The effects of intradialytic exercise on hemodialysis adequacy: A systematic review.

The effects of intradialytic exercise on hemodialysis adequacy: A systematic review. Semin Dial. 2019 Apr 09;: Authors: Kirkman DL, Scott M, Kidd J, Macdonald JH Abstract Dialysis adequacy is an independent predictor of high mortality rates in hemodialysis patients. Intradialytic exercise is a potential strategy to increase uremic solute removal by increasing blood flow to low perfusion tissue beds. The purpose of this review is to establish the efficacy of intradialytic exercise for hemodialysis adequacy. Additionally, this review aims to provide practical information to aid health care professionals implement intradialytic exercise for dialysis adequacy. Database and hand searches identified 15 published interventional studies that implemented intradialytic exercise for dialysis adequacy as a primary outcome measure in adult maintenance hemodialysis patients. Data pertaining to dialytic solute clearance of urea, creatinine, beta2 microglobulin, phosphate, and potassium were extracted. Mean differences, normalized to percentages, and effect sizes were calculated and reported. The current data pertaining to the use of intradialytic exercise for improving dialysis adequacy in terms of Kt/Vurea or small molecule uremic toxin clearance are equivocal. Limited data showed that intradialytic exercise has no effect middle molecule toxin (beta2 - microglobulin) clearance. Intradialytic exercise favored increased phosphate removal showing medium to large effects ...
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research

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ConclusionsCapnometry during resuscitation serves as a marker to be taken into account in relation to the viability of the transplanted organs in uncontrolled non-heart beating donors.ResumenObjetivoLos valores de capnometría durante la resucitación son un factor predictor de la evolución de los riñones obtenidos a partir de donantes en asistolia no controlada.DiseñoCohorte de comienzo retrospectivo de 37 donantes en asistolia, y cohorte de validación de 55 trasplantados de riñón, entre 2013–2017.Ámbitopoblación atendida por el servicio de emergenc...
Source: Medicina Intensiva - Category: Intensive Care Source Type: research
A simpler method for detecting atherosclerosis obliterans is required in the clinical setting. Laser Doppler flowmetry (LDF) is easy to perform and can accurately detect deterioration in skin perfusion. We per...
Source: BMC Nephrology - Category: Urology & Nephrology Authors: Tags: Research article Source Type: research
The Brescia-Cimino arteriovenous fistula (AVF) is the preferred method of providing vascular access for hemodialysis in patients with end-stage renal disease .1 Although uncommon, the dialysis access steal syndrome (DASS) can present as a serious complication of an arteriovenous fistula, characterized by flow dynamic complications that lead to an excess perfusion of the AVF and ischemia of the hand.2 It is frequently associated with the brachial artery fistula which has an incidence rate of 5%.3 Even rarer, however, is its occurrence in the forearm, with incidence rates of 0.25-1.8%.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
Abstract Whereas the usual way to gain access to the vascular bed for hemodialysis is by inserting two needles, an alternative option based on the introduction of only one needle has been available for several decades. Although single needle hemodialysis gradually lost popularity in the early nineties of last century, this option now seems to make a come-back, with the current change in patient mix towards more elderly and cardio-vascular disease and the appearance of more flexible hardware. Single needle hemodialysis offers several advantages, such as the possibility to puncture small or maturing access systems, ...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Publication date: Available online 18 August 2019Source: Journal of Cardiology CasesAuthor(s): Susumu Odajima, Takumi Inoue, Tomoyo Hamana, Ryota Masaki, Wataru Fujimoto, Koji Kuroda, Yutaka Hatani, Masamichi Iwasaki, Hiroshi Okamoto, Masanori Okuda, Takatoshi HayashiAbstractA 58-year-old woman with pallor on her left hand due to chronic hemodialysis presented with a recent intractable skin ulcer on her left 3rd finger; the skin perfusion pressure (SPP) was 19 mmHg. Preoperative angiography revealed an occluded proximal left radial artery, no communication between the ulnar and superficial palmar arteries, several c...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
AbstractIdiopathic systemic capillary leak syndrome (ISCLS) presents with recurrent potentially life-threatening episodes of hypovolemic shock associated with severe hemoconcentration and hypoproteinemia. Timely recognition is of paramount importance because ISCLS, despite resembling other kinds of hypovolemic shock, requires a peculiar approach, to prevent life-threatening iatrogenic damage. Due to the rarity of this condition with only scattered cases described worldwide, evidence-based recommendations are still lacking. Here, we summarize our 40  years’ experience in treating shock in ISCLS patients to derive...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Abstract Renal cortical necrosis (RCN) is characterized by patchy or diffuse destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. It is a rare cause of acute kidney injury (AKI) in developed countries with frequency of 1.9%-2% of all patients of AKI. In contrast, the incidence of RCN is higher in developing countries ranging from 6%-7%. Obstetric complication is the main cause of RCN, earlier it was about 20%-30% which has been declining to 5% in the Indian subcontinent during the past two decades. The aim o...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
ConclusionsThis is the first case of a return of spontaneous circulation after cardiac arrest induced by the intentional ingestion of boric acid and mirtazapine, requiring percutaneous cardiopulmonary bypass for survival. To maintain cerebral perfusion during percutaneous cardiopulmonary bypass, even in a prolonged state of cardiac arrest induced by overdose, is medically, ethically, and economically challenging.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Abstract To allow improved quality of life, renal transplant has been regarded as the best therapeutic option for patients with end-stage renal disease. However, due to shortages of renal sources, annually, only a few patients with renal failure can receive transplants, with most patients requiring hemodialysis to maintain their life. With increasing imbalance of demands and supplies for donor organs, infant organ donors have become an important part of domestic and foreign transplant sources. It is of great importance to guarantee successful kidney transplant outcomes. Examination of the size and blood perfusion ...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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