Hyangkyoung Kim, Hoon Suk Park, Tae Hyun Ban, Seung Boo Yang, Young Joo Kwon
INTRODUCTION: As nearly half of patients with end-stage kidney disease (ESKD) who initiate hemodialysis (HD) are over 65 years old (commonly defined as elderly), the fistula first strategy is controversial even in HD patients ≥65 years. METHODS: In Korea's National Health Insurance Service database from 2008 to 2019, 41,989 elderly (≥ 65 years) HD patients were retrospectively reviewed to identify their clinical characteristics and outcomes...
March 21, 2023: Hemodialysis International
Amir Kazory
Compared to women with normal kidney function, women with end-stage kidney disease (ESKD) are much less likely to become pregnant, but more likely to have a complicated pregnancy. While renal transplantation remains the best option for women who desire to have a child, pregnancy on dialysis should be considered an option for those who may not receive a transplant during their reproductive years. Many physicians do not encounter a pregnant patient with ESKD during their nephrology training, and may not feel prepared to provide care for such patients in a busy practice...
March 16, 2023: Hemodialysis International
Arum Krismi, Retno Danarti, Ida I Dewa Putu Pramantara Setiabudi, Yohanes W Wirohadidjojo
Chronic kidney disease-associated pruritus (CKD-aP) is a common and distressing symptom for patients with CKD and a difficult challenge for nephrologists and dermatologists. Recent results showed the multifactorial nature of the pathophysiology, and therapeutic trials were only successful in certain subsets of patients. The clinical manifestations are varied, with xerosis being the most common dermatological manifestation and correlated with the intensity of CKD-aP. A better understanding of the pathophysiology of xerosis in CKD-aP and appropriate topical treatment could correct xerosis to reduce the intensity of CKD-aP and improve the patient's quality of life...
April 2023: Hemodialysis International
Marta Álvarez Nadal, Nuria Rodríguez Mendiola, Martha Elizabeth Díaz Domínguez, Milagros Fernández Lucas
INTRODUCTION: Intradialytic hypotension (IDH) remains one of the most frequent complications associated to hemodialysis (HD), frequently triggered by a reduction in absolute blood volume (ABV) not compensated by vascular refilling. A recently developed dilutional method allows routinary measurement of ABV and, by a simple algorithm, may turn blood volume monitor (BVM) guided UF (ultrafiltration) biofeedback into an ABV control, automatically adjusting UF rate to maintain ABV above a preset threshold...
April 2023: Hemodialysis International
Tobias Bomholt, Marianne Rix, Thomas Almdal, Filip K Knop, Susanne Rosthøj, Morten B Jørgensen, Bo Feldt-Rasmussen, Mads Hornum
INTRODUCTION: Hemodialysis (HD) induces several physiological changes that can affect plasma glucose levels in patients with diabetes and in turn their glycemic control. Studies using continuous glucose monitoring (CGM) to assess glucose variations on dialysis days compared with nondialysis days report conflicting results. Here, we used CGM to examine glucose variations induced by HD in patients with type 2 diabetes. METHODS: Patients with type 2 diabetes undergoing maintenance HD were included...
April 2023: Hemodialysis International
Derek M Blankenship, Len Usvyat, Michael A Kraus, Dinesh K Chatoth, Rachel Lasky, Joseph E Turk, Franklin W Maddux
INTRODUCTION: Inadequate predialysis care and education impacts the selection of a dialysis modality and is associated with adverse clinical outcomes. Transitional care units (TCUs) aim to meet the unmet educational needs of incident dialysis patients, but their impact beyond increasing home dialysis utilization has been incompletely characterized. METHODS: This retrospective study included adults initiating in-center hemodialysis at a TCU, matched to controls (1:4) with no TCU history initiating in-center hemodialysis...
April 2023: Hemodialysis International
Ya-Ling Tai, Hsin-Yi Shen, Wei-Hsuan Nai, Jen-Fen Fu, I-Kuan Wang, Chien-Chang Huang, Cheng-Hao Weng, Cheng-Chia Lee, Wen-Hung Huang, Huang-Yu Yang, Ching-Wei Hsu, Tzung-Hai Yen
INTRODUCTION: Data on the incidence rates of hungry bone syndrome after parathyroidectomy in patients on dialysis are inconsistent, as the published rates vary from 15.8% to 92.9%. METHODS: Between 2009 and 2019, 120 hemodialysis patients underwent parathyroidectomy for secondary hyperparathyroidism at the Chang Gung Memorial Hospital. The patients were stratified into two groups based on the presence (n = 100) or absence (n = 20) of hungry bone syndrome after parathyroidectomy...
April 2023: Hemodialysis International
Camilla C Correa, Mariana M B Figueiredo, Analucia R Xavier, Salim Kanaan, Jocemir R Lugon
INTRODUCTION: We evaluated the effects of pre-analytical care on total carbon dioxide (tCO2 ) in hemodialysis patients, as calculated by blood gas analysis (ctCO2 ) or measured by an enzymatic assay (mtCO2 ). METHODS: Blood samples were collected via vascular access before dialysis sessions. For blood gas analysis, eight aliquots were collected, refrigerated or non-refrigerated, and analyzed at 0, 4, 8, and 24 h after collection. A blood sample was then collected for the enzymatic method and distributed into 14 aliquots...
February 14, 2023: Hemodialysis International
Gülşah Kesik, Leyla Ozdemir, Tolga Yıldırım, Jabrayil Jabrayilov, Gülseren Çeliksöz
INTRODUCTION: Muscle cramps and fatigue are common complications in hemodialysis patients and have been associated with reduced patient comfort. Among the complementary therapies advocated for the management of these complications have been the application of warm or cold compresses to the extremities during a hemodialysis treatment. In this study, we compared the effects of warm or cold compresses application on cramping, fatigue, and patient comfort. METHODS: This placebo-controlled randomized trial was done in 69 patients, who were stratified and randomly allocated to three treatment arms...
February 14, 2023: Hemodialysis International
Thilina Gunawardena, Hemant Sharma, Sanjay Mehra
INTRODUCTION: The native arteriovenous fistula (AVF) is the gold standard for long-term hemodialysis access. When native vein options are exhausted, arteriovenous graft (AVG) becomes the next choice. An ulcer over an AVF or AVG is a serious condition with the potential for life-threatening hemorrhage. OBJECTIVES: This study aims to present our experience with surgical management of ulcers over AVFs or AVGs. MATERIALS AND METHODS: Electronic records of 26 patients who underwent 27 consecutive surgical procedures for ulcers over AVFs or AVGs from December 31, 2016 to December 31, 2021 at the Royal Liverpool University Hospital were retrospectively analyzed...
February 9, 2023: Hemodialysis International
Derek M Blankenship, Len Usvyat, Rachel Lasky, Franklin W Maddux
No abstract text is available yet for this article.
February 6, 2023: Hemodialysis International
Susie Q Lew, Gurleen Kaur, Neal Sikka, Kevin F Erickson
No abstract text is available yet for this article.
February 6, 2023: Hemodialysis International
Junqing Liang, Ying Wang, Weilin Zhang, Hong Ding, Yanjun Gao, Rui Wang, Xiaofei Sun, Ying Peng, Liangying Gan, Li Zuo
INTRODUCTION: Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China. METHODS: Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020...
February 6, 2023: Hemodialysis International
Babitha Selvananthan, Omar Aziz, Arvind D Lee, Keagan Werner-Gibbings, Bhadran Bose, Kamal Sud
Blood leak alarms are increasingly rare and may be triggered by rupture of the dialyzer membrane, or intravascular hemolysis. We report two patients who developed hemolysis following Angiojet™ thrombolysis and thrombectomy of thrombosed arteriovenous fistulas, triggering blood leak alarms on hemodialysis, the occurrence of which has not been reported before. AngioJet™-induced hemolysis should be considered in the differential diagnosis for blood leak alarms occurring soon after an intervention on an arterio-venous (AV) fistula...
February 3, 2023: Hemodialysis International
Peiheng Zhang, Yang Yu, Ying Gao, Geheng Yuan, Junqing Zhang, Wei Wang
The most appropriate surgical procedure for tertiary hyperparathyroidism is still controversial. Medical management may be considered in those patients with failed previous surgical intervention. There are limited medical options for tertiary hyperparathyroidism with renal dysfunction. The monoclonal antibody denosumab has been used in patients with osteoporosis and hypercalcemia of malignancy. We report a case of medically refractory hypercalcemia caused by tertiary hyperparathyroidism treated with denosumab...
January 31, 2023: Hemodialysis International
Aakanksha Agarwal, Timothy Murray, Nikki Craig, Mercedeh Kiaii
Neuropathic pain at the cannulation site is challenging, both for the patient and the dialysis team. We present a case of a middle-aged man on chronic hemodialysis, who developed excruciating pain at the cannulation area without incident, limiting his dialysis sessions. Multidisciplinary collaboration allowed identification of the cutaneous nerve-the inferior lateral cutaneous nerve of the arm, relaying his pain. Subsequent ultrasound-guided phenol chemoablation resulted in the complete resolution of his pain and allowed continued use of the well-functioning fistula for dialysis...
January 26, 2023: Hemodialysis International
Michael Schmiedecker, Simon Krenn, Maximilian Waller, Christopher Paschen, Sebastian Mussnig, Janosch Niknam, Peter Wabel, Christopher C Mayer, Manfred Hecking, Daniel Schneditz
INTRODUCTION: Prescribing the ultrafiltration in hemodialysis patients remains challenging and might benefit from the information on absolute blood volume, estimated by intradialytic dialysate bolus administration. Here, we aimed at determining the relationship between absolute blood volume, normalized for body mass (specific blood volume, Vs), and ultrafiltration-induced decrease in relative blood volume (∆RBV) as well as clinical parameters including body mass index (BMI). METHODS: This retrospective analysis comprised 77 patients who had their dialysate bolus-based absolute blood volume extracted routinely with an automated method...
January 26, 2023: Hemodialysis International
Sophie E Claudel, Christopher Valente, Hope Serafin, Mohamed Hassan Kamel, Sandeep Ghai
BACKGROUND: Patients with end-stage kidney disease requiring dialysis encounter high hospital readmission rates. One contributor is poor communication between hospitals and outpatient dialysis facilities. We hypothesized that improved communication may reduce 30-day hospital readmissions for patients on dialysis at an urban, safety net hospital. METHODS: We created a standardized discharge handoff tool that is easy to use and provides concise data for dialysis centers...
January 25, 2023: Hemodialysis International
John C Edwards, Amy Mosman, Paul J Hauptman, Taewoo Lee, Marie Philipneri, Firoozeh Farahmand, Louis Yn, Margaret Brandon, Paula M Buchanan
INTRODUCTION: People with end-stage renal disease on hemodialysis are at increased risk for death due to arrhythmia associated with the prolonged interdialytic interval that typically spans the weekend, with bradycardia being the arrhythmia most closely associated with sudden death. In this prospective observational study we assessed whether predialysis fluid and electrolytes values including hyperkalemia are risk factors for the arrhythmias associated with the prolonged interdialytic interval...
January 2023: Hemodialysis International
Maurizio Bossola, Tania Monteburini, Emanuele Parodi, Stefano Santarelli, Vittorio Sirolli, Stefano Cenerelli, Mario Bonomini, Grazia de Ninno, Enrico di Stasio
INTRODUCTION: The present cross-sectional study aimed to compare the prevalence, the characteristics of post-dialysis fatigue and the length of recovery time after hemodialysis in prevalent end-stage renal disease patients (ESRD) receiving bicarbonate hemodialysis (HD) or hemodiafiltration (HDF). METHODS: Patients were suffering from post-dialysis fatigue if they spontaneously offered this complaint when asked the open-ended question: "Do you feel fatigued after dialysis?"...
January 2023: Hemodialysis International
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