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https://www.readbyqxmd.com/read/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#1
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28754014/through-the-patients-eyes-the-experience-of-end-stage-renal-disease-patients-concerning-the-provided-nursing-care
#2
Areti Stavropoulou, Maria G Grammatikopoulou, Michail Rovithis, Konstantina Kyriakidi, Andriani Pylarinou, Anastasia G Markaki
Chronic kidney disease is a condition that affects both the physical and mental abilities of patients. Nursing care is of pivotal importance, in particular when end-stage renal disease (ESRD) patients are concerned, since the quality of the provided care may severely influence the patient's quality of life. This is why it is important to explore patient experiences concerning the rendered care. However, limited up-to-date studies have addressed this issue. The aim of the present study was to stress the experiences of ESRD patients concerning the provided nursing care in the hemodialysis unit at the University Hospital in Heraklion, Crete...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28716035/systematic-evaluation-of-characteristics-of-the-membrane-based-fed-batch-shake-flask
#3
P Philip, K Meier, D Kern, J Goldmanns, F Stockmeier, C Bähr, J Büchs
BACKGROUND: The initial part of process development involves extensive screening programs to identify optimal biological systems and cultivation conditions. For a successful scale-up, the operation mode on screening and production scale must be as close as possible. To enable screening under fed-batch conditions, the membrane-based fed-batch shake flask was developed. It is a shake flask mounted with a central feed reservoir with an integrated rotating membrane tip for a controlled substrate release...
July 17, 2017: Microbial Cell Factories
https://www.readbyqxmd.com/read/28653946/the-truth-on-current-peritoneal-dialysis-state-of-the-art
#4
R T Krediet, A C Abrahams, C W H de Fijter, M G H Betjes, W H Boer, B C van Jaarsveld, C J A M Konings, F W Dekker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased markedly in the Netherlands in the last 15 years. Consequently, the knowledge of nephrologists and nursing staff on PD has declined leading to a negative spiral in which loss of experience resulted in loss of enthusiasm to offer PD to patients and also in less interest in the new PD developments. All these changes took place while the results of PD improved and patient survival was at least similar to that on haemodialysis...
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28644050/hba1c-analysis-by-capillary-electrophoresis-comparison-with-chromatography-and-an-immunological-method
#5
Olav Klingenberg, Torill Furuset, Camilla R Hestbråten, Marit H Hallberg, Astrid Steiro, Iren R Orset, Jens P Berg
BACKGROUND: Haemoglobin A1c (HbA1c) has become an even more important analyte for clinical laboratories during recent years with the introduction of its diagnostic use for diabetes mellitus. Several different analytical principles can be used, each with their advantages and disadvantages. AIM: We wanted to compare Sebia Capillarys 2 Flex Piercing (Capillarys) with our routine HbA1c methods, which were an HPLC method (Tosoh G7) and an immunoassay (Tina-Quant on Roche Modular P) by analysing a large clinical material...
June 23, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28635159/nutrition-in-renal-supportive-care-patient-driven-and-flexible
#6
REVIEW
Jessica Stevenson, Anthony Meade, Ann-Maree Randall, Karen Manley, Stephanie Notaras, Susan Heaney, Maria Chan, Alison Smyth, Elizabeth Josland, Frank Brennan, Mark A Brown
Renal Supportive Care is an alternative treatment pathway in advanced Chronic Kidney Disease (CKD) that is being increasingly adopted, particularly in the elderly. RSC utilises principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognised component of care, and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of RSC are met...
June 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#7
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28612895/preemptive-kidney-transplantation-an-ethical-challenge-for-organ-allocation-policies
#8
C Petrini
Preemptive transplants are advisable in advanced stages of kidney disease. The clinical advantages of preemptive transplantation over dialysis are evident. Nevertheless, preemptive transplantations raise ethical concerns, particularly regarding the allocation of medical resources. The present article proposes some criteria for organ allocation policies regarding preemptive transplantations: criteria regarding medical benefit and justice are absolutely essential when addressing the issue of organ allocation, but other ethical values should also be taken into account...
May 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28608569/membrane-based-therapeutic-plasma-exchange-mtpe-technical-and-clinical-experience
#9
Casey N Gashti, Daniel C Andreoli, Dipal Patel
Therapeutic plasma exchange (TPE) has long been utilized to manage a variety of immune-mediated diseases. The basic principle relies on removal of circulating pathogenic substances from the bloodstream. Methods of plasma separation include centrifuge (cTPE) and membrane (mTPE). Although mTPE has existed for a few decades, recent advances in developing highly permeable filters that are compatible with currently existing dialysis machines has opened a new frontier. Published data in the area of technical and clinical experience with mTPE is lacking...
June 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28574225/three-stream-bicarbonate-based-hemodialysis-solution-delivery-system-revisited-with-an-emphasis-on-some-aspects-of-acid-base-principles
#10
REVIEW
Susie Q Lew, Orly F Kohn, Yuk-Lun Cheng, Carl M Kjellstrand, Todd S Ing
Hemodialysis patients can acquire buffer base (i.e., bicarbonate and buffer base equivalents of certain organic anions) from the acid and base concentrates of a three-stream, dual-concentrate, bicarbonate-based, dialysis solution delivery machine. The differences between dialysis fluid concentrate systems containing acetic acid versus sodium diacetate in the amount of potential buffering power were reviewed. Any organic anion such as acetate, citrate, or lactate (unless when combined with hydrogen) delivered to the body has the potential of being converted to bicarbonate...
June 2017: Artificial Organs
https://www.readbyqxmd.com/read/28535518/extracorporeal-sorbent-technologies-basic-concepts-and-clinical-application
#11
William R Clark, Fiorenza Ferrari, Gaetano La Manna, Claudio Ronco
Limitations imposed by the characteristics of some solutes and the structure of dialysis membranes have spurred new interest in the use of mechanisms beyond diffusion and convection for extracorporeal solute removal. Sorbents have been utilized for more than 50 years in extracorporeal blood treatments for specific purposes, and better understanding of their basic aspects may further expand the potential for their clinical application. In this chapter, the basic principles applying to sorbents are discussed, including composition and structure, along with the fundamental mechanisms of solute removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28507922/sofosbuvir-use-in-the-setting-of-end-stage-renal-disease-a-single-center-experience
#12
Avin Aggarwal, Eric R Yoo, Ryan B Perumpail, George Cholankeril, Radhika Kumari, Tami J Daugherty, Alex S Lapasaran, Aijaz Ahmed
Background and Aims: Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) who are dialysis-dependent form a unique group, in which safety, tolerability and efficacy of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) need further evaluation. Methods: We performed a retrospective analysis of 14 patients with CHC and ESRD on dialysis who received 15 courses of SOF-based therapy. We evaluated dose escalation to standard-dose SOF in this proof-of-principle experience. Results: Sustained virological response (defined as undetectable viral load at 12 weeks, SVR-12) was achieved in 13 out of the 15 (86...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28488689/effects-of-vitamin-d-or-its-analogues-on-the-mortality-of-patients-with-chronic-kidney-disease-an-updated-systematic-review-and-meta-analysis
#13
REVIEW
R J Lu, S M Zhu, F L Tang, X S Zhu, Z D Fan, G L Wang, Y F Jiang, Y Zhang
The objective of this study was to assess whether vitamin D (VD) treatment alters the overall all-cause and cardiovascular mortalities in a chronic kidney disease (CKD) population. We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials without language restriction, until the publication date of 22 February 2016. All related literatures that compared VD treatment with non-VD treatment and reported the mortality of patients with CKD (including those undergoing dialysis) were identified...
June 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28462878/-vascular-steal-syndrome-due-to-the-creation-of-an-arteriovenous-shunt-for-hemodialysis-patient-information-and-nephrologist-responsibility
#14
Alexandre Seidowsky, Eve Vilaine, Sarah Adoff, Emmanuel Dupuis, Caroline Bidault, Cédric Villain, Raphaël Coscas
Although responsibility is a fundamental determinant in medical practice, physicians are generally unfamiliar with its principles. The same is true for disclosure requirements and requests for compensation in the event of physical injury. We report on a representative survey of iatrogenic complications that may arise after the implementation of vascular access for haemodialysis and that illustrate's the physician's responsibility and obligation to inform the patient. Vascular access steal syndrome is a serious complication of arteriovenous fistulas, and physicians may not be sufficiently aware of the likelihood of its occurrence...
April 24, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28377472/time-to-improve-informed-consent-for-dialysis-an-international-perspective
#15
Frank Brennan, Cameron Stewart, Hannah Burgess, Sara N Davison, Alvin H Moss, Fliss E M Murtagh, Michael Germain, Shelley Tranter, Mark Brown
The literature reveals that current nephrology practice in obtaining informed consent for dialysis falls short of ethical and legal requirements. Meeting these requirements represents a significant challenge, especially because the benefits and risks of dialysis have shifted significantly with the growing number of older, comorbid patients. The importance of informed consent for dialysis is heightened by several concerns, including: (1) the proportion of predialysis patients and patients on dialysis who lack capacity in decision making and (2) whether older, comorbid, and frail patients understand their poor prognosis and the full implications to their independence and functional status of being on dialysis...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28375502/pro-prevention-of-acute-kidney-injury-time-for-teamwork-and-new-biomarkers
#16
REVIEW
Claudio Ronco, Lilia Rizo-Topete, Mara Serrano-Soto, Kianoush Kashani
Acute kidney injury (AKI) is a common condition in critically ill patients. Multiple studies have identified AKI as a strong independent risk factor for higher morbidity and mortality. AKI is often multifactorial, asymptomatic and difficult to predict. In recent years, the discovery of several AKI biomarkers, including the recent validation and approval of cell cycle arrest biomarkers (NephroCheck, Astute Medical, San Diego, CA, USA), has provided additional tools to detect patients at high risk of AKI and improve their outcomes...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28284300/renal-replacement-therapy-in-acute-kidney-injury-controversies-and-consensus
#17
REVIEW
Michael Heung, Lenar Yessayan
Acute kidney injury (AKI) is a common complication among critically ill patents, and 5% of intensive care unit (ICU) patients require initiation of renal replacement therapy (RRT). In recent years, clinical trials have provided evidence-based guidance for some important aspects of RRT management in patients with AKI, such as dialysis dosing and approaches to anticoagulation in patients undergoing continuous RRT. However, there remain many areas of uncertainty, and delivery of RRT in the ICU requires clinical judgment, flexibility, and an understanding of dialysis principles...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28202171/residual-renal-function-a-paradigm-shift
#18
Jerome Lowenstein, Jared J Grantham
Residual renal function (RRF) in patients undergoing dialysis treatments is currently viewed as glomerular filtrate that has escaped tubular reabsorption. RRF has been quantified as a clearance of urea or creatinine, or urea + creatinine. A major paradigm shift has followed the recognition that a substantial number of organic anion retention solutes (possible "uremic toxins") are protein-bound and therefore are not readily filtered. These protein-bound aryl compounds are secreted by renal tubular organic anion transporters (OATs)...
March 2017: Kidney International
https://www.readbyqxmd.com/read/28153189/components-of-a-successful-peritoneal-dialysis-program
#19
REVIEW
Xueqing Yu, Rajnish Mehrotra, Xiao Yang
Although varying widely among different countries and geographic regions, the development of peritoneal dialysis invariably requires a well-established program. Key ingredients for the successful delivery of this therapy include adequate chronic kidney disease education, governmental or nongovernmental reimbursement, qualified physicians and nurses trained in the principles and practice of peritoneal dialysis, clinical management that incorporates an excellent and well-trained peritoneal dialysis team, a feasible and well-designed program for catheter insertion, a sound patient training and follow-up scheme, and continuous quality improvement...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28065700/integrating-supportive-care-principles-into-dialysis-decision-making-a-primer-for-palliative-medicine-providers
#20
Alvin H Moss
Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering...
March 2017: Journal of Pain and Symptom Management
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