The permanent catheter
Abstract An elderly woman receiving hemodialysis via a right brachiocephalic arteriovenous fistula presented to the clinic for elective removal of a tunneled hemodialysis catheter inserted 5 years ago. The catheter had not been removed earlier at the patient's request. Removal was now unsuccessful in the clinic. Exploration in the operating room revealed the innominate vein had fibrosed around the length of the catheter. The procedure was abandoned, catheter cut short and the remnant left in situ. This case serves as a reminder to exercise caution if there is difficulty in removing the catheter even after the cuff is disse...
Source: Hemodialysis International - October 28, 2013 Category: Hematology Authors: Ek Khoon Tan, Seck Guan Tan Tags: Case Report Source Type: research
Development of bullous pemphigoid after change of dialysis membrane
Abstract A 75‐year‐old Japanese man presented with pruritic blisters and macules on his trunk and extremities. He had been on hemodialysis for 4 years because of chronic renal failure, and in recent months, a polymethylmethacrylate membrane had been used for dialysis. After a change in dialysis membrane to a cellulose triacetate membrane, pruritic tense blisters developed on the extremities in combination with marked blood eosinophilia. Physical examination showed erythematous macules and tense blisters on the trunk and extremities. A biopsy specimen of an erythematous macule showed subepidermal vesicles and eosinophil...
Source: Hemodialysis International - October 28, 2013 Category: Hematology Authors: Kinuyo Sodemoto, Junya Yamahana, Takeshi Echigo, Chihiro Nishijima, Yuka Shimada, Makoto Inaoki Tags: Case Report Source Type: research
Correlates of ADL difficulty in a large hemodialysis cohort
Abstract Needing assistance with activities of daily living (ADL) is an early indicator of functional decline and has important implications for individuals' quality of life. However, correlates of need for ADL assistance have received limited attention among patients undergoing maintenance hemodialysis (HD). A multicenter cohort of 742 prevalent HD patients was assessed in 2009–2011 and classified as frail, prefrail and nonfrail by the Fried frailty index (recent unintentional weight loss, reported exhaustion, low grip strength, slow walk speed, low physical activity). Patients reported need for assistance with 4 AD...
Source: Hemodialysis International - October 9, 2013 Category: Hematology Authors: Nancy G. Kutner, Rebecca Zhang, Richard M. Allman, C. Barrett Bowling Tags: Original Article Source Type: research
Late onset of clinically apparent central vein stenosis due to previous central venous catheter in a patient with inherited thrombophilia
We describe a case of a patient with a functional kidney transplant who was admitted to our department with clinically evident central vein stenosis (CVS) 7 years after the removal of a central venous catheter (CVC) from the right internal jugular vein. The catheter was used as a hemodialysis access for a 2‐month period. In the interval before his last admission, the patient suffered two episodes of deep vein thrombosis. Investigation revealed heterozygosity for factor V Leiden, the most common inherited thrombophilia encountered in 5% of Caucasians, and anticoagulation treatment was started. Magnetic resonance angiograp...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Theodoros Eleftheriadis, Vassilios Liakopoulos, Georgia Antoniadi, Georgios Pissas, Konstantinos Leivaditis, Ioannis Stefanidis Tags: Case Report Source Type: research
Impaired immune defense in hemodialysis patients: Role of α‐defensins?
Abstract The mechanisms underlying the impaired immune response in hemodialysis (HD) patients are not completely understood. The α‐defensins human neutrophil peptides‐1, 2, and 3 are low molecular weight peptides with antimicrobial activity and important effector molecules of innate immune responses. We now examined the expression of these peptides in HD patients. Seventy‐six patients on chronic HD treatment (mean time on HD 5.8 years; mean age 70 years) were studied and compared with 38 healthy volunteers and 20 patients with infections and normal renal function. Expression of α‐defensins was analyzed ...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Clemens Grupp, Ilka Troche‐Polzien, Christian Noeding, Claudia A. Mueller, Gerhard A. Mueller Tags: Original Article Source Type: research
Toward green dialysis: Focus on water savings
Abstract Hemodialysis is one of the most water and energy‐hungry medical procedures, and thus represents a clear opportunity where improvements should be made concerning the consumption and wastage of water. Three levels were investigated on which there are potential savings: the precise adjustment of water production according to specific needs, the reuse of reverse osmosis rejected water, and finally the huge volumes of post‐patient dialysate effluent. The “AURAL” (Association pour l′Utilisation du Rein Artificiel à Lyon), main unit in Lyon, was the site of investigation for this study, which...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Laurent Ponson, Walid Arkouche, Maurice Laville Tags: Special Article Source Type: research
Does hemodiafiltration reduce vascular stiffness measured by aortic pulse wave velocity compared with high‐flux hemodialysis?
Abstract Hemodialfiltration (HDF) has been reported to reduce the frequency of intradialytic hypotension compared with hemodialysis (HD). We wished to determine whether HDF resulted in improvement of arterial stiffness compared with HD. We reviewed peripheral blood pressure and pulse wave velocity measurements in a cross‐sectional analysis of stable HDF and HD outpatients. One hundred forty‐one HDF patients were matched to 148 HD patients in terms of age, sex, prevalence of diabetes, peripheral blood pressure, and body mass. Pulse wave velocity was not different between the HD and HDF cohorts (median 9.1 [8.0–10....
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Evangelia Charitaki, Andrew Davenport Tags: Original Article Source Type: research
Thrombosed hemodialysis access as an unusual source of emboli in the upper extremity of a kidney transplant recipient
Abstract Arteriovenous fistula (AVF) is no longer used in kidney transplant recipients. However, there is no consensus regarding whether or not to ligate a well‐functioning AVF after successful kidney transplantation, particularly in patients with well and stably functioning kidney transplants. Most AVFs without complications are left in situ and more than one‐third of native AVFs close spontaneously. The currently accepted policy toward thrombosed AVFs is retention within the patient's extremity without treatment. These thrombosed AVFs seldom cause serious problems. However, when combined with aneurysmal dilatation of...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Mi‐Hyeong Kim, Jeong Kye Hwang, Ho Jong Chun, In Sung Moon, Ji Il Kim Tags: Case Report Source Type: research
Effects of citrate‐enriched bicarbonate based dialysate on anticoagulation and dialyzer reuse in maintenance hemodialysis patients
Abstract Systemic anticoagulation with unfractionated heparin is commonly used in maintenance hemodialysis (HD), but it increases the risk of bleeding complications. We investigated whether the use of citrate‐enriched bicarbonate based dialysate (CD) would reduce systemic anticoagulation without compromising the efficacy of reprocessed dialyzers. This is a crossover study in which half of a total of 30 patients initially underwent HD with acetate‐enriched bicarbonate based dialysate and a standard heparin dose of ∼100 IU/kg (Treatment A), whereas the remaining patients were treated with CD and a 30% reduced ...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Amanda D. Rocha, Vanessa C. Padua, Esther Oliveira, Márcia M. Guimaraes, Jocemir R. Lugon, Jorge P. Strogoff de Matos Tags: Original Article Source Type: research
Determinants of hemodialysis‐induced segmental wall motion abnormalities
In conclusion, patients with a history of clinical HF were at higher risk of intradialytic worsening of segmental WM. Further studies are needed to determine the mechanism of this association and whether cardioprotective medications could ameliorate this adverse cardiac effect of hemodialysis. (Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Ruth F. Dubin, Alexis L. Beatty, John R. Teerlink, Nelson B. Schiller, Ann F. Bolger, Dean Alokozai, Carmen A. Peralta, Kirsten L. Johansen Tags: Original Article Source Type: research
Quality of life in dialysis: A Malaysian perspective
Abstract There is a growing interest to use quality of life as one of the dialysis outcome measurement. Based on the Malaysian National Renal Registry data on 15 participating sites, 1569 adult subjects who were alive at December 31, 2012, aged 18 years old and above were screened. Demographic and medical data of 1332 eligible subjects were collected during the administration of the short form of World Health Organization Quality of Life questionnaire (WHOQOL‐BREF) in Malay, English, and Chinese language, respectively. The primary objective is to evaluate the quality of life among dialysis patients using WHOQOL‐BREF. T...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Wen J. Liu, Ramli Musa, Thian F. Chew, Christopher T. S. Lim, Zaki Morad, Adam Bujang Tags: Original Article Source Type: research
Factors predicting failure of AV “fistula first” policy in the elderly
Abstract An arteriovenous fistula (AVF) is the preferential hemodialysis (HD) access. The goal of this study was to identify factors associated with pre‐dialysis AVF failure in an elderly HD population. We used United States Renal Data System + Medicare claims data to identify patients ≥67 years old who had an AVF as their initial vascular access placed pre‐dialysis. Failure of the AVF to be used for initial HD, was used as the outcome. Logistic regression model was used to identify factors associated with AVF failure. The study cohort consisted of 20,360 subjects (76.2 ± 6.02 year...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Tammy Hod, Ranil N. DeSilva, Bhanu K. Patibandla, Yael Vin, Robert S. Brown, Alexander S. Goldfarb‐Rumyantzev Tags: Original Article Source Type: research
FGF‐23 and cognitive performance in hemodialysis patients
Abstract Although cognitive impairment is common in hemodialysis patients, the etiology of and risk factors for its development remain unclear. Fibroblast growth factor 23 (FGF‐23) levels are elevated in hemodialysis patients and are associated with increased mortality and left ventricular hypertrophy. Despite FGF‐23 being found within the brain, there are no prior studies assessing whether FGF‐23 levels are associated with cognitive performance. We measured FGF‐23 in 263 prevalent hemodialysis patients in whom comprehensive neurocognitive testing was also performed. The cross‐sectional association between patien...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: David A. Drew, Hocine Tighiouart, Tammy M. Scott, Kristina V. Lou, Li Fan, Kamran Shaffi, Daniel E. Weiner, Mark J. Sarnak Tags: Original Article Source Type: research
Perihospitalization patterns of hemoglobin levels and erythropoiesis‐stimulating agent doses in US hemodialysis patients, 1998–2009
Abstract Anemia management in hemodialysis patients is of primary importance for clinicians and dialysis providers. Through a retrospective claims analysis, we studied prevalent US hemodialysis patients 1998–2009, and examined patterns of hemoglobin levels and erythropoiesis‐stimulating agent (ESA, epoetin [EPO], and darbepoetin [DPO] ) doses surrounding hospitalization events. Medicare outpatient claims were used to determine monthly ESA doses and associated hemoglobin levels. ESA dose trajectories were defined with repeated measures models incorporating an autoregressive covariance matrix that compared sub...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Robert N. Foley, Craig A. Solid, Kenneth Lamb Tags: Original Article Source Type: research
Disparities in arteriovenous fistula placement in older hemodialysis patients
In this study, we assessed whether disparities exist in the type of first hemodialysis access placed prior to dialysis start (rather than that used at dialysis initiation), to detect whether certain disadvantaged groups might have lower likelihood of AVF placement. Study cohort of 118,767 incident hemodialysis patients ≥67 years of age (1/2005–12/2008) derived from the United States Renal Data System was linked with Medicare claims data to identify the type of initial access placed predialysis. We used logistic regression model with outcome being the initial predialysis placement of an AVF as opposed to an arterio...
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: Bhanu K. Patibandla, Akshita Narra, Ranil DeSilva, Varun Chawla, Yael Vin, Robert S. Brown, Alexander S. Goldfarb‐Rumyantzev Tags: Original Article Source Type: research
It is time for “green dialysis”
(Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: John W. M. Agar Tags: Editorial Source Type: research
Dialysis: History, Development and Promise Todd S. Ing, Mohamed A. Rahman, Carl M. Kjellstrand, editors Singapore: World Scientific
(Source: Hemodialysis International)
Source: Hemodialysis International - October 1, 2013 Category: Hematology Authors: John H. Turney Tags: Book Review Source Type: research
Transonic, thermodilution, or ionic dialysance to manage vascular access: Which method is best?
Abstract Regularly monitoring blood flow through a vascular access (Qa) can predict a dysfunction and dramatically reduce the number of thromboses. The aim of our study was to compare two integrated access flow devices, thermodilution (Qa‐BTM: BTM®, Fresenius Medical Care, Bad Homburg, Germany) and ionic dialysance (Qa‐ID: OCM®, Fresenius Medical Care, Bad Homburg, Germany), with the “gold standard” saline dilution (Qa‐T: Transonic®, Systems Inc., Ithaca, NY, USA). Measurements were performed sequentially and were repeated in the first 90 minutes of a single dialysis session in 24 long‐term ...
Source: Hemodialysis International - September 9, 2013 Category: Hematology Authors: Bouchra Badr, Pierre Bories, Richard Marais, Béatrice Prat, Bruno Seigneuric, Nathalie Longlune, Nassim Kamar, Sébastien Maggioni, Lionel Rostaing Tags: Original Article Source Type: research
Objectively measured and self‐reported nonadherence among Jordanian patients receiving hemodialysis
This study assessed nonadherence behavior to diet and fluid restrictions and examined the association between nonadherence behavior and demographic and clinical characteristics among Jordanian adults with end‐stage renal disease receiving hemodialysis. A descriptive, correlational, cross‐sectional design was used. The patients were interviewed within the first 90 minutes of dialysis session using the Dialysis Dietary and Fluid Nonadherence questionnaire (DDFQ). Demographic and clinical data were gathered from the patients and the medical records. The objective markers of dietary and fluid nonadherence (potassium, phosp...
Source: Hemodialysis International - September 9, 2013 Category: Hematology Authors: Amani A. Khalil, Mohammad Waleed Darawad Tags: Original Article Source Type: research
Calcific mitral stenosis in the hemodialysis patient
We present the case of a young lady on chronic dialysis that developed mitral calcification complicated by severe mitral stenosis, caseous calcification and retinal embolization. She subsequently required mitral valve replacement. (Source: Hemodialysis International)
Source: Hemodialysis International - September 9, 2013 Category: Hematology Authors: Adrian Sequeira, Liam Morris, Brijesh Patel, Lucas Duvall, Deepa Gali, Denisse Menendez, Guy Alexander Tags: Case Report Source Type: research
Accomplishment of integrated management for renal replacement therapy in Portugal
(Source: Hemodialysis International)
Source: Hemodialysis International - September 4, 2013 Category: Hematology Authors: Daniele Marcelli, Aileen Grassmann, Pedro Ponce Tags: Letter to the Editor Source Type: research
Thrombosis of the great cerebral vein in a hemodialysis patient
We present the first documented case of thrombosis of the great cerebral vein in a hemodialysis patient. A 29‐year‐old female patient with end‐stage renal disease of unknown etiology was admitted to a hospital with altered consciousness and nausea. Severe headache in the right parietal area had started 2 days before. On examination, she was in the poor overall condition, dysartric, with a severe nystagmus. Urgent brain multislice computerized tomography and magnetic resonance imaging revealed thrombosis of the great cerebral vein with hypodense zones in hypothalamus, thalamus and basal ganglia. She was treated with h...
Source: Hemodialysis International - September 2, 2013 Category: Hematology Authors: Marina Ratkovic, Nikolina Basic‐Jukic, Branka Gledovic, Danilo Radunovic Tags: Case Report Source Type: research
Symptomatic hyperammonemia after lung transplantation: Lessons learnt
We describe three lung transplant recipients who developed acute hyperammonemia early after transplantation. Two of the three patients survived after a multidisciplinary approach including discontinuation of drugs, which impair urea cycle, aggressive ammonia reduction with prolonged daily intermittent hemodialysis (HD), and overnight slow low‐efficiency dialysis in conjunction with early weaning of steroids and other therapeutic measures. Our experience suggests that early initiation of dialysis, high dialysis dose, increased frequency, and HD preferably to less efficient modalities increases survival in these patients. ...
Source: Hemodialysis International - September 2, 2013 Category: Hematology Authors: Siddiq Anwar, Diptesh Gupta, Muhammad A. Ashraf, Syed A. Khalid, Syed M. RIZVI, Brent W. Miller, Daniel C. Brennan Tags: Special Article Source Type: research
Creation of arteriovenous fistulae for hemodialysis in octogenarians
We present our approach to the creation of vascular access for hemodialysis in this demanding population. In 2006–2012, 39 patients aged 85.9 ± 2.05 with end‐stage renal disease, mainly resulting from ischemic nephropathy, were admitted to the Department of Nephrology to establish permanent vascular access for hemodialysis: preferably AVF. Temporary dialysis catheters were implanted in uremic emergency to bridge the time to fistula creation/maturation. AVF was attempted in 87.2% of the patients. Primary AVF function was achieved in 54% of the patients. Cumulative proportional survival of AVF at...
Source: Hemodialysis International - August 14, 2013 Category: Hematology Authors: Ewa Watorek, Tomasz Golebiowski, Mariusz Kusztal, Krzysztof Letachowicz, Waldemar Letachowicz, Hanna Augustyniak Bartosik, Jerzy Garcarek, Katarzyna Madziarska, Wacław Weyde, Marian Klinger Tags: Original Article Source Type: research
Relationship between Geriatric Nutritional Risk Index and total lymphocyte count and mortality of hemodialysis patients
We examined the relationships between Geriatric Nutritional Risk Index (GNRI), total lymphocyte count (TLC), and mortality in hemodialysis (HD) patients. We examined GNRI and TLC in 120 maintenance HD patients and followed these patients for 120 months. Predictors of all‐cause death were examined using life table analysis and the Cox proportional hazards model. TLC marginally correlated with GNRI (r = 0.176; p = 0.090) and significantly with phosphorus levels (r = 0.206; p = 0.026). Life table analysis revealed that subjects with a GNRI
Source: Hemodialysis International - August 14, 2013 Category: Hematology Authors: Yeon Soon Jung, Gain You, Ho Sik Shin, Hark Rim Tags: Original Article Source Type: research
Is there any interaction of resistin and adiponectin levels with protein‐energy wasting among patients with chronic kidney disease
This study had given significant positive correlations between presence of PEW and serum resistin (r: 0.267, p: 0.001), and serum adiponectin levels (r: 0.349, p: 0.0001). There were no relationship between presence of PEW and ghrelin, acylated‐ghrelin, neuropeptide Y, and leptin levels of the groups. CKD patients except transplant patients had higher adiponectin and resistin levels than control group. PEW was found to be linearly correlated with resistin and adiponectin. High serum resistin and adiponectin levels might have a role in development of PEW among dialysis patients. (Source: Hemodialysis International)
Source: Hemodialysis International - August 6, 2013 Category: Hematology Authors: Kubra Kaynar, Birgul V. Kural, Sukru Ulusoy, Muammer Cansiz, Buket Akcan, Nuray Misir, Selcuk Yaman, Nuh Kaya Tags: Original Article Source Type: research
Impact of arterial microcalcification of the vascular access on cardiovascular mortality in hemodialysis patients
In conclusion, vascular access AMiC is a strong risk factor for cardiovascular mortality in HD patients. (Source: Hemodialysis International)
Source: Hemodialysis International - August 6, 2013 Category: Hematology Authors: Yu Seon Yun, Su Jin Choi, Ja young Lee, Young Soo Kim, Sun Ae Yoon, Sun Chul Park, Ok Ran Shin, Eun Joung Jang, Young Ok Kim Tags: Original Article Source Type: research
Microbial quality of hemodialysis water, a survey of six centers in Lagos, Nigeria
The objective of this study was to evaluate the microbial quality of HD water in Lagos, Nigeria. Four sets of pre‐ and post‐treatment water samples, 20 mL each, were collected from six HD centers in Lagos and tested for microbial contamination using the molten Tryptic soy agar in accordance with Association for Advancement of Medical Instrumentation (AAMI) and European Best Practice Guidelines (EBPG). Pyrogen tests were also conducted on pre‐ and post‐treatment samples using standard technique. Information on water treatment modalities, maintenance practices and quality control measures in each center were o...
Source: Hemodialysis International - August 1, 2013 Category: Hematology Authors: Rotimi Williams Braimoh, Monica Omolara Mabayoje, Christiana Oluwatoyin Amira, Babawale Taslim Bello Tags: Original Article Source Type: research
Save life and improve quality: Report from the 5th Congress of International Society for Hemodialysis
Abstract The 5th congress of International Society for Hemodialysis took place last August 3–5, 2012 at the Grand Hotel in Taipei and focused on “Save Life and Improve Quality.” It attracted a total of 927 participants from 18 countries. The full spectrum of hemodialysis was covered with plenary lectures and symposiums delivered by experts from different subspecialties in nephrology starting from the history of hemodialysis, mineral bone disease, microinflammation and advanced techniques in hemodialysis. It was followed by critical care in nephrology, anemia, and nutrition in dialysis. Last but not the le...
Source: Hemodialysis International - July 30, 2013 Category: Hematology Authors: Hung‐Chun Chen, Lee‐Moay Lim, Jer‐Ming Chang, Madhukar Misra Tags: Special Article Source Type: research
Successful tunneled catheter placement in a hemodialysis patient with idiopathic multiple central venous stenoses
Abstract Central venous stenosis (CVS) in hemodialysis patients could be secondary to central venous catheterization, high flow arteriovenous fistula, as well as extrinsic compression. However, we report a senile hemodialysis patient of left internal jugular vein stenosis and right innominate vein occlusion unrelated to any known risk factors. Aided by computed tomography and digital subtraction angiography, we managed to dilate the stenosis by percutaneous balloon angioplasty, followed by successful tunneled catheter placement. Nephrologists should be aware of idiopathic CVS and its impact on the creation and preservation...
Source: Hemodialysis International - July 24, 2013 Category: Hematology Authors: Yuliang Zhao, Tianlei Cui, Yang Yu, Fang Liu, Ping Fu, Li Zhou, Xiao Li Tags: Case Report Source Type: research
Erythrocyte folate status and serum iron levels in patients undergoing hemodialysis
Abstract The present study was aimed to evaluate erythrocyte folate and the iron levels in diabetes and hypertension patients treated with/without hemodialysis. The effects of erythropoietin and iron treatment as well as vitamin supplementation on measured parameters were considered. The 67 controls consisted of healthy subjects (n = 22), hypertensive subjects (n = 22), and diabetic subjects (n = 23) without any renal disorder. According to primary renal disorders, the patients undergoing hemodialysis (n = 68) were classified into four groups as diabetic nephropathy, ...
Source: Hemodialysis International - July 21, 2013 Category: Hematology Authors: Saziye Sezin Palabiyik, Terken Baydar, Ramazan Cetinkaya, Anil Barak Dolgun, Gönül Sahin Tags: Original Article Source Type: research
Platelet‐to‐Lymphocyte Ratio: One of the novel and valuable platelet indices in hemodialysis patients
(Source: Hemodialysis International)
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Kultigin Turkmen Tags: Letter to the Editor Source Type: research
Epicardial fat thickness is associated with impaired coronary flow reserve in hemodialysis patients
Abstract Cardiovascular disease (CVD) is the main cause of mortality in hemodialysis (HD) patients. Epicardial fat tissue (EFT) is a new risk factor in CVD. The aim of this study was to evaluate the association between EFT and coronary artery flow reserve (CFR), which is an early indicator of endothelial dysfunction in coronary vessels of HD patients. We performed a cross‐sectional study including 71 chronic HD patients and 65 age‐ and sex‐matched healthy controls. Epicardial fat tissue was significantly higher in HD patients when compared to healthy controls (6.53 ± 1.01 mm vs. 5.79&thins...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Aydin Atakan, Beyza Macunluoglu, Yuksel Kaya, Elif Ari, Halit Demir, Ebru Asicioglu, Cigdem Kaspar Tags: Original Article Source Type: research
The neutrophil lymphocyte ratio level in patients with end‐stage renal disease
(Source: Hemodialysis International)
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Sevket Balta, Sait Demırkol, Ugur Kucuk Tags: Letter to the Editor Source Type: research
TSAT is a better predictor than ferritin of hemoglobin response to Epoetin alfa in US dialysis patients
Abstract Clinical guidelines recommend concurrent treatment of anemia in end‐stage renal disease with erythropoiesis‐stimulating agents (ESAs) and iron. However, there are mixed data about optimal iron supplementation. To help address this gap, the relationship between iron markers and hemoglobin (Hb) response to ESA (Epoetin alfa) dose was examined. Electronic medical records of 1902 US chronic hemodialysis patients were analyzed over a 12‐month period between June 2009 and June 2010. The analysis included patients who had at least one Hb value during each 4‐week interval for four consecutive intervals (k &...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Adam E. Gaweda, Premila Bhat, Gregory A. Maglinte, Chun‐Lan Chang, Jerrold Hill, Grace S. Park, Akhtar Ashfaq, Matthew Gitlin Tags: Original Article Source Type: research
Approach to prophylactic measures for central venous catheter‐related infections in hemodialysis: A critical review
Abstract Vascular access is the major risk factor for bacteremia, hospitalization, and mortality among hemodialysis (HD) patients. The type of vascular access most associated with bloodstream infection is central venous catheter (CVC). The incidence of catheter‐related bacteremia ranges between 0.6 and 6.5 episodes per 1000 catheter days and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter‐related bacteremia, which adversely impacts morbidity and mortality rates and costs among HD patients, several prevention measures aimed at reducing t...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Tricya N. V. Silva, Daniel Marchi, Marcela L Mendes, Pasqual Barretti, Daniela Ponce Tags: Review Article Source Type: research
Using disodium monohydrogen phosphate to prepare a phosphate‐enriched hemodialysate
(Source: Hemodialysis International)
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Ramin Sam, Carl M. Kjellstrand, Chav Doherty, Todd S. Ing Tags: Letter to the Editor Source Type: research
Safety analysis of intermittent hemodialysis in patients with continuous flow left ventricular assist devices
In this study, the effect of HD was observed in such patients. Between June 2009 and October 2012, 139 patients received LVADs, of which 10 patients (7%) required intermittent HD postoperatively. The mean age of the patients was 53 ± 14 years and 90% were men. A total of 281 dialysis sessions were administered amounting to 1025 hours of dialysis. The mean systolic blood pressure monitored with Doppler device was 97 ± 18 mmHg. Dialysis durations averaged 218 ± 18 minutes. Mean blood flow rate was 334 ± 38 cc/min, and 2.6&thinsp...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Mohammed A. Quader, Dhiren Kumar, Keyur B. Shah, Yahya I. Fatani, Gundars Katlaps, Vigneshwar Kasirajan Tags: Case Report Source Type: research
The integrated management for renal replacement therapy in Portugal
This article described the implementation of a new model of comprehensive provision of hemodialysis (HD) services and aimed to assess its impact on dialysis care. Quality assessments and reports of patient satisfaction, produced by the Ministry of Health since 2008, as well as national registries and reports, provided the data for this review. Indicators of HD services in all continental facilities show positive results that have successively improved along the period of 2009–2011, in spite of an average annual growth of 3% of the population under HD treatment. Mortality rates for HD patients were 12.7%, 12%, and 11%...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Anabela P. Coelho, Helena O. Sá, José A. Diniz, Gilles Dussault Tags: Original Article Source Type: research
Self‐perceived quality of sleep and mortality in Norwegian dialysis patients
This study aimed to explore possible associations between sleep quality, daytime sleepiness and mortality in dialysis patients. In this study, 301 dialysis patients were followed up to 4.3 years. HRQoL was evaluated at baseline with the Kidney Disease and Quality of Life—Short Form (KDQoL‐SF), depression with Beck Depression Inventory (BDI), sleep quality with Pittsburgh Sleep Quality Index and daytime sleepiness with Epworth Sleepiness Scale. The single item “on a scale from 0–10, how would you evaluate your sleep?” in the sleep subscale in KDQoL‐SF was used to identify poor (0–5) and goo...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Fredrik B. Brekke, Bård Waldum, Amin Amro, Tone B. H. Østhus, Toril Dammen, Helga Gudmundsdottir, Ingrid Os Tags: Original Article Source Type: research
The relationship between neutrophil‐to‐lymphocyte ratio and vascular calcification in end‐stage renal disease patients
Abstract Chronic inflammation was found to be correlated with coronary (CAC) and thoracic peri‐aortic calcification (TAC) in end‐stage renal disease (ESRD) patients. Neutrophil‐to‐lymphocyte ratio (NLR) was introduced as a potential marker to determine inflammation in cardiac and noncardiac disorders. Data regarding NLR and its association with TAC and CAC are lacking. We aimed to determine the relationship between NLR and vascular calcification in ESRD patients. This was a cross‐sectional study involving 56 ESRD patients (22 females, 34 males; mean age, 49.9 ± 14.2 years) receiving peritonea...
Source: Hemodialysis International - July 1, 2013 Category: Hematology Authors: Kultigin Turkmen, Fatih Ozcicek, Adalet Ozcicek, Emin Murat Akbas, Fatih Mehmet Erdur, Halil Zeki Tonbul Tags: Original Article Source Type: research
To transform renal patient care
(Source: Hemodialysis International)
Source: Hemodialysis International - June 25, 2013 Category: Hematology Authors: Paul E. Teschan Tags: Editorial Source Type: research
Modifiable variables affecting interdialytic weight gain include dialysis time, frequency, and dialysate sodium
Abstract Interdialytic weight gain (IDWG) is associated with hypertension, left ventricular hypertrophy, and all‐cause mortality. Dialysate sodium concentration may cause diffusion gradients with plasma sodium and influence subsequent IDWG. Dialysis time and frequency may also influence the outcomes of this Na+ gradient; these have been overlooked. Our objective was to identify modifiable factors influencing IDWG. We performed a retrospective multivariable regression analyses of data from 86 home hemodialysis patients treated by hemodialysis modalities differing in frequency and session duration to determine factors invo...
Source: Hemodialysis International - June 18, 2013 Category: Hematology Authors: Benjamin K. A. Thomson, Stephanie N. Dixon, Shi‐Han S. Huang, Rosemary E. Leitch, Rita S. Suri, Christopher T. Chan, Robert M. Lindsay Tags: Original Article Source Type: research
Multiple metastatic infections in a hemodialysis patient with untunneled internal jugular catheter
We present an end‐stage renal disease patient on dialysis with fever. The primary source was right internal jugular vein catheter which had metastatic infections in the body probably via an arteriovenous communication in a cavity in left lung. Patient had right psoas muscle abscess and a left kidney abscess. An 18F‐fluorodeoxyglucose‐positron emission spectroscopy scan was done to find out left kidney abscess. A search of literature did not reveal many patients of psoas abscess secondary to infection of hemodialysis access. (Source: Hemodialysis International)
Source: Hemodialysis International - June 18, 2013 Category: Hematology Authors: Sandeep Peddi, Rapur Ram, Varalakshmi Devi Boreddy, Sridhar Avssn, Krishna Kishore Chennu, Siva Kumar Vishnubotla Tags: Case Report Source Type: research
The platelet lymphocyte ratio may be useful inflammatory indicator in clinical practice
(Source: Hemodialysis International)
Source: Hemodialysis International - June 14, 2013 Category: Hematology Authors: Sevket Balta, Sait Demırkol, Ugur Kucuk Tags: Letter to the Editor Source Type: research
Comparison of urea clearance in low‐efficiency low‐flux vs. high‐efficiency high‐flux dialyzer membrane with reduced blood and dialysate flow: An in vitro analysis
Abstract Rapid removal of small molecules during hemodialysis places an acutely ill patient with kidney failure at an increased risk of hemodynamic instability and for dialysis disequilibrium syndrome. The use of high‐flux, high‐efficiency (HEF) dialyzers may increase this risk despite reductions in blood and dialysate flow. We performed in vitro experiments to compare urea clearance at low dialysate flow and various blood flows using a low‐efficiency low‐flux (LEF) and a HEF membrane. Compared to LEF, there was a significant increase in the clearance of urea at all blood flows with the HEF (all P values
Source: Hemodialysis International - May 28, 2013 Category: Hematology Authors: Raj Munshi, Suhail Ahmad Tags: Special Article Source Type: research
Positive association between plasma levels of oxidized low‐density lipoprotein and myeloperoxidase after hemodialysis in patients with diabetic end‐stage renal disease
Abstract End‐stage renal disease (ESRD) patients undergoing hemodialysis (HD) have a high prevalence of cardiovascular events. Low‐density lipoprotein (LDL) in dialysis patients has been shown to be susceptible to in vitro peroxidation; therefore, oxidized‐LDL (ox‐LDL) could be generated in these patients. Moreover, myeloperoxidase (MPO) released from activated neutrophils may play a role in the induction of LDL oxidation. The purpose of this study was to investigate the relationship between plasma ox‐LDL levels, plasma MPO levels, and serum high‐sensitivity C‐reactive protein (hs‐CRP) levels during initial...
Source: Hemodialysis International - April 29, 2013 Category: Hematology Authors: Chizuko Kitabayashi, Takahiko Naruko, Kenichi Sugioka, Kei Yunoki, Masashi Nakagawa, Mayumi Inaba, Masahiko Ohsawa, Yoshio Konishi, Masahito Imanishi, Takeshi Inoue, Hiroyuki Itabe, Minoru Yoshiyama, Kazuo Haze, Anton E. Becker, Makiko Ueda Tags: Original Article Source Type: research
Cutaneous and nail changes in patients of chronic kidney disease: Observations in a tertiary care unit from South India
(Source: Hemodialysis International)
Source: Hemodialysis International - April 28, 2013 Category: Hematology Authors: Sridevi Koduru, Nagaraju Delhi, Sriram Naveen Parvathina, Vishnubhotla Siva Kumar Tags: Letter to the Editor Source Type: research
Genome‐wide analysis of histone H3 lysine9 trimethylation by ChIP‐seq in peripheral blood mononuclear cells of uremia patients
Abstract Treatment of uremia is now dominated by dialysis, in some cases, patients are treated with dialysis for decades, but overall outcomes are disappointing. A number of studies have confirmed the relevance of several experimental insights to the pathogenesis of uremia, but the specific biomarkers of uremia have not been fully elucidated. Studies of the epigenome have attracted little interest in nephrology, especially in uremia. However, to date, our knowledge about the alterations in histone methylation in uremia is unclear. H3K9me3 variations were analyzed in peripheral blood mononuclear cells from 10 uremia patient...
Source: Hemodialysis International - April 28, 2013 Category: Hematology Authors: Weiguo Sui, Huiyan He, Qiang Yan, Jiejing Chen, Ruohan Zhang, Yong Dai Tags: Original Article Source Type: research