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Home hemodialysis

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https://www.readbyqxmd.com/read/29588610/unmet-service-needs-evaluated-by-case-managers-among-disabled-patients-on-hemodialysis-in-japan
#1
Hidehiro Sugisawa, Toshio Shinoda, Yumiko Shimizu, Tamaki Kumagai, Hiroaki Sugisaki, Seiji Ohira
Background: This study aimed to investigate the levels of unmet needs for home and community-based services (HCBS) evaluated by case managers (CMs) among disabled patients on hemodialysis (DPHD) and to examine factors related to unmet needs. Unmet needs for HCBS were defined as situations in which patients do not use or underuse HCBS despite needing them. Candidates for the factors relating to unmet needs for HCBS included three dimensions: predisposing, enabling, and need factors. Methods: Self-administrated questionnaires were collected from 391 CMs of DPHD certified with long-term care insurance...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29572611/usefulness-of-a-pleuroperitoneal-shunt-for-treatment-of-refractory-pleural-effusion-in-a-patient-receiving-maintenance-hemodialysis
#2
Masato Habuka, Toru Ito, Yuta Yoshizawa, Koji Matsuo, Shuichi Murakami, Daisuke Kondo, Hiroshi Kanazawa, Ichiei Narita
Refractory pleural effusion can be a life-threatening complication in patients receiving maintenance hemodialysis. We report successful treatment of refractory pleural effusion using a Denver® pleuroperitoneal shunt in one such patient. A 54-year-old Japanese man, who had previously undergone left nephrectomy, was admitted urgently to our department because of a high C-reactive protein (CRP) level, right pleural effusion, and right renal abscess. Because antibiotics proved ineffective and his general state was deteriorating, he underwent emergency insertion of a thoracic drainage tube and nephrectomy, and hemodialysis was started...
March 23, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29528005/influence-of-social-economic-familial-marital-status-and-disease-adaptation-on-the-physical-and-mental-health-dimensions-of-patients-who-are-candidates-for-renal-transplant
#3
Aydan Akyüz Özdemir, Cihat Burak Sayın, Rengin Erdal, Cihangir Özcan, Mehmet Haberal
OBJECTIVES: End-stage renal disease is a disease with a long duration, requiring patients to live with the limitations imposed by their condition. Stressors associated with this disease are demanding, with patients dependent on support from their social environment. Here, we aimed to show the influences of familial, social, economic, and marital status on quality of life in patients with end-stage renal disease. MATERIALS AND METHODS: Patients (190 women/188 men) who were under hemodialysis treatment and on transplant wait lists were included in the study...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29527987/quality-of-life-through-gender-role-perspective-in-candidate-renal-transplant-recipients-a-report-from-ba%C3%A5-kent-university-using-the-short-form-36-health-survey
#4
Aydan Akyüz Özdemir, Cihat Burak Sayın, Rengin Erdal, Cihangir Özcan, Mehmet Haberal
OBJECTIVES: The aim of the study was to evaluate the quality of life of patients with end-stage renal disease through a "gender role perspective." Patients were on hemodialysis treatment and on a wait list for transplant. MATERIALS AND METHODS: This study was conducted at the Başkent University Adana, Ankara, and Istanbul hemodialysis centers. Patients completed Short Form 36 Health Survey questionnaires voluntarily to evaluate quality of life. The questions were answered independently by patients while they were undergoing hemodialysis treatment...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29503373/-dietary-approach-to-improving-the-nutritional-status-in-institutionalized-elderly-hemodialysis-patients-with-a-poor-dietary-intake-a-single-arm-pilot-study
#5
Makiko Yamashita, Rieko Komatsu, Yuko Maruyama, Tomoyuki Takaki, Hiroshi Ichinose, Osamu Sasaki, Kenji Sawase, Takashi Harada, Satoshi Funakoshi
OBJECTIVE: The hemodialysis (HD) diet, which is a high-calorie and high-fat regimen, may inadvertently lead to an inadequate dietary intake, resulting in undernutrition among elderly HD patients. Therefore, an attempt was made to improve the dietary intake by implementing a modified diet regimen in eligible elderly HD patients. SUBJECTS: Elderly HD patients who had ingested < 50% of the meals provided and were diagnosed with undernutrition among all elderly patients institutionalized at the special elderly nursing home annexed to Nagasaki Kidney Hospital between June and November 2012...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29478056/choosing-home-hemodialysis-a-critical-review-of-patient-outcomes
#6
Brent W Miller, Rainer Himmele, Dixie-Ann Sawin, Jeeseon Kim, Robert J Kossmann
BACKGROUND/AIM: Home hemodialysis (HHD) has been associated with improved clinical outcomes vs. in-center HD (ICHD). The prevalence of HHD in the United States is still very low at 1.8%. This critical review compares HHD and ICHD outcomes for survival, hospitalization, cardiovascular (CV), nutrition, and quality of life (QoL). METHODS: Of 545 publications identified, 44 were not selected after applying exclusion criteria. A systematic review of the identified publications was conducted to compare HHD to ICHD outcomes for survival, hospitalization, CV outcomes, nutrition, and QoL...
January 26, 2018: Blood Purification
https://www.readbyqxmd.com/read/29478044/relationships-between-neighborhood-walkability-and-objectively-measured-physical-activity-levels-in-hemodialysis-patients
#7
Maggie Han, Xiaoling Ye, Priscila Preciado, Schantel Williams, Israel Campos, Marcee Bonner, Candace Young, Daniel Marsh, John W Larkin, Len A Usvyat, Franklin W Maddux, Roberto Pecoits-Filho, Peter Kotanko
BACKGROUND/AIMS: Neighborhood walkability is associated with indicators of health in the general population. We explored the association between neighborhood walkability and daily steps in hemodialysis (HD) patients. METHODS: We measured daily steps over 5 weeks using Fitbit Flex (Fitbit, San Francisco, CA, USA) and retrieved Walk Score® (WS) data by patient's home ZIP code (www.walkscore.com; 0 = poorest walkability; 100 = greatest walkability). RESULTS: HD patients took a mean of 6,393 ± 3,550 steps/day (n = 46)...
January 26, 2018: Blood Purification
https://www.readbyqxmd.com/read/29459219/home-blood-pressure-guided-antihypertensive-therapy-in-chronic-kidney-disease-more-data-are-needed
#8
EDITORIAL
Panagiotis I Georgianos, Eleni Champidou, Vassilios Liakopoulos, Elias V Balaskas, Pantelis E Zebekakis
In the era of newly introduced hypertension guidelines recommending lower blood pressure (BP) targets for drug-treated hypertensives, the necessity for optimized management of hypertension becomes even more urgent. The concept of home BP-guided antihypertensive therapy is for long suggested as a simple and feasible approach to improve BP control rates and optimize the management of hypertension. Home BP-guided antihypertensive therapy is particularly applicable to hypertensives with chronic kidney disease (CKD) for several reasons including the following: (1) difficult-to-control BP and high BP variability in the CKD setting; (2) poor accuracy of office BP in determining hypertension control status and detecting "white-coat" and "masked" hypertension; (3) poor value of routine office BP recordings in predicting the longitudinal progression of target-organ damage; and (4) superiority of home BP over office BP recordings in prognosticating the risk of incident end-stage renal disease or death...
February 10, 2018: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29456210/appraising-the-outcome-and-complications-of-peritoneal-dialysis-patients-in-self-care-peritoneal-dialysis-and-assisted-peritoneal-dialysis-a-5-year-review-of-a-single-saudi-center
#9
Jamal Saleh Al Wakeel, Mohammed A Al Ghonaim, Abdullah Aldohayan, Saira Usama, Saad Al Obaili, Ahmad R Tarakji, Mohammad Alkhowaiter
Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1-83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29455202/phosphate-and-calcium-control-in-short-frequent-hemodialysis-with-the-nxstage-system-one-cycler-mass-balance-studies-and-comparison-with-standard-thrice-weekly-bicarbonate-dialysis
#10
Chiara Carla Maria Brunati, Francesca Gervasi, Costanza Casati, Maria Luisa Querques, Alberto Montoli, Giacomo Colussi
BACKGROUND: Short frequent dialysis with NxStage System One cycler (NSO) has become increasingly popular as home hemodialysis prescription. Short dialysis sessions with NSO might not allow adequate phosphate (P) removal. METHODS: Single-session and weekly balances of P and calcium (Ca) were compared in 14 patients treated with NSO (6 sessions/week) and in 14 patients on standard bicarbonate dialysis (BHD). RESULTS: NSO and BHD showed similar plasma P fall, with end-dialysis plasma P slightly lower in BHD (2...
February 16, 2018: Blood Purification
https://www.readbyqxmd.com/read/29437142/prevalence-based-targets-underestimate-home-dialysis-program-activity-and-requirements-for-growth
#11
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
#12
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
#13
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
#14
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...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29336060/what-the-non-nephrologist-needs-to-know-about-dialysis
#15
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...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29326842/barriers-to-peritoneal-dialysis-in-aboriginal-patients
#16
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-v-urea-and-clinical-outcomes-in-home-and-in-center-hemodialysis
#17
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)...
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29314304/role-of-telehealth-in-renal-replacement-therapy-education
#18
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...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29295766/-vancomycin-poisoning-successfully-treated-with-intermittent-hemodialysis-a-case-report
#19
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
#20
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...
February 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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