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Frequent hemodialysis

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https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#1
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28094031/patients-receiving-frequent-hemodialysis-have-better-health-related-quality-of-life-compared-to-patients-receiving-conventional-hemodialysis
#2
Amit X Garg, Rita S Suri, Paul Eggers, Fredric O Finkelstein, Tom Greene, Paul L Kimmel, Alan S Kliger, Brett Larive, Robert M Lindsay, Andreas Pierratos, Mark Unruh, Glenn M Chertow
Most patients with end-stage kidney disease value their health-related quality of life (HRQoL) and want to know how it will be affected by their dialysis modality. We extended the findings of two prior clinical trial reports to estimate the effects of frequent compared to conventional hemodialysis on additional measures of HRQoL. The Daily Trial randomly assigned 245 patients to receive frequent (six times per week) or conventional (three times per week) in-center hemodialysis. The Nocturnal Trial randomly assigned 87 patients to receive frequent nocturnal (six times per week) or conventional (three times per week) home hemodialysis...
January 13, 2017: Kidney International
https://www.readbyqxmd.com/read/28089366/limited-reduction-in-uremic-solute-concentrations-with-increased-dialysis-frequency-and-time-in-the-frequent-hemodialysis-network-daily-trial
#3
Tammy L Sirich, Kara Fong, Brett Larive, Gerald J Beck, Glenn M Chertow, Nathan W Levin, Alan S Kliger, Natalie S Plummer, Timothy W Meyer
The Frequent Hemodialysis Network Daily Trial compared conventional three-times weekly treatment to more frequent treatment with a longer weekly treatment time in patients receiving in-center hemodialysis. Evaluation at one year showed favorable effects of more intensive treatment on left ventricular mass, blood pressure, and phosphate control, but modest or no effects on physical or cognitive performance. The current study compared plasma concentrations of uremic solutes in stored samples from 53 trial patients who received three-times weekly in-center hemodialysis for an average weekly time of 10...
January 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#4
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28064472/arteriovenous-grafts-much-maligned-but-in-need-of-reconsideration
#5
Michael Allon
There are substantial variations in arteriovenous fistula (AVF) use among hemodialysis patients in different countries, in different regions of the U.S., and even in different hemodialysis units within a single metropolitan area. These variations persist after adjustment for patient demographics and comorbidities, suggesting that practice patterns play a major role in determining the frequency of AVF use. These observations led to vascular access guidelines urging nephrologists and surgeons to increase AVF creation in patients with chronic kidney disease...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28063734/safety-of-intravenous-iron-in-hemodialysis-longer-term-comparisons-of-iron-sucrose-versus-sodium-ferric-gluconate-complex
#6
Wolfgang C Winkelmayer, Benjamin A Goldstein, Aya A Mitani, Victoria Y Ding, Medha Airy, Sreedhar Mandayam, Tara I Chang, M Alan Brookhart, Steven Fishbane
BACKGROUND: Controversy exists about any differences in longer-term safety across different intravenous iron formulations routinely used in hemodialysis (HD) patients. We exploited a natural experiment to compare outcomes of patients initiating HD therapy in facilities that predominantly (in ≥90% of their patients) used iron sucrose versus sodium ferric gluconate complex. STUDY DESIGN: Retrospective cohort study of incident HD patients. SETTING & PARTICIPANTS: Using the US Renal Data System, we hard-matched on geographic region and center characteristics HD facilities predominantly using ferric gluconate with similar ones using iron sucrose...
January 4, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28063504/the-metabolite-beta-aminoisobutyric-acid-and-physical-inactivity-among-hemodialysis-patients
#7
Alessio Molfino, Maria Ida Amabile, Thomas Ammann, Alessio Farcomeni, Luana Lionetto, Maurizio Simmaco, Silvia Lai, Alessandro Laviano, Filippo Rossi Fanelli, Maria Grazia Chiappini, Maurizio Muscaritoli
OBJECTIVE: Physical inactivity is frequent in patients on hemodialysis (HD), and represents a reliable predictor of morbidity and mortality. Beta-aminoisobutyric acid (BAIBA) is a contraction-induced myokine, the plasma levels of which increase with exercise and are inversely associated with metabolic risk factors. The aim of this study was to ascertain whether physical inactivity and clinical parameters relate to plasma BAIBA levels in this patient population. METHODS: Adult patients on HD were included, and the presence of physical inactivity was assessed...
February 2017: Nutrition
https://www.readbyqxmd.com/read/28054167/1-year-course-of-fatigue-in-patients-on-chronic-hemodialysis
#8
Maurizio Bossola, Enrico Di Stasio, Manuela Antocicco, Gilda Pepe, Emanuele Marzetti, Carlo Vulpio
PURPOSE: Fatigue is common in end-stage renal disease patients receiving hemodialysis, reduces significantly their quality of life and is associated with all-cause and cardiac-related mortality. Unfortunately, little is known about the course of fatigue in patients on chronic hemodialysis. METHODS: The Vitality Subscale of the SF-36 (SF-36 VS), Short-Form Health Survey, was administered to 45 patients in January (T1), June (T2) and November (T3) 2015. RESULTS: The score of the SF-36 VS did not differ significantly among T1, T2 and T3...
January 4, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#9
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28001025/clinical-benefits-of-phosphate-control-in-progression-of-end-stage-renal-disease
#10
Piergiorgio Bolasco, Stefano Murtas
It is largely agreed that preservation of RKF has a directly proportional affect on general, and in particular cardiovascular, mortality. During evaluation of patients on infrequent hemodialysis (ID) as both as once-weekly or twice-weekly hemodialysis it has been frequently underestimated the importance of phosphaturia, Indeed, the native kidney preserves the ability to eliminate not only toxic molecules but also a significative output of phosphate despite of a severe decrease of residual kidney function (RKF)...
December 21, 2016: Panminerva Medica
https://www.readbyqxmd.com/read/27990732/symptoms-among-patients-receiving-in-center-hemodialysis-a-qualitative-study
#11
Kim J Cox, Mark B Parshall, Stephen H A Hernandez, Sanah Z Parvez, Mark L Unruh
Introduction Assessment of dialysis-related symptoms is not currently a requirement for hemodialysis (HD) providers in the United States. The purpose of this study was to describe patients' perspectives on symptoms associated with end-stage chronic kidney disease treated with thrice-weekly, in-center HD. Methods We performed a qualitative study using interpretive description. Interview questions were based on a KDIGO (Kidney Disease Improving Global Outcomes) controversies conference and a literature review...
December 19, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27990008/anemia-treatment-by-erythropoiesis-stimulating-agents-during-the-6-months-before-initiation-of-hemodialysis-comparison-between-darbepoetin-alfa-and-continuous-erythropoietin-receptor-activator
#12
Tadashi Yoshida, Matsuhiko Hayashi
Anemia in chronic kidney disease (CKD) is a risk factor for cardiovascular diseases and is treated by long-acting erythropoiesis-stimulating agents (ESA). Although results of previous studies showed that the hemoglobin level could not be maintained at initiation of dialysis in CKD patients treated with recombinant human erythropoietin, it remains undetermined if long-acting ESA are effective to prevent the progression of anemia at initiation of dialysis. In the present study, hemoglobin levels in 40 CKD patients treated with darbepoetin alfa (DA) and 15 CKD patients treated with a continuous erythropoietin receptor activator (CERA) were retrospectively compared during the 6 months period prior to initiation of dialysis...
December 19, 2016: Keio Journal of Medicine
https://www.readbyqxmd.com/read/27989049/infective-endocarditis-in-hemodialysis-patients
#13
Rahul Vasudev, Priyank Shah, Supreet Kaur, Chandrika Chitturi, Sundermurthy Yamini, Ashesha Mechineni, Chandra Chandran, Mahesh Bikkina, Fayez Shamoon
BACKGROUND: Infective endocarditis (IE) is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). The study aim was to evaluate the demographic, clinical, microbiological and inpatient mortality data of IE in hemodialysis patients. METHODS: Data were analyzed for all IE patients admitted to the authors' 800-bed tertiary care hospital between January 2001 and December 2014. These data included demographics, comorbidities, clinical and microbiological characteristics, echocardiographic findings, complications, outcomes, and in-patient mortality...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27966247/can-twice-weekly-hemodialysis-expand-patient-access-under-resource-constraints
#14
REVIEW
Dipal Savla, Glenn M Chertow, Timothy Meyer, Shuchi Anand
The convention of prescribing hemodialysis on a thrice weekly schedule began empirically when it seemed that this frequency was convenient and likely to treat symptoms for a majority of patients. Later, when urea was identified as the main target and marker of clearance, studies supported the prevailing notion that thrice weekly dialysis provided appropriate clearance of urea. Today, national guidelines on hemodialysis from most countries recommend patients receive at least thrice weekly therapy. However, resource constraints in low- and middle-income countries (LMIC) have resulted in a substantial proportion of patients using less frequent hemodialysis in these settings...
December 14, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27955924/infants-requiring-maintenance-dialysis-outcomes-of-hemodialysis-and-peritoneal-dialysis
#15
Enrico Vidal, Karlijn J van Stralen, Nicholas C Chesnaye, Marjolein Bonthuis, Christer Holmberg, Aleksandra Zurowska, Antonella Trivelli, José Eduardo Esteves Da Silva, Maria Herthelius, Brigitte Adams, Anna Bjerre, Augustina Jankauskiene, Polina Miteva, Khadizha Emirova, Aysun K Bayazit, Christoph J Mache, Ana Sánchez-Moreno, Jérôme Harambat, Jaap W Groothoff, Kitty J Jager, Franz Schaefer, Enrico Verrina
BACKGROUND: The impact of different dialysis modalities on clinical outcomes has not been explored in young infants with chronic kidney failure. STUDY DESIGN: Cohort study. SETTING & PARTICIPANTS: Data were extracted from the ESPN/ERA-EDTA Registry. This analysis included 1,063 infants 12 months or younger who initiated dialysis therapy in 1991 to 2013. FACTOR: Type of dialysis modality. OUTCOMES & MEASUREMENTS: Differences between infants treated with peritoneal dialysis (PD) or hemodialysis (HD) in patient survival, technique survival, and access to kidney transplantation were examined using Cox regression analysis while adjusting for age at dialysis therapy initiation, sex, underlying kidney disease, and country of residence...
December 9, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27941521/prevention-assessment-and-management-of-post-dialysis-fatigue-in-patients-attending-in-center-hemodialysis-a-best-practice-implementation-project
#16
Veronica Oliver, Matthew Stephenson
BACKGROUND: The hemodialysis (HD) population experiences a myriad of disease-related symptoms that are often not recognized and/or not treated. Post-dialysis fatigue is a frequent complaint of HD patients following a dialysis session, and there is currently no evidence-based approach to alleviate this problem. OBJECTIVES: The object of this best practice implementation project was to implement evidence-based strategies for the prevention, assessment and management of post-dialysis fatigue, with a view to lessening the disease burden experienced by in-center HD patients...
November 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27932111/hepatitis-c-virus-in-kidney-transplant-recipients-a-problem-on-the-path-to-eradication
#17
A Suarez Benjumea, C Gonzalez-Corvillo, J M Sousa, G Bernal Blanco, M Suñer Poblet, M A Perez Valdivia, F M Gonzalez Roncero, P Acevedo, M A Gentil Govantez
BACKGROUND: Hepatitis C virus (HCV) still has significant prevalence in kidney transplant (KT) recipients and is related to poor recipient and graft survival. New direct-acting antivirals (DAA) are leading to a radical change in the problem. METHODS: We studied HCV prevalence at the time of transplantation and in follow-up patients, the way cases are handled, and the results of DAA. RESULTS: A total of 2,001 KT had been performed in our center since 1978...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27916890/indoxyl-sulfate-review-of-toxicity-and-therapeutic-strategies
#18
REVIEW
Sheldon C Leong, Tammy L Sirich
Indoxyl sulfate is an extensively studied uremic solute. It is a small molecule that is more than 90% bound to plasma proteins. Indoxyl sulfate is derived from the breakdown of tryptophan by colon microbes. The kidneys achieve high clearances of indoxyl sulfate by tubular secretion, a function not replicated by hemodialysis. Clearance by hemodialysis is limited by protein binding since only the free, unbound solute can diffuse across the membrane. Since the dialytic clearance is much lower than the kidney clearance, indoxyl sulfate accumulates to relatively high plasma levels in hemodialysis patients...
November 30, 2016: Toxins
https://www.readbyqxmd.com/read/27908905/mortality-hospitalization-and-quality-of-life-among-patients-with-hepatitis-c-infection-on-hemodialysis
#19
David A Goodkin, Brian Bieber, Michel Jadoul, Paul Martin, Eiichiro Kanda, Ronald L Pisoni
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is widely prevalent among patients on hemodialysis (HD), but very rarely treated. The aim of our study is to evaluate the burdens of HCV suffered by patients on HD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Dialysis Outcomes and Practice Patterns Study is an international, prospective, cohort study of patients on HD. We reviewed the HCV status of 76,689 adults enrolled between 1996 and 2015. We compared HCV-positive (HCV+) with HCV-negative (HCV-) patients for risk of mortality, hospitalization, decline in hemoglobin concentration <8...
December 1, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#20
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
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