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https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#1
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#2
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in more than 80% of patients undergoing hemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-dialytic interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28410649/incident-dialysis-access-in-patients-with-end-stage-kidney-disease-what-needs-to-be-improved
#3
REVIEW
Louise M Moist, Charmaine E Lok
The initiation of dialysis is a challenging time of transition for patients, families, and their supporters. Patients with exposure to a comprehensive chronic kidney disease clinic may have had education and subsequent decision making regarding dialysis modality and access; however, many patients with or without prior education will require an urgent start to dialysis, requiring quick decisions regarding dialysis modality and access. In many countries, hemodialysis (HD) using a central venous catheter (CVC) is the most common initial renal replacement modality and dialysis access...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28372955/colloids-in-cardiac-surgery-friend-or-foe
#4
Pia Katarina Ryhammer, Mariann Tang, Joachim Hoffmann-Petersen, Dovile Leonaviciute, Jacob Greisen, Marie Storebjerg Gissel, Carl-Johan Jakobsen
OBJECTIVE: The right choice of fluid replacement still is a matter of debate. Recently, two large-scale studies on the use of hydroxyethyl starches (HES) in the intensive care setting have been published, which have caused a huge shift in the daily practice of volume therapy. These results have been applied to patients outside intensive care. The aim of this study was to evaluate the impact this change has had on the outcomes in a large population of cardiac surgery patients, with a focus on the type of colloid infusion...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28372582/coping-with-kidney-disease-qualitative-findings-from-the-empowering-patients-on-choices-for-renal-replacement-therapy-epoch-rrt-study
#5
Lalita Subramanian, Martha Quinn, Junhui Zhao, Laurie Lachance, Jarcy Zee, Francesca Tentori
BACKGROUND: The highly burdensome effects of kidney failure and its management impose many life-altering changes on patients. Better understanding of successful coping strategies will inform patients and help health care providers support patients' needs as they navigate these changes together. METHODS: A qualitative, cross-sectional study involving semi-structured telephone interviews including open- and closed-ended questions, with 179 U.S. patients with advanced chronic kidney disease (CKD), either not yet on dialysis ([CKD-ND], n = 65), or on dialysis (hemodialysis [HD], n = 76; or peritoneal dialysis [PD], n = 38) recruited through social media and in-person contacts from June to December 2013...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28360371/capd-catheter-exit-site-and-tunnel-infection-with-fungal-etiology-treatment-and-catheter-reinsertion-for-an-extremely-rare-complication
#6
Manmeet Singh Jhawar, Jasmin Das, Pratish George, Anil Luther
Fungal infection is an extremely rare etiology of exit-site and tunnel infection in patients on continuous ambulatory peritoneal dialysis (CAPD). There are few data available regarding its management-especially choice of antifungals, duration of therapy, and removal of catheter. There are no guidelines pertaining to reinsertion of the CAPD catheter following fungal exit-site and tunnel infection. This case report highlights Candida albicans as a rare cause of exit-site and tunnel infection of the CAPD catheter...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28360368/the-pull-technique-for-removal-of-peritoneal-dialysis-catheters-a-call-for-re-evaluation-of-practice-standards
#7
Marvin Grieff, Elizabeth Mamo, Gina Scroggins, Alexander Kurchin
♦ BACKGROUND: The most commonly used peritoneal dialysis (PD) catheters have silicon tubing with attached Dacron cuffs. The current standard of care for PD catheter removal is by complete surgical dissection, withdrawing both the tubing and the cuffs. The intention is to avoid infection of any residual part of the catheter. We retrospectively analyzed our results with the alternative 'pull' technique, by which the silicon tube is pulled out, leaving the Dacron cuffs within the abdominal wall. This technique never gained popularity due to concern that the retained cuffs would get infected...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28345136/twice-weekly-hemodialysis-in-china-can-it-be-a-better-option-for-initiation-or-maintenance-dialysis-therapy
#8
Yucheng Yan, Sylvia Ramirez, Shuchi Anand, Jiaqi Qian, Li Zuo
Cumulative evidence indicates it may be worthwhile revisiting the twice-weekly hemodialysis (HD) regimen as a valid option for individualized or incremental treatments for selected patients with end-stage renal disease. In this article, we will review the current evidences on the potential pros and cons of twice-weekly HD compared to thrice-weekly HD including China's experience in the practice of twice-weekly HD. A prudent patient selection and close dialysis adequacy monitoring might be necessary for this medical treatment choice...
March 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28340820/role-of-everolimus-on-cardiac-functions-in-kidney-transplant-recipients
#9
U Cakir, G Alis, T Erturk, A H Karayagiz, U Karabulut, I Berber
BACKGROUND: Kidney transplantation is known to increase the survival of dialysis patients by ameloriating cardiac status, including both systolic and diastolic functions. We aimed to evaluate the role of immunosuppressive drug regimens on cardiac functions of kidney transplant recipients (KTRs). METHODS: We prospectively evaluated 120 KTRs immediately before and 1 year after the kidney transplantation, using tissue Doppler echocardiography. A triple immunosuppressive therapy including tacrolimus, mycophenoloic acid (MPA), and prednisolone was started for all patients...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28339843/availability-and-cost-of-extracorporeal-treatments-for-poisonings-and-other-emergency-indications-a-worldwide-survey
#10
Josée Bouchard, Valery Lavergne, Darren M Roberts, Monique Cormier, Genevieve Morissette, Marc Ghannoum
Background: Extracorporeal treatments (ECTRs) are used for different conditions, including replacement of organ function and poisoning. Current recommendations for ECTRs in various poisonings suggest that intermittent haemodialysis (IHD) is the most efficient technique. However, the practicality of these recommendations is poorly defined in view of limited information on availability and cost worldwide. Methods: A survey invitation to an Internet-based questionnaire was emailed between January 2014 and March 2015 to members of international societies to determine the availability, time to initiation and cost of ECTRs (including filters, dialysate, catheter, anticoagulant and nursing/physician salary)...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28320238/early-renal-replacement-therapy-versus-standard-care-in-the-icu
#11
Dipayan Chaudhuri, Brent Herritt, Daren Heyland, Louis-Philippe Gagnon, Kednapa Thavorn, Daniel Kobewka, Kwadwo Kyeremanteng
OBJECTIVE: Renal replacement therapy (RRT) is the treatment of choice for severe acute kidney injury, but there are no firm guidelines as to the time of initiation of RRT in the critically ill. The primary objective of this study is to determine 1-month mortality rates of early versus late dialysis in critical care. As secondary end points, we provide a cost analysis of early versus late RRT initiation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and number of patients on dialysis at day 60 postrandomization...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28318629/machine-learning-algorithms-define-pathogen-specific-local-immune-fingerprints-in-peritoneal-dialysis-patients-with-bacterial-infections
#12
Jingjing Zhang, Ida M Friberg, Ann Kift-Morgan, Gita Parekh, Matt P Morgan, Anna Rita Liuzzi, Chan-Yu Lin, Kieron L Donovan, Chantal S Colmont, Peter H Morgan, Paul Davis, Ian Weeks, Donald J Fraser, Nicholas Topley, Matthias Eberl
The immune system has evolved to sense invading pathogens, control infection, and restore tissue integrity. Despite symptomatic variability in patients, unequivocal evidence that an individual's immune system distinguishes between different organisms and mounts an appropriate response is lacking. We here used a systematic approach to characterize responses to microbiologically well-defined infection in a total of 83 peritoneal dialysis patients on the day of presentation with acute peritonitis. A broad range of cellular and soluble parameters was determined in peritoneal effluents, covering the majority of local immune cells, inflammatory and regulatory cytokines and chemokines as well as tissue damage-related factors...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28297053/general-regional-or-local-anesthesia-for-successful-radial-cephalic-arteriovenous-fistula
#13
David Shemesh, Yefim Raikhinstein, Ilya Goldin, Oded Olsha
Autogenous fistulas and in particular radiocephalic fistulas are recommended as the first vascular access for hemodialysis. Unfortunately, the rates of early failure and non-maturation are very high. For more than a decade, brachial plexus block has been proposed as the anesthesia of choice for fistula creation due to its beneficial sympathectomy-like effect, causing vasodilation and attenuation of spasm. Until recently, there was not a single randomized clinical study supporting this proposition. Because performing regional anesthesia is time-consuming and requires expertise, many surgeons prefer local or general anesthesia for vascular access surgery...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28249082/are-non-newtonian-effects-important-in-hemodynamic-simulations-of-patients-with-autogenous-fistula
#14
S M Javid Mahmoudzadeh Akherat, Kevin Cassel, Michael Boghosian, Promila Dhar, Mary Hammes
Given the current emphasis on accurate computational fluid dynamics (CFD) modeling of cardiovascular flows, which incorporates realistic blood vessel geometries and cardiac waveforms, it is necessary to revisit the conventional wisdom regarding the influences of non-Newtonian effects. In this study, patient-specific reconstructed 3D geometries, whole blood viscosity data, and venous pulses postdialysis access surgery are used as the basis for the hemodynamic simulations of renal failure patients with native fistula access...
April 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28238984/race-racism-and-access-to-renal-transplantation-among-african-americans
#15
Kimberly Jacob Arriola
There are clear and compelling racial disparities in access to renal transplant, which is the therapy of choice for many patients with end stage renal disease. This paper conceptualizes the role of racism (i.e., internalized, personally-mediated, and institutionalized) in creating and perpetuating these disparities at multiple levels of the social ecology by integrating two often-cited theories in the literature. Internalized racism is manifested at the intrapersonal level when, for example, African American patients devalue their self-worth, thereby not pursuing the most aggressive treatment available...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#16
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
March 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28215414/meta-analysis-of-comparison-of-drug-eluting-stents-and-bare-metal-stents-in-patients-on-dialysis
#17
Shan Li, Dan Ye, Guoping Chen, Weiwei Xu
Coronary artery disease is common in patients with end-stage renal disease who are on hemodialysis. The efficacy and safety of evidence regarding the use of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with dialysis is unclear. We searched MEDLINE, EMBASE, Science Citation Index, CINAHL, and the Cochrane CENTRAL database of controlled clinical trials for controlled trials that compare DES and BMS in dialysis patients up to June 2016. We conducted a meta-analysis across 14 eligible studies (n = 62,250 patients)...
April 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28212179/hard-choices-better-outcomes-a-review-of-shared-decision-making-and-patient-decision-aids-around-dialysis-initiation-and-conservative-kidney-management
#18
Janet L Davis, Sara N Davison
PURPOSE OF REVIEW: Patients reaching end-stage kidney disease face difficult decisions, including choosing among renal replacement therapies (RRTs). With an increasingly elderly and frail population, there is growing interest in conservative kidney management (CKM) as a viable alternative to dialysis. Shared decision-making (SDM) is a patient-centered approach to these decisions, in which choices are viewed within the explicitly discussed values and preferences of the patient. Patient decision aids (PDAs) are tools designed to facilitate these discussions...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28186578/the-choice-of-renal-replacement-therapy-coreth-project-dialysis-patients-psychosocial-characteristics-and-treatment-satisfaction
#19
Maxi Robinski, Wilfried Mau, Andreas Wienke, Matthias Girndt
No abstract text is available yet for this article.
February 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28178704/the-influence-of-renal-centre-and-patient-sociodemographic-factors-on-home-haemodialysis-prevalence-in-the-uk
#20
Anuradha Jayanti, Philip Foden, Alasdair Rae, Julie Morris, Paul Brenchley, Sandip Mitra
BACKGROUND: In the United Kingdom, socioeconomic disadvantage has been associated with lower use of home dialysis, mostly peritoneal dialysis. In this study, we explore the role of a patient's sociodemographic, socioeconomic differences and the centre's influence on home haemodialysis (HD) prevalence. METHODS: Data is derived from the cross-sectional arm of the UK multi-centre study investigating barriers and enablers of home HD (BASIC-HHD study). Centres were classified as low- (<3%), medium- (5-8%) and high-prevalence groups (>8%)...
February 9, 2017: Nephron
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