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https://www.readbyqxmd.com/read/28937071/insomnia-in-hemodialysis-patients-a-multicenter-study-from-morocco
#1
Mohamed Amine Hamzi, Kawtar Hassani, Mohamed Asseraji, Driss El Kabbaj
Previous studies have shown that insomnia is a common sleep disorder in patients with end-stage renal disease. This study aims to determine the prevalence and risk factors of insomnia in our chronic hemodialysis (HD) patients. This is a cross-sectional study conducted in three HD units in Morocco. To assess the prevalence of insomnia, we used a specific questionnaire. Patients complaining of difficulty in falling asleep and/or nocturnal awakenings occurring seven nights a week during the last month were included in the group "insomnia;" the other patients were used as controls...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28931542/cumulative-kidney-complication-risk-by-50-years-of-type-1-diabetes-the-effects-of-sex-age-and-calendar-year-at-onset
#2
Tina Costacou, Trevor J Orchard
OBJECTIVE: A common belief is that only a minority of patients with type 1 diabetes (T1D) develop advanced kidney disease and that incidence is higher among men and lower in those diagnosed at a younger age. However, because few patients with T1D survived to older ages until recently, long-term risks have been unclear. RESEARCH DESIGN AND METHODS: We examined the 50-year cumulative kidney complication risk in a childhood-onset T1D cohort diagnosed during 1950-80 (n = 932; mean baseline age 29 years, duration 19 years)...
September 20, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28910799/effects-of-hemodialysis-therapy-using-dialyzers-with-medium-cut-off-membranes-on-middle-molecules
#3
Alexander H Kirsch, Alexander R Rosenkranz, Raphael Lyko, Detlef H Krieter
The removal of larger middle molecules, such as free immunoglobulin light chains (FLC), is poor with most currently used dialysis technologies. While hemodiafiltration (HDF) provides enhanced clearance of middle molecules compared to high-flux hemodialysis (HD), this technique is currently not approved in some regions and, hence, not accessible for all patients. The retention of middle molecules is thought to be one factor, which contributes to excessive morbidity and mortality in HD patients. The development of medium cut-off (MCO) dialysis membranes is aimed at a more efficient clearance of larger uremic toxins while retaining albumin and may extend the benefit of enhanced solute removal to more patients...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910797/the-rationale-for-expanded-hemodialysis-therapy-hdx
#4
Colin A Hutchison, Martin Wolley
As dialysis membrane technologies have advanced, the ability to clear increasing numbers of uremic toxins has occurred. To date, however, the class of uremic toxins known as large middle-molecules has been classified as "difficult to remove." Expanded hemodialysis utilizes a new generation of high-retention-onset hemodialysis membranes; these membranes provide the ability to remove large middle-molecules effectively for the first time, without significant albumin loss. In this review, we evaluate the removal of large middle-molecules by the new high-retention-onset membranes, the clinical relevance of these molecules, and how expanded hemodialysis can be prescribed...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910794/membrane-innovation-in-dialysis
#5
Adriana Boschetti-de-Fierro, Werner Beck, Helmut Hildwein, Bernd Krause, Markus Storr, Carina Zweigart
Despite advances in renal replacement therapy, the adequate removal of uremic toxins over a broad molecular weight range remains one of the unmet needs in hemodialysis. Therefore, membrane innovation is currently directed towards enhanced removal of uremic toxins and increased membrane permeability. This chapter presents a variety of opportunities where innovation is brought into dialysis membranes. It covers the membrane formation from solution, describing different approaches to control the phase inversion process through additives that either swell in the polymer solution or influence the pore shrinkage during the membrane drying process...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910791/inflammation-and-protein-energy-wasting-in-the-uremic-milieu
#6
Magdalena Jankowska, Gabriela Cobo, Bengt Lindholm, Peter Stenvinkel
Inflammation is normally a protective and physiological response to harmful stimuli, but typically becomes an uncontrolled, maladaptive, and persistent process in patients with end-stage renal disease (ESRD). Through a deleterious cascade of poorly controlled reactions mediated by biologically active molecules (also called middle molecular weight uremia retention solutes), inflammation associates with a range of complications including cardiovascular disease and protein-energy wasting (PEW). Persistent inflammation, which is central to the conceptual etiological models of PEW and the malnutrition, inflammation, and atherosclerosis syndrome, induces and reignites processes leading to PEW in a number of ways including stimulation of both direct and indirect mechanisms of muscle proteolysis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910786/the-evolving-patterns-of-uremia-unmet-clinical-needs-in-dialysis
#7
Xueqing Yu
End-stage renal disease (ESRD) has become a challenging health problem worldwide. Currently, ESRD patients treated with hemodialysis mainly undergo low-flux hemodialysis, high-flux hemodialysis (HF-HD), or hemodiafiltration (HDF). The clearance of middle and large molecules is, however, quite insufficient as regards HF-HD, HDF, and on-line HDF. An unsatisfactory prognosis has led to improved dialysis technology and materials; both protein-leaking membranes and high cut-off membranes increase the clearance of uremic toxin, but in clinical application they may induce albumin loss...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28900874/effect-of-renal-transplantation-on-cognitive-function-in-hemodialysis-patients-a-longitudinal-study
#8
Yogesh K Chhabra, Sanjay Sood, Omprakash Rathi, Sandeep Mahajan
BACKGROUND: The literature notes high prevalence of cognitive function (CF) impairment among hemodialysis patients. Renal transplantation by reversing metabolic factors should improve cognitive function; however, results in post-transplant patients are inconsistent. Lack of longitudinal studies, variable and small patient population, variable renal function and post-transplantation period and use of non-specific tests make results difficult to interpret. We looked at CF in stable hemodialysis patients just prior to live renal transplantation and approximately 3 months subsequently using well-validated electrophysiological study of P300 cognitive potential obtained by auditory oddball paradigm using multiple scalp electrodes...
September 12, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28886703/factors-associated-with-foot-ulceration-and-amputation-in-adults-on-dialysis-a-cross-sectional-observational-study
#9
Michelle R Kaminski, Anita Raspovic, Lawrence P McMahon, Katrina A Lambert, Bircan Erbas, Peter F Mount, Peter G Kerr, Karl B Landorf
BACKGROUND: Adults on dialysis are at increased risk of foot ulceration, which commonly precedes more serious lower limb complications, including amputation. Limited data exist regarding the prevalence and factors associated with foot disease in this population. Hence, this study set out to investigate factors associated with foot ulceration and amputation in a dialysis cohort. METHODS: This study presents a cross-sectional analysis of baseline data from a multi-center prospective cohort study...
September 8, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28885663/removal-of-bile-acids-by-extracorporeal-therapies-an-in-vitro-study
#10
Jens Hartmann, Stephan Harm
INTRODUCTION: Bile acids (BAs) accumulating in the circulation in patients with liver failure are considered to be responsible for pruritus, which strongly impairs quality of life of the affected patients. The aim of this study was the in vitro characterization of different BAs regarding their removability with high-flux dialysis as well as with different adsorbents, and the evaluation of their binding to plasma proteins. METHODS: Dialysis experiments were conducted in pediatric circuits with human plasma...
September 5, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28881095/albumin-assisted-method-allows-assessment-of-release-of-hydrophobic-drugs-from-nanocarriers
#11
Dmitry Gil, Anastasia Frank-Kamenetskii, John Barry, Vladimir Reukov, Yun Xiang, Arabinda Das, Abhay K Varma, Mark S Kindy, Naren L Banik, Alexey Vertegel
Polymeric nanoparticles have been extensively studied as drug delivery vehicles both in vitro and in vivo for the last two decades. In vitro methods to assess drug release profiles usually utilize degradation of nanoparticles in aqueous medium, followed by the measurement of the concentration of the released drug. This method, however, is difficult to use for drugs that are poorly water soluble. In this study, we describe a protocol for measuring drug release kinetic using albumin solution as the medium. Albumin is a major blood transport protein, which mediates transport of many lipid soluble compounds including fatty acids, hormones, and bilirubin...
September 7, 2017: Biotechnology Journal
https://www.readbyqxmd.com/read/28870376/associations-of-body-mass-index-and-body-fat-with-markers%C3%A2-of%C3%A2-inflammation-and-nutrition-among-patients-receiving%C3%A2-hemodialysis
#12
Cynthia Delgado, Glenn M Chertow, George A Kaysen, Lorien S Dalrymple, John Kornak, Barbara Grimes, Kirsten L Johansen
BACKGROUND: Understanding the extent to which visceral and subcutaneous body fat are associated with markers of nutrition and inflammation in patients on dialysis therapy could shed light on the obesity paradox and the biology of subcutaneous fat. STUDY DESIGN: Cross-sectional. SETTING & PARTICIPANTS: 609 adults receiving hemodialysis who participated in the ACTIVE/ADIPOSE Study. PREDICTORS: Body mass index (BMI), waist circumference, and bioelectrical impedance spectroscopy-derived estimates of percent body fat...
September 1, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28862721/in-vitro-benchmark-of-cytokine-removal-by-dialyzers-with-various-permeability-profiles
#13
Michael Hulko, Rose Speidel, Julia Gauss, Markus Storr, Bernd Krause
PURPOSE: Removal of cytokines is relevant for dialysis patients as they are suspected to promote cardiovascular complications. The objective of this study was to benchmark membranes with different permeability profiles under standardized in vitro test conditions using miniaturized devices with respect to their ability to remove cytokines from human serum and to lower cell activating potential. METHODS: In vitro dialysis was used to dialyze cytokine enriched serum in 3 independent experiments per tested membrane...
August 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28860783/does-whey-protein-supplementation-affect-blood-pressure-in-hypoalbuminemic-peritoneal-dialysis-patients
#14
Kamal Hassan, Fadi Hassan
OBJECTIVE: Hypertension and hypoalbuminemia are common risk factors for cardiovascular complications in peritoneal dialysis (PD) patients. Data are limited regarding the effects of whey protein consumption on blood pressure in this population. The aim of the present study was to examine if whey protein supplementation for 12 weeks to hypoalbuminemic PD patients affects their blood pressure. PATIENTS AND METHODS: This prospective randomized study included 36 stable PD patients with serum albumin levels <3...
2017: Therapeutics and Clinical Risk Management
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
#15
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/28853700/comparison-of-hemodialysis-with-medium-%C3%A2-cut-off-dialyzer-and-on-line-hemodiafiltration-on-the-removal-of-small-and-middle-sized-molecules%C3%A2
#16
Mohamed Belmouaz, Jeremy Diolez, Marc Bauwens, Fabien Duthe, Laure Ecotiere, Estelle Desport, Frank Bridoux
BACKGROUND: Recent data suggest that the use of medium cut-off (MCO) dialyzers in hemodialysis (HD) promotes greater clearance and reduction ratio (RR) for myoglobin and other large-sized molecules than on-line hemodiafiltration (ol-HDF), but its effects on β2-microglobulin are not clear. We compared RR and clearances of small and middle-sized molecules between high-flux ol-HDF and MCO (Theranova) dialyzer in HD (MCO-HD) as well as nutritional parameters. MATERIALS AND METHODS: We retrospectively analyzed 10 patients treated first with ol-HDF who were thereafter switched to MCO-HD over a 1-year period...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28843932/hypervolemia-hypoalbuminemia-and-mitral-calcification-as-markers-of-cardiovascular-risk-in-peritoneal-dialysis-patients
#17
Sara Querido, Patrícia Quadros Branco, Henrique Silva Sousa, Teresa Adragão, Pedro Araújo Gonçalves, Maria Augusta Gaspar, José Diogo Barata
INTRODUCTION: Mortality in patients with end-stage renal disease is higher than in the general population. This is linked to traditional and non-traditional cardiovascular (CV) risk factors, as well as with risk factors associated with end-stage renal disease itself. The aim of this study is to identify CV risk markers in patients beginning peritoneal dialysis (PD) and their association with CV events and CV mortality. METHODS: This was a retrospective cohort study of 112 incident PD patients, in which demographic, clinical and laboratory parameters, valvular calcifications, types of PD solutions, hospitalizations, CV events and death were analyzed...
August 23, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28834362/is-high-volume-online-hemodiafiltration-associated-with-malnutrition
#18
Nicolás Macías, Almudena Vega, Soraya Abad, Alba Santos, Santiago Cedeño, Tania Linares, Ana María García-Prieto, Inés Aragoncillo, Claudia Yuste, Juan Manuel López-Gómez
Chronic malnutrition is a common problem in patients with end-stage renal disease on hemodialysis. Some studies have reported albumin loss into dialysis fluid during postdilution online hemodiafiltration (OL-HDF). The aim of the study was to assess the nutritional status of patients on high-volume OL-HDF and to demonstrate that higher convective clearances are not associated with malnutrition due to possible loss of nutrients with ultrafiltration. Demographic and clinical data, corporal composition with bioimpedance spectroscopy, dialysis features, albumin loss into dialysis fluid and laboratory parameters were collected in twenty-eight patients with ESRD undergoing postdilution OL-HDF with stable convective volumes over 28 L/session...
August 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28818166/assessment-of-quality-of-sleep-and-its-relationship-with-psychiatric-morbidity-and-socio-demographic-factors-in-the-patients-of-chronic-renal-disease-undergoing-hemodialysis
#19
Usama Bin Zubair, Batool Butt
OBJECTIVE: To assess the subjective sleep quality and its relationship with the presence of psychiatric morbidity in the patients suffering from chronic kidney disease (CKD) and undergoing the procedure of hemodialysis (HD); and analyze the associated socio-demographic factors. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Nephrology Department, Military Hospital, Rawalpindi, from July to December 2016. METHODOLOGY: Patients of CKD undergoing the HD were included in the final analysis...
July 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#20
Enrica Fung, Tara I Chang, Glenn M Chertow, I-Chun Thomas, Steven M Asch, Manjula Kurella Tamura
BACKGROUND: Clinical practice guidelines recommend referral to nephrology when estimated glomerular filtration rate (eGFR) decreases to <30mL/min/1.73m(2); however, evidence for benefits of nephrology care are mixed. STUDY DESIGN: Observational cohort using landmark analysis. SETTINGS & PARTICIPANTS: A national cohort of veterans with advanced chronic kidney disease, defined as an outpatient eGFR≤30mL/min/1.73m(2) for January 1, 2010, through December 31, 2010, and a prior eGFR<60mL/min/1...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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