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Hemodialysis hypotension

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https://www.readbyqxmd.com/read/29911459/a-case-of-linezolid-induced-toxicity
#1
Philip E Tobias, Christy A Varughese, Amy P Hanson, Payal K Gurnani
Adverse effects of linezolid are typically limited to diarrhea, nausea, and headache when shorter durations are used; however, as extended durations of linezolid therapy are increasingly more common, additional monitoring parameters should be considered in these patients. We describe a unique case of hypoglycemia, lactic acidosis, and pancreatitis related to an extended duration of linezolid therapy. A 52-year-old woman presented with altered mental status, abdominal pain, and hypotension following six weeks of linezolid and ertapenem therapy...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29885084/ultrafiltration-rate-in-conventional-hemodialysis-where-are-the-limits-and-what-are-the-consequences
#2
Yelena Slinin, Megha Babu, Areef Ishani
BACKGROUND: Ultrafiltration rate (UFR) has attracted attention as a modifiable aspect of volume management. OBJECTIVE: The objective of this review is to summarize the evidence that links UFR to patient outcomes and discuss UFR cut-offs proposed, and discuss possible consequences of adapting UFR as a quality metric. RESULTS: Higher UFRs has been associated with younger age, longer dialysis vintage, greater prevalence of comorbidities, higher Kt/V, lower weight, greater interdialytic weight gain, lower residual renal function, and shorter treatment times...
June 8, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29861374/hemodialysis-in-metformin-associated-lactic-acidosis-due-to-acute-overdose-in-a-metformin-na%C3%A3-ve-patient-a-case-report
#3
Daniel J McCabe, Samuel J Stellpflug
Metformin is a common and generally well-tolerated medication in the treatment of diabetes but rarely has been implicated as the cause for metformin-associated lactate acidosis. This is usually caused by decreased elimination from renal dysfunction but is rarely described after an acute ingestion. We present a case of an acute intentional overdose of metformin in a metformin-naïve patient without renal dysfunction. The patient gradually developed altered mental status, tachypnea, hypotension, hyperglycemia, hypoglycemia, hypothermia, and vasoplegic shock unresponsive to vasopressor support...
May 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29857882/treatment-of-intradialytic-hypotension-with-an-herbal-acupoint-therapy-in-hemodialysis-patients-a-randomized-pilot-study
#4
Ming-Yen Tsai, Chien-Hsing Wu, Yu-Chuen Huang, Shih-Yu Chen, Hwee-Yeong Ng, Yu-Jen Su, Yung-Hsiang Chen
OBJECTIVE: Hypotension during hemodialysis (HD) is the most common complication that negatively affects the quality of life of patients. The objective of the current study was to evaluate the preliminary efficacy and safety of herbal acupoint therapy (HAT) for intradialytic hypotension (IDH). METHODS: A randomized, placebo-controlled trial was performed in 32 HD patients to determine whether HAT was more effective than a sham treatment for the treatment of IDH. The outcomes were frequency of IDH episodes and number of nursing interventions during HD sessions, pre- and post-dialysis BP, subjective change in fatigue as measured by the Visual Analogue Scale (VAS), and recovery time from fatigue after dialysis at the 0th and 4th week...
June 2018: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29848883/recurrent-hypotension-during-hemodialysis-associated-with-double-chamber-right-ventricle-in-hypertrophic-cardiomyopathy
#5
Won-Jong Park, Jang-Won Son, Chan-Hee Lee, Jung-Hee Lee, Ung Kim, Jong-Seon Park, Dong-Gu Shin
No abstract text is available yet for this article.
May 31, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29848417/vital-sign-variations-with-complications-during-dialysis-among-end-stage-renal-disease-patients
#6
Abdul Rehman Qureshi, Naureen Durrani, Naila Asif
OBJECTIVE: To analyse the association of vital sign variations with complications during dialysis among end-stage renal disease patients. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Dialysis Centre, Memon Medical Institute Hospital, Karachi, Pakistan, from December 2016 to February 2017. METHODOLOGY: Patients on regular hemodialysis with permanent vascular access were selected. Analysis was done during their regular hemodialysis session...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29719376/theoretical-overview-of-clinical-and-pharmacological-aspects-of-the-use-of-etelcalcetide-in-diabetic-patients-undergoing-hemodialysis
#7
REVIEW
Jianzhen Ye, Guangrui Deng, Feng Gao
Etelcalcetide is the first intravenous calcimimetic agent authorized for the treatment of secondary hyperparathyroidism (sHPT) in patients undergoing hemodialysis in Europe, the US, and Japan. The relationship between sHPT and diabetes resides on complex, bidirectional effects and largely unknown homeostatic mechanisms. Although 30% or more patients with end-stage renal disease are diabetics and about the same percentage of those patients suffer from sHPT associated with hemodialysis, no data on the specificities of the use of etelcalcetide in such patients are available yet...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29702997/recovery-of-renal-function-in-a-heart-transplantation-recipient-with-over-300-days-of-iatrogenic-anuria-a-case-report
#8
Yong-Hua Peng, Xiao-Min Yu, Chen Yan, Lan Luo, Tao-Sheng Li, Jie Xiao
RATIONALE: Anuria is a severe symptom indicating severe kidney damage. Patient recovery from prolonged anuria is rarely reported. PATIENT CONCERNS: A 15-year-old boy received gender- and weight-mismatch heart transplantation (HT) due to dilated cardiomyopathy. He developed severe hypotension, and heart failure 24 hours after surgery, which were relieved by preload reduction treatments. Although, routine examinations did not show any abnormalities in renal function before surgery, anuria occurred 4 days after preload reduction treatments (24-hour urine volume was 23 mL)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#9
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29669016/hemodynamic-response-to-fluid-removal-during-hemodialysis-categorization-of-causes-of-intradialytic-hypotension
#10
Nathan W Levin, Marcia H F G de Abreu, Lucas E Borges, Helcio A Tavares Filho, Rabia Sarwar, Surendra Gupta, Tahir Hafeez, Shaul Lev, Caroline Williams
Background: Intradialytic hypotension is a clinically significant problem, however, the hemodynamics that underlie ultrafiltration and consequent hypotensive episodes has not been studied comprehensively. Methods: Intradialytic cardiac output, cardiac power and peripheral resistance changes from pretreatment measurements were evaluated using a novel regional impedance cardiographic device (NICaS, NI Medical, Peta Tikva, Israel) in 263 hemodialysis sessions in 54 patients in dialysis units in the USA and Brazil with the goal of determining the various hemodynamic trends as blood pressure decreases...
April 14, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29657203/the-development-of-malnutrition-is-not-dependent-on-its-traditional-contributing-factors-in-patients-on-maintenance-hemodialysis-in-developing-countries
#11
Syed Rizwan Ali Bokhari, Mirza Ameer Faizan Ali, Syed Arsalan Khalid, Bushra Iftikhar, Hafiz Ijaz Ahmad, Ahlam Safdar Hussain, Usman Yaqoob
Malnutrition in dialysis population is associated with significant morbidity and mortality. Nutritional assessment is a neglected area in hemodialysis (HD) patients in developing countries. The aim of the study was to find out whether any traditional parameters have statistically significant correlation with malnutrition. All 58 end-stage renal disease patients on maintenance HD in our dialysis unit were enrolled in this cross-sectional study. The nutritional status was assessed by a predesigned questionnaire including subjective global assessment (SGA)...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29624853/impact-of-salt-reduction-in-meals-consumed-during-hemodialysis-sessions-on-interdialytic-weight-gain-and-hemodynamic-stability
#12
Arthur Colson, Anita Brinkley, Philippe Braconnier, Nadia Ammor, Michel Burnier, Menno Pruijm
INTRODUCTION: Patients on hemodialysis (HD) are advised to limit daily water- and salt intake to reduce interdialytic weight gain (IDWG). To counterbalance protein-losses, protein-rich meals are sometimes provided during HD sessions, but their salt content is not always taken into account. The aim of this study was to assess the influence of a lower salt content of meals provided during HD sessions on IDWG, blood pressure (BP), and hemodynamic stability during dialysis. METHODS: This monocentric, interventional study was proposed to all the patients treated with three weekly HD sessions...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29594137/artificial-intelligence-for-the-artificial-kidney-pointers-to-the-future-of-a-personalized-hemodialysis-therapy
#13
REVIEW
Miguel Hueso, Alfredo Vellido, Nuria Montero, Carlo Barbieri, Rosa Ramos, Manuel Angoso, Josep Maria Cruzado, Anders Jonsson
Background: Current dialysis devices are not able to react when unexpected changes occur during dialysis treatment or to learn about experience for therapy personalization. Furthermore, great efforts are dedicated to develop miniaturized artificial kidneys to achieve a continuous and personalized dialysis therapy, in order to improve the patient's quality of life. These innovative dialysis devices will require a real-time monitoring of equipment alarms, dialysis parameters, and patient-related data to ensure patient safety and to allow instantaneous changes of the dialysis prescription for the assessment of their adequacy...
February 2018: Kidney Diseases
https://www.readbyqxmd.com/read/29593797/factors-influencing-p-terminal-force-in-lead-v1-of-the-ecg-in-hemodialysis-patients
#14
Andrzej Jaroszyński, Anna Jaroszyńska, Wojciech Dąbrowski, Tomasz Zaborowski, Andrzej Stepulak, Marek Iłżecki, Tomasz Zubilewicz
Introduction: Atrial fibrillation (AF) is a highly prevalent arrhythmia in hemodialysis (HD) patients, and an HD session may be a trigger for AF episodes. An abnormal P-terminal force in lead V1 (PTFV1) may predict new-onset AF in HD patients. The aim of the study was to assess the influence of the HD process on PTFV1 and to evaluate possible factors influencing PTFV1 in a group of selected HD patients. Material and methods: One hundred and fifty-three selected HD patients entered the study...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29581966/impaired-gut-epithelial-tight-junction-expression-in-hemodialysis-patients-complicated-with-intradialytic-hypotension
#15
Tsai-Kun Wu, Paik-Seong Lim, Jong-Shiaw Jin, Ming-Ying Wu, Chang-Hsu Chen
Background: There is accumulating evidence pointing to uremia-induced impairment of the intestinal epithelial barrier structure in advanced chronic kidney disease (CKD) and hemodialysis (HD) patients. In this study, the impact of intradialytic hypotension on intestinal barrier integrity is being explored. Methods: Immunohistochemical staining was used to detect the expression of 4 types of tight junction (TJ) proteins such as occludin, zonula occludens-1 (ZO-1), claudin-1, and claudin-4, in colonic samples of a group of patients receiving segmental colectomy...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29528138/when-is-more-frequent-hemodialysis-beneficial
#16
Rita S Suri, Alan S Kliger
The use of frequent hemodialysis (HD) is growing, with the hope of improving outcomes in end-stage renal disease. We narratively review the three randomized trials, 15 comparative cohort studies, and several case series of frequent HD that empirically demonstrate the potential efficacy and adverse effects of these regimens. Taken together, the randomized studies suggest frequent HD may result in left ventricular mass regression. This effect is most pronounced when left ventricular mass is abnormal, but attenuated by significant residual urine output...
March 12, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29511057/hemodiafiltration-to-address-unmet-medical-needs-eskd-patients
#17
Bernard Canaud, Jörg Vienken, Stephen Ash, Richard A Ward
Hemodiafiltration combines diffusive and convective solute removal in a single therapy by ultrafiltering 20% or more of the blood volume processed using a high-flux hemodialyzer and maintaining fluid balance by infusing sterile nonpyrogenic replacement fluid directly into the patient's blood. In online hemodiafiltration, the large volumes of replacement fluid required are obtained by online filtration of standard dialysate through a series of bacteria- and endotoxin-retaining filters. Currently available systems for online hemodiafiltration are on the basis of conventional dialysis machines with added features to safely prepare and infuse replacement fluid and closely control fluid balance...
March 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29483138/mechanisms-clinical-implications-and-treatment-of-intradialytic-hypotension
#18
REVIEW
Patrick B Reeves, Finnian R Mc Causland
Individuals with ESKD requiring maintenance hemodialysis face a unique hemodynamic challenge, typically on a thrice-weekly basis. In an effort to achieve some degree of euvolemia, ultrafiltration goals often involve removal of the equivalent of an entire plasma volume. Maintenance of adequate end-organ perfusion in this setting is dependent on the institution of a variety of complex compensatory mechanisms. Unfortunately, secondary to a myriad of patient- and dialysis-related factors, this compensation often falls short and results in intradialytic hypotension...
February 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29479995/effect-of-acute-intradialytic-aerobic-and-resistance-exercise-on-one-day-blood-pressure-in-patients-undergoing-hemodialysis-a-pilot-study
#19
Joon-Sik Kim, Joo-Hark Yi, Jinho Shin, Yeon-Soo Kim, Sang-Woong Han
BACKGROUND: Hypertension and intradialytic hypotension are independent risk factors for mortality in hemodialysis patients. We hypothesized that intradialytic exercise would increase blood pressure (BP) during dialysis and decrease it during the postdialytic period. The present study aimed to investigate the effect of acute intradialytic exercise on BP both during dialysis and for 20 hours post-dialysis, and to detect any differences in effects of aerobic exercise (AE), resistance exercise (RE), and usual care (UC-the control condition)...
February 26, 2018: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29477417/intradialytic-hypotension-related-episodes-identification-based-on-the-most-effective-features-of-photoplethysmography-signal
#20
Vahid Reza Nafisi, Mina Shahabi
BACKGROUND AND OBJECTIVE: One of the most adverse conditions facing the hemodialysis patient is repetitive hypotension during their dialysis session. Different factors can be used to monitor patient conditions and prevent Intradialytic Hypotension (IDH) during hemodialysis. These factors include blood pressure, blood volume, and electrical Impedance factors. In this paper, pre-IDH and IDH episodes were recognized and classified by using the features of the finger photoplethysmography (PPG) signal...
April 2018: Computer Methods and Programs in Biomedicine
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