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Frequent hemodialysis

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https://www.readbyqxmd.com/read/28444336/intradialytic-hypotension-blood-pressure-changes-and-mortality-risk-in-incident-hemodialysis-patients
#1
Jason A Chou, Elani Streja, Danh V Nguyen, Connie M Rhee, Yoshitsugu Obi, Jula K Inrig, Alpesh Amin, Csaba P Kovesdy, John J Sim, Kamyar Kalantar-Zadeh
Background.: Intradialytic hypotension (IDH) occurs frequently in maintenance hemodialysis (HD) patients and may be associated with higher mortality. We hypothesize that nadir intradialytic systolic blood pressure (niSBP) is inversely related to death risk while iSBP change (Δ) and IDH frequency are incrementally associated with all-cause mortality. Methods.: In a US-based cohort of 112 013 incident HD patients over a 5-year period (2007-11), using niSBP, ΔiSBP (pre-HD SBP minus niSBP) and IDH frequency (proportion of HD treatments with niSBP <90 mmHg) within the first 91 days of HD, we examined mortality-predictability at 1, 2 and 5 years using Cox models and restricted cubic splines adjusted for case-mix, comorbidities and laboratory covariates...
April 21, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28439136/clinical-feasibility-of-monitoring-enoxaparin-anti-xa-concentrations-are-we-getting-it-right
#2
Wesley D Kufel, Robert W Seabury, William Darko, Luke A Probst, Christopher D Miller
Background: Anti-Xa monitoring is utilized to measure the extent of anticoagulation in certain patient populations receiving enoxaparin. It is essential to accurately obtain this pharmacodynamic marker for safe and effective anticoagulation management. Objectives: To determine the frequency of correctly drawn anti-Xa concentrations in accordance with predefined institutional criteria and to determine the number of dose adjustments implemented based on incorrectly drawn anti-Xa concentrations. Methods: This was a retrospective, single-center, cohort study among adult patients who received treatment doses of enoxaparin with measured anti-Xa concentrations...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28419668/prevalence-and-associated-variables-of-postdialysis-fatigue-results-of-a-prospective-multicenter-study
#3
Maurizio Bossola, Emanuele Marzetti, Enrico Di Stasio, Tania Monteburini, Stefano Cenerelli, Katia Mazzoli, Emanuele Parodi, Vittorio Sirolli, Stefano Santarelli, Fabio Ippoliti, Pier Eugenio Nebiolo, Mario Bonomini, Roberta Melatti, Carlo Vulpio
AIMS: Little is known about postdialysis fatigue (PDF), a debilitating symptom of hemodialysis patients. METHODS: In 5 hemodialysis units of northern-centre Italy, patients were regarded to suffer from PDF if they spontaneously offered this complaint when asked the open-ended question: Do you feel better or worse after dialysis? If worse, please specify in which way. A complaint of fatigue would be probed further with questions directed at its duration, frequency and intensity, allowing creation of a fatigue index of severity (one third of the sum of these three parameters, each rated from 1 to 5)...
April 17, 2017: Nephrology
https://www.readbyqxmd.com/read/28413417/the-dialysis-sodium-gradient-a-modifiable-risk-factor-for-fluid-overload
#4
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
#5
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/28407876/more-frequent-hemodialysis-does-not-effectively-clear-protein-bound-azotemic-solutes-derived-from-gut-microbiome-metabolism
#6
Andrew Davenport
The 5-year survival rate for hemodialysis patients remains lower than that for some of the more common solid organ cancers. Trials of increasing urea clearance by hemodialysis have failed to demonstrate improved patient survival. Accumulating evidence suggests that protein-bound azotemic solutes derived from gut microbiome metabolism have greater potential for toxicity than urea. The Frequent Hemodialysis Network Trials group now report that increasing dialysis frequency to 6 times a week did not effectively improve clearance of these protein-bound azotemic solutes compared with standard thrice weekly sessions...
May 2017: Kidney International
https://www.readbyqxmd.com/read/28396942/frequent-hemodialysis-history-of-the-modality-and-assessment-of-outcomes
#7
Douglas M Silverstein
About 660,000 individuals have end-stage renal disease in the USA, the vast majority of whom are receiving standard, in-center, thrice-weekly hemodialysis (HD). The morbidity and mortality among patients receiving standard HD remain unacceptably high. Studies conducted over the past two decades have provided a substantial amount of information on the advantages and drawbacks of providing more frequent HD treatment, either in-center or at home. In this article I summarize these studies, focusing special attention on the randomized, cross-over study assessing outcomes in children who received either frequent, in-center HD or traditional, thrice-weekly, in-center HD performed by Laskin et al...
April 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28396123/unique-hemoglobin-a1c-level-distribution-and-its-relationship-with-mortality-in-diabetic-hemodialysis-patients
#8
Junichi Hoshino, Maria Larkina, Angelo Karaboyas, Brian A Bieber, Yoshifumi Ubara, Kenmei Takaichi, Tadao Akizawa, Takashi Akiba, Shunichi Fukuhara, Ronald L Pisoni, Akira Saito, Bruce M Robinson
Diabetic hemodialysis patients with hemoglobin A1c (HbA1c) levels below 6.5% and over 8.0% face a higher mortality risk. To determine the optimal glycemic control in Japanese patients, we examined the association between HbA1c and mortality in 2,300 Japanese diabetic patients on maintenance hemodialysis with HbA1c levels determined at enrollment in the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS) phases 2-5, using Cox regression analysis with adjustment for baseline age, sex, dialysis vintage, 12 general comorbidities, hemoglobin, albumin and creatinine levels, and insulin use; stratification by JDOPPS phase; and facility clustering taken into account...
April 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28393724/clinical-characteristics-and-outcome-of-healthcare-associated-pneumonia-in-turkey
#9
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28389745/short-frequent-5-days-per-week-in-center-hemodialysis-versus-3-days-per-week-treatment-a-randomized-crossover-pilot-trial-through-the-midwest-pediatric-nephrology-consortium
#10
Benjamin L Laskin, Guixia Huang, Eileen King, Denis F Geary, Christoph Licht, Joshua P Metlay, Susan L Furth, Tom Kimball, Mark Mitsnefes
BACKGROUND: No controlled trials in children with end-stage kidney disease have assessed the benefits of more frequently administered hemodialysis (HD). METHODS: We conducted a multicenter, crossover pilot trial to determine if short, more frequent (5 days per week) in-center HD was feasible and associated with improvements in blood pressure compared with three conventional HD treatments per week. Because adult studies have not controlled for the weekly duration of dialysis, we fixed the total treatment time at 12 h a week of dialysis during two 3-month study periods; only frequency varied from 5 to 3 days per week between study periods...
April 8, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28381550/clinical-and-genetic-spectrum-of-bartter-syndrome-type-3
#11
Elsa Seys, Olga Andrini, Mathilde Keck, Lamisse Mansour-Hendili, Pierre-Yves Courand, Christophe Simian, Georges Deschenes, Theresa Kwon, Aurélia Bertholet-Thomas, Guillaume Bobrie, Jean Sébastien Borde, Guylhène Bourdat-Michel, Stéphane Decramer, Mathilde Cailliez, Pauline Krug, Paul Cozette, Jean Daniel Delbet, Laurence Dubourg, Dominique Chaveau, Marc Fila, Noémie Jourde-Chiche, Bertrand Knebelmann, Marie-Pierre Lavocat, Sandrine Lemoine, Djamal Djeddi, Brigitte Llanas, Ferielle Louillet, Elodie Merieau, Maria Mileva, Luisa Mota-Vieira, Christiane Mousson, François Nobili, Robert Novo, Gwenaëlle Roussey-Kesler, Isabelle Vrillon, Stephen B Walsh, Jacques Teulon, Anne Blanchard, Rosa Vargas-Poussou
Bartter syndrome type 3 is a clinically heterogeneous hereditary salt-losing tubulopathy caused by mutations of the chloride voltage-gated channel Kb gene (CLCNKB), which encodes the ClC-Kb chloride channel involved in NaCl reabsorption in the renal tubule. To study phenotype/genotype correlations, we performed genetic analyses by direct sequencing and multiplex ligation-dependent probe amplification and retrospectively analyzed medical charts for 115 patients with CLCNKB mutations. Functional analyses were performed in Xenopus laevis oocytes for eight missense and two nonsense mutations...
April 5, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28378078/different-clinical-characteristics-associated-with-acute-bleeding-and-delayed-bleeding-after-endoscopic-submucosal-dissection-in-patients-with-early-gastric-cancer
#12
Takafumi Yano, Satoshi Tanabe, Kenji Ishido, Mizuto Suzuki, Natsuko Kawanishi, Sakiko Yamane, Akinori Watanabe, Takuya Wada, Mizutomo Azuma, Chikatoshi Katada, Wasaburo Koizumi
BACKGROUND/AIMS: Few studies have classified risk factors according to the onset time of bleeding after endoscopic submucosal dissection (post-ESD bleeding). METHODS: We studied 1767 consecutive lesions in patients who underwent ESD for early gastric cancer from December 2006 through June 2016. Patients who had a remnant stomach or who had undergone reconstruction with a gastric tube were excluded. Post-ESD bleeding was classified into acute bleeding (0-5 days after ESD) and delayed bleeding (6 or more days after ESD), and the risk factors for each type of bleeding were compared...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28372582/coping-with-kidney-disease-qualitative-findings-from-the-empowering-patients-on-choices-for-renal-replacement-therapy-epoch-rrt-study
#13
Lalita Subramanian, Martha Quinn, Junhui Zhao, Laurie Lachance, Jarcy Zee, Francesca Tentori
BACKGROUND: The highly burdensome effects of kidney failure and its management impose many life-altering changes on patients. Better understanding of successful coping strategies will inform patients and help health care providers support patients' needs as they navigate these changes together. METHODS: A qualitative, cross-sectional study involving semi-structured telephone interviews including open- and closed-ended questions, with 179 U.S. patients with advanced chronic kidney disease (CKD), either not yet on dialysis ([CKD-ND], n = 65), or on dialysis (hemodialysis [HD], n = 76; or peritoneal dialysis [PD], n = 38) recruited through social media and in-person contacts from June to December 2013...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28371203/the-available-intravenous-iron-formulations-history-efficacy-and-toxicology
#14
Michael Auerbach, Iain Macdougall
A number of intravenous iron formulations have been developed over the past 65 years which rely on dextran or other compounds to prevent uncontrolled release of free iron to the circulation. High molecular weight dextran was associated with a number of serious adverse reactions and was removed from markets worldwide in 2009. The preponderance of published evidence suggests that the formulations of parenteral iron currently available in the United States, including low molecular weight iron dextran, are all safe and effective and there are no major, clinically important differences among them in terms of either efficacy or safety...
March 29, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28367862/asymptomatic-plaques-of-lower-peripheral-arteries-and-their-association-with-cardiovascular-disease-an-autopsy-study
#15
Eriko Nakamura, Yuichiro Sato, Takashi Iwakiri, Atsushi Yamashita, Sayaka Moriguchi-Goto, Kazunari Maekawa, Toshihiro Gi, Yujiro Asada
AIM: Patients with peripheral artery disease (PAD) have a high prevalence of cardiovascular morbidity and mortality; however, majority of patients with PAD are asymptomatic. This study aimed to histologically evaluate whether asymptomatic, lower extremity artery plaques are associated with systemic atherosclerosis and the onset of cardiovascular disease (CVD) events using autopsy cases. METHODS: We histologically investigated the atherosclerotic plaques of the common iliac, common carotid, coronary, and renal arteries from 121 autopsy cases without symptoms of PAD (mean age:67...
March 31, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28366150/-clinical-characteristics-and-outcome-of-healthcare-associated-pneumonia-in-turkey
#16
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28355409/life-saving-vascular-access-in-vascular-capital-exhaustion-single-center-experience-in-intra-atrial-catheters-for-hemodialysis
#17
Marta Pereira, Noélia Lopez, Iolanda Godinho, Sofia Jorge, Estela Nogueira, Fernando Neves, Alice Fortes, António G Costa
INTRODUCTION: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. OBJECTIVE: To assess the complications of IAC placement, as well as patient and vascular access survival after this procedure. METHODS: The authors retrospectively analyzed all seven patients with vascular capital exhaustion, without immediate alternative renal replacement therapy (RRT), who underwent IAC placement between January 2004 and December 2015 at a single center...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28353612/the-effectiveness-and-safety-of-angiotensin-converting-enzyme-inhibition-or-receptor-blockade-in-vascular-diseases-in-patients-with-hemodialysis
#18
Kuang-Ming Liao, Hui-Teng Cheng, Yi-Hsuan Lee, Chung-Yu Chen
Patients with end-stage renal disease (ESRD) who are on hemodialysis have high risk of vascular diseases. Our study sought to examine whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin type 1 receptor blockers (ARBs) could reduce the frequencies of cardiovascular and cerebrovascular events in patients receiving hemodialysis using the medication possession ratio (MPR) method of analysis.This retrospective cohort study identified cases of ESRD with dialysis from the National Health Insurance Research Database between 1999 and 2006, and used Cox-regression methods to evaluate risk of poor outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28341094/association-between-exposure-to-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-prior-to-septic-shock-and-acute-kidney-injury
#19
B Suberviola, E Rodrigo, A González-Castro, M Serrano, M Heras, Á Castellanos-Ortega
OBJECTIVE: To evaluate the association between angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) use prior to a septic shock episode and the development, prognosis and long-term recovery from acute kidney injury (AKI). DESIGN: A single-centre, prospective observational study was carried out between September 2005 and August 2010. SCOPE: Patients admitted to the ICU of a third level hospital. PATIENTS: A total of 386 septic shock patients were studied...
January 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28338477/osmotic-and-hemodynamic-effects-of-hypertonic-glucose-during-hemodialysis
#20
Daniel Schneditz, Stanisław Niemczyk, Notburga Sauseng, Isolde Bachler, Edda Zierler, Helmut Karl Lackner, Hildegard Hafner-Giessauf
It was the purpose to quantify the hemodynamic effects of a bolus of hypertonic glucose injected into the extracorporeal system in a group of stable and non-diabetic patients during hemodialysis (HD).Glucose and electrolytes were measured in frequent intervals. Arterial blood pressures and heart rates were continuously recorded by non-invasive vascular unloading technique. Beat-to-beat stroke volume, cardiac output, and total peripheral resistance were determined by Modelflow method. Relative blood volumes were continuously measured by ultrasonic and optical means...
March 22, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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