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https://www.readbyqxmd.com/read/28810244/increasing-haemodialytic-clearances-as-residual-renal-function-declines-an-incremental-approach
#1
Kamonwan Tangvoraphonkchai, Andrew Davenport
Many patients with chronic kidney disease start undergoing thrice-weekly haemodialysis (HD), aiming for an HD sessional dialyzer urea clearance target, irrespective of whether they have residual renal function (RRF). While increasing sessional dialyzer urea clearance above a target of 1.2 has not been shown to improve patient survival, it has been shown that the preservation of RRF improves patient self-reported outcomes and survival. Observational studies have suggested that initiating twice-weekly HD schedules leads to greater preservation of RRF...
August 16, 2017: Blood Purification
https://www.readbyqxmd.com/read/28806191/a-patient-centred-approach-to-measuring-quality-in-kidney-care-patient-reported-outcome-measures-and-patient-reported-experience-measures
#2
Olalekan L Aiyegbusi, Derek Kyte, Paul Cockwell, Nicola Anderson, Melanie Calvert
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is associated with symptoms that can significantly reduce the health-related quality of life (HRQOL) of patients. Patient-reported outcome and experience measures (PROMs and PREMs) may assist with the evaluation of HRQOL and quality of care from the patient perspective. This review focuses on evidence from recent studies exploring the role of PROMs and PREMs in the measurement of quality in CKD care. RECENT FINDINGS: PROMs are increasingly used in CKD research as measures of clinical effectiveness, whereas the current use of PROMs in routine clinical settings and PREMs in all settings is more limited...
August 12, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28803587/the-rise-of-methicillin-resistant-staphylococcus-aureus-now-the-dominant-cause-of-skin-and-soft-tissue-infection-in-central-australia
#3
E Macmorran, S Harch, E Athan, S Lane, S Tong, L Crawford, S Krishnaswamy, S Hewagama
This study aimed to examine the epidemiology and treatment outcomes of community-onset purulent staphylococcal skin and soft tissue infections (SSTI) in Central Australia. We performed a prospective observational study of patients hospitalised with community-onset purulent staphylococcal SSTI (n = 160). Indigenous patients accounted for 78% of cases. Patients were predominantly young adults; however, there were high rates of co-morbid disease. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was the dominant phenotype, accounting for 60% of cases...
August 14, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28799141/trace-element-and-vitamin-concentrations-in-paediatric-dialysis-patients
#4
Triona Joyce, Frances Court Brown, Dean Wallace, Christopher J D Reid, Manish D Sinha
BACKGROUND: There are few recent data regarding blood micronutrient concentrations and supplementation in children on maintenance dialysis. We investigated micronutrient concentrations following dialysis commencement. METHODS: Retrospective review, including all children on maintenance dialysis (peritoneal dialysis, PD; intermittent haemodialysis, IHD), for nutritional blood concentrations measured over the first 12 months. Patients received pyridoxine and Dialyvit® daily with planned 3-monthly micronutrient concentration monitoring including selenium, manganese, copper, zinc, folate and vitamins A, D, B12 and E...
August 10, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28792166/evaluation-of-effect-of-ascorbic-acid-on-ferritin-and-erythropoietin-resistance-in-patients-of-chronic-kidney-disease
#5
N Nand, A R Deshmukh, R Mittal
OBJECTIVE: This study was planned to evaluate the effect of short term intravenous ascorbic acid on reducing ferritin and erythropoietin resistance in patients of chronic kidney disease (CKD) on maintenance haemodialysis (MHD). METHODS: Forty adult patients [20 patients in group A with increased serum ferritin level (>500 ng/ml), transferrin saturation (TSAT) ≤20% and 20 patients in group B with normal serum ferritin level (<200 ng/ml), TSAT ≤20%] of end stage renal disease (ESRD) with erythropoietin hyporesponsiveness undergoing maintenance hemodialysis were included in the study...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28790041/impact-of-nutritional-index-on-the-association-between-phosphorus-concentrations-and-mortality-in-haemodialysis-patients-a-cohort-study-from-dialysis-outcomes-and-practice-pattern-study-in-japan
#6
Shingo Fukuma, Tatsuyoshi Ikenoue, Tadao Akizawa, Shunichi Fukuhara
OBJECTIVES: While maintenance of both phosphorus concentration and nutritional status is a major concern in managing haemodialysis patients, the interaction between these parameters is not well understood. The aim of this study was to assess whether or not nutritional index influences the association between phosphorus concentration and all-cause mortality. DESIGN: A cohort study. SETTING: The Dialysis Outcomes and Practice Pattern Study, which included 99 representative dialysis facilities in Japan between 1997 and 2010...
August 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28777398/impaired-maturation-of-arteriovenous-fistula-for-haemodialysis-due-to-forearm-artery-stenosis-percutaneous-endovascular-treatment
#7
Nicola Pirozzi, Jacopo Scrivano, Roberto Pirozzi, Emanuela Cordova, Giorgio Punzo, Paolo Menè
INTRODUCTION: Distal autogenous arteriovenous fistula (dAVF), considered the "gold standard" vascular access for haemodialysis, suffers from a high rate of impaired maturation. One of the usual causes is low-flow associated forearm arterial stenosis. In such cases, endovascular treatment by percutaneous transluminal angioplasty represents a helpful option to enable maturation of the vascular access.Currently, there are few reports concerning the treatment of this complication. Therefore, we describe our single-centre experience based on a retrospective review of prospectively collected data...
August 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28774582/commentary-on-arteriovenous-fistulas-for-haemodialysis-a-systematic-review-and-meta-analysis-of-efficacy-and-safety-outcomes
#8
J H M Tordoir
No abstract text is available yet for this article.
July 31, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28771129/prevalence-and-risk-factors-for-mrsa-nasal-colonization-among-persons-experiencing-homelessness-in-boston-ma
#9
Jessica H Leibler, Casey León, Lena J P Cardoso, Jennifer C Morris, Nancy S Miller, Daniel D Nguyen, Jessie M Gaeta
Homeless individuals face an elevated risk of methicillin-resistant Staphylococcus aureus (MRSA) infection. Identifying the prevalence and risk factors for MRSA nasal colonization may reduce infection risk. A cross-sectional study was conducted at a health clinic for homeless persons in Boston, MA, USA (n=194). In-person interviews and nasal swab specimens were collected. MRSA isolates were genotyped using pulse-field gel electrophoresis (PFGE) and assessed for antibiotic susceptibility. The prevalence of MRSA nasal colonization was 8...
August 4, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28769539/elevation-of-platelet-and-monocyte-activity-markers-of-atherosclerosis-in-haemodialysis-patients-compared-to-peritoneal-dialysis-patients
#10
Ksenija Stach, Susanne Karb, Ibrahim Akin, Martin Borggrefe, Bernhard Krämer, Thorsten Kälsch, Anna-Isabelle Kälsch
PURPOSE: The predominant cause of mortality in dialysis patients are cardiovascular events. Platelet and monocyte activity markers play an important role in cardiovascular mortality and were assessed and related to dialysis quality criteria in haemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS: For this prospective comparative study, HD patients (n = 41) and PD patients (n = 10) were included. In whole blood samples, surface expression of CD62P and CD40L on platelets, tissue factor binding on monocytes, and platelet-monocyte aggregates were measured by flow cytometry...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28768451/microwave-ablation-an-effective-treatment-for-mild-to-moderate-secondary-hyperparathyroidism-in-patients-undergoing-haemodialysis
#11
Gang Wang, Sha Liu, Xu Liu, Linxue Qian, Zongli Diao, Wenhu Liu
BACKGROUND: Microwave ablation (MWA) is an effective treatment for severe secondary hyperparathyroidism (SHPT), but it can also be used for mild-to-moderate secondary hyperparathyroidism (SHPT). In this randomised, controlled study, the efficacy of MWA in the treatment of mild-to-moderate hyperparathyroidism is investigated. MATERIALS AND METHODS: We assessed outcomes 12 months after the randomisation of 28 patients with mild-to-moderate SHPT. The subjects received either MWA plus calcitriol or calcitriol alone...
August 2, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28767200/correlation-between-activated-partial-thromboplastin-time-and-anti-xa-activity-in-patients-who-received-low-molecular-weight-heparin-as-anticoagulation-for-haemodialysis
#12
Steve Siu-Man Wong, Wai-Yan Lau, Ping-Kwan Chan, Ching-Kit Wan, Yuk-Lun Cheng
Plasma anti-Xa activity, the recommended test to monitor low-molecular weight heparin (LMWH) therapy, is not readily available in many laboratories. In our clinical trials on the use of LMWH as anticoagulation for haemodialysis, a consistent prolongation of APTT in addition to the elevated anti-Xa activity was observed in the patients after LMWH administration. Hence, the paired anti-Xa activity and APTT data were re-analyzed. The APTT ratio, which was the proportional change in APTT from the baseline value after LMWH administration, was found to have a strong correlation with anti-Xa activity (coefficient of determination, R(2) = 0...
August 2, 2017: Nephrology
https://www.readbyqxmd.com/read/28765186/tuberculous-pericarditis-treated-with-steroid-in-a-dialysis-patient
#13
Rie Aoyama, Joji Ishikawa, Kazumasa Harada, Yayoi Tukada
Mycobacterium tuberculosis has spread worldwide and its mortality rate had been very high. The prevention technology and antituberculosis (TB) chemotherapy has improved its prognosis. However, immunocompromised patients, such as those who had HIV infection, older age and on haemodialysis, are still at high risk of TB infection. TB pericarditis is a common cause of constrictive pericarditis and its mortality remains high. Early diagnosis and initiation of appropriate therapy are critical to improve mortality...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764242/page-kidney-in-wunderlich-syndrome-causing-acute-renal-failure-and-urosepsis-successful-timely-minimally-invasive-management-of-a-devastating-clinical-entity
#14
Sundaramoorthy Vijayganapathy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Jayaram Sreenivas
Wunderlich Syndrome (WS) is an uncommon condition where acute onset of spontaneous bleeding occurs into the subcapsular and perirenal spaces. It can prove fatal if not recognized and treated aggressively at the appropriate time. A 32-year-old male diagnosed elsewhere as acute renal failure presented with tender left loin mass, fever and hypovolemic shock with serum creatinine 8.4 mg/dl. He was started on higher antibiotics and initiated on haemodialysis. Ultrasonogram (USG), Non-Contrast Computed Tomography (NCCT) and Magnetic Resonance Imaging (MRI) showed bilateral perirenal subcapsular haematomas - right 3...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28764223/frequency-of-polyneuropathy-in-patients-on-long-term-peritoneal-dialysis-treatment
#15
Taner Basturk, Yener Koc, Aarzu Ozdemir Kayalar, Figen Yilmaz, Nuri Baris Hasbal, Tamer Sakaci, Elbis Ahbap, Abdulkadir Unsal
INTRODUCTION: Uremic polyneuropathy is very common among patients with Chronic Kidney Disease (CKD). The patients have electrophysiologic signs of impaired nerve function, although a lower percentage of patients are symptomatic. Electrophysiological parameters are quantitative indices of Polyneuropathy (PNP) severity. AIM: To assess the frequency of PNP in patients on long term Peritoneal Dialysis (PD) treatment. MATERIALS AND METHODS: Twenty three PD patients were analysed, who were receiving dialysis for at least five years and the study population divided into two groups according to duration of PD treatment...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762106/depression-symptoms-in-haemodialysis-patients-predict-all-cause-mortality-but-not-kidney-transplantation-a-cause-specific-outcome-analysis
#16
Joseph Chilcot, Ayman Guirguis, Karin Friedli, Michael Almond, Clara Day, Maria Da Silva-Gane, Andrew Davenport, Naomi A Fineberg, Benjamin Spencer, David Wellsted, Ken Farrington
BACKGROUND: Depression is common in haemodialysis (HD) patients and associated with poor outcomes. PURPOSE: To evaluate whether depression symptoms predict survival and transplantation in a large sample of haemodialysis patients using cause-specific survival models. METHODS: Survival data was collected between April 2013 and November 2015, as part of the screening phase of a multicentre randomised placebo-controlled trial of sertraline in HD patients...
July 31, 2017: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/28759058/nanoporous-polysulfones-with-in-situ-pegylated-surfaces-by-a-simple-swelling-strategy-using-paired-solvents
#17
Zhaogen Wang, Rui Liu, Hao Yang, Yong Wang
We report the formation of three-dimensionally interconnected nanoporosities with in situ PEGylated pore walls simply by swelling the block copolymers of polysulfone and poly(ethylene glycol) in paired solvents. The produced nanoporous polymers are expected to find important applications in membranes, batteries, chromatography, and haemodialysis.
July 31, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/28755902/low-triiodothyronine-is-associated-with-elevation-of-n-terminal-pro-brain-natriuretic-peptide-nt-probnp-and-mortality-in-dialysis-patients
#18
María Del Carmen Prado-Uribe, María-de-Jesús Ventura, Marcela Ávila-Díaz, Carmen J Mora, Antonio Méndez-Durán, Diana Villanueva-Noches, Alejandra Cisneros, Begoña Ilabaca, Alfonso Cueto-Manzano, Fernando García-Contreras, Bengt Lindholm, Elvia García-López, Ramón Paniagua
BACKGROUND: Low thyroid hormone (TH) levels and myocardial damage are common in dialysis patients and are associated with mortality. However, little is known about the role of THs on myocardial damage as has been described in primary thyroid diseases. The aim of this study was to explore the potential relationship between low total triiodothyronine (total T3) and biomarkers of myocardial damage and the effect of their interaction on mortality, to ascertain if cardiovascular damage is the link between low THs and the risk of death in dialysis patients with CKD...
July 26, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28749067/haemolysis-in-haemodialysis
#19
REVIEW
Dhakshayini Tharmaraj, Peter G Kerr
Haemolysis in haemodialysis, although rare in current times, is associated with significant mortality and morbidity. As such prompt recognition, treatment, analysis of root cause and correction of underlying causative factors is crucial. Dialysate, extracorporeal circuit and patient related factors all contribute to haemolysis risk. Haemolysis can manifest with non-specific signs and symptoms including but not restricted to hypertension, nausea, pain (abdominal, chest, back) and dyspnoea. It may present acutely during the dialysis session or may take a protracted course...
July 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28748414/the-effect-of-arterial-curvature-on-blood-flow-in-arterio-venous-fistulae-realistic-geometries-and-pulsatile-flow
#20
L Grechy, F Iori, R W Corbett, W Gedroyc, N Duncan, C G Caro, P E Vincent
Arterio-Venous Fistulae (AVF) are regarded as the "gold standard" method of vascular access for patients with End-Stage Renal Disease (ESRD) who require haemodialysis. However, up to 60% of AVF do not mature, and hence fail, as a result of Intimal Hyperplasia (IH). Unphysiological flow and oxygen transport patterns, associated with the unnatural and often complex geometries of AVF, are believed to be implicated in the development of IH. Previous studies have investigated the effect of arterial curvature on blood flow in AVF using idealized planar AVF configurations and non-pulsatile inflow conditions...
July 26, 2017: Cardiovascular Engineering and Technology
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