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https://www.readbyqxmd.com/read/28074773/low-dose-dialysis-combined-with-low-protein-intake-can-maintain-nitrogen-balance-in-peritoneal-dialysis-patients-in-poor-economies%C3%A2
#1
Chun-Yan Su, Tao Wang, Xin-Hong Lu, Sha Ma, Wen Tang, Pei-Yu Wang
OBJECTIVE: Due to limited economic conditions, we tried to provide "fitted" dialysis doses instead of the doses recommended by the international guidelines to the individual patients. In the present cross-sectional study, we studied the dialysis adequacy and nutritional status of 5 peritoneal dialysis patients who had a low dialysis dose (2 bags, 4,000 mL/day). METHODS: The 3-day dietary records were reviewed to calculate patients' energy, protein, and nitrogen intake (NI)...
January 11, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28074616/is-hemodialysis-patient-survival-dependent-upon-small-solute-clearance-kt-v-if-so-how-can-kt-v-be-adjusted-to-prevent-under-dialysis-in-vulnerable-groups
#2
Andrew Davenport
Small solute clearance achieved during a single hemodialysis session has been traditionally evaluated by urea clearance, normalized for total body water (Kt/Vurea) for more than 30 years. By consensus, the target sessional KtVurea for thrice weekly treatments has been increased from 0.9 to 1.2 over the years. Although this is supported by observational studies, there is a fundamental lack of prospective studies to support this threshold target. In clinical practice achieving sessional Kt/Vurea targets are most closely followed in the US...
January 11, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28062678/facility-practice-variation-to-help-understand-the-effects-of-public-policy-insights-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#3
Douglas S Fuller, Bruce M Robinson
Recent Centers for Medicare & Medicaid Services policies have used dialysis facility practice variation to develop public ratings and adjust payments. In the Dialysis Facility Compare star rating system (DFC SRS), facility-relative rates of performance-based clinical measures varied nearly two-fold for mortality (standardized mortality ratio; 10th/90th percentiles: 0.71, 1.34) and hospitalization (standardized hospitalization ratio; 10th/90th percentiles: 0.64, 1.37), and nearly four-fold for transfusion (standardized transfusion ratio; 10th/90th percentiles: 0...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28058668/impact-of-gender-and-dialysis-adequacy-on-anaemia-in-peritoneal-dialysis
#4
Alicja Ryta, Michal Chmielewski, Alicja Debska-Slizien, Piotr Jagodzinski, Malgorzata Sikorska-Wisniewska, Monika Lichodziejewska-Niemierko
PURPOSE: In the general population, haemoglobin (Hb) concentration is higher in men than in women. However, target Hb levels in dialysis patients are set constant regardless of the patient's sex. The aim of this study was to evaluate Hb concentration and the use of erythropoiesis-stimulating agents (ESA) in peritoneal dialysis (PD) patients taking gender and dialysis adequacy into account. METHODS: The study comprised two parts. The first was a cross-sectional analysis of Hb and ESA in 2180 prevalent PD patients...
January 5, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28046068/relationship-between-hemoglobin-levels-corrected-by-interdialytic-weight-gain-and-mortality-in-japanese-hemodialysis-patients-miyazaki-dialysis-cohort-study
#5
Tatsunori Toida, Takashi Iwakiri, Yuji Sato, Hiroyuki Komatsu, Kazuo Kitamura, Shouichi Fujimoto
BACKGROUND: Although hemoglobin (Hb) levels are affected by a change in the body fluid status, the relationship between Hb levels and mortality while taking interdialytic weight gain (IDWG) at blood sampling into account has not yet been examined in hemodialysis patients. STUDY DESIGN: Cohort study. SETTING, PARTICIPANTS: Data from the Miyazaki Dialysis cohort study, including 1375 prevalent hemodialysis patients (median age (interquartile range), 69 (60-77) years, 42...
2017: PloS One
https://www.readbyqxmd.com/read/27991478/hemodialysis-delivery-dialysis-dose-achievement-and-vascular-access-types-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcomes-and-practice-patterns-study-phase-5-2012-2015
#6
Anas AlYousef, Sumaya AlGhareeb, Jamal Al Wakeel, Saeed M G Al-Ghamdi, Brian A Bieber, Mohamad Hassan, Yacoub Al Maimani, Naser Alkandari, Haroun Z Ahmed, Ashraf Fawzy, Ronald L Pisoni
The prospective observational Dialysis Outcomes and Practice Patterns Study (DOPPS) was initiated in late 2012 in national samples of hemodialysis (HD) units (n = 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For many years, guidelines have recommended single pool Kt/V ≥1.2 as the minimum adequate dose for chronic HD patients. Here, we report initial DOPPS results regarding HD practices related to dialysis dose achievement in the GCC...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27957414/current-characteristics-of-dialysis-therapy-in-korea-2015-registry-data-focusing-on-elderly-patients
#7
REVIEW
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park
Because of increases in the elderly population and diabetic patients, the proportion of elderly among dialysis patients has rapidly increased during the last decades. The mortality and morbidity of these elderly dialysis patients are obviously much higher than those of young patients, but large analytic studies about elderly dialysis patients' characteristics have rarely been published. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an Internet online registry program and analyzed the characteristics...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27951575/clearance-gap-does-it-really-matter-for-the-evaluation-of-vascular-access-function
#8
Jun-Ichi Ono, Yujiro Shiraga, Fumika Yoshikawa, Yoshisuke Haruna, Tamaki Sasaki, Seiichi Mochizuki
BACKGROUNDS: Vascular access (VA) stenosis increases the risk of VA obstruction due to the gradual progress of intimal thickening. Therefore, we should try to detect VA stenosis early. However, we do not have a cutoff for when a difference between prescribed Kt/V and delivered Kt/V reflects a clinical issue. Thus, we have devised a new index, the 'clearance gap' (CL-Gap), which quantifies the difference between the effective clearance (eCL) of a hemodialysis (HD) patient and the theoretical clearance (tCL) of a dialyzer to detect a decrease in dialysis efficiency due to VA dysfunction...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951574/clinical-performance-assessment-of-cordiax-filters-in-hemodialysis-and-hemodiafiltration
#9
Jacky Potier, Sudhir Bowry, Bernard Canaud
In this study, we evaluate the in vivo clinical performances of CorDiax FX 100 and CorDiax FX 1000 filters incorporating a high-flux membrane (Helixone Plus) designed for use in high-flux hemodialysis (HD) as well as in hemodiafiltration (HDF) in 6 stable end-stage kidney disease patients. In the HDF mode, various substitution modalities (post-, pre-, and mixed) were compared. In addition to conventional markers of efficacy of dialysis dose (urea, ionic dialysance, Kt/V), several additional middle- and large-size solute (β2-microglobulin, myoglobin, serum-free light-chain kappa and lambda, α1-microglobulin, and FGF23) compounds were explored in order to cover the spectrum of uremic toxins that are involved in uremia...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951568/the-clear-space-index
#10
Akihiro C Yamashita
BACKGROUND: Kt/V for urea (Kt/V) is a dimensionless clinical index of dialysis dose; however, it does not directly reflect the removal capacity of the solute. Since the total amount of solute removal, M, is directly proportional to the initial solute concentration CB(0), it is reasonable to introduce an index by dividing M by CB(0). This index was termed 'clear space' (CS) because it was later found that it reflects the body fluid volume, the concentration of which becomes zero by the treatment...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27932118/relationship-between-vitamin-d-blood-levels-and-cancer-development-in-renal-transplant-patients-a-case-control-study
#11
J Ugalde-Altamirano, D Álvarez Villegas, I Revuelta, A Coloma, J-V Torregrosa
BACKGROUND: Malignancy is one of the most common long-term complications in renal transplant patients, often related to immunosuppressive treatment although other factors could be considered. Vitamin D plays an important role in reducing cancer risk. After kidney transplantation (KT), 25-hydroxyvitamin D (25OH-D, or calcidiol) insufficiency concerns >85%. The main aim of the present study was to determine the relationship between calcidiol blood levels and cancer development in KT recipients...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932098/urinary-clara-cell-protein-in-kidney-transplant-patients-a-preliminary-study
#12
P M García-García, E Martín-Izquierdo, C M-F de Basoa, A Jarque-López, G Pérez-Suárez, A Rivero-González, J M González-Posadas, M Macía-Heras, V M García-Nieto, J F Navarro-Gónzález
OBJECTIVE: The aim of this exploratory study was to analyze the urinary excretion of Clara cell protein (CC16), a new marker of proximal tubular dysfunction (PTD), in kidney transplantation (KT). MATERIALS AND METHODS: Urinary concentrations of CC16, β2-microglobulin (β2m), and N-acetyl-glucosaminidase (NAG) were measured in 50 KT patients (72% men; mean age 50.4 ± 12.4 years; diabetes in 24%; duration of KT 4.3 ± 3.1 years) and 10 healthy controls (6 men; mean age 33...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27903996/survival-of-patients-on-hemodialysis-and-predictors-of-mortality-a-single-centre-analysis-of-time-dependent-factors
#13
Shahrzad Ossareh, Farhat Farrokhi, Marjan Zebarjadi
INTRODUCTION: This study aimed to evaluate the outcome and predictors of survival in hemodialysis patients of Hasheminejad Kidney Center where a comprehensive dialysis care program has been placed since 2004. MATERIALS AND METHODS: Data of 560 hemodialysis patients were used to evaluate 9-year survival rates and predictors of mortality. Cox regression models included comorbidities as well as averaged and 6-month-averaged time-dependent values of laboratory findings as independent factors...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27896236/the-effect-of-bcaa-and-iso-whey-oral-nutritional-supplements-on-dialysis-adequacy
#14
Effat Afaghi, Ali Tayebi, Abbas Ebadi, Vahid Sobhani, Behzad Einollahi, Mehdi Tayebi
BACKGROUND: Protein-energy malnutrition is a common problem in hemodialysis patients and has different outcomes such as reduced quality of life, longer hospitalization time, lower dialysis adequacy, and higher mortality rate. Investigation of dialysis adequacy is an important method for assessing hemodialysis patients, and improving the dialysis adequacy is an important healthcare team goal. OBJECTIVES: The present study aims to investigate and compare the effects of BCAA and ISO-WHEY oral nutritional supplements on dialysis adequacy...
November 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27884553/atlas-of-systematic-variation-in-renal-replacement-therapy-in-catalonia-2002-2012
#15
Cristian Tebé Condomí, Emma Arcos, Jordi Comas, Mireia Espallargues, Joan M V Pons, Joan M Díaz, Jaume Tort, Alberto Martinez-Castelao
INTRODUCTION: Variations in the use of healthcare services can be defined as systematic variations of adjusted rates for certain aggregation levels of the population. The study analyses how renal replacement therapy (RRT) is used, identifying RRT variability in Catalonia from 2002 to 2012. MATERIAL AND METHODS: Ecological study by health area using data from the Catalan renal registry. We present incident rates, standardised incidence ratios and prevalence, while variability was calculated through direct and indirect standardisation methods...
November 21, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27884309/would-prescribing-target-kt-dose-adjusted-for-body-surface-area-improve-hemodialysis-outcomes
#16
Ken Farrington, Andrew Davenport
The use of Kt/V to prescribe and monitor hemodialysis adequacy remains the current standard, although it is increasingly questioned. Alternative proposals for dose prescription and monitoring have been advocated. In a noninterventional, prospective study reported in this issue, Maduell et al., utilizing online ionic dialysance, explore the association between outcome measures (mortality and hospitalization rates) and the extent to which delivered Kt dose achieved minimal target Kt doses calculated from individual estimates of body surface area...
December 2016: Kidney International
https://www.readbyqxmd.com/read/27872835/six-end-stage-renal-disease-patients-benefited-from-first-non-simultaneous-single-center-6-way-kidney-exchange-transplantation-in-india
#17
Vivek B Kute, Himanshu V Patel, Umesh T Varyani, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Priya S Shah, Pavan S Wakhare, Vijay A Ghodela, Saiprasad G Shinde, Varsha B Trivedi, Minaxi H Patel, Hargovind L Trivedi
AIM: To avoid desensitization protocols and ABO incompatible kidney transplantation (KT) due to high costs and increased risk of infections from intense immunosuppression. METHODS: We present institutional ethical review board - approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility (n = 1); positive cross-match and/or presence of donor specific antibody (n = 5). The average time required from registration in kidney paired donation (KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27866993/micrornas-223-3p-and-93-5p-in-patients-with-chronic-kidney-disease-before-and-after-renal-transplantation
#18
M Ulbing, A H Kirsch, B Leber, S Lemesch, J Münzker, N Schweighofer, D Hofer, O Trummer, A R Rosenkranz, H Müller, K Eller, V Stadlbauer, B Obermayer-Pietsch
Chronic kidney disease (CKD) is associated with a multifactorial dysregulation of bone and vascular calcification and closely linked to increased cardiovascular mortality and concomitant bone disease. We aimed to investigate specific microRNA (miRNA) signatures in CKD patients to find indicators for vascular calcification and/or bone mineralization changes during CKD and after kidney transplantation (KT). A miRNA array was used to investigate serum miRNA profiles in CKD patients, then selected miRNAs were quantified in a validation cohort comprising 73 patients in CKD stages 3 to 5, 67 CKD patients after KT, and 36 healthy controls...
November 17, 2016: Bone
https://www.readbyqxmd.com/read/27857008/-the-effect-of-dialysate-flow-rate-on-dialysis-adequacy-and-fatigue-in-hemodialysis-patients
#19
Sun Mi Cha, Hye Sook Min
PURPOSE: In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis. METHODS: This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant's own blood flow, 500 mL/min, and 700 mL/min...
October 2016: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/27831920/joint-model-for-mortality-and-hospitalization
#20
Yuqi Chen, Wensheng Guo, Peter Kotanko, Len Usvyat, Yuedong Wang
Modeling hospitalization is complicated because the follow-up time can be censored due to death. In this paper, we propose a shared frailty joint model for survival time and hospitalization. A random effect semi-parametric proportional hazard model is assumed for the survival time and conditional on the follow-up time, hospital admissions or total length of stay is modeled by a generalized linear model with a nonparametric offset function of the follow-up time. We assume that the hospitalization and the survival time are correlated through a latent subject-specific random frailty...
November 1, 2016: International Journal of Biostatistics
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