Hemodialysis hypertension

AIMS AND BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal therapy to support oxygenation of patients with severe cardiac or respiratory failure. Studies have shown that acute kidney injury (AKI) can worsen the outcome in these patients. This study aims to assess the incidence and outcome of AKI in patients on ECMO support. MATERIALS AND METHODS: This retrospective study included 64 patients who underwent ECMO for more than 24 hours...

INTRODUCTION: End-Stage Renal Disease (ESRD) patients necessitate dialysis when kidney transplantation is not feasible. Hemodialysis patients exhibit higher mortality rates compared to the general population due to uremia and an increased burden of comorbidities. In this vulnerable population, defective innate and adaptive immunity contribute to infectious diseases being a leading cause of hospitalization and mortality. Given the COVID-19 pandemic and the potential for a diminished antibody response to the COVID-19 vaccine among dialysis patients, this study aimed to measure IgG antibody titers in this patient group following COVID-19 vaccination and compare them to healthy individuals...

The incidence of cardiovascular disease is increasing around the world, and it is one of the main causes of death in chronic kidney diseases patients. It is urgent to early identify the factors of cardiometabolic risk. Sleep problems have been recognized as a risk factor for cardiometabolic risk in both healthy people and chronic patients. However, the relationship between sleep problems and cardiometabolic risk has not been clearly explored in hemodialysis patients. This study aimed to investigate the relationship between sleep problems and cardiometabolic risk in 3025 hemodialysis patients by a multicenter study...

Priapism, characterized by prolonged and painful penile erection, is a rare urological emergency with diverse etiologies. We present a case of refractory ischemic priapism following hemodialysis in a 57-year-old male with a history of type II diabetes mellitus, hypertension, and end-stage renal disease. Despite standard conservative management, the patient's condition persisted, necessitating penile distal shunting through an intracorporeal dilatation plus Al-Ghorab corporoglandular shunt. Blood gas analysis of corpus cavernosum blood revealed severe acidosis and hypoxemia, emphasizing the systemic impact of ischemic priapism...

Balkan endemic nephropathy (BEN) is a rare progressive chronic renal disease found in residents living along the Balkan peninsula. We present a 92-year-old female who complained initially of cardio-respiratory symptoms and was found to have an acute hypoxemic respiratory failure with hypervolemia. The patient underwent computed tomography imaging and was found to have bilateral pleural effusions and moderate left-sided renal atrophy with left-sided hydronephrosis. The patient underwent diuresis for fluid overload and was treated with broad-spectrum antibiotics for hospital-acquired pneumonia...

Transplant renal artery stenosis is the most common vascular complication that turns out following kidney transplantation and can lead to graft dysfunction and even its loss. The present report, describes A patient with end-stage renal disease who underwent living related renal transplantation. He had oliguria and creatinine rise in the post-operative course but all doppler ultrasonography (DUS) during the 2 months post-operation for the renal graft showed a normal mean resistive index in the graft renal artery...

OBJECTIVE: Hyperphosphatemia is a common complication in patients with kidney failure, despite the use of phosphate binders (PBs). Vitamin B3, either in the form of niacin or niacinamide (NAM), shows potential as "add-on" treatment to reduce serum phosphate concentrations in this population. NAM seems to lack many of the side-effects that are observed with niacin. The aim of this study was to investigate whether NAM is an effective and acceptable treatment in reducing serum phosphate concentrations in patients with kidney failure...

BACKGROUND: In Italy, nephrology residency is available in twenty-one nephrology schools, each with its own strengths and weaknesses. The present study is aimed at exploring the residents' satisfaction with their training programs. METHODS: Between April 20th and May 19th, 2021, a questionnaire on residency satisfaction consisting of 49 items was sent to 586 residents and 175 recently certified specialists (qualified to practice as nephrologists in 2019 and 2020), with a response rate of 81% and 51%, respectively...

BACKGROUND: Low plasma folate levels have been reported in patients undergoing hemodialysis and peritoneal dialysis (PD) in clinical studies. However, folate transport has never been mentioned as a factor contributing to low plasma folate levels in patients undergoing PD. The peritoneal equilibrium test (PET) assesses the plasma creatinine level and glucose transport abilities. This study aimed to evaluate the association between plasma folate levels and folate transport during PD based on PET grades...

BACKGROUND: Hemodialysis (HD) and peritoneal dialysis (PD) are effective ways to treat end-stage renal disease (ERSD). This study aimed to investigate the differences in survival and the factors that influence it in patients with end-stage renal disease treated with HD or PD. METHODS: We retrospectively analyzed factors related to all-cause death with renal replacement therapy and compared the long-term mortality between HD and PD strategies in patients with ESRD who started HD or PD treatment in our renal HD center between January 1, 2008, and December 1, 2021...

OBJECTIVE: The purpose of this study was to create a risk score for the event of mortality within three years of complex fenestrated visceral segment endovascular aortic repair utilizing variables existing at the time of preoperative presentation. METHODS: After exclusions, 1916 patients were identified in the Vascular Quality Initiative who were included in analysis. The first step in development of the risk score was univariable analysis for the primary outcome of mortality within three years of surgery...

INTRODUCTION: The aim of the study was to assess the quality of drugs prescriptions in chronic haemodialysis patients. MATERIAL AND METHODS: The authors conducted a prospective study in chronic haemodialysis patients of two haemodialysis centres in the city of Oujda eastern Morocco, during the year of 2020. The authors identified the drugs prescribed in this population with regards to the product characteristics, in terms of indications, contraindications, dosage and drug interactions...

The influence of chronic kidney disease stage on robot-assisted partial nephrectomy outcomes remains underexplored. This study aimed to assess the impact of chronic kidney disease stage on functional and surgical outcomes of robot-assisted partial nephrectomy and identify preoperative predictors of significant postoperative 1-year renal-function loss (RFL). Clinical data of 408 patients who underwent robot-assisted partial nephrectomy at Yokohama City University Hospital between 2016 and 2023 were retrospectively reviewed...

It is controversial whether renin-angiotensin system inhibitors (RASIs) should be stopped in patients with advanced chronic kidney disease (CKD). Recently, it was reported that stopping RASIs in advanced CKD was associated with increased mortality and cardiovascular (CV) events; however, it remains unclear whether stopping RASIs before dialysis initiation affects clinical outcomes after dialysis, which this study aimed to evaluate. In this multicenter prospective cohort study in Japan, we included 717 patients (mean age, 67 years; 68% male) who had a nephrology care duration ≥90 days, initiated hemodialysis, and used RASIs 3 months before hemodialysis initiation...

PURPOSE: Intradialytic hypertension affects 5-15% of hemodialysis patients, yet relevant studies are relatively scarce. It is also associated with higher interdialytic blood pressure. Beta-blockers can be preferred as antihypertensive drugs due to their superior blood pressure control, decreased risk of cardiovascular events, improved endothelial cell function, and decreased noradrenaline levels. Through this study, beta-blocker antihypertensive effects in intra- and interdialytic hypertension were analyzed...

Long COVID, characterized by persistent symptoms following acute infection, poses a significant health challenge, particularly for patients with pre-existing chronic conditions such as hypertension. We hypothesized that an increase in the production of interleukins (IL)-6 and IL-17 could serve as a potential mechanism linking pre-existing uncontrolled blood pressure (BP) to the occurrence of long-term COVID sequelae in patients undergoing hemodialysis (HD). This cross-sectional study examined serum IL-6 and IL-17 levels in 80 patients undergoing HD, considering preinfection BP, the presence of long-term COVID sequelae, and the time interval after acute COVID-19 infection, which was either 5 or 10 months...

Arterial spin labeling (ASL) and three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) are sensitive tools to detect dural arteriovenous fistula (DAVF), but hyperintensity in these images is also caused by jugular venous reflux. We present a case of a patient with renal failure on hemodialysis with retrograde flow into the internal jugular vein (IJV) mimicking DAVF. A 74-year-old man with a radial arteriovenous fistula for hemodialysis experienced transient dizziness. The TOF MRA and ASL revealed high signal intensity, suggesting the presence of a DAVF in the left transverse and sigmoid sinuses and the IJV...

BACKGROUND: Hypertension is one of the most critical risk factors for cardiovascular disease, which is the leading cause of death in hemodialysis (HD) patients. Medium cut-off (MCO) membrane increases the clearance of medium molecules, which could improve blood pressure (BP) control. This study aimed to compare the effect of MCO and high-flux hemodialysis membranes on BP assessed by ambulatory blood pressure monitoring (ABPM). METHODS: This is a pre-established secondary analysis of a 28-week, randomized, open-label crossover clinical trial...

Atypical hemolytic uremic syndrome (aHUS) is a complement-mediated thrombotic microangiopathy (TMA), caused by uncontrolled activation of the alternative complement pathway in the setting of autoantibodies to or rare pathogenic genetic variants in complement proteins. Pregnancy may serve as a trigger and unmask aHUS/complement-mediated TMA [aHUS/CM-TMA] which has severe, life-threatening consequences. It can be difficult to diagnose aHUS/CM-TMA in pregnancy due to overlapping clinical features with other TMA syndromes including hypertensive disorders of pregnancy...

OBJECTIVE: To identify underlying factors associated with single versus multiple expulsions of tunneled hemodialysis catheter cuffs and their associated complications. MATERIALS AND METHODS: A multicenter, five-year retrospective data analysis was conducted on hemodialysis patients with tunneled catheters. Patient data included age, gender, BMI, and associated comorbidities. The type of procedure (new tunnel insertion vs. exchange), exit site infection, and catheter-related bloodstream infection (CRBSI) were also included...