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Hemodialysis International

Talar W Markossian, Holly J Kramer, Nicholas J Burge, Ivan V Pacold, David J Leehey, Zhiping Huo, Julia Schneider, Benjamin Ling, Kevin T Stroupe
INTRODUCTION: The benefits of statin medications in patients receiving maintenance dialysis remains controversial and clinical trials overall have shown no benefit. Potential side effects of statin medications include myalgias, myopathy, and memory loss and risk of side effects associated with statin medications increase with higher statin doses. We examined statin use and statin dose among Veterans with dialysis dependent CKD. Such information may help clinicians modulate medication use and reduce pill burden in appropriate patients...
February 19, 2019: Hemodialysis International
Julie Ann Kemp, Marta Esgalhado, Renata Azevedo Macedo, Bruna Regis, Nágila Raquel Teixeira Damasceno, Elizabeth Aparecida Ferraz da Silva Torres, Gustavo Henrique Ferreira Gonçalinho, Natália Alvarenga Borges, Lia Sumie Nakao, Denis Fouque, Denise Mafra
INTRODUCTION: Indoxyl sulfate (IS) and p-cresyl sulfate (p-CS) are albumin-bound uremic toxins that are difficult to remove by hemodialysis (HD). Human serum albumin (HSA) carries several compounds, including fatty acids that can bind to site II of HSA and represent competing ligands for uremic toxins. The aim of this study was to investigate the association between fatty acids and uremic toxin plasma levels in patients undergoing HD. METHODS: Thirty-three HD patients (51...
February 19, 2019: Hemodialysis International
Claire Kennedy, Margaret McGrath-Chong, Daniela Arustei, Celine d'Gama, Rose Faratro, Stella Fung, Eduardo Magtoto, Elizabeth Wong, Christopher T Chan
INTRODUCTION: Venous needle dislodgement (or venous port disconnection) during hemodialysis (HD) may lead to catastrophic blood loss, particularly during unsupervised home HD. A prototype venous line clamp was developed for use in conjunction with the Redsense blood loss sensor. We hypothesize that this prototype device will provide additional safety to dialysis without excessive burden. METHODS: This was a single-center, prospective cohort study. Participants kept a log of bleeding, troubleshooting and clamp deployment events, and completed questionnaires before device first use and after device final use...
February 19, 2019: Hemodialysis International
Mavish S Chaudry, Gunnar H Gislason, Anne-Lise Kamper, Marianne Rix, Anders R Larsen, Andreas Petersen, Paal S Andersen, Robert L Skov, Emil L Fosbøl, Henrik Westh, Henrik C Schønheyder, Thomas L Benfield, Vance G Fowler, Christian Torp-Pedersen, Niels E Bruun
INTRODUCTION: Staphylococcus aureus bacteremia (SAB) is a high-risk infection and feared complication related to hemodialysis. This study aimed to investigate incidence and risk factors for SAB depending on hemodialysis access type. METHODS: The Danish National Registry on Regular Dialysis and Transplantation was used to identify patients from January 1, 1996 to December 31, 2011 with end-stage kidney disease. Patients were followed until death, the first episode of SAB, or end of study (December 31, 2011)...
February 19, 2019: Hemodialysis International
Krystina Parker, Ingrid Bull-Engelstad, Willy Aasebø, Nanna von der Lippe, Morten Reier-Nilsen, Ingrid Os, Knut Stavem
INTRODUCTION: Elderly patients with chronic kidney disease (CKD) stage 5 with or without dialysis treatment usually have concomitant comorbidities, which often result in multiple pharmacological therapies. This study aimed to identify factors associated with medication complexity and medication adherence, as well as the association between medication complexity and medication adherence, in elderly patients with CKD. METHODS: This prospective study involved elderly patients with CKD stage 5 (estimated glomerular filtration rate < 15 ml/min/1...
February 19, 2019: Hemodialysis International
Subhas Sitaula, Pratibha Kaul, Vikram Aggarwal
Sudden cardiac death (SCD) is reported as leading cause of death in patients on chronic hemodialysis. Arrhythmias are proposed to be a major predisposing factor for SCD. However, triggers for potentially lethal arrhythmias are not well understood. Here we describe a case of 72-year-old man on chronic hemodialysis via permanent Central venous catheter (CVC) who was admitted for evaluation after unwitnessed fall. Within 10 minutes of his first routine dialysis session in the hospital, he had cardiac-arrest. He was successfully resuscitated within 3 minutes...
February 18, 2019: Hemodialysis International
Navin Pattanashetti, Joyita Bharati, Harbir Singh Kohli, Krishan Lal Gupta, Raja Ramachandran
Patients with end stage renal disease (ESRD) and severe hyponatremia always pose a challenge to manage. It is necessary to correct biochemical parameters, advanced azotemia, and fluid overload with conventional haemodialysis (HD) but it may correct serum sodium (Na) rapidly resulting in neurological complications like seizures and osmotic demyelination syndrome. Continuous renal replacement therapy (CRRT) is an ideal modality to manage such patients. However, most of the centers in the developing or underdeveloped nations do not have CRRT facility...
February 18, 2019: Hemodialysis International
Amanda K Leonberg-Yoo, Weiling Wang, Daniel E Weiner, Eduardo Lacson
INTRODUCTION: Hemodialysis (HD) patients are hospitalized nearly twice yearly, and 35% of these patients are rehospitalized within 30-days postdischarge. We hypothesized that monitored oral nutritional supplementation (ONS) during HD treatment may decrease readmissions. METHODS: A cohort of maintenance HD patients, treated at a large dialysis organization, who were hospitalized with a postdischarge albumin of ≤3.5 g/dL, without documented ONS use 90 days prior to the index hospitalization were identified...
February 14, 2019: Hemodialysis International
Andreas Bozikas, Iliana Kiriakoutzik, Ioannis Petrou, Theodoros Touroutzis, Eleni Kitoukidi, Pinelopi Pisanidou, Styliani Vakiani, Nikolaos Georgilas, Antigoni Martika, Panagiotis Pangidis, Sofia Spaia
INTRODUCTION: Acidemia and alkalemia, as a result of gradual depletion of the body's buffers followed by rapid repletion during hemodialysis (HD), are linked to adverse consequences. We examined the acid-base status with dialysis bath of higher bicarbonate (HC03- ) concentration or standard HC03- bath plus oral HC03- supplementation. METHODS: A total of 60 stable HD patients (pts) were evaluated according to their pre-dialysis acid-base status both before the first and the second session of the week dialyzed against standard base dialysate of 35 mmol/L...
February 14, 2019: Hemodialysis International
Dilek Torun, Baris Soydas, Nihan Tekkarismaz, Ruya Ozelsancak, Hasan Micozkadioglu, Mehmet Haberal
INTRODUCTION: Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in kidney transplant patients. The ability to establish a sustained viral response before renal transplant is important for these patients. Direct-acting antiviral agents can increase the sustained viral response in most patients with HCV infection. In this case series, we aimed to determine the efficacy and safety of a combined therapy of ombitasvir, paritaprevir, ritonavir, and dasabuvir with or without ribavirin in patients with HCV genotype 1 infection without cirrhosis and on hemodialysis who were awaiting deceased-donor kidney transplant...
February 14, 2019: Hemodialysis International
Heather A Morgans, Kathleen F Mallett, Judith F Sebestyen Vansickle, Bradley A Warady
This case report discusses a pediatric patient who developed a hemodialysis catheter line infection from an uncommon etiology, Mycobacterium fortuitum. The initial presentation revealed a well appearing patient with a slow growing skin lesion near the site of the hemodialysis catheter. The treatment course was complicated by resistance to initial antibiotics leading to continued spread of the lesion. The diagnosis was confirmed via skin biopsy of the lesion that required 2 weeks to grow the atypical Mycobacterium...
February 12, 2019: Hemodialysis International
May K Thet, Ma Lourdes F Pelobello, Milton Das, Mohammed M Alhaji, Vui Heng Chong, Muhammad Abdul Mabood Khalil, Terence Chinniah, Jackson Tan
We report a case series of seven patients with nonfermentative Gram-negative bacteria infections in a single dialysis center; four patients with Ralstonia pickettii and three patients with Stenotrophomonas maltophilia. Two of the seven patients were admitted to hospital for intravenous antibiotic treatment, while the rest were treated with oral antibiotics at home. Both the admitted patients had temporary vascular catheter infections from the aforementioned pathogens. We conclude that the outbreak is due to colonization of treated reverse osmosis water, presumably through contamination via polluted filters and compounded by the usage of reprocessed dialysers in the dialysis center...
February 12, 2019: Hemodialysis International
Rebecca Kurnik Seshasai, Tiffany Wong, Joel D Glickman, Judy A Shea, Laura M Dember
INTRODUCTION: Home hemodialysis (HHD) is an under-utilized renal replacement modality in the United States in part because of high rates of discontinuation and transfer to in-center hemodialysis. Understanding, from the perspective of patients, facilitators, and barriers to sustained use of HHD is important for increasing successful use of this modality. METHODS: We conducted 25 semistructured interviews with 15 current and 10 former adult patients treated with home hemodialysis (23 short daily HHD and 2 nocturnal HHD)...
February 11, 2019: Hemodialysis International
James B Wetmore, Nicholas S Roetker, David T Gilbertson, Jiannong Liu
INTRODUCTION: Whether and how factors associated with elective hemodialysis withdrawal differ from those associated with non-withdrawal death soon after maintenance hemodialysis initiation have not been well studied. METHODS: A retrospective cohort analysis was performed using USRDS data from 2011 to 2014. Patients were randomly categorized 2:1 into training and validation samples. Elective withdrawal deaths were identified using the Death Notification form. Multinomial logistic regression was used to fit a prediction model for three outcome categories (withdrawal, non-withdrawal death, survival at 6 months) as a function of demographic, comorbidity, and functional status...
February 11, 2019: Hemodialysis International
Buyun Wu, Daxi Ji, Bin Xu, Rong Fan, Dehua Gong
INTRODUCTION: Micronutrient depletion is a major drawback of high-dose continuous renal replacement therapy (CRRT). We tested two novel CRRT modes, double-filtration hemofiltration (DHF) and dialysate-recycling hemodiafiltration (DHDF), aimed at reducing micronutrient loss while maintaining a high clearance rate of midsized solutes comparable to that of high-volume hemofiltration (HVHF). METHODS: Forty patients with renal failure requiring CRRT were randomly assigned to receive predilutional standard-volume hemofiltration (SVHF, effluent rate 35 mL/kg/h), predilutional HVHF (100 mL/kg/h), DHF (35 mL/kg/h), and DHDF (30 mL/kg/h)...
February 11, 2019: Hemodialysis International
Yıldız ErdoĞanoĞlu, Berna Yalçin, Eyyüp Külah, Defne Kaya
INTRODUCTION: This study was conducted to investigate the relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients. MATERIALS AND METHODS: The study involved 24 hemodialysis patients and 20 healthy volunteers. Light touch-pressure sensation (Semmes Weinstein Monofilament test kit), two-point discrimination sensation (esthesiometer) and vibration sensation (128 Hz diapason) were used to evaluate plantar foot sensation...
February 11, 2019: Hemodialysis International
Orit Kliuk-Ben Bassat, Silviu Brill, Haggai Sharon
Significant chronic pain is highly prevalent in chronic kidney disease patients and is associated with morbidity and mortality. In this study, we retrospectively evaluated the incidence and treatment of pain in the dialysis unit of our tertiary referral center. The cohort included 147 patients. Over 66% reported significant (VAS >40) chronic pain during the preceding 3 months, most often characterized as stabbing (38%) and with concurrent itching (44%). Only 33% of patients received chronic pain medications, while 55...
February 8, 2019: Hemodialysis International
Wen-Fang Chiang, Pei-Ti Chen, Yen-Lin Chen, Ming-Hua Chen
Posterior reversible encephalopathy syndrome (PRES) is a reversible vasogenic brain edema in patients who present with seizure, headache, visual disturbance, and altered mental status, and a characteristic neuroimaging profile. Although PRES predominantly affects the bilateral parieto-occipital areas, involvement of the frontal and temporal lobes, basal ganglia, brainstem, and cerebellum is not uncommon. Isolated involvement of the brainstem and cerebellum sparing the parieto-occipital lobe is rarely reported...
February 8, 2019: Hemodialysis International
Miten Dhruve, Rose Faratro, Celine D'Gama, Stella Fung, Daniela Arustei, Elizabeth Wong, Christopher T Chan
INTRODUCTION: Vascular access complications are associated with increased morbidity and mortality in home hemodialysis (HHD). Nurse-administered vascular access checklist is a feasible quality improvement strategy aimed to lower HHD access errors. METHODS: We conducted a prospective quality improvement initiative for consecutive HHD patients between April 2013 and December 2016 at the Toronto General Hospital. Vascular access audits were administered every 6 months during clinic visits and during retraining sessions after an infection...
February 8, 2019: Hemodialysis International
Ritika Prasad, Thejas Kamath, Charles Ginsberg, O Alison Potok, Joachim H Ix, Pranav S Garimella, Dena E Rifkin
INTRODUCTION: The ankle-brachial index (ABI) is the most common test to diagnose peripheral artery disease (PAD). In dialysis patients, the ABI may under-diagnose PAD, due to a high prevalence of concomitant medial arterial calcification (MAC). The toe-brachial index (TBI) is not as susceptible to misclassification by MAC. Taking the ABI and TBI together in the form of their difference, the ABI-TBI, may provide a single measure for assessing both atherosclerosis and calcification. The relationship of these variables in dialysis patients has not been well studied...
February 8, 2019: Hemodialysis International
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