Hemodialysis Abstracts from the 35th Annual Dialysis Conference 26th Annual Symposium on Pediatric Dialysis New Orleans, Louisiana January 31–February 3, 2015
(Source: Hemodialysis International)
Source: Hemodialysis International - January 14, 2015 Category: Hematology Tags: HEMODIALYSIS ABSTRACTS FROM THE 35TH ANNUAL DIALYSIS CONFERENCE Source Type: research
Preface and comments on Ebola
(Source: Hemodialysis International)
Source: Hemodialysis International - January 14, 2015 Category: Hematology Authors: Christopher R. Blagg Tags: EDITORIAL Source Type: research
Cloxacillin‐induced seizure in a hemodialysis patient
Abstract We are reporting a cloxacillin‐induced seizure in a patient with stage 5 chronic kidney disease requiring hemodialysis. To our knowledge, there are no published case reports of seizures induced by parenteral cloxacillin in hemodialysis patients. A young hemodialysis female was admitted to the hospital with decreased level of consciousness. Blood cultures revealed methicillin‐sensitive Staphylococcus aureus where cloxacillin 2 g intravenously every 4 hours was initiated. Head computed tomography (CT) was not significant. After 14 hours of cloxacillin therapy (4 doses), the patient demonstrated tonic/clon...
Source: Hemodialysis International - January 12, 2015 Category: Hematology Authors: Wasim El Nekidy, Nicole Dziamarski, Derrick Soong, Christine Donaldson, Muhieldean Ibrahim, Albert Kadri Tags: Case Report Source Type: research
Hemodialysis catheter insertion using transrenal approach
We report a patient suffering from end‐stage renal disease (ESRD) because of lupus nephritis presented with exhausted vascular access after multiple arteriovenous grafts creation and hemodialysis catheters insertion. A rare percutaneous transrenal approach was finally used for the insertion of dialysis catheter. After 2 years, this hemodialysis catheter was complicated by blockage but was successfully replaced by a new catheter via the same site. Our report shows that the transrenal route of hemodialysis catheter insertion can provide a glimpse of hope for those ESRD patients with exhausted vascular access. (Source: Hemo...
Source: Hemodialysis International - January 12, 2015 Category: Hematology Authors: Wai Ping Law, Chi Yuen Cheung, Hoi Wong Chan, Philip Chong‐hei Kwok, Wai Leung Chak, Ka Foon Chau Tags: Case Report Source Type: research
Effect of personalized nutritional counseling in maintenance hemodialysis patients
Abstract Monitoring nutritional parameters is an integral part of hemodialysis (HD) patient treatment program. The purpose of this study was to evaluate the impact of the personalized nutritional counseling (PNC) on calcium–phosphorus metabolism, potassium, albumin, protein intake, interdialytic weight gain (IDWG), body composition parameters and fluid overload in HD patients. This was a multicenter longitudinal intervention study with 6 months of follow‐up and 731 patients on maintenance HD from 34 dialysis units in Portugal were enrolled. Biochemical and body composition parameters were measured at baseline, 1, 3...
Source: Hemodialysis International - January 5, 2015 Category: Hematology Authors: Cristina Antunes Garagarza, Ana Tentúgal Valente, Telma Sobral Oliveira, Cristina Guerreiro Caetano Tags: Original Article Source Type: research
Effects of frequent hemodialysis on blood pressure: Results from the randomized frequent hemodialysis network trials
Abstract Hypertension is a common complication of chronic kidney disease and persists among most patients with end‐stage renal disease despite the provision of conventional thrice weekly hemodialysis (HD). We analyzed the effects of frequent HD on blood pressure in the randomized controlled Frequent Hemodialysis Network trials. The daily trial randomized 245 patients to 12 months of 6× (“frequent”) vs. 3× (“conventional”) weekly in‐center hemodialysis; the nocturnal trial randomized 87 patients to 12 months of 6× weekly nocturnal HD vs. 3× weekly predominantly home‐base...
Source: Hemodialysis International - January 5, 2015 Category: Hematology Authors: Peter Kotanko, Amit X. Garg, Tom Depner, Andreas Pierratos, Christopher T. Chan, Nathan W. Levin, Tom Greene, Brett Larive, Gerald J. Beck, Jennifer Gassman, Alan S. Kliger, John B. Stokes, Tags: Original Article Source Type: research
Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report
Abstract Osteitis fibrosa cystica (OFC) is the most frequent type of osseous change in renal osteodystrophy affecting the majority of dialysis patients. Brown tumors are a severe form of OFC. The involvement of the craniofacial skeleton causing facial disfigurement in patients on dialysis appears to be limited to case reports. After searching PubMed, we performed a systematic review of 127 cases with a severe form of OFC resulting in a facial disfigurement to understand possible determinants for this condition. We found that since the first published case in 1974, and after a peak in 1996, there appears to be an increase i...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Rafael M. Baracaldo, Dashi Bao, Pichet Iampornpipopchai, Joshua Fogel, Sofia Rubinstein Tags: Original Article Source Type: research
Calcium‐phosphate and parathyroid intradialytic profiles: A potential aid for tailoring the dialysate calcium content of patients on different hemodialysis schedules
Abstract Severe hyperparathyroidism is a challenge on hemodialysis. The definition of dialysate calcium (Ca) is a pending issue with renewed importance in cases of individualized dialysis schedules and of portable home dialysis machines with low‐flow dialysate. Direct measurement of calcium mass transfer is complex and is imprecisely reflected by differences in start‐to‐end of dialysis Ca levels. The study was performed in a dialysis unit dedicated to home hemodialysis and to critical patients with wide use of daily and tailored schedules. The Ca‐phosphate (P)‐parathyroid hormone (PTH) profile includes creatinine...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Martina Ferraresi, Anna Pia, Gabriella Guzzo, Federica Neve Vigotti, Elena Mongilardi, Marta Nazha, Emiliano Aroasio, Cinzia Gonella, Paolo Avagnina, Giorgina Barbara Piccoli Tags: Original Article Source Type: research
Treatment of vitamin D deficiency/insufficiency with ergocalciferol is associated with reduced vascular access dysfunction in chronic hemodialysis patients
This study aims to determine the relationship between vitamin D and frequency of vascular access dysfunction (VAD) in hemodialysis (HD) patients. We reviewed medical records of all HD patients who had serum 25‐hydroxyvitamin D (25OHD) levels at 4 outpatient dialysis facilities between January 2011 and January 2012. Patients were included if they were ≥18 years of age, had been on maintenance dialysis for ≥3 months, and had native arteriovenous fistula or synthetic polytetrafluoroethylene grafts for dialysis access. Patients with catheters were excluded. 25‐Hydroxyvitamin D levels
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Gaurav Agarwal, Karina Vasquez, Neena Penagaluru, Jonathan Gelfond, Wajeh Y. Qunibi Tags: Original Article Source Type: research
Isoniazid poisoning: Pharmacokinetics and effect of hemodialysis in a massive ingestion
We report a 20‐year‐old female migrant who presented with recurrent seizures after ingesting 25 g of isoniazid. She was treated with activated charcoal, repeated doses of midazolam for the seizures, and given multiple doses of pyridoxine (14 mg), limited by availability. She was admitted to intensive care, and 5.5 hours post‐ingestion, she was commenced on continuous veno‐venous hemodiafiltration (CVVHDF). She was extubated after 24 hours and CVVHDF was ceased 6 hours later (30 hours post‐overdose). Her renal function remained normal and her initial lactate was the highest at 2.3. She made a full re...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Kirsty Skinner, Ana Saiao, Ahmed Mostafa, Jessamine Soderstrom, Gregory Medley, Michael S. Roberts, Geoffrey K. Isbister Tags: Case Report Source Type: research
Does the presence of an arteriovenous fistula alter changes in body water following hemodialysis as determined by multifrequency bioelectrical impedance assessment?
Abstract Multifrequency bioelectrical impedance assessments (MFBIAs) aid clinical assessment of hydration status for hemodialysis (HD) patients. Many MFBIA devices are restricted to whole body measurements and as many patients dialyze using arteriovenous fistulas (AVFs), we wished to determine whether AVFs affected body water measurements. We reviewed pre‐ and post‐HD segmental MFBIA measurements in 229 patients attending for midweek HD sessions. Up to 144 were dialyzed with a left arm AVF (L‐AVF), 42 with a right arm AVF (R‐AVF), and 43 by central venous access catheter (CVC). Water content and lean tissue were gr...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Kwanpeemai Panorchan, Arkom Nongnuch, Sally El‐Kateb, Cate Goodlad, Andrew Davenport Tags: Original Article Source Type: research
An unusual cause of postdialysis dyspnea: Percutaneous endovascular management
Abstract Vascular access through femoral vein is commonly used for hemodialysis treatment in patients with end‐stage renal disease. Consequently, iatrogenic complications, such as femoral arteriovenous fistula, are increasingly being reported in these patients. Percutaneous endovascular management of such iatrogenic arteriovenous fistulas with stent graft placement is a minimally invasive technique with decreased morbidity and hospital stay compared with surgical repair. Here, we report a case with postcatheterization arteriovenous fistula between superficial femoral artery and femoral vein which was successfully managed...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Yashwant Patidar, Taruna Yadav, S Rajesh, Suman Lata, Sachin Kumar, Amar Mukund Tags: Case Report Source Type: research
Phosphate binders and metabolic acidosis
(Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Marco Marano Tags: Letter to the Editor Source Type: research
Relationship between non‐alcoholic fatty liver disease and MIA syndrome
Abstract Non‐alcoholic fatty liver disease (NAFLD) is an important factor in the pathogenesis of cardiovascular diseases in the general population. Recently, it has been shown that NAFLD is highly prevalent in chronic kidney disease (CKD) patients. Ninety‐four hemodialysis (HD) patients were followed for a time period of 18 months or until death. Patient's survival rate was determined in relation to their nutritional and inflammatory state, and the presence of NAFLD. We also investigated the association between the presence of NAFLD and the patients' nutritional and inflammatory state. We did not find any significant a...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Ivana Mikolasevic, Davor Stimac, Sanjin Racki, Luka Zaputovic, Bosiljka Devcic, Ita Jelic, Vesna Lukenda, Mladen Radic, Lidija Orlic Tags: Original Article Source Type: research
Recalcitrant tumor of the fifth metacarpal bone in a hemodialyzed patient
Abstract The article presents a case report about a 38‐year‐old hemodialyzed woman who presented to our department with a painful, expansile, lytic bone lesion of the fifth metacarpal epiphysis. The lesion was resected and replaced by corticocancellous bone graft. At 3 months, imaging suggested signs of graft resorption and local recurrence which necessitated repeat excision and grafting. Because of secondary parathyroidism subsequent subtotal parathyroidectomy was performed. This procedure leads to appropriate bone remodeling by 8 weeks postoperatively, and recurrence has not been observed at 2 years of follow up. (So...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Paweł Reichert, Tomasz Gołębiowski, Przemysław Kowalski, Jerzy Gosk Tags: Case Report Source Type: research
The effects of single hemodialysis session on arterial stiffness in hemodialysis patients
This study aimed to investigate the effects of solute volume removal and hemodynamic changes on PWV and AIx of a single hemodialysis session. Thirty hemodialysis patients were enrolled in the study. Before initiation of hemodialysis, every 15 minutes during hemodialysis, and 30 minutes after the completion of the session, measurements of PWV and AIx@75 (normalized with heart rate 75 bpm) were obtained from each patient. Body composition was analyzed by bioimpedance spectroscopy device before and 30 minutes after completion of the hemodialysis session. During the hemodialysis, no significant change was observed in AIx@75. H...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Handan Öğünç, Hakan Akdam, Alper Alp, Fatih Gencer, Harun Akar, Yavuz Yeniçerioğlu Tags: Original Article Source Type: research
The prevalence of intestinal parasites in hemodialysis patients in Bushehr, Iran
Abstract Hemodialysis patients, due to a dysfunction of the immune response, are prone to a variety of opportunistic infections. Studies of intestinal parasitic infections in these patients are limited. Therefore, the present study was performed to determine the prevalence of these infections in patients on hemodialysis in Bushehr. In this cross‐sectional study, fecal samples have been collected from all hemodialysis patients who were continuously referred from September 2011 to September 2012 to the dialysis center at Bushehr and tested using routine parasitological methods. From a total of 88 patients studied, 25 patie...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Afshin Barazesh, Moradali Fouladvand, Rahim Tahmasebi, Ali Heydari, Jamal Fallahi Tags: Original Article Source Type: research
Massive catheter‐related thrombosis of vena cava superior protruding into the right atrium in a hemodialysis patient
Abstract A 36‐year‐old man with chronic renal insufficiency secondary to type 1 diabetes mellitus was on hemodialysis via central venous catheter (CVC), newly placed into the right subclavian vein after his arteriovenous fistula became dysfunctional. Seven days after CVC insertion, the patient developed fever and on day 11 echocardiography showed a large nearly occluding thrombus in the superior vena cava (SVC) extending into the right atrium (RA). Emergency surgical thrombectomy was successfully performed and an 11 cm long thrombus extending from the RA cranially into the SVC occupying majority of the vein's lu...
Source: Hemodialysis International - January 1, 2015 Category: Hematology Authors: Lukas Mach, Olga Ondruskova, Petr Nemec, Marek Orban Tags: Case Report Source Type: research
Heparin induces an accumulation of atherogenic lipoproteins during hemodialysis in normolipidemic end‐stage renal disease patients
In this study, we aimed to investigate the effects of ESRD on triglyceride‐rich lipoproteins (TRL) subpopulations distribution and acute change following hemodialytic procedures, including the relative contribution of heparin administration. We selected a group of normolipidemic male middle‐aged ESRD patients free of any concomitant disease affecting lipoprotein remnant metabolism compared with controls. We separated TRL subfractions according to density and apoE content and evaluated the changes of these particles after hemodialytic procedures with or without heparin. ESRD subjects had higher TRL subfractions, with th...
Source: Hemodialysis International - December 12, 2014 Category: Hematology Authors: Carlo M. Barbagallo, Davide Noto, Angelo B. Cefalù, Antonia Ganci, Carlo Giammarresi, Donata Panno, Gaspare Cusumano, Massimiliano Greco, Francesca Di Gaudio, Maurizio R. Averna Tags: Original Article Source Type: research
Intensive weight loss combining flexible dialysis with a personalized, ad libitum, coach‐assisted diet program. A “pilot” case series
This study measures weight loss, side effects, and patients' opinions. Over 12–30 months, all patients lost weight (median −10.3 kg [5.7–20], median ΔBMI–3.2). Serum albumin (pre‐diet 3.78; post‐diet 3.83 g/dL), hemoglobin (pre‐diet 11; post‐diet 11.2 g/dL), and acid–base balance (HCO3 pre‐diet: 23.3; post‐diet: 23.4 mmol/L) remained stable, with decreasing needs for erythropoietin and citrate or bicarbonate supplements. Calcium‐phosphate‐parathyroid hormone (PTH) balance improved (PTH‐pre 576; post 286 pg/mL). Three out of 4 hypertens...
Source: Hemodialysis International - December 12, 2014 Category: Hematology Authors: Federica Neve Vigotti, Luigi Teta, Anna Pia, Sara Mirasole, Gabriella Guzzo, Domenica Giuffrida, Irene Capizzi, Paolo Avagnina, Davide Ippolito, Giorgina Barbara Piccoli Tags: Original Article Source Type: research
Construction and validation of a scale of assessment of self‐care behaviors with arteriovenous fistula in hemodialysis
This article describes the process of building a scale of assessment of self‐care behaviors with arteriovenous fistula in hemodialysis (ASBHD‐AVF). This is a cross‐sectional study in which the development, construction, and validation process followed the directions of the authors Streiner and Norman. This is a convenience sample, sequential, and nonprobabilistic constituted by 218 patients. The study was conducted in two stages during 2012–2014. The first phase corresponds to the scale construction process, 64 patients participated, while the second corresponds to the evaluation of metric properties and 154 pa...
Source: Hemodialysis International - December 5, 2014 Category: Hematology Authors: Clemente Neves Sousa, João Luís Alves Apóstolo, Maria Henriqueta Jesus Silva Figueiredo, Vanessa Filipa Ferreira Dias, Paulo Teles, Maria Manuela Martins Tags: Original Article Source Type: research
Longitudinal associations of depressive symptoms and pain with quality of life in patients receiving chronic hemodialysis
Abstract Depressive symptoms and pain are common in patients on chronic hemodialysis (HD), yet their associations with quality of life (QOL) are not fully understood. We sought to characterize the longitudinal associations of these symptoms with QOL. As part of a trial comparing two symptom management strategies in patients receiving chronic HD, we assessed depressive symptoms using the Patient Health Questionnaire‐9 (PHQ‐9), and pain using the Short Form McGill Pain Questionnaire (SF‐MPQ) monthly over 24 months. We assessed health‐related QOL (HR‐QOL) quarterly using the Short Form 12 (SF‐12) and global QOL (G...
Source: Hemodialysis International - November 18, 2014 Category: Hematology Authors: Linda Y. Belayev, Maria K. Mor, Mary Ann Sevick, Anne Marie Shields, Bruce L. Rollman, Paul M. Palevsky, Robert M. Arnold, Michael J. Fine, Steven D. Weisbord Tags: Original Article Source Type: research
Spontaneous calf hematoma in a patient with diabetic nephropathy receiving maintenance hemodialysis: A case report and review of the literature
We report the outcome of a 52‐year‐old patient with diabetic nephropathy and receiving maintenance hemodialysis (HD) using low molecular weight heparin (LMWH) as an anticoagulant for 2 years. He presented right lower limb pain accompanied with difficulty in walking for 2 months, and had no history of bleeding tendency or trauma. Physical examination revealed marked swelling and tenderness on his right lower limb. By ultrasound and magnetic resonance imaging (MRI) diagnoses, the calf hematoma was diagnosed and identified with venous thrombosis. Following treatment with heparin‐free HD, the swelling regressed and pain ...
Source: Hemodialysis International - November 18, 2014 Category: Hematology Authors: Li Xiao, Fengxia Ling, Lihua Tan, Huabing Li, Chun Hu, Ying Luo, Dang Tang, Fuyou Liu, Yashpal S. Kanwar, Lin Sun Tags: Case Report Source Type: research
Correlation between conjunctival and corneal calcification and cardiovascular calcification in patients undergoing maintenance hemodialysis
Abstract The purpose of this study was to investigate the correlation of conjunctival and corneal calcification (CCC) with cardiovascular calcification in patients undergoing maintenance hemodialysis (MHD). A total of 122 patients undergoing MHD in our hospital were included in this study. Conjunctival and corneal calcification was examined by slit lamp and graded. Abdominal aortic calcification (AAC), aortic valve calcification (AVC), and mitral valve calcification (MVC) were determined by X‐ray or ultrasound. The correlation of CCC with AAC, AVC, and MVC was analyzed. Biochemical, hematological, and cardiovascular data...
Source: Hemodialysis International - November 6, 2014 Category: Hematology Authors: Wenxue Sun, Mei Sun, Minghui Zhang, Yi Liu, Xiaomin Lin, Sisi Zhao, Lulu Ma Tags: Original Article Source Type: research
Alkaline phosphatase: Better than PTH as a marker of cardiovascular and bone disease?
(Source: Hemodialysis International)
Source: Hemodialysis International - October 17, 2014 Category: Hematology Authors: Wei Ling Lau, Kamyar Kalantar‐Zadeh, Csaba P. Kovesdy, Rajnish Mehrotra Tags: EDITORIAL Source Type: research
An open‐source practical manual for home hemodialysis: A catalyst for change!
(Source: Hemodialysis International)
Source: Hemodialysis International - October 17, 2014 Category: Hematology Authors: Mark R. Marshall, Christopher T. Chan, Tags: EDITORIAL Source Type: research
Message from the ISHD™ president
(Source: Hemodialysis International)
Source: Hemodialysis International - October 17, 2014 Category: Hematology Authors: Madhukar Misra Tags: EDITORIAL Source Type: research
Assessing the utility of testing aluminum levels in dialysis patients
Abstract Plasma aluminum (Al) is routinely tested in many dialysis patients. Aluminum exposure may lead to acute toxicity and levels in excess of ∼2.2 μmol/L (60 μg/L) should be avoided. Historically, toxicity has been caused by excessive dialyzate Al but modern reverse osmosis (RO) water should be Al free. Nevertheless, many units continue to perform routine Al levels on dialysis patients. This single‐center study retrospectively analyzed Al levels in plasma, raw water feed, and RO product between 2010 and 2013 using our database (Nephworks 6) with the aim of determining the utility of these meas...
Source: Hemodialysis International - October 13, 2014 Category: Hematology Authors: Ashish K. Sharma, Nigel D. Toussaint, Janice Pickering, Tony Beeston, Edward R. Smith, Stephen G. Holt Tags: Original Article Source Type: research
Necrotizing fasciitis and infective endocarditis caused by Escherichia coli in a hemodialysis patient
We report a 40‐year‐old man who was undergoing maintenance hemodialysis and was initially diagnosed with monomicrobal necrotizing fasciitis of the lower limbs, based on blood and pus cultures that yielded Escherichia coli. His condition improved after surgical debridement and antibiotic therapy. However, he eventually died of intracranial hemorrhage related to septic emboli. Concurrent infective endocarditis was diagnosed based on an echocardiogram that indicated vegetation in the left ventricular region. Escherichia coli‐related necrotizing fasciitis and infective endocarditis is rarely seen in clinical practice. Th...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Ming‐Hsien Tsai, Jyh‐Gang Leu, Yu‐Wei Fang, Shih‐Chung Hsieh Tags: Case Report Source Type: research
Treatment of symptomatic coronary artery disease in patients with end‐stage renal disease on hemodialysis with paclitaxel‐eluting TAXUS stent
Abstract Percutaneous coronary intervention (PCI) utilizing drug‐eluting stents is becoming a very common revascularization technique in the dialysis cohort; therefore, we sought to identify the impact of dialysis on outcomes in this group of patients. This is a multicenter registry comparing results of 290 patients (186 with normal kidney function, 104 on dialysis) who underwent PCI with exclusive use of paclitaxel‐eluting TAXUS stent. The primary endpoint was an assessment of major adverse cardiac events (MACE) at 1‐ and 2‐year observation. Mean follow‐up was 23.3 ± 6.1 months. Results at 1...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Szymon L. Wiernek, R. Stefan Kiesz, Barbara K. Wiernek, Piotr P. Buszman, Adam Janas, Jack L. Martin, Blazej Trela, Robert G. Szewc, Pawel E. Buszman Tags: Original Article Source Type: research
Digital infarction in a hemodialysis patient due to embolism from a thrombosed brachial arteriovenous fistula
Abstract Acute onset of digital ischemia and infarction is an unusual complication in patients undergoing hemodialysis. This is a report of a patient on regular hemodialysis who presented with acute distal extremity ischemia, progressing to digital infarction and on evaluation was found to have thrombosis of brachial arteriovenous fistula with embolization to the distal arteries causing digital artery occlusion. (Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Anupama YJ Tags: Case Report Source Type: research
Use of novel oral anticoagulants in patients with end‐stage renal disease
(Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Wolfgang C. Winkelmayer, Charles A. Herzog, Maria E. Montez‐Rath, Tara I. Chang, Glenn M. Chertow Tags: Letter to the Editor Source Type: research
Late acceleration of glomerular filtration rate decline is a risk for hemodialysis catheter use in patients with established nephrology chronic kidney disease care
Abstract Chronic kidney disease (CKD) patients with established nephrology care have a high rate of tunneled dialysis catheters (TDC) as first vascular access when transitioning to hemodialysis (HD). We sought to identify factors associated with this problem. Patients who started HD and had prior CKD care within our renal clinic were categorized according to access type at incident HD. Clinical factors, all estimated glomerular filtration rates (eGFR), renal clinic attendance records, hospital admissions in the 6 months preceding HD start, and patient participation in predialysis education course were analyzed. Three hundr...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Andrew I. Chin, Tuan A. Nguyen, Kumar P. Dinesh, José A. Morfin Tags: Original Article Source Type: research
Differences in coagulation in clotting of vascular access in hemodialysis patients
Abstract Arteriovenous graft (AVG) thrombosis is a frequent cause of graft failure. We evaluated coagulation protein concentrations, platelet function, and viscoelasticity factors in 20 hemodialysis (HD) patients with AVGs. The goal was to determine whether significant differences in protein concentrations, platelet function, and viscoelasticity factors exist among dialysis patients requiring frequent AVG declot procedures vs. those who do not. Twenty HD patients were enrolled: 10 frequent clotters (>3 declots in the previous year) and 10 were nonclotters. Patients on antiplatelets or chronic anticoagulation were exclud...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Chinedu Nweke, Erika Martin, Todd Gehr, Donald Brophy, Daniel Carl Tags: Original Article Source Type: research
Changes in symptom burden and physical performance with initiation of dialysis in patients with chronic kidney disease
(Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Matthew B. Rivara, Cassianne Robinson‐Cohen, Bryan Kestenbaum, Baback Roshanravan, Chang Huei Chen, Jonathan Himmelfarb, Rajnish Mehrotra Tags: Letter to the Editor Source Type: research
Does the extracorporeal blood flow affect survival of the arteriovenous vascular access?
Abstract Hemodiafiltration with high‐convective volumes is associated with improved patient survival, whereby practical realization is contingent on high extracorporeal blood flow (Qb) and dialysis treatment time. However, Qb is restricted by vascular access (VA) quality and/or concerns that high Qb could damage the VA. Taking VA quality into consideration, one can investigate the relationship between Qb and VA survival. We analyzed data from 1039 patients treated by hemodiafiltration over a 21‐month period where access blood flow (Qa) measurements were also available at baseline. VA failure was defined as a surgical i...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Pedro Ponce, Daniele Marcelli, Caecilia Scholz, Wolfgang Wehmeyer, Pedro Gonçalves, Aileen Grassmann, Katharina Brand, Bernard Canaud Tags: Original Article Source Type: research
Health numeracy: Perspectives about using numbers in health management from African American patients receiving dialysis
Abstract Health numeracy is linked to important clinical outcomes. Kidney disease management relies heavily on patient numeracy skills across the continuum of kidney disease care. Little data are available eliciting stakeholder perspectives from patients receiving dialysis about the construct of health numeracy. Using focus groups, we asked patients receiving hemodialysis open‐ended questions to identify facilitators and barriers to their understanding, interpretation, and application of numeric information in kidney care. Transcripts were analyzed using content analysis. Twelve patients participated with a mean (standar...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Julie A. Wright Nunes, Chandra Y. Osborn, T. Alp Ikizler, Kerri L. Cavanaugh Tags: Original Article Source Type: research
Inappropriately elevated endothelin‐1 plays a role in the pathogenesis of intradialytic hypertension
Abstract The aim of this study is to investigate the effects of endogenous vasoactive substances on the occurrence of intradialytic hypertension (IDH) in patients during maintenance hemodialysis. Thirty‐four maintenance hemodialysis patients were enrolled in this trial, and 17 of them were diagnosed with IDH (defined as an increase in blood pressure of at least 10 mmHg during or immediately after a hemodialysis session), while 17 age‐matched and sex‐matched controls without IDH were selected for a retrospective comparison. We collected patients' blood samples before and after a dialysis session and measured th...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Jie Teng, Jie Tian, Wen‐Lv Lv, Xiao‐Yan Zhang, Jian‐Zhou Zou, Yi Fang, Jinbo Yu, Bo Shen, Zhong‐Hua Liu, Xiao‐Qiang Ding Tags: Original Article Source Type: research
Experience with continuous venovenous hemodiafiltration in four newborns: A case series and review of the literature
Abstract When conventional methods for treating complicated problems such as acute and chronic renal failure or metabolic diseases fail, the therapy of choice is peritoneal dialysis (PD) in neonatal period. However, in cases that involve technical difficulties, such as bulky lesions in the abdomen or complications from previous abdominal surgeries, it is not always possible to place a peritoneal catheter. In such situations, continuous venovenous hemodiafiltration (CVVHDF) can be effective. This case series presents our experience in 2013 with the administration of CVVHDF to four patients in our neonatal intensive care uni...
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Ali Ulas Tugcu, Asli Kantar, Aslihan Abbasoglu, Ayse Ecevit, Aylin Tarcan, Esra Baskın Tags: Case Report Source Type: research
Is parathyroidectomy always good for the heart?
(Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2014 Category: Hematology Authors: Maria Júlia C.L.N. Araújo, Rosilene M. Elias, Rosa M. A. Moysés Tags: Letter to the Editor Source Type: research
Prognostic significance of 25‐hydroxivitamin D entirely explained by a higher comorbidity burden: Experience from a South‐Eastern European Dialysis Cohort
Abstract Vitamin D deficiency is still a common problem particularly in the elderly and in individuals with various degrees of renal impairment. The present study aimed to evaluate the association between plasma concentrations of 25(OH)D and death in a large cohort of prevalent patients on hemodialysis (HD) from south‐east Romania, a typical Balkan region. This is an observational prospective study that included a total of 570 patients on maintenance HD. Study patients were classified into three groups by baseline 25(OH)D levels: (1) sufficient 25(OH)D—i.e.,>30 ng/mL; (2) insufficient 25(OH)D—i.e., ...
Source: Hemodialysis International - September 23, 2014 Category: Hematology Authors: Adalbert Schiller, Mugurel Apetrii, Mihai Onofriescu, Dimitrie Siriopol, Gabriel Veisa, Oana Schiller, Flaviu Bob, Romulus Timar, Adelina Mihaescu, Mehmet Kanbay, Adrian Covic Tags: Original Article Source Type: research
Symptomatic hypercalcemia in a rabies survivor underwent hemodialysis
Abstract Adrenal insufficiency is an uncommon and easily ignored cause among most etiologies of hypercalcemia because not all cases of adrenal insufficiency presented with hypercalcemia. In most cases of adrenal insufficiency, viral encephalitis‐related panhypopituitarism is a rare complication that is sporadically encountered in previous studies. However, this complication has never been reported in rabies encephalitis because of the extremely high rate of mortality. Rapid recovery from hypercalcemia state after glucocorticoid supplement is a direct hint of adrenal insufficiency related hypercalcemia. (Source: Hemodialysis International)
Source: Hemodialysis International - August 20, 2014 Category: Hematology Authors: Yu‐Guang Chen, Li‐Ping Kan, Chien‐Hsing Lee, Shih‐Hua Lin, Der‐Ming Chu, Feng‐Yee Chang, Ya‐Sung Yang Tags: Case Report Source Type: research
Potassium kinetics during hemodialysis
Abstract Hyperkalemia in hemodialysis patients is associated with high mortality, but prescription of low dialysate potassium concentrations to decrease serum potassium levels is associated with a high incidence of sudden cardiac arrest or sudden death. Improved clinical outcomes for these patients may be possible if rapid and substantial intradialysis decreases in serum potassium concentration can be avoided while maintaining adequate potassium removal. Data from kinetic modeling sessions during the HEMO Study of the dependence of serum potassium concentration on time during hemodialysis treatments and 30 minutes postdial...
Source: Hemodialysis International - August 4, 2014 Category: Hematology Authors: Baris U. Agar, Bruce F. Culleton, Richard Fluck, John K. Leypoldt Tags: Original Article Source Type: research
Acute kidney injury in China
Abstract China has a large population and bears a heavy burden of kidney diseases. Acute kidney injury (AKI) is increasingly prevalent in China and is associated with severe morbidity and mortality. The inadequacies of early diagnosis and management remain the major challenges to Chinese nephrologists. There is an urgent need for a nationwide, or even a global effort to increase an awareness of the devastating effects of AKI, to develop professional preventive strategies, as well as to achieve early diagnosis and early intervention. In this article, we review the increasing incidence of AKI and complexity behind prevention...
Source: Hemodialysis International - July 22, 2014 Category: Hematology Authors: Yi Fang, Jie Teng, Xiaoqiang Ding Tags: Special Article Source Type: research
Intermittent hemodialysis treatment in cefepime‐induced neurotoxicity: Case report, pharmacokinetic modeling, and review of the literature
We report the case of an 88‐year‐old female patient with impaired renal function who developed life‐threatening neurologic symptoms during cefepime therapy. She was treated with two intermittent 3‐hour high‐flux, high‐efficiency hemodialysis sessions. Serial pre‐, post‐, and peridialytic (pre‐ and postfilter) serum cefepime concentrations were measured. Pharmacokinetic modeling showed that this dialytic strategy allowed for serum cefepime concentrations to return to the estimated nontoxic range 15 hours earlier than would have been the case without an intervention. The patient made a full clinical recover...
Source: Hemodialysis International - July 22, 2014 Category: Hematology Authors: Laila‐Yasmin Mani, Sébastien Kissling, Dragana Viceic, Bruno Vogt, Michel Burnier, Thierry Buclin, Delphine Renard Tags: Case Report Source Type: research
Nephrotic syndrome and acute renal failure during pegylated liposomal doxorubicin treatment
(Source: Hemodialysis International)
Source: Hemodialysis International - July 15, 2014 Category: Hematology Authors: Pierre‐Louis Carron, Marc Padilla, Jocelyne Maurizi Balzan Tags: Letter to the Editor Source Type: research
Unanticipated concerns in initiating dialysis therapy for very old adults are common
(Source: Hemodialysis International)
Source: Hemodialysis International - July 10, 2014 Category: Hematology Authors: Eli A. Friedman Tags: EDITORIAL Source Type: research