dialysis

BACKGROUND/OBJECTIVES: To investigate the correlation between serum 25-hydroxyvitamin D (25(OH)D) and brachial-ankle pulse wave velocity (baPWV) and mortality among peritoneal dialysis (PD) patients. SUBJECTS/METHODS: We retrospectively reviewed the data of 269 PD patients in our center from January 1, 2013, to December 31, 2018. Subjects were divided into groups according to serum 25(OH)D level based on a cut-off of 20 ng/ml. The general linear regression model was employed to explore the correlation between 25(OH)D and baPWV...

Patients with non-dialysis chronic kidney disease (CKD) are at greater risk of early mortality and decreased physical function with an advance in the stage of CKD. However, the effect of exercise in these patients is unclear. This meta-analysis aimed to determine the effects of physical exercise training on the risk of mortality, kidney and physical functions, and adverse events in patients with non-dialysis CKD. The meta-analysis conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the Cochrane Handbook recommendations...

Post-procedural wound haemorrhage is a potentially life-threatening complication. For haemodialysis patients, bleeding is often encountered after vascular access procedures and fatal episodes have been reported. Visual monitoring for bleeding is manpower intensive and bleeding episodes may still be missed between inspections. A device, Blood WArning Technology with Continuous Haemoglobin sensor (BWATCH), was developed to detect bleeding from wounds. This a prospective, observational clinical trial on patients who have had a dialysis catheter inserted or removed...

OBJECTIVE: To strengthen patients' health literacy and their role as active knowledge actors, we developed a health communication intervention including a film-viewing and counselling session for patients awaiting kidney transplantation. We aimed to explore processes of knowing in the translation of the intervention. METHODS: We applied an ethnographic research approach, observing nine intervention sessions with patients and dialysis nurses. Afterwards, the patients and the nurses were interviewed in-depth...

OBJECTIVE: The incremental shuttle walking test (ISWT) is an important marker of aerobic capacity in patients on peritoneal dialysis (PD). This study aimed to evaluate its predictive value for PD-related outcomes. METHODS: This single-center cohort study recruited outpatients on maintenance PD from our hospital between March 2017 and March 2018. Exercise capacity was assessed using measurement of ISWT and handgrip and quadriceps strength. Patients were divided into 2 groups according to the median of exercise capacity and prospectively followed up until cessation of PD, death, or the study end (October 2019)...

INTRODUCTION: Prior abdominal surgery may result in peritoneal membrane adhesions and fibrosis, compromising the success of peritoneal dialysis (PD). The impact of this factor on peritoneal membrane function and PD technique survival has not been adequately investigated. METHODS: Following an observational, retrospective design, we studied 171 incident PD patients, with the main objective of analyzing the influence of prior abdominal surgical procedures (main study variable) on baseline and evolutionary peritoneal transport characteristics (main outcome) and PD patient and technique survival (secondary outcomes)...

BACKGROUND: It is known that hypoxia influences many of the biologic processes involved in erythropoiesis; therefore, the high-altitude hypoxia may affect erythropoietin (EPO) responsiveness in maintenance hemodialysis (MHD) patients. This study aimed to evaluate the impact of altitude on EPO responsiveness in MHD patients. METHODS: In this retrospective study, MHD patients from Tibet Autonomous Region People's Hospital (3,650 m above sea level) and Peking University People's Hospital (43...

OBJECTIVE: An arteriovenous fistula (AVF) is the preferred vascular access for chronic hemodialysis, yet the rates of AVF maturation failure and reintervention remain high. We investigated the AVF geometric parameters and their associations with AVF physiologic maturation and reintervention in a prospective multi-center study. METHODS: From 2011 to 2016, patients undergoing a vein end-to-artery side upper-extremity AVF creation surgery were recruited. Contrast-free dark-blood and phase-contrast magnetic resonance imaging (MRI) scans were performed using 3...

BACKGROUND: Acute occlusion of the renal bridging stent-grafts after fenestrated/branched endovascular aortic repair (F/B-EVAR) is an acknowledged complication with high morbidity often resulting to chronic dialysis dependence. The feasibility and effect of timely or late (≥6 hours of ischemia) renal artery revascularization has not been adequately reported in the literature. METHODS: We performed a retrospective, multi-centre study across 11 tertiary institutions of all consecutive patients that underwent revascularization of renal artery stent-graft occlusions after complex EVAR...

BACKGROUND: Autogenous arteriovenous fistula creation is the preferred route for vascular access for hemodialysis. While preoperative venous mapping ultrasound has been advocated as an operative planning adjunct, and recently incorporated in the Society of Vascular Surgery clinical guidelines, controversy remains as to its usefulness for predicting access success. The purpose of this retrospective clinical study was to test the hypothesis that vein size measured on routine preoperative venous mapping is a poor predictor of primary fistula maturation...

INTRODUCTION: For patients on renal replacement therapy (RRT), "travel" and "independence" are rated as 2 of the top 5 factors that inform their choice of treatment modality. While home dialysis modalities offer patients a high degree of independence, the most common RRT in the United States is in-center hemodialysis (IHD). The limits imposed by IHD treatment can present a variety of challenges for patients who wish to travel. This study explored how IHD patients managed their travel and the role of dialysis social workers in executing travel arrangements for patients...

INTRODUCTION: Data on pathologic features with prognostic utility in adults with minimal change disease (MCD) are limited. We assessed the relationship between histologic chronic changes and clinical presentation and outcomes. METHODS: The consecutive records of 79 patients with MCD and minimum of 6 months follow-up were retrospectively reviewed. Kidney survival was the primary endpoint (doubling serum creatinine or dialysis initiation). Secondary endpoints were time to remission and relapse...

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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 caregivers, and healthcare professionals...

Peritonitis remains a primary challenge for the long-term success of peritoneal dialysis (PD) technique and one of the main reasons for catheter removal. Prevention and treatment of catheter-related infections are major concerns to avoid peritonitis. The use of taurolidine catheter-locking solution to avoid the development of a biofilm in the catheter's lumen has obtained good results in hemodialysis catheters for reducing infection rates, although there is scarce literature available regarding its utility in PD...

Rationale & Objective: Transitions between dialysis modalities can be disruptive to care. Our goals were to evaluate rates of transition from peritoneal dialysis (PD) to in-center hemodialysis (HD), mortality, and transplantation among incident PD patients in the US Renal Data System from 1996 to 2015 and identify factors associated with these outcomes. Study Design: Observational registry-based retrospective cohort study. Setting & Participants: Medicare patients incident to end-stage renal disease (ESRD) from January 1, 1996, through December 31, 2011 (for adjusted analyses; through December 31, 2014, for unadjusted analyses), and treated with PD 1 or more days within 180 days of ESRD incidence (n = 173,533 for adjusted analyses; n = 219,787 for unadjusted analyses)...

Rationale & Objective: Since the change in erythropoiesis-stimulating agent (ESA) labeling and bundling of dialysis services in the United States, few studies have addressed the clinical importance of ESA hyporesponsiveness and none have considered health care resource use in this population. We aimed to further explore ESA hyporesponsiveness and its consequences. Study Design: Retrospective observational cohort study. Setting & Participants: US Renal Data System Medicare participants receiving dialysis with a minimum 6 months of continuous ESA use from 2012 to 2014...

Bilateral hearing loss is attributed to almost 50% of times with genetic etiology, while most unilateral sensorineural hearing loss (USNHL) are not attributable to it. Limited literature is available on epidemiology of USNHL. Etiology of USNHL is very diverse and vast, it ranges from as common as Meniere's disease to as rare as an electric shock injury. A prospective study was carried out to find rare causes of USNHL in adults. In this manuscript, we present a case series of 7 rare etiologies of USNHL in adults like auditory neuropathy, chemoradiotherapy, dialysis-induced SNHL, common cavity inner ear malformation, multiple sclerosis, acute otitis media-induced SNHL and vertebrobasilar dolichoectasia...

An extracellular fructosyltransferase (Ftase) enzyme with a molar mass of ≈70 kDa from a newly isolated indigenous coprophilous fungus Aspergillus niger sp. XOBP48 is purified to homogeneity and characterized in this study. The enzyme was purified to 4.66-fold with a total yield of 15.53% and specific activity of 1219.17 U mg-1 of protein after a three-step procedure involving (NH4 )2 SO4 fractionation, dialysis and anion exchange chromatography. Ftase showed optimum activity at pH 6.0 and temperature 50 °C...

PURPOSE: IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis and a leading cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Recently, some case reports have shown that COL4A5 mutation is associated with IgAN. Here, we identified a new COL4A5 gene mutation in IgAN in a Chinese family. MATERIALS AND METHODS: In the present study, the proband and his 23-year-old younger brother were both diagnosed with IgAN, manifested as haematuria, proteinuria and chronic kidney injury without hearing loss or ocular symptoms...