Effectiveness of a computerized decision support system for anticoagulation management in hemodialysis patients: A before–after study
Discussion Implementing a CDSS‐assisted strategy for anticoagulation management in HD outpatients is effective. Doing so may lead to modest cost savings related to less frequent INR testing. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Edward G. Clark, Marc A. Rodger, Tim O. Ramsay, Greg A. Knoll Tags: Original Article Source Type: research

Lower C‐reactive protein and better hemodialysis survival are associated with regular exercise activity: Longitudinal outcomes from the ACTIVE‐ADIPOSE special study
Abstract Introduction Cross‐sectional and longitudinal studies in the general population have shown that a physically active lifestyle may have anti‐inflammatory properties, but evidence from studies conducted with maintenance hemodialysis (HD) patients is limited. Methods A multicenter prospective cohort of 755 HD participants aged 20–92 was evaluated in a USRDS special study 2009–2013. Kilocalories/week (kcal/week) of leisure time physical activity (LTPA) was estimated from the Minnesota Leisure Time Activity questionnaire. Predialysis serum samples were obtained concurrent with LTPA report date. Generali...
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Nancy G. Kutner, Rebecca Zhang, Yijian Huang, George A. Kaysen, Jeanie Park Tags: Original Article Source Type: research

Efficacy and safety of Cinacalcet on secondary hyperparathyroidism in Chinese chronic kidney disease patients receiving hemodialysis
Discussion This phase III study demonstrated that Cinacalcet is effective and well tolerated in treating SHPT in Chinese chronic kidney disease patients on hemodialysis, and in a patient population with much higher baseline PTH levels. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Changlin Mei, Nan Chen, Xiaoqiang Ding, Xueqing Yu, Li Wang, Jiaqi Qian, Mei Wang, Gengru Jiang, Xuemei Li, Fanfan Hou, Li Zuo, Niansong Wang, Hong Liu Tags: Original Article Source Type: research

Low‐dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5‐y prospective cohort study
In this study, 406 patients on regular HD were involved during a 5‐y follow‐up. Among these, 152 and 254 propensity‐matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the nonaspirin users (log rank χ2 = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all‐cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased i...
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Jun Liu, Yu Pan, Lei Chen, Qing Yan Qiao, Jing Wang, Li Hua Pan, Yan Hong Gu, Hui Fang Gu, Shun Kun Fu, Hui Min Jin Tags: Original Article Source Type: research

Dialysate‐induced hypocalcemia presenting as acute intradialytic hypotension: A case report, safety review, and recommendations
We describe a case of severe intradialytic hypotension during routine chronic dialysis, the presenting symptom of hypocalcemia due to a procedural error involving a zero calcium liquid acid dialysate concentrate. Although human factors were the root cause of this event, we discuss physical and procedural controls that may help to minimize the risk of human error. Citrate anticoagulation for renal replacement therapy is increasingly used, particularly in acute kidney injury. Thus, zero calcium liquid acid dialysate is more likely to be stocked by dialysis units that serve both inpatients and outpatients. Providers in such u...
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: John S. Thurlow, Christina M. Yuan Tags: Case Report Source Type: research

Increased arterial stiffness predicts cognitive impairment in hemodialysis patients
Discussion Cognitive impairment was associated with higher PWV values in our cohort. Further evidence is needed in order to support arterial stiffness as a long‐term predictor for cognitive decline in ESRD patients. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Alexandra Tasmoc, Mihaela‐Dora Donciu, Gabriel Veisa, Ionut Nistor, Adrian Covic Tags: Original Article Source Type: research

Alteplase vs. urokinase for occluded hemodialysis catheter: A randomized trial
Discussion Alteplase and urokinase are effective thrombolytic agents for restoring HD catheter patency. Our study has revealed a likely slight superiority of alteplase over urokinase for unblocking central lines, but which has enrolled too few patients to be able to detect a difference of this size. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Viviane Pollo, Danielle Dionízio, Edwa Maria Bucuvic, João Henrique Castro, Daniela Ponce Tags: Original Article Source Type: research

The greatly misunderstood erythropoietin resistance index and the case for a new responsiveness measure
In this study, we examine whether ERI is an adequate measure of ESA resistance. Methods We used retrospective data from a nonconcurrent cohort study of incident hemodialysis patients in the United States (n = 9386). ERI is defined as average weekly erythropoietin (EPO) dose per kg body weight (wt) per average hemoglobin (Hgb), over a 3‐month period (ERI = (EPO/wt)/Hgb). Linear regression was used to demonstrate the relationship between ERI and weight‐adjusted EPO. The coefficient of variation was used to compare the variability of Hgb with that of weight‐adjusted EPO to explain this relati...
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Yossi Chait, Sahir Kalim, Joseph Horowitz, Christopher V. Hollot, Elizabeth D. Ankers, Michael J. Germain, Ravi I. Thadhani Tags: Original Article Source Type: research

Dog ownership status and self‐assessed health, life‐style and habitual physical activity in chronic hemodialysis patients
Abstract Introduction The Statement from the American Heart Association has emphasized a need for novel strategies that can reduce the risk of cardiovascular disease (CVD). Taking a dog for a walk forces its owner to take physical activity. Several studies have explored the relationship between pet ownership and CVD and most reported benefits. This issue has not been investigated in dialysis patients. The aim of the study was to analyze the influence of pet ownership on health and physical activity in hemodialysis patients. Methods 270 chronic hemodialysis patients (172 male, 98 female, mean age 62.7 ±&thinsp...
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Magdalena Kuban, Jerzy Królikowski, Michał Nowicki Tags: Original Article Source Type: research

Low dose heparin lock (1000 U/mL) maintains tunnelled hemodialysis catheter patency when compared with high dose heparin (5000 U/mL): A randomised controlled trial
Discussion Low dose heparin is adequate to maintain tunnelled hemodialysis catheter patency when compared with high dose heparin. The study also suggests that there is no relationship between catheter malfunction and diabetic, hypertensive or smoking status. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2016 Category: Hematology Authors: Ginger Chu, Gemma M. Fogarty, Leanne F. Avis, Shauna Bergin, Patrick McElduff, Alastair H. Gillies, Peter Choi Tags: Original Article Source Type: research

Reduced protein bound uraemic toxins in vegetarian kidney failure patients treated by haemodiafiltration
Abstract Introduction Indoxyl sulfate (IS) and p cresyl sulfate (PCS) are protein bound toxins which accumulate with chronic kidney disease. Haemodiafiltration (HDF) increases middle molecule clearances and has been suggested to increase IS and PCS clearance. We therefore wished to establish whether higher convective clearances with HDF would reduce IS and PCS concentrations. Methods We measured total plasma IS and PCS in a cohort of 138 CKD5d patients treated by On‐line HDF (Ol‐HDF), by high pressure liquid chromatography. Findings Mean patient age was 64.6 ± 16.5 years, 60.1% male, 57.3% diabetic, media...
Source: Hemodialysis International - December 31, 2015 Category: Hematology Authors: Sakina Kandouz, Ali Shendi Mohamed, Yishan Zheng, Susan Sandeman, Andrew Davenport Tags: Original Article Source Type: research

Meal replacements as a strategy for weight loss in obese hemodialysis patients
Discussion This modified low‐calorie diet was safe and effective to use in this population. Meal replacements are a useful weight loss strategy in hemodialysis patients, therefore, offering an alternative to usual weight loss protocols. (Source: Hemodialysis International)
Source: Hemodialysis International - December 31, 2015 Category: Hematology Authors: Annie‐Claude M. Lassemillante, Veronica Oliver, Ingrid Hickman, Eryn Murray, Katrina L. Campbell Tags: Case Report Source Type: research

Adrenal insufficiency presenting as unexplained hypotension in nocturnal home hemodialysis
We present a series of five cases of patients on nocturnal home hemodialysis with hypotension as the main manifestation of adrenal insufficiency. Unexplained hypotension in patients with a history of corticosteroid therapy should prompt the managing clinician to consider adrenal insufficiency as a possible cause. (Source: Hemodialysis International)
Source: Hemodialysis International - December 31, 2015 Category: Hematology Authors: Timothy Jee Kam Koh, Christopher T. Chan Tags: Case Report Source Type: research

Flow reduction in high‐flow arteriovenous fistulas improve cardiovascular parameters and decreases need for hospitalization
Abstract High output heart failure (HF) and pulmonary hypertension have been demonstrated in patients with prevalent arteriovenous (AV) fistulas. Fistulas with flow>2000 mL/minutes are more likely to induce changes in cardiac geometry and pulmonary artery pressure. The effects of reducing flow in AV access and its implications on HF decompensation and hospitalizations have not been studied. Retrospective analysis of 12 patients who needed hospitalization for acute Congestive Heart Failure (CHF) decompensation with AV access flow of 2 L/minutes (as defined by Kidney Disease Outcomes Quality Initiative (KDOQI)) or more we...
Source: Hemodialysis International - December 14, 2015 Category: Hematology Authors: Saravanan Balamuthusamy, Nishant Jalandhara, Anand Subramanian, Arvindselvan Mohanaselvan Tags: Original Article Source Type: research

Flow reduction in high ‐flow arteriovenous fistulas improve cardiovascular parameters and decreases need for hospitalization
Abstract High output heart failure (HF) and pulmonary hypertension have been demonstrated in patients with prevalent arteriovenous (AV) fistulas. Fistulas with flow>2000 mL/minutes are more likely to induce changes in cardiac geometry and pulmonary artery pressure. The effects of reducing flow in AV access and its implications on HF decompensation and hospitalizations have not been studied. Retrospective analysis of 12 patients who needed hospitalization for acute Congestive Heart Failure (CHF) decompensation with AV access flow of 2 L/minutes (as defined by Kidney Disease Outcomes Quality Initiative (KDOQI)) or more we...
Source: Hemodialysis International - December 13, 2015 Category: Hematology Authors: Saravanan Balamuthusamy, Nishant Jalandhara, Anand Subramanian, Arvindselvan Mohanaselvan Tags: ACCESS Source Type: research

Pulmonary hypertension in patients on chronic hemodialysis and with heart failure
Abstract Pulmonary hypertension (PH) is linked to chronic kidney disease. However, few studies have examined the prevalence, risk factors, or outcomes of PH in patients with chronic hemodialysis and concomitant heart failure. This retrospective cohort study enrolled 160 patients with a history of acute decompensated heart failure after maintenance hemodialysis therapy. All patients were prospectively observed until December 2013 or death. PH was defined as pulmonary artery systolic pressure >35 mmHg, as determined through echocardiography. Fifty‐one (32%) patients had PH, more of whom were female (70% vs...
Source: Hemodialysis International - November 13, 2015 Category: Hematology Authors: Chin‐wen Hsieh, Chien‐te Lee, Chun‐chuan Chen, Li‐ping Hsu, Hao‐huan Hu, Jung‐chou Wu Tags: Original Article Source Type: research

An analysis of caregiver burden of patients with hemodialysis and peritoneal dialysis
This study was performed to determine the burden to primary caregivers of patients undergoing dialysis. This descriptive study was conducted with the family caregivers of 114 patients from Erzurum Ataturk University's Medical Faculty Nephrology Department: 54 were relatives of patients receiving hemodialysis and 60 were relatives of patients receiving peritoneal dialysis during August to December 2014. The percentage of the patients with low levels of caregiver burden is 13% in the hemodialysis group, while it is 35% in the peritoneal dialysis group. These findings are statistically significant. To conclude, chronic diseas...
Source: Hemodialysis International - November 9, 2015 Category: Hematology Authors: Işın Cantekin, Mehtap Kavurmacı, Mehtap Tan Tags: Original Article Source Type: research

Daptomycin antibiotic lock therapy for hemodialysis patients with Gram‐positive bloodstream infections following use of tunneled, cuffed hemodialysis catheters: retrospective single center analysis
Abstract Catheter‐related blood stream infection (CRBSI) is a major complication in hemodialysis patients. We assessed the efficacy of systemic daptomycin (DPT) plus DPT antibiotic lock therapy (DPT‐ALT) for catheter salvage in patients with Gram‐positive CRBSIs. This is a retrospective study of hemodialysis patients with tunneled and cuffed hemodialysis catheters. All patients were from a single institution in Taipei and received systemic DPT plus DPT‐ALT for the treatment of Gram‐positive CRBSI. Successful resolution of CRBSI was implemented. Resolution of fever within 48 hours, negative result of repeated bloo...
Source: Hemodialysis International - November 9, 2015 Category: Hematology Authors: Hung‐Wen Yen, Wu‐Chang Yang, Der‐Cherng Tarng, Chih‐Yu Yang, Chiao‐Lin Chuang, Ling‐Ju Huang, Pei‐Yu Lin, Chih‐Chun Wang, Szu‐Yuan Li Tags: Original Article Source Type: research

Delayed renal dysfunction and flash pulmonary edema post endovascular abdominal aneurysm repair
We report a case of coverage of the renal arteries symptomatic with flash pulmonary edema and renal failure 15 months after EVAR, suggesting a delayed endograft migration. The patient had complete resolution of symptoms and renal function after renal artery stenting with placement between endograft and aneurysm to the left renal artery. (Source: Hemodialysis International)
Source: Hemodialysis International - October 20, 2015 Category: Hematology Authors: Pierre‐Louis Carron, Nicolas Piliero, Morgane Heitz, Marc Kribs, Mathieu Rodière, Patrick Jousse, Silvia Gunther‐Calvino, Frédéric Thony Tags: Case Report Source Type: research

Effect of a postoperative exercise program on arteriovenous fistula maturation: A randomized controlled trial
Abstract Exercises after arteriovenous fistula (AVF) creation may help to improve maturation; however, their usefulness has only been examined in indirect, non‐comparative studies or small trials. Between June 2013 and November 2014, we included all ambulatory patients with stages 5‐5D chronic kidney disease who were candidates for the creation of a native AVF in our center. After surgery, all patients were randomized to an exercise group or a control group with single‐blind control. At 1 month postoperatively, clinical maturation (expert nurse inspection) and ultrasonographic maturation (flow>500 mL/min, v...
Source: Hemodialysis International - October 20, 2015 Category: Hematology Authors: Néstor Fontseré, Gaspar Mestres, Xavier Yugueros, Teresa López, Anna Yuguero, Patricia Bermudez, Fernando Gomez, Vicenç Riambau, Francisco Maduell, Josep M. Campistol Tags: Original Article Source Type: research

Determination of the critical absolute blood volume for intradialytic morbid events
Abstract The reduction of blood volume below a critical threshold is assumed to trigger intradialytic morbid events (IME). Recently, we presented a simple method to determine the absolute blood volume during routine hemodialysis (HD) carried out without blood sampling and without injection of dyes or radiolabeled markers. Such information could be used to detect excessive volume reduction during HD and to prevent IME. Therefore, we performed a pilot study in IME‐prone patients to identify the absolute blood volume at which they developed clinical symptoms. A volume of 240 mL of ultrapure dialysate was automaticall...
Source: Hemodialysis International - October 14, 2015 Category: Hematology Authors: Susanne Kron, Daniel Schneditz, Til Leimbach, Jutta Czerny, Sabine Aign, Joachim Kron Tags: Original Article Source Type: research

Preface and Envoi
(Source: Hemodialysis International)
Source: Hemodialysis International - October 5, 2015 Category: Hematology Authors: Christopher R. Blagg, John T. Daugirdas Tags: PREFACE Source Type: research

Audit of the use of anticoagulation for atrial fibrillation in hemodialysis patients
(Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Sophie E. Waller, Bobby Chacko Tags: Letter to the Editor Source Type: research

Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis
Abstract Optimal dialysate sodium (dNa) is unknown, with both higher and lower values suggested in adult studies to improve outcomes. Similar studies in pediatric hemodialysis (HD) population are missing. This is the first report of the effect of two constant dNa concentrations in pediatric patients on chronic HD. 480 standard HD sessions and interdialytic periods were studied in 5 patients (age 4–17 years, weight 20.8–66 kg) during a period of 6–11 months per patient. dNa was 140 mEq/L during the first half, and 138 mEq/L during the second half of the study period for each patient. Lowering dNa was assoc...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Olivera Marsenic, Michael Anderson, Kevin G. Couloures, Woo S. Hong, E. Kevin Hall, Neera Dahl Tags: Case Report Source Type: research

The possibility of renal function recovery in chronic hemodialysis patients should not be overlooked: Single center experience
Abstract Chronic hemodialysis is implemented when irreversible loss of kidney function occurs. Sometimes renal recovery is overlooked. From January 2005 to December 2014, we identified 28 patients hemodialyzed for more than 3 months who had renal replacement therapy discontinued. The group consisted of 17 (57.7%) males and 11 (42.3%) females. Patients were 18–87 years old. Time of hemodialysis ranged from 3 to 97 months. Of note, 14 (50%) patients were referred from local dialysis units for solution of vascular access problems. In 13 (46.2%) patients dialysis was abandoned within the first 6 months, in 5 (17.8%) pati...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Krzysztof Letachowicz, Katarzyna Madziarska, Waldemar Letachowicz, Magdalena Krajewska, Józef Penar, Mariusz Kusztal, Tomasz Gołębiowski, Wacław Weyde, Marian Klinger Tags: Case Report Source Type: research

Cinacalcet, dialysate calcium concentration, and cardiovascular events in the EVOLVE trial
We examined whether baseline dialysate calcium concentration or the serum–dialysate calcium gradient modified the effect of cinacalcet on the following adjudicated endpoints: (1) primary composite endpoint (death or first non‐fatal myocardial infarction, hospitalization for unstable angina, heart failure, or peripheral vascular event); (2) cardiovascular death; and (3) sudden death. In EVOLVE, use of higher dialysate calcium concentrations was more prevalent in Europe and Latin America compared with North America. There was a significant fall in serum calcium concentration in the cinacalcet group; dialysate calcium...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Patrick H. Pun, Safa Abdalla, Geoffrey A. Block, Glenn M. Chertow, Ricardo Correa‐Rotter, Bastian Dehmel, Tilman B. Drüeke, Jürgen Floege, William G. Goodman, Charles A. Herzog, Gerard M. London, Kenneth W. Mahaffey, Sharon M. Moe, Patrick S. Parfrey, Tags: Original Article Source Type: research

A rare cause of abdominal pain: Catheter in the middle hepatic vein
Abstract Hemodialysis catheters are vital for chronic renal failure patients. Permanent tunneled dialysis catheters may be inserted through the jugular, subclavian, and femoral veins. In this paper, we aimed to present the computed tomography findings of a chronic renal failure patient who had referred our clinic with abdominal pain and dyspnea symptoms. This patient had a formerly inserted hemodialysis catheter for chronic renal failure and her catheter was found to be extending towards the middle hepatic vein with the tip leaning onto the parenchyma. Hemodialysis catheters can provide instant vascular access and can also...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Yeliz Akturk, Serra Ozbal Gunes, Okan Murat Akturk, Seray Akcalar, Baki Hekimoglu Tags: Case Report Source Type: research

Successful use of a bivalirudin treatment protocol to prevent extracorporeal thrombosis in ambulatory hemodialysis patients with heparin‐induced thrombocytopenia
Abstract Heparin‐induced thrombocytopenia (HIT) is an uncommon problem in hemodialysis (HD) patients. There have been a few reports on the use of lepirudin, argatroban, or danaparoid in the management of extracorporeal thrombosis (ECT) during dialysis in these patients, because heparin is contraindicated. Here, we report the first long‐term use of bivalirudin to prevent ECT. Our study was conducted at Fahd Bin Jassim Kidney Center in Doha, Qatar. All patients diagnosed with HIT were included. A bivalirudin treatment protocol was developed with the initial dosage and dosage adjustments based on the value of activated pa...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Fadwa Saqr Al‐Ali, Mohammed Elsayed, Sabah Khalifa, Aisha Elsayed Abdulla, Hoda Tolba, Hisham Bouanane, Rania Ibrahim, Abdullah Hamad Tags: Original Article Source Type: research

Post‐hemodialysis dosing of 1 vs. 2 g of ceftazidime in anuric end‐stage renal disease patients on low‐flux dialysis and its pharmacodynamic implications on clinical use
Abstract Ceftazidime is a cost‐effective antimicrobial against Gram‐negative pathogens associated with sepsis in end‐stage renal disease (ESRD) hemodialysis patients with potential for wider use with the advent of ceftazidime‐avibactam. Dosing ceftazidime post‐hemodialysis appears attractive and convenient, but limited in vivo data on pharmacodynamic efficacy (PE) attainment, defined as>70% of the interdialytic period drug concentrations exceed susceptible pathogens minimal inhibitory concentrations (MICs) (%TMIC), warrants further assessment. We therefore evaluated PE and tolerability of 1 against 2 g ...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Jessica Hui Fen Goh, Siok Ying Lee, Say Tat Ooi, Lawrence Lee Soon‐U, Kim‐Hor Hee, Claude J. Renaud Tags: Original Article Source Type: research

The use of vascular access audit and infections in home hemodialysis
Abstract Vascular access‐related infection is an important adverse event in home hemodialysis (HHD). We hypothesize that errors in self‐cannulation or manipulation of dialysis vascular access are associated with increased incidence of access‐related infection. We conducted a retrospective cohort study of all prevalent HHD patients at the University Health Network. All vascular access‐related infections were recorded from 2006 to 2013. Errors in dialysis access were ascertained by nurse‐administered vascular access checklist. Ninety‐two patients had completed at least one vascular access audit. Median HHD vintag...
Source: Hemodialysis International - October 1, 2015 Category: Hematology Authors: Mathieu Rousseau‐Gagnon, Rose Faratro, Celine D'Gama, Stella Fung, Elizabeth Wong, Christopher T. Chan Tags: Original Article Source Type: research

D‐dimer levels in maintenance hemodialysis patients: High prevalence of positive values also in the group without predisposing diseases
Abstract We aimed to estimate the prevalence of elevated D‐dimer levels in all chronic hemodialysis patients and those without additional disease, and to identify factors associated with increased D‐dimer. In 167 chronic hemodialysis patients from our center, D‐dimer was measured before dialysis. The effects of age, C‐reactive protein (CRP), recent acute illness, vascular access, anticoagulation type, dialysis vintage, and chronic diseases, considered to predispose for increased D‐dimer levels, were analyzed. The median D‐dimer in the whole group was 966 (inter‐quartile range [IQR] 524–1947) μg/L and...
Source: Hemodialysis International - September 28, 2015 Category: Hematology Authors: Jakob Gubensek, Matea Lolic, Rafael Ponikvar, Jadranka Buturovic‐Ponikvar Tags: Original Article Source Type: research

Our experience in using the brachial venae comitantes as a native vascular access for hemodialysis
Abstract A native arteriovenous fistula is the preferred vascular access for patients on long‐term hemodialysis. In the absence of suitable superficial veins, the deep venous system can be used. We intend to present our experience in using the brachial venae comitantes (VC) to create a native arteriovenous fistula. From January 2012 to December 2014, we utilized the brachial vena comitantes to create 12 arteriovenous fistulae. Data from these 12 subjects were analyzed retrospectively to produce this case series. The average age of our subjects was 55.6 years. Forty‐two percent of the subjects were women. Fifty percent ...
Source: Hemodialysis International - September 28, 2015 Category: Hematology Authors: Hon Leong Sha, Tien Loong Luk, Sze Chee Tee, Richard Hardin, Chen Ken Seak Tags: Original Article Source Type: research

Author Index
(Source: Hemodialysis International)
Source: Hemodialysis International - September 10, 2015 Category: Hematology Tags: 9th International Congress of the International Society for Hemodialysis: Global Challenges in Hemodialysis Source Type: research

Poster Abstracts
(Source: Hemodialysis International)
Source: Hemodialysis International - September 10, 2015 Category: Hematology Tags: 9th International Congress of the International Society for Hemodialysis: Global Challenges in Hemodialysis Source Type: research

Free Paper Abstracts
(Source: Hemodialysis International)
Source: Hemodialysis International - September 10, 2015 Category: Hematology Tags: 9th International Congress of the International Society for Hemodialysis: Global Challenges in Hemodialysis Source Type: research

Scientific Committee
(Source: Hemodialysis International)
Source: Hemodialysis International - September 10, 2015 Category: Hematology Tags: 9th International Congress of the International Society for Hemodialysis: Global Challenges in Hemodialysis Source Type: research

Message from Scientific Chairpersons
(Source: Hemodialysis International)
Source: Hemodialysis International - September 10, 2015 Category: Hematology Authors: Hooi Lai Seong, Wong Hin Seng Tags: 9th International Congress of the International Society for Hemodialysis: Global Challenges in Hemodialysis Source Type: research

Enterococcus faecalis endophthalmitis as a metastatic complication of hemodialysis vascular access ‐related sepsis: A case report and review of the literature
Abstract Catheter and/or arteriovenous (A‐V) graft‐related bacteremia is an important cause of morbidity and mortality among hemodialysis (HD) patients. Endocarditis, septic arthritis, epidural abscess, septic embolism, and osteomyelitis are the most common complications of catheter and/or A‐V graft‐related bacteremia; however, endogenous endophthalmitis is rarely seen. To the best of our knowledge, Enterococcus faecalis is the first case report in this population. We hereby report a case of endogenous endophthalmitis caused by E. faecalis as a complication of catheter and/or A‐V graft‐related bacteremia...
Source: Hemodialysis International - September 6, 2015 Category: Hematology Authors: Osman Zikrullah Sahin, Ekrem Kara, Tahir Belice, Teslime Ayaz, Serap Baydur Sahin, Cinar Ozturk, Safak Yildirim, Yavuz Metin, Tuncay Sahutoglu Tags: ACCESS Source Type: research

Changes in biochemical, hemodynamic, and dialysis adherence parameters in hemodialysis patients during Ramadan
Abstract This paper aimed to study the effect of Ramadan fasting on biochemical and clinical parameters and compliance for dialysis. A prospective multicenter observational cross‐sectional study comparing fasting with a non‐fasting stable adult hemodialysis patients for demographic and biochemical parameters, compliance with dialysis, inter‐dialytic weight gain, pre‐ and post‐blood pressure, and frequency of intradialytic hypotensive episodes was carried out. Six hundred thirty‐five patients, of whom 64.1% fasted, were studied. The fasters were younger (53.3 ± 16.2 vs. 58.4 ±&...
Source: Hemodialysis International - September 1, 2015 Category: Hematology Authors: Shaikha Alshamsi, Fatima Binsaleh, Fayez Hejaili, Ayman Karkar, Dujana Moussa, Hamad Raza, Parkash Parbat, Abdulkareem Al Suwida, Saad Alobaili, R. AlSehli, Abdulla Al Sayyari Tags: Original Article Source Type: research

Understanding barriers to home‐based and self‐care in‐center hemodialysis
Abstract Despite superior outcomes and lower associated costs, relatively few patients with end‐stage renal disease undergo self‐care or home hemodialysis. Few studies have examined patient‐ and physician‐specific barriers to self‐care and home hemodialysis in the modern era. The degree to which innovative technology might facilitate the adoption of these modalities is unknown. We surveyed 250 patients receiving in‐center hemodialysis and 51 board‐certified nephrologists to identify key barriers to adoption of self‐care and home hemodialysis. Overall, 172 (69%) patients reported that they were “likely...
Source: Hemodialysis International - September 1, 2015 Category: Hematology Authors: May Yau, Michelle Carver, Luis Alvarez, Geoffrey A. Block, Glenn M. Chertow Tags: Original Article Source Type: research

Is hepcidin‐25 a predictor of atherosclerosis in hemodialysis patients?
Abstract Atherosclerotic cardiovascular disease is an important cause of mortality and morbidity in hemodialysis patients. Iron accumulation in arterial wall macrophages is increased in atherosclerotic lesions. Hepcidin is a key hepatic hormone regulating iron balance. It inhibits iron release from macrophages and iron absorption from enterocytes by binding and inactivating the cellular iron exporter ferroportin. The aim of this study is to investigate the relation of hepcidin‐25, iron parameters, and atherosclerosis measured by carotid intima media thickness (CIMT) in hemodialysis patients. Eighty‐two hemodialysis pat...
Source: Hemodialysis International - September 1, 2015 Category: Hematology Authors: Alaaddin Kali, Ozlem Yayar, Bulent Erdogan, Baris Eser, Mehmet Buyukbakkal, Zafer Ercan, Ozgur Merhametsiz, Ayhan Haspulat, Ebru Gök Oğuz, Basol Canbakan, Mehmet D. Ayli Tags: Original Article Source Type: research

Clinical praxis for assessment of dry weight in Sweden and Denmark: A mixed‐methods study
This study surveyed clinical praxis and local guidelines for dry weight (DW) assessment in Swedish and Danish HD units, and examined if differences in routines and utilization of bioimpedance spectroscopy (BIS) and other assistive technology affected frequency of DW adjustments and blood pressure (BP) levels. Cross‐sectional information on praxis, guidelines and routines, plus treatment‐related data from 99 stratified patients were collected. Qualitative data were analyzed with content analysis and interpreted in convergence with statistical analysis of quantitative data in a mixed‐methods design. Local guidelines co...
Source: Hemodialysis International - August 11, 2015 Category: Hematology Authors: Jenny Stenberg, Magnus Lindberg, Hans Furuland Tags: Original Article Source Type: research

Concordance of absolute and relative plasma volume changes and stability of Fcells in routine hemodialysis
Abstract Central hematocrit (H) measurements are currently used to track the degree of ultrafiltration‐induced hemoconcentration with the aim to detect and prevent excessive intravascular fluid depletion during hemodialysis (HD). Failure to maintain hemodynamic stability is commonly attributed to the misinterpretation of H caused by an unaccountable increase in Fcells, the ratio of whole‐body hematocrit to H. It was the aim to examine Fcells under everyday conditions in a group of stable HD patients. Absolute plasma volume (Vp) and H were concomitantly measured during routine HD in the extracorporeal system in hourly i...
Source: Hemodialysis International - August 5, 2015 Category: Hematology Authors: Daniel Schneditz, Werner Ribitsch, Gernot Schilcher, Matthias Uhlmann, Yossi Chait, Vanessa Stadlbauer Tags: Original Article Source Type: research

High prevalence of subclinical hypothyroidism and nodular thyroid disease in patients on hemodialysis
Abstract Chronic kidney disease has been known to affect thyroid hormone metabolism. Low serum levels of T3 and T4 are the most remarkable laboratorial findings. A high incidence of goiter and nodules on thyroid ultrasonography has been reported in patients with end‐stage renal disease (ESRD). Our objective is to evaluate the prevalence of laboratorial and morphologic alterations in the thyroid gland in a cohort of patients with ESRD on hemodialysis (HD). Sixty‐one patients with ESRD on HD were selected and compared with 43 healthy subjects matched by age, gender, and weight. Patients were submitted to thyroid ultrason...
Source: Hemodialysis International - August 5, 2015 Category: Hematology Authors: Ana Beatriz B.A. Da Costa, Caio Pellizzari, Gisah A. Carvalho, Beatriz C. Sant'Anna, Rafaela L. Montenegro, Roberto G. Zammar Filho, Cleo O. Mesa Junior, Patrícia R. Hauck Prante, Marcia Olandoski, Mauricio Carvalho Tags: Original Article Source Type: research

Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis
The objectives of this study were to assess the prevalence of chronic obstructive pulmonary disease (COPD) in hemodialysis patients with spirometry and to examine the effects of fluid removal by hemodialysis on lung volumes. Patients ≥18 years at two Danish hemodialysis centers were included. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were measured with spirometry before and after hemodialysis. The diagnosis of COPD was based on both the GOLD criteria and the lower limit of normal criteria. There were 372 patients in treatment at the two centers, 255 patients (69%) com...
Source: Hemodialysis International - August 5, 2015 Category: Hematology Authors: Louis L. Plesner, Peder E. Warming, Ture L. Nielsen, Morten Dalsgaard, Morten Schou, Ulla Høst, Casper Rydahl, Lisbet Brandi, Lars Køber, Jørgen Vestbo, Kasper Iversen Tags: Original Article Source Type: research

Fibromyalgia syndrome in Turkish hemodialysis patients
This study was composed of 221 chronic HD patients (99 females and 122 males), and we recorded each participant's age, gender, causes of kidney failure, HD duration, education level, and symptoms related to FMS, which was diagnosed according to the 2010 American College of Rheumatology criteria. We documented the laboratory parameters for all patients. In addition, patients with FMS filled out the Fibromyalgia Impact Questionnaire. Twenty‐two patients met the diagnostic criteria for FMS (9%), and there were no statistically significant differences related to age, gender, or HD duration between FMS and non‐FMS groups (P...
Source: Hemodialysis International - July 22, 2015 Category: Hematology Authors: Berrin Leblebici, Rüya Özelsancak, Emine Ece Yılmaz, Pınar Doruk Tags: Original Article Source Type: research

Purulent pericarditis and pericardiac tamponade in a pregnant hemodialysis patient: A case report
Abstract Bacterial pericarditis is rare in chronic hemodialysis and has poor prognosis. In this case, we report a pregnant hemodialysis patient who developed purulent bacterial pericarditis and pericardiac tamponade in the 28th week of her pregnancy, and who had delivered a healthy living baby. (Source: Hemodialysis International)
Source: Hemodialysis International - July 22, 2015 Category: Hematology Authors: Fatma Ulku Adam, Begum Avci, Mevlut Koc Tags: Case Report Source Type: research

Severe liver failure due to influenza A infection in a hemodialysis patient
We report a case of a hemodialysis patient with influenza A infection who presented with severe hepatitis and liver failure, while his respiratory symptoms were mild. It is important to recognize influenza infection as an unexplained cause of hepatitis and liver failure. In our case, liver failure resolved with supportive treatment. (Source: Hemodialysis International)
Source: Hemodialysis International - July 22, 2015 Category: Hematology Authors: Maggie Ming Yee Mok, Vincent Chi Chung Cheng, Sing Leung Lui, Lorraine Pui Yuen Kwan, Gary Chi Wang Chan, Desmond Yat Hin Yap, Tak Mao Chan, Wai Kei Lo Tags: Case Report Source Type: research

A maintenance hemodialysis diabetic patient with unexplained pulmonary and gastrointestinal involvement
Abstract A 50‐year‐old man with diabetes mellitus with diabetic retinopathy, peripheral neuropathy, hypertension, and end‐stage renal disease on maintenance hemodialysis, presented with persistent cough and hiccups, continued to be unwell with weight loss, poor appetite, and recurrent respiratory symptoms such as wheezing and cough. Whole body positron emission tomography‐computed tomography scan showed metabolically active lesions in liver, stomach/lesser sac, pancreas, and left sixth rib. As he had repeated bilateral transudative pleural effusion, left mini thoracotomy with pleural biopsy showed no evidence of gr...
Source: Hemodialysis International - July 22, 2015 Category: Hematology Authors: Anand Yuvaraj, Georgi Abraham, Abraham Kurien, Priyanka Koshy, Sanjeev Nair, Sudhakshina Ghosh Tags: Case Report Source Type: research

Prescriptions of dialysate potassium concentration during short daily or long nocturnal (high dose) hemodialysis
Abstract The prescription of dialysate potassium concentration during short daily and long nocturnal (high dose) hemodialysis (HD) is challenging due to limited clinical experience with such modalities. The aim here is to propose a quantitative approach for prescribing dialysate potassium concentrations during high‐dose HD. Potassium kinetic parameters based on a pseudo one‐compartment model from 547 patients participating in the HEMO Study were used for prediction purposes in this study. Patients were categorized based on the prescribed dialysate potassium concentration during thrice weekly HD as 1K (mean of 1.02&thin...
Source: Hemodialysis International - July 14, 2015 Category: Hematology Authors: John K. Leypoldt, Baris U. Agar, Angelito A. Bernardo, Bruce F. Culleton Tags: Original Article Source Type: research