MedWorm: Dialysis

Physical compatibility of magnesium sulfate and sodium bicarbonate in a pharmacy-compounded hemofiltration solution.

American Journal of Health-System Pharmacy : AJHP — Sat, 20 Mar 2010 01:34:17 +0100

Conclusion Magnesium sulfate 1.5 meq/L and sodium bicarbonate 50 meq/L were physically compatible in a pharmacy-compounded hemofiltration solution for 48 hours when stored at 22-25 degrees C without protection from light. PMID: 20237384 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

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Dialysis in the poisoned patient

Hemodialysis International — Sat, 20 Mar 2010 00:00:00 +0100

Patients who ingest toxic substances may require extracorporeal removal of the poisons or their toxic metabolites if native renal clearance is not sufficient because of acute kidney injury, acuity of symptoms, or burden of toxin. Here, a case is presented, and the literature on renal replacement therapy in the event of acute intoxication is reviewed. Extracorporeal therapy efficacy is examined in terms of the characteristics of the toxin (molecular size, charge, protein, or lipid binding); the patient (body habitus and volume of distribution); and the process (membrane effects on extraction ratios and sieving, role of blood, and dialysate flow rates). The choice of extracorporeal therapy and hemodialysis prescriptions for specific poisonings are discussed. (Source: Hemodialysis Internation...

Basal Insulin Requirements May Be Less on the Day After Dialysis

Medscape Today Headlines — Fri, 19 Mar 2010 18:00:40 +0100

A study shows a significant (25%) reduction in basal insulin requirements on the day after dialysis vs the day before dialysis in type 2 diabetic patients with end-stage renal disease. Medscape Medical News (Source: Medscape Today Headlines)

Risk factors for acute renal failure after heart surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

CONCLUSION: Renal dysfunction was the most frequent postoperative organ dysfunction in patients undergone CABG and/or valve surgery and age, congestive heart failure, COPD, endocarditis, myocardial infarction < 30 days, valve surgery, cardiopulmonary bypass time >120 min, and peripheral arterial vascular disease were the risk factors independently associated with acute renal failure (ARF). (Source: Revista Brasileira de Cirurgia Cardiovascular)

High mortality in orthotopic liver transplant recipients who require hemodialysis

Clinical Transplantation — Fri, 19 Mar 2010 00:00:00 +0100

Zand MS, Orloff MS, Abt P, Patel S, Tsoulfas G, Kashyap R, Jain A, Safadjou S, Bozorgzadeh A. High mortality in orthotopic liver transplant recipients who require hemodialysis.Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01238.x© 2010 John Wiley & Sons A/S.Abstract: Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri-transplant dialysis on the long-term mortality of liver transplant recipients. We performed a single-center, retrospective cohort study of 743 adult liver transplants; patients who received first liver transplants were divided into four groups: those who received more than one dialysis treatment (hemodialysis [HD], continuous veno-venous hemodialysis [CVVH]) pre-orthotopic li...

Malignancy Incidence After Renal Transplantation in Children: A 20-Year Single-Centre Experience

Medscape Transplantation Headlines — Thu, 18 Mar 2010 19:43:08 +0100

Children who undergo renal transplantation require long-term surveillance for cancer, this research confirms. Nephrology Dialysis Transplantation (Source: Medscape Transplantation Headlines)

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Virtually all kidney disease patients on dialysis have vitamin D deficiency

NaturalNews.com — Thu, 18 Mar 2010 07:00:00 +0100

(NaturalNews) Research abounds that adequate vitamin D is essential for good health (http://www.naturalnews.com/Vitamin_D.html). Unfortunately, however, millions of Americans are not getting enough of this so-called "sunshine" vitamin. Now it turns out that one group in particular is almost universally lacking in vitamin D. According to a study slated for publication in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN), kidney disease patients who have low blood protein levels and who start dialysis during the winter are at extremely high risk of being seriously deficient in vitamin D.Ishir Bhan, MD, of Massachusetts General Hospital, and his research team studied data from 908 U.S. dialysis patients in the Accelerated Mortality on Renal Replacement (ArMO...

Contraindicated Antithrombotics May Be of Use in Dialysis Patients Undergoing PCI

Medscape Today Headlines — Wed, 17 Mar 2010 17:00:17 +0100

Certain drugs that confer an increased risk of bleeding are contraindicated in dialysis patients undergoing PCI. Dr. Lynda Szczech comments on a study that puts this prohibition into new perspective. Medscape Nephrology (Source: Medscape Today Headlines)

Improved erectile function and sex hormone profiles in male Chinese recipients of kidney transplantation

Clinical Transplantation — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: Successful kidney transplantation can significantly ameliorate ED in Chinese patients, especially in individuals with a shorter time on dialysis. Changes in sex hormone levels may contribute to this improvement in ED. (Source: Clinical Transplantation)

Comparative mortality risk of anaemia management practices in incident haemodialysis patients

NeLM - News — Wed, 17 Mar 2010 00:00:00 +0100

Source: JAMA Area: News A study comparing the risk of mortality associated with different practices of anaemia management among different dialysis centres in the US has been published in JAMA. The authors note that the appropriate use of erythropoiesis-stimulating agents (ESAs) and intravenous iron can effectively manage the anaemia of chronic kidney disease and end-stage renal disease (ESRD). Several trials have reported an increased risk of mortality and cardiovascular events in patients treated to achieve higher haematocrit levels - as these trials were conducted in selected patient populations however, some controversy around the management of anaemia in ESRD remains. The purpose of this trial was to address this evidence gap - the researchers sought ...

Mitochondrial Ca2+ Activates a Cation Current in Aplysia Bag Cell Neurons

Journal of Neurophysiology — Tue, 16 Mar 2010 15:19:50 +0100

Ion channels may be gated by Ca2+ entering from the extracellular space or released from intracellular stores—typically the endoplasmic reticulum. The present study examines how Ca2+ impacts ion channels in the bag cell neurons of Aplysia californica. These neuroendocrine cells trigger ovulation through an afterdischarge involving Ca2+ influx from Ca2+ channels and Ca2+ release from both the mitochondria and endoplasmic reticulum. Liberating mitochondrial Ca2+ with the protonophore, carbonyl cyanide-4-trifluoromethoxyphenyl-hydrazone (FCCP), depolarized bag cell neurons, whereas depleting endoplasmic reticulum Ca2+ with the Ca2+-ATPase inhibitor, cyclopiazonic acid, did not. In a concentration-dependent manner, FCCP elicited an inward current associated with an increase in conductanc...

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Management of the peri-operative and critically ill renal transplant patient

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

Summary: Recipients of successful renal transplants experience a markedly improved quality of life and almost certainly improved survival compared to patients treated with dialysis. Haemodialysis treatment in the immediate period prior to transplantation is associated with a poorer outcome including a higher rate of delayed graft function (DGF). Individuals undergoing renal transplantation require close intra-operative monitoring with optimisation of intravascular fluid volume to maximise renal transplant perfusion. Whether mannitol, loop diuretics, dopamine or other therapies influence the rate of DGF is not possible to decide. For renal transplant recipients admitted immediately post-procedure to intensive care unit (ICU) the prognosis is good. This is in contrast to those admitted usual...

Renal replacement therapy in the intensive care unit

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:23 +0100

This article explores the techniques available for renal replacement and support in the intensive care unit, discussing vascular access, choice of technique, choice of membrane, choice of dialysis buffer and strategies for maintaining circuit patency. It examines the techniques in common use in the United Kingdom and the outcome following renal replacement therapy, discussing some of the controversies surrounding renal replacement in terms of timing and dose. It also discusses some future development in technologies for renal replacement. (Source: Current Anaesthesia and Critical Care)

Inappropriate Use of Antithrombotics in Patients Undergoing Percutaneous Coronary Intervention

Medscape Today Headlines — Tue, 16 Mar 2010 11:04:24 +0100

An "alarmingly high" number of dialysis patients receive an inappropriate antithrombotic during percutaneous coronary intervention, increasing their risk of bleeding. Journal Watch (Source: Medscape Today Headlines)

RCT: B Vitamins do not reduce risk of total mortality and cardiovascular disease in end-stage renal disease

NeLM - News — Tue, 16 Mar 2010 00:00:00 +0100

Source: Circulation Area: News According to the "homocysteine hypothesis (Hcy)," elevated blood Hcy is a risk factor for cardiovascular disease (CVD). It is known that elevated homocysteine levels can be lowered by supplementation with folic acid and vitamin B12. In a recent meta-analysis, a 5?mol/L increase in Hcy was associated with a 9% increased risk of CVD among patients with end-stage renal disease (ESRD). The authors of the meta-analysis sought to further test this relationship in an RCT, the results of which have been published early online in Circulation. The study conducted in 33 dialysis centres in north and east Germany between July 2002 and July 2008 involved 650 patients with ESRD undergoing haemodialysis, who were randomised to receive 2 post-dialysis treatments:...

Cardio-renal syndromes: report from the consensus conference of the Acute Dialysis Quality Initiative

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

A consensus conference on cardio-renal syndromes (CRS) was held in Venice Italy, in September 2008 under the auspices of the Acute Dialysis Quality Initiative (ADQI). The following topics were matter of discussion after a systematic literature review and the appraisal of the best available evidence: definition/classification system; epidemiology; diagnostic criteria and biomarkers; prevention/protection strategies; management and therapy. The umbrella term CRS was used to identify a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Different syndromes were identified and classified into five subtypes. Acute CRS (type 1): acute worsening of heart function (AHF–ACS) leading to kidney injury an...

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Angola: Health Minister Announces Expansion of Haemodialysis Services

AllAfrica News: Health and Medicine — Mon, 15 Mar 2010 10:07:40 +0100

Angola's Health minister, José Van-Dúnem, on Thursday here announced the expansion soon of haemodialysis services to the provinces of Cabinda, Huila, Benguela and Huambo, Angop has learnt. (Source: AllAfrica News: Health and Medicine)

Comparison of intradialytic blood pressure variability between conventional thrice-weekly hemodialysis and short daily hemodialysis

Hemodialysis International — Mon, 15 Mar 2010 00:00:00 +0100

We examined the effect of short daily hemodialysis (SDHD) on intradialytic BP variability relative to conventional thrice-weekly HD (CHD). This is a retrospective cohort study. Subjects were those converted from CHD to SDHD (n=12). All intradialytic BPs were collected on the last month of CHD, and on month 6 of SDHD. Absolute predialysis BP level and intradialytic BP variability were defined as the intercept and average residual terms, respectively, from a mixed-effects linear regression model of time on BP. Dialysis modality was a predictor variable (CHD vs. SDHD). Outcome variables were intradialytic BP variability and hypotension (BP (Source: Hemodialysis International)

Non-convulsive status epilepticus triggered by haemodialysis in an epileptic patient

Internal Medicine Journal — Mon, 15 Mar 2010 00:00:00 +0100

(Source: Internal Medicine Journal)

Effect of hemodialysis on the plasma levels of clofarabine

Pediatric Blood and Cancer — Mon, 15 Mar 2010 00:00:00 +0100

Clofarabine, a nucleoside analogue for treatment of relapsed leukemia, is 50-60% excreted in urine. Clofarabine has not been studied in patients on hemodialysis. We measured levels in one patient in acute renal failure. Prior to dialysis, 43 hr after a 40 mg/m2 infusion, plasma concentration was 139 ng/ml. One hour after begining hemodialysis, a 20 mg/m2 infusion began. Plasma concentrations were 84.2, 81.1, and 88.0 ng/ml while the dialysis and clofarabine infusion occurred simultaneously. Post-dialysis, while the clofarabine was still infusing, the level was 95.8 ng/ml. Hemodialysis does decrease clofarabine levels, but given its large volume distribution, hemodialysis may not be effective for clofarabine overdose. Pediatr Blood Cancer. © 2010 Wiley-Liss, Inc. (Source: Pediatric Blood a...

The Effect of Lupus Nephritis on Pregnancy Outcome and Fetal and Maternal Complications.

J Rheumatol — Mon, 15 Mar 2010 00:00:00 +0100

CONCLUSION: Lupus nephritis in pregnancy does not lead to worsened pregnancy or fetal outcomes. Active renal disease, however, is associated with pregnancy-induced hypertension, as well as a flare of lupus activity during pregnancy. PMID: 20231194 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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B Vitamins and the Risk of Total Mortality and Cardiovascular Disease in End-Stage Renal Disease. Results of a Randomized Controlled Trial.

Circulation — Mon, 15 Mar 2010 00:00:00 +0100

Conclusions-Increased intake of folic acid, vitamin B12, and vitamin B6 did not reduce total mortality and had no significant effect on the risk of cardiovascular events in patients with end-stage renal disease. Clinical Trial Registration-URL: www.anzctr.org.au. Unique identifier: ACTRN12609000911291. URL: www.cochrane-renal.org. Unique identifier: CRG010600027. PMID: 20231532 [PubMed - as supplied by publisher] (Source: Circulation)

Low-density lipoprotein (LDL) apheresis reduces atherogenic and oxidative markers in uremic patients with hyperlipidemia

International Urology and Nephrology — Sun, 14 Mar 2010 12:26:37 +0100

This study aimed to investigate whether LDL apheresis was capable of reducing oxidative and atherogenic markers in uremic patients with hyperlipidemia. We found that oxidative metabolites (methylquanidine, dityrosine, and ox-LDL) and atherogenic markers (lipoprotein (a), LDL, and LDL/HDL ratio) were significantly reduced (P < 0.05) after LDL apheresis. On the other hand, plasma total antioxidant status (TAS) was not influenced after LDL apheresis. Our results suggest that LDL apheresis reduces oxidative and atherogenic markers and do not influence plasma TAS in uremic patients with hyperlipidemia. This may lead to a decreased risk of atherosclerosis in these patients. However, supplementation of dietary proteins may be necessary because of the removal of some “useful�...

Rex Medical Cleaner™ Rotational Thrombectomy System Receives 510(k) Clearance

Health News from Medical News Today — Sun, 14 Mar 2010 07:00:00 +0100

Rex Medical, L.P., announced that it has received 510(k) Clearance from the U.S. Food and Drug Administration (FDA) for the Cleaner™ Rotational Thrombectomy System. Cleaner™ technology is indicated for mechanical declotting of occluded native vessel dialysis fistulae and synthetic dialysis access grafts. Argon Medical Devices, Inc. will lead all marketing and distribution efforts for Cleaner™ in the United States, European Union and Canada... (Source: Health News from Medical News Today)

Rex Medical Cleaner™ Rotational Thrombectomy System Receives 510(k) Clearance

Medical Devices News From Medical News Today — Sun, 14 Mar 2010 07:00:00 +0100

Rex Medical, L.P., announced that it has received 510(k) Clearance from the U.S. Food and Drug Administration (FDA) for the Cleaner™ Rotational Thrombectomy System. Cleaner™ technology is indicated for mechanical declotting of occluded native vessel dialysis fistulae and synthetic dialysis access grafts. Argon Medical Devices, Inc... (Source: Medical Devices News From Medical News Today)

Development and utility of a multi-dimensional grid to assess individual mineral metabolism control in hemodialysis patients: A potential aid for therapeutic decision making?

Hemodialysis International — Sun, 14 Mar 2010 00:00:00 +0100

A grid was developed to evaluate control of serum calcium, phosphate, and parathyroid hormone levels in hemodialysis patients, based on guideline recommendations (National Kidney Foundation Kidney Disease Outcomes Quality Initiative and Canadian Society of Nephrology), and its face validity was examined in a representative sample of Canadian patients. A retrospective chart review was undertaken in hemodialysis patients from 7 Canadian units. Patients >18 years, on hemodialysis for [ge]12 months, and [ge]3 parathyroid hormone levels measured [ge]1 month apart were included. The grid classified mineral metabolism control as optimal, suboptimal, or poor (mean of 3 measurements). Medication use, hospitalization, and Emergency Department visits were evaluated in relation to grid occupancy. A se...

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'I gave my sister a kidney. I don't know if I'll ever do a better thing'

Guardian Unlimited Science — Sat, 13 Mar 2010 00:05:41 +0100

This week saw the first three-way kidney transplant, in which living donors gave to a stranger in return for an organ for a loved one. Peter Martin, who donated a kidney to his sister, describes how it feelsFour years ago I gave my sister Paula a kidney. It was just before Christmas and I'm sure we exchanged books, or knitwear or something too, but the details of the gifts we wrapped remain sketchy. The kidney (her kidney, now) is doing fine work filtering impurities from her blood. I don't think she works it as hard as I did, so things have worked out well for both of them.When she was 21, Paula had an allergic reaction to penicillin that caused her immune system to attack her skin and kidneys. It began with pinprick sensations around her lower legs, and within two days both her ankles an...

The prevalence and predictors of atrial fibrillation in hemodialysis patients.

Turk Kardiyoloji Dernegi arsivi — Fri, 12 Mar 2010 11:50:04 +0100

CONCLUSION: Our findings highlight age and right atrial diameter as independent predictors of atrial fibrillation in hemodialysis patients. In addition, the E/E' ratio and pulmonary artery pressure may be considered new risk factors of atrial fibrillation in this population. PMID: 20215836 [PubMed - as supplied by publisher] (Source: Turk Kardiyoloji Dernegi arsivi)

South Africa: 'Hospital Sent Me Home to Die'

AllAfrica News: Health and Medicine — Fri, 12 Mar 2010 11:19:45 +0100

As the world commemorates the sixth World Kidney Day today, it will be a day of suffering and uncertainty for Cape Town musician Brett Nicol, who is fighting for his life at home after being turned down for life-saving dialysis treatment in the state health sector almost two years ago. (Source: AllAfrica News: Health and Medicine)

Right Ventricular Outflow Tract Obstruction: Metastatic Thyroid Carcinoma

Journal of the American College of Cardiology — Thu, 11 Mar 2010 13:54:40 +0100

A 62-year old female dialysis patient presented with intermittent fever, dyspnea, and hoarseness (due to a diagnosed thyroid tumor). While she was treated for fever of unknown origin, transthoracic echocardiography (A) showed a solid high-echoic mass (arrow) extending into the main pulmonary artery (PA) and obliterating the right ventricular outflow tract (Online Video 1). The 64-multislice computed tomography scan (B) demonstrated a large ellipsoid mass (59 × 55 × 35 mm) extensively involving the right ventricle (RV) wall. Transvenous biopsy confirmed undifferentiated thyroid carcinoma. At 20 days after admission, the patient died of decompensated heart failure. An autopsy (C) was performed and confirmed the findings of the transthoracic echocardiography, multislice computed tomography,...

Rex Medical Cleaner Rotational Thrombectomy System Receives 510(k) Clearance

HSMN NewsFeed — Thu, 11 Mar 2010 13:14:15 +0100

CONSHOHOCKEN, Pa.--(HSMN NewsFeed)--Rex Medical, L.P., today announced that it has received 510(k) Clearance from the U.S. Food and Drug Administration (FDA) for the Cleaner Rotational Thrombectomy System. Cleaner technology is indicated for mechanical d... Devices, Interventional, FDARex Medical, Argon Medical Devices, Thrombectomy, dialysis access (Source: HSMN NewsFeed)

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Rex Medical Cleaner Rotational Thrombectomy System Receives 510(k) Clearance

Medical Design Online News — Thu, 11 Mar 2010 11:30:00 +0100

Rex Medical, L.P., today announced that it has received 510(k) Clearance from the U.S. Food and Drug Administration (FDA) for the CleanerT Rotational Thrombectomy System. Cleaner technology is indicated for mechanical declotting of occluded native vessel dialysis fistulae and synthetic dialysis access grafts (Source: Medical Design Online News)

Bilateral vocal cord paralysis in a patient with chronic renal failure associated with Alport syndrome

Journal of Anesthesia — Thu, 11 Mar 2010 02:41:20 +0100

Abstract A 61-year-old woman with chronic renal failure (CRF) associated with Alport syndrome underwent coronary artery aneurysmectomy under general anesthesia. Hemorrhage control was difficult during the surgery, and she became hemodynamically unstable. The surgery and anesthesia lasted 446 and 552 min, respectively. On postoperative day 1, she developed severe respiratory distress several minutes after extubation. Her trachea was immediately reintubated. The second attempt to extubate her trachea also failed. Fiberoptic examination revealed bilateral vocal cord paralysis (VCP) due to recurrent laryngeal nerve (RLN) paralysis. Although she needed a temporary tracheostomy, vocal cord movement recovered without treatment 3 months after surgery. The mechanisms unde...

Management of regional citrate anticoagulation in pediatric high-flux dialysis: activated coagulation time versus post-filter ionized calcium

Pediatric Nephrology — Thu, 11 Mar 2010 02:41:11 +0100

The objective of this retrospective analysis was to establish adequate coagulation management using post-filter iCa values. Normal values for ACTester-based ACT were established using a group of 64 children who were divided into two subgroups, with one subgroup comprising children without chronic kidney disease or coagulation disorder (age 1.2–17.5 years, median 9.7 years) and one consisting of 32 uremic patients (age 0.6–17.5 years, median 13.7 years). In a second group of 13 patients (aged 7–17 years), all of whom were undergoing high-flux dialysis (HD) with regional citrate anticoagulation (RCA), we assessed 73 post-filter blood samples for ionized calcium and ACT. A receiver operating characteristic graph was used to identify the iCa threshold needed to achie...

Identification and Treatment of Protein-energy Malnutrition in Renal Disease.

Canadian Journal of Dietetic Practice and Research — Thu, 11 Mar 2010 01:02:03 +0100

Authors: McKnight K, Farmer A, Zuberbuhler L, Mager D A web-based cross-country survey of renal registered dietitians (RRDs) was launched. It was used to assess whether or not their clinical practice in identifying and treating protein-energy malnutrition (PEM) in adults with end-stage renal disease (ESRD) and dialysis was based on current nutrition practice guidelines (NPGs). The survey included questions on strategies, timelines, and markers used for the identification and treatment of PEM. Fifty-nine RRDs responded (21%). Sixty-seven percent did not base clinical practice on NPGs, while 33% indicated they followed the guidelines. Of those who followed guidelines, 76% use the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative nutrition guidelines. Strategies used t...

A rare but ominous association: Intracardiac thrombus and vegetation simultaneously in a hemodialysis patient

Hemodialysis International — Thu, 11 Mar 2010 00:00:00 +0100

(Source: Hemodialysis International)

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Sustained LDL inhibition may contribute to dialysis PAD benefits

MedWire News - Lipidology — Thu, 11 Mar 2010 00:00:00 +0100

Sustained inhibition of low-density lipoprotein may contribute to long-term benefits in dialysis patients with peripheral arterial disease who respond to apheresis, Japanese researchers suggest. (Source: MedWire News - Lipidology)

Patency rate and complications of polytetrafluoroethylene grafts compared with polyurethane grafts for hemodialysis access.

Upsala Journal of Medical Sciences — Thu, 11 Mar 2010 00:00:00 +0100

Conclusion. It could be concluded that either PTFE or PVAG grafts can be used with the same expected outcomes. PMID: 20218943 [PubMed - as supplied by publisher] (Source: Upsala Journal of Medical Sciences)

Pharmacists find satisfaction in dialysis clinics.

American Journal of Health-System Pharmacy : AJHP — Wed, 10 Mar 2010 17:22:46 +0100

Authors: Traynor K PMID: 20208046 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Diabetics on hemodialysis in El-Minia Governorate, Upper Egypt: five-year study

International Urology and Nephrology — Wed, 10 Mar 2010 15:29:17 +0100

Conclusion Diabetic nephropathy among HD patients in El-Minia Governorate is increasing but is less prevalent than in the United States and other Western countries, probably because of a higher incidence of other causes of ESRD in El-Minia governorate, or because of premature death of diabetic patients. Therefore, meticulous management of diabetic patients is mandatory. Content Type Journal ArticleCategory Nephrology – Original PaperDOI 10.1007/s11255-010-9713-zAuthors Osama El-Minshawy, El Minia University School of Medicine Department of Internal Medicine El Minia EgyptEmad G. Kamel, El Minia University School of Medicine Department of Public Health El Minia Egypt Journal International Urology and NephrologyOnline ISSN 1573-2584Print ISSN 0301-1623 (Sourc...

Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study

International Urology and Nephrology — Wed, 10 Mar 2010 15:29:16 +0100

Conclusions This exercise program and the outcome measures were feasible for older HD patients: in-hospital participation was high, and physical performance and QOL measures exhibited moderate levels of responsiveness. Future, larger studies are needed to demonstrate whether intra-dialysis exercise, with or without home exercise, can lead to improved outcomes in this population. Content Type Journal ArticleCategory Nephrology – Original PaperDOI 10.1007/s11255-010-9718-7Authors Mika L. Nonoyama, Toronto Rehabilitation Institute 550 University Avenue Toronto ON M5G 2A2 CanadaDina Brooks, Toronto Rehabilitation Institute 550 University Avenue Toronto ON M5G 2A2 CanadaAlexandra Ponikvar, Toronto Rehabilitation Institute 550 University Avenue Toronto ON M5G 2A2 Canada...

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One's Enough: People Who Donate a Kidney Live Just as Long as Those Who Don't

Scientific American Topic - Medical Technology — Wed, 10 Mar 2010 12:00:00 +0100

Every 30 minutes, all of the blood in our bodies is filtered through two fist-size kidneys. But diseases such as diabetes can cause them to fail, leading to a build-up of chemicals in the blood that without dialysis (mechanical blood filtration) or a kidney transplant would be fatal. And the wait for a new kidney can be long, unless someone you know is willing to give one of theirs to you. [More] (Source: Scientific American Topic - Medical Technology)

One's Enough: People Who Donate a Kidney Live Just as Long as Those Who Don't

Scientific American - Official RSS Feed — Wed, 10 Mar 2010 12:00:00 +0100

Protect Your Kidneys, Control Diabetes, Op-ed

Government of Nova Scotia News Releases - Health — Wed, 10 Mar 2010 00:00:00 +0100

NOTE: The following is an op-ed piece by Susan MacNeil, manager, Nova Scotia Renal Program. Diabetes is the leading cause of kidney disease. More than 40 per cent of people that need dialysis also have diabetes. (Source: Government of Nova Scotia News Releases - Health)

Evaluation of neopterin levels in patients undergoing hemodialysis

Hemodialysis International — Wed, 10 Mar 2010 00:00:00 +0100

Neopterin is a diagnostic or a prognostic biomarker for several pathologies including renal diseases. However, the association between neopterin status and causative main reasons such as diabetes and hypertension for renal disease remains unclear. The aim of the study was to evaluate neopterin levels in diabetes and hypertension patients treated with/without hemodialysis. According to primary renal disorders, the patients undergoing hemodialysis were classified into 4 groups as diabetic nephropathy, hypertensive nephropathy, reflux nephropathy or interstitial nephritis, and others. The controls consisted of healthy subjects, hypertensive subjects, and diabetic individuals without any renal disorder. In the study, both urinary and serum neopterin levels were measured using high performance ...

Use of 3-hour daily hemodialysis and paricalcitol in patients with severe secondary hyperparathyroidism: A case series

Hemodialysis International — Wed, 10 Mar 2010 00:00:00 +0100

We present 5 patients with severe secondary hyperparathyroidism (median iPTH=1783 pg/mL) who were treated with 3-hour daily hemodialysis (3 hours × 6 times a week). Daily hemodialysis, at 1 year, was associated with a 70.4% reduction in median PTH (1783 pg/mL [interquartile range: 1321[ndash]1983][ndash]472 pg/mL [334, 704], P (Source: Hemodialysis International)

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Small incision basilic vein transposition technique: A good alternative to standard method

Indian Journal of Urology — Tue, 09 Mar 2010 16:12:01 +0100

Veeramani Muthu, Vyas Jigish, Sabnis Ravindra, Desai MaheshIndian Journal of Urology 2010 26(1):145-147End-stage renal disease is a significant health problem. The primary use of the autogenous arteriovenous access is recommended by NKF-DOQI (National Kidney Foundation-Dialysis Outcomes Quality Initiative) guidelines. Though basilic vein transposition is well established in multiple failed fistulae's and obese patients, it requires large incision and morbidities like edema and infection. To avoid such compilations we, at our institution, adopted a small incision technique using two small 3-4&#8197;cm incisions. This method is inspired by videoendoscopic minimally invasive method used to dissect the basilic vein, thus avoiding extensive dissection and related morbidities. ...

NxStage Announces New FREEDOM Data Showing The Positive Impact Of Its Daily Home Hemodialysis Therapy On Sleep Quality And Restless Legs Syndrome

Health News from Medical News Today — Tue, 09 Mar 2010 09:00:00 +0100

Booths # 23-25 at the Annual Dialysis Conference -- NxStage Medical, Inc. (Nasdaq: NXTM), a leading manufacturer of innovative dialysis products, announced the latest interim results from its ongoing FREEDOM study, which show the significant improvement of overall sleep quality and marked improvement in Restless Legs Syndrome (RLS) experienced by patients after four months of daily home hemodialysis therapy with the NxStage System One™... (Source: Health News from Medical News Today)

NxStage Announces New FREEDOM Data Showing The Positive Impact Of Its Daily Home Hemodialysis Therapy On Sleep Quality And Restless Legs Syndrome

Medical Devices News From Medical News Today — Tue, 09 Mar 2010 09:00:00 +0100

Booths # 23-25 at the Annual Dialysis Conference -- NxStage Medical, Inc... (Source: Medical Devices News From Medical News Today)

Significance of elevated gingival crevicular fluid tumor necrosis factor-α and interleukin-8 levels in chronic hemodialysis patients with periodontal disease

Journal of Periodontal Research — Tue, 09 Mar 2010 00:00:00 +0100

Conclusion: The levels of TNF-[alpha] and IL-8 in gingival crevicular fluid were significantly higher in HD patients than in controls. There were strong, positive correlations between clinical periodontal parameters and the levels of inflammatory cytokines in gingival crevicular fluid from the HD patients. (Source: Journal of Periodontal Research)

Day-to-day variation of insulin requirements of patients with type 2 diabetes and end-stage renal disease undergoing maintenance hemodialysis.

Diabetes Care — Tue, 09 Mar 2010 00:00:00 +0100

Conclusions: The present study has demonstrated a significant 25% reduction in basal insulin requirements the day after dialysis compared to the day before. No significant change in boluses was observed, and overall the reduction of total insulin requirements was -15% equivalent to -4IU/day post HD of marginal statistical significance. PMID: 20215452 [PubMed - as supplied by publisher] (Source: Diabetes Care)

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NxStage Announces New FREEDOM Data Showing the Positive Impact of its Daily Home Hemodialysis Therapy on Sleep Quality and Restless Legs Syndrome

HSMN NewsFeed — Mon, 08 Mar 2010 15:27:02 +0100

LAWRENCE, Mass. and SEATTLE, March 8 (HSMN NewsFeed) -- Booths # 23-25 at the Annual Dialysis Conference -- NxStage Medical, Inc. (Nasdaq:NXTM ), a leading manufacturer of innovative dialysis products, today announced the latest interim results from its ... DevicesNxStage Medical, home hemodialysis, hemodialysis, Restless Legs Syndrome (Source: HSMN NewsFeed)

The Association of Serum Osteoprotegerin and Osteoporosis in Postmenopausal Hemodialysis Patients: A Pilot Study

Journal of Women — Mon, 08 Mar 2010 14:51:06 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Fatigue Found Predictive of Cardiovascular Events in ESRD

Modern Medicine — Mon, 08 Mar 2010 00:00:00 +0100

Fatigue may predict cardiovascular events in patients with end-stage renal disease utilizing hemodialysis, according to research published online March 3 in the Clinical Journal of the American Society of Nephrology. (Source: Modern Medicine)

KPC-producing extreme-drug resistant (XDR) Klebsiella pneumoniae isolate from a patient with diabetic mellitus and chronic renal failure on hemodialysis in South Korea.

Antimicrobial Agents and Chemotherapy — Mon, 08 Mar 2010 00:00:00 +0100

Authors: Rhee JY, Park YK, Shin JY, Choi JY, Lee MY, Ran Peck K, Song JH, Ko KS Prevalence of extended-spectrum beta-lactamases (ESBLs) has limited the available therapeutic options and necessitated the increased use of carbapenems against Klebsiella pneumoniae infections. ... PMID: 20211897 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Bromide poisoning: psychiatric symptoms and negative anion gap

The Poison Review — Sun, 07 Mar 2010 18:27:34 +0100

3.5 out of 5 stars Bromide Toxicity from Consumption of Dead Sea Salt. Sosa R, Stone W. Am J Med March 2010;123:e11-12. Full text Until the middle of the 20th century, when bromide was removed from such over-the-counter products as Dr. Miles’ Nervine and Bromo-Seltzer, chronic bromism was reported to be responsible for approximately 5-10% of admissions to psychiatric hospitals. Bromide has sedative and anticonvulsant properties. At high levels, bromide replaces chloride in nerve transport mechanisms, stabilizing the membrane and impairing nerve transmission. In addition, bromide is preferentially re-absorbed by the kidney over chloride, producing a very long half-life (9-12 days). Because bromide is identified as chloride in many laboratory testing systems, patients with si...

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Clinical Trial Summary: Stent Graft Versus Balloon Angioplasty for Failing Dialysis-Access Grafts (Stent Graft Versus Balloon Angioplasty for Failing Dialysis-Access Grafts)

Cardiosource — Sun, 07 Mar 2010 00:00:00 +0100

Although hemodialysis access is traditionally done with native fistulas, especially the first time, prosthetic grafts are often used to create permanent access hemodialysis circuits. Prosthetic arteriovenous (AV) graft failure is related to stenosis at the venous site of the anastomosis, usually due. . . (Source: Cardiosource)

Antineutrophil cytoplasmic antibody-associated vasculitis with renal involvement: the evidence for treatment

International Journal of Evidence-Based Healthcare — Sun, 07 Mar 2010 00:00:00 +0100

Antineutrophil cytoplasmic antibody-associated vasculitis is an autoimmune disease involving small to medium blood vessels. It is an uncommon illness, but can have devastating consequences, particularly on kidney function and other vital organs. Exciting progress has been made in the treatment of the disease largely because of international collaboration in randomised clinical trials. Patient survival has improved dramatically with advancements in disease diagnosis and medical treatment. The long-term morbidity from the disease, although improving, remains substantial with up to 10% of survivors requiring dialysis or kidney transplantation. Clinical trials are underway using more specifically targeted immunosuppressants in the hope to improve the long-term patient outcomes. Advancements ar...

Revascularization options in patients with chronic kidney disease.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

Authors: Ashrith G, Elayda MA, Wilson JM Cardiovascular disease is the leading cause of death in patients who have chronic kidney disease or end-stage renal disease and are undergoing hemodialysis. Chronic kidney disease is a recognized risk factor for premature atherosclerosis. Unfortunately, most major randomized clinical trials that form the basis for evidence-based use of revascularization procedures exclude patients who have renal insufficiency. Retrospective, observational studies suggest that patients with end-stage renal disease and severe coronary occlusive disease have a lower risk of death if they undergo coronary revascularization rather than medical therapy alone. Due to a lack of prospective studies, however, the relative merits of percutaneous versus surgical revasculari...

Effect of Synthetic Vitamin E-Bonded Membrane on Responsiveness to Erythropoiesis-Stimulating Agents in Hemodialysis Patients: A Pilot Study

Karger Publishers — Sat, 06 Mar 2010 13:45:35 +0100

Nephron Clin Pract 2010;115:c82c89 (DOI:10.1159/000294281) (Source: Karger Publishers)

Selective Ignorability Assumptions in Causal Inference

The International Journal of Biostatistics — Sat, 06 Mar 2010 00:25:44 +0100

Most attempts at causal inference in observational studies are based on assumptions that treatment assignment is ignorable. Such assumptions are usually made casually, largely because they justify the use of available statistical methods and not because they are truly believed. It will often be the case that it is plausible that conditional independence holds at least approximately for a subset but not all of the experience giving rise to one's data. Such selective ignorability assumptions may be used to derive valid causal inferences in conjunction with structural nested models. In this paper, we outline selective ignorability assumptions mathematically and sketch how they may be used along with otherwise standard G-estimation or likelihood-based methods to obtain inference on structural ...

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Some Baxter dialysis systems recalled [News and Features]

AAP News — Fri, 05 Mar 2010 19:53:52 +0100

(Source: AAP News)

Melamine-Related Kidney Stones Can Be Managed Conservatively

Medscape Nephrology Headlines — Fri, 05 Mar 2010 16:44:33 +0100

Kidney stones linked to melamine-tainted infant milk formula can usually be managed conservatively, Chinese authors report. For infants with renal failure, hemodialysis without surgery was usually adequate. Reuters Health Information (Source: Medscape Nephrology Headlines)

Home care for the elderly undergoing Continuous Ambulatory Peritoneal Dialysis

Acta Paulista de Enfermagem — Fri, 05 Mar 2010 14:50:24 +0100

Conclusion: Caregivers need support for the development of knowledge and skills to deal with the elders' demand of care, particularly in regard to the management of CAPD.Objetivos: Caracterizar a los ancianos con insuficiencia renal crónica terminal (IRTC) en tratamiento de diálisis peritoneal en ambulatorio y la continuación (DPAC) del cuidado en el domicilio; caracterizar a sus cuidadores; y, describir el proceso de cuidar de esos ancianos. Métodos: Se trata de un estudio con abordaje cualitativo, utilizando la historia oral temática para la recolección de datos con nueve cuidadores y el análisis temático de los datos. Resultados: Entre los nueve ancianos, cinco eran hombres; promedio de edad 70 años; todos dependían del cuidador para cambiar la bolsa de diálisis. Entre los cu...

FDA, Baxter Recall Dialysis System that May Overflow

MedPage Today Nephrology — Fri, 05 Mar 2010 14:43:08 +0100

WASHINGTON (MedPage Today) -- The FDA and manufacturer of the HomeChoice and HomeChoice PRO dialysis systems notified patients of a class I device recall -- the FDA's most severe -- after a number of reported injuries and one death. (Source: MedPage Today Nephrology)

FDA, Baxter Recall Dialysis System that May Malfunction

MedPage Today Product Alert — Fri, 05 Mar 2010 12:43:12 +0100

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Molecular adsorbent recirculating system is ineffective in the management of type 1 hepatorenal syndrome in patients with cirrhosis with ascites who have failed vasoconstrictor treatment

Gut — Fri, 05 Mar 2010 11:12:51 +0100

Conclusions In patients with cirrhosis, refractory ascites and type 1 HRS not responding to vasoconstrictor treatment, MARS is ineffective in improving systemic haemodynamics and renal function despite reduction in NO levels, suggesting that vasodilatation in advanced cirrhosis is not due to excess systemic vasodilators alone. Transient reduction in serum creatinine indicates direct removal by MARS, and may not represent improved renal function. (Source: Gut)

Is Goal-Directed Therapy for Sepsis Appropriate for Chronic Dialysis Patients?

Medscape Today Headlines — Fri, 05 Mar 2010 01:08:26 +0100

Early goal-directed therapy for sepsis is largely untested in chronic dialysis patients. Dr. Jeff Berns questions how to treat dialysis patients who arrive at the ER with a bacterial infection. Medscape Nephrology (Source: Medscape Today Headlines)

Ultrasonographic Detection of Thyroid Nodules in Hemodialysis Patients in Japan

Therapeutic Apheresis and Dialysis — Fri, 05 Mar 2010 00:00:00 +0100

In conclusion, patients undergoing hemodialysis frequently develop thyroid abnormalities and ultrasonography is a useful imaging modality to identify these lesions. (Source: Therapeutic Apheresis and Dialysis)

Spontaneous perirenal hematoma (wunderlich's syndrome) in a man on haemodialysis

Nephrology — Fri, 05 Mar 2010 00:00:00 +0100

(Source: Nephrology)

Autosomal dominant polycystic kidney disease: risk factor for nonmelanoma skin cancer following kidney transplantation

Transplant International — Fri, 05 Mar 2010 00:00:00 +0100

Nonmelanoma skin cancers (NMSC) are the most common malignant tumors following solid organ transplantation. Risk factors for NMSC mainly include immunosuppression, age, sun exposure and patient phototype. Recent findings have suggested that autosomal dominant polycystic kidney disease (ADPKD) may increase the risk of developing NMSC. We performed a monocenter retrospective study including all kidney recipients between 1985 and 2006 (n = 1019). We studied the incidence of NMSC, solid cancers and post-transplantation lymphoproliferative disease (PTLD), and analyzed the following parameters: age, gender, phototype, time on dialysis, graft rank, immunosuppressive regimen, history of cancer and kidney disease (ADPKD versus others). Median follow-up was 5.5 years (range: 0.02[ndash]20.6; 79 838 ...

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Vitamin D Deficiency Common Among Dialysis Patients

Modern Medicine — Fri, 05 Mar 2010 00:00:00 +0100

Kidney disease patients who have low blood levels of the protein albumin and who begin hemodialysis during the winter season are almost certain to develop vitamin D deficiency, according to a study in the March 1 issue of the Clinical Journal of the American Society of Nephrology. (Source: Modern Medicine)

Tumoral pulmonary mass secondary to Schistosoma mansoni infection resembling neoplasia: case report

Revista Brasileira de Terapia Intensiva — Thu, 04 Mar 2010 17:26:01 +0100

Indivíduos infectados com Schistosoma mansoni na fase crônica da doença podem apresentar comprometimento pulmonar com sintomatologia e alterações radiológicas variáveis. Os pulmões podem ser acometidos pela migração anômala de ovos do sistema porta para o sistema arterial pulmonar (através de anastomoses porto-sistêmicas) e menos comumente por migrações ectópicas de vermes adultos. Há casos com extenso comprometimento parenquimatoso e outros com predomínio de arterites, com hipertensão pulmonar e cor pulmonale. Paciente jovem, residente em área endêmica de esquistossomose, com massa pulmonar sugestiva de neoplasia foi submetida a toracotomia exploradora sem possibilidade de ressecção da massa. Exame histopatológico mostrou vários granulomas esquistossomóticos e hi...

My approach to cardiothoracic transplantation and the role of the histocompatibility and immunogenetics laboratory in a rapidly developing field

Journal of Clinical Pathology — Thu, 04 Mar 2010 15:42:49 +0100

Cardiothoracic transplantation presents specific challenges. The lack of long-term replacement therapy (such as dialysis for kidney patients) creates a more urgent situation than for other forms of transplantation, necessitating a different approach. This review looks at ways in which the challenges are being met and the integral role of the histocompatibility and immunogenetics laboratory. (Source: Journal of Clinical Pathology)

FDA Classifies Baxter's January HomeChoice Peritoneal Dialysis Cycler Field Corrective Action As A Class I Recall

Health News from Medical News Today — Thu, 04 Mar 2010 10:00:00 +0100

Baxter Healthcare Corporation announced that the U.S. Food and Drug Administration (FDA) has classified Baxter's recent Urgent Product Recall regarding Increased Intraperitoneal Volume (IIPV), or overfill of the abdominal cavity, associated with HomeChoice and HomeChoice Pro peritoneal dialysis cyclers as a Class I recall. This action has been classified as a Class I recall because of the risk of serious injury or patient death that could be associated with the use of this device... (Source: Health News from Medical News Today)

FDA Classifies Baxter's January HomeChoice Peritoneal Dialysis Cycler Field Corrective Action As A Class I Recall

Medical Devices News From Medical News Today — Thu, 04 Mar 2010 10:00:00 +0100

Baxter Healthcare Corporation announced that the U.S. Food and Drug Administration (FDA) has classified Baxter's recent Urgent Product Recall regarding Increased Intraperitoneal Volume (IIPV), or overfill of the abdominal cavity, associated with HomeChoice and HomeChoice Pro peritoneal dialysis cyclers as a Class I recall... (Source: Medical Devices News From Medical News Today)

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Study Examines Outcomes Associated With Anemia Management For Patients With End-Stage Renal Disease

Health News from Medical News Today — Thu, 04 Mar 2010 09:00:00 +0100

Greater use of erythropoiesis-stimulating agents (ESAs) and more frequent use of iron at lower hematocrit levels (the proportion of the blood that consists of red blood cells) was associated with a decreased risk of death for hemodialysis patients, according to a study in the March 3 issue of JAMA... (Source: Health News from Medical News Today)

Study Examines Outcomes Associated With Anemia Management For Patients With End-Stage Renal Disease

Urology / Nephrology News From Medical News Today — Thu, 04 Mar 2010 09:00:00 +0100

Aliskiren ameliorates chlorhexidine digluconate-induced peritoneal fibrosis in rats

European Journal of Clinical Investigation — Thu, 04 Mar 2010 00:00:00 +0100

Conclusions Aliskiren protected against chlorhexidine digluconate-induced PF in rats by decreasing TGF-[beta]1 production. (Source: European Journal of Clinical Investigation)

Impact of Serum Apolipoprotein A-IV as a Marker of Cardiovascular Disease in Maintenance Hemodialysis Patients

Therapeutic Apheresis and Dialysis — Thu, 04 Mar 2010 00:00:00 +0100

The aim of this study was to investigate the relationship between serum apolipoprotein (apo) A-IV levels and markers for atherosclerosis, including carotid intima-media thickness (CIMT) and the ankle[ndash]brachial index (ABI), in hemodialysis patients. We performed a cross-sectional study involving 116 maintenance hemodialysis patients (70 males; median age, 64 years), measuring CIMT, ABI, the usual laboratory examinations, and serum apo A-IV before the dialysis session. The apo A-IV concentration was measured by a noncompetitive ELISA. Serum apo A-IV concentrations were significantly lower in hemodialysis patients with cardiovascular disease and plaque in the carotid artery. The apo A-IV level was positively associated with urea nitrogen and creatinine, and negatively associated with age...

Virus Removal and Eradication by Modified Double Filtration Plasmapheresis Decreases Factor XIII Levels

Therapeutic Apheresis and Dialysis — Thu, 04 Mar 2010 00:00:00 +0100

Factor XIII (FXIII) deficiency increases the chance for pathological bleeding, but this disorder cannot be detected by routine laboratory tests. Virus removal and eradication (VRAD, the trademark of Asahikasei Kuraray Medical) by double filtration plasmapheresis (DFPP) is an effective technique used to eradicate the hepatitis C virus in people afflicted with the disease. We have previously reported that DFPP significantly reduced FXIII in those undergoing this treatment. VRAD is a modified type of DFPP with a larger pore size of the second filter compared to conventional DFPP. Because VRAD may have similar effects on FXIII levels, we investigated the kinetics of FXIII during the course of VRAD therapy. A retrospective, observational study of the patients who underwent VRAD between July 200...

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RheoNet Registry Analysis of Rheopheresis for Microcirculatory Disorders With a Focus on Age-related Macular Degeneration

Therapeutic Apheresis and Dialysis — Thu, 04 Mar 2010 00:00:00 +0100

The purpose of establishing the RheoNet registry was to evaluate the safety and efficacy of rheopheresis, a specific method of therapeutic apheresis used to treat microcirculatory disorders. Apheresis centers providing rheopheresis therapy and physicians caring for the underlying disease were asked to participate in the registry, and the registry data were analyzed for safety and tolerability. Age-related macular degeneration (AMD) was selected as a model disease to evaluate efficacy. The RheoNet registry was successfully established recording 7722 rheopheresis treatments of 1110 patients, including 833 AMD patients. The mean age of patients was 72 years. Adverse events (AE) were reported in 5.67% of treatments, but termination of the treatment session was only required in 0.48%. Transient...

Sustained Inhibition of Oxidized Low-Density Lipoprotein Is Involved in the Long-Term Therapeutic Effects of Apheresis in Dialysis Patients.

Arteriosclerosis, Thrombosis and Vascular Biology — Thu, 04 Mar 2010 00:00:00 +0100

CONCLUSIONS: These results demonstrate that LDL apheresis decreases oxidized LDL and inflammation and improves endothelial cell function in the responders. This may be one of the mechanisms involved in the long-term therapeutic effect of LDL apheresis on peripheral circulation in hemodialysis patients. PMID: 20203302 [PubMed - as supplied by publisher] (Source: Arteriosclerosis, Thrombosis and Vascular Biology)

Pandemic 2009 Influenza A(H1N1) in Argentina: A Study of 337 Patients on Mechanical Ventilation.

American Journal of Respiratory and Critical Care Medicine — Thu, 04 Mar 2010 00:00:00 +0100

CONCLUSIONS: Patients with 2009 influenza A(H1N1) requiring mechanical ventilation were mostly middle-aged adults, often with comorbidities, and frequently developed severe ARDS and multiorgan failure requiring advanced organ support. Case-fatality rate was accordingly high. PMID: 20203241 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

Effect of Membrane Permeability on Inflammation and Arterial Stiffness: A Randomized Trial.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 04 Mar 2010 00:00:00 +0100

CONCLUSIONS: Our findings suggest that dialysis with polyamide membranes with different flux characteristics did not modify the inflammatory indices and lipid profile in stable HD patients; however, a seemingly beneficial effect on aortic stiffness was noted for patients who were maintained on high-flux polyamide membrane. PMID: 20203165 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Cholecalciferol Supplementation in Hemodialysis Patients: Effects on Mineral Metabolism, Inflammation, and Cardiac Dimension Parameters.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 04 Mar 2010 00:00:00 +0100

CONCLUSIONS: Oral cholecalciferol supplementation in HD patients seems to be an easy and cost-effective therapeutic measure. It allows reduction of vitamin D deficiency, better control of mineral metabolism with less use of active vitamin D, attenuation of inflammation, reduced dosing of erythropoiesis-stimulating agents, and possibly improvement of cardiac dysfunction. PMID: 20203163 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

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Anemia Drugs Help End-Stage Anemic Kidney Patients

Medscape Medical News Headlines — Wed, 03 Mar 2010 17:26:04 +0100

Aggressive treatment with blockbuster anemia drugs may offer the best approach for kidney dialysis patients with severe anemia, U.S. researchers said on Tuesday. Reuters Health Information (Source: Medscape Medical News Headlines)

Baxter HomeChoice and HomeChoice PRO Automated Peritoneal Dialysis Systems: Class I Recall

FDA MedWatch — Wed, 03 Mar 2010 16:55:00 +0100

Reports of serious injuries and at least one death have been associated with increased Intraperitoneal Volume (IIPV), also known as overfill of the abdominal cavity. (Source: FDA MedWatch)

More aggressive ESA, iron use associated with decreased mortality in anemia patients on hemodialysis

HemOncToday.com — Wed, 03 Mar 2010 16:45:00 +0100

(Source: HemOncToday.com)

Anemia Therapies in Dialysis Patients with Higher Hematocrit May Be 'Problematic'

Physician's First Watch current issue — Wed, 03 Mar 2010 13:47:28 +0100

(Source: Physician's First Watch current issue)

Study Identifies Risks, Benefits Of Anemia Drugs

Health News from Medical News Today — Wed, 03 Mar 2010 11:00:00 +0100

Aggressive treatment of anemia with intravenous iron and drugs known as erythropoiesis-stimulating agents (ESAs) may lower the risk of death for dialysis patients with severe anemia but also may increase the risk of death among patients with milder anemia, a new study led by a University of North Carolina at Chapel Hill epidemiologist suggests. Anemia is a common and often debilitating complication of kidney disease that has been linked to poor quality of life and increased risk of hospitalization and death... (Source: Health News from Medical News Today)

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Study Identifies Risks, Benefits Of Anemia Drugs

Urology / Nephrology News From Medical News Today — Wed, 03 Mar 2010 11:00:00 +0100

Aggressive treatment of anemia with intravenous iron and drugs known as erythropoiesis-stimulating agents (ESAs) may lower the risk of death for dialysis patients with severe anemia but also may increase the risk of death among patients with milder anemia, a new study led by a University of North Carolina at Chapel Hill epidemiologist suggests... (Source: Urology / Nephrology News From Medical News Today)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Cancer General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Cancer General)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Cholesterol General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Cholesterol General)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Heart General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Heart General)

For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet Crohn's Disease General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet Crohn's Disease General)

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For Some on Dialysis, Anemia Drugs Pose Risks

MedicineNet HIV General — Wed, 03 Mar 2010 07:00:00 +0100

Title: For Some on Dialysis, Anemia Drugs Pose RisksCategory: Health NewsCreated: 3/2/2010 4:10:00 PMLast Editorial Review: 3/3/2010 (Source: MedicineNet HIV General)

Hematocrit Tied to Anemia Treatment Outcomes in Dialysis

Modern Medicine — Wed, 03 Mar 2010 00:00:00 +0100

In patients with end-stage renal disease utilizing hemodialysis, greater use of erythropoiesis-stimulating agents and iron was associated with higher and lower mortality risk, depending on patients' hematocrit levels, according to research published in the March 3 issue of the Journal of the American Medical Association. (Source: Modern Medicine)

Sulpor 200mg/5ml Oral Solution (sulpiride) - Revised SPC

NeLM - Mental Health — Wed, 03 Mar 2010 00:00:00 +0100

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Changes to the following: In Section 4.4 (Special warnings and precautions for use): Text has been added to include the risk of venous thromboembolism and the identification of risk factors. Text has also been added to include increased risk of mortality in elderly people with dementia. A sentence to state that sulpiride is not licensed for the treatment of dementia-related behavioural disturbances, has been added. In Section 4.8 (Undesirable effects): An update to include venous thromboembolism, including pulmonary embolism and deep vein thrombosis has been made. In Section 4.9 (Overdose) Additional text added for removal of sulpiride with haemodialysis and information on the management of overd...

Performance evaluation of the body fluid mode on the platform Sysmex XE-5000 series automated hematology analyzer

Clinical and Laboratory Haematology — Wed, 03 Mar 2010 00:00:00 +0100

We evaluated the performance of the automated body fluid mode of the Sysmex XE-5000 series automated haematology analyzer and compared the performance of the automated method for obtaining white blood cell (WBC), red blood cell (RBC) counts and WBC differential counts with microscopic method. One hundred and seventy-four samples were analysed: 81 ascitic fluid, 32 cerebrospinal fluid (CSF), 26 pleural fluid (PF), 18 synovial fluid (SF), 13 peritoneal fluid (PeF) and 4 other types. The agreement between the automated method and the manual reference showed high correlation, with Pearson correlation coefficients greater than 0.9 for all types of body fluids. We also demonstrate that the automated body fluid analysis on the XE-5000 is an acceptable alternative to the microscopic reference meth...

The effect of paricalcitol and cinacalcet on serum phosphate, FGF-23 and bone in rats with chronic kidney disease.

Am J Physiol Renal P... — Wed, 03 Mar 2010 00:00:00 +0100

In conclusion, due to its effects on bone and to the hypocalcemia and severe hyperphosphatemia it induces, we believe that cinacalcet should not be used in patients with CKD without further detailed studies. Key words: calcimimetics, vitamin D, Uremia, hyperphosphatemia. PMID: 20200094 [PubMed - as supplied by publisher] (Source: Am J Physiol Renal P...)

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Glucose-based peritoneal dialysis fluids downregulates TLR and triggers hyporesponsiveness to pathogen-associated molecular patterns in human peritoneal mesothelial cells.

Clinical and Vaccine Immunology — Wed, 03 Mar 2010 00:00:00 +0100

Conclusions: Glucose-based PD solution, but not Icodextrin-based PD solution downregulates expression of TLR2/TLR4 by huamn peritoneal mesothelial cells and triggers hyporesponsiveness to pathogen-associated molecular patterns. PMID: 20200188 [PubMed - as supplied by publisher] (Source: Clinical and Vaccine Immunology)

Testosterone concentrations in diabetic and non-diabetic obese men.

Diabetes Care — Wed, 03 Mar 2010 00:00:00 +0100

Conclusion: 40% of obese non-diabetic and 50% of obese diabetic men above the age of 45 years have subnormal FT concentrations. In view of its high prevalence, obesity is probably the condition most frequently associated with subnormal FT concentration in males. The concomitant presence of diabetes is associated with an additional increase in prevalence of subnormal FT concentration. PMID: 20200299 [PubMed - as supplied by publisher] (Source: Diabetes Care)

[Cost minimisation analysis for darbepoetin alpha vs. epoetin alpha in chronic kidney disease patients on haemodialysis.]

Farmacia Hospitalaria — Wed, 03 Mar 2010 00:00:00 +0100

CONCLUSION: In our study, we found that r-HuEpo and NESP were similarly effective in patients with CRF on haemodialysis, but that there was a significant cost increase associated with NESP treatment. PMID: 20206567 [PubMed - as supplied by publisher] (Source: Farmacia Hospitalaria)

Performance evaluation of the body fluid mode on the platform Sysmex XE-5000 series automated hematology analyzer.

International Journal of Laboratory Hematology — Wed, 03 Mar 2010 00:00:00 +0100

Authors: Paris A, Nhan T, Cornet E, Perol JP, Malet M, Troussard X Summary We evaluated the performance of the automated body fluid mode of the Sysmex XE-5000 series automated haematology analyzer and compared the performance of the automated method for obtaining white blood cell (WBC), red blood cell (RBC) counts and WBC differential counts with microscopic method. One hundred and seventy-four samples were analysed: 81 ascitic fluid, 32 cerebrospinal fluid (CSF), 26 pleural fluid (PF), 18 synovial fluid (SF), 13 peritoneal fluid (PeF) and 4 other types. The agreement between the automated method and the manual reference showed high correlation, with Pearson correlation coefficients greater than 0.9 for all types of body fluids. We also demonstrate that the automated body fluid analysi...

FDA Classifies Baxter's January HomeChoice Peritoneal Dialysis Cycler Field Corrective Action as a Class I Recall

HSMN NewsFeed — Tue, 02 Mar 2010 22:25:43 +0100

Baxter is Deploying Revised Labeling, Training and Upcoming Software Revisions to Further Assist Clinicians and Patients DEERFIELD, Ill.--(HSMN NewsFeed)--Baxter Healthcare Corporation announced today that the U.S. Food and Drug Administration (FDA) has... Devices, Product Recall, FDABaxter, HomeChoice, peritoneal dialysis, home dialysis, dialysis (Source: HSMN NewsFeed)

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Anemia drugs help end-stage anemic kidney patients

Reuters: Health — Tue, 02 Mar 2010 21:43:08 +0100

CHICAGO (Reuters) - Aggressive treatment with blockbuster anemia drugs may offer the best approach for kidney dialysis patients with severe anemia, U.S. researchers said on Tuesday. (Source: Reuters: Health)

For Some on Dialysis, Anemia Drugs Pose Risks

MedlinePlus Health News — Tue, 02 Mar 2010 21:00:00 +0100

But experts say not using them would lower people's quality of life Source: HealthDay Related MedlinePlus Pages: Anemia, Dialysis, Drug Safety (Source: MedlinePlus Health News)

Comparative Mortality Risk of Anemia Management Practices in Incident Hemodialysis Patients [Original Contribution]

JAMA — Tue, 02 Mar 2010 20:50:35 +0100

Conclusions Greater ESA and iron use were associated with decreased mortality risk at lower hematocrit levels, in which mortality rates are the highest. Although the overall mortality rate was lower at higher hematocrit levels, elevated mortality risk was associated with greater use of ESAs and iron in these patients. (Source: JAMA)

Heart valve replacement for patients with end-stage renal disease in Japan.

Annals of Thoracic and Cardiovascular Surgery — Tue, 02 Mar 2010 19:36:49 +0100

Authors: Misawa Y There is some controversy regarding the choice of prosthetic valves in patients with heart disease and concomitant end-stage renal disease requiring chronic dialysis. Dialysis patients tend to have a short life expectancy. In Japan, the 1-year survival of the dialysis patients was 80% in the 1980s, but exceeds 85% in the 2000s. The 5-year survival has been 54%-60% for the past 20 years. In addition, the 10-year and 15-year survivals have been 35%-42% and 23%-31%, respectively. However, in the United States, the 5-year survival had only improved to 35% among patients who started dialysis between 1996 and 2000, and the life expectancies of chronic dialysis patients in their sixth, seventh and eighth decades is 5.3-6.2 years, 3.8-4.5 years, and 2.7-3.2 years, respectivel...

Video-assisted thoracoscopic surgery for non-small cell lung cancer in patients on hemodialysis.

Annals of Thoracic and Cardiovascular Surgery — Tue, 02 Mar 2010 19:36:26 +0100

We describe two patients on HD undergoing thoracoscopic resection for lung cancer. For the thoracoscopic operation, anatomies of the patients were confirmed by three-dimensional multidetector computed tomography (3D-MDCT). The first patient underwent a right lower lobectomy thoracoscopically, and the second patient underwent a resection of the superior segment of the right lower lobe thoracoscopically. They were discharged on postoperative days 10 and 4, respectively. A review of the literature reveals that morbidity and mortality for pulmonary resection on HD are 74% and 11%, respectively. Thoracoscopic operations for lung cancer patients on HD may minimize the operative invasiveness. Preoperative 3D-MDCT angiography was useful because it supports understanding of the patient's personal a...

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NxStage(R) and Dirinco Sign Distribution Agreement For System One(TM) in the Netherlands

HSMN NewsFeed — Tue, 02 Mar 2010 18:30:11 +0100

LAWRENCE, Mass., March 2 (HSMN NewsFeed) -- NxStage Medical, Inc. (Nasdaq:NXTM ), a leading manufacturer of innovative dialysis products, today announced that it signed a five-year distribution agreement with Dirinco, an independent company, for the prom... Devices, DistributionNxStage Medical, PureFlow, dialysis (Source: HSMN NewsFeed)

Fatigue Rating Scale May Predict Cardiovascular Events in Dialysis Patients

Medscape Today Headlines — Tue, 02 Mar 2010 16:20:59 +0100

A study suggests that fatigue can be an important predictor for cardiovascular events in patients with end-stage renal disease, independent of nutritional or inflammatory status. Medscape Medical News (Source: Medscape Today Headlines)

The 2009 Proposed Rule for Prospective ESRD Payment: Perspectives From a For-Profit Small Dialysis Organization

Medscape Today Headlines — Tue, 02 Mar 2010 12:08:56 +0100

Under the proposed payment rules, some small for-profit centers will win and some will lose; those that lose will be a strain on the entire ESRD program. American Journal of Kidney Diseases (Source: Medscape Today Headlines)

The angiotensin II type 2 receptor in renal disease

Journal of the Renin-Angiotensin-Aldosterone System : JRAAS — Tue, 02 Mar 2010 10:44:14 +0100

Suppression of angiotensin II formation by angiotensin-converting enzyme inhibitors or blockade of the angiotensin II receptor by angiotensin receptor blockers is a powerful therapeutic strategy to slow the progression of renal disease. However, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers provide only imperfect protection against the progression of chronic kidney disease to end-stage renal failure. Hence, innovative approaches are needed to keep patients with chronic kidney disease off dialysis. Angiotensin II activates at least two receptors, namely the angiotensin II type 1 (AT 1) and angiotensin II type 2 (AT2) receptors. The majority of the effects of angiotensin II, such as vasoconstriction, inflammation, and matrix deposition, are mediated via the AT1 r...

Study examines outcomes associated with anemia management for patients with end-stage renal disease

EurekAlert! - Infectious and Emerging Diseases — Tue, 02 Mar 2010 05:00:00 +0100

(JAMA and Archives Journals) Greater use of erythropoiesis-stimulating agents and more frequent use of iron at lower hematocrit levels (the proportion of the blood that consists of red blood cells) was associated with a decreased risk of death for hemodialysis patients, according to a study in the March 3 issue of JAMA. (Source: EurekAlert! - Infectious and Emerging Diseases)

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Baxter Healthcare Renal Div - HomeChoice Automated Peritoneal Dialysis Systems - Class 1 Recall

Medical Device Recalls since July 07, 2006 — Tue, 02 Mar 2010 02:00:07 +0100

Baxter HomeChoice Automated Peritoneal Dialysis Systems; Manufactured for Baxter Healthcare Corporation, Deerfield, IL 60015 U.S.A., Made in U.S.A; Catalog Numbers: 5C4471, 5C4471R, 5C4474, 5C4474R, T5C4441, and T5C4441R. The HomeChoice dialysis system is a personal cycler automated peritoneal dialysis system for pediatric and adult renal patients with fill volumes ranging from 60 mL to 3000 mL. (Source: Medical Device Recalls since July 07, 2006)

Baxter Healthcare Renal Div - HomeChoice PRO Automated Peritoneal Dialysis Systems - Class 1 Recall

Medical Device Recalls since July 07, 2006 — Tue, 02 Mar 2010 02:00:07 +0100

HomeChoice PRO Automated Peritoneal Dialysis Systems; Manufactured for Baxter Healthcare Corporation, Deerfield, IL 60015 U.S.A., Made in U.S.A.; Catalog Numbers; 5C8310, 5C8310R, R5C8320, R5C8320R, T5C8300, and T5C8300R. The HomeChoice dialysis system is a personal cycler automated peritoneal dialysis system for pediatric and adult renal patients with fill volumes ranging from 60 mL to 3000 mL. The HomeChoice PRO model has a PRO card, a small electronic data card, which stores information from the nurse or doctor and automatically sets up the system for the patient. (Source: Medical Device Recalls since July 07, 2006)

Intravenous levosimendan-norepinephrine combination during off-pump coronary artery bypass grafting in a hemodialysis patient with severe myocardial dysfunction

Journal of Cardiothoracic Surgery — Tue, 02 Mar 2010 00:00:00 +0100

This the case of a 63 year-old man with end-stage renal disease (on chronic hemodialysis), unstable angina and significantly impaired myocardial contractility with low left ventricular ejection fraction, who underwent off-pump one vessel coronary bypass surgery. Combined continuous levosimendan and norepinephrine infusion (at 0.07 mug/kg/min and 0.05 mug/kg/min respectively) started immediately after anesthesia induction and continued for 24 hours. The levosimendan / norepinephrine combination helped maintain an appropriate hemodynamic profile, thereby contributing to uneventful completion of surgery and postoperative hemodynamic stability. Although levosimendan is considered contraindicated in ESRD patients, this case report suggests that combined perioperative levosimendan / norepinephri...

Systematic review: vitamin d and calcium supplementation in prevention of cardiovascular events.

Annals of Internal Medicine — Tue, 02 Mar 2010 00:00:00 +0100

Conclusion: Evidence from limited data suggests that vitamin D supplements at moderate to high doses may reduce CVD risk, whereas calcium supplements seem to have minimal cardiovascular effects. Further research is needed to elucidate the role of these supplements in CVD prevention. Primary Funding Source: The American Heart Association and the National Heart, Lung, and Blood Institute. PMID: 20194238 [PubMed - in process] (Source: Annals of Internal Medicine)

Fenestrated Stent Grafting for Short-necked and Juxtarenal Abdominal Aortic Aneurysm: An 8-Year Single-centre Experience.

PubMed: Eur J Vasc Endovasc ... — Tue, 02 Mar 2010 00:00:00 +0100

CONCLUSIONS: Fenestrated stent grafting for short-necked and juxtarenal abdominal aortic aneurysm appears safe and effective on the longer term. Renal function deterioration, however, is a major concern. PMID: 20202868 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

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The impacts of continuous veno-venous hemofiltration on plasma cytokines and monocyte human leukocyte antigen-DR expression in septic patients.

Cytokine — Tue, 02 Mar 2010 00:00:00 +0100

Authors: Peng Z, Pai P, Hong-Bao L, Rong L, Han-Min W, Chen H The aim of this study was to investigate the impacts of continuous veno-venous hemofiltration (CVVH) on plasma cytokines and monocyte human leukocyte antigen-DR (HLA-DR) expression and to evaluate the relationship between them during CVVH treatment in septic patients. Forty septic patients were enrolled in this study. They were randomly divided into control group (who received conventional treatment, n=20) and CVVH group (who received conventional treatment and CVVH treatment, n=20). The blood samples were taken to measure the changes of plasma cytokines (IFN-gamma, TNF-alpha, IL-1, IL-2, IL-4, IL-6, IL-10 and IL-13) and HLA-DR expression on monocytes. After CVVH treatment, the plasma levels of IFN-gamma, IL-1, IL-2, IL-4, I...

Substitution of Chloride by Bromide Modifies the Low-Temperature Tyrosine Z Oxidation in Active Photosystem II.

Biochimica et Biophysica Acta — Tue, 02 Mar 2010 00:00:00 +0100

Authors: Ren Y, Zhang C, Zhao J Chloride is an essential cofactor for photosynthetic water oxidation. However, its location and functional roles in active photosystem II are still a matter of debate. We have investigated this issue by studying the effects of Cl(-) replacement by Br(-) in active PSII. In Br(-) substituted samples, Cl(-) is effectively replaced by Br(-) in the presence of 1.2 M NaBr under room light with protection of anaerobic atmosphere followed by dialysis. Following results have been obtained. i) The oxygen evolving activities of the Br(-) -PSII samples are significantly lower than that of the Cl(-) -PSII samples; ii) The same S(2) multiline EPR signals are observed in both Br(-) and Cl(-) -PSII samples; iii) The amplitudes of the visible light induced S(1)Tyr(Z)() a...

Vitamin D Deficiency Likely Among Many Patients Starting Dialysis

Medscape Today Headlines — Mon, 01 Mar 2010 16:12:42 +0100

Vitamin D deficiency was almost universal in patients with low blood albumin levels who begin dialysis during the winter; black race and female sex were also predictors. Medscape Medical News (Source: Medscape Today Headlines)

Health Headlines: Decaf and Blood Sugar, Younger Stroke Victims and Benefits of Cheer

MedlinePlus Health News — Mon, 01 Mar 2010 13:26:33 +0100

Source: HealthDay - Related MedlinePlus Pages: Caffeine, Diabetes, Dialysis, Kidney Diseases, Mental Health (Source: MedlinePlus Health News)

Autosomal Dominant Polycystic Kidney Disease

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic form of kidney disease and affects 1 in 500 to 1,000 individuals worldwide, regardless of ethnicity. It is characterized by progressive renal cyst formation, which distorts normal kidney architecture and ultimately causes 5% of all cases of ESRD in developed countries. Renal complications such as hypertension, cyst hemorrhage, and pain occur frequently, particularly in patients with large kidneys. Extrarenal manifestations of ADPKD are common although most of them are not serious. However, severe liver cystic involvement and ruptured intracranial aneurysms can result in significant morbidity and mortality in some patients. Currently, there are limited options for the clinical management of ADPKD. Therapy is pri...

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Management of ESRD in Patients With Autosomal Dominant Polycystic Kidney Disease

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Autosomal dominant polycystic kidney disease (ADPKD) is the leading hereditary cause of ESRD in the United States. Because of the renal and extrarenal manifestations of ADPKD, specific challenges exist caring for these patients once they reach ESRD. In this article, we report the overall outcomes of individuals with ADPKD after ESRD as compared with non-ADPKD patients. We also review the available literature concerning issues specific to dialysis or kidney transplantation. For the ADPKD patient on dialysis, we address the use of peritoneal dialysis, the management of renal cystic, and extrarenal complications, and we discuss the significance of the relative polycythemia often observed in this population. For the ADPKD patient undergoing kidney transplantation, we highlight issues of anemia...

National Kidney Foundation 2010 Spring Clinical Meetings Abstracts April 13 - 17, 2010

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Efficacy and Tolerability of Oral Iron as Initial Treatment for Iron Deficiency in Pre-Dialysis Anemia of CKD (Source: Advances in Chronic Kidney Disease)

Effect of Ergocalciferol Treatment on Mineral Metabolism in Chronic Hemodialysis Patients

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Use of activated vitamin D (VDRA) to treat secondary hyperparathyroidism (SHPT) and mineral metabolism (MM) is considered to be an essential management tool in hemodialysis (HD) patients(pts). There is growing interest in achieving sufficient 25-hydroyvitamin D (25D) levels in the general population. Replacement of 25D is not traditionally performed in the HD pt and there is little information regarding effects of replacement. We looked at the ability of ergocalciferol (Ergo) treatment to correct 25D insufficiency in HD pts and the effect on SHPTand markers of MM. (Source: Advances in Chronic Kidney Disease)

Impact of Reductions in Infectious Complications, with the Use of the HeRO Vascular Access Device, on Dialysis Provider Revenue in an Era of Bundling

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

The purpose of this abstract is to report projected revenue savings by the dialysis provider when hospitalization secondary to catheter infections is decreased. It is widely recognized that the use of chronic hemodialysis catheters for vascular access is associated with increased morbidity, mortality, and costs. Hospitalization for catheter-related bacteremias is a major contributor to this increased cost of care. Missed dialysis sessions resulting from hospitalization for catheter-related bactermias can also negatively impact dialysis provider revenue. The HeRO vascular access device is an FDA approved 6 mm ePTFE graft, which attaches via a titanium connector to a 5 mm outflow component comprised of silicone with nitinol reinforcement designed to traverse central venous stenosis by routin...

Efficacy and Tolerability of Oral Iron as Initial Treatment for Iron Deficiency in Pre-Dialysis Anemia of CKD

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Oral (OFe) or intravenous (IvFe) iron is required for most CKD patients receiving Erythropoesis Stimulating Agents (ESA). We retrospectively examined the efficacy and tolerability of OFe plus oral ascorbic acid (VitC) in iron naïve CKD patients as initial treatment for iron deficiency anemia. (Source: Advances in Chronic Kidney Disease)

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Improving Adherence in Adolescents with ESRD: A Case Study

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

For teenagers undergoing chronic hemodialysis, the recommended medication routines, dietary restrictions and the stress of undergoing three times weekly hemodialysis treatments in-center may result in significant depression and nonadherence. Until this nonadherence is corrected, the adolescent is at considerable risk for life threatening complications and may not be accepted on the active kidney transplantation waiting list. (Source: Advances in Chronic Kidney Disease)

Adequate Estimation of Tumor Markers in Hemodialysis (HD) Patients

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

The purpose of this study is to clarify clinical characteristics affecting the serum levels of tumor markers, consequently to evaluate the levels of the markers adequately in HD patients. One hundred and twelve HD patients (68 males and 44 females) with clinically no malignancies were subjected to this study. Serum CEA, AFP, CA19-9 in males and females as well as those of PSA in males and SCC in females were measured and investigated a relationship to clinical features of age, duration of HD therapy, and primary kidney diseases which caused end stage renal disease (ESRD). Serum levels of CEA, AFP, CA19-9, PSA and SCC in the HD patients were 4.9±0.4 ng/ml, 3.0±0.2 ng/ml, 13.3±1.4 U/ml, 1.2±0.1 ng/ml and 4.5±1.1 ng/ml, respectively (mean±SEM). The mean CEA level in HD patients were wit...

Impact of a Nurse-Driven Vascular Access Management Program on Achieving and Maintaining Optimal Vascular Access for a Chronic Hemodialysis (HD) Population

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

The purpose of this evidence-based practice improvement project is to monitor the impact of use of aggressive vascular access monitoring in addition to promotion of timely access placement on the overall percentage of patients who are actively using an arteriovenous fistulae (AVF) in the chronic hemodialysis (HD) unit. (Source: Advances in Chronic Kidney Disease)

Streamline Bloodlines Improve Kt/V While Lowering Dialysate Usage

Advances in Chronic Kidney Disease — Mon, 01 Mar 2010 00:00:00 +0100

Blood flow and dialysate flow are critical inputs to achieve required dialysis dose (Kt/V). Blood flow for a given patient and their access is not generally different based on bloodline. We evaluated the Medisystems Streamline® bloodline (SL), designed to allow higher blood flows, and its impact on Kt/V and dialysate usage. (Source: Advances in Chronic Kidney Disease)

Percutaneous intervention in axillary loop-configured arteriovenous grafts for chronic hemodialysis patients.

Korean J Radiol — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Dysfunctional axillary loop-configured arteriovenous grafts almost always had subclavian venous and graft-related stenosis. Interventional treatments are helpful to overcome this and these treatments are expected to play a major role in restoring and maintaining the axillary loop-configured arteriovenous loop grafts. PMID: 20191067 [PubMed - in process] (Source: Korean J Radiol)

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Detecting bacterial growth in continuous ambulatory peritoneal dialysis effluent using two culture methods.

The Korean Journal of Internal Medicine — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: The blood culture method using the BacT/Alert system is useful for culturing dialysates and improves the positive culture rate in patients with suspected peritonitis compared to the conventional culture method. PMID: 20195408 [PubMed - in process] (Source: The Korean Journal of Internal Medicine)

Application of cystatin C reduction ratio to high-flux hemodialysis as an alternative indicator of the clearance of middle molecules.

The Korean Journal of Internal Medicine — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: Compared to the LF dialyzer, the HF dialyzer removed CyC and beta(2)MG more efficiently. Unlike the beta(2)MGRR, the CyCRR was correlated with the eKt/V(urea) and beta(2)MGRR. This study suggests a role for the CyCRR as an alternative indicator of the removal of MMs. PMID: 20195407 [PubMed - in process] (Source: The Korean Journal of Internal Medicine)

Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis.

Neurosurgical Focus — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions Degenerative scoliosis of the adult spine is secondary to asymmetrical degeneration of the discs. Surgical decompression and correction of the deformity can be performed from an anterior, posterior, or combined approach. These procedures are often associated with long operative times and a high incidence of complications. The authors' experience with the minimally invasive, lateral retroperitoneal transpsoas approach for placement of a large interbody graft for anterior column support, restoration of disc height, arthrodesis, and realignment is a feasible alternative to these procedures. PMID: 20192668 [PubMed - in process] (Source: Neurosurgical Focus)

Review article: Hepatitis B and dialysis

Nephrology — Mon, 01 Mar 2010 00:00:00 +0100

The incidence of hepatitis B virus (HBV) infection in dialysis populations has declined over recent decades, largely because of improvements in infection control and widespread implementation of HBV vaccination. Regardless, outbreaks of infection continue to occur in dialysis units, and prevalence rates remain unacceptably high. For a variety of reasons, dialysis patients are at increased risk of acquiring HBV. They also demonstrate different disease manifestations compared with healthy individuals and are more likely to progress to chronic carriage. This paper will review the epidemiology, modes of transmission and diagnosis of HBV in this population. Prevention and treatment will be discussed, with a specific focus on strategies to improve vaccination response, new therapeutic options an...

Diabetic kidney disease: act now or pay later.

Med J Aust — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Atkins RC, Zimmet PZ The 21st century has the most diabetogenic environment in human history with the number of people with diabetes worldwide increasing to 380 million by 2025. The fastest rate of increase will be in developing countries. Diabetes is now the major cause of end-stage kidney disease globally; 20%-40% of people on dialysis are diabetic. In Australia, the number of people with type 2 diabetes starting dialysis increased fivefold between 1993 and 2007. We must act now at local, national and international levels to prevent type 2 diabetes; screen for early diabetic kidney disease; increase public awareness of kidney disease; treat with medications proven to reduce kidney disease progression; and promote research into and trialling of new therapies. The problem is g...

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Short-term Outcomes of Borderline Stenoses in Vascular Accesses with PTFE Grafts

Journal of Vascular Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Borderline stenoses associated with polytetrafluoroethylene (PTFE) dialysis access grafts can be safely followed up and do not require transluminal angioplasty. Summary: The authors previously performed a randomized trial indicating ultrasound surveillance significantly prolongs patency of PTFE dialysis access grafts (Kidney Int 2005;65:1554-8). They identified certain stenoses they termed “borderline.” They believed a “watch and wait” strategy for such stenoses that were asymptomatic was appropriate but had a relatively small number of patients in the original study. The present study tested the hypothesis that it is safe to delay treatment of borderline stenoses in patients without evidence of impaired dialysis function. They also sought to determine possible risk fa...

Surgical Techniques to Improve Cannulation of Hemodialysis Vascular Access

Journal of Vascular Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Objective: Successful access cannulation is of utmost importance for adequate hemodialysis treatment. Upper arm fistulae, obesity and deep or tortuous veins may impair needling and can cause significant complications and inconvenience for the patient. In the ultimate case, cannulation problems lead to temporary central vein catheter use for dialysis or even to irreversible access loss. Surgical access revision may enhance successful cannulation. (Source: Journal of Vascular Surgery)

Low Body Fat Tied to High Mortality in Dialysis

Internal Medicine News — Mon, 01 Mar 2010 00:00:00 +0100

SAN DIEGO — A low percentage of total body fat is associated with higher 5-year mortality in hemodialysis patients, even after adjustment for demographics, comorbid conditions, and other surrogates of nutritional status, results from a large study showed. (Source: Internal Medicine News)

Usefulness of rotational atherectomy for the implantation of drug-eluting stents in the calcified lesions of hemodialysis patients.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: PTCRA may be useful for improving the mid-term outcome of DES implantation in hemodialysis patients with calcified lesions. PMID: 20206077 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Risk factors for early peritoneal dialysis catheter failure in children

Journal of Pediatric Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Omentectomy at the time of catheter placement decreased the risk of early catheter failure. In contrast, type of catheter or laparoscopic placement did not influence the likelihood of early catheter failure. (Source: Journal of Pediatric Surgery)

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Impact of Pain and Symptom Burden on the Health-Related Quality of Life of Hemodialysis Patients

Journal of Pain and Symptom Management — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Symptom burden in end-stage renal disease was substantial and had a tremendous negative impact on all aspects of hemodialysis patients' HRQL. These patients, therefore, would likely benefit from the institution of programs to reduce symptom burden. (Source: Journal of Pain and Symptom Management)

Hematological profile of chronic kidney disease (CKD) patients in Iran, in pre-dialysis stages and after initiation of hemodialysis.

Saudi Journal of Kidney Diseases and Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

In conclusion, data shows that anemia in our patients with CKD is a predominant manifestation, with high frequency but of moderate degree. The most likely cause is inadequate erythropoietin production. PMID: 20228535 [PubMed - in process] (Source: Saudi Journal of Kidney Diseases and Transplantation)

Prostate specific antigen levels in pre-dialysis chronic kidney disease patients.

Saudi Journal of Kidney Diseases and Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Hussain S, Abbas G PMID: 20228531 [PubMed - in process] (Source: Saudi Journal of Kidney Diseases and Transplantation)

Clinical significance of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) in hemodialysis patients.

Saudi Journal of Kidney Diseases and Transplantation — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Helal I, Belhadj R, Mohseni A, Bazdeh L, Drissa H, Elyounsi F, Abdallah TB, Abdelmoula J, Kheder A Circulating biomarkers play a major role in the early detection of cardiovascular di-sease. The purpose of this study was to determine levels of N-Terminal Pro-B-type Natriuretic Pep-tide (NT-proBNP) in hemodialysis (HD) patients and to examine the relationship of this marker to left ventricular hypertrophy and to cardiac dysfunction. Plasma NT-proBNP concentrations were measured in patients undergoing chronic HD, who did not any clinical evidence of heart failure, (n=32; mean age 43.14 +/- 12 years; sex-ratio 1.8) as well as healthy volunteers (n=32; mean age 45.84 +/- 1.9 years; sex-ratio 1). In addition, the correlation between plasma NT-proBNP concentration and parameters of ...