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Survival hemodialysis

Rafia Chaudhry, Anum Bilal, Adam Austin, Swati Mehta, Loay Salman, Llewellyn Foulke, Paul Feustel, Roman Zuckerman, Arif Asif
BACKGROUND AND OBJECTIVES: Anti-neutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis is a small vessel vasculitis with insufficient epidemiologic estimates in the United States. We aimed to determine demographic and clinical features of ANCA associated vasculitis patients presenting to a large tertiary care referral center in Upstate New York. Design, setting, participants, and measurements: A retrospective analysis of cases with pauci-immune GN on renal biopsy and clinical diagnosis of ANCA vasculitis presenting over 11 years was conducted...
August 9, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
M Rouer, S Godier, A Monnot, I Etienne, D Bertrand, D Guerrot, D Plissonnier
The occurrence of transplant renal artery stenosis (TRAS) ranges from 1% to 23%, and is associated with resistant hypertension, volume overload, graft dysfunction and poor long-term graft and patient survival. Enhancing graft availability with expanded criteria donors results in the transplantation of kidneys with atherosclerotic arteries, increasing the risk of vascular complications. Although endovascular management is the first line strategy in this context, in some patients surgery has to be considered...
August 6, 2018: Annals of Vascular Surgery
Frederic Sacher, Laurence Jesel, Claire Borni-Duval, Valerie De Precigout, Frédéric Lavainne, Jean-Philippe Bourdenx, Atman Haddj-Elmrabet, Bruno Seigneuric, Adrien Keller, Julien Ott, Helene Savel, Yahsou Delmas, Dorothée Bazin-Kara, Nicolas Klotz, Sylvain Ploux, Sébastien Buffler, Philippe Ritter, Virginie Rondeau, Pierre Bordachar, Claire Martin, Antoine Deplagne, Sylvain Reuter, Michel Haissaguerre, Jean-Baptiste Gourraud, Cécile Vigneau, Philippe Mabo, Philippe Maury, Thierry Hannedouche, Antoine Benard, Christian Combe
OBJECTIVES: The aim of this study was to identify using implantable loop recorder (ILR) monitoring the mechanisms leading to sudden death (SD) in patients undergoing hemodialysis (HD). BACKGROUND: SD accounts for 11% to 25% of death in HD patients. METHODS: Continuous rhythm monitoring was performed using the remote monitoring capability of the ILR device in patients undergoing HD at 8 centers. Clinical, biological, and technical HD parameters were recorded and analyzed...
March 2018: JACC. Clinical Electrophysiology
Cleber Machado-Souza, Ana Paula Ribeiro Braosi, Sônia Mara Luczyszyn, Marcia Olandoski, Miguel Carlos Riella, Paula Cristina Trevilatto, Roberto Pecoits-Filho
INTRODUCTION: The vitamin D-receptor axis is involved in multiple physiological functions and altered states such as hypertension, mineral metabolism disorders, and inflammation. These disturbances are major risk factors for progression to end-stage kidney disease and cardiovascular disease. In addition, changes in internal systemic environment could be influencing the impact of survival in patients with kidney disease. This study aimed to evaluate the impact of vitamin D receptor (VDR) polymorphisms on hemodialysis patients' survival...
July 2018: Iranian Journal of Kidney Diseases
Janet M Chiang, George A Kaysen, Mark Segal, Glenn M Chertow, Cynthia Delgado, Kirsten L Johansen
Background: Despite the high prevalence of frailty among patients receiving hemodialysis, few preventable or treatable contributing causes have been identified. Hypogonadism is also common in this population and low serum testosterone concentrations share several clinical phenotypes with frailty. We hypothesized that low serum testosterone concentrations would be associated with frailty and several of its individual components. Methods: We used data from 440 men from A Cohort Study To Investigate the Value of Exercise in ESRD/Analysis Designed to Investigate the Paradox of Obesity and Survival in ESRD, a longitudinal study that recruited participants from 14 dialysis centers in Atlanta, GA and the San Francisco, CA Bay Area from 2009 to 2011...
August 1, 2018: Nephrology, Dialysis, Transplantation
Connie M Rhee, Yoshitsugu Obi, Anna T Mathew, Kamyar Kalantar-Zadeh
Launched in 2016, the overarching goal of the Precision Medicine Initiative is to promote a personalized approach to disease management that takes into account an individual's unique underlying biology and genetics, lifestyle, and environment, in lieu of a one-size-fits-all model. The concept of precision medicine is pervasive across many areas of nephrology and has been particularly relevant to the care of advanced chronic kidney disease patients transitioning to end-stage kidney disease (ESKD). Given many uncertainties surrounding the optimal transition of incident ESKD patients to dialysis and transplantation, as well as the high mortality rates observed during this delicate transition period, there is a pressing urgency for implementing precision medicine in the management of this population...
July 2018: Seminars in Nephrology
April A Pottebaum, Jennifer C Hagopian, Daniel C Brennan, Ara Gharabagi, Timothy A Horwedel
Evaluation of potential kidney transplant recipients is important to identify and treat conditions that may influence graft or patient survival after transplantation. We performed a single-center, observational cohort study to determine whether pre-transplant midodrine use influences outcomes after kidney transplantation. We analyzed graft and patient outcomes for adult patients who underwent a kidney-only transplantation at Barnes-Jewish Hospital from January 1999 to December 2015. We quantified adjusted associations of pre-transplant midodrine use with post-transplant complications by multivariable Cox regression...
August 4, 2018: Clinical Transplantation
C Barth, M Soares, A C Toffart, J F Timsit, G Burghi, C Irrazabal, N Pattison, E Tobar, B F Almeida, U V Silva, L C Azevedo, A Rabbat, C Lamer, A Parrot, V C Souza-Dantas, F Wallet, F Blot, G Bourdin, C Piras, J Delemazure, M Durand, J Salluh, E Azoulay, Virginie Lemiale
BACKGROUND: Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients. METHODS: A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013...
August 4, 2018: Annals of Intensive Care
Chung-Kuan Wu, Chia-Hsun Lin, Chih-Cheng Hsu, Der-Cherng Tarng, Chew-Teng Kor, Yi-Chun Chen, Chia-Lin Wu, Chia-Chu Chang
The long-term survival and life quality of hemodialysis (HD) patients depend on adequacy of dialysis via a well-functioning vascular access. Loss of primary functional patency (PFP) of an arteriovenous access (AVA) eventually happens in HD patients. The association between time to loss of PFP of AVAs and mortality in HD patients remains unclear. The retrospective nationwide population-based cohort study compared the hazards of mortality with time to loss of PFP. We enrolled 1618 adult incident HD patients who received HD via AVAs for at least 90 days between January 1, 2001 and December 31, 2013...
August 2018: Medicine (Baltimore)
Jun-Li Tsai, Shang-Feng Tsai
Renal transplant is the preferred choice of treatment for end-stage renal diseases. To avoid rejection, increasingly potent immunosuppressants are administered to recipients of kidney transplants. Complications, when there is excess immunosuppression, include possible lethal infections, which reduce allograft survival and compromise patient survival. When there is insufficient immunosuppression, rejections could impair allograft outcomes. Moreover, recurrent primary diseases could also threaten allograft outcomes...
July 31, 2018: Experimental and Clinical Transplantation
Sheru K Kansal, Jose A Morfin, Eric D Weinhandl
BACKGROUND: Peritoneal dialysis (PD) technique failure is often accompanied by complications that increase risks of hospitalization and death. Planned transition to hemodialysis may improve outcomes. Transitioning patients from PD to home hemodialysis (HHD) may improve continuity of lifestyle and facilitate delivery of more frequent treatment. METHODS: We analyzed United States Renal Data System (USRDS) data to compare the incidence of death and kidney transplant in patients who transferred from PD to HHD and matched patients who transferred from PD to in-center HD (IHD)...
July 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Yan Sun, Yankui Wang, Wenhong Yu, Yan Zhuo, Qian Yuan, Xiongfei Wu
BACKGROUND Dialysis frequency and dose are controversial prognostic factors of hemodialysis morbidity and mortality. The aim of this study was to find out the effect of frequency and dosage of dialysis on mortality and survival in a group of Chinese hemodialysis patients. MATERIAL AND METHODS In total, 183 patients seen from February 2008 to January 2018, who were on maintenance hemodialysis for at least 3 months, were included in the study cohort. An anonymized database of age, gender, diabetic status, comorbidities, date of initiation of dialysis, hematological characters, biochemical variables, and status of survived or died was established from DICOM (Digital Imaging and Communications in Medicine) files of patients...
July 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Kathryn Eckert, Lila Motemaden, Michelle Alves
Patients with end-stage renal disease (ESRD) should choose a treatment modality, such as hemodialysis (HD) or conservative medical management (CMM), to improve their symptoms with the goal of attaining a good quality of life (QOL), a concept highly aligned with palliative care principles. This article aims to answer if elderly patients with ESRD have improved QOL with CMM compared with HD. Conservative medical management focuses on managing symptoms, rather than invasive procedures such as HD, with more focus on holistic care...
June 2018: Journal of Hospice and Palliative Nursing: JHPN
Takayasu Ohtake, Yasuhiro Mochida, Kunihiro Ishioka, Machiko Oka, Kyoko Maesato, Hidekazu Moriya, Sumi Hidaka, Satoshi Higashide, Tetsuya Ioji, Yasuyuki Fujita, Atsuhiko Kawamoto, Masanori Fukushima, Shuzo Kobayashi
Critical limb ischemia (CLI) is a devastating disease in patients undergoing hemodialysis (HD). Based on the unsatisfactory results of autologous mononuclear cell transplantation for patients with CLI undergoing HD, we conducted a phase II clinical trial to evaluate the safety and efficacy of granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood-derived autologous purified CD34 positive (CD34+) cell transplantation for CLI in patients undergoing HD. Six patients with CLI (two with Rutherford category 4 and four with Rutherford category 5) were enrolled...
July 30, 2018: Stem Cells Translational Medicine
K Hap, K Madziarska, S Zmonarski, D Kamińska, M Magott-Procelewska, M Banasik, K Jędrzejak, M Madziarski, W Hap, M Klinger, O Mazanowska
Posttransplant diabetes mellitus (PTDM) adversely affects renal graft and patient survival. Fasting plasma glucose (FPG) alone underestimates diagnosis of glucose metabolism disorders (GMD) detected using the oral glucose tolerance test (OGTT-75). Prediabetes including impaired fasting glucose (IFG): 100 to 125 mg/dL (5.6-6.9 mmol/L) and impaired glucose tolerance (IGT): 140 to 199 mg/dL (7.8-11 mmol/L) 2 hours post 75-g OGTT in the pretransplant period can have a connection with the occurrence of PTDM after renal transplantation (RTx)...
July 2018: Transplantation Proceedings
Masafumi Fukagawa, Ryutaro Shimazaki, Tadao Akizawa
Secondary hyperparathyroidism (SHPT) leads to cardiovascular calcification, which affects survival and quality of life in patients with chronic kidney disease. Cinacalcet is used to control SHPT, but it may induce gastrointestinal symptoms, resulting in lower adherence and insufficient dosages. Therefore, a need exists to develop new calcimimetics that cause fewer gastrointestinal symptoms. Here we conducted a phase 3, randomized, double-blind, double-dummy trial for a head-to-head comparison of the efficacy and safety of evocalcet, a new oral calcimimetic, to the established cinacalcet...
July 20, 2018: Kidney International
Denise Kim, Cynthia Bhola, Naomi Eisenberg, Janice Montbriand, George Oreopoulos, Charmaine E Lok, Graham Roche-Nagle
INTRODUCTION: A proportion of hemodialysis patients exhaust all options for arteriovenous access in upper extremities. Arteriovenous thigh grafts are a potential vascular access option in such patients. METHODS: We performed a retrospective study of all thigh arteriovenous access grafts placed between 1995 and 2015. The clinical, demographic patient information and patency of each thigh graft was determined from the time of surgical creation placement until abandonment, transfer to other modality, or center or end of study, and the reason for access failure documented...
July 25, 2018: Journal of Vascular Access
Grzegorz Piecha, Agata Kujawa-Szewieczek, Piotr Kuczera, Katarzyna Skiba, Ewelina Sikora-Grabka, Andrzej Wiecek
Experimental data have shown increased plasma levels of marinobufagenin in kidney failure. In this case-controlled retrospective analysis we evaluated plasma marinobufagenin immunoreactivity in hemodialysis patients compared to subjects with normal kidney function. Sixty eight adult hemodialysis patients with chronic kidney disease (34 females and 34 males) as well as 68 age-, gender-, and blood pressure-matched subjects without chronic kidney disease were enrolled. Patients on stable hemodialysis regimen for at least 3 months prior to the study were included...
July 25, 2018: American Journal of Physiology. Renal Physiology
Sabreen Mkalaluh, Marcin Szczechowicz, Bashar Dib, Alexander Weymann, Gabor Szabo, Matthias Karck
OBJECTIVE: Open surgical repair of thoracoabdominal aortic aneurysm remains an important treatment option and continues to be challenging. The objective of this study was to investigate the results after open repair of thoracoabdominal aortic aneurysms in a contemporary non-high-volume center collective. METHODS: A total of 38 patients underwent operation for thoracoabdominal aortic aneurysm between August 2007 and April 2017. Patients had aortic aneurysm and chronic aortic dissection...
June 6, 2018: Journal of Thoracic and Cardiovascular Surgery
Koji Tomori, Hirokazu Okada
Home hemodialysis (HHD) has been available as a modality of renal replacement therapy since the 1960s. HHD allows intensive dialysis such as nocturnal hemodialysis or short daily hemodialysis. Previous studies have shown that patients receiving HHD have an increased survival and better quality of life compared with those receiving in-center conventional HD. However, HHD may increase the risk for specific complications such as vascular access complications, infection, loss of residual kidney function and patient and caregiver burden...
2018: Contributions to Nephrology
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