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Dialysis Adequacy

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https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28760111/differences-in-prevalence-of-muscle-wasting-in-patients-receiving-peritoneal-dialysis-per-dual-energy-x-ray-absorptiometry-due-to-variation-in-guideline-definitions-of-sarcopenia
#15
Rachel Hung, Bethany Wong, Gabrielle Goldet, Andrew Davenport
BACKGROUND: Muscle wasting is associated with increased risk for mortality. There is no agreed universal definition for muscle wasting (sarcopenia), and we wished to determine whether using different criteria altered the prevalence in patients treated by peritoneal dialysis. METHODS: We measured lean body and appendicular lean mass indices in 325 outpatients by dual-energy x-ray absorptiometry, comparing muscle mass with that used to define muscle wasting (sarcopenia) by various clinical guideline publications...
August 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28729968/reproducibility-of-serial-creatinine-excretion-measurements-in-peritoneal-dialysis
#16
Zhi Xu, Glen H Murata, Yijuan Sun, Robert H Glew, Clifford Qualls, Darlene Vigil, Karen S Servilla, Thomas A Golper, Antonios H Tzamaloukas
AIM: To test whether muscle mass evaluated by creatinine excretion (EXCr) is maintained in patients with end-stage kidney disease (ESKD) treated by peritoneal dialysis (PD), we evaluated repeated measurements of EXCr in a PD population. METHODS: One hundred and sixty-six PD patients (94 male, 72 female) receiving the same PD dose for the duration of the study (up to approximately 2.5 years) had repeated determinations of total (in urine plus spent dialysate) 24-h EXCr (EXCr T) to assess the adequacy of PD by creatinine clearance...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28691599/sheep-model-of-haemodialysis-treatment
#17
Jolanta Bujok, Tomasz Walski, Albert Czerski, Katarzyna Gałecka, Karolina Grzeszczuk-Kuć, Wojciech Zawadzki, Wojciech Witkiewicz, Małgorzata Komorowska
More than two million patients received haemodialysis (HD) in 2013. Many methods for improving dialysis therapy outcomes have been tested. Nevertheless, patients continue to experience high morbidity and mortality rates. We aimed to develop an animal model of HD treatment to study methods that would prevent the adverse effects of renal replacement therapy. The study was conducted using six male Merino sheep. The animals underwent a two-step bilateral nephrectomy, and a permanent dual-lumen catheter was inserted into the jugular vein...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28653946/the-truth-on-current-peritoneal-dialysis-state-of-the-art
#18
R T Krediet, A C Abrahams, C W H de Fijter, M G H Betjes, W H Boer, B C van Jaarsveld, C J A M Konings, F W Dekker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased markedly in the Netherlands in the last 15 years. Consequently, the knowledge of nephrologists and nursing staff on PD has declined leading to a negative spiral in which loss of experience resulted in loss of enthusiasm to offer PD to patients and also in less interest in the new PD developments. All these changes took place while the results of PD improved and patient survival was at least similar to that on haemodialysis...
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28633456/feeding-during-dialysis-risks-and-uncertainties
#19
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/28573315/pediatric-renal-transplant-biopsy-with-ultrasound-guidance-the-core-essentials
#20
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...
November 2017: Pediatric Radiology
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