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https://www.readbyqxmd.com/read/29223620/impact-of-obesity-on-modality-longevity-residual-kidney-function-peritonitis-and-survival-among-incident-peritoneal-dialysis-patients
#1
Yoshitsugu Obi, Elani Streja, Rajnish Mehrotra, Matthew B Rivara, Connie M Rhee, Melissa Soohoo, Daniel L Gillen, Wei-Ling Lau, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: The prevalence of severe obesity, often considered a contraindication to peritoneal dialysis (PD), has increased over time. However, mortality has decreased more rapidly in the PD population than the hemodialysis (HD) population in the United States. The association between obesity and clinical outcomes among patients with end-stage kidney disease remains unclear in the current era. STUDY DESIGN: Historical cohort study. SETTING & PARTICIPANTS: 15,573 incident PD patients from a large US dialysis organization (2007-2011)...
December 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29211216/cardiac-surgery-in-jehovah-s-witness-patients-experience-of-a-brazilian-tertiary-hospital
#2
Felipe Homem Valle, Fernando Pivatto, Bruna Sessim Gomes, Tanara Martins de Freitas, Vanessa Giaretta, Miguel Gus
INTRODUCTION: The outcomes of Jehovah's Witness (JW) patients submitted to open heart surgery may vary across countries and communities. The aim of this study was to describe the morbidity and mortality of JW patients undergoing cardiac surgery in a tertiary hospital center in Southern Brazil. METHODS: A case-control study was conducted including all JW patients submitted to cardiac surgery from 2008 to 2016. Three consecutive surgical non-JW controls were matched to each selected JW patient...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29203125/vascular-access-outcomes-reported-in-maintenance-hemodialysis-trials-a-systematic-review
#3
Andrea K Viecelli, Emma O'Lone, Benedicte Sautenet, Jonathan C Craig, Allison Tong, Eric Chemla, Lai-Seong Hooi, Timmy Lee, Charmaine Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Ashley B Irish, Trevor A Mori, Elaine M Pascoe, David W Johnson, Carmel M Hawley
BACKGROUND: Many randomized controlled trials have been performed with the goal of improving outcomes related to hemodialysis vascular access. If the reported outcomes are relevant and measured consistently to allow comparison of interventions across trials, such trials can inform decision making. This study aimed to assess the scope and consistency of vascular access outcomes reported in contemporary hemodialysis trials. STUDY DESIGN: Systematic review. SETTING & POPULATION: Adults requiring maintenance hemodialysis...
December 1, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29198388/patient-reported-outcome-measures-for-fatigue-in-patients-on-hemodialysis-a-systematic-review
#4
Angela Ju, Mark L Unruh, Sara N Davison, Juan Dapueto, Mary Amanda Dew, Richard Fluck, Michael Germain, Sarbjit Vanita Jassal, Gregorio Obrador, Donal O'Donoghue, Peter Tugwell, Jonathan C Craig, Angelique F Ralph, Martin Howell, Allison Tong
BACKGROUND: Fatigue is a prevalent and debilitating symptom in patients receiving hemodialysis. We aimed to identify and evaluate the characteristics and psychometric properties of patient-reported outcome measures for fatigue in patients receiving hemodialysis, to inform the selection of a robust and feasible measure for use in randomized trials in hemodialysis. STUDY DESIGN: Systematic review of outcome measures for fatigue. SETTING & POPULATION: Patients receiving hemodialysis...
November 29, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29190861/-outcome-of-acute-kidney-injury-in-critically-ill-patients-treated-with-intermittent-hemodialysis-versus-crrt
#5
Mariana Ávalos-López, María Juana Pérez-López, Carolina Aguilar-Martínez, Ana María Del Carmen Díaz-Franco, Alejandro Esquivel-Chávez, José Angel Baltazar-Torres
BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients and it is associated with poor outcome. Some patients require renal replacement therapy (RRT), and the most frequently used are intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT). Current evidence is insufficient to conclude which modality is most appropriate to treat critically ill patients with AKI. METHODS: We reviewed the clinical records of critically ill patients with stage 3 AKI treated with RRT...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29179699/gastrointestinal-tuberculosis-following-renal-transplantation-accompanied-with-septic-shock-and-acute-respiratory-distress-syndrome-a-survival-case-presentation
#6
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29178510/the-pathogenesis-of-hemodialysis-vascular-access-failure-and-systemic-therapies-for-its-prevention-optimism-unfulfilled
#7
REVIEW
Andrea K Viecelli, Trevor A Mori, Prabir Roy-Chaudhury, Kevan R Polkinghorne, Carmel M Hawley, David W Johnson, Elaine M Pascoe, Ashley B Irish
In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are essential. Inadequate vascular remodeling and neointimal hyperplasia resulting in stenosis and frequently thrombosis are critical to the pathogenesis of access failure. Systemic medical therapies with pleiotropic effects including antiplatelet agents, omega-3 polyunsaturated fatty acids (fish oils), statins, and inhibitors of the renin-angiotensin-aldosterone system (RAAS) may reduce vascular access failure by promoting vascular access maturation and reducing stenosis and thrombosis through antiproliferative, antiaggregatory, anti-inflammatory and vasodilatory effects...
November 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29171000/applying-pharmacokinetic-pharmacodynamic-principles-for-optimizing-antimicrobial-therapy-during-continuous-renal-replacement-therapy
#8
Patrick M Honore, Rita Jacobs, Elisabeth De Waele, Herbert D Spapen
Continuous renal replacement therapy (CRRT) is progressively supplanting intermittent hemodialysis (IHD) in critically ill patients. CRRT indeed offers more appropriate hemodynamic, fluid, and metabolic stability but concern is rising about its impact on concomitant drug, and in particular antimicrobial, treatment. Antimicrobial dose recommendations have been elaborated to avoid drug accumulation and toxicity in patients undergoing IHD. However, these dosing regimens resulted in significant underdosing in patients undergoing CRRT thereby increasing the risk of treatment failure and development of resistance...
November 24, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29165964/preventing-intradialytic-hypotension-translating-evidence-into-practice
#9
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/29162677/feasibility-of-urgent-start-peritoneal-dialysis-in-older-patients-with-end-stage-renal-disease-a-single-center-experience
#10
Haijiao Jin, Zhaohui Ni, Shan Mou, Renhua Lu, Wei Fang, Jiaying Huang, Chunhua Hu, Haifen Zhang, Hao Yan, Zhenyuan Li, Zanzhe Yu
BACKGROUND: Patients with end-stage renal disease (ESRD) frequently require urgent-start dialysis. Recent evidence suggests that peritoneal dialysis (PD) might be a feasible alternative to hemodialysis (HD) in these patients, including in older patients. METHODS: This retrospective study enrolled patients aged > 65 years with ESRD who underwent urgent dialysis without functional vascular access or PD catheter at a single center, from January 2011 to December 2014...
November 21, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29161686/impact-of-an-in-hospital-patient-education-program-on-choice-of-renal-replacement-modality-in-unplanned-dialysis-initiation
#11
Moritz Schanz, Markus Ketteler, Markus Heck, Juergen Dippon, Mark Dominik Alscher, Martin Kimmel
BACKGROUND/AIMS: Up to 50% patients requiring dialysis receive an urgent, unplanned start (UPS) to renal replacement therapy (RRT). Most of these are initiated with an intravenous catheter and commenced and maintained on hemodialysis (HD). Although peritoneal dialysis (PD) could be an equipotent initial modality for RRT, it is used less frequently as long-term RRT in UPS patients. This multicenter-study aimed to evaluate the impact of a structured, in-hospital education program and factors influencing PD rates, especially in UPS patients...
November 21, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29148130/a-pseudo-one-compartment-model-of-phosphorus-kinetics-during-hemodialysis-further-supporting-evidence
#12
John K Leypoldt, Baris U Agar, Alfred K Cheung, Angelito A Bernardo
A pseudo-one compartment model has been proposed to describe phosphorus kinetics during hemodialysis and the immediate post-dialysis period. This model assumes that phosphorus mobilization from tissues is proportional to the difference between the pre-dialysis serum concentration (a constant) and the instantaneous serum concentration. The current study is exploratory and evaluated the ability of a pseudo-one compartment model to describe the kinetics of phosphorus during two short hemodialysis treatments separated by a 60-min inter-treatment period without dialysis; the latter is the post-dialysis rebound period for the first short hemodialysis treatment...
November 2017: Artificial Organs
https://www.readbyqxmd.com/read/29143935/a-propensity-matched-comparison-of-hard-outcomes-in-children-on-chronic-dialysis
#13
Enrico Vidal, Nicholas C Chesnaye, Fabio Paglialonga, Bruno Minale, Giovanna Leozappa, Mario Giordano, Bruno Gianoglio, Ciro Corrado, Rosa Maria Roperto, Roberto Chimenz, Francesca Mencarelli, Ilse-Maria Ratsch, Luisa Murer, Enrico Verrina
Data concerning outcomes of children on hemodialysis (HD) and peritoneal dialysis (PD) are scarce and frequently derived from single-center experiences. We sought to compare survival and transplantation rates in a large cohort of PD and HD patients. We extracted all patients initiating dialysis under 16 years of age between 2004 and 2013 from the Italian Registry of Pediatric Chronic Dialysis. Patients on PD were propensity-matched to those on HD based on gender, age, primary cause of ESRD, and the number of co-morbidities...
November 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29134617/vascular-calcification-is-not-related-to-serum-fetuin-a-and-osteopontin-levels-in-hemodialysis-patients
#14
O Ulutas, M C Taskapan, A Dogan, T Baysal, H Taskapan
INTRODUCTION: Vascular calcification (VC) in hemodialysis (HD) patients is a sign of severe cardiovascular disease and can predict cardiovascular outcomes. Fetuin-A and osteopontin (OPN) inhibit VC. Serum fetuin-A levels are lower in patients with end-stage kidney disease (ESKD) and in those who are on chronic HD therapy. However, there are limited data concerning OPN in patients who are on dialysis. The aim of our study was to determine VC in HD patients, the relationship between VC and 25-OH-vitamin D, fetuin-A, and OPN levels, and independent predictors of VC...
November 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29123006/outcomes-of-simultaneous-peritoneal-dialysis-and-arteriovenous-fistula-placement-in-end-stage-renal-disease-patients
#15
Nosratollah Nezakatgoo, Albert Ndzengue, Manhunath Ramaiah, Elvira O Gosmanova
Peritoneal dialysis (PD) interruption requiring hemodialysis (HD) is not uncommon and its frequently abrupt nature prevents timely creation of permanent HD access and avoidance of central venous catheters (CVC). We retrospectively studied a cohort of 24 end-stage renal disease (ESRD) patients (mean age 50.7 years, 83.3% African-Americans, 58.3% females, time on dialysis interquartile range [IQR] 0 - 65 days) who had simultaneous PD catheter insertion and backup arteriovenous fistula (AVF) creation between January 1, 2012, and December 31, 2013...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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
#16
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/29097857/like-the-eye-of-the-tiger-inpatient-psychiatric-facility-exclusionary-criteria-and-its-knockout-of-the-emergency-psychiatric-patient
#17
Veronica Tucci, John Liu, Anu Matorin, Asim Shah, Nidal Moukaddam
Context: Over 6% of all emergency department (ED) visits in the United States involve primary mental health or behavioral issues. The patients are stabilized in the ED but frequently require admission to an inpatient psychiatric unit or institution for longer term treatment and management. To facilitate this process, an emergency physician (EP) must first "medically clear" the patient as stable for transfer. At present, there is no interdisciplinary consensus regarding the necessary elements of the medical clearance or stability assessment process...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29082626/two-stage-basilic-vein-transposition-second-stage-results
#18
Duarte Rego, Clara Nogueira, António Matos, Paulo Almeida, José Queirós, Fernanda Silva, Clemente Sousa, Rui Almeida
The increasing survival of hemodialysis patients results in the depletion of superficial venous capital justifying the use of the basilic vein. Many groups still prefer an arteriovenous graft due to transposition complexity and the time needed to achieve maturation. In this work we review the results of our series of basilic vein transpositions (BVT). BVTs were performed in two stages: first, creation of the fistula; second, transposition of the vein using three small incisions in the arm. All patients had to have direct arterialization of the basilic vein, therefore, patients with previous ipsilateral wrist fistulas also followed a two-stage protocol...
October 30, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29077786/intradialytic-hypertension-frequency-and-short-term-clinical-outcomes-among-individuals-receiving-maintenance-hemodialysis
#19
Magdalene M Assimon, Lily Wang, Jennifer E Flythe
Background: Intradialytic hypertension occurs in 5-20% of hemodialysis treatments. Observational data support an association between intradialytic hypertension and long-term mortality. However, the short-term consequences of recurrent intradialytic hypertension are unknown. Methods: Data were taken from a cohort of prevalent hemodialysis patients receiving treatment at a large U.S. dialysis organization on 01/01/2010. A retrospective cohort design with a 180-day baseline, 30-day exposure assessment and 30-day follow-up period was used to estimate the associations between intradialytic hypertension frequency and 30-day outcomes...
October 25, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29064172/measuring-residual-renal-function-for-hemodialysis-adequacy-is-there-an-easier-option
#20
REVIEW
Andrew Davenport
Most patients starting hemodialysis (HD) have residual renal function. As such, there has been increased interest in starting patients with less frequent and shorter dialysis session times. However, for this incremental approach to be successful, patients require regular monitoring of residual renal function, so that as residual renal function declines, the amount of HD is appropriately increased. Currently most dialysis centers rely on interdialytic urine collections. However, many patients find these inconvenient and there may be marked intrapatient variability due to compliance issues...
October 2017: Hemodialysis International
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