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https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#1
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28912982/severe-thyrotoxicosis-secondary-to-povidone-iodine-from-peritoneal-dialysis
#2
Kirstie Lithgow, Christopher Symonds
A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28899901/do-the-stars-align-distribution-of-high-quality-ratings-of-healthcare-sectors-across-us-markets
#3
Jose Figueroa, Yevgeniy Feyman, Daniel Blumenthal, Ashish Jha
BACKGROUND: The US government created five-star rating systems to evaluate hospital, nursing homes, home health agency and dialysis centre quality. The degree to which quality is a property of organisations versus geographical markets is unclear. OBJECTIVES: To determine whether high-quality healthcare service sectors are clustered within US healthcare markets. DESIGN: Using data from the Centers for Medicare and Medicaid Services' Hospital, Dialysis, Nursing Home and Home Health Compare databases, we calculated the mean star ratings of four healthcare sectors in 304 US hospital referral regions (HRRs)...
September 12, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28886703/factors-associated-with-foot-ulceration-and-amputation-in-adults-on-dialysis-a-cross-sectional-observational-study
#4
Michelle R Kaminski, Anita Raspovic, Lawrence P McMahon, Katrina A Lambert, Bircan Erbas, Peter F Mount, Peter G Kerr, Karl B Landorf
BACKGROUND: Adults on dialysis are at increased risk of foot ulceration, which commonly precedes more serious lower limb complications, including amputation. Limited data exist regarding the prevalence and factors associated with foot disease in this population. Hence, this study set out to investigate factors associated with foot ulceration and amputation in a dialysis cohort. METHODS: This study presents a cross-sectional analysis of baseline data from a multi-center prospective cohort study...
September 8, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28869959/screening-of-cognitive-impairment-in-the-dialysis-population-a-scoping-review
#5
Aye San, Balaji Hiremagalur, Wendy Muircroft, Laurie Grealish
BACKGROUND: Cognitive impairment in end-stage kidney disease patients on dialysis is increasingly common. This study aimed to review the practice of screening and to evaluate the evidence on cognitive impairment prevalence in this population. METHODS: This scoping review of studies summarises the evidence on cognitive impairment in dialysis populations. The search included the Medline, CINAHL, Embase, PsycINFO, PubMed, and Cochrane Library databases for English-language articles published between 2000 and 2015...
September 5, 2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28851680/remote-monitoring-systems-for-chronic-patients-on-home-hemodialysis-field-test-of-a-copresence-enhanced-design
#6
Na Liu, Jinman Kim, Younhyun Jung, Adani Arisy, Mary Ann Nicdao, Mary Mikaheal, Tanya Baldacchino, Mohamed Khadra, Kamal Sud
BACKGROUND: Patients undertaking long-term and chronic home hemodialysis (HHD) are subject to feelings of isolation and anxiety due to the absence of physical contact with their health care professionals and lack of feedback in regards to their dialysis treatments. Therefore, it is important for these patients to feel the "presence" of the health care professionals remotely while on hemodialysis at home for better compliance with the dialysis regime and to feel connected with health care professionals...
August 29, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28844317/short-daily-nocturnal-and-conventional-home-hemodialysis-have-similar-patient-and-treatment-survival
#7
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/28835369/racial-differences-in-home-dialysis-utilization-and-outcomes-in-canada
#8
Emilie Trinh, Yingbo Na, Manish M Sood, Christopher T Chan, Jeffrey Perl
BACKGROUND AND OBJECTIVES: Data on racial disparities in home dialysis utilization and outcomes are lacking in Canada, where health care is universally available. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied patients starting maintenance dialysis between 1996 and 2012 in the Canadian Organ Replacement Register, stratified by race: white, Asian, black, Aboriginal, Indian subcontinent, and other. The association between race and treatment with home dialysis was examined using generalized linear models...
August 23, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28832356/blood-pressure-in-hemodialysis-targets
#9
Panagiotis I Georgianos, Rajiv Agarwal
PURPOSE OF REVIEW: In the absence of 'hard' clinical-trial evidence to define optimal blood pressure (BP) targets and validate different BP measurement techniques, management of hypertension in hemodialysis is based on expert opinions. In this review, we provide a comparative evaluation of out-of-dialysis BP monitoring versus dialysis-unit BP recordings in diagnosing hypertension, guiding its management and prognosticating mortality risk. RECENT FINDINGS: Owing to their high variability and poor reproducibility, predialysis and postdialysis BP recordings provide inaccurate reflection of the actual BP load outside of dialysis...
August 21, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28764090/synthesis-characterization-and-application-of-a-new-fluorescence-reagent-for-the-determination-of-aluminum-in-food-samples
#10
Esra Yıldız, Şerife Saçmacı, Mustafa Saçmacı, Ahmet Ülgen
A new sensitive fluorimetry method for the simple and rapid measurement of aluminum in some food samples, which used 3',6'-bis(diethylamino)-2-{[(1E)-(4-ethoxyphenyl) methylene] amino}spiro[isoindole-1,9'-xanthen]-3(2H)-one (DEMAX) for Al(III) chelation is described herein. The fluorescence intensity of the aluminum-DEMAX complex remains unaltered for over 24h at room temperature and is a linear function of the concentration of aluminum in the 0-1000mg/L range with a detection limit (LOD, defined as 3s/b) of 3...
December 15, 2017: Food Chemistry
https://www.readbyqxmd.com/read/28762611/pregnancy-on-short-daily-home-hemodialysis-using-low-dialysate-flow-rate-a-new-hope-for-the-end-stage-renal-disease-patients
#11
Vincent Leduc, Maxence Ficheux, Clémence Bechade, Michel Dreyfus, Thierry Lobbedez, Patrick Henri
INTRODUCTION: In France in 2014, there were approximately 1500 patients of reproductive age treated by dialysis. Pregnancy in these patients remains rare, however, the incidence has increased since the 2000s, with a parallel increase in the fetal survival rate. We report 2 cases of pregnancy in short-daily home hemodialysis using low dialysate flow rate. METHODS: Short-daily hemodialysis was continued at the request of the patients. The treatment consisted in an increase of frequency and duration of hemodialysis sessions, an independent blood pressure and dry weight control supervised by nephrological monitoring twice a month and a regular obstetrics follow-up...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28750875/chronic-kidney-disease-in-hypertensive-subjects-%C3%A2-60-years-treated-in-primary-care
#12
Betlem Salvador-González, Jordi Mestre-Ferrer, Maria Soler-Vila, Luisa Pascual-Benito, Eva Alonso-Bes, Oriol Cunillera-Puértolas
BACKGROUND: Hypertension (HT) is the second leading cause of kidney failure. In hypertensive patients with chronic kidney disease (CKD), blood pressure (BP) control is the most important intervention to minimise progression. For CKD diagnosis, standardised creatinine and estimated glomerular filtration rate (eGFR) testing by CKD-EPI is recommended. OBJECTIVES: To describe the prevalence and factors associated with a moderate decrease in eGFR (by CKD-EPI) and BP control in subjects with HT...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28739573/quality-assurance-audit-of-technique-failure-and-90-day-mortality-after-program-discharge-in-a-canadian-home-hemodialysis-program
#13
Nikhil Shah, Frances Reintjes, Mark Courtney, Scott W Klarenbach, Feng Ye, Kara Schick-Makaroff, Kailash Jindal, Robert P Pauly
BACKGROUND AND OBJECTIVES: Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance...
July 24, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28729965/fluid-overload-as-a-major-target-in-management-of-cardiorenal-syndrome-implications-for-the-practice-of-peritoneal-dialysis
#14
REVIEW
Amir Kazory
Congestion is an integral component of cardiorenal syndrome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability of modulating the interactions between the kidney and the heart in this setting. Peritoneal dialysis (PD) is a home-based therapeutic modality that is not only offered to patients with end-stage renal disease to provide solute clearance and ultrafiltration, but it has also been used in patients with refractory heart failure and fluid overload to help optimize volume status...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28729384/characteristics-and-outcomes-of-patients-discharged-home-from-an-emergency-department-with-aki
#15
Rey R Acedillo, Ron Wald, Eric McArthur, Danielle Marie Nash, Samuel A Silver, Matthew T James, Michael J Schull, Edward D Siew, Michael E Matheny, Andrew A House, Amit X Garg
BACKGROUND AND OBJECTIVES: Patients discharged home from an emergency department with AKI are not well described. This study describes their characteristics and outcomes and compares these outcomes to two referent groups. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a population-based retrospective cohort study in Ontario, Canada from 2003 to 2012 of 6346 patients aged ≥40 years who were discharged from the emergency department with AKI (defined using serum creatinine values)...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28724404/temporal-trends-of-dialysis-requiring-acute-kidney-injury-after-orthotopic-cardiac-and-liver-transplant-hospitalizations
#16
Girish N Nadkarni, Kinsuk Chauhan, Achint Patel, Aparna Saha, Priti Poojary, Sunil Kamat, Shanti Patel, Rocco Ferrandino, Ioannis Konstantinidis, Pranav S Garimella, Madhav C Menon, Charuhas V Thakar
BACKGROUND: The epidemiology and outcomes of acute kidney injury (AKI) in prevalent non-renal solid organ transplant recipients is unknown. METHODS: We assessed the epidemiology of trends in acute kidney injury (AKI) in orthotopic cardiac and liver transplant recipients in the United States. We used the Nationwide Inpatient Sample to evaluate the yearly incidence trends (2002 to 2013) of the primary outcome, defined as AKI requiring dialysis (AKI-D) in hospitalizations after cardiac and liver transplantation...
July 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28710094/perspectives-from-the-kidney-health-initiative-on-advancing-technologies-to-facilitate-remote-monitoring-of-patient-self-care-in-rrt
#17
Mitchell H Rosner, Susie Lew, Paul Conway, Jennifer Ehrlich, Robert Jarrin, Uptal D Patel, Karen Rheuban, R Brooks Robey, Neal Sikka, Eric Wallace, Patrick Brophy, James Sloand
Telehealth and remote monitoring of a patient's health status has become more commonplace in the last decade and has been applied to conditions such as heart failure, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. Conversely, uptake of these technologies to help engender and support home RRTs has lagged. Although studies have looked at the role of telehealth in RRT, they are small and single-centered, and both outcome and cost-effectiveness data are needed to inform future decision making...
July 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28704826/dialysis-in-the-elderly-and-impact-of-institutionalization-in-the-united-states-renal-data-system
#18
Amarpali Brar, Mary Mallappallil, Dimitre G Stefanov, David Kau, Moro O Salifu
BACKGROUND: We hypothesized that in the very elderly dialysis patients in the United States, institutionalization in nursing homes would increase mortality in addition to age alone. METHODS: Incident dialysis patients from 2001 to 2008 above the age of 70 were included. Patients above 70 were categorized into 4 groups according to age as 70-75, 76-80, 81-85, and >85 years and further divided into institutionalized and noninstitutionalized. Kaplan-Meier survival curves were plotted to assess patient survival...
July 14, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28698249/pd-vs-hd-in-post-economic-crisis-greece-differences-in-patient-characteristics-and-estimation-of-therapy-cost
#19
Marilena Koukou
OBJECTIVE: The aim of this study was to investigate patient characteristics and make an estimation of the cost of peritoneal dialysis (PD) and hemodialysis (HD) on Greek society during the economic crisis. METHODS: We recorded the characteristics and the total cost of dialysis treatment in 100 patients on PD and 100 on HD. Total cost included dialysis procedure, consumables, drugs, laboratory tests, food, and transportation fees (only HD) and were covered by patients' insurance...
July 11, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28685187/compatibility-of-fosfomycin-with-different-commercial-peritoneal-dialysis-solutions
#20
M Kussmann, A Baumann, S Hauer, P Pichler, M Zeitlinger, M Wiesholzer, H Burgmann, W Poeppl, G Reznicek
For treatment of peritoneal dialysis-related peritonitis, intraperitoneal administration of antibiotics remains the preferable route. For home-based therapy, patients are commonly supplied with peritoneal dialysis fluids already containing antimicrobial agents. The present study set out to investigate the compatibility of fosfomycin with different peritoneal dialysis fluids, namely, Extraneal(®), Nutrineal(®), Physioneal(®) 1.36% and Physioneal(®) 2.27%, under varying storage conditions. The peritoneal dialysis fluid bags including 4 g fosfomycin were stored over 14 days at refrigeration temperature (6°C) and room temperature (25°C) and over 24 h at body temperature (37°C)...
July 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
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