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Liselotte C R Hensen, Kathleen Goossens, Tomaz Podlesnikar, Joris I Rotmans, J Wouter Jukema, Victoria Delgado, Jeroen J Bax
BACKGROUND: Patients with advanced chronic kidney disease (CKD) have high risk for sudden cardiac death (SCD) and may benefit from implantable cardioverter-defibrillators (ICDs). However, the risk for ICD-related complications is also high in this population. Therefore, there is an unmet need for accurate risk stratification tools to identify patients with CKD at risk for ventricular arrhythmias (VAs), who may benefit from ICD implantation. The aim of this hypothesis-generating study was to investigate the association between left ventricular (LV) mechanical dispersion and LV global longitudinal strain (GLS) measured using two-dimensional speckle-tracking echocardiography and VA and SCD in patients with CKD...
March 10, 2018: Journal of the American Society of Echocardiography
Hamid Tayebi Khosroshahi, Nosratola D Vaziri, Behzad Abedi, Bahlol Habibi Asl, Morteza Ghojazadeh, Wanghui Jing, Amir Mansur Vatankhah
INTRODUCTION: Systemic inflammation and oxidative stress play a central role in the pathogenesis of cardiovascular disease and numerous other complications of CKD. Recent studies demonstrated that consumption of a diet enriched with amylose (HAM-RS2), attenuates oxidative stress and inflammation, and improves intestinal microbiome in CKD rats. The present study was designed to explore the effect of dietary amylose supplementation in hemodialysis patients. METHODS: Forty-six stable hemodialysis patients were randomized to receive biscuits containing 20 g/day during the first four weeks and 25 g/day in the next four weeks of either HAM-RS2 or wheat-flour...
March 13, 2018: Hemodialysis International
Sebastian Mas, Enrique Bosch-Panadero, Pedro Abaigar, Vanesa Camarero, Ignacio Mahillo, Esther Civantos, Didier Sanchez-Ospina, Alberto Ruiz-Priego, Jesus Egido, Alberto Ortiz, Emilio González-Parra
INTRODUCTION: Bisphenol A (BPA) is an ubiquitous environmental toxin that is also found in dialyzers. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, the BPA contents of dialysis membranes may be a source of BPA loading during OL-HDF. METHODS: A prospective study assessed plasma BPA levels in OL-HDF patients using BPA-free (polynephron) or BPA-containing (polysulfone) dialyzers in a crossover design with two arms, after a run-in OL-HDF period of at least 6 months with the same membrane: 31 patients on polynephron at baseline were switched to polysulfone membranes for 3 months (polynephron-to-polysulfone) and 29 patients on polysulfone were switched to polynephron for 3 months (polysulfone-to-polynephron)...
2018: PloS One
Thijs Thomas Jansz, Akin Özyilmaz, Muriel P C Grooteman, Tiny Hoekstra, Marieke Romijn, Peter J Blankestijn, Michael L Bots, Brigit C van Jaarsveld
OBJECTIVES: Nocturnal haemodialysis (NHD), characterised by 8-hour sessions ≥3 times a week, is known to improve clinical parameters in the short term compared with conventional-schedule haemodialysis (HD), generally 3×3.5-4 hours a week. We studied long-term effects of NHD and used patients on conventional HD/haemodiafiltration (HDF) as controls. DESIGN: Four-year prospective follow-up of patients who switched to NHD; we compared patients with patients on HD/HDF using propensity score matching...
March 8, 2018: BMJ Open
Ping Liu, Robert R Quinn, Matthew J Oliver, Paul E Ronksley, Brenda R Hemmelgarn, Hude Quan, Swapnil Hiremath, Aminu K Bello, Peter G Blake, Amit X Garg, John Johnson, Mauro Verrelli, James M Zacharias, Samar Abd ElHafeez, Marcello Tonelli, Pietro Ravani
BACKGROUND AND OBJECTIVES: Early nephrology referral is recommended for people with CKD on the basis of observational studies showing that longer nephrology care before dialysis start (predialysis care) is associated with lower mortality after dialysis start. This association may be observed because predialysis care truly reduces mortality or because healthier people with an uncomplicated course of disease will have both longer predialysis care and lower risk for death. We examined whether the survival benefit of longer predialysis care exists after accounting for the potential confounding effect of disease course that may also be affected by predialysis care...
March 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
F John Gennari
Acid-base assessment of patients receiving conventional hemodialysis (HD) has been based solely on predialysis serum [total CO2 ], and treatment is currently driven by the KDOQI guideline from 2000. This guideline was directed solely at minimizing metabolic acidosis and thereby improving bone and muscle metabolism. In 2000, no data were available to assess the effects of acid-base status on morbidity and mortality. Since then, new data have emerged from several large cohort studies about the association between variations in predialysis serum [total CO2 ], as well as blood pH, and morbidity and mortality risk...
March 1, 2018: Seminars in Dialysis
Samir Patel, Alice Topping, Xiaoling Ye, Hanjie Zhang, Bernard Canaud, Paola Carioni, Cristina Marelli, Adrian Guinsburg, Albert Power, Neill Duncan, Jeroen Kooman, Frank van der Sande, Len A Usvyat, Yuedong Wang, Xiaoqi Xu, Peter Kotanko, Jochen G Raimann
BACKGROUND: Tall people have improved metabolic profiles and better cardiovascular outcomes, a relationship inverted in dialysis patients. We investigated the relationship between height and outcomes in incident hemodialysis (HD) patients commencing treatment in an analysis of the international Monitoring Dialysis Outcomes (MONDO) database. METHODS: In this retrospective cohort study, we included incident HD patients commencing treatment between -January 1, 2006 and December 31, 2010 and investigated the association between height and mortality using the MONDO database...
January 26, 2018: Blood Purification
Shuang Liang, Wen-Ling Wang, Fang-Lei Zhu, Shu-Wei Duan, Xue-Feng Sun, Xiang-Mei Chen, Guang-Yan Cai
INTRODUCTION: The proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk...
February 24, 2018: BMJ Open
Ye Zhang, Ulf-G Gerdtham, Helena Rydell, Johan Jarl
Background: Few studies have examined the association between individual-level socioeconomic status and access to kidney transplantation. This study aims to investigate the association between predialysis income and education, and access to (i) the kidney waitlist (first listing), and (ii) kidney transplantation conditional on waitlist placement. Adjustment will be made for a number of medical and nonmedical factors. Methods: The Swedish Renal Register was linked to national registers for adult patients in Sweden who started dialysis during 1995 to 2013...
February 2018: Transplantation Direct
Hatem Ali, Tarek Abdelaziz, Fatima Abdelaal, Jyoti Baharani
The relationship between frailty and chronic kidney disease in elderly population has been recognized; however, studies concentrating on frailty in predialysis patients are limited. For nephrologists, the recognition of frailty is important as it has impact on decisions on the choice of dialysis modality and sometimes on whether dialysis is indeed in the patients' best interests. Many of the tools for routine assessment of frailty are not easily applicable to those clinicians not practicing elderly care medicine...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Pasquale Esposito, Edoardo La Porta, Maria Antonietta Grignano, Daniela Verzola, Samantha Milanesi, Francesca Ansaldo, Marilena Gregorini, Carmelo Libetta, Giacomo Garibotto, Teresa Rampino
OBJECTIVE: Toll-like receptor 4 (TLR4) promotes inflammation in hemodialysis patients (HD). A soluble form of extracellular TLR4 (sTLR4) has been recently characterized, which showed the ability to attenuate TLR4 signalling. In this study, we describe the sTLR4 profile in regular HD patients. SUBJECTS: In a cross-sectional study we enrolled forty prevalent HD patients (68.2 ± 16.3 years, twenty-five males) with a median dialysis vintage of 41 months. Nineteen patients were undergoing standard bicarbonate HD (BHD) and 21 patients on-line hemodiafiltration (HDF)...
February 8, 2018: Journal of Renal Nutrition
Ying Wang, Yan Qin, Xiaohong Fan, Jianfang Cai, Wei Ye, Jinghua Xia, Mingxi Li, Xuemei Li, Xuewang Li, Limeng Chen
BACKGROUND/AIMS: While systolic blood pressure variability (SBPV) is an independent risk factor for mortality in the general population, its association with outcomes in hemodialysis patients has been less well-investigated. METHODS: In this retrospective study, we enrolled 99 eligible HD patients from 2006 to 2016. Predialysis blood pressure measurements obtained over 1-year period were used to determine each patient's BPV. The standard deviation (SD), the coefficient of variation (CV) and the variation independent of the mean (VIM) were used as metrics of BPV...
January 31, 2018: Kidney & Blood Pressure Research
Cristina Căpuşă, Gabriel Ştefan, Simona Stancu, Mariana Lipan, Lilach Daniel Tsur, Gabriel Mircescu
The effect of chronic metabolic acidosis (MA) on cardiovascular disease (CVD) in the setting of chronic kidney disease (CKD) is largely unknown. Therefore, we aimed to study this relationship in nondialysis CKD patients.This cross-sectional, single-center study prospectively enrolled 95 clinically stable CKD patients (median age 61 (58, 65) years, 60% male, median eGFR 27 (22, 32) mL/min). Data on CKD etiology, CVD history, CVD traditional, and nontraditional risk factors were obtained. Also, markers of subclinical CVD were assessed: intima-media thickness (IMT), abdominal aortic calcifications (Kauppila score-AACs), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), ejection fraction, and interventricular septum thickness...
November 2017: Medicine (Baltimore)
Juan Jesus Carrero, Manfred Hecking, Nicholas C Chesnaye, Kitty J Jager
Improved understanding of sex and gender-specific differences in the aetiology, mechanisms and epidemiology of chronic kidney disease (CKD) could help nephrologists better address the needs of their patients. Population-based studies indicate that CKD epidemiology differs by sex, affecting more women than men, especially with regard to stage G3 CKD. The effects of longer life expectancy on the natural decline of glomerular filtration rate (GFR) with age, as well as potential overdiagnosis of CKD through the inappropriate use of GFR equations, might be in part responsible for the greater prevalence of CKD in women...
January 22, 2018: Nature Reviews. Nephrology
Daijo Inaguma, Eri Ito, Shigehisa Koide, Kazuo Takahashi, Hiroki Hayashi, Midori Hasegawa, Yukio Yuzawa
Background: Several human studies reported that the combined use of renin-angiotensin system blockers (RASBs) and vitamin D receptor activators (VDRAs) resulted in decreased urinary protein excretion. However, it is unknown whether this combination therapy influences the incidence of cardiovascular (CV) events in dialysis patients. Methods: The study was a multicenter nonrandomized prospective cohort analysis including 1,518 patients. Patients were classified into 4 groups based on medications prescribed before dialysis initiation: those who did not receive RASBs or oral VDRAs (N group), those receiving only RASBs, those receiving only VDRAs, and those receiving a combination of RASBs and VDRAs (RD group)...
December 2017: Cardiorenal Medicine
Anna T Mathew, Joonho Park, Mala Sachdeva, Manish M Sood, Karen Yeates
Background: Aboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population. Objective: We aim to assess the barriers to PD utilization in Aboriginal patients with ESKD. Design: This article is a prospective observational cohort study...
2018: Canadian Journal of Kidney Health and Disease
Zhe Yan, Yu Wang, Shaomei Li, Jinwei Wang, Luxia Zhang, Huibin Tan, Sumin Li, Lin Yang, Huaying Pei, Liping Zhang, Yan Wang, Jianzhao Duan, Sumin Jiao, Minghui Zhao, Shuxia Fu
Background: Hypertension contributes to increased morbidity and mortality in the chronic kidney disease (CKD) population. Studies on blood pressure control in CKD patients in China are limited. In this study, we aimed to describe the status of blood pressure control in Chinese CKD patients based on the first national prospective CKD cohort data. Methods: A subgroup of Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) participants with hypertension at baseline was included in the present study...
January 3, 2018: American Journal of Hypertension
Jacques Vigan, Séraphin Ahoui, Dominique Hounsou, Aline Céline Kpèhouédo Goudoté, Jeanne Vehounkpe Sacca
INTRODUCTION: Left ventricular hypertrophy (LVH) is a predictor of mortality in hemodialysis. It takes a very high proportion among cardiovascular complications. OBJECTIVE: It was to determine the frequency of LVH and identify its associated factors among chronic hemodialysis patients of CNHU-HKM. METHODS: This is a cross-sectional, descriptive and analytical, which took place 1st February to 31st October 2014. The sample consisted of patients aged over 15 years, chronic hemodialysis for at least 3 months...
December 21, 2017: Néphrologie & Thérapeutique
Eliza Lee, Gabriel Ramos-Gonzalez, Nancy Rodig, Scott Elisofon, Khashayar Vakili, Heung Bae Kim
OBJECTIVE: Primary hyperoxaluria type-1 (PH-1) is a rare genetic disorder in which normal hepatic metabolism of glyoxylate is disrupted resulting in diffuse oxalate deposition and end-stage renal disease (ESRD). While most centers agree that combined liver-kidney transplant (CLKT) is the appropriate treatment for PH-1, perioperative strategies for minimizing recurrent oxalate-related injury to the transplanted kidney remain unclear. We present our management of children with PH-1 and ESRD on hemodialysis (HD) who underwent CLKT at our institution from 2005 to 2015...
December 14, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ken J Park, Eric S Johnson, Ning Smith, David M Mosen, Micah L Thorp
CONTEXT: Central venous catheter (CVC) use is associated with increased mortality and complications in hemodialysis recipients. Although prevalent CVC use has decreased, incident use remains high. OBJECTIVE: To examine characteristics associated with CVC use at initial dialysis, specifically looking at proteinuria as a predictor of interest. DESIGN: Retrospective cohort of 918 hemodialysis recipients from Kaiser Permanente Northwest who started hemodialysis from January 1, 2004, to January 1, 2014...
2017: Permanente Journal
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