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HD/ESRD

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61 papers 100 to 500 followers
By Venkatesh Ariyamuthu Transplant Nephrologist at UT Southwestern Medical Center
https://www.readbyqxmd.com/read/29719190/calciphylaxis
#1
REVIEW
Sagar U Nigwekar, Ravi Thadhani, Vincent M Brandenburg
New England Journal of Medicine, Volume 378, Issue 18, Page 1704-1714, May 2018.
May 3, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29730670/haemodialysis-membranes
#2
REVIEW
Claudio Ronco, William R Clark
Haemodialysis is an extracorporeal process in which the blood is cleansed via removal of uraemic retention products by a semipermeable membrane. Traditionally, dialysis membranes have been broadly classified on the basis of their composition (cellulosic or noncellulosic) and water permeability (low flux or high flux). However, advances in materials technology and polymer chemistry have led to the development of membranes with specific characteristics and refined properties that mandate a reconsideration of traditional membrane classification systems...
June 2018: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29482260/beta-blockers-in-patients-with-end-stage-renal-disease-evidence-based-recommendations
#3
REVIEW
Matthew A Weir, Charles A Herzog
For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular sequelae. However, the evidence supporting their use in patients receiving hemodialysis is sparse and the heterogeneity of the beta blocker class makes it difficult to prescribe these medications with confidence...
May 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29483138/mechanisms-clinical-implications-and-treatment-of-intradialytic-hypotension
#4
REVIEW
Patrick B Reeves, Finnian R Mc Causland
Individuals with ESKD requiring maintenance hemodialysis face a unique hemodynamic challenge, typically on a thrice-weekly basis. In an effort to achieve some degree of euvolemia, ultrafiltration goals often involve removal of the equivalent of an entire plasma volume. Maintenance of adequate end-organ perfusion in this setting is dependent on the institution of a variety of complex compensatory mechanisms. Unfortunately, secondary to a myriad of patient- and dialysis-related factors, this compensation often falls short and results in intradialytic hypotension...
February 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29148094/acid-base-alterations-in-esrd-and-effects-of-hemodialysis
#5
REVIEW
Qi Qian
Acid-base alterations in patients with kidney failure and on hemodialysis (HD) treatment contribute to (1) intradialytic hypercapnia and hypoxia, (2) hemodynamic instability and cardiac arrhythmia, (3) systemic inflammation, and (4) a number of associated electrolyte alterations including potentiating effects of hypokalemia, hypocalcemia and, chronically, soft-tissue and vascular calcification, imparting poor prognosis and mortality. This paper discusses acid-base regulation and pathogenesis of dysregulation in patients with kidney failure...
May 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29310884/prognostic-value-of-high-sensitivity-versus-conventional-cardiac-troponin-t-assays-among-patients-with-type-2-diabetes-mellitus-undergoing-maintenance-hemodialysis
#6
Till Keller, Christoph Wanner, Vera Krane, Daniel Kraus, Bernd Genser, Hubert Scharnagl, Winfried März, Christiane Drechsler
BACKGROUND: Mortality is high among patients undergoing hemodialysis for whom cardiac troponin concentration is a strong predictor of outcome. Modern troponin assays allow measurement of very low concentrations. STUDY DESIGN: Using data from a randomized controlled trial, a cohort analysis to evaluate the prognostic value of very low cardiac troponin T (TnT) concentrations. SETTING & PARTICIPANTS: 1,255 patients with end-stage renal disease and type 2 diabetes mellitus undergoing maintenance hemodialysis from the German Diabetes and Dialysis Study (4D) who had a median follow-up of 4 years...
June 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28938954/blood-pressure-targets-for-hemodialysis-patients
#7
REVIEW
Jeffrey M Turner, Aldo J Peixoto
The association between blood pressure (BP) and mortality is unique in hemodialysis patients compared with that in the general population. This is because of an altered benefit-risk balance associated with BP reduction in these patients. An adequately designed study comparing BP targets in hemodialysis patients remains to be conducted. The current evidence available to guide dialysis providers regarding treatment strategies for managing hypertension in this population is limited to large observational studies and small randomized controlled trials...
October 2017: Kidney International
https://www.readbyqxmd.com/read/27866964/dialysate-potassium-serum-potassium-mortality-and-arrhythmia-events-in-hemodialysis-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#8
MULTICENTER STUDY
Angelo Karaboyas, Jarcy Zee, Steven M Brunelli, Len A Usvyat, Daniel E Weiner, Franklin W Maddux, Allen R Nissenson, Michel Jadoul, Francesco Locatelli, Wolfgang C Winkelmayer, Friedrich K Port, Bruce M Robinson, Francesca Tentori
BACKGROUND: Sudden death is a leading cause of death in patients on maintenance hemodialysis therapy. During hemodialysis sessions, the gradient between serum and dialysate levels results in rapid electrolyte shifts, which may contribute to arrhythmias and sudden death. Controversies exist about the optimal electrolyte concentration in the dialysate; specifically, it is unclear whether patient outcomes differ among those treated with a dialysate potassium concentration of 3 mEq/L compared to 2 mEq/L...
February 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27516235/bp-control-and-long-term-risk-of-esrd-and-mortality
#9
Elaine Ku, Jennifer Gassman, Lawrence J Appel, Miroslaw Smogorzewski, Mark J Sarnak, David V Glidden, George Bakris, Orlando M Gutiérrez, Lee A Hebert, Joachim H Ix, Janice Lea, Michael S Lipkowitz, Keith Norris, David Ploth, Velvie A Pogue, Stephen G Rostand, Edward D Siew, Mohammed Sika, C Craig Tisher, Robert Toto, Jackson T Wright, Christina Wyatt, Chi-Yuan Hsu
We recently showed an association between strict BP control and lower mortality risk during two decades of follow-up of prior participants in the Modification of Diet in Renal Disease (MDRD) trial. Here, we determined the risk of ESRD and mortality during extended follow-up of the African American Study of Kidney Disease and Hypertension (AASK) trial. We linked 1067 former AASK participants with CKD previously randomized to strict or usual BP control (mean arterial pressure ≤92 mmHg or 102-107 mmHg, respectively) to the US Renal Data System and Social Security Death Index; 397 patients had ESRD and 475 deaths occurred during a median follow-up of 14...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27492146/central-venous-occlusion-in-the-hemodialysis-patient
#10
Vinay Narasimha Krishna, Joseph B Eason, Michael Allon
Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27493258/coronary-revascularization-in-patients-with-ckd-stage-5d-pragmatic-considerations
#11
REVIEW
Gautam R Shroff, Charles A Herzog
Coronary revascularization decisions for patients with CKD stage 5D present a dilemma for clinicians because of high baseline risks of mortality and future cardiovascular events. This population differs from the general population regarding characteristics of coronary plaque composition and behavior, accuracy of noninvasive testing, and response to surgical and percutaneous revascularization, such that findings from the general population cannot be automatically extrapolated. However, this high-risk population has been excluded from all randomized trials evaluating outcomes of revascularization...
December 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27085737/novel-extracorporeal-therapies-for-combined-renal-pulmonary-dysfunction
#12
REVIEW
Stefano Romagnoli, Zaccaria Ricci, Claudio Ronco
In modern intensive care medicine, lungs and kidneys frequently are involved in the context of multiorgan failure. When organ dysfunction occurs, the primary clinical management of critically ill patients is based on support/replacement of organ function until recovery. Mechanical ventilation is the first-line intervention in case of respiratory failure, but in most severe cases may, itself, cause ventilator-induced lung injury. The same inflammatory mechanism also may harm the kidney through mediator spillover from the injured lungs into the bloodstream...
January 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27133436/management-of-the-hemodialysis-unit-core-curriculum-2016
#13
Susan M Blankschaen, Sharmeela Saha, Jay B Wish
No abstract text is available yet for this article.
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26976799/efficacy-of-direct-acting-antiviral-combination-for-patients-with-hepatitis-c-virus-genotype-1-infection-and-severe-renal-impairment-or-end-stage-renal-disease
#14
MULTICENTER STUDY
Paul J Pockros, K Rajender Reddy, Parvez S Mantry, Eric Cohen, Michael Bennett, Mark S Sulkowski, David E Bernstein, Daniel E Cohen, Nancy S Shulman, Deli Wang, Amit Khatri, Manal Abunimeh, Thomas Podsadecki, Eric Lawitz
BACKGROUND & AIMS: Although hepatitis C virus (HCV) infection is common in patients with end-stage renal disease, highly efficacious, well-tolerated, direct-acting antiviral regimens have not been extensively studied in this population. We investigated the safety and efficacy of ombitasvir co-formulated with paritaprevir and ritonavir, administered with dasabuvir (with or without ribavirin) in a prospective study of patients with stage 4 or 5 chronic kidney disease (CKD). METHODS: We performed a single-arm, multicenter study of treatment-naïve adults with HCV genotype 1 infection, without cirrhosis and with CKD stage 4 (estimated glomerular filtration rate, 15-30 mL/min/1...
June 2016: Gastroenterology
https://www.readbyqxmd.com/read/26918174/renal-replacement-therapy
#15
REVIEW
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury...
2016: F1000Research
https://www.readbyqxmd.com/read/26926841/how-can-the-complications-of-central-vein-catheters-be-reduced-central-venous-stenosis-in-hemodialysis-patients
#16
REVIEW
Seth Toomay, John Rectenwald, Miguel A Vazquez
No abstract text is available yet for this article.
May 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/26709108/communication-skills-and-decision-making-for-elderly-patients-with-advanced-kidney-disease-a-guide-for-nephrologists
#17
REVIEW
Holly M Koncicki, Jane O Schell
Elderly patients comprise the most rapidly growing population initiating dialysis therapy and may derive particular benefit from comprehensive assessment of geriatric syndromes, coexisting comorbid conditions, and overall prognosis. Palliative care is a philosophy that aims to improve quality of life and assist with treatment decision making for patients with serious illness such as kidney disease. Palliative skills for the nephrology provider can aid in the care of these patients. This review provides nephrology providers with 4 primary palliative care skills to guide treatment decision making: (1) use prognostic tools to identify patients who may benefit from conservative management, (2) disclose prognostic information to patients who may not do well with dialysis therapy, (3) incorporate patient goals and values to outline a treatment plan, and (4) prepare patients and families for transitions and end of life...
April 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26709061/end-stage-kidney-disease-in-the-elderly-approach-to-dialysis-initiation-choosing-modality-and-predicting-outcomes
#18
REVIEW
Joseph R Berger, Vishal Jaikaransingh, S Susan Hedayati
The number of patients with end-stage kidney disease 65 years and older is growing, and this growth is expected to continue. The presence of medical comorbidities, limited life expectancy, frailty, and poor functional status in these patients poses substantial challenges in clinical decision-making and provision of optimal care. Frailty is more common in elderly patients with CKD than without and is associated with poor outcomes. Several prognostic tools were developed to estimate the rate of CKD progression among elderly, and risk of mortality after dialysis initiation...
January 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/26712807/effect-of-lowering-the-dialysate-temperature-in-chronic-hemodialysis-a-systematic-review-and-meta-analysis
#19
REVIEW
Reem A Mustafa, Fadi Bdair, Elie A Akl, Amit X Garg, Heather Thiessen-Philbrook, Hassan Salameh, Sood Kisra, Gihad Nesrallah, Ahmad Al-Jaishi, Parth Patel, Payal Patel, Ahmad A Mustafa, Holger J Schünemann
BACKGROUND AND OBJECTIVES: Lowering the dialysate temperature may improve outcomes for patients undergoing chronic hemodialysis. We reviewed the reported benefits and harms of lower temperature dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched the Cochrane Central Register, OVID MEDLINE, EMBASE, and Pubmed until April 15, 2015. We reviewed the reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included all randomized, controlled trials that evaluated the effect of reduced temperature dialysis versus standard temperature dialysis in adult patients receiving chronic hemodialysis...
March 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26561355/intensive-hemodialysis-and-mortality-risk-in-australian-and-new-zealand-populations
#20
Mark R Marshall, Kevan R Polkinghorne, Peter G Kerr, Carmel M Hawley, John W M Agar, Stephen P McDonald
BACKGROUND: Intensive hemodialysis (HD) is characterized by increased frequency and/or session length compared to conventional HD. Previous analyses from Australia and New Zealand did not suggest benefit with intensive HD, although recent research suggests that relationships have changed. We present updated analyses. STUDY DESIGN: Observational cohort study using marginal structural modeling to adjust for changes in renal replacement modality and time-varying medical comorbid conditions...
April 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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