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Haemodialysis

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https://www.readbyqxmd.com/read/29678992/clinicians-and-researchers-perspectives-on-establishing-and-implementing-core-outcomes-in-haemodialysis-semistructured-interview-study
#1
Allison Tong, Sally Crowe, John S Gill, Tess Harris, Brenda R Hemmelgarn, Braden Manns, Roberto Pecoits-Filho, Peter Tugwell, Wim van Biesen, Angela Yee Moon Wang, David C Wheeler, Wolfgang C Winkelmayer, Talia Gutman, Angela Ju, Emma O'Lone, Benedicte Sautenet, Andrea Viecelli, Jonathan C Craig
OBJECTIVES: To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact. DESIGN: Face-to-face, semistructured interviews; thematic analysis. STETTING: Twenty-seven centres across nine countries. PARTICIPANTS: Fifty-eight nephrologists (42 (72%) who were also triallists). RESULTS: We identified six themes: reflecting direct patient relevance and impact (survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus); amenable and responsive to interventions (realistic and possible to intervene on, differentiating between treatments); reflective of economic burden on healthcare; feasibility of implementation (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); authoritative inducement and directive (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); instituting patient-centredness (explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life)...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29672277/early-flow-disturbances-of-tunnelled-haemodialysis-catheters-and-topographic-landmarks-in-chest-x-ray
#2
Jeanette Fahnert, Patrick Stumpp, Thomas Kahn, Frieder Keller, Stephan Schiekofer, Sirak Petros, Jan Halbritter, Tom H Lindner, Franz Maximilian Rasche
BACKGROUND/AIMS: The position of the tip of tunnelled haemodialysis (HD) catheters (THC) might influence flow characteristics during HD. In chest X-ray (CXR), carina-related landmarks may be practicable to verify the THC position, and tip-carina distance (TCD) might be useful to predict early-flow dysfunctions. METHODS: In this single-centre, retrospective study, the TCD and the angle between the distal catheter and the body vertical axis (tip-body vertical-angle [TVA]) was measured in 115 THC by post-procedure CXR with 2 investigators...
April 19, 2018: Blood Purification
https://www.readbyqxmd.com/read/29669765/ribavirin-induced-anaemia-reduced-tacrolimus-level-in-a-hepatitis-c-patient-receiving-haemodialysis
#3
Hin-Yee Liu, Catherine Yuen Shan Cheung, Susan Elizabeth Cooper
A 37-year-old man with hepatitis C virus (HCV) genotype 3A developed renal failure. In 2007, the patient received a renal transplant and started receiving tacrolimus (Tac); the transplant subsequently failed. In April 2015, the patient restarted haemodialysis and in May initiated sofosbuvir 400 mg and ribavirin 400 mg daily. Baseline Tac level was 6.6 ng/mL and haemoglobin (Hb) was 10.3 g/dL. The patient then left the country for vacation and Hb was found to be dramatically low at 3.7 g/dL on return on 5 August...
April 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29669332/paritaprevir-ritonavir-ombitasvir-plus-dasabuvir-regimen-in-the-treatment-of-genotype-1-chronic-hepatitis-c-infection-in-patients-with-severe-renal-impairment-and-end-stage-renal-disease-a-real-life-cohort
#4
Jan Sperl, Miluse Kreidlova, Dusan Merta, Klara Chmelova, Renata Senkerikova, Sona Frankova
BACKGROUND/AIMS: Chronic hepatitis C (HCV) virus infection reactivates under immunosuppressive drugs and therefore has a negative impact on long-term survival of kidney transplant recipients. Treatment-induced clearance of hepatitis C virus (HCV) in kidney transplant candidates prevents virus reactivation after transplantation. Paritaprevir/Ritonavir/Ombitasvir with Dasabuvir (PrOD) represents a highly effective treatment regimen for HCV genotype 1 (GT1), also suitable for patients with end-stage renal disease (ESRD)...
April 13, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29665795/design-and-methods-of-the-removal-hd-study-a-trial-evaluating-mid-cut-off-value-membrane-clearance-of-albumin-and-light-chains-in-haemodialysis-patients
#5
R Krishnasamy, C M Hawley, M J Jardine, M A Roberts, Y J Cho, M G Wong, A Heath, C L Nelson, S Sen, P F Mount, E M Pascoe, D Darssan, L A Vergara, P A Paul-Brent, N D Toussaint, D W Johnson, C A Hutchison
BACKGROUND: Removal of uraemic toxins is inadequate using current dialysis strategies. A new class of dialysis membranes have been developed that allow clearance of larger middle molecules. The REMOVAL-HD study (a tRial Evaluating Mid cut-Off Value membrane clearance of Albumin and Light chains in HaemoDialysis patients) will address safety, efficacy and the impact on patient-centred outcomes with the use of a mid cut-off (MCO) dialyser in a chronic haemodialysis (HD) population. METHODS: REMOVAL-HD is an open label, prospective, non-randomised, single-arm, multi-centre device study in 85 chronic HD participants...
April 17, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29664189/hydration-and-nutritional-status-in-patients-on-home-dialysis-a-single-centre-study
#6
Janet S C Li, John Y H Chan, Mandy M Y Tai, So M Wong, S M Pang, Fanny Y F Lam, Carmen H M Chu, Chris S Y Ching, Joseph H S Wong, W L Chak
BACKGROUND: Over-hydration (OH) and malnutrition are prevalent among patients on dialysis therapy. The prevalence of OH and malnutrition as well as the risk factors associated with OH and malnutrition in our patients on home peritoneal dialysis (PD) and home haemodialysis (HD) are examined. DESIGN AND METHODS: This was a cross-sectional study. The hydration and nutritional status of the study groups were assessed by a Body Composition Monitor. Patients who were stable on home dialysis therapy for over one year were invited to participate...
April 17, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29664179/developing-and-pilot-testing-a-shared-decision-making-intervention-for-dialysis-choice
#7
Jeanette Finderup, Jens K D Jensen, Kirsten Lomborg
BACKGROUND: Evidence is inconclusive on how best to guide the patient in decision-making around haemodialysis and peritoneal dialysis choice. International guidelines recommend involvement of the patient in the decision to choose the dialysis modality most suitable for the individual patient. Nevertheless, studies have shown lack of involvement of the patient in decision-making. OBJECTIVES: To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality...
April 17, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29664034/incidence-prognosis-of-acute-kidney-injury-in-individuals-of-snakebite-in-a-tertiary-care-hospital-in-india
#8
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29658218/-burden-of-healthcare-associated-infections-in-outpatient-care
#9
Walter Zingg, Aliki Metsini, Qiao Fu, Diana Neves, Didier Pittet
There is little evidence on healthcare-associated infections in outpatient care. The Swiss Federal Office for Public Health commissioned a systematic review to estimate the incidence of healthcare-associated infections in non-institutional settings. A total of 126 papers were eligible for data abstraction. The identified reports and studies were heterogeneous and generally of low quality. The main outcomes were surgical site infections, central venous catheter-related bloodstream infections, and urinary tract infections...
April 11, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29656667/haemodialysis-at-home-review-of-current-dialysis-machines
#10
Sabrina Haroon, Andrew Davenport
Only a minority of patients with chronic kidney disease treated by hemodialysis are currently treated at home. Until relatively recently, the only type of hemodialysis machine available for these patients was a slightly smaller version of the standard machines used for in-center dialysis treatments. Areas covered: There are now an alternative generation of dialysis machines specifically designed for home hemodialysis. The home dialysis patient wants a smaller machine, which is intuitive to use, easy to trouble shoot, robust and reliable, quick to set-up and put away, requiring minimal waste disposal...
April 14, 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29652680/impact-of-intra-operative-fluid-and-noradrenaline-administration-on-early-postoperative-renal-function-after-cystectomy-and-urinary-diversion-a-retrospective-observational-cohort-study
#11
Marc A Furrer, Marc P Schneider, Lukas M Löffel, Fiona C Burkhard, Patrick Y Wuethrich
BACKGROUND: The use of noradrenaline to enable a restrictive approach to intra-operative fluid therapy to avoid salt and water overload has gained increasing acceptance. However, concerns have been raised about the impact of this approach on renal function. OBJECTIVES: To identify risk factors for acute kidney injury (AKI) in patients undergoing cystectomy with urinary diversion and determine whether administration of noradrenaline and intra-operative hydration regimens affect early postoperative renal function...
April 12, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29649802/is-there-not-sufficient-evidence-to-show-that-haemodiafiltration-is-superior-to-conventional-haemodialysis-in-treating-end-stage-kidney-disease-patients
#12
Bernard Canaud, Ellen Busink, Christian Apel, Sudhir K Bowry
No abstract text is available yet for this article.
April 12, 2018: Blood Purification
https://www.readbyqxmd.com/read/29644070/intravenous-drug-users-who-require-dialysis-causes-of-renal-failure-and-outcomes
#13
Jemima K Scott, Dominic M Taylor, Chris R K Dudley
Background: Intravenous drug use is associated with progressive kidney disease of several aetiologies. It is associated with behavioural and lifestyle characteristics that make the provision of renal replacement therapies (RRTs) challenging. We observed that patients who use intravenous drugs [people who inject drugs (PWID)] present late to renal services and struggle to engage with treatment. We describe the experience of a UK centre providing renal services to a mixed city and rural population...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29644064/intensive-haemodialysis-using-pmma-dialyser-does-not-increase-renal-response-rate-in-multiple-myeloma-patients-with-acute-kidney-injury
#14
Laurent Hudier, Olivier Decaux, Atmann Haddj-Elmrabet, Marie Lino, Lise Mandart, Pascale Siohan, Eric Renaudineau, Theophile Sawadogo, Thierry Lamy De La Chapelle, Emmanuel Oger, Frank Bridoux, Cécile Vigneau
Background: Intensive haemodialysis (IHD) in addition to bortezomib-based chemotherapy might be efficient to rapidly decrease serum immunoglobulin-free light chains removal in patients with multiple myeloma (MM) and to improve renal prognosis and survival. Methods: The aim of this retrospective multi-centre study was to compare the efficacy (renal recovery rate) of IHD and of standard haemodialysis (SHD) in patients with MM and dialysis-dependent acute kidney injury (AKI), concomitantly treated with bortezomib-based chemotherapy...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29642725/comparison-of-methods-to-estimate-haemodialysis-urea-clearance
#15
Ahmed Mohamed, Andrew Davenport
INTRODUCTION: Dialysis adequacy is traditionally measured by monthly blood urea sampling and calculating sessional Kt/Vurea. Modern dialysis machines can estimate clearances each session, so we wished to compare online measurements with standard Kt/Vurea. METHODS: Urea clearance was estimated by intermittent changes in effective ionic dialysance and by continuous ultraviolet light absorption spent during the mid-week dialysis session. Total body water was calculated by the Watson equation and measured by multifrequency bioimpedance...
April 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29623579/pharmacokinetics-safety-and-tolerability-of-oral-semaglutide-in-subjects-with-renal-impairment
#16
Charlotte Granhall, Flemming L Søndergaard, Mette Thomsen, Thomas W Anderson
BACKGROUND: Semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, has been co-formulated with the absorption enhancer sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC) as a tablet for oral administration. This trial (NCT02014259) investigated the pharmacokinetics, safety and tolerability of oral semaglutide in subjects with and without renal impairment. METHODS: Subjects were categorised as having normal renal function (n = 24), mild (n = 12), moderate (n = 12) or severe (n = 12) renal impairment, or end-stage renal disease (ESRD) requiring haemodialysis (n = 11) and received once-daily oral semaglutide (5 mg for 5 days followed by 10 mg for 5 days) in the fasting state, followed by 30 min fasting after dosing...
April 6, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29622705/native-valve-endocarditis-fusarium-and-end-stage-renal-disease
#17
Supradip Ghosh, Atul Phillips, Sonali Ghosh, Amandeep Singh
We would like to report a case of invasive Fusariosis involving the native mitral valve and complicated by septic thromboembolism. The patient was a known case of end-stage renal disease on maintenance haemodialysis and did not have any of the known risk factors for invasive Fusariosis like neutropaenia, severe T cell immunodeficiency, postsolid organ transplant recipients, posthaematopoietic stem cell transplant recipients and patients who received cytotoxic and/or high-dose corticosteroid therapy.
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29616470/peritoneal-dialysis-as-initial-dialysis-modality-a-viable-option-for-late-presenting-end-stage-renal-disease
#18
REVIEW
Muhammad Masoom Javaid, Behram Ali Khan, Srinivas Subramanian
Late-presenting end-stage renal disease is a significant problem worldwide. Up to 70% of patients start dialysis in an unplanned manner without a definitive dialysis access in place. Haemodialysis via a central venous catheter is the default modality for the majority of such patients, and peritoneal dialysis is usually not considered as a feasible option. However, in the recent years, some reports on urgent-start peritoneal dialysis in the late-presenting end-stage renal disease have been published. The collective experience shows that PD can be a safe, efficient and cost-effective alternative to haemodialysis in late-presenting end-stage renal disease with comparable outcomes to the conventional peritoneal dialysis and urgent-start haemodialysis...
April 3, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29614907/haemodialysis-access-thrombosis-outcomes-after-surgical-thrombectomy-versus-catheter-directed-thrombolytic-infusion
#19
Linn Koraen-Smith, Matteus Krasun, Matteo Bottai, Ulf Hedin, Carl M Wahlgren, Peter Gillgren
INTRODUCTION: Thrombosis is one of the most common complications of dialysis vascular access and is a significant source of morbidity and healthcare-associated costs. In this retrospective study, outcomes for surgical thrombectomy and thrombolysis after access thrombosis in patients with arteriovenous fistulas or prosthetic grafts (arteriovenous grafts) were analysed. METHODS: All patients with a primary episode of dialysis access thrombosis between 2005 and 2013 were included which yielded 131 patients with 149 episodes of access thrombosis (108 arteriovenous grafts; 41 arteriovenous fistulas)...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29611250/differences-in-the-prevalence-of-sarcopenia-in-haemodialysis-patients-the-effects-of-gender-and-ethnicity
#20
S Yoowannakul, K Tangvoraphonkchai, S Vongsanim, A Mohamed, A Davenport
BACKGROUND: There is no universal consensus definition of sarcopenia, although there is agreement that sarcopenia is a risk factor for mortality in haemodialysis (HD) patients. We aimed to determine the effect of using different operational definitions in a multiracial group of HD patients. METHODS: We measured hand grip strength (HGS) and appendicular lean mass (ALM) by segmental bioimpedance using the Foundation for the National Institutes of Health Sarcopenia Project (FNIH), European Working Group on Sarcopenia (EWGS) and Asian Working Group on Sarcopenia definitions for HGS weakness and loss of appendicular lean mass...
April 2, 2018: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
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