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 'Seminars In Dialysis' source. Wed, 08 Feb 2012 17:42:11 +0100 http://www.medworm.com/index.php?rid=5668096&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01018.x AbstractWe previously demonstrated that simulation‐based education (SBE) improved temporary hemodialysis catheter (THDC) insertion skills by nephrology fellows. SBE, featuring deliberate practice and rigorous achievement standards, was a powerful method to enhance THDC insertion skills in nephrology fellows. However, experts have called for further research to evaluate skill transfer from the simulated environment to actual clinical care and skill retention. This is a prospective observational cohort study of THDC insertion skills. Twelve nephrology fellows from three academic centers in Chicago were evaluated using a skills checklist from July 2008 to June 2009. Simulator‐trained fellows were tested after the SBE intervention and expected to meet or exceed a minimum passing score (MPS... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5668096 Tue, 07 Feb 2012 05:00:00 +0100 5668096 http://www.medworm.com/index.php?rid=5635513&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22276964%26dopt%3DAbstract Authors: Ahmed S, Roy-Chaudhury P Abstract Hemodialysis vascular access dysfunction is a major cause of morbidity and hospitalization in the hemodialysis population at a cost of well over $1 billion per annum. Venous stenosis (due to venous neointimal hyperplasia [VNH]) is the most common cause of polytetrafluroethylene PTFE) dialysis access graft and arteriovenous fistula (AVF) failure. Despite the magnitude of the clinical problem, however, there are currently no effective therapies for this condition. We and others have previously demonstrated that VNH in PTFE dialysis grafts and AVF is composed of smooth muscle cells/myofibroblasts, endothelial cells within neointimal microvessels, and peri-graft macrophages. Radiation therapy blocks the proliferation and activation of all th... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5635513 Wed, 25 Jan 2012 05:00:00 +0100 5635513 http://www.medworm.com/index.php?rid=5635512&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22276991%26dopt%3DAbstract This article will provide an overview of blood component descriptions, patient testing, and blood component options and preparations for therapeutic apheresis procedures. PMID: 22276991 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5635512 Wed, 25 Jan 2012 05:00:00 +0100 5635512 http://www.medworm.com/index.php?rid=5635511&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22277020%26dopt%3DAbstract Authors: Chhibber V, Weinstein R Abstract Several neurologic disorders have been treated with therapeutic plasma exchange (TPE). Case reports, case series, and clinical trials have published results regarding the outcomes in such patients. The data gathered have been used to formulate evidence-based guidelines, which can be used to guide therapy in patients with these neurological disorders. Adequately designed and powered randomized controlled trials have proven the efficacy of TPE in some disease entities, while other diseases are lacking such data. In the latter, decisions for the use of TPE must be made using the limited published data available. In this review, we discuss the published evidence regarding the use of TPE in neurological disorders, focusing on the most recent gui... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5635511 Wed, 25 Jan 2012 05:00:00 +0100 5635511 http://www.medworm.com/index.php?rid=5635510&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22277063%26dopt%3DAbstract Authors: Winters JL Abstract Low-density lipoprotein (LDL) apheresis describes a group of apheresis techniques that selectively remove apolipoprotein B-containing lipoproteins producing an acute reduction in LDL-cholesterol (LDL-C). Six devices are available for the removal of LDL-C while sparing other important plasma components. The LDL-apheresis (LDL-A) is not routinely used for the treatment of hypercholesterolemia, which usually responds to medical management, but is used to treat familial hypercholesterolemia, an inherited metabolic abnormality resulting in premature death due to progressive coronary artery disease, and to treat patients who fail medical management. The mechanism of action of the available LDL-A devices, reactions that can occur with these treatments, and the... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5635510 Wed, 25 Jan 2012 05:00:00 +0100 5635510 http://www.medworm.com/index.php?rid=5635509&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22277080%26dopt%3DAbstract Authors: Hayes JS, Balogun RA, Chang J, Abdel Rahman EM Abstract The elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal indications at our institution between January 1, 2000 and June 30, 2010 and compared renal indications and mortality associated with the use of TPE in older versus younger patients. During this period, 621 patients underwent 4722 sessions of TPE. Of them, 191 patients were elderly (30.7%) and they underwent 1289 sessions (27.3%) of TPE. A total of 104 patients (16.7%) underwent 593 sessions of TPE becau... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5635509 Wed, 25 Jan 2012 05:00:00 +0100 5635509 http://www.medworm.com/index.php?rid=5635508&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22277133%26dopt%3DAbstract Authors: Goldstein SL Abstract The provision of therapeutic apheresis to children is a technically challenging procedure, requiring trained personnel and an understanding of the disease processes that leads to the need for apheresis. Most apheresis protocols are derived from studies in adult patients, even though most studies are of limited sample size. The focus of this review is to highlight the disease processes commonly treated with therapeutic apheresis in children, and to address the technical considerations pertinent to the provision of safe and effective apheresis in the pediatric setting. PMID: 22277133 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5635508 Wed, 25 Jan 2012 05:00:00 +0100 5635508 http://www.medworm.com/index.php?rid=5629859&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01006.x AbstractHemodialysis vascular access dysfunction is a major cause of morbidity and hospitalization in the hemodialysis population at a cost of well over $1 billion per annum. Venous stenosis (due to venous neointimal hyperplasia [VNH]) is the most common cause of polytetrafluroethylene PTFE) dialysis access graft and arteriovenous fistula (AVF) failure. Despite the magnitude of the clinical problem, however, there are currently no effective therapies for this condition. We and others have previously demonstrated that VNH in PTFE dialysis grafts and AVF is composed of smooth muscle cells/myofibroblasts, endothelial cells within neointimal microvessels, and peri‐graft macrophages. Radiation therapy blocks the proliferation and activation of all these cell types. The current review will d... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629859 Wed, 25 Jan 2012 05:00:00 +0100 5629859 http://www.medworm.com/index.php?rid=5629858&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01021.x This article will provide an overview of blood component descriptions, patient testing, and blood component options and preparations for therapeutic apheresis procedures. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629858 Wed, 25 Jan 2012 05:00:00 +0100 5629858 http://www.medworm.com/index.php?rid=5629857&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01023.x AbstractSeveral neurologic disorders have been treated with therapeutic plasma exchange (TPE). Case reports, case series, and clinical trials have published results regarding the outcomes in such patients. The data gathered have been used to formulate evidence‐based guidelines, which can be used to guide therapy in patients with these neurological disorders. Adequately designed and powered randomized controlled trials have proven the efficacy of TPE in some disease entities, while other diseases are lacking such data. In the latter, decisions for the use of TPE must be made using the limited published data available. In this review, we discuss the published evidence regarding the use of TPE in neurological disorders, focusing on the most recent guidelines published by the American Societ... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629857 Wed, 25 Jan 2012 05:00:00 +0100 5629857 http://www.medworm.com/index.php?rid=5629856&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01025.x AbstractLow‐density lipoprotein (LDL) apheresis describes a group of apheresis techniques that selectively remove apolipoprotein B‐containing lipoproteins producing an acute reduction in LDL‐cholesterol (LDL‐C). Six devices are available for the removal of LDL‐C while sparing other important plasma components. The LDL‐apheresis (LDL‐A) is not routinely used for the treatment of hypercholesterolemia, which usually responds to medical management, but is used to treat familial hypercholesterolemia, an inherited metabolic abnormality resulting in premature death due to progressive coronary artery disease, and to treat patients who fail medical management. The mechanism of action of the available LDL‐A devices, reactions that can occur with these treatments, and the role of this... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629856 Wed, 25 Jan 2012 05:00:00 +0100 5629856 http://www.medworm.com/index.php?rid=5629855&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01027.x AbstractThe elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal indications at our institution between January 1, 2000 and June 30, 2010 and compared renal indications and mortality associated with the use of TPE in older versus younger patients. During this period, 621 patients underwent 4722 sessions of TPE. Of them, 191 patients were elderly (30.7%) and they underwent 1289 sessions (27.3%) of TPE. A total of 104 patients (16.7%) underwent 593 sessions of TPE because of renal‐related indications: 26 patients in the elderly gro... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629855 Wed, 25 Jan 2012 05:00:00 +0100 5629855 http://www.medworm.com/index.php?rid=5593343&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22239110%26dopt%3DAbstract This article reviews the unique aspects of managing obese patients with ESRD. PMID: 22239110 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5593343 Thu, 12 Jan 2012 05:00:00 +0100 5593343 http://www.medworm.com/index.php?rid=5668095&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01035.x AbstractThe classification of thrombotic microangiopathy has evolved and expanded due to treatment and mechanistic advances. The two basic clinical forms of thrombotic microangiopathy (excluding disseminated intravascular coagulation [DIC]), thrombotic thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (HUS) encompass a wide range of primary and secondary forms. The advent of plasma therapy and the identification of an inhibitor to ADAMTS13 in the idiopathic or acute forms of TTP and its absence in diarrheal HUS have had a major impact on our current classification of thrombotic microangiopathy. In adults, the difficulty of differentiating TTP, which is much more common than HUS and the need for a speedy diagnosis to provide life‐saving plasma therapy has resulted in the term ... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5668095 Sun, 01 Jan 2012 05:00:00 +0100 5668095 http://www.medworm.com/index.php?rid=5629871&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01058.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629871 Sun, 01 Jan 2012 05:00:00 +0100 5629871 http://www.medworm.com/index.php?rid=5629870&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01014.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629870 Sun, 01 Jan 2012 05:00:00 +0100 5629870 http://www.medworm.com/index.php?rid=5629869&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01043.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629869 Sun, 01 Jan 2012 05:00:00 +0100 5629869 http://www.medworm.com/index.php?rid=5629868&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01011.x AbstractHeart failure (HF) is very common in the general population, and risk factors for HF, such as coronary artery disease, diabetes, obesity, and hypertension, are frequently present in patients with CKD. Therefore, HF is also an important cause of morbidity and mortality in this population. Diastolic heart failure (DHF), also called HF with preserved ejection fraction, refers to a clinical syndrome in which patients have symptoms and signs of HF, normal or near normal left ventricular (LV) systolic function, and evidence of diastolic dysfunction (e.g., abnormal LV filling and elevated filling pressure). Recent data suggest that HF with normal ejection fraction is even more common in patients than HF with low ejection fraction, including those on hemodialysis. Not surprisingly, DHF is ... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629868 Sun, 01 Jan 2012 05:00:00 +0100 5629868 http://www.medworm.com/index.php?rid=5629867&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01046.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629867 Sun, 01 Jan 2012 05:00:00 +0100 5629867 http://www.medworm.com/index.php?rid=5629866&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01047.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629866 Sun, 01 Jan 2012 05:00:00 +0100 5629866 http://www.medworm.com/index.php?rid=5629865&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01045.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629865 Sun, 01 Jan 2012 05:00:00 +0100 5629865 http://www.medworm.com/index.php?rid=5629864&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01048.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629864 Sun, 01 Jan 2012 05:00:00 +0100 5629864 http://www.medworm.com/index.php?rid=5629863&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01044.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629863 Sun, 01 Jan 2012 05:00:00 +0100 5629863 http://www.medworm.com/index.php?rid=5629862&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01009.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629862 Sun, 01 Jan 2012 05:00:00 +0100 5629862 http://www.medworm.com/index.php?rid=5629861&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01016.x AbstractSudden cardiac death (SCD) is common in dialysis patients accounting for up to 25% of all‐cause mortality. Unlike in the general population, occlusive coronary artery disease is implicated in a minority of these deaths. Activation of the sympathetic nervous system is prevalent in the dialysis population and may underlie this high rate of SCD. β‐blockers reduce SCD in the general population and, given their mode of action, β‐blockers would seem to be an ideal class of agents to prevent SCD in dialysis patients. In this review, we will explore the etiology of SCD in dialysis patients and discuss the evidence supporting the use of β‐blockers in patients with ESRD. We will also examine potential impediments to the use β‐blocker in the dialysis population and outline direc... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629861 Sun, 01 Jan 2012 05:00:00 +0100 5629861 http://www.medworm.com/index.php?rid=5629860&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01015.x AbstractA thrice‐weekly schedule dominates hemodialysis practice today. Inherent in such a schedule is a 72‐hour interweek break over the weekend. A growing body of evidence suggests that this break may be associated with increased cardiovascular morbidity and mortality. Five recent studies have linked dialysis session timing to higher cardiovascular event rates, and have shed light on possible underlying physiologic mechanisms. We reviewed outcome data linking the “long break” to cardiovascular outcomes, and suggest physiologic rationale for this relationship while identifying knowledge gaps that require further study to inform discussions regarding the application and composition of individualized dialysis prescriptions. Further work is needed to determine the relative importance... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629860 Sun, 01 Jan 2012 05:00:00 +0100 5629860 http://www.medworm.com/index.php?rid=5629854&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01028.x AbstractThe provision of therapeutic apheresis to children is a technically challenging procedure, requiring trained personnel and an understanding of the disease processes that leads to the need for apheresis. Most apheresis protocols are derived from studies in adult patients, even though most studies are of limited sample size. The focus of this review is to highlight the disease processes commonly treated with therapeutic apheresis in children, and to address the technical considerations pertinent to the provision of safe and effective apheresis in the pediatric setting. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5629854 Sun, 01 Jan 2012 05:00:00 +0100 5629854 http://www.medworm.com/index.php?rid=5523254&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22175233%26dopt%3DAbstract Authors: Keith DS Abstract Recurrent idiopathic focal segmental glomerulosclerosis (FSGS) after renal transplantation can lead to a rapid failure of the allograft. A circulating, nonimmunoglobulin factor appears to be important in the pathogenesis of this complication in many cases. Between 30% and 50% of transplant recipients with FSGS develop recurrent disease. Three major risk factors for recurrence have been identified: short duration of native kidney disease, history of recurrence with previous kidney transplant, and pediatric aged recipients. Although no properly controlled trials have been conducted, plasmapheresis has emerged as one of the important treatment modalities for this entity. Retrospective studies prior to the routine use of plasmapheresis showed graft loss rates... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5523254 Fri, 16 Dec 2011 05:00:00 +0100 5523254 http://www.medworm.com/index.php?rid=5523253&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22175277%26dopt%3DAbstract Authors: Weiss N Abstract Lipid apheresis effectively lowers LDL-cholesterol even in drug-unresponsive severely hypercholesterolemic patients. This results in improvement of symptoms of coronary artery disease, reduces progression of coronary atherosclerosis, and decreases coronary event rates. Besides aggressive lipid lowering itself, these effects may also be due to nonselective removal of other high molecular weight proteins leading to improved hemorheology. Lipid apheresis is also used for treating symptoms of vascular diseases outside the coronary arteries, such as peripheral arterial disease and the angioneuropathic diabetic foot syndrome. This review discusses putative effects of lipid apheresis and rheophereis on restoring pathophysiological processes involved in the develo... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5523253 Fri, 16 Dec 2011 05:00:00 +0100 5523253 http://www.medworm.com/index.php?rid=5523252&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22175421%26dopt%3DAbstract Authors: Niyyar VD Abstract Vascular access dysfunction is a major cause of morbidity in hemodialysis (HD) patients. An upper extremity autogenous arteriovenous fistula (AVF) that preferentially involves the cephalic vein is the access of choice for HD patients, followed by autogenous AVF utilizing the basilic vein and the use of prosthetic arteriovenous grafts (AVGs). Despite these recommendations, central venous catheter (CVC) use is widespread among both incident and prevalent HD patients. Long-term use of CVCs for HD is complicated by a high rate of infection and thrombus-related dysfunction. Catheter locking solutions have been used both prophylactically and therapeutically for catheter thrombosis as well as catheter-related infections, with varying degrees of success. This re... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5523252 Fri, 16 Dec 2011 05:00:00 +0100 5523252 http://www.medworm.com/index.php?rid=5523251&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22176495%26dopt%3DAbstract Authors: Okafor C, Kalantarinia K Abstract The success of therapeutic apheresis (TA), similar to hemodialysis, depends on the integrity of the extracorporeal circuit as well as a reliable vascular access. However, unlike hemodialysis, which requires high flow of blood around 400 mL/minute through the extracorporeal circuit for effective clearance, TA is usually carried out with much lower blood flow rates (<100 ml/minute). Therefore, even peripheral venous access can be considered for TA. The main determinants of the choice of vascular access for TA is the duration of the planned treatment and, to a certain degree, the indication for its use. While peripheral venous access and temporary central venous catheters are sufficient for short-term TA, tunnelled catheters and arteri... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5523251 Fri, 16 Dec 2011 05:00:00 +0100 5523251 http://www.medworm.com/index.php?rid=5516052&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01031.x AbstractRecurrent idiopathic focal segmental glomerulosclerosis (FSGS) after renal transplantation can lead to a rapid failure of the allograft. A circulating, nonimmunoglobulin factor appears to be important in the pathogenesis of this complication in many cases. Between 30% and 50% of transplant recipients with FSGS develop recurrent disease. Three major risk factors for recurrence have been identified: short duration of native kidney disease, history of recurrence with previous kidney transplant, and pediatric aged recipients. Although no properly controlled trials have been conducted, plasmapheresis has emerged as one of the important treatment modalities for this entity. Retrospective studies prior to the routine use of plasmapheresis showed graft loss rates as high as 80%, a rate muc... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5516052 Fri, 16 Dec 2011 05:00:00 +0100 5516052 http://www.medworm.com/index.php?rid=5516051&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01024.x AbstractThe success of therapeutic apheresis (TA), similar to hemodialysis, depends on the integrity of the extracorporeal circuit as well as a reliable vascular access. However, unlike hemodialysis, which requires high flow of blood around 400 mL/minute through the extracorporeal circuit for effective clearance, TA is usually carried out with much lower blood flow rates (<100 ml/minute). Therefore, even peripheral venous access can be considered for TA. The main determinants of the choice of vascular access for TA is the duration of the planned treatment and, to a certain degree, the indication for its use. While peripheral venous access and temporary central venous catheters are sufficient for short‐term TA, tunnelled catheters and arteriovenous fistulae (AVF) are usually used f... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5516051 Fri, 16 Dec 2011 05:00:00 +0100 5516051 http://www.medworm.com/index.php?rid=5516050&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01036.x AbstractLipid apheresis effectively lowers LDL‐cholesterol even in drug‐unresponsive severely hypercholesterolemic patients. This results in improvement of symptoms of coronary artery disease, reduces progression of coronary atherosclerosis, and decreases coronary event rates. Besides aggressive lipid lowering itself, these effects may also be due to nonselective removal of other high molecular weight proteins leading to improved hemorheology. Lipid apheresis is also used for treating symptoms of vascular diseases outside the coronary arteries, such as peripheral arterial disease and the angioneuropathic diabetic foot syndrome. This review discusses putative effects of lipid apheresis and rheophereis on restoring pathophysiological processes involved in the development of symptoms of p... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5516050 Fri, 16 Dec 2011 05:00:00 +0100 5516050 http://www.medworm.com/index.php?rid=5503986&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22150691%26dopt%3DAbstract Authors: Parker MG, Doebbeling BN Abstract Methicillin-resistant Staphylococcus aureus (MRSA) infections have challenged care process and resource utilization in the acute hospital care setting for nearly 30 years. These infections have become important causes of morbidity, mortality, and a source of concern in the primary and emergency care context over the past decade. As individuals receiving recurrent therapy with features of both ambulatory care and acute care, hemodialysis patients are exposed to numerous opportunities for MRSA acquisition. Surprisingly, high prevalence rates for MRSA colonization have been demonstrated for both hemodialysis patients and their care providers. The necessity of vascular access and the persistent high prevalence of endovascular catheter use am... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5503986 Fri, 09 Dec 2011 05:00:00 +0100 5503986 http://www.medworm.com/index.php?rid=5503985&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22151562%26dopt%3DAbstract Authors: Wadhwa R, Toms J, Nanda A, Abreo K, Cuellar H Abstract Hemodialysis catheterization through the right internal jugular vein (IJV) is widely used for mid- to long-term hemodialysis for patients with renal failure. The purpose of this report is to address a serious complication in conjunction with this procedure. This is a case report of an iatrogenic jugular-carotid fistula (JCF) and a method for rectifying such a vascular conundrum, using endovascular techniques. We describe the technique used to achieve closure of the fistula as well a review of the literature. An 82-year-old woman with history of congestive heart failure, chronic renal failure, and diabetes mellitus developed an iatrogenic arteriovenous fistula, following an attempt of canalizing the right IJV. The patie... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5503985 Fri, 09 Dec 2011 05:00:00 +0100 5503985 http://www.medworm.com/index.php?rid=5503984&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22151601%26dopt%3DAbstract In conclusion, partial aneurysmectomy is a simple and effective intervention for managing aneurysm-associated complications and preserving fistula function. Owing to its advantages over other interventions, we recommend partial aneurysmectomy as first-line choice for managing aneurysm-associated complications. PMID: 22151601 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5503984 Fri, 09 Dec 2011 05:00:00 +0100 5503984 http://www.medworm.com/index.php?rid=5487859&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01005.x AbstractHemodialysis catheterization through the right internal jugular vein (IJV) is widely used for mid‐ to long‐term hemodialysis for patients with renal failure. The purpose of this report is to address a serious complication in conjunction with this procedure. This is a case report of an iatrogenic jugular‐carotid fistula (JCF) and a method for rectifying such a vascular conundrum, using endovascular techniques. We describe the technique used to achieve closure of the fistula as well a review of the literature. An 82‐year‐old woman with history of congestive heart failure, chronic renal failure, and diabetes mellitus developed an iatrogenic arteriovenous fistula, following an attempt of canalizing the right IJV. The patient was treated using three different stents, which ach... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487859 Fri, 09 Dec 2011 05:00:00 +0100 5487859 http://www.medworm.com/index.php?rid=5487858&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00990.x In conclusion, partial aneurysmectomy is a simple and effective intervention for managing aneurysm‐associated complications and preserving fistula function. Owing to its advantages over other interventions, we recommend partial aneurysmectomy as first‐line choice for managing aneurysm‐associated complications. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487858 Fri, 09 Dec 2011 05:00:00 +0100 5487858 http://www.medworm.com/index.php?rid=5503987&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22141430%26dopt%3DAbstract Authors: Vanholder R, Eloot S, Schepers E, Neirynck N, Glorieux G, Massy Z Abstract This publication comments on the recently published findings of a study by Eloot et al. (cJASN, 6: 1266-1273, 2011) that evaluated the correlation between several formulae for calculating estimated GFR (eGFR) and different low molecular weight uremic toxins; eGFRs were based on serum creatinine (SCrea), cystatin C (Cys C), or a combination of both. Unexpectedly, the correlations for the different solutes were highly inconsistent, irrespective of the eGFR formula. On the other hand, the different eGFR formulae gave consistent results per solute. Correlation coefficients for some solutes were low (hippuric acid, p-cresylsulfate, indole acetic acid, uric acid, asymmetric dimethylarginine) to nonsignif... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5503987 Tue, 06 Dec 2011 05:00:00 +0100 5503987 http://www.medworm.com/index.php?rid=5458846&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01001.x AbstractThe recently concluded Frequent Hemodialysis Network (FHN) trials have demonstrated some striking and unexpected results. Both the daily arm and the nocturnal arm of the trial clearly demonstrated that frequent (daily or nightly) dialysis reduced blood pressure, reduced the number of antihypertensive medications, and reduced serum phosphorous concentration. One of the major questions addressed by these studies was the extent to which left ventricular mass was reduced by frequent dialysis. While the daily FHN trial showed a clear effect of frequent dialysis to reduce left ventricular mass, the nocturnal FHN trial produced inconclusive results. These apparently contradictory results are probably influenced by inadequate power and the somewhat skewed patient selection in the nocturnal... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5458846 Tue, 29 Nov 2011 05:00:00 +0100 5458846 http://www.medworm.com/index.php?rid=5458845&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01007.x AbstractHemodialysis (HD) is often used as an example of the most expensive chronic medical intervention that society will pay for on an ongoing basis. More intensive forms of HD have been associated with improved clinical outcomes, but concerns have been raised regarding the possibility of increased costs. We review recent Canadian studies examining the costs and cost utility of intensive HD, with a focus on comparisons with conventional in‐center hemodialysis (IHD). The costs of starting a new home nocturnal hemodialysis (HNHD) program in British Columbia was estimated to be about $510,000 for the first year of the program, including the training of the first 53 patients, or about $18,830 per patient. A study by Lee et al. found the costs of home HD to be substantially less than IHD (... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5458845 Tue, 29 Nov 2011 05:00:00 +0100 5458845 http://www.medworm.com/index.php?rid=5458844&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01010.x The objective of this review is to present available evidence supporting the hypothesis that in an attempt to provide a “more normal physiology,” intensified HD regimens achieve outcomes superior to those historically achieved with CHD. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5458844 Tue, 29 Nov 2011 05:00:00 +0100 5458844 http://www.medworm.com/index.php?rid=5458843&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00995.x We describe an elderly dialysis patient who did well on nocturnal home hemodialysis (HD), and we hypothesize how intensive HD (i.e., nocturnal HD and/or short daily HD) may reduce the incidence of these dialysis complications and may therefore be considered as an option to attempt to preserve functional status and quality of life, especially early after the transition from predialysis to dialysis. Before general adoption of this strategy, further studies on the etiology of functional loss at the time of dialysis initiation, as well as on the potential advantageous effects of intensive HD in the elderly ESRD patient as compared with conventional HD, peritoneal dialysis and kidney transplantation, are required. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5458843 Tue, 29 Nov 2011 05:00:00 +0100 5458843 http://www.medworm.com/index.php?rid=5442127&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00992.x This article explores the reasons for the success of HHD in this region. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5442127 Tue, 22 Nov 2011 05:00:00 +0100 5442127 http://www.medworm.com/index.php?rid=5442126&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00993.x This article considers the potential effect of this reimbursement change on home dialysis. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5442126 Tue, 22 Nov 2011 05:00:00 +0100 5442126 http://www.medworm.com/index.php?rid=5442125&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00997.x AbstractAlternate night nocturnal hemodialysis (HD) is a popular modality in Australia. This modality grew out of a desire to increase the availability and accessibility of nocturnal HD without incurring excessive costs. It has proven popular with staff, patients, and administrators. There are limited data to support the benefits of this modality and undoubtedly, more data are required. As in 5–6 times per week nocturnal HD, the major benefits appear to be in phosphate control, volume control, and patient wellbeing. Economically, this approach to nocturnal HD costs much the same as conventional home HD, with only one extra dialysis session every 2 weeks. This review expands on some aspects of this dialysis modality and how it is practiced in Australia. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5442125 Tue, 22 Nov 2011 05:00:00 +0100 5442125 http://www.medworm.com/index.php?rid=5423132&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01004.x AbstractManitoba has the highest prevalence of ESRD in Canada. Northern Manitoba is a very sparsely settled area with a high proportion of aboriginal ESRD patients. Relocating to urban areas for dialysis is psychosocially and culturally stressful to patients. Delivering dialysis care in a home setting has demonstrated advantages in both clinical, economic, and health related quality of life domains. Establishing home hemodialysis in very remote communities has significant challenges, including poor and inadequate housing, unreliable water supply, limited community medical backup, and poor road access to communities especially for delivery of supplies. These challenges necessitate the development of strong community partnerships, and well documented processes for contingencies. A dedicated ... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5423132 Fri, 18 Nov 2011 05:00:00 +0100 5423132 http://www.medworm.com/index.php?rid=5423131&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01020.x AbstractChildren receiving chronic hemodialysis (HD) three times a week have many obstacles to overcome. Not only do they have to endure dietary restrictions, but they also need to take various medications on a daily basis, which contribute to anorexia. Children on such conventional dialysis programs often have poorly controlled blood pressure (which can lead to left ventricular hypertrophy and/or left ventricular dysfunction) and impaired statural growth. Therefore, the need for more frequent and/or intensive dialysis is recognized. Nevertheless despite limited center experience, daily dialysis is currently most often limited as a rescue treatment. When performed, daily intensified HD provides a modality for preserving cardiovascular health and promoting normal growth in children. Therefo... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5423131 Fri, 18 Nov 2011 05:00:00 +0100 5423131 http://www.medworm.com/index.php?rid=5406856&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22074188%26dopt%3DAbstract Authors: Sofroniadou S, Revela I, Smirloglou D, Makriniotou I, Zerbala S, Kouloubinis A, Samonis G, Iatrou C Abstract The use of antibiotic lock solutions (ALSs) for the prevention of catheter-related blood stream infections (CRBSIs) is a promising option. The efficacy and safety of linezolid as ALS were evaluated in a randomized double-blind prospective study where 131 patients who required nontunneled catheter (NTC) for hemodialysis (HD) were randomized to receive an ALS with either (A) unfractionated heparin (2000 U/ml) alone as a catheter lock control, (B) vancomycin (5 mg/ml) + heparin (2000 U/ml), or (C) linezolid (2 mg/ml) + heparin (2000 U/ml). The primary endpoint of the study was CRBSI. A total of 152 NTCs were inserted in 131 patients. The linezolid-loc... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5406856 Thu, 10 Nov 2011 05:00:00 +0100 5406856 http://www.medworm.com/index.php?rid=5406834&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22074231%26dopt%3DAbstract Authors: Parikh S, Nijmeh R, Van Cleef S, Timmerman S, Bhatt UY, Agarwal AK Abstract Heparin and citrate are used as catheter lock solutions to reduce risk of catheter dysfunction and infection in hemodialysis. There is a paucity of data comparing these two locks in the short-term, inpatient setting. We compared the efficacy of 2.2% acid citrate dextrose (ACD) versus 5000 U/ml heparin as catheter lock in the inpatient setting. The study was conducted at two sites within our system, with ACD locks used at site 1 and heparin locks at site 2. We assessed catheters for catheter dysfunction and infection. Both nontunneled dialysis catheters (NTDC) and tunneled dialysis catheters (TDC) were evaluated. We studied 250 catheters and 139 met inclusion criteria: 90 catheters in the ACD grou... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5406834 Thu, 10 Nov 2011 05:00:00 +0100 5406834 http://www.medworm.com/index.php?rid=5401344&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00966.x AbstractHeparin and citrate are used as catheter lock solutions to reduce risk of catheter dysfunction and infection in hemodialysis. There is a paucity of data comparing these two locks in the short‐term, inpatient setting. We compared the efficacy of 2.2% acid citrate dextrose (ACD) versus 5000 U/ml heparin as catheter lock in the inpatient setting. The study was conducted at two sites within our system, with ACD locks used at site 1 and heparin locks at site 2. We assessed catheters for catheter dysfunction and infection. Both nontunneled dialysis catheters (NTDC) and tunneled dialysis catheters (TDC) were evaluated. We studied 250 catheters and 139 met inclusion criteria: 90 catheters in the ACD group and 49 in the heparin group. ACD had superior outcomes for NTDC; event rate was 0... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5401344 Thu, 10 Nov 2011 05:00:00 +0100 5401344 http://www.medworm.com/index.php?rid=5583361&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01017.x This article reviews the unique aspects of managing obese patients with ESRD. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5583361 Tue, 01 Nov 2011 04:00:00 +0100 5583361 http://www.medworm.com/index.php?rid=5516049&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00991.x AbstractVascular access dysfunction is a major cause of morbidity in hemodialysis (HD) patients. An upper extremity autogenous arteriovenous fistula (AVF) that preferentially involves the cephalic vein is the access of choice for HD patients, followed by autogenous AVF utilizing the basilic vein and the use of prosthetic arteriovenous grafts (AVGs). Despite these recommendations, central venous catheter (CVC) use is widespread among both incident and prevalent HD patients. Long‐term use of CVCs for HD is complicated by a high rate of infection and thrombus‐related dysfunction. Catheter locking solutions have been used both prophylactically and therapeutically for catheter thrombosis as well as catheter‐related infections, with varying degrees of success. This review aims to address t... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5516049 Tue, 01 Nov 2011 04:00:00 +0100 5516049 http://www.medworm.com/index.php?rid=5487866&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01041.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487866 Tue, 01 Nov 2011 04:00:00 +0100 5487866 http://www.medworm.com/index.php?rid=5487865&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00980.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487865 Tue, 01 Nov 2011 04:00:00 +0100 5487865 http://www.medworm.com/index.php?rid=5487864&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01013.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487864 Tue, 01 Nov 2011 04:00:00 +0100 5487864 http://www.medworm.com/index.php?rid=5487863&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01012.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487863 Tue, 01 Nov 2011 04:00:00 +0100 5487863 http://www.medworm.com/index.php?rid=5487862&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01002.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487862 Tue, 01 Nov 2011 04:00:00 +0100 5487862 http://www.medworm.com/index.php?rid=5487861&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01000.x AbstractModality comparisons focusing on survival outcomes of nocturnal hemodialysis (NHD) or short daily hemodialysis (SDHD) versus other treatment paradigms of end‐stage renal disease (ESRD) are sparse. The existing literature consists of cohort studies that are small, retrospective, underpowered, and poorly controlled. The only randomized controlled trial that included mortality as part of a complex composite endpoint is unable to provide information on survival only. Even if concerns with internal validity of this literature are set aside, the generalizability of a few hundred NHD and SDHD patients is an important consideration as it remains uncertain whether or not the purported survival benefits of intensive hemodialysis readily translate into similar benefits for the global ESRD p... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487861 Tue, 01 Nov 2011 04:00:00 +0100 5487861 http://www.medworm.com/index.php?rid=5487860&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01008.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487860 Tue, 01 Nov 2011 04:00:00 +0100 5487860 http://www.medworm.com/index.php?rid=5487857&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00999.x AbstractMethicillin‐resistant Staphylococcus aureus (MRSA) infections have challenged care process and resource utilization in the acute hospital care setting for nearly 30 years. These infections have become important causes of morbidity, mortality, and a source of concern in the primary and emergency care context over the past decade. As individuals receiving recurrent therapy with features of both ambulatory care and acute care, hemodialysis patients are exposed to numerous opportunities for MRSA acquisition. Surprisingly, high prevalence rates for MRSA colonization have been demonstrated for both hemodialysis patients and their care providers. The necessity of vascular access and the persistent high prevalence of endovascular catheter use among patients repeatedly exposed to health... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5487857 Tue, 01 Nov 2011 04:00:00 +0100 5487857 http://www.medworm.com/index.php?rid=5371829&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21992685%26dopt%3DAbstract Authors: Hegde U, Rajapurkar M, Gang S, Khanapet M, Durugkar S, Gohel K, Aghor N, Ganju A, Dabhi M Abstract Atherosclerotic renal artery stenosis (ARAS) is an important cause of kidney disease, accelerated hypertension (HTN), and its treatment is controversial. Our aim was to evaluate the outcomes, safety, and efficacy of percutaneous transluminal angioplasty (PTA) for ARAS. Retrospective analysis of ARAS was performed among 470 angiographies during 1995-2010. Patients with nonatherosclerotic RAS and renal transplant were excluded. We assessed preintervention and postintervention mean arterial pressure (MAP), antihypertensive medications, and renal function to classify as deteriorated (>10% increase in MAP/increase in drugs/>20% reduced GFR), improved (>10% reduced MAP/red... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5371829 Thu, 13 Oct 2011 04:00:00 +0100 5371829 http://www.medworm.com/index.php?rid=5371828&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21992711%26dopt%3DAbstract Authors: Eknoyan G, De Santo NG Abstract The intellectual movement of inquiry by direct observation and inductive reasoning to acquire new knowledge matured in the Enlightenment. In medicine, personal observation as the prime mover of investigation began in anatomy, and gradually extended into studies of function, site of disease, and composition of body fluids. This led to the generation of new information on renal structure, function, and urine composition in health and to some extent in disease. Studies on the dissected, injected, and teased kidneys have left us with many of the eponymous renal structures described by Eustachio, Bellini, Malpighi, and Ferrein. Subsequent studies by Haller of the renal circulation and scrutiny of the separation of serous fluid from blood in the r... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5371828 Thu, 13 Oct 2011 04:00:00 +0100 5371828 http://www.medworm.com/index.php?rid=5316321&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00962.x AbstractAtherosclerotic renal artery stenosis (ARAS) is an important cause of kidney disease, accelerated hypertension (HTN), and its treatment is controversial. Our aim was to evaluate the outcomes, safety, and efficacy of percutaneous transluminal angioplasty (PTA) for ARAS. Retrospective analysis of ARAS was performed among 470 angiographies during 1995–2010. Patients with nonatherosclerotic RAS and renal transplant were excluded. We assessed preintervention and postintervention mean arterial pressure (MAP), antihypertensive medications, and renal function to classify as deteriorated (>10% increase in MAP/increase in drugs/>20% reduced GFR), improved (>10% reduced MAP/reduced drugs/>20% increased eGFR), or stabilized (<10% change in MAP/same antihypertensive drugs/<2... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5316321 Thu, 13 Oct 2011 04:00:00 +0100 5316321 http://www.medworm.com/index.php?rid=5292857&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21967444%26dopt%3DAbstract Authors: Heaf JG, Joffe P, Marckmann P Abstract Vitamin D receptor agonists (VDRA) are currently recommended for the treatment of secondary hyperparathyroidism in stage 5 CKD. They are considered to be contraindicated in the presence of low or normal (for a dialysis patient) levels of PTH due to the risk of developing adynamic bone disease, with consequent vascular calcification. However, these recommendations are increasingly at odds with the epidemiological evidence, which consistently shows a large survival advantage for patients treated with low-dose VDRAs, regardless of plasma calcium, phosphate, or PTH. A large number of pleiotropic effects of vitamin D have been described, including inhibition of renin activity, anti-inflammation, and suppression of vascular calcification st... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5292857 Tue, 04 Oct 2011 04:00:00 +0100 5292857 http://www.medworm.com/index.php?rid=5292856&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21967476%26dopt%3DAbstract Authors: Chilcot J Abstract Illness perceptions refer to organized beliefs surrounding the symptoms, consequences, time course, controllability, and causes of an illness. Illness perceptions have been shown to predict a range of psychosocial and clinical outcomes in patients with ESRD including depression, nonadherence, and even survival. Accordingly, personal illness beliefs are novel yet potentially modifiable prognostic factors. Studies are required to assert whether illness perception-based interventions deliver the promise of improved subjective and clinical well-being in patients with ESRD. PMID: 21967476 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5292856 Tue, 04 Oct 2011 04:00:00 +0100 5292856 http://www.medworm.com/index.php?rid=5286655&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00986.x AbstractVitamin D receptor agonists (VDRA) are currently recommended for the treatment of secondary hyperparathyroidism in stage 5 CKD. They are considered to be contraindicated in the presence of low or normal (for a dialysis patient) levels of PTH due to the risk of developing adynamic bone disease, with consequent vascular calcification. However, these recommendations are increasingly at odds with the epidemiological evidence, which consistently shows a large survival advantage for patients treated with low‐dose VDRAs, regardless of plasma calcium, phosphate, or PTH. A large number of pleiotropic effects of vitamin D have been described, including inhibition of renin activity, anti‐inflammation, and suppression of vascular calcification stimulators and stimulation of vascular calcif... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5286655 Tue, 04 Oct 2011 04:00:00 +0100 5286655 http://www.medworm.com/index.php?rid=5239034&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00924.x AbstractNephrologists in India have embraced providing complete care to their patients and recognize the benefits of coordinated care. This review describes the practice of interventional nephrology in India. Even though the benefits of using tunneled catheters over nontunneled catheters are well recognized, the use of nontunneled catheters is preferred, primarily because of financial constraints and the lack of training facilities. Arteriovenous fistulas (AVFs) are the most common form of dialysis vascular access, often created by nephrologists. Upper arm AVF and arteriovenous grafts are uncommon. The implementation of surveillance tests and elective endovascular interventions on arteriovenous accesses is limited in India, compared to being a routine practice in the United States. The cli... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5239034 Mon, 19 Sep 2011 04:00:00 +0100 5239034 http://www.medworm.com/index.php?rid=5239033&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00950.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5239033 Mon, 19 Sep 2011 04:00:00 +0100 5239033 http://www.medworm.com/index.php?rid=5239032&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00964.x AbstractHigh brachial artery bifurcation (HiBAB) is not a rare occurrence. Recent data have emphasized that HiBAB can have major clinical implications including high failure rate and decreased functional patency of an arteriovenous (AV) fistula. In this retrospective study, we investigated the incidence of HiBAB. Patients with advanced chronic kidney disease and end‐stage renal disease on chronic hemodialysis undergoing preoperative vascular mapping for the creation of an AV access were included in this analysis. Ultrasound examination was used to map the arteries of the upper extremities. Four hundred and eighty‐one arms in 340 patients were examined (right arm = 181, left arm = 300). Sixty‐nine of the 481 (12.3%) demonstrated HiBAB. The internal diameter of the radial and u... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5239032 Mon, 19 Sep 2011 04:00:00 +0100 5239032 http://www.medworm.com/index.php?rid=5237663&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21929569%26dopt%3DAbstract Authors: Kian K, Shapiro JA, Salman L, Khan RA, Merrill D, Garcia L, Eid N, Asif A, Aldahan A, Beathard G Abstract High brachial artery bifurcation (HiBAB) is not a rare occurrence. Recent data have emphasized that HiBAB can have major clinical implications including high failure rate and decreased functional patency of an arteriovenous (AV) fistula. In this retrospective study, we investigated the incidence of HiBAB. Patients with advanced chronic kidney disease and end-stage renal disease on chronic hemodialysis undergoing preoperative vascular mapping for the creation of an AV access were included in this analysis. Ultrasound examination was used to map the arteries of the upper extremities. Four hundred and eighty-one arms in 340 patients were examined (right arm = 181, lef... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237663 Mon, 19 Sep 2011 04:00:00 +0100 5237663 http://www.medworm.com/index.php?rid=5237662&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21929570%26dopt%3DAbstract Authors: Sainaresh VV, Jain SH, Patel HV, Shruti G, Trivedi HL PMID: 21929570 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237662 Mon, 19 Sep 2011 04:00:00 +0100 5237662 http://www.medworm.com/index.php?rid=5237661&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21929590%26dopt%3DAbstract Authors: Meyer TW, Sirich TL, Hostetter TH Abstract Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot be adjusted to control the levels of these solutes. The current solution to this problem is to define an adequate dose of dialysis on the basis of fraction of urea removed from the body. This has provided a practical guide to treatment as the dialysis population has grown over the past 25 years. Indeed, a lower limit to Kt/V(urea) (or the related urea reduction ratio) is now established as a quality indicator by the Centers for Medicare and Medicaid for chronic hemodialysis patients in the United States. For the present, this urea-based standard provides a usefu... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237661 Mon, 19 Sep 2011 04:00:00 +0100 5237661 http://www.medworm.com/index.php?rid=5237660&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21929592%26dopt%3DAbstract Authors: Vachharajani TJ, Balasubramaniam J, Abraham G Abstract Nephrologists in India have embraced providing complete care to their patients and recognize the benefits of coordinated care. This review describes the practice of interventional nephrology in India. Even though the benefits of using tunneled catheters over nontunneled catheters are well recognized, the use of nontunneled catheters is preferred, primarily because of financial constraints and the lack of training facilities. Arteriovenous fistulas (AVFs) are the most common form of dialysis vascular access, often created by nephrologists. Upper arm AVF and arteriovenous grafts are uncommon. The implementation of surveillance tests and elective endovascular interventions on arteriovenous accesses is limited in India, co... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237660 Mon, 19 Sep 2011 04:00:00 +0100 5237660 http://www.medworm.com/index.php?rid=5237668&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21916998%26dopt%3DAbstract Authors: White CA, Akbari A Abstract The glomerular filtration rate (GFR) is considered the best index of overall kidney function. The level of GFR is used in patients with chronic kidney disease (CKD) to classify them into CKD stages. Stage 5 CKD encompasses patients with a GFR below 15 ml/minute/1.73 m(2) and those requiring chronic dialysis. Preservation of GFR, even at its very low level, is of great importance in both dialysis and non-dialysis stage 5 CKD patients. Residual GFR is considered in the prescription of both hemodialysis and peritoneal dialysis and interventions to preserve residual GFR are an active area of clinical research. The application of traditional methods of estimating and measuring GFR can be problematic in this patient population. This review will fo... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237668 Thu, 15 Sep 2011 04:00:00 +0100 5237668 http://www.medworm.com/index.php?rid=5237667&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21916999%26dopt%3DAbstract Authors: Solomon LR, Cheesbrough JS, Bhargava R, Mitsides N, Heap M, Green G, Diggle P Abstract Catheter-related blood stream infections may be reduced by interdialytic locking with Taurolidine, a nontoxic antimicrobial agent. A formulation of 1.35% Taurolidine in 4% citrate (TC) is associated with a greater need for thrombolysis to maintain catheter patency than 5000 U/ml heparin. Our aim was to determine whether addition of 500 Units/ml of heparin to TC reduces the need for thrombolysis. TCH (1.35% taurolidine, 4% citrate and 500 U/ml heparin) was compared to TC and Heparin 5000 U/ml using retrospective data. Hundred and six adult hemodialysis patients with internal jugular tunnelled intravascular catheters using TCH were compared with 34 patients using TC and 34 patients... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237667 Thu, 15 Sep 2011 04:00:00 +0100 5237667 http://www.medworm.com/index.php?rid=5237666&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21917000%26dopt%3DAbstract Authors: Bossola M, Vulpio C, Tazza L Abstract Fatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, the causes of this symptom are often unclear. In the absence of an underlying, treatable disorder, the results of therapeutic intervention are typically frustrating. So far, none of the drugs tested can be recommended for preventing and treating fatigue in chronic HD patients. There is some evidence that exercise may significantly improve fatigue in dialysis patients; however, this requires confirmation through large, prospe... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237666 Thu, 15 Sep 2011 04:00:00 +0100 5237666 http://www.medworm.com/index.php?rid=5237665&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21917001%26dopt%3DAbstract Authors: Yevzlin AS Abstract The impact of renal artery stenosis (RAS) and resulting ischemic nephropathy on kidney function has been well described. Based on several recent randomized, multicenter trials that revealed limitations to the utility of nonselective renal artery intervention, the general nephrology community has recently taken a conservative stance on this disease state. The purpose of this report is to summarize some recent contributions to our understanding of renal artery stenosis, which may cast RAS intervention in a new light. PMID: 21917001 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237665 Thu, 15 Sep 2011 04:00:00 +0100 5237665 http://www.medworm.com/index.php?rid=5237664&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21917012%26dopt%3DAbstract Authors: Lee T, Wadehra D Abstract The major cause of hemodialysis vascular access failure is venous stenosis resulting from neointimal hyperplasia. Genetic factors have been shown to be associated with cardiovascular disease and peripheral vascular disease (PVD) in the general population. Genetic factors may also play an important role in vascular access stenosis and development of neointimal hyperplasia by affecting pathways that lead to inflammation, endothelial function, oxidative stress, and vascular smooth muscle proliferation. This review will discuss the role of genetics in understanding neointimal hyperplasia development in hemodialysis vascular access dysfunction and other disease processes with similar neointimal hyperplasia development such as coronary artery disease an... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237664 Thu, 15 Sep 2011 04:00:00 +0100 5237664 http://www.medworm.com/index.php?rid=5227162&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00951.x AbstractCatheter‐related blood stream infections may be reduced by interdialytic locking with Taurolidine, a nontoxic antimicrobial agent. A formulation of 1.35% Taurolidine in 4% citrate (TC) is associated with a greater need for thrombolysis to maintain catheter patency than 5000 U/ml heparin. Our aim was to determine whether addition of 500 Units/ml of heparin to TC reduces the need for thrombolysis. TCH (1.35% taurolidine, 4% citrate and 500 U/ml heparin) was compared to TC and Heparin 5000 U/ml using retrospective data. Hundred and six adult hemodialysis patients with internal jugular tunnelled intravascular catheters using TCH were compared with 34 patients using TC and 34 patients using heparin 5000 U/ml respectively. Outcomes were time to first use of thrombolysis and b... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5227162 Thu, 15 Sep 2011 04:00:00 +0100 5227162 http://www.medworm.com/index.php?rid=5227161&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00967.x AbstractThe major cause of hemodialysis vascular access failure is venous stenosis resulting from neointimal hyperplasia. Genetic factors have been shown to be associated with cardiovascular disease and peripheral vascular disease (PVD) in the general population. Genetic factors may also play an important role in vascular access stenosis and development of neointimal hyperplasia by affecting pathways that lead to inflammation, endothelial function, oxidative stress, and vascular smooth muscle proliferation. This review will discuss the role of genetics in understanding neointimal hyperplasia development in hemodialysis vascular access dysfunction and other disease processes with similar neointimal hyperplasia development such as coronary artery disease and PVD. (Source: Seminars In Dialysi... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5227161 Thu, 15 Sep 2011 04:00:00 +0100 5227161 http://www.medworm.com/index.php?rid=5227160&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00943.x AbstractThe glomerular filtration rate (GFR) is considered the best index of overall kidney function. The level of GFR is used in patients with chronic kidney disease (CKD) to classify them into CKD stages. Stage 5 CKD encompasses patients with a GFR below 15 ml/minute/1.73 m2 and those requiring chronic dialysis. Preservation of GFR, even at its very low level, is of great importance in both dialysis and non‐dialysis stage 5 CKD patients. Residual GFR is considered in the prescription of both hemodialysis and peritoneal dialysis and interventions to preserve residual GFR are an active area of clinical research. The application of traditional methods of estimating and measuring GFR can be problematic in this patient population. This review will focus on the methods available to quant... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5227160 Thu, 15 Sep 2011 04:00:00 +0100 5227160 http://www.medworm.com/index.php?rid=5227159&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00956.x AbstractFatigue is common in chronic hemodialysis (HD) patients and impacts on daily living, impairs significantly the quality of life, increases the risk of cardiovascular events and negatively influences survival. Although numerous social, demographic, clinical, and laboratory variables have been associated with fatigue, the causes of this symptom are often unclear. In the absence of an underlying, treatable disorder, the results of therapeutic intervention are typically frustrating. So far, none of the drugs tested can be recommended for preventing and treating fatigue in chronic HD patients. There is some evidence that exercise may significantly improve fatigue in dialysis patients; however, this requires confirmation through large, prospective, randomized studies. (Source: Seminars In... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5227159 Thu, 15 Sep 2011 04:00:00 +0100 5227159 http://www.medworm.com/index.php?rid=5237670&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21913987%26dopt%3DAbstract In conclusion, patients receiving care at VAMC-associated facilities were more likely to start hemodialysis with AVFs, perhaps because of better pre-ESRD care. Nonetheless, AVF rates remain suboptimal, indicating a need for ongoing vascular access evaluation and improvement. PMID: 21913987 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237670 Tue, 13 Sep 2011 04:00:00 +0100 5237670 http://www.medworm.com/index.php?rid=5237669&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21913988%26dopt%3DAbstract Authors: Penfield JG, Reilly RF Abstract Imaging is an increasingly important part of clinical medicine and contrast enhancement adds valuable diagnostic information. Prior to 2006 gadolinium based contrast agents (GBCA) were used in patients with kidney disease in an attempt to avoid the adverse consequences of iodinated contrast agents. The amount administered often exceeded the United States Food and Drug Administration (FDA)-recommended dosing. After the association between GBCA and nephrogenic systemic fibrosis (NSF) was reported, usage of GBCA was markedly reduced in patients with kidney disease. As a result, iodinated contrast was often used in place of GBCA. Recently, several studies showed that the risk of NSF using GBCA with increased thermodynamic and kinetic stability o... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237669 Tue, 13 Sep 2011 04:00:00 +0100 5237669 http://www.medworm.com/index.php?rid=5227164&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00920.x In conclusion, patients receiving care at VAMC‐associated facilities were more likely to start hemodialysis with AVFs, perhaps because of better pre‐ESRD care. Nonetheless, AVF rates remain suboptimal, indicating a need for ongoing vascular access evaluation and improvement. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5227164 Tue, 13 Sep 2011 04:00:00 +0100 5227164 http://www.medworm.com/index.php?rid=5227163&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00945.x AbstractImaging is an increasingly important part of clinical medicine and contrast enhancement adds valuable diagnostic information. Prior to 2006 gadolinium based contrast agents (GBCA) were used in patients with kidney disease in an attempt to avoid the adverse consequences of iodinated contrast agents. The amount administered often exceeded the United States Food and Drug Administration (FDA)‐recommended dosing. After the association between GBCA and nephrogenic systemic fibrosis (NSF) was reported, usage of GBCA was markedly reduced in patients with kidney disease. As a result, iodinated contrast was often used in place of GBCA. Recently, several studies showed that the risk of NSF using GBCA with increased thermodynamic and kinetic stability or increased relaxivity along with a res... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5227163 Tue, 13 Sep 2011 04:00:00 +0100 5227163 http://www.medworm.com/index.php?rid=5237676&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21906164%26dopt%3DAbstract This article reviews the available evidence, and its limitations, for deciding between various revascularization strategies for patients with end-stage renal disease. Several considerations that arise while making such decisions are discussed. PMID: 21906164 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237676 Fri, 09 Sep 2011 04:00:00 +0100 5237676 http://www.medworm.com/index.php?rid=5237675&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21906165%26dopt%3DAbstract Authors: Parfrey PS Abstract Hyporesponsiveness to erythropoietin stimulating agents occurs frequently, and may be observed at initiation of treatment or during maintenance therapy. An inverse relationship between hyporesponsiveness and incident cardiovascular events has been reported. It is related at least in part to co-morbidity and its occurrence requires a search for the cause. Treatment of anemia in hyporesponsive patients should be individualized, with consideration given to the indication for ESA therapy, the target hemoglobin for therapy, and maximal dose limitations. PMID: 21906165 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237675 Fri, 09 Sep 2011 04:00:00 +0100 5237675 http://www.medworm.com/index.php?rid=5237674&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21906166%26dopt%3DAbstract Authors: Lee T, Mokrzycki M, Moist L, Maya I, Vazquez M, Lok CE, Abstract Vascular access dysfunction is one of the leading causes of morbidity and mortality among end-stage renal disease patients. Vascular access dysfunction exists in all three types of available accesses: arteriovenous fistulas, arteriovenous grafts, and tunneled catheters. To improve clinical research and outcomes in hemodialysis (HD) access dysfunction, the development of a multidisciplinary network of collaborative investigators with various areas of expertise, and common standards for terminology and classification in all vascular access types, is required. The North American Vascular Access Consortium (NAVAC) is a newly formed multidisciplinary and multicenter network of experts in the area of HD vascular a... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237674 Fri, 09 Sep 2011 04:00:00 +0100 5237674 http://www.medworm.com/index.php?rid=5237673&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21906167%26dopt%3DAbstract This article focuses on the economic challenges that limit evidence generation in nephrology. Conditionally funded field evaluations such as coverage with evidence development can allow both earlier access to new treatments and rigorous evaluation. The authors propose that field evaluations will stimulate an environment that promotes pivotal renal care advances. Certainly, the evidence challenge faced by nephrology requires urgent discussions on creating conditions that catalyze and accelerate innovation, and improve patient outcomes. PMID: 21906167 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237673 Fri, 09 Sep 2011 04:00:00 +0100 5237673 http://www.medworm.com/index.php?rid=5237672&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21906168%26dopt%3DAbstract We present the case of a patient who presented with renal failure requiring dialysis and also with a serum Na of 112 mEq/l. Using a dialysate Na concentration of 130 mEq/l and by limiting the blood flow to 50 ml/minute, we were able to raise her serum Na by only 2 mEq/l/hour during her hemodialysis treatment and thus control both the rate and total change in the patient's serum Na. PMID: 21906168 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237672 Fri, 09 Sep 2011 04:00:00 +0100 5237672 http://www.medworm.com/index.php?rid=5237671&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21906169%26dopt%3DAbstract Authors: Besarab A PMID: 21906169 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5237671 Fri, 09 Sep 2011 04:00:00 +0100 5237671 http://www.medworm.com/index.php?rid=5210099&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00970.x This article focuses on the economic challenges that limit evidence generation in nephrology. Conditionally funded field evaluations such as coverage with evidence development can allow both earlier access to new treatments and rigorous evaluation. The authors propose that field evaluations will stimulate an environment that promotes pivotal renal care advances. Certainly, the evidence challenge faced by nephrology requires urgent discussions on creating conditions that catalyze and accelerate innovation, and improve patient outcomes. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5210099 Fri, 09 Sep 2011 04:00:00 +0100 5210099 http://www.medworm.com/index.php?rid=5210098&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00969.x AbstractVascular access dysfunction is one of the leading causes of morbidity and mortality among end‐stage renal disease patients. Vascular access dysfunction exists in all three types of available accesses: arteriovenous fistulas, arteriovenous grafts, and tunneled catheters. To improve clinical research and outcomes in hemodialysis (HD) access dysfunction, the development of a multidisciplinary network of collaborative investigators with various areas of expertise, and common standards for terminology and classification in all vascular access types, is required. The North American Vascular Access Consortium (NAVAC) is a newly formed multidisciplinary and multicenter network of experts in the area of HD vascular access, who include nephrologists and interventional nephrologists from th... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5210098 Fri, 09 Sep 2011 04:00:00 +0100 5210098 http://www.medworm.com/index.php?rid=5210097&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00948.x This article reviews the available evidence, and its limitations, for deciding between various revascularization strategies for patients with end‐stage renal disease. Several considerations that arise while making such decisions are discussed. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5210097 Fri, 09 Sep 2011 04:00:00 +0100 5210097 http://www.medworm.com/index.php?rid=5210096&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00949.x AbstractHyporesponsiveness to erythropoietin stimulating agents occurs frequently, and may be observed at initiation of treatment or during maintenance therapy. An inverse relationship between hyporesponsiveness and incident cardiovascular events has been reported. It is related at least in part to co‐morbidity and its occurrence requires a search for the cause. Treatment of anemia in hyporesponsive patients should be individualized, with consideration given to the indication for ESA therapy, the target hemoglobin for therapy, and maximal dose limitations. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5210096 Fri, 09 Sep 2011 04:00:00 +0100 5210096 http://www.medworm.com/index.php?rid=5210095&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00981.x We present the case of a patient who presented with renal failure requiring dialysis and also with a serum Na of 112 mEq/l. Using a dialysate Na concentration of 130 mEq/l and by limiting the blood flow to 50 ml/minute, we were able to raise her serum Na by only 2 mEq/l/hour during her hemodialysis treatment and thus control both the rate and total change in the patient’s serum Na. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5210095 Fri, 09 Sep 2011 04:00:00 +0100 5210095 http://www.medworm.com/index.php?rid=5212499&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21895770%26dopt%3DAbstract Authors: Kirksey L Abstract A thorough consideration of all factors contributing to successful dialysis access creation is necessary to achieve optimal outcomes. A high bifurcation of the brachial artery (brachioradial variant) occurs in greater than 20% of patients. Dialysis access was created in 22 limbs with this variant-15 fistula, and 7 prosthetic grafts. Nonmaturation occurred in 33% of fistula. Early thromboses occurred in 29% of prosthetic bridge grafts. In this experience, the brachioradial variant is associated with a relatively higher rate of fistula nonmaturation and prosthetic graft thromboses. These findings reinforce the critical role of preoperative imaging studies in dialysis access creation. A sound algorithm for the surgical management of the brachioradial variat... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5212499 Sun, 04 Sep 2011 04:00:00 +0100 5212499 http://www.medworm.com/index.php?rid=5212498&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21895771%26dopt%3DAbstract Authors: Dwyer A, Shelton P, Brier M, Aronoff G Abstract The Centers for Medicare and Medicaid Services set the prevalent arteriovenous fistula (AVF) rate of 66% as a national standard. To test the hypothesis that the use of a clinical vascular access coordinator could increase the rate of AVF in a large Nephrology group practice, we implemented an aggressive, multidisciplinary vascular access improvement program led by a trained vascular access coordinator (VAC). In early 2009, we established protocols, approved by all physicians, for the care of vascular access and implemented by a nurse VAC. We retrospectively reviewed Network vascular access data reports from January 2008 through December 2010. The data show that after the implementation of a comprehensive access program led by... Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5212498 Sun, 04 Sep 2011 04:00:00 +0100 5212498 http://www.medworm.com/index.php?rid=5197019&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00923.x AbstractA thorough consideration of all factors contributing to successful dialysis access creation is necessary to achieve optimal outcomes. A high bifurcation of the brachial artery (brachioradial variant) occurs in greater than 20% of patients. Dialysis access was created in 22 limbs with this variant—15 fistula, and 7 prosthetic grafts. Nonmaturation occurred in 33% of fistula. Early thromboses occurred in 29% of prosthetic bridge grafts. In this experience, the brachioradial variant is associated with a relatively higher rate of fistula nonmaturation and prosthetic graft thromboses. These findings reinforce the critical role of preoperative imaging studies in dialysis access creation. A sound algorithm for the surgical management of the brachioradial variation facilitates decision m... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5197019 Sat, 03 Sep 2011 23:00:00 +0100 5197019 http://www.medworm.com/index.php?rid=5477391&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.01003.x AbstractThis publication comments on the recently published findings of a study by Eloot et al. (cJASN, 6: 1266–1273, 2011) that evaluated the correlation between several formulae for calculating estimated GFR (eGFR) and different low molecular weight uremic toxins; eGFRs were based on serum creatinine (SCrea), cystatin C (Cys C), or a combination of both. Unexpectedly, the correlations for the different solutes were highly inconsistent, irrespective of the eGFR formula. On the other hand, the different eGFR formulae gave consistent results per solute. Correlation coefficients for some solutes were low (hippuric acid, p‐cresylsulfate, indole acetic acid, uric acid, asymmetric dimethylarginine) to nonsignificant (carboxy‐methyl‐propyl‐furanpropionic acid). These data point to the... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5477391 Thu, 01 Sep 2011 04:00:00 +0100 5477391 http://www.medworm.com/index.php?rid=5458842&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00996.x AbstractThe ovulatory menstrual cycle is known to be affected on multiple levels in women with advanced renal disease. Menstrual irregularities, sexual dysfunction, and infertility worsen in parallel with the renal disease. Pregnancy in women with ESRD on dialysis is therefore uncommon. Furthermore, when pregnancy does occur, it can prove hazardous to both mother and baby owing to a multitude of potential complications including accelerated hypertension and preeclampsia, poor fetal growth, anemia, and polyhydramnios. Data are emerging, however, to suggest that pregnancy while on intensified renal replacement regimens may result in better pregnancy outcomes, and emerging trends include the decreased rate of therapeutic abortions probably reflecting a change in counseling practices over time... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5458842 Thu, 01 Sep 2011 04:00:00 +0100 5458842 http://www.medworm.com/index.php?rid=5442124&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00998.x AbstractFavorable clinical outcomes related to morbidity, mortality, patient well‐being, laboratory biomarkers, and medication use have been reported with in‐center nocturnal hemodialysis (INHD); nevertheless, it is not entirely clear how much patient selection or physiologic mechanisms related to better fluid management and phosphorus (and calcium) metabolism may explain these outcomes. There are indications that INHD may be a preferred treatment option in specific cases, such as in patients with high interdialytic weight gain, poor tolerance to high ultrafiltration rate, hyperphosphatemia, or for those patients who work or go to school during the day. In the era of the new prospective payment system where quality standards become intertwined with reimbursement, an INHD program may be... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5442124 Thu, 01 Sep 2011 04:00:00 +0100 5442124 http://www.medworm.com/index.php?rid=5423130&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00994.x AbstractDespite many years of experience with hemodialysis, the outcomes of maintenance dialysis patients remain poor. The Frequent Hemodialysis Network‐Daily (FHN‐Daily) Trial found that six times per week in‐center short hemodialysis decreased left ventricular mass and improved self‐reported physical functioning over a 1‐year intervention period compared with conventional thrice‐weekly dialysis. Despite the promising results, caution is needed in the projection of these intermediate outcomes to hard clinical endpoints, such as cardiovascular events and death. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5423130 Thu, 01 Sep 2011 04:00:00 +0100 5423130 http://www.medworm.com/index.php?rid=5401343&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00965.x AbstractThe use of antibiotic lock solutions (ALSs) for the prevention of catheter‐related blood stream infections (CRBSIs) is a promising option. The efficacy and safety of linezolid as ALS were evaluated in a randomized double‐blind prospective study where 131 patients who required nontunneled catheter (NTC) for hemodialysis (HD) were randomized to receive an ALS with either (A) unfractionated heparin (2000 U/ml) alone as a catheter lock control, (B) vancomycin (5 mg/ml) + heparin (2000 U/ml), or (C) linezolid (2 mg/ml) + heparin (2000 U/ml). The primary endpoint of the study was CRBSI. A total of 152 NTCs were inserted in 131 patients. The linezolid‐locked group did not present any infective episode (CRBSI rate = 0/1000 catheter days) compared with 2 episodes... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5401343 Thu, 01 Sep 2011 04:00:00 +0100 5401343 http://www.medworm.com/index.php?rid=5324630&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00975.x AbstractAnemia treatment in hemodialysis‐dependent (HDD) CKD patients involves adequate supply of iron and an erythropoiesis‐stimulating agent (ESA). Despite widespread usage of these agents, there is no generally accepted “standard dosing algorithm” for treating anemia in HDD‐CKD patients. The new anemia Quality Incentive Program (QIP) introduced by the Centers for Medicare & Medicaid Services represents a motivation to standardize and harmonize iron and ESA regimens with interactive electronic algorithms and novel modes of deliveries for IV iron and ESA doses. In addition, quality assessment and performance improvement programs at dialysis facilities include achieving measurable improvement in health outcomes, healthcare cost, and reductions in medical errors. Thus, the Cor... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324630 Thu, 01 Sep 2011 04:00:00 +0100 5324630 http://www.medworm.com/index.php?rid=5324629&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00974.x AbstractPharmatech comprises systems for the automated use and coordination of clinical information, medical devices, care paths, and pharmacologic agents into specific prescription and care‐delivery processes tailored to meet individual patient needs. In ESRD, future suites of applications to run on hemodialysis, peritoneal dialysis machines, external computers and devices both in‐center and in the home setting offer the potential to further automate billing and inventory, improve documentation, reduce medical errors, and decrease costs. On a clinical basis, these systems will aid nurses, physician assistants, nurse practitioners, and physicians in performing and overseeing a wide range of clinical activities that constitute 21st‐century medicine. Future innovations may allow Pharma... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324629 Thu, 01 Sep 2011 04:00:00 +0100 5324629 http://www.medworm.com/index.php?rid=5324628&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00973.x AbstractNumerous reports in the general and the dialysis population have shown associations of sodium (Na+) intake, blood pressure, and survival. In addition to dietary Na+ intake, positive Na+ balance during dialysis needs to be considered as a source of Na+. Dialysate Na+ (DNa+) concentrations above the serum Na+ concentration (SNa+) result in diffusive Na+ flux from the dialysate into the patient, which has recently been reported to be associated with increased interdialytic weight gain and mortality. Individualization of the Na+ prescription and Na+ alignment (DNa+ equal to SNa+) prevents positive Na+ balance and improves patient outcomes. Alignment requires the knowledge of patients’ SNa+, which can be estimated from previous SNa+ in the monthly routine laboratory measurements. Na+ ... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324628 Thu, 01 Sep 2011 04:00:00 +0100 5324628 http://www.medworm.com/index.php?rid=5324627&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00972.x AbstractPatients with CKD face many consequences of renal failure, including disorders of bone and mineral metabolism. The current approach to management of these mineral metabolism issues lacks comprehensive quantitative assessment, so a kinetic modeling program has been designed to quantify intake and removal of phosphorus and calcium, as well as provide recommendations for treatment and prescriptions based on total mass balance and serum concentrations. This program is known as phosphorus kinetic modeling or PKM. The modeling program and associated graphical reports have been developed as a tool for clinicians in the management of mineral metabolism in CKD patients. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324627 Thu, 01 Sep 2011 04:00:00 +0100 5324627 http://www.medworm.com/index.php?rid=5324626&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00971.x AbstractThe collection of papers published in this issue of Seminars in Dialysis describes our approach to Pharmatech, which is the integration of services, medical devices, and pharmacologic agents, into specific prescription processes. Pharmatech is developed to systematically facilitate an individual's prescription according to each patient's specific needs. This includes evidence‐based algorithms for control, anemia management and isonatremic dialysis, devices to deliver precise doses of injectable drugs, and future developments to simplify loading new applications into the system. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324626 Thu, 01 Sep 2011 04:00:00 +0100 5324626 http://www.medworm.com/index.php?rid=5324625&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00989.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324625 Thu, 01 Sep 2011 04:00:00 +0100 5324625 http://www.medworm.com/index.php?rid=5324624&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00985.x AbstractThe development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political “turf” issues.” Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrolo... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324624 Thu, 01 Sep 2011 04:00:00 +0100 5324624 http://www.medworm.com/index.php?rid=5324623&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00963.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324623 Thu, 01 Sep 2011 04:00:00 +0100 5324623 http://www.medworm.com/index.php?rid=5324622&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00988.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324622 Thu, 01 Sep 2011 04:00:00 +0100 5324622 http://www.medworm.com/index.php?rid=5324621&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00984.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324621 Thu, 01 Sep 2011 04:00:00 +0100 5324621 http://www.medworm.com/index.php?rid=5324620&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00983.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324620 Thu, 01 Sep 2011 04:00:00 +0100 5324620 http://www.medworm.com/index.php?rid=5324619&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00968.x AbstractResidual renal function (RRF) is well recognized as an important marker of outcomes in peritoneal dialysis (PD), and contributes vitally to solute clearance. Recently, its importance in hemodialysis (HD) has emerged with evidence that it is strongly associated with improved outcomes. The presence of RRF is associated with improved nutrition, reduced erythropoetin requirements, better potassium clearance, and improved quality of life. Retrospective and observational evidence is now available, which suggests that the presence of RRF is independently associated with survival and that this benefit goes beyond what is expected simply from augmentation of small solute clearance. Preservation of RRF is now considered by many to be an important aspect of dialysis strategy. Evidence in favo... Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5324619 Thu, 01 Sep 2011 04:00:00 +0100 5324619 http://www.medworm.com/index.php?rid=5182920&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21883466%26dopt%3DAbstract In conclusion, our data support that the use of "no-wait lysis" approach for dialysis graft thrombectomy substantially reduces procedure time and radiation exposure, and it may serve as an efficient and economical alternative to other existing approaches. PMID: 21883466 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5182920 Sat, 27 Aug 2011 23:00:00 +0100 5182920 http://www.medworm.com/index.php?rid=5182919&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21883467%26dopt%3DAbstract Authors: Beathard GA PMID: 21883467 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5182919 Sat, 27 Aug 2011 23:00:00 +0100 5182919 http://www.medworm.com/index.php?rid=5182918&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21883468%26dopt%3DAbstract Authors: Inrig JK PMID: 21883468 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5182918 Sat, 27 Aug 2011 23:00:00 +0100 5182918 http://www.medworm.com/index.php?rid=5182917&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21883469%26dopt%3DAbstract Authors: Kallen AJ, Jernigan JA, Patel PR Abstract Staphylococcus aureus infections remain common in patients undergoing hemodialysis, and the consequences of these infections are potentially severe. Although a number of evidence-based practices have been shown to decrease the healthcare-associated infections that this organism can cause, many questions remain about the utility of decolonization as a mechanism to prevent these infections. This brief review describes the current epidemiology of S. aureus infections in patients undergoing hemodialysis and reviews the evidence surrounding decolonization as an infection prevention strategy. PMID: 21883469 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5182917 Sat, 27 Aug 2011 23:00:00 +0100 5182917 http://www.medworm.com/index.php?rid=5170931&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00922.x In conclusion, our data support that the use of “no‐wait lysis” approach for dialysis graft thrombectomy substantially reduces procedure time and radiation exposure, and it may serve as an efficient and economical alternative to other existing approaches. (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5170931 Sat, 27 Aug 2011 23:00:00 +0100 5170931 http://www.medworm.com/index.php?rid=5170930&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00957.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5170930 Sat, 27 Aug 2011 23:00:00 +0100 5170930 http://www.medworm.com/index.php?rid=5170929&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00958.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5170929 Sat, 27 Aug 2011 23:00:00 +0100 5170929 http://www.medworm.com/index.php?rid=5131302&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801224%26dopt%3DAbstract Authors: Dager WE PMID: 21801224 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131302 Sat, 30 Jul 2011 23:00:00 +0100 5131302 http://www.medworm.com/index.php?rid=5131301&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801225%26dopt%3DAbstract Authors: Gupta G, Choi MJ PMID: 21801225 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131301 Sat, 30 Jul 2011 23:00:00 +0100 5131301 http://www.medworm.com/index.php?rid=5131300&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801226%26dopt%3DAbstract Authors: Buller GK, Moskowitz CB PMID: 21801226 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131300 Sat, 30 Jul 2011 23:00:00 +0100 5131300 http://www.medworm.com/index.php?rid=5131299&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801227%26dopt%3DAbstract Authors: Foley RN PMID: 21801227 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131299 Sat, 30 Jul 2011 23:00:00 +0100 5131299 http://www.medworm.com/index.php?rid=5131298&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801228%26dopt%3DAbstract Authors: van der Weerd NC, Grooteman MP, Blankestijn PJ, van den Dorpel MA, Lars Penne E, Ter Wee PM, Nubé MJ PMID: 21801228 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131298 Sat, 30 Jul 2011 23:00:00 +0100 5131298 http://www.medworm.com/index.php?rid=5131297&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801229%26dopt%3DAbstract Authors: Daugirdas JT PMID: 21801229 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131297 Sat, 30 Jul 2011 23:00:00 +0100 5131297 http://www.medworm.com/index.php?rid=5131296&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801230%26dopt%3DAbstract Authors: Sprague SM PMID: 21801230 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131296 Sat, 30 Jul 2011 23:00:00 +0100 5131296 http://www.medworm.com/index.php?rid=5131295&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801231%26dopt%3DAbstract Authors: Blake PG PMID: 21801231 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131295 Sat, 30 Jul 2011 23:00:00 +0100 5131295 http://www.medworm.com/index.php?rid=5131294&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801232%26dopt%3DAbstract Authors: Canaud B, Granger-Vallée A PMID: 21801232 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131294 Sat, 30 Jul 2011 23:00:00 +0100 5131294 http://www.medworm.com/index.php?rid=5080778&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00928.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080778 Sat, 30 Jul 2011 23:00:00 +0100 5080778 http://www.medworm.com/index.php?rid=5080777&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00929.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080777 Sat, 30 Jul 2011 23:00:00 +0100 5080777 http://www.medworm.com/index.php?rid=5080776&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00930.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080776 Sat, 30 Jul 2011 23:00:00 +0100 5080776 http://www.medworm.com/index.php?rid=5080775&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00931.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080775 Sat, 30 Jul 2011 23:00:00 +0100 5080775 http://www.medworm.com/index.php?rid=5080774&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00932.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080774 Sat, 30 Jul 2011 23:00:00 +0100 5080774 http://www.medworm.com/index.php?rid=5080773&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00941.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080773 Sat, 30 Jul 2011 23:00:00 +0100 5080773 http://www.medworm.com/index.php?rid=5080772&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00942.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080772 Sat, 30 Jul 2011 23:00:00 +0100 5080772 http://www.medworm.com/index.php?rid=5080771&cid=s_29470_19_f&fid=29470&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1525-139X.2011.00946.x (Source: Seminars In Dialysis) Seminars In Dialysis journals http://www.medworm.com/rss/comments.php?id=5080771 Sat, 30 Jul 2011 23:00:00 +0100 5080771 http://www.medworm.com/index.php?rid=5131323&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801204%26dopt%3DAbstract Authors: Johnson DW PMID: 21801204 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131323 Thu, 28 Jul 2011 23:00:00 +0100 5131323 http://www.medworm.com/index.php?rid=5131322&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801205%26dopt%3DAbstract Authors: Allon M PMID: 21801205 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131322 Thu, 28 Jul 2011 23:00:00 +0100 5131322 http://www.medworm.com/index.php?rid=5131321&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801206%26dopt%3DAbstract Authors: Basile C, Lomonte C PMID: 21801206 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131321 Thu, 28 Jul 2011 23:00:00 +0100 5131321 http://www.medworm.com/index.php?rid=5131320&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801207%26dopt%3DAbstract Authors: Lerma EV PMID: 21801207 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131320 Thu, 28 Jul 2011 23:00:00 +0100 5131320 http://www.medworm.com/index.php?rid=5131319&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801208%26dopt%3DAbstract Authors: Jimenez PM, Douthat W, Orías M PMID: 21801208 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131319 Thu, 28 Jul 2011 23:00:00 +0100 5131319 http://www.medworm.com/index.php?rid=5131318&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801209%26dopt%3DAbstract Authors: Acharya V, Atta MG PMID: 21801209 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131318 Thu, 28 Jul 2011 23:00:00 +0100 5131318 http://www.medworm.com/index.php?rid=5131317&cid=s_29470_47_f&fid=36081&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21801210%26dopt%3DAbstract Authors: Holley JL PMID: 21801210 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis) Seminars in Dialysis journals http://www.medworm.com/rss/comments.php?id=5131317 Thu, 28 Jul 2011 23:00:00 +0100 5131317