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Haemodialysis

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https://www.readbyqxmd.com/read/28100952/gangrene-of-the-hand-following-a-haemodialysis-access-lessons-to-be-learnt
#1
Gaurav Aggarwal, Samiran Das Adhikary
Renal replacement therapy is a "way of life" for patients with chronic kidney disease (CKD), and haemodialysis forms their "lifeline". Haemodialysis access, via a small surgery, to anastomose an artery and a vein in the arm or forearm, is the universally accepted standard of care. However, even this minor surgical intervention can lead to devastating complications without adequate pre-operative evaluation and apt intra-operative decision making. The following article pictorically exemplifies the most dreaded complication of a gangrenous hand as well as highlights the lessons to be learnt, in order to avoid this infirmity...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28097800/inception-and-utility-of-a-renal-replacement-registry-using-administrative-health-data-in-north-east-italy
#2
Francesca Valent, Anna Busolin, Giuliano Boscutti
BACKGROUND: Disease registries are useful tools for public health planning, evaluating clinical practice and providing information on cohorts of patients. METHODS: The administrative databases of the regional health information system of Friuli Venezia Giulia, Italy were used to build a regional registry of the resident population in renal replacement therapy (including dialysis and renal transplantation), through an algorithm taking into account hospital discharge and outpatient ambulatory care data...
January 18, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28096230/haemodialysis-in-acute-paracetamol-poisoning
#3
L Serjeant, J Evans, F Sampaziotis, W G Petchey
A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigating N-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as a treatment option in selected cases of paracetamol overdose, consistent with the international guidelines...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28077410/health-policies-on-dialysis-modality-selection-a-nationwide-population-cohort-study
#4
Yi-Chun Lin, Yen-Chung Lin, Chih-Chin Kao, Hsi-Hsien Chen, Chih-Cheng Hsu, Mai-Szu Wu
OBJECTIVES: In Taiwan, peritoneal dialysis (PD) and haemodialysis are fully accessible to patients with end-stage renal disease. However, the usage of PD is considered low in Taiwan. Since 2005, 4 major policies have been implemented by Taiwan's Ministry of Health and Welfare, namely a multidisciplinary predialysis care programme and usage increasing the PD incidence as a key performance indicator (KPI) for hospital accreditation, both of which were implemented in 2006; reimbursement of the glucose-free dialysate, icodextrin that was implemented in 2007; and insurance reimbursement for renting automated PD machines that was implemented in 2008...
January 11, 2017: BMJ Open
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
#5
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/28062418/103-year-old-on-dialysis-was-it-worth-it
#6
Alvin Shrestha, Aine Burns
It is increasingly common for nephrologists to be faced with the question of whether starting dialysis on an elderly patient is appropriate. We present an extraordinary case of a 103-year-old person who has become the oldest patient in our unit, reportedly the world, to not only remain on haemodialysis, but to thrive on it. This case adds to the compelling literature, which suggests that it is indeed the number and severity of comorbidities that is more likely to impact survival than age alone.
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28058703/fatal-outcome-of-haemodialysis-catheter-malposition-into-the-hepatic-vein-causing-budd-chiari-syndrome
#7
Mohammad Ali Husainy, Rajdeep Chhina, Riad Alchanan, Praveen Peddu
No abstract text is available yet for this article.
January 3, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28057873/attainment-of-guideline-targets-in-eurodopps-haemodialysis-patients-are-differences-related-to-a-country-s-healthcare-expenditure-and-nephrologist-workforce
#8
Sophie Liabeuf, Karlijn J Van Stralen, Fergus Caskey, Francesca Tentori, Ronald L Pisoni, Ayesha Sajjad, Kitty J Jager, Ziad A Massy
BACKGROUND: In the field of chronic kidney disease, global clinical practice guidelines have been developed and implemented with a view to improving patient care and outcomes. The attainment of international and European guideline targets for haemodialysis patients in European countries has not been audited recently. Hence, we sought to establish whether the attainment of the targets set out in guidelines and inappropriate care are similar across European countries and whether inter-country differences are related to disparities in national healthcare expenditures (as a percentage of gross domestic product) and/or the nephrologist workforce per capita...
January 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28057872/a-phase-3-multicentre-randomized-double-blind-placebo-controlled-parallel-group-study-to-evaluate-the-efficacy-and-safety-of-etelcalcetide-ono-5163-amg-416-a-novel-intravenous-calcimimetic-for-secondary-hyperparathyroidism-in-japanese-haemodialysis-patients
#9
Masafumi Fukagawa, Keitaro Yokoyama, Takashi Shigematsu, Takashi Akiba, Akifumi Fujii, Takuto Kuramoto, Motoi Odani, Tadao Akizawa
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a major complication associated with chronic kidney disease. We evaluated the efficacy and safety of etelcalcetide (ONO-5163/AMG 416), a novel intravenous calcimimetic, in Japanese haemodialysis patients with SHPT. METHODS: In this phase 3, multicentre, randomized, double-blind, placebo-controlled, parallel-group study, etelcalcetide was administered three times per week at an initial dose of 5 mg, and subsequently adjusted to doses between 2...
January 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28056864/skin-and-plasmaautofluorescence-in-hemodialysis-with-glucose-free-or-glucose-containing-dialysate
#10
Bernd Ramsauer, Gerwin Erik Engels, Reindert Graaff, Aleksandar Sikole, Stefan Arsov, Bernd Stegmayr
BACKGROUND: Haemodialysis (HD) patients suffer from an increased risk of cardiovascular disease (CVD). Skin autofluorescence (SAF) is a strong marker for CVD. SAF indirectly measures tissue advanced glycation end products (AGE) being cumulative metabolites of oxidative stress and cytokine-driven inflammatory reactions. The dialysates often contain glucose. METHODS: Autofluorescence of skin and plasma (PAF) were measured in patients on HD during standard treatment (ST) with a glucose-containing dialysate (n = 24)...
January 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28056851/quality-of-life-in-patients-on-chronic-dialysis-in-south-africa-a-comparative-mixed-methods-study
#11
Elliot K Tannor, Elize Archer, Kenneth Kapembwa, Susan C van Schalkwyk, M Razeen Davids
BACKGROUND: The increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic haemodialysis (HD) and peritoneal dialysis (PD). METHODS: We conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis...
January 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28052529/successful-salvage-and-reconstruction-of-a-finger-threatened-by-vibrio-vulnificus-necrotising-fasciitis-using-fenestrated-type-artificial-dermis-and-three-steps-of-topical-negative-pressure-wound-therapy
#12
Chi-Yu Wang, Hao-Yu Chiao, Chang-Yi Chou, Chien-Ju Wu, Chun-Kai Chang, Tzi-Shiang Chu, Niann-Tzyy Dai
Vibrio vulnificus can cause severe skin and soft tissue infection (SSTI). The pathogen is an opportunistic marine bacterium that is likely to infect patients with chronic liver disease, patients in an immunocompromised state, and those in end-stage renal disease. V. vulnificus gains entry through soft tissues by direct penetration of a wound by infected marine organisms, such as raw oysters, shellfish and other seafood, or by exposing a wound to contaminated water. Despite its ease of entry, V. vulnificus necrotising fasciitis with compartment syndrome has rarely been described...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28052451/a-clinical-study-on-low-molecular-weight-heparin-infusion-as-anticoagulation-for-nocturnal-home-haemodialysis
#13
Steve Siu-Man Wong, Wai-Yan Lau, Man-Luen Ng, Shuk-Yin Chan, So-Fan Chan, Ping-Kwan Chan, Ching-Kit Wan, Yuk-Lun Cheng
AIM: This study was conducted to evaluate low-molecular weight heparin (LMWH) as anticoagulation for nocturnal home haemodialysis (NHHD). Whilst its longer half-life may cause drug accumulation in frequent dialysis, the essential need of a supplementary intra-dialytic bolus for the sleeping patients also renders LMWH's use impractical. METHODS: The recruited patients, who were on alternate-day 8-hour haemodialysis, were randomized to receive either nadroparin or unfractionated heparin (UFH) for a week...
January 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28045760/bleeding-risk-of-anti-thrombotic-treatment-in-patients-on-haemodialysis
#14
Eduardo Vázquez, Carmen Sánchez-Perales, Sonia Ortega, Teresa Vázquez-Sánchez, Enrique Quesada, Daniel Salas, Juan Carlos Fernández-Guerrero
BACKGROUND: The risk-benefit of anti-thrombotic treatment (ATT) has not been established in patients on dialysis. Our objective was to determine the influence of ATT on the risk of haemorrhage in patients on haemodialysis. METHODS: We included patients who began dialysis between 2003 and 2007. We determined the rates of fatal bleeding or bleeding leading to hospitalisation or transfusion. RESULTS: 221 patients were included. Over the follow-up period (45...
December 28, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28044237/relationship-between-plasma-levels-of-zonulin-bacterial-lipopolysaccharides-d-lactate-and-markers-of-inflammation-in-haemodialysis-patients
#15
Joanna Ficek, Katarzyna Wyskida, Rafał Ficek, Jarosław Wajda, Dariusz Klein, Joanna Witkowicz, Sylwia Rotkegel, Urszula Spiechowicz-Zatoń, Joanna Kocemba-Dyczek, Jarosław Ciepał, Andrzej Więcek, Magdalena Olszanecka-Glinianowicz, Jerzy Chudek
BACKGROUND: Increased permeability of the intestinal wall and intestinal dysbiosis may contribute to chronic systemic inflammation, one of the causes of accelerated atherosclerosis and cardiovascular morbidity and mortality burden in patients with chronic kidney disease. The aim of this study was to evaluate the association between markers of intestinal permeability and inflammation in haemodialysis (HD) patients. METHODS: Plasma concentration of zonulin, haptoglobin, TNFα, IL6, D-lactates and bacterial lipopolysaccharides (LPS) was assessed in blood samples obtained after overnight fast before midweek morning HD session in 150 stable, prevalent HD patients...
January 2, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28043216/hybrid-haemodialysis-vascular-access-salvage
#16
Maja Potisek, Tomaž Ključevšek, Boštjan Leskovar
A well-functioning vascular access is essential for successful haemodialysis in patients with end-stage kidney failure. Sometimes, when we have exploited all conventional ways of vascular access salvage, we have to find a unique solution to preserve it.
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January 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28039288/how-long-do-patients-with-chronic-disease-expect-to-live-a-systematic-review-of-the-literature
#17
Barnaby Hole, Joseph Salem
OBJECTIVE: To systematically identify and summarise the literature on perceived life expectancy among individuals with non-cancer chronic disease. SETTING: Published and grey literature up to and including September 2016 where adults with non-cancer chronic disease were asked to estimate their own life expectancy. PARTICIPANTS: From 6837 screened titles, 9 articles were identified that met prespecified criteria for inclusion. Studies came from the UK, Netherlands and USA...
December 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/28033185/use-of-the-body-composition-monitor-for-fluid-status-measurements-in-elderly-malnourished-subjects
#18
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/28033104/micronuclei-and-other-nuclear-anomalies-in-buccal-epithelial-cells-of-children-with-chronic-kidney-disease
#19
Banu Aykanat, Gonca Cakmak Demircigil, Necla Buyan, Esra Baskin, Kaan Gulleroglu, Kibriya Fidan, Umut Selda Bayrakci, Aydin Dalgic, Hamdi Karakayali, Mehmet Haberal, Sema Burgaz
The objective of this study was to reveal the likely genomic instability in children with chronic kidney disease (CKD) using micronucleus (MN) assay on buccal epithelial cells (BEC). We investigated the frequencies of micronuclei and other nuclear anomalies, such as nuclear buds, binucleated cells, condensed chromatin, and karyorrhectic and pyknotic cells in BEC. Children with CKD were grouped as follows: children in the pre-dialysis (PreD) stage (N=17), children on regular haemodialysis (HD) (N=14), and children who have undergone transplantation (Tx) (N=17)...
December 1, 2016: Arhiv za Higijenu Rada i Toksikologiju
https://www.readbyqxmd.com/read/28029154/changes-in-the-worldwide-epidemiology-of-peritoneal-dialysis
#20
REVIEW
Philip Kam-Tao Li, Kai Ming Chow, Moniek W M Van de Luijtgaarden, David W Johnson, Kitty J Jager, Rajnish Mehrotra, Sarala Naicker, Roberto Pecoits-Filho, Xue Qing Yu, Norbert Lameire
As the global burden of chronic kidney disease continues to increase, so does the need for a cost-effective renal replacement therapy. In many countries, patient outcomes with peritoneal dialysis are comparable to or better than those with haemodialysis, and peritoneal dialysis is also more cost-effective. These benefits have not, however, always led to increased utilization of peritoneal dialysis. Use of this therapy is increasing in some countries, including China, the USA and Thailand, but has proportionally decreased in parts of Europe and in Japan...
February 2017: Nature Reviews. Nephrology
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