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Short daily dialysis

Sadudee Peerapornratana, Pajaree Chariyavilaskul, Talerngsak Kanjanabuch, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Pisut Katavetin
♦ Background: Current guidelines suggest that intraperitoneal (IP) antibiotics should be administered only in a long peritoneal dialysis (PD) dwell (≥ 6 hours). The long dwell might result in low ultrafiltration and volume overload. We aim to examine plasma and dialysate concentration of cefazolin and ceftazidime after IP administration in a short-dwell (≤ 2 hours) automated cyclingexchange. ♦ Methods: Stable PD patients without peritonitis were invited to participate in the present study. Patients underwent 5 2-liter exchanges of PD fluid over 10 hours by the PD cycling machine without last fill or additional dwell...
October 13, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Bhawna Gupta, Ali Dodge-Khatami, Juan Tucker, Mary B Taylor, Douglas Maposa, Miguel Urencio, Jorge D Salazar
BACKGROUND: Antegrade cerebral perfusion (ACP) typically is used with deep hypothermia for cerebral protection during aortic arch reconstructions. The impact of ACP on cerebral oxygenation and serum creatinine at a more tepid 25 °C was studied in newborns and children. METHODS: Between 2010 and 2014, 61 newborns and children (<5 years old) underwent aortic arch reconstruction using moderate hypothermia (25.0±0.9 °C) with ACP and a pH-stat blood gas management strategy...
July 2016: Translational pediatrics
Ji In Park, Jung Tak Park, Yong-Lim Kim, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Yun Kyu Oh, Chun Soo Lim, Yon Su Kim, Jung Pyo Lee
BACKGROUND: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. METHODS: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline...
September 28, 2016: Nephrology, Dialysis, Transplantation
Michael V Rocco
BACKGROUND: Chronic hemodialysis (HD) in the 1960s encompassed a wide variety of prescriptions from twice weekly to five times per week HD. Over time, HD prescriptions in the West became standardized at three times per week, 2.5-4 h per session, with occasional additional treatments for volume overload. SUMMARY: When clinical trials of dialysis dose failed to show significant benefit of extending time compared with the traditional dialysis prescription, interest in more frequent HD was renewed...
December 2015: Kidney Diseases
Hwee-Lin Wee, Benjamin Jun Jie Seng, Jia Jia Lee, Kok Joon Chong, Pallavi Tyagi, Anantharaman Vathsala, Priscilla How
BACKGROUND: Patients with chronic kidney disease (CKD) have poor health-related quality of life (HRQoL). The association of CKD-related complications such as anemia and mineral and bone disorders (MBD) with HRQoL in pre-dialysis patients is not well-studied. As such, this study aimed to determine the association of anemia and MBD with HRQoL in pre-dialysis patients. METHODS: This was a cross-sectional study involving 311 adult pre-dialysis patients with stage 3-5 CKD from an acute-care hospital in Singapore...
2016: Health and Quality of Life Outcomes
Anne-Sophie Truche, Michael Darmon, Sébastien Bailly, Christophe Clec'h, Claire Dupuis, Benoit Misset, Elie Azoulay, Carole Schwebel, Lila Bouadma, Hatem Kallel, Christophe Adrie, Anne-Sylvie Dumenil, Laurent Argaud, Guillaume Marcotte, Samir Jamali, Philippe Zaoui, Virginie Laurent, Dany Goldgran-Toledano, Romain Sonneville, Bertrand Souweine, Jean-Francois Timsit
PURPOSE: The best renal replacement therapy (RRT) modality remains controversial. We compared mortality and short- and long-term renal recovery between patients treated with continuous RRT and intermittent hemodialysis. METHODS: Patients of the prospective observational multicenter cohort database OUTCOMEREA™ were included if they underwent at least one RRT session between 2004 and 2014. Differences in patients' baseline and daily characteristics between treatment groups were taken into account by using a marginal structural Cox model, allowing one to substantially reduce the bias resulting from confounding factors in observational longitudinal data analysis...
September 2016: Intensive Care Medicine
Maria Eleni Roumelioti, Thomas Nolin, Mark L Unruh, Christos Argyropoulos
BACKGROUND: Beta-2 Microglobulin (β2M) is a prototypical "middle molecule" uremic toxin that has been associated with a higher risk of death in hemodialysis patients. A quantitative description of the relative importance of factors determining β2M concentrations among patients with impaired kidney function is currently lacking. METHODS: Herein we undertook a systematic review of existing studies reporting patient level data concerning generation, elimination and distribution of β2M in order to develop a population model of β2M kinetics...
2016: PloS One
Laurent Alric, Delphine Bonnet
INTRODUCTION: Hepatitis C virus (HCV)-related liver disease is a cause of significant morbidity and mortality worldwide. Currently, direct-acting antiviral drugs (DAAs) are associated with an increased sustained virologic response (SVR) and are the gold standard for treating HCV infection. AREAS COVERED: The new combination of grazoprevir, an inhibitor of HCV NS3/4A, and elbasvir, an inhibitor of HCV NS5A, once daily will be available for the treatment of HCV infection...
2016: Expert Opinion on Pharmacotherapy
John Liantonio, Serife Eti
No abstract text is available yet for this article.
December 2015: Journal of Family Practice
Mohammed Rafique Moosa, Anthony M Meyers, Errol Gottlich, Sarala Naicker
Very few patients with end-stage kidney disease in South Africa receive renal replacement treatment (RRT), despite the rapidly growing demand, because of resource constraints. Nephrologists who agonise daily about who to treat and who not to, and have been doing so since the inception of dialysis in this country, welcomed the opportunity to interact with the National Department of Health at a recent summit of stakeholders. The major challenges were identified and recommendations for short- to long-term solutions were made...
February 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Neil F Goodman, Rhoda H Cobin, Walter Futterweit, Jennifer S Glueck, Richard S Legro, Enrico Carmina
Polycystic Ovary Syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists (AACE) and the Androgen Excess and PCOS Society (AES) aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2015. PCOS has been defined using various criteria, including menstrual irregularity, hyperandrogenism, and polycystic ovary morphology (PCOM)...
November 2015: Endocrine Practice
Mohamed A Ibrahim, Iman I Sarhan, Mohamed R Halawa, Essam N Afify, Hayam A Hebah, Eman A Al-Gohary, Islam O El-Shazly
Vitamin D is claimed to have an adjuvant effect on glycemic control by dual action on pancreatic β-cells and insulin resistance. The aim of this study was to assess the possible effect of short-term alfacalcidol supply on glycemic control in type 2 diabetic hemodialysis (HD) patients. Twenty type 2 diabetic HD patients (using diet and oral drugs but not insulin) were randomly selected from our dialysis unit as well as 20 non-diabetic HD patients as control. A third group of 12 healthy subjects were studied as well...
October 2015: Hemodialysis International
Dori Schatell
Dialysis options education in the United States for patients tends to focus on clinical aspects of ESRD treatment and on how each option is done. The non-profit Medical Education Institute (MEI) has developed an online, patient-centered dialysis decision aid that maps six dialysis options (peritoneal dialysis, standard incenter hemodialysis, conventional home hemodialysis, short daily hemodialysis, and nocturnal hemodialysis--incenter or at home) in four categories onto 24 different lifestyle and health values...
March 2015: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
G Muduma, I Odeyemi, R F Pollock
BACKGROUND AND AIMS: While short-term kidney graft survival has gradually improved over time, improvements in long-term graft survival have been more modest. One key clinical factor limiting improved longer-term outcomes is antibody-mediated rejection (AbMR), the incidence of which appears to be higher in patients who are non-adherent to immunosuppressants. Recent data show that adherence can be improved by reducing pill burden. The aim of the present study was to model the incidence and economic consequences of graft loss and AbMR in patients taking once- vs twice-daily tacrolimus in the UK...
2015: Journal of Medical Economics
Raymond Vanholder, Griet Glorieux, Sunny Eloot
After its proposal as a marker of dialysis adequacy in the eighties of last century, Kt/V(urea) helped to improve dialysis efficiency and to standardize the procedure. However, the concept was developed when dialysis was almost uniformly short and was applied thrice weekly with small pore cellulosic dialyzers. Since then dialysis evolved in the direction of many strategic alternatives, such as extended or daily dialysis, large pore high-flux dialysis, and convective strategies. Although still a useful baseline marker, Kt/V(urea) no longer properly covers up for most of these modifications so that urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients...
September 2015: Kidney International
Rapeephan R Maude, Michael Barretti
INTRODUCTION: Hydrothorax is a rare complication of continuous ambulatory peritoneal dialysis (CAPD) which can progress quickly to cause acute respiratory distress. CASE PRESENTATION: We present a 76 year-old female with a past medical history significant for end-stage renal disease (ESRD) on daily home peritoneal dialysis for 2 years presented to the hospital from home with shortness of breath at rest and cough for 2 days prior to admission. She developed severe respiratory distress and had emergent pleurocentesis that released 3...
2014: Respiratory Medicine Case Reports
Damir R Rebić, Senija R Rašić, Muamer D Dervišević, Aida H M Hamzić-Mehmedbašić, Alma M Muslimović, Edina H Hasanagić
AIMS: Cardiovascular alterations contribute to a high mortality rate in patients with end-stage renal disease (ESRD). The aims of the present study are to evaluate left ventricular (LV) function and common carotid artery (CCA) parameters and to determine risk factors associated with these changes in patients undergoing peritoneal dialysis (PD). METHODS: This longitudinal prospective study was conducted in 50 ESRD patients in whom PD had been initiated and who were observed for 18 months after the commencement of dialysis treatment, with echocardiography and CCA ultrasound parameter evaluation...
April 2015: Cardiorenal Medicine
Manish M Sood, Robert P Pauly, Claudio Rigatto, Paul Komenda
Cardiovascular disease in the haemodialysis population continues to contribute to mortality and morbidity. Disorders of left ventricular geometry and function are highly prevalent and lead to increased mortality in this highly vulnerable population. Left ventricular dysfunction (LVDys), often as a result of hypertension, ischaemic cardiac disease or dilated cardiomyopathy, has not been uniformly defined in the literature making diagnosis and therapy problematic. Although routinely available, screening by echocardiography is critically volume dependent and prone to underestimation in left ventricular ejection fraction...
August 2008: NDT Plus
Brigitte Schiller
Thrice weekly in-center hemodialysis is the standard of care for dialysis patients with end-stage renal disease (ESRD). However, there is ongoing debate as to whether more frequent hemodialysis, with its readier management of both toxin and fluid removal, benefits patients. New evidence from recent studies, both in center dialysis and in home haemodialysis patients, adds further confirmation of improved cardiovascular outcome and quality of life in patients undergoing short daily hemodialysis. A paradigm shift in ESRD care delivery may be facilitated due to new technology enabling daily therapy at home...
December 2011: NDT Plus
Julie A Wright Nunes, Cheryl A M Anderson, Jane H Greene, Talat Alp Ikizler, Kerri L Cavanaugh
BACKGROUND: Reducing dietary sodium has potential to benefit patients with chronic kidney disease (CKD). Little research is available defining dietary sodium knowledge gaps in patients with pre-dialysis CKD. We designed a brief screening tool to rapidly identify patient knowledge gaps related to dietary sodium for patients with CKD not yet on dialysis. METHODS: A Short Sodium Knowledge Survey (SSKS) was developed and administered to patients with pre-dialysis CKD...
2015: BMC Nephrology
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