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Dialysis Adequacy

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https://www.readbyqxmd.com/read/29326306/weekly-standard-kt-vurea-and-clinical-outcomes-in-home-and-in-center-hemodialysis
#1
Matthew B Rivara, Vanessa Ravel, Elani Streja, Yoshitsugu Obi, Melissa Soohoo, Alfred K Cheung, Jonathan Himmelfarb, Kamyar Kalantar-Zadeh, Rajnish Mehrotra
BACKGROUND AND OBJECTIVES: Patients undergoing hemodialysis with a frequency other than thrice weekly are not included in current clinical performance metrics for dialysis adequacy. The weekly standard Kt/Vurea incorporates treatment frequency, but there are limited data on its association with clinical outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used multivariable regression to examine the association of dialysis standard Kt/Vurea with BP and metabolic control (serum potassium, calcium, bicarbonate, and phosphorus) in patients incidental to dialysis treated with home (n=2373) or in-center hemodialysis (n=109,273)...
January 11, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29314721/peritoneal-protein-losses-depend-on-more-than-just-peritoneal-dialysis-modality-and-peritoneal-membrane-transporter-status
#2
Suree Yoowannakul, Lauren S Harris, Andrew Davenport
Peritoneal protein clearance (PPCl) depends upon vascular supply and size selective permeability. Some previous reports suggested PPCl can distinguish fast peritoneal membrane transport due to local or systemic inflammation. However, as studies have been discordant, we wished to determine factors associated with an increased PPCl. Consecutive patients starting peritoneal dialysis (PD) who were peritonitis-free were studied. Data included a baseline peritoneal equilibration test (PET), measurement of dialysis adequacy, 24-h dialysate PPCl and body composition measured by multifrequency bioimpedance...
January 4, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29229170/care-of-the-pediatric-patient-on-chronic-dialysis
#3
REVIEW
Annabelle N Chua, Bradley A Warady
Optimal care of the pediatric end-stage renal disease (ESRD) patient on chronic dialysis is complex and requires multidisciplinary care as well as patient/caregiver involvement. The dialysis team, along with the family and patient, should all play a role in choosing the dialysis modality which best meets the patient's needs, taking into account special considerations and management issues that may be particularly pertinent to children who receive peritoneal dialysis or hemodialysis. Meticulous attention to dialysis adequacy in terms of solute and fluid removal, as well as to a variety of clinical manifestations of ESRD, including anemia, growth and nutrition, chronic kidney disease-mineral bone disorder, cardiovascular health, and neurocognitive development, is essential...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29210176/online-measurement-of-hemodialysis-adequacy-using-effective-ionic-dialysance-of-sodium-a-review-of-its-principles-applications-benefits-and-risks
#4
REVIEW
Shakil Aslam, Subodh J Saggi, Moro Salifu, Robert J Kossmann
Dialysis dose is an important determinant of clinical outcomes in patients with end stage renal disease on maintenance dialysis. In clinical practice dialysis dose is monitored at least monthly by urea clearance based on Urea Kinetic Modeling. Online clearance monitoring using effective ionic dialysance (EID) of sodium (Na+ ) is available on some hemodialysis machines. This paper reviews the background, methodology, additional applications, and potential risks associated with EID. Effective ionic dialysance provides a reliable, real-time, noninvasive, and inexpensive measurement of dialysis dose during an ongoing hemodialysis (HD) session to allow interventions and assess the impact of these changes on clearance...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29198453/effects-of-rotigotine-on-clinical-symptoms-quality-of-life-and-sleep-hygiene-adequacy-in-haemodialysis-associated-restless-legs-syndrome
#5
Vicent Esteve, Jose Carneiro, Gabriel Salazar, Mónica Pou, Irati Tapia, Miquel Fulquet, Verónica Duarte, Anna Saurina, Fátima Moreno, Manel Ramírez de Arellano
BACKGROUND: Restless legs syndrome (RLS) is a neurological disorder characterised by bothersome symptoms associated with impaired quality of life and sleep hygiene. Rotigotine is a novel therapeutic alternative, although few studies have been published in patients on haemodialysis (HD) with RLS treated with rotigotine. OBJECTIVES: 1.- To establish the prevalence of RLS in our HD unit. 2.- To evaluate the efficacy and safety profile of rotigotine and its effect on symptoms, quality of life and sleep hygiene in our HD population with RLS...
November 30, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29191576/-comparison-of-citrate-4-and-heparin-as-tunneled-catheters-locking-solution-in-chronic-hemodialysis
#6
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/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#7
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29139376/the-longitudinal-effects-of-peritonitis-on-peritoneal-membrane-function%C3%A2
#8
Christopher S B Sia, Eldho Paul, Peter Tregaskis, Rowan G Walker, Scott G Wilson
BACKGROUND: The longitudinal effects of peritoneal dialysis (PD) peritonitis on small solute clearance and ultrafiltration are controversial. MATERIALS AND METHODS: We identified 27 patients with PD peritonitis over a 4-year period at a tertiary hospital. Adequacy tests at an "early" (1 - 3 months), "intermediate" (6 ± 2 months), and a "late" (12 ± 2 months) time period after the episode were compared with a pre-peritonitis baseline. The effect of time on serum albumin, weekly creatinine clearance, Kt/V, and net fluid volume removal was assessed...
December 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#9
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29106676/safety-and-efficacy-of-taurolidine-urokinase-versus-taurolidine-heparin-as-a-tunneled-catheter-lock-solution-in-hemodialysis-patients-a-prospective-randomized-controlled-study
#10
Fadwa Al-Ali, Ahmad F Hamdy, Abdullah Hamad, Mohamed Elsayed, Zafar Zafar Iqbal, Aisha Elsayed, Rania Ibrahim, Hoda Tolba, Hisham Buanan, Ashraf Fawzy
Background: Taurolidine citrate with heparin (Taurolock/Hep) is a promising central venous catheter lock solution. Despite its universal use among our hemodialysis patients, the prevalence of catheter malfunction was high. We aimed to compare Taurolock/Hep and taurolidine citrate with urokinase (Taurolock/U) as a catheter lock solution in order to identify whether either solution could reduce catheter-related dysfunction. Methods: In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months...
July 4, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29064172/measuring-residual-renal-function-for-hemodialysis-adequacy-is-there-an-easier-option
#11
REVIEW
Andrew Davenport
Most patients starting hemodialysis (HD) have residual renal function. As such, there has been increased interest in starting patients with less frequent and shorter dialysis session times. However, for this incremental approach to be successful, patients require regular monitoring of residual renal function, so that as residual renal function declines, the amount of HD is appropriately increased. Currently most dialysis centers rely on interdialytic urine collections. However, many patients find these inconvenient and there may be marked intrapatient variability due to compliance issues...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29024379/can-a-renal-nurse-assess-fluid-status-using-ultrasound-on-the-inferior-vena-cava-a-cross-sectional-interrater-study
#12
Ulrich Steinwandel, Nicholas Gibson, Amanda Towell, James J R Rippey, Johan Rosman
INTRODUCTION: Ultrasound of the inferior vena cava (IVC-US) has been used to estimate intravascular volume status and fluid removal during a hemodialysis session. Usually, renal nurses rely on other, imprecise methods to determine ultrafiltration. To date, no study has examined whether renal nurses can reliably perform ultrasound for volume assessment and for potential prevention of intradialytic hypotension. This pilot study aimed to determine if a renal nurse could master the skill of performing and correctly interpreting Point of Care Ultrasound on patients receiving hemodialysis...
October 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28992335/how-to-set-the-stage-for-a-full-fledged-clinical-trial-testing-incremental-haemodialysis
#13
Francesco Gaetano Casino, Carlo Basile
Most people who make the transition to maintenance haemodialysis (HD) therapy are treated with a fixed dose of thrice-weekly HD (3HD/week) regimen without consideration of their residual kidney function (RKF). The RKF provides an effective and naturally continuous clearance of both small and middle molecules, plays a major role in metabolic homeostasis, nutritional status and cardiovascular health, and aids in fluid management. The RKF is associated with better patient survival and greater health-related quality of life...
July 21, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28975489/use-of-lung-ultrasonography-to-determine-the-accuracy-of-clinically-estimated-dry-weight-in-chronic-hemodialysis-patients
#14
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/28919820/prediction-models-for-the-mortality-risk-in-chronic-dialysis-patients-a-systematic-review-and-independent-external-validation-study
#15
Chava L Ramspek, Pauline Wm Voskamp, Frans J van Ittersum, Raymond T Krediet, Friedo W Dekker, Merel van Diepen
OBJECTIVE: In medicine, many more prediction models have been developed than are implemented or used in clinical practice. These models cannot be recommended for clinical use before external validity is established. Though various models to predict mortality in dialysis patients have been published, very few have been validated and none are used in routine clinical practice. The aim of the current study was to identify existing models for predicting mortality in dialysis patients through a review and subsequently to externally validate these models in the same large independent patient cohort, in order to assess and compare their predictive capacities...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28917224/simple-method-to-estimate-daily-sodium-intake-during-measurement-of-dialysis-adequacy-in-chronic-peritoneal-dialysis-patients
#16
So Mi Kim, Eun Kyoung Lee, Shin Sook Kang, Soon Mi Kim, Hye-Won Kim, Soon Bae Kim
BACKGROUND AND OBJECTIVES: Restriction of dietary sodium intake for peritoneal dialysis (PD) patients is recommended, but there is limited information on the measurement and monitoring of sodium intake. We have developed a simple method to estimate daily sodium intake during the measurement of dialysis adequacy in PD patients. METHODS AND STUDY DESIGN: A total of 83 PD patients were enrolled in the study. The patients were divided into two groups based on residual renal function (RRF)...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28904934/comparison-of-complications-of-arteriovenous-fistula-with-permanent-catheter-in-hemodialysis-patients-a-six-month-follow-up
#17
Ali Momeni, Saeed Mardani, Maryam Kabiri, Masoud Amiri
BACKGROUND: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis procedure. Due to insufficient reliable information on the comparison between AVF and PC, this study was conducted to compare AVF and PC regarding dialysis adequacy. MATERIALS AND METHODS: This prospective study was carried out from March, 2013 to September, 2013. In this study, 76 hemodialysis patients were enrolled and assigned to two unequal groups of AVF and PC...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28891419/effects-of-listening-to-holy-qur-an-recitation-and-physical-training-on-dialysis-efficacy-functional-capacity-and-psychosocial-outcomes-in-elderly-patients-undergoing-haemodialysis
#18
Bechir Frih, Wajdi Mkacher, Abir Bouzguenda, Hamdi Jaafar, Salem Ali ALkandari, Zohra Ben Salah, Bart Sas, Mohamed Hammami, Ameur Frih
The purpose of this study was to determine whether listening to Holy Qur'an recitation would augment the beneficial effects of physical exercise on physiological and psychological measures in elderly patients undergoing haemodialysis. Fifty-three male haemodialysis patients were randomly assigned to an intervention group (listening to Holy Qur'an recitation in combination with endurance-resistance training, n = 28) or a control group (endurance-resistance training only, n = 25). Functional capacity was assessed using the Timed Up and Go test (TUG) and the Six-Minute Walk Test (6MWT)...
December 2017: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/28862725/longitudinal-dialysis-adequacy-and-clinical-performance-of-the-vectorflow-hemodialysis-catheter-a-prospective-study
#19
John R Ross, Tatiana A Puga, Thomas E Philbeck
PURPOSE: To report clinical performance and longitudinal assessment of hemodialysis adequacy with the Arrow-Clark VectorFlow catheter, a symmetrical-tip device with a distal lumen configuration designed to reduce platelet shear stress and catheter thrombosis. METHODS AND MATERIALS: We prospectively enrolled patients who required de novo placement of a chronic tunneled catheter for hemodialysis or exchange of a dysfunctional catheter as part of an Institutional Review Board (IRB)-approved protocol...
August 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28760431/predicting-clinical-outcomes-using-phase-angle-as-assessed-by-bioelectrical-impedance-analysis-in-maintenance-hemodialysis-patients
#20
Jung-Ho Shin, Chae Rim Kim, Ki Hyun Park, Jin Ho Hwang, Su Hyun Kim
OBJECTIVE: Protein-energy wasting is common in patients on hemodialysis and is an independent risk factor for adverse events. The aim of this study was to retrospectively investigate whether phase angle (PA), known as a nutritional marker, can predict various clinical outcomes in patients with end-stage renal disease (ESRD) who are receiving hemodialysis. METHODS: Using bioelectrical impedance analysis (BIA), PA was obtained every 6 mo, and patients were divided into two groups according to baseline PA: group A included patients with PA ≥4...
September 2017: Nutrition
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