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https://www.readbyqxmd.com/read/29143698/using-the-integrate-hta-guidance-experience-from-cadth
#1
Ken Bond, Laura Weeks
OBJECTIVES: The aim of this study was to describe an initial exploration by CADTH, Canada's pan-Canadian health technology assessment (HTA) agency, in using the INTEGRATE-HTA guidance in the production of an HTA that examined the use of both in-center and in-home dialysis modalities for the treatment of end-stage kidney disease in adults in Canada. METHODS AND RESULTS: We outline CADTH's standard HTA production process and context and then describe the experience of the assessment team in using the INTEGRATE-HTA guidance, specifically to help structure and guide the use of a logic model, the identification of implementation issues, and the identification and examination of ethical issues...
November 16, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29122999/can-home-hemodialysis-and-peritoneal-dialysis-programs-coexist-and-grow-together
#2
Nikhil Shah, Robert R Quinn, Stephanie Thompson, Robert P Pauly
No abstract text is available yet for this article.
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29106648/validation-of-echocardiographic-criteria-for-the-clinical-diagnosis-of-heart-failure-in-chronic-kidney-disease
#3
Kathrin Untersteller, Sarah Seiler-Mußler, Francesca Mallamaci, Danilo Fliser, Gérard M London, Carmine Zoccali, Gunnar H Heine
Background: The Acute Dialysis Quality Initiative (ADQI) XI Workgroup has suggested defining heart failure (HF) in patients with end-stage renal disease by the presence of at least one out of eight predefined echocardiographic criteria. Given the high prevalence of echocardiographic alterations in chronic kidney disease (CKD) patients, we hypothesized that application of echocardiographic ADQI criteria will result in overdiagnosis of HF, without providing substantial prognostic information...
July 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29101459/symmetric-dimethylarginine-sdma-outperforms-asymmetric-dimethylarginine-adma-and-other-methylarginines-as-predictor-of-renal-and-cardiovascular-outcome-in-non-dialysis-chronic-kidney-disease
#4
Insa E Emrich, Adam M Zawada, Jens Martens-Lobenhoffer, Danilo Fliser, Stefan Wagenpfeil, Gunnar H Heine, Stefanie M Bode-Böger
BACKGROUND: Chronic kidney disease (CKD) is associated with increased risk of renal and cardiovascular events. It has been claimed that endogenous methylarginines, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), are contributing factors. However, earlier studies were partly contradictory and mainly focused on prevalent dialysis patients. Moreover, the potential contribution of degradation products, such as acetylated ADMA and SDMA (AcADMA and AcSDMA) and other methylarginines including L-N(G)-monomethylarginine (LNMMA) remains unknown...
November 3, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29072166/effect-of-an-intradialytic-protein-rich-meal-intake-in-nutritional-and-body-composition-parameters-on-hemodialysis-patients
#5
Cristina Caetano, Ana Valente, Francisco Jorge Silva, Jorge Antunes, Cristina Garagarza
BACKGROUND AND AIMS: Protein intake is a key point to maintain an adequate nutritional status in hemodialysis (HD) patients. There are some studies that confirm the positive influence of intradialytic oral nutritional supplementation in several nutritional parameters in HD patients. The aim of this study was to evaluate the effect of an intradialytic protein rich meal in nutritional and body composition parameters on HD patients. METHODS: This was a 6-months single center non-randomized study with 99 patients in HD from one Nephrocare dialysis unit in Portugal...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29064179/a-case-of-hypothermia-on-crrt
#6
Gurwant Kaur, Prameela Banoth, Preethi Yerram, Madhukar Misra
A 64-year-old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29056170/sister-earth-our-common-home-toward-a-sustainable-planet-friendly-approach-to-dialysis-a-paradigm-of-high-technology-medicine
#7
Giorgina Barbara Piccoli, David Mery
In our high-technology, highly polluted world, medicine plays an important role balancing saving lives with the expenses of growing amounts of waste products, not only biologically dangerous (the potentially "contaminated" or "hazardous" waste) but also potentially harmful for the planet (nonrecyclable, plastic waste). Dialysis, the prototype of high-technology medicine, is central to these problems, as the present treatment of about 2 million patients produces an enormous quantity of waste (considering hazardous waste only about 2 kg per session, with 160 sessions per year, that is 320 kg per patient, or about 640,000 tons of hazardous waste per year for 2 million patients, roughly corresponding to 6 nuclear aircraft carriers)...
November 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29051145/a-discrete-choice-study-of-patient-preferences-for-dialysis-modalities
#8
Rachael C Walker, Rachael L Morton, Suetonia C Palmer, Mark R Marshall, Allison Tong, Kirsten Howard
BACKGROUND AND OBJECTIVES: Improved knowledge about factors that influence patient choices when considering dialysis modality could facilitate health care interventions to increase rates of home dialysis. We aimed to quantify the attributes of dialysis care and the tradeoffs that patients consider when making decisions about dialysis modalities. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a prospective, discrete choice experiment survey with random parameter logit analysis to quantify preferences and tradeoffs for attributes of dialysis treatment in 143 adult patients with CKD expected to require RRT within 12 months (predialysis)...
October 19, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29051144/sociodemographic-psychologic-health-and-lifestyle-outcomes-in-young-adults-on-renal-replacement-therapy
#9
Alexander J Hamilton, Rhian L Clissold, Carol D Inward, Fergus J Caskey, Yoav Ben-Shlomo
BACKGROUND AND OBJECTIVES: Young adults receiving RRT face additional challenges in life. The effect of established kidney failure on young adulthood is uncertain. We aimed to establish the psychosocial and lifestyle status of young adults receiving RRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our study was a systematic review and meta-analysis of 16-30-year olds receiving RRT compared with the general population. We selected randomized, controlled trials; cohort studies; or cross-sectional studies without language restriction and extracted proportions of sociodemographic and lifestyle outcomes or validated psychologic health tests producing quality of life, wellbeing, and self-esteem scores...
October 19, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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
#10
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/29024613/remote-monitoring-of-automated-peritoneal-dialysis-patients-assessing-clinical-and-economic-value
#11
Dilip Makhija, Mark Dominik Alscher, Stefan Becker, Silvia D'Alonzo, Raj Mehrotra, Leslie Wong, Kim McLeod, Judy Danek, Mary Gellens, Todd Kudelka, James A Sloand, Suzanne Laplante
BACKGROUND: For chronic kidney disease patients who progress to end-stage renal disease, survival is dependent on renal replacement therapy in the form of kidney transplantation or chronic dialysis. Peritoneal dialysis (PD), which can be performed at home, is both more convenient and less costly than hemodialysis that requires three 4-h visits per week to the dialysis facility and complicated equipment. Remote therapy management (RTM), technologies that collect medical information and transmit it to healthcare providers for patient management, has the potential to improve the outcomes of patients receiving automated peritoneal dialysis (APD) at home...
October 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28983956/transitional-dialysis-care-units-a-new-approach-to-increase-home-dialysis-modality-uptake-and-patient-outcomes
#12
REVIEW
José A Morfín, Alex Yang, Elizabeth Wang, Brigitte Schiller
Home hemodialysis (HHD) and peritoneal dialysis (PD) are associated with better clinical outcomes, lower hospitalization rates, and improved quality of life compared with conventional in-center hemodialysis. However, <12% of patients requiring dialysis therapy use HHD or PD in the United States, even though over 90% of nephrologists would choose home-based dialysis modalities for themselves. Inadequate patient education and decision-making support are key barriers to patients choosing home-based therapy...
October 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28981231/-home-dialysis-techniques-from-dream-to-reality
#13
S Treille, B Guillaume
The economic environment has pushed our political leaders to severely limit the health care spending. Belgian nephrologists have signed an agreement to attain more than 40 % of " alternative " dialysis techniques such as peritoneal dialysis (PD) and home hemodialysis (HHD). They will become unavoidable and major future therapy modalities. This article summarizes PD and HDD techniques in order to help health professionals and to inform them about innovative research in home dialysis techniques. It is a non exhaustive list of the many advantages, if not superiority, of the treatment of end stage renal disease (ESRD) at home instead of in-center HD...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28972690/on-line-hemodiafiltration-at-home
#14
Almudena Vega, Soraya Abad, Nicolás Macías, Inés Aragoncillo
Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC(©) ) monitor, and the Acqua C(©) (Fresenius Medical Care) for water treatment...
October 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28970366/experiences-of-living-with-assisted-peritoneal-dialysis-a-qualitative-study
#15
Ingrid Petersson, Annette Lennerling
BACKGROUND: People's experiences of living with assisted peritoneal dialysis (aPD) have not been studied previously. Assisted PD is successfully used as renal replacement therapy for elderly and disabled patients with end-stage renal disease. To be treated with aPD implies being dependent on lifelong treatment at home. The aim of this study was to explore adults' experiences of living with aPD. METHODS: In-depth interviews were conducted with 10 participants with aPD, median age 82...
September 28, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28963833/-home-daily-hemodialysis-with-nxstage-system-one-monocentric-italian-casistic-results
#16
Chiara Brunati, Franca Cassaro, Laura Cretti, Michela Izzo, Marisa Pegoraro, Daniela Negri, Francesca Gervasi, Giacomo Colussi
NxStage System One is a new dialytic technology based on easy setup, simplicity of use and reduced dimensions, which is increasingly in use worldwide for home hemodialysis treatments. The system utilizes a low amount of dialysate, usually 15-30 liters according to anthropometric patients' values. The dialysate is supplied at very low flux, generally about 1/3 of blood flow, in order to obtain an elevated saturation of dialysate for solutes. In these conditions the clearance of urea will be almost equal to dialysate flow rate...
September 28, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28941964/unmet-palliative-care-needs-among-patients-with-end-stage-kidney-disease-a-national-registry-study-about-the-last-week-of-life
#17
Lena Axelsson, Anette Alvariza, Jenny Lindberg, Joakim Öhlén, Cecilia Håkanson, Helene Reimertz, Carl-Johan Fürst, Kristofer Årestedt
CONTEXT: End-stage kidney disease (ESKD) is characterized by high physical and psychological burden and therefore, more knowledge about the palliative care provided close to death is needed. OBJECTIVES: To describe symptom prevalence, relief and management during the last week of life, as well as end-of-life communication, in patients with ESKD. METHODS: This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (ICD-10-SE; N18...
September 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#18
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...
November 7, 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
#19
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
#20
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
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