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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Adrian Liew
Haemodialysis (HD) was the first procedure that had demonstrated the ability to partially replace renal function, and became the most widely utilized treatment for patients with end-stage renal disease (ESRD). In a great majority of countries around the world, conventional in-centre HD had become the predominant renal replacement therapy, being touted as able to achieve better solute clearance and more successful in attaining euvolemia than patients on peritoneal dialysis. This is despite the antecedent hemodynamic risks, more rapid loss of residual renal function, greater infectious perils, excessive erythropoietin requirements and higher infrastructure costs...
October 2018: Nephrology
Cristina Caetano, Ana Valente, Telma Oliveira, Cristina Garagarza
BACKGROUND AND AIMS: Coffee is one of the most widely consumed beverages worldwide. However, fluid intake restriction is an important and difficult challenge for hemodialysis (HD) patients. The aim of this study was to analyze the effect of coffee intake on hydration and nutritional parameters of HD patients. METHODS: This was an observational, cross-sectional, multicenter study where 373 HD patients from 8 dialysis centers in Portugal were enrolled. A face-to-face questionnaire was applied and patient's clinical and body composition parameters were analyzed...
October 8, 2018: European Journal of Clinical Nutrition
Sabrina Haroon, Andrew Davenport
The objectives of hemodialysis have moved from the diffusive clearance of small molecular weight uremic toxins and achieving dialyzer urea adequacy targets to emphasis on improving clinical outcomes in end stage renal failure patients by increasing larger sized uremic toxin clearance. Clinical emphasis in the last few decades has focused on increasing middle molecule weight toxin clearance by hemodiafiltration. Although long-term data is still lacking, short-term outcomes appear promising. Advancements in nanotechnology have now introduction a new generation of medium cut-off membrane dialyzers which allow diffusive clearance of similar middle molecular weight uremia toxin clearance as hemodiafiltration, without increased albumin losses...
October 8, 2018: Hemodialysis International
Sami Deniz, Yusuf Aydemir, Aysun Şengül, Jülide Çeldir Emre, Mehmet Tanrisev, Mustafa Hikmet Özhan, İbrahim Güney
INTRODUCTION: The risk of TB is increased in patients with chronic kidney disease (CKD) when compared with individuals with normal renal function. We aimed to determine tuberculin skin test (TST) response and the factors which might affect the response in patients with CKD undergoing dialysis in this study. METHODS: The purified protein derivative solution was administered to the patients and the diameter of induration was measured. Additionally, the age, gender and smoking status of the patients were interrogated...
October 5, 2018: Hemodialysis International
Masako Fujiwara, Itiro Ando, Keisuke Satoh, You Shishido, Kazuhito Totsune, Hiroshi Sato, Yutaka Imai
Recently, the ratio of patients with diabetes mellitus (DM) among hemodialysis (HD) patients has increased to become the largest sub-population. Their prognoses are significantly worse than those of patients without diabetes (non-DM). In the present study, 10 DM patients who did not take meals and 10 non-DM patients who took meals during HD sessions were investigated. The time courses of the change in plasma levels of metabolites during HD were determined. DM patients exhibited decreased plasma levels of lactate, pyruvate and alanine and dramatically increased levels of ketone bodies...
2018: PloS One
Renhua Lu, Chenqi Xu, Yan Li, Ling Yu, Xinghua Shao, Kewei Xie, Jiaqi Gu, Zanzhe Yu, Yucheng Yan, Yangtai Guan, Zhaohui Ni, Claudio Ronco, Leyi Gu
OBJECTIVE: To investigate the incidence and the prognosis of cognitive impairment (CI) and to find out the risk factors associated with the outcome in maintenance haemodialysis (MHD) patients. METHODS: Enrolled the patients who met the criteria as below: MHD (≥3 months) patients before July 2014, ≥18 years old and could carry on the cognitive function test (Montreal Cognitive Assessment [MoCA]). All enrolled patients were divided into 2 groups: CI group (MoCA < 26) and non-CI group (MoCA ≥26)...
September 25, 2018: Blood Purification
John K Leypoldt, Eric D Weinhandl, Allan J Collins
With dialysis delivery systems that operate at low dialysate flow rates, prescriptions for more frequent hemodialysis (HD) employ dialysate volume as the primary parameter for small solute removal rather than blood-side urea dialyzer clearance (K). Such delivery systems, however, yield dialysate concentrations that almost completely saturate with blood (water), suggesting that the volume of urea cleared (the product of K and treatment time or Kt) can be readily estimated from the prescribed dialysate volume to target small solute removal...
September 25, 2018: Hemodialysis International
Jong Hyun Jhee, Jimin Park, Hyoungnae Kim, Youn Kyung Kee, Jung Tak Park, Seung Hyeok Han, Chul Woo Yang, Nam-Ho Kim, Yon Su Kim, Shin-Wook Kang, Yong-Lim Kim, Tae-Hyun Yoo
Hypertension is common and contributes to adverse outcomes in patients undergoing dialysis. However, the proper blood pressure (BP) target remains controversial and several factors make this difficult. This study aimed to investigate the adequate BP target in patients undergoing prevalent dialysis. Data were retrieved from the Clinical Research Center for End-Stage Renal Disease (2009-2014). 2,299 patients undergoing dialysis were evaluated. Patients were assigned into eight groups according to predialysis systolic blood pressure (SBP)...
September 20, 2018: Scientific Reports
Gianmarco Troiano, Gabriele Messina, Elisabetta Zanieri, Valeria Li Donni, Nicola Nante, Lea Magisti, Maria Beatrice Pulci, Fabrizio Niccolini
BACKGROUND: A dialyzed patient weekly gets in touch with a large amount of water (on average 350 liters) through the dialysis bath. It is therefore essential that this solution would have a high quality and purity. The aim of our study was to monitor the microbiological quality of the hemodialysis water in order to identify possible factors that could affect it. METHODS: We conducted a cross-sectional study from January 2015 to October 2017 collecting the dialysis water in AOU Careggi...
September 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Raquel Esteras, Juan Martín-Navarro, Gabriel Ledesma, Raúl Fernández-Prado, Gilda Carreño, Melissa Cintra, Ignacio Cidraque, Ignacio Sanz, Blanca Tarragón, Simona Alexandru, Mónica Milla, Elena Astudillo, Emilio Sánchez, Sebastian Mas, Rafael Díaz Tejeiro, Alberto Ortiz, Rafael Sánchez, Emilio González-Parra
BACKGROUND/AIMS: A recent alert from Spanish health authorities warned of a higher incidence of reported hypersensitivity reactions to hemodialysis membranes with polysulfone, in the 2017 review of acute reactions to dialyzers found only published reports in the 21st century on polysulfone and its derivatives. The aim is to assess/evaluate the current incidence and characteristics of hypersensitivity reactions in hemodialysis patients. METHODS: A retrospective multicentre study in 9 Spanish hospitals evaluated patients in whom a hypersensitivity reaction required a change in dialyzer membrane...
September 20, 2018: Kidney & Blood Pressure Research
Min-Feng Tseng, Chu-Lin Chou, Chi-Hsiang Chung, Wu-Chien Chien, Ying-Kai Chen, Hsiu-Chien Yang, Chen-Yi Liao, Kuang-Yu Wei, Chia-Chao Wu
OBJECT: Traumatic intracranial hemorrhage (TICH) patients with acute kidney injury (AKI) were reported to have a high mortality rate. Renal replacement therapy (RRT) is indicated for patients with a severe kidney injury. This study aimed to compare the effects of different RRT modalities regarding chronic dialysis rate among adult TICH patients with AKI. METHODS: A retrospective search of computerized hospital records from 2000 to 2010 for patients with a discharge diagnosis of TICH was conducted to identify the index cases...
2018: PloS One
Maurizio Bossola, Enrico Di Stasio, Tania Monteburini, Emanuele Parodi, Fabio Ippoliti, Stefano Cenerelli, Stefano Santarelli, Pier Eugenio Nebiolo, Vittorio Sirolli, Mario Bonomini, Manuela Antocicco, Giuseppe Zuccalà, Alice Laudisio
INTRODUCTION: The present study aimed to determine the variables that are associated with a longer dialysis recovery time (DRT) and to define the relationship that exists between DRT and the ultrafiltration rate (UFR) in prevalent chronic hemodialysis (CHD) patients. METHODS: We studied 210 prevalent CHD of 5 hemodialysis units in Central Italy. Patients were invited to answer to the question: "How long does it take you to recover from a dialysis session?" Answers to this question were subsequently converted into minutes...
September 19, 2018: Blood Purification
Mayanka Kamboj, Amir Kazory
Over the last decades, there have been major advancements in the field of renal replacement therapy (RRT) with utilization of newer technologies and advent of various modalities. Once exclusively used for treatment of renal failure and its metabolic consequences, the science of RRT has expanded to include non-renal indications such as treatment of fluid overload in patients with refractory heart failure. Hepatic encephalopathy due to sudden rise in serum ammonia level in the setting of acute liver failure represents an underexplored area in which RRT can potentially be helpful...
September 18, 2018: Blood Purification
Guillaume L Hoareau, Carl A Beyer, Lauren E Walker, Kevin K Chung, Ian J Stewart
Trauma-induced acute kidney injury (AKI) has affected many U.S. warfighters throughout history. We seek to provide a historical review of the epidemiology of combat-acquired AKI and to highlight the importance of adapting current renal replacement therapy (RRT) capabilities to prepare for the next armed conflict. While severe AKI was rare in the recent conflicts in Iraq and Afghanistan, an analysis of prior wars suggests that it will be more common in future combat operations characterized by prolonged evacuation times, limited resuscitation capabilities, and delayed aeromedical evacuation...
September 12, 2018: Military Medicine
Akiko Owaki, Daijo Inaguma, Isao Aoyama, Shinichiro Inaba, Shigehisa Koide, Eri Ito, Kazuo Takahashi, Hiroki Hayashi, Midori Hasegawa, Yukio Yuzawa
INTRODUCTION: As glomerular filtration rate (GFR) decreases, serum phosphate level increases. Previous reports indicated that serum phosphate level was associated with mortality in patients on dialysis. However, few reports have examined the association using dialysis initiation as the baseline period. METHODS: This was a multicenter prospective cohort analysis including 1492 patients. Patients were classified into four quartiles based on the serum phosphate level at dialysis initiation, with Q1 being the lowest and Q4 the highest...
November 2018: Renal Failure
Sayaka Shimizu, Shingo Fukuma, Tatsuyoshi Ikenoue, Tadao Akizawa, Shunichi Fukuhara
BACKGROUND/AIMS: Hemodialysis patients are at high risk of hospitalization and their condition may worsen with repeated hospitalization. The aim of this study was to evaluate the impact of the cumulative number of hospitalizations on post-discharge mortality. METHODS: This study was a prospective cohort study. We examined 3,359 adult patients on hemodialysis for at least 90 days who participated in the Japanese Dialysis Outcomes and Practice Patterns Study phases 3 and 4 (2005-2012)...
August 28, 2018: Nephron
Sahir Kalim
PURPOSE OF REVIEW: Protein carbamylation is a posttranslational protein modification caused, in part, by exposure to urea's dissociation product cyanate. Additional modulators of protein carbamylation include circulating free amino acid levels, inflammation, diet, smoking, and environmental pollution exposures. Carbamylation reactions can modify protein charge, structure, and function, leading to adverse molecular and cellular responses. These changes have been linked to several pathologic biochemical pathways relevant to patients with end stage renal disease (ESRD) such as accelerated atherosclerosis and dysfunctional erythropoiesis, among others...
November 2018: Current Opinion in Nephrology and Hypertension
Yuji Sato, Tatsunori Toida, Hideto Nakagawa, Takashi Iwakiri, Ryuzoh Nishizono, Masao Kikuchi, Shouichi Fujimoto
OBJECTIVES: To investigate the relationship between dry weight (DW) change and survival in long-term maintenance prevalent dialysis patients. METHODS: We conducted a prospective data collection study with retrospective analysis of the registered data. Patients were followed up for 5 years (1-year observation of DW changes and subsequent 4-year follow-up). The outcome was all-cause mortality. The predictors were 1-year DW change rates. The hazard ratios (HRs) for all-cause mortality were calculated using multivariable Cox regression analysis, fully adjusted for age, sex, basal kidney disease, dialysis vintage, current smoking, past cardiovascular events, serum albumin, DW at enrollment, serum creatinine, mean predialysis systolic blood pressure, and cardiothoracic ratio or 1-year cardiothoracic ratio change rate...
2018: PloS One
Marinella Ruospo, Suetonia C Palmer, Patrizia Natale, Jonathan C Craig, Mariacristina Vecchio, Grahame J Elder, Giovanni Fm Strippoli
BACKGROUND: Phosphate binders are used to reduce positive phosphate balance and to lower serum phosphate levels for people with chronic kidney disease (CKD) with the aim to prevent progression of chronic kidney disease-mineral and bone disorder (CKD-MBD). This is an update of a review first published in 2011. OBJECTIVES: The aim of this review was to assess the benefits and harms of phosphate binders for people with CKD with particular reference to relevant biochemical end-points, musculoskeletal and cardiovascular morbidity, hospitalisation, and death...
August 22, 2018: Cochrane Database of Systematic Reviews
Ljubomir M Ilic, Roger B Davis, Robert S Brown, Stewart H Lecker
BACKGROUND: Volume overload poses a major risk in hemodialysis patients but simple detection methods are lacking. We propose a novel marker, the Interdialytic Creatinine Rise (IDCR), readily calculated as the change in serum creatinine over time (in mg/dL/h), to assess volume overload and predict mortality risk in hemodialysis patients. METHODS: First, we calculated IDCR changes with volume in a prospective cohort of 35 hospitalized hemodialysis patients awaiting hemodialysis and 33 hospitalized patients undergoing hemodialysis every other day...
August 16, 2018: BMC Nephrology
2018-08-19 10:14:37
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