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https://www.readbyqxmd.com/read/28360370/barriers-to-increasing-use-of-peritoneal-dialysis-in-bangladesh-a-survey-of-patients-and-providers
#1
Dipal Savla, Sweety Ahmed, Karen Yeates, Anna Matthew, Shuchi Anand
Despite a lower requirement for technology and equipment than hemodialysis (HD), peritoneal dialysis (PD) is an underutilized modality in low- and middle-income countries (LMICs). Bangladesh has the lowest use of PD in the world (fewer than 2% of prevalent patients). We evaluated nephrologists' attitudes toward PD and examined differences between patients on HD and PD in Dhaka. We asked nephrologists to fill out an English-language questionnaire. Using convenience sampling but targeting both public and private hospitals in Dhaka, we asked trained nurses to administer a Bangla-language questionnaire to patients on HD (n = 116) and PD (n = 41)...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28264150/blood-pressure-management-in-hemodialysis-patients-what-we-know-and-what-questions-remain
#2
REVIEW
Dana C Miskulin, Daniel E Weiner
Despite having thousands of blood pressure (BP) readings on individual dialysis patients over the course of a year, our knowledge about the optimal assessment of BP, the mechanisms underlying hypertension and its management remain incomplete. Observational studies reveal that BP is lower at home than when measured in the dialysis unit. However, we do not know if using home vs. in-center measurements to guide treatment decisions improves BP control and/or clinical outcomes. Moreover, a recent US study suggests that typical hemodialysis patients are unlikely to adhere to home monitoring over the long term...
March 6, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28243134/home-hemodialysis-a-comprehensive-review-of-patient-centered-and-economic-considerations
#3
REVIEW
Rachael C Walker, Kirsten Howard, Rachael L Morton
Internationally, the number of patients requiring treatment for end-stage kidney disease (ESKD) continues to increase, placing substantial burden on health systems and patients. Home hemodialysis (HD) has fluctuated in its popularity, and the rates of home HD vary considerably between and within countries although there is evidence suggesting a number of clinical, survival, economic, and quality of life (QoL) advantages associated with this treatment. International guidelines encourage shared decision making between patients and clinicians for the type of dialysis, with an emphasis on a treatment that aligned to the patients' lifestyle...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28157814/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#4
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#5
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
March 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28113962/a-handheld-and-textile-enabled-bioimpedance-system-for-ubiquitous-body-composition-analysis-an-initial-functional-validation
#6
Javier Ferreira Gonzalez, Ivan Pau de la Cruz, Kaj Lindecrantz, Fernando Seoane
In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease...
November 15, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28078825/ethanol-combined-with-heparin-as-a-locking-solution-for-the-prevention-of-catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-randomized-study
#7
Sofia Sofroniadou, Ioanna Revela, Alexandros Kouloubinis, Ioanna Makriniotou, Sinodi Zerbala, Despina Smirloglou, Petros Kalocheretis, Apostolos Drouzas, George Samonis, Christos Iatrou
Introduction Ethanol lock solution has been mainly administered in paediatric and home parenteral nutrition patients in order to prevent catheter related blood stream infections (CRBSI). Its utility in hemodialysis (HD) patients with non-tunneled-uncuffed catheter (NTC) has been poorly explored. Methods We conducted a prospective randomized study in chronic HD patients requiring a newly inserted NTC-while awaiting for the maturation of an already established arteriovenous fistula (AVF) or arteriovenous graft (AVG) or tunneled-cuffed catheter insertion...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/27951549/recent-trends-in-home-hemodialysis-therapy-in-japan
#8
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/27900968/analyzing-the-long-term-survival-of-the-patients-undergoing-peritoneal-dialysis-in-the-peritoneal-dialysis-center-in-shiraz-2002-2011
#9
Abdolreza Rajaeefard, Sara Sarvandian, Abbas Rezaianzadeh, Jamshid Roozbeh
One of the advantages of peritoneal dialysis (PD) compared to hemodialysis is it can be performed at home. The present study aims at determining the long-term survival of patients and technique survival and investigates the risk factors affecting the mortality rate in PD patients. The study was conducted on 290 patients undergoing PD in the main PD center in Shiraz, Iran, between April 2002 and March 2012. The patients' survival rate and the factors affecting their survival were assessed using the Kaplan-Meier method...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27876356/-low-flux-dialysate-daily-home-hemodialysis-a-result-for-the-62%C3%A2-first-french-and-belgian-patients
#10
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/27680765/introduction-of-renal-key-performance-indicators-associated-with-increased-uptake-of-peritoneal-dialysis-in-a-publicly-funded-health-service
#11
Nigel D Toussaint, Lawrence P McMahon, Gregory Dowling, Stephen G Holt, Gillian Smith, Maria Safe, Richard Knight, Kathleen Fair, Leanne Linehan, Rowan G Walker, David A Power
♦ Background: Increased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27664108/cost-effectiveness-of-high-dose-hemodialysis-in-comparison-to-conventional-in-center-hemodialysis-in-the-netherlands
#12
Anna Trisia Beby, Tom Cornelis, Raymund Zinck, Frank Xiaoqing Liu
INTRODUCTION: In the Netherlands, the current standard of care for treating patients with end-stage renal disease is three sessions of in-center hemodialysis (conventional ICHD). However, the literature indicates that high dose hemodialysis (high dose HD) may provide better health outcome such as survival and quality of life. The objective of this study was to determine the cost-effectiveness of high dose HD, both in-center and at home, in comparison to conventional ICHD from a Dutch payer's perspective over a 5 year period...
September 23, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27612017/survival-of-elderly-adults-undergoing-incident-home-hemodialysis-and-kidney-transplantation
#13
Miklos Z Molnar, Vanessa Ravel, Elani Streja, Csaba P Kovesdy, Matthew B Rivara, Rajnish Mehrotra, Kamyar Kalantar-Zadeh
OBJECTIVES: To compare the mortality of elderly adults with end-stage renal disease (ESRD) treated with home hemodialysis (HD) with that of those receiving a kidney transplant (KTx). DESIGN: Prospective cohort. SETTING: Pertinent data for the two groups were obtained from electronic medical records from a large dialysis provider and the U.S. Renal Data System. PARTICIPANTS: Using data from elderly adults (aged ≥65) who started home HD and underwent KTx in the US between 2007 and 2011, a 1:1 propensity score (PS)-matched cohort of 960 elderly adults was created, and the association between treatment modality and all-cause mortality was examined using Cox proportional hazards and competing risk regression survival models using modality failure as a competing event...
October 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27536676/peritoneal-dialysis-in-western-countries
#14
REVIEW
Dirk G Struijk
BACKGROUND: Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. SUMMARY: First the major events in the history of the development of PD are described...
December 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27344461/home-or-institutional-hemodialysis-a-matched-pair-cohort-study-comparing-survival-and-some-modifiable-factors-related-to-survival
#15
COMPARATIVE STUDY
Helena Rydell, Naomi Clyne, Mårten Segelmark
BACKGROUND/AIMS: Survival for dialysis patients is poor. Earlier studies have shown better survival in home-hemodialysis (HHD). The aims of this study are to compare survival for matched patients with HHD and institutional hemodialysis (IHD) and to elucidate the effect on factors related to survival such as hyperphosphatemia, fluid overload and anemia. METHODS: In this retrospective, observational study, incident patients starting HHD and IHD were matched according to sex, age, comorbidity and date of start...
2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27324681/preparation-of-the-dialysis-access-in-stages-4-and-5-ckd
#16
REVIEW
Louise M Moist, Ahmed A Al-Jaishi
Patients with Stages 4 and 5 CKD are optimally managed within a multidisciplinary care setting. This provides an opportunity to create a "patient centered" approach to renal replacement modality options and conservative care. The care team engages with the patient and caregivers to assist with the understanding of their health status, modality and vascular access selection, and overall living with the comorbidity of chronic illness. A systematic approach to provision of education, modality, and access selection, are in part, driven by the patient's expected survival and need for dialysis, the risks and benefits with different modalities, and access and adaptation to their preferences and home situations...
July 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/27216547/survival-of-a-very-low-birthweight-infant-with-potter-sequence-on-long-term-hemodialysis
#17
Jun Miyahara, Masaki Yamamoto, Kyoko Motoshige, Naoya Fujita, Shigeru Ohki
Recent advances in neonatal cardiorespiratory management and neonatal renal replacement therapy have led to occasional reports of favorable short-term and long-term outcomes for Potter sequence, once thought to be fatal. The present patient was a girl born at a gestational age of 34 weeks 4 days with a birthweight of 1398 g. She was diagnosed with Potter sequence complicated by pulmonary hypoplasia due to left renal agenesis and small right kidney. Hemodialysis was started because anuria persisted even after persistent pulmonary hypertension receded and cardiorespiratory status improved...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27067614/obese-and-diabetic-patients-with-end-stage-renal-disease-peritoneal-dialysis-or-hemodialysis
#18
REVIEW
Robert Ekart, Radovan Hojs
Obesity is a chronic disease that is increasingly prevalent around the world and is a well-recognized risk factor for type 2 diabetes and hypertension, leading causes of end-stage renal disease (ESRD). The obese diabetic patient with ESRD is a challenge for the nephrologist with regard to the type of renal replacement therapy that should be suggested and offered to the patient. There is no evidence that either peritoneal dialysis or hemodialysis is contraindicated in obese ESRD patients. In the literature, we can find a discrepancy in the impact of obesity on mortality among hemodialysis vs...
July 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27000827/intra-renal-hemodynamic-changes-after-habitual-physical-activity-in-patients-with-chronic-kidney-disease
#19
REVIEW
Antonia Kaltsatou, Christina Karatzaferi, Georgia I Mitrou, Konstantina P Poulianiti, Giorgos K Sakkas
BACKGROUND: Chronic Kidney Disease (CKD) is considered a silent epidemic with a continuously growing prevalence around the world. Due to uremia many functional and morphological abnormalities occur in almost all systems. Mostly affected, the cardiovascular system, leads to diminished cardiac function that affects patients' functional capacity and physical activity levels, reducing survival and increasing all-cause mortality. Systematic exercise training ameliorates uremia induced body deficits and significantly improves the survival of CKD patients...
2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/26991430/daily-home-hemodialysis-is-an-available-option-for-renal-replacement-therapy-in-spain
#20
Almudena Vega, María José Sequí, Soraya Abad, Claudia Yuste, Alba Santos, Nicolás Macías, Juan M López-Gómez
The objective of the present study was to analyze the characteristics and survival of patients from our hospital who started home hemodialysis. We analyzed all patients receiving home hemodialysis from 1969 to 2015 (51 patients; age 45 ± 23 years; men 77%). We collected characteristics, hospital admission, and mortality. After a median follow-up of 43 (22-76) months, we found 0-1 hospital admissions per year. Sixty-nine percent received a kidney transplant, and the global mortality was 10%. Survival at 5 years was 96%...
August 2016: Therapeutic Apheresis and Dialysis
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