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Pre- dialysis

Shashidhar Cherukuri, Maria Bajo, Giacomo Colussi, Roberto Corciulo, Hafedh Fessi, Maxence Ficheux, Maria Slon, Eric Weinhandl, Natalie Borman
BACKGROUND: Utilization of home hemodialysis (HHD) is low in Europe. The Knowledge to Improve Home Dialysis Network in Europe (KIHDNEy) is a multi-center study of HHD patients who have used a transportable hemodialysis machine that employs a low volume of lactate-buffered, ultrapure dialysate per session. In this retrospective cohort analysis, we describe patient factors, HHD prescription factors, and biochemistry and medication use during the first 6 months of HHD and rates of clinical outcomes thereafter...
October 11, 2018: BMC Nephrology
Mariette J Chartier, Navdeep Tangri, Paul Komenda, Randy Walld, Ina Koseva, Charles Burchill, Kari-Lynne McGowan, Allison Dart
BACKGROUND: Chronic Kidney Disease (CKD) is common and its prevalence has increased steadily over several decades. Monitoring of rates and severity of CKD across populations is critical for policy development and resource planning. Administrative health data alone has insufficient sensitivity for this purpose, therefore utilizing population level laboratory data and novel methodology is required for population-based surveillance. The aims of this study include a) develop the Manitoba CKD Cohort, b) estimate CKD prevalence, c) identify individuals at high risk of progression to kidney failure and d) determine rates of comorbid health conditions...
October 10, 2018: BMC Nephrology
Jin K Kim, Armando J Lorenzo, Walid A Farhat, Michael E Chua, Jessica M Ming, Martin A Koyle
PURPOSE: To determine whether there is a benefit to pre-emptive kidney transplantation in reducing surgical complications in pediatric population. METHODS: A retrospective review of kidney transplantations in our institution from 2000 to 2015 was performed. Intra- and post-operative complication rates and one-year graft survival were compared in their respective donor type groups (DD pre-emptive vs. DD post-dialysis; LD pre-emptive vs. LD post-dialysis). RESULTS: 318 patients were identified (DD pre-emptive n=21, DD post-dialysis n=145, LD pre-emptive n=54, LD post-dialysis n=98)...
October 10, 2018: Clinical Transplantation
M Spacek, K Kunze, J Mehrholz
This study describes the course of renal recovery after dialysis in a specific population of chronically critically ill patients with a history of prolonged and complicated treatment in an intensive care unit. This study shows that, in a specialized center, patients can be successfully weaned from dialysis even months after acute kidney injury (AKI). Of the patients who could be recompensated (33%), approximately 20% achieved renal recovery more than 3 months after the start of dialysis. The duration of renal recovery after AKI did not differ between those patients with pre-existing chronic kidney disease (CKD) and those without...
October 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Amy S You, John J Sim, Csaba P Kovesdy, Elani Streja, Danh V Nguyen, Gregory A Brent, Kamyar Kalantar-Zadeh, Connie M Rhee
Background: Advanced chronic kidney disease (CKD) patients, including those receiving dialysis, have a high prevalence of thyroid dysfunction. Although hypothyroidism is associated with higher death risk in end-stage renal disease (ESRD) patients, no studies have examined whether thyroid status in the pre-ESRD period impacts mortality after dialysis initiation. Methods: Among US veterans with CKD identified from the national Veterans Affairs database that transitioned to dialysis over the period from October 2007 to September 2011, we examined the association of pre-ESRD serum thyrotropin (TSH) levels averaged over the 1-year pre-dialysis ('prelude') period with all-cause mortality in the first year following dialysis initiation...
October 8, 2018: Nephrology, Dialysis, Transplantation
Mei-Yi Wu, Mai-Szu Wu
Taiwan renal care system is an evolving learning health-care system. There are four facets of this system. From the early history of dialysis and Taiwan Renal Registry Data System, it facilitates the generation of data to knowledge. National multidisciplinary pre-end-stage renal disease care project and outcome enhances knowledge to practice. Early chronic kidney disease (CKD) programs and 2015 Taiwan CKD clinical guidelines implicate the practice to customer, and then explore the causes of CKD help to resume customer to data...
October 2018: Nephrology
Giorgina Barbara Piccoli, Louise Nielsen, Lurilyn Gendrot, Antioco Fois, Emanuela Cataldo, Gianfranca Cabiddu
There is no simple way to prescribe hemodialysis. Changes in the dialysis population, improvements in dialysis techniques, and different attitudes towards the initiation of dialysis have influenced treatment goals and, consequently, dialysis prescription. However, in clinical practice prescription of dialysis still often follows a "one size fits all" rule, and there is no agreed distinction between treatment goals for the younger, lower-risk population, and for older, high comorbidity patients. In the younger dialysis population, efficiency is our main goal, as assessed by the demonstrated close relationship between depuration (tested by kinetic adequacy) and survival...
October 8, 2018: Journal of Clinical Medicine
Flore Duranton, Alfonso Palma, Bernd Stegmayr, Michel Wauthier, Armando Torres, Àngel Argilés
BACKGROUND/AIMS: Climate influences the regulation of blood pressure (BP). Our objective was to precisely estimate BP seasonality in hemodialysis (HD) patients from five European cities with marked climate differences. METHODS: Stable prevalent HD patients from 5 European facilities (Santa Cruz de Tenerife (Spain), Seville (Spain), Montpellier (France), Ottignies (Belgium), Umea (Sweden)) present over the years 1995-1999 were included in this historical longitudinal observational study...
October 4, 2018: Kidney & Blood Pressure Research
Maja Pajek, Alexander Jerman, Joško Osredkar, Jadranka Buturović Ponikvar, Jernej Pajek
Association of higher serum levels of uremic toxins and inflammatory markers with poorer physical performance is understudied. We measured the six-minute walk test (6MWT), 10 repetition sit-to-stand test (STS-10), handgrip strength (HGS), and Human Activity Profile (HAP) questionnaire score in 90 prevalent hemodialysis patents, with low comorbidity to reduce the potential confounding of concomitant disease. Midweek pre-dialysis serum levels of asymmetric dimethyl-arginine (ADMA), β2-microglobulin (B2M), high-sensitivity C-reactive protein (hs-CRP), indoxyl sulfate (IS), insulin-like growth factor 1 (IGF-1), interleukin 6 (IL-6), myostatin, and urea were analyzed as predictor parameters of physical performance measures in adjusted models...
October 1, 2018: Toxins
Adrianna Douvris, Khalid Zeid, Swapnil Hiremath, Pierre Antoine Brown, Manish M Sood, Rima Abou Arkoub, Gurpreet Malhi, Edward G Clark
Background: Safety lapses in hospitalized patients with acute kidney injury (AKI) may lead to hemodialysis (HD) being required before renal recovery might have otherwise occurred. We sought to identify safety lapses that, if prevented, could reduce the need for unnecessary HD after AKI; Methods: We conducted a retrospective observational study that included consecutive patients treated with HD for AKI at a large, tertiary academic center between 1 September 2015 and 31 August 2016. Exposures of interest were pre-specified iatrogenic processes that could contribute to the need for HD after AKI, such as nephrotoxic medication or potassium supplement administration...
October 1, 2018: Journal of Clinical Medicine
Mariana P Cardoso, Luciano A L Pereira
Chronic kidney disease patients have a high prevalence of vitamin D insufficiency/deficiency. Vitamin D deficiency has been associated with a variety of bone, metabolic and cardiovascular disorders. However, the role of native vitamin D supplementation (ergocalciferol, cholecalciferol or calcifediol) remains unclear in chronic kidney disease (CKD), particularly in the pre-dialytic phase. Several international guidelines have been developed on CKD-Mineral and Bone Disorder, but the optimal strategy for native vitamin D supplementation and its clinical benefit remains a subject of debate in the scientific community...
September 28, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Stefania Marzocco, Gholamreza Fazeli, Lucia Di Micco, Giuseppina Autore, Simona Adesso, Fabrizio Dal Piaz, August Heidland, Biagio Di Iorio
BACKGROUND: In end-stage renal disease (ESRD), gut-derived uremic toxins play a fundamental role in the systemic inflammation and oxidative stress promoting the excess morbidity and mortality. The biochemical derangement is in part a consequence of an insufficient generation of short-chain fatty acids (SCFA) due to the dysbiosis of the gut and an insufficient consumption of the fermentable complex carbohydrates. AIM OF THE STUDY: The primary end-point was to evaluate the potential efficacy of SCFA (specifically, sodium propionate (SP)) for patients on maintenance hemodialysis (MHD) on systemic inflammation...
September 30, 2018: Journal of Clinical Medicine
Daniëlla G Straatsburg, Elisabeth A Hoekman, Raymond M Smulders, Jeroen G Lijmer
No abstract text is available yet for this article.
October 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Dugan W Maddux, Len A Usvyat, Thomas Blanchard, Yue Jiao, Peter Kotanko, Frank M van der Sande, Jeroen P Kooman, Franklin W Maddux
BACKGROUND: Peritoneal dialysis (PD) starters generally have a better outcome compared with hemodialysis (HD) starters, perhaps related to treatment characteristics or case mix. We previously showed that pre- and post-dialysis start clinical parameter trajectories are related to outcomes. The aim of this study was to investigate these trajectories in PD and HD starters. METHODS: This retrospective observational study analyzing data from the Fresenius Medical Care-chronic kidney disease (CKD) Registry from January 2009 to March 2018 examines trends in key clinical parameters through the transition period covering 12 months before to 12 months after dialysis start in 8,088 HD and 1,015 PD starters...
September 25, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
James B Wetmore, Suying Li, Heng Yan, Hairong Xu, Yi Peng, Marvin V Sinsakul, Jiannong Liu, David T Gilbertson
Whether and how anemia treatment with erythropoiesis stimulating agents (ESAs) before hemodialysis initiation may be associated with lower mortality after dialysis initiation is unknown. We compared all-cause and cardiovascular mortality in two groups of patients who experienced distinct anemia treatment patterns with ESAs before and after hemodialysis initiation. This retrospective cohort analysis included patients initiating hemodialysis April 1, 2012-June 30, 2013, identified from United States Renal Data System end-stage renal disease (ESRD) and pre-ESRD files...
2018: PloS One
Isibor J Arhuidese, Babak J Orandi, Besma Nejim, Mahmoud Malas
BACKGROUND: This study examines the utilization and outcomes of vascular access for long-term hemodialysis in the United States and describes the impact of temporizing catheter use on outcomes. We aimed to evaluate the prevalence, patency, and associated patient survival for pre-emptively placed autogenous fistulas and prosthetic grafts; for autogenous fistulas and prosthetic grafts placed after a temporizing catheter; and for hemodialysis catheters that remained in use. METHODS: We performed a retrospective study of all patients who initiated hemodialysis in the United States during a 5-year period (2007-2011)...
October 2018: Journal of Vascular Surgery
Stephanie Choo, Azeem Tariq Malik, Nikhil Jain, Elizabeth Yu, Jeffery Kim, Safdar N Khan
OBJECTIVES: Despite vertebral fractures being a common occurrence in elderly osteoporotic individuals, literature remains scant with regards to 30-day outcomes following vertebral augmentation for these injuries. We studied a national database of elderly osteoporotic patients who underwent vertebroplasty and kyphoplasty. PATIENTS AND METHODS: The 2012-2014 ACS-NSQIP database was queried using CPT codes for vertebroplasty (22520, 22521 and 22522) and kyphoplasty (22523, 22524 and 22525)...
August 12, 2018: Clinical Neurology and Neurosurgery
Christine Firth, Fadi Shamoun, Stephen Cha, Nan Zhang, Salma Patel, Paul Wennberg, Hatem Amer, Hani Wadei, Raymond Heilman, Mira Keddis
BACKGROUND: We evaluated the role of increased cardiac troponin T (cTnT), vascular, and cardiac diseases in predicting 5 and 10-year all-cause mortality after kidney transplantation. METHODS: We reviewed a cohort of 764 kidney transplant recipients and analyzed pertinent cardiovascular risk factors at the time of transplant evaluation. Proportional hazards regression analysis with bootstrapping method was utilized to provide a risk stratification score for mortality...
September 20, 2018: American Journal of Nephrology
Adamasco Cupisti, Giuliano Brunori, Biagio Raffaele Di Iorio, Claudia D'Alessandro, Franca Pasticci, Carmela Cosola, Vincenzo Bellizzi, Piergiorgio Bolasco, Alessandro Capitanini, Anna Laura Fantuzzi, Annalisa Gennari, Giorgina Barbara Piccoli, Giuseppe Quintaliani, Mario Salomone, Massimo Sandrini, Domenico Santoro, Patrizia Babini, Enrico Fiaccadori, Giovanni Gambaro, Giacomo Garibotto, Mariacristina Gregorini, Marcora Mandreoli, Roberto Minutolo, Giovanni Cancarini, Giuseppe Conte, Francesco Locatelli, Loreto Gesualdo
The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and / or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis...
September 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
A Viswanathan, T Leffler, N Paloian, M Cain, P H McKenna
INTRODUCTION: Management of severe antenatally detected oligohydramnios with and without obstruction is improving with the result that more fetuses are surviving with early renal failure. Significant advances have occurred in all specialties involved in the management of these patients. All these specialties working together have resulted in the survival of more patients born with renal failure. OBJECTIVE: The aim of this study is to highlight the medical advances in antenatal management of fetal oligohydramnios and pulmonary hypoplasia and to demonstrate that transplantation into a diverted urinary system is safe and leads to good outcomes...
August 8, 2018: Journal of Pediatric Urology
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