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https://www.readbyqxmd.com/read/28319597/relationship-between-changes-in-blood-pressure-and-left-ventricular-mass-over-1-year-in-end-stage-renal-disease
#1
Bradley Sarak, Ron Wald, Marc B Goldstein, Djeven P Deva, Jonathon Leipsic, Mercedeh Kiaii, General Leung, Joseph J Barfett, Jeffrey Perl, Darren A Yuen, Kim A Connelly, Andrew T Yan
OBJECTIVE: The optimal timing of blood pressure (BP) measurement is not firmly established for patients undergoing hemodialysis. We sought to assess which BP measurement change best correlates with changes in left ventricular mass index (LVMI) over 1 year in patients with end-stage renal disease. METHODS: Fifty-seven patients were included in a prospective cohort study comparing the cardiovascular impact of conversion to in-center nocturnal hemodialysis versus continuing conventional hemodialysis...
March 17, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28318624/treatment-tolerance-and-patient-reported-outcomes-favor-online-hemodiafiltration-compared-to-high-flux-hemodialysis-in-the-elderly
#2
Marion Morena, Audrey Jaussent, Lotfi Chalabi, Hélène Leray-Moragues, Leila Chenine, Alain Debure, Damien Thibaudin, Lynda Azzouz, Laure Patrier, Francois Maurice, Philippe Nicoud, Claude Durand, Bruno Seigneuric, Anne-Marie Dupuy, Marie-Christine Picot, Jean-Paul Cristol, Bernard Canaud
Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration...
March 15, 2017: Kidney International
https://www.readbyqxmd.com/read/28296033/predictors-of-post-hospitalization-recovery-of-renal-function-among-patients-with-acute-kidney-injury-requiring-dialysis
#3
Russell Pajewski, Patrick Gipson, Michael Heung
INTRODUCTION: Acute kidney injury (AKI) requiring dialysis complicates 1% of all hospital admissions, and up to 30% of survivors will still require dialysis at hospital discharge. There is a paucity of data to describe the postdischarge outcomes or to guide evidence-based dialysis management of this vulnerable population. METHODS: Single-center, retrospective analysis of 100 consecutive patients with AKI who survived to hospital discharge and required outpatient dialysis...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28270412/relationship-between-hypotension-and-cerebral-ischemia-during-hemodialysis
#4
Clare MacEwen, Sheera Sutherland, Jonathan Daly, Christopher Pugh, Lionel Tarassenko
The relationship between BP and downstream ischemia during hemodialysis has not been characterized. We studied the dynamic relationship between BP, real-time symptoms, and cerebral oxygenation during hemodialysis, using continuous BP and cerebral oxygenation measurements prospectively gathered from 635 real-world hemodialysis sessions in 58 prevalent patients. We examined the relationship between BP and cerebral ischemia (relative drop in cerebral saturation >15%) and explored the lower limit of cerebral autoregulation at patient and population levels...
March 7, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28264150/blood-pressure-management-in-hemodialysis-patients-what-we-know-and-what-questions-remain
#5
REVIEW
Dana C Miskulin, Daniel E Weiner
Despite having thousands of blood pressure (BP) readings on individual dialysis patients over the course of a year, our knowledge about the optimal assessment of BP, the mechanisms underlying hypertension and its management remain incomplete. Observational studies reveal that BP is lower at home than when measured in the dialysis unit. However, we do not know if using home vs. in-center measurements to guide treatment decisions improves BP control and/or clinical outcomes. Moreover, a recent US study suggests that typical hemodialysis patients are unlikely to adhere to home monitoring over the long term...
March 6, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28194419/intestinal-barrier-disturbances-in-haemodialysis-patients-mechanisms-consequences-and-therapeutic-options
#6
REVIEW
D S March, M P M Graham-Brown, C M Stover, N C Bishop, J O Burton
There is accumulating evidence that the intestinal barrier and the microbiota may play a role in the systemic inflammation present in HD patients. HD patients are subject to a number of unique factors, some related to the HD process and others simply to the uraemic milieu but with common characteristic that they can both alter the intestinal barrier and the microbiota. This review is intended to provide an overview of the current methods for measuring such changes in HD patients, the mechanisms behind these changes, and potential strategies that may mitigate these modifications...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28185407/effects-of-sodium-concentration-and-dialysate-temperature-changes-on-blood-pressure-in-hemodialysis-patients-a-randomized-triple-blind-crossover-clinical-trial
#7
Hossein Ebrahimi, Mahboobeh Safavi, Marzieh Hossein Saeidi, Mohammad Hassan Emamian
The present study investigated the effects of different temperatures and sodium dialysate concentration on blood pressure in hemodialysis patients. Following Williams' design, hemodialysis patients were randomly assigned into four dialysis modes. Dialysate temperature was set at 37°C for modes A and C and, 35°C for modes B and D. Sodium concentration was set at 138 mmol/L in modes A and B, while it changed from 150 mmol/L to 138 mmol/L in modes C and D. Using analysis of variance for repeated measures, the mean values of systolic and diastolic blood pressure were investigated...
February 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28135703/vascular-refilling-is-not-reduced-in-dialysis-sessions-with-morbid-events
#8
Susanne Kron, Daniel Schneditz, Til Leimbach, Sabine Aign, Joachim Kron
BACKGROUND: It is commonly believed that insufficient vascular refilling leads to hypovolemia during hemodialysis and contributes to intradialytic morbid events (IME). But data of refilling volumes at the time of IME are lacking. METHODS: We compared the vascular refilling in 10 patients with IME with 14 stable patients with normal blood volume at the dialysis end (66-80 mL/kg). RESULTS: The refilling characteristics in patients with IME did not differ from those in stable patients...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28134403/-hfr-aequilibrium-can-be-an-answer-to-malnutrition-and-hypotension-in-dialisys-case-report
#9
Isabella Corino, Paolo Ria, Nicoletta Pertica, Gianluigi Zaza, Antonio Lupo
The interdialytic hypotension is still the most frequent complication during the hemodialysis. A-HFR has dynamic profiles of ultrafiltration and conductivity of the dialysate that ensure a better refilling and reduce compliance during the dialysis treatment, furthermore reduce the amino acid loss and has a lower inflammatory effect. In our Center, we wanted to analyze the impact of this kind of dialysis on intradialytic tolerance and nutritional status in two malnourished patients with encouraging data on the use of AHFR in malnutrition and disequilibrium syndromes...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28122851/intradialytic-cardiac-magnetic-resonance-imaging-to-assess-cardiovascular-responses-in-a-short-term-trial-of-hemodiafiltration-and-hemodialysis
#10
Charlotte Buchanan, Azharuddin Mohammed, Eleanor Cox, Katrin Köhler, Bernard Canaud, Maarten W Taal, Nicholas M Selby, Susan Francis, Chris W McIntyre
Hemodynamic stress during hemodialysis (HD) results in recurrent segmental ischemic injury (myocardial stunning) that drives cumulative cardiac damage. We performed a fully comprehensive study of the cardiovascular effect of dialysis sessions using intradialytic cardiac magnetic resonance imaging (MRI) to examine the comparative acute effects of standard HD versus hemodiafiltration (HDF) in stable patients. We randomly allocated 12 patients on HD (ages 32-72 years old) to either HD or HDF. Patients were stabilized on a modality for 2 weeks before undergoing serial cardiac MRI assessment during dialysis...
November 10, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28120381/use-of-ultrasound-by-registered-nurses-a-systematic-literature-review
#11
REVIEW
Ulrich Steinwandel, Nicholas P Gibson, James Charles Rippey, Amanda Towell, Johan Rosman
BACKGROUND: In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on-site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non-invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse...
January 25, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28110688/intradialytic-creatine-supplementation-a-scientific-rationale-for-improving-the-health-and-quality-of-life-of-dialysis-patients
#12
Theo Wallimann, Uwe Riek, Michael Möddel
The CK/PCr-system, with creatine (Cr) as an energy precursor, plays a crucial role in cellular physiology. In the kidney, as in other organs and cells with high and fluctuating energy requirements, energy-charged phospho-creatine (PCr) acts as an immediate high-energy source and energy buffer, and as an intracellular energy transport vehicle. A maximally filled total Cr (Cr plus PCr) pool is a prerequisite for optimal functioning of the body and its organs, and health. Skeletal- and cardiac muscles of dialysis patients with chronic kidney disease (CKD) are depleted of Cr in parallel with the duration of dialysis...
February 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28098098/a-study-of-clinical-assessment-of-frailty-in-patients-on-maintenance-hemodialysis-supported-by-cashless-government-scheme
#13
Manjusha Yadla, Jyothi Priyadarshini John, Mahesh Mummadi
This is a prospective cohort study to assess the prevalence of frailty in patients undergoing maintenance hemodialysis (HD) under the government-funded scheme at our center and to assess the relationship between frailty and falls, hospitalizations, and mortality. This was done at our center which is completely supported by the government, which provides HD to all the patients under poverty line. Epidemiological data, anthropometric measurements, comorbidities assessment, frailty assessment using Fried criteria, subsequent hospitalizations, falls, and mortality were recorded in our prevalent dialysis population at our center between October 2014 and October 2015...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28066913/dialysate-sodium-rationale-for-evolution-over-time
#14
Jennifer E Flythe, Finnian R Mc Causland
Oligo-anuric individuals receiving hemodialysis (HD) are dependent on the dialysis machine to regulate sodium and water balance. Interest in adjusting the dialysate sodium concentration to promote tolerance of the HD procedure dates back to the early years of dialysis therapy. Evolution of dialysis equipment technologies and clinical characteristics of the dialysis population have prompted clinicians to increase the dialysate sodium concentration over time. Higher dialysate sodium concentrations generally promote hemodynamic stabilization and reduce intradialytic symptoms but often do so at the expense of stimulating thirst and promoting volume expansion...
March 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28024931/a-randomized-single-blind-crossover-trial-of-recovery-time-in-high-flux-hemodialysis-and-hemodiafiltration
#15
James R Smith, Norica Zimmer, Elizabeth Bell, Bernard G Francq, Alex McConnachie, Robert Mactier
BACKGROUND: The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD. STUDY DESIGN: Randomized patient-blinded crossover trial. SETTINGS & PARTICIPANTS: 100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom...
December 23, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27992875/calf-resistivity-values-in-chronic-kidney-disease-in-a-caucasian-population
#16
Eric Seibert, Stephan G Müller, Johanna Pattmöller, Peter Kotanko, Fansan Zhu, Nathan W Levin, Roman Fiedler, Martin K Kuhlmann, Matthias Girndt
BACKGROUND: Continuous intradialytic calf bioimpedance spectroscopy (cBIS) allows assessment of changes in calf extracellular fluid volume (ECV) to determine dry weight (DW) in hemodialysis patients. During dialysis, calf ECV decreases until excessive ECV has been removed and normalized resistivity ρN,5 rises to values comparable to those of a normal population (cBIS-DW). It is not clear whether chronic kidney disease (CKD) itself influences ρN,5 and whether normal values depend on race and ethnicity...
2017: Nephron
https://www.readbyqxmd.com/read/27951579/evidence-for-the-clinical-advantages-of-predilution-on-line-hemodiafiltration
#17
Ikuto Masakane, Kan Kikuchi, Hideki Kawanishi
BACKGROUND: On-line hemodiafiltration (OL-HDF) is a rapidly developing dialysis modality that is expected to ameliorate the quality of life and survival rate of chronic dialysis patients. There are generally 2 types of dilution methods in OL-HDF: postdilution and predilution. SUMMARY: Postdilution OL-HDF is widely performed worldwide, whereas predilution OL-HDF accounts for >90% of all OL-HDF sessions performed in Japan. The reasons for the preference for predilution are to increase the substitution volume at a lower blood flow rate and to remove larger low-molecular-weight proteins (LMWPs)...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951544/haemodiafiltration-at-higher-volumes-and-patient-survival
#18
Francesco Locatelli, Lucia Del Vecchio, Vincenzo La Milia
Patient morbidity and mortality rates are still very high in standard low-flux haemodialysis (lf-HD). On-line haemodiafiltration (OL-HDF) is considered the most efficient dialysis technique, as clearances of small solutes, like urea, may be even higher than in lf-HD and clearances of middle solutes, like β2-microglobulin, are much higher than in lf-HD. OL-HDF has been suggested to reduce mortality compared to HD, possibly due to more effective removal of larger uraemic retention solutes and/or better fluid removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27942169/assessment-of-hemodialysis-adequacy-in-patients-with-chronic-kidney-disease-in-the-hemodialysis-unit-at-tanta-university-hospital-in-egypt
#19
M El-Sheikh, G El-Ghazaly
Worldwide, hemodialysis (HD) constitutes the most common form of renal replacement therapy. Many studies have shown strong correlation between HD dose and clinical outcome. The cross-sectional study was conducted on 100 patients in Hemodialysis Unit at Tanta University Hospital, Egypt. Data were collected using a reliable questionnaire (including clinical, demographic, dialysis, laboratory, and radiological data). SpKt/V was used to assess the adequacy of HD. The results revealed inadequate HD dose among 60% of the study population...
November 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27928711/dry-weight-assessment-by-combined-ultrasound-and-bioimpedance-monitoring-in-low-cardiovascular-risk-hemodialysis-patients-a-randomized-controlled-trial
#20
Dimitrie Siriopol, Mihai Onofriescu, Luminita Voroneanu, Mugurel Apetrii, Ionut Nistor, Simona Hogas, Mehmet Kanbay, Radu Sascau, Dragos Scripcariu, Adrian Covic
PURPOSE: Fluid overload is associated with adverse outcomes in hemodialysis (HD) patients. The precise assessment of hydration status in HD patients remains a major challenge for nephrologists. Our study aimed to explore whether combining two bedside methods, lung ultrasonography (LUS) and bioimpedance, may provide complementary information to guide treatment in specific HD patients. METHODS: In total, 250 HD patients from two dialysis units were included in this randomized clinical trial...
January 2017: International Urology and Nephrology
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