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Adequate dialysis

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https://www.readbyqxmd.com/read/28633456/feeding-during-dialysis-risks-and-uncertainties
#1
Rajiv Agarwal, Panagiotis Georgianos
Allowing dialysis patients to eat during the treatment is controversial. It is, therefore, no surprise that practices and policies with respect to intradialytic food consumption vary considerably from unit to unit and from country to country. Those who defend the position of feeding during dialysis reason that intradialytic meals offer a supervised and effective therapy for protein-energy wasting. Those who take the opposite view argue that intradialytic food intake should be avoided for the following three reasons...
June 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28619127/bone-mineral-disturbances-in-patients-with-chronic-kidney-disease-stage-5-not-yet-on-dialysis
#2
Andreja Marn Pernat, Matej Zrimšek
AIMS: This retrospective study evaluates the success of a treatment strategy for secondary hyperparathyroidism in our cohort of patients with chronic kidney disease stage 5 who were not yet on dialysis. MATERIALS AND METHODS: 81 predialysis patients from the outpatient clinic of the Department of Nephrology, University Medical Center Ljubljana were reviewed. We focused on serum markers for bone mineral metabolism including intact parathyroid hormone (PTH), phosphate, corrected calcium, and the usage of phosphate-binding agents and vitamin D analogs...
June 16, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28608981/health-related-quality-of-life-of-patients-on-chronic-dialysis-the-need-for-a-focused-effort
#3
EDITORIAL
Maurizio Bossola, Gilda Pepe, Emanuele Marzetti
Health-related quality of life (HRQOL) in patients on chronic hemodialysis has not improved significantly in the last 20 years. This is largely due to their substantial symptom burden which is rarely assessed and treated in routine clinical practice. It also is a consequence of the lack of an appropriate armamentarium for the treatments of such symptoms. Adequate studies on the causes and pathogenesis of the symptoms of hemodialysis patients are needed followed by high quality studies on possible therapeutic pharmacological and nonpharmacological interventions...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#4
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
June 8, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28591760/cultural-challenges-in-the-care-of-refugees-with-end-stage-renal-disease-what-western-nephrologists-should-know
#5
Mohamed A Sekkarie, Emaad M Abdel-Rahman
Forced migration is on the rise, mainly from the Middle East to western countries, resulting in unprecedented moral, political, and economic challenges for both refugees and host communities. Recent research showed that refugees represent around 1.5% of the dialysis population in several European and Middle Eastern countries surveyed. Despite the fact that refugees represent a small percentage of all dialysis patients in these countries, adequate care for this population is challenging. There are cultural differences between refugee patients with end-stage renal disease hailing from the Middle East, who are predominantly Muslims, and people from the western host countries...
June 8, 2017: Nephron
https://www.readbyqxmd.com/read/28589054/a-patient-with-msud-acute-management-with-sodium-phenylacetate-sodium-benzoate-and-sodium-phenylbutyrate
#6
Melis Köse, Ebru Canda, Mehtap Kagnici, Sema Kalkan Uçar, Mahmut Çoker
In treatment of metabolic imbalances caused by maple syrup urine disease (MSUD), peritoneal dialysis, and hemofiltration, pharmacological treatments for elimination of toxic metabolites can be used in addition to basic dietary modifications. Therapy with sodium phenylacetate/benzoate or sodium phenylbutyrate (NaPB) in urea-cycle disorder cases has been associated with a reduction in branched-chain amino acid (BCAA) concentrations when the patients are on adequate dietary protein intake. Moreover, NaPB in treatment of MSUD patients is also associated with reduction of BCAA levels in a limited number of cases...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28578687/target-weight-achievement-and-ultrafiltration-rate-thresholds-potential-patient-implications
#7
Jennifer E Flythe, Magdalene M Assimon, Robert A Overman
BACKGROUND: Higher ultrafiltration (UF) rates and extracellular hypo- and hypervolemia are associated with adverse outcomes among maintenance hemodialysis patients. The Centers for Medicare and Medicaid Services recently considered UF rate and target weight achievement measures for ESRD Quality Incentive Program inclusion. The dual measures were intended to promote balance between too aggressive and too conservative fluid removal. The National Quality Forum endorsed the UF rate measure but not the target weight measure...
June 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28577730/-sucroferric-oxyhydroxide-a-novel-iron-based-phosphate-binder-which-current-use-in-dialysis-patients
#8
Pierre Bataille, Vincent Delattre, Maité Daroux
International guidelines suggest lowering elevated phosphorus level to the normal range in patients on dialysis. Among the phosphate-lowering strategies, phosphate binder is frequently used in addition to dietary phosphate restriction and an adequate dialysis strategy. However, serum phosphate concentration higher than 1.78mmol/L is observed in more than 40% of patients justifying the quest for new drugs. Sucroferric oxyhydroxide is one of the new iron-based agents and is available in France since May 2016...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28573315/pediatric-renal-transplant-biopsy-with-ultrasound-guidance-the-core-essentials
#9
REVIEW
Aris Oates, Saveen Ahuja, Marsha M Lee, Andrew S Phelps, John D Mackenzie, Jesse L Courtier
This review provides a comprehensive and practical approach to pediatric percutaneous renal transplant biopsies, highlighting techniques and strategies to optimize adequate sample yield and ensure patient safety. In children with end-stage renal disease, transplantation is the preferred choice of therapy, providing for overall lower long-term morbidity and mortality compared with dialysis. In the ongoing management of renal transplant patients, core tissue sampling via a percutaneous renal biopsy remains the gold standard when transplant dysfunction is suspected...
June 1, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28571995/is-peritoneal-dialysis-feasible-after-laparotomy-in-children-a-case-control-series-to-compare-outcomes
#10
A Bouty, A Faure, L Shaw, J Ah Toy, E Dobremez, M O'Brien, Y Heloury
OBJECTIVES: Peritoneal dialysis (PD) is the modality of choice for children with end-stage renal disease (ESRD) awaiting renal transplant; however, this option is sometimes avoided for those with previous laparotomy. The goal of this study was to compare the outcomes of PD in patients with and without previous laparotomy. PATIENTS AND METHODS: Twenty-four patients who had been started on peritoneal dialysis were retrospectively analysed. Group LAP consisted of six patients with previous laparotomy, and Group NO-LAP of 18 controls with either retroperitoneal or no abdominal surgery...
May 12, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28546765/vitamin-d-prohormone-in-the-treatment-of-secondary-hyperparathyroidism-in-patients-with-chronic-kidney-disease
#11
REVIEW
Claudia Friedl, Emanuel Zitt
Secondary hyperparathyroidism (sHPT) represents the adaptive and very often, finally, maladaptive response of the organism to control the disturbed homeostasis of calcium, phosphorus, and vitamin D metabolism caused by declining renal function in chronic kidney disease (CKD). sHPT leads to cardiovascular and extravascular calcifications and is directly linked to an increased risk of cardiovascular morbidity and mortality as well as excess all-cause mortality. Vitamin D plays an important role in the development of sHPT...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28546368/effects-of-a-comprehensive-predialysis-education-program-on-the-home-dialysis-therapies-a-retrospective-cohort-study
#12
Ashutosh Shukla, Andrea K Easom, Manisha Singh, Richa Pandey, Dumitru Rotaru, Xuerong Wen, Sudhir V Shah
♦Background: Improvement in the rates of home dialysis has been a desirable but difficult-to-achieve target for United States nephrology. Provision of comprehensive predialysis education (CPE) in institutes with established home dialysis programs has been shown to facilitate a higher home dialysis choice amongst chronic kidney disease (CKD) patients. Unfortunately, limited data have shown the efficacy of such programs in the United States or in institutes with small home dialysis (HoD) programs. ♦ Methods: We report the retrospective findings examining the efficacy of a CPE program in the early period after its establishment, with reference to its impact on the choice and growth of a small HoD program...
May 25, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28531904/routine-monitoring-of-sodium-and-phosphorus-removal-in-peritoneal-dialysis-pd-patients-treated-with-continuous-ambulatory-pd-capd-automated-pd-apd-or-combined-capd-apd
#13
Veronika Moor, Robert Wagner, Michael Sayer, Marlies Petsch, Sandra Rueb, Hans-Ulrich Häring, Nils Heyne, Ferruh Artunc
BACKGROUND: Adequate removal of sodium (Na) and phosphorus (P) is of paramount importance for patients with dialysis-dependent kidney disease can easily quantified in peritoneal dialysis (PD) patients. Some studies suggest that automated PD (APD) results in lower Na and P removal. METHODS: In this study we retrospectively analysed our data on Na and P removal in PD patients after implementation of a routine monitoring in 2011. Patients were stratified in those treated with continuous ambulatory PD (CAPD, n=24), automated PD (APD, n=23) and APD with one bag change (CAPD+APD, n=10)...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28525779/systematic-review-and-meta-analysis-of-renal-replacement-therapy-modalities-for-acute-kidney-injury-in-the-intensive-care-unit
#14
Danielle M Nash, Sebastian Przech, Ron Wald, Daria O'Reilly
PURPOSE: To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). MATERIALS AND METHODS: We completed a systematic review and meta-analysis of studies published in 2015 or earlier using MEDLINE®, EMBASE®, Cochrane databases and grey literature. Eligible studies included randomized clinical trials (RCTs) or prospective cohort studies comparing outcomes of mortality, dialysis dependence or length of stay among critically ill adults receiving CRRT, IHD or SLED to treat AKI...
May 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28506446/serum-24-25-dihydroxyvitamin-d3-response-to-native-vitamin-d2%C3%A2-and%C3%A2-d3-supplementation-in-patients-with-chronic-kidney-disease%C3%A2-on%C3%A2-hemodialysis
#15
Laura A Graeff-Armas, Martin Kaufmann, Elizabeth Lyden, Glenville Jones
BACKGROUND & AIMS: While vitamin D deficiency is common in patients with end stage renal disease on dialysis and treatment with Vitamin D2 and Vitamin D3 is becoming increasingly common in these patients, little is known about 24,25(OH)2D3 metabolite production. Some authors report that the CYP24A1 enzyme is upregulated in CKD, but reports of low serum levels of 24,25(OH)2D3 in these patients bring this into question. Lack of substrate or increased clearance of the metabolite have been proposed as possible causes...
April 30, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28495878/local-amplifiers-of-il-4r%C3%AE-mediated-macrophage-activation-promote-repair-in-lung-and-liver
#16
Carlos M Minutti, Lucy H Jackson-Jones, Belén García-Fojeda, Johanna A Knipper, Tara E Sutherland, Nicola Logan, Emma Rinqvist, Raquel Guillamat-Prats, David A Ferenbach, Antonio Artigas, Cordula Stamme, Zissis C Chroneos, Dietmar M Zaiss, Cristina Casals, Judith E Allen
The type 2 immune response controls helminth infection and maintains tissue homeostasis but can lead to allergy and fibrosis if not adequately regulated. We have discovered local tissue-specific amplifiers of type-2 mediated-macrophage activation. In the lung, surfactant protein A (SP-A) enhanced IL-4-dependent macrophage proliferation and activation, accelerating parasite clearance and reducing pulmonary injury following infection with a lung-migrating helminth. In the peritoneal cavity and liver, C1q enhancement of type 2 macrophage activation was required for liver repair following bacterial infection, but resulted in fibrosis following peritoneal dialysis...
May 11, 2017: Science
https://www.readbyqxmd.com/read/28468236/non-traditional-aspects-of-renal-diets-focus-on-fiber-alkali-and-vitamin-k1-intake
#17
Adamasco Cupisti, Claudia D'Alessandro, Loreto Gesualdo, Carmela Cosola, Maurizio Gallieni, Maria Francesca Egidi, Maria Fusaro
Renal diets for advanced chronic kidney disease (CKD) are structured to achieve a lower protein, phosphate and sodium intake, while supplying adequate energy. The aim of this nutritional intervention is to prevent or correct signs, symptoms and complications of renal insufficiency, delaying the start of dialysis and preserving nutritional status. This paper focuses on three additional aspects of renal diets that can play an important role in the management of CKD patients: the vitamin K1 and fiber content, and the alkalizing potential...
April 29, 2017: Nutrients
https://www.readbyqxmd.com/read/28460209/low-fixed-dose-defibrotide-in-management-of-hepatic-veno-occlusive-disease-post-stem-cell-transplantation
#18
Bhausaheb Bagal, Arun Chandrasekharan, Aliya Chougle, Navin Khattry
OBJECTIVE/BACKGROUND: Hepatic veno-occlusive disease (VOD) is well recognized potentially serious regimen-related toxicity seen after stem cell transplantation. Severe VOD is associated with poor long-term outcomes with very high mortality. Besides supportive care, only defibrotide has been found to be effective in the management of VOD. The recommended dose of defibrotide is 25mg/kg/d but there has been no classical dose finding study done for this drug. A higher dose of defibrotide is associated with increased risk of bleeding and this drug is prohibitively expensive...
April 25, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28457920/antibody-response-to-hbv-vaccination-on-dialysis-does-not-correlate-with-the-development-of-denovo-anti-hla-antibodies-after-renal-transplantation
#19
Teresa Kauke, Maximilian Link, Markus Rentsch, Manfred Stangl, Markus Guba, Joachim Andrassy, Jens Werner, Bruno Meiser, Michael Fischereder, Antje Habicht
BACKGROUND: Response to Hepatitis B virus (HBV) vaccination can be diminished in some (50-80%) but not all dialysis patients. We hypothesized, that the response to vaccination on dialysis may correlate with the development of anti-HLA antibodies after renal transplantation and might therefore be a valuable parameter to predict alloresponses. METHODS: The response to HBV vaccination on dialysis and the development of deNovo anti-HLA antibodies post-transplant was analyzed in 188 non-immunized renal transplant recipients...
April 28, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28445520/serum-irisin-levels-correlated-to-peritoneal-dialysis-adequacy-in-nondiabetic-peritoneal-dialysis-patients
#20
Zhijun Tan, Zengchun Ye, Jun Zhang, Yanru Chen, Cailian Cheng, Cheng Wang, Xun Liu, Tanqi Lou, Hui Peng
BACKGROUND: Irisin is a recently discovered myokine thought to be involved in multiple metabolism abnormalities in most dialysis patients. However, the myokine has not been thoroughly studied in peritoneal dialysis. This study aimed to evaluate serum irisin levels and establish their relation to dialysis adequacy, insulin resistance, and bone metabolism status in patients on peritoneal dialysis. METHODS: A total of 59 nondiabetic prevalent peritoneal dialysis patients and 52 age- and sex-matched healthy controls were enrolled in this cross-sectional study...
2017: PloS One
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