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https://www.readbyqxmd.com/read/27797886/pharmacotherapy-of-hypertension-in-chronic-dialysis-patients
#1
Panagiotis I Georgianos, Rajiv Agarwal
Among patients on dialysis, hypertension is highly prevalent and contributes to the high burden of cardiovascular morbidity and mortality. Strict volume control via sodium restriction and probing of dry weight are first-line approaches for the treatment of hypertension in this population; however, antihypertensive drug therapy is often needed to control BP. Few trials compare head-to-head the superiority of one antihypertensive drug class over another with respect to improving BP control or altering cardiovascular outcomes; accordingly, selection of the appropriate antihypertensive regimen should be individualized...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27792838/adsorption-of-shiga-toxin-to-poly-%C3%AE-glutamate-precipitated
#2
Tsukie Goto, Makiko Tsuji, Kaori Kanemaru, Kumio Yokoigawa
We screened foods containing indigestible ingredients in the ability to adsorb Shiga toxin (Stx). When 5 mg of foods and dietary fibers such as dry vegetables and inulin were mixed and incubated with 0.5 mL of Stx solution (100 ng/mL) containing 0.5% bovine serum albumin, both Stx1 and Stx2 seemed to be adsorbed by only a fermented food, natto (a traditional Japanese food prepared from steamed soybeans by the biological action of Bacillus subtilis). We purified the Stx-adsorbing substance from natto by extraction with H2 O, acid treatment, Proteinase K treatment, and an ion exchange chromatography...
October 28, 2016: Journal of Food Science
https://www.readbyqxmd.com/read/27772639/intensive-hemodialysis-blood-pressure-and-antihypertensive-medication-use
#3
George L Bakris, John M Burkart, Eric D Weinhandl, Peter A McCullough, Michael A Kraus
Hypertension is a cardinal feature of end-stage renal disease (ESRD). Hypertensive nephropathy is the primary cause of ESRD for nearly 30% of patients, and the prevalence of hypertension is >85% in new patients with ESRD. In contemporary hemodialysis (HD) patients, mean predialysis systolic blood pressure (SBP) is nearly 150mmHg, and about 70%, 50%, and 40% use β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors, respectively. Predialysis SBP generally exhibits a U-shaped association with mortality risk...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27573731/epidemiology-diagnosis-and-management-of-hypertension-among-patients-on-chronic-dialysis
#4
REVIEW
Panagiotis I Georgianos, Rajiv Agarwal
The diagnosis and management of hypertension among patients on chronic dialysis is challenging. Routine peridialytic blood pressure recordings are unable to accurately diagnose hypertension and stratify cardiovascular risk. By contrast, blood pressure recordings taken outside the dialysis setting exhibit clear prognostic associations with survival and might facilitate the diagnosis and long-term management of hypertension. Once accurately diagnosed, management of hypertension in individuals on chronic dialysis should initially involve non-pharmacological strategies to control volume overload...
October 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/27350116/transient-mediastinal-mass-from-fluid-overload
#5
David Massicotte-Azarniouch, Joseph P O'Sullivan, Edward G Clark
Mediastinal masses incidentally discovered on chest imaging often suggest underlying malignancy such as lymphoma or metastatic cancer. However, the radiographic appearance of mediastinal edema can mimic a mediastinal mass in the context of acute fluid overload. We describe the case of a 75 year old woman known for end-stage renal disease on hemodialysis who presented with acute pulmonary edema in the context of a Non ST-Elevation Myocardial Infarction. Chest CT imaging showed pulmonary edema, pleural effusions, and a middle mediastinum soft-tissue mass of 4...
June 27, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27284847/-treatment-of-hypertension-in-chronic-kidney-disease
#6
Silvia Palomo-Piñón, Martín Rosas-Peralta, José Ramón Paniagua-Sierra
Systemic arterial hypertension (SAH) is a progressive cardiovascular syndrome caused by complex and interrelated causes. The early markers of this syndrome are often present even before the blood pressure (BP) elevation; therefore, SAH cannot only be classified by the BP elevation threshold, which sometimes is discreet. Its progression is strongly associated with structural and functional cardiovascular abnormalities, which lead to end-organ damage (heart, kidney, brain, blood vessels and other organs), and cause premature morbidity and death...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27263809/recurrent-brachiocephalic-vein-stenosis-as-a-cause-for-persistent-left-sided-transudative-pleural-effusion-in-a-hemodialysis-patient
#7
Muhammad Abdul Mabood Khalil, Muhammad Sharoz Rabbani, Noor Rehman Chima, Jackson Tan, Muhammad Ashhad Ullah Khalil, Zia Ur Rehman
BACKGROUND: Effusion is common in dialysis patients. The most common causes include fluid overload due to renal failure and nonrenal causes like congestive heart failure and infection. We here report a case of left side transudative effusion due to brachiocephalic venous stenosis. METHODS: A 34-year-old female who had chronic kidney disease V during transplant work-up was found to be having left arm swelling and left transudative effusion. Work-up for transudative effusion did not show any cardiac cause or liver problem...
August 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27126356/the-effect-of-ambient-temperature-and-humidity-on-interdialytic-weight-gains-in-end-stage-renal-disease-patients-on-maintenance-hemodialysis
#8
Mihály B Tapolyai, Mária Faludi, Klára Berta, Tibor Szarvas, Zsolt Lengvárszky, Miklos Z Molnar, Neville R Dossabhoy, Tibor Fülöp
PURPOSE: Interdialytic weight gain (IDWG) is both a measure of dietary compliance and a well-established predictor of future adverse outcomes in dialysis patients. The impact of environmental conditions on IDWG in end-stage renal disease is little studied to date. METHODS: We retrospectively reviewed IDWG for 100 consenting chronic end-stage renal disease patients undergoing thrice weekly in-center hemodiafiltration under three different climatic conditions in a Central European city: Weekend_1 was humid (93 %) and warm (24 °C); Weekend_2 was dry (38 %) and hot (33 °C); and Weekend_3 was dry (30 %) and warm (24 °C)...
July 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27061224/vascular-refilling-is-independent-of-volume-overload-in-hemodialysis-with-moderate-ultrafiltration-requirements
#9
Susanne Kron, Daniel Schneditz, Til Leimbach, Sabine Aign, Joachim Kron
Introduction Blood volume changes and vascular refilling during hemodialysis (HD) and ultrafiltration (UF) have been assumed to depend on volume overload (Vo ). It was the aim to study the magnitude of vascular refilling in stable HD patients with moderate volume expansion in everyday dialysis using novel technical approaches. Methods Patients were studied during routine dialysis and UF based on clinical dry weight assessment. Pre-dialysis Vo was independently measured by bioimpedance spectroscopy. Vascular refilling volume (Vref ) was calculated as: Vref  = Vuf  - ΔV, where ΔV is the absolute blood volume change determined by on-line dialysate dilution using a commercial on-line hemodiafiltration machine incorporating a relative blood volume monitor, and where Vuf is the prescribed UF volume...
July 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27052263/which-dialysis-unit-blood-pressure-is-the-most-accurate-for-predicting-home-blood-pressure-in-patients-undergoing-hemodialysis
#10
In-Cheol Yoon, Hye-Min Choi, Dong-Jin Oh
Background/Aims: We investigated which dialysis unit blood pressure (BP) is the most useful for predicting home BP in patients undergoing hemodialysis (HD). Methods: Patients undergoing HD who had been treated > 3 months were included in this study. Exclusion criteria were hospitalized patients with acute illness and changes in dry weight and anti-hypertensive drugs 2 weeks before the study. We used the dialysis unit BP recording data, such as pre-HD, intra-HD, post-HD, mean pre-HD, and post-HD (pre-post-HD), mean pre-HD, intra-HD, and postHD (pre-intra-post-HD) BP...
April 7, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/26956887/two-successive-pregnancies-in-a-patient-during-14-years-of-hemodialysis-a-case-report
#11
Ayse Seker
BACKGROUND: The incidence of pregnancy in women with end-stage renal disease seems to be increasing. Improvements in dialysis, obstetrical care, and antenatal fetal monitoring over the past two decades appear to have increased fertility rates and successful pregnancies in dialysis-dependent women. A pregnancy with a successful outcome despite the long dialysis period, as in the patient described here, is very rarely reported in the literature. CASE PRESENTATION: I report a case of a 34-year-old white Kurdish woman who had had two uncomplicated pregnancies while on hemodialysis, with delivery of healthy babies...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/26912548/apoprotein-b-apoprotein-a-1-ratio-and-mortality-among-prevalent-dialysis-patients
#12
Yuji Sato, Shouichi Fujimoto, Tatsunori Toida, Hideto Nakagawa, Yasuhiro Yamashita, Takashi Iwakiri, Akihiro Fukuda, Shuji Iwatsubo
BACKGROUND AND OBJECTIVES: In dialysis patients, the associations between apoprotein profile and all-cause or cardiovascular disease (CVD)-related mortality are not well known. We, therefore, investigated whether apoprotein levels are associated with these events. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We undertook a prospective observational cohort study of prevalent hemodialysis patients aged ≥18 years (n=1081), who were followed for 4 years (2011-2014)...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26765312/mechanisms-and-treatment-of-intradialytic-hypertension
#13
Peter Noel Van Buren, Jula K Inrig
BACKGROUND: Intradialytic hypertension is a condition where there is an increase in blood pressure (BP) from pre- to post-hemodialysis; this condition has been recently identified as an independent mortality risk factor in hypertensive hemodialysis patients. The mechanisms and management of intradialytic hypertension have been explored in numerous research studies over the past few years. SUMMARY: Patients with intradialytic hypertension have been found to be more chronically volume overloaded compared to other hemodialysis patients, although no causal role has been established...
2016: Blood Purification
https://www.readbyqxmd.com/read/26632642/body-composition-and-mortality-predictors-in-hemodialysis-patients
#14
Cristina Caetano, Ana Valente, Telma Oliveira, Cristina Garagarza
OBJECTIVE: To evaluate how different compartments of body composition can affect survival in hemodialysis (HD) patients. DESIGN: Multicenter longitudinal observational study of a cohort of patients in HD with 12 months of follow-up. SETTING: Patients from 34 Nephrocare dialysis units in Portugal were included. SUBJECTS: A total of 697 patients on maintenance HD during 4 hours 3 days per week were enrolled. INTERVENTION: Dry weight, presence of diabetes, body mass index (BMI), lean tissue index (LTI), fat tissue index (FTI), body cell mass index (BCMI), albumin and hydration status were recorded at baseline...
March 2016: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/26550558/long-term-efficacy-of-vildagliptin-in-patients-with-type-2-diabetes-undergoing-hemodialysis
#15
Jun-Ichiro Mera, Eiko Okada, Masumi Okuda, Tatsuru Ota, Shigeru Sibata, Shunya Uchida
BACKGROUND: There are few studies evaluating long-term glycemic control using a dipeptidyl peptidase-4 inhibitor in type 2 diabetes patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the safety and efficacy of vildagliptin therapy over 2 years in type 2 diabetes with ESRD. METHODS: Patients with ESRD resulting from type 2 diabetes requiring dialysis who had ≥20 % glycated albumin (GA) were enrolled. Vildagliptin 50 mg once daily was administered for 2 years...
2015: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/26546591/treating-hypertension-in-hemodialysis-improves-symptoms-seemingly-unrelated-to-volume-excess
#16
RANDOMIZED CONTROLLED TRIAL
Rajiv Agarwal
BACKGROUND: Among hemodialysis patients, probing dry weight is an effective strategy for improving control of hypertension. Whether controlling hypertension improves or worsens symptoms among such patients remains unclear. The purpose of the study was to develop a tool to evaluate symptoms and examine the relationship of the change in these symptoms with blood pressure (BP) control. METHODS: Among patients participating in the Hemodialysis Patients Treated with Atenolol or Lisinopril (HDPAL) randomized controlled trial, a confirmatory factor analysis (CFA) was performed to establish the relationship between symptoms and organ systems...
January 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/26521887/neutrophil-to-lymphocyte-ratio-and-platelet-tolymphocyte-ratio-in-evaluation-of-inflammation-in-end-stage-renal-disease
#17
COMPARATIVE STUDY
Elbis Ahbap, Tamer Sakaci, Ekrem Kara, Tuncay Sahutoglu, Yener Koc, Taner Basturk, Mustafa Sevinc, Cuneyt Akgol, Arzu O Kayalar, Zuhal A Ucar, Feyza Bayraktar, Abdulkadir Unsal
OBJECTIVE: To evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and inflammation in end-stage renal disease (ESRD) patients on maintenance hemodialysis (HD). METHODS: 100 ESRD patients on maintenance HD (mean ± SD age: 52.3 ± 1.7 years, 52% were males) were included in this cross-sectional study. Data on patient demographics, dry weight, body mass index, duration of HD (months), etiology of ESRD, delivered dose of dialysis (spKt/V), complete blood count, blood biochemistry and inflammatory markers including hs-CRP (mg/L), TNF-α (pg/mL), NLR, and PLR were recorded in all patients and compared in patients with hs-CRP levels of ≤ 3 mg/L vs...
April 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/26354560/non-invasive-method-for-preventing-intradialytic-hypotension-a-pilot-study
#18
Anita Saxena, R K Sharma, Amit Gupta, Manns Manohar John
Intradialytic hypotension (IDH) is a life-threatening condition. We evaluated the feasibility of blood volume monitoring (BVM) and blood temperature monitoring (BTM) in preventing IDH in patients prone to the same. Fourteen hemodynamically unstable end-stage renal disease patients who were prone to IDH and unable to achieve dry weight were given BVM treatment twice weekly for two weeks. Forty patients who were not on BVM treatment served as controls. Patients were anemic, had low serum albumin (3.4 ± 0.43 g/dL) and fluid overload and were edematous...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/26316015/frequency-of-intradialytic-hypotensive-episodes-old-problem-new-insights
#19
Ana Rocha, Clemente Sousa, Paulo Teles, Augusto Coelho, Eva Xavier
Symptomatic intradialytic hypotension (IDH) continues to be an important complication of hemodialysis treatment. There is some evidence that besides an IDH episode, repeated episodes could represent an even more important independent risk factor for mortality in hemodialysis patients. A retrospective cross-sectional study was performed to study 18 dialysis treatments in 43 patients during 6 weeks. Relationships of IDH episodes with baseline variables were examined using a Poisson regression model (generalized linear model)...
October 2015: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/26219166/vancomycin-dosing-regimen-by-monte-carlo-simulation-in-patients-on-intermittent-high-efficiency-hemodialysis-hehd
#20
Daraporn Rungprai, Sutep Jaruratanasirikul, Wibul Wongpoowarak, Sutthiporn Pattharachayakul, Usanee Wanakamanee, Phongsak Dandecha, Arnurai Jitsurong
OBJECTIVE: To evaluate the effective vancomycin dosing regimens by Monte Carlo simulation among patients on intermittent high-efficiency hemodialysis (HEHD). MATERIAL AND METHOD: The present study was conducted on eight end-stage renal disease patients receiving HEHD. The patients received an initial dose of vancomycin 1 g followedby 500 mg immediately after HEHD session for a supplementation. Blood samplings were obtained to investigate vancomycin pharmacokinetic parameters...
June 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
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