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https://www.readbyqxmd.com/read/29222290/chronic-organ-failure-in-adult-sickle-cell-disease
#1
REVIEW
Elliott Vichinsky
Sickle cell disease is now a chronic adult illness characterized by progressive multiorgan failure, particularly involving the brain and kidney. The etiology is multifactorial; it includes hemolysis and nitric oxide deficiency. As patients age, most experience neurologic insult. Twenty-five percent of older adults have had a clinical stroke and at least half of the population have had a silent infarct, cortical atrophy, and neurocognitive impairment. Periodic screening with neuroimaging and neurocognitive testing is recommended...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29212081/in-patients-with-chronic-kidney-disease-short-term-blood-pressure-variability-is-associated-with-the-presence-and-severity-of-sleep-disorders
#2
Martino F Pengo, Donatella Ioratti, Valeria Bisogni, Verdiana Ravarotto, Barbara Rossi, Luciana Bonfante, Francesca Simioni, Federico Nalesso, Giuseppe Maiolino, Lorenzo A Calò
BACKGROUND/AIMS: In chronic kidney disease (CKD) patients blood pressure variability (BPV) is associated with poor outcome. Sleep disturbances alter BP profiles in hypertensives but their influence on BPV in CKD patients is unknown. We screened a cohort of CKD/ESRD patients to investigate whether sleep quality impacts on BPV. METHODS: Consecutive CKD patients' sleep quality was assessed using validated questionnaires (Epworth Sleepiness Scale-ESS); International Restless legs scale-IRLS; Functional Outcomes of Sleep Questionnaire-FOSQ: Insomnia Severity Index-ISI; STOP-Bang)...
November 28, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29103152/barriers-for-implementation-of-intensified-hemodialysis-survey-results-from-the-international-pediatric-dialysis-network
#3
Julia Thumfart, Dominik Müller, Steffen Wagner, Anuradha Jayanti, Dagmara Borzych-Duzalka, Franz Schaefer, Bradley Warady, Claus Peter Schmitt
BACKGROUND: In patients on conventional hemodialysis (HD), morbidity is high and quality of life is poor. Intensified HD programs have been developed to help overcome these shortcomings, , but very few pediatric dialysis centers have reported the implementation of such a HD program. METHODS: An online survey was sent to all 221 pediatric dialysis centers which participate in the International Pediatric Dialysis Network (IPDN). The aim of the survey was to assess the attitude of pediatric nephrologists towards intensified HD, the penetrance of intensified HD into their clinical practice and barriers to implementation...
November 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29064128/the-association-between-change-in-serum-bicarbonate-and-change-in-thyroid-hormone-levels-in-patients-receiving-conventional-or-more-frequent-maintenance-hemodialysis
#4
Alessio Molfino, Gerald J Beck, Minwei Li, Joan C Lo, George A Kaysen
AIM: Correction of metabolic acidosis in patients with chronic kidney disease has been associated with improvement in thyroid function. We examined whether changes in bicarbonate were associated with changes in thyroid function in patients with end-stage renal disease receiving conventional or more frequent hemodialysis. METHODS: In the Frequent Hemodialysis Network Trials, the relationship between changes in serum bicarbonate, free triiodothyronine (FT3) and free thyroxine (FT4) was examined among 147 and 48 patients with endogenous thyroid function who received conventional (3x/week) or more frequent (6x/week) hemodialysis (Daily Trial) or who received conventional or more frequent nocturnal hemodialysis (Nocturnal Trial)...
October 24, 2017: Nephrology
https://www.readbyqxmd.com/read/29044930/effect-of-incident-nocturnal-home-hemodialysis-versus-incident-continuous-ambulatory-peritoneal-dialysis-on-employment-rate-clinical-and-laboratory-outcomes-a-1-year-retrospective-observation-study
#5
John Wing Li, Joseph Ho Sing Wong, Wai Leung Chak, Ka Foon Chau
INTRODUCTION: While studies demonstrated favorable outcomes of nocturnal home hemodialysis (NHHD), direct comparison on employment rate, clinical and laboratory outcomes between the NHHD and continuous ambulatory peritoneal dialysis (CAPD) had not been previously performed. METHODS: A 1-year retrospective observation study was performed in 20 incidents alternate night NHHD and 81 incident CAPD patients of Chinese ethnicity, who were sex, diabetic status, and Charlson comorbidity index matched, but not age due to our center's age limit for NHHD enrollment...
October 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28992094/association-between-conversion-to-in-center-nocturnal-hemodialysis-and-right-ventricular-remodeling
#6
Gauri R Karur, Ron Wald, Marc B Goldstein, Rachel Wald, Laura Jimenez-Juan, Mercedeh Kiaii, Jonathon Leipsic, Anish Kirpalani, Olugbenga Bello, Ashita Barthur, Ming-Yen Ng, Djeven P Deva, Andrew T Yan
Background: In-center nocturnal hemodialysis (INHD) is associated with favorable left ventricular (LV) remodeling. Although right ventricular (RV) structure and function carry prognostic significance, the impact of dialysis intensification on RV is unknown. Our objectives were to evaluate changes in RV mass index (MI), end-diastolic volume index (EDVI), end-systolic volume index (ESVI) and ejection fraction (EF) after conversion to INHD and their relationship with LV remodeling. Methods: Of 67 conventional hemodialysis (CHD, 4 h/session, three times/week) patients, 30 continued on CHD and 37 converted to INHD (7-8 h/session, three times/week)...
August 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28944153/sequential-development-of-non-arteritic-anterior-ischemic-optic-neuropathy-in-a-patient-on-hemodialysis
#7
Mukesh Jain, Renuka Srinivasan, K Ramesh Babu, M Swapnil Parchand
Purpose: Non-arteritic anterior ischemic optic neuropathy (NA-AION) is typically a disorder of patients 50 years and older predisposed to the vascular and structural optic disc risk factors. We present an interesting case of sequential development of NA-AION in a 45-year-old patient with end-stage renal disease undergoing hemodialysis. Methods: Observational case report. Results: A 45-year-old female on hemodialysis for chronic renal failure complained of sequential acute onset sudden painless gross diminution of vision in right eye followed by the left eye...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28937071/insomnia-in-hemodialysis-patients-a-multicenter-study-from-morocco
#8
Mohamed Amine Hamzi, Kawtar Hassani, Mohamed Asseraji, Driss El Kabbaj
Previous studies have shown that insomnia is a common sleep disorder in patients with end-stage renal disease. This study aims to determine the prevalence and risk factors of insomnia in our chronic hemodialysis (HD) patients. This is a cross-sectional study conducted in three HD units in Morocco. To assess the prevalence of insomnia, we used a specific questionnaire. Patients complaining of difficulty in falling asleep and/or nocturnal awakenings occurring seven nights a week during the last month were included in the group "insomnia;" the other patients were used as controls...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28927285/impact-of-a-basal-bolus-insulin-regimen-on-metabolic-control-and-risk-of-hypoglycemia-in-patients-with-diabetes-undergoing-peritoneal-dialysis
#9
Ana María Gómez, Santiago Vallejo, Freddy Ardila, Oscar M Muñoz, Álvaro J Ruiz, Mauricio Sanabria, Alfonso Bunch, Elly Morros, Laura Kattah, Maira García-Jaramillo, Fabián León-Vargas
INTRODUCTION: Clinical interventional studies in diabetes mellitus usually exclude patients undergoing peritoneal dialysis (PD). This study evaluates the impact of an educational program and a basal-bolus insulin regimen on the blood glucose level control and risk of hypoglycemia in this population. METHODS: A before-and-after study was conducted in type 1 and type 2 DM patients undergoing PD at the Renal Therapy Services (RTS) clinic network, Bogota, Colombia. An intervention was instituted consisting of a three-month educational program and a basal-bolus detemir (Levemir, NovoNordisk) and aspart (Novorapid, NovoNordisk) insulin regimen...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28912971/sleep-parameters-in-short-daily-versus-conventional-dialysis-an-actigraphic-study
#10
Ludimila D'Avila E Silva Allemand, Otávio Toledo Nóbrega, Juliane Pena Lauar, Joel Paulo Russomano Veiga, Einstein Francisco Camargos
Previous studies have observed worse sleep quality in patients undergoing conventional dialysis as compared to daily dialysis. Our aim was to compare the sleep parameters of patients undergoing daily or conventional dialysis using an objective measure (actigraphy). This cross-sectional study was performed in three dialysis centers, including a convenience sample (nonprobability sampling) of 73 patients (36 patients on daily hemodialysis and 37 patients on conventional hemodialysis). The following parameters were evaluated: nocturnal total sleep time (NTST), expressed in minutes; wake time after sleep onset (WASO), expressed in minutes; number of nighttime awakenings; daytime total sleep time (DTST), expressed in minutes; number of daytime naps; and nighttime percentage of sleep (% sleep)...
2017: International Journal of Nephrology
https://www.readbyqxmd.com/read/28844317/short-daily-nocturnal-and-conventional-home-hemodialysis-have-similar-patient-and-treatment-survival
#11
Karthik K Tennankore, Yingbo Na, Ron Wald, Christopher T Chan, Jeffrey Perl
Home hemodialysis (HHD) has many benefits, but less is known about relative outcomes when comparing different home-based hemodialysis modalities. Here, we compare patient and treatment survival for patients receiving short daily HHD (2-3 hours/5 plus sessions per week), nocturnal HHD (6-8 hours/5 plus sessions per week) and conventional HHD (3-6 hours/2-4 sessions per week). A nationally representative cohort of Canadian HHD patients from 1996-2012 was studied. The primary outcome was death or treatment failure (defined as a permanent return to in-center hemodialysis or peritoneal dialysis) using an intention to treat analysis and death-censored treatment failure as a secondary outcome...
August 23, 2017: Kidney International
https://www.readbyqxmd.com/read/28791560/night-time-blood-pressure-and-pulse-wave-velocity-in-dialysis-patients
#12
Xiurong Li, Qingbo Jiang, Wenhui Wu, Xianlin Xu, Liying Miao, Lina Jin, Lina Xue, Tian Huang, Jia Di, Jinfeng Liu, Xiaozhou He
BACKGROUND: Ambulatory blood pressure (ABP) monitoring and carotid-femoral pulse wave velocity (cfPWV) provide important cardiovascular risk information for dialysis patients. This study aims to evaluate the risk factors of cfPWV and the associations between ambulatory blood pressure, especially night-time blood pressure and cfPWV. METHODS: We conducted a cross-sectional study in patients on maintenance hemodialysis. ABP and cfPWV were measured on a midweek interdialytic day...
August 8, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28761231/renal-manifestations-in-paroxysmal-nocturnal-hemoglobinuria
#13
R Ram, K P Adiraju, S Gudithi, K V Dakshinamurty
Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired chronic disorder characterized by a triad of clinical features - hemolytic anemia, pancytopenia, and thrombosis. Not many reports of renal involvement in PNH are available in literature. We present a case series of PNH with renal involvement. We present the data of PNH patients who attended to Departments of General Medicine and Nephrology at a government-run tertiary care institute in South India. The diagnosis of PNH in these patients during initial phase, between 1998 and 2004 was based on sucrose lysis and Ham's test...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28674854/icodextrin-and-peritoneal-dialysis-advantages-and-new-applications
#14
REVIEW
Periklis Dousdampanis, Carlos Guido Musso, Konstantina Trigka
The impact of icodextrin (ico) on peritoneal dialysis (PD) extension and patient survival is well established. Predominantly, ico-based solutions were prescribed in high-transporter PD patients. Advantages of the ico-based solutions include increased biocompatibility, avoidance of glucotoxicity, enhanced ultrafiltration failure (UF), sodium removal rates, better metabolic and blood pressure control. Bimodal solutions and twice daily exchanges of ico-based solutions are two newly introduced strategies to avoid glucose exposure and/or enhance UF in PD patients with UF failure...
July 3, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28573387/the-impact-of-change-of-renal-replacement-therapy-modality-on-sleep-quality-in-patients-with-end-stage-renal-disease-a-systematic-review-and-meta-analysis
#15
REVIEW
C Kennedy, S A Ryan, T Kane, R W Costello, P J Conlon
BACKGROUND: Sleep disorders are common and multi-factorial in patients with advanced chronic kidney disease and end-stage renal disease (ESRD). Sleep disorders and disturbance have a negative impact on wellbeing and quality of life. OBJECTIVE: To assess the impact of a change in renal replacement therapy (RRT) modality on sleep quality and sleep disturbance in patients with ESRD. DATA SOURCES: Multiple electronic databases were searched without publication type/period restrictions...
June 1, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28460640/physical-performance-and-protein-energy-wasting-in-patients-treated-with-nocturnal-haemodialysis-compared-to-conventional-haemodialysis-protocol-of-the-diaprifit-study
#16
Manouk Dam, Floor Neelemaat, Trudeke Struijk-Wielinga, Peter J Weijs, Brigit C van Jaarsveld
BACKGROUND: Poor physical performance and protein-energy wasting (PEW) are health issues of major concern in haemodialysis patients. The conventional haemodialysis (CHD) regime, three times per week 3-5 h, is subject of discussion because of high morbidity and mortality rates. When patients switch from CHD to longer dialysis sessions, i.e. nocturnal haemodialysis (NHD), improvement in protein intake and increase in body weight is seen. However, it is unclear whether physical performance and more important aspects of PEW, such as body composition, improve as well...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28456922/nutritional-status-after-conversion-from-conventional-to-in-centre-nocturnal-hemodialysis
#17
Nazanin Noori, Andrew T Yan, Mercedeh Kiaii, Andrea Rathe, Marc B Goldstein, Olugbenga Bello, Ron Wald
INTRODUCTION: Recipients of conventional hemodialysis (CHD; 3-4 h/session, 3 times/week) experience volume expansion and nutritional impairment which may contribute to high mortality. Prolongation of sessions with in-centre nocturnal hemodialysis (INHD; 7-8 h/session, 3 times/week) may improve clinical outcomes by enhancement of ultrafiltration and uremic toxin removal. MATERIALS AND METHODS: In this prospective cohort study, 56 adult patients who were receiving maintenance CHD for at least 90 days were assigned to CHD (patients who remained in CHD) and INHD (patients who switched to INHD) groups...
August 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28401120/estimating-patient-borne-water-and-electricity-costs-in-home-hemodialysis-a-simulation
#18
Matthew Nickel, Wes Rideout, Nikhil Shah, Frances Reintjes, Justin Z Chen, Robert Burrell, Robert P Pauly
BACKGROUND: Home hemodialysis is associated with lower costs to the health care system compared with conventional facility-based hemodialysis because of lower staffing and overhead costs, and by transferring the treatment cost of utilities (water and power) to the patient. The purpose of this study was to determine the utility costs of home hemodialysis and create a formula such that patients and renal programs can estimate the annual patient-borne costs involved with this type of treatment...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28366347/sleep-disturbance-in-pediatric-patients-on-automated-peritoneal-dialysis
#19
Cláudia Gomes, Lia Oliveira, Rosário Ferreira, Carla Simão
OBJECTIVE: There are few reports describing sleep disturbance (SD) in children on automated peritoneal dialysis (APD), and they are mostly based on the application of questionnaires. As far as we know, only two studies used polysomnography (PSG), the gold standard for the diagnosis of SD. This is the first study assessing SD in children with chronic kidney disease (CKD) on APD in our country. METHODS: This was an observational and descriptive study. Children up to 18 years of age who had undergone APD for a minimum of three months were considered eligible...
April 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28359656/in-center-nocturnal-hemodialysis-versus-conventional-hemodialysis-a-systematic-review-of-the-evidence
#20
REVIEW
Ben Wong, David Collister, Maliha Muneer, Dale Storie, Mark Courtney, Anita Lloyd, Sandra Campbell, Robert P Pauly
BACKGROUND: Owing to its longer treatment duration-up to 8 hours per dialysis treatment-in-center thrice-weekly nocturnal hemodialysis (HD) is receiving greater attention. To better understand the evidence for in-center nocturnal HD, we sought to systematically review the literature to determine the effects of in-center nocturnal HD versus conventional HD on clinically relevant outcomes. STUDY DESIGN: We searched MEDLINE, Embase, Evidence-Based Medicine Reviews (EBMR), Web of Science, and Scopus from the earliest date in the database to November 2016...
August 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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