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Survival hemodialysis

Inkyong Hur, Yong Kyu Lee, Kamyar Kalantar-Zadeh, Yoshitsugu Obi
BACKGROUND: Residual kidney function (RKF) is often expected to inevitably and rapidly decline among hemodialysis patients and, hence, has been inadvertently ignored in clinical practice. The importance of RKF has been revisited in some recent studies. Given that patients with end-stage renal disease now tend to initiate maintenance hemodialysis therapy with higher RKF levels, there seem to be important opportunities for incremental hemo-dialysis by individualizing the dose and frequency according to their RKF levels...
December 11, 2018: Cardiorenal Medicine
Johannes W Drouven, Cor de Bruin, Arie M van Roon, Job Oldenziel, Clark J Zeebregts
BACKGROUND: Radial-cephalic arteriovenous fistula and brachial-cephalic arteriovenous fistula are the first and second choices for creating vascular access in dialysis patients as recommended by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Basilic vein transposition or use of a forearm (polytetrafluoroethylene [PTFE]) loop graft is recommended thereafter. The aim of this study was twofold: first, to compare the outcomes and patency rates of patients treated with a basilic vein transposition with those of patients treated with a PTFE loop; and second, to identify patient-related factors of influence on patency rates...
October 24, 2018: Journal of Vascular Surgery
Jason K Wagner, Ellen Dillavou, Uttara Nag, Adham Abou Ali, Sandra Truong, Rabih Chaer, Eric Hager, Theodore Yuo, Michel Makaroun, Efthymios D Avgerinos
BACKGROUND: No independent comparisons, with midterm follow-up, of standard arteriovenous grafts (SAVGs) and immediate-access arteriovenous grafts (IAAVGs) exist. The goal of this study was to compare "real-world" performance of SAVGs and IAAVGs. METHODS: Consecutive patients who underwent placement of a hemodialysis graft between November 2014 and April 2016 were retrospectively identified from the electronic medical record and Vascular Quality Initiative database at two tertiary centers...
October 24, 2018: Journal of Vascular Surgery
Thomas A Mavrakanas, Karl Asfour, Murray Vasilevsky, Paul E Barré, Ahsan Alam
AIMS: Different prediction models have been established to estimate mortality in the dialysis population. This study aims to externally validate the different available mortality prediction models in an incident dialysis population. MATERIALS: This was a retrospective cohort study of incident hemodialysis and peritoneal dialysis patients at two academic tertiary care centers. METHODS: Three previously published prediction models were used: the Liu index, the Urea5 score, and a predictive model estimating the survival probability by Hemke et al...
December 11, 2018: Clinical Nephrology
Hanjie Zhang, Israel Campos, Lili Chan, Anna Meyring-Wösten, Leticia M Tapia Silva, Lemuel Rivera Fuentes, Priscila Preciado, Stephan Thijssen, Jeroen P Kooman, Frank M van der Sande, Peter Kotanko
BACKGROUND: Central venous oxygen saturation (ScvO2) is correlated with cardiac output. In most patients, ScvO2 declines during hemodialysis (HD) due to factors such as reduced preload, myocardial stunning, and intermittent arrhythmias. Previous research has shown that low ScvO2 is associated with higher mortality in chronic HD patients. In this research, we tested the hypothesis that ScvO2 variability is associated with all-cause mortality. METHODS: We conducted a retrospective study in 232 chronic HD patients with central venous catheter as vascular access...
December 6, 2018: Blood Purification
Kátia Alves Ramos, Cristiane Bitencourt Dias
INTRODUCTION: Among patients undergoing cardiac surgery, the occurrence of acute renal injury appears to be associated with worse prognosis and increased mortality. The objective of this study was to evaluate risk factors and the impact this complication on mortality and survival after cardiac surgery among patients without chronic kidney disease. METHODS: In this retrospective study, we reviewed the medical records of 142 patients who underwent elective coronary artery bypass grafting, valve replacement (single or multiple), or both (simultaneously) at a tertiary care hospital...
September 2018: Brazilian Journal of Cardiovascular Surgery
Yuan-Yi Miao, Cong-Min Xu, Min Xia, Huai-Qiu Zhu, Yu-Qing Chen
Background: Hyperphosphatemia is a risk factor associated with mortality in patients on maintenance hemodialysis. Gut absorption of phosphate is the major source. Recent studies indicated that the intestinal flora of uremic patients changed a lot compared with the healthy population, and phosphorus is an essential element of bacterial survival and reproduction. The purpose of this study was to explore the role of intestinal microbiota in phosphorus metabolism. Methods: A prospective self-control study was performed from October 2015 to January 2016...
December 5, 2018: Chinese Medical Journal
Luyao Ma, Qun Gu, Buqing Ni, Haoliang Sun, Xiangxiang Zhen, Shijiang Zhang, Yongfeng Shao
Background: To explore surgical management of complex coarctation of aorta (COA) concomitant with intracardiac abnormality, in order to provide recommendations for safe and reliable treatment. Methods: Totally, six adult cases demonstrating complex COA concomitant with intracardiac abnormality were reviewed from our department between May 2012 and June 2017. Four patients were male and two patients were female, the age range being 43.8±10.6 years old. The associated intracardiac abnormality included 3 aortic root aneurysms, 3 aortic insufficiency, 1 aortic stenosis, 3 mitral regurgitation (MR), 1 coronary artery disease (CAD), 1 patent ductus arteriosus (PDA) and 1 ventricular septal defect (VSD)...
October 2018: Journal of Thoracic Disease
Ting Yan, Wenhan Peng, Junhao Lv, Jianyong Wu, Jianghua Chen
BACKGROUND/AIMS: Hemodialysis (HD) or peritoneal dialysis (PD) is an important renal replacement method in patients with delayed graft function (DGF) after kidney transplantation; however, it is not clear which dialysis modality is superior. This study determined the impact of different dialysis modalities on patients with DGF. METHODS: It was a single-center, retrospective and descriptive study. We performed 673 kidney transplants from donors after cardiac death (DCD) between January 2010 and December 2016 at our center and 138 (20...
November 30, 2018: Kidney & Blood Pressure Research
Samuel L Brilleman, Margarita Moreno-Betancur, Kevan R Polkinghorne, Stephen P McDonald, Michael J Crowther, Jim Thomson, Rory Wolfe
BACKGROUND: The relationship between body mass index (BMI) and patient survival in end-stage kidney disease is not well understood and has been the subject of much debate over recent years. METHODS: This study used a latent class joint modeling approach to identify latent groups that underpinned associations between patterns of change in BMI during hemodialysis and two competing events: transplant and death without transplant. We included all adult patients who initiated chronic hemodialysis treatment in Australia or New Zealand between 2005 and 2014...
January 2019: Epidemiology
Yen-Hung Yao, Yiing-Jenq Chou, Nicole Huang
AIM: Existing studies on the association between hemodialysis facility size/volume and patient survival are mostly limited to freestanding dialysis units in the United States. This study in Taiwan explored the facility size-mortality association in both hospital-based and freestanding hemodialysis units. METHODS: In this nationwide population-based retrospective cohort study, we used the Taiwan National Health Insurance Research Database to patients who began maintenance hemodialysis between 2008 and 2012...
November 29, 2018: Nephrology
Jinnan Wan, Wenhuan Li, Yuan Zhong
BACKGROUND: The objective of this study was to assess the effect of parathyroidectomy (PTX) treatment on prolonging overall survival (OS) as well as decreasing levels of intact parathyroid hormone (iPTH), calcium (Ca), and phosphorus (P) in elderly hemodialysis patients with severe secondary hyperparathyroidism (SHPT). METHODS: A total of 304 elderly hemodialysis patients with severe SHPT were consecutively enrolled in this cohort study. According to whether PTX operations were applied, patients were classified into PTX group (N = 112) and Control group (N = 192) and were followed up for 3 years...
November 28, 2018: Journal of Clinical Laboratory Analysis
Mélanie Tia Weu, Cyr Guei Monlet, Amidou Sawadogo, Albert Coulibaly Pessa, Amelie Lagou Delphine, Apollinaire Gnionsahé Daze
BACKGROUND: Renal involvement is common during monoclonal gammopathies and their occurrence impacts the survival of the patients. Our objective was to describe the renal features during monoclonal gammopathies from 2004 to 2016 at the University Hospital of Yopougon in Abidjan. METHODS: Renal failure was defined as blood creatinine level > 20 mg/L and/or proteinuria > 500 mg/24 hours. RESULTS: We identified 42 cases of monoclonal gammopathiesincluding multiple myeloma (n=40) and monoclonal gammopathy of underdetermined significance (n=2)...
2018: Le Mali Médical
Harold D Love, Mingfang Ao, Seiver Jorgensen, Lindsey Swearingen, Nicholas J Ferrell, Rachel C Evans, Leslie Gewin, Raymond C Harris, Roy Zent, Shuvo Roy, William H Fissell
End-stage renal disease afflicts nearly 750,000 Americans and claims over 100,000 lives annually in the United States. Kidney transplantation is associated with longest survival and least cost but is limited by scarcity of donor organs. Most patients are treated with hemodialysis. Each hemodialysis treatment consumes over 160 liters of water and anchors the patient to a machine for 12-15 hours per week. Cultured tubule cells can reduce the obligate fluid requirements of a bioengineered artificial kidney by concentrating wastes and reabsorbing filtered salt and water...
November 28, 2018: Tissue Engineering. Part A
Stephen Stonelake, Jyoti Baharani, Mark Thomas, Roger Adkins, Lee Hollingsworth, Teun Wilmink
BACKGROUND: The weighted catheter has shown promising results in retrospective and randomized studies. We examined its usefulness in patients with previous failed non-weighted peritoneal dialysis (PD) catheters or previous abdominal surgery. METHODS: The insertion, start, end, and removal dates were recorded for all-type catheter insertions from 2011 to 2016. Primary and secondary failure rates were recorded, defined as failure to ever establish flow (primary) or failure after a period of successful PD (secondary)...
November 25, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Thomas F X O'Donnell, Laura T Boitano, Sarah E Deery, William D Clouse, Jeffrey J Siracuse, Marc L Schermerhorn, Richard Green, Hiroo Takayama, Virendra I Patel
BACKGROUND: Renal dysfunction is a well-described complication of open juxtarenal abdominal aortic aneurysm repair, but the associated risk factors and corresponding impact on survival are not well described. METHODS: We identified all patients not on hemodialysis undergoing open repair of nonruptured juxtarenal aneurysms in the Vascular Quality Initiative from 2003 to 2017. We used mixed-effects logistic regression to determine factors associated with in-hospital postoperative renal dysfunction, including acute kidney injury (AKI, defined as serum creatinine concentration increase >0...
November 23, 2018: Journal of Vascular Surgery
Pei Yi Fan, Cheng Chia Lee, Shou Hsuan Liu, I-Jung Li, Cheng Hao Weng, Kun Hua Tu, Mei Yun Hsieh, Chang Fu Kuo, Ting-Yu Chang, Ya Chung Tian, Chih Wei Yang, Hsin Hsu Wu
BACKGROUND: Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis. OBJECTIVES: This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. PATIENTS AND METHODS: We studied patients with end-stage renal disease registered in the Taiwan National Health Insurance program from January 1, 1997 to December 31, 2012...
November 25, 2018: Journal of Thrombosis and Haemostasis: JTH
Felipe F Tuon, Jaime L Rocha, Juliano Gasparetto
INTRODUCTION: Polymyxin B and colistin are nephrotoxic drugs used in the treatment of carbapenem-resistant Enterobacteriaceae. The aim of this study is to evaluate the burden of costs due to polymyxin associated AKI and propose a simulated break-even price for new therapies. METHODS: The pharmacoeconomic model is based on two large cross-sectional studies of polymyxin nephrotoxicity. Total direct costs in patients with and without renal failure were compared. Direct cost of each hemodialysis section (USD82...
November 23, 2018: Journal of Medical Economics
Shaur-Zheng Chong, Chih-Yuan Fang, Hsiu-Yu Fang, Huang-Chung Chen, Chien-Jen Chen, Cheng-Hsu Yang, Chi-Ling Hang, Hon-Kan Yip, Chiung-Jen Wu, Wei-Chieh Lee
BACKGROUND: Acute fulminant myocarditis (AFM) is a serious disease that progresses rapidly, and leads to failing respiratory and circulatory systems. When medications fail to reverse the patient's clinical course, extracorporeal membrane oxygenation (ECMO) is considered the most effective, supportive and adjunct strategy. In this paper we analyzed our experience in managing AFM with ECMO support. METHODS: During October 2003 and February 2017, a total of 35 patients (≥18 years) were enrolled in the study...
November 20, 2018: Journal of Clinical Medicine
Berkan Ozpak, Yeliz Yilmaz
PURPOSE: This study aimed to evaluate the effects of hemodialysis catheters on the survival of subsequent arteriovenous fistulas, according to the relative localization to the catheters. METHODS: A total of 201 patients who initiated dialysis therapy using a hemodialysis catheter were eligible for this retrospective study. Arteriovenous fistulas were created on the nondominant upper extremity after the placement of hemodialysis catheters. The catheters were removed after four consecutive successful dialyses via arteriovenous fistulas...
November 19, 2018: Vascular
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