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Hemodialysis International

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https://www.readbyqxmd.com/read/27896892/recent-advances-in-ckd-and-esrd-a-literature-update
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27804262/effects-of-end-stage-renal-disease-and-dialysis-modalities-on-blood-ammonia-level
#9
Nosratola D Vaziri, Mahyar Khazaeli, Ane C F Nunes, Kevin T Harley, Hyder Said, Omeed Alipour, Wei Ling Lau, Madeleine V Pahl
Introduction Uremia results in a characteristic breath odor (uremic fetor) which is largely due to its high ammonia content. Earlier studies have shown a strong correlation between breath ammonia and blood urea levels and a 10-fold reduction in breath ammonia after hemodialysis in patients with chronic kidney disease. Potential sources of breath ammonia include: (i) local ammonia production from hydrolysis of urea in the oropharyngeal and respiratory tracts by bacterial flora, and (ii) release of circulating blood ammonia by the lungs...
November 1, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27804233/quality-of-life-development-during-initial-hemodialysis-therapy-and-association-with-loss-of-residual-renal-function
#10
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. The SAFIR study was a randomized, placebo-controlled, double-blind intervention study, examining the effects of the angiotensin II receptor blocker irbesartan...
November 1, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27804229/pulmonary-artery-hypertension-in-methylmalonic-acidemia
#11
Jun Kido, Hiroshi Mitsubuchi, Mina Sakanashi, Junichi Matsubara, Shirou Matsumoto, Rieko Sakamoto, Fumio Endo, Kimitoshi Nakamura
Methylmalonic acidemia (MMA) is an autosomal recessive disorder that can be classified into two types: (1) vitamin B12-responsive and (2) vitamin B12-non-responsive. In MMA cases with long-term survival, renal failure is often a problem, and timing for kidney transplantation for MMA is controversial. We encountered a vitamin B12-non-responsive MMA case for which regular hemodialysis for renal failure was initiated; the patient was 16 years old when she first received regular hemodialysis and 35 years old when she developed pulmonary artery hypertension (PAH)...
November 1, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27804204/assessing-the-contact-activation-of-coagulation-during-hemodialysis-with-three-different-polysulfone-filters-a-prospective-randomized-cross-over-trial
#12
Igor Salvadè, Rosaria Del Giorno, Donato Gaetano, Luca Gabutti
Introduction During hemodialysis (HD) the interaction of the blood with the dialyzer triggers both an inflammatory reaction and an activation of the coagulation cascade. An accepted parameter to quantify the extent of coagulation activation during HD is not available. This study aims to evaluate its amplitude, comparing dialyzers made of different polysulfone polymers, by measuring D-dimers in the filter-rinsing fluids (Frf) and to test whether Frf D-dimers are suitable candidate markers to assess contact coagulation activation during HD...
November 1, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27790813/hemodialysis-practice-patterns-in-the-russia-dialysis-outcomes-and-practice-patterns-study-dopps-with-international-comparisons
#13
Boris Bikbov, Brian Bieber, Anton Andrusev, Natalia Tomilina, Alexander Zemchenkov, Junhui Zhao, Friedrich Port, Bruce Robinson, Ronald Pisoni
Introduction There is little comparable information about hemodialysis (HD) practices in low- and middle income countries, including Russia. Evaluation of HD in Russia and its international comparisons could highlight factors providing opportunities for improvement. Methods We examined treatment patterns for 481 prevalent HD patients in 20 Russian facilities, and compared them to contemporary data for 8512 patients from 311 facilities in seven European countries, Japan, and North America. Data were collected according to the uniform methodology of the Dialysis Outcomes and Practice Patterns Study, phase 5...
October 27, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27781388/the-dialysis-outcomes-and-practice-patterns-study-dopps-in-turkey
#14
Tevfik Ecder, Cengiz Utas, Kenan Ates, Brian Bieber, Bruce M Robinson, Ronald L Pisoni, Gültekin Süleymanlar
Introduction Turkey has one of the largest treated end-stage renal disease (ESRD) patient populations in Europe (N = 66,711). In 2013, the international Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective study of hemodialysis (HD) practices and outcomes, initiated data collection in Turkey. Here we provide comparisons of HD patients in DOPPS-Turkey with other international regions and with patients in the Registry of Turkish Nephrology, Dialysis and Transplantation. Methods DOPPS-Turkey study sites were randomly selected from all Turkish HD units treating ≥25 in-center chronic HD patients...
October 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27781373/home-hemodialysis-associated-infection-the-achilles-heel-of-intensive-hemodialysis
#15
REVIEW
Clara K Poon, Christopher T Chan
Home hemodialysis (HHD) is emerging as an important alternate renal replacement therapy. Although there are multiple clinical advantages with HHD, concerns surrounding increased risks of infection in this group of patients remain a major barrier to its implementation. In contrast to conventional hemodialysis, infection related complication represents the major morbidity in this mode of renal replacement therapy. Vascular access related infection is an important cause of infection in this population. Use of central vein catheters and buttonhole cannulation in HHD are important modifiable risk factors for HHD associated infection...
October 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27774730/hyperprolactinemia-in-end-stage-renal-disease-and-effects-of-frequent-hemodialysis
#16
Joan C Lo, Gerald J Beck, George A Kaysen, Christopher T Chan, Alan S Kliger, Michael V Rocco, Glenn M Chertow
Introduction End-stage renal disease is associated with elevations in circulating prolactin concentrations, but the association of prolactin concentrations with intermediate health outcomes and the effects of hemodialysis frequency on changes in serum prolactin have not been examined. Methods The FHN Daily and Nocturnal Dialysis Trials compared the effects of conventional thrice weekly hemodialysis with in-center daily hemodialysis (6 days/week) and nocturnal home hemodialysis (6 nights/week) over 12 months and obtained measures of health-related quality of life, self-reported physical function, mental health and cognition...
October 23, 2016: 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. Methods For this report, we developed two methods (a "simple method" and a "rehabilitation-adjusted method") to identify acute care, IRF, and long-term care hospital stays from United States Renal Data System claims data, and compared them to methods used in previously published reports...
October 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27761981/dialysate-bicarbonate-variation-in-maintenance-hemodiafiltration-patients-impact-on-serum-bicarbonate-intradialytic-hypotension-and-interdialytic-weight-gain
#18
Márcio Viegas, Cristina Cândido, Joana Felgueiras, José Clemente, Sara Barros, Rostislav Farbota, Filipa Vera, Antero Matos, Francisco Sousa
Introduction The dialysate bicarbonate (DB) influences the acid-base balance in dialysis patients. Very low and high serum bicarbonate (SB) have been related with a higher mortality. Acid-base balance also has been associated with hemodynamic effects in these patients. The trial aim was to compare the effect of DB concentration variation on SB levels in maintenance hemodiafiltration (HDF) patients and the effect on intradialytic hypotension and interdialytic weight gain. Methods  A prospective study, with 9 months of follow-up, involving 93 patients, divided in two groups: group 1 and group 2 with a DB of 34 mmol/L and 30 mmol/L, respectively, with monitoring of pre and post HDF SB, intradialytic hypotension, and interdialytic weight gain...
October 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27734602/recurrent-heparin-induced-thrombocytopenia-due-to-heparin-rinsing-before-priming-the-machine-in-a-hemodialysis-patient-a-case-report
#19
Jin Han Lim, Kyung Pyo Kang, Sik Lee, Sung Kwang Park, Won Kim
Heparin has remained the most commonly used anticoagulant for patients undergoing hemodialysis. It is usually safe to use but can have severe adverse effects in some cases. Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of exposure to heparin. It results from an autoantibody directed against endogenous platelet factor 4 (PF4) in complex with heparin, which activates platelets and can cause catastrophic arterial and venous thromboses. Here, we present the case of an 80-year-old woman with a recent diagnosis of chronic renal failure who developed acute HIT (platelet count nadir, 15 × 10(9) /L) on day 7 of hemodialysis performed with routine heparin anticoagulation, who despite subsequent heparin-free hemodialysis (with argatroban and warfarin) developed recurrent HIT (complicated by acute cerebral infarction) on day 11 that we attributed to "rinsing" of the circuit with heparin-containing saline (3,000 units of unfractionated heparin, with subsequent saline washing) performed pre-dialysis as per routine...
October 13, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27723234/a-combination-of-corticosteroid-sirolimus-and-intradialytic-parenteral-nutrition-in-encapsulating-peritoneal-sclerosis-case-report-and-literature-review
#20
Alexandre Minetto Brabo, Nayrana Soares Do Carmo Reis, Pasqual Barretti, Daniela Ponce
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS...
October 9, 2016: Hemodialysis International
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