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Dialysis. Hypertension

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https://www.readbyqxmd.com/read/28717990/iron-based-phosphate-binders-a-paradigm-shift-in-the-treatment-of-hyperphosphatemic-anemic-ckd-patients
#1
REVIEW
Francesco Locatelli, Lucia Del Vecchio
The partial correction of anemia and the normalization of phosphate and blood pressure are the mainstay of treatment of patients with chronic kidney disease (CKD). Available anti-hypertensive drugs, erythropoiesis stimulating agents (ESAs) and iron supplements have resolved quite satisfactorily the goal of controlling hypertension and partially correcting anemia. Unfortunately, the treatment of hyperphosphatemia is still far from resolved. Phosphate binders have poor tolerability and/or limited efficacy, leading to the prescription of many tablets that achieve only a mild-to-moderate effect...
July 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28711400/thirty-day-outcomes-after-fenestrated-endovascular-repair-are-superior-to-open-repair-of-abdominal-aortic-aneurysms-involving-visceral-vessels
#2
Prateek K Gupta, Reshma Brahmbhatt, Kelly Kempe, Shaun M Stickley, Michael J Rohrer
OBJECTIVE: Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs. METHODS: Patients who underwent FEVAR (n = 535) and OS (n = 1207) for elective AAA-Vs were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) 2008 to 2013 database...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711072/chronic-kidney-disease-and-pregnancy
#3
Michelle A Hladunewich
Women with chronic kidney disease (CKD) are at risk for adverse pregnancy-associated outcomes, including progression of their underlying renal dysfunction, a flare of their kidney disease, and adverse pregnancy complications such as preeclampsia and preterm delivery. Earlier-stage CKD, as a rule, is a safer time to have a pregnancy, but even women with end-stage kidney disease have attempted pregnancy in recent years. As such, nephrologists need to be comfortable with pregnancy preparation and management at all stages of CKD...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28710615/aldosterone-antagonist-therapy-and-its-relationship-with-inflammation-fibrosis-thrombosis-mineral-bone-disorder-and-cardiovascular-complications-in-peritoneal-dialysis-pd-patients
#4
Rafał Donderski, Paweł Stróżecki, Beata Sulikowska, Magdalena Grajewska, Ilona Miśkowiec, Anna Stefańska, Joanna Siódmiak, Grażyna Odrowąż-Sypniewska, Jacek Manitius
BACKGROUND: High aldosterone level may contribute to pathogenesis of hypertension, vessels damage and cardiovascular system deterioration in chronic kidney disease patients. Besides its classical action via mineralocorticoid receptor, aldosterone is also involved in cell growth, inflammation, oxidative stress, endothelial dysfunction and exerts fibroproliferative effects. The aim of the study was to assess whether aldosterone antagonist treatment may influence serum level of inflammatory, fibrosis, thrombosis and mineral-bone metabolism markers in peritoneal dialysis (PD) patients and blood pressure, aortic stiffness, echocardiographic indices after 12 months of treatment...
July 14, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28710094/perspectives-from-the-kidney-health-initiative-on-advancing-technologies-to-facilitate-remote-monitoring-of-patient-self-care-in-rrt
#5
Mitchell H Rosner, Susie Lew, Paul Conway, Jennifer Ehrlich, Robert Jarrin, Uptal D Patel, Karen Rheuban, R Brooks Robey, Neal Sikka, Eric Wallace, Patrick Brophy, James Sloand
Telehealth and remote monitoring of a patient's health status has become more commonplace in the last decade and has been applied to conditions such as heart failure, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. Conversely, uptake of these technologies to help engender and support home RRTs has lagged. Although studies have looked at the role of telehealth in RRT, they are small and single-centered, and both outcome and cost-effectiveness data are needed to inform future decision making...
July 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28707302/dialysate-sodium-and-intradialytic-hypotension
#6
Wael F Hussein, Brigitte Schiller
Intradialytic hypotension (IDH) is a common complication in hemodialysis, particularly with the time and frequency constraints of standard session delivery in contemporary practice. High intradialytic weight gain (IDWG), high ultrafiltration rates (UFR), and frequent IDH are highly interlinked, and separately or together contribute to the high cardiovascular morbidity and mortality observed in the hemodialysis population. Using a lower concentration of sodium in the dialysate (D-Na) reduces sodium delivery to the patient during dialysis, and several studies reported the beneficial effect in controlling IDWG, UFR, and hypertension...
July 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28683120/cardiovascular-risk-associated-with-high-sodium-containing-drugs-a-systematic-review
#7
Germain Perrin, Virginie Korb-Savoldelli, Alexandre Karras, Nicolas Danchin, Pierre Durieux, Brigitte Sabatier
BACKGROUND: Excess dietary sodium is associated with increased blood pressure (BP). Some drugs are associated with high sodium intake (in particular effervescent tablets), but the cardiovascular risk associated with such high sodium-containing drugs (HSCD) is largely underevaluated. OBJECTIVES: To summarize the evidence for a potential cardiovascular risk associated with exposure to HSCD, and to highlight possible risk factors associated with this iatrogenic issue; in general and/or specific populations...
2017: PloS One
https://www.readbyqxmd.com/read/28682027/-pulmonary-congestion-and-hypertension-in-hemodialysis-patients
#8
Francesca Mallamaci, Giovanni Tripepi
Mild to moderate volume expansion is a frequent complication in dialysis patients and acute volume overload, such as acute pulmonary oedema, is one of the most worrying medical emergency in these patients. Estimated systolic blood pressure in the pulmonary artery (ePASP) is an important risk factor of mortality and cardiovascular (CV) events in the general population and in patients on dialysis. Therefore, the assessment of body water in dialysis patients is useful both from the clinical point of view for monitoring fluids as well as for prognostic purposes...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28666409/end-stage-renal-disease-in-french-guiana-data-from-r-e-i-n-registry-south-american-or-french
#9
Dévi Rita Rochemont, Mohamed Meddeb, Raoul Roura, Cécile Couchoud, Mathieu Nacher, Célia Basurko
BACKGROUND: End-Stage renal disease (ESRD) causes considerable morbidity and mortality, and significantly alters patients' quality of life. There are very few published data on this problem in the French Overseas territories. The development of a registry on end stage renal disease in French Guiana in 2011 allowed to describe the magnitude of this problem in the region for the first time. METHODS: Using data from the French Renal Epidemiology and Information Network registry (R...
June 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28666072/special-situations-intradialytic-hypertension-chronic-hypertension-and-intradialytic-hypotension
#10
Peter Noel Van Buren, Jula K Inrig
Hypertension is a comorbidity that is present in the majority of end-stage renal disease patients on maintenance hemodialysis. This population is particularly unique because of the dynamic nature of blood pressure (BP) during dialysis. Modest BP decreases are expected in most hemodialysis patients, but intradialytic hypotension and intradialytic hypertension are two special situations that deviate from this as either an exaggerated or paradoxical response to the dialysis procedure. Both of these phenomena are particularly important because they are associated with increased mortality risk compared to patients with modest decreases in BP during dialysis...
June 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28666069/setting-the-dry-weight-and-its-cardiovascular-implications
#11
Arjun D Sinha, Rajiv Agarwal
Volume overload is common and associated with adverse outcomes in the hemodialysis population including systemic hypertension, pulmonary hypertension, left ventricular hypertrophy, and mortality. Since the beginning of the era of maintenance dialysis, prescribing and maintaining a dry weight remains the standard of care for managing volume overload on hemodialysis. Reducing dry weight even by relatively small amounts has been shown to improve blood pressure and has been associated with reductions in left ventricular hypertrophy...
June 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28661565/a-brief-review-of-intradialytic-hypotension-with-a-focus-on-survival
#12
Jason A Chou, Kamyar Kalantar-Zadeh, Anna T Mathew
Intradialytic hypotension (IDH), a common complication of ultrafiltration during hemodialysis therapy, is associated with high mortality and morbidity. IDH, defined as a nadir systolic blood pressure of less than 90 mm Hg on more than 30% of treatments, is a relevant definition and is correlated with mortality. Risk factors for IDH include patient demographics, anti-hypertensive medication use, larger interdialytic weight gain, and dialysis prescription features as dialysate sodium, high ultrafiltration rate, and dialysate temperature...
June 29, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28651783/optimal-timing-of-heart-transplant-after-heartmate-ii-left-ventricular-assist-device-implantation
#13
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
June 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28640481/using-analytic-morphomics-to-describe-body-composition-associated-with-post-kidney-transplantation-diabetes-mellitus
#14
David C Cron, Kelly A Noon, Devan R Cote, Michael N Terjimanian, Joshua J Augustine, Stewart C Wang, Michael J Englesbe, Kenneth J Woodside
BACKGROUND: Better risk assessment tools are needed to predict post-transplantation diabetes mellitus (PTDM). Using analytic morphomic measurements from computed tomography (CT) scans, we aimed to identify specific measures of body composition associated with PTDM. METHODS: We retrospectively reviewed 99 non-diabetic kidney transplant recipients who received pre-transplant CT scans at a single institution between 1/2005 and 5/2014. Analytic morphomic techniques were used to measure abdominal adiposity, abdominal size, and psoas muscle area and density, standardized by gender...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28638613/cuff-extrusion-in-peritoneal-dialysis-single-centre-experience-with-the-cuff-shaving-procedure-in-five-patients-over-a-4-year-period
#15
Jedrzej A Debowski, Cora Wærp, Stig A Kjellevold, Sadollah Abedini
Catheter-related infections in peritoneal dialysis (PD) remain a significant complication, and some patients with recurrent exit-site (ESI) and/or tunnel infections may experience external cuff extrusion. In these cases, cuff-shaving has been described as a possible course of treatment. During a 4-year period, there were 44 patients with PD at our department; all received double-cuffed Tenckhoff catheters. Six (13%) never started on PD. Five (13%) of the 38 active PD patients experienced cuff extrusion. Causes of end-stage renal disease (ESRD) were diabetic nephropathy (n = 1), toxic nephropathy (n = 1), hypertensive nephrosclerosis (n = 1), systemic disease (n = 1) and one with unknown cause...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28638005/sclerosing-mesenteritis-causing-chylous-ascites-and-small-bowel-perforation
#16
Huei-Wen Lim, Keith S Sultan
BACKGROUND Sclerosing mesenteritis (SM) is a rare idiopathic inflammation and fibrosis of the mesentery. Its etiology and pathogenesis remain unclear. It has been linked to abdominal trauma related to peritoneal dialysis, recent abdominal surgery, idiopathic inflammatory disorder, paraneoplastic syndrome, ischemia/infection, and autoimmunity. Abdominal CT is the most sensitive imaging modality, and diagnosis is usually confirmed by surgical biopsy. Patients most often present with abdominal pain, nausea, vomiting, diarrhea, and weight loss, and less commonly with chylous ascites and small bowel obstruction...
June 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28635363/early-mortality-risk-in-incident-chinese-hemodialysis-patients-a-retrospective-cohort-study
#17
Xinju Zhao, Mei Wang, Li Zuo
BACKGROUND: Early mortality risk of maintenance hemodialysis (MHD) patients varies by country and ethnicity. Here, early mortality in incident Chinese HD patients were studied. METHODS: Data from 1 January 2007 to 31 December 2013 were pulled from Beijing dialysis registry system. All included patients were followed to the end of 2013. This time period of dialysis was divided into six intervals (≤120, 121-365 days; 1-2, 2-3, 3-4, ≥5 years). Patients' demographics, primary cause of end-stage renal disease (ESRD), date of first HD, date of death, cause for death, date and cause of censoring were extracted from the registry database...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28635327/within-visit-blood-pressure-variability-and-cardiovascular-risk-factors-in-hypertensive-patients-with-non-dialysis-chronic-kidney-disease
#18
Kengo Azushima, Hiromichi Wakui, Kazushi Uneda, Sona Haku, Ryu Kobayashi, Kohji Ohki, Sho Kinguchi, Kotaro Haruhara, Tetsuya Fujikawa, Yoshiyuki Toya, Satoshi Umemura, Kouichi Tamura
As there may be an association between within-visit blood pressure (BP) variability and cardiovascular disease (CVD), we investigated the clinical significance of this BP variability in non-dialysis chronic kidney disease (CKD) patients. MATERIALS AND METHODS: According to the median of coefficient of variation (CV) of three systolic BP (SBP) readings within a single visit, we divided hypertensive patients with stage G1-4 CKD already treated with antihypertensive therapy into the high SBP-CV group and the low SBP-CV group...
June 21, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28633804/protective-effect-of-n-acetylcysteine-on-progression-to-end-stage-renal-disease-necessity-for-prospective-clinical-trial
#19
Chen-Yi Liao, Chi-Hsiang Chung, Chai-Chao Wu, Fu-Huang Lin, Chang-Huei Tsao, Chih-Chiang Wang, Wu-Chien Chien
BACKGROUND: We aimed to evaluate the potential benefits of N-acetylcysteine (NAC) on the risk of chronic kidney disease (CKD) progression to dialysis-requiring end-stage renal disease (ESRDd). METHODS: In a population-based cohort study of 145,062 individuals, 123,608 CKD patients who were followed up for 10years were included, and CKD patients treated with NAC (ICD-9-CM) were compared with those who were not treated. Using propensity score matching, we analyzed the predictors of CKD progression to ESRDd by Cox proportional hazards regression with adjustments for sex, age, and comorbidities, and evaluated the effect of NAC using cumulative defined daily dose (cDDD)...
June 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28632927/prospective-associations-between-environmental-heavy-metal-exposure-and-renal-outcomes-in-adults-with-chronic-kidney-disease
#20
Chun-Chieh Tsai, Chia-Lin Wu, Chew-Teng Kor, Ie-Bin Lian, Chin-Hua Chang, Teng-Hsiang Chang, Chia-Chu Chang, Ping-Fang Chiu
BACKGROUND: In Taiwan, Changhua County residents were exposed to high heavy metal pollution and exhibited high heavy metal levels in blood and urine. We examined associations between heavy metals in residential soil and renal outcomes of residents with chronic kidney disease (CKD). METHOD: From January 01, 2003 to June 30, 2015, we retrospectively identified CKD patients with an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) at one tertiary care center...
June 20, 2017: Nephrology
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