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Intermittent hemodialysis

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https://www.readbyqxmd.com/read/28721515/prolonged-intermittent-renal-replacement-therapy-in-children
#1
REVIEW
Rajiv Sinha, Sidharth Kumar Sethi, Timothy Bunchman, Valentine Lobo, Rupesh Raina
Wide ranges of age and weight in pediatric patients makes renal replacement therapy (RRT) in acute kidney injury (AKI) challenging, particularly in the pediatric intensive care unit (PICU), wherein children are often hemodynamically unstable. Standard hemodialysis (HD) is difficult in this group of children and continuous veno-venous hemofiltration/dialysis (CVVH/D) has been the accepted modality in the developed world. Unfortunately, due to cost constraints, CVVH/D is often not available and peritoneal dialysis (PD) remains the common mode of RRT in resource-poor facilities...
July 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28709598/simplifying-the-hemodialysis-prescription-in-patients-with-ethylene-glycol-poisoning
#2
Darren M Roberts, Tom N Lea-Henry
The management of ethylene glycol poisoning is multimodal and usually includes hemodialysis. The usual approach for guiding treatment duration is iterative, based on serial measurements of ethylene glycol concentration and routine biochemistry. In this issue, Iliuta et al. present a simplified approach to determining the duration of hemodialysis based on a single ethylene glycol concentration. Although this appears reasonable in many cases, there are circumstances in which further consideration is warranted and it only applies to high-efficiency intermittent hemodialysis...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28692694/renal-replacement-therapy-practices-for-patients-with-acute-kidney-injury-in-china
#3
William R Clark, Xiaoqiang Ding, Haibo Qiu, Zhaohui Ni, Ping Chang, Ping Fu, Jiarui Xu, MinMin Wang, Li Yang, Jing Wang, Claudio Ronco
Recent data indicate AKI is very common among hospitalized Chinese patients and continuous renal replacement therapy (CRRT) is increasingly offered for treatment. However, only anecdotal information regarding CRRT's use in relation to other modalities and the specific manner in which it is prescribed exists currently. This report summarizes the results of a comprehensive physician survey designed to characterize contemporary dialytic management of AKI patients in China, especially with respect to the utilization of CRRT...
2017: PloS One
https://www.readbyqxmd.com/read/28674380/exceptionally-high-creatine-kinase-ck-levels-in-multicausal-and-complicated-rhabdomyolysis-a-case-report
#4
Pavan Luckoor, Mashal Salehi, Afua Kunadu
BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure...
July 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28666082/intradialytic-hypotension-in-acute-kidney-injury-requiring-renal-replacement-therapy
#5
Shilpa Sharma, Sushrut S Waikar
The treatment of severe acute kidney injury (AKI) with dialytic support for renal replacement therapy can be life sustaining and permit recovery from critical illness. Like any interventional therapy, however, renal replacement therapy with intermittent hemodialysis or continuous therapy can cause complications. Intradialytic hypotension is a common complication and can cause further ischemic injury to the recovering kidneys, thereby reducing the probability of renal recovery. The optimal dialytic technique-continuous or intermittent-has not been conclusively demonstrated in randomized controlled trials...
June 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28665828/monitoring-volume-status-using-bioelectrical-impedance-analysis-in-chronic-hemodialysis-patients
#6
Chae Rim Kim, Jung-Ho Shin, Jin Ho Hwang, Su Hyun Kim
Fluid overload can be an independent risk factor of cardiovascular events and all-cause death in end-stage renal disease (ESRD) patients on chronic hemodialysis. We performed a retrospective study to investigate whether intermittent control of fluid status decreases the rate of these complications using bioelectrical impedance analysis (BIA). In ESRD patients on chronic hemodialysis, we identified the ratio of extracellular water to total body water (ECW/TBW) every 6 months using InBody S10 (Biospace, Seoul, Korea), which was measured within 30 minutes after dialysis initiation on the first dialysis day of the week...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#7
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28627930/randomized-comparative-efficacy-and-safety-study-of-intermittent-simvastatin-versus-fenofibrate-in-hemodialysis
#8
Aya M Abdel Magid, Maggie M Abbassi, Essam Eldin M Iskander, Osama Mohamady, Samar F Farid
AIM: Compare the safety and efficacy of intermittent fenofibrate versus simvastatin in chronic hemodialysis patients. PATIENTS & METHODS: Sixty patients received either fenofibrate 100 mg or simvastatin 20 mg after their dialysis session (parallel study). The safety and efficacy of drugs on lipid profile, oxidized low-density lipoprotein (Ox-LDL), glutathione peroxidase and C-reactive protein were compared before and after 16-week treatment. RESULTS: After treatment, significant increase in glutathione peroxidase, significant decrease in total cholesterol, triglycerides, low density lipoprotein (LDL) and ox-LDL (p < 0...
June 19, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28582998/comparison-of-levetiracetam-dosing-regimens-in-end-stage-renal-disease-patients-undergoing-intermittent-hemodialysis
#9
Harn J Shiue, Maria Taylor, Kara A Sands
BACKGROUND: Levetiracetam (LEV) is primarily renally eliminated. In end-stage renal disease (ESRD) patients on hemodialysis (HD), pharmacokinetic studies recommend daily dosing with 50% supplemental doses after 4-hour HD sessions. However, poor medication adherence after HD could result in fluctuating plasma drug levels. OBJECTIVE: To compare two LEV dosing regimens, daily versus twice-daily (BID), in ESRD patients undergoing HD. METHODS: Consecutive ESRD patients (April 2013 to May 2014) receiving maintenance inpatient HD and prescribed LEV prior to admission to our academic tertiary hospital were prospectively analyzed...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28574999/predictors-of-renal-function-recovery-among-patients-undergoing-renal-replacement-therapy-following-orthotopic-liver-transplantation
#10
Maria Claudia Cruz Andreoli, Nádia Karina Guimarães de Souza, Adriano Luiz Ammirati, Thais Nemoto Matsui, Fabiana Dias Carneiro, Ana Claudia Mallet de Souza Ramos, Ilson Jorge Iizuca, Maria Paula Vilela Coelho, Rogério Carballo Afonso, Ben-Hur Ferraz-Neto, Marcio Dias de Almeida, Marcelino Durão, Marcelo Costa Batista, Julio Cesar Monte, Virgílio Gonçalves Pereira, Oscar Pavão Dos Santos, Bento Cardoso Dos Santos
Renal dysfunction frequently occurs during the periods preceding and following orthotopic liver transplantation (OLT), and in many cases, renal replacement therapy (RRT) is required. Information regarding the duration of RRT and the rate of kidney function recovery after OLT is crucial for transplant program management. We evaluated a sample of 155 stable patients undergoing post-intensive care hemodialysis (HD) from a patient population of 908 adults who underwent OLT. We investigated the average time to renal function recovery (duration of RRT required) and determined the risk factors for remaining on dialysis > 90 days after OLT...
2017: PloS One
https://www.readbyqxmd.com/read/28558415/obstacles-to-reducing-plasma-levels-of-uremic-solutes-by-hemodialysis
#11
EDITORIAL
Tammy L Sirich
More intensive hemodialysis has provided limited clinical benefit. The lack of benefit may be due in part to the failure of intensive dialysis to reduce uremic solute levels in plasma. Two well-described factors limiting the reduction in these levels are the intermittency of dialysis treatment and the distribution of solutes in multiple body compartments. Efforts to increase the clearance of large solutes and protein-bound solutes have revealed two other considerations-the presence of nonrenal clearance and increases in solute generation...
May 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28553356/asymptomatic-brain-edema-after-hemodialysis-initiation-in-a-patient-with-severe-uremia
#12
Kiichiro Fujisaki, Kaneyasu Nakagawa, Hiroshi Nagae, Toshiaki Nakano, Masatomo Taniguchi, Kosuke Masutani, Takanari Kitazono, Kazuhiko Tsuruya
A 66-year-old man with severe renal insufficiency presented with mild confusion associated with uremia. Cranial magnetic resonance imaging (MRI) showed no remarkable changes. The patient was placed on short-duration hemodialysis (2 hours) with smaller surface area and low blood flow (100 mL/min) to avoid dialysis disequilibrium syndrome (DDS). His consciousness gradually improved and he did not develop apparent DDS symptoms. However, T2-weighted FLAIR MRI showed increased signal intensities bilaterally in the cortical and subcortical areas of the occipital lobe on day 15...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28538504/clofarabine-dosing-in-a-patient-with-acute-myeloid-leukemia-on-intermittent-hemodialysis-case-report-and-review-of-the-literature
#13
Lydia L Benitez, Katherine Gharibian, David Frame, Rajen Mody, Erika Mora
Clofarabine containing chemotherapeutic regimens have demonstrated efficacy in the treatment of relapsed refractory acute myeloid leukemia. Nonetheless, there are limited data on the use of clofarabine in patients with renal failure. The present report describes the use of clofarabine in a patient with renal failure undergoing intermittent dialysis. We describe our rationale for dosing, clofarabine plasma levels obtained, and discuss our findings in the context of other available literature. Consistent with previous findings, intermittent hemodialysis was not found to be a reliable method of removing clofarabine in patients with renal insufficiency...
May 22, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28531901/a-comparison-between-intermittent-peritoneal-dialysis-and-automatic-peritoneal-dialysis-on-urgent-peritoneal-dialysis
#14
Chang Wang, Xiao Fu, Yuan Yang, Jun Deng, Hong-Qing Zhang, Hong-Mei Deng, Jia Lu, Youming Peng, Hong Liu, Fu-You Liu, Yinghong Liu
BACKGROUND: Urgent-start dialysis is a major problem for incident dialysis population. Urgent start on hemodialysis is associated with an increased risk of infectious or mechanical complications, and its mortality is equal to or higher than that of urgent start on peritoneal dialysis (PD). However, compared to patients starting PD in a planned setting, those on urgent-started PD have an increased risk of mechanical complications and lower technique survival. METHODS: In this study, 101 adult incident dialysis patients (≥18 years old) who underwent Tenckhoff catheter implantation were enrolled...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28525779/systematic-review-and-meta-analysis-of-renal-replacement-therapy-modalities-for-acute-kidney-injury-in-the-intensive-care-unit
#15
Danielle M Nash, Sebastian Przech, Ron Wald, Daria O'Reilly
PURPOSE: To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). MATERIALS AND METHODS: We completed a systematic review and meta-analysis of studies published in 2015 or earlier using MEDLINE®, EMBASE®, Cochrane databases and grey literature. Eligible studies included randomized clinical trials (RCTs) or prospective cohort studies comparing outcomes of mortality, dialysis dependence or length of stay among critically ill adults receiving CRRT, IHD or SLED to treat AKI...
May 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28508982/renal-hemorrhage-caused-by-acquired-inhibitors-to-coagulation-factors-viii-and-v-in-a-hemodialysis-patient
#16
Naoya Niwa, Tadashi Yoshida, Ryuichi Mizuno, Mototsugu Oya, Matsuhiko Hayashi
Acquired coagulation factor deficiency is a rare bleeding disorder caused by the inhibitors to coagulation factors. We report a case of an elderly hemodialysis patient who presented with the intermittent hematuria and anemia, associated with the prolonged activated partial thromboplastin time and prothrombin time. Laboratory examination revealed undetectable factor VIII activity, decreased factor V activity, and the presence of inhibitors to these coagulation factors. The patient was diagnosed to have inhibitors to coagulation factors VIII and V simultaneously...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28487869/a-curious-case-of-persistently-relapsing-hyperkalemia-in-an-esrd-patient-on-maintenance-hemodialysis-following-bioprosthetic-aortic-valve-replacement-a-potential-case-for-the-use-of-the-new-agent-patiromer-for-hyperkalemia-management
#17
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi, Fidelis Oguejiofor, Charles Odenigbo
Hyperkalemia is not uncommon in patients with end-stage renal disease (ESRD) on maintenance hemodialysis, often related to dietary indiscretion, following the prolonged inter-dialytic weekend interval in patients on thrice weekly hemodialysis treatments, and sometimes the adverse effects of medications such as RAAS blocking agents. Moreover, hyperkalemia following extended cardiac surgery can result from the use of high-potassium containing cardioplegic solutions used during cardiopulmonary bypass. Nevertheless, different from the foregoing, in the nephrology literature, there have been very rare reports of potentially life-threatening hyperkalemia following cardiac valve replacement procedure...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28472927/renal-replacement-therapy-in-acute-kidney-injury-from-a-chinese-cross-sectional-study-patient-clinical-socioeconomic-and-health-service-predictors-of-treatment
#18
Fang Wang, Daqing Hong, Yafang Wang, Yunlin Feng, Li Wang, Li Yang
BACKGROUND: Renal replacement therapy (RRT) is important to support critically ill patients with acute kidney injury (AKI). This study, a part of a nation-wide survey for AKI conducted by the ISN AKF 0 by 25 China Consortium, aims to study the current RRT practical situation and problems in China. METHODS: The current study is a part of a nation-wide survey for AKI conducted by ISN AKF 0 by 25 China Consortium. The survey included 44 sites all over the country, including 22 academic hospitals in big cities and 22 local hospitals in smaller cities or rural areas...
May 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28464841/the-impact-of-continuous-renal-replacement-therapy-on-renal-outcomes-in-dialysis-requiring-acute-kidney-injury-may-be-related-to-the-baseline-kidney-function
#19
Marisa Aparecida de Souza Oliveira, Thais Oliveira Claizoni Dos Santos, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão
BACKGROUND: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. METHODS: We conducted a retrospective study investigating patients (≥16 years old) admitted to an intensive care unit with D-AKI from 1999 to 2012. We analyzed D-AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28455110/-combination-of-hemodialysis-and-hemofiltration-in-severe-caffeine-intoxication
#20
Eugénie Colin-Benoit, Raymond Friolet, Marco Rusca, Daniel Teta, Niels Gobin
A 21-year-old man ingested 75g of pure caffeine, in an attempt to commit suicide. This represents 7.5 times the minimal lethal dose. Caffeine, 1,3,7-trimethylxanthine, is the most widely consumed psychoactive compound worldwide. It is mostly found in coffee, tea, energizing drinks and in some drugs. However, it has become really easy to obtain pure caffeine (powder or tablets) on the Internet. Mechanisms of action are dose-dependent. When caffeine overdosing occurs, neurologic, cardiovascular and renal systems are mainly affected...
May 2017: Néphrologie & Thérapeutique
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