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https://www.readbyqxmd.com/read/28325686/errors-in-computing-the-normalized-protein-catabolic-rate-due-to-use-of-single-pool-urea-kinetic-modeling-or-to-omission-of-the-residual-kidney-urea-clearance
#1
John T Daugirdas
OBJECTIVES: The protein catabolic rate normalized to body size (PCRn) often is computed in dialysis units to obtain information about protein ingestion. However, errors can manifest when inappropriate modeling methods are used. METHODS: We used a variable volume 2-pool urea kinetic model to examine the percent errors in PCRn due to use of a 1-pool urea kinetic model or after omission of residual urea clearance (Kru). RESULTS: When a single-pool model was used, 2 sources of errors were identified...
March 18, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28302754/apixaban-pharmacokinetics-at-steady-state-in-hemodialysis-patients
#2
Thomas A Mavrakanas, Caroline F Samer, Sharon J Nessim, Gershon Frisch, Mark L Lipman
It is unclear whether warfarin is protective or harmful in patients with ESRD and atrial fibrillation. This state of equipoise raises the question of whether alternative anticoagulants may have a therapeutic role. We aimed to determine apixaban pharmacokinetics at steady state in patients on hemodialysis. Seven patients received apixaban 2.5 mg twice daily for 8 days. Blood samples were collected before and after apixaban administration on days 1 and 8 (nondialysis days). Significant accumulation of the drug was observed between days 1 and 8 with the 2...
March 16, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28301096/effects-of-tenapanor-on-cytochrome-p450-mediated-drug-drug-interactions
#3
Susanne Johansson, David P Rosenbaum, Marie Ahlqvist, Helen Rollison, Mikael Knutsson, Bergur Stefansson, Marie Elebring
Tenapanor (RDX5791, AZD1722) is an inhibitor of sodium/hydrogen exchanger isoform 3 in development for the treatment of constipation-predominant irritable bowel syndrome and the treatment of hyperphosphatemia in patients with chronic kidney disease on dialysis. We aimed to investigate whether tenapanor inhibits or induces cytochrome P450s (CYPs). In vitro experiments assessing the potential of tenapanor to affect various CYPs indicated that it could inhibit CYP3A4/5 (IC50 0.4-0.7 μM). An open-label, phase 1 clinical study (NCT02140268) evaluated the pharmacokinetics of the CYP3A4 substrate midazolam when administered with and without tenapanor...
March 16, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28301073/thyroid-function-in-end-stage-renal-disease-and-effects-of-frequent-hemodialysis
#4
Joan C Lo, Gerald J Beck, George A Kaysen, Christopher T Chan, Alan S Kliger, Michael V Rocco, Minwei Li, Glenn M Chertow
INTRODUCTION: End-stage renal disease (ESRD) is associated with perturbations in thyroid hormone concentrations and an increased prevalence of hypothyroidism. Few studies have examined the effects of hemodialysis dose or frequency on endogenous thyroid function. METHODS: Within the Frequent Hemodialysis Network (FHN) trials, we examined the prevalence of hypothyroidism in patients with ESRD. Among those with endogenous thyroid function (without overt hyper/hypothyroidism or thyroid hormone supplementation), we examined the association of thyroid hormone concentration with multiple parameters of self-reported health status, and physical and cognitive performance, and the effects of hemodialysis frequency on serum thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) levels...
March 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28292607/looking-for-engineered-nanoparticles-enps-in-wastewater-treatment-systems-qualification-and-quantification-aspects
#5
Soohoon Choi, Murray V Johnston, Gen-Suh Wang, C P Huang
The current study developed a rationalized method for the quantification and identification of engineered nanoparticles (ENPs) in wastewaters. A review of current literature revealed that overall, presently available methods focused on single ENP mostly and were applicable mainly to samples of low organic loadings or under well-controlled laboratory conditions. In the present research, procedures including dialysis for desalting and low-temperature oxidation for organic removal were used to pretreat samples of high organic loadings, specifically, municipal wastewater and sludge...
March 11, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28271257/outcomes-of-diuretic-use-in-pre-dialysis-ckd-patients-with-moderate-renal-deterioration-attending-tertiary-care-referral-center
#6
Yusra Habib Khan, Azmi Sarriff, Azreen Syazril Adnan, Amer Hayat Khan, Tauqeer Hussain Mallhi
INTRODUCTION: Diuretic therapy has been the mainstay of treatment in chronic kidney disease (CKD) patients, primarily for hypertension and fluid overload. Apart from their beneficial effects, diuretic use is associated with adverse renal outcomes. The current study is aimed to determine the outcomes of diuretic therapy. METHODOLOGY: A prospective observational study was conducted by inviting pre-dialysis CKD patients. Fluid overload was assessed by Bioimpedance analysis (BIA)...
March 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28264150/blood-pressure-management-in-hemodialysis-patients-what-we-know-and-what-questions-remain
#7
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/28258380/clinical-pharmacokinetics-of-dasabuvir
#8
REVIEW
Jennifer R King, Jiuhong Zha, Amit Khatri, Sandeep Dutta, Rajeev M Menon
Dasabuvir is a nonstructural (NS) 5B non-nucleoside inhibitor of the hepatitis C virus (HCV) used in combination with ombitasvir/paritaprevir/ritonavir for the treatment of chronic HCV infection. It is primarily metabolized by cytochrome P450 (CYP) 2C8, with a minor contribution from CYP3A. Biotransformation of dasabuvir forms the M1 metabolite, which retains antiviral activity. Dasabuvir exhibits linear pharmacokinetics with a terminal half-life of approximately 5-8 h, allowing for twice-daily dosing. The M1 metabolite of dasabuvir is the major metabolite in plasma and has a half-life similar to that of dasabuvir...
March 4, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28236252/clinical-pharmacokinetics-of-paritaprevir
#9
REVIEW
Rajeev M Menon, Akshanth R Polepally, Amit Khatri, Walid M Awni, Sandeep Dutta
Paritaprevir is a potent hepatitis C virus (HCV) nonstructural (NS) protein 3/4A protease inhibitor that is used in combination with other direct-acting antivirals (DAAs) for the treatment of chronic HCV infection. Paritaprevir is primarily metabolized by cytochrome P450 (CYP) 3A4 and is administered with a low dose of ritonavir to achieve drug concentrations suitable for once-daily dosing. Coadministration of paritaprevir with ritonavir increases the half-life of single-dose paritaprevir from approximately 3 h to 5-8 h, doubles the time to maximum plasma concentration (T max) from 2...
February 25, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28210031/effects-of-exercise-therapy-during-dialysis-for-elderly-patients-undergoing-maintenance-dialysis
#10
Yusuke Chigira, Takahiro Oda, Masataka Izumi, Tukasa Yoshimura
[Purpose] Exercise therapy during dialysis is currently being recommended since it is easy for patients to follow and results in high participation rates. In this study, this therapy was performed for elderly patients undergoing maintenance dialysis, and its effects were examined. [Subjects and Methods] Seven elderly patients (age: 70.6 ± 4.4) with chronic renal failure, who were able to perform exercises during maintenance dialysis, received the exercise therapy 2 or 3 times weekly for 3 months. Lower-limb muscle strength as well as the standardized dialysis dose (Kt/V) was measured before and after intervention...
January 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28191857/auricular-acupressure-helps-alleviate-xerostomia-in-maintenance-hemodialysis-patients-a-pilot-study
#11
Guowen Yang, Shaoqin Lin, Yuchi Wu, Shangpeng Zhang, Xiuqing Wu, Xusheng Liu, Chuan Zou, Qizhan Lin
BACKGROUND: Xerostomia is one of the most common complaints in maintenance hemodialysis (MHD) patients. This problem contributes to excess fluid intake and results in poor survival outcome. Based on Traditional Chinese Medicine (TCM) theory and literature studies, the authors have been practicing auricular acupressure therapy (AAT) to help patients with xerostomia. This pilot study was conducted to demonstrate the potential of AAT for xerostomia in MHD patients. METHODS: Eligible subjects who agreed to participate in this study were recruited and provided with AAT for 4 weeks...
February 13, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28183858/comparison-of-topical-chlorhexidine-and-mupirocin-for-the-prevention-of-exit-site-infection-in-incident-peritoneal-dialysis-patients
#12
Htay Htay, David W Johnson, Sin Yan Wu, Elizabeth L Oei, Marjorie Wai Yin Foo, Jason C Choo
♦ Objective: Prevention of exit-site infection (ESI) is of paramount importance to peritoneal dialysis (PD) patients. The aim of this study was to evaluate the effectiveness of chlorhexidine in the prevention of ESI in incident PD patients compared with mupirocin. ♦ Methods: This retrospective, pre-test/post-test observational study included all incident PD patients at Singapore General Hospital from 2012 to 2015. Patients received daily topical exit-site application of either mupirocin (2012 - 2013) or chlorhexidine (2014 - 2015) in addition to routine exit-site cleaning with 10% povidone-iodine...
February 9, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28174691/beta-catenin-participates-in-dialysate-induced-peritoneal-fibrosis-via-enhanced-peritoneal-cell-epithelial-to-mesenchymal-transition
#13
Shuiyu Ji, Hao Deng, Wei Jin, Pengpeng Yan, Rending Wang, Lisha Pang, Jingyi Zhou, Jiaming Zhang, Xiaoying Chen, Xiang Zhao, Jia Shen
Long-term exposure to peritoneal dialysate with high glucose (HG) leads to peritoneal fibrosis and thus decreases dialysis efficiency. In this study, we explored the role of β-catenin in this process. C57BL/6 mice received daily intraperitoneal injection with 10% of the body weight of saline (control), 4.25% glucose peritoneal dialysis fluid (PDF), or PDF combined with 5 mg·kg(-1) of the β-catenin inhibitor ICG-001 (PDF+ICG) for 30 days. Also, mice peritoneal epithelial cells (mPECs) were cultured in 4.25% glucose (HG) or combined with 10 μm ICG-001 (HG+ICG) for 48 h...
February 2017: FEBS Open Bio
https://www.readbyqxmd.com/read/28152289/cqi-proiect-every-other-day-nocturnal-hhd-an-alternative-approach-to-reduce-burden
#14
(no author information available yet)
More frequent dialysis, typically performed five to six times per week at home, has been associated with a num- ber of clinical, cardiovascular, and health-related quality of life (HRQOL) benefits. Daily therapy often results in a burden for patients and care partners. A continuous qual- ity improvement (CQI) initiative was conducted to evaluate if an alternate day, longer duration therapy (3.5 treatments with six to 10 hour treatments per week) would provide a viable alternative for home hemodialysis (HHD)...
August 2016: Nephrology News & Issues
https://www.readbyqxmd.com/read/28139394/serious-fall-injuries-before-and-after-initiation-of-hemodialysis-among-older-esrd-patients-in-the-united-states-a-retrospective-cohort-study
#15
Laura C Plantinga, Rachel E Patzer, Harold A Franch, C Barrett Bowling
BACKGROUND: Because initiation of dialysis therapy often occurs in the setting of acute illness and may signal worsening health and functional decline, we examined whether rates of serious fall injuries among older hemodialysis patients differ before and after dialysis therapy initiation. STUDY DESIGN: Retrospective cohort study of claims data from the 2 years spanning dialysis therapy initiation among patients initiating dialysis therapy in 2010 to 2012. SETTING & PARTICIPANTS: Claims from 81,653 Medicare end-stage renal disease beneficiaries aged 67 to 100 years...
January 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28127739/phosphate-equilibration-rate-and-daily-clearance-in-patients-on-capd-ccpd-and-apd
#16
Rafael Gomez, Jacek Waniewski, Adelaida Zapata, Mauro Pietribiasi, Bengt Lindholm
BACKGROUND: Criteria for how to assess removal rate of inorganic phosphorous (iP) in peritoneal dialysis (PD) and whether iP removal differs between different PD modalities are debated. METHODS: In a cross-sectional study, 73 prevalent patients on continuous ambulatory PD (n = 16), continuous cyclic PD (n = 8) or automated PD (n = 49) with mean age 54 (range, 18-87) years, 46 males, underwent standard peritoneal equilibration test (PET) and 24-hour collection of dialysate with measurements of iP, urea and creatinine in all samples and bags...
January 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28114147/physical-activity-and-sleep-patterns-in-hemodialysis-patients-in-a-suburban-environment
#17
RANDOMIZED CONTROLLED TRIAL
Schantel Williams, Maggie Han, Xiaoling Ye, Hanjie Zhang, Anna Meyring-Wösten, Marcee Bonner, Candace Young, Stephan Thijssen, Daniel Marsh, Peter Kotanko
BACKGROUND/AIMS: Hemodialysis (HD) patients are less active than their healthy counterparts. They are often plagued with sleep disorders that affect the quality of their sleep. Our aim was to objectively quantify activity and sleep quality among HD patients in a suburban HD population. METHODS: Activity and sleep parameters were measured using a commercially available activity tracker in 29 HD patients from Baton Rouge, LA, USA. Patients in the feedback group received their activity and sleep data at each dialysis treatment...
2017: Blood Purification
https://www.readbyqxmd.com/read/28114144/hepatitis-c-treatment-in-chronic-kidney-disease-patients-the-kidney-disease-improving-global-outcomes-perspective
#18
REVIEW
Michel Jadoul, Paul Martin
BACKGROUND: Hepatitis C virus (HCV) infection is a very common infection found among hemodialysis (HD) and kidney transplant patients. It is associated with substantial morbidity and mortality. Direct-acting antiviral agents (DAAs) have much better efficacy (sustained viral response (SVR)) and tolerance than interferon-based regimens. Very recent studies extend this breakthrough finding to chronic kidney disease (CKD) populations. SUMMARY: CKD patients with an estimated glomerular filtration rate (eGFR) >30 ml/min/1...
2017: Blood Purification
https://www.readbyqxmd.com/read/28104106/peritoneal-dialysis-in-class-2-3-obesity-a-single-center-experience
#19
Yougandhar V Akula, Tibor Fülöp, Mehul P Dixit
Extreme obesity may hamper successful peritoneal dialysis (PD) delivery. Among our PD patients, we have identified 15 markedly obese (class 2-3 obesity: body mass index [BMI] ≥35kg/m(2)) and 20 lean (BMI: 20-25kg/m(2)) dialysis patients and reviewed multiple clinical, laboratory and dialysis-related parameters. Extreme outliers of obesity (BMI > 40; 6 subjects) received detailed review. Although weight (P < 0.0001) and BMI (P < 0.0001) differed significantly, weekly Kt/V (obese versus lean: 2.05 ± 0...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28094031/patients-receiving-frequent-hemodialysis-have-better-health-related-quality-of-life-compared-to-patients-receiving-conventional-hemodialysis
#20
Amit X Garg, Rita S Suri, Paul Eggers, Fredric O Finkelstein, Tom Greene, Paul L Kimmel, Alan S Kliger, Brett Larive, Robert M Lindsay, Andreas Pierratos, Mark Unruh, Glenn M Chertow
Most patients with end-stage kidney disease value their health-related quality of life (HRQoL) and want to know how it will be affected by their dialysis modality. We extended the findings of two prior clinical trial reports to estimate the effects of frequent compared to conventional hemodialysis on additional measures of HRQoL. The Daily Trial randomly assigned 245 patients to receive frequent (six times per week) or conventional (three times per week) in-center hemodialysis. The Nocturnal Trial randomly assigned 87 patients to receive frequent nocturnal (six times per week) or conventional (three times per week) home hemodialysis...
March 2017: Kidney International
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