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Hemodialysis hypotension

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https://www.readbyqxmd.com/read/27834457/investigation-of-the-knowledge-and-attitudes-of-patients-who-are-undergoing-hemodialysis-treatment-regarding-their-arteriovenous-fistula
#1
Nurten Ozen, Nuran Tosun, Fatma Ilknur Cinar, Gulcan Bagcivan, Mahmut Ilker Yilmaz, Dilek Askin, Dilek Mut, Volkan Ozen, Mujdat Yenicesu, Evis Zajm
PURPOSE: The major cause of morbidity in hemodialysis patients is arteriovenous fistula deficiency. The patient should have adequate knowledge to ensure arteriovenous fistula patency. Our aim is to investigate the knowledge and attitude of the patients undergoing hemodialysis treatment regarding arteriovenous fistula. METHODS: This study was conducted on 335 patients who met the study criteria. Data collection forms evaluating the "Socio-Demographic and Medical Characteristics" and "Knowledge and Attitudes about arteriovenous fistula" of the patients were developed following a literature review by the investigators...
November 3, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27833921/management-of-patient-care-in-hemodialysis-while-focusing-on-cardiovascular-disease-events-and-the-atypical-role-of-hyper-and-or-hypotension-a-systematic-review
#2
REVIEW
Amjad Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Siew Hua Gan, Irfanullah Khan
Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27800516/a-fatal-case-of-hepatic-portal-venous-gas-associated-with-hemodialysis
#3
Tahmina Begum, Mashrafi Ahmed
Hepatic portal venous gas is a rare cause of acute abdomen caused by leakage of air from the gastrointestinal tract to the portal venous system. The mortality is high, particularly when associated with intestinal ischemia or necrosis. We describe a fatal case of hepatic portal venous gas and pneumatosis intestinalis due to hemodialysis-related hypotension and severe atherosclerotic disease.
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27783636/online-haemodiafiltration-improves-inflammatory-state-in-dialysis-patients-a-longitudinal-study
#4
Ines Rama, Ines Llaudó, Pere Fontova, Gema Cerezo, Carlos Soto, Casimiro Javierre, Miguel Hueso, Nuria Montero, Alberto Martínez-Castelao, Juan Torras, Josep M Grinyó, Josep M Cruzado, Nuria Lloberas
BACKGROUND: Patients undergoing conventional hemodialysis (C-HD) present a greater immuno-inflammatory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompatibility, which could improve with a technique-switching to online hemodiafiltration (OL-HD). The antigen-independent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammatory state of patients in C-HD assessed by DC maturation...
2016: PloS One
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#5
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
https://www.readbyqxmd.com/read/27772642/intensive-hemodialysis-and-treatment-complications-and%C3%A2-tolerability
#6
Jose A Morfin, Richard J Fluck, Eric D Weinhandl, Sheru Kansal, Peter A McCullough, Paul Komenda
Hemodialysis (HD) treatment can be difficult to tolerate. Common complications are intradialytic hypotension (IDH) and long time to recovery after an HD session. IDH, as defined by nadir systolic blood pressure < 90mmHg and intradialytic decline > 30mmHg, occurs in almost 8% of HD sessions. IDH may be caused by aggressive ultrafiltration in response to interdialytic weight gain, can lead to myocardial stunning and cardiac arrhythmias, and is associated with increased risk for death. Long recovery time after a treatment session is also common...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27758157/clinical-significance-of-different-carnitine-levels-for-improving-the-prognosis-of-patients-undergoing-hemodialysis
#7
Yu-Mei Zhang, Li Zhuo, Jing Hu, Gang Cui, Ling Zhang, Xiang-Lin Zhang, Wen-Ge Li
OBJECTIVE: To investigate plasma-free carnitine (Fc), acylcarnitine (Ac), and total carnitine (Tc) levels in patients undergoing hemodialysis (HD), and to explore their clinical significance. METHODS: A total of 20 subjects were in the normal control group and 133 patients undergoing HD were divided into medicated (received carnitine treatment) and non-medicated groups. The medicated group was further divided into three subgroups according to Fc level: Fc = 80-199, 200-299, and ≥ 300 μmol/L...
October 19, 2016: Renal Failure
https://www.readbyqxmd.com/read/27757709/idiopathic-pre-capillary-pulmonary-hypertension-in-patients-with-end-stage-kidney-disease-effect-of-endothelin-receptor-antagonists
#8
Masato Nishimura, Toshiko Tokoro, Satoru Yamazaki, Tetsuya Hashimoto, Hiroyuki Kobayashi, Toshihiko Ono
BACKGROUND: We examined the prevalence, prognosis, and effect of endothelin receptor antagonists on survival in end-stage kidney disease patients with idiopathic pre-capillary pulmonary hypertension. METHODS: We investigated 1988 end-stage kidney disease patients in Toujinkai Hospital from January 1, 2001 to December 31, 2014. Pulmonary hypertension was screened by symptoms (dyspnea, hypotension, or near syncope) and echocardiography, and diagnosed by computed tomography with enhancement, pulmonary flow scintigraphy, and right heart catheterization...
October 19, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27753856/hw-01-4-cardioankle-vascular-index-cavi-in-hypertension
#9
Kohji Shirai
BACKGROUND: The cardio-ankle vascular index (CAVI) is a new arterial stiffness index of the arterial tree from the origin of the aorta to the ankle, and was essentially derived from the stiffness parameterβtheory proposed by Hayashi. The conspicuous feature of CAVI is independency from blood pressure at the time of measurement. AIM: The purpose is to clarify the meaning of CAVI as a surrogate marker of arteriosclerosis, and also the role of CAVI in the blood pressure control system...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27698566/calciphylaxis-in-peritoneal-dialysis-patients-a-single-center-cohort-study
#10
Yanchen Zhang, Kristin M Corapi, Maria Luongo, Ravi Thadhani, Sagar U Nigwekar
BACKGROUND: Calciphylaxis is a rare but devastating condition in end-stage renal disease (ESRD) patients. Most research in the field of calciphylaxis is focused on hemodialysis (HD) patients; however, data on calciphylaxis incidence, risk factors, and mortality in peritoneal dialysis (PD) patients are limited. METHODS: In this cohort study, we examined data from adult patients who initiated PD for ESRD management at our institute's PD unit from January 2001 to December 2015...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27669546/blood-pressure-targets-for-hemodialysis-patients-aspirational-or-practical
#11
Andrew Davenport
Whereas there is strong relationship between high blood pressure and increased overall and cardiovascular mortality for the general population, observational studies in hemodialysis patients have reported a "U" shaped relationship between pre-hemodialysis blood pressure recordings and patient survival. Previous attempts to introduce pre and post-hemodialysis blood pressure targets were associated with an increased frequency of intra-dialytic hypotension, itself an independent risk factor for mortality. Conversely, meta-analyses of trials of antihypertensive medications in hemodialysis patients, reported survival benefit for those prescribed medication...
October 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27668164/cardiac-arrest-caused-by-nafamostat-mesilate
#12
Hyo Shik Kim, Kyung Eun Lee, Ji Hyun Oh, Chan Sung Jung, Dughyun Choi, Yunsuek Kim, Jin Seok Jeon, Dong Cheol Han, Hyunjin Noh
A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit for 5 days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the intensive care unit...
September 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27661862/ombitasvir-paritaprevir-ritonavir-dasabuvir-viekira-pak-induced-lactic-acidosis
#13
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
September 22, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27643093/hw-01-4-cardioankle-vascular-index-cavi-in-hypertension
#14
Kohji Shirai
BACKGROUND: The cardio-ankle vascular index (CAVI) is a new arterial stiffness index of the arterial tree from the origin of the aorta to the ankle, and was essentially derived from the stiffness parameterβtheory proposed by Hayashi. The conspicuous feature of CAVI is independency from blood pressure at the time of measurement. AIM: The purpose is to clarify the meaning of CAVI as a surrogate marker of arteriosclerosis, and also the role of CAVI in the blood pressure control system...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642391/-intradialytic-arterial-hypotension-in-a-patient-on-chronic-hemodialysis-revealing-ante-hypophyseal-insufficiency
#15
Jaouad El Maghraoui, Hanane Ouahabi, Nadia Kabbali, Mohamed Arrayhani, Farida Ajdi, Tariq Sqalli Houssaini
No abstract text is available yet for this article.
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27635266/fatal-cerebral-air-embolism-a-case-series-and-literature-review
#16
Rashmi Mishra, Pavithra Reddy, Misbahuddin Khaja
Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27615278/a-meta-analysis-of-sodium-profiling-techniques-and-the-impact-on-intradialytic-hypotension
#17
Nina Dunne
Introduction Hemodialysis has improved in recent years, however, despite such improvements, intra-dialytic hypotensive episodes still persist which can lead to a reduction in the overall effectiveness of the treatment. Profiling sodium levels during dialysis can improve vascular refilling and therefore may prevent hypotensive events. A number of profiling methods exist and this meta-analysis set out to examine the effectiveness of these methods. Methods To assess the effectiveness of hemodialysis sodium profiling techniques...
September 12, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27601912/predialysis-hypotension-is-not-a-predictor-for-mortality-in-long-term-hemodialysis-patients-insight-from-a-single-center-observational-study
#18
Wen-Hung Huang, Ching-Wei Hsu, Ching-Chih Hu, Tzung-Hai Yen, Cheng-Hao Weng
INTRODUCTION: Predialysis hypotension has been noted to be a predictor of mortality in hemodialysis (HD) patients. Previous studies evaluating the impact of predialysis hypotension on the mortality of HD patients did not exclude patients with diabetes mellitus (DM) or cardiovascular disease. METHODS: Eight hundred and sixty-six patients on maintenance HD were recruited. Clinical parameters were recorded and subjected to the analysis of predictors of predialysis hypotension and mortality...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27572624/intra-dialytic-blood-oxygen-saturation-so2-association-with-dialysis-hypotension-the-soglia-study
#19
E Mancini, C Perazzini, L Gesualdo, F Aucella, A Limido, F Scolari, S Savoldi, M Tramonti, L Corazza, M Atti, S Severi, P Bolasco, A Santoro
BACKGROUND: Intradialytic hypotension (IDH) has a dramatic impact on the main outcomes of dialysis patients. Early warning of hemodynamic worsening during dialysis would enable preventive measures to be taken. Blood oxygen saturation (SO2) is used for hemodynamic monitoring in the critical care setting and may provide useful information about IDH onset. AIM: To evaluate whether short- and medium-term variations in the SO2 signal (ST-SO2var, MT-SO2var,) during dialysis are a predictor of IDH...
August 29, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27556272/an-update-on-intradialytic-cardiac-dysfunction
#20
Aghogho Odudu, Christopher W McIntyre
Cardiac dysfunction is a key factor in the high morbidity and mortality rates seen in hemodialysis (HD) patients. Much of the dysfunction is manifest as adverse changes in cardiac and vascular structure prior to commencing dialysis. This adverse vascular remodeling arises as a dysregulation between pro- and antiproliferative signaling pathways in response to hemodynamic and nonhemodynamic factors. The HD procedure itself further promotes cardiomyopathy by inducing hypotension and episodic regional cardiac ischemia that precedes global dysfunction, fibrosis, worsening symptoms, and increased mortality...
November 2016: Seminars in Dialysis
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