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https://www.readbyqxmd.com/read/29772982/randomized-pilot-study-to-compare-metal-needles-versus-plastic-cannulae-in-the-development-of-complications-in-hemodialysis-access
#1
Rosa M Marticorena, Niki Dacouris, Sandra M Donnelly
BACKGROUND: Hemodialysis requires needle insertions every treatment. Needle injury (mechanical or hemodynamic) may cause complications (aneurysms/stenosis) that compromise dialysis delivery requiring interventions. Metal needles have a sharp slanted "V"-shaped cutting tip; plastic cannulae have a dull round tip and four side holes. Preliminary observations demonstrated a difference in intradialytic blood flow images and mean Doppler velocities at cannulation sites between the two devices...
May 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29745006/effects-of-acute-intradialytic-exercise-on-cardiovascular-responses-in-hemodialysis-patients
#2
Jin Hee Jeong, Annabel Biruete, Bo Fernhall, Kenneth R Wilund
BACKGROUND: In patients with kidney failure requiring hemodialysis (HD) treatment, intradialytic exercise (IDEX) has been advocated for its feasibility and effectiveness in improving important health outcomes. However, IDEX as an adjunct therapeutic strategy is infrequently implemented, in part due to potential risks of IDEX, especially in patients with chronic volume overload. This study was performed to evaluate the safety of IDEX performed at different time points by examining its effect on intradialytic cardiovascular hemodynamics...
May 9, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29738032/does-high-intensity-exercise-affects-irisin-plasma-levels-in-hemodialysis-patients-a-pilot-study
#3
Marta Gormicho Boavida Marques Esgalhado, Milena Barcza Stockler-Pinto, Ludmila Ferreira Medeiros de França Cardozo, Jorge Eduardo Barboza, Denise Mafra
BACKGROUND: Irisin is a recently identified exercise-induced hormone that stimulates the "browning" of the white adipose tissue, at least in mice. In chronic kidney disease (CKD) patients, irisin regulation is not fully understood, and little attention has been given to the effects of exercise on irisin levels in these patients. The purpose of this study was to assess the effects of high intensity exercise on irisin plasma levels in CKD patients under hemodialysis (HD). METHODS: Fifteen HD patients (5 men, 44...
April 23, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29709531/-impact-of-the-adjunction-of-boiled-egg-during-the-chronic-hemodialysis-session-on-the-nutrition-state
#4
Clotilde Muller, Fabienne Knoerr, Isabelle Kolb, Antoine Garstka, Jean-Valère Fumaroli, Sarah Richter
Denutrition for chronic hemodialysed patients is common and severe, often the first step of many complication and comorbidities. This work was aimed to study the impact of the adjunction of hard-boiled egg during six months, at the time of the hemodialysis session, if the classic nutritional support with oral nutritional supplements and intradialytic parenteral nutrition has failed. Required criteria were: Albuminemia, prealbuminemia and Moreau and Gaudry's score. Thirty-six patients have been included. During the six months, the following nutritional parameters have improved: Moreau and Gaudry's score decreased of 0...
April 27, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29688552/haemodialysis-or-haemodiafiltration-that-is-the-question
#5
Francesco Locatelli, Fabio Carfagna, Lucia Del Vecchio, Vincenzo La Milia
Despite the technological and pharmacological advancements in the last 30 years, morbidity and mortality of dialysis patients are still astonishingly high. Today, convective treatments, such as high-flux haemodialysis (hf-HD) and haemodiafiltration (HDF), are established techniques; the online production of fresh pure dialysate has provided clinical and economic advantages. Nevertheless, the actual benefits of HDF, even with high-convective-volume treatments, are still debatable. Three recent, randomized controlled trials compared survival outcomes in prevalent patients receiving conventional HD or post-dilution HDF and reported conflicting results...
April 24, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29682559/hemodynamic-instability-during-dialysis-the-potential-role-of-intradialytic-exercise
#6
REVIEW
Scott McGuire, Elizabeth Jane Horton, Derek Renshaw, Alofonso Jimenez, Nithya Krishnan, Gordon McGregor
Acute haemodynamic instability is a natural consequence of disordered cardiovascular physiology during haemodialysis (HD). Prevalence of intradialytic hypotension (IDH) can be as high as 20-30%, contributing to subclinical, transient myocardial ischemia. In the long term, this results in progressive, maladaptive cardiac remodeling and impairment of left ventricular function. This is thought to be a major contributor to increased cardiovascular mortality in end stage renal disease (ESRD). Medical strategies to acutely attenuate haemodynamic instability during HD are suboptimal...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#7
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29669016/hemodynamic-response-to-fluid-removal-during-hemodialysis-categorization-of-causes-of-intradialytic-hypotension
#8
Nathan W Levin, Marcia H F G de Abreu, Lucas E Borges, Helcio A Tavares Filho, Rabia Sarwar, Surendra Gupta, Tahir Hafeez, Shaul Lev, Caroline Williams
Background: Intradialytic hypotension is a clinically significant problem, however, the hemodynamics that underlie ultrafiltration and consequent hypotensive episodes has not been studied comprehensively. Methods: Intradialytic cardiac output, cardiac power and peripheral resistance changes from pretreatment measurements were evaluated using a novel regional impedance cardiographic device (NICaS, NI Medical, Peta Tikva, Israel) in 263 hemodialysis sessions in 54 patients in dialysis units in the USA and Brazil with the goal of determining the various hemodynamic trends as blood pressure decreases...
April 14, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29657203/the-development-of-malnutrition-is-not-dependent-on-its-traditional-contributing-factors-in-patients-on-maintenance-hemodialysis-in-developing-countries
#9
Syed Rizwan Ali Bokhari, Mirza Ameer Faizan Ali, Syed Arsalan Khalid, Bushra Iftikhar, Hafiz Ijaz Ahmad, Ahlam Safdar Hussain, Usman Yaqoob
Malnutrition in dialysis population is associated with significant morbidity and mortality. Nutritional assessment is a neglected area in hemodialysis (HD) patients in developing countries. The aim of the study was to find out whether any traditional parameters have statistically significant correlation with malnutrition. All 58 end-stage renal disease patients on maintenance HD in our dialysis unit were enrolled in this cross-sectional study. The nutritional status was assessed by a predesigned questionnaire including subjective global assessment (SGA)...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29629281/use-of-fludrocortisone-for-intradialytic-hypotension
#10
Yuri Seo, Soomin Jeung, Sun-Myoung Kang, Won Seok Yang, Hyosang Kim, Soon Bae Kim
Intradialytic hypotension during dialysis adversely affects a patient's prognosis and increases mortality. We report a case in which intradialytic hypotension that persisted after the administration of midodrine was relieved after the use of fludrocortisone. Administration of 0.2 mg of fludrocortisone occurred 30 minutes before dialysis. We compared 45 sessions of dialysis without fludrocortisone administration and 45 sessions of dialysis with fludrocortisone administration in one patient. The number of times in which systolic blood pressure became lower than 80 mmHg and the number of early terminations of dialysis due to a decrease in systolic blood pressure were higher in the sessions without fludrocortisone administration than in the sessions with fludrocortisone administration ( P < 0...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29624853/impact-of-salt-reduction-in-meals-consumed-during-hemodialysis-sessions-on-interdialytic-weight-gain-and-hemodynamic-stability
#11
Arthur Colson, Anita Brinkley, Philippe Braconnier, Nadia Ammor, Michel Burnier, Menno Pruijm
INTRODUCTION: Patients on hemodialysis (HD) are advised to limit daily water- and salt intake to reduce interdialytic weight gain (IDWG). To counterbalance protein-losses, protein-rich meals are sometimes provided during HD sessions, but their salt content is not always taken into account. The aim of this study was to assess the influence of a lower salt content of meals provided during HD sessions on IDWG, blood pressure (BP), and hemodynamic stability during dialysis. METHODS: This monocentric, interventional study was proposed to all the patients treated with three weekly HD sessions...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29618823/oxygen-extraction-ratio-oer-as-a-measurement-of-hemodialysis-hd-induced-tissue-hypoxia-a-pilot-study
#12
Silverio Rotondi, Lida Tartaglione, Maria Luisa Muci, Alessio Farcomeni, Marzia Pasquali, Sandro Mazzaferro
HD tissue hypoxia associates with organ dysfunctions. OER, the ratio between SaO2 and central-venous-oxygen-saturation, could estimate oxygen requirements during sessions, but no data are available. We evaluated OER behavior in 20 HD patients with permanent central venous catheter (CVC) as vascular access. Pre-HD OER (33.6 ± 1.4%; M ± SE) was higher than normal (range 20-30%). HD sessions increased OER to 39.2 ± 1.5% (M ± SE; p < 0.05) by 30' and to 47.4 ± 1.5% (M ± SE; p < 0...
April 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29614972/aortic-stenosis-is-a-risk-factor-for-all-cause-mortality-in-patients-on-dialysis-a-multicenter-prospective-cohort-analysis
#13
Daijo Inaguma, Yuji Sasakawa, Noriko Suzuki, Eri Ito, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Midori Hasegawa, Yukio Yuzawa
BACKGROUND: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding the association between AS in patients on dialysis and mortality. Therefore, we will investigate whether morbidity of AS in patients on dialysis is associated with mortality...
April 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29608708/effects-of-intradialytic-cycling-exercise-on-exercise-capacity-quality-of-life-physical-function-and-cardiovascular-measures-in-adult-haemodialysis-patients-a-systematic-review-and-meta-analysis
#14
Hannah M L Young, Daniel S March, Matthew P M Graham-Brown, Arwel W Jones, Ffion Curtis, Charlotte S Grantham, Darren R Churchward, Patrick Highton, Alice C Smith, Sally J Singh, Chris Bridle, James O Burton
Background: Intradialytic cycling (IDC), delivered during haemodialysis (HD), has the potential to improve many health issues. This systematic review and meta-analysis examine the evidence on the effects of IDC on exercise capacity, quality of life (QoL), physical function and cardiovascular health. Methods: Twenty-four databases were searched alongside Internet and hand searching, and consultation with experts. Eligibility criteria were cluster randomized, randomized and quasi-randomized controlled trials (RCTs) of IDC versus usual care in prevalent adult HD patients...
March 28, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29590459/systemic-haemodynamics-in-haemodialysis-intradialytic-changes-and-prognostic-significance
#15
Stefanie Haag, Björn Friedrich, Andreas Peter, Hans-Ulrich Häring, Nils Heyne, Ferruh Artunc
Background: Although haemodialysis (HD) leads to alterations of systemic haemodynamics that can be monitored using dilution methods, there is a lack of data on the diagnostic and prognostic significance of haemodynamic monitoring during routine HD. Methods: In this multicentre study, we measured cardiac index (CI), access flow (AF) and central blood volume index (CBVI) during a single HD session in stable HD patients (n = 215) using the Transonic HD03 monitor (Transonic, Ithaca, NY, USA)...
March 26, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29587288/effect-of-sodium-thiosulfate-on-arterial-stiffness-in-end-stage-renal-disease-patients-undergoing-chronic-hemodialysis-sodium-thiosulfate-hemodialysis-study-a-randomized-controlled-trial
#16
Donlawat Saengpanit, Pairoj Chattranukulchai, Monravee Tumkosit, Monchai Siribumrungwong, Pisut Katavetin, Visith Sitprija, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Paweena Susantitaphong
BACKGROUND: Arterial stiffness (AS) and vascular calcification are significantly related to a high cardiovascular mortality risk in hemodialysis (HD) patients. Intravenous sodium thiosulfate (IV STS) can prevent and delay the vascular calcification progression in uremic states; however, the STS effect on AS has not been assessed. This study aimed to evaluate the STS efficacy on vascular calcification and AS in HD patients. METHODS: Fifty HD patients with abnormal AS, as measured via the cardio-ankle vascular index (CAVI ≥8), were prospectively randomized to open-label 12...
March 23, 2018: Nephron
https://www.readbyqxmd.com/read/29584458/the-effect-of-an-l-n-type-calcium-channel-blocker-on-intradialytic-blood-pressure-in-intradialytic-hypertensive-patients
#17
Takayasu Ito, Naoki Fujimoto, Eiji Ishikawa, Kaoru Dohi, Mika Fujimoto, Tomohiro Murata, Michiyo Kiyohara, Hideyuki Takeuchi, Sukenari Koyabu, Hiroyuki Nishimura, Toshiaki Takeuchi, Masaaki Ito
BACKGROUND: Intradialytic hypertension (HTN), which is one of the poor prognostic markers in patients undergoing hemodialysis, may be associated with sympathetic overactivity. The L/N-type calcium channel blocker, cilnidipine, has been reported to suppress sympathetic nerves activity in vivo. Therefore, we hypothesized that cilnidipine could attenuate intradialytic systolic blood pressure (SBP) elevation. METHODS: Fifty-one patients on chronic hemodialysis who had intradialytic-HTN (SBP elevation ≥10 mmHg during hemodialysis) and no fluid overload were prospectively randomized into two groups: control and cilnidipine groups...
March 27, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29581966/impaired-gut-epithelial-tight-junction-expression-in-hemodialysis-patients-complicated-with-intradialytic-hypotension
#18
Tsai-Kun Wu, Paik-Seong Lim, Jong-Shiaw Jin, Ming-Ying Wu, Chang-Hsu Chen
Background: There is accumulating evidence pointing to uremia-induced impairment of the intestinal epithelial barrier structure in advanced chronic kidney disease (CKD) and hemodialysis (HD) patients. In this study, the impact of intradialytic hypotension on intestinal barrier integrity is being explored. Methods: Immunohistochemical staining was used to detect the expression of 4 types of tight junction (TJ) proteins such as occludin, zonula occludens-1 (ZO-1), claudin-1, and claudin-4, in colonic samples of a group of patients receiving segmental colectomy...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29544387/a-case-series-of-favorable-vessel-dilatation-using-a-nitinol-scoring-element-equipped-helical-balloon-catheter-angiosculpt%C3%A2
#19
Ryo Sato, Tetsuhiko Sato, Yuichi Shirasawa, Chika Kondo, Masao Tadakoshi, Michio Fukuda, Nobuyuki Ohte, Kunio Morozumi
OBJECTIVE: Although percutaneous transluminal angioplasty is an effective therapy against vascular access failure in hemodialysis patients, recurrent stenosis imposes enormous burden for hemodialysis patients. A nitinol scoring element-equipped helical balloon catheter (AngioSculpt® ) has been altered the landscape for treating several vascular diseases. It is not, however, fully elucidated whether AngioSculpt for advanced vascular access stenosis, difficult to expand by conventional balloons, successfully provides bailout angioplasty...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29530855/elimination-of-doripenem-during-dialysis-and-pharmacokinetic-evaluation-of-post-hemodialytic-dosing-in-intermittent-renal-replacement-therapy
#20
M G Vossen, L Ehmann, S Pferschy, A Maier-Salamon, M Haidinger, C Weiser, J M Wenisch, K Saria, C Kajahn, S Jilch, R Lemmerer, M Bécède, M Zeitlinger, C Kloft, W Jäger, F Thalhammer
OBJECTIVES: Doripenem is a broad-spectrum parenteral carbapenem with enhanced activity against Pseudomonas aeruginosa and Enterobacteriaceae. Current dosing regimens recommend the administration of 0.25-0.5 g once daily in patients undergoing intermittent renal replacement therapy. As patients are usually dialyzed thrice weekly, we aimed to investigate a 1-g post-hemodialysis regimen, thus reducing treatment costs and enhancing patient compliance. A second objective of this trial was to describe the pharmacokinetics of intradialytic doripenem...
March 12, 2018: Antimicrobial Agents and Chemotherapy
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