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Daily hemodialysis

Patrícia T Goldenstein, Precil D Neves, Bruno E Balbo, Rosilene M Elias, Alexandre C Pereira, Luiz F Onuchic, Harald Jüppner, Vanda Jorgetti, Hugo Abensur, Rosa Maria Moysés
Primary tumoral calcinosis is a rare autosomal recessive disorder characterized by ectopic calcified tumoral masses. Mutations in 3 genes (GALNT3, FGF23, and KL) have been linked to this human disorder. We describe a case of a 28-year-old man with a history of painful firm masses over his right and left gluteal region, right clavicle region, knees, and left elbow. Biochemical analysis disclosed hyperphosphatemia (phosphate, 9.0 mg/dL) and normocalcemia (calcium, 4.8 mg/dL), with normal kidney function and fractional excretion of phosphate of 3%...
March 14, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Yueh-Min Liu, Hong-Jer Chang, Ru-Hwa Wang, Li-King Yang, Kuo-Cheng Lu, Yi-Chou Hou
Background: Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD)...
2018: Therapeutics and Clinical Risk Management
M G Vossen, L Ehmann, S Pferschy, A Maier-Salamon, M Haidinger, C Weiser, J M Wenisch, K Saria, C Kajahn, S Jilch, R Lemmerer, M Bécède, M Zeitlinger, C Kloft, W Jäger, F Thalhammer
OBJECTIVES: Doripenem is a broad-spectrum parenteral carbapenem with enhanced activity against Pseudomonas aeruginosa and Enterobacteriaceae. Current dosing regimens recommend the administration of 0.25-0.5 g once daily in patients undergoing intermittent renal replacement therapy. As patients are usually dialyzed thrice weekly, we aimed to investigate a 1-g post-hemodialysis regimen, thus reducing treatment costs and enhancing patient compliance. A second objective of this trial was to describe the pharmacokinetics of intradialytic doripenem...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Elliot M Silver, William Ochoa
BACKGROUND Chronic intake of high-dose corticosteroids is associated with multiple adverse clinical effects, including hypertension, insulin resistance, impaired wound healing, immunosuppression, myopathy, and osteoporosis. In cases of autoimmune disease, use of steroid-sparing treatment modalities is preferred over chronic steroid therapy to limit these side effects. Glucocorticoid-induced myopathy is a less common side effect of chronic steroid use in patients treated with <10 mg/day of prednisone. However, doses exceeding 40-60 mg/day can induce clinically significant myopathy and weakness...
March 11, 2018: American Journal of Case Reports
Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
Katarzyna Wyskida, Jarosław Wajda, Dariusz Klein, Joanna Witkowicz, Rafał Ficek, Sylwia Rotkegel, Urszula Spiechowicz-Zatoń, Joanna Kocemba-Dyczek, Jarosław Ciepał, Magdalena Olszanecka-Glinianowicz, Andrzej Więcek, Jerzy Chudek
BACKGROUND: Diet is a key factor that determines proper alignment of calcium-phosphate and nutritional status among hemodialysis (HD) patients. OBJECTIVES: To assess the nutrient intake in relation to long-term calcium-phosphate control in HD patients with end-stage renal failure. MATERIAL AND METHODS: The study included 107 patients (66 men, 41 women) from 10 dialysis centers in the Upper Silesia region of Poland. To analyze the diet composition during the previous year, a portion-sized version of the Diet History Questionnaire II (DHQ-II) from National Institutes of Health was used...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Jordanne Feldberg, Param Patel, Ashley Farrell, Sylvia Sivarajahkumar, Karen Cameron, Jennifer Ma, Marisa Battistella
Background: There is a lack of clear benefit and a potential risk of bleeding with direct oral anticoagulant (DOAC) use in chronic kidney disease (CKD) and dialysis patients with atrial fibrillation. The objective of this study was to evaluate how treatment with DOACs affects stroke and bleeding outcomes compared with warfarin or aspirin. Methods: We conducted a systematic review of randomized controlled trials, cohort studies and case series, and searched electronic databases from 1946 to 2017...
March 2, 2018: Nephrology, Dialysis, Transplantation
Sushil Mehandru, Attiya Haroon, Avais Masud, Mayurkumar Patel, Elmer Sadiang-Abay, Eric J Costanzo, Tushar J Vachharajani
While an arteriovenous fistula is the best available access, many patients continue to rely on a tunneled hemodialysis catheter for dialysis therapy. Despite the highest risk of catheter-related bacteremia and associated morbidity and mortality, patients often prefer tunneled hemodialysis catheter to avoid pain associated with cannulation of an arteriovenous access. We report three tunneled hemodialysis catheter-dependent end-stage renal disease patients (age: 38, 35, 33 years), who became pregnant. Pregnancy was discovered at 10, 12 and 10 weeks of gestation...
March 1, 2018: Journal of Vascular Access
Tara Nikonow Morgan, Mohammed Shahait, Avinash Maganty, Michael C Ost, Stephen V Jackman, Timothy D Averch, Michelle Jo Semins
BACKGROUND: To describe the clinical characteristics, infectious and kidney function patterns, and overall outcomes in a cohort of patients with staghorn calculi treated conservatively. METHODS: Staghorn calculi treated non-operatively between January 2009 and January 2017 were identified. A retrospective analysis was completed. RESULTS: Twenty-nine patients were identified with median age of 74 (IQR 61-81). Mean follow-up was 24 months. Fifty nine percent (17/29) had complete staghorn calculi with 6/29 (21%) bilateral...
March 1, 2018: Journal of Endourology
Jiro Aoki, Ken Kozuma, Masaki Awata, Mamoru Nanasato, Nobuo Shiode, Kengo Tanabe, Junichi Yamaguchi, Hajime Kusano, Hong Nie, Takeshi Kimura
The Cobalt Chromium Everolimus-Eluting Stent (CoCr-EES) Post Marketing Surveillance (PMS) Japan study is a prospective multicenter registry designed to evaluate the safety and efficacy of XIENCE V/PROMUS everolimus-eluting stents in routine clinical practice at 47 centers representative of the clinical environment in Japan. We enrolled 2010 consecutive patients (2649 lesions) who underwent percutaneous coronary intervention using CoCr-EES. Clinical outcomes were evaluated through 5 years. Mean age was 68.8 years, 41...
February 26, 2018: Cardiovascular Intervention and Therapeutics
Sunil Taneja, Ajay Duseja, Arka De, Manu Mehta, Raja Ramachandran, Vivek Kumar, Harbir Singh Kohli, Krishan Lal Gupta, Radha Krishan Dhiman, Yogesh Chawla
BACKGROUND AND AIMS: There is sparse data on the use of Sofosbuvir based directly acting antiviral (DAA) drug regimens in chronic hepatitis C (CHC) patients with chronic kidney disease (CKD) with estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m2 . We evaluated the safety and efficacy of low-dose Sofosbuvir plus full-dose Daclatasvir in CHC patients with CKD. METHODS: Sixty-five CHC patients with CKD with eGFR less than 30 mL/min/1.73 m2 [54 (83%) patients with ESRD on hemodialysis] were included...
February 26, 2018: Digestive Diseases and Sciences
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 (; 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
Hatem Ali, Tarek Abdelaziz, Fatima Abdelaal, Jyoti Baharani
The relationship between frailty and chronic kidney disease in elderly population has been recognized; however, studies concentrating on frailty in predialysis patients are limited. For nephrologists, the recognition of frailty is important as it has impact on decisions on the choice of dialysis modality and sometimes on whether dialysis is indeed in the patients' best interests. Many of the tools for routine assessment of frailty are not easily applicable to those clinicians not practicing elderly care medicine...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Roberto Biondi, Stefano Brancorsini, Giulia Poli, Maria Giulia Egidi, Enrico Capodicasa, Livio Bottiglieri, Sandro Gerli, Eleonora Brillo, Gian Carlo Di Renzo, Dragos Cretoiu, Romeo Micu, Nicolae Suciu
Hydroxyl radical (.OH) is highly reactive, and therefore very short-lived. Finding new means to accurately detect .OH, and testing the ability of known .OH scavengers to neutralize them in human biological fluids would leverage our ability to more effectively counter oxidative (.OH) stress-mediated damage in human diseases. To achieve this, we pursued the evaluation of secondary products resulting from .OH attack, using a detection system based on Fenton reaction-mediated D-phenylalanine (D-Phe) hydroxylation...
May 1, 2018: Talanta
Jielong Jiang, Lijun Ni, Wei Ren, Xiaowan Zhou, Keliang Su, Lihua Wang, Lei Lan, Wei Chen, Yuanbo Wu
PURPOSE: Malnutrition is the main determinant of mortality and morbidity in maintenance hemodialysis patients. In many countries except for China, it has been reported that short daily hemodialysis (SDHD) could improve nutritional status. We will report here the nutritional results obtained in the SDHD therapy period compared with conventional hemodialysis (cHD) therapy period in Chinese patients. METHODS: This study compared 29 SDHD patients (SDHD group), each patient served as his own control, with 30 cHD patients (cHD group) serving as the parallel controls...
February 5, 2018: International Urology and Nephrology
Osama Sawalmeh, Shaheed Moala, Zakaria Hamdan, Huda Masri, Khubaib Ayoub, Emad Khazneh, Mujahed Shraim
Background: Secondary hyperparathyroidism is a common complication of chronic kidney disease and is managed using vitamin D replacement therapy. Very few studies have examined the effectiveness of pulse alfacalcidol therapy in comparison to daily oral alfacalcidol therapy in suppressing serum parathyroid hormone (PTH) levels in hemodialysis patients. The aim of this randomized controlled trial was to replicate the findings of prior studies comparing effectiveness of pulse oral alfacalcidol therapy versus daily oral alfacalcidol therapy in suppressing PTH after 13 weeks of therapy using a Palestinian sample of hemodialysis patients, and to identify demographic and biomedical characteristics of patients that are independently associated with PTH levels...
2018: International Journal of Nephrology and Renovascular Disease
Takahiro Yajima, Kumiko Yajima, Makoto Hayashi, Hiroshi Takahashi, Keigo Yasuda
AIMS: To evaluate the efficacy and safety of adding once-weekly dulaglutide to insulin therapy in type 2 diabetes mellitus (T2DM) patients on hemodialysis. METHODS: Fifteen insulin-treated T2DM patients on hemodialysis were enrolled. Continuous glucose monitoring was performed before (1st hospitalization) and after the fifth dulaglutide administration (2nd hospitalization). The insulin dose was reduced after the first administration of dulaglutide (1st hospitalization day 6)...
December 21, 2017: Journal of Diabetes and its Complications
Maria das Graças Mariano Nunes de Paiva, Jéssica Dantas de Sá Tinôco, Maria Isabel da Conceição Dias Fernandes, Juliane Rangel Dantas, Isadora Lorenna Alves Nogueira, Ana Beatriz de Almeida Medeiros, Marcos Venícios de Oliveira Lopes, Ana Luisa Brandão de Carvalho Lira
This study analyzed the accuracy of clinical indicators of ineffective health management in hemodialysis patients. A diagnostic accuracy study was performed in 200 chronic kidney disease patients undergoing hemodialysis during the first half of 2015. Measures of sensitivity and specificity were calculated using latent class analysis. Ineffective health management was present in 66.28% of patients. Accurate clinical indicators included expressed nonadherence to treatment, daily life choices ineffective to achieve health goals, expression of difficulty with prescribed regimens, inappropriate use of medicines, lack of expression of willingness to control the disease, irregular attendance of dialysis sessions, and infection...
January 1, 2018: Clinical Nursing Research
Ji-Hyung Cho, Ji-Yeon Lee, Sukyung Lee, Hyuntae Park, Seung-Wook Choi, Jun Chul Kim
PURPOSE: Physical inactivity and sleep disturbance are frequently observed and relate to poor clinical outcomes in maintenance hemodialysis patients. We aimed to investigate the effect of intradialytic exercise on daily physical activity and sleep quality, measured by an accelerometer, in maintenance hemodialysis patients. METHODS: This study randomly assigned ambulatory maintenance hemodialysis patients aged ≥ 20 years on dialysis ≥ 6 months, without a hospitalization history for the previous 3 months to 4 groups: aerobic exercise (AE), resistance exercise (RE), combination exercise (CE), and control...
January 23, 2018: International Urology and Nephrology
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
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