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Mortality hemodialysis

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https://www.readbyqxmd.com/read/28434550/renal-failure-after-cardiac-operations-not-all-acute-kidney-injury-is-the-same
#1
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Shin-Rong Lee, Alejandro Suarez-Pierre, David Lehenbauer, Christopher M Sciortino, Robert S Higgins, Duke E Cameron, John V Conte, Glenn J Whitman
BACKGROUND: The Society of Thoracic Surgeons (STS) database does not distinguish between a decline in creatinine clearance vs new hemodialysis (HD) when qualifying acute renal failure (ARF) after a cardiac operation. We hypothesized that patients requiring HD experience significantly greater postoperative morbidity and death. METHODS: We included all patients who underwent STS index cardiac operations at our institution from 2008 to March 2015 and did not have preexisting renal failure (creatinine >4...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#2
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432490/thallium-201-washout-rate-of-stress-myocardial-perfusion-imaging-as-a-predictor-of-mortality-in-diabetic-kidney-disease-patients-initiating-hemodialysis-an-observational-follow-up-study
#3
Toshihide Hayashi, Nobuhiko Joki, Yuri Tanaka, Masaki Iwasaki, Shun Kubo, Ai Matsukane, Yasunori Takahashi, Yoshihiko Imamura, Koichi Hirahata, Hiroki Hase
BACKGROUND: Thallium-201 washout rate of stress myocardial perfusion imaging (MPI) has been reported to correlate with coronary flow reserve which is a parameter of myocardial microcirculation. However, the evidence for its use in diabetic kidney disease (DKD) has been lacking, and the association between thallium-201 washout rate and adverse outcomes including death is unknown. Therefore, the present study was conducted to evaluate the predictive ability of thallium-201 washout rate for mortality in DKD patients initiating hemodialysis...
April 21, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#4
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28430311/effect-of-hemodialysis-access-blood-flow-on-cardiac-events-after-coronary-artery-bypass-grafting-using-an-internal-thoracic-artery
#5
Leonid Feldman, Ilia Beberashvili, Ahmad Abu Tair, Shai Efrati, Oleg Gorelik, Walter G Wasser, Eitan Heldenberg, Igor Rabin
BACKGROUND: The possibility of coronary steal through an arteriovenous fistula (AVF) in hemodialysis (HD) patients with coronary artery bypass grafts (CABGs) using an ipsilateral internal thoracic artery (ITA) has been suggested. In order to define the significance of such a possibility, we analyzed cardiac events and mortality risk in patients in relation to AVF flow. METHODS: A retrospective cohort study was performed on prevalent HD patients from a single center...
April 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430145/the-association-of-ankle-brachial-index-protein-energy-wasting-and-inflammation-status-with-cardiovascular-mortality-in-patients-on-chronic-hemodialysis
#6
Hideki Ishii, Hiroshi Takahashi, Yasuhiko Ito, Toru Aoyama, Daisuke Kamoi, Takashi Sakakibara, Norio Umemoto, Yoshitaka Kumada, Susumu Suzuki, Toyoaki Murohara
Protein-energy wasting (PEW) is highly prevalent in hemodialysis (HD) patients. We investigated the association of abnormal ankle brachial index (ABI), PEW, and chronic inflammation status with clinical prognosis in HD patients. A total of 973 HD patients were enrolled and were followed-up for 8 years. As a marker of the PEW, geriatric nutritional risk index (GNRI) was used. Cut-off levels were 91.2 for GNRI defined from previous studies and 1.9 mg/L for C-reactive protein (CRP) as median value, respectively...
April 21, 2017: Nutrients
https://www.readbyqxmd.com/read/28428932/a-prime-determinant-in-selecting-dialysis-modality-peritoneal-dialysis-patient-survival
#7
REVIEW
Hyunwook Kim, Dong-Ryeol Ryu
The number of patients with end-stage renal disease (ESRD) has rapidly increased, as has the cost of dialysis. Peritoneal dialysis (PD) is an established treatment for ESRD patients worldwide; it has a variety of advantages, including autonomy and flexibility, as well as economic benefits in many countries compared to hemodialysis (HD). However, the long-term survival rate of PD remains poor. Although direct comparison of survival rate between the dialysis modalities by randomized controlled trials is difficult due to the ethical issues, it has always been a crucial point when deciding which dialysis modality should be recommended to patients...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28426815/using-controlled-attenuation-parameter-combined-with-ultrasound-to-survey-non-alcoholic-fatty-liver-disease-in-hemodialysis-patients-a-prospective-cohort-study
#8
Yi-Hao Yen, Jin-Bor Chen, Ben-Chung Cheng, Jung-Fu Chen, Kuo-Chin Chang, Po-Lin Tseng, Cheng-Kun Wu, Ming-Chao Tsai, Ming-Tsung Lin, Tsung-Hui Hu
BACKGROUND AND AIMS: Controlled attenuation parameter (CAP) is a non-invasive method for measuring hepatic steatosis (HS). Non-alcoholic fatty liver disease (NAFLD) is closely related to cardiovascular diseases (CVDs). CVDs are the leading cause of morbidity and mortality in hemodialysis patients. The aim of this study was to investigate the prevalence of NAFLD in hemodialysis patients. METHOD: We prospectively enrolled patients undergoing chronic hemodialysis, as well as patients with normal renal function who served as controls...
2017: PloS One
https://www.readbyqxmd.com/read/28425077/unexpected-and-striking-effect-of-heparin-free-dialysis-on-cytokine-release
#9
Alicja Rydzewska-Rosolowska, Joanna Gozdzikiewicz-Lapinska, Jacek Borawski, Ewa Koc-Zorawska, Michal Mysliwiec, Beata Naumnik
Heparin (both unfractionated and low molecular weight) is not only a potent anticoagulant but also has many pleiotropic effects, some of which are mediated by cytokine release. We compared the effect of hemodialysis (HD) with enoxaparin as an anticoagulant and without systemic anticoagulation (heparin-grafted membrane-Evodial) on the release of monocyte chemoattractant protein 1 (MCP-1), endostatin (ES) and activin A (Act-A). Nineteen stable HD patients were dialyzed with or without heparin, and plasma levels of MCP-1, ES and Act-A were measured after such a dialysis...
April 19, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28421638/renal-replacement-therapy-and-incremental-hemodialysis-for-veterans-with-advanced-chronic-kidney-disease
#10
Kamyar Kalantar-Zadeh, Susan T Crowley, Srinivasan Beddhu, Joline L T Chen, John T Daugirdas, David S Goldfarb, Anna Jin, Csaba P Kovesdy, David J Leehey, Hamid Moradi, Sankar D Navaneethan, Keith C Norris, Yoshitsugu Obi, Ann O'Hare, Tariq Shafi, Elani Streja, Mark L Unruh, Tushar J Vachharajani, Steven Weisbord, Connie M Rhee
Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources...
April 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28420212/nutritional-status-predicts-10-year-mortality-in-patients-with-end-stage-renal-disease-on-hemodialysis
#11
Shin Sook Kang, Jai Won Chang, Yongsoon Park
Protein-energy wasting (PEW) is associated with mortality in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. The correct diagnosis of PEW is extremely important in order to predict clinical outcomes. However, it is unclear which parameters should be used to diagnose PEW. Therefore, this retrospective observational study investigated the relationship between mortality and nutritional parameters in ESRD patients on maintenance hemodialysis. A total of 144 patients were enrolled. Nutritional parameters, including body mass index, serum albumin, dietary intake, normalized protein catabolic rate (nPCR), and malnutrition inflammation score (MIS), were measured at baseline...
April 18, 2017: Nutrients
https://www.readbyqxmd.com/read/28416170/hepcidin-serum-levels-and-resistance-to-recombinant-human-erythropoietin-therapy-in-hemodialysis-patients
#12
Kristina Petrulienė, Edita Žiginskienė, Vytautas Kuzminskis, Irena Nedzelskienė, Inga Arūnė Bumblytė
OBJECTIVE: The aim of this study was to analyze the factors that are associated with the response to erythropoiesis-stimulating agents (ESAs) and its association with hospitalization and mortality rates; to evaluate the serum hepcidin level and its associations with iron profile, inflammatory markers, ESA responsiveness, and mortality; and to determine independent factors affecting ERI and hepcidin. MATERIALS AND METHODS: To evaluate a dose-response effect of ESAs we used the erythropoietin resistance index (ERI)...
March 31, 2017: Medicina
https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#13
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in more than 80% of patients undergoing hemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-dialytic interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413417/the-dialysis-sodium-gradient-a-modifiable-risk-factor-for-fluid-overload
#14
Emilie Trinh, Catherine Weber
BACKGROUND: Fluid overload in patients on conventional hemodialysis is a frequent complication, associated with increased cardiovascular morbidity and mortality. The dialysate sodium prescription is a potential modifiable risk factor. Our primary objective was to describe associations between dialysate-to-serum sodium gradient and parameters of fluid status. A secondary objective was to evaluate the 6-month risk of hospitalization and mortality in relation to sodium gradient. METHODS: We performed a cross-sectional study of 110 prevalent conventional hemodialysis patients at a single center...
January 2017: Nephron Extra
https://www.readbyqxmd.com/read/28412129/acute-kidney-injury-after-burn
#15
REVIEW
Audra Clark, Javier A Neyra, Tarik Madni, Jonathan Imran, Herb Phelan, Brett Arnoldo, Steven E Wolf
Acute kidney injury (AKI) is a common and morbid complication after severe burn, with an incidence and mortality as high as 30% and 80%, respectively. AKI is a broad clinical condition with many etiologies, which makes definition and diagnosis challenging. The most recent Kidney Disease: Improving Global Outcomes (KDIGO) consensus guidelines defined stage and severity of AKI based on changes of serum creatinine and urine output (UOP) across time. Burn-related kidney injury is typically classified as early (0-3days after injury) or late (4-14days after injury)...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#16
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28403540/monocyte-lymphocyte-ratio-as-a-better-predictor-of-cardiovascular-and-all-cause-mortality-in-hemodialysis-patients-a-prospective-cohort-study
#17
Fangfang Xiang, Rongyi Chen, Xuesen Cao, Bo Shen, Zhonghua Liu, Xiao Tan, Xiaoqiang Ding, Jianzhou Zou
INTRODUCTION: Patients with chronic kidney disease, especially those with end-stage renal disease, have an increased risk of death. Previous studies have suggested neutrophil/lymphocyte ratio (NLR) was related to worse outcome in patients undergoing hemodialysis (HD). However, monocyte/lymphocyte ratio (MLR) has not been evaluated in HD patients. In this study, we prospectively studied the predictive value of MLR for all-cause and cardiovascular mortality in HD patients and compared it with NLR...
April 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28402487/circulating-klotho-associates-with-cardiovascular-morbidity-and-mortality-during-hemodialysis
#18
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/28399019/pathophysiology-and-implications-of-intradialytic-hypertension
#19
Peter Noel Van Buren
PURPOSE OF REVIEW: Intradialytic hypertension occurs regularly in 10--15% of hemodialysis patients. A large observational study recently showed that intradialytic hypertension of any magnitude increased mortality risk comparable to the most severe degrees of intradialytic hypotension. The present review review discusses the most recent evidence underlying the pathophysiology of intradialytic hypertension and implications for its management. RECENT FINDINGS: Patients with intradialytic hypertension typically have small interdialytic weight gains, but bioimpedance spectroscopy shows these patients have significant chronic extracellular volume excess...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28398983/effectiveness-of-educational-or-behavioral-interventions-on-adherence-to-phosphate-control-in-adults-receiving-hemodialysis-a-systematic-review
#20
Molly Milazi, Ann Bonner, Clint Douglas
BACKGROUND: People with end-stage kidney disease (ESKD) develop impaired excretion of phosphate. Hyperphosphatemia develops in ESKD as a result of the kidney's reduced ability to excrete ingested phosphate load and is characterized by high bone turnover and increased musculoskeletal morbidity including bone pain and muscle weakness. Increased serum phosphate levels are also associated with cardiovascular disease and associated mortality. These effects are significant considering that cardiovascular disease is the leading cause of death in ESKD, making phosphate control a crucial treatment goal...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
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