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Hemodialysis hypotension

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https://www.readbyqxmd.com/read/29437702/diagnosis-and-treatment-of-intradialytic-hypotension-in-maintenance-hemodialysis-patients
#1
Christopher W McIntyre, Fabio R Salerno
No abstract text is available yet for this article.
February 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29436152/immersion-enhanced-fluid-redistribution-can-prevent-intradialytic-hypotension-a-prospective-randomized-crossover-clinical-trial
#2
Keren Doenyas-Barak, Nedal Garra, Ilia Beberashvili, Shai Efrati
INTRODUCTION: Intradialytic hypotension (IDH) is an important cause of morbidity and mortality among hemodialysis patients. We used an immersion model to evaluate the role of reduced effective circulating volume, and to examine whether facilitated refilling can prevent IDH. METHODS: Ten male hemodialysis patients who had frequent episodes of IDH were randomized to a mid-week "wet" or "dry" hemodialysis session, and subsequently underwent the other session in a crossover manner...
February 13, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29430730/cerebral-ischemia-during-hemodialysis-finding-the-signal-in-the-noise
#3
EDITORIAL
Clare MacEwen, Peter Watkinson, Lionel Tarassenko, Christopher Pugh
Hemodialysis patients have multiple risk factors for small vessel cerebrovascular disease and cognitive dysfunction. Hemodialysis itself may cause clinically significant neurological injury through repetitive cerebral ischemia. However, supporting evidence to date consists of epidemiological associations, expert opinion, and small, single-centre studies of variable methodological quality. Isolating the impact of intra-dialytic hemodynamic instability from underlying renal and vascular disease on clinically relevant functional outcomes would require very large, controlled studies, given the heterogeneity and confounding comorbidities of the population, and the complex relationship between blood pressure and cerebral oxygen delivery...
February 11, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29402775/intradialytic-hypotension-as-an-independent-risk-factor-for-long-term-mortality-in-maintaining-hemodialysis-patients-a-5-year-follow-up-cohort-study
#4
Jinbo Yu, Zhonghua Liu, Bo Shen, Jie Teng, Jianzhou Zou, Xiaoqiang Ding
AIMS: This study aimed to assess risk factors of intradialytic hypotension (IDH) and the association of prognosis and IDH among maintenance hemodialysis (MHD) patients. METHODS: Among 293 patients, 117 were identified with IDH (more than 4 hypotensive events during 3 months). The association between IDH and survival was evaluated. RESULTS: The incidence of IDH was 39.9%. Age, ultrafiltration rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin, β2-microglobulin (β2MG), and aortic root inside diameter (AoRD) were independently associated with IDH...
February 2, 2018: Blood Purification
https://www.readbyqxmd.com/read/29390237/-customization-of-hemodialysis-therapy-dialysis-is-not-a-washing-machine
#5
EDITORIAL
Antonio Santoro
In recent years, the population of chronic dialysis has grown in number but also in age and frequency of co-morbidies such as cardiac diseases, vascular pathologies, diabetes, etc. The majority of patients on chronic hemodialysis are over 70 years and, given the high number of comorbidities, they often exhibit poor tolerance to dialysis treatments. A non-tolerated dialytic treatment can have side-effects that would require an intensification of the dialysis sessions and many hospitalizations. Consequently, the problematic dialysis treatments, as well as harmful for the patient, become economically more detrimental than other treatments apparently more expensive but more tolerated ones In the current days we have, thanks to the huge developments in dialysis technology, powerful weapons to ensure effective and scarcely symptomatic dialysis treatments to the majority of the HD patients...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29383633/a-fatal-case-of-amlodipine-toxicity-following-iatrogenic-hypercalcemia
#6
Narges-Sadat Zahed, Hossein Hassanian-Moghaddam, Nasim Zamani
Using calcium salts in management of amlodipine overdose is challenging. A 25-year-old male with known history of adult polycystic kidney disease presented with hypotension, tachycardia, and intact neurological status after ingestion of 450 mg of amlodipine. Immediately, normal saline infusion and norepinephrine were initiated. Two grams of calcium gluconate was injected, followed by intravenous infusion of 1.16 mg/kg/h. The patient was put on insulin-glucose protocol to maintain euglycemia and hyperinsulinemia...
January 30, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29363796/long-term-impacts-of-hemodialysis-on-the-right-ventricle-assessment-via-3-dimensional-speckle-tracking-echocardiography
#7
Minmin Sun, Xuesen Cao, Yao Guo, Xiao Tan, Lili Dong, Cuizhen Pan, Xianhong Shu
BACKGROUND: Right ventricular (RV) dysfunction is a major cause of death in patients undergoing maintenance hemodialysis (MHD). We used 3-dimensional speckle-tracking echocardiography (3DSTE) to evaluate long-term impacts of MHD on RV function. HYPOTHESIS: In this study, RV dysfunction in MHD patients will be revealed and studied in depth by 3DSTE. METHODS: Echocardiography was performed on 110 consecutively enrolled individuals: 30 controls and 80 patients with MHD...
January 24, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#8
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29325338/-supplementation-with-high-dose-l-carnitine-on-hemodialysis-tolerance-in-uremic-patients-with-severe-heart-diseases
#9
Y J Pan, F P Lu
Objective: To investigate the effect of intravenous supplementation with high-dose L-carnitinen on hemodialysis tolerance in uremic patients with severe heart disease (ischemic heart disease, congestive heart disease and arrhythmia). Methods: Between March 2012 and March 2017, 5 gram L-carnitine was given after the completion of each hemodialysis treatment (3-4 times a week) over a period of two weeks in 29 maintenance hemodialysis patients with severe heart diseases manifested by frequently symptomatic hypotension, chest tightness, wheezing, palpitation, chest pain and other symptoms during hemodialysis...
December 26, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29277506/high-output-cardiac-failure-and-coronary-steal-with-an-arteriovenous-fistula
#10
Amtul Aala, Sairah Sharif, Leslie Parikh, Paul C Gordon, Susie L Hu
Creation of an arteriovenous access for hemodialysis can provoke a sequence of events that significantly affects cardiovascular hemodynamics. We present a 78-year-old man with end-stage renal disease and concomitant coronary artery disease previously requiring coronary artery bypass grafting including a left internal mammary graft to the left anterior descending artery, ischemic cardiomyopathy with left ventricular systolic dysfunction, and severe aortic stenosis who developed hypotension unresponsive to medical therapy after recent angioplasty of his ipsilateral arteriovenous fistula for high-grade outflow stenosis...
December 22, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29249295/eating-during-hemodialysis-treatment-a%C3%A2-consensus-statement-from-the-international-society-of-renal-nutrition-and-metabolism
#11
REVIEW
Brandon M Kistler, Debbie Benner, Jerrilynn D Burrowes, Katrina L Campbell, Denis Fouque, Giacomo Garibotto, Joel D Kopple, Csaba P Kovesdy, Connie M Rhee, Alison Steiber, Peter Stenvinkel, Pieter Ter Wee, Daniel Teta, Angela Y M Wang, Kamyar Kalantar-Zadeh
Poor nutritional status and protein-energy wasting are common among maintenance dialysis patients and associated with unfavorable outcomes. Providing foods, meal trays, snack boxes, and/or oral nutritional supplements during hemodialysis can improve nutritional status and might also reduce inflammation, enhance health-related quality of life, boost patient satisfaction, and improve survival. Potential challenges include postprandial hypotension and other hemodynamic instabilities, aspiration risk, gastrointestinal symptoms, hygiene issues, staff burden, reduced solute removal, and increased costs...
January 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29227585/effect-of-ultrafiltration-on-placental-fetal-blood-flow-in-pregnancy-of-woman-undergoing-chronic-hemodialysis
#12
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/29221340/sudden-hypotension-occurring-after-4-days-of-left-sided-central-catheter-placement
#13
Youn-Jung Kim, Won Young Kim
Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vascular perforation occurring after 4 days of left-sided hemodialysis catheter insertion. A 74-year-old male with septic shock was treated with continuous renal replacement therapy (CRRT) and recovered smoothly during hospitalization...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29166634/sodium-prescription-in-the-prevention-of-intradialytic-hypotension-new-insights-into-an-old-concept
#14
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
#15
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/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/29127555/continuous-monitoring-of-blood-pressure-by-analyzing-the-blood-flow-sound-of-arteriovenous-fistula-in-hemodialysis-patients
#17
Yuka Kamijo, Eiichiro Kanda, Hayato Horiuchi, Noriyuki Kounoue, Keisuke Ono, Keizo Maeda, Akane Yanai, Kazuya Honda, Ryuji Tsujimoto, Mai Yanagi, Yoshitaka Ishibashi, Masayuki Yoshida
BACKGROUND: Patients with end-stage renal disease undergoing hemodialysis (HD) have an elevated risk of cardiovascular disease-related morbidity and mortality. To prevent from such a life-threatening event, the continuous blood pressure (BP) monitoring system may contribute to detect BP decline in early stages and may help to do appropriate disposal. Our research team has introduced an electronic stethoscope (Asahi Kasei Co, Ltd., Tokyo, Japan), which translates sound intensity of Arteriovenous Fistula (AVF) to BP data using the technique of Fourier transformation that can predict continuous BP non-invasively...
November 10, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29122210/strategies-to-increase-patient-safety-in-hemodialysis-application-of-the-modal-analysis-system-of-errors-and-effects-fema-system
#18
María Dolores Arenas Jiménez, Gabriel Ferre, Fernando Álvarez-Ude
BACKGROUND: Haemodialysis (HD) patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, systems that ensure the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. OBJECTIVES: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE), and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems])...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29060339/an-extended-kalman-filter-with-inequality-constraints-for-real-time-detection-of-intradialytic-hypotension
#19
Sardar Ansari, Somayeh Molaei, Kenn Oldham, Michael Heung, Kevin R Ward, Kayvan Najarian
Intradialytic hypotension (IDH) is the most common complication of hemodialysis, affecting 15-50% of all dialysis sessions. Previously, we had presented a non-invasive Polyvinylidene Fluoride (PVDF) based sensor in the form of a ring to measure vascular tone and we showed that the morphology of the signal can be utilized to predict IDH. This paper presents an approach for analyzing the PVDF signal using extended Kalman filter (EKF) and a synthetic model that has previously been used to model the ECG signal with Gaussian functions...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29049308/the-relationship-between-intradialytic-hypotension-and-vascular-calcification-in-hemodialysis-patients
#20
AJin Cho, Young-Ki Lee, Jieun Oh, Jong-Woo Yoon, Dong Ho Shin, Hee Jung Jeon, Myung-Jin Choi, Jung-Woo Noh
BACKGROUND: Vascular calcification is associated with structural and functional abnormality of the heart and blood vessels. We investigated the relationship between intradialytic hypotension (IDH) and vascular calcification in hemodialysis (HD) patients, and their impacts on cardiovascular events (CVEs). METHOD: We enrolled 191 maintenance HD patients who underwent plain abdomen radiography for abdominal aortic calcification score (AACS). A nadir systolic blood pressure (BP) < 90 mm Hg or the requirement of bolus fluid administration was required to quantify the hypotension diagnosis...
2017: PloS One
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