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https://www.readbyqxmd.com/read/28066913/dialysate-sodium-rationale-for-evolution-over-time
#1
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...
January 8, 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
#2
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
#3
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...
December 20, 2016: Nephron
https://www.readbyqxmd.com/read/27951579/evidence-for-the-clinical-advantages-of-predilution-on-line-hemodiafiltration
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/27924083/haemodialysis-intradialytic-meals-addressing-a-neglected-problem
#8
Francesco Locatelli, Lucia Del Vecchio
No abstract text is available yet for this article.
January 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/27923526/the-effect-of-intradialytic-intralipid-therapy-in-pediatric-hemodialysis-patients
#9
Orly Haskin, Scott M Sutherland, Cynthia J Wong
OBJECTIVE: Growth of children on maintenance hemodialysis is poor. Oral nutritional supplements are the preferred way to augment nutrition; however, many children have difficulties adhering to prescribed oral supplements. In our unit, we have been utilizing intralipid (IL) therapy as nutritional supplement during hemodialysis sessions. The aim of this study was to assess the safety, efficacy, and benefits of intradialytic IL therapy. DESIGN: A retrospective chart review...
December 3, 2016: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/27915344/intractable-intradialytic-hypotension-with-ischemic-retinopathy
#10
Il Sang Shin, Soo Jeong Choi, Bo Yeon Kim, Jin Kuk Kim, Seung Duk Hwang, Sun Young Jang
No abstract text is available yet for this article.
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27833921/management-of-patient-care-in-hemodialysis-while-focusing-on-cardiovascular-disease-events-and-the-atypical-role-of-hyper-and-or-hypotension-a-systematic-review
#11
REVIEW
Amjad Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Siew Hua Gan, Irfanullah Khan
Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27832647/extracellular-volume-overload-and-increased-vasoconstriction-in-patients-with-recurrent-intradialytic-hypertension
#12
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)...
2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27822564/design-of-a-randomized-controlled-clinical-trial-assessing-dietary-sodium-restriction-and-hemodialysis-related-symptom-profiles
#13
Maya N Clark-Cutaia, Marilyn S Sommers, Emily Anderson, Raymond R Townsend
AIM: In hemodialysis patients, the need to have intercurrent sodium and water intake removed by ultrafiltration increases disease burden through the symptoms and signs that occur during hemodialysis (HD). This added burden may be mitigated by reduction of dietary sodium intake. The National Kidney Foundation (NKF) recommends 2400 mg of dietary sodium daily for patients on HD, and the American Heart Association (AHA) suggests 1500 mg, evidence is lacking, however, to support these recommendations in HD...
August 15, 2016: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/27804262/effects-of-end-stage-renal-disease-and-dialysis-modalities-on-blood-ammonia-level
#14
Nosratola D Vaziri, Mahyar Khazaeli, Ane C F Nunes, Kevin T Harley, Hyder Said, Omeed Alipour, Wei Ling Lau, Madeleine V Pahl
Introduction Uremia results in a characteristic breath odor (uremic fetor) which is largely due to its high ammonia content. Earlier studies have shown a strong correlation between breath ammonia and blood urea levels and a 10-fold reduction in breath ammonia after hemodialysis in patients with chronic kidney disease. Potential sources of breath ammonia include: (i) local ammonia production from hydrolysis of urea in the oropharyngeal and respiratory tracts by bacterial flora, and (ii) release of circulating blood ammonia by the lungs...
November 1, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27789324/-predictors-of-physical-incapacity-degree-to-chronic-hemodialysis-patients-in-kinshasa%C3%A2-key-role-of-the-residual-diuresis
#15
Vieux Momeme Mokoli, Justine Busanga Bukabau, Patrick Parmba Osa Izeidi, Jeanine Losa Luse, Stéphane Kalambay Mukendi, Désiré Kulimba Mashinda, Jean Robert Rissassy Makulo, Ernest Kiswaya Sumaili, François Bompeka Lepira, Nazaire Mangani Nseka
OBJECTIVE: Identifying predictors of physical incapacity degree in patients on chronic hemodialysis in Kinshasa. METHODS: Bicentric analytical study, between January 2007 and July 2013. Degree of physical handicap was evaluated at 6months of hemodialysis based on the scale of Rosser. Logistic regression sought the predictors of no or light physical incapacity (Rosser<3) vs. moderate to maximum (Rosser≥3). P was set at 0.05. RESULTS: One hundred twenty-seven patients (127) patients received at least 6months of hemodialysis (53...
December 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#16
REVIEW
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
https://www.readbyqxmd.com/read/27772642/intensive-hemodialysis-and-treatment-complications-and%C3%A2-tolerability
#17
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/27761981/dialysate-bicarbonate-variation-in-maintenance-hemodiafiltration-patients-impact-on-serum-bicarbonate-intradialytic-hypotension-and-interdialytic-weight-gain
#18
Márcio Viegas, Cristina Cândido, Joana Felgueiras, José Clemente, Sara Barros, Rostislav Farbota, Filipa Vera, Antero Matos, Francisco Sousa
Introduction The dialysate bicarbonate (DB) influences the acid-base balance in dialysis patients. Very low and high serum bicarbonate (SB) have been related with a higher mortality. Acid-base balance also has been associated with hemodynamic effects in these patients. The trial aim was to compare the effect of DB concentration variation on SB levels in maintenance hemodiafiltration (HDF) patients and the effect on intradialytic hypotension and interdialytic weight gain. Methods  A prospective study, with 9 months of follow-up, involving 93 patients, divided in two groups: group 1 and group 2 with a DB of 34 mmol/L and 30 mmol/L, respectively, with monitoring of pre and post HDF SB, intradialytic hypotension, and interdialytic weight gain...
October 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27754086/os-19-09-bioelectrical-impedance-phase-angle-as-intradialytic-hypotension-predictor
#19
Vaidas Vicka, Laurynas Rimsevicius, Alvita Gincaite, Diana Sukackiene, Marius Miglinas
OBJECTIVE: Water balance and blood pressure (BP) alterations are strongly associated in haemodialysis (HD) patients. Aim of this study was to determine whether bioelectrical impedance analysis (BIA) parameters can be used as predictors of intradialytic hypotension (IDH). DESIGN AND METHOD: We conducted an observational study of chronic HD patients. BIA was measured before the HD procedure using InBody S10 (Biospace, Seoul, Korea) body composition analyzer. Intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/TBW ratio and phase angle (PhA) were selected as markers of hydration state and thus possible predictors of IDH...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27738230/haemodialysis-acutely-deteriorates-left-and-right-diastolic-function-and-myocardial-performance-an-effect-related-to-high-ultrafiltration-volumes
#20
Pantelis A Sarafidis, Vasilios Kamperidis, Charalampos Loutradis, Konstantinos Tsilonis, Fani Mpoutsiouki, Athanasios Saratzis, Georgios Giannakoulas, Georgios Sianos, Haralambos Karvounis
BACKGROUND: The effect of acute preload reduction during haemodialysis on left ventricle (LV) and right ventricle (RV) function is not well understood. This study aimed to evaluate acute changes in novel echocardiographic and tissue Doppler-derived indices of LV and RV function during the first and a standard weekly dialysis session and to examine the possible effect of acute intradialytic volume changes in LV and RV diastolic function and pulmonary circulation loading. METHODS: Forty-one adult patients receiving standard thrice-weekly haemodialysis participated in this study...
October 13, 2016: Nephrology, Dialysis, Transplantation
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