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hemodialysis; nephrology

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https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#1
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28205136/a-comparative-study-of-the-risk-profile-of-hemodialysis-patients-in-a-for-profit-network-and-in-two-regional-registries-of-the-italian-society-of-nephrology
#2
Maurizio Postorino, Claudia Amato, Elena Mancini, Paola Carioni, Graziella D'Arrigo, Attilio Di Benedetto, Fabrizio Cerino, Carmela Marino, Antonio Vilasi, Giovanni Tripepi, Stefano Stuard, Giovanbattista Capasso, Antonio Santoro, Carmine Zoccali
In 2013, the Italian Society of Nephrology joined forces with Nephrocare-Italy to create a clinical research cohort of patients on file in the data-rich clinical management system (EUCLID) of this organization for the performance of observational studies in the hemodialysis (HD) population. To see whether patients in EUCLID are representative of the HD population in Italy, we set out to compare the whole EUCLID population with patients included in the regional HD registries in Emilia-Romagna (Northern Italy) and in Calabria (Southern Italy), the sole regions in Italy which have systematically collected an enlarged clinical data set allowing comparison with the data-rich EUCLID system...
February 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28182041/assessment-of-health-related-quality-of-life-and-its-determinants-in-patients-with-chronic-kidney-disease
#3
M Manavalan, A Majumdar, K T Harichandra Kumar, P S Priyamvada
Health-related quality of life is an important, yet neglected aspect of chronic kidney disease (CKD) care. We evaluated the quality of life and its determinants across CKD 3 to 5D using a kidney disease specific tool (Kidney Disease Quality of Life-SF™) in an underprivileged, predominantly rural population with high rates of illiteracy and unemployment. The scores of individual domains were summarized to three composite scores - physical composite summary (PCS), mental composite summary (MCS), and kidney disease component summary score (KDCS)(...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28156631/survival-benefits-among-patients-with-end-stage-renal-disease-receiving-dialysis-versus-no-dialysis
#4
Maen Abdelrahim, Valda D Page, Shouhao Zhou, Chan Shen, Sriram Yennu, Bo Zhao, Joanna-Grace Mayo Manzano, Marina Ciny George, Joseph L Nates, Alvin Howard Moss, Rima Pai, Ala Abudayyeh
: 55 Background: Retrospective study of the outcomes of Stage IV Cancer Patients with End Stage Renal disease Receiving Dialysis and comparing the survival benefits among the patients who received Hemodialysis versus who didn't at a Comprehensive Cancer Center. METHODS: Retrospectively review all patients admitted to MDACC from 2005-2014 and diagnosed with stage IV solid tumor admitted with Acute kidney injury and a nephrology consult were included (N = 903) 19...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#5
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28139394/serious-fall-injuries-before-and-after-initiation-of-hemodialysis-among-older-esrd-patients-in-the-united-states-a-retrospective-cohort-study
#6
Laura C Plantinga, Rachel E Patzer, Harold A Franch, C Barrett Bowling
BACKGROUND: Because initiation of dialysis therapy often occurs in the setting of acute illness and may signal worsening health and functional decline, we examined whether rates of serious fall injuries among older hemodialysis patients differ before and after dialysis therapy initiation. STUDY DESIGN: Retrospective cohort study of claims data from the 2 years spanning dialysis therapy initiation among patients initiating dialysis therapy in 2010 to 2012. SETTING & PARTICIPANTS: Claims from 81,653 Medicare end-stage renal disease beneficiaries aged 67 to 100 years...
January 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28122510/a-prospective-2-site-parallel-intervention-trial-of-a-research-based-film-to-increase-exercise-amongst-older-hemodialysis-patients
#7
Pia Kontos, Shabbir M H Alibhai, Karen-Lee Miller, Dina Brooks, Romeo Colobong, Trisha Parsons, Sarbjit Vanita Jassal, Alison Thomas, Malcolm Binns, Gary Naglie
BACKGROUND: Evidence suggests that exercise training for hemodialysis patients positively improves morbidity and mortality outcomes, yet exercise programs remain rare and are not systematically incorporated into care. We developed a research-based film, Fit for Dialysis, designed to introduce, motivate, and sustain exercise for wellness amongst older hemodialysis patients, and exercise counseling and support by nephrologists, nurses, and family caregivers. The objective of this clinical trial is to determine whether and in what ways Fit for Dialysis improves outcomes and influences knowledge/attitudes regarding the importance of exercise for wellness in the context of end-stage renal disease...
January 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28110970/-plasma-exchange-in-nephrology-indications-and-technique
#8
Christophe Ridel, Sébastien Kissling, Laurent Mesnard, Alexandre Hertig, Éric Rondeau
Plasma exchange is a non-selective apheresis technique that can be performed by filtration or centrifugation allowing rapid purification of high molecular weight pathogens. An immunosuppressive treatment is generally associated to reduce the rebound effect of the purified substance. Substitution solutes such as human albumin and macromolecules are needed to compensate for plasma extraction. Compensation by viro-attenuated plasma is reserved solely for the treatment of thrombotic microangiopathies or when there is a risk of bleeding, because this product is very allergenic and expensive...
January 16, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28109741/eight-unexpected-cases-of-vancomycin-associated-acute-kidney-injury-with-contemporary-dosing
#9
J Nicholas O'Donnell, Cybele Ghossein, Nathaniel J Rhodes, Jessica Peng, Tina Lertharakul, C Kim Pham, Marc H Scheetz
Vancomycin is one of the most commonly utilized antibiotics in US hospitals. It remains the drug of choice for the treatment of serious infections caused by methicillin-resistant Staphylococcus aureus. For many of these deep-seated infections, guidelines recommend achieving troughs of 15-20 mg/L for treatment efficacy. At our institution we observed a number of cases of presumed vancomycin-induced acute tubular necrosis clinically diagnosed by the nephrology service. We report eight cases of presumed vancomycin-induced acute tubular necrosis, three of which required hemodialysis before resolution of nephrotoxicity...
January 18, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#10
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077371/markers-of-endothelial-damage-in-patients-with-chronic-kidney-disease-on-hemodialysis
#11
Andrés Carmona, Maria Luisa Agüera, Carlos Luna Ruiz, Paula Buendia, Laura Calleros, Andrea Garcia-Jerez, Manuel Rodríguez-Puyol, Manuel Arias, Marta Arias-Guillen, Gabriel de Arriba, Jose Ballarin, Carmen Bernis, Elvira Fernandez, Sagrario Garcia-Rebollo, Javier Mancha, Gloria Del Peso, Estefania Perez, Esteban Poch, Jose M Portoles, Diego Rodriguez-Puyol, Rafael Sánchez-Villanueva, Felipe Sarro, Armando Torres, Alejandro Martin-Malo, Pedro Aljama, Rafael Ramirez, Julia Carracedo
Patients with stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (REDinREN, Madrid): 80 patients with diabetes mellitus (DM) and 80 patients without DM who were matched for clinical and demographic criteria...
January 11, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28069285/dialysis-modality-and-readmission-following-hospital-discharge-a-population-based-cohort-study
#12
Jeffrey Perl, Eric McArthur, Chaim Bell, Amit X Garg, Joanne M Bargman, Christopher T Chan, Shai Harel, Lihua Li, Arsh K Jain, Danielle M Nash, Ziv Harel
BACKGROUND: Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. STUDY DESIGN: Population-based retrospective-cohort observational study. SETTINGS & PARTICIPANTS: Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada...
January 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#13
Luciene P Magalhães, Luciene M Dos Reis, Fabiana G Graciolli, Benedito J Pereira, Rodrigo B de Oliveira, Altay A L de Souza, Rosa M Moyses, Rosilene M Elias, Vanda Jorgetti
BACKGROUND: Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28042060/the-relationship-between-fatigue-and-depression-in-adults-with-end-stage-renal-disease-on-chronic-in-hospital-hemodialysis-a-scoping-review
#14
REVIEW
Janine F Farragher, Helene J Polatajko, Sarbjit V Jassal
CONTEXT: Fatigue and depression are two prominent concerns in patients on in-hospital hemodialysis (IHHD) that have recently been identified as research priorities in the nephrology community. Although they are often reported to co-exist, no synthesis of the literature examining their relationship is available. OBJECTIVE: To characterize the literature on the relationship between fatigue and depression in IHHD patients. METHODS: A scoping review as described by Arksey and O'Malley was conducted...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28025835/bedside-tunneled-dialysis-catheter-removal-a-lesson-learned-from-nephrology-trainees
#15
REVIEW
Tibor Fülöp, Mihály B Tapolyai, Mohit Agarwal, Arnaldo Lopez-Ruiz, Miklos Z Molnar, Neville R Dossabhoy
Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27957414/current-characteristics-of-dialysis-therapy-in-korea-2015-registry-data-focusing-on-elderly-patients
#16
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
#17
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/27941742/experience-of-percutaneous-versus-surgically-placed-catheter-for-continuous-ambulatory-peritoneal-dialysis-in-children-with-chronic-kidney-disease-stage-v
#18
S Afroz, T Ferdaus, S A Khondokar, M H Khan, M Hanif
The lifespan and outcome of end stage renal disease (ESRD) children have dramatically improved since the development of continuous ambulatory peritoneal dialysis (CAPD), it offers several advantages over hemodialysis. Percutaneous placement of CAPD catheters in children is minimally invasive, reliable, safe and cost-effective method. Percutaneous method of CAPD catheter insertion can be used in children to avoid the complications of general anesthesia and surgery. This study was done to evaluate the efficacy of CAPD in children, to find out the complication profile of CAPD & to compare the advantages of surgical versus percutaneously placed CAPD catheters in children...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#19
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27908792/freebie-rhabdomyolysis-a-public-health-concern-spin-class-induced-rhabdomyolysis
#20
Maureen Brogan, Rudrick Ledesma, Alan Coffino, Praveen Chander
BACKGROUND: Rhabdomyolysis is a pathologic condition in which intracellular muscle constituents leak into the blood circulation. It is usually caused by muscle trauma. "Spinning" is an indoor form of cycling where participants use a special stationary exercise bicycle with a weighted flywheel and undergo high-intensity cycling classes focusing on endurance. There have been several case reports in the literature of exertional rhabdomyolysis following spin class. METHODS: Our nephrology practices have diagnosed a number of cases of symptomatic patients presenting to our emergency departments following their first spin classes, with histories and creatinine phosphokinase levels diagnostic of exertional rhabdomyolysis...
November 29, 2016: American Journal of Medicine
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