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https://www.readbyqxmd.com/read/27908905/mortality-hospitalization-and-quality-of-life-among-patients-with-hepatitis-c-infection-on-hemodialysis
#1
David A Goodkin, Brian Bieber, Michel Jadoul, Paul Martin, Eiichiro Kanda, Ronald L Pisoni
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is widely prevalent among patients on hemodialysis (HD), but very rarely treated. The aim of our study is to evaluate the burdens of HCV suffered by patients on HD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Dialysis Outcomes and Practice Patterns Study is an international, prospective, cohort study of patients on HD. We reviewed the HCV status of 76,689 adults enrolled between 1996 and 2015. We compared HCV-positive (HCV+) with HCV-negative (HCV-) patients for risk of mortality, hospitalization, decline in hemoglobin concentration <8...
December 1, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27905303/peritoneal-dialysis-underscores-its-merits-in-portal-hypertensionrelated-and-nephrogenic-ascites
#2
C W H de Fijter, V Leijdekkers, D J van Leeuwen, Y F C Smets, J O Groeneveld
In the Western world, peritoneal dialysis (PD) is less frequently applied as substitute therapy in end-stage renal disease (ESRD). In the Netherlands the use of PD has decreased from 30.3 to 13.5% due to several factors, but not due to lower PD-related outcome. The lower penetrance of PD diminishes experience with and exposure of young professionals to this treatment modality. This does not enhance a free and motivated choice among renal replacement therapies for patients who cannot be transplanted pre-emptively...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27903998/survival-benefit-of-hemodiafiltration-compared-with-prolonged-high-flux-hemodialysis
#3
Petar S Djuric, Aleksandar Jankovic, Jovan Popovic, Jelena Tosic Dragovic, Ana Bulatovic, Zivka Djuric, Milos Mitrovic, Nada Dimkovic
INTRODUCTION:  Patients on dialysis have a high rate of death, mainly of cardiovascular cause. Nephrologists are actively looking for ways to improve patients' outcomes, and alternative dialysis strategies, such as long conventional hemodialysis and hemodiafiltration, are currently being investigated. The aim of this study was to compare anemia, nutrition, inflammation, mineral metabolism, and 3-year survival rates between patients treated with hemodiafiltration and prolonged high-flux hemodialysis (HFH)...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27899108/geographic-variation-of-parathyroidectomy-in-patients-receiving-hemodialysis-a-retrospective-cohort-analysis
#4
James B Wetmore, Jiannong Liu, Paul J Dluzniewski, Areef Ishani, Geoffrey A Block, Allan J Collins
BACKGROUND: Secondary hyperparathyroidism (SHPT) is associated with adverse outcomes in patients receiving maintenance dialysis. Parathyroidectomy is a treatment for SHPT; whether parathyroidectomy utilization varies geographically in the US is unknown. METHODS: A retrospective cohort analysis was undertaken to identify all patients aged 18 years or older who were receiving in-center hemodialysis between 2007 and 2009, were covered by Medicare Parts A and B, and had been receiving hemodialysis for at least 1 year...
November 29, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#5
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27844184/possible-prevention-of-uremic-nausea-by-vitamin-d-receptor-activators-in-non-dialysis-patients-with-stage-5-chronic-kidney-disease
#6
Masato Ikeda, Yoshimi Ueda, Yukio Maruyama, Keitaro Yokoyama, Takashi Yokoo, Nobuhiko Joki, Ryoichi Ando, Toshio Shinoda, Daijo Inaguma, Toshihiko Yamaka, Yasuhiro Komatsu, Fumihiko Koiwa, Toshifumi Sakaguchi, Shigeo Negi, Takashi Shigematsu
BACKGROUND: Nausea is a major uremic symptom and a frequent indication for starting dialysis. However, preventive medication for uremic nausea has not yet been identified. Vitamin D receptor activators (VDRAs) may prevent uremic nausea via their pleiotropic actions. The objective of this study was to explore whether VDRA administration during the predialysis period is associated with a reduced prevalence of uremic nausea just prior to beginning dialysis. METHODS: A multicenter, retrospective, cross-sectional study was performed to identify a medication to prevent uremic nausea...
November 14, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27834451/elements-of-dialysis-nursing-practice-associated-with-successful-cannulation-result-of-an-international-survey
#7
Maria Teresa Parisotto, Francesco Pelliccia, Aileen Grassmann, Daniele Marcelli
BACKGROUND/AIM: Vascular access (VA) cannulation is an essential skill for dialysis nurses: failure to correctly repeat this operation daily may result in serious complications for the patients. This study investigates if different aspects of arteriovenous fistula and graft cannulation have an effect on the development of acute access complications, which may affect the VA survival. METHODS: In April 2009 a cross-sectional survey was conducted in 171 dialysis units located in Europe, the Middle East and Africa to collect details on VA cannulation practices...
November 9, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27832647/extracellular-volume-overload-and-increased-vasoconstriction-in-patients-with-recurrent-intradialytic-hypertension
#8
Peter Noel Van Buren, Yunyun Zhou, Javier A Neyra, Guanghua Xiao, Wanpen Vongpatanasin, Jula Inrig, Robert Toto
BACKGROUND/AIMS: Intradialytic hypertension (IH) occurs frequently in some hemodialysis patients and increases mortality risk. We simultaneously compared pre-dialysis, post-dialysis and changes in extracellular volume and hemodynamics in recurrent IH patients and controls. METHODS: We performed a case-control study among prevalent hemodialysis patients with recurrent IH and hypertensive hemodialysis controls. We used bioimpedance spectroscopy and impedance cardiography to compare pre-dialysis, post-dialysis, and intradialytic change in total body water (TBW) and extracellular water (ECW), as well as cardiac index (CI) and total peripheral resistance index (TPRI)...
November 11, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27821636/potentially-preventable-hospitalization-among-patients-with-ckd-and-high-inpatient-use
#9
Paul E Ronksley, Brenda R Hemmelgarn, Braden J Manns, James Wick, Matthew T James, Pietro Ravani, Robert R Quinn, Nairne Scott-Douglas, Richard Lewanczuk, Marcello Tonelli
BACKGROUND AND OBJECTIVES: Although patients with CKD are commonly hospitalized, little is known about those with frequent hospitalization and/or longer lengths of stay (high inpatient use). The objective of this study was to explore clinical characteristics, patterns of hospital use, and potentially preventable acute care encounters among patients with CKD with at least one hospitalization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We identified all adults with nondialysis CKD (eGFR<60 ml/min per 1...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27819399/cytomegalovirus-encephalitis-in-a-hemodialysis-patient-a-rare-association
#10
Alberto Vera, Pablo Ruano, Esther Ortega, Borja Quiroga
Haemodialysis patients are at greater risk of infections than individuals not on dialysis due to their immunosuppressive state caused by several factors (uraemia, vascular access, inflammation, malnutrition). However, infections affecting the central nervous system are not frequent in this population. We present the case of a 77-year-old man with end-stage renal disease who was admitted to the emergency department for a decreased level of consciousness and fever. Although the initial clinical suspicion oriented to a urinary infection, the lack of improvement forced us to perform a lumbar puncture...
November 7, 2016: New Microbiologica
https://www.readbyqxmd.com/read/27809803/a-prospective-study-of-treatment-of-carbapenem-resistant-enterobacteriaceae-infections-and-risk-factors-associated-with-outcome
#11
Claudia M D de Maio Carrilho, Larissa Marques de Oliveira, Juliana Gaudereto, Jamile S Perozin, Mariana Ragassi Urbano, Carlos H Camargo, Cintia M C Grion, Anna Sara S Levin, Silvia F Costa
BACKGROUND: To describe the clinical and microbiological data of carbapenem-resistant Enterobacteriaceae (CRE) infections, the treatment used, hospital- and infection-related mortality, and risk factors for death. METHODS: A prospective cohort conducted from March 2011 to December 2012. Clinical, demographic, and microbiological data such as in vitro sensitivity, clonality, carbapenemase gene mortality related to infection, and overall mortality were evaluated. Data were analyzed using Epi Info version 7...
November 3, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27801488/peritoneal-dialysis-experience-of-the-department-of-pediatrics-of-the-hospital-charles-nicolle-of-tunis
#12
Manel Jellouli, Meriem Ferjani, Amal Oueslati, Kamel Abidi, Ouns Naija, Yousra Hammi, Taieb Ben Abdallah, Tahar Gargah
Introduction Peritoneal dialysis (PD) is still the most common modality used in treatment for children with End Stage Renal Disease (ESRD). The objective of this study was to identify the epidemiological, clinical, and microbiological factors affecting the outcome of PD. Methods In this study, we retrospectively reviewed the records of 85 patients who were treated with DP for the last ten years (from January 2004 to December 2013) in the Department of Pediatrics in Charles Nicolle hospital, Tunis. Results The mean duration of PD was 18...
May 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27796026/-census-of-the-renal-and-dialysis-units-by-italian-society-of-nephrology-nephrologist-s-workload-for-renal-patient-assistance-in-italy-2014-2015
#13
Giuseppe Quintaliani, Marina Di Luca, Anteo Di Napoli, Giusto Viglino, Maurizio Postorino, Alessandro Amore, Simeone Andrulli, Antonio Bellasi, Giuliano Brunori, Erasmo Buongiorno, Santina Castellino, Alessandro D'Amelio, Luca De Nicola, Loreto Gesualdo, Domenico Di Landro, Sandro Feriozzi, Giovanni Strippoli, Ugo Teatini, Antonio Santoro
BACKGROUND: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted acensusof the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to theyear 2014. METHODS: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit...
September 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27791450/cutting-balloons-covered-stents-and-paclitaxel-coated-balloons-for-the-treatment-of-dysfunctional-dialysis-access
#14
Panagiotis Kitrou, Stavros Spiliopoulos, Dimitris Karnabatidis, Konstantinos Katsanos
Percutaneous transcatheter balloon angioplasty has evolved to the current mainstay treatment for salvage of dysfunctional dialysis access. Nonetheless, it is frequently associated with recurrent vessel restenosis and the need for multiple repeat treatments in order to maintain hemodynamic patency. Cutting-balloons, covered stents or stent-grafts, and paclitaxel-coated balloons have been extensively tested and investigated with the aim to improve immediate anatomical and long-term clinical results. Areas covered: In the present overview, we discuss the background and appraise relevant medical literature on the aforementioned technologies and provide a more in-depth synthesis of the results of different clinical studies for each device category...
November 15, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27774730/hyperprolactinemia-in-end-stage-renal-disease-and-effects-of-frequent-hemodialysis
#15
Joan C Lo, Gerald J Beck, George A Kaysen, Christopher T Chan, Alan S Kliger, Michael V Rocco, Glenn M Chertow
Introduction End-stage renal disease is associated with elevations in circulating prolactin concentrations, but the association of prolactin concentrations with intermediate health outcomes and the effects of hemodialysis frequency on changes in serum prolactin have not been examined. Methods The FHN Daily and Nocturnal Dialysis Trials compared the effects of conventional thrice weekly hemodialysis with in-center daily hemodialysis (6 days/week) and nocturnal home hemodialysis (6 nights/week) over 12 months and obtained measures of health-related quality of life, self-reported physical function, mental health and cognition...
October 23, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27772644/intensive-hemodialysis-and-potential-risks-with-increasing%C3%A2-treatment
#16
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27772643/intensive-hemodialysis-left-ventricular-hypertrophy-and-cardiovascular-disease
#17
Peter A McCullough, Christopher T Chan, Eric D Weinhandl, John M Burkart, George L Bakris
The prevalence of cardiovascular disease, including cardiac arrhythmia, coronary artery disease, cardiomyopathy, and valvular heart disease, is higher in hemodialysis (HD) patients than in the US resident population. Cardiovascular disease is the leading cause of death in HD patients and the principal discharge diagnosis accompanying 1 in 4 hospital admissions. Furthermore, the rate of hospital admissions for either heart failure or fluid overload is persistently high despite widespread use of β-blockers and renin-angiotensin system inhibitors and attempts to manage fluid overload with ultrafiltration...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27772642/intensive-hemodialysis-and-treatment-complications-and%C3%A2-tolerability
#18
Jose A Morfin, Richard J Fluck, Eric D Weinhandl, Sheru Kansal, Peter A McCullough, Paul Komenda
Hemodialysis (HD) treatment can be difficult to tolerate. Common complications are intradialytic hypotension (IDH) and long time to recovery after an HD session. IDH, as defined by nadir systolic blood pressure < 90mmHg and intradialytic decline > 30mmHg, occurs in almost 8% of HD sessions. IDH may be caused by aggressive ultrafiltration in response to interdialytic weight gain, can lead to myocardial stunning and cardiac arrhythmias, and is associated with increased risk for death. Long recovery time after a treatment session is also common...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27772640/intensive-hemodialysis-mineral-and-bone-disorder-and-phosphate-binder-use
#19
Michael Copland, Paul Komenda, Eric D Weinhandl, Peter A McCullough, Jose A Morfin
Mineral and bone disorder is a common complication of end-stage renal disease. Notably, hyperphosphatemia likely promotes calcification of the myocardium, valves, and arteries. Hyperphosphatemia is associated with higher risk for cardiovascular mortality and morbidity along a gradient beginning at 5.0mg/dL. Among contemporary hemodialysis (HD) patients, mean serum phosphorus level is 5.2mg/dL, although 25% of patients have serum phosphorus levels of 5.5 to 6.9mg/dL; and 13%, >7.0mg/dL. Treatment of hyperphosphatemia is burdensome...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27772639/intensive-hemodialysis-blood-pressure-and-antihypertensive-medication-use
#20
George L Bakris, John M Burkart, Eric D Weinhandl, Peter A McCullough, Michael A Kraus
Hypertension is a cardinal feature of end-stage renal disease (ESRD). Hypertensive nephropathy is the primary cause of ESRD for nearly 30% of patients, and the prevalence of hypertension is >85% in new patients with ESRD. In contemporary hemodialysis (HD) patients, mean predialysis systolic blood pressure (SBP) is nearly 150mmHg, and about 70%, 50%, and 40% use β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors, respectively. Predialysis SBP generally exhibits a U-shaped association with mortality risk...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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