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36 papers 100 to 500 followers
By Erica Yama Nephrologist
Sylvia Paz B Ramirez, Keith P McCullough, Jyothi R Thumma, Robert G Nelson, Hal Morgenstern, Brenda W Gillespie, Masaaki Inaba, Stefan H Jacobson, Raymond Vanholder, Ronald L Pisoni, Fritz K Port, Bruce M Robinson
OBJECTIVE: Lowering hemoglobin A(1c) to <7% reduces the risk of microvascular complications of diabetes, but the importance of maintaining this target in diabetes patients with kidney failure is unclear. We evaluated the relationship between A(1c) levels and mortality in an international prospective cohort study of hemodialysis patients. RESEARCH DESIGN AND METHODS: Included were 9,201 hemodialysis patients from 12 countries (Dialysis Outcomes and Practice Patterns Study 3 and 4, 2006-2010) with type 1 or type 2 diabetes and at least one A(1c) measurement during the first 8 months after study entry...
December 2012: Diabetes Care
Yelena Slinin, Nancy Greer, Areef Ishani, Roderick MacDonald, Carin Olson, Indulis Rutks, Timothy J Wilt
BACKGROUND: In 2006, NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) published clinical practice guidelines for hemodialysis adequacy. Recent studies evaluating hemodialysis adequacy as determined by initiation timing, frequency, duration, and membrane type and prompted an update to the guideline. STUDY DESIGN: Systematic review and evidence synthesis. SETTING & POPULATION: Patients with advanced chronic kidney disease receiving hemodialysis...
November 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Hyeon Seok Hwang, Yoo Ah Hong, Hye Eun Yoon, Yoon Kyung Chang, Suk Young Kim, Young Ok Kim, Dong Chan Jin, Su-Hyun Kim, Yong-Lim Kim, Yon-Su Kim, Shin-Wook Kang, Nam-Ho Kim, Chul Woo Yang
Residual kidney function (RKF) contributes to improved survival in hemodialysis (HD) patients. However, it is not clear whether RKF allows a comparable survival rate in patients undergoing twice-weekly HD compared with thrice-weekly HD.We enrolled 685 patients from a prospective multicenter observational cohort. RKF and HD adequacy was monitored regularly over 3-year follow-up. Patients with RKF were divided into groups undergoing twice-weekly HD (n = 113) or thrice-weekly HD (n = 137). Patients without RKF undergoing thrice-weekly HD (n = 435) were included as controls...
February 2016: Medicine (Baltimore)
Reem A Mustafa, Fadi Bdair, Elie A Akl, Amit X Garg, Heather Thiessen-Philbrook, Hassan Salameh, Sood Kisra, Gihad Nesrallah, Ahmad Al-Jaishi, Parth Patel, Payal Patel, Ahmad A Mustafa, Holger J Schünemann
BACKGROUND AND OBJECTIVES: Lowering the dialysate temperature may improve outcomes for patients undergoing chronic hemodialysis. We reviewed the reported benefits and harms of lower temperature dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched the Cochrane Central Register, OVID MEDLINE, EMBASE, and Pubmed until April 15, 2015. We reviewed the reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included all randomized, controlled trials that evaluated the effect of reduced temperature dialysis versus standard temperature dialysis in adult patients receiving chronic hemodialysis...
March 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Harold Franch
No abstract text is available yet for this article.
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Yoshitsugu Obi, Connie M Rhee, Anna T Mathew, Gaurang Shah, Elani Streja, Steven M Brunelli, Csaba P Kovesdy, Rajnish Mehrotra, Kamyar Kalantar-Zadeh
In patients with ESRD, residual kidney function (RKF) contributes to achievement of adequate solute clearance. However, few studies have examined RKF in patients on hemodialysis. In a longitudinal cohort of 6538 patients who started maintenance hemodialysis over a 4-year period (January 2007 through December 2010) and had available renal urea clearance (CLurea ) data at baseline and 1 year after hemodialysis initiation, we examined the association of annual change in renal CLurea rate with subsequent survival...
December 2016: Journal of the American Society of Nephrology: JASN
Anna T Mathew, Steven Fishbane, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Residual kidney function (RKF) may confer a variety of benefits to patients on maintenance dialysis. RKF provides continuous clearance of middle molecules and protein-bound solutes. Whereas the definition of RKF varies across studies, interdialytic urine volume may emerge as a pragmatic alternative to more cumbersome calculations. RKF preservation is associated with better patient outcomes including survival and quality of life and is a clinical parameter and research focus in peritoneal dialysis. We propose the following practical considerations to preserve RKF, especially in newly transitioned (incident) hemodialysis patients: (1) periodic monitoring of RKF in hemodialysis patients through urine volume and including residual urea clearance with dialysis adequacy and outcome markers such as anemia, fluid gains, minerals and electrolytes, nutritional, status and quality of life; (2) avoidance of nephrotoxic agents such as radiocontrast dye, nonsteroidal anti-inflammatory drugs, and aminoglycosides; (3) more rigorous hypertension control and minimizing intradialytic hypotensive episodes; (4) individualizing the initial dialysis prescription with consideration of an incremental/infrequent approach to hemodialysis initiation (e...
August 2016: Kidney International
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury...
2016: F1000Research
Laura E K Ratcliffe, Wayne Thomas, Jessica Glen, Smita Padhi, Ben A J Pordes, David Wonderling, Roy Connell, Suzanne Stephens, Ashraf I Mikhail, Damian G Fogarty, Jan K Cooper, Belinda Dring, Mark A J Devonald, Chris Brown, Mark E Thomas
The UK-based National Institute for Health and Care Excellence (NICE) has updated its guidance on iron deficiency and anemia management in chronic kidney disease. This report outlines the recommendations regarding iron deficiency and their rationale. Serum ferritin alone or transferrin saturation alone are no longer recommended as diagnostic tests to assess iron deficiency. Red blood cell markers (percentage hypochromic red blood cells, reticulocyte hemoglobin content, or reticulocyte hemoglobin equivalent) are better than ferritin level alone at predicting responsiveness to intravenous iron...
April 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Iain C Macdougall, Andreas J Bircher, Kai-Uwe Eckardt, Gregorio T Obrador, Carol A Pollock, Peter Stenvinkel, Dorine W Swinkels, Christoph Wanner, Günter Weiss, Glenn M Chertow
Before the introduction of erythropoiesis-stimulating agents (ESAs) in 1989, repeated transfusions given to patients with end-stage renal disease caused iron overload, and the need for supplemental iron was rare. However, with the widespread introduction of ESAs, it was recognized that supplemental iron was necessary to optimize hemoglobin response and allow reduction of the ESA dose for economic reasons and recent concerns about ESA safety. Iron supplementation was also found to be more efficacious via intravenous compared to oral administration, and the use of intravenous iron has escalated in recent years...
January 2016: Kidney International
(no author information available yet)
The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for all stages of chronic kidney disease (CKD) and related complications since 1997. The 2015 update of the KDOQI Clinical Practice Guideline for Hemodialysis Adequacy is intended to assist practitioners caring for patients in preparation for and during hemodialysis. The literature reviewed for this update includes clinical trials and observational studies published between 2000 and March 2014...
November 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jonathan Wong, Enric Vilar, Andrew Davenport, Ken Farrington
Thrice-weekly haemodialysis schedules have become the standard default haemodialysis prescription worldwide. Whereas the measurement of residual renal function is accepted practice for peritoneal dialysis patients and the importance of residual renal function in determining technique success is well established, few centres routinely assess residual renal function in haemodialysis patients. Although intradialytic hypotension and episodes of acute kidney injury may predispose to an earlier loss of residual renal function, a significant proportion of haemodialysis patients maintain some residual function long after dialysis initiation...
October 2015: Nephrology, Dialysis, Transplantation
Raymond Vanholder, Griet Glorieux, Sunny Eloot
After its proposal as a marker of dialysis adequacy in the eighties of last century, Kt/V(urea) helped to improve dialysis efficiency and to standardize the procedure. However, the concept was developed when dialysis was almost uniformly short and was applied thrice weekly with small pore cellulosic dialyzers. Since then dialysis evolved in the direction of many strategic alternatives, such as extended or daily dialysis, large pore high-flux dialysis, and convective strategies. Although still a useful baseline marker, Kt/V(urea) no longer properly covers up for most of these modifications so that urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients...
September 2015: Kidney International
David A Goodkin, George R Bailie
No abstract text is available yet for this article.
June 2015: Kidney International
Cecile Couchoud, Davide Bolignano, Ionut Nistor, Kitty J Jager, James Heaf, Olle Heimburger, Wim Van Biesen
BACKGROUND: Diabetes is the leading cause of end-stage kidney disease (ESKD). Because of conflicting results in observational studies, it is still subject to debate whether in diabetic patients the dialysis modality selected as first treatment (haemodialysis or peritoneal dialysis) may have a major impact on outcomes. We therefore aimed at performing a systematic review of the available evidence. METHODS: MEDLINE, EMBASE and CENTRAL databases were searched until February 2014 for English-language articles without time or methodology restrictions by highly sensitive search strategies focused on diabetes, end-stage kidney disease and dialysis modality...
February 2015: Nephrology, Dialysis, Transplantation
Carmine Zoccali, Evangelia Dounousi, Samar Abd ElHafeez, Giovanni Tripepi, Francesca Mallamaci
Observational studies associate long dialysis intervals with an excess risk for mortality and cardiovascular disease hospitalizations. The application alternate day dialysis is an appealing possibility to reduce the cardiovascular burden of long dialysis intervals and a small pilot study demonstrated that this regimen allows safe reduction of dry body weight, BP and left ventricular mass index. However, the actual impact of alternate day hemodialysis and of frequent hemodialysis in general on survival remains unknown...
January 2015: Nephrology, Dialysis, Transplantation
Laura Labriola, Johann Morelle, Michel Jadoul
Frequent haemodialysis (HD) regimens have been proposed with the aim to improve survival and other important patient outcomes. They indeed avoid the long interdialytic interval and have been associated with some proven benefits, i.e. an improvement in blood pressure and phosphataemia control, a reduction in left ventricular mass and lower ultrafiltration rates. However, the actual impact of frequent HD regimens on survival is, at best, inconclusive and, at worse, harmful, and remains uncertain regarding nutritional status and anaemia control...
January 2015: Nephrology, Dialysis, Transplantation
Daniel E Weiner, Steven M Brunelli, Abigail Hunt, Brigitte Schiller, Richard Glassock, Frank W Maddux, Douglas Johnson, Tom Parker, Allen Nissenson
Addressing fluid intake and volume control requires alignment and coordination of patients, providers, dialysis facilities, and payers, potentially necessitating a "Volume First" approach. This article reports the consensus opinions achieved at the March 2013 symposium of the Chief Medical Officers of 14 of the largest dialysis providers in the United States. These opinions are based on broad experience among participants, but often reinforced by only observational and frequently retrospective studies, highlighting the lack of high-quality clinical trials in nephrology...
November 2014: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Manish M Sood, Paul Komenda, Claudio Rigatto, Brett Hiebert, Navdeep Tangri
Automated reporting of eGFR by laboratories has been widely implemented during the last decade. Over this same period, a steady increase in eGFR at dialysis initiation has been reported. This study examined trends in eGFR at dialysis initiation over time among incident dialysis patient populations before and after eGFR reporting. All patients who initiated dialysis between January of 2001 and December of 2010 in four Canadian provinces that implemented province-wide automated eGFR reporting and had an eGFR measure at dialysis initiation were included in the study (n=22,208)...
September 2014: Journal of the American Society of Nephrology: JASN
Kamyar Kalantar-Zadeh, Francesco G Casino
No abstract text is available yet for this article.
September 2014: Nephrology, Dialysis, Transplantation
2014-09-05 23:28:07
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