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https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#1
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in >80% of patients undergoing haemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413417/the-dialysis-sodium-gradient-a-modifiable-risk-factor-for-fluid-overload
#2
Emilie Trinh, Catherine Weber
BACKGROUND: Fluid overload in patients on conventional hemodialysis is a frequent complication, associated with increased cardiovascular morbidity and mortality. The dialysate sodium prescription is a potential modifiable risk factor. Our primary objective was to describe associations between dialysate-to-serum sodium gradient and parameters of fluid status. A secondary objective was to evaluate the 6-month risk of hospitalization and mortality in relation to sodium gradient. METHODS: We performed a cross-sectional study of 110 prevalent conventional hemodialysis patients at a single center...
January 2017: Nephron Extra
https://www.readbyqxmd.com/read/28409034/increased-intracranial-pressure-during-hemodialysis-in-a-patient-with-anoxic-brain-injury
#3
Anton Lund, Mette B Damholt, Ditte G Strange, Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28399019/pathophysiology-and-implications-of-intradialytic-hypertension
#4
Peter Noel Van Buren
PURPOSE OF REVIEW: Intradialytic hypertension occurs regularly in 10--15% of hemodialysis patients. A large observational study recently showed that intradialytic hypertension of any magnitude increased mortality risk comparable to the most severe degrees of intradialytic hypotension. The present review review discusses the most recent evidence underlying the pathophysiology of intradialytic hypertension and implications for its management. RECENT FINDINGS: Patients with intradialytic hypertension typically have small interdialytic weight gains, but bioimpedance spectroscopy shows these patients have significant chronic extracellular volume excess...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28372556/a-randomized-cross-over-study-comparing-the-performance-of-hd-integra%C3%A2-central-concentrate-system-versus-pre-produced-concentrate-in-hemodialysis
#5
K Fauziah, K W Go, A Ghazali, M Zaki, T O Lim
BACKGROUND: Pre-produced bicarbonate concentrates (PPC) are still widely used in developing countries despite its cost and risk but Central Concentrate System (CCS) is lacking in data to support its wider adoption. METHODS: We conducted an 8-week randomized crossover study on 16 Hemodialysis machines to compare CCS versus PPC. Performance is assessed by solute concentrations while safety is assessed by microbial count, endotoxin level and adverse event reporting...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28340239/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#6
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles J Ferro, Jean-Michel Halimi, Gunnar H Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verhaar, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28290369/effect-of-different-iron-compounds-on-rheological-and-technological-parameters-as-well-as-bioaccessibility-of-minerals-in-whole-wheat-bread
#7
Ana Paula Rebellato, Jéssica Bussi, Joyce Grazielle Siqueira Silva, Ralf Greiner, Caroline Joy Steel, Juliana Azevedo Lima Pallone
This study aimed at investigating the effect of iron compounds used in whole wheat flour (WWF) fortification, both on rheological properties of the dough and on bread technological quality. Furthermore, bioaccessibility of iron (Fe), zinc (Zn) and calcium (Ca) in the final breads was determined. Rheological properties (mainly dough development time, stability, mixing tolerance index, resistance to extension and ratio number) of the dough and the technological quality of bread (mainly oven spring and cut opening) were altered...
April 2017: Food Research International
https://www.readbyqxmd.com/read/28247603/-high-glucose-dialysate-enhances-peritoneal-fibrosis-through-upregulating-glucose-transporters-glut1-and-sglt1
#8
Mengqi Hong, Zhenyu Nie, Zhengyue Chen, Xiongwei Yu, Beiyan Bao
Objective: To investigate the role of glucose transporter 1 (GLUT1) and sodium-glucose cotransporter 1 (SGLT1) in high glucose dialysate-induced peritoneal fibrosis. Methods: Thirty six male SD rats were randomly divided into 6 groups (6 in each):normal control group, sham operation group, peritoneal dialysis group (PD group), PD+phloretin group (PD+T group), PD+phlorizin group (PD+Z group), PD+phloretin+phlorizin group (PD+T+Z group). Rat model of uraemia was established using 5/6 nephrotomy, and 2.5% dextrose peritoneal dialysis solution was used in peritoneal dialysis...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28185407/effects-of-sodium-concentration-and-dialysate-temperature-changes-on-blood-pressure-in-hemodialysis-patients-a-randomized-triple-blind-crossover-clinical-trial
#9
Hossein Ebrahimi, Mahboobeh Safavi, Marzieh Hossein Saeidi, Mohammad Hassan Emamian
The present study investigated the effects of different temperatures and sodium dialysate concentration on blood pressure in hemodialysis patients. Following Williams' design, hemodialysis patients were randomly assigned into four dialysis modes. Dialysate temperature was set at 37°C for modes A and C and, 35°C for modes B and D. Sodium concentration was set at 138 mmol/L in modes A and B, while it changed from 150 mmol/L to 138 mmol/L in modes C and D. Using analysis of variance for repeated measures, the mean values of systolic and diastolic blood pressure were investigated...
February 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28157814/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#10
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28066913/dialysate-sodium-rationale-for-evolution-over-time
#11
Jennifer E Flythe, Finnian R Mc Causland
Oligo-anuric individuals receiving hemodialysis (HD) are dependent on the dialysis machine to regulate sodium and water balance. Interest in adjusting the dialysate sodium concentration to promote tolerance of the HD procedure dates back to the early years of dialysis therapy. Evolution of dialysis equipment technologies and clinical characteristics of the dialysis population have prompted clinicians to increase the dialysate sodium concentration over time. Higher dialysate sodium concentrations generally promote hemodynamic stabilization and reduce intradialytic symptoms but often do so at the expense of stimulating thirst and promoting volume expansion...
March 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28012100/the-peritoneal-sieving-of-sodium-a-simple-and-powerful-test-to-rule-out-the-onset-of-encapsulating-peritoneal-sclerosis-in-patients-undergoing-peritoneal-dialysis
#12
Vincenzo La Milia, Selena Longhi, Elisabetta Sironi, Giuseppe Pontoriero
BACKGROUND AND AIMS: Encapsulating peritoneal sclerosis (EPS) is an uncommon but severe complication of peritoneal dialysis (PD). A reliable screening tool to identify patients at risk of developing or not EPS is currently not available. We aimed to evaluate whether the reduction in dialysate sodium concentration (sodium sieving) at 60 min (ΔDNa60), during a peritoneal equilibration test with 3.86% glucose concentration (3.86%-PET) was able to early rule out patients who will not develop EPS...
December 24, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27878114/efficacy-of-biofilm-removal-from-hemodialysis-piping
#13
Yutaka Isakozawa, Heihachi Migita, Shingo Takesawa
BACKGROUND: Central dialysate fluid delivery systems (CDDS) are used by dialysis centers in Japan, and although these systems are effective at delivering dialysate, they have a complex piping network with numerous sites where contamination can develop. In Japan, cleaning disinfectants have been clinically evaluated based on endotoxin levels and bacterial counts, but there have been no published studies evaluating the biofilm removal efficacy of these agents at the electron microscope level...
September 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27866963/interdialytic-weight-gain-trends-predictors-and-associated-outcomes-in-the-international-dialysis-outcomes-and-practice-patterns-study-dopps
#14
Michelle M Y Wong, Keith P McCullough, Brian A Bieber, Juergen Bommer, Manfred Hecking, Nathan W Levin, William M McClellan, Ronald L Pisoni, Rajiv Saran, Francesca Tentori, Tadashi Tomo, Friedrich K Port, Bruce M Robinson
BACKGROUND: High interdialytic weight gain (IDWG) is associated with adverse outcomes in hemodialysis (HD) patients. We identified temporal and regional trends in IDWG, predictors of IDWG, and associations of IDWG with clinical outcomes. STUDY DESIGN: Analysis 1: sequential cross-sections to identify facility- and patient-level predictors of IDWG and their temporal trends. Analysis 2: prospective cohort study to assess associations between IDWG and mortality and hospitalization risk...
March 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27834449/finite-element-modeling-of-time-dependent-sodium-exchange-across-the-hollow-fiber-of-a-hemodialyzer-by-coupling-with-a-blood-pool-model
#15
Enrico Ravagli, Elena Grandi, Paolo Rovatti, Stefano Severi
INTRODUCTION: Hollow fiber models describe the exchange of solutes between blood and dialysate across the membrane of a single fiber of the hemodialysis filter (hemodialyzer). This work aims to develop a new approach to simulate the solute exchange in a hollow fiber in a dynamic and realistic way. Sodium was chosen as our solute of interest due to its importance in hemodialysis as an osmotic regulator. METHODS: A 2-dimensional (2D) hollow fiber model based on the finite element method (FEM) is coupled to a simple blood pool model to dynamically update the concentration of the solute entering the dialyzer...
November 11, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27810276/-peritoneal-equilibration-test-conventional-versus-adapted-preliminary-study
#16
Ariane Zaloszyc, Claus Peter Schmitt, Betti Schaefer, Armelle Doutey, Joëlle Terzic, Soraya Menouer, Laetitia Higel, Michel Fischbach
Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of cycles with the same dwell time and the same fill volume. Water and sodium balance remains a common problem among patients on peritoneal dialysis. More recently, adapted automated peritoneal dialysis was described, as a combination of short dwells with a low volume, in order to enhance ultrafiltration, followed by long dwells with a large fill volume to favor solute removal. We performed a preliminary crossover study on 4 patients...
October 31, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27689106/the-evaluation-of-relationship-between-blood-pressure-and-dialysate-na-concentration-in-chronic-hemodialysis-patients
#17
Narges Sadat Zahed, Omid Gharooi, Latif Gachkar, Hajar Nikbakht
INTRODUCTION: Hypertension is one of the traditional risk factors of cardiovascular disease (CVD). Extra cellular volume expansion and Na retention remain the main cause of hypertension. OBJECTIVES: The aim of this study was to investigate the relation between concentration of Na dialysate and blood pressure (BP) in chronic hemodialysis (HD) patient. PATIENTS AND METHODS: This cross-sectional study was performed on 266 adult patients undergoing HD for at least three months...
2016: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/27669545/reliability-of-delivered-dialysate-sodium-concentration
#18
Nasirul J Ekbal, Anne Consalus, Jahm Persaud, Andrew Davenport
Background The results of studies investigating the effects of hyponatraemic dialysates have been mixed, with some reporting positive effects including reduction in blood pressure and inter-dialytic weight gains, whereas others have not been able to demonstrate any effect. These studies assume that setting a lower dialysate sodium results in the delivery of a hyponatraemic dialysate. We therefore measured delivered sodium to determine reliability. Methods We measured dialysate sodium in 10 BBraun Dialog+(®) and 6 Fresenius 4008H dialysis machines, which had been set up to deliver a sodium of 136 mmol/L, using flame photometry and indirect ion selective electrode (ISE) methods...
October 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27660058/sodium-ion-transport-participates-in-non-neuronal-acetylcholine-release-in-the-renal-cortex-of-anesthetized-rabbits
#19
Shuji Shimizu, Tsuyoshi Akiyama, Toru Kawada, Yusuke Sata, Michael James Turner, Masafumi Fukumitsu, Hiromi Yamamoto, Atsunori Kamiya, Toshiaki Shishido, Masaru Sugimachi
This study examined the mechanism of release of endogenous acetylcholine (ACh) in rabbit renal cortex by applying a microdialysis technique. In anesthetized rabbits, a microdialysis probe was implanted into the renal cortex and perfused with Ringer's solution containing high potassium concentration, high sodium concentration, a Na(+)/K(+)-ATPase inhibitor (ouabain), or an epithelial Na(+) channel blocker (benzamil). Dialysate samples were collected at baseline and during exposure to each agent, and ACh concentrations in the samples were measured by high-performance liquid chromatography...
September 22, 2016: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/27606498/intradialytic-hypotension
#20
Ambreen Gul, Dana Miskulin, Antonia Harford, Philip Zager
PURPOSE OF REVIEW: This review focuses on recent advances in our understanding of intradialytic hypotension (IDH) and measures that may reduce its frequency. RECENT FINDINGS: The frequency and severity of IDH predict the risk for adverse clinical outcomes. The highest mortality risks associated with IDH were observed when the intradialytic systolic blood pressure (SBP) nadirs were <90 and <100 mmHg and the predialysis SBP were ≤159 mmHg or ≥160 mmHg, respectively...
November 2016: Current Opinion in Nephrology and Hypertension
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