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dialysis choice

J C Araújo, R W D S Barbosa, M F Machado, P S Furtado, C M D Pugas, J S D A Filho, C F Lopes, R J C Mattoso, C L Neves
BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment...
September 2016: Transplantation Proceedings
Pablo Molina, José L Górriz, Sandra Beltrán, Belén Vizcaino, Luis M Pallardó
Although some experimental targets involved in calcium deposition are emerging, no intervention has been described to reliably reverse vascular calcification (VC). We report a case of severe VC regression in a parathyroidectomized patient on hemodialysis over 12-year follow-up, highlighting the use of calcium-free phosphate binders and a 2.5 mEq/L calcium dialysate for reducing calcium loading, despite persistent asymptomatic hypocalcemia occurrences. This case suggests that phosphate-binder choice and calcium dialysate concentration could be influenced by other components of CKD-MBD besides biochemical parameters, such as the presence of VC, so concluding that asymptomatic hypocalcemia may not be as harmful as once supposed, and conferring greater prognostic weight to the presence of VC than to calcium levels...
October 10, 2016: Clinical Nephrology
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
Manuel Kussmann, Linda Schuster, Sarah Wrenger, Petra Pichler, Gottfried Reznicek, Heinz Burgmann, Wolfgang Poeppl, Markus Zeitlinger, Martin Wiesholzer
♦ Background: Peritonitis is a major problem among patients on peritoneal dialysis (PD). The influence of diverse PD fluids on the activity of frequently used antibiotics has been insufficiently investigated. Thus, the present study set out to investigate the impact of different PD fluids on the activity of cefepime, ciprofloxacin, ertapenem, meropenem, and tobramycin against Escherichia coli. ♦ Methods: Time-kill curves in 4 different PD fluids (Dianeal PDG4, Extraneal, Nutrineal PD4 and Physioneal 40, all Baxter Healthcare Corp...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Takayuki Adachi, Tsutomu Sakurada, Takanori Otowa, Keita Uehara, Shina Sueki, Shigeki Kojima, Nagayuki Kaneshiro, Katsuomi Matsui, Tadahisa Tomohiro, Yugo Shibagaki
Vascular access intervention therapy (VAIVT) has been positioned as the first choice of treatment for stenosis lesions frequently observed in arteriovenous fistula (AVF) for hemodialysis patients in Japan. Furthermore, increased blood flow can provide a stable dialysis. In contrast, it has been reported that excess blood flow of AVF causes high-output heart failure. Although VAIVT is used to increase blood flow of AVF, the impact of VAIVT on cardiac load has been rarely reported. We examined the factors associated with cardiac load in hemodialysis patients undergoing VAIVT by measuring levels of α human atrial natriuretic polypeptide (hANP) and brain natriuretic peptide (BNP) before and after VAIVT...
October 2016: Hemodialysis International
Louise E Ross, Pauline A Swift, Sandra M Newbold, Kate Bramham, Anne Hurley, Hugh Gallagher
Pregnancy outcomes in patients with end-stage renal disease (ESRD) on dialysis are improving. Recent literature supports intensive hemodialysis (HD) as the modality of choice during pregnancy in ESRD. We report the successful delivery of a healthy infant at full term in a patient with ESRD by supplementing peritoneal dialysis (PD) with intermittent HD to achieve adequate dialysis intensity.
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Ana Maria Cusumano, Guillermo Javier Rosa-Diez, Maria Carlota Gonzalez-Bedat
In 2015, 634387 million people (9% of the world's population) resided in Latin America (LA), with half of those populating Brazil and Mexico. The LA Dialysis and Transplant Registry was initiated in 1991, with the aim of collecting data on renal replacement therapy (RRT) from the 20 LA-affiliated countries. Since then, the Registry has revealed a trend of increasing prevalence and incidence of end-stage kidney disease on RRT, which is ongoing and is correlated with gross national income, life expectancy at birth, and percentage of population that is older than 65 years...
September 6, 2016: World Journal of Nephrology
Patrice Cacoub, Anne Claire Desbois, Corinne Isnard-Bagnis, Dario Rocatello, Clodoveo Ferri
Hepatitis C virus (HCV) infection is associated with tremendous morbidity and mortality due to liver complications. HCV infection is also associated with many extrahepatic manifestations including cardiovascular diseases, glucose metabolism impairment, cryoglobulinemia vasculitis, B cell non-Hodgkin lymphoma and chronic kidney disease (CKD). Many studies have shown a strong association between HCV and CKD, by reporting (i) an increased prevalence of HCV infection in patients on haemodialysis, (ii) an increased incidence of CKD and proteinuria in HCV-infected patients, and (iii) the development of membranoproliferative glomerulonephritis secondary to HCV-induced cryoglobulinemia vasculitis...
October 2016: Journal of Hepatology
Tammy Hod, Alexander S Goldfarb-Rumyantzev, Bhanu K Patibandla, Akshita Narra, Robert S Brown
BACKGROUND: In patients with failure of an initial arteriovenous fistula (AVF), a subsequent vascular access is needed before hemodialysis (HD) initiation. METHODS: To assess the optimal access strategy after a failed AVF, we linked data from the US Renal Data System with Medicare claims data identifying 21,436 patients ≥ 67 years old who started HD between January 1, 2005, and December 31, 2008, with an AVF placed as their first predialysis access. Of the 10,568 subjects whose AVF failed, 1,796 patients had an AVF placed as a second access predialysis (AVF2 group) and 399 patients had an arteriovenous graft placed as a second access predialysis (AVG2 group)...
November 2016: Clinical Nephrology
Francesco Esposito, Marco Di Serafino, Concetta Ambrosio, Maria Rita Panico, Francesca Malacario, Carmela Mercogliano, Carmine Pecoraro, Patrizia Oresta
PURPOSE: Over the past two decades, continuous ambulatory peritoneal dialysis has emerged as the first-choice dialysis modality in children awaiting for transplantation. Despite the improvements observed in catheter survival over the past several years, the obstruction is one of the reasons for immediate catheter non-function. This study assessed usefulness of ultrasound (US) in visualizing the obstruction of chronic peritoneal dialysis (CPD) catheter and identifying the etiology. MATERIALS AND METHODS: Between January 2000 and November 2012, 38 patients (20 M, 18 F) were treated with CPD and examined with US...
September 2016: Journal of Ultrasound
Rachel E Patzer, Mohua Basu, Sumit Mohan, Kayla D Smith, Michael Wolf, Daniela Ladner, John J Friedewald, Mariana Chiles, Allison Russell, Laura McPherson, Jennifer Gander, Stephen Pastan
Kidney transplantation is the preferred treatment for patients with end-stage renal disease, as it substantially increases a patient's survival and is cost saving compared to a lifetime of dialysis. However, transplantation is not universally chosen by patients with renal failure, and limited knowledge about the survival benefit of transplantation vs. dialysis may play a role. We created a mobile application clinical decision aid called iChoose Kidney to improve access to individualized prognosis information comparing dialysis and transplantation outcomes...
May 2016: KI Rep
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Rossella Attini, Martina Gerbino, Paola Todeschini, Maria Luisa Perrino, Ana Maria Manzione, Gian Benedetto Piredda, Elisa Gnappi, Flavia Caputo, Giuseppe Montagnino, Vincenzo Bellizzi, Pierluigi Di Loreto, Francesca Martino, Domenico Montanaro, Michele Rossini, Santina Castellino, Marilisa Biolcati, Federica Fassio, Valentina Loi, Silvia Parisi, Elisabetta Versino, Antonello Pani, Tullia Todros
BACKGROUND: Kidney transplantation is the treatment of choice to restore fertility to women on renal replacement therapy. Over time, immunosuppressive, support therapies and approaches towards high-risk pregnancies have changed. The aim of this study was to analyse maternal-foetal outcomes in two cohorts of transplanted women who delivered a live-born baby in Italy in 1978-2013, dichotomized into delivery before and after January 2000. METHODS: A survey involving all the Italian transplant centres was carried out, gathering data on all pregnancies recorded since the start of activity at each centre; the estimated nationwide coverage was 75%...
July 5, 2016: Nephrology, Dialysis, Transplantation
Carlo Basile, Andrew Davenport, Peter J Blankestijn
The mortality rate of patients on maintenance dialysis remains alarmingly high, at approximately 15-20 % per year. Increasing dialyzer urea clearance has not been shown to improve survival and hence interest has shifted towards convective therapies, such as hemodiafiltration (HDF) which can remove middle molecular weight uremic toxins, which have been suggested to increase mortality in patients with end-stage kidney disease. During the last few years, four large prospective randomized controlled trials (RCTs) have been conducted in different European countries to compare survival outcomes in prevalent patients receiving conventional hemodialysis with online post-dilution HDF (OL HDF)...
September 1, 2016: Journal of Nephrology
Martin B Lee, Joanne M Bargman
PURPOSE OF REVIEW: To clarify misconceptions about the feasibility and risks of peritoneal dialysis that unnecessarily limit peritoneal dialysis uptake or continuation in patients for whom peritoneal dialysis is the preferred dialysis modality. The inappropriate choice of haemodialysis as a result of these misconceptions contributes to low peritoneal dialysis penetrance, increases transfer from peritoneal dialysis to haemodialysis, increases expenditure on haemodialysis and compromises quality of life for these patients...
November 2016: Current Opinion in Nephrology and Hypertension
Keren Ladin, Naomi Lin, Emily Hahn, Gregory Zhang, Susan Koch-Weser, Daniel E Weiner
BACKGROUND: Although shared decision-making (SDM) can better align patient preferences with treatment, barriers remain incompletely understood and the impact on patient satisfaction is unknown. METHODS: This is a qualitative study with semistructured interviews. A purposive sample of prevalent dialysis patients ≥65 years of age at two facilities in Greater Boston were selected for diversity in time from initiation, race, modality and vintage. A codebook was developed and interrater reliability was 89%...
August 30, 2016: Nephrology, Dialysis, Transplantation
Leah Krischock, Sean E Kennedy, Andrew Hayen
AIM: Improve the understanding of outcomes and complications of dialysis in Adolescents and Young Adults (AYA) to inform decisions about dialysis modality in this patient population. METHODS: Registry data on Australian AYA aged 13 to 20 years who commenced dialysis between 1/1/2000 and 31/12/2013 were retrieved from the Australia and New Zealand Dialysis and Transplantation Registry and analysed to determine associations between demographic characteristics, dialysis modality and outcomes...
August 30, 2016: Nephrology
Panagiotis I Georgianos, Rajiv Agarwal
The diagnosis and management of hypertension among patients on chronic dialysis is challenging. Routine peridialytic blood pressure recordings are unable to accurately diagnose hypertension and stratify cardiovascular risk. By contrast, blood pressure recordings taken outside the dialysis setting exhibit clear prognostic associations with survival and might facilitate the diagnosis and long-term management of hypertension. Once accurately diagnosed, management of hypertension in individuals on chronic dialysis should initially involve non-pharmacological strategies to control volume overload...
October 2016: Nature Reviews. Nephrology
Vincenzo Bellizzi, Giuseppe Conte, Silvio Borrelli, Adamasco Cupisti, Luca De Nicola, Biagio R Di Iorio, Gianfranca Cabiddu, Marcora Mandreoli, Ernesto Paoletti, Giorgina B Piccoli, Giuseppe Quintaliani, Maura Ravera, Domenico Santoro, Serena Torraca, Roberto Minutolo
This position paper of the study group "Conservative treatment of Chronic Kidney Disease-CKD" of the Italian Society of Nephrology addresses major practical, unresolved, issues related to the conservative treatment of chronic renal disease. Specifically, controversial topics from everyday clinical nephrology practice which cannot find a clear, definitive answer in the current literature or in nephrology guidelines are discussed. The paper reports the point of view of the study group. Concise and practical advice is given on several common issues: renal biopsy in diabetes; dual blockade of the renin-angiotensin-aldosterone system (RAAS); management of iron deficiency; low protein diet; dietary salt intake; bicarbonate supplementation; treatment of obesity; the choice of conservative therapy vs...
August 27, 2016: Journal of Nephrology
Rachael C Walker, Kirsten Howard, Rachael L Morton
No abstract text is available yet for this article.
September 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Djalila Mekahli, Karlijn J van Stralen, Marjolein Bonthuis, Kitty J Jager, Ayşe Balat, Elisa Benetti, Nathalie Godefroid, Vidar O Edvardsson, James G Heaf, Augustina Jankauskiene, Larissa Kerecuk, Svetlana Marinova, Flora Puteo, Tomas Seeman, Aleksandra Zurowska, Jacques Pirenne, Franz Schaefer, Jaap W Groothoff
BACKGROUND: The choice for either kidney or combined liver-kidney transplantation in young people with kidney failure and liver fibrosis due to autosomal recessive polycystic kidney disease (ARPKD) can be challenging. We aimed to analyze the characteristics and outcomes of transplantation type in these children, adolescents, and young adults. STUDY DESIGN: Cohort study. SETTING & PARTICIPANTS: We derived data for children, adolescents, and young adults with ARPKD with either kidney or combined liver-kidney transplants for 1995 to 2012 from the ESPN/ERA-EDTA Registry, a European pediatric renal registry collecting data from 36 European countries...
August 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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