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Hemodialysis Prescription

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https://www.readbyqxmd.com/read/27895933/influence-of-proton-pump-inhibitors-and-histamine-h2-receptor-antagonists-on-serum-phosphorus-level-control-by-calcium-carbonate-in-patients-undergoing-hemodialysis-a-retrospective-medical-chart-review
#1
Masaomi Tatsuzawa, Ryuichi Ogawa, Atsushi Ohkubo, Kazuyo Shimojima, Kunimi Maeda, Hirotoshi Echizen, Akihisa Miyazaki
BACKGROUND: Hyperphosphatemia is one of the common complications in patients undergoing hemodialysis. Although calcium carbonate (CaC) is often used to control serum inorganic phosphorus level in dialysis patients, co-administration of gastric acid reducers (ARs) may interfere with the phosphate binding effect of CaC. We performed a retrospective medical chart review to study whether ARs attenuate the hypophosphatemic effect of CaC in patients undergoing hemodialysis. METHODS: One hundred and eight chronic hemodialysis patients receiving either CaC alone or CaC concomitant with one of the ARs (proton pump inhibitors and histamine H2-receptor antagonists) were retrieved from the medical charts in Juntendo University Nerima Hospital...
2016: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/27884309/would-prescribing-target-kt-dose-adjusted-for-body-surface-area-improve-hemodialysis-outcomes
#2
Ken Farrington, Andrew Davenport
The use of Kt/V to prescribe and monitor hemodialysis adequacy remains the current standard, although it is increasingly questioned. Alternative proposals for dose prescription and monitoring have been advocated. In a noninterventional, prospective study reported in this issue, Maduell et al., utilizing online ionic dialysance, explore the association between outcome measures (mortality and hospitalization rates) and the extent to which delivered Kt dose achieved minimal target Kt doses calculated from individual estimates of body surface area...
December 2016: Kidney International
https://www.readbyqxmd.com/read/27881607/bicarbonate-balance-and-prescription-in-esrd
#3
Matthew K Abramowitz
The optimal approach to managing acid-base balance is less well defined for patients receiving hemodialysis than for those receiving peritoneal dialysis. Interventional studies in hemodialysis have been limited and inconsistent in their findings, whereas more compelling data are available from interventional studies in peritoneal dialysis. Both high and low serum bicarbonate levels associate with an increased risk of mortality in patients receiving hemodialysis, but high values are a marker for poor nutrition and comorbidity and are often highly variable from month to month...
November 23, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27876356/-low-flux-dialysate-daily-home-hemodialysis-a-result-for-the-62%C3%A2-first-french-and-belgian-patients
#4
Anaïs Benabed, Patrick Henri, Thierry Lobbedez, Eric Goffin, Simona Baluta, Abdelkader Benziane, Ahmed Rachi, Johan W van der Pijl, Clémence Bechade, Maxence Ficheux
Since 2011, a new device is available for low flux dialysate quotidian home hemodialysis in France and Belgium. This study aims to evaluate the characteristics and dialysis prescriptions for Nx Stage System One™ users. We retrospectively included patients trained between 2011 and 2013 in France and Belgium. We collected data concerning their clinical features, their dialysis prescriptions, their laboratory parameters until 6 months of dialysis and, reason for dropping in case of cessation. Sixty-two patients from 31 centers, aged 48±18 years old, with a sex ratio 46/16 (M/F) are included with a median Charlson comorbidity index of 1 [0-3]...
November 18, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27866964/dialysate-potassium-serum-potassium-mortality-and-arrhythmia-events-in-hemodialysis-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#5
Angelo Karaboyas, Jarcy Zee, Steven M Brunelli, Len A Usvyat, Daniel E Weiner, Franklin W Maddux, Allen R Nissenson, Michel Jadoul, Francesco Locatelli, Wolfgang C Winkelmayer, Friedrich K Port, Bruce M Robinson, Francesca Tentori
BACKGROUND: Sudden death is a leading cause of death in patients on maintenance hemodialysis therapy. During hemodialysis sessions, the gradient between serum and dialysate levels results in rapid electrolyte shifts, which may contribute to arrhythmias and sudden death. Controversies exist about the optimal electrolyte concentration in the dialysate; specifically, it is unclear whether patient outcomes differ among those treated with a dialysate potassium concentration of 3 mEq/L compared to 2 mEq/L...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27814946/phosphate-containing-prescription-medications-contribute-to-the-daily-phosphate-intake-in-a-third-of-hemodialysis-patients
#6
Seana M L Nelson, Samantha R S Sarabia, Erin Christilaw, Emilie C Ward, Stephanie K Lynch, Michael A Adams, Rachel M Holden
OBJECTIVES: Hyperphosphatemia is associated with all-cause mortality in hemodialysis (HD) patients and is managed by restricting dietary phosphate. Many patients are unable to adhere to the recommended dietary phosphate limit. We sought to quantify the additional phosphate burden from prescription medication in a hemodialysis population. DESIGN: Cross-sectional study. SUBJECTS: Adult patients on hemodialysis at a single center. SETTING: The Health Canada Drug Product Database was used to identify formulations of medications prescribed in an HD program that contain phosphate salts...
November 1, 2016: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/27790813/hemodialysis-practice-patterns-in-the-russia-dialysis-outcomes-and-practice-patterns-study-dopps-with-international-comparisons
#7
Boris Bikbov, Brian Bieber, Anton Andrusev, Natalia Tomilina, Alexander Zemchenkov, Junhui Zhao, Friedrich Port, Bruce Robinson, Ronald Pisoni
Introduction There is little comparable information about hemodialysis (HD) practices in low- and middle income countries, including Russia. Evaluation of HD in Russia and its international comparisons could highlight factors providing opportunities for improvement. Methods We examined treatment patterns for 481 prevalent HD patients in 20 Russian facilities, and compared them to contemporary data for 8512 patients from 311 facilities in seven European countries, Japan, and North America. Data were collected according to the uniform methodology of the Dialysis Outcomes and Practice Patterns Study, phase 5...
October 27, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27789113/baclofen-toxicity-in-a-patient-with-hemodialysis-dependent-end-stage-renal-disease
#8
Lauren M Porter, Stephanie S Merrick, Kenneth D Katz
BACKGROUND: Oral baclofen toxicity is extremely rare, but can affect patients with renal disease due to the drug's predominant renal clearance of approximately 69-85%. Patients with severely impaired renal function typically develop symptoms soon after initiating baclofen therapy, even at relatively low doses. CASE REPORT: A 69-year-old woman with a history of hemodialysis-dependent end-stage renal disease presented to the Emergency Department with encephalopathy, ataxia, and dystonia after the addition of a recent baclofen prescription for back pain (10 mg twice daily)...
October 24, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27781388/the-dialysis-outcomes-and-practice-patterns-study-dopps-in-turkey
#9
Tevfik Ecder, Cengiz Utas, Kenan Ates, Brian Bieber, Bruce M Robinson, Ronald L Pisoni, Gültekin Süleymanlar
Introduction Turkey has one of the largest treated end-stage renal disease (ESRD) patient populations in Europe (N = 66,711). In 2013, the international Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective study of hemodialysis (HD) practices and outcomes, initiated data collection in Turkey. Here we provide comparisons of HD patients in DOPPS-Turkey with other international regions and with patients in the Registry of Turkish Nephrology, Dialysis and Transplantation. Methods DOPPS-Turkey study sites were randomly selected from all Turkish HD units treating ≥25 in-center chronic HD patients...
October 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27738228/a-two-pool-kinetic-model-predicts-phosphate-concentrations-during-and-shortly-following-a-conventional-three-times-weekly-hemodialysis-session
#10
John T Daugirdas
BACKGROUND: Previous studies have suggested that a conventional two-pool model cannot be used to predict intradialysis and early postdialysis phosphorus concentrations. METHODS: A conventional two-pool urea model was modified by increasing the distal compartment volume from two-thirds to three times the total body water and by the use of a dynamically variable intercompartmental phosphorus clearance during dialysis. The phosphate solver model parameters were derived from an examination of the results in the literature, and fine-tuned using a training set (F4) of 415 Hemodialysis (HEMO) Study patients studied during a dialysis session where phosphorus was measured at 4 months of follow-up...
October 13, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27721548/prescribing-patterns-of-medicines-in-chronic-kidney-disease-patients-on-maintenance-hemodialysis
#11
Sourav Chakraborty, Saugata Ghosh, Avishek Banerjea, Radha Raman De, Avijit Hazra, Swapan Kumar Mandal
OBJECTIVES: To study medicine prescribing pattern for chronic kidney disease (CKD) patients on maintenance hemodialysis. MATERIALS AND METHODS: This prospective observational study was conducted in hemodialysis unit of a teaching hospital with adult CKD patients on maintenance hemodialysis. Patients' clinical profile, drug-use pattern, and medication-related problem data were captured in a structured case report form and the data were analyzed descriptively. Adherence level was assessed by Morisky Medication-Taking Adherence Scale 4-item...
September 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/27672007/a-comparative-study-of-renal-care-in-brazil-and-mexico-hemodialysis-treatment-from-the-perspective-of-esrd-sufferers
#12
Francisco J Mercado-Martinez, Denise Guerreiro V da Silva, Mauricio E Correa-Mauricio
Renal replacement therapy is the indicated treatment for individuals with chronic kidney disease (CKD) to survive. However, not all sick people have access to the same treatment. This study compares renal care in two developing countries with different health systems. Specifically, it explores hemodialysis treatment from the perspective of low-income individuals. A qualitative, comparative study was performed in Brazil and Mexico. Using purposive sampling, the research was based on open-ended interviews with nineteen participants with kidney failure undergoing hemodialysis treatment in public hospitals and ten relatives...
September 27, 2016: Nursing Inquiry
https://www.readbyqxmd.com/read/27663037/scaling-hemodialysis-target-dose-to-reflect-body-surface-area-metabolic-activity-and-protein-catabolic-rate-a-prospective-cross-sectional-study
#13
Sivakumar Sridharan, Enric Vilar, Andrew Davenport, Neil Ashman, Michael Almond, Anindya Banerjee, Justin Roberts, Ken Farrington
BACKGROUND: Women and small men treated by hemodialysis (HD) have reduced survival. This may be due to use of total-body water (V) as the normalizing factor for dialysis dosing. In this study, we explored the equivalent dialysis dose that would be delivered using alternative scaling parameters matching the current recommended minimum Kt/V target of 1.2. STUDY DESIGN: Prospective cross-sectional study. SETTING & PARTICIPANTS: 1,500 HD patients on a thrice-weekly schedule, recruited across 5 different centers...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27660305/the-agreement-between-auscultation-and-lung-ultrasound-in-hemodialysis-patients-the-lust-study
#14
Claudia Torino, Luna Gargani, Rosa Sicari, Krzysztof Letachowicz, Robert Ekart, Danilo Fliser, Adrian Covic, Kostas Siamopoulos, Aristeidis Stavroulopoulos, Ziad A Massy, Enrico Fiaccadori, Alberto Caiazza, Thomas Bachelet, Itzchak Slotki, Alberto Martinez-Castelao, Marie-Jeanne Coudert-Krier, Patrick Rossignol, Faikah Gueler, Thierry Hannedouche, Vincenzo Panichi, Andrzej Wiecek, Giuseppe Pontoriero, Pantelis Sarafidis, Marian Klinger, Radovan Hojs, Sarah Seiler-Mussler, Fabio Lizzi, Dimitrie Siriopol, Olga Balafa, Linda Shavit, Rocco Tripepi, Francesca Mallamaci, Giovanni Tripepi, Eugenio Picano, Gérard Michel London, Carmine Zoccali
BACKGROUND AND OBJECTIVES: Accumulation of fluid in the lung is the most concerning sequela of volume expansion in patients with ESRD. Lung auscultation is recommended to detect and monitor pulmonary congestion, but its reliability in ESRD is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a subproject of the ongoing Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial, we compared a lung ultrasound-guided ultrafiltration prescription policy versus standard care in high-risk patients on hemodialysis...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27598317/patients-characteristics-affect-the-survival-benefit-of-warfarin-treatment-for-hemodialysis-patients-with-atrial-fibrillation-a-historical-cohort-study
#15
Diego Brancaccio, Luca Neri, Francesco Bellocchio, Carlo Barbieri, Claudia Amato, Flavio Mari, Bernard Canaud, Stefano Stuard
BACKGROUND: Stroke prevention in dialysis-dependent patients with atrial fibrillation (AF) is an unresolved clinical dilemma. Indeed, no randomized controlled trial evaluating the efficacy and safety of oral anticoagulants in this population, has been conducted so far. Observational research on the use of warfarin in patients on dialysis has shown conflicting results. This uncertainty is mirrored by the wide variations in warfarin prescription patterns across centers. We sought to evaluate the association between the use of vitamin K antagonists (VKAs) and mortality among hemodialysis patient with AF and to assess potential factors affecting the risk-benefit profile of warfarin in this population...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27578429/effect-of-treatment-duration-and-frequency-on-uremic-solute-kinetics-clearances-and-concentrations
#16
John K Leypoldt, Björn K I Meijers
The kinetics of uremic solute clearances are discussed based on two categories of uremic solutes, namely those that are and those that are not derived directly from nutrient intake, particularly dietary protein intake. This review highlights dialysis treatments that are more frequent and longer (high-dose hemodialysis) than conventional thrice weekly therapy. It is proposed that the dialysis dose measures based on urea as a marker uremic solute, such as Kt/V and stdKt/V, be referred to as measures of dialysis inadequacy, not dialysis adequacy...
November 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27576879/evaluation-of-dialysis-adequacy-in-hemodialysis-patients-a-systematic-review
#17
Hengameh Barzegar, Mahmoud Moosazadeh, Hedayat Jafari, Ravanbakhsh Esmaeili
PURPOSE: Hemodialysis is the common kidney replacement therapy in Iran. Doing an adequate and effective dialysis can improve patients' quality of life and reduce kidney failure complications. Additionally, dialysis quality is an important factor in reducing mortality in patients with chronic kidney failure. This systematic review has investigated the adequacy of dialysis in studies done on hemodialysis patients of Iran. MATERIALS AND METHODS: All articles related to the dialysis adequacy in hemodialysis patients in English and Farsi (contemporary Persian) were identified by searching the related keywords in various electronic databases...
2016: Urology Journal
https://www.readbyqxmd.com/read/27536678/chronic-hemodialysis-therapy-in-the-west
#18
REVIEW
Michael V Rocco
BACKGROUND: Chronic hemodialysis (HD) in the 1960s encompassed a wide variety of prescriptions from twice weekly to five times per week HD. Over time, HD prescriptions in the West became standardized at three times per week, 2.5-4 h per session, with occasional additional treatments for volume overload. SUMMARY: When clinical trials of dialysis dose failed to show significant benefit of extending time compared with the traditional dialysis prescription, interest in more frequent HD was renewed...
December 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27477358/hemodialysis-prescription-for-incident-patients-twice-seems-nice-but-is-it-incremental
#19
EDITORIAL
Stephanie M Toth-Manikowski, Tariq Shafi
No abstract text is available yet for this article.
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27453712/confronting-practical-problems-for-initiation-of-on-line-hemodiafiltration-therapy
#20
REVIEW
Yang Wook Kim, Sihyung Park
Conventional hemodialysis, which is based on the diffusive transport of solutes, is the most widely used renal replacement therapy. It effectively removes small solutes such as urea and corrects fluid, electrolyte and acid-base imbalance. However, solute diffusion coefficients decreased rapidly as molecular size increased. Because of this, middle and large molecules are not removed effectively and clinical problem such as dialysis amyloidosis might occur. Online hemodiafiltration which is combined by diffusive and convective therapies can overcome such problems by removing effectively middle and large solutes...
June 2016: Electrolyte & Blood Pressure: E & BP
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