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Nocturnal dialysis

Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
Darren R Churchward, Matthew P M Graham-Brown, Robert Preston, Warren Pickering, Gerry P McCann, James O Burton
INTRODUCTION: In-centre nocturnal haemodialysis (INHD) is an underutilised dialysis regimen that can potentially provide patients with better clinical outcomes due to extended treatment times. We have established an INHD programme within our clinical network, fulfilling a previously unmet patient need. This feasibility study aims to gather sufficient data on numerous outcome measures to inform the design of a multicentre randomised controlled trial that will establish the potential benefits of INHD and increase the availability of this service nationally and internationally...
2016: BMJ Open
Ka Lung Chong, Amir Samsudin, Tee Chau Keng, Tengku Ain Kamalden, Norlina Ramli
PURPOSE: To evaluate the effect of nocturnal intermittent peritoneal dialysis (NIPD) on intraocular pressure (IOP) and anterior segment optical coherence tomography (ASOCT) parameters. Systemic changes associated with NIPD were also analyzed. METHODS: Observational study. Nonglaucomatous patients on NIPD underwent systemic and ocular assessment including mean arterial pressure (MAP), body weight, serum osmolarity, visual acuity, IOP measurement, and ASOCT within 2 hours both before and after NIPD...
September 2, 2016: Journal of Glaucoma
Michael V Rocco
BACKGROUND: Chronic hemodialysis (HD) in the 1960s encompassed a wide variety of prescriptions from twice weekly to five times per week HD. Over time, HD prescriptions in the West became standardized at three times per week, 2.5-4 h per session, with occasional additional treatments for volume overload. SUMMARY: When clinical trials of dialysis dose failed to show significant benefit of extending time compared with the traditional dialysis prescription, interest in more frequent HD was renewed...
December 2015: Kidney Diseases
Rosemary Masterson, Susan Blair, Kevan R Polkinghorne, Kenneth K Lau, Michael Lian, Boyd J Strauss, John G Morgan, Peter Kerr, Nigel D Toussaint
Introduction Higher calcium dialysate is recommended for quotidian nocturnal hemodialysis (NHD) (≥6 nights/week) to maintain bone health. It is unclear what the optimal calcium dialysate concentration should be for alternate night NHD. We aimed to determine the effect of low calcium (LC) versus high calcium (HC) dialysate on cardiovascular and bone parameters in this population. Methods A randomized controlled trial where participants were randomized to LC (1.3 mmol/L, n = 24) or HC dialysate (1.6 or 1...
June 30, 2016: Hemodialysis International
Jun Zhang, Cheng Wang, Wenyu Gong, Zengchun Ye, Ying Tang, Wenbo Zhao, Hui Peng, Tanqi Lou
AIM: This study was designed to evaluate the relationship between sleep quality and hypertension and to determine if there was an association between nondipper blood pressure (BP) and sleep quality in chronic kidney disease (CKD) patients. METHODS: A total of 775 pre-dialysis CKD patients (314 normal BP patients, 461 hypertension patients) defined as dippers or nondippers by ambulatory BP monitoring were recruited for this study. Demographics and clinical correlates were collected, including body mass index, estimated glomerular filtration rate (eGFR) and other measures...
June 10, 2016: Nephrology
Francisco Maduell, Raquel Ojeda, Marta Arias-Guillen, Florencia Rossi, Néstor Fontseré, Manel Vera, Nayra Rico, Leonardo Nicolás Gonzalez, Gastón Piñeiro, Mario Jiménez-Hernández, Lida Rodas, José Luis Bedini
BACKGROUND: New haemodialysis therapeutic regimens are required to improve patient survival. Longer and more frequent dialysis sessions have produced excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. METHODS: In this single-centre observational study, 57 patients on 4-5-hour thrice-weekly OL-HDF were switched to nocturnal every-other-day OL-HDF. Inclusion criteria consisted of stable patients with good prospects for improved occupational, psychological and social rehabilitation...
2016: Nephron
Bourne L Auguste, Darren Yuen, Christopher T Chan
BACKGROUND: Compared with the general population, end-stage renal disease patients are at increased risk for bone loss and fractures. Nocturnal hemodialysis offers superior calcium-phosphate control and improved uremic clearance compared with conventional hemodialysis. Rates of bone loss by type of hemodialysis are unknown. OBJECTIVES: This study aims to determine whether there are differences in bone loss between frequent nocturnal hemodialysis and conventional hemodialysis...
2016: Canadian Journal of Kidney Health and Disease
Orlando Camacho, Maria Carmela Rosales, Tariq Shafi, Jonathan Fullman, Natalie S Plummer, Timothy W Meyer, Tammy L Sirich
BACKGROUND: The protein-bound solutes p-cresol sulfate (PCS) and indoxyl sulfate (IS) accumulate to high plasma levels in renal failure and have been associated with adverse events. The clearance of these bound solutes can be altered independently of the urea clearance by changing the dialysate flow and dialyzer size. This study tested whether a sustained difference in clearance would change the plasma levels of PCS and IS. METHODS: Fourteen patients on thrice-weekly nocturnal hemodialysis completed a crossover study of two periods designed to achieve widely different bound solute clearances...
August 2016: Nephrology, Dialysis, Transplantation
Chong-Ting Lin, Xi-Ning Liu, Hong-Lei Xu, Hui-Yan Sui
OBJECTIVE: To evaluate menstrual disturbances and sex hormonal status in premenopausal women with end-stage renal disease (ESRD). SUBJECTS AND METHODS: The study consisted of 184 patients with ESRD treated with one of four treatment modalities (46/modality): conventional hemodialysis (CHD), continuous ambulatory peritoneal dialysis (CAPD), nocturnal hemodialysis (NHD) and renal transplantation (RT). Blood samples were collected to determine sex hormone levels. Sociodemographic and clinical data were collected from medical records...
2016: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Maria-Eleni Roumelioti, Christos Argyropoulos, Vernon Shane Pankratz, Manisha Jhamb, Filitsa H Bender, Daniel J Buysse, Patrick Strollo, Mark L Unruh
BACKGROUND: Automated peritoneal dialysis (APD) is one of the fastest growing dialysis modalities. It is unknown whether sleep and mood are disturbed while performing repeated overnight exchanges. OBJECTIVES: In this report, we aim to describe and compare the prevalence of sleep-disordered breathing (SDB), periodic limb movements (PLMS), poor sleep quality (SQ), and depression among APD patients compared with stages 3b-5 (estimated glomerular filtration rate ≤44 ml/min/1...
2016: Canadian Journal of Kidney Health and Disease
Neha Sharma, Elizabeth Harvey, Reshma Amin
Sleep-disordered breathing (SDB) is prevalent in children with chronic kidney disease (CKD), and has the potential to worsen vascular and neuro-cognitive health and quality of life. We present 2 children with CKD who experience central sleep apnea and nocturnal hypoventilation and discuss the possible underlying mechanisms in relation to CKD and dialysis.
January 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Bradley S Dixon, John M VanBuren, James R Rodrigue, Robert S Lockridge, Robert Lindsay, Christopher Chan, Michael V Rocco, Jacob J Oleson, Leigh Beglinger, Kevin Duff, Jane S Paulsen, John B Stokes
BACKGROUND: It is uncertain whether switching to frequent nocturnal hemodialysis improves cognitive function in well-dialyzed patients and how this compares to patients who receive a kidney transplant. METHODS: We conducted a multicenter observational study with longitudinal follow-up of the effect on cognitive performance of switching dialysis treatment modality from conventional thrice-weekly hemodialysis to frequent nocturnal hemodialysis, a functioning renal transplant or remaining on thrice-weekly conventional hemodialysis...
2016: BMC Nephrology
Naomi Clyne, Matthias Hellberg, Evangelia Kouidi, Asterios Deligiannis, Peter Höglund
AIM: Cardiac and vascular autonomic neuropathy contributes to increased morbidity and mortality in patients with chronic kidney disease. The aim of this study was to analyze the effects of a decline in GFR on heart rate variability (HRV) and nocturnal blood pressure dipping. METHODS: This cross-sectional study comprises 124 patients (46 women, 78 men; age 66±14 years) with CKD 3-5, not on renal replacement therapy. GFR was measured with iohexol clearance, HRV with 24-hour Holter ECG and nocturnal dipping with 24-hour ambulatory blood pressure...
December 29, 2015: Nephrology
Takahiko Mitsui, Kimihiko Moriya, Ken Morita, Daiki Iwami, Takeya Kitta, Yukiko Kanno, Masayuki Takeda, Nobuo Shinohara
BACKGROUND: We investigated risk factors for lower urinary tract (LUT) dysfunction and LUT symptoms in patients who successfully underwent renal transplantation (RTX). MATERIAL AND METHODS: Ninety-five patients (54 males and 41 females) undergoing RTX (median age: 45 years old) at Hokkaido University Hospital were included in this study. Uroflowmetry (UFM), postvoid residual urine volume (PVR), and 24-h bladder diaries were performed. We analyzed risk factors for voiding dysfunction, urinary frequency, polyuria, nocturia, and nocturnal polyuria after RTX using logistic regression analysis...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Edward Buitenwerf, Arne J Risselada, Eric N van Roon, Nic J G M Veeger, Marc H Hemmelder
BACKGROUND: Nadroparin is used during hemodialysis to prevent clotting of the extra corporeal system. During nocturnal hemodialysis patients receive an increased dosage of nadroparin compared to conventional hemodialysis. We tested whether the prescribed dosage regimen of nadroparin, according to Dutch guidelines, causes accumulation of nadroparin. METHODS: Anti-Xa levels were used as an indicator of nadroparin accumulation. Anti-Xa was measured photometrically in 13 patients undergoing nocturnal hemodialysis for 4 nights a week...
June 2015: BBA Clinical
D Gupta, S Chaturvedi, S Chandy, I Agarwal
Hypertension is common in children with chronic kidney disease (CKD) and is a major determinant of CKD progression. Ambulatory blood pressure monitoring (ABPM) has been proposed to be better in detecting hypertension as compared to casual blood pressure (CBP). This study aims to study the usefulness of ABPM in detecting masked hypertension, evaluating the adequacy of blood pressure (BP) control and predicting left ventricular hypertrophy (LVH) amongst children with CKD. A prospective cross-sectional study of 46 children with stage 3-5 CKD was conducted at the Pediatric Nephrology department of a tertiary hospital in South India...
November 2015: Indian Journal of Nephrology
Sisse H Laursen, Amanda Buus, Morten H Jensen, Peter Vestergaard, Ole K Hejlesen
PURPOSE: Hyperphosphatemia constitutes a major problem in end-stage renal disease patients. At this stage, dialysis efficacy usually plays an important role in obtaining phosphate levels within the normal range. Currently, no practical tool capable of making individualized predictions about phosphate changes during and after hemodialysis (HD) have gained clinical acceptance. As a result, optimal dialysis prescriptions seem to be difficult to achieve. The objective of the present study was to develop and test a quantitative tool to predict intradialytic and postdialytic (2 hours) phosphate kinetics in HD therapy...
November 2015: International Journal of Artificial Organs
Matthew P M Graham-Brown, Darren R Churchward, Alice C Smith, Richard J Baines, James O Burton
BACKGROUND: Extended periods of haemodialysis (HD) can improve patient outcomes. In-centre nocturnal haemodialysis (INHD) should be explored as a method of offering extended periods of HD to patients unsuitable for or unable to perform home therapy. METHODS: Ten self-selecting, prevalent HD patients started an INHD programme to assess feasibility and patient satisfaction. Quality-of-life (QOL) measures were evaluated at enrolment and after 4 months of INHD using the EQ-5D, the Hospital Anxiety and Depression Scale (HADS) and the SF-12 questionnaires...
December 2015: Clinical Kidney Journal
Ayman Karkar, Jörgen Hegbrant, Giovanni F M Strippoli
Home hemodialysis (HD) is a modality of renal replacement therapy that can be safely and independently performed at home by end-stage renal disease (ESRD) patients. Home HD can be performed at the convenience of the patients on a daily basis, every other day and overnight (nocturnal). Despite the great and many perceived benefits of home HD, including the significant improvements in health outcomes and resource utilization, the adoption of home HD has been limited; lack or inadequate pre-dialysis education and training constitute a major barrier...
November 2015: Saudi Journal of Kidney Diseases and Transplantation
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