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Pre- dialysis

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
Eun Ji Park, Su Woong Jung, Da Rae Kim, Jin Sug Kim, Tae Won Lee, Chun Gyoo Ihm, Kyung Hwan Jeong
Background: The objective of this study was to compare the impact of citrate dialysate (CD) and standard acetate dialysate (AD) in hemodialysis by central delivery system (CDS) on heparin demand, and clinical parameters. Methods: We retrospectively evaluated 75 patients on maintenance hemodialysis with CDS. Patients underwent hemodialysis with AD over a six-month period (AD period), followed by another six-month period using CD (CD period). Various parameters including mean heparin dosage, high sensitivity C-reactive protein (hsCRP), calcium-phosphate product (CaxP), intact parathyroid hormone (iPTH), and urea reduction ratio (URR) were collated at the end of each period...
February 12, 2019: Kidney Research and Clinical Practice
Katarzyna Hap, Katarzyna Madziarska, Wojciech Hap, Sławomir Zmonarski, Dorota Zielińska, Dorota Kamińska, Mirosław Banasik, Katarzyna Kościelska-Kasprzak, Marian Klinger, Oktawia Mazanowska
<strong>BACKGROUND</strong> Being overweight for kidney transplant recipients can cause serious side effects. Weight gain affects two-thirds of kidney transplant recipients and has been attributed to a more liberal diet after transplantation, recovery of appetite due to lack of uremic toxicity, corticosteroid use, and inadequate lifestyle changes. The aim of this study was to assess gender-dependent profile of body mass index (BMI) changes after kidney transplantation (KTx). <strong>MATERIAL AND METHODS</strong> Sixty-two kidney transplant recipients (38 males and 24 females), aged 46...
January 29, 2019: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Jin K Kim, Armando J Lorenzo, Walid A Farhat, Michael E Chua, Jessica M Ming, Joana Dos Santos, Martin A Koyle
PURPOSE: Little is known regarding post-transplant renal function following pediatric pre-emptive KT. Therefore, this study aims to determine whether there is a difference in 1 year post-transplant renal function outcomes between pre-emptive and post-dialysis KT in pediatric transplant recipients. METHODS: A retrospective review of patients who underwent kidney transplant at our institution between 2000 and 2015 was performed. Kidney transplant recipients were divided into four groups: pre-DD, post-DD, pre-LD, and post-LD...
February 8, 2019: Pediatric Transplantation
Yuhei Otobe, Koji Hiraki, Chiharu Hotta, Kazuhiro P Izawa, Tsutomu Sakurada, Yugo Shibagaki
BACKGROUND: No longitudinal study has investigated the impact of combination of kidney function (KF) and physical function (PF) on cognitive decline in these patients. METHODS: We conducted a 2-year prospective cohort study enrolling 131 patients ≥ 65 years with pre-dialysis chronic kidney disease (CKD). We assessed cognitive function with the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We calculated %MoCA-J based on the rate of change between baseline and follow-up MoCA-J scores, and defined cognitive decline over 2 years as a %MoCA-J of less than the first quartile value...
February 8, 2019: Clinical and Experimental Nephrology
Ruth Dubin, Anna Rubinsky
BACKGROUND: Patient education regarding end-stage renal disease (ESRD) has the potential to reduce adverse outcomes and increase the use of in-home renal replacement therapies. OBJECTIVE: This study aimed to investigate whether an online, easily scalable education program can improve patient knowledge and facilitate decision making regarding renal replacement therapy options. METHODS: We developed a 4-week online, digital educational program that included written information, short videos, and social networking features...
February 6, 2019: JMIR formative research
Jacqueline G O'Leary, Jasmohan S Bajaj, Puneeta Tandon, Scott W Biggins, Florence Wong, Patrick S Kamath, Guadalupe Garcia-Tsao, Benedict Maliakkal, Jennifer Lai, Michael Fallon, Hugo E Vargas, Paul Thuluvath, Ram Subramanian, Leroy R Thacker, Rajender K Reddy
Acute-on-Chronic Liver Failure (ACLF) characterized with ≥2 extra-hepatic organ failures in cirrhosis carries a high mortality. Outcomes of patients listed for liver transplant (LT) after ACLF and after LT are largely unknown. NACSELD (North American Consortium for the Study of End-Stage Liver Disease) prospectively enrolled 2,793 non-electively hospitalized patients with cirrhosis; 768 were LT-listed. Within 3-months 265 (34%) received a LT, 395 remained alive without LT, and 108 died/delisted. Compared to non-listed patients, those listed were younger, more often had ACLF, AKI, and a higher admission MELD...
February 5, 2019: Liver Transplantation
GuoCun Hou, Hua Gan, XiuLi Sun, Jing Li
Purpose: Fluid management using a body composition monitor (BCM) based on bioimpedance spectroscopy has been found to be beneficial for maintenance hemodialysis (MHD) patients. Our purpose was to provide a management procedure for the adjustment of post-dialysis overhydration (OHpost ) and to evaluate whether this approach could improve blood pressure. Methods: Post-dialysis fluid status was assessed weekly using the BCM. The reference value of OHpost and the flow procedure for post-dialysis target weight (PDTW) adjustment were established via measurements of OHpost in 60 normotensive MHD patients...
March 2019: Biochemistry and Biophysics Reports
Tushar Kotecha, Ana Martinez-Naharro, Suree Yoowannakul, Tabitha Lambe, Tamer Rezk, Daniel S Knight, Philip N Hawkins, James C Moon, Vivek Muthurangu, Peter Kellman, Roby D Rakhit, Julian D Gillmore, Paramjit Jeetley, Andrew Davenport, Marianna Fontana
In patients with chronic kidney disease (CKD), reverse left ventricular (LV) remodelling, including reduction in LV mass, can be observed following long-term haemodialysis (HD) and has been attributed to regression of LV hypertrophy. However, LV mass can vary in response to changes in myocyte volume, edema, or fibrosis. The aims of this study were to investigate the acute changes in structural (myocardial mass and biventricular volumes) and tissue characterization parameters (native T1 and T2) following HD using cardiovascular magnetic resonance (CMR)...
February 4, 2019: Scientific Reports
Fabian Hammer, Uwe Malzahn, Julian Donhauser, Christoph Betz, Markus P Schneider, Clemens Grupp, Nils Pollak, Stefan Störk, Christoph Wanner, Vera Krane
Mineralocorticoid receptor antagonists have beneficial effects on left ventricular remodeling, cardiac fibrosis, and arrhythmia in heart failure, but efficacy and safety in dialysis patients is less clear. We evaluated the effect of spironolactone on left ventricular mass (LVM), an independent predictor of all-cause and cardiovascular mortality, in hemodialysis patients. In this placebo-controlled, parallel-group trial, 97 hemodialysis patients (23% female; mean age 60.3 years) were randomized to spironolactone 50 mg once daily (n=50) or placebo (n=47)...
January 29, 2019: Kidney International
(no author information available yet)
BACKGROUND: Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large statin trials to compare the effects of statin therapy at different ages. METHODS: In this meta-analysis, randomised trials of statin therapy were eligible if they aimed to recruit at least 1000 participants with a scheduled treatment duration of at least 2 years...
February 2, 2019: Lancet
Deepika Jain, Danny B Haddad, Narender Goel
The population of patients with end stage renal disease (ESRD) is increasing, lengthening waiting lists for kidney transplantation. Majority of the patients are not able to receive a kidney transplant in timely manner even though it is well established that patient survival and quality of life after kidney transplantation is far better when compared to being on dialysis. A large number of patients who desire a kidney transplant ultimately end up needing some form of dialysis therapy. Most of incident ESRD patients choose hemodialysis (HD) over peritoneal dialysis (PD) as the modality of choice in the United States, even though studies have favored PD as a better choice of pre-transplant dialysis modality than HD...
January 21, 2019: World Journal of Nephrology
Ilchom T Murkamilov, K A Aitbaev, A Sh Sarybaev, V V Fomin, I G Gordeev, Z R Rayimzhanov, N A Redjapova, F A Yusupov
PURPOSE: to study clinical-functional features of remodeling of carotid arteries and its relation to restructuring of the left ventricle (LV) in patients with chronic glomerulonephritis at pre-dialysis stage. MATERIALS AND METHODS: We examined 269 patients (189 men, 80 women) with chronic glomerulonephritis (CGN) aged 17-71 years, at pre-dialysis stages of the disease. We analyzed biochemical parameters of peripheral blood with the determination of daily proteinuria and glomerular filtration rate (GFR)...
November 18, 2018: Kardiologiia
Keita Sueyoshi, Yusuke Watanabe, Tsutomu Inoue, Yoichi Ohno, Hiroyuki Nakajima, Hirokazu Okada
The long-term prognosis of patients with postoperative acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) after cardiovascular surgery is unclear. We aimed to investigate long-term renal outcomes and survival in these patients to determine the risk factors for negative outcomes. Long-term prognosis was examined in 144 hospital survivors. All patients were independent and on renal replacement therapy at hospital discharge. The median age at operation was 72.0 years, and the median pre-operative estimated glomerular filtration rate (eGFR) was 39...
2019: PloS One
I N Bobkova, S S Gussaova, E V Stavrovskaya, A V Struve
Obesity, including morbid obesity, is a growing worldwide problem. The adverse effect of obesity on the kidneys is associated with the development of comorbid conditions, such as insulin resistance (IR), metabolic syndrome (MS), diabetes mellitus (DM), arterial hypertension (AH), which are the recognized risk factors of chronic kidney disease (СKD). Obesity also causes direct kidney damage with the development of non-immune focal segmental glomerulosclerosis. The leading pathophysiological mechanisms of kidney damage in obesity are intrarenal hemodynamic disorders with the formation of hyperfiltration and damaging effects of adipokines produced by adipose tissue...
June 20, 2018: Terapevticheskiĭ Arkhiv
Vaibhav Maheshwari, Stephan Thijssen, Xia Tao, Doris H Fuertinger, Franz Kappel, Peter Kotanko
Protein-bound uremic toxins (PBUTs) are poorly removed during hemodialysis (HD) due to their low free (dialyzable) plasma concentration. We compared PBUT removal between HD, hemodiafiltration (HDF), membrane adsorption, and PBUT displacement in HD. The latter involves infusing a binding competitor pre-dialyzer, which competes with PBUTs for their albumin binding sites and increases their free fraction. We used a mathematical model of PBUT/displacer kinetics in dialysis comprising a three-compartment patient model, an arterial/venous tube segment model, and a dialyzer model...
January 29, 2019: Scientific Reports
Nicole Ata, Subhashini Ayloo, Alan Tsung, Michele Molinari
BACKGROUND: The oncological effects of obesity on liver transplant (LT) patients with hepatocellular carcinoma (HCC) remains unclear. We investigated patient overall survival and tested two-way interactions between donor and recipient obesity status. METHODS: Using the UNOS database, a total of 8352 LT recipients with HCC were included. Donors and recipients were stratified in normal weight (NW), overweight (OW) and obese (OB). Hazard ratios (HR) for any cause of death and interactions between recipient and donor BMI were estimated by multivariate flexible parametric models...
January 2019: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Guang Yang, Yifei Ge, Xiaoming Zha, Huijuan Mao, Ningning Wang, Changying Xing
PURPOSE: It is unclear whether clinical courses of hungry bone syndrome (HBS) after parathyroidectomy (PTX) in peritoneal dialysis (PD) and hemodialysis (HD) patients are different. The present study aimed to investigate the possible differences of postoperative hypocalcemia and hyperkalemia between PD and HD patients. METHODS: We performed retrospectively 29 PD patients as the PD group and 169 HD patients as the HD group undergoing successful total PTX with autotransplantation...
January 28, 2019: International Urology and Nephrology
Patricia de Sequera Ortiz, Rafael Pérez García, Manuel Molina Nuñez, Rosa Inés Muñoz González, Gracia Álvarez Fernández, Eva Mérida Herrero, María Jesús Camba Caride, Luís Alberto Blázquez Collado, M Paz Alcaide Lara, Rocío Echarri Carrillo
INTRODUCTION: Dialysis fluid (DF), an essential element in hemodialysis (HD), is manufactured in situ by mixing three components: treated water, bicarbonate concentrate and acid concentrate. To avoid the precipitation of calcium and magnesium carbonate that is produced in DF by the addition of bicarbonate, it is necessary to add an acid. There are 2 acid concentrates that contain acetate (ADF) or citrate (CDF) as a stabilizer. OBJECTIVE: To compare the acute effect of HD with CDF vs...
January 24, 2019: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Guy J M Cameron, Simon H Jiang, Svenja Loering, Aniruddh V Deshpande, Philip M Hansbro, Malcolm R Starkey
Acute kidney injury remains a global challenge and, despite the availability of dialysis and transplantation, can be fatal. Those that survive an acute kidney injury are at increased risk of developing chronic kidney disease and end stage renal failure. Understanding the fundamental mechanisms underpinning the pathophysiology of acute kidney injury is critical for developing novel strategies for diagnosis and treatment. A growing body of evidence indicates that amplifying type 2 immunity may have therapeutic potential in kidney injury and disease...
January 25, 2019: Journal of Pathology
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