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https://www.readbyqxmd.com/read/28078814/life-threatening-nutritional-deficiencies-in-a-dialysis-patient
#1
Fahad Aziz, Kunal Chaudhary
Nutritional deficiencies are very common among the patient on chronic hemodialysis. But they can be easily overlooked or misdiagnosed. Deficiencies of trace elements and phosphorous is rare among this patient population but if neglected can lead to catastrophic effects. We describe a case report of a patient with ESRD recently started on outpatient maintenance hemodialysis, who presented with life threatening muscular weakness with respiratory failure requiring prolonged mechanical ventilation. On initial workup, it was unclear what the cause of her weakness was, however, further investigations showed undetectable phosphorous levels as well as very low levels of trace elements...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28074773/low-dose-dialysis-combined-with-low-protein-intake-can-maintain-nitrogen-balance-in-peritoneal-dialysis-patients-in-poor-economies%C3%A2
#2
Chun-Yan Su, Tao Wang, Xin-Hong Lu, Sha Ma, Wen Tang, Pei-Yu Wang
OBJECTIVE: Due to limited economic conditions, we tried to provide "fitted" dialysis doses instead of the doses recommended by the international guidelines to the individual patients. In the present cross-sectional study, we studied the dialysis adequacy and nutritional status of 5 peritoneal dialysis patients who had a low dialysis dose (2 bags, 4,000 mL/day). METHODS: The 3-day dietary records were reviewed to calculate patients' energy, protein, and nitrogen intake (NI)...
January 11, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28067935/hepatitis-b-vaccination-in-haemodialysis-patients-an-underestimated-problem-factors-influencing-immune-responses-in-ten-years-of-observation-in-an-italian-haemodialysis-centre-and-literature-review
#3
E Cordova, I Miglia, F Festuccia, M G Sarlo, G Scornavacca, G Punzo, P Menè, C Fofi
OBJECTIVES: Despite universal infection control precautions, the risk of hepatitis B virus (HBV) infection in patients on chronic haemodialysis (HD) remains high. For this reason anti-HBV vaccination is recommended in these subjects. In hemodialyzed patients vaccinal response is often suboptimal and it's not clear what factors may influence it. STUDY DESIGN: The aim of our study is to assess the influence of some clinical and laboratory factors on seroconversion rate after anti HBV vaccination in a cohort of patients on maintenance HD...
January 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28064444/phosphate-binders-and-targets-over-decades-do-we-have-it-right-now
#4
Morgan Marcuccilli, Michel Chonchol, Anna Jovanovich
In advanced renal disease, the kidney is unable to maintain phosphate balance due to decreased urinary excretion as well as the imbalance of the bone metabolic axis. It is well established that hyperphosphatemia is associated with increased cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, there are no randomized controlled trials that demonstrate a clear benefit on hard outcomes in lowering serum phosphate levels to recommended targets in the CKD or dialysis population...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28064158/serum-uric-acid-protein-intake-and-mortality-in-hemodialysis-patients
#5
Christina Park, Yoshitsugu Obi, Elani Streja, Connie M Rhee, Christina J Catabay, Nosratola D Vaziri, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: The association between serum uric acid (SUA) and mortality has been conflicting among studies using hemodialysis (HD) patients. Given the close link between purine and protein in foods, we hypothesized that normalized protein catabolic rate (nPCR), a dietary protein intake surrogate, modifies the SUA-mortality association in the HD population. METHODS: We identified 4298 patients who initiated HD and had one or more SUA measurement in a contemporary cohort of HD patients over 5 years (1 January 2007-31 December 2011), and examined survival probability according to the first uric acid measurement, adjusting for dialysis vintage, case-mix and malnutrition-inflammation complex-related variables...
January 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28060690/-peritoneal-dialysis-in-the-first-two-years-of-life-experience-of-a-nephrology-and-renal-transplantation-pediatric-unit
#6
Sofia Deuchande, Tânia Mano, Cristina Novais, Rute Machado, Rosário Stone, Margarida Almeida
INTRODUCTION: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purpose was to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life. MATERIAL AND METHODS: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28040717/predictors-of-the-use-of-specific-critical-care-therapies-in-patients-with-metastatic-cancer
#7
Kah Poh Loh, Ankit Kansagra, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Mihaela Stefan, Tara Lagu
OBJECTIVE: Understanding which factors are associated with the use of critical care therapies (CCTs) can help with clinical decision-making and goals of care discussion. The goal of this study was to describe the predictors of CCT use (eg, mechanical ventilation, tracheostomy, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, acute use of dialysis) in hospitalized patients with metastatic cancer. METHODS: We used the 2010 California State Inpatient Databases sponsored by the Agency for Healthcare Research and Quality to identify all hospitalizations with a diagnosis of metastatic cancer (patients aged ≥18 years)...
January 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28035769/impact-of-empagliflozin-on-diabetic-kidney-disease
#8
Daisuke Koya
Diabetic kidney disease is a leading cause of end stage kidney disease requiring renal transplantation or dialysis in not only Asian but also western countries. Recent data has also implicated that the prevalence of diabetic kidney disease was similar between 1988 and 2014 in cross-sectional studies of adults aged 20 years or older with diabetes mellitus participating in National Health and Nutrition Examination Surveys 1), although newly introduced treatments such as renin-angiotensin-aldosterone system inhibitors did affect the prevalence and clinical manifestations of diabetic kidney disease...
December 30, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28033185/use-of-the-body-composition-monitor-for-fluid-status-measurements-in-elderly-malnourished-subjects
#9
David F Keane, Kim Bowra, Kathryn Kearney, Elizabeth Lindley
Most haemodialysis (HD) patients are able to finish dialysis at or below the normally hydrated weight determined using the body composition monitor (BCM). However, a minority become symptomatic when they are still fluid overloaded based on BCM-measured overhydration (OH). Malnourished patients frequently fall into this group, suggesting that they may have OH that is inaccessible to ultrafiltration. To isolate any effect of malnutrition on BCM-measured OH from those relating to renal failure, OH measurements for twenty elderly subjects with normal renal function who were classified as malnourished were compared with an age-matched cohort with no known nutritional issues...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28013381/pilot-study-of-the-effect-of-cholecalciferol-supplementation-on-hepcidin-in-children-with-chronic-kidney-disease-results-of-the-d-fense-trial
#10
Meredith A Atkinson, Stephen P Juraschek, Michael S Bertenthal, Barbara Detrick, Susan L Furth, Edgar R Miller
BACKGROUND: Hepcidin is a key mediator of the anemia of chronic kidney disease (CKD). There is emerging evidence that 25-hydroxyvitamin D (25D) regulates hepcidin production. METHODS: A randomized controlled trial of daily vitamin D supplementation for 12 weeks was performed with the aim to test the effects of 4000 versus 400 IU of cholecalciferol on serum hepcidin levels in children with non-dialysis CKD recruited at a tertiary care children's hospital. Hepcidin was quantified using a validated competitive enzyme-linked immunosorbent assay...
December 24, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28001186/hypercalcemia-and-renal-function-impairment-associated-with-vitamin-d-toxicity-case-report
#11
Vanessa Guerra, Osvaldo Merege Vieira Neto, Alan Fernandes Laurindo, Francisco Jose Albuquerque de Paula, Miguel Moysés Neto
Nowadays vitamin D (25-OHD) deficiency is supposed to be a global epidemic condition. Expectedly, vitamin D measurement and intake exponentially increased in Brazil in this decade. Although the benefit of vitamin D to general health is still in debate, its indiscriminate use potentially may lead to enhance the incidence of vitamin D intoxication, which is considered a rare disorder. We report a case of a 70 year old diabetic male with chronic renal disease (blood creatinine of 1.6 mg/dL) who progressed suddenly to acute kidney injury (blood creatinine of 5...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28001026/keto-analogues-and-essential-amino-acids-and-other-supplements-in-the-conservative-management-of-chronic-kidney-disease
#12
Adamasco Cupisti, Piergiorgio Bolasco
The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with an aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of CKD patients...
December 21, 2016: Panminerva Medica
https://www.readbyqxmd.com/read/27992532/what-s-the-optimal-lipids-level-for-dialysis-patients-a-cohort-study-from-a-chinese-dialysis-center-in-a-university-hospital
#13
Wen-Ling Yang, Xue-Yan Zhu, Ning Zhu, Chun-Yan Su, Qing-Feng Han, Tao Wang, Ai-Hua Zhang
BACKGROUND: With lipid level being a major contributing factor for cardiovascular health, the high cardiovascular mortality among dialysis patients has raised substantial concerns in regard to the optimal lipid level in these patient population. OBJECTIVE: To explore the optimal lipid level for the survival of dialysis patients. METHODS: The lipid profile was measured for each patient. All participants were followed throughout the course of the study...
2016: PloS One
https://www.readbyqxmd.com/read/27991477/nutritional-status-and-outcomes-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcome-and-practice-patterns-study-phase-5-2012-2015
#14
Fadwa S Al-Ali, Brian A Bieber, Ronald L Pisoni, Hany Ezzat, Mohammed AlGhonaim, Fayez AlHejaili, Sumaya AlGhareeb, Abdulkarim Saleh, Yacoub Al Maimani, Anas Alyousef, Haroun Z Ahmed, Abdullah Hamad
Nutrition is an important factor in maintaining good health of hemodialysis (HD) patients, affecting their morbidity and mortality. The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international observational study assessing differences in dialysis practices and outcomes across >20 countries. Here, we present the results for the Gulf Cooperation Council (GCC) countries regarding nutrition data and its relationship with outcomes as a part of the DOPPS Phase 5 study (2012-2015). Data were from Phase 5 of the DOPPS...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27957414/current-characteristics-of-dialysis-therapy-in-korea-2015-registry-data-focusing-on-elderly-patients
#15
REVIEW
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park
Because of increases in the elderly population and diabetic patients, the proportion of elderly among dialysis patients has rapidly increased during the last decades. The mortality and morbidity of these elderly dialysis patients are obviously much higher than those of young patients, but large analytic studies about elderly dialysis patients' characteristics have rarely been published. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an Internet online registry program and analyzed the characteristics...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27951558/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvements
#16
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27939593/dietary-patterns-and-clinical-outcomes-in-chronic-kidney-disease-the-ckd-qld-nutrition-study
#17
Shu Ning Wai, Jaimon T Kelly, David W Johnson, Katrina L Campbell
OBJECTIVE: Emerging evidence suggests that dietary patterns are associated with survival in people with chronic kidney disease (CKD). This study evaluated the relationship between dietary habits and renal-related clinical outcomes in an established CKD cohort. DESIGN: Prospective cohort study. SETTING: Three outpatient nephrology clinics in Queensland, Australia. SUBJECTS: A total of 145 adult patients with Stage 3 or 4 CKD (estimated glomerular filtration rate 15-59 mL/minute/1...
December 8, 2016: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/27934551/relationship-between-geriatric-nutritional-risk-index-and-subpopulation-lymphocyte-counts-in-patients-undergoing-hemodialysis-and-peritoneal-dialysis
#18
Gyong Hoon Kang, Ye Na Kim, Ho Sik Shin
We investigated the relationship between geriatric nutritional risk index (GNRI) and subpopulation lymphocyte counts (SLCs) in hemodialysis (HD) and peritoneal dialysis (PD) patients and evaluated whether they can be helpful in the diagnosis of malnutrition in these patients. We examined the GNRI and SLCs of 50 HD patients (mean: 55.8 ± 12.7 years; 28 men and 22 women) and 16 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients (mean: 49.8 ± 14.5 years; 10 men and six women). The GNRI is calculated based on the serum albumin level, dry weight, and ideal body weight and uses the following equation: GNRI = [14...
November 2016: Renal Failure
https://www.readbyqxmd.com/read/27925048/resting-energy-expenditure-in-critically-ill-patients-evaluation-methods-and-clinical-applications
#19
Ana Cláudia Soncini Sanches, Cassiana Regina de Góes, Marina Nogueira Berbel Bufarah, André Luiz Balbi, Daniela Ponce
Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27903998/survival-benefit-of-hemodiafiltration-compared-with-prolonged-high-flux-hemodialysis
#20
Petar S Djuric, Aleksandar Jankovic, Jovan Popovic, Jelena Tosic Dragovic, Ana Bulatovic, Zivka Djuric, Milos Mitrovic, Nada Dimkovic
INTRODUCTION:  Patients on dialysis have a high rate of death, mainly of cardiovascular cause. Nephrologists are actively looking for ways to improve patients' outcomes, and alternative dialysis strategies, such as long conventional hemodialysis and hemodiafiltration, are currently being investigated. The aim of this study was to compare anemia, nutrition, inflammation, mineral metabolism, and 3-year survival rates between patients treated with hemodiafiltration and prolonged high-flux hemodialysis (HFH)...
November 2016: Iranian Journal of Kidney Diseases
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