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Home hemodialysis

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https://www.readbyqxmd.com/read/29437142/prevalence-based-targets-underestimate-home-dialysis-program-activity-and-requirements-for-growth
#1
Micheli U Bevilacqua, Lee Er, Michael A Copland, R S Singh, Abeed Jamal, Orla Dunne, Catherine Brumby, Adeera Levin
BACKGROUND: Many renal programs have targets to increase home dialysis prevalence. Data from a large Canadian home dialysis program were analyzed to determine if home dialysis prevalence accurately reflects program activity and whether prevalence-based assessments adequately reflect the work required for program growth. METHODS: Data from home dialysis programs in British Columbia, Canada, were analyzed from 2005 to 2015. Prevalence data were compared to dialysis activity data including intakes and exits to describe program turnover...
February 7, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29360282/left-ventricular-assist-device-patient-maintained-on-home-hemodialysis-a-novel-class-of-patients-to-the-home-dialysis-population
#2
Ramy M Hanna, Daniel Cruz, Umut Selamet, Huma Hasnain, Murray Kwon, Arnold Baas, James Wilson
Severe heart failure is increasingly being managed by cardiac transplantation, and in some cases mechanical support devices serve as destination therapies. Left ventricular assist devices (LVADs) were approved for destination therapy for end stage heart failure patients before the more advanced total artificial heart modality became available. One common complication of mechanical assist device placement is acute kidney injury. Historically, patients with mechanical support devices have had to have inpatient hemodialysis until combined heart kidney transplant...
January 23, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29348924/mortality-and-hospitalizations-in-intensive-dialysis-a-systematic-review-and-meta-analysis
#3
Anna Mathew, Jody-Ann McLeggon, Nirav Mehta, Samuel Leung, Valerie Barta, Thomas McGinn, Gihad Nesrallah
Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29336064/home-hemodialysis-education-during-postdoctoral-training-challenges-and-innovations
#4
Joel D Glickman, Rebecca Kurnik Seshasai
Inadequate education in home hemodialysis (HHD) fellowship training might contribute to underutilization of this modality in the United States. Most graduates of nephrology fellowships do not grade themselves as competent in HHD suggesting that fellowship training in HHD is inadequate. An essential component for fellow education is at least one faculty member with expertise in HHD who is passionate about promoting the use of this modality. At a minimum, fellow training should utilize a curriculum that includes both lectures about HHD and outpatient clinical exposure to this modality over a period of at least 6-12 months...
January 15, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29336060/what-the-non-nephrologist-needs-to-know-about-dialysis
#5
Matt Foy, C John Sperati
The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients on chronic dialysis, with 42.3% surviving 5 years. As this is a vulnerable population, it is important in the care of ESRD patients that non-nephrologists have a working knowledge of issues germane to dialysis...
January 15, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29326842/barriers-to-peritoneal-dialysis-in-aboriginal-patients
#6
Anna T Mathew, Joonho Park, Mala Sachdeva, Manish M Sood, Karen Yeates
Background: Aboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population. Objective: We aim to assess the barriers to PD utilization in Aboriginal patients with ESKD. Design: This article is a prospective observational cohort study...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29326306/weekly-standard-kt-vurea-and-clinical-outcomes-in-home-and-in-center-hemodialysis
#7
Matthew B Rivara, Vanessa Ravel, Elani Streja, Yoshitsugu Obi, Melissa Soohoo, Alfred K Cheung, Jonathan Himmelfarb, Kamyar Kalantar-Zadeh, Rajnish Mehrotra
BACKGROUND AND OBJECTIVES: Patients undergoing hemodialysis with a frequency other than thrice weekly are not included in current clinical performance metrics for dialysis adequacy. The weekly standard Kt/Vurea incorporates treatment frequency, but there are limited data on its association with clinical outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used multivariable regression to examine the association of dialysis standard Kt/Vurea with BP and metabolic control (serum potassium, calcium, bicarbonate, and phosphorus) in patients incidental to dialysis treated with home (n=2373) or in-center hemodialysis (n=109,273)...
January 11, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29314304/role-of-telehealth-in-renal-replacement-therapy-education
#8
Anna Malkina, Delphine S Tuot
The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29295766/-vancomycin-poisoning-successfully-treated-with-intermittent-hemodialysis-a-case-report
#9
Jérémy Zaworski, Marie Frimat, Marion Duval, Camille Saint-Jacques, Élise Bouderlique, François Glowacki, Christian Noël, Marc Hazzan, François Provôt
We report a case of a 43 years old man who was intoxicated by a 25g vancomycin overload. An anuric acute renal failure rapidly occured. The vancomycinemia was measured as high as 360mg/L (normal range: 15-35mg/L). We started an intermittent hemodialysis program to clear out the vancomycin. The vancomycinemia decreased below the treshold of our laboratory after the eighth session. Three supplementary sessions were needed because of a persistant oliguria. The kidney function slowly improved and was back to normal (seric creatinin: 80micromol/L) 3 weeks after the patient had gone home...
December 30, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#10
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
December 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29210164/relative-risk-of-home-hemodialysis-attrition-in-patients-using-a-telehealth-platform
#11
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/29182543/home-hemodialysis-hhd-treatment-as-effective-yet-underutilized-treatment-modality-in-the-united-states
#12
REVIEW
Jihane J Hajj, Krzysztof Laudanski
End-stage renal disease (ESRD) is a major health burden and its incidence has been increasing yearly reaching 120,000 cases in 2014. Home hemodialysis (HHD) is a treatment modality option that has been shown to contribute to numerous clinical benefits but is largely underutilized due to many contributing factors. The purpose of this review paper is to analyze the advantages and disadvantages of HHD and the reasons for its low utilization with a special focus on its socioeconomic impact as compared to facility hemodialysis...
November 28, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29171682/in-hospital-outcomes-of-transcatheter-versus-surgical-aortic-valve-replacement-in-end-stage-renal-disease
#13
Ahmad Alkhalil, Shervin Golbari, David Song, Harveen Lamba, Anas Fares, Amer Alaiti, Salil Deo, Guilherme F Attizzani, Homam Ibrahim, Carlos E Ruiz
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at intermediate and high risk for surgery. Commercial use of TAVR has expanded to patients with end stage renal disease (ESRD). OBJECTIVES: Compare in-hospital outcomes of TAVR versus SAVR in ESRD patients requiring hemodialysis (HD). METHODS: ESRD patients on HD undergoing TAVR (n = 328) or SAVR (n = 697) between 2012 and 2014 were identified in the National Inpatient Sample (NIS)...
November 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29122999/can-home-hemodialysis-and-peritoneal-dialysis-programs-coexist-and-grow-together
#14
Nikhil Shah, Robert R Quinn, Stephanie Thompson, Robert P Pauly
No abstract text is available yet for this article.
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29072166/effect-of-an-intradialytic-protein-rich-meal-intake-in-nutritional-and-body-composition-parameters-on-hemodialysis-patients
#15
Cristina Caetano, Ana Valente, Francisco Jorge Silva, Jorge Antunes, Cristina Garagarza
BACKGROUND AND AIMS: Protein intake is a key point to maintain an adequate nutritional status in hemodialysis (HD) patients. There are some studies that confirm the positive influence of intradialytic oral nutritional supplementation in several nutritional parameters in HD patients. The aim of this study was to evaluate the effect of an intradialytic protein rich meal in nutritional and body composition parameters on HD patients. METHODS: This was a 6-months single center non-randomized study with 99 patients in HD from one Nephrocare dialysis unit in Portugal...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29065161/critical-illness-among-adults-with-cystic-fibrosis-in-texas-2004-2013-patterns-of-icu-utilization-characteristics-and-outcomes
#16
Lavi Oud
OBJECTIVE: Available reports on critically ill adults with cystic fibrosis (CF) suggest improving short-term outcomes. However, there is marked heterogeneity in reported findings, with studies mostly based on single-centered data, limiting generalizability. We sought to examine population-level patterns of demand for critical care resources, and the characteristics, resource utilization, and outcomes of ICU-managed adults with CF. METHODS: We used the Texas Inpatient Public Use Data File to identify ICU admissions with CF aged ≥18 years in Texas between 2004-2013...
2017: PloS One
https://www.readbyqxmd.com/read/29051145/a-discrete-choice-study-of-patient-preferences-for-dialysis-modalities
#17
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)...
January 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29044930/effect-of-incident-nocturnal-home-hemodialysis-versus-incident-continuous-ambulatory-peritoneal-dialysis-on-employment-rate-clinical-and-laboratory-outcomes-a-1-year-retrospective-observation-study
#18
John Wing Li, Joseph Ho Sing Wong, Wai Leung Chak, Ka Foon Chau
INTRODUCTION: While studies demonstrated favorable outcomes of nocturnal home hemodialysis (NHHD), direct comparison on employment rate, clinical and laboratory outcomes between the NHHD and continuous ambulatory peritoneal dialysis (CAPD) had not been previously performed. METHODS: A 1-year retrospective observation study was performed in 20 incidents alternate night NHHD and 81 incident CAPD patients of Chinese ethnicity, who were sex, diabetic status, and Charlson comorbidity index matched, but not age due to our center's age limit for NHHD enrollment...
October 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29024613/remote-monitoring-of-automated-peritoneal-dialysis-patients-assessing-clinical-and-economic-value
#19
Dilip Makhija, Mark Dominik Alscher, Stefan Becker, Silvia D'Alonzo, Raj Mehrotra, Leslie Wong, Kim McLeod, Judy Danek, Mary Gellens, Todd Kudelka, James A Sloand, Suzanne Laplante
BACKGROUND: For chronic kidney disease patients who progress to end-stage renal disease, survival is dependent on renal replacement therapy in the form of kidney transplantation or chronic dialysis. Peritoneal dialysis (PD), which can be performed at home, is both more convenient and less costly than hemodialysis that requires three 4-h visits per week to the dialysis facility and complicated equipment. Remote therapy management (RTM), technologies that collect medical information and transmit it to healthcare providers for patient management, has the potential to improve the outcomes of patients receiving automated peritoneal dialysis (APD) at home...
October 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28988703/cost-of-achieving-equivalent-outcomes-in-sicker-patients-after-liver-transplant
#20
Vikrom K Dhar, Koffi Wima, Young Kim, Richard S Hoehn, Andrew D Jung, Audrey E Ertel, Tayyab S Diwan, Flavio Paterno, Shimul A Shah
BACKGROUND: We aimed to characterize variability in cost after straightforward orthotopic liver transplant (OLT). METHODS: Using the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified patients who underwent OLT between 2011 and 2014. Patients meeting criteria for straightforward OLT, defined as length of stay < 14 days with discharge to home, were selected (n = 5763) and grouped into tertiles (low, medium, high) according to cost of perioperative stay...
October 4, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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