response is controlled by the prolyl hydroxylase domain/hypoxia-inducible factor (HIF) pathway, which regulates a broad spectrum of cellular functions. The discovery of this pathway as a key regulator of erythropoiesis has led to the development of small molecules that stimulate the production of endogenous erythropoietin and enhance iron metabolism. This review provides a concise overview of the cellular and molecular mechanisms that govern HIF-induced erythropoietic responses and provides an update on clinical experience with compounds that target HIF-prolyl hydroxylases for anemia therapy...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28449417/iron-and-anemia-in-chronic-kidney-disease-new-treatments-changing-old-paradigms
#19
EDITORIAL
John T Daugirdas
No abstract text is available yet for this article.
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28436206/clinical-practice-guidelines-on-iron-therapy-a-critical-evaluation
#20
REVIEW
Lucia Del Vecchio, Francesco Locatelli
Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide. Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform...
June 2017: Hemodialysis International
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