Serum NT-proBNP levels are associated with cognitive functions in hemodialysis patients.
Abstract It has been demonstrated that NT-proBNP and macrophage inhibitor cytokine-1 (MIC-1/GDF-15) are associated with cognitive functions in patients without renal disease. In the present study, we examined the association of these two molecules with cognitive functions in hemodialysis patients for the first time in the literature. A total of 94 patients were enrolled. The Mini-Mental Test and the Montreal Cognitive Assessment Test (MoCA) were applied for the purpose of measuring the cognitive functions. The NT-proBNP and MIC-1/GDF-15 levels were examined with the ELISA. The mean age of the patients was 48 ...
Source: Seminars in Dialysis - January 10, 2021 Category: Urology & Nephrology Authors: Akkus G, Seyithanoglu M, Akkus H, Ulu S, Ciftcioglu M, Erken E, Altunoren O, Gungor O Tags: Semin Dial Source Type: research

Ultrasound appearances and histological correlation of native arteriovenous fistula stenoses - A retrospective case series.
Abstract The pathophysiology of haemodialysis arteriovenous fistulae (AVF) stenoses is not fully understood. The aim of this study was to perform histology assessment of stenoses in native AVF and compare and correlate the findings between ultrasound and histology. Intimal medial thickness (IMT) was measured on ultrasound where there was measurable neointimal hyperplasia at the site of stenosis and percentage intimal thickening calculated. Ultrasound findings were then compared with histology analysis of AVF stenoses in nine patients. In this small sample, different sonographic appearances and histology were demon...
Source: Seminars in Dialysis - January 7, 2021 Category: Urology & Nephrology Authors: Steiner K, Ramanarayanan S, Metcalfe M, Jeevaratnum P, Selvakumar S, Narula A Tags: Semin Dial Source Type: research

Continuous renal replacement therapy without anticoagulation in critically ill patients at high risk of bleeding: A systematic review and meta-analysis.
Abstract The current clinical guideline recommends continuous renal replacement therapy (CRRT) proceed without anticoagulation in patients with contraindication to citrate and increased bleeding risk. Nevertheless, the efficacy of anticoagulation-free CRRT remains inconsistent. The purpose of our present systematic review is to evaluate the efficacy and safety of anticoagulant-free CRRT based on the current literatures. The primary outcomes were filter lifespan and risk factors for filter failure. Seventeen observational studies and three randomized controlled trials were included in our present meta-analysis. The...
Source: Seminars in Dialysis - January 5, 2021 Category: Urology & Nephrology Authors: Zhang W, Bai M, Yu Y, Chen X, Zhao L, Chen X Tags: Semin Dial Source Type: research

A case of cyclic hemoperitoneum in a hemodialysis patient: Encapsulated peritoneal sclerosis complicated by endometriosis and fungal peritonitis.
, Ersoy F Abstract Encapsulated peritoneal sclerosis (EPS) is a rare, but frequently fatal, long-term complication of peritoneal dialysis. Endometriosis is a common gynecological problem but hemoperitoneum due to endometriosis has been reported to be extremely rare in hemodialysis (HD) patients. A 25-year-old female HD patient was admitted to our clinic with nausea, vomiting, abdominal pain, and weight loss for last 3 months. Candida tropicalis and Candida glabrata were isolated in the fungal cultures from peritoneal fluid. Her abdominal computerized tomography scan has shown irregular peritoneal calcificatio...
Source: Seminars in Dialysis - December 22, 2020 Category: Urology & Nephrology Authors: Yılmaz F, Bora F, Çetinkaya R, Gelen MT, Süleymanlar G, Ersoy F Tags: Semin Dial Source Type: research

Hemodialysis taping styles and their effect on reducing the chance of venous needle dislodgement.
CONCLUSIONS: We recommend that either the Chevron or butterfly style is used for dialysis needle taping, with the butterfly better suited to home dialysis (where monitors may be used) and the Chevron better suited for in-care patients who may present erratic movements. The overlapping style is not recommended for use. PMID: 33336846 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - December 18, 2020 Category: Urology & Nephrology Authors: Chan DYF, Dobson S, Barber T Tags: Semin Dial Source Type: research

Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta-analysis.
Abstract Cardiac resynchronization therapy with or without a defibrillator (CRT(D)) and implantable cardioverter defibrillator (ICD) may reduce the risk of arrhythmia or heart failure-specific mortality and improves the prognosis of patients with chronic kidney disease (CKD) or dialysis. The aim of this study was to perform a meta-analysis investigating the relationship between CRT(D)/ICD and renal insufficiency. Cochrane Library, Web of Science, Embase, and Pubmed were systematically searched from inception to 29 October 2019. We included studies that report all-cause mortality of patients with renal insufficienc...
Source: Seminars in Dialysis - December 9, 2020 Category: Urology & Nephrology Authors: Liu Y, Sun JY, Zhu YS, Li ZM, Li KL, Wang RX Tags: Semin Dial Source Type: research

Circulating endothelial cells as predictor of long-term mortality and adverse cardiovascular outcomes in hemodialysis patients.
al MS Abstract Circulating endothelial cells (CEC) are thought to be markers of endothelial injury. We hypothesized that the numbers of CEC may provide a novel means for predicting long-term survival and cardiovascular events in hemodialysis patients. 54 hemodialysis patients underwent enumeration of their CEC number. We retrospectively analyzed their survival and incidence of adverse cardiovascular events. 22 deaths (41%) were noted over the median follow up period of 3.56 years (IQR 1.43-12) and 6 were attributed to cardiovascular deaths (11%) of which 1 (4%) was in the low CEC (CEC20 cells/ml was associate...
Source: Seminars in Dialysis - December 5, 2020 Category: Urology & Nephrology Authors: Mohandas R, Diao Y, Chamarthi G, Krishnan S, Agrawal N, Wen X, Dass B, Shukla AM, Gopal S, Koç M, Segal MS Tags: Semin Dial Source Type: research

The relationship of soluble klotho level with uremic cardiomyopathy and ecocardiographic parameters in hemodialysis patients.
Abstract There are studies reporting that soluble kltho (sKlotho) deficiency plays a role in cardiovascular disease in addition to traditional risk factors such as diabetes, hypertension, anemia, smoking, and excessive volume burden. Our aim in this study was to investigate the relationship of sKlotho with uremic cardiomyopathy and echocardiographic parameters in patients receiving hemodialysis treatment. According to the median value, the sKlotho value was divided into two groups as ≥1.24 and
Source: Seminars in Dialysis - November 30, 2020 Category: Urology & Nephrology Authors: Erkus E, Buyukterzı Z, Karakose S, Kurku H, Kurtgoz PO, Topal M, Guney I Tags: Semin Dial Source Type: research

Dialysis adequacy reconsidered: The person comes first.
Abstract Although many nephrologists see value in maximizing clearance and time on dialysis, clinical trials have failed to show a clear and consistent benefit of increasing clearance above the minimum threshold level recommended in clinical practice guidelines or of increasing dialysis session length or frequency. Available evidence suggests that patients and clinicians do not necessarily agree on what matters most when it comes to dialysis care, and that what patients consider to be an adequate dialysis session is highly individual and has little to do with solute clearance. Qualitative studies suggest that pati...
Source: Seminars in Dialysis - November 26, 2020 Category: Urology & Nephrology Authors: O'Hare AM Tags: Semin Dial Source Type: research

Acute coronary syndrome following arteriovenous fistula creation in a post CABG patient: A steal phenomenon from coronary artery to subclavian artery.
Abstract A 70-year-old man with a history of coronary artery bypass grafting 15 years back and arteriovenous (AV) fistula creation in the left arm 1 month back presented with acute coronary syndrome (ACS). He had not received dialysis before his referral. We felt the most likely etiology for these complaints was increased cardiac oxygen demand from an increased cardiac output related to the newly formed left AV fistula. Coronary angiography was done to detect any significant stenosis in the native or grafted vessels. This revealed that the left subclavian artery was totally occluded in the ostioproximal ...
Source: Seminars in Dialysis - November 22, 2020 Category: Urology & Nephrology Authors: Alemzadeh-Ansari MJ, Sarreshtehdari A, Abdi S, Moosavi J, Shafe O, Sadeghipour P, Pouraliakbar H, Mohebbi B Tags: Semin Dial Source Type: research

Barriers to optimal ESKD management.
PMID: 33210322 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - November 19, 2020 Category: Urology & Nephrology Authors: Williams ME Tags: Semin Dial Source Type: research

Barriers to home dialysis: Unraveling the tapestry of policy.
Abstract Home dialysis use as a treatment for end-stage kidney disease varies locally, nationally, and internationally. There is a call to action in the United States to significantly increase access and uptake of home dialysis as the preferred dialysis treatment option. Although most do not object to patient choice in modality selection, the reality is that there are multilevel barriers both obvious and subtle that interfere with expanding home dialysis access. Financial barriers and how payment is structured continue to be key drivers, although new models of care are emerging that include for the first time ince...
Source: Seminars in Dialysis - November 19, 2020 Category: Urology & Nephrology Authors: Fissell RB, Cavanaugh KL Tags: Semin Dial Source Type: research

Predictors of successful discontinuation from renal replacement therapy during AKI: A meta-analysis.
Abstract The predictors of weaning time of renal replacement therapy (RRT) remain controversial for special patients suffering from acute kidney injury (AKI). The present work aims to perform a meta-analysis to evaluate proper predictors of RRT weaning in AKI patients. We systematically searched EMBASE, PubMed, and Cochrane Central Register of Controlled trials for literatures between 1984 and June 2019. Studies evaluating predictors of weaning success of RRT in patients of AKI were included. Random-effects model or fixed-effects model meta-analyses were performed to compute a standard mean difference (SMD). Newca...
Source: Seminars in Dialysis - November 19, 2020 Category: Urology & Nephrology Authors: Wang L, Li J, Sun S, Du H, Chen P, Xu Y, Shen Y, Xin S, Dan Y, Li H, Chen J, Li Z, Su B Tags: Semin Dial Source Type: research

Healthcare in the new age of transparency.
Abstract Debates around access to and ownership of an individual's digital information have taken center stage in health care. A decade ago, the idea of offering patients ready access to their clinical notes was a fringe idea. Today, information transparency in health care is a pressing legislative and regulatory issue in the United States and elsewhere. The 21st Century Cures Act of 2016 requires that clinicians and health care organizations give patients electronic access to the information in their electronic medical records. Rules to enact this legislative priority by the Office of the National Coordinator for...
Source: Seminars in Dialysis - November 19, 2020 Category: Urology & Nephrology Authors: DesRoches CM Tags: Semin Dial Source Type: research

Medication management in dialysis: Barriers and strategies.
This article explores the factors that affect optimal medication use for people on dialysis, including the broader drug use system, and offers recommendations around medication reconciliation, medication review, deprescribing, and considering social determinants of health to improve medication management among patients with ESKD. PMID: 33210373 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - November 19, 2020 Category: Urology & Nephrology Authors: Cardone KE, Parker WM Tags: Semin Dial Source Type: research

The reliability and success of peritoneal dialysis during the COVID-19 pandemic.
Abstract We evaluated the symptoms, changes in laboratory findings during the novel coronavirus disease (COVID-19) pandemic, and the effect of depression in patients with peritoneal dialysis (PD). This is an observational and cross-sectional study. All patients were asked to fill the clinical assessment form and Beck depression and anxiety inventory. Also, the last two laboratory evaluations during this period were examined. A total of 123 patients performing PD were included. None of the patients were diagnosed with COVID-19. In the total study population, parathyroid hormone (PTH), serum albumin, phosphorus and ...
Source: Seminars in Dialysis - November 19, 2020 Category: Urology & Nephrology Authors: Yeter HH, Gok Oguz E, Akcay OF, Karaer R, Yasar E, Duranay M, Ayli MD, Guz G Tags: Semin Dial Source Type: research

Clearing the clouds: Case-report and review of the literature.
ana M Abstract In peritoneal dialysis (PD), a cloudy dialysate is an alarming finding. Bacterial peritonitis is the most common cause, however, atypical infections and non-infectious causes must be considered. A 46-year-old man presented with asthenia, paraesthesia, foamy urine and hypertension. Laboratory testing revealed severe azotaemia, anaemia, hyperkalaemia and nephrotic-range proteinuria. Haemodialysis was started through a central venous catheter. Later, due to patient preference, a Tenckhoff catheter was inserted. Conversion to PD occurred 3 weeks later, during hospitalization for a presumed central ...
Source: Seminars in Dialysis - November 2, 2020 Category: Urology & Nephrology Authors: Relvas M, Beco A, Pereira L, Oliveira A, Silvano J, Silva R, Marques N, Santos L, Coentrão L, Pestana M Tags: Semin Dial Source Type: research

Anticoagulation in hemodialysis: A narrative review.
Abstract Systemic anticoagulation in maintenance hemodialysis (HD) has historically been considered necessary to maintain the extracorporeal circuit (ECC) and preserve dialysis efficiency. Unfractionated heparin (UFH) is the most commonly used anticoagulant due to low cost and staff familiarity. Despite widespread use, there is little standardization of heparin dosing protocols in the United States. Although the complication rates with UFH are low for the general population, certain contraindications have led to exploration in alternative anticoagulants in patients with end-stage kidney disease (ESKD). Here we rev...
Source: Seminars in Dialysis - November 1, 2020 Category: Urology & Nephrology Authors: Claudel SE, Miles LA, Murea M Tags: Semin Dial Source Type: research

Fragmentation of care as a barrier to optimal ESKD management.
This article describes the role of care fragmentation in the delivery of optimal ESKD care and identifies research gaps in the evidence across the continuum of care. We then consider the impact of care fragmentation on ESKD care from the patient and health system perspectives and explore opportunities for system-level interventions aimed at improving care for patients with ESKD. PMID: 33128300 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - October 31, 2020 Category: Urology & Nephrology Authors: Sloan CE, Zhong J, Mohottige D, Hall R, Diamantidis CJ, Boulware LE, Wang V Tags: Semin Dial Source Type: research

Clinical features of patients undergoing hemodialysis with COVID-19.
In conclusion, for hemodialysis patients with COVID-19, lymphocytopenia and ground-glass opacities or patchy opacities were common but not specific to them, early active treatment and interventions against nosocomial infection can significantly reduce the mortality and the risk of SARS-CoV-2 infection. PMID: 33118200 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - October 29, 2020 Category: Urology & Nephrology Authors: Tian M, Li H, Yan T, Dai Y, Dong L, Wei H, Song X, Dong J, Cheng F, Li W Tags: Semin Dial Source Type: research

Association of diabetes, education level, and care dependency with use of temporary vascular access in patients with chronic kidney disease.
This study included patients in a single-center CKD care program who initiated long-term renal replacement therapy. The primary outcome was TVA use at first dialysis. Factors possibly associated with TVA use were analyzed using Cox regression. RESULTS: Temporary vascular access was used in 53.2% of the patients at first dialysis. In total, 73.2% (n = 865) and 26.8% (n = 317) of the patients were on hemodialysis and peritoneal dialysis, respectively. Multivariate Cox regression analysis showed that TVA use in patients with CKD was associated with diabetes (hazard ratio [HR] 1.52, 95% confidence inte...
Source: Seminars in Dialysis - October 26, 2020 Category: Urology & Nephrology Authors: Chen HC, Lai MJ, Wu WC, Lee CY, Lin HJ, Lin CC, Chang CT, Wang CCN, Chou CY Tags: Semin Dial Source Type: research

Peritoneal dialysis patient selection from a comorbidity perspective.
m B Abstract Despite many medical and socioeconomic advantages, peritoneal dialysis (PD) is an underutilized dialysis modality that in most countries is used by only 5%-20% of dialysis patients, while the vast majority are treated with in-center hemodialysis. Several factors may explain this paradox, such as lack of experience and infrastructure for training and monitoring of PD patients, organizational issues, overcapacity of hemodialysis facilities, and lack of economic incentives for dialysis centers to use PD instead of HD. In addition, medical conditions that are perceived (rightly or wrongly) as contraindica...
Source: Seminars in Dialysis - October 22, 2020 Category: Urology & Nephrology Authors: Eroglu E, Heimbürger O, Lindholm B Tags: Semin Dial Source Type: research

ATTENTION: Workforce shortages as a barrier to optimal dialysis.
This article brings attention to this complex workforce shortage and addresses the limited information available regarding how it might constitute a barrier to optimal dialysis care. PMID: 33094515 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - October 22, 2020 Category: Urology & Nephrology Authors: Gaietto KJ, Williams ME Tags: Semin Dial Source Type: research

Immigration status and end-stage kidney disease: Role of policy and access to care.
Abstract Immigration status is an important mitigating factor in determining the provision of dialysis and kidney-related care. Immigrants make up the largest uninsured group in the country. For immigrants with end-stage kidney disease (ESKD), dialysis access varies by insurance type and by state, leading to great variability in the availability of kidney care. In some states, undocumented immigrants may only qualify for hemodialysis when critically ill (emergency hemodialysis), which is associated with higher mortality, hospital length of stay, and cost, in addition to an emotional burden on patients, their careg...
Source: Seminars in Dialysis - October 21, 2020 Category: Urology & Nephrology Authors: Rizzolo K, Cervantes L Tags: Semin Dial Source Type: research

A mathematical approach to severe hyponatremia and hypernatremia in renal replacement therapies.
Abstract Severe dysnatremias are perplexing problems in patients undergoing renal replacement therapy on a chronic or acute basis. The ability to manipulate sodium concentration in the dialysate or replacement solutions is limited. Compounding dialysate or replacement fluids to alter sodium concentration could result in errors. Rapid correction of hyponatremia or hypernatremia due to equilibrium with dialysate or replacement solutions could lead to osmotic demyelination syndrome or cerebral edema respectively. Continuous renal replacement therapy is the preferred dialysis modality in patients with severe dysnatrem...
Source: Seminars in Dialysis - October 16, 2020 Category: Urology & Nephrology Authors: Tinawi M, Bastani B Tags: Semin Dial Source Type: research

Evaluating dialysis adequacy: Origins, evolution, and future directions.
Abstract The expansion and transformation over time of dialysis therapies have been inexorably linked to the concept of adequacy. While initially the goal of dialysis was simple survival of patients until their next treatment, this changed with the publication of the National Cooperative Dialysis Study. It brought about a focus on defining adequate dialysis through measurements of the removal of small solutes, in particular urea. This spurred significant improvements in patient outcomes by standardizing therapy and providing benchmarks for each center to achieve. Over time, however, further research has found this...
Source: Seminars in Dialysis - October 16, 2020 Category: Urology & Nephrology Authors: Momciu B, Chan CT Tags: Semin Dial Source Type: research

Assessment of nutritional status in maintenance hemodialysis patients: A multicenter cross-sectional study in Iran.
CONCLUSION: HD patients are at risk of malnutrition and in this regard training the patient, periodic assessment of nutritional status, and referring them to a dietitian seems necessary. PMID: 33058310 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - October 14, 2020 Category: Urology & Nephrology Authors: Akhlaghi Z, Sharifipour F, Nematy M, Safarian M, Malekahmadi M, Barkhidarian B, Norouzy A Tags: Semin Dial Source Type: research

Breaking the adherence barriers: Strategies to improve treatment adherence in dialysis patients.
Abstract Nonadherence to therapy (dietary/fluid restrictions, medications, and dialysis treatment), is common in patients with end-stage kidney disease (ESKD) undergoing dialysis. It is associated with a higher risk of mortality and adverse outcomes. Clinical trials evaluating adherence improvement interventions have largely addressed patient-related factors by employing educational/cognitive, counselling/behavioral, psychological strategies, or combinations thereof. A major barrier to progress in addressing ESKD-related adherence is the difficulty in comparing these trials due to the highly diverse nature of inte...
Source: Seminars in Dialysis - October 9, 2020 Category: Urology & Nephrology Authors: Murali KM, Lonergan M Tags: Semin Dial Source Type: research

Barriers to kidney transplantation in ESKD.
Abstract Kidney transplantation is the ideal treatment option for patients with end-stage kidney disease (ESKD). Since there is clear mortality benefit to receiving a transplant regardless of comorbidities and age, the gold standard of care should focus on attaining kidney transplantation and minimizing, or better yet eliminating, time on dialysis. Unfortunately, only a small percentage of patients with ESKD receive a kidney transplant. Several barriers to kidney transplantation have been identified. Barriers can largely be grouped into three categories: patient-related, physician/provider-related, and system-rela...
Source: Seminars in Dialysis - October 3, 2020 Category: Urology & Nephrology Authors: Venkataraman S, Kendrick J Tags: Semin Dial Source Type: research

Being on hemodialysis during the COVID-19 outbreak: A mixed-methods' study exploring the impacts on dialysis adequacy, analytical data, and patients' experiences.
This study aimed to explore the impacts of the COVID-19 pandemic in non-COVID-19 patients with ESRD undergoing in-center hemodialysis (HD). A mixed-methods study was conducted with a purposive sample recruited from one dialysis unit in Portugal. Quantitative data were collected retrospectively from patients' medical records from February 2020 (T1-before the outbreak) and from April 2020 (T2-during lockdown). Semi-structured interviews were conducted with 20 patients (66.9 ± 11.9 years old) undergoing HD for an average of 46.1 months (±39.5) in April 2020. Overall results suggested that dia...
Source: Seminars in Dialysis - September 15, 2020 Category: Urology & Nephrology Authors: Sousa H, Ribeiro O, Costa E, Frontini R, Paúl C, Amado L, Miranda V, Ribeiro F, Figueiredo D Tags: Semin Dial Source Type: research

Barriers to optimal peritoneal dialysis.
Abstract Peritoneal dialysis in the United States is underutilized when compared to the experience in other developed countries. The reasons for this are multifactorial and include government regulatory issues, the priority of dialysis facilities, and education and training of nephrology trainees and patients. The challenges to expanding PD in the United States are discussed and strategies to overcome the barriers are outlined. PMID: 32924163 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - September 12, 2020 Category: Urology & Nephrology Authors: Finkelstein FO Tags: Semin Dial Source Type: research

Artificial intelligence enabled applications in kidney disease.
We present the current status of AI in research toward kidney disease and discuss future pathways for AI. The clinical applications of AI in progression to end-stage kidney disease and dialysis can be broadly subdivided into three main topics: (a) predicting events in the future such as mortality and hospitalization; (b) providing treatment and decision aids such as automating drug prescription; and (c) identifying patterns such as phenotypical clusters and arteriovenous fistula aneurysm. At present, the use of prediction models in treating patients with kidney disease is still in its infancy and further evidence is needed...
Source: Seminars in Dialysis - September 12, 2020 Category: Urology & Nephrology Authors: Chaudhuri S, Long A, Zhang H, Monaghan C, Larkin JW, Kotanko P, Kalaskar S, Kooman JP, van der Sande FM, Maddux FW, Usvyat LA Tags: Semin Dial Source Type: research

Temporal changes in dialysate [Na+] prescription from 1996 to 2018 and their clinical significance as judged from a meta-regression of clinical trials.
Abstract Over the last two decades, the clinical care of dialysis patients has refocused sharply on fluid volume control. Dialysate [Na+] is a key, albeit under-investigated, clinical tool for manipulation of fluid volume on dialysis. In the article, we firstly use data from the Dialysis Outcomes and Practice Patterns Study to document the global decrease in dialysate [Na+] that has occurred from 1996 to 2018, and demonstrate the virtual disappearance of [Na+] profiling from routine dialysis practice over the same period. Second, we used data from previously synthesized randomized clinical trial evidence combined ...
Source: Seminars in Dialysis - August 31, 2020 Category: Urology & Nephrology Authors: Marshall MR, Karaboyas A Tags: Semin Dial Source Type: research

A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis.
Abstract INTRODUCTION: Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. METHODS: Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end-to-side variety. Parameters studied were age, gender, diabetes mellitus, hypertension prior to end-stage kidney disease (ESKD), site of fistula, blood flow rate, venous pressure, dialysis vintage and frequency, needle gauge used during dialysis, year of fistula creation, and details of fistula failure. FINDING...
Source: Seminars in Dialysis - August 20, 2020 Category: Urology & Nephrology Authors: Jothi S, Kg H, Lesley N, Vijayan M, Haridas Anupama S, Mathew M, Parthasarathy R, Sundarajan S, P N, Kumaraswamy L, Abraham G Tags: Semin Dial Source Type: research

Hemodialysis using a low bicarbonate dialysis bath: Implications for acid-base homeostasis.
Abstract The low bath bicarbonate concentration ([ HCO 3 - ]) used by a nephrology group in Japan (25.5 mEq/L), coupled with a bath [acetate] of 8 mEq/L, provided an opportunity to study the acid-base events occurring during hemodialysis when HCO 3 - flux is from the patient to the bath. We used an analytic tool that allows calculation of HCO 3 - delivery during hemodialysis and the physiological response to it in 17 Japanese outpatients with an average pre-dialysis blood [ HCO 3 - ] of 25 mEq/L. Our analysis demonstrates that HCO 3 - addition is markedly reduced and that all of it comes from acetat...
Source: Seminars in Dialysis - August 14, 2020 Category: Urology & Nephrology Authors: Sargent JA, Yamamoto T, Yamakawa T, De Waal D, Gennari FJ Tags: Semin Dial Source Type: research

On the CO2 gain in on-line hemodiafiltration.
Abstract BACKGROUND: The dialysis bath holds up to 90 mmHg carbon dioxide (CO2 ) in order to keep pH low and salts in their soluble forms. CO2 crosses the dialyzer membrane and diffuses to patients. In post-dilution on-line hemodiafiltration (HDF) many liters of CO2 -containing dialysis bath - in the form of infusate - are delivered directly to patients bypassing the filtering membrane, but the precise amount of CO2 delivered is unknown. METHODS: To gain insights on this issue 18 outpatients undergoing their regular on-line HDF were investigated by means of blood gas analysis. RESULTS: Arterial pre-...
Source: Seminars in Dialysis - August 9, 2020 Category: Urology & Nephrology Authors: Marano M, Izzo F Tags: Semin Dial Source Type: research

Transitional care units: How successful in increasing home dialysis?
PMID: 32776577 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - August 9, 2020 Category: Urology & Nephrology Authors: Singh N Tags: Semin Dial Source Type: research

Point-of-care ultrasound use for vascular access assessment and cannulation in hemodialysis: A scoping review.
Abstract Point-of-care ultrasound (POCUS) for access assessment and guided cannulation has become more common in hemodialysis units. The aims of this scoping review were to determine: circumstances in which renal nurses and technicians use POCUS; the barriers and facilitators; and evidence of the effects of POCUS in guiding assessment and cannulation. A search was conducted of CINAHL, Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ProQuest, Trove and Google Scholar as grey literature sources. Of 1904 publications, 21 studies met inclusion criteria (11 full tex...
Source: Seminars in Dialysis - August 2, 2020 Category: Urology & Nephrology Authors: Schoch M, Bennett PN, Currey J, Hutchinson AM Tags: Semin Dial Source Type: research

Efficacy of stent-graft placement to salvage central vein stents with recalcitrant restenosis in patients with arteriovenous fistulas.
Abstract The purpose of this study was to determine the effectiveness and permanency of stent-graft placement to salvage stents with recalcitrant restenosis due to central vein stenosis (CVS). Between May 2014 and February 2016, VIABAHN stent-grafts were deployed in patients with functioning arteriovenous (AV) fistulas who underwent previous bare metal stent (BMS) placement and had recalcitrant stent restenosis that did not respond to percutaneous transluminal angioplasty (PTA). Surveillance was carried out at 3, 6, 12, 18, and 24 months with diagnostic fistulography. Fourteen patients initially underwent 15 ...
Source: Seminars in Dialysis - August 2, 2020 Category: Urology & Nephrology Authors: Gong M, Zhou Y, Zhao B, Kong J, He X Tags: Semin Dial Source Type: research

Comparison of peritoneal dialysis catheter insertion techniques by nephrologists: Surgical vs blind methods.
CONCLUSION: Our study shows that catheter outcomes are similar between blind and surgical insertion techniques performed by nephrologists. These findings reveal that patients without previous major abdominal surgery would be suitable to receive any one of the two methods according to the operator-friendly technique. PMID: 32705710 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - July 22, 2020 Category: Urology & Nephrology Authors: Kang SH, Park JW, Cho KH, Do JY Tags: Semin Dial Source Type: research

The relation between epicardial fat tissue thickness and atrial fibrillation ın hemodialysis patients.
Abstract The prevalence of arrhythmia has increased in hemodialysis (HD) patients and the most frequent is atrial fibrillation (AF). It was reported that the amount of epicardial fat tissue (EFT) in the population without renal disease is closely related to AF. In the present study of ours, the relation between EFT thickness and AF was examined in HD patients. A total of 79 patients who underwent HD for periods longer than 3 months were included in the study. The mean age of the patients was 53.6 ± 15.2 years and 50.6% were male. The mean EFT thicknesses were measured as 7.2 ±&nbs...
Source: Seminars in Dialysis - July 21, 2020 Category: Urology & Nephrology Authors: Guzel FB, Altunoren O, Gunes H, Seyithanoglu M, Kerkutluoglu M, Sezal DT, Gungor O Tags: Semin Dial Source Type: research

Can vasohibin-1, an endothelium-derived angiogenesis inhibitor, be a marker of endothelial dysfunction in hemodialysis patients?
Abstract BACKGROUND: Endothelial dysfunction (ED) is associated with high cardiovascular disease burden in hemodialysis (HD) patients. Vasohibin-1, an endothelium-derived angiogenesis inhibitor, is essential for endothelial cell survival, therefore it may be a promising marker of ED. We aimed to investigate whether vasohibin-1 levels are associated with ED markers in HD patients. METHODS: Fifty HD patients and 30 healthy controls were included in the study. As markers of ED, endothelium-dependent flow-mediated dilatation (FMD), carotid intima-media thickness (CIMT), and pulse wave velocity (PWV) were examined...
Source: Seminars in Dialysis - July 18, 2020 Category: Urology & Nephrology Authors: Altunoren O, Kerkutluoglu M, Sarısık FN, Akkus G, Seyithanoglu M, Doganer A, Tutuncu Sezal D, Cagrı Aykan A, Eren N, Erken E, Gungor O Tags: Semin Dial Source Type: research

The advantages of peritoneal dialysis over hemodialysis during the COVID-19 pandemic.
PMID: 32677120 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - July 15, 2020 Category: Urology & Nephrology Authors: Chen TH, Wen YH, Chen CF, Tan AC, Chen YT, Chen FY, Lin CC Tags: Semin Dial Source Type: research

Bacteriological water quality and biofilm formation in the treatment system of the hemodialysis unit in Tlemcen, Algeria.
CONCLUSION: This study indicates bacterial water contamination. The formation of a biofilm will certainly harm the effectiveness of the various disinfection methods in this unit. Water quality is influenced not only by the high rate of bacterial colonization, but also differences in standards for dialysis water. PMID: 32652741 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - July 10, 2020 Category: Urology & Nephrology Authors: Morghad T, Hassaine H, Boutarfi Z, Gaouar S, Bellifa S, Meziani Z Tags: Semin Dial Source Type: research

Chest pain when infused with peritoneal dialysate.
PMID: 32627276 [PubMed - in process] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - June 30, 2020 Category: Urology & Nephrology Authors: Jiang Z Tags: Semin Dial Source Type: research

Outcomes after transfer from hemodialysis to peritoneal dialysis vs peritoneal dialysis as initial therapy: A systematic review and meta-analysis.
Abstract Outcomes of patients who are transferred to peritoneal dialysis (PD) after an initial phase of hemodialysis (HD) compared to patients initiating dialysis with PD is controversial. We performed a systematic literature to assess evidence. Primary outcome was overall survival (OS), while secondary outcomes were technique failure, mortality and peritonitis. Meta-analysis indicated that PD initial group had significantly better OS as compared to HD to PD group. Pooled analysis demonstrated a significantly higher probability of technique failure in the HD to PD group as compared to PD initial group. Mortality r...
Source: Seminars in Dialysis - June 28, 2020 Category: Urology & Nephrology Authors: Wang J, Zeng J, Liu B, Cai B, Li Y, Dong L Tags: Semin Dial Source Type: research

TAVI (transcatheter aortic valve implantation) for a dialysis patient with severe aortic stenosis unfit for surgery.
PMID: 32596925 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - June 28, 2020 Category: Urology & Nephrology Authors: Habeeb MKA, AlMaimany YAY, Elias FM, Salib KS Tags: Semin Dial Source Type: research

Preventive care for patients with end-stage kidney  disease: crossroads between nephrology and primary care.
Preventive care for patients with end-stage kidney disease: crossroads between nephrology and primary care. Semin Dial. 2020 Jun 24;: Authors: Phen SS, Kazory A, Bozorgmehri S, Ozrazgat-Baslanti T, Sattari M Abstract Patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis (HD) might expect their nephrologists to coordinate all their healthcare needs. We performed a survey among adult patients with ESKD undergoing HD in two outpatient dialysis centers at the University of Florida to identify differences in characteristics between patients with and without primary car...
Source: Seminars in Dialysis - June 23, 2020 Category: Urology & Nephrology Authors: Phen SS, Kazory A, Bozorgmehri S, Ozrazgat-Baslanti T, Sattari M Tags: Semin Dial Source Type: research

Erroneous introduction of femoral venous catheter into a broad ligament varicose vein causing hemoperitoneum in a woman with postpartum thrombotic microangiopathy.
Abstract Femoral venous catheterization is a common procedure in critical care patients. Pregnant women and those in the postpartum period are at risk of various complications such as shock, acute kidney injury, and thrombotic microangiopathic syndromes requiring hemodialysis and plasma exchange, which may necessitate central venous catheterization. Femoral vein catheters may also sometimes be needed. These women may have underlying pelvic congestion and varicosities. Here we present a 24-year-old female patient, who has been treated for postpartum thrombotic microangiopathy with initial clinical improvements, bec...
Source: Seminars in Dialysis - June 23, 2020 Category: Urology & Nephrology Authors: Shemies RS, Taman MA, Elrefaey RM, Hammad MA, Eldieb AM, Sayed-Ahmed NA Tags: Semin Dial Source Type: research

Outcome of renal cell carcinoma in patients on dialysis compared to non-dialysis patients.
CONCLUSIONS: This study suggested that hemodialysis was an independent prognostic factor for cancer-specific survival in RCC patients, along with the tumor stage and Fuhrman nuclear grade. PMID: 32557805 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - June 17, 2020 Category: Urology & Nephrology Authors: Hayami N, Ubara Y, Okaneya T, Fujii T, Nagashima Y, Ohashi K Tags: Semin Dial Source Type: research