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Pediatric Hemodialysis

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12 papers 25 to 100 followers
By P O Pediatrics, Nephrology
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)
Enric Vilar, Capella Boltiador, Jonathan Wong, Adie Viljoen, Ashwini Machado, Arani Uthayakumar, Ken Farrington
BACKGROUND: Residual Kidney Function (RKF) is associated with survival benefits in haemodialysis (HD) but is difficult to measure without urine collection. Middle molecules such as Cystatin C and β2-microglobulin accumulate in renal disease and plasma levels have been used to estimate kidney function early in this condition. We investigated their use to estimate RKF in patients on HD. DESIGN: Cystatin C, β2-microglobulin, urea and creatinine levels were studied in patients on incremental high-flux HD or hemodiafiltration(HDF)...
2015: PloS One
Alexander Reshetnik, Christian Scheurig-Muenkler, Markus van der Giet, Markus Tölle
A young patient develops cerebral posttransplant lymphoproliferative disorder. Despite concurrent significantly impaired transplant kidney function use of add-on high-flux hemodialysis for additional clearance made the administration of high-dose methotrexate feasible in this patient without occurence of acute chronic kidney failure and significant hematological toxicity.
November 2015: Clinical Case Reports
(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
John R Prowle, Andrew Davenport
There is a paucity of high-quality evidence to guide clinicians on thresholds for commencement of renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI), and wide international practice variation. Wald et al. report a pilot randomized trial examining accelerated use of RRT for moderate AKI in the intensive care unit, providing a workable design for a definitive trial examining the timing of RRT in critical illness.
October 2015: Kidney International
Mélanie Godin, Patrick Murray, Ravindra L Mehta
Sepsis and acute kidney injury (AKI) frequently are combined in critical care patients. They both are associated independently with increased mortality and morbidity. AKI may precede, coincide with, or follow a sepsis diagnosis. Risk factors for sepsis followed by AKI differ from those associated with AKI preceding or coinciding with sepsis, and the pathophysiologic mechanisms may be different. In this article, we review the available clinical, laboratory, and imaging tools available for the recognition of septic AKI...
January 2015: Seminars in Nephrology
Andrew Davenport, Sanne A E Peters, Michiel L Bots, Bernard Canaud, Muriel P C Grooteman, Gulay Asci, Francesco Locatelli, Francisco Maduell, Marion Morena, Menso J Nubé, Ercan Ok, Ferran Torres, Mark Woodward, Peter J Blankestijn
Mortality remains high for hemodialysis patients. Online hemodiafiltration (OL-HDF) removes more middle-sized uremic toxins but outcomes of individual trials comparing OL-HDF with hemodialysis have been discrepant. Secondary analyses reported higher convective volumes, easier to achieve in larger patients, and improved survival. Here we tested different methods to standardize OL-HDF convection volume on all-cause and cardiovascular mortality compared with hemodialysis. Pooled individual patient analysis of four prospective trials compared thirds of delivered convection volume with hemodialysis...
January 2016: Kidney International
John W M Agar
While the solute clearance marker (Kt/Vurea ) is widely used, no effective marker for volume management exists. Two principles apply to acute volume change in hemodialysis: (1) the plasma refill rate, the maximum rate the extracellular fluid can replace a contracting intravascular volume (±5 mL/kg/hour) and (2) the rate of intravascular volume contraction where coronary hypoperfusion, myocardial stun, and vascular risk escalates (observed at ≥10 mL/kg/hour). In extended hour and higher frequency hemodialysis, intravascular contraction rates are usually equilibrated by the plasma refill rate, but in "conventional" in-center hemodialysis, volume contraction rates commonly exceed the capabilities of the plasma refill rate, resulting in inevitable hypovolemia...
January 2016: Hemodialysis International
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
Muriel P C Grooteman, Peter J Blankestijn, Menso J Nubé
No abstract text is available yet for this article.
November 2014: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Steven J Rosansky, Martin W Durkin
Although the goal glomerular filtration rate (GFR) for chronic dialysis initiation is currently above 5 ml/min per 1.73 m(2), there is no convincing evidence that patients will benefit from this approach. With close follow-up of advanced chronic kidney disease patients, aiming to start dialysis at an estimated GFR (eGFR) less than 5 ml/min per 1.73 m(2) may result in the avoidance of potentially unnecessary end-of-life dialysis and could result in significant dialysis-free time for a large segment of the world's future dialysis population...
October 2014: Kidney International
Pedro-Jose Lopez, Bernardita Troncoso, Jean Grandy, Francisco Reed, Alejandra Ovalle, Soledad Celis, Danielle Reyes, Nelly Letelier, Ricardo Zubieta
PURPOSE: Central venous catheters (CVC) are frequently used for haemodialysis (HD) in children. However, there is paucity of information on the outcomes of CVCs when used for HD in very young patients. Our objective is to report the success, safety and complication rates of CVCs used for HD in children weighing less than 15 kg. MATERIALS AND METHODS: This is a single-center retrospective study of all patients with end-stage renal disease (ESRD) weighing <15kg, who underwent a tunneled CVC placement for HD, between July 2006 and June 2012 at our institution...
August 2014: Journal of Pediatric Surgery
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