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Cognitive hemodialysis

Kathryn S Agarwal, Rabia Kazim, Jiaqiong Xu, Soo Borson, George E Taffet
OBJECTIVES: To determine whether 30-day readmissions were associated with presence of cognitive impairment more in elderly adults with heart failure (HF) than in those with other diagnoses and whether medical teams recognized cognitive impairment. DESIGN: One-year prospective cohort quality improvement program of cognitive screening and retrospective chart review of documentation and outcomes. SETTING: Academic tertiary care hospital medical unit with a cardiovascular focus and an enhanced discharge program of individualized patient education...
September 27, 2016: Journal of the American Geriatrics Society
Aghogho Odudu, Christopher W McIntyre
Cardiac dysfunction is a key factor in the high morbidity and mortality rates seen in hemodialysis (HD) patients. Much of the dysfunction is manifest as adverse changes in cardiac and vascular structure prior to commencing dialysis. This adverse vascular remodeling arises as a dysregulation between pro- and antiproliferative signaling pathways in response to hemodynamic and nonhemodynamic factors. The HD procedure itself further promotes cardiomyopathy by inducing hypotension and episodic regional cardiac ischemia that precedes global dysfunction, fibrosis, worsening symptoms, and increased mortality...
August 24, 2016: Seminars in Dialysis
Lukman Femi Owolabi, Aliyu Abdu, Aliyu Ibrahim, Desola Shakira Owolabi, Aisha Nalado, Adamu Bappa, Aminu Abdullahi Taura
AIM: The purpose of this comparative study was to evaluate cognitive function in end-stage renal disease (ESRD) patients in comparison with age, sex, and level of education-matched control. MATERIALS AND METHODS: This is a cross-sectional study involving 80 ESRD patients receiving maintenance hemodialysis treatment and recruited conservatively at the nephrology unit of our hospital. Eighty apparently healthy control, that were matched with the patients for age, sex and education, were also recruited...
July 2016: Annals of African Medicine
Muhammad Anees, Muhammad Ibrahim, Marium Imtiaz, Shazia Batool, Irfan Elahi, Muzammil Riaz Malik
OBJECTIVE: To translate, validate and assess the reliability of kidney disease quality of life - short form (KDQOL-SF-36) in Urdu, national language of Pakistan. STUDY DESIGN: Amulticentric descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Nephrology, Mayo Hospital, Lahore, from February to July 2015. METHODOLOGY: Patients of end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) for more than three months, were included in the study...
August 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Judy Mullan, Kylie Mansfield, Maureen Lonergan
AIM: The aim of this study was to compare the extent of cogntive impairment and the types of cognitive deficits in an Australian cohort of four patient groups with end stage kidney disease. Characteristics predicting the presence of cognitive impairment were also evaluated. METHODS: Observational cross sectional study of one hundred and fifty five patients with end stage kidney disease recruited from a regional Australian renal unit. Eligible participants included those whose estimated Glomerular Filtration Rate was < 30 ml/min/1...
August 9, 2016: Nephrology
Manjula Kurella Tamura, Glenn M Chertow, Thomas A Depner, Allen R Nissenson, Brigitte Schiller, Ravindra L Mehta, Sai Liu, Tammy L Sirich
Retention of uremic metabolites is a proposed cause of cognitive impairment in patients with ESRD. We used metabolic profiling to identify and validate uremic metabolites associated with impairment in executive function in two cohorts of patients receiving maintenance dialysis. We performed metabolic profiling using liquid chromatography/mass spectrometry applied to predialysis plasma samples from a discovery cohort of 141 patients and an independent replication cohort of 180 patients participating in a trial of frequent hemodialysis...
July 21, 2016: Journal of the American Society of Nephrology: JASN
Silvio Borrelli, Roberto Minutolo, Luca De Nicola, Walter De Simone, Emanuele De Simone, Bruno Zito, Biagio Raffaele Di Iorio, Lucia Di Micco, Luigi Leone, Antonio Bassi, Angelo Romano, Maria Carla Porcu, Riziero Fini, Edward Vezza, Caterina Saviano, Ludovica D'Apice, Roberto Simonelli, Vincenzo Bellizzi, Giuseppe Palladino, Olga Credendino, Raffaele Genualdo, Maria Capuano, Pasquale Guastaferro, Filippo Nigro, Vittorio Stranges, Giuseppe Iuianiello, Francesco Saverio Russo, Maria Rita Auricchio, Antonio Treglia, Patrizia Palombo, Nunzio Rifici, Remo Nacca, Alberto Caliendo, Stefania Brancaccio, Giuseppe Conte
INTRODUCTION: in hemodialysis (HD) patients, poor health-related quality of life (HR-QoL) is prevalent and associated with adverse outcomes. HR-QoL is strictly linked to nutritional status of HD patients. Hemodiafiltration with endogenous reinfusion (HFR) is an alternative dialysis technique that combines diffusion, convection and absorption. It reduces burden of inflammation and malnutrition and this effect may cause beneficial effect on HR-QoL. However no data on HR-QoL in HFR is currently available...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Tomasz Gołębiowski, Hanna Augustyniak-Bartosik, Wacław Weyde, Marian Klinger
The recent epidemiologic data pointed out, that the general number of patients on hemodialysis is steadily increasing, especially in group of elderly patients over 75 years old. The geriatric syndromes are a multietiological disorder related to physiological aging and partly associated with comorbid conditions. Frailty, falls, functional decline and disability, cognitive impairment and depression are main geriatric syndromes and occurs in patients with impaired renal function more often than among general population...
2016: Postȩpy Higieny i Medycyny Doświadczalnej
Nosratola D Vaziri
Intravenous iron products are essential for the treatment of anemia in end-stage renal disease patients maintained on hemodialysis. Although proper use of these compounds is necessary for the prevention of iron deficiency, their indiscriminate use could potentially cause insidious adverse consequences. Iron overload can intensify the chronic kidney disease-associated oxidative stress, inflammation, and cardiovascular disease; increase the risk of infections; worsen the severity of type 2 diabetes; and exacerbate neurologic and cognitive dysfunction...
March 2016: Seminars in Nephrology
Xiao Lu Jiang, Ji Qiu Wen, Long Jiang Zhang, Gang Zheng, Xue Li, Zhe Zhang, Ya Liu, Li Juan Zheng, Long Wu, Hui Juan Chen, Xiang Kong, Song Luo, Guang Ming Lu, Xue Man Ji, Zong Jun Zhang
We used arterial-spin labeling (ASL) MR imaging, a non-invasive technique to evaluate cerebral blood flow (CBF) changes in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) and hemodialysis (HD), and nondialysis ESRD patients compared with healthy cohort. Ninety seven ESRD patients including 32 PD patients (20 male, 12 female; mean age 33 ± 8 years), 33 HD patients (22 male, 11 female; mean age 33 ± 8 years) and 32 nondialysis patients (20 male, 12 female; mean age 35 ± 7 years) and 31 age- and gender-matched healthy controls (20 male, 11 female; mean age 32 ± 8 years) were included in this study...
August 2016: Metabolic Brain Disease
Chao Chai, Zhiye Wang, Linlin Fan, Mengjie Zhang, Zhiqiang Chu, Chao Zuo, Lei Liu, E Mark Haacke, Wenmei Guo, Wen Shen, Shuang Xia
The aim of this study was to explore the risk factors associated with longitudinal changes in hemodialysis patients including the correlation between number and distribution of cerebral microbleeds (CMBs).Sixty-one hemodialysis patients were enrolled in this prospective study. Twenty-eight patients had follow-up examinations with a mean interval of 24.79 ± 5.17 months. The number of CMBs was manually counted on susceptibility-weighted imaging. Subjects were divided into 2 groups with and without CMBs. In the CMB group, 8 of 33 patients did not have a mini-mental state examination (MMSE) because of blurred vision...
March 2016: Medicine (Baltimore)
Mariana Murea, Scott Satko
Vascular access preparation, a pervasive challenge in hemodialysis (HD), is emerging as a multidimensional subject in geriatric nephrology. Previously published guidelines declared arteriovenous fistulas (AVF) as the preferred vascular access for all patients on HD. In this article, the benefit-risk evidence for using AVF versus an alternative access (arteriovenous graft [AVG] or tunneled central venous catheter [TCVC]) in the elderly is pondered. Compared to their younger counterparts, the elderly have significantly lower survival rates independent of the vascular access used for HD...
September 2016: Seminars in Dialysis
Emma O'Lone, Michael Connors, Philip Masson, Sunny Wu, Patrick J Kelly, David Gillespie, Daniel Parker, William Whiteley, Giovanni F M Strippoli, Suetonia C Palmer, Jonathan C Craig, Angela C Webster
BACKGROUND: Cognitive impairment is associated with poorer quality of life, risk for hospitalization, and mortality. Cognitive impairment is common in people with end-stage kidney disease treated with hemodialysis, yet the severity and specific cognitive deficits are uncertain. STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Adults receiving hemodialysis compared with the general population, people with non-dialysis-dependent chronic kidney disease (NDD-CKD), people receiving peritoneal dialysis, or people with nondialyzed chronic kidney failure...
June 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Sang Heon Suh, Young Hwan Choi, Chang Seong Kim, Joon Seok Choi, Jeong Woo Park, Eun Hui Bae, Seong Kwon Ma, Byeong C Kim, Soo Wan Kim
We report an unusual case of probable Creutzfeldt-Jakob disease (CJD) in hemodialysis patient. A woman 59 years of age with a past history of hypertension and end-stage renal disease presented with a stuporous state preceded by rapidly progressive cognitive dysfunction, myoclonus, and akinetic mutism. At first, the cause of the altered mental status was assumed to be uremic or hypertensive encephalopathy combined with fever. Proper managements, however, did not improve the neurologic symptoms. Diffusion-weighted magnetic resonance imaging revealed bilaterally asymmetric high signal intensity in both basal ganglia and cerebral cortices...
March 2012: Kidney Research and Clinical Practice
Mary Ann Sevick, Beth M Piraino, David E St-Jules, Linda J Hough, Joseph T Hanlon, Zachary A Marcum, Susan L Zickmund, Linda G Snetselaar, Ann R Steenkiste, Roslyn A Stone
OBJECTIVE: To evaluate the efficacy of behavioral counseling combined with technology-based self-monitoring for sodium restriction in hemodialysis (HD) patients. DESIGN: Randomized clinical trial. SUBJECTS: English literate adults undergoing outpatient, in-center intermittent HD for at least 3 months. INTERVENTIONS: Over a 16-week period, both the intervention and the attention control groups were shown 6 educational modules on the HD diet...
May 2016: Journal of Renal Nutrition
Alexandra Tasmoc, Mihaela-Dora Donciu, Gabriel Veisa, Ionut Nistor, Adrian Covic
Introduction Cognitive impairment is a major, but underdiagnosed, risk factor for negative outcomes in patients with chronic kidney disease (CKD). The main goal of this study was to evaluate, for the first time, the relationship between arterial stiffness and cognitive impairment in a cohort of hemodialysis patients. Methods We prospectively analyzed the cognitive function and pulse wave velocity (PWV) of 72 hemodialysis patients, mean age 56.54 ± 13.96 y, from two Romanian dialysis centers. We administered to all patients the Mini Mental State Examination (MMSE), Trail Making Test Part-A (TMTA) and Part-B (TMTB), and Mini-Cog Test...
July 2016: Hemodialysis International
Terry King-Wing Ma, Philip Kam-Tao Li
Depression is the most common psychiatric illness in patients with end-stage renal disease (ESRD). The reported prevalence of depression in dialysis population varied from 22.8% (interview-based diagnosis) to 39.3% (self- or clinician-administered rating scales). Such differences were attributed to the overlapping symptoms of uraemia and depression. Systemic review and meta-analysis of observational studies showed that depression was a significant predictor of mortality in dialysis population. The optimal screening tool for depression in dialysis patients remains uncertain...
August 2016: Nephrology
Yijie Fang, Guobin Hong, Huifang Lu, Yongfei Guo, Wen Yu, Xueguo Liu
OBJECTIVE: To explore the clinical, pathological characteristics and imaging manifestations of brown tumors caused by hyperparathyroidism, to improve the cognition of the disease. METHODS: The clinical, pathological characteristics and imaging manifestations of 15 cases of pathologically confirmed brown tumors were retrospectively reviewed. To analyze the imaging and pathological correlations, in addition, between the primary and secondary hyperparathyroidism led to brown tumors differential diagnoses...
December 1, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Bradley S Dixon, John M VanBuren, James R Rodrigue, Robert S Lockridge, Robert Lindsay, Christopher Chan, Michael V Rocco, Jacob J Oleson, Leigh Beglinger, Kevin Duff, Jane S Paulsen, John B Stokes
BACKGROUND: It is uncertain whether switching to frequent nocturnal hemodialysis improves cognitive function in well-dialyzed patients and how this compares to patients who receive a kidney transplant. METHODS: We conducted a multicenter observational study with longitudinal follow-up of the effect on cognitive performance of switching dialysis treatment modality from conventional thrice-weekly hemodialysis to frequent nocturnal hemodialysis, a functioning renal transplant or remaining on thrice-weekly conventional hemodialysis...
2016: BMC Nephrology
Tiffany Washington, Sheryl Zimmerman, Teri Browne
Chronic kidney disease (CKD) affected 26 million U.S. adults. Many end-stage CKD patients undergoing hemodialysis experience self-management challenges. However, factors associated with CKD self-management are underidentified. This article describes a mixed-methods study to identify factors associated with self-management in end-stage CKD patients undergoing hemodialysis. A total of 107 patients age 50 and older were interviewed. Overall, participants had low mean scores for exercise (2.46), communication with physicians (2...
March 2016: Social Work in Public Health
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