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https://www.readbyqxmd.com/read/27903998/survival-benefit-of-hemodiafiltration-compared-with-prolonged-high-flux-hemodialysis
#1
Petar S Djuric, Aleksandar Jankovic, Jovan Popovic, Jelena Tosic Dragovic, Ana Bulatovic, Zivka Djuric, Milos Mitrovic, Nada Dimkovic
INTRODUCTION:  Patients on dialysis have a high rate of death, mainly of cardiovascular cause. Nephrologists are actively looking for ways to improve patients' outcomes, and alternative dialysis strategies, such as long conventional hemodialysis and hemodiafiltration, are currently being investigated. The aim of this study was to compare anemia, nutrition, inflammation, mineral metabolism, and 3-year survival rates between patients treated with hemodiafiltration and prolonged high-flux hemodialysis (HFH)...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27896908/bixalomer-in-hyperphosphatemic-patients-with-chronic-kidney-disease-not-on-dialysis-phase-3-randomized-trial
#2
Tadao Akizawa, Hideki Origasa, Chisato Kameoka, Junko Tsukada, Kentarou Kuroishi, Yusuke Yamaguchi
Currently, calcium- or metal-containing phosphate binders are available to treat hyperphosphatemia in predialysis patients with chronic kidney disease. Bixalomer, a non-calcium, metal-free phosphate binder, has not been studied in these patients. We evaluated the efficacy and safety of bixalomer versus placebo for treatment of hyperphosphatemia in Japanese predialysis patients with chronic kidney disease. This multicenter, randomized, double-blind, phase 3 trial, randomized eligible patients 1:1 to receive bixalomer or placebo for 12 weeks...
November 29, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27881607/bicarbonate-balance-and-prescription-in-esrd
#3
Matthew K Abramowitz
The optimal approach to managing acid-base balance is less well defined for patients receiving hemodialysis than for those receiving peritoneal dialysis. Interventional studies in hemodialysis have been limited and inconsistent in their findings, whereas more compelling data are available from interventional studies in peritoneal dialysis. Both high and low serum bicarbonate levels associate with an increased risk of mortality in patients receiving hemodialysis, but high values are a marker for poor nutrition and comorbidity and are often highly variable from month to month...
November 23, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27876356/-low-flux-dialysate-daily-home-hemodialysis-a-result-for-the-62%C3%A2-first-french-and-belgian-patients
#4
Anaïs Benabed, Patrick Henri, Thierry Lobbedez, Eric Goffin, Simona Baluta, Abdelkader Benziane, Ahmed Rachi, Johan W van der Pijl, Clémence Bechade, Maxence Ficheux
Since 2011, a new device is available for low flux dialysate quotidian home hemodialysis in France and Belgium. This study aims to evaluate the characteristics and dialysis prescriptions for Nx Stage System One™ users. We retrospectively included patients trained between 2011 and 2013 in France and Belgium. We collected data concerning their clinical features, their dialysis prescriptions, their laboratory parameters until 6 months of dialysis and, reason for dropping in case of cessation. Sixty-two patients from 31 centers, aged 48±18 years old, with a sex ratio 46/16 (M/F) are included with a median Charlson comorbidity index of 1 [0-3]...
November 18, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27804262/effects-of-end-stage-renal-disease-and-dialysis-modalities-on-blood-ammonia-level
#5
Nosratola D Vaziri, Mahyar Khazaeli, Ane C F Nunes, Kevin T Harley, Hyder Said, Omeed Alipour, Wei Ling Lau, Madeleine V Pahl
Introduction Uremia results in a characteristic breath odor (uremic fetor) which is largely due to its high ammonia content. Earlier studies have shown a strong correlation between breath ammonia and blood urea levels and a 10-fold reduction in breath ammonia after hemodialysis in patients with chronic kidney disease. Potential sources of breath ammonia include: (i) local ammonia production from hydrolysis of urea in the oropharyngeal and respiratory tracts by bacterial flora, and (ii) release of circulating blood ammonia by the lungs...
November 1, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27783275/a-new-peritoneal-dialysis-fluid-for-japanese-patients-a-randomized-non-inferiority-clinical-trial-of-safety-and-efficacy
#6
Masaaki Nakayama, Yoshindo Kawaguchi, Takashi Akiba, Masao Kim, Hidemune Naito, Shigeko Hara, Teruhiko Maeba, Noriaki Yorioka, James A Sloand, Mark R Marshall
BACKGROUND: We report here two new peritoneal dialysis fluids (PDFs) for Japan [BLR 250, BLR 350 (Baxter Limited, Japan)]. The PDFs use two-chamber systems, and have bicarbonate and lactate buffer to a total of 35 mmol/L. In separate trials, the new PDFs were compared to two "standard" systems [PD-4, PD-2 (Baxter Limited, Japan)]. The trials aimed to demonstrate non-inferiority of peritoneal creatinine clearance (pCcr), peritoneal urea clearance (pCurea) and ultrafiltration volume (UF), and compare acid-base and electrolyte balance...
October 25, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27761981/dialysate-bicarbonate-variation-in-maintenance-hemodiafiltration-patients-impact-on-serum-bicarbonate-intradialytic-hypotension-and-interdialytic-weight-gain
#7
Márcio Viegas, Cristina Cândido, Joana Felgueiras, José Clemente, Sara Barros, Rostislav Farbota, Filipa Vera, Antero Matos, Francisco Sousa
Introduction The dialysate bicarbonate (DB) influences the acid-base balance in dialysis patients. Very low and high serum bicarbonate (SB) have been related with a higher mortality. Acid-base balance also has been associated with hemodynamic effects in these patients. The trial aim was to compare the effect of DB concentration variation on SB levels in maintenance hemodiafiltration (HDF) patients and the effect on intradialytic hypotension and interdialytic weight gain. Methods  A prospective study, with 9 months of follow-up, involving 93 patients, divided in two groups: group 1 and group 2 with a DB of 34 mmol/L and 30 mmol/L, respectively, with monitoring of pre and post HDF SB, intradialytic hypotension, and interdialytic weight gain...
October 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27693260/a-dynamic-predictive-model-for-progression-of-ckd
#8
Navdeep Tangri, Lesley A Inker, Brett Hiebert, Jenna Wong, David Naimark, David Kent, Andrew S Levey
BACKGROUND: Predicting the progression of chronic kidney disease (CKD) is vital for clinical decision making and patient-provider communication. We previously developed an accurate static prediction model that used single-timepoint measurements of demographic and laboratory variables. STUDY DESIGN: Development of a dynamic predictive model using demographic, clinical, and time-dependent laboratory data from a cohort of patients with CKD stages 3 to 5. SETTING & PARTICIPANTS: We studied 3,004 patients seen April 1, 2001, to December 31, 2009, in the outpatient CKD clinic of Sunnybrook Hospital in Toronto, Canada...
September 29, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27689113/the-effects-of-different-electrolyte-composition-in-dialysate-on-qtc-interval-a-controlled-trial
#9
Foroogh Sabzghabaei, Seyed Alireza Heydariezade, Rashin S Joodat
INTRODUCTION: Hemodialysis (HD) has impact on the cardiovascular system by inducing changes in the characteristics of body fluids such as PH, temperature and electrolyte concentrations. In the previous studies, prolongation of the QT interval and increase of QT dispersion have been reported during HD sessions. These changes were more significant while using solutions with less potassium and higher bicarbonate during dialysis. OBJECTIVES: The aim of our study was to investigate the effects of different potassium and bicarbonate concentrations on electrocardiography (ECG) parameters and the electrochemical balance of cell membranes...
2016: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/27648406/carbon-dioxide-global-warning-for-nephrologists
#10
REVIEW
Marco Marano, Anna D'Amato, Alessandra Cantone
The large prevalence of respiratory acid-base disorders overlapping metabolic acidosis in hemodialysis population should prompt nephrologists to deal with the partial pressure of carbon dioxide (pCO2) complying with the reduced bicarbonate concentration. What the most suitable formula to compute pCO2 is reviewed. Then, the neglected issue of CO2 content in the dialysis fluid is under the spotlight. In fact, a considerable amount of CO2 comes to patients' bloodstream every hemodialysis treatment and "acidosis by dialysate" may occur if lungs do not properly clear away this burden of CO2...
September 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27590717/serum-levels-of-the-adipomyokine-irisin-in-patients-with-chronic-kidney-disease
#11
Ana Rodríguez-Carmona, Miguel Pérez Fontán, Susana Sangiao Alvarellos, Teresa García Falcón, María Lara Pena Bello, Andrés López Muñiz, Fernando Cordido
BACKGROUND: Irisin is an adipomyokine with claimed anti-obesity and anti-diabetic effects. This hormone has been insufficiently studied in patients with advanced chronic kidney disease (CKD). OBJECTIVE: To perform an exploratory analysis of serum irisin levels in patients undergoing different CKD treatments. METHOD: Following a cross-sectional design, we estimated serum levels of irisin in 95 patients with CKD managed conservatively (advanced CKD), with peritoneal dialysis (PD) or with haemodialysis, and compared our findings with a control group of 40 healthy individuals...
September 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27568307/controversial-issues-in-ckd-clinical-practice-position-statement-of-the-ckd-treatment-working-group-of-the-italian-society-of-nephrology
#12
Vincenzo Bellizzi, Giuseppe Conte, Silvio Borrelli, Adamasco Cupisti, Luca De Nicola, Biagio R Di Iorio, Gianfranca Cabiddu, Marcora Mandreoli, Ernesto Paoletti, Giorgina B Piccoli, Giuseppe Quintaliani, Maura Ravera, Domenico Santoro, Serena Torraca, Roberto Minutolo
This position paper of the study group "Conservative treatment of Chronic Kidney Disease-CKD" of the Italian Society of Nephrology addresses major practical, unresolved, issues related to the conservative treatment of chronic renal disease. Specifically, controversial topics from everyday clinical nephrology practice which cannot find a clear, definitive answer in the current literature or in nephrology guidelines are discussed. The paper reports the point of view of the study group. Concise and practical advice is given on several common issues: renal biopsy in diabetes; dual blockade of the renin-angiotensin-aldosterone system (RAAS); management of iron deficiency; low protein diet; dietary salt intake; bicarbonate supplementation; treatment of obesity; the choice of conservative therapy vs...
August 27, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27545631/-nutritional-and-functional-assessment-of-peritoneal-dialysis-patients-in-the-clinical-practice-report-from-mito-dp-group
#13
Adamasco Cupisti, Claudia D'Alessandro, Gian Marco Caselli
Nutritional abnormalities and physical inactivity are risk factors of increased morbidity and mortality in patients with ESRD. Identify and define malnutrition, in particular protein-energy depletion (PEW), is an important task in the management of renal patients. The aim of this multicenter observational study was to implement the assessment of nutritional status and functional capacity in patients on peritoneal dialysis, including tests and validated methods which are relatively easy to apply in daily clinical practice...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27509590/peritoneal-dialysis-treatment-of-metformin-associated-lactic-acidosis-in-a-diabetic-nephropathy-patient%C3%A2
#14
Jianjun Gao, Zhaoyan Gu, Yongxing Xu, Yu Na
We report a case of metformin-associated lactic acidosis (MALA) in a 66-year-old man with end-stage renal disease on peritoneal dialysis (PD). The patient presented with severe lactic acidosis and was treated successfully with automated peritoneal dialysis (APD). During the treatment, PD solution was prepared from hemofiltration substitute fluid. The prescription was 8 cycles of 2,000 mL over 24 hours with the prepared solution, and venoclysis with sodium bicarbonate to improve the acidosis. After 3 days of treatment, his lactic acidosis was corrected...
November 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27509584/fever-thrombocytopenia-and-aki-a-profile-of-malaria-dengue-and-leptospirosis-with-renal-failure-in-a-south-indian-tertiary-care-hospital
#15
Mayoor V Prabhu, Arun S, Venkat Ramesh
INTRODUCTION: In the tropics, the triad of fever, thrombocytopenia, and AKI portends a grim prognosis with high mortality and a severe strain on already-stretched resources. Malaria, dengue, and leptospirosis account for most cases. We undertook a review of cases to determine factors accounting for adverse prognosis. METHODS: All patients presenting to the emergency room (ER) with a history of fever, thrombocytopenia, and renal failure were included in the study...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27502170/normal-saline-versus-lower-chloride-solutions-for-kidney-transplantation
#16
REVIEW
Susan Wan, Matthew A Roberts, Peter Mount
BACKGROUND: The ideal intravenous fluid for kidney transplantation has not been defined, despite the common use of normal saline during the peri-operative period. The high chloride content of normal saline is associated with an increased risk of hyperchloraemic metabolic acidosis, which may in turn increase the risk of hyperkalaemia and delayed graft function. Balanced electrolyte solutions have a lower chloride content which may decrease this risk and avoid the need for dialysis due to hyperkalaemia in the immediate post-transplant period...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27438973/parathyroid-responsiveness-during-hypocalcemia-after-total-parathyroidectomy-and-autotransplantation-in-patients-with-renal-hyperparathyroidism
#17
Patricia Dreyer, Monique Nakayama Ohe, Livia Marcela Dos Santos, Ilda Sizue Kunii, Rodrigo Oliveira Santos, Aluizio Barbosa de Carvalho, Jose Gilberto Henriques Vieira
INTRODUCTION: Hyperparathyroidism is a frequent complication of chronic kidney disease (CKD). Total parathyroidectomy (PTX) with parathyroid tissue autotransplantation (AT) is a treatment option in those individuals that do not respond to clinical management. OBJECTIVE: To evaluate grafted parathyroid tissue response during induced hypocalcemia among CKD patients who underwent total PTX with AT. METHODS: Eighteen patients with renal hyperparathyroidism were submitted to total PTX with parathyroid AT selected by stereomicroscopy between April and October 2008...
June 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27411725/moderator-s-view-higher-serum-bicarbonate-in-dialysis-patients-is-protective
#18
Kamyar Kalantar-Zadeh
Several observational studies have reported an association between higher serum bicarbonate level and high mortality risk in dialysis patients. However, in such studies mere discovery of associations does not allow one to infer causal relationships. This association may be related to inadequate dietary protein intake that may lead to less acid generation and hence a higher serum bicarbonate level. Since undernutrition is a strong predictor of death in hemodialysis patients, the observed association may be an epiphenomenon and not a biologically plausible relationship...
August 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27411724/con-higher-serum-bicarbonate-in-dialysis-patients-is-protective
#19
Philippe Chauveau, Claire Rigothier, Christian Combe
Metabolic acidosis is often observed in advanced chronic kidney disease, with deleterious consequences on the nutritional status, bone and mineral status, inflammation and mortality. Through clearance of the daily acid load and a net gain in alkaline buffers, dialysis therapy is aimed at correcting metabolic acidosis. A normal bicarbonate serum concentration is the recommended target in dialysis patients. However, several studies have shown that a mild degree of metabolic acidosis in patients treated with dialysis is associated with better nutritional status, higher protein intake and improved survival...
August 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27411723/pro-higher-serum-bicarbonate-in-dialysis-patients-is-protective
#20
Madhukar Misra
Chronic metabolic acidosis is common in dialysis patients. Bicarbonate administration via the dialysate helps maintain the acid-base balance in these patients. Serum bicarbonate level in dialysis patients is determined by several factors that include dietary protein intake, nutritional status and dialysis prescription, etc. Additionally, a meaningful interpretation of serum bicarbonate in dialysis patients requires an understanding of complexities involving its measurement. Both very low as well very high levels of serum bicarbonate have been associated with adverse outcomes in observational studies...
August 2016: Nephrology, Dialysis, Transplantation
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