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https://www.readbyqxmd.com/read/29221439/catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-cohort-study
#1
Stephanie Thompson, Natasha Wiebe, Scott Klarenbach, Rick Pelletier, Brenda R Hemmelgarn, John S Gill, Braden J Manns, Marcello Tonelli
BACKGROUND: For people requiring hemodialysis, infectious mortality is independently associated with geographic distance from a nephrologist. We aimed to determine if differential management of catheter-related blood stream infections (CRBSIs) could explain poorer outcomes. METHODS: We prospectively collected data from adults initiating hemodialysis with a central venous catheter between 2005 and 2015 in Alberta, Canada. We collected indicators of CRBSI management (timely catheter removal, relapsing bacteremia); frequency of CRBSIs; hospitalizations; predictors of CRBSIs, and bacteremia...
December 8, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29218971/an-evaluation-of-medication-reconciliation-in-an-outpatient-nephrology-clinic
#2
Matthew Phillips, Jo-Anne Wilson, Amany Aly, Marsha Wood, Penelope Poyah, Sarah Drost, Anne Hiltz, Holly Carver
Background: Accreditation Canada recognizes medication reconciliation as a key required organizational practice (ROP) to enhance patient safety. Patients with chronic kidney disease (CKD) carry a high risk for adverse drug events due to multiple co-morbidities, using many medications, and being cared for by many practitioners. Data evaluating the benefits of ambulatory medication reconciliation (AmbMR) in patients with advanced CKD is limited. Methods: We retrospectively evaluated types and rates of medication discrepancies and their potential index for patient harm using the Cornish classification system in a cohort of consecutive non-dialysis-dependent CKD stage 5 patients who received AmbMR...
April 2017: CANNT Journal, Journal ACITN
https://www.readbyqxmd.com/read/29210164/relative-risk-of-home-hemodialysis-attrition-in-patients-using-a-telehealth-platform
#3
Eric D Weinhandl, Allan J Collins
INTRODUCTION: Home hemodialysis (HHD) facilitates increased treatment frequency, which may improve patient outcomes. However, attrition due to technique failure limits the clinical effectiveness of the modality. Nx2me Connected Health is a telehealth platform that enables ongoing assessment of HHD patients using NxStage equipment, and that may reduce patient burden. We aimed to assess whether use of Nx2me was associated with risk of HHD attrition. METHODS: We compared risks of all-cause attrition, dialysis cessation (i...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29207228/-clinical-practice-for-the-diagnosis-of-cardiac-arrhythmias-in-patients-on-renal-replacement-therapy-data-from-a-lombard-survey
#4
Simonetta Genovesi, Elisa Nava, Alice Pasa, Enzo Corghi, Patrizia Ondei, Elisabetta Marta, Antonio Bellasi, Fabio Malberti, Ugo Teatini, Carlo Maria Guastoni, Leonardo Spatola, Maria Carmen Luise, Renza Tiboldo, Silvio Bertoli, Piergiorgio Messa, Maria Doria, Maurizio Gallieni, Mario Cozzolino, Donatella Spotti, Valeria Sala, Elisabetta Sironi, Giuseppe Boriani
Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#5
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29163492/t-cell-composition-of-the-lymph-node-is-associated-with-the-risk-for-early-rejection-after-renal-transplantation
#6
Burç Dedeoglu, Nicolle H R Litjens, Annelies E de Weerd, Frank Jmf Dor, Mariska Klepper, Derek Reijerkerk, Carla C Baan, Michiel G H Betjes
Background: The T-cell composition within the lymph node (LN) of end-stage renal disease (ESRD) patients differs from the composition within the circulation. Activation of the alloreactive T-cell response within secondary lymphoid organs is important after organ transplantation. However, to date no data are present on LN T-cell subsets and the risk for acute rejection after kidney transplantation. Methods: T cells from LNs of ESRD patients were analyzed for frequency of recent thymic emigrants, relative telomere length, expression of differentiation markers, and were related to the development of early acute rejection (EAR), occurring within 3 months after renal transplantation (RT)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29161686/impact-of-an-in-hospital-patient-education-program-on-choice-of-renal-replacement-modality-in-unplanned-dialysis-initiation
#7
Moritz Schanz, Markus Ketteler, Markus Heck, Juergen Dippon, Mark Dominik Alscher, Martin Kimmel
BACKGROUND/AIMS: Up to 50% patients requiring dialysis receive an urgent, unplanned start (UPS) to renal replacement therapy (RRT). Most of these are initiated with an intravenous catheter and commenced and maintained on hemodialysis (HD). Although peritoneal dialysis (PD) could be an equipotent initial modality for RRT, it is used less frequently as long-term RRT in UPS patients. This multicenter-study aimed to evaluate the impact of a structured, in-hospital education program and factors influencing PD rates, especially in UPS patients...
November 21, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29157740/unplanned-readmissions-after-open-thoracoabdominal-aortic-aneurysm-repair
#8
Darrell Wu, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Sandra J Woodside, Adam Tullos, Qianzi Zhang, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Although reducing the incidence of unplanned readmission after thoracoabdominal aortic aneurysm (TAAA) repair represents an important opportunity to improve outcomes, predictors of readmissions are not known. We sought to characterize and identify factors associated with unplanned readmission after discharge in survivors of open TAAA repair. METHODS: Through prospective phone contact and retrospective record review, we determined the frequency and characteristics of unplanned readmissions within 30 days of discharge in 363 patients who were discharged after open TAAA repair...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29156003/chronic-respiratory-disease-an-unrecognized-risk-factor-in-dialysis
#9
Cécile Couchoud, Clémence Béchade, Abdelkader Bemrah, Jean-Christophe Delarozière, Guillaume Jean
Background: Few studies have analysed the impact of chronic respiratory disease (CRD) on outcomes in dialysis. We therefore sought to describe patients with CRD and end-stage renal disease and their outcomes after dialysis start, compared with patients without CRD, focusing especially on causes of death, access to renal transplantation and causes of hospital admissions. Methods: The study included 52 797 adults aged 18 years and older who began dialysis from 2008 to 2013 and are recorded in the French national REIN registry...
May 30, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29153377/iatrogenic-iron-overload-and-its-potential-consequences-in-patients-on-hemodialysis
#10
Guy Rostoker, Nosratola D Vaziri
Iron overload was considered rare in hemodialysis patients until recently, but its clinical frequency is now increasingly recognized. The liver is the main site of iron storage and the liver iron concentration (LIC) is closely correlated with total iron stores in patients with secondary hemosiderosis and genetic hemochromatosis. Magnetic resonance imaging (MRI) is now the gold standard method for estimating and monitoring LIC. Studies of LIC in hemodialysis patients by magnetic susceptometry thirteen years ago and recently by quantitative MRI have demonstrated a relation between the risk of iron overload and the use of intravenous (IV) iron products prescribed at doses determined by the iron biomarker cutoffs contained in current anemia management guidelines...
November 16, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29150711/epidemiology-of-peritonitis-following-maintenance-peritoneal-dialysis-catheter-placement-during-infancy-a-report-of-the-scope-collaborative
#11
Joshua Jacob Zaritsky, Coral Hanevold, Raymond Quigley, Troy Richardson, Cynthia Wong, Jennifer Ehrlich, John Lawlor, Jonathan Rodean, Alicia Neu, Bradley A Warady
BACKGROUND: Maintenance peritoneal dialysis (PD) is the dialysis modality of choice for infants and young children. However, there are limited outcome data for those who undergo PD catheter insertion and initiate maintenance PD within the first year of life. METHODS: Using data from the Children's Hospital Association's Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (ESRD) Collaborative (SCOPE), we examined peritonitis rates and patient survival in 156 infants from 29 North American pediatric dialysis centers who had a chronic PD catheter placed prior to their first birthday...
November 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29146137/the-impact-of-additives-on-the-phosphorus-potassium-and-sodium-content-of-commonly-consumed-meat-poultry-and-fish-products-among-patients-with-chronic-kidney-disease
#12
Arti Sharma Parpia, Mary L'Abbé, Marc Goldstein, Joanne Arcand, Bernadene Magnuson, Pauline Darling
OBJECTIVE: Patients with chronic kidney disease (CKD) are advised to limit their dietary intake of phosphorus and potassium as hyperphosphatemia and hyperkalemia are both associated with an increased risk of mortality. There is uncertainty concerning the actual content of these minerals in the Canadian food supply, as phosphorus and potassium are increasingly being used as food additives. This study aimed to determine the impact of food additives on the chemically analyzed content of phosphorus, potassium, sodium, and protein in commonly consumed meat, poultry, and fish products (MPFs)...
November 14, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#13
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29106625/association-of-the-frequency-of-pre-end-stage-renal-disease-medical-care-with-post-end-stage-renal-disease-mortality-and-hospitalization
#14
Jun Ling Lu, Miklos Z Molnar, Keiichi Sumida, Charles D Diskin, Elani Streja, Omer A Siddiqui, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
Background: Previous studies have demonstrated that early pre-end-stage renal disease (ESRD) nephrology care could improve postdialysis prognosis. However, less is known about the specific types of interventions responsible for the improved outcomes. We hypothesized that more frequent predialysis laboratory testing is associated with better postdialysis outcomes in incident ESRD patients. Methods: In all, 23 089 patients with available outpatient laboratory tests performed during the 2-year predialysis (i...
July 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29090028/evaluation-of-the-effect-of-statins-on-post-surgical-patients-with-acute-kidney-injury
#15
Abkhiz Saeed, Valizade Hasanloei Mohammad Amin, Mahoori Alireza, Hooshiar Hadi, Alizadeh Osalou Rahimeh
INTRODUCTION: Acute kidney injury is the sudden and almost complete loss of renal function with reduced glomerular filtration rate, and it occurs whenever the kidneys are unable to excrete metabolic waste products. METHOD: This randomized double-blinded clinical trial was performed in an intensive care unit (ICU) of a university educational hospital. After randomization with a random assigning table of numbers, patients were divided into two groups: an intervention group and a control group...
June 2017: Mædica
https://www.readbyqxmd.com/read/29077786/intradialytic-hypertension-frequency-and-short-term-clinical-outcomes-among-individuals-receiving-maintenance-hemodialysis
#16
Magdalene M Assimon, Lily Wang, Jennifer E Flythe
Background: Intradialytic hypertension occurs in 5-20% of hemodialysis treatments. Observational data support an association between intradialytic hypertension and long-term mortality. However, the short-term consequences of recurrent intradialytic hypertension are unknown. Methods: Data were taken from a cohort of prevalent hemodialysis patients receiving treatment at a large U.S. dialysis organization on 01/01/2010. A retrospective cohort design with a 180-day baseline, 30-day exposure assessment and 30-day follow-up period was used to estimate the associations between intradialytic hypertension frequency and 30-day outcomes...
October 25, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29067650/ckd-complications-in-kidney-transplanted-patients-going-back-to-dialysis-impact-on-patients-outcomes
#17
Julien Aniort, Saleh Kaysi, Cyril Garrouste, Mohamed Hadj Abdelkader, Myriam Isnard, Didier Aguilera, Youssef Ali, Marc Bouiller, Aurelien Mulliez, Anne Elisabeth Heng
AIMS: The management of chronic kidney disease (CKD) complications is not always adequate in patients with a failed kidney transplant. We aimed to evaluate the frequency of CKD complications and assess whether they may lead to worse outcomes in this patient population. METHOD: We analyzed 49 kidney transplant recipients with a failed transplant (T+) and matched non-transplanted patients (T-) starting dialysis between 2000 and 2010 in five dialysis centers in France...
October 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29067057/a-comparison-of-anxiety-and-depression-between-pre-dialysis-chronic-kidney-disease-patients-and-hemodialysis-patients-using-hospital-anxiety-and-depression-scale
#18
Salman T Shafi, Tahir Shafi
OBJECTIVE: Tocompare frequency of anxiety and depression between pre-dialysis chronic kidney disease (CKD) and hemodialysis patients (ESRD) in Pakistan. METHODS: This study was conducted in an out-patient department and hemodialysis unit of Sharif Medical City Hospital. Inclusion criteria included age above 18 years and a diagnosis of CKD including both pre-dialysis CKD and ESRD patients. Patients were screened for anxiety and depression using hospital anxiety and depression scale (HADS)...
July 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29064128/the-association-between-change-in-serum-bicarbonate-and-change-in-thyroid-hormone-levels-in-patients-receiving-conventional-or-more-frequent-maintenance-hemodialysis
#19
Alessio Molfino, Gerald J Beck, Minwei Li, Joan C Lo, George A Kaysen
AIM: Correction of metabolic acidosis in patients with chronic kidney disease has been associated with improvement in thyroid function. We examined whether changes in bicarbonate were associated with changes in thyroid function in patients with end-stage renal disease receiving conventional or more frequent hemodialysis. METHODS: In the Frequent Hemodialysis Network Trials, the relationship between changes in serum bicarbonate, free triiodothyronine (FT3) and free thyroxine (FT4) was examined among 147 and 48 patients with endogenous thyroid function who received conventional (3x/week) or more frequent (6x/week) hemodialysis (Daily Trial) or who received conventional or more frequent nocturnal hemodialysis (Nocturnal Trial)...
October 24, 2017: Nephrology
https://www.readbyqxmd.com/read/29051145/a-discrete-choice-study-of-patient-preferences-for-dialysis-modalities
#20
Rachael C Walker, Rachael L Morton, Suetonia C Palmer, Mark R Marshall, Allison Tong, Kirsten Howard
BACKGROUND AND OBJECTIVES: Improved knowledge about factors that influence patient choices when considering dialysis modality could facilitate health care interventions to increase rates of home dialysis. We aimed to quantify the attributes of dialysis care and the tradeoffs that patients consider when making decisions about dialysis modalities. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a prospective, discrete choice experiment survey with random parameter logit analysis to quantify preferences and tradeoffs for attributes of dialysis treatment in 143 adult patients with CKD expected to require RRT within 12 months (predialysis)...
October 19, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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