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Mortality in hemodialysis

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https://www.readbyqxmd.com/read/29027182/preoperative-management-of-arteriovenous-fistula-avf-for-hemodialysis
#1
Gaetano Alfano, Francesco Fontana, Mario Iannaccone, Patrizia Noussan, Gianni Cappelli
Native arteriovenous fistula (AVF) is the favorite access for hemodialysis (HD). The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recommends its creation in most patients with renal failure. Unfortunately, intensive efforts to promote native AVF in patients with marginal vessels have increased the rate of primary fistula failure. A non-functioning fistula prompts the use of central venous catheter (CVC) that, unlike AVF, has been associated with an increased risk of morbidity and mortality among patients receiving HD...
October 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29021274/prevalence-and-outcomes-of-left-sided-valvular-heart-disease-associated-with-chronic-kidney-disease
#2
Zainab Samad, Joseph A Sivak, Matthew Phelan, Phillip J Schulte, Uptal Patel, Eric J Velazquez
BACKGROUND: Chronic kidney disease (CKD) is an adverse prognostic marker for valve intervention patients; however, the prevalence and related outcomes of valvular heart disease in CKD patients is unknown. METHODS AND RESULTS: Included patients underwent echocardiography (1999-2013), had serum creatinine values within 6 months before index echocardiogram, and had no history of valve surgery. CKD was defined as diagnosis based on the International Classification of Diseases, Ninth Revision or an estimated glomerular filtration rate <60 mL/min per 1...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29021271/impact-of-hemodialysis-on-procedural-outcomes-of-percutaneous-coronary-intervention-for-chronic-total-occlusion-insights-from-the-japanese-multicenter-registry
#3
Tatsuya Nakachi, Shun Kohsaka, Masahisa Yamane, Toshiya Muramatsu, Atsunori Okamura, Yoshifumi Kashima, Shunsuke Matsuno, Masami Sakurada, Mikihiko Kijima, Masaki Tanabe, Maoto Habara
BACKGROUND: Among patients treated with percutaneous coronary intervention for chronic total occlusion (CTO-PCI), patients on long-term hemodialysis are at significantly high risk for cardiovascular mortality and morbidity. However, clinical or angiographic predictors that might aid in better patient selection remain unclear. We aimed to assess the acute impact of hemodialysis in patients who underwent CTO-PCI. METHODS AND RESULTS: The Retrograde Summit registry is a multicenter, prospective registry of patients undergoing CTO-PCI at 65 Japanese centers...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29017465/frequency-of-arrhythmia-symptoms-and-acceptability-of-implantable-cardiac-monitors-in-hemodialysis-patients
#4
Naya El Hage, Bernard G Jaar, Alan Cheng, Chloe Knight, Elena Blasco-Colmenares, Luis Gimenez, Eliseo Guallar, Tariq Shafi
BACKGROUND: Arrhythmia-related complications and sudden death are common in dialysis patients. However, routine cardiac monitoring has so far not been feasible. Miniaturization of implantable cardiac monitors offers a new paradigm for detection and management of arrhythmias in dialysis patients. The goal of our study was to determine the frequency of arrhythmia-related symptoms in hemodialysis patients and to assess their willingness to undergo implantation of a cardiac monitor. METHODS: We conducted a survey of in-center hemodialysis patients at a hemodialysis clinic in Baltimore, Maryland...
October 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29017155/effectiveness-of-ihd-with-adsorptive-pmma-membrane-in-myeloma-cast-nephropathy-a-cohort-study
#5
Florence Sens, Déborah Chaintreuil, Anne Jolivot, Fitsum Guebre-Egziabher, Philip Robinson, Lionel Karlin, Frank Bridoux, Laurent Juillard
BACKGROUND: In patients with cast nephropathy and acute kidney injury (AKI) requiring dialysis, the reduction of serum free light chains (FLC) using chemotherapy and intensive hemodialysis (IHD) with a high cut-off filter may improve renal and patient outcomes. We evaluated the effectiveness of a combination of chemotherapy and IHD with an adsorbent polymethylmethacrylate membrane (IHD-PMMA) on renal recovery and survival. METHODS: A single-center retrospective cohort-study was conducted...
October 10, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29016441/epidemiology-and-outcomes-of-infectious-spondylodiscitis-in-hemodialysis-patients
#6
Yueh-An Lu, Wei-Chiao Sun, George Kuo, Chao-Yu Chen, Huang-Kai Kao, YuJr Lin, Chia-Hui Lee, Cheng-Chieh Hung, Ya-Chung Tian, Yu-Shien Ko, Hsiang-Hao Hsu
STUDY DESIGN: A retrospective study of patients who were hospitalized for infectious spondylodiscitis over a 13 year period. OBJECTIVE: To elucidate the epidemiology and prognostic factors of infectious spondylodiscitis in hemodialysis (HD) patients and to identify the impact of HD on infectious spondylodiscitis. SUMMARY OF BACKGROUND DATA: Only a few case studies of infectious spondylodiscitis in HD patients can be found in the literature...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28993507/dialysate-potassium-dialysate-magnesium-and-hemodialysis-risk
#7
Patrick H Pun, John P Middleton
One of the fundamental goals of the hemodialysis prescription is to maintain serum potassium levels within a narrow normal range during both the intradialytic and interdialytic intervals. Considering the extraordinarily high rate of cardiovascular mortality in the hemodialysis population, clinicians are obligated to explore whether factors related to dialytic potassium removal can be modified to improve clinical outcomes. Observational studies and circumstantial evidence suggest that extreme concentrations of serum and dialysate potassium can trigger cardiac arrest...
October 9, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28992971/diabetes-mellitus-adversely-affects-mortality-and-recurrence-after-valve-surgery-for-infective-endocarditis
#8
Daisuke Yoshioka, Koichi Toda, Jun-Ya Yokoyama, Ryohei Matsuura, Shigeru Miyagawa, Satoshi Kainuma, Taichi Sakaguchi, Masayuki Sakaki, Hiroyuki Nishi, Yukitoshi Shirakawa, Keiji Iwata, Hitoshi Suhara, Ryoto Sakaniwa, Hirotsugu Fukuda, Yoshiki Sawa
BACKGROUND: Although diabetes mellitus (DM) increases the incidence of infective endocarditis (IE), little is known about the outcome of valve surgery for active IE in patients with DM. We evaluated the clinical outcomes of valve surgery for IE in patients with DM. METHODS: Between 2009 and 2016, 470 patients underwent valve surgery for definitive left-sided active IE at 12 affiliated hospitals. We compared the preoperative variables and clinical outcomes between patients without (n = 374) and with DM (n = 96)...
September 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28992849/severe-myoglobinuric-acute-kidney-injury-in%C3%A2-a%C3%A2-kidney-recipient-rapid-recovery-after-hemodialysis-with-the-super-high-flux-membrane-theralite%C3%A2-%C3%A2
#9
Ahmed Goubella, Fabrice Gankam-Kengne, Thomas Baudoux, David Fagnoul, Cécile Husson, Marie-Luce Delforge, Nilufer Broeders, Joëlle Nortier
Myoglobinuric acute kidney injury (AKI) is a severe condition requiring early therapeutic strategies. Early recognition and treatment are crucial to reduce morbidity and mortality rate. Here, we report a kidney recipient with severe rhabdomyolysis and AKI secondary to parvovirus B19 infection. Initiation of hemodialysis with the super high-flux filter Theralite® (Gambro, cut-off 45 kDa, 2.1 m2) resulted in the clearance of myoglobin from 61 to 71% after 3 hours. Elimination rates of IL-6 and β2-microglobulin were ~ 30 - 64% and 55 - 71% after 3 hours, respectively...
October 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28992343/serum-to-dialysate-potassium-gradient-and-its-association-with-short-term-outcomes-in-hemodialysis-patients
#10
Steven M Brunelli, David M Spiegel, Charles Du Mond, Nina Oestreicher, Wolfgang C Winkelmayer, Csaba P Kovesdy
Background: A high serum-to-dialysate potassium (K + ) gradient at the start of dialysis leads to rapid lowering of serum K + and may confer a greater risk of adverse events. Here, we examined the near-term association of K + gradient with clinical outcomes. Methods: This retrospective (2010-11) event-based study considered 830 741 patient-intervals, each defined by a pre-dialysis measurement of serum K + made among adult Medicare Parts A and B enrollees who received in-center hemodialysis on a Monday/Wednesday/Friday schedule at a large US dialysis organization...
August 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992129/development-and-validation-of-a-prediction-model-for-loss-of-physical-function-in-elderly-hemodialysis-patients
#11
Shingo Fukuma, Sayaka Shimizu, Ayumi Shintani, Tsukasa Kamitani, Tadao Akizawa, Shunichi Fukuhara
Background: Among aging hemodialysis patients, loss of physical function has become a major issue. We developed and validated a model of predicting loss of physical function among elderly hemodialysis patients. Methods: We conducted a cohort study involving maintenance hemodialysis patients  ≥65 years of age from the Dialysis Outcomes and Practice Pattern Study in Japan. The derivation cohort included 593 early phase (1996-2004) patients and the temporal validation cohort included 447 late-phase (2005-12) patients...
September 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992124/impact-of-trajectories-of-abdominal-aortic-calcification-over-2-years-on-subsequent-mortality-a-10-year-longitudinal-study
#12
Hiroki Inoue, Sayaka Shimizu, Keita Watanabe, Yasuhiro Kamiyama, Hitomi Shima, Azuna Nakase, Hironori Ishida, Noriaki Kurita, Shingo Fukuma, Shunichi Fukuhara, Yukari Yamada
Background: Although both the presence and progression over time of vascular calcification have been shown to independently predict cardiovascular disease and mortality in chronic dialysis patients, the impact of the pattern of accumulation of abdominal aortic calcification on mortality has not yet been investigated. Methods: We conducted a longitudinal study at a dialysis hospital in Hokkaido, Japan from 2005 to 2014. An abdominal calcification index (ACI) was generated for 396 patients from their annual abdominal computed tomography (CT) scans...
August 25, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28991722/risk-of-psychiatric-disorders-in-guillain-barre-syndrome-a-nationwide-population-based-cohort-study
#13
Nian-Sheng Tzeng, Hsin-An Chang, Chi-Hsiang Chung, Fu-Huang Lin, Chin-Bin Yeh, San-Yuan Huang, Chuan-Chia Chang, Ru-Band Lu, Yu-Chen Kao, Hui-Wen Yeh, Wei-Shan Chiang, Wu-Chien Chien
BACKGROUND: Guillain-Barre syndrome (GBS) is a rare immune-related neurological disorder with high mortality and morbidity, but the comorbid psychiatric disorders garnered little attention in the GBS patients. This study aimed to investigate the association between GBS and the risk of developing psychiatric disorders. METHODS: A total of 18,192 enrolled patients, with 4548 study subjects who had suffered GBS, and 13,644 controls matched for gender and age, from the Inpatient Dataset of 2000-2013 in Taiwan, and selected from the National Health Insurance Research Database (NHIRD)...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28985622/outcomes-and-changes-in-code-status-of-patients-with-acute-myeloid-leukemia-undergoing-induction-chemotherapy-who-were-transferred-to-the-intensive-care-unit
#14
Tamjeed Ahmed, Abby L Koch, Scott Isom, Heidi D Klepin, Jonathan M Bishop, Leslie R Ellis, Dmitriy Berenzon, Dianna Howard, Susan Lyerly, Bayard L Powell, Timothy S Pardee
Patients with Acute Myeloid Leukemia (AML) have compromised marrow function and chemotherapy causes further suppression. As a result complications are frequent, and patients may require admission to the intensive care unit (ICU). How codes status changes when these events occur and how those changes influence outcome are largely unknown. Outcomes for adult patients with AML, undergoing induction chemotherapy, and transferred to the ICU between January 2000 and December 2013 were analyzed. 94 patients were included...
September 27, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28985442/periodontal-disease-and-pneumonia-mortality-in-hemodialysis-patients-a-7-year-cohort-study
#15
Masanori Iwasaki, George W Taylor, Shuji Awano, Akihiro Yoshida, Shota Kataoka, Toshihiro Ansai, Hidetoshi Nakamura
AIM: To evaluate the association between periodontal disease and pneumonia mortality in hemodialysis patients. MATERIALS AND METHODS: This prospective cohort study included 211 patients (mean age, 64.4 years) undergoing hemodialysis at a single medical center. The patients underwent a baseline clinical dental examination in 2008 and were then followed up until July 2015. Periodontal disease was defined as the presence of clinical attachment loss of ≥4 mm in ≥30% of the probed sites...
October 6, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/28979632/-staphylococcal-toxic-shock-syndrome-at-a-chronic-hemodialysis
#16
Hassan Alaoui, Ayoub Belhadj, Younes Aissaoui, Rachid Seddiki, Mohamed Zoubir, Mohamed Bougalem
Staphylococcal toxic shock syndrome is an acute and systemic infectious syndrome associated with the super-antigenic activity of staphylococcal toxins. It is a pathology that is rather rare but remains burdened with a considerable mortality despite the therapeutic management. The gateway is usually cutaneous with secondary bacteremic spread could be subject to preventive measures. We report the case of a rapidly fatal staphylococcal toxic shock, developed in a chronic hemodialysis whose entry from the arteriovenous fistula was suspected...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28978256/cardiac-surgery-in-patients-with-end-stage-renal-disease-on-dialysis
#17
Caroline Bäck, Mads Hornum, Christian Joost Holdflod Møller, Peter Skov Olsen
OBJECTIVES: Over the past decade, the number of patients on dialysis and with cardiovascular diseases has steadily increased. This retrospective analysis compares the postoperative mortality after cardiac surgery between patients on hemodialysis and peritoneal dialysis. METHODS: Between 1998 and 2015, 136 patients with end-stage renal disease initiating dialysis more than one month before surgery underwent cardiac surgery. Demographics, preoperative hemodynamic and biochemical data were collected from the patient records...
October 4, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28975108/comparing-the-values-of-intact-parathormone-and-1-84-pth-to-predict-hyperparathyroidism-in-hemodialysis-patients
#18
Aria Jenabi, Mosadegh Jabbari, Hossein Ziaie
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD) leading high mortality and even long-term morbidity. SHPT is manifested by elevation of parathyroid hormone (PTH) and accurate determining the level of serum PTH is very essential for early diagnosis of SHPT secondary to CKD. It is very important to match the values obtained for intact parathormone (iPTH) and 1- 84 PTH with the minimized measurement bias. OBJECTIVES: The present study aimed to first determine the agreement value between the iPTH and 1- 84 PTH measures in patients with hyperparathyroidism secondary to endstage renal disease under chronic hemodialysis...
July 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28974524/risk-of-infective-endocarditis-in-patients-with-end-stage-kidney-disease
#19
Mavish S Chaudry, Nicholas Carlson, Gunnar H Gislason, Anne-Lise Kamper, Marianne Rix, Vance G Fowler, Christian Torp-Pedersen, Niels E Bruun
BACKGROUND AND OBJECTIVES: Endocarditis is a serious complication in patients treated with RRT. The study aimed to examine incidence and risk factors of endocarditis in patients with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Danish National Registry on Regular Dialysis and Transplantation contains data on all Danish patients receiving renal replacement (hemodialysis, peritoneal dialysis, or kidney transplantation) for ESRD. Incidence of endocarditis was estimated for each RRT modality...
October 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28974498/association-between-circulating-ketone-bodies-and-worse-outcomes-in-hemodialysis-patients
#20
Masaru Obokata, Kazuaki Negishi, Hiroaki Sunaga, Hideki Ishida, Kyoko Ito, Tetsuya Ogawa, Tatsuya Iso, Yoshitaka Ando, Masahiko Kurabayashi
BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in patients receiving hemodialysis. Systemic metabolic perturbation is one of the hallmark abnormalities in patients at high cardiovascular risk. We sought to determine the relationship between circulating ketone body and clinical outcomes in patients with prevalent hemodialysis. METHODS AND RESULTS: We retrospectively assessed the relationship between serum β-hydroxybutyrate (βOHB), the most abundant ketone body in the circulation, and prognosis in 405 stable hemodialysis patients...
October 3, 2017: Journal of the American Heart Association
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