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Hemodialysis International

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https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#1
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28078825/ethanol-combined-with-heparin-as-a-locking-solution-for-the-prevention-of-catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-randomized-study
#2
Sofia Sofroniadou, Ioanna Revela, Alexandros Kouloubinis, Ioanna Makriniotou, Sinodi Zerbala, Despina Smirloglou, Petros Kalocheretis, Apostolos Drouzas, George Samonis, Christos Iatrou
Introduction Ethanol lock solution has been mainly administered in paediatric and home parenteral nutrition patients in order to prevent catheter related blood stream infections (CRBSI). Its utility in hemodialysis (HD) patients with non-tunneled-uncuffed catheter (NTC) has been poorly explored. Methods We conducted a prospective randomized study in chronic HD patients requiring a newly inserted NTC-while awaiting for the maturation of an already established arteriovenous fistula (AVF) or arteriovenous graft (AVG) or tunneled-cuffed catheter insertion...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28078814/life-threatening-nutritional-deficiencies-in-a-dialysis-patient
#3
Fahad Aziz, Kunal Chaudhary
Nutritional deficiencies are very common among the patient on chronic hemodialysis. But they can be easily overlooked or misdiagnosed. Deficiencies of trace elements and phosphorous is rare among this patient population but if neglected can lead to catastrophic effects. We describe a case report of a patient with ESRD recently started on outpatient maintenance hemodialysis, who presented with life threatening muscular weakness with respiratory failure requiring prolonged mechanical ventilation. On initial workup, it was unclear what the cause of her weakness was, however, further investigations showed undetectable phosphorous levels as well as very low levels of trace elements...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28078796/hyperparathyroidism-caused-by-distant-pulmonary-lesions-and-parathyromatosis-after-ethanol-injection-parathyroidectomy-for-secondary-hyperparathyroidism
#4
Michio Nakamura, Kiho Tanaka, Takeshi Fujii
Secondary hyperparathyroidism (SHPT) treatment includes parathyroidectomy and percutaneous ethanol injection therapy (PEIT), which are invasive procedures. The condition in which benign hyperfunctioning parathyroid tissue is distributed throughout the neck and mediastinum is termed parathyromatosis. Here, we present the case of a 51-year-old woman who began hemodialysis in 1986 due to chronic kidney disease of unknown etiology and developed SHPT in 1999. She underwent 6 rounds of PEIT followed by total a parathyroidectomy with partial forearm autotransplantation...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28074626/radio-cephalic-fistula-recovered-with-drainage-to-forearm-basilic-vein
#5
António Norton de Matos, Clemente Neves Sousa, Paulo Almeida, Paulo Teles, Luís Loureiro, Gabriela Teixeira, Duarte Rego, Sérgio Teixeira
Dysfunction problems with vascular access are a concern to patients and dialysis units. The vascular surgeon should analyse such dysfunction and perform a careful assessment of the vascular network in order to find new fistula layouts. We introduce and discuss the case of creation of a radio-cephalic fistula with outflow into the forearm basilic vein through rotation of the forearm basilic vein toward the cephalic vein in the forearm of an 88-year-old hemodialysis male patient. This technique enables extending fistula patency and improves cost efficiency...
January 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28067468/sticking-to-the-script-a-curious-case-of-confusion-in-an-esrd-patient
#6
Barry R Gorlitsky, John T Herion
A 60-year-old male Dialysis patient presented with altered mental status and Hypertensive Urgency. He had a significant lesion noted on his glans penis. He was treated for infection and hypertension with expectant management, without significant improvement in his mental acuity. Laboratory and radiologic workup were unrevealing for the etiology. Upon detailed review it was noted he had recently been given Acyclovir for a presumed Herpes Simplex Virus infection. He had been prescribed what is considered correct dosing for an ESRD patient...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#7
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28066992/native-arteriovenous-fistula-placement-in-three-patients-after-implantation-of-a-left-ventricular-assist-device-with-non-pulsatile-blood-flow
#8
Johannes F Schaefers, Christian Ertmer
Patients with left ventricular assist device have an increased risk for postoperative acute kidney injury and long-term requirement of dialysis. As a chronic access for dialysis, native arteriovenous fistulae are uncommon options due to suspected maturation failure. We present three patients who received successful arteriovenous fistulae placement after left ventricular assist device implantation with assisted long term patency.
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28044402/time-extended-local-rtpa-infiltration-for-acutely-thrombosed-hemodialysis-fistulas
#9
Susanne Regus, Werner Lang, Marco Heinz, Ulrich Rother, Alexander Meyer, Veronika Almási-Sperling, Michael Uder, Axel Schmid
Introduction This study describes results of a modified local thrombolysis technique for acutely thrombosed hemodialysis (HD) arteriovenous fistulas (AVF), which is characterized by prolonged recombinant tissue plasminogen activator (rtPA) local exposure times. Contrary to the standard lyse- and- wait (L&W) technique with local reaction times of 20-40 minutes, the modified protocol allows timing of challenging angioplasty maneuvers to the next regular working day. Methods From February 2009 to April 2014, 84 patients on HD presented with 152 acutely thrombosed AVF...
January 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/27990732/symptoms-among-patients-receiving-in-center-hemodialysis-a-qualitative-study
#10
Kim J Cox, Mark B Parshall, Stephen H A Hernandez, Sanah Z Parvez, Mark L Unruh
Introduction Assessment of dialysis-related symptoms is not currently a requirement for hemodialysis (HD) providers in the United States. The purpose of this study was to describe patients' perspectives on symptoms associated with end-stage chronic kidney disease treated with thrice-weekly, in-center HD. Methods We performed a qualitative study using interpretive description. Interview questions were based on a KDIGO (Kidney Disease Improving Global Outcomes) controversies conference and a literature review...
December 19, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27966253/treatment-of-a-soft-tissue-calcification-in-a-patient-receiving-peritoneal-dialysis
#11
Kristine Lindhard, Bo Broberg, Henrik Groenberg, Henrik Post Hansen
Chronic Kidney Disease patients suffer from Mineral and Bone Disorder (CKD-MBD) leading to increased vascular and soft-tissue calcification. The prevalence of soft tissue calcification in dialysis patients is not well described, and most cases describe such calcifications in hemodialysis patients. We describe a case of a massive soft tissue calcification in the right gluteal region in a peritoneal dialysis patient. The patient had severe pain and were disabled. The treatment was converted to an intensive hemodialysis regimen with a minimal calcium load and high dose of cinacalcet...
December 14, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27966247/can-twice-weekly-hemodialysis-expand-patient-access-under-resource-constraints
#12
REVIEW
Dipal Savla, Glenn M Chertow, Timothy Meyer, Shuchi Anand
The convention of prescribing hemodialysis on a thrice weekly schedule began empirically when it seemed that this frequency was convenient and likely to treat symptoms for a majority of patients. Later, when urea was identified as the main target and marker of clearance, studies supported the prevailing notion that thrice weekly dialysis provided appropriate clearance of urea. Today, national guidelines on hemodialysis from most countries recommend patients receive at least thrice weekly therapy. However, resource constraints in low- and middle-income countries (LMIC) have resulted in a substantial proportion of patients using less frequent hemodialysis in these settings...
December 14, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27896892/recent-advances-in-ckd-and-esrd-a-literature-update
#13
REVIEW
Tushar Chopra, Mitchell H Rosner
The past year has seen interesting publications in the fields of chronic kidney disease and end stage renal disease. This review highlights some of these important papers and places their findings in the context of clinical care.
November 28, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27885815/changes-in-urine-volume-and-serum-albumin-in-incident-hemodialysis-patients
#14
Rieko Eriguchi, Yoshitsugu Obi, Connie M Rhee, Jason A Chou, Amanda R Tortorici, Anna T Mathew, Taehee Kim, Melissa Soohoo, Elani Streja, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
Introduction Hypoalbuminemia is a predictor of poor outcomes in dialysis patients. Among hemodialysis patients, there has not been prior study of whether residual kidney function or decline over time impacts serum albumin levels. We hypothesized that a decline in residual kidney function is associated with an increase in serum albumin levels among incident hemodialysis patients. Methods In a large national cohort of 38,504 patients who initiated hemodialysis during 1/2007-12/2011, we examined the association of residual kidney function, ascertained by urine volume and renal urea clearance, with changes in serum albumin over five years across strata of baseline residual kidney function, race, and diabetes using case-mix adjusted linear mixed effects models...
November 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27885786/effects-of-flaxseed-oil-on-blood-hepcidin-and-hematologic-factors-in-hemodialysis-patients
#15
Hadi Tabibi, Maryam Mirfatahi, Mehdi Hedayati, Alireza Nasrollahi
Introduction In hemodialysis (HD) patients, one of the common complications is renal anemia. Therefore, the present study was designed to investigate the effects of flaxseed oil consumption on blood hepcidin and hematologic factors in HD patients. Methods In this randomized, double-blind, clinical trial, 38 HD patients were randomly assigned to either the flaxseed oil or the control group. The patients in the flaxseed oil group received 6 g/d flaxseed oil for 8 wk, whereas the control group received 6 g/d medium chain triglycerides (MCT) oil...
November 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27878949/dialytic-hemodynamics-are-associated-with-changes-in-gait-speed
#16
Dawn F Wolfgram, Zubin Lathara, Aniko Szabo, Jeff Whittle
Introduction Functional impairment and reduced mobility are prevalent in patients on chronic hemodialysis (HD). The impact of HD on physical performance and mobility needs evaluation. Methods We measured gait speed in a cohort of chronic HD patients both pre and post an HD session. We collected demographic and laboratory data and dialytic hemodynamic parameters for the HD session. Participants completed the Falls Efficacy Scale International (FES-I) survey to assess concern for falling. We used linear regression analysis to tests for associations between our predictor variables of intra-dialytic hemodynamic change and change in gait speed from pre to post HD (primary outcome) and FES-I score (secondary outcome)...
November 22, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27868336/vascular-imaging-for-hemodialysis-vascular-access-planning
#17
Rita L McGill, Robin Ruthazer, Eduardo Lacson, Klemens B Meyer, Dana C Miskulin, Daniel E Weiner
Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010-2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time-dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27866393/potentially-pathogenic-circulating-autoantibodies-to-cardiac-troponin-are-present-in-hemodialysis-patients
#18
Helen J Jefferies, Risto Tertti, Saara Wittfooth, James O Burton, Kaj Metsärinne, Kim Pettersson, Christopher W McIntyre
Introduction Repetitive dialysis-induced cardiac injury is associated with elevated troponin levels, inflammation, and longitudinal reduction in cardiac function. Pathogenic autoantibodies to cardiac troponins (cTnAAb) produce inflammatory cardiomyopathy in murine models. This study aimed to explore the possibility that analogous autoimmune processes might occur in hemodialysis (HD) patients, by initially investigating cTnAAb prevalence, and exploring potential links with HD-induced myocardial stunning. Methods In 130 prevalent HD patients from two centers (Derby, UK; Turku, Finland), cTnAAb (immunoassay) and cardiac troponins were quantified...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27866377/unusual-cause-of-hypercalcaemia-in-end-stage-renal-failure-patients
#19
Hooi Khee Teo, Jiunn Wong
Immobility-induced hypercalcaemia is rarely considered in patients on dialysis and is a challenging diagnosis to make. This is especially so due to the lack of biomarkers as well as the notion that calcium metabolism is mostly related to chronic kidney disease-metabolic bone disorder due to the role of iPTH. We present two cases of our dialysis patients, who were clinically unwell from hypercalcemia. We were initially uncertain of the cause of hypercalcemia as despite our attempts to adjust treatment based on their biochemical findings, we were unable to correct the hypercalcemia...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27860119/bioimpedance-monitoring-of-cellular-hydration-during-hemodialysis-therapy
#20
Leslie D Montgomery, Richard W Montgomery, Wayne A Gerth, Susie Q Lew, Michael D Klein, Julian M Stewart, Marvin S Medow, Manuel T Velasquez
Introduction The aim of this paper is to describe and demonstrate how a new bioimpedance analytical procedure can be used to monitor cellular hydration of End Stage Renal Disease (ESRD) patients during hemodialysis (HD). Methods A tetra-polar bioimpedance spectroscope (BIS), (UFI Inc., Morro Bay, CA), was used to measure the tissue resistance and reactance of the calf of 17 ESRD patients at 40 discrete frequencies once a minute during dialysis treatment. These measurements were then used to derive intracellular, interstitial, and intravascular compartment volume changes during dialysis...
November 8, 2016: Hemodialysis International
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