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dry weight dialysis

Marijke J E Dekker, Frank M van der Sande, Florence van den Berghe, Karel M L Leunissen, Jeroen P Kooman
Extracellular fluid overload (FO), which is assessed using bioimpedance technologies, is an important predictor of outcome in dialysis patients and in patients with early stages of chronic kidney disease. While traditional cardiovascular abnormalities are assumed to mediate this risk, recently also, the importance of noncardiovascular factors, such as systemic inflammation and malnutrition has been shown. While both FO and inflammation are independent risk factors for mortality, recent studies have shown that their combined presence can lead to a cumulative risk profile...
January 26, 2018: Blood Purification
Chihiro Kawagoe, Yuji Sato, Tatsunori Toida, Hideto Nakagawa, Yasuhiro Yamashita, Akihiro Fukuda, Shuji Iwatsubo, Shouichi Fujimoto
N-terminal-pro-B-type-natriuretic peptide (NT-proBNP) was a predictive marker of cardiovascular disease (CVD)-related death in chronic dialysis patients. NT-proBNP was also correlated with markers of inflammation, malnutrition and protein-energy wasting. We hypothesized whether NT-proBNP was also associated with non-CVD death in chronic dialysis patients. A prospective observational study for incidence of death in chronic dialysis patients was conducted. Prevalent chronic dialysis patients (n = 1310) were enrolled and followed for 24 months...
November 2018: Renal Failure
Antonio Santoro
In recent years, the population of chronic dialysis has grown in number but also in age and frequency of co-morbidies such as cardiac diseases, vascular pathologies, diabetes, etc. The majority of patients on chronic hemodialysis are over 70 years and, given the high number of comorbidities, they often exhibit poor tolerance to dialysis treatments. A non-tolerated dialytic treatment can have side-effects that would require an intensification of the dialysis sessions and many hospitalizations. Consequently, the problematic dialysis treatments, as well as harmful for the patient, become economically more detrimental than other treatments apparently more expensive but more tolerated ones In the current days we have, thanks to the huge developments in dialysis technology, powerful weapons to ensure effective and scarcely symptomatic dialysis treatments to the majority of the HD patients...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Xavier Torterüe, Laurène Dehoux, Marie-Alice Macher, Olivier Niel, Thérésa Kwon, Georges Deschênes, Julien Hogan
BACKGROUND: Evaluation of patient's dry weight remains challenging in chronic hemodialysis (HD) especially in children. Inferior Vena Cava (IVC) measurement was reported useful to assess fluid overload both in adults and children. METHODS: We performed a monocentric prospective study to evaluate the relation between predialytic IVC diameter measurements and hydration status evaluated by physicians and bioimpedance spectroscopy (BIS) and between IVC measurements and persistent hypertension...
December 28, 2017: BMC Nephrology
M Belén Rubio, Alonso J Pardal, Rosa E Cardoza, Santiago Gutiérrez, Enrique Monte, Rosa Hermosa
Trichoderma harzianum is a filamentous fungus well adapted to different ecological niches. Owing to its ability to antagonize a wide range of plant pathogens, it is used as a biological control agent in agriculture. Selected strains of T. harzianum are also able to increase the tolerance of plants to biotic and abiotic stresses. However, little is known about the regulatory elements of the T. harzianum transcriptional machinery and their role in the biocontrol by this species. We had previously reported the involvement of the transcription factor THCTF1 in the T...
2017: Frontiers in Microbiology
Samer R Abbas, Stephan Thijssen, Erik L Penne, Jochen G Raimann, Li Liu, Murat H Sipahioglu, Eric Seibert, Yuedong Wang, Yuqi Chen, Qingqing Xiao, Nathan W Levin, Peter Kotanko, Fansan Zhu
OBJECTIVE: This prospective study uses calf bioimpedance spectroscopy (cBIS) to guide the attainment of dry weight (DWcBIS) in chronic hemodialysis (HD) patients. The primary aim of this study was to evaluate whether body composition is altered when fluid status is reduced to DWcBIS. METHODS: Target post-HD weight was gradually reduced from baseline (BL) until DWcBIS was achieved. DWcBIS was defined as the presence of both flattening of the curve of extracellular resistance and the attainment calf normalized resistivity in the normal range during the dialysis treatment...
November 18, 2017: Journal of Renal Nutrition
Afsoon Emami Naeeni, Nazila Poostiyan, Zahra Teimouri, Mojgan Mortazavi, Mojgan Soghrati, Elnaz Poostiyan, Zamzam Paknahad
Background: Regarding to the complications of malnutrition in dialysis patients, using an easy and reliable method for evaluating of malnutrition is important in patients with the end-stage renal disease. Based on the effect of inflammatory factors in malnutrition, A new scale has been designed which is called malnutrition-inflammatory scale (MIS). We designed current study to assess the severity of malnutrition in peritoneal dialysis patients in Isfahan via MIS. Materials and Methods: In this cross-sectional MIS was used for evaluation of malnutrition...
2017: Advanced Biomedical Research
George Kosmadakis, Enrique Da Costa Correia, Julie Albaret, Frédéric Somda, Didier Aguilera
PURPOSE: Acetate in hemodialysis solutions exerts inflammatory, vasodilatatory and cardio-depressive effects. Citrate has been proposed as an optimal substitute. The aim of the present trial was the comparison of the hemodynamic and biological parameters on a group of patients dialysed consecutively with 4 acetate-free haemodialysis techniques. METHODS: In a prospective crossover manner, we measured the hemodynamic and biological effects of four acetate-free hemodialysis methods: he acetate-free biofiltration with variable potassium (AFBK) and three methods with a citrate buffer: onventional hemodialysis (HD), on-line hemodiafiltration (HDF) and on-line hemofiltration (HF)...
December 2017: Néphrologie & Thérapeutique
Cristina Caetano, Ana Valente, Francisco Jorge Silva, Jorge Antunes, Cristina Garagarza
BACKGROUND AND AIMS: Protein intake is a key point to maintain an adequate nutritional status in hemodialysis (HD) patients. There are some studies that confirm the positive influence of intradialytic oral nutritional supplementation in several nutritional parameters in HD patients. The aim of this study was to evaluate the effect of an intradialytic protein rich meal in nutritional and body composition parameters on HD patients. METHODS: This was a 6-months single center non-randomized study with 99 patients in HD from one Nephrocare dialysis unit in Portugal...
August 2017: Clinical Nutrition ESPEN
Kelvin C W Leung, Robert R Quinn, Pietro Ravani, Henry Duff, Jennifer M MacRae
BACKGROUND AND OBJECTIVES: Intradialytic hypotension (IDH) is associated with morbidity. The effect of blood volume-guided ultrafiltration biofeedback, which automatically adjusts fluid removal rate on the basis of blood volume parameters, on the reduction of IDH was tested in a randomized crossover trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a 22-week, single blind, randomized crossover trial in patients receiving maintenance hemodialysis who had >30% of sessions complicated by symptomatic IDH in five centers in Calgary, Alberta, Canada...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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
Adrian Covic, Adi-Ionut Ciumanghel, Dimitrie Siriopol, Mehmet Kanbay, Raluca Dumea, Cristina Gavrilovici, Ionut Nistor
BACKGROUND: Volume overload is a common complication in patients with end-stage kidney disease who undergo maintenance dialysis therapy and associated with hypertension, left ventricular hypertrophy and mortality in this population. Although bioimpedance analysis (BIA), an objective method to assess overhydration, is associated with poor outcomes in observational studies, in randomized controlled trials (RCTs) the results were conflicting. We have examined the role of BIA for assessing the "dry weight" and fluid status in order to improve fluid overload in comparison with a control or clinical-based prescription in patients with ESKD receiving haemodialysis or peritoneal dialysis...
December 2017: International Urology and Nephrology
Mun Jang, Won Hak Kim, Jung Hee Lee, Mi Soon Kim, Eun Kyoung Lee, So Mi Kim, Jai Won Chang
BACKGROUND: Volume overload results in higher mortality rates in patients on continuous ambulatory peritoneal dialysis (CAPD). The ratio of bioimpedance (RBI) might be a helpful parameter in adjusting dry body weight in CAPD patients. This study examined whether it is possible to distinguish between non-hypervolemic status and hypervolemic status in CAPD patients by using only RBI. METHODS: RBI was calculated as follows: RBI = impedance at 50 kHz/impedance at 500 kHz...
September 2017: Kidney Research and Clinical Practice
So Yon Rhee, Jin Kyung Song, Suk Chul Hong, Jae Won Choi, Hee Jung Jeon, Dong Ho Shin, Eun Hee Ji, Eun-Hee Choi, Jiyeon Lee, Aram Kim, Seung Wook Choi, Jieun Oh
Background/Aims: As numbers of maintenance hemodialysis patients are growing, debilitating conditions of muscle wasting and atrophy are becoming some of the greatest concerns in end-stage renal disease patients. Exercise training has various potential benefits in terms of prevention of a sustained decline in functional status. This study aimed to evaluate the physical, psychological, laboratory, and dialysis-related effects of intradialytic exercise. Methods: We enrolled 22 patients from a hemodialysis center for a 6-month non-randomized prospective trial...
August 25, 2017: Korean Journal of Internal Medicine
Jason A Chou, Kamyar Kalantar-Zadeh
PURPOSE OF REVIEW: Volume management in hemodialysis patients is often challenging. Assessing volume status and deciding how much fluid to remove during hemodialysis, the so-called ultrafiltration rate (UFR), has remained a conundrum. RECENT FINDINGS: To date there is no objective assessment tool to determine the needed UFR during each hemodialysis session. Higher volume overload or higher UFR is associated with poor outcomes including worse mortality and unfavorable clinical outcomes...
October 2017: Current Heart Failure Reports
Vincent Leduc, Maxence Ficheux, Clémence Bechade, Michel Dreyfus, Thierry Lobbedez, Patrick Henri
INTRODUCTION: In France in 2014, there were approximately 1500 patients of reproductive age treated by dialysis. Pregnancy in these patients remains rare, however, the incidence has increased since the 2000s, with a parallel increase in the fetal survival rate. We report 2 cases of pregnancy in short-daily home hemodialysis using low dialysate flow rate. METHODS: Short-daily hemodialysis was continued at the request of the patients. The treatment consisted in an increase of frequency and duration of hemodialysis sessions, an independent blood pressure and dry weight control supervised by nephrological monitoring twice a month and a regular obstetrics follow-up...
August 1, 2017: Hemodialysis International
Marlies Antlanger, Peter Josten, Michael Kammer, Isabella Exner, Katharina Lorenz-Turnheim, Manfred Eigner, Gernot Paul, Renate Klauser-Braun, Gere Sunder-Plassmann, Marcus D Säemann, Manfred Hecking
BACKGROUND: Because chronic fluid volume overload is associated with higher mortality, we tested whether blood-volume monitored regulation of ultrafiltration and dialysate conductivity (UCR) and/or regulation of ultrafiltration and temperature (UTR) would facilitate dry weight reduction, in comparison to conventional dialysis (CONV). METHODS: We carried out a multicenter, 4-week, randomized controlled trial in hemodialysis patients ≥15% above normal extracellular fluid volume (ECV), per bioimpedance spectroscopy, who were randomized 1:1:1...
July 17, 2017: BMC Nephrology
Arjun D Sinha, Rajiv Agarwal
Volume overload is common and associated with adverse outcomes in the hemodialysis population including systemic hypertension, pulmonary hypertension, left ventricular hypertrophy, and mortality. Since the beginning of the era of maintenance dialysis, prescribing and maintaining a dry weight remains the standard of care for managing volume overload on hemodialysis. Reducing dry weight even by relatively small amounts has been shown to improve blood pressure and has been associated with reductions in left ventricular hypertrophy...
November 2017: Seminars in Dialysis
Molly Wong Vega, Poyyapakkam R Srivaths
OBJECTIVE: Protein energy wasting is difficult to assess in pediatric hemodialysis (HD) populations because of fluid shifts. Body composition (BC) analysis aids in monitoring nutrition therapy's effects on fat and lean mass. Air displacement plethysmography (ADP) is a "practical" gold standard for fat mass (FM) measurements. We aim to compare BC measures in a pediatric HD population via anthropometry, ADP, and bioelectrical impedance (BIA). DESIGN: The study was prospective cohort study and the setting was 1 pediatric HD unit in Houston, Texas...
November 2017: Journal of Renal Nutrition
F Paglialonga, S Consolo, A Edefonti, G Montini
Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM)...
February 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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