Predictors switching dialysis

PURPOSE: The lifespan of maintenance hemodialysis patients is reduced mainly because of cardiovascular complications due to accelerated atherosclerosis and impaired angiogenesis. We aimed to compare the effect of unfractionated heparin (UFH) and enoxaparin used as anticoagulants during hemodialysis (HD) on circulating levels of heparin-binding, anti-angiogenic Endostatin, pro-inflammatory RANTES (Regulated upon Activation, Normal T cell Expressed and Secreted), and MCP-1 (Monocyte Chemoattractant Protein-1)...

BACKGROUND: Chronic hepatitis B patients (CHB) treated with adefovir were followed up to evaluate nephrotoxicity and its outcome. AIM: To assess the incidence of renal dysfunction during adefovir therapy in Asian patients and factors associated with it, and evaluate strategies to improve adefovir-related renal dysfunction and their impact on viral suppression. METHODS: Chronic hepatitis B clinic patients from a tertiary hospital on adefovir treatment, with their clinical and laboratory parameters were extracted from the hospital electronic clinical database in an observational study design...

BACKGROUND: There is growing evidence that transradial (TRI) as compared to transfemoral (TFI) percutaneous coronary intervention (PCI) is associated with improved clinical outcome driven by less hemorrhagic complications, in particular in STEMI patients receiving aggressive antithrombotic treatment. Feasibility rate of TRI in STEMI patients has not yet been evaluated. METHODS/RESULTS: Four-hundred seventy-five consecutive STEMI patients (<12h) without cardiogenic shock were prospectively screened for this all-comer single-centre registry between January 2008 and August 2010...

To examine the relationship between dialysis modality and prognosis in Japanese patients, we conducted a prospective multicenter observational study. We recruited 83 background-matched peritoneal dialysis (PD) and 83 hemodialysis (HD) patients (average age, 64.9 years; men, 53.6%; diabetic patients, 22.9%; median duration of dialysis, 48 months in all patients) and followed them for 5 years. During the follow-up period, 27 PD patients (16 cardiovascular and 11 non-cardiovascular deaths) and 27 HD patients died (14 cardiovascular and 13 non-cardiovascular deaths)...

AIM: The aim of this study is to investigate the mortality and the factors which may affect it in patients who were transferred to peritoneal dialysis (PD) from hemodialysis (HD), compared to patients assigned to PD as first-line therapy. MATERIAL AND METHODS: A total of 322 patients treated with PD between 2001 and 2010 were evaluated retrospectively. Twenty three patients were excluded and the data of remaining 299 patients (167F, mean follow up time 38.5±26...

BACKGROUND: Peritoneal dialysis (PD) technique failure is high compared to hemodialysis (HD). There is a lack of data on the impact of duration of PD treatment on technique survival and on whether there is a difference in risk factors with respect to early and late failure. The aim of this study was to clarify these issues by performing a time-dependent analysis of PD technique and patient survival in a large cohort of incident PD patients. METHODS: We analyzed 709 incident PD patients participating in the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD), who started their treatment between 1997 and 2007...

BACKGROUND: The use of peritoneal dialysis (PD) has declined in the United States over the past decade and technique failure is also reportedly higher in PD compared to hemodialysis (HD), but there are little data in the United States addressing the factors and outcomes associated with switching modalities from PD to HD. METHODS: In a prospective cohort study of 262 PD patients enrolled from 28 peritoneal dialysis clinics in 13 U.S. states, we examined potential predictors of switching from PD to HD (including demographics, clinical factors, and laboratory values) and the association of switching with mortality...

OBJECTIVES: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association. METHODS: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively. RESULTS: A ventricular septal defect was present in 186 (30%) patients...

BACKGROUND: A change in the licensing arrangements for the use of erythropoietin alpha in haemodialysis patients has required a switch in the route of administration from subcutaneous (SC) to intravenous (IV). Previous work suggested that the IV route was less efficacious but studies since the enforced switch have not confirmed this. METHODS: We studied haemoglobin levels and the mean weekly dose of erythropoietin alpha in 86 haemodialysis patients at monthly intervals over the 6 month period before and after a change in the route of administration of erythropoietin alpha from SC to IV...

BACKGROUND: Serum cardiac troponin T (cTnT) levels are elevated in a high percentage of hemodialysis (HD) patients and as a result, they have been considered low specificity for ischemic heart disease (IHD). Recently, several authors have indicated the value of cTnT as a marker of IHD and left ventricular hypertrophy (LVH), as well as a mortality predictor. We try to establish the value of cTnT as an IHD marker and a mortality predictor in our patients on HD. SUBJECTS AND METHODS: Fifty-eight HD patients were prospectively studied from October 2000 to April 2002...

Diabetes mellitus is increasing, and in some countries is the single most important cause, for end-stage renal disease. In general, primarily elderly patients on renal replacement therapy, are not only affected by diabetes-related long-term complications, but also frequently with a wide range of co-morbidities. Apart from cardiac complications, the patients are subject to a wide range of vascular (i.e. peripheral vascular disease, stroke) and infectious complications. In the past this has been reflected by a relatively poor survival rate on dialysis, and minimized chances to obtain renal transplantation...

BACKGROUND: Hyperleptinaemia in chronic haemodialysis (CHD) patients has been associated with malnutrition, which is an independent predictor of morbidity and mortality in this patient group. METHODS: To assess the influence of HD on plasma leptin, 10 CHD patients were crossover randomized to low-flux polysulfone (PS: F 6HPS), high-flux PS (F 60S), super-flux PS (F 500S) or super-flux cellulose-tri-acetate (CTA: Tricea 150G) for 12 weeks each. Blood samples were collected at the start of the study and each 12-week period...

BACKGROUND: Relative blood volume (RBV) changes during hemodialysis (HD) are poorly understood. We wish to define characteristics of RBV profiles at different hydration states predictive of hemodynamic instability. METHODS: Thirty patients underwent online RBV monitoring during an HD session with intermittent ultrafiltration (UF) pulses administered until the onset of hypotension. The RBV decay constant (tau) was derived from curve fitting. Linear divergence, the net deviation of the RBV curve during UF from predicted linear decay, was computed from initial 1-minute slopes...

BACKGROUND: Recent investigation has shown that on-line hemodiafiltration (HDF) can reduce the amount of recombinant human erythropoietin (rhEPO) deemed necessary to reach the target hematocrit. The aim of this study was to analyze the potential effect of on-line HDF on rhEPO resistance in relation to iron utilization and anemia-related parameters, when compared to conventional hemodialysis (HD). METHODS: Ninety-two chronic uremic patients were treated with conventional HD and then shifted to on-line HDF...

Malnutrition affects up to half of all chronic dialysis patients and is an important predictor of mortality, but the efficacy of interventions designed to improve the nutritional status of dialysis patients has been poorly studied. Specifically, although enteral tube feeding is often cited as an important option in the treatment of malnourished dialysis patients, there are few studies examining the effectiveness and complications of enteral tube feedings in adults on dialysis. We performed a retrospective analysis of a small cohort (n = 10) of chronic hemodialysis patients who received enteral tube feeding as all or part of their nutrition between January 1 and May 1, 1999, with follow-up through May 1, 2000, to assess the efficacy and complications of enteral tube feeding...

BACKGROUND: Renal vascular thrombosis (RVT) is a rare but catastrophic complication of renal transplantation. Although a plethora of risk factors has been identified, a large proportion of cases of RVT is unexplained. Uremic coagulopathy and dialysis modality may predispose to RVT. We investigated the impact of the pretransplant dialysis modality on the risk of RVT in adult renal transplant recipients. METHODS: Renal transplant recipients (age 18 years or more) who were enrolled in the national registry between 1990 and 1996 (N = 84,513) were evaluated for RVT occurring within 30 days of transplantation...

The current report describes the distributions of selected demographic and biochemical parameters, clearance, and other transport values among patients undergoing peritoneal dialysis (PD) and evaluates the associates of mortality using those values, with and without clearance and peritoneal equilibration test (PET) data. All patients receiving PD on January 1, 1994 were selected (n = 2,686). Patients who switched to another form of dialysis during the study period were removed from the study at the time of therapy change...

Survival estimates were performed on 683 chronic dialysis patients who started dialysis from 1970 through 1989 and followed through 1991. Patients were grouped by dialysis type, renal diagnosis, start-year group and age at start. During these 20 entry, years, the median starting age rose from 47 to 61 years. Patients with a renal diagnosis of diabetes mellitus or renal vascular disease increased to 41% of those starting dialysis during the last 8 years of study. Survival analysis for all of the 683 patients revealed a 51-month median survival and a 43% and 23% 5- and 10-year survival estimates, respectively...