MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Hemodialysis International' source. Wed, 08 Feb 2012 17:42:02 +0100 http://www.medworm.com/index.php?rid=5660568&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00657.x AbstractRecent studies have suggested improvements in quality of life (QOL) in patients on quotidian dialysis compared with conventional hemodialysis. Few studies have focused on the burden and QOL in caregivers of patients with end‐stage renal disease (ESRD) on nocturnal home hemodialysis (NHD). We aim to assess the caregivers’ burden, QOL, and depressive symptoms and to compare these parameters with their patients’ counterparts. Cross‐sectional surveys were sent to 61 prevalent NHD patients and their caregivers. Surveys assessed demographics, general self‐perceived health using the 12‐Item Short Form Health Survey (SF‐12) and the presence of depression using the Beck Depression Inventory. Subjective burden on caregivers was assessed by the Caregiver Burden scale and was com... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5660568 Fri, 03 Feb 2012 05:00:00 +0100 5660568 http://www.medworm.com/index.php?rid=5660567&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00658.x We present a 59‐year‐old male on chronic hemodialysis (HD). We made the diagnosis of necrotizing fasciitis of the right thigh due to the crepitus from physical examination and subcutaneous emphysema from an X film. He was successfully treated with antibiotics and surgical debridement. The blood and surgical drainage cultures showed Escherichia coli, which is less commonly seen in cutaneous infection. The colonoscopic finding revealed adenomatous polyps. Necrotizing fasciitis in patients on HD requires early diagnosis and aggressive treatment to ensure the favorable clinical outcomes. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5660567 Fri, 03 Feb 2012 05:00:00 +0100 5660567 http://www.medworm.com/index.php?rid=5629850&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00653.x AbstractThe purpose of this study is to evaluate the efficacy and safety of direct right atrial catheter insertion for hemodialysis in patients with multiple venous access failure. We retrospectively evaluated the charts of 27 patients with multiple venous access failure who had intra‐atrial dialysis catheter placement between October 2005 and October 2010 in our clinic. Permanent right atrial dialysis catheters were placed through a right anterior mini‐thoracotomy under intratracheal general anesthesia in all patients. Demographics of the cases, the patency rates of hemodialysis via atrial catheterization, existence of any catheter thrombosis, and catheter‐related infections were documented and used in statistical analysis. Seventeen women (63%) and 10 men (37%) with the mean age of... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5629850 Thu, 26 Jan 2012 05:00:00 +0100 5629850 http://www.medworm.com/index.php?rid=5660566&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00637.x AbstractVascular accesses both permanent and temporary play an essential role in the procedure of hemodialysis (HD). The double lumen catheter (DLC) is one form of temporal vascular access which may produce different complications based on where the DLC is inserted. Here, we report a case of a cirrhotic patient receiving HD. The DLC was inserted through the left femoral vein. Later on, an unusual catheter position, mimicking a perforation in the iliac vessel, was noted in the incidental image finding. After venography, we concluded that this DLC had entered the dilated left gonadal vein, and was working well. This condition may be explained by portal hypertension leading to increased frequency of collateral branches and easy dilatation of the left gonadal vein. This condition may develop i... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5660566 Sun, 01 Jan 2012 05:00:00 +0100 5660566 http://www.medworm.com/index.php?rid=5649203&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2012.00667.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649203 Sun, 01 Jan 2012 05:00:00 +0100 5649203 http://www.medworm.com/index.php?rid=5649202&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2012.00666.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649202 Sun, 01 Jan 2012 05:00:00 +0100 5649202 http://www.medworm.com/index.php?rid=5649201&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2012.00665.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649201 Sun, 01 Jan 2012 05:00:00 +0100 5649201 http://www.medworm.com/index.php?rid=5649200&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00651.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649200 Sun, 01 Jan 2012 05:00:00 +0100 5649200 http://www.medworm.com/index.php?rid=5649199&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00656.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649199 Sun, 01 Jan 2012 05:00:00 +0100 5649199 http://www.medworm.com/index.php?rid=5649198&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00635.x In conclusion, IL‐6, but not CRP, is a strong predictor of ESA hyporesponsiveness in hemodialysis patients who have sufficient iron. It may be difficult to use hepcidin as an independent clinical marker because of the many factors that influence it and their interactions. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649198 Sun, 01 Jan 2012 05:00:00 +0100 5649198 http://www.medworm.com/index.php?rid=5649197&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00652.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649197 Sun, 01 Jan 2012 05:00:00 +0100 5649197 http://www.medworm.com/index.php?rid=5649196&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00654.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5649196 Sun, 01 Jan 2012 05:00:00 +0100 5649196 http://www.medworm.com/index.php?rid=5477377&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00646.x This study aims to compare clinical, laboratory, and echocardiographic features between the ESRD patients with and without DM. Fifty‐eight ESRD patients on dialysis were prospectively divided into two groups according to the presence of DM. Demographic, clinical, laboratory, and echocardiographic features (ejection fraction and wall motion score index) were compared between the two groups. Overall, 20 out of 58 patients (37.8%) with ESRD had DM. There were no significant differences between the patients with DM and those without DM when it comes to age (60.6 ± 10.6 vs. 59.0 ± 10.6 years, P = 0.665), ejection fraction (52.6% ± 12.8% vs. 54.2% ± 12.8%, P = 0.59), and wall motion score index (1.21 ± 0.3 vs.1.15 ± 0.3, P = 0.37). In multivariant anal... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5477377 Sun, 04 Dec 2011 05:00:00 +0100 5477377 http://www.medworm.com/index.php?rid=5450090&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00645.x AbstractHemodialysis (HD) patients are vulnerable to transfusion‐transmitted infections such as hepatitis B virus (HBV). HBV infection with undetectable hepatitis B surface antigens (HBsAg) is described as occult HBV and can lead to serious complications. The aim of this study was to evaluate the prevalence of occult HBV and concomitant factors in HD patients. Using a cross‐sectional design, clinical and epidemiological data were obtained from May to September 2009 in 11 different HD units in Guilan province in northern Iran. After serological testing for HBV surface antigens in 514 HD patients using a third‐generation enzyme‐linked immunosorbent assay kit (Diapro, Milano, Italy), HBsAg‐negative patients were tested for HBV DNA using a Qiagen PCR kit (Artus Qiagen GmbH, Hilden, G... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5450090 Mon, 28 Nov 2011 05:00:00 +0100 5450090 http://www.medworm.com/index.php?rid=5450089&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00642.x AbstractPatients with secondary hyperparathyroidism experience a variety of clinical symptoms which may adversely affect physical and mental function. As part of a multicenter, open‐label clinical trial, subjects completed a questionnaire that included the Medical Outcomes Study Short Form‐36 and 14 kidney disease‐related symptoms at multiple time points during the study. Out of the 567 subjects who received at least one dose of cinacalcet, 528 to 535 (93.8–94.4%) completed all or portions of the questionnaire at baseline. The median bioactive parathyroid hormone (PTH) was 294 pg/mL (10%, 90% range, 172–655 pg/mL). Following treatment with cinacalcet and low‐dose vitamin D sterols, subjects reported significant improvement in the frequency of pain in muscles, joints and bon... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5450089 Mon, 28 Nov 2011 05:00:00 +0100 5450089 http://www.medworm.com/index.php?rid=5442104&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00643.x AbstractA 43‐year‐old Chinese man with chronic viral hepatitis and end‐stage renal disease, receiving conventional hemodialysis for 6 years, presented with general malaise and abdominal fullness. After 4.5 hours of hemodialysis, the hollow fibers of the dialyzer turned yellow. Biochemistry studies showed hyperbilirubinemia. The actual serum bilirubin (7.4 mg/dL) could be proved. Abdominal echography survey was negative. Hyperbilirubinemia was secondary to acute exacerbation of chronic viral hepatitis. Anuria and skin hyperpigmentation in uremia lack the tea‐color urine and mask clinical jaundice in the presence of hyperbilirubinemia. Careful observation of dialyzer yellowish discoloration gave us timely discovery of patient's hyperbilirubinemia. (Source: Hemodialysis Internationa... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5442104 Tue, 22 Nov 2011 05:00:00 +0100 5442104 http://www.medworm.com/index.php?rid=5423122&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00618.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5423122 Fri, 18 Nov 2011 05:00:00 +0100 5423122 http://www.medworm.com/index.php?rid=5423121&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00639.x AbstractWhile medical health professionals are trained to detect, treat, and comfort, they are not trained to consider the environmental impact of the services they provide. Dialysis practitioners seem particularly careless in the use of natural resources—especially water and power—and seem broadly ignorant of the profound medical waste issues created by single use dialysis equipment. If the data we have collected is an indication, then extrapolation of this data to a dialysis population currently estimated at ∼2 million patients worldwide, a “world dialysis service” would use ∼156 billion liters of water and discard ∼2/3 of that during reverse osmosis. This waste occurs, despite the discarded water being high‐grade “gray water” of potable standard. The same world d... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5423121 Fri, 18 Nov 2011 05:00:00 +0100 5423121 http://www.medworm.com/index.php?rid=5423120&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00640.x AbstractIn Japan, self‐monitoring of blood glucose (SMBG) devices are widely used both at home and in hospitals, but many analytical errors and safety concerns have been reported about the SMBG devices used in hospitals. Analytical performances of StatStrip (Nova Biomedical Corporation, MA, USA), a new point‐of‐care testing device and Glutest (Sanwa Chemical, Aichi, Japan), a routinely used SMBG device were compared in glucose measurement of pre‐ and postdialysis blood samples and we evaluated which factors in blood modified by hemodialysis affect accuracy of these devices. Subjects in this study were 44 hemodialysis patients. Blood samples were obtained from patients just before and just after the hemodialysis. Blood glucose concentrations of samples were measured by StatStrip and... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5423120 Fri, 18 Nov 2011 05:00:00 +0100 5423120 http://www.medworm.com/index.php?rid=5401336&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00631.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5401336 Fri, 11 Nov 2011 05:00:00 +0100 5401336 http://www.medworm.com/index.php?rid=5401335&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00632.x We report the case of a 76‐year‐old female who underwent femoral catheterization for hemodialysis using ultrasound guidance. The first hemodialysis session was conducted without incident. Unfortunately, inadvertent injury and delayed perforation of the iliac vein resulted in severe hemorrhage and retroperitoneal hematoma. Surgical repair was performed. The patient was asymptomatic after the procedure and was discharged 15 days later. Based on this case and a review of the literature, we present mechanisms and ways to prevent this complication. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5401335 Fri, 11 Nov 2011 05:00:00 +0100 5401335 http://www.medworm.com/index.php?rid=5401334&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00634.x AbstractC.E.R.A., a continuous erythropoietin receptor activator, is a long‐acting erythropoiesis‐stimulating agent approved for the treatment of anemia in patients with chronic kidney disease. Although the large molecular weight and the carbohydrate chain make it unlikely that C.E.R.A. could be removed during hemodialysis or hemofiltration, no such data have been published. In vitro studies were performed to assess the removal of C.E.R.A. during hemodialysis and hemofiltration, using both low‐flux and high‐flux membranes and parameters very similar to those used in clinical practice. Clinical pharmacokinetic studies of plasma C.E.R.A. concentrations in patients undergoing hemodialysis were also performed following subcutaneous injection of C.E.R.A. In the in vitro studies, plasma ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5401334 Fri, 11 Nov 2011 05:00:00 +0100 5401334 http://www.medworm.com/index.php?rid=5401333&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00636.x AbstractObesity is a major health problem that has entered the nephrology community and is challenging our conventional management strategies. In this case report, we present a morbidly obese dialysis patient whom dry‐weight assessment was disturbed by excess epicardial fat mass due to obesity. This case suggests that problems related to obesity seem not to be limited to dealing with obesity‐associated kidney injury, chronic kidney disease and mortality, but also other concepts in nephrology such that, as described, excess epicardial fat mass related to morbid obesity in this patient erroneously suggested a high cardiothoracic index, and misled patient management. Interpretation of chest X‐ray in dry‐weight assessment should take into account the patient's body weight especially in... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5401333 Fri, 11 Nov 2011 05:00:00 +0100 5401333 http://www.medworm.com/index.php?rid=5388761&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00633.x AbstractChronic dialysis patients are a vulnerable population that may be highly susceptible to medical errors, particularly when they are hospitalized. We performed a chart review of chronic hemodialysis patients admitted to surgical services at a tertiary care center in order to characterize lapses in patient safety. We conducted a retrospective chart review of admissions of patients receiving chronic hemodialysis to various surgical services at St. Michael's Hospital from January 1, 2009 to December 31, 2010. For each hospitalization, we collected data on four process of care indicators of potential safety lapses. When these lapses were identified, we sought to determine whether: (i) the lapse was detected and remedied; and (ii) the lapse resulted in an adverse event. Among the 41 patie... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5388761 Tue, 08 Nov 2011 05:00:00 +0100 5388761 http://www.medworm.com/index.php?rid=5388760&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00617.x AbstractIt is commonly accepted that the longer the time on extracorporeal cardiopulmonary bypass (CPB), the higher is the likelihood of developing acute renal failure requiring dialysis (ARF‐D). Nonetheless, previous works elicited conflicting evidence. We investigated the relationship between CPB duration and ARF‐D occurrence. Data were extracted from a large observational study. All factors independently associated with ARF‐D were detected. Overall, 11,092 case record forms were analyzed. At the univariate analyses, time on CBP was associated with an increase in the ARF‐D risk (odds ratio of fifth vs. first quintile of CBP time: 3.84; 95% confidence interval: 2.58–5.7; P < 0.001). However, after adjusting for confounders, the association between time on CBP and ARF‐D ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5388760 Tue, 08 Nov 2011 05:00:00 +0100 5388760 http://www.medworm.com/index.php?rid=5388759&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00627.x We report in this study the evolution of brain natriuretic peptide (BNP), blood pressure and body weight in hospitalized patients and the relationship between BNP plasma level and nutritional and inflammation parameters. We have studied 42 patients requiring hospitalization (F/M: 18/24; 72.5 ± 12.5 years old; 19/42 with diabetes). The plasma BNP levels at baseline, during hospitalization (BNP‐Hosp), and in the recovery phase were compared. Predialysis and postdialysis blood pressure and postdialysis body weight were recorded and compared. BNP‐Hosp increased significantly when compared with BNP levels at baseline, from 421 ± 647.2 pg/mL to 1584 ± 1584.4 pg/mL (P < 0.0001). Brain natriuretic peptide decreased from 1223 ± 1342.1 pg/mL during hospitalizat... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5388759 Tue, 08 Nov 2011 05:00:00 +0100 5388759 http://www.medworm.com/index.php?rid=5362600&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00622.x In this study, we determined the atherosclerotic risk and the significance of ADPN levels in our HD patients and also examined its relationship to other traditional CVD risk factors. A cross‐sectional study of 84 patients on maintenance HD (58 Blacks and 26 non‐Blacks) and 63 healthy controls matched for age, sex and race (35 Blacks and 28 non‐Blacks) was undertaken. Serum ADPN levels and other risk factors, including blood pressure, serum lipid, and C‐reactive protein, were studied in HD patients and were compared with the controls. Carotid artery intima‐media thickness and plaque occurrence was measured by B‐mode ultrasonography while echocardiography was done according to American Society of Echocardiography guidelines. Serum ADPN levels were higher in the HD group compared ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5362600 Thu, 27 Oct 2011 04:00:00 +0100 5362600 http://www.medworm.com/index.php?rid=5362599&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00630.x AbstractFibroblast growth factor 23 (FGF‐23) is elevated in patients with end‐stage kidney disease and has been linked with mortality, vascular calcification, markers of bone turnover, and left ventricular hypertrophy. In this cohort study, we determined the correlates of FGF‐23 (including cardiac troponin T [cTNT]) and determined its association with mortality over 3.5 years of follow‐up in 103 prevalent hemodialysis patients. Mean age was 61.2 (15.5) and the mean dialysis vintage was 4.19 years (4.6). The median (interquartile range) FGF‐23 was 1259 (491, 2885) RU/mL. Independent predictors (estimate standard error) of log‐transformed FGF‐23 concentrations included phosphorus (0.75 [0.237], P = 0.002) and cardiac troponin T (1.04 [0.41], P = 0.01). There were 57 dea... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5362599 Thu, 27 Oct 2011 04:00:00 +0100 5362599 http://www.medworm.com/index.php?rid=5362598&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00615.x In conclusion, we showed that higher education level is associated with improved survival of patients on dialysis. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5362598 Thu, 27 Oct 2011 04:00:00 +0100 5362598 http://www.medworm.com/index.php?rid=5324613&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00623.x AbstractPatients with chronic kidney disease often use religion as a coping strategy to relieve suffering and serve as a source of strength. The aim of this study was to identify religious aspects associated with mental health and quality of life in Brazilian dialysis patients. A cross‐sectional study was performed involving two dialysis centers in Brazil. Patients were selected consecutively over three typical dialysis treatment days. The questionnaire was self‐administered and covered the following aspects: socio‐demographic aspects, religiousness (using the Portuguese version of the Private and Social Religious Practice Scale), quality of life (World Health Organization Quality of Life brief Scale Brief Version), depression and anxiety (Beck Inventory), and pain grade. For statist... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5324613 Mon, 17 Oct 2011 04:00:00 +0100 5324613 http://www.medworm.com/index.php?rid=5305161&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00619.x We describe a successful insertion and use of a cuffed‐tunneled catheter in a patient with unusual anatomy of the central venous system. Computed tomography angiography revealed thrombosis of the right subclavian vein and bilateral occlusion of innominate veins. The left internal jugular and subclavian veins joined to form a large vessel that drained through the accessory hemiazygos and azygos veins into the superior vena cava. The catheter was implanted through the left internal jugular vein into the accessory hemiazygos vein. The presented case demonstrates that the catheter can be implanted into distended collateral, especially when no other location is possible. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5305161 Mon, 10 Oct 2011 04:00:00 +0100 5305161 http://www.medworm.com/index.php?rid=5629849&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00660.x We report an unusual location of Kimura disease in a patient on maintenance hemodialysis, who had a prolonged, persistent asymptomatic eosinophilia. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5629849 Sat, 01 Oct 2011 04:00:00 +0100 5629849 http://www.medworm.com/index.php?rid=5620873&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00659.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5620873 Sat, 01 Oct 2011 04:00:00 +0100 5620873 http://www.medworm.com/index.php?rid=5553036&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00655.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5553036 Sat, 01 Oct 2011 04:00:00 +0100 5553036 http://www.medworm.com/index.php?rid=5506070&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00649.x AbstractThere is variable emphasis on dialysis‐specific training among US nephrology fellowship programs. Our study objective was to determine the association between nephrology training experience and subsequent clinical practice. We conducted a national survey of clinical nephrologists using a fax‐back survey distributed between March 8, 2010 and April 30, 2010 (N = 629). The survey assessed the time distribution of clinical practice, self‐assessment of preparedness to provide care for dialysis patients at the time of certification examination, distribution of dialysis modality among patients, and nephrologists' choice of dialysis modality for themselves if their kidneys failed. While respondents spent 28% of their time caring for dialysis patients, 38% recalled not feeling ver... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5506070 Sat, 01 Oct 2011 04:00:00 +0100 5506070 http://www.medworm.com/index.php?rid=5477376&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00648.x This study showed that despite similar SQ scores between two groups, HD patients had better HRQoL and less depression than PD patients. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5477376 Sat, 01 Oct 2011 04:00:00 +0100 5477376 http://www.medworm.com/index.php?rid=5450088&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00647.x We describe in our case a particular good compliant patient with slow digestive transit, which ends by pseudo‐occlusion. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5450088 Sat, 01 Oct 2011 04:00:00 +0100 5450088 http://www.medworm.com/index.php?rid=5442103&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00644.x This study was designed prospectively. Clinical, laboratory, and echocardiographic variables were assessed in 72 patients on hemodialysis. The ERI was determined as the weekly weight‐adjusted dose of EPO (U/kg/week) divided by hemoglobin concentration (g/dL). Patients were divided into three groups by tertiles of ERI. Patients with higher tertiles of ERI had a higher LVM index and lower LV ejection fraction compared with those with lower tertiles of ERI (P = 0.019 and P = 0.030, respectively). The median follow‐up period was 53 months. The Kaplan–Meier plot showed increased frequency of cardiovascular events in patients with higher tertiles of ERI, compared with those with lower tertiles of ERI (P = 0.011, log‐rank test). The multivariate Cox proportional hazard models ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5442103 Sat, 01 Oct 2011 04:00:00 +0100 5442103 http://www.medworm.com/index.php?rid=5423119&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00641.x AbstractExcessive fluid overload is common in hemodialysis patients. Understanding fluid intake behavior in relation to used cognitive coping style would serve the fluid restriction consultation. The aim of this study was to explore whether hemodialysis patients' fluid intake behavior differs as a function of used coping style. Secondary analysis of data from 51 hemodialysis patients regarding cognitive coping style (assessed by the Threatening Medical Situations Inventory) and fluid intake behavior were used. The participants' mean age was 62.9 years (range 27–84), they had received dialysis treatment for 3.9 years on average (range 0–22), 63% were male and they had gained 3.6% (±1.3) of their dry body weight during the interdialytic period. There was a significant difference in flui... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5423119 Sat, 01 Oct 2011 04:00:00 +0100 5423119 http://www.medworm.com/index.php?rid=5401332&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00638.x AbstractA 55‐year‐old female was hospitalized for melena. The patient was suspected of having uremia symptoms. Use of a tunneled cuffed hemodialysis catheter of the right internal jugular vein was planned. At one point, the wire could not be extracted or advanced. In addition, whenever the guide wire was manipulated, ventricular premature rhythms developed. Fluoroscopy revealed knotting of the guide wire in the right ventricle. A 7 French guiding catheter was inserted along the guide wire, which loosened the knotting of the guide wire. The present case shows that entrapment within the heart can develop due to use of a J‐tip guide wire. If a guide wire cannot be removed despite several attempts with gentle pressure, this event should be ruled out by fluoroscopy and chest X‐ray. Usin... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5401332 Sat, 01 Oct 2011 04:00:00 +0100 5401332 http://www.medworm.com/index.php?rid=5388758&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00629.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5388758 Sat, 01 Oct 2011 04:00:00 +0100 5388758 http://www.medworm.com/index.php?rid=5362597&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00628.x In conclusion, our results reveal correlation indicating a relationship between antioxidant status (as measured by GPx) and nutritional status as assessed by BIA in nondiabetic HD patients. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5362597 Sat, 01 Oct 2011 04:00:00 +0100 5362597 http://www.medworm.com/index.php?rid=5337197&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00614.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5337197 Sat, 01 Oct 2011 04:00:00 +0100 5337197 http://www.medworm.com/index.php?rid=5337196&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00624.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5337196 Sat, 01 Oct 2011 04:00:00 +0100 5337196 http://www.medworm.com/index.php?rid=5337195&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00613.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5337195 Sat, 01 Oct 2011 04:00:00 +0100 5337195 http://www.medworm.com/index.php?rid=5337194&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00621.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5337194 Sat, 01 Oct 2011 04:00:00 +0100 5337194 http://www.medworm.com/index.php?rid=5337193&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00616.x We describe a patient who developed severe psoriasis despite undergoing chronic maintenance hemodialysis for 5 years and was treated successfully with oral cyclosporin A. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5337193 Sat, 01 Oct 2011 04:00:00 +0100 5337193 http://www.medworm.com/index.php?rid=5239009&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00579.x AbstractThe aim of this study was to measure P‐selectin, E‐selectin, and CD‐4L levels over time in chronic hemodialysis (HD) patients. Thirty stable patients with end‐stage renal failure undergoing chronic HD were included in the study. Blood samples were obtained before HD for measurement of P‐selectin, E‐selectin, and CD‐40L. Measurements were performed at month 0 (T0), 3 (T2), 8 (T3), and 13 (T4). The levels of P‐selectin, E‐selectin, and CD40L were also analyzed according to the occurrence of cardiovascular disease (CVD) and to CVD‐related mortality. The levels of CD40L and P‐selectin changed significantly over time, decreasing at month 3 and 6 and returning at the T0 levels at month 13. Conversely, E‐selectin levels did not. The levels of CD40L, P‐selectin an... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5239009 Mon, 19 Sep 2011 04:00:00 +0100 5239009 http://www.medworm.com/index.php?rid=5239008&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00591.x This report describes the clinical characteristics of a young man with first presentation of hyperammonemia in adult life. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5239008 Mon, 19 Sep 2011 04:00:00 +0100 5239008 http://www.medworm.com/index.php?rid=5227130&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00610.x The objective was compare the reduction rate (RR) of Hcy and cysteine in stable dialyzed patients treated by standard HD or hemodiafiltration (HDF). Seventy‐five patients undergoing stable dialysis through standard high‐flux HD (n = 35) or HDF (n = 40) were included. Biological parameters were determined before and after a midweek dialysis session. Urea percent reduction per session and Kt/V index (K, body urea clearance, T, time of dialysis, and V, urea distribution volume), defined as a marker of dialysis efficacy, were similar between HD and HDF groups. By contrast, higher RR of beta2 microglobulin (β2m) was observed in HDF compared with HD (78.6 vs. 72.0%, respectively; P < 0.001). Likewise, higher RR of Hcy was obtained with HDF compared to HD (46.0 vs. 41.5%, resp... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227130 Wed, 14 Sep 2011 04:00:00 +0100 5227130 http://www.medworm.com/index.php?rid=5227135&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00589.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227135 Tue, 13 Sep 2011 04:00:00 +0100 5227135 http://www.medworm.com/index.php?rid=5227134&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00592.x We report a case of levofloxacin‐induced rhabdomyolysis requiring hospitalization in a hemodialysis patient. Physicians should be aware of the risk of this potentially severe adverse drug reaction. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227134 Tue, 13 Sep 2011 04:00:00 +0100 5227134 http://www.medworm.com/index.php?rid=5227133&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00593.x We examined genetic polymorphisms of eight candidate genes associated with endothelial function: endothelial constitutive nitric oxide synthase (ecNOS) T‐786C, endothelin‐1 G5727T, methylenetetrahydrofolate reductase (MTHFR) C677T, paraoxonase‐1 Q192R and M55L, angiotensinogen M235T, angiotensin‐converting enzyme (ACE) I/D and angiotensin II type 1 receptor A1166C gene. Six gene polymorphisms were detected by real‐time polymerase chain reaction with melting‐point analysis, and two via allele‐specific amplification and gel electrophoresis. Control group patients were in Hardy‐Weinberg equilibrium for all tested genotypes. In ESRD patients attributed to hypertension, the endothelin gene G5727TGG genotype occurred significantly less but GT genotype more frequently (P < ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227133 Tue, 13 Sep 2011 04:00:00 +0100 5227133 http://www.medworm.com/index.php?rid=5227132&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00594.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227132 Tue, 13 Sep 2011 04:00:00 +0100 5227132 http://www.medworm.com/index.php?rid=5227131&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00609.x AbstractHemodialysis (HD) catheter dysfunction compromises HD adequacy and increases the cost of patient care. Repeated administration of alteplase in HD catheters typically produces only short‐term benefits. The purpose of this study was to design, implement, and evaluate the efficacy of an experimental alteplase algorithm to manage HD catheter dysfunction. This was a two‐part prospective nonrandomized study. Baseline data of alteplase use and catheter exchange were collected during part 1 of the study. Part 2 consisted of the alteplase algorithm implementation and repeat collection of catheter data. Rates of alteplase use and catheter exchange per 1000 catheter‐days were the primary and secondary outcomes of the study. One hundred and seventy‐two catheters in 131 patients were fo... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227131 Tue, 13 Sep 2011 04:00:00 +0100 5227131 http://www.medworm.com/index.php?rid=5210072&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00607.x AbstractThere is no consensus about the toxicity of erythropoiesis‐stimulating agents among hemodialysis patients. We aimed to calculate the risk of death according to anemia control and erythropoietin (EPO) dosing among end‐stage renal disease patients undergoing hemodialysis. We retrospectively studied 156 end‐stage renal disease patients on hemodialysis from a single renal unit during 12 months. Participants were classified according to anemia control into four groups: excellent (A), good (B), moderate (C) and bad (D) control. They were also classified according to EPO dosing into two groups: usual and high EPO dosing. The Cox proportional hazards regression model, adjusted for the difference in age, sex, time on dialysis, comorbidity, albumin, and Kt/V index, was performed to cal... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5210072 Fri, 09 Sep 2011 04:00:00 +0100 5210072 http://www.medworm.com/index.php?rid=5144836&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00585.x This study aimed to investigate the relation of depressive and anxiety symptoms to sexual functioning among hemodialysis (HD) and peritoneal dialysis patients. A sample of 144 patients was recruited from three general hospitals in the broader area of Athens, consisting of 84 patients undergoing in‐center HD and 60 patients in continuous ambulatory peritoneal dialysis. Measurements were conducted with the following instruments: the World Health Organization Quality of Life instrument, the General Health Questionnaire (GHQ‐28), the State‐Trait Anxiety Inνentory (STAI 1/STAI 2), and the Center for Epidemiologic Studies Depression Scale. The results indicated that satisfaction about sexual life had negative association with all the subscales of GHQ‐28 questionnaire (somatic symptoms, ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5144836 Wed, 17 Aug 2011 23:00:00 +0100 5144836 http://www.medworm.com/index.php?rid=5144835&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00588.x AbstractDialysis is entirely funded by the public health care sector in Libya. Access to treatment is unrestricted for citizens but there is a lack of local information and no renal registry to gather national data. This cross‐sectional study aimed to investigate dialysis provision and practice in Libyan dialysis facilities in 2009. A structured interview regarding dialysis capacity, staffing and methods of assessment of dialysis patients, and infection control measures was conducted with the medical directors of all 40 dialysis centers and 28 centers were visited. A total of 2417 adult patients were receiving maintenance dialysis in 40 centers, giving a population prevalence of approximately 624 per million. Most dialysis units were located in the northern part of the country and only 1... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5144835 Wed, 17 Aug 2011 23:00:00 +0100 5144835 http://www.medworm.com/index.php?rid=5132948&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00578.x AbstractPerforming chronic hemodialysis in patients suffering from end‐stage renal disease needs a suitable vascular access like arteriovenous fistula in the upper limbs and bridge fistula in the upper or lower limbs, and also use of permanent and temporary catheters. The purpose of this study is to compare frozen saphenous vein versus using synthetic Gore‐tex vascular graft for A–V fistula. In the prospective randomized study, 70 patients needing for dialysis access were randomly divided into two groups. We performed the frozen saphenous vein A–V fistula in the test group and the Gore‐tex fistula in the control group. An assessment included function criteria (fistula thrill and murmur) and complications (infection and thrombosis) in planned intervals. At the end of the follow‐... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5132948 Mon, 15 Aug 2011 23:00:00 +0100 5132948 http://www.medworm.com/index.php?rid=5132947&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00586.x We present a novel case of a patient with both recurrent O. anthropi and S. putrefaciensBSI complicating hemodialysis. There have been no reports in the literature of such a case. We also discuss the microbiology, clinical features, and the challenging aspects of treatment of such infections. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5132947 Mon, 15 Aug 2011 23:00:00 +0100 5132947 http://www.medworm.com/index.php?rid=5120439&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00583.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5120439 Thu, 11 Aug 2011 23:00:00 +0100 5120439 http://www.medworm.com/index.php?rid=5120438&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00584.x AbstractBacteremia from central venous catheter (CVC) infection causes morbidity and mortality in patients on hemodialysis (HD). Diagnosis of the infection can be difficult and may require special imaging. A 70‐year‐old man with diabetic nephropathy was on HD for 11 months through a permanent CVC. Because of symptomatic osteoporosis, he had kyphoplasty in three lumbar vertebrae (L2, L3, L4) 6 months after starting HD. Severe back pain persisted after kyphoplasty. Throughout the HD period, the exit site of the CVC had a clean appearance, there was no fever, and blood leukocyte counts were normal. During the 11th month of HD, he complained of subjective fever at home. Blood count revealed normal leukocyte count with neutrophilic predominance and blood cultures grew methicillin‐resistan... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5120438 Thu, 11 Aug 2011 23:00:00 +0100 5120438 http://www.medworm.com/index.php?rid=5120437&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00580.x AbstractHemodiafiltration (HDF) has been reported to improve nutritional intake, but as it increases convective losses, it could also increase micronutrient loss. We prospectively audited the effect of HDF on vitamin B12, zinc and selenium. Thirty‐four patients dialyzing (T/Th/Sa) switched to HDF, and 44 dialyzing (M/W/F) remained on high‐flux hemodialysis (HD) and were followed for 12 months. Dialysis adequacy, weight, hemoglobin, and serum albumin did not differ between the groups and did not change over 12 months’ follow up. Similarly, vitamin B12 did not differ: HDF, 443 (325–682) ng/mL HD vs. 478 (327–690) ng/mL HDF; 6 months, 513 (351–664) ng/mL vs. 460 (379–647) ng/mL; or 12 months, 444 (317–617) ng/mL vs. 492 (323–644) ng/mL. And no patient had subnormal values. F... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5120437 Thu, 11 Aug 2011 23:00:00 +0100 5120437 http://www.medworm.com/index.php?rid=5120436&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00581.x We describe a 69‐year‐old woman submitted to long‐term chronic hemodialysis that developed painful, bilateral hip tumors. Radiographic investigation showed extensive periarticular calcifications, and a bone biopsy was suggestive of adynamic bone disease and contained substantial amounts of aluminum. The lesions were surgically excised, and the histological analysis demonstrated amorphous, calcified material associated with densely collagenized connective tissue. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5120436 Thu, 11 Aug 2011 23:00:00 +0100 5120436 http://www.medworm.com/index.php?rid=5120435&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00582.x AbstractInadequate dietary intakes are a major determinant of malnutrition in hemodialysis (HD) patients. Considering the lack of information available on dietary intakes of HD patients in Iran, the present study was designed to assess the dietary intakes of HD patients in Tehran, Iran. For this cross‐sectional study, from among adult HD patients of 50 Tehran hemodialysis centers, 291 patients were randomly selected. Dietary intakes of these patients were assessed using a 4‐day dietary recall. In addition, 4 mL of blood was obtained from each patient before dialysis to measure serum urea, creatinine, albumin, phosphorus, calcium, potassium, and high sensitive C‐reactive protein levels. Dietary intakes of energy, protein and fiber were lower than recommended intakes in 88%, 84.5%, a... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5120435 Thu, 11 Aug 2011 23:00:00 +0100 5120435 http://www.medworm.com/index.php?rid=5080759&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00576.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5080759 Thu, 28 Jul 2011 23:00:00 +0100 5080759 http://www.medworm.com/index.php?rid=5080758&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00573.x AbstractPrimary hyperoxaluria (PH) is a rare genetic disorder characterized by overproduction of oxalate due to specific enzyme deficiencies in glyoxylate metabolism. The primary clinical presentation is in the form of recurrent urolithiasis, progressive nephrocalcinosis, end‐stage renal disease, and systemic oxalosis. Herein, we present a case of PH who was diagnosed at 47 years of age after 6 years on hemodialysis. He presented with fatigue, anorexia, weight loss, and was found to have cachexia, diffuse edema, hepatomegaly, ascites, hypercalcemia, hyperphosphatemia, hypoalbuminemia, low parathyroid hormone levels, lytic and resorptive areas in the vertebrae, diffusely increased echogenity of the liver, multiple renal stones, and bilateral nephrocalcinosis. Bone marrow biopsy showed... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5080758 Thu, 28 Jul 2011 23:00:00 +0100 5080758 http://www.medworm.com/index.php?rid=5070548&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00572.x AbstractThe prevalence of coronary artery disease (CAD) is high in hemodialysis (HD) patients. The aim of the study was to assess the diagnostic and prognostic value of dipyridamole stress echocardiography (DSE) in nondiabetic HD patients without signs or symptoms of CAD. In 51 out of 158 evaluated HD patients (21 females, age 67 [33–85] years, HD duration 38 [9–271] months), resting echocardiography and DSE were performed. Exclusion criteria were known CAD, diabetes mellitus, and pulmonary and oncologic pathologies. Logistic regression analysis was carried out to identify predictors of abnormal DSE response, while Cox regression analysis was performed to determine variables associated with total and cardiovascular mortality, after 43.3 (11–60) months of follow‐up. Seven patients (... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5070548 Mon, 25 Jul 2011 23:00:00 +0100 5070548 http://www.medworm.com/index.php?rid=5070547&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00575.x AbstractA favorable survival effect of phosphate binders (PBs) on incident hemodialysis (HD) patients was recently reported, but no definitive advantages of calcium‐based or noncalcium‐based PBs have been demonstrated. The aim of this study was to assess the impact of the prescription of PBs using calcium carbonate (CaCO3) or sevelamer HCl (SV) on survival. Baseline PB prescription was recorded using a cross‐sectional analysis of prevalent HD patients from the regional Association Régionale des Néphrologues OStéodystrophie French cohort. A prospective 42‐month survival analysis study was performed. In July 2005, 1347 HD patients were included. CaCO3, SV, and mixed PBs were prescribed in 55%, 42%, and 24% of cases, respectively, and 26% were not prescribed PBs. Using a Cox propor... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5070547 Mon, 25 Jul 2011 23:00:00 +0100 5070547 http://www.medworm.com/index.php?rid=5040799&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00568.x AbstractOxidative stress is accepted as a nonclassical cardiovascular risk factor in chronic renal failure patients. The aim of this study was to evaluate the relation between oxidative DNA damage (8‐hydroxy‐2′‐deoxyguanosine/deoxyguanosine [8‐OHdG/dG] ratio), oxidative stress biomarkers, antioxidant enzymes, and carotid artery intima‐media thickness (CIMT) in hemodialysis (HD) patients. Forty chronic HD patients without known atherosclerotic disease and 48 age‐ and sex‐matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8‐OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. CIMT was assessed by carotid artery ultrasonogra... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5040799 Sun, 17 Jul 2011 23:00:00 +0100 5040799 http://www.medworm.com/index.php?rid=5040798&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00569.x This study examined the effect of reduction of space between needles from 5 cm to 2.5 cm on access recirculation, the measurement of access blood flow rate (by indicator dilution technology), and dialysis efficiency (by effective ionic dialysance). Twelve patients were studied, with half having their dialysis needles placed 2.5 cm apart for five consecutive dialysis treatments followed by placing needles 5 cm apart for a further five consecutive treatments. The other half initiated with 5 cm followed by 2.5 cm distance for a similar number of treatments. All 120 dialyses had successful cannulations with access recirculation excluded. Access blood flow (Qa mL/min) measurement was attempted for each patient twice, with each of the two needle positions. The Qa with needles 2.5 c... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5040798 Sun, 17 Jul 2011 23:00:00 +0100 5040798 http://www.medworm.com/index.php?rid=5040797&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00570.x AbstractBreast swelling is caused by many etiological factors, but should alert central vein occlusion in hemodialysis patients when the permanent vascular access is in the same arm. The swelling of the breast is caused by venous hypertension in the venous plexus draining the breast. Endovascular treatment relieves venous hypertension and related clinical signs. Additional diagnostic workup or invasive interventions such as a biopsy should be avoided in such patients, as diagnosis is straightforward with the presence of a functioning arteriovenous fistula in the same arm. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5040797 Sun, 17 Jul 2011 23:00:00 +0100 5040797 http://www.medworm.com/index.php?rid=5324612&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00625.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5324612 Fri, 01 Jul 2011 04:00:00 +0100 5324612 http://www.medworm.com/index.php?rid=5305160&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00620.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5305160 Fri, 01 Jul 2011 04:00:00 +0100 5305160 http://www.medworm.com/index.php?rid=5239007&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00608.x AbstractOnce‐monthly administration of CERA, a continuous erythropoietin receptor activator, has shown equivalent efficacy to shorter‐acting erythropoiesis‐stimulating agents (ESAs) that require more frequent dosing, but data on routine use of once‐monthly CERA in hemodialysis patients are lacking. Study on Efficacy, Safety and Applicability of Mircera (SESAM) was a prospective, multicenter, noninterventional trial with a duration of up to 9 months (month 0–5 “titration phase”; month 6−8 “evaluation phase”) to test the stability of Hb control in hemodialysis patients under routine conditions. Patient selection, Hb targets and CERA dosing were at the discretion of the local nephrologist. 918 patients from 92 German nephrology centers were included. Ninety‐three percent... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5239007 Fri, 01 Jul 2011 04:00:00 +0100 5239007 http://www.medworm.com/index.php?rid=5227129&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00612.x AbstractMantle cell lymphoma (MCL), owing to its insensitivity to chemotherapy, has a poor prognosis, with a median survival of 3 years to 4 years. MCL frequently infiltrates other organs. However, reports involving kidney in living patients are rare. Here, we report a case of MCL with renal involvement leading to end stage renal disease that required renal replacement therapy. A 69‐year‐old man diagnosed with MCL 3 years earlier was admitted to our emergency room due to uremic symptoms. After eight cycles of chemotherapy, he had displayed complete remission, but experienced a recurrence 1.5 years later; after refusing chemotherapy, the patient was lost on follow‐up in the final 10 months. On presentation at the emergency room, the patient's serum blood urea nitrogen was 10... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5227129 Fri, 01 Jul 2011 04:00:00 +0100 5227129 http://www.medworm.com/index.php?rid=5210071&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00606.x AbstractThe aim of the study was to investigate the oral hygiene behavior and state of oral health of hemodialysis (HD) patients in Germany. HD patients attending two dialysis centers were asked to participate in the study. Anamneses and oral hygiene behavior were recorded in a questionnaire. Dental examination included the dental status (DMF‐T) and the degree of gingival inflammation (PDI: Periodontol Disease Index). Of 129 patients contacted, 54 (42%), aged 63.9 ± 13.0 years (23 women and 31 men), took part in the study. At an average, dialysis was required for 4.1 years. The cause of terminal renal failure was glomerulonephritis in 30% of patients and diabetic nephropathy in 22% of patients. Since dialysis therapy, 63% of the patients (n = 34) only visited a dentist when they... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5210071 Fri, 01 Jul 2011 04:00:00 +0100 5210071 http://www.medworm.com/index.php?rid=5144834&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00590.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5144834 Thu, 30 Jun 2011 23:00:00 +0100 5144834 http://www.medworm.com/index.php?rid=5132946&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00587.x We report a prospective observational study comparing patients who underwent hemodialysis in our center in 2009 for cast nephropathy revealing multiple myeloma vs. patients treated for the same condition during the same period in other centers in our region. The main difference in the management protocols was the use of high cutoff (HCO) membranes in our center. We described the clinical features, the management protocols, and the outcomes as of June 1, 2010. In 2009, five patients were treated for myeloma cast nephropathy with HCO hemodialysis in our center. At 386 ± 100 days follow‐up, one patient died, while three of the five patients recovered their renal function, allowing cessation of hemodialysis. During the same period, five patients were treated for myeloma cast nephropathy... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5132946 Thu, 30 Jun 2011 23:00:00 +0100 5132946 http://www.medworm.com/index.php?rid=5120434&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00562.x AbstractAdiponectin exerts cardiovascular protective actions, although some studies have shown the opposite. In hemodialysis, obese subjects display lower mortality rates despite hypoadiponectinemia, while higher adiponectin concentrations correlate with an elevated cardiovascular risk in nonobese subjects. The aim of the study is to suggest that adiponectin level variations are associated with differences in the body mass index (BMI). The interplay between adiponectin and pro‐brain natriuretic peptide (Pro‐BNP) levels may vary according to body fat mass. Fifty‐two chronic hemodialysis patients were divided into three groups. Group A, BMI<25 (n=20); Group B, BMI 25 to 30 (n=21), and Group C, BMI>30 (n=11). Diabetics: Group A 10%; Group B 6 29%; Group C 55%, P=0.027. Determinati... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5120434 Thu, 30 Jun 2011 23:00:00 +0100 5120434 http://www.medworm.com/index.php?rid=5080757&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00574.x This study suggests that continuous surveillance for S. aureus nasal colonization is essential to properly identify all hemodialysis patients using catheters at risk of developing S. aureus bacteremias. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5080757 Thu, 30 Jun 2011 23:00:00 +0100 5080757 http://www.medworm.com/index.php?rid=5070546&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00577.x AbstractCost reduction and quality improvement seem to be conflicting issues. However, online hemodiafiltration (oHDF) with new automatic functions offers a cost‐efficient therapy compared to hemodialysis (HD). Seven dialysis centers conducted a randomized clinical trial with cross‐over design: high‐flux HD vs. postdilutional oHDF with functions coupling both dialysate and substitution flow rates to blood flow rates. During the 6 weeks of the study, all treatment parameters remained unchanged for HD and oHDF, apart from dialysate and substitution flow rate. Treatment data were recorded during each treatment, and predialytic and postdialytic concentrations of urea were recorded at the end of each study phase. The analysis involved 956 treatments of 54 patients. The mean dialysate co... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5070546 Thu, 30 Jun 2011 23:00:00 +0100 5070546 http://www.medworm.com/index.php?rid=5040796&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00571.x The objective of this study was to evaluate risk factors for AoAC progression. The enrolled subjects were 125 newly treated hemodialysis patients and 59 peritoneal dialysis patients. In the patients who had undergone chest radiography before initial dialysis therapy and every year, we estimated AoACS and then divided the patients into two groups based on the presence or absence of AoAC progression. We also compared the baseline clinical and biochemical profiles in the two groups. Eighty‐five (46.2%) were men (mean age, 58.6 ± 12.7 years). Seventy‐six patients (41.3%) had AoAC before initial dialysis, with a mean AoACS of 13.0 ± 20.4%. The mean duration of follow‐up was 2.7 ± 1.0 years. Half of the patients (50%) had progressive AoAC. Age >65 years (p = 0.003), d... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5040796 Thu, 30 Jun 2011 23:00:00 +0100 5040796 http://www.medworm.com/index.php?rid=5000031&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00564.x AbstractDialysis procedures are life‐sustaining renal replacement therapies indicated for patients with limited or no kidney function. The formation of clots in the extracorporeal circuit during dialysis is an undesirable event. Anticoagulation is therefore routinely practiced in this context. Unfractionated heparin (UFH) is largely used in dialysis patients. However, except in patients with an elevated risk of bleeding, the 2002 European Best Practice Guidelines Expert Group on Hemodialysis recommended the use of low–molecular‐weight heparins over UFH, in view of their equal efficacy, improved safety, and easy handling. Low–molecular‐weight heparins comprise several drugs, differing in a number of pharmacological and clinical properties. This manuscript reviews the data obtained... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5000031 Thu, 30 Jun 2011 23:00:00 +0100 5000031 http://www.medworm.com/index.php?rid=5000030&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00566.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=5000030 Thu, 30 Jun 2011 23:00:00 +0100 5000030 http://www.medworm.com/index.php?rid=4978192&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00565.x AbstractTo compare cardiac output (CO) and cardiac index (CI) and left ventricular ejection fraction (LVEF) in end‐stage renal disease (ESRD) with a control group using gated single photon emission computed tomography (SPECT)/computed tomography (CT) imaging. Altered cardiovascular function with increased CO secondary to arterio‐venous fistulas (AVF) for dialysis has been reported in patients with ESRD. Thirty‐two patients (18 with AVF or graft) referred for pre‐renal transplant cardiac assessment using SPECT/CT were studied with 2 comparison groups, 42 normal weight (body mass index<30) and 46 obese (body mass index>30) patients. End‐stage renal disease patients had overall reduced mean hemoglobin 11.6 mg/dL and elevated mean parathyroid hormone of 396 pg/mL. Gated SPE... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4978192 Sun, 26 Jun 2011 23:00:00 +0100 4978192 http://www.medworm.com/index.php?rid=4886284&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00553.x AbstractThe majority of severe hypersensitivity reactions in hemodialysis patients have occurred due to sensitization to ethylene oxide or to nonbiocompatible membrane dialyzers. The use of polysulfone dialyzers rarely causes hypersensitivity reactions. In the present study, we describe a case of severe life‐threatening reactions induced by polysulfone dialyzers (from different manufacturers subjected to a variety of sterilization methods), which occurred after 9 sessions of hemodialysis with the same prescription, exemplifying the complexity of such reactions. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886284 Mon, 30 May 2011 23:00:00 +0100 4886284 http://www.medworm.com/index.php?rid=4886283&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00554.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886283 Mon, 30 May 2011 23:00:00 +0100 4886283 http://www.medworm.com/index.php?rid=4886282&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00555.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886282 Mon, 30 May 2011 23:00:00 +0100 4886282 http://www.medworm.com/index.php?rid=4886281&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00556.x We report a case of diabetic end‐stage renal disease patient who presented with a right common carotid artery jugular arteriovenous fistula as a complication of the insertion of a polyurethane double‐lumen hemodialysis catheter into the right internal jugular vein .On physical examination of the neck, a pulsating mass with a palpable thrill and a bruit was noted in the right subclavicular region. The diagnosis was confirmed by color doppler ultrasonography of the neck and carotid angiography. The review of the literature suggests the occurrence of this complication as rather rare. The fistula was successfully repaired surgically. It is emphasized that while securing the access, a thorough physical examination with a special emphasis on seeking any neck swellings, thrill, and bruit alon... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886281 Mon, 30 May 2011 23:00:00 +0100 4886281 http://www.medworm.com/index.php?rid=4886280&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00557.x AbstractEnd stage renal failure is associated with very high risk of cardiovascular disease. Serum levels of B‐type natriuretic peptide (BNP) and NT proBNP reflect cardiovascular risk but it is unknown which of these peptides is a better predictor of survival in this population. BNP and NT proBNP levels and other relevant parameters were measured in 103 patients on high‐flux hemodialysis (HD) and hemodiafiltration. Patients were followed for 4 years or until transplantation or death. Median BNP level was 262 pg/mL while the corresponding NT proBNP level was 362 pg/mL. Levels of these peptides were significantly lower in patients receiving hemodiafiltration than in those on high‐flux HD. Only 1 of the 26 patients with normal NT proBNP died during follow‐up while 3 of the 33 pati... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886280 Mon, 30 May 2011 23:00:00 +0100 4886280 http://www.medworm.com/index.php?rid=4886279&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00558.x AbstractUremic optic neuropathy (UON) is extremely rare, although sporadic cases have been reported. UON is sometimes regarded as a manifestation of uremic neuropathy. Here, we report a case of end‐stage renal disease presenting as UON. A 22‐year‐old male was transferred to our nephrology department due to azotemia. Sudden deterioration of his vision occurred 3 days before his transfer. The patient's blood pressure was 150/90 mmHg, and he had no symptoms or signs of uremia, except for the visual disturbance. Blood tests showed an elevated serum creatinine of 6.0 mg/dL and serum BUN of 53.6 mg/dL. Both kidneys were decreased in size on ultrasound. His best‐corrected vision was 20/62.5 in both the eyes. Ophthalmoscopy revealed hyperemia, swelling of both optic nerve heads, and ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886279 Mon, 30 May 2011 23:00:00 +0100 4886279 http://www.medworm.com/index.php?rid=4886278&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00559.x AbstractA 48‐year‐old man was brought to the emergency room after ingesting an unknown amount of carbamazepine. He was unconscious and not responding to the noxious stimuli. He was intubated and was placed on mechanical ventilation because of respiratory insufficiency. Primary detoxification was performed with a gastric lavage and charcoal instillation. His serum carbamazepine level was 25.6 mcg/mL at the time of admission. His computed tomography of the brain was normal. He was managed conservatively but there was no improvement in his neurological status in the next 24 hours. Serum carbamazepine level was repeated and reported to be 28.3 mcg/mL. As there was no improvement in his sensorium and the serum carbamazepine levels remained persistently high, extracorporeal removal of ca... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886278 Mon, 30 May 2011 23:00:00 +0100 4886278 http://www.medworm.com/index.php?rid=4822731&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00550.x AbstractIron sucrose and low‐molecular‐weight iron dextran (LMW‐ID), two commonly used iron solutions, have been compared in terms of allergic adverse event profiles to date. However, the safety of total dose infusion of LMW‐ID has been investigated by only one study in chronic kidney disease (CKD) (not dialysis) patients. Thus, we aimed to compare adverse event profiles of total and high‐dose LMW‐ID and iron sucrose infusions in a heterogenous renal patient group comprising CKD, hemodialysis, and peritoneal dialysis. In this retrospective chart review study, we included 110 predialysis CKD, 101 peritoneal dialysis, and 118 hemodialysis patients. We included a total of 329 patients who were administered parenteral iron sucrose or LMW‐ID between September 2006 and April 2010. ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4822731 Thu, 12 May 2011 23:00:00 +0100 4822731 http://www.medworm.com/index.php?rid=4749271&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00546.x This study was initiated to know demographic and clinical data of end‐stage renal disease (ESRD) patients presenting to maintenance hemodialysis (MHD) at a government funded tertiary care centre in a developing country. A prospective analysis of all new ESRD patients attending to hemodialysis at our centre from 2004 to 2007 had been done. There were 237 new hemodialysis patients during a three‐year period. Males were 153 and females were 84, with the mean age 44.92 years. Diabetes mellitus (31.22%) was the most common cause of ESRD. Only 29.95% of patients had education on renal replacement therapy. 65.40% patients had emergency hemodialysis. Internal jugular catheter was the most common form of vascular access at initiation of hemodialysis. Arteriovenous fistula was secured in 29.95% ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4749271 Sat, 23 Apr 2011 23:00:00 +0100 4749271 http://www.medworm.com/index.php?rid=4736782&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00549.x AbstractWe aimed to evaluate the long‐term effect of hemodialysis (HD) treatment on left and right ventricular (LV and RV) functions in patients with end‐stage renal disease. The study population consisted of 22 patients with newly diagnosed end‐stage renal disease. Before an arteriovenous fistula was surgically created for HD, the patients were evaluated by echocardiography for systolic and diastolic functions. After the first HD session (mean 24.22 ± 2.14 months), the second echocardiographic evaluations were performed. Left ventricular and RV functions before and after long‐term HD treatment were compared. The mean age was 55 ± 13 years and 10 (45%) of the patients were female. After long‐term HD treatment, the isovolumic relaxation time was significantly decreased; however,... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4736782 Tue, 19 Apr 2011 23:00:00 +0100 4736782 http://www.medworm.com/index.php?rid=4978191&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00561.x We present a case of a 51‐year‐old woman who developed thrombocytopenia associated with dialysis treatments. Laboratory values revealed a platelet count of 50,000 or less postdialysis, with recovery of platelet count during her interdialytic period. An extensive work up including infectious serology and heparin‐induced thrombocytopenia test was negative. Based on the pattern of thrombocytopenia and negative work‐up, it is concluded that her thrombocytopenia was due to her dialysis treatments. We discuss the literature on thrombocytopenia and hemodialysis and postulate that our patient had a reaction to her dialyzer membrane or to the electron beam radiation method used to sterilize her dialyzer. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4978191 Thu, 31 Mar 2011 23:00:00 +0100 4978191 http://www.medworm.com/index.php?rid=4962049&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00567.x AbstractEntrapment of guidewires by inferior vena cava filters can occur during the blind insertion of a jugular or a subclavian central venous catheter. Recently, few case reports have been published in the radiology literature. In addition, others have described endovascular techniques aimed at removing entrapped guidewires, avoiding the possibility of vena cava rupture. Given that a temporary hemodialysis venous catheter is frequently used as a first access, the possibility of entrapping the dialysis catheter guidewire should not be neglected. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4962049 Thu, 31 Mar 2011 23:00:00 +0100 4962049 http://www.medworm.com/index.php?rid=4938758&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00563.x We present a case of CBZ intoxication successfully managed with sequential HD and CVVHD. The CBZ half‐life during CVVHD was 14.7 hours, compared with the patient's endogenous half‐life of 30.8 hours. The CBZ‐epoxide half‐life was 3.2 hours during HD. We conclude that HD and CVVHD provide effective clearance of CBZ and the epoxide metabolite and should be considered in the management of an acute toxic ingestion. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4938758 Thu, 31 Mar 2011 23:00:00 +0100 4938758 http://www.medworm.com/index.php?rid=4914630&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00560.x AbstractIntradialytic hypotension and hypertension are both independently associated with mortality among persons with end‐stage renal disease on hemodialysis. Endothelial dysfunction and arterial stiffness are two possible mechanisms underlying these phenomena, but their association with hemodynamic instability during dialysis has not been evaluated. Thirty patients were recruited from chronic dialysis units at San Francisco General Hospital and San Francisco Veterans Affairs Medical Center. Endothelial dysfunction was assessed with flow‐mediated dilation of the brachial artery after upper arm occlusion. Arterial stiffness was assessed using carotid‐femoral pulse wave velocity measured by tonometry. Intradialytic hypotension and hypertension were defined as the average decrease in s... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4914630 Thu, 31 Mar 2011 23:00:00 +0100 4914630 http://www.medworm.com/index.php?rid=4886277&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00552.x AbstractAn increasing number of successful pregnancies have been reported among women on chronic hemodialysis. Even with reduced fertility and high risk of complications, women of childbearing age receiving hemodialysis, should not be discouraged from pregnancy. Practitioners should be familiar with the effects of renal disease on pregnancy, consult patients about the possibility of pregnancy and its hazards and provide, if necessary, prompt surveillance and treatment. This paper describes the case of an unplanned but successful pregnancy of a woman receiving hemodialysis, emphasizing pregnancy management, mother's response evaluation, and infant growth. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4886277 Thu, 31 Mar 2011 23:00:00 +0100 4886277 http://www.medworm.com/index.php?rid=4822730&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00551.x AbstractHospitalization rate is high in patients on chronic hemodialysis (HD). We investigated whether initiation of HD changes the rate and length of hospitalization. We analyzed hospitalizations in HD patients in one hospital over 15 years. We compared annual rate and length of hospitalizations, both presented as mean (95% confidence interval [CI]) between the pre‐HD and HD period. Three hundred ninety‐two patients, 98% men, 59% diabetic, and 66.3 ± 11.2 years old at the onset of HD, had 1016 hospitalizations in the pre‐HD period (60.0 ± 42.9 months) and 1627 hospitalizations in the HD period (32.5 ± 25.9 months). Higher values were found in the HD than the pre‐HD period for rate, (pre‐HD 0.557 [95% CI 0.473–0.611], HD 2.198 [95% CI 1.997–2.399] admissions/[patient‐yea... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4822730 Thu, 31 Mar 2011 23:00:00 +0100 4822730 http://www.medworm.com/index.php?rid=4749270&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00545.x AbstractWe have already demonstrated that in chronic hemodialysis (HD) patients, the cyclic variations in both hydration status and blood pressure are responsible for changes in pulse wave velocity (PWV). The aim of this study is to verify whether the cyclic variation of PWV influences mortality in dialysis patients. We studied 167 oligoanuric (urinary output <500 mL/day) patients on chronic standard bicarbonate HD for at least 6 months. They performed 3 HD sessions of 4 hours per week. Patients were classified into 3 groups: normal PWV before and after dialysis (LL); high PWV before and normal PWV after dialysis (HL); and high PWV before and after dialysis (HH). The carotid‐femoral PWV was measured with an automated system using the foot‐to‐foot method. Analysis of variance was... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4749270 Thu, 31 Mar 2011 23:00:00 +0100 4749270 http://www.medworm.com/index.php?rid=4736781&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00547.x ABSTRACTPatients with end‐stage renal disease are prone to inflammation and inflammation is related to erythropoietin‐stimulating agent hyporesponsiveness and mortality in this population. Statins have been demonstrated to reduce cardiovascular mortality in selected populations of end‐stage renal disease patients. These drugs have pleiotrophic effects such as anti‐inflammation. In this retrospective analysis, we determined whether the use of statins improves inflammation and inflammation‐related anemia in a cohort of hemodialysis patients. Data were analyzed from Fresenius Medical Care Dialysis Clinics in Turkey between 2005 and 2007. Seventy prevalent hemodialysis patients who were on statins at the start of the study and have been on statins during follow‐up (statin users) an... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4736781 Thu, 31 Mar 2011 23:00:00 +0100 4736781 http://www.medworm.com/index.php?rid=4699062&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00548.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4699062 Thu, 31 Mar 2011 23:00:00 +0100 4699062 http://www.medworm.com/index.php?rid=4581992&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00529.x AbstractPatients with end‐stage renal disease (ESRD) are likely to have cardiac autonomic dysfunction, which is related with an increased risk of sudden death. The aim of this study is to detect cardiac autonomic dysfunction in patients with ESRD and to evaluate the possible acute effects of hemodialysis (HD) on cardiac autonomic functions measured by heart rate variability (HRV) and heart rate turbulence (HRT). Thirty‐one (mean age 50 ± 13 years, 15 males) with ESRD on regular HD program and 31 healthy volunteers (mean age 51 ± 12 years, 15 males) were included in the study. Twenty‐four‐hour ambulatory electrocardiogram recordings were taken from the subjects before and after HD and from the control group. Heart rate variability and HRT parameters were calculated from these reco... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581992 Sun, 13 Mar 2011 00:00:00 +0100 4581992 http://www.medworm.com/index.php?rid=4581991&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00530.x AbstractA bioartificial renal tubule device (BTD) consisting of a hollow‐fiber module and human proximal tubular epithelial cells has been completed technically by Humes and colleagues and a few other groups. Humes and colleagues developed BTD, treated acute kidney injury patients with multiorgan failure by continuous hemofiltration (CHF) in conjunction with BTD, and reported a significantly higher survival rate than that by CHF with BTD without cells in the Food and Drug Administration phase IIa trial. However, BTD has never been approved by the US Government, as the CHF+BTD treatment did not show a significant difference from the control group in the phase IIb trial. Human proximal tubular epithelial cells were confirmed to be overgrown on artificial membrane, which resulted in the inh... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581991 Sun, 13 Mar 2011 00:00:00 +0100 4581991 http://www.medworm.com/index.php?rid=4581990&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00533.x The objectives of this study were 4‐fold. First, we determined whether predictable final dialysate phosphate concentrations could be achieved by adding varying amounts of Fleet® enema. Second, we assessed the stability of calcium (Ca) and phosphate dialysate levels under simulated nocturnal hemodialysis conditions. Third, we assessed for Ca‐phosphate precipitate. Finally, we evaluated whether dialysate containing Fleet® enema met the current sterility standards. We added serial aliquots of enema to 4.5 L of dialysate acid concentrate and proportioned the solution on Gambro and Althin/Baxter dialysis machines for up to 8 hours. We measured dialysate phosphate, Ca, pH, and bicarbonate concentrations at baseline, and after simulated dialysis at 4 and 8 hours. We evaluated for precipit... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581990 Sun, 13 Mar 2011 00:00:00 +0100 4581990 http://www.medworm.com/index.php?rid=4581989&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00536.x AbstractNowadays, there is a renewed interest in bone changes in experimental and clinical nephrology. However, the need for understanding the peculiarity of bone can be traced back to the 5th century BC, when Empedocles of Acragas put forward a theory of a world made of air, water, fire, and earth governed by love and hate. By observing the various body tissues, he strove to demonstrate that they consisted of 4 elements assembled with different mathematical ratios (logos). Blood is considered the most perfect tissue, because the ratio between elements is one. Bone is a very unusual tissue because it is made of 2 parts of earth, 2 parts of water, and 4 parts of fire. This kind of reasoning could be considered the first cry in the birth of quantitative chemistry. (Source: Hemodialysis Inter... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581989 Sun, 13 Mar 2011 00:00:00 +0100 4581989 http://www.medworm.com/index.php?rid=4581988&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00537.x AbstractUltrasonic tissue characterization with integrated backscatter (IBS) offers a promising method for the noninvasive assessment of myocardial fibrosis and contractile performance. The aim of this study was to investigate the effect of thrice‐weekly in‐center nocturnal hemodialysis (INHD) and conventional hemodialysis (CHD) on myocardial fibrosis and left ventricular function in end‐stage renal disease patients. Thirty‐two INHD and 58 matched CHD patients were enrolled; baseline and 12‐month measures of blood pressure (BP), serum calcium and phosphorus, echocardiographic left ventricular mass index (LVMI) and left ventricular function, the myocardial calibrated IBS (C‐IBS), and systodiastolic cyclical variations in IBS (CV‐IBS) were collected. The baseline characteristic... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581988 Sun, 13 Mar 2011 00:00:00 +0100 4581988 http://www.medworm.com/index.php?rid=4581987&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00539.x AbstractMedication regimen simplification may improve adherence in end‐stage kidney disease. The effect of nocturnal home hemodialysis (NHHD) on medication burden is unknown. A retrospective pilot study of NHHD patients was conducted. Medication information was collected at baseline, NHHD start, and at 3, 6, 12, 18, and 24 months. SF‐36 scores were collected at baseline, 6, 12, and 24 months. The number of medications, pill burden, and number of administrations per day were determined. Medication Regimen Complexity Index was used at each time point as a comparator. Medications for anemia, mineral and bone disorders (MBD), cardiovascular (CV) disease, infection, and vitamins were analyzed for number of medications and pill burden. Thirty‐five patients were included. Patients used 10.5... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581987 Sun, 13 Mar 2011 00:00:00 +0100 4581987 http://www.medworm.com/index.php?rid=4518587&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00534.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4518587 Fri, 25 Feb 2011 00:00:00 +0100 4518587 http://www.medworm.com/index.php?rid=4346047&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00512.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346047 Fri, 14 Jan 2011 00:00:00 +0100 4346047 http://www.medworm.com/index.php?rid=4346046&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00521.x AbstractThe International Quotidian Dialysis Registry (IQDR) is a global initiative designed to study practices and outcomes associated with the use of hemodialysis (HD) regimens of increased frequency and/or duration. The IQDR grew out of the initiative that lead to the randomized prospective studies of nocturnal HD and short hours daily dialysis vs. conventional thrice weekly HD that are conducted by the Frequent Hemodialysis Network sponsored by the National Institutes of Health. These 2 separate studies are drawing to a close and the first results are expected to be reported later this year. These studies use surrogate outcomes for their primary endpoints as they are not powered to look at outcomes of mortality and hospitalization. The IQDR attempts to aggregate long‐term follow‐up... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346046 Fri, 14 Jan 2011 00:00:00 +0100 4346046 http://www.medworm.com/index.php?rid=4346045&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00523.x AbstractClimate change presents a global health threat. However, the provision of healthcare, including dialysis, is associated with greenhouse gas emissions. The aim of this study was to determine the carbon footprints of the differing modalities and treatment regimes used to deliver maintenance hemodialysis (HD), in order to inform carbon reduction strategies at the level of both individual treatments and HD programs. This was a component analysis study adhering to PAS2050. Emissions factors were applied to data that were collected for building energy use, travel and procurement. Thrice weekly in‐center HD has a carbon footprint of 3.8 ton CO2 Eq per patient per year. The majority of emissions arise within the medical equipment (37%), energy use (21%), and patient travel (20%) se... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346045 Fri, 14 Jan 2011 00:00:00 +0100 4346045 http://www.medworm.com/index.php?rid=4346044&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00525.x We describe a case of a carotid‐jugular arteriovenous fistula and a cerebrovascular infarct following the insertion of a double‐lumen catheter for hemodialysis access. We provide recommendations for the prevention and the early detection of this iatrogenic complication. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346044 Fri, 14 Jan 2011 00:00:00 +0100 4346044 http://www.medworm.com/index.php?rid=4346043&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00526.x AbstractInternational Vicenza Courses represent important educational events held yearly in the city of Palladio. Claudio Ronco organizes since 1982 international courses on peritoneal dialysis, hemodialysis and critical care nephrology. The faculty is outstanding and the content very informative and useful for beginners and for experts in the various fields. Every year the entire course is recorded in a DVD and the proceedings are available at the beginning of the course. Information can be obtained at http://www.vicenzanephrocourses.com. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346043 Fri, 14 Jan 2011 00:00:00 +0100 4346043 http://www.medworm.com/index.php?rid=4346042&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00528.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346042 Fri, 14 Jan 2011 00:00:00 +0100 4346042 http://www.medworm.com/index.php?rid=4332808&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00502.x This study demonstrated for the first time that individually optimized doses of nadroparin are sufficient for safe and effective HD in patients with a bleeding risk. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332808 Wed, 12 Jan 2011 00:00:00 +0100 4332808 http://www.medworm.com/index.php?rid=4332807&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00513.x AbstractHemodialysis (HD) has been associated with higher 1‐year mortality than peritoneal dialysis (PD) after dialysis start. Confounding effects of late referral, emergency dialysis start, or start with central venous catheter on this association have never been studied concomitantly. Survival was studied among the 495 incident dialysed patients in our department from 1995 to 2006 and followed at least 1 year until December 31, 2007. Nested Cox models adjusted on patient characteristics explored factors associated with 1‐year and ≥1‐year mortality. Hemodialysis patients were 332 (67.1%), 104 (21.0%) were late referred (<6 months), 167 (33.7%) started dialysis in emergency, and 144 (29.1%) started with central venous catheter. When adjusted only on age, sex, and comorbidities, ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332807 Wed, 12 Jan 2011 00:00:00 +0100 4332807 http://www.medworm.com/index.php?rid=4332806&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00514.x AbstractParicalcitol is more effective than calcitriol in hemodialysis patients (HD) with secondary hyperparathyroidism (SHPT), but it is not effective in some of them. We have investigated the relationship between paricalcitol responsiveness and parathyroid gland (PTG) size. Thirty HD with SHPT treated previously with calcitriol for at least 6 months were switched to paricalcitol (1:4 conversion ratio). Parathyroid gland number and size (maximum longitudinal diameter [MLD] of largest PTG) was measured by ultrasonography. Patients were divided into 2 groups: group A (MLD ≤9.0 mm [17 HD]); and group B (MLD >9.0 mm [13 HD]). They were defined responder if both the last 2 monthly determinations of inhibit parathyroid hormone (iPTH) were within the target (<300 pg/mL) according t... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332806 Wed, 12 Jan 2011 00:00:00 +0100 4332806 http://www.medworm.com/index.php?rid=4332805&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00518.x AbstractIn the hemodialysis patient population, a surgically created arteriovenous fistula is the preferred vascular access option. Development of high‐output heart failure may be an underappreciated complication in patients who have undergone this procedure. When a large proportion of arterial blood is shunted from the left‐sided circulation to the right‐sided circulation via the fistula, the increase in preload can lead to increased cardiac output. Over time, the demands of an increased workload may lead to cardiac hypertrophy and eventual heart failure. Patients may present with the usual signs of high‐output heart failure including tachycardia, elevated pulse pressure, hyperkinetic precordium, and jugular venous distension. Typically, the AV fistula is quite large and is likely... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332805 Wed, 12 Jan 2011 00:00:00 +0100 4332805 http://www.medworm.com/index.php?rid=4332804&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00519.x AbstractElevated levels of serum pancreatic enzymes are frequently observed in hemodialysis (HD) patients. The complex hemodynamic, biochemical, and physiological alterations in uremia were speculated to cause excessive release of pancreatic enzymes beyond decreased renal clearance. However, hemodynamic factors are seldom explored in this aspect. We performed the study to evaluate the association between intradialytic hemodynamic change and elevated serum pancreatic amylase (SPA). Eighty‐three prevalent HD patients without any clinical evidence of acute pancreatitis underwent pre‐HD and post‐HD blood sampling for serum pancreatic enzyme levels. Demographic, biochemical, and hematological data were collected from patient record review. Hemodialysis information including intradialytic ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332804 Wed, 12 Jan 2011 00:00:00 +0100 4332804 http://www.medworm.com/index.php?rid=4332803&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00522.x In conclusion, nephrologist should have a heightened awareness to the potential of this complication and should at least document a normal exam following the removal of femoral catheters. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332803 Wed, 12 Jan 2011 00:00:00 +0100 4332803 http://www.medworm.com/index.php?rid=4687213&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00544.x AbstractErectile dysfunction (ED) is very common in dialysis patients because of organic and psychological risk factors. It has a negative impact on patients' quality of life. In Senegal, ED is assumed to be frequent in the general adult population but its prevalence in dialysis patients is unknown. This cross‐sectional study aimed to assess the prevalence and risk factors associated with ED in Senegalese dialysis patients. Seventy dialyzed men >18 years old were included. Erectile dysfunction was assessed using the abridged version of International Index of Erectile Function already validated in dialysis patients. Multivariate analysis was performed to identify the factors associated with ED in patients. The mean age of the patients was 52±11.3 years (21–70 years) and the median d... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4687213 Sat, 01 Jan 2011 00:00:00 +0100 4687213 http://www.medworm.com/index.php?rid=4623425&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00532.x AbstractWe investigated the frequencies and associated risk factors of cardiac arrhythmias and heart rate variability (HRV) in hemodialysis (HD) patients. One hundred fifty prevalent HD patients underwent 48‐hour Holter monitoring. Holter monitoring was analyzed in 4 phases: early post‐HD phase (12 hours), late post‐HD phase (20 hours), pre‐HD phase (12 hours), and HD phase (4 hours). Echocardiography was applied to measure the left ventricular mass index in a subgroup of patients (n: 52). Patients with ventricular premature contraction (VPC) were significantly older, had a longer HD duration, and higher hemoglobin (Hb) levels. Left ventricular mass index was significantly correlated with the frequency of VPC, during the HD and pre HD phases (r: 0.435, 0.312, respectively). In logi... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4623425 Sat, 01 Jan 2011 00:00:00 +0100 4623425 http://www.medworm.com/index.php?rid=4617319&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00542.x AbstractNightly home hemodialysis (NHHD) has been reported to have a much better survival than the excessive mortality of thrice‐weekly in‐center dialysis, but the factors influencing survival of NHHD have not been investigated in detail. We studied the association of survival in a 12‐year study of 87 NHHD patients from a single center evaluating demographic, sociologic, and anthropomorphic factors, diagnosis, comorbidity, vintage, and dialysis performance and efficiency. Secondly, we compared the survival of the 87 NHHD patients with that reported by the United States Renal Data System (USRDS) using standardized mortality rate (SMR). The average patient age was 52 ± 15 years, and 59% were males, 51% African Americans, and 25% had diabetes. The patients dialyzed 40 ± 6 hours weekly... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4617319 Sat, 01 Jan 2011 00:00:00 +0100 4617319 http://www.medworm.com/index.php?rid=4607136&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00541.x This study serves as an example of a best practice to evaluate the in vitro stability and compatibility of a biologic agent with CVAD materials. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4607136 Sat, 01 Jan 2011 00:00:00 +0100 4607136 http://www.medworm.com/index.php?rid=4596470&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00543.x We examined the factors associated with IAC and its relationship with acute ischemic stroke in this population. We retrospectively studied 490 head computed tomographic scans from 2225 hemodialysis patients presenting with neurological symptoms at our center (October 2005–May 2009). Intracranial arterial calcification was graded using a validated scoring system. Multivariate regression was used to examine the factors associated with the presence of IAC, its severity, and its ability to predict acute ischemic stroke. Weibull's survival models analyzed the relationship between IAC severity and survival. Ninety‐five percent of patients with ischemic stroke had IAC vs. 83% in the nonstroke group (P=0.02). Intracranial arterial calcification severity increased with age (P<0.001), hemodia... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4596470 Sat, 01 Jan 2011 00:00:00 +0100 4596470 http://www.medworm.com/index.php?rid=4581986&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00540.x In this study, we report complete remission of RCC with lung metastases in 2 hemodialysis patients after low‐dose interferon therapy (Sumiferon® 3 × 106 international unit 3 times a week). These results suggest that interferon therapy is important for clear cell RCC with lung metastases in dialysis patients, even in the era of molecular‐targeted therapies. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4581986 Sat, 01 Jan 2011 00:00:00 +0100 4581986 http://www.medworm.com/index.php?rid=4518586&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00538.x We studied phosphorus (P) dynamics and its relation to urea dynamics in a wide range of dialyses by measuring predialysis and postdialysis serum P levels and all removed P and urea in dialysate during 455 hemodialyses. Dialyses were performed at different frequencies (range 3–6 treatments/wk); duration of dialysis (t) (range 80–560 minutes), varied blood and dialysate flow, and with high‐flux and low‐flux membranes. Kt/V‐P, Kt/V‐urea, weekly removal of P—and urea and removal volumes (Vr) and their relationships to varying dialyses, and predialysis concentrations, and protein catabolic rates were studied in linear and multiple regression analyses. A weekly dialysis time of >30 hours was needed to maintain serum P concentration normal without the use of phosphate binders. Vr... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4518586 Sat, 01 Jan 2011 00:00:00 +0100 4518586 http://www.medworm.com/index.php?rid=4503189&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2011.00531.x AbstractAnticoagulation is required during hemodialysis to prevent thrombus formation within the extracorporeal circuit. The low–molecular‐weight heparin tinzaparin is more expensive than unfractionated heparin (UFH) in Canada but more convenient to administer. We conducted a time‐and‐motion study to test the hypothesis that tinzaparin may reduce nursing time and total health care costs compared with UFH. Data on health care resource use associated with anticoagulation during hemodialysis for chronic renal failure were collected at an academic hospital in Quebec. Nursing time was recorded for 8 nurses performing 16 dialysis sessions for 4 patients receiving tinzaparin and 4 receiving UFH (2 dialysis sessions per patient). Nurses had ≥1 year of experience supervising hemodialysis.... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4503189 Sat, 01 Jan 2011 00:00:00 +0100 4503189 http://www.medworm.com/index.php?rid=4415775&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.subindex_1.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4415775 Sat, 01 Jan 2011 00:00:00 +0100 4415775 http://www.medworm.com/index.php?rid=4415774&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.auindex_1.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4415774 Sat, 01 Jan 2011 00:00:00 +0100 4415774 http://www.medworm.com/index.php?rid=4415773&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00516.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4415773 Sat, 01 Jan 2011 00:00:00 +0100 4415773 http://www.medworm.com/index.php?rid=4415772&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00511.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4415772 Sat, 01 Jan 2011 00:00:00 +0100 4415772 http://www.medworm.com/index.php?rid=4415771&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00515.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4415771 Sat, 01 Jan 2011 00:00:00 +0100 4415771 http://www.medworm.com/index.php?rid=4246772&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00508.x AbstractThe risks/benefits of anemia treatment in dialysis patients have been redefined in the US Epoetin α label. This analysis was carried out to determine if increasing hemoglobin (Hb) levels improve exercise tolerance and physical function in anemic dialysis patients. This is a new analysis of the Canadian Erythropoietin Study Group trial, a double‐blind, randomized, placebo‐controlled trial in dialysis patients. Subjects were 18 to 75 years old, on hemodialysis for >3 months, and had a baseline Hb <9.0 g/dL. Patients with a history of diabetes mellitus, ischemic heart disease, or severe/uncontrolled hypertension were excluded. Patients were randomized to receive Epoetin α to a target Hb of 9.5 to 11.0 g/dL (n=40) or a target of 11.5 to 13.0 g/dL (n=38), or receive pl... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4246772 Tue, 07 Dec 2010 00:00:00 +0100 4246772 http://www.medworm.com/index.php?rid=4198187&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00504.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4198187 Wed, 24 Nov 2010 00:00:00 +0100 4198187 http://www.medworm.com/index.php?rid=4198186&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00507.x AbstractMethicillin‐sensitive Staphylococcus aureus (MSSA) bacteremia is a leading cause of infection in hemodialysis (HD) patients. Cloxacillin, cefazolin, and vancomycin are the mainstay antimicrobials. Cloxacillin administration leads to frequent drug dosing, longer length of stay (LOS), and higher cost, while resistance and poorer outcomes are associated with vancomycin use. Dosing cefazolin during HD allows for prolonged blood therapeutic levels. We assessed the outcomes and safety of a strategy of treating MSSA bacteremia with 2–3 g cefazolin on HD only. All HD patients with MSSA bacteremia admitted in June–December 2009 at our center and receiving this regime were compared with historical controls who received cloxacillin. Demographic characteristics and outcome measures lik... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4198186 Wed, 24 Nov 2010 00:00:00 +0100 4198186 http://www.medworm.com/index.php?rid=4180306&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00501.x AbstractContinuous ionic dialysance monitoring is a useful clinical tool to determine the dialysis dose in real time in each hemodialysis session. We followed up 49 patients for 16 months. Six patients with a Kt reduction of ≥20% in >3 consecutive hemodialysis sessions were identified. Fistulography demonstrated significant stenosis in all 6 patients. Angioplasty was performed in 5 with an excellent angiographic result and optimal Kt levels were restored. Unexplained and persistent Kt reduction in patients with stable chronic kidney disease under hemodialysis could represent, together with an accurate vascular access examination, a practical and additional indirect method for the early detection of vascular access dysfunction. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4180306 Thu, 18 Nov 2010 00:00:00 +0100 4180306 http://www.medworm.com/index.php?rid=4373796&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00506.x AbstractButtonhole cannulation is a method of cannulation of native arteriovenous fistulae traditionally practiced by self‐cannulators. At St Michael's Hospital, this method has been modified to allow its use in problematic fistulae by multiple cannulators. In a busy dialysis unit, the need for a few specific cannulators to establish the tunnel tracks in combination with the variable dialysis schedules creates logistical challenges. A new method of creating tunnel tracks with the use of the BioHole™ device was evaluated. Buttonhole tracks were created in 12 patients using a peg of polycarbonated material with a holder (BioHole™ kit). The peg was inserted into the path left by the hemodialysis sharp needle following the index cannulation. Four of the 12 patients had an alternate acces... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4373796 Fri, 01 Oct 2010 00:00:00 +0100 4373796 http://www.medworm.com/index.php?rid=4346041&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00527.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4346041 Fri, 01 Oct 2010 00:00:00 +0100 4346041 http://www.medworm.com/index.php?rid=4339426&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00520.x AbstractSymptomatic cytomegalovirus (CMV) infection in immunocompetent patients has traditionally been considered to have a benign and self‐limited course. Moreover, current concept is that CMV infection in immunocompetent patients does not require treatment. However, recent studies reveal that CMV infection in immunocompetent patient with clinical manifestation is not a rare condition as thought previously. Here, we report a case of CMV colitis, which occurred in an immunocompetent hemodialysis patient who neither had HIV infection nor had medication that could cause immunosuppression. Our case revealed that the conservative treatment was not enough, and the administration of ganciclovir was essential for improving the disease course. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4339426 Fri, 01 Oct 2010 00:00:00 +0100 4339426 http://www.medworm.com/index.php?rid=4332802&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00524.x We report a case of fatal bacteremia caused by C. testosteroni in a 64‐year‐old woman on hemodialysis. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4332802 Fri, 01 Oct 2010 00:00:00 +0100 4332802 http://www.medworm.com/index.php?rid=4327757&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00510.x We report an unusual case of straight descent of hemodialysis catheter into superior intercostal vein. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4327757 Fri, 01 Oct 2010 00:00:00 +0100 4327757 http://www.medworm.com/index.php?rid=4282646&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00517.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4282646 Fri, 01 Oct 2010 00:00:00 +0100 4282646 http://www.medworm.com/index.php?rid=4246771&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00509.x This study was conducted to determine the P‐binding efficacy of crushed lanthanum and compare it with chewed lanthanum in hemodialysis (HD) patients. After a 1‐week washout period, 11 hemodialysis patients (7 men, 4 women) were randomized to receive, in a crossover fashion, lanthanum 1000 mg 3 times daily chewed with meals and lanthanum 1000 mg 3 times daily crushed into a fine powder, mixed with applesauce and taken with meals, for 4 weeks each. Serum P was measured at the end of each washout (baseline) and weekly during treatment. Changes in serum P from baseline for crushed lanthanum were compared with chewed lanthanum using paired sample t test. Administration of crushed lanthanum resulted in a significant reduction in serum P from baseline (P reduction [mg/dL] for crushed lant... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4246771 Fri, 01 Oct 2010 00:00:00 +0100 4246771 http://www.medworm.com/index.php?rid=4198185&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00505.x This study showed a high incidence of vitamin C deficiency in extended hours hemodialysis patients, suggesting that supplementation is warranted. It also supports an ongoing role for multivitamin supplementation in conventional hemodialysis patients. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4198185 Fri, 01 Oct 2010 00:00:00 +0100 4198185 http://www.medworm.com/index.php?rid=4180305&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00503.x AbstractThe purpose of the present study was to compare the end‐to‐end (ETEa) with the end‐to‐side (ETSa) anastomosis in patients starting hemodialysis by means of radio‐cephalic artero‐venous fistulae (AVF). In our experience, we compared the results, as early failure (EF), late thrombosis (LT), stenosis, steal syndrome, and primary patency (PP), in 2 groups of hemodialysis incident patients that had been placed an AVF by means of ETEa or ETSa. The observation period lasted 24 months for each of the 2 types of AVF, starting from October 2005 to September 2007 for ETEa and from October 2007 to September 2009 for ETSa. One hundred forty patients were included in the present study. We have consecutively performed 99 AVF interventions at the wrist or at the third distal of the for... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=4180305 Fri, 01 Oct 2010 00:00:00 +0100 4180305