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Hemodialysis International

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https://www.readbyqxmd.com/read/28662308/gender-disparity-in-fistula-use-at-initiation-of-hemodialysis-varies-markedly-across-esrd-networks-analysis-of-usrds-data
#1
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
#2
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
#3
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
#4
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/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#5
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
#6
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
#7
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
#8
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/27804233/quality-of-life-development-during-initial-hemodialysis-therapy-and-association-with-loss-of-residual-renal-function
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28403561/iron-deficiency-anemia-in-chronic-kidney-disease-uncertainties-and-cautions
#14
REVIEW
Rajiv Agarwal
Anemia in chronic kidney disease is common and iron deficiency is an important cause. To repair iron-deficiency anemia, replacement of iron is needed. Iron can be replaced either by the oral route or by the intravenous route. In a meta-analysis, 5 of the 6 trials were short-term, 1 to 3 months, and compared to oral iron, the mean increase in hemoglobin with intravenous iron was only 0.31 g/dL. However, one of the studies included in this meta-analysis was 6 months long and had a mean decline in hemoglobin of 0...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28371203/the-available-intravenous-iron-formulations-history-efficacy-and-toxicology
#15
REVIEW
Michael Auerbach, Iain Macdougall
A number of intravenous iron formulations have been developed over the past 65 years which rely on dextran or other compounds to prevent uncontrolled release of free iron to the circulation. High molecular weight dextran was associated with a number of serious adverse reactions and was removed from markets worldwide in 2009. The preponderance of published evidence suggests that the formulations of parenteral iron currently available in the United States, including low molecular weight iron dextran, are all safe and effective and there are no major, clinically important differences among them in terms of either efficacy or safety...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28371161/ferric-pyrophosphate-citrate-as-an-iron-replacement-agent-for-patients-receiving-hemodialysis
#16
REVIEW
Steven Fishbane, Hitesh H Shah
Treatment of anemia remains an integral component in the care of patients with end stage kidney disease receiving dialysis. Currently, both erythropoiesis stimulating agents and iron replacement agents remain important anemia management strategies for patients undergoing hemodialysis (HD). Ferric pyrophosphate citrate (FPC) was approved by the U.S. Food and Drug Administration in January 2015 as an iron replacement product in adult patients receiving long-term maintenance HD. FPC is administered to patients on HD through the dialysate...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28370957/safety-of-intravenous-iron-in-hemodialysis-patients
#17
REVIEW
Xiaojuan Li, Abhijit V Kshirsagar, M Alan Brookhart
Among end-stage renal disease patients maintained by hemodialysis, anemia has been managed primarily through erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron. Following concerns about the cardiovascular (CV) safety of ESAs and changes in the reimbursement policies in Medicare's ESRD program, the use of IV iron has increased. IV iron supplementation promotes hemoglobin production and reduces ESA requirements, yet there exists relatively little evidence on the long-term safety of iron supplementation in hemodialysis patients...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28332306/impact-of-iatrogenic-iron-overload-on-the-course-of-hepatitis-c-in-the-dialysis-population-a-plea-for-caution
#18
REVIEW
Guy Rostoker, Nosratola D Vaziri
About 2.5% of the world population, corresponding to about 177 million individuals, are infected by hepatitis C virus (HCV), a small, single-stranded RNA virus. The prevalence of HCV infection among dialysis patients in Japan, Europe, and North America during the 2012 to 2015 period was found to be 8.7% in the DOPPS study. Nosocomial HCV spread in hemodialysis facilities still occurs. Increased hepatic tissue iron has been shown to play a deleterious role in the course of hepatitis C, favor development of fibrosis and cirrhosis and possibly increase the risk of liver cancer in the general population...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28328181/role-of-hepcidin-ferroportin-axis-in-the-pathophysiology-diagnosis-and-treatment-of-anemia-of-chronic-inflammation
#19
REVIEW
Arielle L Langer, Yelena Z Ginzburg
Anemia of chronic inflammation (ACI) is a frequently diagnosed anemia and portends an independently increased morbidity and poor outcome associated with multiple underlying diseases. The pathophysiology of ACI is multifactorial, resulting from the effects of inflammatory cytokines which both directly and indirectly suppress erythropoiesis. Recent advances in molecular understanding of iron metabolism provide strong evidence that immune mediators, such as IL-6, lead to hepcidin-induced hypoferremia, iron sequestration, and decreased iron availability for erythropoiesis...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28328144/diagnosing-and-preventing-iron-overload
#20
REVIEW
Ganesh Ramanathan, John K Olynyk, Paolo Ferrari
Absolute or functional iron (Fe) deficiency is an important determinant of anemia in hemodialysis patients and parenteral Fe is routinely used to treat this condition in conjunction with erythropoiesis stimulating agents. While restoration of hemoglobin toward the target range is a good outcome of Fe replacement, it is well known that Fe overload and toxicity may be adverse consequences of this therapy. Dialysis clinical practice guidelines recommend tailoring Fe therapy based on transferrin saturation and serum ferritin levels...
June 2017: Hemodialysis International
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