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Hemodialysis adequacy

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https://www.readbyqxmd.com/read/29229170/care-of-the-pediatric-patient-on-chronic-dialysis
#1
REVIEW
Annabelle N Chua, Bradley A Warady
Optimal care of the pediatric end-stage renal disease (ESRD) patient on chronic dialysis is complex and requires multidisciplinary care as well as patient/caregiver involvement. The dialysis team, along with the family and patient, should all play a role in choosing the dialysis modality which best meets the patient's needs, taking into account special considerations and management issues that may be particularly pertinent to children who receive peritoneal dialysis or hemodialysis. Meticulous attention to dialysis adequacy in terms of solute and fluid removal, as well as to a variety of clinical manifestations of ESRD, including anemia, growth and nutrition, chronic kidney disease-mineral bone disorder, cardiovascular health, and neurocognitive development, is essential...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29210176/online-measurement-of-hemodialysis-adequacy-using-effective-ionic-dialysance-of-sodium-a-review-of-its-principles-applications-benefits-and-risks
#2
REVIEW
Shakil Aslam, Subodh J Saggi, Moro Salifu, Robert J Kossmann
Dialysis dose is an important determinant of clinical outcomes in patients with end stage renal disease on maintenance dialysis. In clinical practice dialysis dose is monitored at least monthly by urea clearance based on Urea Kinetic Modeling. Online clearance monitoring using effective ionic dialysance (EID) of sodium (Na+ ) is available on some hemodialysis machines. This paper reviews the background, methodology, additional applications, and potential risks associated with EID. Effective ionic dialysance provides a reliable, real-time, noninvasive, and inexpensive measurement of dialysis dose during an ongoing hemodialysis (HD) session to allow interventions and assess the impact of these changes on clearance...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29191576/-comparison-of-citrate-4-and-heparin-as-tunneled-catheters-locking-solution-in-chronic-hemodialysis
#3
Guillaume Chazot, Manolie Mehdi, Christie Lorriaux, Patrik Deleaval, Brice Mayor, Guillaume Jean, Charles Chazot, Sylvain Lechevallier, Oriane Moncel, Cyril Vo-Van, Jean-Marc Hurot
INTRODUCTION: Citrate 4% is an alternative to heparin as catheter-locking solution in chronic hemodialysis patients. We compared catheter dysfunction episodes, dialysis adequacy, plasminogen-tissular activators use and costs according to catheter-locking solution in our centre. METHODS: Prospective, monocentric, cohort study (NephroCare Tassin-Charcot) on 49 prevalent patients in chronic hemodialysis. Two main groups were formed according to the prescription of catheter-locking solution at the beginning of the study (03/02/2016) and followed until 05/10/2016: heparin (n=26) and citrate (n=22)...
November 27, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29187389/value-of-excess-pressure-integral-for-predicting-15-year-all-cause-and-cardiovascular-mortalities-in-end-stage-renal-disease-patients
#4
Jui-Tzu Huang, Hao-Min Cheng, Wen-Chung Yu, Yao-Ping Lin, Shih-Hsien Sung, Jiun-Jr Wang, Chung-Li Wu, Chen-Huan Chen
BACKGROUND: The excess pressure integral (XSPI), derived from analysis of the arterial pressure curve, may be a significant predictor of cardiovascular events in high-risk patients. We comprehensively investigated the prognostic value of XSPI for predicting long-term mortality in end-stage renal disease patients undergoing regular hemodialysis. METHODS AND RESULTS: A total of 267 uremic patients (50.2% female; mean age 54.2±14.9 years) receiving regular hemodialysis for more than 6 months were enrolled...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29171099/regional-citrate-anticoagulation-for-intermittent-hemodialysis-in-dogs
#5
T Francey, A Schweighauser
BACKGROUND: The traditional systemic heparinization used for anticoagulation in extracorporeal therapies may cause fatal complications in animals at risk of bleeding. HYPOTHESIS/OBJECTIVES: To develop and validate a protocol of regional citrate anticoagulation (RCA) for intermittent hemodialysis in dogs. ANIMALS: A total of 172 dogs treated with hemodialysis for acute kidney injury. METHODS: In vitro titration was performed, adding trisodium citrate and calcium chloride to heparinized canine blood...
November 24, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29139376/the-longitudinal-effects-of-peritonitis-on-peritoneal-membrane-function%C3%A2
#6
Christopher S B Sia, Eldho Paul, Peter Tregaskis, Rowan G Walker, Scott G Wilson
BACKGROUND: The longitudinal effects of peritoneal dialysis (PD) peritonitis on small solute clearance and ultrafiltration are controversial. MATERIALS AND METHODS: We identified 27 patients with PD peritonitis over a 4-year period at a tertiary hospital. Adequacy tests at an "early" (1 - 3 months), "intermediate" (6 ± 2 months), and a "late" (12 ± 2 months) time period after the episode were compared with a pre-peritonitis baseline. The effect of time on serum albumin, weekly creatinine clearance, Kt/V, and net fluid volume removal was assessed...
December 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29106676/safety-and-efficacy-of-taurolidine-urokinase-versus-taurolidine-heparin-as-a-tunneled-catheter-lock-solution-in-hemodialysis-patients-a-prospective-randomized-controlled-study
#7
Fadwa Al-Ali, Ahmad F Hamdy, Abdullah Hamad, Mohamed Elsayed, Zafar Zafar Iqbal, Aisha Elsayed, Rania Ibrahim, Hoda Tolba, Hisham Buanan, Ashraf Fawzy
Background: Taurolidine citrate with heparin (Taurolock/Hep) is a promising central venous catheter lock solution. Despite its universal use among our hemodialysis patients, the prevalence of catheter malfunction was high. We aimed to compare Taurolock/Hep and taurolidine citrate with urokinase (Taurolock/U) as a catheter lock solution in order to identify whether either solution could reduce catheter-related dysfunction. Methods: In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months...
July 4, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29064172/measuring-residual-renal-function-for-hemodialysis-adequacy-is-there-an-easier-option
#8
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
https://www.readbyqxmd.com/read/29024379/can-a-renal-nurse-assess-fluid-status-using-ultrasound-on-the-inferior-vena-cava-a-cross-sectional-interrater-study
#9
Ulrich Steinwandel, Nicholas Gibson, Amanda Towell, James J R Rippey, Johan Rosman
INTRODUCTION: Ultrasound of the inferior vena cava (IVC-US) has been used to estimate intravascular volume status and fluid removal during a hemodialysis session. Usually, renal nurses rely on other, imprecise methods to determine ultrafiltration. To date, no study has examined whether renal nurses can reliably perform ultrasound for volume assessment and for potential prevention of intradialytic hypotension. This pilot study aimed to determine if a renal nurse could master the skill of performing and correctly interpreting Point of Care Ultrasound on patients receiving hemodialysis...
October 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28975489/use-of-lung-ultrasonography-to-determine-the-accuracy-of-clinically-estimated-dry-weight-in-chronic-hemodialysis-patients
#10
Chuan Jiang, Satyam Patel, Andrew Moses, Maria V DeVita, Michael F Michelis
PURPOSE: The use of lung ultrasound (LUS) to identify extravascular lung water has received increasing acceptance. Sonographic B-lines, discrete vertical lines that originate from the pleura, represent pulmonary edema and are correlated with the accumulation of fluid. The goal of this study was to evaluate the utility of LUS to determine the accuracy of prescribed dry weight (DW) in chronic hemodialysis (HD) patients and to ascertain the adequacy of fluid removal. METHODS: LUS was scheduled to be performed pre- and post-HD in 20 patients...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28904934/comparison-of-complications-of-arteriovenous-fistula-with-permanent-catheter-in-hemodialysis-patients-a-six-month-follow-up
#11
Ali Momeni, Saeed Mardani, Maryam Kabiri, Masoud Amiri
BACKGROUND: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis procedure. Due to insufficient reliable information on the comparison between AVF and PC, this study was conducted to compare AVF and PC regarding dialysis adequacy. MATERIALS AND METHODS: This prospective study was carried out from March, 2013 to September, 2013. In this study, 76 hemodialysis patients were enrolled and assigned to two unequal groups of AVF and PC...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28862725/longitudinal-dialysis-adequacy-and-clinical-performance-of-the-vectorflow-hemodialysis-catheter-a-prospective-study
#12
John R Ross, Tatiana A Puga, Thomas E Philbeck
PURPOSE: To report clinical performance and longitudinal assessment of hemodialysis adequacy with the Arrow-Clark VectorFlow catheter, a symmetrical-tip device with a distal lumen configuration designed to reduce platelet shear stress and catheter thrombosis. METHODS AND MATERIALS: We prospectively enrolled patients who required de novo placement of a chronic tunneled catheter for hemodialysis or exchange of a dysfunctional catheter as part of an Institutional Review Board (IRB)-approved protocol...
August 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28760431/predicting-clinical-outcomes-using-phase-angle-as-assessed-by-bioelectrical-impedance-analysis-in-maintenance-hemodialysis-patients
#13
Jung-Ho Shin, Chae Rim Kim, Ki Hyun Park, Jin Ho Hwang, Su Hyun Kim
OBJECTIVE: Protein-energy wasting is common in patients on hemodialysis and is an independent risk factor for adverse events. The aim of this study was to retrospectively investigate whether phase angle (PA), known as a nutritional marker, can predict various clinical outcomes in patients with end-stage renal disease (ESRD) who are receiving hemodialysis. METHODS: Using bioelectrical impedance analysis (BIA), PA was obtained every 6 mo, and patients were divided into two groups according to baseline PA: group A included patients with PA ≥4...
September 2017: Nutrition
https://www.readbyqxmd.com/read/28711962/the-relation-between-hemoglobin-variability-and-carotid-intima-media-thickness-in-chronic-hemodialysis-patients
#14
Safa Ersen Ganidagli, Orcun Altunoren, Ertuğrul Erken, Ismet Onder Isık, Berivan Ganidagli, Necmi Eren, Yasemin Coskun Yavuz, Ozkan Gungor
PURPOSE: Hemoglobin variability is a common problem among hemodialysis patients. We have previously demonstrated an association between Hb variability and left ventricular mass index. In this study, we investigated a possible relation between Hb variability and carotid intima-media thickness (CIMT). METHODS: Twelve-month hemoglobin (Hb) values of 135 patients on maintenance hemodialysis were examined retrospectively. The range of 11-12 gr/dl was accepted as normal according to the KDOQI guidelines...
October 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28552124/application-of-genetic-algorithm-for-hemodialysis-schedule-optimization
#15
Jin Woo Choi, Hajeong Lee, Jung Chan Lee, Saram Lee, Yon Su Kim, Hyung-Jin Yoon, Hee Chan Kim
BACKGROUND: The conventional hemodialysis (HD) schedule has been used for decades, even though new modalities have been introduced. Many reasons limit practices of frequent dialysis, such as patients' environments and unknown optimal schedules for each patient. This research provides a theoretical recommendation of HD schedule through genetic algorithm (GA). METHODS: An end-stage renal disease (ESRD) with various dialysis conditions was modeled through a classic variable-volume two-compartment kinetic model to simulate an anuric patient, and GA was implemented to search for an optimal HD schedule for each individual considering and ignoring burden consumption of each dialysis session...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28497092/the-relationship-between-dialysis-adequacy-and-serum-uric-acid-in-dialysis-patients-a-cross-sectional-multi-center-study-in-iranian-hemodialysis-centers
#16
Eghlim Nemati, Arezoo Khosravi, Behzad Einollahi, Mehdi Meshkati, Mehrdad Taghipour, Shahin Abbaszadeh
Introduction: Uric acid is one of the most significant uremic toxins accumulating in chronic renal failure patients treated with standard dialysis. Its clearance has not any exact relation with urea and creatinine clearance. Objectives: The aim of this study was to investigate the relationship between adequacy of dialysis and serum level of uric acid in dialysis patients of some dialysis centers in Iran. Patients and Methods: In this study 1271 hemodialysis patients who have been treated for more than 3 months were evaluated...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#17
Niloufar Zadeh Saraji, Maryam Hami, Reza Boostani, Mohammad Javad Mojahedi
Introduction: Restless leg syndrome (RLS) is a sensory motor disorder. Patients with this syndrome have serious and uncontrollable desire to move their legs, which is mostly due to an uncomfortable feeling intensified when they are motionless. It may be a genetic disorder or secondary to iron deficiency, neurodegenerations, pregnancy, some drugs and severe kidney diseases. Objectives: This study was designed to find out the prevalence and its risk factors of RLS in hemodialysis patients. Patients and Methods: This multicenter cross-sectional study was done on 260 hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28449305/c-reactive-protein-variability-is-associated-with-vascular-access-outcome-in-hemodialysis-patients
#18
Wei-Hung Kuo, Yueh-Ting Lee, Hwee-Yeong Ng, Chun-Yeh Wang, Chien-Hsing Wu, Chien-Te Lee
BACKGROUND: Hemodialysis (HD) vascular access failure is one of the most important causes of morbidity and contributes to the cost of dialysis care. There is paucity of data evaluating long-term monitoring of C-reactive protein (CRP) on outcome of HD vascular access. METHODS: We conducted a retrospective study to investigate whether variability of serum CRP level was associated with vascular access failure rate over a 7-year period. A total of 318 HD patients were included...
April 27, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28418614/efficacy-and-safety-of-low-dose-heparin-in-hemodialysis
#19
Mariana Murea, Gregory B Russell, Pirouz Daeihagh, Anita M Saran, Karan Pandya, Mark Cabrera, John M Burkart, Barry I Freedman
INTRODUCTION: The dose of unfractionated heparin (UFH) administered during hemodialysis (HD) varies widely. This prospective study evaluated the safety and efficacy of UFH dose de-escalation. METHODS: Sixty-six prevalent patients on HD receiving UFH per standard-dose protocol (load dose [LD] 50-75 units/kg, maintenance dose [MD] 500-1000 units/hour) had heparin prescription converted to low-dose protocol (start LD 15 units/kg and MD 500 units/hour; dose adjusted in small increments based on assessments of extracorporeal blood circuit)...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28417217/levels-of-cystatin-c-in-low-and-high-flux-hemodialysis-in-children-with-end-stage-renal-disease
#20
Fatina I Fadel, Abbass A Mourad, Azza M O Abdel Rahman, Hafez M Bazaraa, Mohamed Farouk Mohamed, Dalia H El-Lebedy, Mohamed M Soliman
BACKGROUND: Cystatin-C (CyC) is a middle molecule that is freely filtered at the glomerulus and almost completely reabsorbed by the proximal tubules. The aim of this study was to evaluate serum CyC and its reduction ratio as a biomarker for assessing the adequacy of the hemodialysis (HD) sessions in children with end-stage renal disease on maintenance HD. We also compared levels of CyC in patients on low-flux HD (LFH) and high-flux HD (HFH). METHODS: Forty patients were included in the study and divided into two groups, with one group (16 patients) receiving HFH and the other group receiving LFH (24 patients) (high-flux and low-flux polysulfone filters, respectively)...
April 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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