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https://www.readbyqxmd.com/read/29340317/intradialytic-cognitive-and-exercise-training-may-preserve-cognitive-function
#1
Mara A McAdams-DeMarco, Jonathan Konel, Fatima Warsame, Hao Ying, Marlís González Fernández, Michelle C Carlson, Derek M Fine, Lawrence J Appel, Dorry L Segev
Introduction: Cognitive decline is common and increases mortality risk in hemodialysis patients. Intradialytic interventions like cognitive training (CT) and exercise training (ET) may preserve cognitive function. Methods: We conducted a pilot randomized controlled trial of 20 hemodialysis patients to study the impact of 3 months of intradialytic CT (tablet-based brain games) (n = 7), ET (foot peddlers) (n = 6), or standard of care (SC) (n = 7) on cognitive function...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29329515/engaging-clinicians-and-patients-to-assess-and-improve-frailty-measurement-in-adults-with-end-stage-renal-disease
#2
Sarah Van Pilsum Rasmussen, Jonathan Konel, Fatima Warsame, Hao Ying, Brian Buta, Christine Haugen, Elizabeth King, Sandra DiBrito, Ravi Varadhan, Leocadio Rodríguez-Mañas, Jeremy D Walston, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: The Fried frailty phenotype, a measure of physiologic reserve defined by 5 components (exhaustion, unintentional weight loss, low physical activity, slow walking speed, and poor grip strength), is associated with poor outcomes among ESRD patients. However, these 5 components may not fully capture physiologic reserve in this population. We aimed to ascertain opinions of ESRD clinicians and patients about the usefulness of the Fried frailty phenotype and interventions to improve frailty in ESRD patients, and to identify novel components to further characterize frailty in ESRD...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29273022/on-line-hemodiafiltration-did-not-induce-an-overproduction-of-oxidative-stress-and-inflammatory-cytokines-in-intensive-care-unit-acute-kidney-injury
#3
Kada Klouche, Laurent Amigues, Marion Morena, Vincent Brunot, Anne Marie Dupuy, Audrey Jaussent, Marie Christine Picot, Noémie Besnard, Delphine Daubin, Jean Paul Cristol
BACKGROUND: Though on-line intermittent hemodiafiltration (OL-IHDF) is a routine therapy for chronic dialysis patients, it is not yet widespread used in critically ill patients. This study was undergone to evaluate efficiency and tolerance of OL-IHDF and to appreciate inflammatory consequences of its use in intensive care unit (ICU)-acute kidney injury (AKI) patients. METHODS: In this prospective cohort study conducted in a medical academic ICU in France, 30 AKI patients who underwent OL-IHDF were included...
December 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29230952/children-tolerate-intradialytic-oral-nutrition
#4
Andrew M South, Bonnie Fainman, Scott M Sutherland, Cynthia J Wong
BACKGROUND: People undergoing haemodialysis (HD) often have poor nutrition, which in turn can contribute to worse outcomes. Inadequate nutrition has a particularly deleterious effect on growth and neurocognitive development, as well as mortality, in children and adolescents. Nutritional supplementation can improve outcomes but can be difficult to administer. OBJECTIVE: Determine the tolerability of intradialytic oral nutrition in children and adolescents. DESIGN: A cross-sectional quality improvement study in an outpatient paediatric HD unit...
December 12, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/29227585/effect-of-ultrafiltration-on-placental-fetal-blood-flow-in-pregnancy-of-woman-undergoing-chronic-hemodialysis
#5
Luiz Paulo José Marques, Paulo Roberto Silva Marinho, Regina Rocco, Caroline de Azevedo Martins, Henrique Novo Costa Pereira, Ana Clara Lopes Barbosa Ferreira
INTRODUCTION: Patient who was undergoing hemodialysis (HD) thrice weekly usually gain 1 to 4 kg of weight in interdialytic period, mainly due to fluid accumulation by ingestion of water. Ultrafiltration (UF) during HD will be need to remove fluid excess to avoid severe medical complications secondary to fluid overload. However, in pregnant woman UF can increase the episodes of intradialytic hypotension which may lead to placental ischemic injury and predispose to fetal distress. There is little information about safe fluid amount withdrawn by UF during pregnancy...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29225811/regular-exercise-during-haemodialysis-promotes-an-anti-inflammatory-leucocyte-profile
#6
Maurice Dungey, Hannah M L Young, Darren R Churchward, James O Burton, Alice C Smith, Nicolette C Bishop
Background: Cardiovascular disease is the most common cause of mortality in haemodialysis (HD) patients and is highly predicted by markers of chronic inflammation. Regular exercise may have beneficial anti-inflammatory effects, but this is unclear in HD patients. This study assessed the effect of regular intradialytic exercise on soluble inflammatory factors and inflammatory leucocyte phenotypes. Methods: Twenty-two HD patients from a centre where intradialytic cycling was offered thrice weekly and 16 HD patients receiving usual care volunteered...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29221626/effects-of-oral-nutritional-supplements-on-mortality-missed-dialysis-treatments-and-nutritional-markers-in-hemodialysis-patients
#7
Debbie Benner, Steven M Brunelli, Becky Brosch, Jane Wheeler, Allen R Nissenson
OBJECTIVE: Protein-energy wasting is common in end-stage renal disease patients undergoing dialysis and is strongly associated with mortality and adverse outcomes. Intradialytic oral nutritional supplements (ONS) reduce risk of mortality in these patients. Large studies characterizing the impact of ONS on other outcomes are lacking. We assessed the associations between administration of ONS and clinical and nutritional outcomes. DESIGN: Retrospective evaluation of a pilot program providing ONS to patients at a large dialysis organization in the United States...
December 5, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29214739/evaluation-of-intradialytic-hypertension-using-bioelectrical-impedance-combined-with-echocardiography-in-maintenance-hemodialysis-patients
#8
Hongqi Ren, Dehua Gong, Xu He, Fengyu Jia, Qunpeng He, Bin Xu, Zhihong Liu
Although intra-dialytic hypertension (IDH) has been noted in clinical settings for many years, its pathogenesis remains unclear. In this cross-sectional study, we analyzed IDH incidence in our center and the correlation between postdialysis volume state and IDH. One hundred thirty-one maintenance hemodialysis (MHD) patients were enrolled in our study, and bioelectrical impedance (BIA) and echocardiography (ECG) were recorded. In addition, demographic data were collected, and laboratory examinations were conducted...
December 7, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29186549/intradialytic-hypertension-is-associated-with-low-intradialytic-arterial-oxygen-saturation
#9
Anna Meyring-Wösten, Ya Luo, Hanjie Zhang, Priscila Preciado, Stephan Thijssen, Yuedong Wang, Peter Kotanko
Background: The pathophysiology of a paradoxical systolic blood pressure (SBP) rise during hemodialysis (HD) is not yet fully understood. Recent research indicated that 10% of chronic HD patients suffer from prolonged intradialytic hypoxemia. Since hypoxemia induces a sympathetic response we entertained the hypothesis that peridialytic SBP change is associated with arterial oxygen saturation (SaO 2 ). Methods: We retrospectively analyzed intradialytic SaO 2 and peridialytic SBP change in chronic HD patients with arteriovenous vascular access...
November 24, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29166634/sodium-prescription-in-the-prevention-of-intradialytic-hypotension-new-insights-into-an-old-concept
#10
Gabriele Donati, Mauro Ursino, Alessandra Spazzoli, Nicolò Natali, Roberto Schillaci, Diletta Conte, Andrea Angeletti, Anna Laura Croci Chiocchini, Irene Capelli, Olga Baraldi, Gaetano La Manna
BACKGROUND: Sodium prescription in patients with intradialytic hypotension remains a challenge for the attending nephrologist, as it increases dialysate conductivity in hypotension-prone patients, thereby adding to dietary sodium levels. METHODS: New sodium prescription strategies are now available, including the use of a mathematical model to compute the sodium mass to be removed during dialysis as a physiological controller. RESULTS: This review describes the sodium load of patients with end-stage renal disease on chronic hemodialysis (HD) and discusses 2 strategies to remove excess sodium in patients prone to intradialytic hypotension, namely, Profiled HD and the hemodiafiltration Aequilibrium System...
November 23, 2017: Blood Purification
https://www.readbyqxmd.com/read/29165964/preventing-intradialytic-hypotension-translating-evidence-into-practice
#11
Wendi Bradshaw, Paul N Bennett, Cherene Ockerby, Alison M Hutchinson, Peter G Kerr
Intradialytic hypotension (IDH) remains the most frequent severe side effect of hemodialysis. This prospective, exploratory study aimed to measure the compliance of an IDH prevention pathway and to identify the effects of pathway use on hypotension incidence. Additionally, the study explored barriers and facilitators to pathway implementation in five hemodialysis centers. Instituting an ultrafiltration pause decreased the odds of hypotensive episodes by 44% (OR = 0.56, 95% CI = 0.20 to 1.56, χ2 1 = 1.25, p = 0...
March 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29158062/effect-of-change-in-fluid-status-evaluated-by-bioimpedance-techniques-on-body-composition-in-hemodialysis-patients
#12
Samer R Abbas, Stephan Thijssen, Erik L Penne, Jochen G Raimann, Li Liu, Murat H Sipahioglu, Eric Seibert, Yuedong Wang, Yuqi Chen, Qingqing Xiao, Nathan W Levin, Peter Kotanko, Fansan Zhu
OBJECTIVE: This prospective study uses calf bioimpedance spectroscopy (cBIS) to guide the attainment of dry weight (DWcBIS) in chronic hemodialysis (HD) patients. The primary aim of this study was to evaluate whether body composition is altered when fluid status is reduced to DWcBIS. METHODS: Target post-HD weight was gradually reduced from baseline (BL) until DWcBIS was achieved. DWcBIS was defined as the presence of both flattening of the curve of extracellular resistance and the attainment calf normalized resistivity in the normal range during the dialysis treatment...
November 18, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29148094/acid-base-alterations-in-esrd-and-effects-of-hemodialysis
#13
REVIEW
Qi Qian
Acid-base alterations in patients with kidney failure and on hemodialysis (HD) treatment contribute to (1) intradialytic hypercapnia and hypoxia, (2) hemodynamic instability and cardiac arrhythmia, (3) systemic inflammation, and (4) a number of associated electrolyte alterations including potentiating effects of hypokalemia, hypocalcemia and, chronically, soft-tissue and vascular calcification, imparting poor prognosis and mortality. This paper discusses acid-base regulation and pathogenesis of dysregulation in patients with kidney failure...
November 16, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29142968/the-effect-of-renal-function-and-hemodialysis-treatment-on-plasma-vasopressin-and-copeptin-levels
#14
Esmée M Ettema, Judith Heida, Niek F Casteleijn, Lianne Boesten, Ralf Westerhuis, Carlo A J M Gaillard, Ron T Gansevoort, Casper F M Franssen, Debbie Zittema
Introduction: Copeptin is increasingly used in epidemiological studies as a substitute for vasopressin. The effect of renal function per se on copeptin and vasopressin concentrations as well as their ratio have, however, not been well described. Methods: Copeptin and vasopressin levels were measured in 127 patients with various stages of chronic kidney disease, including 42 hemodialysis patients and 16 healthy participants in this observational study. Linear (segmental) regression analyses were performed to assess the association between renal function and copeptin, vasopressin and the C/V ratio...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29134614/acute-exercise-during-hemodialysis-prevents-the-decrease-in-natural-killer-cells-in-patients-with-chronic-kidney-disease-a-pilot-study
#15
Maria Isabel Fuhro, Gilson P Dorneles, Francini P Andrade, Pedro R T Romão, Alessandra Peres, Mariane B Monteiro
PURPOSE: To evaluate the acute response of natural killer (NK) cell subsets of chronic kidney disease patients submitted to intradialytic exercise in a randomized crossover study. METHODS: Nine patients were submitted to a single bout of 20-min intradialytic exercise and a control hemodialysis (HD) session with an interval of 7 days between them. Peripheral blood sample was collected at baseline, during HD and immediately after HD in each trial to evaluate the peripheral frequency of NK cells and their subsets (CD3-CD56(bright) and CD3-CD56(dim)), systemic cortisol concentrations, C-reactive protein (CRP), creatine kinase activity (CK), and urea and creatinine levels...
November 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29133076/comparison-of-the-hemodynamic-tolerance-and-the-biological-parameters-of-four-acetate-free-hemodialysis-methods
#16
George Kosmadakis, Enrique Da Costa Correia, Julie Albaret, Frédéric Somda, Didier Aguilera
PURPOSE: Acetate in hemodialysis solutions exerts inflammatory, vasodilatatory and cardio-depressive effects. Citrate has been proposed as an optimal substitute. The aim of the present trial was the comparison of the hemodynamic and biological parameters on a group of patients dialysed consecutively with 4 acetate-free haemodialysis techniques. METHODS: In a prospective crossover manner, we measured the hemodynamic and biological effects of four acetate-free hemodialysis methods: he acetate-free biofiltration with variable potassium (AFBK) and three methods with a citrate buffer: onventional hemodialysis (HD), on-line hemodiafiltration (HDF) and on-line hemofiltration (HF)...
November 10, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29132056/central-venous-pressure-and-ultrasonographic-measurement-correlation-and-their-associations-with-intradialytic-adverse-events-in-hospitalized-patients-a-prospective-observational-study
#17
Hiroshi Sekiguchi, Luke A Seaburg, Jun Suzuki, Walter J Astorne, Anil S Patel, A Scott Keller, Ognjen Gajic, Kianoush B Kashani
PURPOSE: To investigate correlation of central venous pressure (CVP) with ultrasonographic measurement of central veins, along with association between these variables and occurrence of intradialytic adverse events in hospitalized patients. MATERIALS AND METHODS: Patients requiring hemodialysis via dialysis catheter were prospectively enrolled. CVP measurements through catheter, internal jugular vein aspect ratio, subclavian vein collapsibility, inferior vena cava (IVC) maximal diameter, and IVC collapsibility were recorded before and after hemodialysis...
October 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29126841/-exercise-as-a-protective-cardiovascular-and-metabolic-factor-in-end-stage-renal-disease-patients
#18
Myriam Isnard-Rouchon, Céline Coutard
OBJECTIVE: The aim of the study was to test the effectiveness of Physical Activity (PA) during haemodialysis as a protective treatment against cardiovascular (CV) diseases. METHODS: Eighty volunteer patients were included in this multicentric prospective study and followed for two years: 40 patients in the Exercise group (EX), 40 patients in the Control group (Ctrl). CV risk factors: Total Cholesterol, HDL Cholesterol (HDL-c), LDL cholesterol (LDL-c), Triglycerides (TG) and Hemoglobin (Hb), and Prealbumin, Albumin, Parathormon, 25-OH Vitamin D, were checked at Month 0 (M0) and Month 24 (M24)...
November 7, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29126178/the-impact-of-intradialytic-pedaling-exercise-on-arterial-stiffness-a-pilot-randomized-controlled-trial-in-a-hemodialysis-population
#19
Alexandra B Cooke, Vincent Ta, Sameena Iqbal, Yessica-Haydee Gomez, Thomas Mavrakanas, Paul Barré, Murray Vasilevsky, Elham Rahme, Stella S Daskalopoulou
Objectives: Regular exercise is known to reduce arterial stiffness (AS) in hemodialysis patients. However, the impact of a more realistic intradialytic form of exercise, such as pedaling, is unclear. We aimed to examine 1) the effect of intradialytic pedaling exercise on AS over 4 months, and 2) the longer-term effect of pedaling on AS 4 months after exercise cessation. Methods: Patients on stable in-center hemodialysis (3x/week) were randomly assigned 1:1 to either intradialytic pedaling exercise (EX) or to a control group receiving usual hemodialysis (nonEX) for 4 months...
November 6, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29124988/extracorporeal-elimination-of-butalbital-in-acute-aspirin-butalbital-caffeine-codeine-fiorinal-with-codeine-poisoning
#20
Janelle O Poyant, Robert Albright, Jeremy Clain, Govind Pandompatam, Erin F Barreto
BACKGROUND: Butalbital is a small molecule (approximately 220 Da), with 26% protein binding, a 0.8 L/kg volume of distribution, and is eliminated nearly 80% unchanged in the urine. Although hemodialysis has been used to treat overdoses of other barbiturates, the extracorporeal clearance of butalbital is unknown. The objective of this case is to describe the use of extracorporeal therapy to augment elimination of butalbital after an overdose of aspirin 325 mg-butalbital 50 mg-caffeine 40 mg with codeine 30 mg (Fiorinal with Codeine)...
November 10, 2017: Clinical Toxicology
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