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https://www.readbyqxmd.com/read/28426914/recommended-dose-of-idarucizumab-may-not-always-be-sufficient-for-sustained-reversal-of-dabigatran
#1
Alexander Simon, Hans Domanovits, Cihan Ay, Gürkan Sengölge, Jerrold H Lewy, Alexander O Spiel
Idarucizumab is a monoclonal antibody fragment designed for reversing the anticoagulant effects of dabigatran. Administration is recommended as two intravenous boluses of 2.5 g within 15 minutes of each other or as a single 5 g bolus. However, in certain situations a second dose of the drug could be necessary. We report the case of a 77-year old man, treated with dabigatran for paroxysmal atrial fibrillation. He presented at our department with acute renal failure, concomitant massive dabigatran accumulation, and subsequent acute gastrointestinal bleeding...
April 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28423972/sexual-function-and-testosterone-level-in-men-with-conservatively-treated-chronic-kidney-disease
#2
Kerstin S Fugl-Meyer, Marie Nilsson, Britta Hylander, Mikael Lehtihet
Sexual dysfunctions are common, but underrecognized, in patients with chronic kidney disease (CKD) and are inversely associated with the glomerular filtration rate (GFR). Sexual dysfunctions may affect quality of life in males with CKD. The aim of this study was to analyze the relationship among sex hormones, sexual function, and sexual satisfaction in a group of men between 18 and 50 years of age with CKD Stages 1 to 5 not treated with hemodialysis or peritoneal dialysis. Fasting blood samples for hemoglobin, testosterone, prolactin, and luteinizing hormone and questionnaire surveys (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) were evaluated in 100consecutive men...
April 1, 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28422703/differential-hemoglobin-a-sequestration-between-hemodialysis-modalities
#3
Uzma Naseeb, Shamshad Zarina, Theres Jägerbrink, Jawed Shafqat, Hans Jörnvall, Jonas Axelsson
This report evaluates plasma protein patterns, dialysates and protein analysis of used dialysis membranes from the same patient under hemodialysis in three separate modalities, using high-flux membranes in concentration-driven transport (HD), convection-driven hemofiltration (HF) and combined hemodialfiltration (HDF). The plasma protein changes induced by each of the three dialysis modalities showed small differences in proteins identified towards our previous plasma analyses of chronic kidney disease (CKD) patients...
April 19, 2017: Biomolecular Concepts
https://www.readbyqxmd.com/read/28418614/efficacy-and-safety-of-low-dose-heparin-in-hemodialysis
#4
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/28402487/circulating-klotho-associates-with-cardiovascular-morbidity-and-mortality-during-hemodialysis
#5
Christophe Marçais, Delphine Maucort-Boulch, Jocelyne Drai, Emmanuelle Dantony, Marie-Christine Carlier, Emilie Blond, Leslie Genet, François Kuentz, Dominique Lataillade, Eric Legrand, Xavier Moreau-Gaudry, Guillaume Jean, Denis Fouque
Background: Klotho gene was identified as an aging suppressor. In animals klotho over-expression extends lifespan and defective klotho results in rapid aging and early death. The kidney is the main contributor to circulating klotho levels and during chronic kidney disease, renal klotho gene expression is drastically reduced in animals and humans as well. Objective: We aimed to determine the consequences of a serum klotho defect on cardiovascular morbidity and mortality during chronic dialysis...
April 11, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28397716/analysis-of-factors-associated-with-death-in-maintenance-hemodialysis-patients-a-multicenter-study-in-china
#6
Kang-Kang Song, De-Long Zhao, Yuan-Da Wang, Yong Wang, Xue-Feng Sun, Li-Ning Miao, Zhao-Hui Ni, Hong-Li Lin, Fu-You Liu, Ying Li, Ya-Ni He, Nian-Song Wang, Cai-Li Wang, Ai-Hua Zhang, Meng-Hua Chen, Xiao-Ping Yang, Yue-Yi Deng, Feng-Min Shao, Shu-Xia Fu, Jing-Ai Fang, Guang-Yan Cai, Xiang-Mei Chen
BACKGROUND: Patients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death. METHODS: Participants were selected from 16 blood purification centers in China from January 2012 to December 2014...
April 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28396123/unique-hemoglobin-a1c-level-distribution-and-its-relationship-with-mortality-in-diabetic-hemodialysis-patients
#7
Junichi Hoshino, Maria Larkina, Angelo Karaboyas, Brian A Bieber, Yoshifumi Ubara, Kenmei Takaichi, Tadao Akizawa, Takashi Akiba, Shunichi Fukuhara, Ronald L Pisoni, Akira Saito, Bruce M Robinson
Diabetic hemodialysis patients with hemoglobin A1c (HbA1c) levels below 6.5% and over 8.0% face a higher mortality risk. To determine the optimal glycemic control in Japanese patients, we examined the association between HbA1c and mortality in 2,300 Japanese diabetic patients on maintenance hemodialysis with HbA1c levels determined at enrollment in the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS) phases 2-5, using Cox regression analysis with adjustment for baseline age, sex, dialysis vintage, 12 general comorbidities, hemoglobin, albumin and creatinine levels, and insulin use; stratification by JDOPPS phase; and facility clustering taken into account...
April 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28381875/masked-uncontrolled-hypertension-in-patients-on-maintenance-hemodialysis
#8
Wenjin Liu, Liang Wang, Zhuxing Sun, Xiurong Li, Jianmei Zhou, Chaoqing Gao, Hong Chu, Wei Fan, Youwei Bai, Junwei Yang
Masked uncontrolled hypertension (MUCH) has been proven to be associated with increased cardiovascular risk in the general population. We performed the current analysis to determine its prevalence in dialysis patients and its association with pulse wave velocity (PWV). From 368 participants of another cohort study, we selected 145 subjects with controlled predialysis blood pressure (BP). All subjects underwent ambulatory BP monitoring and PWV measurement. MUCH was defined as controlled predialysis BP with daytime BP⩾135/85 mm Hg (definition-1); total ambulatory BP⩾130/80 mm Hg (definition-2); and either daytime BP⩾135/85 mm Hg or nighttime BP⩾120/70 mm Hg (definition-3)...
April 6, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28381747/the-resection-of-thyroid-cancer-was-associated-with-the-resolution-of-hyporesponsiveness-to-an-erythropoiesis-stimulating-agent-in-a-hemodialysis-patient-with-aceruloplasminemia
#9
Soichiro Nagata, Naoki Ikegaya, Shuhei Ogino, Shinichi Uchida, Mikiko Itaya, Aoi Momita, Shingo Shinozaki, Masaharu Ohura, Ken Kuriki, Satoshi Kono, Hiroaki Miyajima, Akira Hishida
We herein report the case of a hemodialysis patient whose response to an erythropoiesis-stimulating agent (ESA) improved following the resection of thyroid cancer. Her hemoglobin level remained below 7 g/dL, despite the use of ESA. During the search for the causes of her hyporesponsiveness to ESA, papillary thyroid cancer and aceruloplasminemia were found. The existence of other potential causes, such as iron deficiency, infectious disease, severe hyperparathyroidism and malnutrition were ruled out. Following the resection of the thyroid cancer tumor, her hemoglobin level increased to 10...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28372549/the-ferumoxytol-for-anemia-of-ckd-trial-fact-a-randomized-controlled-trial-of-repeated-doses-of-ferumoxytol-or-iron-sucrose-in-patients-on-hemodialysis-background-and-rationale
#10
Iain C Macdougall, Naomi V Dahl, Kristine Bernard, Zhu Li, Alka Batyky, William E Strauss
BACKGROUND: Iron deficiency anemia (IDA) is a common manifestation of chronic kidney disease (CKD), affecting most patients on hemodialysis and imposing a substantial clinical burden. Treatment with iron supplementation increases hemoglobin levels and can reduce the severity of anemia in patients with CKD. While correcting anemia in these patients is an important therapeutic goal, there is a lack of long-term trials directly comparing intravenous iron therapies in patients with CKD receiving hemodialysis...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28371161/ferric-pyrophosphate-citrate-as-an-iron-replacement-agent-for-patients-receiving-hemodialysis
#11
Steven Fishbane, Hitesh H Shah
Treatment of anemia remains an integral component in the care of patients with end stage kidney disease receiving dialysis. Currently, both erythropoiesis stimulating agents and iron replacement agents remain important anemia management strategies for patients undergoing hemodialysis (HD). Ferric pyrophosphate citrate (FPC) was approved by the U.S. Food and Drug Administration in January 2015 as an iron replacement product in adult patients receiving long-term maintenance HD. FPC is administered to patients on HD through the dialysate...
April 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28370957/safety-of-intravenous-iron-in-hemodialysis-patients
#12
Xiaojuan Li, Abhijit V Kshirsagar, M Alan Brookhart
Among end-stage renal disease patients maintained by hemodialysis, anemia has been managed primarily through erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron. Following concerns about the cardiovascular (CV) safety of ESAs and changes in the reimbursement policies in Medicare's ESRD program, the use of IV iron has increased. IV iron supplementation promotes hemoglobin production and reduces ESA requirements, yet there exists relatively little evidence on the long-term safety of iron supplementation in hemodialysis patients...
April 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28359656/in-center-nocturnal-hemodialysis-versus-conventional-hemodialysis-a-systematic-review-of-the-evidence
#13
Ben Wong, David Collister, Maliha Muneer, Dale Storie, Mark Courtney, Anita Lloyd, Sandra Campbell, Robert P Pauly
BACKGROUND: Owing to its longer treatment duration-up to 8 hours per dialysis treatment-in-center thrice-weekly nocturnal hemodialysis (HD) is receiving greater attention. To better understand the evidence for in-center nocturnal HD, we sought to systematically review the literature to determine the effects of in-center nocturnal HD versus conventional HD on clinically relevant outcomes. STUDY DESIGN: We searched MEDLINE, Embase, Evidence-Based Medicine Reviews (EBMR), Web of Science, and Scopus from the earliest date in the database to November 2016...
March 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28353156/restless-legs-syndrome-in-maintenance-hemodialysis-patients-an-epidemiologic-survey-in-hefei
#14
Jian-Ping Xiao, Gui-Xia Zhang, Lei Chen, Ben-Gui Sun, Hong-Xu Zhang, Li-Hong Chen, Liang Yuan, Li Hao, De-Guang Wang
OBJECTIVE: To investigate the prevalence of restless legs syndrome (RLS) in maintenance hemodialysis (MHD) patients and its possible influencing factors. METHODS: MHD patients were consecutively enrolled from five hemodialysis centers in Hefei. Clinical, demographics, and laboratory data were recorded from December 2013 to March 2014. RLS diagnosis scale, Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), and kidney disease and quality of life (KDQOLTM-36) were used for analysis...
March 28, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28341375/risk-factors-for-mortality-in-patients-undergoing-hemodialysis-a-systematic-review-and-meta-analysis
#15
Lijie Ma, Sumei Zhao
BACKGROUND: No consensus exists regarding the factors influencing mortality in patients undergoing hemodialysis (HD). This meta-analysis aimed to evaluate the impact of various patient characteristics on the risk of mortality in such patients. METHODS: PubMed, Embase, and Cochrane Central were searched for studies evaluating the risk factors for mortality in patients undergoing HD. The factors included age, gender, diabetes mellitus (DM), body mass index (BMI), previous cardiovascular disease (CVD), HD duration, hemoglobin, albumin, white blood cell, C-reactive protein (CRP), parathyroid hormone, total iron binding capacity (TIBC), iron, ln ferritin, adiponectin, apolipoprotein A1 (ApoA1), ApoA2, ApoA3, high-density lipoprotein (HDL), total cholesterol, hemoglobin A1c (HbA1c), serum phosphate, troponin T (TnT), and B-type natriuretic peptide (BNP)...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28335671/the-relationship-between-survival-rate-and-intradialytic-blood-pressure-changes-in-maintenance-hemodialysis-patients
#16
Jiayue Lu, Minxia Zhu, Shang Liu, Mingli Zhu, Huihua Pang, Xinghui Lin, Zhaohui Ni, Jiaqi Qian, Hong Cai, Weiming Zhang
OBJECTIVE: The objective of this study is to investigate the relationship between blood pressure changes and all-cause mortality, and between blood pressure changes and cardiovascular mortality, for maintenance hemodialysis (MHD) patients during dialysis. METHODS: Data regarding general condition, biochemical indices, and survival prognosis of MHD patients who were treated at the Shanghai Jiao Tong University School of Medicine-affiliated Renji Hospital from July 2007 to December 2012 were collected, in order to evaluate the relationship between patients' blood pressure changes during hemodialysis and mortality...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28328144/diagnosing-and-preventing-iron-overload
#17
Ganesh Ramanathan, John K Olynyk, Paolo Ferrari
Absolute or functional iron (Fe) deficiency is an important determinant of anemia in hemodialysis patients and parenteral Fe is routinely used to treat this condition in conjunction with erythropoiesis stimulating agents. While restoration of hemoglobin toward the target range is a good outcome of Fe replacement, it is well known that Fe overload and toxicity may be adverse consequences of this therapy. Dialysis clinical practice guidelines recommend tailoring Fe therapy based on transferrin saturation and serum ferritin levels...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28320343/targets-for-adapting-intravenous-iron-dose-in-hemodialysis-a-proof-of-concept-study
#18
N O Peters, N Jay, J Cridlig, G Rostoker, L Frimat
BACKGROUND: Intravenous iron is widely used to control anemia in dialysis patients and limits costs related to erythropoiesis-stimulating agents (ESA). Current guidelines do not clearly set upper limits for serum ferritin (SF) and transferrin saturation (TSAT). International surveys such as the Dialysis Outcomes and Practice Patterns Study (DOPPS) showed that this lack of upper limits potentially led nephrologists to prescribe iron infusions even for patients with a high SF. Recent publications have suggested a risk of short- and long-term adverse effects related to iron overload...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28316963/the-results-of-proximal-femoral-nail-for-intertrochanteric-fracture-in-hemodialysis-patient
#19
Kyung Sub Song, Sang Phil Yoon, Su Keon Lee, Seung Hwan Lee, Bong Seok Yang, Byeong Mun Park, Ick Hwan Yang, Beom Seok Lee, Ji Ung Yeom
PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30)...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28285317/efficacy-of-intravenous-iron-sucrose-in-hemodialysis-patients-with-restless-legs-syndrome-rls-a-randomized-placebo-controlled-study
#20
Yinghui Deng, Jinglin Wu, Qiang Jia
BACKGROUND Restless legs syndrome (RLS) is a common disorder in hemodialysis (HD) patients that causes sleep disturbances and diminished quality of life. Because iron deficiency has been implicated in the pathogenesis of RLS, we sought to investigate the effects of intravenous (IV) iron sucrose on symptoms of RLS in HD patients. MATERIAL AND METHODS The study was a randomized, placebo-controlled study of 1000 mg iron sucrose versus normal saline as placebo. Patients were evaluated at baseline and 2 weeks after the last injection...
March 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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