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Hemodialysis adequacy

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https://www.readbyqxmd.com/read/28098103/relation-of-fibroblast-growth-factor-23-and-cardiovascular-calcification-in-end-stage-kidney-disease-patients-on-regular-hemodialysis
#1
Tarek Zakaria El Baz, Osama Ahmed Khamis, Osama Ashry Ahmed Gheith, Salama Saad Abd Ellateif, Abdallah Mahmoud Abdallah, Hussein Chahine Abd El Aal
More than half of deaths in end-stage kidney disease (ESKD) patients are due to cardiovascular disease. Elevated fibroblast growth factor 23 (FGF-23) was found to be associated with mortality in hemodialysis (HD) patients and correlates with peripheral calcification. Aortic calcification is associated with coronary artery calcification. Both aortic and peripheral vascular calcifications were associated with mortality in chronic kidney disease. We aimed to investigate the relation between intact FGF-23 and cardiovascular calcification in patients with ESKD who were maintained on regular HD...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28092113/hemodialysis-treatment-time-as-important-as-it-seems
#2
John T Daugirdas
Hemodialysis treatment time and Kt/V can both be considered to be primary measures of hemodialysis adequacy, because when either goes to zero, mortality is certain in patients without residual kidney function. Treatment time is important, but it needs to be adjusted based on surface-area-normalized Kt/V, residual kidney function, and expected ultrafiltration rate. Rescaling dose of dialysis measured as Kt/V to body surface area prevents ultrashort dialysis in small patients, women, and children with minimal residual kidney function...
January 16, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/27991478/hemodialysis-delivery-dialysis-dose-achievement-and-vascular-access-types-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcomes-and-practice-patterns-study-phase-5-2012-2015
#3
Anas AlYousef, Sumaya AlGhareeb, Jamal Al Wakeel, Saeed M G Al-Ghamdi, Brian A Bieber, Mohamad Hassan, Yacoub Al Maimani, Naser Alkandari, Haroun Z Ahmed, Ashraf Fawzy, Ronald L Pisoni
The prospective observational Dialysis Outcomes and Practice Patterns Study (DOPPS) was initiated in late 2012 in national samples of hemodialysis (HD) units (n = 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For many years, guidelines have recommended single pool Kt/V ≥1.2 as the minimum adequate dose for chronic HD patients. Here, we report initial DOPPS results regarding HD practices related to dialysis dose achievement in the GCC...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27991476/cardiovascular-and-cerebrovascular-comorbidities-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcome-and-practice-pattern-study-phase-5-2012-2015
#4
Faissal A M Shaheen, Jamal Al Wakeel, Saeed M G Al-Ghamdi, Bassam Alhelal, Sumaya AlGhareeb, Ali Abdulkarim Al Obaidli, Issa AlSalmi, Hani Ezzat Abdulaziz, Brian A Bieber, Ronald L Pisoni
To determine the prevalence of cardiovascular comorbidities and their active risk factors in the selected hemodialysis centers in the Gulf Cooperation Council (GCC) countries, the Dialysis Outcome and Practice Pattern Study (DOPPS) was performed on 40 dialysis centers in the six GCC countries from June 2012 to May 2015. There were 21 dialysis centers from Saudi Arabia, nine from the United Arab Emirates (UAE), four from Kuwait, four from Oman, two from Qatar, and one from Bahrain. There were 922 patients participating in the study; 419 patients from Saudi Arabia, 144 from the UAE, 164 from Kuwait, 89 from Oman, 58 from Qatar, and 25 from Bahrain...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27960188/effects-of-vitamin-e-coated-versus-conventional-membranes-in-chronic-hemodialysis-patients-a-systematic-review-and-meta-analysis
#5
Graziella D'Arrigo, Rossella Baggetta, Giovanni Tripepi, Francesco Galli, Davide Bolignano
INTRODUCTION: Accruing evidence suggests that vitamin E-coated membranes (ViE-m) might improve the clinical management of chronic hemodialysis (HD) patients. METHODS: We conducted a systematic review and meta-analysis of RCTs comparing ViE-m to conventional HD. Endpoints of interest were a series of biomarkers pertaining to anemia status, inflammation, oxidative stress and dialysis efficacy/status. RESULTS: Sixty studies were included. ViE-m significantly improved the Erythropoietin Resistance Index but had no impact on other anemia parameters...
December 14, 2016: Blood Purification
https://www.readbyqxmd.com/read/27957414/current-characteristics-of-dialysis-therapy-in-korea-2015-registry-data-focusing-on-elderly-patients
#6
REVIEW
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park
Because of increases in the elderly population and diabetic patients, the proportion of elderly among dialysis patients has rapidly increased during the last decades. The mortality and morbidity of these elderly dialysis patients are obviously much higher than those of young patients, but large analytic studies about elderly dialysis patients' characteristics have rarely been published. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an Internet online registry program and analyzed the characteristics...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27951549/recent-trends-in-home-hemodialysis-therapy-in-japan
#7
Ikuto Masakane, Norio Hanafusa, Tomoyuki Kita, Kenji Maeda
BACKGROUND: Home hemodialysis (HHD) is rapidly becoming more widespread because HHD programs enable patients to receive a sufficient dialysis dose to improve their quality of life and survival rate without compromising their lifestyle. SUMMARY: Although HHD in Japan has a long history, the 529 dialysis patients being treated with HHD as of the end of 2014 account for only 0.17% of all dialysis patients. HHD is well indicated for patients who are younger, male, and nondiabetic...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27942169/assessment-of-hemodialysis-adequacy-in-patients-with-chronic-kidney-disease-in-the-hemodialysis-unit-at-tanta-university-hospital-in-egypt
#8
M El-Sheikh, G El-Ghazaly
Worldwide, hemodialysis (HD) constitutes the most common form of renal replacement therapy. Many studies have shown strong correlation between HD dose and clinical outcome. The cross-sectional study was conducted on 100 patients in Hemodialysis Unit at Tanta University Hospital, Egypt. Data were collected using a reliable questionnaire (including clinical, demographic, dialysis, laboratory, and radiological data). SpKt/V was used to assess the adequacy of HD. The results revealed inadequate HD dose among 60% of the study population...
November 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27903856/laparoscopic-left-hemicolectomy-for-colon-cancer-in-peritoneal-dialysis-patients-a-valid-and-safe-surgical-technique-to-ensure-peritoneal-dialysis-survival
#9
Sara Auricchio, Giulio Mari, Andrea Galassi, Beatrice Dozio, Marco Pozzi, Dario Maggioni, Renzo Scanziani
A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27896236/the-effect-of-bcaa-and-iso-whey-oral-nutritional-supplements-on-dialysis-adequacy
#10
Effat Afaghi, Ali Tayebi, Abbas Ebadi, Vahid Sobhani, Behzad Einollahi, Mehdi Tayebi
BACKGROUND: Protein-energy malnutrition is a common problem in hemodialysis patients and has different outcomes such as reduced quality of life, longer hospitalization time, lower dialysis adequacy, and higher mortality rate. Investigation of dialysis adequacy is an important method for assessing hemodialysis patients, and improving the dialysis adequacy is an important healthcare team goal. OBJECTIVES: The present study aims to investigate and compare the effects of BCAA and ISO-WHEY oral nutritional supplements on dialysis adequacy...
November 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27884309/would-prescribing-target-kt-dose-adjusted-for-body-surface-area-improve-hemodialysis-outcomes
#11
Ken Farrington, Andrew Davenport
The use of Kt/V to prescribe and monitor hemodialysis adequacy remains the current standard, although it is increasingly questioned. Alternative proposals for dose prescription and monitoring have been advocated. In a noninterventional, prospective study reported in this issue, Maduell et al., utilizing online ionic dialysance, explore the association between outcome measures (mortality and hospitalization rates) and the extent to which delivered Kt dose achieved minimal target Kt doses calculated from individual estimates of body surface area...
December 2016: Kidney International
https://www.readbyqxmd.com/read/27876356/-low-flux-dialysate-daily-home-hemodialysis-a-result-for-the-62%C3%A2-first-french-and-belgian-patients
#12
Anaïs Benabed, Patrick Henri, Thierry Lobbedez, Eric Goffin, Simona Baluta, Abdelkader Benziane, Ahmed Rachi, Johan W van der Pijl, Clémence Bechade, Maxence Ficheux
Since 2011, a new device is available for low flux dialysate quotidian home hemodialysis in France and Belgium. This study aims to evaluate the characteristics and dialysis prescriptions for Nx Stage System One™ users. We retrospectively included patients trained between 2011 and 2013 in France and Belgium. We collected data concerning their clinical features, their dialysis prescriptions, their laboratory parameters until 6 months of dialysis and, reason for dropping in case of cessation. Sixty-two patients from 31 centers, aged 48±18 years old, with a sex ratio 46/16 (M/F) are included with a median Charlson comorbidity index of 1 [0-3]...
November 18, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27859427/citrate-buffered-dialysis-solution-citrasate-allows-avoidance-of-anticoagulation-during-intermittent-hemodiafiltration-at-the-cost-of-decreased-performance-and-systemic-biocompatibility
#13
Pavlina Richtrova, Jan Mares, Lukas Kielberger, Ladislav Trefil, Jaromir Eiselt, Tomas Reischig
Reportedly, citrate-based dialysis solution enables heparin dose tapering or even complete exclusion, particularly in postdilution hemodiafiltration (HDF). The aim of the study was to verify this strategy in predilution setting and to assess its short-term safety, efficacy, and biocompatibility. Ten regular hemodialysis patients were assigned to predilution HDF on acetate- and citrate-based dialysis solutions (0.8 mmol/l trisodium citrate) at random order. Acetate HDF was performed using routine dose of heparin while citrate HDF was heparin free...
November 10, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27857008/-the-effect-of-dialysate-flow-rate-on-dialysis-adequacy-and-fatigue-in-hemodialysis-patients
#14
Sun Mi Cha, Hye Sook Min
PURPOSE: In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis. METHODS: This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant's own blood flow, 500 mL/min, and 700 mL/min...
October 2016: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/27803725/association-between-anxiety-and-depression-with-dialysis-adequacy-in-patients-on-maintenance-hemodialysis
#15
Afshan Najafi, Sorena Keihani, Nazila Bagheri, Atefeh Ghanbari Jolfaei, Azadeh Mazaheri Meybodi
BACKGROUND: Depression and anxiety are common among hemodialysis patients and affect their treatment outcomes. Dialysis adequacy also affects the hemodialysis patients' survival rates. OBJECTIVES: This study aimed to evaluate the correlation between anxiety and depression with dialysis adequacy. PATIENTS AND METHODS: In this cross-sectional study, 127 hemodialysis patients (73 males, 57.5%) with the mean age of 55.7 ± 17.5 were enrolled. Demographic and recent laboratory data were collected using self-administered questionnaires and by reviewing medical records...
June 2016: Iranian Journal of Psychiatry and Behavioral Sciences
https://www.readbyqxmd.com/read/27766679/hemodialysis-time-and-kt-v-less-may-be-better
#16
EDITORIAL
James Tattersall
Current guidelines focus on conventional dialysis defined as 3-5 hours, three times per week, and suggest that longer or more frequent dialysis be considered. This paper presents the case for considering that shorter or less frequent dialysis should also be considered. More frequent and/or longer dialysis facilitates control of fluid overload, blood pressure, and phosphate levels. These benefits will require time to translate into probable hard outcome improvement. Patients are unlikely to participate in productive or pleasurable activities while undergoing dialysis in center or traveling to treatment...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/27721228/a-randomized-clinical-trial-of-the-effect-of-pentoxifylline-on-c-reactive-protein-level-and-dialysis-adequacy-in-end-stage-renal-disease-patients-on-maintenance-hemodialysis
#17
Parvin Soltani, Pardis Ketabi Moghaddam, Farshid Haghverdi, Ali Cheraghi
INTRODUCTION:  C-reactive protein (CRP) is increased among patients on maintenance hemodialysis. Such inflammatory markers can result in protein-energy deficit syndromes and low adequacy of dialysis in these patients. This study evaluated the effect of pentoxifylline on serum CRP level and KT/V in end-stage renal disease patients on maintenance hemodialysis. MATERIAL AND METHODS: This 1-month randomized, double-blind, placebo-controlled clinical trial involving 73 patients with end-stage renal disease on maintenance hemodialysis assessed the effectiveness of 400 mg/d of pentoxifylline on serum CRP level decrease and improvement of dialysis adequacy...
September 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27679720/the-impact-of-haemodialysis-arteriovenous-fistula-on-haemodynamic-parameters-of-the-cardiovascular-system
#18
Carlo Basile, Luigi Vernaglione, Francesco Casucci, Pasquale Libutti, Piero Lisi, Luigi Rossi, Valentina Vigo, Carlo Lomonte
BACKGROUND: Satisfactory vascular access flow (Qa) of an arteriovenous fistula (AVF) is necessary for haemodialysis (HD) adequacy. The aim of the present study was to further our understanding of haemodynamic modifications of the cardiovascular system of HD patients associated with an AVF. The main objective was to calculate using real data in what way an AVF influences the load of the left ventricle (LLV). METHODS: All HD patients treated in our dialysis unit and bearing an AVF were enrolled into the present observational cross-sectional study...
October 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27668161/low-prealbumin-levels-are-independently-associated-with-higher-mortality-in-patients-on-peritoneal-dialysis
#19
Kyung Hee Lee, Jang-Hee Cho, Owen Kwon, Sang-Un Kim, Ryang Hi Kim, Young Wook Cho, Hee-Yeon Jung, Ji-Young Choi, Chan-Duck Kim, Yong-Lim Kim, Sun-Hee Park
BACKGROUND: Prealbumin, a sensitive marker for protein-energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients. METHODS: In total, 136 incident PD patients (mean age, 53.0 ± 15.8 years) between 2002 and 2007 were enrolled in the study. Laboratory data, dialysis adequacy, and nutritional parameters were assessed 3 months after PD initiation...
September 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27663037/scaling-hemodialysis-target-dose-to-reflect-body-surface-area-metabolic-activity-and-protein-catabolic-rate-a-prospective-cross-sectional-study
#20
Sivakumar Sridharan, Enric Vilar, Andrew Davenport, Neil Ashman, Michael Almond, Anindya Banerjee, Justin Roberts, Ken Farrington
BACKGROUND: Women and small men treated by hemodialysis (HD) have reduced survival. This may be due to use of total-body water (V) as the normalizing factor for dialysis dosing. In this study, we explored the equivalent dialysis dose that would be delivered using alternative scaling parameters matching the current recommended minimum Kt/V target of 1.2. STUDY DESIGN: Prospective cross-sectional study. SETTING & PARTICIPANTS: 1,500 HD patients on a thrice-weekly schedule, recruited across 5 different centers...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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