A minimally painful, comfortable, and safe technique for hemodialysis catheter placement in children: Superficial cervical plexus block
Abstract The superficial cervical plexus block (SCPB) is utilized in pediatric patients to perform certain surgical procedures, but there is no evidence supporting its use in hemodialysis catheter placement. We evaluated the analgesic effectiveness, intraoperative complications, and patient satisfaction associated with SCPB for pediatric patients in renal failure undergoing emergent dialysis catheterization. A total of 52 patients ranging from 1 to 17 years old that required emergent dialysis catheter placement and received SCPB were included in this study. During the catheterization, intraoperative pain scores, requiremen...
Source: Hemodialysis International - April 1, 2014 Category: Hematology Authors: Taner Çiftci, Hayrettin Daskaya, Mehmet B. Yıldırım, Haluk Söylemez Tags: Original Article Source Type: research

Sternal instability in a hemodialysis patient with secondary hyperparathyroidism
Abstract A 77‐year‐old man, 11 years under chronic hemodialysis treatment for chronic renal failure of unknown origin, presented with anterior chest pain, dyspnea with paradoxical breathing, and sternal instability after a simple fall from a standing height. Patient underwent three‐vessel coronary artery bypass grafting 31 months ago. Computed tomography with three‐dimensional volume rendering showed sternal nonunion with a great gap between the two halves of the sternum and at least one fracture in the left half of the sternum. A successful surgical repair followed. Patient suffered from severe secondary hyperpara...
Source: Hemodialysis International - April 1, 2014 Category: Hematology Authors: Theodoros Eleftheriadis, Georgia Antoniadi, Konstantinos Leivaditis, Georgios Pissas, Vassilios Liakopoulos, Ioannis Stefanidis Tags: Case Report Source Type: research

Chryseobacterium meningosepticum in a parapneumonic effusion in a chronic kidney disease patient on hemodialysis
We report a case where the bacterium was isolated from the pleural fluid from a chronic kidney disease patient on hemodialysis, who developed pneumonia with complicated parapneumonic effusion. To the best of our knowedge, this is the first case where C. meningosepticum is isolated from the pleural effusion, from India. (Source: Hemodialysis International)
Source: Hemodialysis International - April 1, 2014 Category: Hematology Authors: Vanitha Gnanasoundran, Edwin Fernando M, Senthil Kumar, Raj Kumar, Thiruma Valavan, Chandra Mohan, Noor Mohammed, Srinivasa Prasad Tags: Case Report Source Type: research

Association between vascular access type and patient mortality among elderly patients on hemodialysis in Canada
Abstract Optimal vascular access in elderly patients requires consideration of the benefits and risks in a population with increased comorbidity and mortality. Our objective was to examine the association between vascular access type and patient mortality by age category among incident adult hemodialysis patients registered in the Canadian Organ Replacement Register between 2001 and 2010. We also describe the secular trend in incident and prevalent vascular access use. We used a Cox proportional hazards model to evaluate the overall mortality in patients aged less than 65, 65–74, 75–85, and greater than 85 year...
Source: Hemodialysis International - March 18, 2014 Category: Hematology Authors: Joyce C. Zhang, Ahmed A. Al‐Jaishi, Yingbo Na, Eric Sa, Louise M. Moist Tags: Original Articles Source Type: research

Impact of inflammation on anti‐oxidative effects of vitamin E‐coated membrane dialyzer in patients on chronic hemodialysis
Abstract Hemodialysis (HD) with the use of vitamin E‐coated membrane (VEM) dialyzers is shown to exert anti‐inflammatory and antioxidative effects in patients with end‐stage renal disease on HD. However, the association of baseline inflammatory status with the antioxidative effects of VEM has not been investigated thus far. Thirty‐five stable end‐stage renal disease patients treated with VEM for 6 months were enrolled in the present prospective, observational cohort study. For the previous 3 months minimum, 17 (48%) patients were dialyzed with a cellulose, eight (23%) patients with a hemophane, and 10 (29%) patie...
Source: Hemodialysis International - March 18, 2014 Category: Hematology Authors: Dimitrios Kirmizis, Aikaterini Papagianni, Georgios Efstratiadis, Dimitrios Memmos Tags: Original Article Source Type: research

Endovascular treatment of arteriovenous graft pseudoaneurysms, indications, complications, and outcomes: A systematic review
Abstract There are limited data regarding endovascular treatment of arteriovenous graft (AVG) pseudoaneurysms using stent grafts. We performed a comprehensive literature review on the use of stent grafts in the treatment of AVG pseudoaneurysms. We included 10 studies (121 patients). The mean AVG age was 3.1 years (95% confidence interval [CI]: 2.2–4) and pseudoaneurysm mean diameter was 34 mm (95% CI: 23–46). The majority (71%) of the pseudoaneurysms were located on the arterial limb of the AVG and 77% presented with venous anastomosis stenosis requiring angioplasty. The mean number of stents used to tre...
Source: Hemodialysis International - March 16, 2014 Category: Hematology Authors: Marius C. Florescu, Fang Qiu, Troy J. Plumb, Jennifer A. Fillaus Tags: Original Article Source Type: research

Gender, low Kt/V, and mortality in Japanese hemodialysis patients: Opportunities for improvement through modifiable practices
Abstract Guidelines have recommended single pool Kt/V > 1.2 as the minimum dose for chronic hemodialysis (HD) patients on thrice weekly HD. The Dialysis Outcomes and Practice Patterns Study (DOPPS) has shown that “low Kt/V” (1 year and receiving thrice weekly dialysis. Logistic regression models estimated the relationships of patient characteristics with Kt/V. Logistic models also were used to estimate the proportion of low Kt/V cases attributable to various treatment practices. Multivariable Cox regression was used to estimate the associations of low Kt/V, blood flow rate (BFR), and treatment ...
Source: Hemodialysis International - February 24, 2014 Category: Hematology Authors: Naoki Kimata, Angelo Karaboyas, Brian A. Bieber, Ronald L. Pisoni, Hal Morgenstern, Brenda W. Gillespie, Akira Saito, Tadao Akizawa, Shunichi Fukuhara, Bruce M. Robinson, Friedrich K. Port, Takashi Akiba Tags: Original Article Source Type: research

Enhanced expression of hemoglobin scavenger receptor and heme oxygenase‐1 is associated with aortic valve stenosis in patients undergoing hemodialysis
Abstract A high prevalence and a rapid progression of aortic valve stenosis (AS) in patients undergoing hemodialysis (HD) has been reported. In these circumstances, intraleaflet hemorrhage of aortic valve may be related to the development of AS in HD patients. We immunohistochemically examined the relationship among intraleaflet hemorrhage, neovascularization, hemoglobin scavenger receptor (CD163), and heme oxygenase‐1 (HO‐1) using surgically resected aortic valve specimens from AS patients undergoing HD. The study population consisted of 26 HD patients and 25 non‐HD patients with severe AS who had undergone aortic v...
Source: Hemodialysis International - February 24, 2014 Category: Hematology Authors: Mayumi Inaba, Kenichi Sugioka, Takahiko Naruko, Kei Yunoki, Yasuyuki Kato, Toshihiko Shibata, Takeshi Inoue, Masahiko Ohsawa, Minoru Yoshiyama, Makiko Ueda Tags: Original Article Source Type: research

Intradialytic hypotension: Frequency, sources of variation and correlation with clinical outcome
In conclusion, IH frequency was highly variable, associated with individual facilities, patient and treatment characteristics, and correlated with mortality and hospitalization. Identifying practice patterns associated with IH coupled with routine reporting of IH will facilitate medical management and may result in the prevention of IH, decreased mortality, and decreased hospitalization. (Source: Hemodialysis International)
Source: Hemodialysis International - January 27, 2014 Category: Hematology Authors: Jeffrey J. Sands, Len A. Usvyat, Terry Sullivan, Jonathan H. Segal, Paul Zabetakis, Peter Kotanko, Franklin W. Maddux, Jose A. Diaz‐Buxo Tags: Original Article Source Type: research

Vascular access‐related infection in nocturnal home hemodialysis
Abstract Frequent hemodialysis is associated with increased vascular access adverse events. We hypothesized that bacteremia would be more frequent in patients with central venous catheter (CVC) than arteriovenous fistula or arteriovenous graft (AVF/AVG) in nocturnal home hemodialysis (NHHD). We reviewed blood culture reports and concurrent clinical data for a cohort of one hundred eighty‐seven NHHD patients between January 1, 2006 and June 30, 2012. The primary outcome was time to first bacteremia, technique failure, or death after commencing NHHD. Types of bacteremia and clinical consequences were analyzed. Analyses wer...
Source: Hemodialysis International - January 27, 2014 Category: Hematology Authors: Wesley N. Hayes, Karthik Tennankore, Marisa Battistella, Christopher T. Chan Tags: Original Article Source Type: research

Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft
This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long‐term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities,...
Source: Hemodialysis International - January 27, 2014 Category: Hematology Authors: Michael Thompson, Umasankar Mathuram Thiyagarajan, Jacob A. Akoh Tags: Case Report Source Type: research

Severe carbamazepine intoxication unresponsive to albumin‐enhanced continuous venovenous hemodiafiltration with low dialysate flow
Abstract Carbamazepine (CBZ) intoxication can be associated with severe toxicity, including neurological and cardio‐respiratory abnormalities. Highly protein‐bound, CBZ is not removed efficiently through conventional hemodialysis. Charcoal hemoperfusion is the most effective extracorporeal elimination therapy for CBZ intoxication. Recent reports have indicated that continuous venovenous hemodiafiltration (CVVHDF), albumin‐enhanced continuous venovenous hemodialysis, high‐flux hemodialysis and plasma exchange can be as effective as charcoal hemoperfusion. In contrast to recent reports, which demonstrated the effecti...
Source: Hemodialysis International - January 15, 2014 Category: Hematology Authors: Young K. Chung, Kyung Y. Chang, Hoon S. Park, Mi‐Hee Kim, Kang‐Min Lee, Tae‐Seok Lim, Hyung W. Kim Tags: Case Report Source Type: research

Anti‐inflammatory effects of linagliptin in hemodialysis patients with diabetes
We examined 21 diabetic HD patients who were not receiving oral diabetes drugs or insulin therapy and with poor glycemic control (glycated albumin [GA] level,>20%). Linagliptin (5 mg) was administered to the patients daily. The levels of prostaglandin E2 (PGE2), interleukin‐6 (IL‐6), high‐sensitivity C‐reactive protein, GA, blood glucose, and active glucagon‐like peptide‐1 were determined before and 6 months after treatment. Body weight and serum levels of albumin, hemoglobin, total cholesterol, and low‐density lipoprotein cholesterol were also recorded before and after treatment. The levels ...
Source: Hemodialysis International - January 10, 2014 Category: Hematology Authors: Yuya Nakamura, Mayumi Tsuji, Hitomi Hasegawa, Kengo Kimura, Kiichiro Fujita, Michiyasu Inoue, Tatsuo Shimizu, Hiromichi Gotoh, Yoshikazu Goto, Masahiro Inagaki, Katsuji Oguchi Tags: Original Article Source Type: research

Inverse association between docosahexaenoic acid and mortality in patients on hemodialysis during over 10 years
Abstract We have previously conducted a cohort study to investigate n‐3 polyunsaturated fatty acids (PUFAs) in red blood cells (RBCs) and risk of all‐cause mortality in hemodialysis (HD) patients over 5 years and found that n‐3 PUFAs, especially docosahexaenoic acid (DHA), might be an independent predictor of all‐cause mortality. In the present study, we extended the study for another 5 years to determine whether DHA levels in RBCs still predict the mortality of HD patients during a 10‐year study period. The study cohort consisted of 176 patients (64.1 ± 12.0 [mean ± stan...
Source: Hemodialysis International - January 10, 2014 Category: Hematology Authors: Yoshihiro Terashima, Kei Hamazaki, Miho Itomura, Shin Tomita, Masahiro Kuroda, Hitoshi Hirata, Tomohito Hamazaki, Hidekuni Inadera Tags: Original Article Source Type: research

Anatomical factors associated with left innominate vein stenosis in hemodialysis patients
Abstract Central venous stenosis remains a challenge in hemodialysis patients. Venograms have shown that left innominate vein (LIV) stenosis often occurs in front of the trachea, where it crosses the aortic arch, suggesting that there may be an anatomical factor involved, such as iliac vein compression syndrome. The goal of this study was to determine whether LIV stenosis can be attributed to compression. From September 2008 to December 2011, 19 hemodialysis patients (ten women, nine men) with symptomatic venous hypertension of the upper‐left extremity were enrolled in this study. Venography and multidetector computed to...
Source: Hemodialysis International - January 10, 2014 Category: Hematology Authors: Yaxue Shi, Jiejun Cheng, Yanyan Song, Jiwei Zhang Tags: Original Article Source Type: research

2013 List of Reviewers
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Tags: 2013 List of Reviewers Source Type: research

VI Congress of the International Society for Hemodialysis Buenos Aires, Argentina September 11–14, 2013
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Tags: Abstracts Source Type: research

Subject Index
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Tags: Indexes to Abstracts Source Type: research

Author Index
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Tags: Indexes to Abstracts Source Type: research

Hemodialysis Abstracts from the 34th Annual Dialysis Conference Atlanta, Georgia February 8–11, 2014
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Tags: Abstracts Source Type: research

High‐dose hemodialysis: Time for a change
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Authors: Eero Honkanen, Ian Hazel, Deborah Zimmerman Tags: Editorial Source Type: research

Preface
(Source: Hemodialysis International)
Source: Hemodialysis International - January 8, 2014 Category: Hematology Authors: Christopher R. Blagg Tags: Preface Source Type: research

Esophageal actinomycosis in a patient with end‐stage renal disease
We report a case of esophageal actinomycosis in an end‐stage renal disease patient. A 28‐year‐old lady, known case of systemic lupus erythematosus, hepatitis B virus infection with end‐stage renal disease on regular maintenance hemodialysis since 5 years presented with history of epigastric pain and odynophagia for 1 week. Her upper gastrointestinal endoscopic examination revealed extensive necrotic areas with membrane in the esophagus. Histopathology revealed actinomycotic colonies and bacterial clumps. She was treated with intravenous penicillin followed by oral ampicillin for 6 months. She showed marked clinical...
Source: Hemodialysis International - January 7, 2014 Category: Hematology Authors: Shankar Prasad Nagaraju, Dilip Ashok Kirpalani, Aditya S. Bhabhe, Raghvendra Prasad, Hardik Shah, Ashok L. Kirpalani Tags: Case Report Source Type: research

Reprocessing high‐flux polysulfone dialyzers does not negatively impact solute removal in short‐daily online hemodiafiltration
Abstract There are no studies evaluating the impact of dialyzer reprocessing on solute removal in short‐daily online hemodiafiltration (OL‐HDF). Our aim was to evaluate the impact of dialyzer reuse on solute removal in daily OL‐HDF and compare with that in high‐flux short‐daily hemodialysis (SDH). Fourteen patients undergoing a SDH program were included. Pre‐dialysis and post‐dialysis blood samples and effluent dialysate were collected in the 1st, 7th, and 13th dialyzer uses in SDH sessions and in daily OL‐HDF sessions. Directly quantified small solute (urea, phosphorus, creatinine, and uric acid) total mas...
Source: Hemodialysis International - January 7, 2014 Category: Hematology Authors: Natalia C. V. Melo, Rosa M. A. Moyses, Rosilene M. Elias, Manuel C. M. Castro Tags: Original Article Source Type: research

Complication of diagnostic pleural aspiration: Is it of value in hemodialysis patients?
Abstract Pleural effusions are common in hemodialysis patients and are associated with significant morbidity. Diagnostic pleural aspiration and subsequent biochemical analysis can be used to differentiate exudates and transudates. In particular, Light's criteria have been validated in the general population although their efficacy in hemodialysis patients is unclear. Furthermore, aspiration is not without risk; we report the case of a life‐threatening thoracic bleed as a complication of diagnostic thoracocentesis in a hemodialysis patient, in whom a transudative effusion was misclassified according to Light's criteria. R...
Source: Hemodialysis International - January 7, 2014 Category: Hematology Authors: Richard W. Corbett, Damien R. Ashby Tags: Case Report Source Type: research

The level of C‐reactive protein in chronic hemodialysis patients: A comparative study between patients with noninfected catheters and arteriovenous fistula in two large Gulf hemodialysis centers
Abstract Hemodialysis (HD) patients have greater morbidity and mortality when they have a central venous catheter (CVC) rather than an arteriovenous fistula (AVF) access. Inflammation associated with dialysis catheter use and resultant higher C‐reactive protein (CRP) levels could have an independent adverse effect on patient outcomes. In this prospective study, we investigated whether HD catheters induce inflammation independent of infection. We compared the mean levels of the inflammatory marker (CRP) in 67 patients on maintenance HD using noninfected catheters with 86 HD patients using AVFs at Prince Salman Center for ...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Alaa A. Sabry, Eid M. Elshafey, Khalid Alsaran, Medhat Shalaby, Sherrine Alsherbeiny, Mohamed Abdelkader Tags: Original Article Source Type: research

In‐center hemodialysis attendance: Patient perceptions of risks, barriers, and recommendations
Abstract Missed hemodialysis treatments lead to increased morbidity and mortality in the end‐stage renal disease population. Little is known about why patients have difficulty attending their scheduled in‐center dialysis treatments. Semistructured interviews with 15 adherent and 15 nonadherent hemodialysis patients were conducted to determine patients' attitudes about dialysis, health beliefs and risk perception regarding missed treatments, barriers and facilitators to hemodialysis attendance, and recommendations to improve the system to facilitate dialysis attendance. Average time on dialysis was 2.5 years for the non...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Kara B. Chenitz, Michael Fernando, Judy A. Shea Tags: Special Article Source Type: research

Aerobic exercise increases phosphate removal during hemodialysis: A controlled trial
Abstract Previous studies have suggested that exercise during hemodialysis (HD) could increase the efficacy of solute removal, although this hypothesis has not been conclusively evaluated. The goal of this study was to compare the removal of low‐molecular weight solutes between HD sessions, with and without aerobic exercise. It was a controlled clinical trial, including HD patients in a randomly cross‐over design, such that each patient received a HD session with exercise (intervention) and the next one without exercise (control), three times each. In the exercise sessions, patients pedaled on a cycle ergometer for 60 ...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Rafael Orcy, Maria Fernanda Antunes, Tamires Schiller, Thamires Seus, Maristela Böhlke Tags: Original Article Source Type: research

Which fluid space is affected by ultrafiltration during hemodiafiltration?
Abstract Ultrafiltration (UF) is a common procedure performed during almost all dialysis sessions. During UF, several liters of fluid are removed; however, what proportion of this fluid is removed from which fluid space could not be clinically measured easily until now; we designed this study to evaluate the fluid spaces most affected by UF. This is a prospective cohort study of 40 prevalent chronic hemodialysis patients receiving thrice weekly hemodiafiltration (HDF). We measured the patients' fluid spaces using a whole‐body bioimpedance apparatus to evaluate the changes of fluid spaces before and immediately after the ...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Mihály B. Tapolyai, Mária Faludi, Tibor Fülöp, Neville R. Dossabhoy, Anita Szombathelyi, Klára Berta Tags: Original Article Source Type: research

Revisiting the association between altitude and mortality in dialysis patients
Abstract It was recently reported that residential altitude is inversely associated with all‐cause mortality among incident dialysis patients; however, no adjustment was made for key case‐mix and laboratory variables. We re‐examined this question in a contemporary patient database with comprehensive clinical and laboratory data. In a contemporary 8‐year cohort of 144,892 maintenance dialysis patients from a large dialysis organization, we examined the relationship between residential altitude and all‐cause mortality. Using data from the US Geological Survey, the average residential altitudes per approximately 43,...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Bryan B. Shapiro, Elani Streja, Connie M. Rhee, Miklos Z. Molnar, Leeka Kheifets, Csaba P. Kovesdy, Joel D. Kopple, Kamyar Kalantar‐Zadeh Tags: Original Article Source Type: research

Heparin‐induced thrombocytopenia due to heparin lock in a hemodialysis patient: A case report
We report a 58‐year‐old woman with acute kidney injury because of obstructive uropathy who developed HIT after heparin‐free hemodialysis. She was found to have severe thrombocytopenia with deep vein thrombosis of left lower limb and arterial thrombosis of the right anterior and middle cerebral arteries. The heparin‐platelet factor 4 antibody was positive and she was put on plasmapharesis. However, her condition further deteriorated and succumbed shortly. Heparin lock solution in the hemodialysis catheter was believed to be the cause of HIT in our patient. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Koon Ming Chan, Chi Yuen Cheung, Ka Foon Chau Tags: Case Report Source Type: research

Effects of music on complications during hemodialysis for chronic renal failure patients
Abstract The study was planned as a case‐control study to examine the effects of music on some of the complications experienced by chronic renal failure (CRF) patients during hemodialysis. A total of 60 patients (30 intervention and 30 control) diagnosed with end‐stage renal failure undergoing hemodialysis treatment participated in this study. The study was conducted in Manisa Merkez Efendi State Hospital Hemodialysis Unit and Manisa Özel Anemon Hemodialysis between April 2012 and July 2012. The intervention group listened 30 minutes in each session (12 total sessions) Turkish art music at the beginning of the thi...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Adalet Koca Kutlu, Ayşe Gül Eren Tags: Original Article Source Type: research

Hypomagnesemia, chronic kidney disease and cardiovascular mortality: Pronounced association but unproven causation
Abstract Magnesium is as an essential metal implicated in numerous physiological functions of human cells. The kidney plays a crucial role in magnesium homeostasis. In advanced chronic kidney disease, serum magnesium levels are increased. Data from experimental and observational studies suggest that low levels of magnesium are associated with several factors, such as insulin resistance, diabetes, oxidative stress, hypertension, atherosclerosis, and inflammation which are implicated in the progression of chronic kidney disease. Moreover, low levels of magnesium have been correlated with cardiovascular disease and all‐caus...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Periklis Dousdampanis, Konstantina Trigka, Costas Fourtounas Tags: Review Article Source Type: research

Predictive value of serum myeloperoxidase activity for thrombosis of arteriovenous fistulas
Abstract Myeloperoxidase is a proinflammatory protein that appears as a result of increased oxidative stress. It plays an important role in the promotion and progression of atherosclerosis. The aim of this study was to determine the importance of MPO as a predictive parameter for thrombosis of arteriovenous fistula (AVF). The study involved monitoring patients with AVFs for hemodialysis over a period of 2 years. There were 41 patients, 19 (46%) men and 22 (54%) women, with mean age of 65 ± 12.7 years. Routine laboratory analyses were carried out in all respondents, including determination of MPO concen...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Radojica V. Stolic, Trajkovic Z. Goran, Mirjana Kostic, Dragica Z. Stolic, Dijana J. Miric, Bojana M. Kisic, Slavica D. Pajovic, Vladan M. Peric Tags: Original Article Source Type: research

Association of blood pressure with all‐cause mortality and stroke in Japanese hemodialysis patients: The Japan dialysis outcomes and practice pattern study
Abstract The association of low blood pressure (BP) with high mortality is a characteristic for hemodialysis patients. This analysis clarifies the association of BP with mortality and stroke in Japanese hemodialysis (HD) patients and examines the association separately for patients with and without antihypertensive medication (BP meds). We analyzed 9134 patients from Japan in phases 1–4 (1999–2011) of the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective cohort study of in‐center HD patients. The association of patient systolic (SBP) and diastolic (DBP) blood pressure with all‐cause and c...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Masaaki Inaba, Angelo Karaboyas, Takashi Akiba, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Christian Combe, Bruce M. Robinson Tags: Original Article Source Type: research

Anticoagulation, delivered dose and outcomes in CRRT: The program to improve care in acute renal disease (PICARD)
Abstract Delivered dialysis dose by continuous renal replacement therapies (CRRT) depends on circuit efficacy, which is influenced in part by the anticoagulation strategy. We evaluated the association of anticoagulation strategy used on solute clearance efficacy, circuit longevity, bleeding complications, and mortality. We analyzed data from 1740 sessions 24 h in length among 244 critically ill patients, with at least 48 h on CRRT. Regional citrate, heparin, or saline flushes was variably used to prevent or attenuate filter clotting. We calculated delivered dose using the standardized Kt/Vurea. We monitored f...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Rolando Claure‐Del Granado, Etienne Macedo, Sharon Soroko, YeonWon Kim, Glenn M. Chertow, Jonathan Himmelfarb, T. Alp Ikizler, Emil P. Paganini, Ravindra L. Mehta Tags: Original Article Source Type: research

Non catheter‐related bacteremia caused by Pseudomonas oryzihabitans in a patient undergoing hemodialysis
We report the first case of P. orizyhabitans bacteremia in a chronic hemodialysis patient; this patient did not have a central venous catheter angioaccess as a potential portal of entry. (Source: Hemodialysis International)
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Elias Hellou, Suheil Artul, Sohaib Omari, Mohamad Taha, Zaher Armaly, William Nseir Tags: Case Report Source Type: research

Evaluation of the oral health status in Chinese hemodialysis patients
This study was aimed to evaluate the dental health status and oral hygiene behavior of the HD patients in China. Patients undergoing HD therapy at two hospitals were asked to finish a questionnaire and receive dental examination (DMF‐T). A total of 306 patients, aged 24–88 (58.09 ± 14.06), took part in this study. Although majority of the patients (77.78%) brushed their teeth at least twice a day, few (less than 5%) had ever used dental floss or mouthwash. More than half of the patients have not visited a dentist since the commencement of HD therapy. The dental examination showed that DMF‐T w...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Tian Xie, Ziliang Yang, Guanyu Dai, Kaixiao Yan, Yuan Tian, Dan Zhao, Huawei Zou, Fei Deng, Xiaolei Chen, Quan Yuan Tags: Original Article Source Type: research

Hemodialysis‐induced changes in the blood composition affect function of the endothelium
Abstract Hemodialysis induces oxidative stress causing intravascular inflammation, which may cause endothelial dysfunction. We evaluated how hemodialysis‐induced changes in blood affect the function of endothelial cells in in vitro culture. Serum samples were collected from 42 uremic patients treated with hemodialysis, one before the start of dialysis and the other one at the end of session. All patients were dialysed with polysulfone dialyzer. Concentrations of the inflammatory molecules carbonyl protein and metabolites of NO synthesis were measured in blood. Additionally, the effect of the serum obtained before and aft...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Oleśkowska‐Florek Weronika, Połubinska Alicja, Baum Ewa, Matecka MONIKA, Pyda Małgorzata, Pawlaczyk Krzysztof, Bręborowicz Andrzej Tags: Original Article Source Type: research

Geographic disparities in arteriovenous fistula placement in patients approaching hemodialysis in the United States
Abstract Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD). Several factors associated with AVF placement have been identified (e.g., age, sex, race, comorbidities). We hypothesized that geographic location of patient residence might be associated with the probability of AVF placement as the initial access. We used the data from the United States Renal Data System (USRDS) database (2005–2008) linked to Medicare claims (2003–2008). Logistic regression was used to estimate specific characteristics of population associated with the AVF as first access placed or attempted for HD ini...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Alexander S. Goldfarb‐Rumyantzev, Wajih Syed, Bhanu K. Patibandla, Akshita Narra, Ranil Desilva, Varun Chawla, Tammy Hod, Yael Vin Tags: Original Article Source Type: research

A miniseries of spontaneous intramural esophageal hematoma in hemodialysis patients: A rare cause of dysphagia
We report a miniseries of 3 patients on hemodialysis, who developed IEH. All 3 of them presented with sudden onset and progressively worsening dysphagia and hematemesis. Diagnosis of IEH was established by upper gastrointestinal endoscopy. All patients were managed conservatively, and symptoms of dysphagia and chest pain improved within 6–8 days. Good resolution of hematoma was noted by repeat endoscopy within 2–3 weeks. The reported case of IEH in hemodialysis patients is rare and needs to be identified early when patients present with dysphagia, as anticoagulation during hemodialysis would possibly worsen the...
Source: Hemodialysis International - January 1, 2014 Category: Hematology Authors: Vinod Kumar, Mallikarjuna Hm, Gokulnath Tags: Case Report Source Type: research

Lactic acidosis induced metformin in a chronic hemodialysis patient with diabetes mellitus tip 2
We describe a chronic hemodialysis patient treated with metformin, presenting to the nephrology department with altered mental status. (Source: Hemodialysis International)
Source: Hemodialysis International - December 3, 2013 Category: Hematology Authors: Eda Altun, Bülent Kaya, Saime Paydaş, Barış Sarıakçalı, İbrahim Karayaylalı Tags: Case Report Source Type: research

Lactic acidosis induced by metformin in a chronic hemodialysis patient with diabetes mellitus type 2
We describe a chronic hemodialysis patient treated with metformin, presenting to the nephrology department with altered mental status. (Source: Hemodialysis International)
Source: Hemodialysis International - December 3, 2013 Category: Hematology Authors: Eda Altun, Bülent Kaya, Saime Paydaş, Barış Sarıakçalı, İbrahim Karayaylalı Tags: CASE REPORT Source Type: research

High Hemoglobin A1c levels and glycemic variability increase risk of severe hypoglycemia in diabetic hemodialysis patients
Abstract While hyperglycemia is central to the pathogenesis and management of diabetes mellitus, hypoglycemia and glucose variability also contribute to outcomes. We previously reported on the relationship of glycemic control to outcomes in a large population of diabetic end‐stage renal disease (ESRD) patients. Recognizing that ESRD is a risk factor for severe hypoglycemia, we have now analyzed the association between glycosylated hemoglobin A1c (HgbA1c) levels and glycemic variability in those with hypoglycemia. This is a retrospective study of patients with diabetes enrolled in a large hemodialysis program. Hypoglycemi...
Source: Hemodialysis International - November 26, 2013 Category: Hematology Authors: Mark E. Williams, Rajesh Garg, Weiling Wang, Ronilda Lacson, Franklin Maddux, Eduardo Lacson Tags: Original Article Source Type: research

Effect of a hydrogen (H2)‐enriched solution on the albumin redox of hemodialysis patients
In conclusion, the application of H2‐enriched solutions could ameliorate OS during HD. (Source: Hemodialysis International)
Source: Hemodialysis International - November 26, 2013 Category: Hematology Authors: Hiroyuki Terawaki, Wan‐Jun Zhu, Yukie Matsuyama, Tomoyoshi Terada, Yasuhito Takahashi, Kaoru Sakurai, Shigeru Kabayama, Mariko Miyazaki, Noritomo Itami, Ryoichi Nakazawa, Sadayoshi Ito, Seiichi Era, Masaaki Nakayama Tags: Original Article Source Type: research

Patient mood flux on‐ and off‐hemodialysis
Abstract Mood in hemodialysis patients is most often evaluated off‐dialysis, possibly underestimating mood during dialysis. We compared mood in patients on‐ and off‐dialysis using the Positive and Negative Affect Schedule for 6 consecutive days. Initially, scores are normal, but subsequently positive affect falls below, and negative affect increases above, off‐dialysis values, suggesting increasing depression and anxiety, particularly in women. Quality‐of‐life questions confirm the effects of the dialysis session on mood. Prevalence and severity of depression evaluated off‐dialysis, or once only, may be under...
Source: Hemodialysis International - November 26, 2013 Category: Hematology Authors: Micah Leshem, Wisam Sliman, Souzan Taweel, Rana Shamshoum, Zaher Armaly Tags: Original Article Source Type: research

Role of sodium thiosulfate therapy in the treatment of digital necrosis due to Mönckeberg sclerosis
We describe a 56‐year‐old Hispanic male with a history of end‐stage renal disease, diabetes mellitus type 2, and medical noncompliance who developed sequential digital ischemia and necrosis involving both hands as well as right foot as a result of Mönckeberg sclerosis. An extensive metabolic and serologic workup was unrevealing but radiographic studies and histopathology revealed the diagnosis. A multifaceted approach was instituted including wound debridement and amputations along with intensive medical support. In addition to improving hypertensive control and striving for improved calcium and phosphate balanc...
Source: Hemodialysis International - November 25, 2013 Category: Hematology Authors: Michael Brucculeri, Eugenia Rullan, Antonela Zanchi, Anthony Marcotte Tags: Case Report Source Type: research

Reversible hyperglycemic encephalopathy in a hemodialysis patient
(Source: Hemodialysis International)
Source: Hemodialysis International - November 22, 2013 Category: Hematology Authors: Chia‐Ter Chao Tags: Letter to the Editor Source Type: research

Radioisotope blood volume measurement in hemodialysis patients
We report the first study of BV measurement for assessing volume status in HD patients using the indicator dilutional method. Ten adult HD patients were enrolled in this prospective observational study. BV measurement was performed before and after HD using BV analysis (BVA)‐100 (Daxor Corporation, New York, NY, USA). BVA‐100 calculates BV using radiolabeled albumin (Iodine‐131) followed by serial measures of the radioisotope. Fluid loss from the extravascular space was calculated by subtracting the change in BV from total weight loss. Intradialytic changes in RBV were measured by CLM‐III. Eight out of 10 cases had...
Source: Hemodialysis International - November 22, 2013 Category: Hematology Authors: Sonika Puri, Jun‐Ki Park, Frank Modersitzki, David S. Goldfarb Tags: Original Article Source Type: research

Improving arteriovenous fistula rate: Effect on hemodialysis quality
Abstract Vascular access (VA) is the lifeline for patients with end‐stage renal disease on regular hemodialysis (HD). Tunneled catheters have been associated with increased risk of luminal thrombosis, infection, hospitalization, and high cost. Our aims were to follow the “Fistula First Initiative,” avoid or reduce the rate of catheter insertion, improve the rate of arteriovenous fistula (AVF) use, and study the effect of increased AVF use on quality of dialysis and patient's outcome. A VA program has been established in collaboration with an enthusiastic and professional vascular surgery team to manage 358 pa...
Source: Hemodialysis International - October 28, 2013 Category: Hematology Authors: Ayman Karkar, Ahmed Chaballout, Maher Haj Ibrahim, Mohammed Abdelrahman, Mona Al Shubaili Tags: Original Article Source Type: research