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https://www.readbyqxmd.com/read/29151284/association-between-initial-vascular-access-and-survival-in-hemodialysis-according-to-age
#1
Ha Yeon Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
Background/Aims: This study aims to demonstrate whether the association between initial vascular access and mortality among hemodialysis patients varies by age. Methods: We conducted a retrospective study that included 2,552 patients who started hemodialysis. Vascular access was divided into three categories: percutaneous catheter, tunneled cuffed catheter, and arteriovenous (AV) access. Results: Survival rates for patients who received a central venous catheter, such as percutaneous or tunneled cuffed catheter, aged 65 to 74 years and those ≥ 75 years were reduced, but not for those aged < 65 years (log-rank test; p < 0...
November 20, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#2
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29148130/a-pseudo-one-compartment-model-of-phosphorus-kinetics-during-hemodialysis-further-supporting-evidence
#3
John K Leypoldt, Baris U Agar, Alfred K Cheung, Angelito A Bernardo
A pseudo-one compartment model has been proposed to describe phosphorus kinetics during hemodialysis and the immediate post-dialysis period. This model assumes that phosphorus mobilization from tissues is proportional to the difference between the pre-dialysis serum concentration (a constant) and the instantaneous serum concentration. The current study is exploratory and evaluated the ability of a pseudo-one compartment model to describe the kinetics of phosphorus during two short hemodialysis treatments separated by a 60-min inter-treatment period without dialysis; the latter is the post-dialysis rebound period for the first short hemodialysis treatment...
November 2017: Artificial Organs
https://www.readbyqxmd.com/read/29148008/supervised-preoperative-forearm-exercise-to-increase-blood-vessel-diameter-in-patients-requiring-an-arteriovenous-access-for-hemodialysis-rationale-and-design-of-the-pinch-trial
#4
Esther D Wilschut, Joris I Rotmans, Ernst Jan Bos, Daniëlle van Zoest, Daniël Eefting, Jaap F Hamming, Koen E A van der Bogt
BACKGROUND: Failure of maturation occurs in 30%-60% of arteriovenous fistula (AVF) creation for hemodialysis, with highest rates in distal radiocephalic fistulas. This is partly due to initial small blood vessel size with limited blood flow capacity. Forearm exercise has shown potential as stimulus for increasing blood vessel size in patients with end-stage renal disease (ESRD) and may promote maturation of AVFs in the upper limb when applied postoperatively. However, it is unknown if forearm exercise increases blood vessel size pre-operatively, which may contribute to more distal AVF creation and raise success rates of AVF surgery...
November 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29146139/how-to-prevent-renal-cachexia-a-clinical-randomized-pilot-study-testing-oral-supplemental-nutrition-in-hemodialysis-patients-with-and-without-human-immunodeficiency-virus-infection
#5
Michael Zilles, Christoph Betz, Oliver Jung, Stefan Gauer, Renate Hammerstingl, Astrid Wächtershäuser, Thomas J Vogl, Helmut Geiger, Aida Asbe-Vollkopf, Rainer U Pliquett
OBJECTIVE: End-stage renal disease associates with catabolism and sarcopenia. Hypothetically, peroral supplemental nutrition over 6 months prevents catabolism in hemodialysis patients. DESIGN: Prospective randomized pilot study (ClinicalTrials.gov Identifier: NCT00687050). SUBJECTS: Twenty-three hemodialysis patients (15 males and 7 females) with or without human immunodeficiency virus (HIV) infection of 2 ambulatory hemodialysis centers...
November 14, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29143935/a-propensity-matched-comparison-of-hard-outcomes-in-children-on-chronic-dialysis
#6
Enrico Vidal, Nicholas C Chesnaye, Fabio Paglialonga, Bruno Minale, Giovanna Leozappa, Mario Giordano, Bruno Gianoglio, Ciro Corrado, Rosa Maria Roperto, Roberto Chimenz, Francesca Mencarelli, Ilse-Maria Ratsch, Luisa Murer, Enrico Verrina
Data concerning outcomes of children on hemodialysis (HD) and peritoneal dialysis (PD) are scarce and frequently derived from single-center experiences. We sought to compare survival and transplantation rates in a large cohort of PD and HD patients. We extracted all patients initiating dialysis under 16 years of age between 2004 and 2013 from the Italian Registry of Pediatric Chronic Dialysis. Patients on PD were propensity-matched to those on HD based on gender, age, primary cause of ESRD, and the number of co-morbidities...
November 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#7
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#8
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29131496/suboptimal-initiation-predicts-short-term-prognosis-and-vulnerability-among-very-elderly-patients-who-start-hemodialysis
#9
Atsuhiro Kanno, Masaaki Nakayama, Satoru Sanada, Mitsuhiro Sato, Toshinobu Sato, Yoshio Taguma
AIM: A recent, growing concern regarding hemodialysis in Japan is a sustained increase in the elderly population. Among very elderly people who start hemodialysis, the prognosis is considered to be poor; however, this has not been fully elucidated. This study aimed to discover the short-term prognosis and related factors in very elderly patients who commence hemodialysis. METHODS: Between January 2008 and December 2013, 122 patients aged ≥85 years at hemodialysis initiation were documented in our hospital...
November 13, 2017: Nephrology
https://www.readbyqxmd.com/read/29103931/timely-thrombectomy-can-improve-patency-of-hemodialysis-arteriovenous-fistulas
#10
Mu-Yang Hsieh, Lin Lin, Tsung-Yan Chen, Dao-Ming Chen, Ming-Hsien Lee, Yung-Fang Shen, Chung-Wei Yang, Shao-Yuan Chuang, Chih-Cheng Wu, Kuan-Yu Hung
OBJECTIVE: The urgency with which salvage of thrombosed vascular accesses for dialysis should be attempted remains unknown. We examined the effect of a timely thrombectomy approach on vascular access outcomes for dialysis. METHODS: A before-and-after study was conducted with patients on hemodialysis who had undergone endovascular thrombectomy. A timely thrombectomy initiative (ie, salvage within 24 hours of thrombosis diagnosis) was started in July 2015 at our institution...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29097481/efficacy-and-long-term-safety-of-c-e-r-a-maintenance-in-pediatric-hemodialysis-patients-with-anemia-of-ckd
#11
Michel Fischbach, Elke Wühl, Sylvie C Meyer Reigner, Zoe Morgan, Franz Schaefer
BACKGROUND AND OBJECTIVES: The study was conducted to identify a conversion factor for switching from previous erythropoiesis-stimulating agents (ESAs) to continuous erythropoietin receptor activator-methoxy polyethylene glycol-epoetin beta (C.E.R.A.) and to document the efficacy and long-term safety of C.E.R.A. in pediatric patients with anemia of CKD undergoing hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this open-label, multicenter study, patients aged 6-17 years, with stable chronic anemia of CKD, undergoing hemodialysis received C...
November 2, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29092735/potentially-inappropriate-prescribing-of-drugs-in-elderly-patients-on-chronic-hemodialysis-treatment%C3%A2
#12
Gorana Nedin Ranković, Slobodan M Janković, Radmila Veličković Radovanović, Zorica Jović, Gordana Pešić, Svetlana Pavlović, Branislava Ranković, Jasmina Ranković, Dragana Stokanović, Dane Krtinić
PURPOSE: The aim of this study was to determine the prevalence of potentially inappropriate drug prescription (PIP) in older patients who were on chronic hemodialysis treatment and to explore the factors that lead to PIP. MATERIALS AND METHODS: The study was performed at the Department of Nephrology, Clinical Center Niš, Serbia. It included patients who were 65 years old and older who suffered from the end-stage of kidney failure and were treated by hemodialysis...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29092714/pylephlebitis-presenting-as-spontaneous-coronary-sinus-thrombosis-a-case-report
#13
Michael A Hart, Mengistu A Simegn
BACKGROUND: Coronary sinus thrombosis is a rare phenomenon. When identified, it most often is a complication of infective endocarditis or procedural intervention. We present an unusual and unreported case of spontaneous coronary sinus thrombosis as embolic sequela of an intra-abdominal infectious process. CASE PRESENTATION: We report a case of a 61-year-old white woman with a history of end-stage renal disease on hemodialysis, paroxysmal atrial fibrillation not on long-term systemic anticoagulation, and history of recurrent diverticulitis that presented with acute onset abdominal pain and nausea...
November 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29081491/deep-vein-thrombosis-complicated-by-spontaneous-iliopsoas-hematoma-in-patient-with-septic-shock
#14
Muhammad Umer Butt, Lili A Buzsaki, Susan S Smyth, Samy-Claude Elayi
BACKGROUND Spontaneous retroperitoneal hemorrhage (SRH) is a rare and difficult-to-diagnose entity. It is not associated with trauma, pathology, or iatrogenic manipulations. Few cases have been reported, with the only precipitating factor recognized being bleeding diatheses such as anticoagulation states, inherited coagulopathies, and hemodialysis. However, none of these have been described in combination with septic shock, which itself is associated with platelet dysfunction, coagulation dysfunction, and vasculopathy...
October 30, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29072166/effect-of-an-intradialytic-protein-rich-meal-intake-in-nutritional-and-body-composition-parameters-on-hemodialysis-patients
#15
Cristina Caetano, Ana Valente, Francisco Jorge Silva, Jorge Antunes, Cristina Garagarza
BACKGROUND AND AIMS: Protein intake is a key point to maintain an adequate nutritional status in hemodialysis (HD) patients. There are some studies that confirm the positive influence of intradialytic oral nutritional supplementation in several nutritional parameters in HD patients. The aim of this study was to evaluate the effect of an intradialytic protein rich meal in nutritional and body composition parameters on HD patients. METHODS: This was a 6-months single center non-randomized study with 99 patients in HD from one Nephrocare dialysis unit in Portugal...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29065404/urgent-start-peritoneal-dialysis-the-first-year-of-brazilian-experience
#16
Dayana Bitencourt Dias, Marcela Lara Mendes, Vanessa Burgugi Banin, Pasqual Barretti, Daniela Ponce
BACKGROUND: This study aimed to evaluate mechanical and infectious complications associated with urgent-start peritoneal dialysis (PD) and patients and technique survival in the first 180 days. METHODS: It was a prospective study that evaluated chronic patients who started unplanned PD using high-volume PD (HVPD) right after (<72 h) PD catheter placement. After hospital discharge, patients were treated with intermittent PD on alternate days in a dialysis unit until family training was provided...
October 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/29064172/measuring-residual-renal-function-for-hemodialysis-adequacy-is-there-an-easier-option
#17
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/28992343/serum-to-dialysate-potassium-gradient-and-its-association-with-short-term-outcomes-in-hemodialysis-patients
#18
Steven M Brunelli, David M Spiegel, Charles Du Mond, Nina Oestreicher, Wolfgang C Winkelmayer, Csaba P Kovesdy
Background: A high serum-to-dialysate potassium (K + ) gradient at the start of dialysis leads to rapid lowering of serum K + and may confer a greater risk of adverse events. Here, we examined the near-term association of K + gradient with clinical outcomes. Methods: This retrospective (2010-11) event-based study considered 830 741 patient-intervals, each defined by a pre-dialysis measurement of serum K + made among adult Medicare Parts A and B enrollees who received in-center hemodialysis on a Monday/Wednesday/Friday schedule at a large US dialysis organization...
August 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28983956/transitional-dialysis-care-units-a-new-approach-to-increase-home-dialysis-modality-uptake-and-patient-outcomes
#19
REVIEW
José A Morfín, Alex Yang, Elizabeth Wang, Brigitte Schiller
Home hemodialysis (HHD) and peritoneal dialysis (PD) are associated with better clinical outcomes, lower hospitalization rates, and improved quality of life compared with conventional in-center hemodialysis. However, <12% of patients requiring dialysis therapy use HHD or PD in the United States, even though over 90% of nephrologists would choose home-based dialysis modalities for themselves. Inadequate patient education and decision-making support are key barriers to patients choosing home-based therapy...
October 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28975090/chronic-dietary-oxalate-nephropathy-after-intensive-dietary-weight-loss-regimen
#20
Gebran Khneizer, Ahmad Al-Taee, Meher S Mallick, Bahar Bastani
BACKGROUND: Hyperoxaluria has been associated with nephrolithiasis as well as acute and chronic kidney disease. We present a case of end stage renal failure caused by excessive dietary oxalate intake in a dietary weight loss regimen. CASE PRESENTATION: A 51-year-old Caucasian male with the past medical history of type 2 diabetes mellitus, gout, hypertension and morbid obesity was referred to the primary care clinic after being found pale and easily fatigued. The patient had lost 36 kg over a 7-month period by implementing exercise and intense dietary measures that included 6 meals of spinach, kale, berries, and nuts...
July 2017: Journal of Nephropathology
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