Bioimpedance analysis versus lung ultrasonography for optimal risk prediction in hemodialysis patients

Abstract Fluid overload is associated with adverse outcomes in hemodialysis (HD) patients. Two bedside methods are increasingly utilized to evaluate objectively fluid status—bioimpedance and lung ultrasonography, but there is no available direct, head-to-head comparison of their prognostic significance. Importantly, their predictive abilities have never been tested in a HD population, alongside those of a classic model that also incorporates established echocardiographic parameters of increased mortality risk. Between 26 May 2011 and 26 October 2012, we included in the study 173 patients undergoing chronic HD treatment for at least 3 months in a single dialysis unit. Relative fluid overload (RFO) and B-lines score (BLS) were used as candidate predictors. From Cox survival analysis we evaluated the increase in the predictive abilities for all-cause mortality of adding continuous RFO or BLS to a model including conventional predictors . 31 patients (17.9 %) died during a median follow-up of 21.3 (interquartile range 19.9–30.3) months. All Cox models showed good calibration. The C statistic for the all-cause mortality prediction increased significantly when the RFO was included into the baseline model (ΔC statistics 0.058 95 %CI = 0.003–0.114), but not when the BLS was included into the baseline model. Only the model that incorporated RFO showed significantly better risk reclassification abilities than the baseline...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

Related Links:

ConclusionsTransplanting kidneys from HCV-viremic donors into HCV-uninfected recipients increased quality-adjusted life expectancy and reduced costs compared with a strategy of transplanting kidneys from HCV-unexposed donors.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
AbstractIn a rapidly expanding population of patients with chronic kidney disease, including 2 million people requiring renal replacement therapy, cardiovascular mortality is 15 times greater than the general population. In addition to traditional cardiovascular risk factors, more poorly defined risks related to uraemia and it ’s treatments appear to contribute to this exaggerated risk. In this context, the microcirculation may play an important early role in cardiovascular disease associated with chronic kidney disease. Experimentally the uraemic environment and dialysis have been linked to multiple pathways causing...
Source: Microcirculation - Category: Research Authors: Tags: REVIEW Source Type: research
Conclusion A lower dialysis dose might be associated with a higher risk of cancer death in patients undergoing HD. Kt/V is a simple indicator of dialysis dose used in clinical practice and might be a useful modifiable factor for predicting the risk of cancer death. Further basic and interventional studies are needed to confirm the apparent reduction in cancer death associated with increasing the dialysis dose. PMID: 32051383 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conditions:   Arteriovenous Fistula;   Hemodialysis;   Dialysis Adequacy Intervention:   Sponsor:   Istanbul Bilim University Completed
Source: - Category: Research Source Type: clinical trials
ConclusionsTreatment of central vein obstructions in hemodialysis patients with stent grafts has been appealing owing to the tapered shape with a larger diameter and the availability of various lengths.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
In this study, a randomized, controlled, and experimental study was conducted to examine the effect of PRE on pain, fatigue, and quality of life in hemodialysis patients; the study was carried out with 48 intervention and 48 control patients receiving treatment in the hemodialysis units of 2 hospitals. Data were collected by a questionnaire prepared by the researcher, which included questions about sociodemographic variables and the disease; Piper Fatigue Scale; Visual Analog Scale that measures pain severity; and SF-36 Quality of Life Scale. The results of study revealed that mean total fatigue score and mean pain score d...
Source: Holistic Nursing Practice - Category: Nursing Tags: FEATURES Source Type: research
This study aimed to examine the association between the mode of dialysis or the values of sclerostin or DKK1 and carotid-femoral pulse wave velocity (cfPWV) in ESRD patients. There were 122 HD and 72 PD patients enrolled in this study. By a validated tonometry system, cfPWV was measured and then segregated patients into values of >10 m/s as the high central arterial stiffness (AS) group and values ≤ 10 m/s as the control group. Serum levels of sclerostin and DKK1 were measured using a commercial enzyme-linked immunosorbent assay kit. Possible risk factors for the development of AS were analyzed by logistic regres...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Authors: Supriyadi R, Rakhima F, Gondodiputro RS, Darmawan G Abstract BACKGROUND: the prevalence of chronic kidney disease (CKD) and dialysis patients is increasing every year in Indonesia. The impact of CKD and dialysis on patient quality of life (QOL) has been recognized as an important outcome measure in the management of CKD. The Kidney Disease Quality of Life (KDQOL-36) has been validated and is widely used as a measure of QOL for CKD and dialysis patients in many countries, but not in Indonesia. The aim of this study is to determine the reliabity and validity of the Indonesian version of KDQOL-36 on hemodialy...
Source: Acta medica Indonesiana - Category: Internal Medicine Tags: Acta Med Indones Source Type: research
Conclusion: This is the first study to define 9-year mortality predictors in PD patients in our center. Although peritonitis is the most feared complication of PD, our study showed that peritonitis did not reduce patient survival. PMID: 32041385 [PubMed - as supplied by publisher]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
CONCLUSIONS: Physical activity levels, sedentary behavior levels, and muscle strength are related to physical function status for patients receiving dialysis. There is a need for robust longitudinal data to confirm the results of this investigation and for more focus on populations receiving peritoneal dialysis. PMID: 32045878 [PubMed - as supplied by publisher]
Source: Journal of Physical Activity and Health - Category: Sports Medicine Tags: J Phys Act Health Source Type: research
More News: Cardiology | Cardiovascular | Dialysis | Heart | Hemodialysis | Radiology | Statistics | Study