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Switch hemodialysis

Khajohn Tiranathanagul, Paweena Susantitaphong, Nattachai Srisawat, Nanta Mahatanan, Kriang Tungsanga, Kearkiat Praditpornsilpa, Somchai Eiam-Ong
BACKGROUND: Recently, in the first hemodiafiltration (HDF) experience report from South East Asia (SEA), we reported a 3-year prospective study demonstrating the various short-term benefits of high-efficiency online HDF (OL-HDF) over high-flux hemodialysis (HD). Very few long-term survival reports of high-efficiency OL-HDF are available and the data are heterogeneous and incomplete. OBJECTIVES: The present historical cohort study was conducted to determine the long-term survival and outcome of high-efficiency OL-HDF-treated patients...
March 7, 2018: Nephron
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
Kotaro Matsumoto, Jun Kikuchi, Yuko Kaneko, Hidekata Yasuoka, Kazuko Suzuki, Hirobumi Tokuyama, Kaori Kameyama, Kunihiro Yamaoka, Tsutomu Takeuchi
RATIONALE: Dialysis-related amyloidosis (DRA) can present rheumatic manifestations in patients on long-term hemodialysis. Typical articular symptoms with DRA involve carpal-tunnel syndrome, effusion in large joints, spondyloarthropathy, or cystic bone lesions, which are usually with non-inflammatory processes. PATIENT CONCERNS: A 64-year-old man on hemodialysis for >30 years was admitted because of intermittent fever, polyarthritis, and elevated serum C-reactive protein (CRP) level, which was continuous for 2 years...
January 2018: Medicine (Baltimore)
Aleksey Etinger, Kumar, William Ackley, Leland Soiefer, Jonathan Chun, Prabjhot Singh, Eric Grossman, Albert Matalon, Robert S Holzman, Bjorn Meijers, Jerome Lowenstein
BACKGROUND: There is growing evidence that the accumulation of protein- bound uremic retention solutes, such as indoxyl sulfate, p-cresyl sulfate and kynurenic acid, play a role in the accelerated cardiovascular disease seen in patients undergoing chronic hemodialysis. Protein-binding, presumably to albumin, renders these solutes poor-dialyzable. We previously observed that the free fraction of indoxyl sulfate was markedly reduced at the end of hemodialysis. We hypothesized that solute binding might be pH-dependent and attributed the changes in free solute concentration to the higher serum pH observed at the end of standard hemodialysis with dialysis buffer bicarbonate concentration greater than 35 mmol/L...
2018: PloS One
Dugan Maddux, Len A Usvyat, Danqing Xu, Yuedong Wang, Peter Kotanko, Frank M van der Sande, Jeroen P Kooman, Franklin W Maddux
BACKGROUND/AIMS: Few studies examine the impact of systolic blood pressure (SBP) on mortality in the incident hemodialysis (HD) period, and throughout the first HD year. This large retrospective observational study analyzes the impact of "current" and cumulative low preSBP <110 mmHg (L), and variations in preSBP on short-term (1 week) mortality over the first HD year. METHODS: Weekly mean preSBP for HD weeks 1 to 51 was categorized into L or high preSBP>=110 mmHg (H) for each patient...
January 31, 2018: Kidney & Blood Pressure Research
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
Januvi Jegatheswaran, Jeffrey Warren, Deborah Zimmerman
Patients treated with peritoneal dialysis (PD) are often required to switch to hemodialysis (HD) temporarily when they develop abdominal wall hernias and dialysate leaks, peritonitis or undergo thoracic or abdominal surgeries. There are significant risks associated with incident hemodialysis including possible central venous catheter infections, thrombosis, and need for invasive procedures. Therefore, strategies to avoid temporary transfer to hemodialysis are desirable. The increased intra-abdominal pressure associated with PD is largely responsible for the issues requiring withholding PD...
January 30, 2018: Seminars in Dialysis
Joan Perelló, M Gómez, M D Ferrer, N Y Rodríguez, C Salcedo, J M Buades, M M Pérez, J V Torregrosa, E Martín, F Maduell
BACKGROUND: Cardiovascular calcification (CVC) is a major concern in hemodialysis (HD) and the loss of endogenous modulators of calcification seems involved in the process. Phytate is an endogenous crystallization inhibitor and its low molecular mass and high water solubility make it potentially dialyzable. SNF472 (the hexasodium salt of phytate) is being developed for the treatment of calciphylaxis and CVC in HD patients. We aimed to verify if phytate is lost during dialysis, and evaluate SNF472's behaviour during dialysis...
January 19, 2018: Journal of Nephrology
Fumihiko Koiwa, Keitaro Yokoyama, Masafumi Fukagawa, Tadao Akizawa
Introduction: In this phase III, open-label, single-arm, multi-center 12-week study, we evaluated the efficacy and safety of combination therapy with sucroferric oxyhydroxide (PA21) and calcium carbonate for hemodialysis patients with hyperphosphatemia. Methods: We enrolled 35 subjects aged ≥ 20 years with end-stage kidney disease and serum phosphorus 3.5-6.0 mg/dl who were undergoing hemodialysis 3 times weekly and taking calcium carbonate and sevelamer hydrochloride...
January 2018: KI Reports
Satoru Mitsuboshi, Hitoshi Yamada, Kazuhiko Nagai, Hideo Okajima
 This prospective observational study was conducted to evaluate the continuity, efficacy, and tolerability of sucroferric oxyhydroxide (SO) among hemodialysis (HD) patients who switched to SO from sevelamer hydrochloride (SH) or bixalomer (BX). Participants were 9 HD patients in Kaetsu Hospital who had been receiving more than 9 tablets/d of SH or BX and were switched to SO 750 mg/d. All the participants were men. Over a 6-month observational period, 6 of the 9 patients (67%) discontinued SO because of adverse events, including diarrhea, atheroma, and polycythemia...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Koichi Kanozawa, Yuichi Noguchi, Souichi Sugahara, Satoko Nakamura, Hirohisa Yamamoto, Keiko Kaneko, Rika Kono, Saeko Sato, Tomonari Ogawa, Hajime Hasegawa, Shigehiro Katayama
BACKGROUND: We conducted the multicenter, prospective, open-label study in type 2 diabetic (T2DM) patients with renal dysfunction, to clarify the efficacy and the safety in relation to renal function and glycemic control, and the economic effect when other dipeptidyl peptidase-4 (DPP-4) inhibitors were switched to a small dose of sitagliptin depending on their renal function. METHODS: Vildagliptin, alogliptin, or linagliptin received for more than 2 months were changed to sitagliptin at 25 or 12...
December 23, 2017: Clinical and Experimental Nephrology
Enrico Vidal, Nicholas C Chesnaye, Fabio Paglialonga, Bruno Minale, Giovanna Leozappa, Mario Giordano, Bruno Gianoglio, Ciro Corrado, Rosa Maria Roperto, Roberto Chimenz, Francesca Mencarelli, Ilse-Maria Ratsch, Luisa Murer, Enrico Verrina
Data concerning outcomes of children on hemodialysis (HD) and peritoneal dialysis (PD) are scarce and frequently derived from single-center experiences. We sought to compare survival and transplantation rates in a large cohort of PD and HD patients. We extracted all patients initiating dialysis under 16 years of age between 2004 and 2013 from the Italian Registry of Pediatric Chronic Dialysis. Patients on PD were propensity-matched to those on HD based on gender, age, primary cause of ESRD, and the number of co-morbidities...
November 16, 2017: European Journal of Pediatrics
Michel Fischbach, Elke Wühl, Sylvie C Meyer Reigner, Zoe Morgan, Franz Schaefer
BACKGROUND AND OBJECTIVES: The study was conducted to identify a conversion factor for switching from previous erythropoiesis-stimulating agents (ESAs) to continuous erythropoietin receptor activator-methoxy polyethylene glycol-epoetin beta (C.E.R.A.) and to document the efficacy and long-term safety of C.E.R.A. in pediatric patients with anemia of CKD undergoing hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this open-label, multicenter study, patients aged 6-17 years, with stable chronic anemia of CKD, undergoing hemodialysis received C...
January 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Rosaria Del Giorno, Lorenzo Berwert, Silvio Pianca, Giorgia Bianchi, Olivier Giannini, Luca Gabutti
INTRODUCTION: Thrombocytopenia is a potential complication of hemodialysis (HD), and its occurrence has been described even with highly biocompatible polysulfone (PSf) membranes. Dialysis units routinely monitor platelet (PLT) count at the beginning of HD sessions. However, considering that the long-term effects on PLT count could easily be missed, the prevalence of HD-related thrombocytopenia could be underestimated. In the present study, we aimed to investigate the following: 1) the long-term impact of HD treatment on PLT count, comparing two families of dialysis membranes made up of similar PSfs; 2) whether the switch between the dialysis membranes studied significantly affects PLT count; and 3) the prevalence and the risk of HD-induced thrombocytopenia according to the dialysis membranes used...
2017: Therapeutics and Clinical Risk Management
Jonathan C Cho, Matthew P Crotty, Bryan P White, Marylee V Worley
Delafloxacin is a new fluoroquinolone antimicrobial approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in adults using dosage regimens of 300 mg intravenously every 12 hours, 450 mg orally every 12 hours, or switching from intravenous to oral regimens for a 5- to 14-day treatment duration. Dosage adjustments in patients with severe renal dysfunction (estimated glomerular filtration rate [eGFR] = 15-29 ml/min/1.73 m2 ) are not required for oral doses but should be decreased to 200 mg intravenously every 12 hours in patients requiring parenteral therapy...
January 2018: Pharmacotherapy
Bancha Satirapoj, Rattanawan Dispan, Ouppatham Supasyndh
BACKGROUND: Anemia associated with chronic kidney disease (CKD) often requires treatment with recombinant human erythropoietin (EPO). This study investigated the therapeutic equivalence between lyophilized powder and standard liquid EPO alfa by subcutaneous (SC) administration in hemoglobin maintenance among patients on hemodialysis. METHODS: This was a single-blinded, randomized, controlled, single-center, parallel-group study regarding the treatment of anemia among CKD patients on hemodialysis and being treated with stable doses of EPO alfa at least for 12 weeks...
2017: International Journal of Nephrology and Renovascular Disease
Maen Aboul Hosn, Zeina Nasser, Elias Elias, Walid Medawar, Majida Daouk, Jamal Hoballah, Fady Haddad
BACKGROUND: Shifting from a short-term catheter to a long-term one is done either by removing the old catheter and placing a new long-term one via fresh new puncture site, or by replacing the old catheter with a long-term one over a guidewire. AIM: We aimed to describe our technique in changing a temporary line to a long-term catheter (LTC) over a guidewire and to determine the incidence of line-related infections following this procedure. MATERIALS AND METHODS: A retrospective pilot study was conducted between 2005 and 2010 at the American University of Beirut Hospital...
November 2017: Clinical Nephrology
S Izoard, L Ayzac, J Meynier, J-C Seghezzi, B Jolibois, M L Tolani
BACKGROUND: International guidelines recommend to limit the long-term use of central-veinous catheters in patients undergoing hemodialysis, because they expose the patient to a higher infectious risk than the fistulas. However, for some patients with comorbidity, switching to a permanent vascular access is not possible. In such case, the catheter is used for a longer period. It seems therefore important to study the influence of a prolonged duration of catheterization on infectious complications...
September 22, 2017: Néphrologie & Thérapeutique
Satoru Mitsuboshi, Hitoshi Yamada, Kazuhiko Nagai, Hideo Okajima
To determine the response of hemodialysis (HD) patients to topiroxostat after a switch from febuxostat, we evaluated the efficacy, tolerability, and serum concentration of topiroxostat in HD patients after the switch. In this 16-month prospective observational study, we assessed the serum uric acid (UA) levels, other laboratory data, and serum topiroxostat concentrations of 10 HD patients who had been receiving febuxostat at a dose of 10 mg/d for over 1 year. No statistical difference was observed between the tolerability index at baseline and 16 months after the switch to topiroxostat...
2017: Biological & Pharmaceutical Bulletin
Mohamed Belmouaz, Jeremy Diolez, Marc Bauwens, Fabien Duthe, Laure Ecotiere, Estelle Desport, Frank Bridoux
BACKGROUND: Recent data suggest that the use of medium cut-off (MCO) dialyzers in hemodialysis (HD) promotes greater clearance and reduction ratio (RR) for myoglobin and other large-sized molecules than on-line hemodiafiltration (ol-HDF), but its effects on β2-microglobulin are not clear. We compared RR and clearances of small and middle-sized molecules between high-flux ol-HDF and MCO (Theranova) dialyzer in HD (MCO-HD) as well as nutritional parameters. MATERIALS AND METHODS: We retrospectively analyzed 10 patients treated first with ol-HDF who were thereafter switched to MCO-HD over a 1-year period...
August 30, 2017: Clinical Nephrology
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