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Hemodialysis Prescription

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https://www.readbyqxmd.com/read/29191576/-comparison-of-citrate-4-and-heparin-as-tunneled-catheters-locking-solution-in-chronic-hemodialysis
#1
Guillaume Chazot, Manolie Mehdi, Christie Lorriaux, Patrik Deleaval, Brice Mayor, Guillaume Jean, Charles Chazot, Sylvain Lechevallier, Oriane Moncel, Cyril Vo-Van, Jean-Marc Hurot
INTRODUCTION: Citrate 4% is an alternative to heparin as catheter-locking solution in chronic hemodialysis patients. We compared catheter dysfunction episodes, dialysis adequacy, plasminogen-tissular activators use and costs according to catheter-locking solution in our centre. METHODS: Prospective, monocentric, cohort study (NephroCare Tassin-Charcot) on 49 prevalent patients in chronic hemodialysis. Two main groups were formed according to the prescription of catheter-locking solution at the beginning of the study (03/02/2016) and followed until 05/10/2016: heparin (n=26) and citrate (n=22)...
November 27, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29166634/sodium-prescription-in-the-prevention-of-intradialytic-hypotension-new-insights-into-an-old-concept
#2
Gabriele Donati, Mauro Ursino, Alessandra Spazzoli, Nicolò Natali, Roberto Schillaci, Diletta Conte, Andrea Angeletti, Anna Laura Croci Chiocchini, Irene Capelli, Olga Baraldi, Gaetano La Manna
BACKGROUND: Sodium prescription in patients with intradialytic hypotension remains a challenge for the attending nephrologist, as it increases dialysate conductivity in hypotension-prone patients, thereby adding to dietary sodium levels. METHODS: New sodium prescription strategies are now available, including the use of a mathematical model to compute the sodium mass to be removed during dialysis as a physiological controller. RESULTS: This review describes the sodium load of patients with end-stage renal disease on chronic hemodialysis (HD) and discusses 2 strategies to remove excess sodium in patients prone to intradialytic hypotension, namely, Profiled HD and the hemodiafiltration Aequilibrium System...
November 23, 2017: Blood Purification
https://www.readbyqxmd.com/read/29150416/-bicarbonate-from-physiology-to-treatment-for-all-clinicians
#3
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3(-)) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29142984/the-combination-of-beta-blockers-and-renin-angiotensin-system-blockers-improves-survival-in-incident-hemodialysis-patients-a-propensity-matched-study
#4
José Luño, Javier Varas, Rosa Ramos, Ignacio Merello, Pedro Aljama, Alejandro MartinMalo, Julio Pascual, Manuel Praga
Introduction: Although several studies suggest that the prognosis of hypertensive dialysis patients can be improved by using antihypertensive drug therapy, it is unknown whether the prescription of a particular class or combination of antihypertensive drugs is beneficial during hemodialysis. Methods: We performed a propensity score matching study to compare the effectiveness of various classes of antihypertensive drugs on cardiovascular (CV) mortality in 2518 incident hemodialysis patients in Spain...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29092735/potentially-inappropriate-prescribing-of-drugs-in-elderly-patients-on-chronic-hemodialysis-treatment%C3%A2
#5
Gorana Nedin Ranković, Slobodan M Janković, Radmila Veličković Radovanović, Zorica Jović, Gordana Pešić, Svetlana Pavlović, Branislava Ranković, Jasmina Ranković, Dragana Stokanović, Dane Krtinić
PURPOSE: The aim of this study was to determine the prevalence of potentially inappropriate drug prescription (PIP) in older patients who were on chronic hemodialysis treatment and to explore the factors that lead to PIP. MATERIALS AND METHODS: The study was performed at the Department of Nephrology, Clinical Center Niš, Serbia. It included patients who were 65 years old and older who suffered from the end-stage of kidney failure and were treated by hemodialysis...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29080898/thiamine-diphosphate-status-and-dialysis-related-losses-in-end-stage-kidney-disease-patients-treated-with-hemodialysis
#6
Magdalena Jankowska, Paweł Rudnicki-Velasquez, Hanna Storoniak, Przemysław Rutkowski, Bolesław Rutkowski, Karol Krzymiński, Alicja Dębska-Ślizień
AIM: (1) To describe the whole blood content of thiamine diphosphate (TDP), a biologically active form of vitamin B1 in end-stage kidney disease patients treated with hemodialysis (HD); (2) to establish the impact of a single HD procedure on TDP blood concentrations; and (3) to describe potential explanatory variables influencing TDP dialysis related losses, including dialysis prescription, vitamin B1 dietary intake and supplementation. METHODS: Single-center, cross-sectional study in 50 clinically stable maintenance HD patients...
October 28, 2017: Blood Purification
https://www.readbyqxmd.com/read/29061163/an-integrative-review-of-the-methodology-and-findings-regarding-dietary-adherence-in-end-stage-kidney-disease
#7
Kelly Lambert, Judy Mullan, Kylie Mansfield
BACKGROUND: Dietary modification is an important component of the management of end stage kidney disease (ESKD). The diet for ESKD involves modifying energy and protein intake, and altering sodium, phosphate, potassium and fluid intake. There have been no comprehensive reviews to date on this topic. The aims of this integrative review were to (i) describe the methods used to measure dietary adherence (ii) determine the rate of dietary adherence and (iii) describe factors associated with dietary adherence in ESKD...
October 23, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29018100/randomized-crossover-trial-of-blood-volume-monitoring-guided-ultrafiltration-biofeedback-to-reduce-intradialytic-hypotensive-episodes-with-hemodialysis
#8
Kelvin C W Leung, Robert R Quinn, Pietro Ravani, Henry Duff, Jennifer M MacRae
BACKGROUND AND OBJECTIVES: Intradialytic hypotension (IDH) is associated with morbidity. The effect of blood volume-guided ultrafiltration biofeedback, which automatically adjusts fluid removal rate on the basis of blood volume parameters, on the reduction of IDH was tested in a randomized crossover trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a 22-week, single blind, randomized crossover trial in patients receiving maintenance hemodialysis who had >30% of sessions complicated by symptomatic IDH in five centers in Calgary, Alberta, Canada...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28993507/dialysate-potassium-dialysate-magnesium-and-hemodialysis-risk
#9
Patrick H Pun, John P Middleton
One of the fundamental goals of the hemodialysis prescription is to maintain serum potassium levels within a narrow normal range during both the intradialytic and interdialytic intervals. Considering the extraordinarily high rate of cardiovascular mortality in the hemodialysis population, clinicians are obligated to explore whether factors related to dialytic potassium removal can be modified to improve clinical outcomes. Observational studies and circumstantial evidence suggest that extreme concentrations of serum and dialysate potassium can trigger cardiac arrest...
October 9, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28975489/use-of-lung-ultrasonography-to-determine-the-accuracy-of-clinically-estimated-dry-weight-in-chronic-hemodialysis-patients
#10
Chuan Jiang, Satyam Patel, Andrew Moses, Maria V DeVita, Michael F Michelis
PURPOSE: The use of lung ultrasound (LUS) to identify extravascular lung water has received increasing acceptance. Sonographic B-lines, discrete vertical lines that originate from the pleura, represent pulmonary edema and are correlated with the accumulation of fluid. The goal of this study was to evaluate the utility of LUS to determine the accuracy of prescribed dry weight (DW) in chronic hemodialysis (HD) patients and to ascertain the adequacy of fluid removal. METHODS: LUS was scheduled to be performed pre- and post-HD in 20 patients...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28968454/reduction-of-intracerebral-hemorrhage-in-hemodialysis-patients-after-reducing-aspirin-use-a-quality-assurance-observational-study
#11
Mabel Aoun, Sahar H Koubar, Leony Antoun, Hani Tamim, Maha Makki, Dania Chelala
There is so far no international consensus concerning the prescription of antithrombotic agents in hemodialysis patients. It is not clear yet why they cause more bleeding in some patients and are beneficial in others. We therefore tried to find out what triggers bleeding in this population. This is an observational before-and-after study that included all patients undergoing hemodialysis in our center between 2005 and 2015. We divided the study into two phases: phase one (125 patients) where aspirin was used without restrictions and phase two (110 patients) where aspirin was avoided in severe hypertension and primary prevention...
2017: PloS One
https://www.readbyqxmd.com/read/28937925/effect-of-self-reported-distress-thermometer-score-on-the-maximal-handgrip-and-pinch-strength-measurements-in-hemodialysis-patients
#12
Stephanie Camilleri, Stephanie Chong, Kamonwan Tangvoraphonkchai, Suree Yoowannakul, Andrew Davenport
BACKGROUND: Muscle weakness is a risk factor for mortality in hemodialysis (HD) patients. Muscle strength measurements are routinely used as a screening tool but depend on patient cooperation and motivation. We wished to determine whether measuring maximal voluntary muscle strength was affected by patient self-reported distress. METHODS: We measured pinch strength (PS) and handgrip strength (HGS) in 382 adult HD patients with a corresponding self-reported distress thermometer (DT) scores...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28918555/prognostic-factors-for-mortality-in-middle-aged-and-older-hemodialysis-patients-a-5-year-observational-study
#13
Kojiro Nagai, Motokazu Matsuura, Kenji Tsuchida, Hiro-Omi Kanayama, Toshio Doi, Jun Minakuchi
Clinical guidelines for hemodialysis therapy have been described in an evidence-based manner with most evidence from randomized control trials or retrospective studies in which all generations of the hemodialysis patients were enrolled. Therefore, the question still remains whether these guidelines can be applied to increasing older patients. This study is an observational study, including 735 patients who received maintenance hemodialysis in April 2006. At baseline, the participants' age was 62.1 ± 12...
September 16, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28910798/expanded-hemodialysis-therapy-prescription-and-delivery
#14
Nils Heyne
Expanded hemodialysis (HDx) therapy is a novel treatment concept in hemodialysis patients, using innovative membrane technology with a high retention onset for improved solute clearance in the upper middle molecular range. HDx therapy thereby resolves a key limitation of current hemodialysis techniques and targets an important pathophysiologic link to many of the sequelae of end-stage renal disease. The present chapter reviews the current evidence and discusses considerations for prescription and delivery of HDx therapy upon implementation in clinical practice...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28874131/a-chronic-hemodialysis-patient-with-isolated-pulmonary-valve-infective-endocarditis-caused-by-non-albicans-candida-a-rare-case-and-literature-review
#15
Chih-Hao Chang, Myo-Ming Huang, Dong-Feng Yeih, Kuo-Cheng Lu, Yi-Chou Hou
BACKGROUND: Isolated pulmonary valve infective endocarditis caused by Candida is rare in chronic hemodialysis patients. The 2009 Infectious Diseases Society of America guidelines suggest the combined use of surgery and antibiotics to treat candidiasis; however, successful nonsurgical treatment of Candida endocarditis has been reported. CASE PRESENTATION: A 63-year-old woman with end-stage kidney disease was admitted to our hospital after experiencing disorientation for 5 days...
September 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28870161/chronic-dialysis-nat2-polymorphisms-and-the-risk-of-isoniazid-induced-encephalopathy-case-report-and-literature-review
#16
Stefan Matei Constantinescu, Benoit Buysschaert, Vincent Haufroid, Franck Broly, Michel Jadoul, Johann Morelle
BACKGROUND: Isoniazid is the most widely used anti-tuberculosis agent, yet it may lead to life-threatening complications. CASE PRESENTATION: Here we report the case of a chronic hemodialysis patient who developed severe encephalopathy after the start of isoniazid. Blood levels of isoniazid were elevated, and acetyl-isoniazid over isoniazid ratio was decreased 3 h after intake of the medication, suggesting that a slow acetylator phenotype may have contributed to drug toxicity, in addition to pyridoxal phosphate removal by dialysis...
September 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28853704/comparison-of-hypoalbuminemia-corrected-serum-calcium-using-bcp-albumin-assay-to-ionized-calcium-and-impact-on-prescribing-in-hemodialysis-patients%C3%A2
#17
Wenxin Cindy Pan, Wynnie Lau, Andre Mattman, Mercedeh Kiaii, Beverly Jung
BACKGROUND: Albumin-corrected calcium (cCa) is recommended over ionized calcium (iCa) in hemodialysis (HD) patients per the Kidney Disease: Improving Global Outcomes position statements due to cost and feasibility. Two common albumin assays, bromocresol green (BCG) and bromocresol purple (BCP), produce differing results in uremic patients. All previous studies compared iCa to cCa from a BCG assay. This study, using the BCP assay, aimed to compare cCa and total calcium, respectively, to iCa...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28834360/ras-inhibitor-is-not-associated-with-cardiovascular-benefits-in-patients-undergoing-hemodialysis-in-japan
#18
Masahide Mizobuchi, Hiroaki Ogata, Yoshihiro Onishi, Shingo Fukuma, Tadao Akizawa, Shunichi Fukuhara
Definitive evidence of whether renin angiotensin system (RAS) inhibition is beneficial on cardiovascular events (CVE) among patients undergoing hemodialysis (HD) is lacking. The objective of this study was to investigate the association of RAS inhibitor usage with CVEs in patients enrolled in the Dialysis Outcomes Practice Pattern Study in Japan (J-DOPPS). Association of RAS inhibitor prescription with outcomes including all-cause death, death caused by CVE, and hospitalization due to cardiac failure was investigated by using a multivariable Cox proportional hazards model...
August 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28747155/indole-3-acetic-acid-indoxyl-sulfate-and-paracresyl-sulfate-do-not-influence-anemia-parameters-in-hemodialysis-patients
#19
Stanislas Bataille, Marion Pelletier, Marion Sallée, Yvon Berland, Nathalie McKay, Ariane Duval, Stéphanie Gentile, Yosra Mouelhi, Philippe Brunet, Stéphane Burtey
BACKGROUND: The main reason for anemia in renal failure patients is the insufficient erythropoietin production by the kidneys. Beside erythropoietin deficiency, in vitro studies have incriminated uremic toxins in the pathophysiology of anemia but clinical data are sparse. In order to assess if indole 3-acetic acid (IAA), indoxyl sulfate (IS), and paracresyl sulfate (PCS) -three protein bound uremic toxins- are clinically implicated in end-stage renal disease anemia we studied the correlation between IAA, IS and PCS plasmatic concentrations with hemoglobin and Erythropoietin Stimulating Agents (ESA) use in hemodialysis patients...
July 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28739573/quality-assurance-audit-of-technique-failure-and-90-day-mortality-after-program-discharge-in-a-canadian-home-hemodialysis-program
#20
Nikhil Shah, Frances Reintjes, Mark Courtney, Scott W Klarenbach, Feng Ye, Kara Schick-Makaroff, Kailash Jindal, Robert P Pauly
BACKGROUND AND OBJECTIVES: Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance...
July 24, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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