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. Sat, 13 Mar 2010 14:30:03 +0100 http://www.medworm.com/index.php?rid=3351963&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00444.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=3351963 Thu, 11 Mar 2010 00:00:00 +0100 3351963 http://www.medworm.com/index.php?rid=3351965&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00424.x We present 5 patients with severe secondary hyperparathyroidism (median iPTH=1783 pg/mL) who were treated with 3-hour daily hemodialysis (3 hours × 6 times a week). Daily hemodialysis, at 1 year, was associated with a 70.4% reduction in median PTH (1783 pg/mL [interquartile range: 1321[ndash]1983][ndash]472 pg/mL [334, 704], P (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=3351965 Wed, 10 Mar 2010 00:00:00 +0100 3351965 http://www.medworm.com/index.php?rid=3351964&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2010.00439.x Neopterin is a diagnostic or a prognostic biomarker for several pathologies including renal diseases. However, the association between neopterin status and causative main reasons such as diabetes and hypertension for renal disease remains unclear. The aim of the study was to evaluate neopterin levels in diabetes and hypertension patients treated with/without hemodialysis. According to primary renal disorders, the patients undergoing hemodialysis were classified into 4 groups as diabetic nephropathy, hypertensive nephropathy, reflux nephropathy or interstitial nephritis, and others. The controls consisted of healthy subjects, hypertensive subjects, and diabetic individuals without any renal disorder. In the study, both urinary and serum neopterin levels were measured using high performance ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=3351964 Wed, 10 Mar 2010 00:00:00 +0100 3351964 http://www.medworm.com/index.php?rid=3112850&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00418.x Hyperphosphatemia is common among patients receiving dialysis and is associated with increased mortality. Nocturnal hemodialysis (NHD) is a long, slow dialytic modality that may improve hyperphosphatemia and disorders of mineral metabolism. We performed a randomized-controlled trial of NHD compared with conventional hemodialysis (CvHD); in this paper, we report detailed results of mineral metabolism outcomes. Prevalent patients were randomized to receive NHD 5 to 6 nights per week for 6to 10 hours per night or to continue CvHD thrice weekly for 6 months. Oral phosphate binders and vitamin D analogs were adjusted to maintain phosphate, calcium and parathyroid hormone (PTH) levels within recommended targets. Compared with CvHD patients, patients in the NHD group had a significant decrease in... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=3112850 Wed, 23 Dec 2009 00:00:00 +0100 3112850 http://www.medworm.com/index.php?rid=2956462&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00421.x C.E.R.A., a continuous erythropoietin receptor activator is approved for the treatment of anemia in patients with chronic kidney disease (CKD). The ARCTOS (administration of C.E.R.A. in CKD patients to treat anemia with a twice-monthly schedule) phase 3 study demonstrated the efficacy and safety of C.E.R.A. in correcting anemia when administered once every 2 weeks (Q2W) subcutaneously in patients with CKD not on dialysis. We assessed the feasibility and long-term safety of converting patients who responded to treatment with C.E.R.A. Q2W to C.E.R.A. once every 4 weeks (Q4W) during a 24-week extension period. After the core ARCTOS study period (28 weeks), 296 patients entered the 24-week extension period. At week 29, patients who responded to C.E.R.A. Q2W during the core period were rerandom... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2956462 Wed, 04 Nov 2009 00:00:00 +0100 2956462 http://www.medworm.com/index.php?rid=2956464&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00403.x This study aimed to investigate the contribution of impaired baroreflex sensitivity (BRS) to the pathophysiology of IDH. Thirty-four chronic HD (12 IDH-prone, 22 IDH-resistant) patients underwent BRS measurement during HD with relative blood volume monitoring. During analysis, patients were separated into four age-matched groups according to resting BRS[ge]4.5 ms/mmHg and hemodynamic stability. Resting BRS was extremely heterogenous (geometric mean BRS 5.78±1.41 [range 1.76[ndash]41.41] ms/mmHg). Relative blood volume reduction was well matched in all groups (mean reduction in relative blood volume for all patients [minus]6.74%±0.86%, P>0.05). Thirty-seven episodes of IDH occurred in the IDH prone, reduced BRS group. Patients with impaired resting BRS and prone to IDH had markedly differ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2956464 Tue, 03 Nov 2009 00:00:00 +0100 2956464 http://www.medworm.com/index.php?rid=2956463&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00409.x There is limited safety information about ferric carboxymaltose (FCM), a new intravenous iron preparation. This randomized, crossover study compared the safety and tolerability of double-blinded intravenous doses of FCM or placebo in patients with iron deficiency anemia. Subjects (559) with iron deficiency anemia received a dose of either FCM (15 mg/kg, maximum 1000 mg) over 15 minutes or placebo on day 0. On day 7, subjects received the other agent. Safety evaluations were performed on days 7 and 14. The primary endpoint was the incidence of treatment-emergent adverse events during each 7-day study period. During the first 24 hours and during the 7-day treatment period, at least one treatment-emergent adverse event was experienced by 15.0% and 29.3% of subjects after FCM and 11.4% and 19.... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2956463 Tue, 03 Nov 2009 00:00:00 +0100 2956463 http://www.medworm.com/index.php?rid=2802165&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00400.x We report the case of a 54-year-old hemodialysis patient who presented with recurrent fever due to Streptococcus bovis bacteremia related to colonic tubulovillous adenoma. Following polypectomy and broad-spectrum antibiotic therapy, the patient totally recovered. In this paper, we discussed the relation between S. bovis bacteremia, colonic adenomas, and hemodialysis. Awareness of this association is critical for early diagnosis and management. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802165 Wed, 16 Sep 2009 23:00:00 +0100 2802165 http://www.medworm.com/index.php?rid=2802176&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00381.x This study introduces a new parameter for dialysis monitoring that may be used as a complementary parameter, the area under UV-absorbance curve (AUCa), to reflect a total solute removal during dialysis. The aim was to investigate the relationship between this new dialysis on-line monitoring parameter, AUCa, and the total removal of a few solutes. Fifteen patients were monitored during hemodialysis using UV absorbance at the wavelength of 297 nm. All spent dialysate passed through a flow cuvette in a spectrophotometer and then further to a collection tank where solute concentrations in the entire spent dialysate were determined. The AUCa at 297 nm was compared with the total amount of removed solute in the tank (reference method). The result shows strong correlations between AUCa and the to... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802176 Tue, 15 Sep 2009 23:00:00 +0100 2802176 http://www.medworm.com/index.php?rid=2802175&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00384.x Native arteriovenous fistulae (AVF) remain the vascular access of choice for hemodialysis (HD). Despite being associated with superior long-term outcomes (cf. catheter use), little is known about the systemic hemodynamic consequences of AVFs. Repetitive myocardial injury (myocardial stunning) is an under-recognized common consequence of HD. The aim of this study was to examine the impact of AVF flow (Qa) on dialysis-induced cardiac injury. We studied 50 chronic HD patients. All patients underwent echocardiography (and subsequent quantitative offline analysis) at baseline, during and post dialysis, to assess left ventricular function and the development of regional wall motion abnormalities. Qa was measured using ionic dialysance. Patients were divided into Qa tertiles (1000, mean 1265±221... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802175 Tue, 15 Sep 2009 23:00:00 +0100 2802175 http://www.medworm.com/index.php?rid=2802174&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00386.x This study was designed to evaluate the changes in TFC in comparison with the traditional indices of fluid removal (FR) and to understand the trends in CO changes in HD patients. Minute-by-minute changes in TFC and CO were prospectively collected using the bioreactance system (NICOM®) in HD patients of a single unit. Changes in body weight ([Delta]W), hematocrit ([Delta]Hct), and amount of FR were also measured. Twenty-five patients (age 77 ± 11 years) were included. The TFC decreased in all patients by an average of 5.4 ± 7.9 k[Omega][minus]1, weight decreased by 1.48 ± 0.98 kg, and FR averaged 2.07 ± 1.93 L over a 3- to 4-hour HD session. There were good correlations between [Delta]TFC and [Delta]W (R=0.80, P (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802174 Tue, 15 Sep 2009 23:00:00 +0100 2802174 http://www.medworm.com/index.php?rid=2802173&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00393.x Calcium, phosphorus, and parathyroid hormone (PTH) levels are routinely measured in patients undergoing chronic hemodialysis. Medications, diet, and dialytic therapies are modified based upon these lab values to achieve specific goal values in the hope of improving outcomes. However, the variability of these values in patients undergoing chronic hemodialysis has only been rarely studied. We prospectively investigated the variability of these measures in 35 patients undergoing chronic hemodialysis as well as the impact of this variability on clinical decision-making in a prospective manner over a month. There is significant session-to-session variability in phosphorus and PTH values (mean coefficient of variations [CV] of 0.19 and 0.31, respectively). Calcium variability is much lower (mean... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802173 Tue, 15 Sep 2009 23:00:00 +0100 2802173 http://www.medworm.com/index.php?rid=2802172&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00394.x We report the evolution of MM parameters in a stable HD population undergoing long hemodialysis by performing an annual cross-sectional analysis for every year from 1994 to 2008. The therapeutic strategy has changed: the dialysate calcium concentration has decreased from a mean of 1.7 ± 0.1 to 1.5 ± 0.07 mmol/L and has been adapted to parathyroid hormone serum levels (from 1 to 1.75 mmol/L). The use of calcium-based and aluminum-based phosphate binders has decreased and they have been replaced by sevelamer; alfacalcidol has partly been replaced by native vitamin D. The percentage of patients with a parathyroid hormone serum level between 150 and 300 pg/mL has increased from 9% to 67% (P (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802172 Tue, 15 Sep 2009 23:00:00 +0100 2802172 http://www.medworm.com/index.php?rid=2802171&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00398.x End-stage renal disease has emerged as a major public health problem around the world. In recent decades, several important advances have been made in the therapy of hemodialysis (HD) with the introduction of international guidelines to ensure the delivery of optimum care to HD patients. An increased mortality risk in HD patients unable to meet six targets in different areas of HD practice has been reported by the Dialysis Outcomes and Practice Patterns Study investigators. In this retrospective study, we assessed the current practice patterns of care for HD patients in the Kaser El-Aini Nephrology and Dialysis Center in comparison with Dialysis Outcomes Quality Initiative Guidelines, European Best Practice Guidelines, Centers for Disease Control and Prevention guidelines for prevention of... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802171 Tue, 15 Sep 2009 23:00:00 +0100 2802171 http://www.medworm.com/index.php?rid=2802170&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00399.x In this study, the impact of the use of low dialysate volumes on the removal rates of solutes of different molecular weights and volumes of distribution was evaluated. Serum measurements before and after dialysis and total dialysate collection were performed over 30 times in 5 functionally anephric patients undergoing short-daily home hemodialysis (6 d/wk) over the course of 8 to 16 months. Measured solutes included [beta]2 microglobulin ([beta]2M), phosphorus, urea nitrogen, and potassium. The average spent dialysate volume (dialysate plus ultrafiltrate) was 25.4±4.7 L and the dialysis duration was 175±15 min. [beta]2 microglobulin clearance of the polyethersulfone dialyzer averaged 53±14 mL/min. Total [beta]2M recovered in the dialysate was 106±42 mg per treatment (n=38). Predialysis... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802170 Tue, 15 Sep 2009 23:00:00 +0100 2802170 http://www.medworm.com/index.php?rid=2802169&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00404.x While substantial attention has been paid to the issue of sexual dysfunction in men on chronic dialysis, less is known about this problem in women with end-stage renal disease. We sought to assess sexual dysfunction in women on chronic dialysis and determine whether patients discuss this problem with their providers and receive treatment. We prospectively enrolled women receiving chronic hemodialysis or peritoneal dialysis in Pittsburgh, PA. We asked patients to complete the 19-item Female Sexual Function Index (FSFI) to assess sexual function and a 5-item survey that assessed whether patients had discussed sexual dysfunction with their providers and/or received treatment for this problem in the past. We enrolled 66 patients; 59 (89%) on hemodialysis and 7 (11%) on peritoneal dialysis. All... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802169 Tue, 15 Sep 2009 23:00:00 +0100 2802169 http://www.medworm.com/index.php?rid=2802168&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00405.x We present the clinicopathological features of APD in patients with diabetic kidney disease and discuss the recent advances in management. We retrospectively analyzed the data of 8 patients with APD presenting to our center. All patients were known cases of Type 2 diabetes and chronic kidney disease requiring maintenance dialysis. Acquired perforating dermatoses was diagnosed based on clinical presentation of itchy, keratotic papulonodular lesions, and characteristic histopathological features of transepithelial elimination on skin biopsy. The patients were subdivided into 4 types of APD based on the biopsy features. All our patients had Type 2 diabetes over 5 years duration and were on maintenance dialysis for more than 6 months before presentation. Acquired perforating dermatoses symptom... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802168 Tue, 15 Sep 2009 23:00:00 +0100 2802168 http://www.medworm.com/index.php?rid=2802167&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00395.x Renal failure due to leukemic infiltration of kidney in chronic lymphocytic leukemia is an extremely rare condition. The authors report a case of a 59-year-old white female, with a past medical history of chronic lymphocytic leukemia (CLL) with 2 years of evolution without medical therapy, admitted with nonoliguric acute renal failure needing dialysis. Renal biopsy showed extensive small lymphocytes' infiltration in the cortical interstitium by CLL cells. Cyclophosphamide and prednisolone were started and 1 month later changed to fludarabine plus cyclophosphamide with improvement of renal function. Although renal failure due to leukemic infiltration has been described in many cases of acute leukemia, only 11 cases of renal failure due to CLL cells' infiltration have been described in the l... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802167 Tue, 15 Sep 2009 23:00:00 +0100 2802167 http://www.medworm.com/index.php?rid=2802166&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00396.x Despite the broad consensus that native arteriovenous fistula is the access of choice for hemodialysis, national-level information about vascular access at dialysis initiation has been unavailable in the United States. For incident hemodialysis patients, June 2005 to October 2007 (n=220,157), vascular access type was determined from the new Centers for Medicare & Medicaid Services Medical Evidence Report (form CMS-2728). Proportions with each type at first dialysis, demographic and clinical associations of each type, and associations between initial access type and survival were assessed. The mean patient age was 63.6 years; 29.4% of patients were African American, and for 44.5%, end-stage renal disease was due to diabetes. Vascular access proportions were: fistula, 13.2% of patients; graf... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2802166 Tue, 15 Sep 2009 23:00:00 +0100 2802166 http://www.medworm.com/index.php?rid=2739257&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00375.x A 25-year-old patient with end-stage renal disease on maintenance peritoneal dialysis underwent parathyroidectomy when his secondary hyperparathyroidism did not respond to medical management. However, over the subsequent months he developed extremely raised parathyroid hormone (PTH) levels. When surgical removal of the autotransplant was considered, preoperative work-up revealed a PTH level within the target range. It became apparent that the very high PTH values were due to the location of the blood draw close to the autotransplant, thus measuring a local rather than the systemic PTH value. The multiple causes of varying PTH measurements other than clinical and physiological reasons are reviewed. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2739257 Thu, 27 Aug 2009 23:00:00 +0100 2739257 http://www.medworm.com/index.php?rid=2739256&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00378.x This study examined erythropoietin and intravenous (IV) iron requirements in hemodialysis (HD) patients with HFE mutations. Patients on HD for >90 days with no cause of anemia except chronic kidney disease were tested for HFE mutations (H63D and C282Y). Intravenous iron and erythropoietin doses were adjusted to achieve recommended targets. Monthly hemoglobin (Hb), ferritin, mean corpuscular volume, mean cell hemoglobin, erythropoietin, and IV iron doses for 3 consecutive months were averaged. Of 172 patients, 71 (41.3%) had [ge]1 HFE mutation: 24 (14%) C282Y heterozygotes, 40 (23.3%) H63D heterozygotes, 5 compound heterozygotes, and 2 homozygotes. Comparing patients with [ge]1 HFE mutation to those without mutations showed no significant difference in Hb or serum ferritin. There was a tren... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2739256 Thu, 27 Aug 2009 23:00:00 +0100 2739256 http://www.medworm.com/index.php?rid=2739255&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00397.x Secondary hyperparathyroidism is common among dialysis patients and leads to numerous complications including cardiovascular disease and renal osteodystrophy. Cinacalcet, an oral daily calcimimetic agent that sensitizes the calcium receptor to serum calcium, is approved for treatment of secondary hyperparathyroidism in dialysis patients. We identified 101 patients who received their first cinacalcet prescription between November 2004 and April 2005. All patients were participating in a Missouri state-funded pharmacy program providing free or low cost medications. We tracked the cinacalcet refill rate and refills for another control medication prescribed to each patient. The average cinacalcet refill rate over the first 12 months was 56% vs. 64% for the control medication (P=0.02). Good adh... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2739255 Thu, 27 Aug 2009 23:00:00 +0100 2739255 http://www.medworm.com/index.php?rid=2603925&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00392.x Previous studies have indirectly suggested the prescription of antihypertensive medications may contribute to blood pressure control in dialysis patients. Before exploring this largely unknown field, it is necessary to examine if there is diversity in antihypertensive prescription for dialysis patients. The questionnaire by the Midwest Pediatric Nephrology Consortium was mailed to members of American Society of Pediatric Nephrology holding faculty positions in North America and Puerto Rico. Eighty-three (23.9%) of the mailed 357 surveys were analyzable. End-organ damage (43.2% respondents), interdialytic blood pressure levels (35.1%), achievement of dry weight (29.7%), duration of action of medications (25.7%), and underlying diseases (24.3%) were considered as the most important factor(s)... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603925 Wed, 15 Jul 2009 23:00:00 +0100 2603925 http://www.medworm.com/index.php?rid=2603931&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00369.x The objective of this study was to evaluate the effect of sevelamer hydrochloride (SH) and calcium acetate (CA) on oxidative stress and inflammation markers in HD patients. Hemodialysis patients were randomly assigned to therapy with SH (n=17) or CA (n=14) for 1 year. Before the initiation of therapy (baseline) and at 12 months, we measured in vitro reactive oxygen species (ROS) production by stimulated and unstimulated polymorphonuclear neutrophils and serum levels of tumor necrosis factor [alpha], interleukin-10, C-reactive protein, and albumin. There was a significant reduction of spontaneous ROS production in both groups after 12 months of therapy. There was a significant decrease of Staphylococcus aureus stimulated ROS production in the SH group. There was a significant increase in al... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603931 Tue, 14 Jul 2009 23:00:00 +0100 2603931 http://www.medworm.com/index.php?rid=2603930&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00376.x Even though the use of erythropoietin and intravenous iron has improved the treatment of anemia in hemodialysis patients, a considerable proportion of these patients still have anemia. The aim of this study was to identify predictors of anemia in a hemodialysis population. In a single-center hemodialysis unit, all patients were studied with blood tests and their medication recorded during a period of 22 months. Correlations with hemoglobin (Hb) were performed with a simple regression or a t test. Variables that reached 5% significance were entered in a multiple regression analysis. Selected variables were presented in quartiles with levels of Hb. Mean Hb was 11.3 g/dL, and 53 patients (40%) had Hb (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603930 Tue, 14 Jul 2009 23:00:00 +0100 2603930 http://www.medworm.com/index.php?rid=2603929&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00389.x Endovascular stents have recently been shown to extend access patency in thrombosed and stenotic arteriovenous grafts (AVG). Concern remains over the frequency and severity of in-stent restenosis, though this has not been rigorously defined to date. The study was a retrospective analysis of hemodialysis patients referred for access dysfunction during a 2-year period. Using a prospectively collected, vascular access database, we identified 76 patients seen for follow-up angiography due to access dysfunction after stent placement. We compared the effect of in-stent restenosis vs. de novo lesions in patients with previously placed endovascular stents. Measured outcomes were primary assisted patency and frequency of in-stent and de novo lesions. Thirty-five (46.1%) patients had de novo lesions... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603929 Tue, 14 Jul 2009 23:00:00 +0100 2603929 http://www.medworm.com/index.php?rid=2603928&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00390.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603928 Tue, 14 Jul 2009 23:00:00 +0100 2603928 http://www.medworm.com/index.php?rid=2603927&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00337.x In this study, we attempted to elucidate the factors influencing atherosclerosis, as measured by carotid artery intima-media thickness (IMT), in HD patients and their impact on cardiovascular mortality. A cohort of 50 patients started on HD was selected for this study. At baseline, IMT and the presence of atheromatous plaques were assessed. Plasma homocysteine (Hcy), malondialdehyde, total antioxidant capacity, von Willebrand factor, vitamins C, E, B6, B12, folate, and C-reactive protein (CRP) were also measured. Patients were followed up for 2 years to determine the impact of IMT and associated markers on mortality using survival analysis as well as Cox proportional hazard. At baseline, 40% of the patients had IMT>0.8 mm. They were older, had higher CRP (P0.8 mm was associated with high c... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603927 Tue, 14 Jul 2009 23:00:00 +0100 2603927 http://www.medworm.com/index.php?rid=2603926&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00385.x We report a 58-year-old type 2 diabetic, hypertensive, end-stage renal disease patient, who 2 months after initiation of hemodialysis through a right internal jugular vein catheter, developed clinical features suggestive of pulmonary thromboembolism. An echocardiography revealed presence of a serpentine thrombus in right atrium. The internal jugular vein catheter was removed and unfractionated heparin was initiated. At the end of 6 weeks he was symptom free. We compared conservative treatment with surgery for RAT. Conservative management with central venous catheter removal and anticoagulation therapy is not inferior to the surgery. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2603926 Tue, 14 Jul 2009 23:00:00 +0100 2603926 http://www.medworm.com/index.php?rid=2578319&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00387.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2578319 Tue, 07 Jul 2009 23:00:00 +0100 2578319 http://www.medworm.com/index.php?rid=2565149&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00371.x This study sought to assess the relationship between leukocytes conjugated with platelets (leukocyte aggregates [LA]) and atherosclerosis in patients with HD. The present study included 118 patients on HD. As surrogate markers of atherosclerosis, aortic stiffness measured by brachial-ankle pulse wave velocity, and carotid intima-media thickness (IMT) were measured. As an assessment of LA, a method, microchannel array flow analyzer, which makes it possible to directly observe the flow of blood cell elements through the microchannel, was used. We measured a number of LA during 50 [mu]L flow of whole blood through microchannels. In 12 age-matched healthy individuals, a number of LA during 50 [mu]L flow of whole blood was 25.7±5.4, whereas in HD patients it was significantly increased up to 4... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2565149 Sat, 04 Jul 2009 23:00:00 +0100 2565149 http://www.medworm.com/index.php?rid=2565150&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00377.x Despite data that traditional laboratory-based outcome measures in dialysis are improving over time, population-based data indicate that mortality rates are not improving in parallel. With increased focus on performance measures based on laboratory-based outcomes (e.g., hematocrit, albumin, and parathyroid hormone), less emphasis has been placed on other markers, some of which may be stronger predictors of mortality. We performed a systematic review to interpret the predictive value of laboratory-based outcome measures in dialysis. We identified studies with data regarding the predictive value of laboratory-based outcomes for mortality in dialysis. We calculated the sample size-weighted pooled relative risk of death with dichotomized "high" vs. "low" levels of each measure. We rank-ordered... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2565150 Thu, 02 Jul 2009 23:00:00 +0100 2565150 http://www.medworm.com/index.php?rid=2490709&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00367.x Insulin resistance is a characteristic feature of uremia. Insulin resistance and concomitant hyperinsulinemia are present irrespective of the type of renal disease. Treatment with recombinant human erythropoietin (rHuEPO) was said to be associated with improvement in insulin sensitivity in uremic patients. The aim of this study was to compare insulin resistance in adult uremic hemodialysis (HD) patients including diabetic patients treated with or without rHuEPO. A total of 59 HD patients were studied, patients were divided into 2 groups of subjects: 30 HD patients on regular rHuEPO treatment (group A), and 29 HD patients not receiving rHuEPO (group B) diabetic patients were not excluded. Full medical history and clinical examination, hematological parameters, lipid profile, serum albumin, ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2490709 Wed, 24 Jun 2009 23:00:00 +0100 2490709 http://www.medworm.com/index.php?rid=2490711&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00350.x We describe a 45-year-old female with end-stage renal disease secondary to nephrolithiasis, who presented with a fulminating vascular syndrome before confirming the diagnosis of primary hyperoxaluria. This case illustrates that in this infrequent clinical entity, the diagnosis is often delayed with incorrect initial management. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2490711 Sun, 21 Jun 2009 23:00:00 +0100 2490711 http://www.medworm.com/index.php?rid=2490710&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00363.x Kidney/Disease Outcome Quality Initiative (K/DOQI) guidelines recommend baseline echocardiography at the initiation of dialysis and every 3 years thereafter in patients for early detection of cardiac disease to optimize medical therapy. Because dialysis patients are at increased cardiovascular risk and thus most are already on cardioprotective medications, we hypothesize that serial screening echocardiography will not alter cardioprotective medications in dialysis patients. Retrospective analysis of medication administration of 231 dialysis patients was conducted. Patients were divided into 2 groups, those with and those without echocardiograms. Medication changes post echocardiography were compared with subjects without echocardiograms at comparable time points. The primary end point was ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2490710 Sun, 21 Jun 2009 23:00:00 +0100 2490710 http://www.medworm.com/index.php?rid=2465598&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00373.x The preference for fistulae as the hemodialysis access of choice has led to a significant number of accesses that are less than ideal for cannulation. Buttonhole cannulation is ideal for such accesses, but the technique for creation provides major challenges. In 12 patients, buttonhole tunnel tracks were created by leaving the polyurethane catheter of a Clampcath® hemodialysis needle indwelling for 10 days after the initial cannulation. After each dialysis the catheter was flushed, and dressed with an antibacterial ointment and gauze. Dialysis was carried out via the catheter during that time. After day 10, the catheter was removed, the tunnel track covered with an antibacterial dressing and the tunnel track was cannulated with a dull buttonhole needle at the next dialysis. Successful but... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2465598 Tue, 09 Jun 2009 04:00:00 +0100 2465598 http://www.medworm.com/index.php?rid=2465599&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00370.x We report a case of a 40-year-old female with acetaminophen-induced fulminant liver failure with associated AKI who underwent intraoperative dialytic support during liver transplantation anticoagulated with citrate dialysate during the entire procedure. The patient tolerated the procedure well without any signs of citrate toxicity and maintained adequate anticoagulation for patency of the dialysis circuit. Citrate dialysate is a safe alternative for intradialytic support of liver transplantation in fulminant liver failure. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2465599 Mon, 08 Jun 2009 04:00:00 +0100 2465599 http://www.medworm.com/index.php?rid=2444176&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00380.x We describe a case report of severe hypocalcemia (secondary to surgical hypoparathyroidism) and "hungry bone syndrome," treated successfully with teriparatide (Forteo®) in a patient who underwent renal transplantation following subtotal parathyroidectomy. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2444176 Sat, 30 May 2009 04:00:00 +0100 2444176 http://www.medworm.com/index.php?rid=2444177&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00368.x The objective of this study was to evaluate the chemical stability of the vancomycin in 4% sodium citrate in HD catheters as an interdialytic lock. Vancomycin was prepared and diluted with sodium citrate 4% and stored in polyvinyl chloride syringes, 2 carbothane dialysis catheters (Hemostar®) and 2 dual floating HD catheters (CardioMed®). Syringes were stored at 4 °C or 23 °C and the catheters were stored in an incubator at 37 °C for 72 hours. Samples underwent daily chromatographic analysis and the luminal concentration of vancomycn was determined on study days 0, 1, and 3. When vancomycin is reconstituted with normal saline to achieve a concentration of 50 mg/mL, and then further diluted in 4% sodium citrate, to achieve concentrations of either 1 or 3 mg/mL, and then stored at 4 °C... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2444177 Thu, 28 May 2009 04:00:00 +0100 2444177 http://www.medworm.com/index.php?rid=2437826&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00366.x Vascular calcification is associated with a poor prognosis in dialysis patients. It can be assessed with computed tomography but simple inoffice techniques may provide useful information. We compared the results obtained with a simple noninvasive technique with those obtained using multidetector computed tomography for aortic arch calcification volume (AoACV) in chronic hemodialysis (HD) patients. The enrolled study subjects were 63 (32 men and 31 women) maintenance HD patients. Calcification of the aortic arch was semiquantitatively estimated with a AoAC score (AoACS) on plain chest radiology. The AoACV was increased, with a mean value of 6.6 ranging from 0% to 36.5%. The coefficient of intraobserver variation was less than 2.5%. Aortic arch calcification score was highly correlated with ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2437826 Wed, 27 May 2009 04:00:00 +0100 2437826 http://www.medworm.com/index.php?rid=2419356&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00339.x In this paper we wish to report our clinical experience with a new heparin-coated dialysis catheter with a symmetric tip. Over a 16-month period, 60 heparin-coated Tal Palindrome[trade] catheters were placed in 57 patients. Catheter patency, catheter-related complications, and reasons for catheter removal were recorded. The patient's initial cause of end-stage renal disease, underlying diseases, and site of access were recorded as well. Patients were specifically followed for development of heparin-induced thrombocytopenia. Patient ages were 34[ndash]91 (average 66). Fifty-four percent of patients had a history of diabetes. Sixty catheters were placed for a total of 5353 catheter-days. The average catheter indwell time was 107 days (range of 2[ndash]381 days). Catheter-related infection oc... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2419356 Tue, 19 May 2009 04:00:00 +0100 2419356 http://www.medworm.com/index.php?rid=2408024&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00379.x To evaluate the survival pattern of hemodialysis patients at a dialysis unit in Kumasi, Ghana, through a retrospective (observational) study. Patients who were placed on hemodialysis at the dialysis unit at Komfo Anokye teaching hospital from October 25, 2006 to December 2007. The patients were followed from initiation of dialysis until December 31, 2007. The overall mortality was 14 (35.9%) on the incident population for the period and that for the first 90 days was 12 (32.4%) patients. Chronic glomerulonephritis was the underlying kidney disease in 35.9%. This was followed by hypertension (19.1%) and diabetes mellitus (15.4%), respectively. Cardiovascular diseases accounted for 42% of mortality. This was followed by septicemia (25%) from the access site and anemia (25%). Fifty percent of... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2408024 Fri, 15 May 2009 04:00:00 +0100 2408024 http://www.medworm.com/index.php?rid=2408026&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00364.x Observational data suggest that elevated magnesium levels in dialysis patients may prevent vascular calcification and in vitro magnesium can prevent hydroxyapatite crystal growth. However, the effects of magnesium on vascular calcification and bone mineral density have not been studied prospectively. Seven chronic hemodialysis patients participated in this open label, prospective pilot study to evaluate the effects of a magnesium-based phosphate binder on coronary artery calcification (CAC) scores and vertebral bone mineral density (V-BMD) in patients with baseline CAC scores >30. Magnesium carbonate/calcium carbonate (elemental Mg: 86 mg/elemental Ca 100 mg) was administered as the principal phosphate binder for a period of 18 months and changes in CAC and V-BMD were measured at baseline,... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2408026 Tue, 12 May 2009 04:00:00 +0100 2408026 http://www.medworm.com/index.php?rid=2408025&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00365.x Dialysis-induced hypotension remains a significant problem in hemodialysis (HD) patients. Numerous factors result in dysregulation of blood pressure control and impaired myocardial reserve in response to HD-induced cardiovascular stress. Episodic intradialytic hypotension may be involved in the pathogenesis of evolving myocardial injury. We performed an initial pilot investigation of cardiovascular functional response to pharmacological cardiovascular stress in hypotension-resistant (HR) and hypotension-prone (HP) HD patients. We studied 10 matched chronic HD patients (5 HP, 5 HR). Dobutamine-atropine stress (DAS) was performed on a nondialysis short interval day, with noninvasive pulse-wave analysis using the Finometer® to continuously measure hemodynamic variables. Baroreflex sensitivit... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2408025 Tue, 12 May 2009 04:00:00 +0100 2408025 http://www.medworm.com/index.php?rid=2355116&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00361.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355116 Tue, 21 Apr 2009 04:00:00 +0100 2355116 http://www.medworm.com/index.php?rid=2355115&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00352.x Inflammation is common among hemodialysis patients, and evidence is accumulating to suggest that inflammation is a major contributor to morbidity and mortality. Several factors have been suggested as potential causes of inflammation, including infections and the atherosclerosis process, as well as etiologies directly related to kidney disease such as reduced renal function and dialysis. Among several inflammatory biomarkers investigated, serum C-reactive protein (CRP) is the most widely used. In hemodialysis patients, raised CRP levels have been shown to be predictive of cardiovascular events, hospitalization, and all-cause and cardiovascular mortality. Elevated CRP levels may correlate with comorbidities and intercurrent events, all of which may impact the response to erythropoiesis-stimu... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355115 Tue, 21 Apr 2009 04:00:00 +0100 2355115 http://www.medworm.com/index.php?rid=2355114&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00351.x The classic assumption that a large fraction of blood creatinine remains sequestered within erythrocytes when blood is dialyzed has been challenged by recent observations where approximately 60% of erythrocyte water appeared accessible to diffusive creatinine transport during a dialyzer transit. This discrepancy provided the motivation to revisit and reanalyze the equilibration of creatinine across the erythrocyte membrane in a series of in vitro studies with normal human blood under erythrocyte loading and unloading conditions at 37 °C. The time course of plasma creatinine concentrations measured by a kinetic picric acid assay was analyzed using a 2-compartment model. In 7 experiments, the equilibration constant was 0.052 ± 0.013/min, corresponding to a mean half-life of 13.8 ± 2.8 min... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355114 Tue, 21 Apr 2009 04:00:00 +0100 2355114 http://www.medworm.com/index.php?rid=2355111&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00342.x Outcome of acute renal failure (ARF) and use of continuous renal replacement therapy (CRRT) have shown a consistently high mortality. (1) Evaluate the short-term patient survival. (2) Evaluate dialysis-free survival. (3) Evaluate risk factors associated with overall survival and the continued need for intermittent dialysis. We identified adults ([ge]18 years) needing CRRT, treated in the critical care units of Froedtert Medical and Lutheran Hospital from January 1, 2003 till December 31, 2005. Patients were divided into two major groups needing CRRT, end stage renal disease (ESRD) (chronic dialysis) and non-ESRD with ARF. Continuous renal replacement therapy was performed with an average of 2 L replacement fluid exchanges/h. Sigma stat software was used for analysis. Comparison was done fo... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355111 Tue, 21 Apr 2009 04:00:00 +0100 2355111 http://www.medworm.com/index.php?rid=2355109&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00356.x Low and not high cholesterol seems to predict high mortality in hemodialysis (HD) patients. The confirmation of this reverse epidemiology as well as its possible interconnection with the increased inflammatory activity observed in this population is being explored in the present study. A group of 136 HD patients was prospectively studied for 2 years, and cardiovascular disease (CVD) as well as all-cause mortality and morbidity were recorded. Baseline lipid profile, inflammatory status, and patients' characteristics were studied as potential survival and hospitalization predictors. During the 24-month follow-up, 21 deaths (52.4% due to CVD) and 38 hospitalizations (55.3% due to CVD) were recorded. In multivariate Cox regression analysis, decreased interleukin-10 (IL-10) and decreased total ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355109 Tue, 21 Apr 2009 04:00:00 +0100 2355109 http://www.medworm.com/index.php?rid=2355108&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00355.x This study aimed to investigate if the baroreflex sensitivity (BRS) response to HD differed between standard and cool-temperature dialysate. Ten patients (mean age 67±2 years) prone to IDH were recruited into a randomized, crossover study to compare BRS variation at dialysate temperatures of 37 °C (HD37) and 35 °C (HD35). Each patient underwent continuous beat-to-beat BP monitoring during a dialysis session of HD37 and HD35. During HD37 2 patients developed symptomatic IDH, as opposed to 1 with HD35. However, asymptomatic IDH occurred with a frequency of 0.4 episodes per session with HD35 and 6.2 episodes per session during HD37 (odds ratio15.5; 95%CI 5.6[ndash]14.2). Although absolute BRS measurements did not differ between the 2 modalities, BRS variability increased during HD35. Our s... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355108 Tue, 21 Apr 2009 04:00:00 +0100 2355108 http://www.medworm.com/index.php?rid=2355106&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00354.x This study aimed to estimate the prevalence of high fluid consumers, describe UFR patterns, and describe patient characteristics associated with IWG and UFR. The Swedish Dialysis DataBase and The Swedish Renal Registry of Active Treatment of Uremia were used as data sources. Data were analyzed from patients aged [ge]18 on regular treatment with hemodialysis (HD) and registered during 2002 to 2006. Interdialytic weight gain and dialytic UFR were examined in annual cohorts and the records were based on 9693 HD sessions in 4498 patients. Differences in proportions were analyzed with the chi-square test and differences in means were tested using the ANOVA or the t test. About 30% of the patients had IWG that exceed 3.5% of dry body weight and 5% had IWG [ge]5.7%. The volume removed during HD w... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355106 Tue, 21 Apr 2009 04:00:00 +0100 2355106 http://www.medworm.com/index.php?rid=2355104&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00333.x In this report, we studied the relation of calcium-sensing receptor (CaSR) gene polymorphisms to the development of VC in chronic hemodialysis patients. A total of 41 chronic hemodialysis patients (26 male, mean age 47.23 ± 11.36 years vs. 15 females, mean age 48.13 ± 14.66 years) undergoing treatment for more than 1 year were evaluated with transthoracic echocardiography. In patients with and without VC, CaSR gene polymorphisms (A990G, C1011G) were investigated by PCR, using allele-specific primers. In randomly chosen subjects, PCR analysis was verified by DNA sequencing. Cardiac valve calcification was detected in 21 patients (51.2%). Five of these patients (12.2%) had mitral valve calcification, 4 (9.75%) had aortic valve calcification, and 12 (29.27%) had both. In patients with VC, t... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355104 Tue, 21 Apr 2009 04:00:00 +0100 2355104 http://www.medworm.com/index.php?rid=2355102&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00358.x A 51-year-old Korean man with end-stage renal disease and who was on intermittent hemodialysis was admitted with progressive dysarthria, gait disturbance, and myoclonus. The liver function tests and the electrolyte and arterial gas analyses were normal. The Magnetic resonance imaging scan showed a diffuse symmetric high signal intensity in the basal ganglia on the T2-weighted image. After a thorough history taking, we knew that he had been treated with metformin for 3 months at other hospital without our hospitals staff's knowledge. After stopping the metformin, the patient's neurologic signs and symptoms disappeared and the Magnetic resonance imaging findings after 20 days were markedly improved. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355102 Tue, 21 Apr 2009 04:00:00 +0100 2355102 http://www.medworm.com/index.php?rid=2355100&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00357.x The number of patients requiring dialysis because of diabetes mellitus is increasing and such patients often have complex chronic wounds, which are difficult to heal. However, there are few retrospective studies of wounds requiring surgical treatment. We evaluated 14 patients receiving hemodialysis (HD) (8 because of diabetes and 6 because of other diseases) who had extremity wounds and underwent surgical treatment in our unit from 2004 through 2007. We investigated differences in the cause of wounds, and in the interval between the start of HD and wound development. Wounds in patients undergoing HD because of diabetes originated due to ischemia in 2 cases (25%), trauma in 2 cases (25%), and infection in 4 cases (50%). Seven of 8 wounds developed infection with methicillin-resistant Staphy... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355100 Tue, 21 Apr 2009 04:00:00 +0100 2355100 http://www.medworm.com/index.php?rid=2355098&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00353.x We report a uremic patient who developed uncontrolled hyperparathyroidism rapidly within 6 months after commencing hemodialysis (HD) therapy, with clinical presentations of tumoral calcinosis, calciphylaxis, and myocardial calcifications. After treatment with a low-calcium dialysate, non[ndash]calcium-containing phosphate binders, and parathyroidectomy, a dramatic resolution of soft tissue calcification was achieved. However, there was relatively little change in the vascular and other visceral calcifications over the 3-month observation period. This case highlights an unusual and rapid development of tertiary hyperparathyroidism, the importance of tight calcium/phosphate control in uremic patients, the potential hazards of a high calcium concentration dialysate, and the dangers of the ove... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355098 Tue, 21 Apr 2009 04:00:00 +0100 2355098 http://www.medworm.com/index.php?rid=2355096&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00359.x Most arteriovenous grafts fail due to irreversible thrombosis, and most clotted grafts have an underlying stenotic lesion. These observations raise the plausible hypothesis that early detection of graft stenosis with preemptive angioplasty will reduce the likelihood of graft thrombosis. A number of noninvasive methods can be used to detect hemodynamically significant graft stenosis with a high positive predictive value. These tests include clinical monitoring, as well as surveillance by static dialysis venous pressures, flow monitoring, or duplex ultrasound. However, these surveillance tests have a much lower positive predictive value for graft thrombosis in the absence of preemptive angioplasty. In other words, none of the currently available surveillance tests can reliably distinguish be... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355096 Tue, 21 Apr 2009 04:00:00 +0100 2355096 http://www.medworm.com/index.php?rid=2355094&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00362.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355094 Tue, 21 Apr 2009 04:00:00 +0100 2355094 http://www.medworm.com/index.php?rid=2355092&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00360.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2355092 Wed, 01 Apr 2009 04:00:00 +0100 2355092 http://www.medworm.com/index.php?rid=2127282&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.subindex_1.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127282 Thu, 22 Jan 2009 05:00:00 +0100 2127282 http://www.medworm.com/index.php?rid=2127281&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.auindex_1.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127281 Thu, 22 Jan 2009 05:00:00 +0100 2127281 http://www.medworm.com/index.php?rid=2127280&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00325.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127280 Thu, 22 Jan 2009 05:00:00 +0100 2127280 http://www.medworm.com/index.php?rid=2127279&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00344.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127279 Thu, 22 Jan 2009 05:00:00 +0100 2127279 http://www.medworm.com/index.php?rid=2127278&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00341.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127278 Thu, 22 Jan 2009 05:00:00 +0100 2127278 http://www.medworm.com/index.php?rid=2127277&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00338.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127277 Thu, 22 Jan 2009 05:00:00 +0100 2127277 http://www.medworm.com/index.php?rid=2127276&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00343.x The objectives of this study were to (1) study and compare the predialysis and postdialysis mini mental status examination score and 2 subscores and compare them with those of a control group and (2) determine the factors affecting these scores. This was a prospective study of 54 HD patients, which involved calculation of their predialysis (PrHDSc) and (2[ndash]4 weeks later) postdialysis (PoHDSc) scores and comparison of these with the control scores (CoSc). The mean scores for PreHDSc and PoHDSc were 26.5±2.7 and 26.4±3.3, respectively. Both were significantly lower than CoSc, 28.4±1.6 (95% CI for score difference 0.99[ndash]2.97, P (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127276 Thu, 22 Jan 2009 05:00:00 +0100 2127276 http://www.medworm.com/index.php?rid=2127275&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00328.x End-stage renal disease and initiation of hemodialysis (HD) adversely affect health-related quality of life (HRQOL). There are currently no data evaluating the effect of pharmaceutical care (PC) on HRQOL in HD patients. HD patients were randomized to receive PC; one-on-one, in-depth medication reviews conducted by a clinical pharmacist or Standard of Care (SOC); and brief medication reviews conducted by dialysis nurses. The renal quality of life profile (RQLP) was administered at baseline and then at 1 and 2 years after study initiation. The RQLP is a 43-item questionnaire that has 5 dimensions: Eating/Drinking, Physical Activities, Leisure Time, Psychosocial Activities, and Impact of Treatment, where increasing scores reflect worsening of HRQOL. A total of 107 patients were enrolled (SOC:... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127275 Thu, 22 Jan 2009 05:00:00 +0100 2127275 http://www.medworm.com/index.php?rid=2127274&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00329.x Hepatitis C virus (HCV) infection may deteriorate quality of life. The relationship between HCV infection and quality of life in hemodialysis (HD) patients is unknown. The demographic characteristics, comorbidities, biochemical parameters, and Malnutrition-Inflammation Score (MIS) were recorded. Child-Pugh classification, Beck Depression Inventory, and SF-36 were performed. Liver histopathology was examined. Thirty-two patients (21 Child-Pugh-A, 11 Child-Pugh-B) were included. There was high-grade portal necroinflammatory activity in 14, high-grade lobular necroinflammatory activity in 26, and hepatic fibrosis in 19 patients. Three patients had cirrhosis. Patients with a high stage of liver fibrosis had lower social functioning scores than patient with a low stage of fibrosis (P= 0.011). T... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127274 Thu, 22 Jan 2009 05:00:00 +0100 2127274 http://www.medworm.com/index.php?rid=2127273&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00347.x Coronary artery disease is a major cause of death in patients with a renal dysfunction. Among the patients who undergo coronary artery bypass grafting, renal dysfunction is known to be a major predictor of in-hospital and out-of-hospital mortality. From 2004 to 2007, we performed elective open-heart surgeries on 2380 patients in whom there was no primary renal failure. Of those patients, only 185 in whom acute renal failure (ARF) was developed were included in the study. The patients were divided into 2 groups: a late dialysis group (n=90) and an early dialysis group (n=95). The mean age of the patients was 62.3±6.4 in the late dialysis group and 64.5±5.2 in the early dialysis group. There were 32 female and 58 male patients in the late dialysis group and 36 female and 59 male patients i... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127273 Thu, 22 Jan 2009 05:00:00 +0100 2127273 http://www.medworm.com/index.php?rid=2127272&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00330.x This study reviews our experience with the use of implantable cardioverter defibrillators (ICDs) in patients with ventricular tachycardia who are under maintenance HD. We retrospectively reviewed 71 consecutive patients who underwent an ICD implantation in our hospital. There were 11 patients under maintenance HD and 60 patients without HD. The group of patients with HD (HD group) was compared with the patients without HD (control group). The mean follow-up period was 30±9 vs. 39±4 months in the HD group vs. the control group, respectively. Among these patients, 6 in the HD group and 26 in the control group received appropriate ICD therapies. There was no difference in appropriate ICD therapy, time to the first therapy, and electrical storm between the 2 groups. In the HD group, 1 patien... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127272 Thu, 22 Jan 2009 05:00:00 +0100 2127272 http://www.medworm.com/index.php?rid=2127271&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00336.x To study and compare the anticoagulant activity of enoxaparin sodium during on-line hemodiafiltration (OL-HDF) and conventional hemodialysis (C-HD). Enoxaparin was administered as an anticoagulant to 21 hemodialysis patients at the beginning of a single 4-hour OL-HDF session as an intravenous bolus dose of 80 mg/kg. On-line hemodiafiltration was performed using a high-flux polyester polymer alloy dialyzer and a total of 18 L replacement fluid (session A). One week later, the study was repeated in the same patients during a single 4-hour session of C-HD using a low-flux polysulfone dialyzer (session B). Blood samples for the measurement of Hb, blood urea and nitrogen (BUN), activated partial thromboplastin time (APTT), and anti-Xa levels were taken before each study session and 5-minute pos... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127271 Thu, 22 Jan 2009 05:00:00 +0100 2127271 http://www.medworm.com/index.php?rid=2127270&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00346.x The objective of this study is to analyze the prevalence of pruritus in hemodialysis patients and the possible factors implicated in its genesis. In a cross-sectional study, 101 patients on hemodialysis at our center were screened for pruritus. The relationship of various factors with pruritus was evaluated. Of the 101 patients included, 31(30.7%) had pruritus at the time of examination. Patients with pruritus were significantly older than those without pruritus (P=0.0027). Pruritus tended to be more prevalent in patients undergoing dialysis 3 times a week than in those undergoing daily dialysis, but the difference did not reach statistical significance (P=0.0854). Lower transferrin saturation levels were found in patients with pruritus than in those without pruritus (P=0.0144). C-reactive... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127270 Thu, 22 Jan 2009 05:00:00 +0100 2127270 http://www.medworm.com/index.php?rid=2127269&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00332.x Despite a global focus on resource conservation, most hemodialysis (HD) services still wastefully or ignorantly discard reverse osmosis (R/O) "reject water" (RW) to the sewer. However, an R/O system is producing the highly purified water necessary for dialysis, it rejects any remaining dissolved salts from water already prefiltered through charcoal and sand filters in a high-volume effluent known as RW. Although the RW generated by most R/O systems lies well within globally accepted potable water criteria, it is legally "unacceptable" for drinking. Consequently, despite being extremely high-grade gray water, under current dialysis practices, it is thoughtlessly "lost-to-drain." Most current HD service designs neither specify nor routinely include RW-saving methodology, despite its simplici... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127269 Thu, 22 Jan 2009 05:00:00 +0100 2127269 http://www.medworm.com/index.php?rid=2127268&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00335.x The risk of death is increased for hemodialysis (HD) patients compared with age-matched healthy subjects, the main reason for this being cardiovascular conditions. This prospective study investigated whether the burden of interdialytic weight gain (IDWG) was of importance for cardiovascular end points and survival. A total of 97 HD patients were studied. The end points included death (reasons given), acute myocardial infarction, or coronary vascular intervention. The extent of ultrafiltration was measured at predefined follow-up points. The IDWG was calculated as ultrafiltration/body weight given in weight%. The burden of IDWG was analyzed. End points occurred in 77 (79%) of the patients during the 5-year study period. The extent of IDWG was higher in those with end points due to cardiovas... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127268 Thu, 22 Jan 2009 05:00:00 +0100 2127268 http://www.medworm.com/index.php?rid=2127267&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00334.x This study determined the association between VAT and 7 candidate gene polymorphisms (factor V Leiden 1691G>A, factor II 20210G>A, methylenetetrahydrofolate reductase 677C>T, angiotensin converting enzyme 287 base pair (bp) insertion/deletion, transforming growth factor-[beta]1 869T>C and 915G>C, NOS3 [minus]786T>C and intron 4 27 bp tandem repeat, and endotoxin receptor CD14 [minus]159C>T). This was a retrospective case-control pilot study conducted in 101 hemodialysis patients at a large tertiary-care, University health-science center. Sixty cases that experienced frequent VAT and 41 controls that had not experienced VAT in at least 3 years were evaluated for demographics and genotyping. These data were summarized, and univariable and multivariable regression models were constructed. Uni... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127267 Thu, 22 Jan 2009 05:00:00 +0100 2127267 http://www.medworm.com/index.php?rid=2127266&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00348.x This study was carried out over a 5-year period in a single center, where, in the first 2½ years, the exit sites were cleansed with betadine at every hemodialysis session and then covered with a transparent dressing (pre-Biopatch® Era). During the next 2½ years, Biopatch® was applied to the exit site once a week after cleansing with betadine, and then covered with a transparent dressing (Biopatch® Era). The application of Biopatch® significantly decreased the incidence of exit site infections (ESI) (P (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127266 Thu, 22 Jan 2009 05:00:00 +0100 2127266 http://www.medworm.com/index.php?rid=2127265&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00327.x Access-related bacteremia is an important cause of morbidity in chronic hemodialysis patients. The incidence of bacteremia is higher in patients dialyzing through a tunneled central venous catheter (TCVC) compared with an arteriovenous fistula (AVF). Our aim was to explore if this is explained by patient comorbidity. Two groups of chronic hemodialysis outpatients were compared: all patients who dialyzed through a TCVC at any time during 2003 and were fit enough to subsequently have a functioning AVF or renal transplant even if it was after 2003 (Group 1; n=93); and all patients who dialyzed through a TCVC in 2003 and were not fit enough to have a functioning AVF or renal transplant (Group 2; n=119). Episodes of bacteremia (n=71) were identified and those not related to access were excluded... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127265 Thu, 22 Jan 2009 05:00:00 +0100 2127265 http://www.medworm.com/index.php?rid=2127264&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00349.x Use of depopulated bovine ureteric xenografts for hemodialysis vascular access has recently been described. Cellular components have been removed, giving a connective tissue matrix which can be neocellularized, retaining native biomechanics. A 24-year-old male with end-stage renal disease from focal segmental glomerulosclerosis presented with particularly difficult vascular access. A depopulated bovine ureteric xenograft was implanted from the left subclavian artery to innominate vein. It became massively aneurysmal, requiring emergency embolization. Biopsy of the graft stained positive for [alpha]-gal. We believe this is the first reported case of massive aneurysmal dilatation of a depopulated bovine ureteric xenograft. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127264 Thu, 22 Jan 2009 05:00:00 +0100 2127264 http://www.medworm.com/index.php?rid=2127263&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00326.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127263 Thu, 22 Jan 2009 05:00:00 +0100 2127263 http://www.medworm.com/index.php?rid=2127262&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2009.00340.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=2127262 Thu, 01 Jan 2009 05:00:00 +0100 2127262 http://www.medworm.com/index.php?rid=1849696&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00314.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849696 Fri, 03 Oct 2008 04:00:00 +0100 1849696 http://www.medworm.com/index.php?rid=1849695&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00313.x The purpose of this study was to assess the health service cost of hemodialysis (HD) delivered at hospitals in Iran as a developing country with a well-defined program of renal replacement therapy. A cost analysis was performed from the viewpoint of the 2 hospitals, with 3 shifts and full chairs, on current practice for dialysis maintenance. Cost and patient data were collected in 2006 and from April 1 to May 31, 2007, respectively. A total of 22,464 HD sessions were performed and 247 patients were studied during the study period. The reference year for the value of USD for different mentioned costs was 2006. Health care sector costs associated with each HD session were estimated at US$78.87. Most of the total maintenance expenditure was made up of medical supplies (36.19%), with dialyzers... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849695 Fri, 03 Oct 2008 04:00:00 +0100 1849695 http://www.medworm.com/index.php?rid=1849694&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00312.x The Dialysis Clinical Outcomes Revisited (DCOR) trial was a large randomized, multicenter 3-year trial comparing the effects of sevelamer with calcium-based binders on mortality, hospitalization, morbidity, and medical costs in hemodialysis subjects. Dialysis Clinical Outcomes Revisited was prospectively designed to link subjects to the Centers for Medicare & Medicaid Services End-Stage Renal Disease (CMS ESRD) database to collect additional baseline characteristic data and to enhance outcome evaluation. Subjects were linked to the CMS ESRD database by means of an algorithm using several patient identifiers. Some baseline characteristic data were collected exclusively from the CMS ESRD database. Mortality and hospitalization end points were obtained from the CMS ESRD database and compared ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849694 Fri, 03 Oct 2008 04:00:00 +0100 1849694 http://www.medworm.com/index.php?rid=1849693&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00311.x This study aimed to investigate the activity of serum paraoxonase in uremic patients on hemodialysis (HD) and in the predialysis period, and to evaluate the correlations of vascular disease with paraoxonase activity. Thirty patients with chronic renal failure (CRF) undergoing HD (group 1), 30 patients with CRF under conservative treatment (group 2), and 30 healthy controls (group 3) were included. Basal, salt-stimulated, and arylesterase activity were tested by UV spectrophotometry. Serum lipid parameters were determined. B-Mode Doppler ultrasound was used to assess common carotid intima-media thickness (IMT). Basal paraoxonase, salt-stimulated, and arylesterase activity showed no significant difference between group 1 and group 2. However, it was significantly lower in group 1 and in grou... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849693 Fri, 03 Oct 2008 04:00:00 +0100 1849693 http://www.medworm.com/index.php?rid=1849692&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00310.x Infective spondylodiscitis (ISD) is a rare but potentially devastating condition in hemodialysis (HD) patients. Reports are limited especially in patients receiving high-flux HD and hemodiafiltration (HDF). In a retrospective analysis, 13 patients on our maintenance high-flux HD/HDF program were identified as having has infective spondylodiscitis over a 10-year period (1997[ndash]2006), an incidence of approximately 1 episode every 215 patient-years. The incidence was around 3 times higher in patients dialyzing with tunnelled central venous catheters (TCVC) than in those with arteriovenous fistulae. Affected patients were elderly (mean age 70 years) and had multiple comorbidities. Access problems, particularly TCVC infection, were common in the months preceding it's onset. Tunnelled centra... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849692 Fri, 03 Oct 2008 04:00:00 +0100 1849692 http://www.medworm.com/index.php?rid=1849691&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00309.x While national mortality rates for end-stage renal disease (ESRD) patients remain high, for the past 4 years, lower than expected local mortality rates have been consistently seen in our facilities. Because of these progressive improvements in mortality rates, a study of 687 hemodialysis patients over a 4-year period, 2003 through 2006, was undertaken to analyze which factors may be contributing to the enhanced survival rates. We also examined the partially overlapping United States Renal Data System clinical performance measures national data sets of hemodialysis patients for 2001 to 2004. Proportional hazards and logistic regression models were used to determine significant predictors of short-term survival. Variables tested included hemoglobin (Hb), albumin, calcium, phosphorus, infecti... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849691 Fri, 03 Oct 2008 04:00:00 +0100 1849691 http://www.medworm.com/index.php?rid=1849690&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00308.x Use of erythropoiesis-stimulating agents (ESAs) presents a significant time and cost burden in the management of anemia of chronic kidney disease (CKD). We conducted a prospective, observational, activity-based costing study to estimate the health care personnel time and resulting direct medical costs associated with administering epoetin 3 times weekly to patients with end-stage renal disease on dialysis. The study was conducted at 5 US hemodialysis centers. The personnel time and costs were derived from time and motion observations. Predicted time and cost savings were modeled for switching patients to once-monthly ESA therapy. Patients also completed a survey questionnaire to assess their level of CKD knowledge and information needs. Total per-patient-per-year (PPPY) time expended on an... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849690 Fri, 03 Oct 2008 04:00:00 +0100 1849690 http://www.medworm.com/index.php?rid=1849689&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00307.x Although symptoms are common and frequently severe in patients on maintenance hemodialysis, little is known about the relationship between cultural background and symptom burden. The aim of this study was to explore differences in the prevalence and severity of symptoms between American and Italian hemodialysis patients. We administered the 30-item Dialysis Symptom Index to American and Italian patients receiving maintenance hemodialysis during routine dialysis sessions. The prevalence and severity of individual symptoms were compared between patient populations, adjusting for multiple comparisons. Multivariable logistic regression and ordinal logistic regression were used to assess the independent associations of cultural background with the prevalence and severity of symptoms, respective... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849689 Fri, 03 Oct 2008 04:00:00 +0100 1849689 http://www.medworm.com/index.php?rid=1849688&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00306.x We describe a case of heparin leak from a hemodialysis catheter, which caused significant clinical bleeding requiring multiple transfusions and may have ultimately been responsible for the patient's death after transplantation. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849688 Fri, 03 Oct 2008 04:00:00 +0100 1849688 http://www.medworm.com/index.php?rid=1849687&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00305.x We report a case of a 65-year-old chronic hemodialyzed male patient who developed cerebritis and brain abscesses complicating a spontaneous subdural hematoma, following Staphylococcus aureus bacteremia related to infected arteriovenous fistula. In spite of adequate antibiotherapy and several surgical brain drainages, our patient did not survive. Prevention of S. aureus is highly important in hemodialysis patients. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849687 Fri, 03 Oct 2008 04:00:00 +0100 1849687 http://www.medworm.com/index.php?rid=1849686&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00304.x Sodium balance is precisely regulated by intake and output. The kidneys are responsible for adjusting sodium excretion to maintain balance at varying intakes. Our distant ancestors were herbivores. Their diet contained little sodium, so they developed powerful mechanisms for conserving sodium and achieving low urinary excretion. About 10,000 years ago, early humans became villagers and discovered that food could be preserved in brine. This led to increased consumption of salt. High salt intake increases extracellular volume (ECV), blood volume, and cardiac output resulting in elevation of blood pressure. High ECV induces release of a digitalis-like immunoreactive substance and other inhibitors of Na+-K+-ATPase. As a consequence, intracellular sodium and calcium concentrations increase in v... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849686 Fri, 03 Oct 2008 04:00:00 +0100 1849686 http://www.medworm.com/index.php?rid=1849685&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00303.x Cholesterol embolization or atheroembolic renal disease (AERD) is an often underdiagnosed issue in patients featuring a prevalent risk profile. It is a multisystemic disease with progressive renal insufficiency due to foreign body reaction of cholesterol crystals flushed into a small vessel system of the kidneys from the arteriosclerotic plaques. The most common setting in which it occurs is iatrogenic after vascular catheterization and less frequent spontaneously. Typical clinical symptoms are delayed impairment of renal function, cutaneous manifestations such as livedo reticularis or purple toes with persistingly palpable arterial pulse, myalgia, systemic symptoms such as weight loss and fever, and abdominal and neurological symptoms. Diagnosis is generally made by clinical appearance, r... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849685 Fri, 03 Oct 2008 04:00:00 +0100 1849685 http://www.medworm.com/index.php?rid=1849684&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00302.x The concept of dry weight (DW) is central to dialysis therapy. The most commonly used definition of DW is the weight below which patients become hypotensive on dialysis. However, this definition is dependent on patient symptoms. A more rigorous definition of DW is the body weight at a physiological extracellular volume (ECV) state. Overhydration is an excess in ECV above that found in healthy subjects. In healthy subjects, within extremes of salt intake, ECV may vary between 280 and 340 mL/kg lean body mass. Sodium accumulation is one of the many consequences of renal failure; it results in increased water intake and an increase in ECV, and an accompanying rise in blood pressure with its clinical sequelae, most prominently cardiovascular and cerebrovascular diseases. Recently characterized... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1849684 Wed, 01 Oct 2008 04:00:00 +0100 1849684 http://www.medworm.com/index.php?rid=1843057&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00324.x A patient on hemodialysis for end-stage renal disease secondary to diabetic nephropathy was admitted in a coma with Kussmaul breathing and hypertension (232/124 mmHg). She had extreme hyperglycemia (1884 mg/dL), acidosis (total CO2 4 mmol/L), hyperkalemia (7.2 mmol/L) with electrocardiographic abnormalities, and hypertonicity (330.7 mOsm/kg). Initial treatment with insulin drip resulted in a decrease in serum potassium to 5.3 mmol/L, but no significant change in mental status or other laboratory parameters. Hemodialysis of 1.75 hours resulted in rapid decline in serum glucose and tonicity and rapid improvement of the acidosis, but no change in mental status, which began to improve slowly after the hemodialysis was stopped, but with ongoing treatment with continuous insulin infusion. The ra... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843057 Wed, 01 Oct 2008 04:00:00 +0100 1843057 http://www.medworm.com/index.php?rid=1843056&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00323.x A hemodialysis patient with hepatitis C virus infection developed painful blisters on her hands that burst spontaneously. She was found to have serum porphyrin levels >2000 nmol/L. A punch biopsy revealed subepidermal blistering with festooning of dermal papillae associated with a mixed inflammatory infiltrate. Based on the clinical, biochemical, and histologic findings, a diagnosis of porphyria cutanea tarda was made. Treatment was started with twice-weekly phlebotomy and oral hydroxychloroquine and significant clinical improvement resulted. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843056 Wed, 01 Oct 2008 04:00:00 +0100 1843056 http://www.medworm.com/index.php?rid=1843055&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00322.x Unfractionated heparin (UFH) is a series of molecules, and as such has variable pharmacodynamics. Low-molecular-weight heparins were developed to improve both drug pharmacokinetics and dynamics, so as to provide a reliable clinical effect. These are potent agents, but have an increased half-life compared with UFH in dialysis patients, and also require special laboratory monitoring. We switched our chronic hemodialysis patients from unfractionated to low-molecular-weight heparins. Low-molecular-weight heparins proved to be effective in preventing extracorporeal circuit clotting, and safe with fewer bleeding episodes and heparin-induced thrombocytopenia than standard UFH. Indeed, we stopped routine laboratory monitoring because of the lack of side effects, and simply dosed by clinical inspec... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843055 Wed, 01 Oct 2008 04:00:00 +0100 1843055 http://www.medworm.com/index.php?rid=1843054&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00321.x Dialyzer membrane flux is currently defined according to [beta]2-microglobulin (a middle molecule) clearance. Traditionally, high flux membranes were synthetic, and caused less inflammatory reaction in the extracorporeal circuit, compared with standard low-flux cuprophan bio-incompatible dialyzers. Initial reports suggested improved patient outcomes in acute renal failure when noncuprophan dialyzer membranes were used. However, over time these positive observations have not been substantiated. As the price differential between these dialyzer membrane types has become marginal, more high-flux dialyzers are now used in routine clinical practice. Two multicenter trials have recently reported a survival advantage for high-flux dialyzers. Whether this is directly consequent upon the choice of d... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843054 Wed, 01 Oct 2008 04:00:00 +0100 1843054 http://www.medworm.com/index.php?rid=1843053&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00320.x Hemodialysis (HD) is primarily a diffusion-based transfer of small solutes. Diffusion is dependent on Fick's law. Convective removal, used mainly for removal of excess plasma water by ultrafiltration, also removes larger molecular-weight solutes by the process of solvent drag. A number of physicochemical factors operative on the blood and the dialysate side impact solute and water removal during HD. A comprehensive yet brief discussion of these 2 basic processes operative in HD is presented in this article. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843053 Wed, 01 Oct 2008 04:00:00 +0100 1843053 http://www.medworm.com/index.php?rid=1843052&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00319.x The study set out to investigate the relationship between physical functioning, inflammatory status, and sleep disturbance in a chronic hemodialysis (HD) population. Forty-six maintenance HD patients from the McGill University Health Centre were enrolled in this study between October 2005 and 2006. The well-validated Human Activity Profile (HAP) questionnaire and the RAND 36-item survey were used to assess physical functioning. Subjects were given the Pittsburgh Sleep Quality Index (PSQI) survey to evaluate the degree of sleep disturbance. Inflammatory status was assessed with the average value of serial C-reactive protein (CRP) levels for each patient, over a period of 12 months before their enrollment in the study. A multivariate logistic regression model was created for these analyses t... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843052 Wed, 01 Oct 2008 04:00:00 +0100 1843052 http://www.medworm.com/index.php?rid=1843051&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00318.x Elderly patients form the most rapidly expanding group of hemodialysis (HD) patients in Europe and the United States. There are initiatives to promote an increase in arteriovenous fistula (AVF) formation. There are concerns that elderly patients may have lower rates of surgical vascular access compared with younger patients due to risks of higher co-morbidities, surgical complications, and higher AVF nonuse rates. The aim of this study was to compare access-related survival and morbidity for dialysis catheters and AVFs and to evaluate the AVF nonuse rate in an elderly population. We have performed a retrospective analysis of access survival and morbidity in patients [ge]70 years of age, either on maintenance HD or predialysis with preemptive formation of surgical access. One hundred and fo... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843051 Wed, 01 Oct 2008 04:00:00 +0100 1843051 http://www.medworm.com/index.php?rid=1843050&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00317.x Maintenance of the red blood cell volume is a fundamental aspect of ensuring oxygen supply to the tissue. Recombinant human erythropoietin (rHuEPO) was approved for marketing in Japan in 1990 for the treatment of anemia in patients on dialysis. Recombinant human erythropoietin caused a significant increase in hemoglobin (Hb) levels in patients on dialysis. However, not all have a good response to rHuEPO therapy; the causes of rHuEPO failure include iron deficiency, infection, uremia, and interaction of some drugs. Juzen-taiho-to (TJ-48), a mixture of extracts from 10 medicinal herbs, has been used traditionally to treat patients with anemia, anorexia, or fatigue. To clarify the effect of TJ-48 on erythropoietin-resistant anemia, we studied the effect of TJ-48 in patients on hemodialysis wi... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843050 Wed, 01 Oct 2008 04:00:00 +0100 1843050 http://www.medworm.com/index.php?rid=1843049&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00316.x Patients on dialysis constitute a major healthcare burden with high prevalence of coronary artery disease frequently requiring coronary revascularization. Prior studies have reported high complications rates with revascularization in patients on dialysis. However, information on the use glycoprotein and direct thrombin inhibitors in this patient population undergoing percutaneous revascularization is limited. We retrospectively analyzed the procedural success and in-hospital outcomes of percutaneous coronary revascularization in 56 consecutive patients on dialysis compared with 524 patients without renal failure, between January 2001 and August 2007 at our facility. Additionally, we also analyzed the off-label use of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors during revascularization i... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843049 Wed, 01 Oct 2008 04:00:00 +0100 1843049 http://www.medworm.com/index.php?rid=1843048&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00315.x (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1843048 Wed, 01 Oct 2008 04:00:00 +0100 1843048 http://www.medworm.com/index.php?rid=1613004&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00285.x The source of hemolysis during hemodialysis must be quickly identified to avoid life-threatening complications. At a single clinic, over a 10-day period in which 550 treatments were performed, 5 case-patients were retrospectively identified for experiencing acute hemolysis (4 deaths) from an unknown origin. The investigation focused on the postpump arterial tubing as the pressure was not monitored in this region, and the segment was shorter than required and could kink if overly stressed at bend points (i.e., tubing support clips, dialyzer inlet). To determine whether the circuit pressures indicated kinked tubing, a relative comparison between each case-patient's recorded arterial (prepump) and venous circuit pressures throughout their adverse event treatment and their immediately precedin... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1613004 Tue, 08 Jul 2008 04:00:00 +0100 1613004 http://www.medworm.com/index.php?rid=1613003&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00284.x Hepatitis B (HBV) and C (HCV) viruses are the most important infections transmitted by the parenteral route in patients receiving maintenance dialysis. The prevalence varies markedly from country to country. The aim of this study is to review the efficacy of the strategies to reduce the incidence of these infections and the trend of results in Iran. As a routine, all hemodialysis patients in Iran have biannual blood samples for assessment of serum HBSAg, HBS Abs, and HCV Abs. The data are collected in the Ministry of Health. For statistical analysis, prevalence, and incidence were calculated. There is an increasing prevalence/incidence of end-stage renal disease (ESRD) in Iran, from 238/49.9 pmp in 2000 to 357/63.8 pmp in 2006. The prevalence of positive HBSAg and HCV Abs decreased from 3.... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1613003 Tue, 08 Jul 2008 04:00:00 +0100 1613003 http://www.medworm.com/index.php?rid=1613002&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00283.x Intradialytic hypotension (IDH) is one of the most important short-term complications to hemodialysis (HD). Inadequate cardiac filling due to a reduction in the central blood volume is believed to be a major etiological factor. The aim of this study was to evaluate whether these pathophysiologic events are reflected in the central venous oxygen saturation (ScO2) and thoracic admittance (TA) during dialysis. Twenty ambulatory HD patients, 11 hypotension prone (HP) and 9 hypotension resistant, with central vascular access, were monitored during 3 HD sessions each. ScO2, TA, finger blood pressure (BP), and relative change in blood volume ([Delta]BV) were measured and sampled continuously. The relative TA decrease and [Delta]BV were both largest in the HP group (p (Source: Hemodialysis Interna... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1613002 Tue, 08 Jul 2008 04:00:00 +0100 1613002 http://www.medworm.com/index.php?rid=1613001&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00282.x Inflammation is a nontraditional cardiovascular risk factor in hemodialysis patients. This pilot study tested the hypothesis that intravenous iron adds to this inflammation by increasing oxidative stress. Secondly, we described the association between iron indices and myocardial structure and function. Thirteen hemodialysis patients from a teaching hospital were recruited for this descriptive study and divided into 3 groups according to their iron profile (high, low, and intermediate). Oxidative stress was determined in vivo by mass spectroscopy with measurement of malondialdehyde (MDA), hexanal, and nonenal. Cardiac magnetic resonance imaging and 2-dimensional echocardiography were used to study any structural or functional changes, respectively. A strong correlation was found between iro... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1613001 Tue, 08 Jul 2008 04:00:00 +0100 1613001 http://www.medworm.com/index.php?rid=1613000&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00281.x Interleukin-10 (IL-10) predominantly acts as an anti-inflammatory factor. Polymorphisms in the IL-10 gene promoter determine quantitative cytokine production. Doppler echocardiography and tissue Doppler imaging (TDI) are superior to conventional echocardiography to evaluate diastolic dysfunction. The IL-10 gene promoter polymorphism at position ([minus]1082) was studied for its association with conventional and Doppler echocardiographic and TDI parameters in 112 hemodialysis (HD) patients. Blood pressure, serum C-reactive protein (CRP), and albumin levels were also examined for the association study. The genetic association study showed that among the HD patients, there was no difference in the prevalence of systolic and diastolic dysfunction between genotypes on conventional echocardiogra... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1613000 Tue, 08 Jul 2008 04:00:00 +0100 1613000 http://www.medworm.com/index.php?rid=1612999&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00280.x This study was designed to define the hematologic consequences of using tissue plasminogen activator (t-PA) as an alternative locking solution after heparin-free hemodialysis (HF-HD). Following HF-HD, t-PA 2 mg was instilled into each lumen of the dialysis catheter in 10 patients. Euglobulin clot lysis time (ECLT), fibrinogen, D-dimer, and fibrin degradation products were measured during the last hour of dialysis, and repeated 15 and 30 minutes after catheter locking. Dialysis catheter performance was reassessed at the time of the next hemodialysis. Fibrinogen, D-dimer, and fibrin degradation products were elevated at all time points, but did not change after t-PA. ECLT decreased significantly from baseline 15 minutes after catheter locking (217±64 vs. 132±75 min, p=0.016). ECLT values h... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612999 Tue, 08 Jul 2008 04:00:00 +0100 1612999 http://www.medworm.com/index.php?rid=1612998&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00279.x We conducted an in vitro study to assess the effect of a 30% ethanol/4% trisodium citrate (TSC) catheter locking solution on isolates of Candida albicans. Twelve isolates obtained from human blood cultures were tested in control solutions composed of broth and normal saline, and a test solution of 30% ethanol, 4% TSC, and broth. Colony counts were determined for control and test solutions at baseline and after 1, 24, and 48 hours of exposure. After 48 hours, the remaining test solution was filtered through a sterile filter funnel and rinsed with 10 mL of sterile water. Filters were aseptically transferred to agar plates and incubated for 24 hours. Control solutions grew well over the incubation period, as expected. In contrast, no viable growth was observed in test solutions 1 hour after i... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612998 Tue, 08 Jul 2008 04:00:00 +0100 1612998 http://www.medworm.com/index.php?rid=1612997&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00278.x This study was a cross-sectional review of anemia management in hemodialysis patients. The purpose was to evaluate factors responsible for Hgb decreases of 0.5 or 1.0 g/dL and to determine the primary factors responsible for Hgb decreases below 11 g/dL. Hgb values and clinical events were extracted from patient management databases between January 1, 2005 and November 30, 2006. Isolated events were defined as events that occurred at least 30 days after any previous event and had Hgb measurements within 2 weeks before and after the event. Increasing hospital length of stay and surgical access intervention were the most common events that resulted in a decrease in Hgb. The most common factor present in patients with Hgb decreases below 11 g/dL was the withholding of recombinant human erythro... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612997 Tue, 08 Jul 2008 04:00:00 +0100 1612997 http://www.medworm.com/index.php?rid=1612996&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00277.x To investigate the association between the polymorphisms of human platelet antigen (HPA)-1,2,3,4,5 and susceptibility to develop thrombosis accident in arteriovenous fistula (AVF), genomic DNA of 112 hemodialysis (HD) patients and 100 healthy blood donors were genotyped by PCR-SSP. The patients were classified into 2 groups: G1 included 54 HD patients presented at least one thrombotic episode on the level of the AVF, and G2 included 58 HD patients without any episode of thrombosis. The allelic frequencies of HPA-1, 2, 3, and 5 among patients and controls did not reveal significant differences. However, the HPA-4b allele was significantly more frequent in G1 than in controls or in G2 patients (23.1% vs. 11.5% and 0.9%, respectively), p (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612996 Tue, 08 Jul 2008 04:00:00 +0100 1612996 http://www.medworm.com/index.php?rid=1612995&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00276.x A survey conducted by Bonucchi et al. underlined the different types of doctors placing arteriovenous fistula (AVF) for hemodialysis in the United States and Europe (in particular Italy). In fact, nephrologists definitely prevail in Italy, where almost 48.8% of nephrologists place an AVF themselves or with the help of a vascular surgeon (26.4%). In Europe, only 35% do so, whereas 89% of AVF are performed by surgeons in the United States. In 98% of the cases occurring at our center, the AVF was placed and reviewed by the nephrologists. This paper reports surgery cases related to the period between January 1983 and September 2006. Over this time, 1386 operations for placing and reviewing vascular access were conducted. Among these, 47 (3.3%) were related to a cuffed central venous catheter (... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612995 Tue, 08 Jul 2008 04:00:00 +0100 1612995 http://www.medworm.com/index.php?rid=1612994&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00275.x Unlike in subjects with normal renal function, the relationship between hypertension and cardiovascular morbidity and mortality in dialysis patients is still being debated. In order to clarify this issue, we performed 44-hour ambulatory blood pressure measurements (ABPM) during the interdialytic period in a group of 164 hypertensive patients, the blood pressure (BP) control based on conventional antihypertensive strategy previously, on chronic hemodialysis treatment in the Mediterranean region of Turkey. These results were then compared with their echocardiographic data. This is a cross-sectional analysis. The mean ABPM during 44 hours was close to the manually measured predialysis value, but there was a gradual increase in the ABPM values in the interdialytic period. When divided into a g... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612994 Tue, 08 Jul 2008 04:00:00 +0100 1612994 http://www.medworm.com/index.php?rid=1612993&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00274.x Sepsis is an important and serious complication in hemodialysis (HD) patients. Here we report on a case of spina bifida with ventriculo-peritoneal (VP) shunt infection who was on HD and underwent at least 5 months of investigations before a source of the infection was found and eventually treated successfully. We believe this to be the first reported case of VP shunt-associated sepsis in a patient on HD. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612993 Tue, 08 Jul 2008 04:00:00 +0100 1612993 http://www.medworm.com/index.php?rid=1612992&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00273.x This report describes a localized enlargement of the mandible due to a brown tumor in a patient undergoing chronic hemodialysis. Literature on jaw involvement in secondary hyperparathyroidism is reviewed. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612992 Tue, 08 Jul 2008 04:00:00 +0100 1612992 http://www.medworm.com/index.php?rid=1612991&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00272.x We report a patient suffering from chronic kidney disease who presented to us with severe pulmonary edema. His clinical, laboratory, and sonological parameters were suggestive of end-stage renal disease. Hemodialysis was initiated, and after 48 hours (3 sessions of hemodialysis) he became drowsy and a neurological examination revealed left upper limb monoplegia with left facial palsy. Urgent computerized tomography scan of the brain revealed diffuse hypodensity in the cerebral white matter bilaterally, and brain magnetic resonance imaging showed diffuse hyperintensity in the cerebral white matter bilaterally, right internal capsule and external capsule on fluid attenuated inversion recovery and T2 sequences (hypointense on T1 sequence). He made a gradual but complete neurological recovery ... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612991 Tue, 08 Jul 2008 04:00:00 +0100 1612991 http://www.medworm.com/index.php?rid=1612990&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00271.x The incidence of acute brain injury in chronic hemodialysis patients is increasing, as the dialysis population is becoming increasingly older, often hypertensive, at risk of ischemic and/or hemorrhagic stroke, and subdural hemorrhage. Standard intermittent hemodialysis treatments typically lead to an increase in cerebral swelling, which can exacerbate underlying cerebral damage. In critically ill patients, continuous modes of renal replacement therapy may be required, but depending upon the clinical condition, simple modifications to standard intermittent therapies may suffice, and allow effective delivery of renal replacement therapy, but ensure that patient outcomes both in terms of mortality and residual functional brain damage is no different between those with normal renal function an... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612990 Tue, 08 Jul 2008 04:00:00 +0100 1612990 http://www.medworm.com/index.php?rid=1612989&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00270.x We present the case of a young adult with severe uremia who, despite application of recommended measures, developed DDS and non-cardiogenic pulmonary edema. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612989 Tue, 08 Jul 2008 04:00:00 +0100 1612989 http://www.medworm.com/index.php?rid=1612988&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00269.x Fortunately, the literature on exercise among patients on hemodialysis has grown too broad to be included in a single review. The focus of this review is on interventional studies, with an emphasis on those studies that included a control group. The good news is that there is ample evidence that exercise can improve fitness (VO2 peak), physical functioning, and some cardiovascular risk factors in the dialysis population. However, there have been few comparative studies, and there is no consensus regarding the most beneficial regimen or the one most acceptable to large numbers of patients. A new set of recommendations from the American College of Sports Medicine and the American Heart Association for older individuals and individuals with chronic diseases is relevant for our patient populat... Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612988 Tue, 08 Jul 2008 04:00:00 +0100 1612988 http://www.medworm.com/index.php?rid=1612987&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1542-4758.2008.00268.x This report is the fourth annual update and describes recruitment progress, baseline characteristics of enrolled patients, and worldwide prescription patterns. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1612987 Tue, 01 Jul 2008 04:00:00 +0100 1612987 http://www.medworm.com/index.php?rid=1350594&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00267.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 115-160, April 2008. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350594 Fri, 04 Apr 2008 18:21:47 +0100 1350594 http://www.medworm.com/index.php?rid=1350602&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00260.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 236-243, April 2008. Abstract Biomarkers of inflammation, especially C-reactive protein (CRP), have been consistently shown to predict poor outcomes in chronic hemodialysis (CHD) patients. However, the determinants of CRP and the value of its monitoring in CHD patients have ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350602 Fri, 04 Apr 2008 02:34:33 +0100 1350602 http://www.medworm.com/index.php?rid=1350604&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00262.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 254-263, April 2008. Abstract Cardiovascular (CV) disease is the most common cause of mortality in end-stage kidney disease (ESKD), and arterial stiffness, measured by pulse wave velocity (PWV), is an independent predictor of all-cause and CV mortality. B-type natriuretic ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350604 Fri, 04 Apr 2008 02:34:13 +0100 1350604 http://www.medworm.com/index.php?rid=1350599&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00257.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 227-229, April 2008. Abstract Vascular access infection is a frequent problem in patients undergoing maintenance hemodialysis. Infection of arteriovenous fistula (AVF) is less common than dialysis catheter-associated infection. Previous case reports described endophthalmitis ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350599 Fri, 04 Apr 2008 02:33:57 +0100 1350599 http://www.medworm.com/index.php?rid=1350608&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00266.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 280, April 2008. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350608 Fri, 04 Apr 2008 02:33:51 +0100 1350608 http://www.medworm.com/index.php?rid=1350603&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00261.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 244-253, April 2008. Abstract In sorbent-based hemodialysis, factors limiting a treatment session are urea conversion capacity and sodium release from the cartridge. In vitro experiments were performed to model typical treatment scenarios using various dialyzers and 4 types ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350603 Fri, 04 Apr 2008 02:33:48 +0100 1350603 http://www.medworm.com/index.php?rid=1350598&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00256.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 221-226, April 2008. Abstract Hemodialysate solutions often contain high concentrations of glucose (up to 200 mg/dL). The historical reasons for the addition of glucose to the dialysate included: (1) aid in performance of ultrafiltration and (2) minimization of nutritional (... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350598 Fri, 04 Apr 2008 02:33:36 +0100 1350598 http://www.medworm.com/index.php?rid=1350605&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00263.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 264-267, April 2008. Abstract Accidental venous needle dislodgement during hemodialysis may cause serious bleeding including a sometimes fatal outcome. The venous pressure gauge of the dialysis monitor does not react when dislodgement occurs. A sensor patch put as an ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350605 Fri, 04 Apr 2008 02:33:34 +0100 1350605 http://www.medworm.com/index.php?rid=1350601&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00259.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 233-235, April 2008. Abstract Dialysis patients exhibit a higher morbidity and mortality rate than those in the general population of comparable age. Survival on dialysis has become significantly longer and is mainly related to comorbid factors. Patients are usually the main ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350601 Fri, 04 Apr 2008 02:33:33 +0100 1350601 http://www.medworm.com/index.php?rid=1350596&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00254.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 211-214, April 2008. Abstract Hemodialysis is only infrequently used in drug overdosage situations. The efficacy of hemodialysis to remove the drug depends upon the pharmacokinetics and pharmacodynamics of the drug. At normal therapeutic concentrations, valproic acid is ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350596 Fri, 04 Apr 2008 02:33:32 +0100 1350596 http://www.medworm.com/index.php?rid=1350595&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00253.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 173-210, April 2008. Abstract Accumulation of knowledge requisite for development of hemodialysis started in antiquity and continued through Middle Ages until the 20th century. Firstly, it was determined that the kidneys produce urine containing toxic substances that ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350595 Fri, 04 Apr 2008 02:33:26 +0100 1350595 http://www.medworm.com/index.php?rid=1350607&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00265.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 275-279, April 2008. Abstract The Dialysis Outcomes and Practice Patterns Study reported a statistically non-significant protective effect of HMG-co reductase inhibitors (statins) on bone fracture risk in hemodialysis (HD) patients. We sought to determine whether statin ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350607 Fri, 04 Apr 2008 02:33:11 +0100 1350607 http://www.medworm.com/index.php?rid=1350597&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00255.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 215-220, April 2008. Abstract The basics of targeting, writing, adjusting, and monitoring a hemodialysis prescription are reviewed for patients being dialyzed 3 or 4 times a week. K/DOQI 2006 adequacy guidelines and practice recommendations are reviewed, and a practical ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350597 Fri, 04 Apr 2008 02:33:11 +0100 1350597 http://www.medworm.com/index.php?rid=1350600&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00258.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 230-232, April 2008. Abstract Gustatory sweating is a rare disorder characterized by profuse sweating on the forehead, face, scalp, and neck occurring soon after ingesting food, which has been reported in diabetic patients. The mechanism is thought to be triggered by taste ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350600 Fri, 04 Apr 2008 02:33:10 +0100 1350600 http://www.medworm.com/index.php?rid=1350606&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00264.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 2, Page 268-274, April 2008. Abstract Bone/joint pain and difficulty with sexual arousal are prevalent, frequently severe, and potentially treatable in patients on maintenance hemodialysis. However, the mediators and adequacy of treatment for these symptoms have been less well ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1350606 Fri, 04 Apr 2008 02:33:08 +0100 1350606 http://www.medworm.com/index.php?rid=1211161&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00232.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 1-5, January 2008. Abstract Physicians should prescribe the dialysis mode most likely to result in the best outcome for the end-stage renal disease patient, not leave it to the patient or dialysis center to choose. That prescription, in order of decreasing desirability, ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211161 Wed, 06 Feb 2008 19:23:12 +0100 1211161 http://www.medworm.com/index.php?rid=1211169&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00240.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR The objective is to evaluate bacteremia outcomes and survival rates when using guidewire exchange to place tunnelled hemodialysis catheter (THDC) compared with a new-site replacement. Retrospectively, all patients were identified who received a ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211169 Wed, 06 Feb 2008 08:03:02 +0100 1211169 http://www.medworm.com/index.php?rid=1211174&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00245.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 80-84, January 2008. Abstract The need for reliable, long-term hemodialysis vascular access remains critical. To determine the long-term outcomes of transposed basilic vein arteriovenous fistulae (BVT) and their comparability with other vascular accesses, we determined ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211174 Wed, 06 Feb 2008 08:02:47 +0100 1211174 http://www.medworm.com/index.php?rid=1211167&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00238.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 39-44, January 2008. Abstract Dialysis hypotension occurs frequently and is associated with increased morbidity, mortality, and may influence quality of life. We investigated the influence of blood volume (BV)-controlled ultrafiltration on hemodynamic stability and quality ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211167 Wed, 06 Feb 2008 08:02:45 +0100 1211167 http://www.medworm.com/index.php?rid=1211172&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00243.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 66-72, January 2008. Abstract Fibromyalgia syndrome (FMS) is characterized by widespread musculoskeletal pain. It has negative effects on quality of life and has been poorly investigated in specific populations. Our aim was to determine the prevalence of FMS in Brazilian ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211172 Wed, 06 Feb 2008 08:02:29 +0100 1211172 http://www.medworm.com/index.php?rid=1211165&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00236.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 30-33, January 2008. Abstract A 76-year-old woman hemodialysis patient was hospitalized for community-acquired pneumonia complicating chronic obstructive pulmonary disease. End-stage renal disease secondary to hypertension had been diagnosed at the age of 64 for which the ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211165 Wed, 06 Feb 2008 08:02:28 +0100 1211165 http://www.medworm.com/index.php?rid=1211171&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00242.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR The objective of this study was to quantify OI and to examine its association with hypotension ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211171 Wed, 06 Feb 2008 08:02:27 +0100 1211171 http://www.medworm.com/index.php?rid=1211164&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00235.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 23-29, January 2008. Abstract More frequent and intensive hemodialysis (HD) schedules continue to garner interest internationally. Two dominant regimens have emerged, namely short-daily and nocturnal HD. A growing body of observational data suggests that these regimens allow ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211164 Wed, 06 Feb 2008 08:01:53 +0100 1211164 http://www.medworm.com/index.php?rid=1211168&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00239.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 45-51, January 2008. Abstract To characterize the nutritional status of renal failure patients and its relationship with hemodialysis adequacy measured by Kt/V, a study was carried out with a population of 44 adult patients with renal failure and mean age 51±15 years. ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211168 Wed, 06 Feb 2008 08:01:42 +0100 1211168 http://www.medworm.com/index.php?rid=1211173&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00244.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 73-79, January 2008. Abstract The optimal dialysate calcium (Ca) concentration for hemodialysis (HD) patients is set at 2.5 mEq/L according to Kidney Disease Outcomes Quality Initiative (K-DOQI) guidelines. This recommendation is opinion-based and could negatively affect ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211173 Wed, 06 Feb 2008 08:01:32 +0100 1211173 http://www.medworm.com/index.php?rid=1211179&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00250.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 108-113, January 2008. Abstract Cardiac arrhythmias are a frequent event in chronic hemodialysis patients. The aim of this study was to evaluate the efficacy and safety of acetate-free hemofiltration with potassium-profiled dialysate (AFB-K) dialysis compared with constant ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211179 Wed, 06 Feb 2008 08:01:31 +0100 1211179 http://www.medworm.com/index.php?rid=1211162&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00233.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 6-15, January 2008. Abstract Patients with end-stage renal disease treated with maintenance hemodialysis suffer substantial impairments in health-related quality of life (HRQOL). Despite widespread efforts, there are few interventions that improve the overall well-being and ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211162 Wed, 06 Feb 2008 08:01:11 +0100 1211162 http://www.medworm.com/index.php?rid=1211178&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00249.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 100-107, January 2008. Abstract Sexual hormone concentrations are commonly affected in chronic renal failure. The contribution of sex steroids to bone turnover regulation implies that sex steroid's dysfunction may be implicated in the emergence of renal osteodystrophy. This ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211178 Wed, 06 Feb 2008 08:01:07 +0100 1211178 http://www.medworm.com/index.php?rid=1211182&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00252_1.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 165-172, January 2008. (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211182 Wed, 06 Feb 2008 08:01:06 +0100 1211182 http://www.medworm.com/index.php?rid=1211163&cid=s_29463_19_f&fid=29463&url=http%3A%2F%2Fwww.blackwell-synergy.com%2Fdoi%2Fabs%2F10.1111%2Fj.1542-4758.2008.00234.x%3Fai%3D3vp%26mi%3D4mpuw%26af%3DR Hemodialysis International, Volume 12, Issue 1, Page 16-22, January 2008. Abstract Vascular calcification is highly prevalent and often severe in patients with chronic kidney disease. Arterial calcification in patients with chronic kidney disease can result from the deposition of mineral along the intimal layer of arteries in ... (Source: Hemodialysis International) Hemodialysis International journals http://www.medworm.com/rss/comments.php?id=1211163 Wed, 06 Feb 2008 08:00:56 +0100 1211163