5,070 results match your criteria dialysis initiation

Multicenter European Real-World Utilization of VasQ™ Anastomotic External Support Device for Arteriovenous Fistulae.

J Vasc Surg 2021 Jul 24. Epub 2021 Jul 24.

Department of Angiology and Vascular Surgery, Clinica Sagrada Familia, Barcelona, Spain.

Objectives: To evaluate the outcomes of arteriovenous fistulae (AVF), created with VasQ™ external support device under standard clinical practice across three vascular access clinics.

Methods: This was a multi-national, retrospective study to evaluate prospectively collected clinical outcomes of both forearm and upper-arm brachiocephalic AVF (BCAVF) created using the VasQ™ device. 51 AVF patients were pooled from three different vascular access centers in Germany, Italy and Spain. Read More

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Early Palliative Care Consultation in the Burn Unit: A Quality Improvement Initiative to Increase Utilization.

J Burn Care Res 2021 Jul 24. Epub 2021 Jul 24.

Department of Surgery, University of Colorado School of Medicine.

Despite significant morbidity and mortality for major burns, palliative care consultation (PCC) is underutilized in this population. The purpose of this study is to examine the impact of a protocol using recommended "triggers" for PCC at a single academic burn center. This is a retrospective review of patient deaths over a four-year period. Read More

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Trends in home dialysis use differ among age categories in past two decades: a Dutch registry study.

Eur J Clin Invest 2021 Jul 22:e13656. Epub 2021 Jul 22.

Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam, Research institute Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Background: Although the number of patients with end stage kidney disease is growing, the number of patients that perform dialysis at home has decreased during the past two decades. The aim of this study is to explore time trends in the use of home dialysis in the Netherlands.

Methods: Dialysis episodes of patients who started dialysis treatment were studied using Dutch registry data (RENINE). Read More

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Association of Dyskalemias with Ischemic Stroke in Advanced Chronic Kidney Disease Patients Transitioning to Dialysis.

Am J Nephrol 2021 Jul 21:1-9. Epub 2021 Jul 21.

Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Introduction: Hypo- and hyperkalemia are associated with a higher risk of ischemic stroke. However, this association has not been examined in an advanced chronic kidney disease (CKD) population.

Methods: From among 102,477 US veterans transitioning to dialysis between 2007 and 2015, 21,357 patients with 2 pre-dialysis outpatient estimated glomerular filtration rates <30 mL/min/1. Read More

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Association between conscientiousness and peritoneal dialysis-related peritonitis.

Nephrology (Carlton) 2021 Jul 21. Epub 2021 Jul 21.

Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Nagano,, Japan.

Aim: Peritonitis is a critical complication in patients undergoing peritoneal dialysis. Patient characteristics, especially conscientiousness, potentially influence self-care activity. This study aimed to examine the relationship between the risk of peritonitis and conscientiousness of the patient. Read More

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Mortality After Home Hemodialysis Treatment Failure and Return to In-Center Hemodialysis.

Am J Kidney Dis 2021 Jul 15. Epub 2021 Jul 15.

ANZDATA Registry, SA Health and Medical Research Institute, Adelaide, SA; Adelaide Medical School, University of Adelaide, Adelaide, SA.

Rationale Objective: Patients on home hemodialysis (HHD) may eventually return to in-center hemodialysis (ICHD) for clinical, technical or psycho-social reasons. We studied the mortality of patients returning to ICHD after HHD comparing it to the mortality experience among patients receiving HHD and patients receiving ICHD without prior treatment with HHD.

Study Design: Retrospective cohort study. Read More

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Etelcalcetide Utilization, Dosing Titration, and Chronic Kidney Disease-Mineral and Bone Disease (CKD-MBD) Marker Responses in US Hemodialysis Patients.

Am J Kidney Dis 2021 Jul 14. Epub 2021 Jul 14.

Arbor Research Collaborative for Health, Ann Arbor, MI, USA.

Rationale And Objective: Clinical trial data have demonstrated the efficacy of etelcalcetide for reducing parathyroid hormone (PTH) levels in hemodialysis (HD) patients. We provide a real-world summary of etelcalcetide utilization, dosing, effectiveness, and discontinuation since its US introduction in April 2017.

Study Design: New-user design within prospective cohort. Read More

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Associations of Community Water Lead Concentrations with Hemoglobin Concentrations and Erythropoietin-Stimulating Agent Use among Patients with Advanced CKD.

J Am Soc Nephrol 2021 Jul 15. Epub 2021 Jul 15.

Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota.

Background: Although patients with kidney disease may be particularly susceptible to the adverse health effects associated with lead exposure, whether levels of lead found commonly in drinking water are associated with adverse outcomes in patients with ESKD is not known.

Methods: To investigate associations of lead in community water systems with hemoglobin concentrations and erythropoietin stimulating agent (ESA) use among incident patients with ESKD, we merged data from the Environmental Protection Agency (EPA) Safe Drinking Water Information System (documenting average 90 percentile lead concentrations in community water systems during 5 years before dialysis initiation, according to city of residence) with patient-level data from the United States Renal Data System.

Results: Among 597,968 patients initiating dialysis in the United States in 2005 through 2017, those in cities with detectable lead levels in community water had significantly lower pre-ESKD hemoglobin concentrations and more ESA use per 0. Read More

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Evaluation of Statin Use and Prescribing in Patients with Chronic Kidney Disease Not Receiving Treatment with Kidney Transplant or Dialysis.

Can J Hosp Pharm 2021 1;74(3):219-226. Epub 2021 Jul 1.

, MD, SM, FRCPC, is with Vancouver General Hospital, Vancouver, British Columbia.

Background: Chronic kidney disease (CKD) is a risk factor for cardiovascular disease. The Kidney Disease Improving Global Outcomes 2013 guidelines and the Canadian Cardiovascular Society 2016 guidelines recommend statins for primary prevention of cardiovascular disease in CKD patients aged 50 years or older who are not receiving treatment with kidney transplant or dialysis.

Objectives: To evaluate statin use for patients in the Vancouver General Hospital Kidney Care Clinic (VGH KCC) and to gain insight into the KCC nephrologists' practices and perspectives regarding the prescribing of statins for patients with CKD. Read More

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Association of blood pressure after peritoneal dialysis initiation with the decline rate of residual kidney function in newly-initiated peritoneal dialysis patients.

PLoS One 2021 8;16(7):e0254169. Epub 2021 Jul 8.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background: Lower blood pressure (BP) levels are linked to a slower decline of kidney function in patients with chronic kidney disease (CKD) without kidney replacement therapy. However, there are limited data on this relation in peritoneal dialysis (PD) patients. Here we evaluated the association of BP levels with the decline of residual kidney function (RKF) in a retrospective cohort study. Read More

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Efficacy and safety of furosemide for prevention of intradialytic hypotension in haemodialysis patients: protocol for a multicentre randomised controlled trial.

BMJ Open 2021 Jul 5;11(7):e048015. Epub 2021 Jul 5.

Department of Nephrology, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.

Introduction: Intradialytic hypotension (IDH) is a frequent and serious complication of maintaining haemodialysis (HD) patients and associated with subsequent cardiovascular events and higher mortality. Furosemide is commonly used in non-dialysis chronic kidney disease patients and can effectively manage the volume and blood pressure. However, these agents are often discontinued on initiation of dialysis. Read More

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Factors affecting pre-end-stage kidney disease haemoglobin control and outcomes following dialysis initiation: a nationwide study.

Clin Kidney J 2021 Jul 5;14(7):1780-1788. Epub 2021 Feb 5.

Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.

Background: Attaining the narrow haemoglobin (Hb) range recommended by European Renal Best Practice Guidelines renal anaemia guidelines may be difficult, and whether this leads to better outcomes following dialysis initiation is not known.

Methods: This was an observational study from the Swedish Renal Registry 2012-16, including all patients with non-dialysis-dependent chronic kidney disease (CKD) initiating renal anaemia treatment. We evaluated factors associated with off-target Hb attainment (<10 and >12 g/dL). Read More

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Predialysis predictors for identifying patients requiring dialysis at a higher glomerular filtration rate.

Ren Fail 2021 Dec;43(1):1087-1093

Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Current evidence suggests that the initiation of maintenance hemodialysis should not be based on a specific glomerular filtration rate (GFR) but on symptoms or signs attributable to kidney disease. However, it is difficult to predict the time point at which overt uremic syndrome develops in individuals. The estimated GFR is poorly correlated with occurrence of uremic symptoms, and some patients require dialysis at a higher eGFR than others. Read More

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December 2021

Association between tubulointerstitial CD8+T cells and renal prognosis in lupus nephritis.

Int Immunopharmacol 2021 Jul 1;99:107877. Epub 2021 Jul 1.

National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address:

Objective: Inflammatory cell infiltration is a pathological change commonly seen in renal biopsies from patients with lupus nephritis(LN), but its clinicalcorrelationwith clinical parameters and prognosis is unclear.

Methods: Included in this retrospective study were 197 patients with ISN/ RPS Class III-V LN, in whom renal biopsy was performed to analyze the histological pattern. Tubulointerstitial infiltrates were quantitated by standard histochemical staining. Read More

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Mean corpuscular hemoglobin concentration: an anemia parameter predicting cardiovascular disease in incident dialysis patients.

J Nephrol 2021 Jul 2. Epub 2021 Jul 2.

Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Background: Hemoglobin levels usually decline before dialysis initiation. The influence of overhydration on anemia progression and iron sequestration is poorly documented. Furthermore, clinical implications of anemia at dialysis initiation remain to be elucidated. Read More

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Effect of social deprivation on peritoneal dialysis uptake: A mediation analysis with the data of the REIN registry.

Perit Dial Int 2021 Jul 1:8968608211023268. Epub 2021 Jul 1.

Centre Universitaire des Maladies Rénales, CHU de Caen Avenue Côte de Nacre, Caen, France.

Background: Social deprivation could act as a barrier to peritoneal dialysis (PD). The objective of this study was to assess the association between social deprivation estimated by the European deprivation index (EDI) and PD uptake and to explore the potential mediators of this association.

Methods: From the Renal Epidemiology and Information Network registry, patients who started dialysis in 2017 were included. Read More

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Continuous Renal Replacement Therapy in Critically Ill Children in the Pediatric Intensive Care Unit: A Retrospective Analysis of Real-Life Prescriptions, Complications, and Outcomes.

Front Pediatr 2021 14;9:696798. Epub 2021 Jun 14.

Section of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Florence, Italy.

Severe acute kidney injury is a common finding in the Pediatric Intensive Care Unit (PICU), however, Continuous Renal Replacement Therapy (CRRT) is rarely applied in this setting. This study aims to describe our experience in the rate of application of CRRT, patients' clinical characteristics at admission and CRRT initiation, CRRT prescription, predictors of circuit clotting, short- and long-term outcomes. A 6-year single center retrospective study in a tertiary PICU. Read More

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Perspective: Plant-based Whole-Grain Foods for Chronic Kidney Disease: The Phytate-Phosphorus Conundrum.

Adv Nutr 2021 Jun 30. Epub 2021 Jun 30.

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Restriction of dietary phosphorus intake is an important component of good clinical practice in kidney failure patients, particularly after dialysis initiation. Greater consumption of predominantly plant-based diets, including phytate-rich foods, is increasingly recommended for health maintenance/disease prevention in this population, with the implicit assumption that phytate-phosphorus in whole-grain cereals, legumes, pulses, and nuts is poorly absorbed. Review of human interventions with diets high in phytate-phosphorus indeed suggests an absorption of at least 50%, still less than animal protein-bound phosphorus, but higher than the generally believed 10-30%. Read More

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Factors Associated With Hospital Readmissions Among U.S. Dialysis Facilities.

J Healthc Qual 2021 Jun 29. Epub 2021 Jun 29.

Introduction: The Centers for Medicare and Medicaid uses the standardized readmission ratio (SRR) to evaluate 30-day readmissions among dialysis providers in the U.S. Readmissions among dialysis recipients remains 37%. Read More

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[Present practise patterns of renal replacement therapy in German intensive care medicine].

Med Klin Intensivmed Notfmed 2021 Jun 30. Epub 2021 Jun 30.

Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.

About 50% of all critically ill patients develop acute kidney injury (AKI) and approximately 15% receive renal replacement therapy (RRT). Although RRT is frequently used in intensive care units in Germany, it is currently unknown which RRT procedures are available, which qualification the involved staff has, which anticoagulation strategies are used and how RRT doses are prescribed. To investigate quality and structural characteristics of the performance of RRT in intensive care units throughout Germany, the German Interdisciplinary Society of Intensivists (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin [DIVI]) performed an inquiry among their members. Read More

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Decision-making around Commencing Dialysis.

Indian J Palliat Care 2021 May 30;27(Suppl 1):S6-S10. Epub 2021 May 30.

Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.

The decision regarding dialysis initiation is complex. Awareness that renal replacement therapy should not be regarded as default therapy for every patient with advanced renal failure is necessary. Decision to initiate dialysis and modality should be individualized in a shared decision-making process involving the treating nephrologist and the patient. Read More

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Different kidney function trajectory patterns before dialysis in elderly patients: clinical implications and outcomes.

Ren Fail 2021 Dec;43(1):1049-1059

Nephrology Department, Centro Hospitalar Universitário do Porto (CHUP), Porto, Portugal.

. Identifying trajectories of kidney disease progression in chronic kidney disease (CKD) patients may help to deliver better care. We aimed to identify and characterize trajectories of renal function decline in CKD patients and to investigate their association with mortality after dialysis. Read More

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December 2021

Frailty Severity and Hospitalization After Dialysis Initiation.

Can J Kidney Health Dis 2021 10;8:20543581211023330. Epub 2021 Jun 10.

Department of Medicine, Dalhousie University, Halifax, NS, Canada.

Background: Frailty is associated with hospitalization and mortality among dialysis patients. To now, few studies have considered the degree of frailty as a predictor of hospitalization.

Objective: We evaluated whether was associated with hospitalization after dialysis initiation. Read More

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Lithium therapy in patients on dialysis: A systematic review.

Int J Psychiatry Med 2021 Jun 26:912174211028544. Epub 2021 Jun 26.

Comprehensive Pharmacy Services, Department of Pharmacy, 474265Comprehensive Pharmacy Services, Central State Hospital, Louisville, KY, USA.

Background: Lithium is a first-line pharmacotherapy for the treatment of bipolar disorder, but long-term use is associated with nephrotoxicity. However, as dialysis effectively eliminates lithium, it remains a pharmacotherapeutic option for patients on dialysis. This systematic review seeks to evaluate the dosing, safety, efficacy, and monitoring of lithium in patients receiving dialysis. Read More

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Temporal changes and risk factors of death from early withdrawal within 12 months of dialysis initiation - a cohort study.

Nephrol Dial Transplant 2021 Jun 27. Epub 2021 Jun 27.

Medical School, University of Western Australia, Perth, Australia.

Background: Mortality risk is high soon after dialysis initiation in patients with kidney failure, and dialysis withdrawal is a major cause of early mortality, attributed to psychosocial or medical reasons. The temporal trends and risk factors associated with cause-specific early dialysis withdrawal within 12 months of dialysis initiation remain uncertain.

Methods: Using data from the Australian and New Zealand Dialysis and Transplant Registry, we examined the temporal trends and risk factors associated with mortality attributed to early psychosocial and medical withdrawals in incident adult dialysis patients in Australia between 2005 and 2018 using adjusted competing risk analyses. Read More

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Surgical management of pleuro-peritoneal fistula in chronic renal failure patient-safety and effectiveness.

J Thorac Dis 2021 May;13(5):2979-2985

Department of Cardiothoracic Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong, China.

Background: Pleuro-peritoneal fistula (PPF) is a known complication arising in patients receiving continuous ambulatory peritoneal dialysis (CAPD) as a form of renal replacement therapy with an incidence of approximately 2% (1). Previous literature has shown that the recurrence rate of non-operative management of PPF to be ~45%. Video-assisted thoracoscopic surgery (VATS) has been shown to be an effective and safe means of treating patients with PPF. Read More

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Prolonged exposure to continuous renal replacement therapy in patients with acute kidney injury.

J Nephrol 2021 Jun 23. Epub 2021 Jun 23.

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Background: Little is known about the process of deciding to discontinue continuous renal replacement therapy (CRRT) in patients with acute kidney injury (AKI) and the impact of CRRT duration on outcomes.

Methods: We report the clinical parameters of prolonged CRRT exposure and predictors of doubling of serum creatinine or need for dialysis at 90 days after CRRT with propensity score matching, including covariates that were likely to influence patients in the prolonged CRRT group.

Results: Among 104 survey responders, most use urine output (87%) to guide CRRT discontinuation, 24% use improvement in clinical or hemodynamic status. Read More

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The WISHED Randomized Controlled Trial: Impact of an Interactive Health Communication Application on Home Dialysis Use in People With Chronic Kidney Disease.

Can J Kidney Health Dis 2021 4;8:20543581211019631. Epub 2021 Jun 4.

Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.

Background: While home dialysis therapies are more cost effective and may offer improved health-related quality of life, uptake compared to in-center hemodialysis remains low.

Objective: To test whether a web-based interactive health communication application (IHCA) compared to usual care would increase home dialysis use.

Design: Randomized control trial. Read More

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How important is dietary management in chronic kidney disease progression? A role for low protein diets.

Korean J Intern Med 2021 07 22;36(4):795-806. Epub 2021 Jun 22.

Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA, USA.

High dietary protein intake may lead to increased intraglomerular pressure and glomerular hyperfiltration, which in the long-term can lead to de novo or aggravating preexisting chronic kidney disease (CKD). Hence, a low protein diet (LPD, 0.6 to 0. Read More

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Risks associated with continuation of potentially inappropriate antihypertensive medications in older adults receiving hemodialysis.

BMC Nephrol 2021 Jun 19;22(1):232. Epub 2021 Jun 19.

Departments of Medicine and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.

Background And Objectives: After dialysis initiation, older adults may experience orthostatic or post-dialysis hypotension. Some orthostasis-causing antihypertensives (i.e. Read More

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