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Hemoglobin variability hemodialysis

Calvin J Meaney, Spinel Karas, Ben Robinson, Jamie Gaesser, Alan Forrest, Wojciech Krzyzanski, Mandip Panesar, Gauri G Rao
Erythropoiesis-stimulating agents (eg, epoetin alfa) are the primary treatment for anemia in patients with end-stage renal disease . Hemoglobin variability in and out of a narrow target range is common and associated with higher morbidity and mortality risk. More robust erythropoiesis-stimulating agent response metrics are needed to define optimal dosing and their association with clinical outcomes. In this cross-sectional, single-center, retrospective study, 49 patients with end-stage renal disease on hemodialysis were followed over 12 months...
November 9, 2018: Journal of Clinical Pharmacology
Beena Salman, Mehwish Hussain, Kashif Shafique, Salman Imtiaz, Murtaza Fakhruddin Dhrolia
Chronic kidney disease (CKD) affects health and life of patients. They confront anemia, hypertension, infections and cardiovascular disease. Due to these health issues, they are at risk of repeated hospitalizations. The risk factors which propel them to hospitalize are important to know, and by controlling these factors, we can impede preventable hospitalization. This case-control study included 1050 adult CKD patients, conducted in two tertiary care hospitals of Karachi. Variables included were age, gender, ethnicity, area of residence, marital status, education smoking status, comorbids, blood pressure, type of angioaccess, hemodialysis (HD) status, stage of CKD, activity level, and laboratory parameters...
September 2018: Saudi Journal of Kidney Diseases and Transplantation
María Del Mar Sánchez-Fernández, Gustavo A Reyes Del Paso, José Manuel Gil-Cunquero, María José Fernández-Serrano
OBJECTIVE: There is evidence of cognitive impairment in patients with end-stage renal disease in hemodialysis (ESRD-HD). However, few studies have exhaustively analyzed executive functions (EFs) in this population, especially considering the influence of a wide range of clinical variables. This study analyzes performance in different EF components in ESRD-HD patients compared to a group of healthy controls (HCs), in addition to the acute effects of HD and the associations of cognitive performance with clinical variables...
2018: PloS One
Hyeseong Hwang, Ju Byung Chae, Jin Young Kim, Byung Gil Moon, Dong Yoon Kim
PURPOSE: To investigate the spectral domain optical coherence tomography findings before and after dialysis in patients with diabetic end-stage renal disease undergoing dialysis for the first time. METHODS: A retrospective medical review of patients with diabetic end-stage renal disease who recently started dialysis was conducted. Spectral domain optical coherence tomography findings before and after initiation of dialysis were analyzed. Systemic blood pressure, body weight, estimated glomerular filtration rate, and serum levels of blood urea nitrogen, creatinine (Cr), albumin, hemoglobin (Hb), and total CO2 were measured before and 1 month after starting dialysis...
August 30, 2018: Retina
Ladan Golestaneh, Eran Bellin, Joel Neugarten, Yungtai Lo
BACKGROUND: In national samples drawn from the USRDS, female patients utilize the hospital ED and inpatient services at a higher rate than their male counterparts and have a higher rate of re-hospitalization. We wanted to explore the association of sex with avoidable ED visits made by a cohort of patients on hemodialysis in a mostly minority, lower socioeconomic status (SES), population in the Bronx to test the applicability of the USRDS findings. METHODS: We used Montefiore's clinical database to build a cohort of patients on hemodialysis with a first ED visit between 2013 and 2017...
2018: PloS One
Saime Sagiroglu, Adem Doganer
OBJECTIVE: The aim of the study was to demonstrate the effect of blood electrolytes on the voice in chronic hemodialysis patients. METHODS: The study included a total of 59 hemodialysis patients. Pre- and post-dialysis voice recordings were performed. In the analysis of vocal acoustic parameters, fundamental frequency (F0), jitter, shimmer, the noise-to-harmonics ratio (NHR), and F0 minimum and F0 maximum were measured. The Voice Handicap Index-10 (VHI-10), and maximum phonation time (MPT) were evaluated...
November 2018: European Archives of Oto-rhino-laryngology
Toshihide Hayashi, Yuri Tanaka, Masaki Iwasaki, Hiroki Hase, Hiroyuki Yamamoto, Yasuhiro Komatsu, Ryoichi Ando, Masato Ikeda, Daijo Inaguma, Toshifumi Sakaguchi, Toshio Shinoda, Fumihiko Koiwa, Shigeo Negi, Toshihiko Yamaka, Takashi Shigematsu, Nobuhiko Joki
OBJECTIVES: High prevalence of iron deficiency (ID) and cardiomyopathy have been observed in patients with end-stage kidney disease (ESKD). Our objective was to clarify associations between ID and cardiac remodeling in patients with ESKD. DESIGN AND METHODS: A cross-sectional study was conducted using 1974 Japanese patients with ESKD at the initiation of maintenance dialysis. Levels of hemoglobin (Hb), iron status, and cardiac enlargement as assessed by the cardiothoracic ratio (CTR) were determined immediately before the first hemodialysis session...
August 7, 2018: Journal of Renal Nutrition
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
Anderson Tavares Rodrigues, Fernando Antônio Basile Colugnati, Marcus Gomes Bastos
INTRODUCTION: Arteriovenous fistula (AVF) is considered the gold standard vascular access for chronic hemodialysis, and its failure predicts higher morbidity and mortality rates. OBJECTIVE: 1) To evaluate the success rate of AVF created by a nephrologist and 2) to identify clinical, laboratory, and demographic variables that influence AVF patency. METHODS: A retrospective cohort study of 101 patients with chronic kidney disease for a total of 159 AVF created by a nephrologist between June 2010 and June 2013...
August 2, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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
Adam E Gaweda, Alfred A Jacobs, George R Aronoff, Michael E Brier
BACKGROUND: Standard protocol-based approaches to erythropoiesis stimulating agent (ESA) dosing in anemia management of end-stage renal disease (ESRD) fail to address the inter-individual variability in patient's response to ESA. We conducted a single-center quality improvement project to investigate the long-term performance of a computer-designed dosing system. MATERIALS AND METHODS: The study was a retrospective case-control study with long-term follow-up. All hemodialysis patients who received treatment at University Kidney Center (Louisville, KY, USA) between September 1, 2009, and March 31, 2017, were included...
October 2018: Clinical Nephrology
Fu-Jun Lin, Xi Zhang, Lu-Sheng Huang, Gang Ji, Hai-Dong Huang, Yun Xie, Geng-Ru Jiang, Xin Zhou, Wei Lu
PURPOSE: Although the association between anemia and cardiovascular mortality in hemodialysis patients is well established, whether hemoglobin variability (Hgb-Var) affects the prognosis remains unclear. We aimed to evaluate the association between Hgb-Var and cardiovascular mortality in Chinese hemodialysis patients. METHODS: This retrospective study included 252 patients starting hemodialysis in Xin Hua Hospital between January 2009 and December 2015. Patients were divided into three tertiles based on Hgb-Var, as reflected by SD Hgbmean , SD Hgbrange , and Hgbdeflection during a 12-month evaluation period after hemodialysis initiation...
September 2018: International Urology and Nephrology
Li Wan, Dongliang Zhang
TARGET: To observe the effect on hemoglobin (Hb) variability with different treatment frequencies of intravenous iron in maintenance hemodialysis (MHD) patients. METHODS: There were 41 MHD patients enrolled in the cohort. The patients were separated into two groups randomly. The baseline data were collected after oral iron agents for 1 month (wash out). There were two methods of intravenous iron administration, either continuous or intermittent. For continuous administration (CA), 100 mg sucrose iron agents were given during every HD session with total dose of 1000 mg...
August 2018: International Urology and Nephrology
Douglas S Fuller, Bruce M Robinson, Francesco Locatelli, Ronald L Pisoni
BACKGROUND: Clinicians providing dialysis care have numerous erythropoiesis-stimulating agents (ESAs) available for treating anemia. We sought to provide a contemporary description of ESA types used in hemodialysis (HD) settings in nine European countries. METHODS: Our study uses Dialysis Outcomes and Practice Patterns Study phase 5 (2012-2015) data from nine European countries (Belgium, France, -Germany, Italy, Russia, Spain, Sweden, Turkey, and the United Kingdom)...
2018: Nephron
Zeynep Bal, Bahar Gurlek Demirci, Suleyman Karakose, Emre Tutal, Mehtap Erkmen Uyar, Nurhan Ozdemir Acar, Siren Sezer
Purpose: We aimed to investigate the factors influencing hemoglobin variability with inflammatory and nutritional parameters and its associations with all-cause mortality among hemodialysis patients. Methods: One hundred and sixty-nine patients during the entire 12 months were enrolled into the study. Fasting plasma glucose, creatinine, calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), C-reactive protein (CRP), serum iron, serum iron-binding capacity, and transferrin saturation were analyzed...
2018: TheScientificWorldJournal
Teppei Okamoto, Shingo Hatakeyama, Yoshimi Tanaka, Kengo Imanishi, Tooru Takashima, Fumitada Saitoh, Takuya Koie, Tadashi Suzuki, Chikara Ohyama
BACKGROUND: Erythropoiesis-stimulating agent (ESA) responsiveness is related to the nutritional status of patients on hemodialysis (HD). Serum butyrylcholinesterase (BChE), an alpha-glycoprotein, may decrease in case of malnutrition. We investigated whether BChE was independently related to ESA resistance in patients on HD. METHODS: The laboratory data and ESA resistance index (ERI), defined as ESA dosage per week divided by dry weight and hemoglobin, were investigated in 215 patients on HD between July and September 2017...
October 2018: Clinical and Experimental Nephrology
Minxia Zhu, Linbin Dou, Mingli Zhu, Shang Liu, Yaping Zhan, Jiayue Lu, Zhaohui Ni, Jiaqi Qian, Hong Cai, Weiming Zhang
OBJECTIVE: To determine the relationship between the variability of serum phosphorus and mortality among maintenance hemodialysis (MHD) patients. MATERIALS AND METHODS: A total of 502 MHD cases were studied from the Shanghai Renal Registry Network. Serum phosphorus variability was indicated by a coefficient of variation (CV). According to the CV median of serum phosphorus, patients were divided into two groups: a high-variability group (CV ≥ 0.226 mmol/L) and a low-variability group (CV < 0...
August 2018: Clinical Nephrology
Sheng-Wen Niu, Jiun-Chi Huang, Szu-Chia Chen, Hugo Y-H Lin, I-Ching Kuo, Pei-Yu Wu, Yi-Wen Chiu, Jer-Ming Chang
Background: Heart rate variability (HRV) represents changes in the time between successive heart beats, and it has been used to assess the autonomic nervous system. Previous studies have reported autonomic dysfunction in diabetic patients undergoing hemodialysis (HD), however, no studies have evaluated the effects of age on changes in HRV in these patients. The aim of this study was to examine the effects of age on changes in HRV in diabetic HD patients. Methods: We enrolled 84 diabetic patients receiving maintenance HD...
2018: Frontiers in Aging Neuroscience
Georgios Vlachopanos, Theodoras Kassimatis, Anastasia Kokkona, Adamantia Zerva, Eirini Stavroulaki, Charilaos Zacharogiannis, Athanasios Agrafiotis
Abnormal bone architecture contributes to high incidence of hip fractures in chronichemodialysis (HD) patients. Their clinical epidemiology is incompletely described. We conducted a retrospective cohort study to assess the implications ofhospitalization with hip fracture in HD patients compared to the nonchronic kidney disease population. Thirty-three chronic HD patients admitted with hip fracture overfiveyears were age- and sex-matched on a 1:1 ratio with controls that had hip fracture and normal renal function...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Rui Abreu, Sara Rioja, Joaquin Vallespin, Xavier Vinuesa, Ruben Iglesias, Jose Ibeas
BACKGROUND: Native arteriovenous fistula (AVF) is considered the gold standard of vascular access for hemodialysis due to its longer survival, fewer complications, lower mortality and costs. Patency is important for effective dialysis treatment and this remains a challenge in nephrology. There are no well-defined prognostic factors for early and long-term AVF survival. The aim of this study was to evaluate comorbidity, analytical and ultrasound (US) variables as prognostic factors for early failure and AVF patency...
August 2018: International Angiology: a Journal of the International Union of Angiology
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