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Hemodialysis

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125 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28419668/prevalence-and-associated-variables-of-postdialysis-fatigue-results-of-a-prospective-multicenter-study
#1
Maurizio Bossola, Emanuele Marzetti, Enrico Di Stasio, Tania Monteburini, Stefano Cenerelli, Katia Mazzoli, Emanuele Parodi, Vittorio Sirolli, Stefano Santarelli, Fabio Ippoliti, Pier Eugenio Nebiolo, Mario Bonomini, Roberta Melatti, Carlo Vulpio
AIMS: Little is known about postdialysis fatigue (PDF), a debilitating symptom of hemodialysis patients. METHODS: In 5 hemodialysis units of northern-centre Italy, patients were regarded to suffer from PDF if they spontaneously offered this complaint when asked the open-ended question: Do you feel better or worse after dialysis? If worse, please specify in which way. A complaint of fatigue would be probed further with questions directed at its duration, frequency and intensity, allowing creation of a fatigue index of severity (one third of the sum of these three parameters, each rated from 1 to 5)...
April 17, 2017: Nephrology
https://www.readbyqxmd.com/read/28399019/pathophysiology-and-implications-of-intradialytic-hypertension
#2
Peter Noel Van Buren
PURPOSE OF REVIEW: Intradialytic hypertension occurs regularly in 10--15% of hemodialysis patients. A large observational study recently showed that intradialytic hypertension of any magnitude increased mortality risk comparable to the most severe degrees of intradialytic hypotension. The present review review discusses the most recent evidence underlying the pathophysiology of intradialytic hypertension and implications for its management. RECENT FINDINGS: Patients with intradialytic hypertension typically have small interdialytic weight gains, but bioimpedance spectroscopy shows these patients have significant chronic extracellular volume excess...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28377472/time-to-improve-informed-consent-for-dialysis-an-international-perspective
#3
Frank Brennan, Cameron Stewart, Hannah Burgess, Sara N Davison, Alvin H Moss, Fliss E M Murtagh, Michael Germain, Shelley Tranter, Mark Brown
The literature reveals that current nephrology practice in obtaining informed consent for dialysis falls short of ethical and legal requirements. Meeting these requirements represents a significant challenge, especially because the benefits and risks of dialysis have shifted significantly with the growing number of older, comorbid patients. The importance of informed consent for dialysis is heightened by several concerns, including: (1) the proportion of predialysis patients and patients on dialysis who lack capacity in decision making and (2) whether older, comorbid, and frail patients understand their poor prognosis and the full implications to their independence and functional status of being on dialysis...
April 4, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28340239/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#4
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles J Ferro, Jean-Michel Halimi, Gunnar H Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verhaar, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28314806/the-use-of-a-multidimensional-measure-of-dialysis-adequacy-moving-beyond-small-solute-kinetics
#5
REVIEW
Jeffrey Perl, Laura M Dember, Joanne M Bargman, Teri Browne, David M Charytan, Jennifer E Flythe, LaTonya J Hickson, Adriana M Hung, Michel Jadoul, Timmy Chang Lee, Klemens B Meyer, Hamid Moradi, Tariq Shafi, Isaac Teitelbaum, Leslie P Wong, Christopher T Chan
Urea removal has become a key measure of the intensity of dialysis treatment for kidney failure. Small solute removal, exemplified by Kt/Vurea, has been broadly applied as a means to quantify the dose of thrice weekly hemodialysis. Yet, the reliance on small solute clearances alone as a measure of dialysis adequacy fails fully to quantify the intended clinical effects of dialysis therapy. This review aims to (1) understand the strengths and limitations of small solute kinetics as a surrogate marker of dialysis dose, and (2) present the prospect of a more comprehensive construct for dialysis dose, one that considers more broadly the goals of ESRD care to maximize both quality of life and survival...
March 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28187786/low-renal-replacement-therapy-incidence-among-slowly-progressing-elderly-chronic-kidney-disease-patients-referred-to-nephrology-care-an-observational-study
#6
Ulrika Hahn Lundström, Alessandro Gasparini, Rino Bellocco, Abdul Rashid Qureshi, Juan-Jesus Carrero, Marie Evans
BACKGROUND: Elderly patients with advanced chronic kidney disease (CKD) have a high risk of death before reaching end-stage kidney disease. In order to allocate resources, such as advanced care nephrology where it is most needed, it is essential to know which patients have the highest absolute risk of advancing to renal replacement therapy (RRT). METHODS: We included all nephrology-referred CKD stage 3b-5 patients in Sweden 2005-2011 included in the Swedish renal registry (SRR-CKD) who had at least two serum creatinine measurements one year apart (+/- 6 months)...
February 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28166331/the-illness-experience-of-undocumented-immigrants-with-end-stage-renal-disease
#7
Lilia Cervantes, Stacy Fischer, Nancy Berlinger, Maria Zabalaga, Claudia Camacho, Stuart Linas, Debora Ortega
Importance: The exclusion of undocumented immigrants from Medicare coverage for hemodialysis based on a diagnosis of end-stage renal disease (ESRD) requires physicians in some states to manage chronic illness in this population using emergent-only hemodialysis. Emergent-only dialysis is expensive and burdensome for patients. Objective: To understand the illness experience of undocumented immigrants with ESRD who lack access to scheduled hemodialysis. Design, Setting, and Participants: A qualitative, semistructured, interview study was conducted in a Colorado safety-net hospital from July 1 to December 31, 2015, with 20 undocumented immigrants (hereinafter referred to as undocumented patients) with ESRD and no access to scheduled hemodialysis...
April 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28166268/consequences-of-increasing-convection-onto-patient-care-and-protein-removal-in-hemodialysis
#8
Nathalie Gayrard, Alain Ficheux, Flore Duranton, Caroline Guzman, Ilan Szwarc, Fernando Vetromile, Chantal Cazevieille, Philippe Brunet, Marie-Françoise Servel, Àngel Argilés, Moglie Le Quintrec
INTRODUCTION: Recent randomised controlled trials suggest that on-line hemodiafiltration (OL-HDF) improves survival, provided that it reaches high convective volumes. However, there is scant information on the feasibility and the consequences of modifying convection volumes in clinics. METHODS: Twelve stable dialysis patients were treated with high-flux 1.8 m2 polysulphone dialyzers and 4 levels of convection flows (QUF) based on GKD-UF monitoring of the system, for 1 week each...
2017: PloS One
https://www.readbyqxmd.com/read/28102815/assessment-of-the-characteristics-and-quality-of-life-of-patients-with-uremic-peripheral-neuropathy%C3%A2
#9
Xiu-Zhi Yu, Shi Lu, Wei Gou, Wei Wang, Shui-Hong Zou, Yin-Xia Han, Wei-Wei Wang, Jin-Yuan Zhang
OBJECTIVES: This study seeks to examine the characteristics and health-related quality of life (HRQL) of patients with uremic peripheral neuropathy. METHODS: Uremic patients undergoing maintenance hemodialysis (MHD) at our hospital were enrolled in this study. Data collection began in January 2011 and ended in June 2011. The patients were divided into two groups, the lesion group (110 cases) and the non-lesion group (168 cases), based on the presence or absence of peripheral neuropathy...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28032484/treatment-of-methicillin-resistant-staphylococcus-aureus-bacteremia
#10
REVIEW
Eun Ju Choo, Henry F Chambers
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available.
December 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28089366/limited-reduction-in-uremic-solute-concentrations-with-increased-dialysis-frequency-and-time-in%C3%A2-the%C3%A2-frequent-hemodialysis-network-daily-trial
#11
Tammy L Sirich, Kara Fong, Brett Larive, Gerald J Beck, Glenn M Chertow, Nathan W Levin, Alan S Kliger, Natalie S Plummer, Timothy W Meyer
The Frequent Hemodialysis Network Daily Trial compared conventional three-times weekly treatment to more frequent treatment with a longer weekly treatment time in patients receiving in-center hemodialysis. Evaluation at one year showed favorable effects of more intensive treatment on left ventricular mass, blood pressure, and phosphate control, but modest or no effects on physical or cognitive performance. The current study compared plasma concentrations of uremic solutes in stored samples from 53 trial patients who received three-times weekly in-center hemodialysis for an average weekly time of 10...
May 2017: Kidney International
https://www.readbyqxmd.com/read/28073820/predicting-6-month-mortality-risk-of-patients-commencing-dialysis-treatment-for-end-stage-kidney-disease
#12
Sara E Ivory, Kevan R Polkinghorne, Yeasmin Khandakar, Jessica Kasza, Sophia Zoungas, Retha Steenkamp, Paul Roderick, Rory Wolfe
BACKGROUND: There is evidence that end-stage kidney disease patients who are older or with more comorbidity may have a poor trade-off between benefits of dialysis and potential harms. We aimed to develop a tool for predicting patient mortality in the early stages of receiving dialysis. METHODS: In 23 658 patients aged 15+ years commencing dialysis between 2000 and 2009 in Australia and New Zealand a point score tool was developed to predict 6-month mortality based on a logistic regression analysis of factors available at dialysis initiation...
January 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27993572/chills-during-hemodialysis-prediction-and-prevalence-of-bacterial-infections-a-retrospective-cohort-study
#13
Daniel Shepshelovich, Dana Yelin, Lior Or Bach, Noy Halevy, Yonatan Ziv, Hefziba Green, Benaya Rozen-Zvi, Haim Ben-Zvi, Jihad Bishara, Anat Gafter-Gvili, Dafna Yahav
INTRODUCTION: Chills are a complication of patients undergoing hemodialysis. The rate of infection among hemodialysis patients presenting with chills is not well established, and empirical broad-spectrum antibiotics are usually the rule. METHODS: We performed a retrospective study aiming to assess the rates of infection and bacteremia in hemodialysis patients presenting with chills. We evaluated risk factors for infection and bacteremia and tested a prediction model for infection...
December 16, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/28032072/effect-of-mealtime-during-hemodialysis-on-patients-complications
#14
Seyed Reza Borzou, Fahimeh Mahdipour, Khodayar Oshvandi, Mohsen Salavati, Neda Alimohammadi
Introduction: Food intake during hemodialysis increases the risk of problems such as hypotension, nausea, and vomiting in patients undergoing hemodialysis. This study aimed to determine the effect of mealtime during dialysis on the patients' complications. Methods: This is a quasi-experimental study consisted of all eligible hemodialysis patients in Hamadan teaching hospitals. All of 48 patients were selected through census method. The research was conducted in two sessions. At both sessions, patients were kept fasting prior to hemodialysis...
December 2016: Journal of Caring Sciences
https://www.readbyqxmd.com/read/27925100/strategies-for-thirst-relief-integrative-literature-review
#15
Aline Korki Arrabal Garcia, Lígia Fahl Fonseca, Patricia Aroni, Cristina Maria Galvão
Objective: to analyze the strategies used to relieve the thirst of hospitalized patients. Method: an integrative review, for which the databases PubMed, LILACS, CINAHL and the group of references organized by the Group for Study and Research of Thirst were selected for the search of primary studies, with the keywords: thirst, ice, cold, intervention, nursing care, artificial saliva. Results: the review sample was composed of ten primary studies...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27898419/high-pulse-wave-velocity-defines-a-very-high-cardiovascular-risk-cohort-of-dialysis-patients-under-age-60
#16
João Pedro Ferreira, Nicolas Girerd, Bruno Pannier, Patrick Rossignol, Gerard M London
BACKGROUND: Patients with end-stage renal disease (ESRD) are at a high risk of cardiovascular mortality (CVM). In patients with ESRD, arterial stiffness increases at an earlier age when compared to the general population and this contributes to the overall risk of cardiovascular mortality. The main objective of this study was to clarify the interplay between age and cardiovascular alterations in ESRD. METHODS: Prospective, observational cohort study initiated in April 1987 until the end of 1998 with events recorded until the end of the year 2000 at the F...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/27856091/a-clinical-risk-prediction-tool-for-6-month-mortality-after-dialysis-initiation-among-older-adults
#17
James P Wick, Tanvir C Turin, Peter D Faris, Jennifer M MacRae, Robert G Weaver, Marcello Tonelli, Braden J Manns, Brenda R Hemmelgarn
BACKGROUND: Information on an individual's risk for death following dialysis therapy initiation may inform the decision to initiate maintenance dialysis for older adults. We derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment. STUDY DESIGN: Prediction model using retrospective administrative and clinical data. SETTING & PARTICIPANTS: We linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada, who initiated maintenance dialysis therapy (excluding acute kidney injury) in May 2003 to March 2012...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27831511/diagnosis-treatment-and-prevention-of-hemodialysis-emergencies
#18
REVIEW
Manish Saha, Michael Allon
Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27693261/sleep-disorders-restless-legs-syndrome-and-uremic-pruritus-diagnosis-and-treatment-of-common-symptoms-in-dialysis%C3%A2-patients
#19
Jennifer S Scherer, Sara A Combs, Frank Brennan
Maintenance dialysis patients experience a high burden of physical and emotional symptoms that directly affect their quality of life and health care utilization. In this review, we specifically highlight common troublesome symptoms affecting dialysis patients: insomnia, restless legs syndrome, and uremic pruritus. Epidemiology, pathophysiology, and evidence-based current treatment are reviewed with the goal of providing a guide for diagnosis and treatment. Finally, we identify multiple additional areas of further study needed to improve symptom management in dialysis patients...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27573731/epidemiology-diagnosis-and-management-of-hypertension-among-patients-on-chronic-dialysis
#20
REVIEW
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
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