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Dialysis Adequacy

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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/28573315/pediatric-renal-transplant-biopsy-with-ultrasound-guidance-the-core-essentials
#2
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/28555712/frailty-in-end-stage-renal-disease-patients-under-dialysis-and-its-association-with-clinical-and-biochemical-markers
#3
V Poveda, M Filgueiras, V Miranda, A Santos-Silva, C Paúl, E Costa
Frailty is a common complication in elderly patients with end-stage renal disease (ESRD) under dialysis, which is a strong risk factor for low quality of life, morbidity, and mortality. In this work, we aimed to evaluate the prevalence of frailty in a group of Portuguese ESRD patients, and its association with socio-demographic, clinical and biochemical markers. We performed a cross-sectional study with 83 ESRD patients (44 males and 39 females, 64.3 [±14.6] years old) on regular dialysis. The classification of the ESRD patients as robust, pre-frail and frail was performed using the FRAIL questionnaire...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28552124/application-of-genetic-algorithm-for-hemodialysis-schedule-optimization
#4
Jin Woo Choi, Hajeong Lee, Jung Chan Lee, Saram Lee, Yon Su Kim, Hyung-Jin Yoon, Hee Chan Kim
BACKGROUND: The conventional hemodialysis (HD) schedule has been used for decades, even though new modalities have been introduced. Many reasons limit practices of frequent dialysis, such as patients' environments and unknown optimal schedules for each patient. This research provides a theoretical recommendation of HD schedule through genetic algorithm (GA). METHODS: An end-stage renal disease (ESRD) with various dialysis conditions was modeled through a classic variable-volume two-compartment kinetic model to simulate an anuric patient, and GA was implemented to search for an optimal HD schedule for each individual considering and ignoring burden consumption of each dialysis session...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28500518/incremental-start-to-pd-as-experienced-in-italy-results-of-censuses-carried-out-from-2005-to-2014
#5
Loris Neri, Giusto Viglino, Giancarlo Marinangeli, Anna Rachele Rocca, Alessandro Laudon, Antonino Ragusa, Gianfranca Cabiddu
BACKGROUND: It is not known how widely used in Italy an incremental start to in peritoneal dialysis (Incr-PD) is. METHODS: By analyzing the peritoneal dialysis (PD) censuses conducted by the PD Study Group (GSDP-SIN) for the years 2005, 2008, 2010, 2012 and 2014 in all the Centers performing PD in Italy, the use of Incr-PD, i.e. continuous ambulatory peritoneal dialysis (CAPD) with 1 or 2 exchanges/day or automated peritoneal dialysis (APD) with 3-4 sessions/week, was examined among incident PD patients...
May 12, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28497092/the-relationship-between-dialysis-adequacy-and-serum-uric-acid-in-dialysis-patients-a-cross-sectional-multi-center-study-in-iranian-hemodialysis-centers
#6
Eghlim Nemati, Arezoo Khosravi, Behzad Einollahi, Mehdi Meshkati, Mehrdad Taghipour, Shahin Abbaszadeh
Introduction: Uric acid is one of the most significant uremic toxins accumulating in chronic renal failure patients treated with standard dialysis. Its clearance has not any exact relation with urea and creatinine clearance. Objectives: The aim of this study was to investigate the relationship between adequacy of dialysis and serum level of uric acid in dialysis patients of some dialysis centers in Iran. Patients and Methods: In this study 1271 hemodialysis patients who have been treated for more than 3 months were evaluated...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#7
Niloufar Zadeh Saraji, Maryam Hami, Reza Boostani, Mohammad Javad Mojahedi
Introduction: Restless leg syndrome (RLS) is a sensory motor disorder. Patients with this syndrome have serious and uncontrollable desire to move their legs, which is mostly due to an uncomfortable feeling intensified when they are motionless. It may be a genetic disorder or secondary to iron deficiency, neurodegenerations, pregnancy, some drugs and severe kidney diseases. Objectives: This study was designed to find out the prevalence and its risk factors of RLS in hemodialysis patients. Patients and Methods: This multicenter cross-sectional study was done on 260 hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28490530/il-6-promotes-epithelial-to-mesenchymal-transition-of-human-peritoneal-mesothelial-cells-possibly-through-jak2-stat3-signaling-pathway
#8
Jing Xiao, Yanan Gong, Ying Chen, Dahai Yu, Xiaoyang Wang, Xiaoxue Zhang, Yanna Dou, Dong Liu, Genyang Cheng, Shan Lu, Wenming Yuan, Yansheng Li, Zhanzheng Zhao
Long-term peritoneal dialysis (PD) therapy results in functional and structural alteration of the peritoneal membrane, including epithelial-to-mesenchymal transition (EMT). Interleukin 6 (IL-6) is a local pleiotropic cytokine, hypothesized to play an important role in EMT. This study was designed to investigate the role of IL-6 in EMT and peritoneal membrane dysfunction in long-term PD patients by assessing the level of IL-6 in dialysate and exploring the relationship between IL-6, the related signaling pathway JAK2/STAT3, and EMT, using in vitro cellular and molecular techniques...
May 10, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28481830/dose-prescription-and-delivery-in-neonates-with-congenital-heart-diseases-treated-with-continuous-veno-venous-hemofiltration
#9
Zaccaria Ricci, Francesco Guzzi, Germana Tuccinardi, Luca Di Chiara, William Clark, Stuart L Goldstein, Claudio Ronco
OBJECTIVES: Renal replacement therapy may be required for acute kidney injury treatment in neonates with complex cardiac conditions. Continuous veno-venous hemofiltration is applied safely in this population but no published recommendations for dose prescription in neonates currently exist. The aim of our study was to evaluate the effects of a relatively small dialysis dose on critically ill neonates. DESIGN: Retrospective analysis of clinical charts. SETTING: Pediatric Cardiac ICU...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28449305/c-reactive-protein-variability-is-associated-with-vascular-access-outcome-in-hemodialysis-patients
#10
Wei-Hung Kuo, Yueh-Ting Lee, Hwee-Yeong Ng, Chun-Yeh Wang, Chien-Hsing Wu, Chien-Te Lee
BACKGROUND: Hemodialysis (HD) vascular access failure is one of the most important causes of morbidity and contributes to the cost of dialysis care. There is paucity of data evaluating long-term monitoring of C-reactive protein (CRP) on outcome of HD vascular access. METHODS: We conducted a retrospective study to investigate whether variability of serum CRP level was associated with vascular access failure rate over a 7-year period. A total of 318 HD patients were included...
April 27, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28445520/serum-irisin-levels-correlated-to-peritoneal-dialysis-adequacy-in-nondiabetic-peritoneal-dialysis-patients
#11
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
https://www.readbyqxmd.com/read/28437596/membrane-transport-status-does-not-predict-peritonitis-risk-in-patients-on-peritoneal-dialysis
#12
Sarah So, Laraine Aw, Kamal Sud, Vincent W Lee
AIM: To determine whether peritoneal membrane transport status (MTS) is associated with peritonitis or poor peritoneal dialysis (PD)-related outcomes. METHODS: This retrospective cohort study analysed data of incident adult patients on PD in Western Sydney between October 1, 2003 and December 31, 2012. Only patients who underwent peritoneal equilibration and adequacy tests within 6 months of commencement were included. Kaplan-Meier survival curves for time until first peritonitis and time until composite endpoint of peritonitis, death, or technique failure, censored for transplant, were constructed...
April 24, 2017: Nephrology
https://www.readbyqxmd.com/read/28418614/efficacy-and-safety-of-low-dose-heparin-in-hemodialysis
#13
Mariana Murea, Gregory B Russell, Pirouz Daeihagh, Anita M Saran, Karan Pandya, Mark Cabrera, John M Burkart, Barry I Freedman
INTRODUCTION: The dose of unfractionated heparin (UFH) administered during hemodialysis (HD) varies widely. This prospective study evaluated the safety and efficacy of UFH dose de-escalation. METHODS: Sixty-six prevalent patients on HD receiving UFH per standard-dose protocol (load dose [LD] 50-75 units/kg, maintenance dose [MD] 500-1000 units/hour) had heparin prescription converted to low-dose protocol (start LD 15 units/kg and MD 500 units/hour; dose adjusted in small increments based on assessments of extracorporeal blood circuit)...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28417217/levels-of-cystatin-c-in-low-and-high-flux-hemodialysis-in-children-with-end-stage-renal-disease
#14
Fatina I Fadel, Abbass A Mourad, Azza M O Abdel Rahman, Hafez M Bazaraa, Mohamed Farouk Mohamed, Dalia H El-Lebedy, Mohamed M Soliman
BACKGROUND: Cystatin-C (CyC) is a middle molecule that is freely filtered at the glomerulus and almost completely reabsorbed by the proximal tubules. The aim of this study was to evaluate serum CyC and its reduction ratio as a biomarker for assessing the adequacy of the hemodialysis (HD) sessions in children with end-stage renal disease on maintenance HD. We also compared levels of CyC in patients on low-flux HD (LFH) and high-flux HD (HFH). METHODS: Forty patients were included in the study and divided into two groups, with one group (16 patients) receiving HFH and the other group receiving LFH (24 patients) (high-flux and low-flux polysulfone filters, respectively)...
April 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28407121/urea-and-chronic-kidney-disease-the-comeback-of-the-century-in-uraemia-research
#15
Raymond Vanholder, Tessa Gryp, Griet Glorieux
Urea, a marker of uraemic retention in chronic kidney disease (CKD) and of adequacy of intradialytic solute removal, has traditionally been considered to be biologically inert. However, a number of recent experimental data suggest that urea is toxic at concentrations representative for CKD. First of all, at least five studies indicate that urea itself induces molecular changes related to insulin resistance, free radical production, apoptosis and disruption of the protective intestinal barrier. Second, urea is at the origin of the generation of cyanate, ammonia and carbamylated compounds, which as such all have been linked to biological changes...
April 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28348100/effects-of-conversion-to-a-bicarbonate-lactate-buffered-neutral-ph-low-gdp-pd-regimen-in-prevalent-pd-a-2-year-randomized-clinical-trial
#16
Karima Farhat, Caroline E Douma, E Ferrantelli, Pieter M Ter Wee, Robert H J Beelen, Frans J van Ittersum
♦ BACKGROUND: The use of pH-neutral peritoneal dialysis (PD) fluids low in glucose degradation products (GDP) may better preserve the peritoneal membrane and have fewer systemic effects. The effects of conversion from conventional to neutral-pH, low-GDP PD fluids in prevalent patients are unclear. Few studies on the role of neutral-pH, low-GDP PD have studied residual renal function, ultrafiltration, peritonitis incidence and technique failure, transport characteristics, and local and systemic markers of inflammation in prevalent PD patients...
May 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28345136/twice-weekly-hemodialysis-in-china-can-it-be-a-better-option-for-initiation-or-maintenance-dialysis-therapy
#17
Yucheng Yan, Sylvia Ramirez, Shuchi Anand, Jiaqi Qian, Li Zuo
Cumulative evidence indicates it may be worthwhile revisiting the twice-weekly hemodialysis (HD) regimen as a valid option for individualized or incremental treatments for selected patients with end-stage renal disease. In this article, we will review the current evidences on the potential pros and cons of twice-weekly HD compared to thrice-weekly HD including China's experience in the practice of twice-weekly HD. A prudent patient selection and close dialysis adequacy monitoring might be necessary for this medical treatment choice...
May 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28314806/the-use-of-a-multidimensional-measure-of-dialysis-adequacy-moving-beyond-small-solute-kinetics
#18
REVIEW
Jeffrey Perl, Laura M Dember, Joanne M Bargman, Teri Browne, David M Charytan, Jennifer E Flythe, LaTonya J Hickson, Adriana M Hung, Michel Jadoul, Timmy Chang Lee, Klemens B Meyer, Hamid Moradi, Tariq Shafi, Isaac Teitelbaum, Leslie P Wong, Christopher T Chan
Urea removal has become a key measure of the intensity of dialysis treatment for kidney failure. Small solute removal, exemplified by Kt/Vurea, has been broadly applied as a means to quantify the dose of thrice weekly hemodialysis. Yet, the reliance on small solute clearances alone as a measure of dialysis adequacy fails fully to quantify the intended clinical effects of dialysis therapy. This review aims to (1) understand the strengths and limitations of small solute kinetics as a surrogate marker of dialysis dose, and (2) present the prospect of a more comprehensive construct for dialysis dose, one that considers more broadly the goals of ESRD care to maximize both quality of life and survival...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28281281/hemodialysis-disparities-in-african-americans-the-deeply-integrated-concept-of-race-in-the-social-fabric-of-our-society
#19
REVIEW
Keith C Norris, Sandra F Williams, Connie M Rhee, Susanne B Nicholas, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, L Ebony Boulware
End-stage renal disease (ESRD) is one of the starkest examples of racial/ethnic disparities in health. Racial/ethnic minorities are 1.5 to nearly 4 times more likely than their non-Hispanic White counterparts to require renal replacement therapy (RRT), with African Americans suffering from the highest rates of ESRD. Despite improvements over the last 25 years, substantial racial differences are persistent in dialysis quality measures such as RRT modality options, dialysis adequacy, anemia, mineral and bone disease, vascular access, and pre-ESRD care...
May 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28267753/impact-of-arteriovenous-fistula-blood-flow-on-serum-il-6-cardiovascular-events-and-death-an-ambispective-cohort-analysis-of-64-chinese-hemodialysis-patients
#20
Zhizhi Hu, Fengmin Zhu, Nan Zhang, Chunxiu Zhang, Guangchang Pei, Pengge Wang, Juan Yang, Yujiao Guo, Meng Wang, Yuxi Wang, Qian Yang, Han Zhu, Wenhui Liao, Zhiguo Zhang, Ying Yao, Rui Zeng, Gang Xu
Flows (Qa) of arteriovenous fistula (AVF) impact the dialysis adequacy in hemodialysis (HD) patients. However, data for different access flow levels on outcomes related to long-term dialysis patients, especially in Chinese patients, are limited. Herein, we performed an ambispective, mono-centric cohort study investigating the association between the AVF flows and inflammation, cardiovascular events and deaths in Chinese hemodialysis patients bearing a radio-cephalic fistula (AVF) from 2009 to 2015. Twenty-three patients (35...
2017: PloS One
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