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Hemodialysis start

Lawrence A Lavery, David C Lavery, Nathan A Hunt, Javier La Fontaine, Ryan D Lavery
BACKGROUND: Dialysis therapy is associated with an increased incidence of lower-extremity wounds and amputations. We compared the incidence of foot ulcers and amputations before and after the start of dialysis. METHODS: We evaluated 150 consecutive diabetic patients receiving dialysis and compared the incidence of foot complications 30 months before and after initiation of hemodialysis. We used claims data for diabetes, ulceration, and dialysis and abstracted medical records to verify diagnoses and dates of ulcers and amputations...
January 2018: Journal of the American Podiatric Medical Association
Benjamin Wu, Murad Melhem, Raju Subramanian, Ping Chen, Bethlyn Jaramilla Sloey, Bruno Fouqueray, M Benjamin Hock, Gary L Skiles, Andrew T Chow, Edward Lee
Etelcalcetide, a d-amino acid peptide, is an intravenous calcimimetic approved for the treatment of secondary hyperparathyroidism. Etelcalcetide binds the calcium-sensing receptor and increases its sensitivity to extracellular calcium, thereby decreasing secretion of parathyroid hormone (PTH) by chief cells. Etelcalcetide and its low-molecular-weight transformation products are rapidly cleared by renal excretion in healthy subjects, but clearance is substantially reduced and dependent on hemodialysis in end-stage renal disease...
March 13, 2018: Journal of Clinical Pharmacology
Dorina Esendagli, Irem Serifoglu, Serife Savas Bozbas, Merih Tepeoglu, Sule Akcay, Mehmet Haberal
Invasive pulmonary aspergillosis is an infection seen in patients receiving intensive immunosuppressive regimens, such as transplant recipients. Some risk factors that increase the incidence of infection have been determined, and patients defined as having high risk are recommended to take antifungal prophylaxis and be monitored closely. Here, we present a liver transplant patient with mild respiratory symptoms and a normal chest radiography on day 26 posttransplant. However, he had acute renal failure and underwent hemodialysis, which are both defined to increase significantly the risk of aspergillosis...
March 2018: Experimental and Clinical Transplantation
Ayse Ebru Bahadir Kilavuzoglu, Gurkan Yurteri, Nurgul Guven, Savas Marsap, Ali Riza Cenk Celebi, Cemile Banu Cosar
BACKGROUND: The effect of hemodialysis (HD) on intraocular pressure (IOP) has been investigated before, but there is a lack of consensus. Clinicians dealing with renal failure patients are interested in the potential negative effects of HD on IOP and the course of glaucoma. OBJECTIVES: The aim of this study was to investigate the effects of HD on IOP in patients with end-stage renal disease. MATERIAL AND METHODS: This prospective study included 106 patients who were receiving outpatient hemodialysis...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Chisa Fukasawa, Saori Ooishi, Takuma Kumagai, Megumi Koshiisi, Yuki Sueki, Kei Nakajima, Toru Mitsumori, Yoko Yoshida, Hideki Kato, Masaomi Nangaku, Toshiyuki Miyata, Keita Kirito
Herein, we present an elderly onset case of aHUS successfully treated with eculizumab. An 80-year-old woman with severe anemia, thrombocytopenia, and acute renal dysfunction was admitted to our hospital. A laboratory test revealed steep elevation in the LDH level, and the peripheral blood smear showed erythrocyte fragmentations. Accordingly, we diagnosed thrombotic microangiopathy, and treatment with plasma exchange was immediately initiated. In addition, she required hemodialysis because of rapid impairment of the renal function...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Sang Won Kim, Jun Nyung Lee, Hyun Tae Kim, Eun Sang Yoo
A vesicocutaneous fistula (VCF) is a tract that is formed abnormally between the bladder and the external surface of the body. VCF results in a great deal of inconvenience, discomfort, and physical disability for the affected patient. This condition can be caused by extensive trauma with pelvic bone fracture, radical pelvic surgery, irradiation of pelvic malignancies, hip arthroplasty, a large bladder calculus, and various other pathologies. The management of VCF should be approached on a case-by-case basis because of the complexity of the disease...
March 2018: Turkish Journal of Urology
Makiko Yamashita, Rieko Komatsu, Yuko Maruyama, Tomoyuki Takaki, Hiroshi Ichinose, Osamu Sasaki, Kenji Sawase, Takashi Harada, Satoshi Funakoshi
OBJECTIVE: The hemodialysis (HD) diet, which is a high-calorie and high-fat regimen, may inadvertently lead to an inadequate dietary intake, resulting in undernutrition among elderly HD patients. Therefore, an attempt was made to improve the dietary intake by implementing a modified diet regimen in eligible elderly HD patients. SUBJECTS: Elderly HD patients who had ingested < 50% of the meals provided and were diagnosed with undernutrition among all elderly patients institutionalized at the special elderly nursing home annexed to Nagasaki Kidney Hospital between June and November 2012...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Harmke A Polinder-Bos, David Vállez García, Johanna Kuipers, Jan Willem J Elting, Marcel J H Aries, Wim P Krijnen, Henk Groen, Antoon T M Willemsen, Peter J van Laar, Fijanne Strijkert, Gert Luurtsema, Riemer H J A Slart, Ralf Westerhuis, Ron T Gansevoort, Carlo A J M Gaillard, Casper F M Franssen
The initiation of hemodialysis is associated with an accelerated decline of cognitive function and an increased incidence of cerebrovascular accidents and white matter lesions. Investigators have hypothesized that the repetitive circulatory stress of hemodialysis induces ischemic cerebral injury, but the mechanism is unclear. We studied the acute effect of conventional hemodialysis on cerebral blood flow (CBF), measured by [15 O]H2 O positron emission tomography-computed tomography (PET-CT). During a single hemodialysis session, three [15 O]H2 O PET-CT scans were performed: before, early after the start of, and at the end of hemodialysis...
March 1, 2018: Journal of the American Society of Nephrology: JASN
Joel D Kopple, Denis Fouque
Dietary treatment offers many benefits to patients with advanced chronic kidney disease (CKD) who are approaching the need for renal replacement therapy. A large number of these benefits are independent of whether diets slow the rate of progression of CKD. These diets are low in protein and many minerals, and provide adequate energy for the CKD patient. The diets can reduce accumulation of potentially toxic metabolic products derived from protein and amino acid degradation, maintain a healthier balance of body water, sodium, potassium, phosphorus, calcium and other minerals, and prevent or improve protein-energy wasting...
February 19, 2018: Nephrology, Dialysis, Transplantation
Kevin F Erickson, Yuanchao Zheng, Vivian Ho, Wolfgang C Winkelmayer, Jay Bhattacharya, Glenn M Chertow
OBJECTIVE: To examine whether market competition is associated with improved health outcomes in hemodialysis. DATA SOURCES: Secondary analysis of data from a national dialysis registry between 2001 and 2011. STUDY DESIGN: We conducted one- and two-part linear regression models, using each hospital service area (HSA) as its own control, to examine the independent associations among market concentration and health outcomes. DATA COLLECTION: We selected cohorts of patients receiving in-center hemodialysis in the United States at the start of each calendar year...
February 22, 2018: Health Services Research
Hatem Ali, Tarek Abdelaziz, Fatima Abdelaal, Jyoti Baharani
The relationship between frailty and chronic kidney disease in elderly population has been recognized; however, studies concentrating on frailty in predialysis patients are limited. For nephrologists, the recognition of frailty is important as it has impact on decisions on the choice of dialysis modality and sometimes on whether dialysis is indeed in the patients' best interests. Many of the tools for routine assessment of frailty are not easily applicable to those clinicians not practicing elderly care medicine...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Chiara Carla Maria Brunati, Francesca Gervasi, Costanza Casati, Maria Luisa Querques, Alberto Montoli, Giacomo Colussi
BACKGROUND: Short frequent dialysis with NxStage System One cycler (NSO) has become increasingly popular as home hemodialysis prescription. Short dialysis sessions with NSO might not allow adequate phosphate (P) removal. METHODS: Single-session and weekly balances of P and calcium (Ca) were compared in 14 patients treated with NSO (6 sessions/week) and in 14 patients on standard bicarbonate dialysis (BHD). RESULTS: NSO and BHD showed similar plasma P fall, with end-dialysis plasma P slightly lower in BHD (2...
February 16, 2018: Blood Purification
Christine L H Snozek, Theresa N Kinard, Jill Adamski
This report describes a patient with light chain myeloma and acute renal injury. Serum kappa free light chain (FLC) was extremely elevated, >33,000 mg/dL. Treatment with therapeutic plasma exchange (TPE) started day 2 for biopsy-confirmed cast nephropathy. Bortezomib-containing chemotherapy was initiated on day 5, and hemodialysis for tumor lysis syndrome on day 7. TPE alone decreased kappa FLC >70% by day 5, indicating direct FLC removal was successful in this patient. A total of 25 TPE procedures were performed in a 31-day hospitalization...
February 10, 2018: Journal of Clinical Apheresis
Kathryn A McDougall, John W Larkin, Rebecca L Wingard, Yue Jiao, Sophia Rosen, Lin Ma, Len A Usvyat, Franklin W Maddux
Background: The prevalence of depressive affect is not well defined in the incident hemodialysis (HD) population. We investigated the prevalence of and associated risk factors and hospitalization rates for depressive affect in incident HD patients. Methods: We performed a prospective investigation using the Patient Health Questionnaire 2 (PHQ2) depressive affect assessment. From January to July of 2013 at 108 in-center clinics randomly selected across tertiles of baseline quality measures, we contacted 577 and 543 patients by telephone for depressive affect screening...
February 2018: Clinical Kidney Journal
Shaikha Al Jawder, Eiman AlJishi, Shaikhah Al-Otaibi, Mohammed S Al-Shahrani
A 51-year-old woman, who intentionally ingested a massive dose of ~60 g of valproic acid which she was using as a mood stabilizer for bipolar affective disorder, presented within 30 minutes of ingestion to the emergency department. The patient was asymptomatic and was immediately started on decontamination therapy with activated charcoal (AC). Drug serum levels, liver functions, and ammonia levels were tested and followed up during treatment. Due to the massive ingestion and continuous rise in serum drug levels, the patient received regular multiple doses of AC, as well as l-carnitine for liver protection...
2018: Open Access Emergency Medicine: OAEM
Fariba Samadian, Nooshin Dalili, Fatemeh Poor-Reza Gholi, Mahtab Fattah, Narges Malih, Mohsen Nafar, Ahmad Firoozan, Pedram Ahmadpoor, Shiva Samavat, Shadi Ziaie
OBJECTIVE: Despite advances in prevention of inflammatory milieu with different anti-inflammatory modalities in hemodialysis patients the rate of inflammatory markers in this population are still high. Inflammation is considered as a major player in uremia associated with morbidity and mortality in hemodialysis patients. The aim of this study was to evaluate the turmeric s effects on reduction of inflammatory markers in hemodialysis patients. METHODS: Hemodialysis patients over 18 years were recruited after fulfilling the inclusion criteria...
December 2017: Clinical Nutrition ESPEN
Y C Yavuz, N Y Selcuk, L Altıntepe, I Güney, S Yavuz
PURPOSE: In chronic hemodialysis patients, the low flow of vascular access may leads to inadequate dialysis, increased rate of hospitalization, morbidity, and mortality. It was found that surveillance should be performed for native arteriovenous (AV) should not be performed for AV graft in various studies. However, surveillance was done in graft AV fistulas in most studies. Doppler ultrasonography (US) was suggested for surveillance of AV fistulas by the last vascular access guideline of National Kidney Foundation Disease Outcomes Quality Initiative (NKF KDOQI)...
January 2018: Nigerian Journal of Clinical Practice
Paula Cox-North, Kelsey L Hawkins, Sean T Rossiter, Marie N Hawley, Renuka Bhattacharya, Charles S Landis
Sofosbuvir (SOF) is a nonstructural 5B polymerase inhibitor with activity in all hepatitis C virus (HCV) genotypes and is the backbone of many anti-HCV drug regimens. SOF is converted into inactive metabolites that undergo renal excretion. Patients with an estimated glomerular filtration rate (eGFR) < 30 mL/minute/1.73 m 2 may experience increased drug exposure and thus potential toxicities along with decreased efficacy due to dose reduction or drug discontinuation. This is a single-center study evaluating safety and effectiveness of SOF-based regimens in patients with severe renal dysfunction, defined as eGFR <30 mL/minute/1...
May 2017: Hepatology Communications
Masanori Yamada, Koji Nakai, Takeshi Hijikawa, Taisaku Hachimine, Hiroya Masaki, Kazuhiko Yoshioka, Kentaro Inoue
A 73-year-old man, receiving maintenance continuous ambulatory peritoneal dialysis(CAPD)was admitted to our hospital for chief complaining of heartburn. Gastrointestinal endoscopy disclosed 0- II a on the greater curvature of the upper gastric body. On further examination, the clinical diagnosis was defined as gastric cancer and c-stage I A(cT1aN0M0). The patient was recovered with conservative treatment from the perforated peritonitis after undergoing endoscopic submucosal dissection(ESD). Pathology revealed pT1b, INF b, UL(-), ly2, v0, pHM0, pVM0, for which he underwent total gastrectomy after changed to temporary hemodialysis(HD)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
K Shivanand Nayak, Sreepada V Subhramanyam, Navva Pavankumar, Sinoj Antony, M A Sarfaraz Khan
BACKGROUND/AIMS: Initiating renal replacement therapy in late referred patients with central venous catheter (CVC) hemodialysis (HD) causes serious complications. In urgent start peritoneal dialysis, initiating peritoneal dialysis (PD) within 14 days of catheter insertion still needs HD with CVC. We initiated Emergent start PD (ESPD) with Automated PD (APD) at our center within 48 h from the time of presentation. METHODS: A prospective, case-controlled, intention-to-treat study with 56 patients was conducted between March 2016 and August 2017...
January 30, 2018: Blood Purification
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