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Dialysis outcomes

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https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#1
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28081061/vital-signs-decrease-in-incidence-of-diabetes-related-end-stage-renal-disease-among-american-indians-alaska-natives-united-states-1996-2013
#2
Ann Bullock, Nilka Ríos Burrows, Andrew S Narva, Karen Sheff, Israel Hora, Akaki Lekiachvili, Hannah Cain, David Espey
BACKGROUND: American Indians and Alaska Natives (AI/AN) have the highest diabetes prevalence among any racial/ethnic group in the United States. Among AI/AN, diabetes accounts for 69% of new cases of end-stage renal disease (ESRD), defined as kidney failure treated with dialysis or transplantation. During 1982-1996, diabetes-related ESRD (ESRD-D) in AI/AN increased substantially and disproportionately compared with other racial/ethnic groups. METHODS: Data from the U...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28078211/a-case-series-of-the-safety-and-efficacy-of-testosterone-replacement-therapy-in-renal-failure-and-kidney-transplant-patients
#3
Ahmad Majzoub, Daniel A Shoskes
BACKGROUND: Hypogonadism is common in patients with renal dysfunction and does not always correct following transplantation. Recent studies show increased mortality for dialysis and transplant patients with low testosterone (T). These patients are often not treated due to concerns over efficacy and complications (both real and imagined). There is surprisingly scant literature supporting the use of T therapy in these patients. We wished to examine the results of T therapy in our patients with renal failure or following transplant...
December 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28077080/should-patients-older-than-65-years-be-offered-a-second-kidney-transplant
#4
Kristian Heldal, Anders Hartmann, Kjersti Lønning, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Hallvard Holdaas, Karsten Midtvedt
BACKGROUND: Age and number of recipients in need of kidney re-transplantation are increasing. Re-transplantation practices and outcomes in elderly recipients are not previously explored. We aimed to retrospectively evaluate the outcomes of recipients 65 years and older receiving their second deceased donor allograft. METHODS: The study was designed as a retrospective registry based study. All recipients 65 years or older who received a deceased donor kidney transplant at Oslo University Hospital between 2000 and 2014 were included in the study...
January 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28074307/clinical-characteristics-and-long-term-outcome-of-diarrhea-associated-hemolytic-uremic-syndrome-a-single-center-experience
#5
Takeshi Ninchoji, Kandai Nozu, Keita Nakanishi, Tomoko Horinouchi, Junya Fujimura, Tomohiko Yamamura, Shogo Minamikawa, Shingo Ishimori, Koichi Nakanishi, Norishige Yoshikawa, Ichiro Morioka, Hiroshi Kaito, Kazumoto Iijima
OBJECTIVES: To clarify the clinical characteristics and long-term outcomes of patients with diarrhea-associated hemolytic uremic syndrome (D + HUS) with a particular focus on time course. METHODS: We retrospectively analyzed the medical records of 61 patients with D + HUS who were admitted to Kobe University Hospital between 1995 and 2015. The onset of D + HUS was defined as day 1 of diarrhea. RESULTS: The age of onset was 4.1 (1...
January 10, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28073668/drug-eluting-stenting-for-femoropopliteal-lesions-followed-by-cilostazol-treatment-reduces-stent-restenosis-in-patients-with-symptomatic-peripheral-artery-disease
#6
Kan Zen, Mitsuyoshi Takahara, Osamu Iida, Yoshimitsu Soga, Daizo Kawasaki, Shinsuke Nanto, Hiroyoshi Yokoi, Satoaki Matoba
BACKGROUND: Cilostazol improves clinical endovascular therapy outcomes for femoropopliteal (FP) lesions in patients with symptomatic peripheral arterial disease, but whether it also has clinical benefits for patients after drug-eluting stent implantation remains unclear. METHODS: This study is a subanalysis of the ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy (ZEPHYR) study, a prospective multicenter study investigating FP lesions treated with the Zilver (Cook Medical, Bloomington, Ind) paclitaxel-eluting stent...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28073619/cytomegalovirus-serostatus-as-predictor-for-adverse-events-after-cardiac-surgery-a-prospective-observational-study
#7
Malte Ziemann, Matthias Heringlake, Philipp Lenor, David Juhl, Thorsten Hanke, Michael Petersen, Julika Schön, Hermann Heinze, Heinrich V Groesdonk, Hauke Paarmann, Holger Hennig
OBJECTIVE: To clarify whether reactivated cytomegalovirus (CMV) infections in critically ill patients lead to worse outcome or just identify more severely ill patients. If CMV has a pathogenic role, latently infected (CMV-seropositive) patients should have worse outcome than seronegative patients because only seropositive patients can experience a CMV reactivation. DESIGN: Post-hoc analysis of a prospective observational study. SETTING: Single university hospital...
October 20, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28073343/risk-factors-and-clinical-course-of-hungry-bone-syndrome-after-total-parathyroidectomy-in-dialysis-patients-with-secondary-hyperparathyroidism
#8
Lo-Yi Ho, Ping-Nam Wong, Ho-Kwan Sin, Yuk-Yi Wong, Kwok-Chi Lo, Shuk-Fan Chan, Man-Wai Lo, Kin-Yee Lo, Siu-Ka Mak, Andrew Kui-Man Wong
BACKGROUND: Hungry bone syndrome (HBS) is an important postoperative complication after parathyroidectomy for severe secondary hyperparathyroidism (SHPT). There is, however, little data in the literature on its detailed clinical course, and the associated risk factors remain controversial. METHODS: We did a single-center retrospective study on 62 consecutive dialysis patients who underwent total parathyroidectomy for SHPT to examine the risk factors, clinical course and outcome...
January 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#9
María José Pérez-Sáez, Nuria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor (ECD) or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index (KDPI) policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28070047/-clinical-analysis-for-patients-with-continuous-ambulatory-peritoneal-dialysis-associated-peritonitis
#10
Jian Liu, Xun Huang, Yao Liu, Hui Xu, Rui'e Gong, Chunhui Li
To analyze the clinical characteristics of continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis in the tertiary hospitals and to discuss the preventive and therapeutic strategy.
 Methods: The clinical characteristics, pathogens, resistance and outcomes of 126 CAPD associated peritonitis in 104 patients from Jan, 2013 to June, 2016, were retrospectively analyzed.
 Results: Among the patients, the incidence rates of abdominal pain, fever, diarrhea and emesis were 104 (82.54%), 56 (44.44%), 49 (38...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28067862/impact-of-indoxyl-sulfate-on-progenitor-cell-related-neovascularization-of-peripheral-arterial-disease-and-post-angioplasty-thrombosis-of-dialysis-vascular-access
#11
REVIEW
Chih-Cheng Wu, Szu-Chun Hung, Ko-Lin Kuo, Der-Cherng Tarng
Patients with chronic kidney disease (CKD) have an increased risk of vascular disease, which is associated with considerable health care costs. Vascular disease in CKD differs clinically and pathobiologically from that in patients with normal renal function. Besides the traditional risk factors, retention of uremic toxins contributes to the pathogenesis of vascular disease in patients with CKD. Indoxyl sulfate is a protein-bound uremic toxin and is inefficiently removed by conventional dialysis. Accumulating evidence suggests that indoxyl sulfate is a vascular toxin involved in atherosclerosis, arteriosclerosis, vascular calcification and vascular repair...
January 7, 2017: Toxins
https://www.readbyqxmd.com/read/28067459/surgical-and-oncologic-outcomes-of-laparoscopic-radical-nephrectomy-for-non-metastatic-renal-cancer-in-long-term-dialysis-patients
#12
Kenji Omae, Tsunenori Kondo, Toshio Takagi, Junpei Iizuka, Hirohito Kobayashi, Yasunobu Hashimoto, Kazunari Tanabe
This study aimed to compare the outcomes of laparoscopic radical nephrectomy (LRN) between patients undergoing dialysis for ≤240 and >240 months. Data from all dialysis patients with non-metastatic renal cell carcinoma (RCC) treated with LRN between 2008 and 2015 in our hospital were evaluated retrospectively. Patients were divided into two groups, shorter- and longer-term dialysis patients, according to the preoperative duration of dialysis (≤240 vs. >240 months). Of 174 patients, 58 (33.3%) were on longer-term dialysis...
January 9, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28066919/innovations-in-treatment-delivery-risk-of-peritonitis-and-patient-retention-on-peritoneal-dialysis
#13
Beth Piraino
Early innovations in the delivery of peritoneal dialysis (PD) markedly improved its acceptability and lowered peritonitis rates. The standard osmotic agent was, and continues to be dextrose, an agent that is not ideal as it is readily absorbed. The development of icodextrin-containing dialysis fluid has allowed a long dwell time to provide more effective ultrafiltration. The development of a smaller, more easily used automated cycler, led to an increase in the proportion of patients on the cycler as opposed to CAPD...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28066913/dialysate-sodium-rationale-for-evolution-over-time
#14
Jennifer E Flythe, Finnian R Mc Causland
Oligo-anuric individuals receiving hemodialysis (HD) are dependent on the dialysis machine to regulate sodium and water balance. Interest in adjusting the dialysate sodium concentration to promote tolerance of the HD procedure dates back to the early years of dialysis therapy. Evolution of dialysis equipment technologies and clinical characteristics of the dialysis population have prompted clinicians to increase the dialysate sodium concentration over time. Higher dialysate sodium concentrations generally promote hemodynamic stabilization and reduce intradialytic symptoms but often do so at the expense of stimulating thirst and promoting volume expansion...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28066881/short-acting-erythropoiesis-stimulating-agents-for-anaemia-in-predialysis-patients
#15
REVIEW
Deirdre Hahn, Christopher I Esezobor, Noha Elserafy, Angela C Webster, Elisabeth M Hodson
BACKGROUND: The benefits of erythropoiesis-stimulating agents (ESA) for chronic kidney disease (CKD) patients have been previously demonstrated. However, the efficacy and safety of short-acting epoetins administered at larger doses and reduced frequency as well as of new epoetins and biosimilars remains uncertain. OBJECTIVES: This review aimed to evaluate the benefits and harms of different routes, frequencies and doses of epoetins (epoetin alpha, epoetin beta and other short-acting epoetins) for anaemia in adults and children with CKD not receiving dialysis...
January 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28065517/peritoneal-macrophage-heterogeneity-is-associated-with-different-peritoneal-dialysis-outcomes
#16
Chia-Te Liao, Robert Andrews, Leah E Wallace, Mohd Wajid A Khan, Ann Kift-Morgan, Nicholas Topley, Donald J Fraser, Philip R Taylor
Peritonitis remains the major obstacle for the maintenance of long-term peritoneal dialysis and dysregulated host peritoneal immune responses may compromise local anti-infectious defense, leading to treatment failure. Whilst, tissue mononuclear phagocytes, comprising macrophages and dendritic cells, are central to a host response to pathogens and the development of adaptive immune responses, they are poorly characterized in the human peritoneum. Combining flow cytometry with global transcriptome analysis, the phenotypic features and lineage identity of the major CD14(+) macrophage and CD1c(+) dendritic cell subsets in dialysis effluent were defined...
January 5, 2017: Kidney International
https://www.readbyqxmd.com/read/28065454/the-prevalence-association-and-clinical-outcomes-of-frailty-in-maintenance-dialysis-patients
#17
So-Young Lee, Dong Ho Yang, Eunah Hwang, Seock Hui Kang, Sun-Hee Park, Tae Woo Kim, Duk Hyun Lee, Kisoo Park, Jun Chul Kim
OBJECTIVE: To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis. DESIGN: In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period...
January 3, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28065453/protective-effects-of-l-carnitine-against-delayed-graft-function-in-kidney-transplant-recipients-a-pilot-randomized-double-blinded-placebo-controlled-clinical-trial
#18
Atefeh Jafari, Mohammad-Reza Khatami, Simin Dashti-Khavidaki, Mahboob Lessan-Pezeshki, Alireza Abdollahi, Azadeh Moghaddas
OBJECTIVE: Delayed graft function (DGF) is an early complication after deceased donor kidney transplantation with significant adverse effects on graft outcomes. Ischemia-reperfusion injury during transplantation is a major cause of DGF. Tissue concentrations of carnitine, an antioxidant and regulator of cellular energy supply, decrease in the kidney following ischemia-reperfusion insult. Based on promising animal data, this study evaluated the possible protective effect of L-carnitine against DGF...
January 3, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28065190/cholecalciferol-v-ergocalciferol-for-25-hydroxyvitamin-d-25-oh-d-repletion-in-chronic-kidney-disease-a-randomised-clinical-trial
#19
James B Wetmore, Cassandra Kimber, Jonathan D Mahnken, Jason R Stubbs
Patients with chronic kidney disease (CKD) demonstrate complex mineral metabolism derangements and a high prevalence of vitamin D deficiency. However, the optimal method of 25-hydroxyvitamin D (25(OH)D) repletion is unknown, and trials analysing the comparative efficacy of cholecalciferol and ergocalciferol in this population are lacking. We conducted a randomised clinical trial of cholecalciferol 1250μg (50 000 IU) weekly v. ergocalciferol 1250μg (50 000 IU) weekly for 12 weeks in forty-four non-dialysis-dependent patients with stage 3-5 CKD...
January 9, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28064444/phosphate-binders-and-targets-over-decades-do-we-have-it-right-now
#20
Morgan Marcuccilli, Michel Chonchol, Anna Jovanovich
In advanced renal disease, the kidney is unable to maintain phosphate balance due to decreased urinary excretion as well as the imbalance of the bone metabolic axis. It is well established that hyperphosphatemia is associated with increased cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, there are no randomized controlled trials that demonstrate a clear benefit on hard outcomes in lowering serum phosphate levels to recommended targets in the CKD or dialysis population...
January 8, 2017: Seminars in Dialysis
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