Hemodialysis International最新文献

{"title":"Associations of vitamin D levels and clinical parameters with COVID-19 infection, severity and mortality in hemodialysis patients: A cohort study","authors":"Yanhua You,&nbsp;Chun Xu,&nbsp;Yuqing Hu,&nbsp;Meng Liang,&nbsp;Qi Sun","doi":"10.1111/hdi.13194","DOIUrl":"10.1111/hdi.13194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vitamin D deficiency is prevalent among patients undergoing hemodialysis. This study aimed to investigate the associations between vitamin D levels and clinical parameters with the risk of COVID-19 infection, severity, and mortality in hemodialysis patients with end-stage kidney disease (ESKD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 198 hemodialysis patients from a single center. Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL. Vitamin D deficiency and vitamin D supplements were combined to categorize patients into three groups: deficiency, uncertain deficiency, and likely sufficient. COVID-19 infection status, severity, and outcomes were recorded. Statistical analyses were performed to assess the associations between vitamin D levels and COVID-19 severity and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Among the 198 patients, 73 patients (37%) were in the deficiency group, 29 patients (15%) had uncertain deficiency, and 96 patients (48%) were likely sufficient. The overall COVID-19 infection rate was 59%. The deficiency group had a similar infection rate (60.3%) compared to those with likely sufficient levels (54.2%). However, the severity and mortality rates of vitamin D deficiency group had a significantly higher rate than those with likely sufficient levels. Multivariate logistic regression analysis showed that vitamin D deficiency and uncertain deficiency group were significantly associated with an increased risk of COVID-19 severity (OR = 22.57, <i>p</i> = 0.01 and OR = 15.8, <i>p</i> = 0.03, respectively). Uncertain deficiency group was significantly associated with an increased risk of COVID-19 mortality (OR = 12.93, <i>p</i> = 0.04), while the deficiency group should similarly trend but did not reach statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Vitamin D deficiency is associated with an increased risk of COVID-19 severity in hemodialysis patients with ESKD. These findings suggest that monitoring and managing vitamin D levels may be important in reducing the risk of COVID-19 severity in this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"63-73"},"PeriodicalIF":1.2,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for arteriovenous fistula maturation: A prospective study","authors":"Ana Luisa Correia,&nbsp;Ana Rita Silva,&nbsp;Filipe Mira,&nbsp;Rui Pinto,&nbsp;Emanuel Ferreira,&nbsp;Maria Guedes Marques,&nbsp;Catarina Romãozinho,&nbsp;Rui Alves","doi":"10.1111/hdi.13193","DOIUrl":"10.1111/hdi.13193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Arteriovenous fistula (AVF) maturation failure remains common despite preoperative ultrasound mapping. Identifying predictive biomarkers can help anticipate primary failure and reducing invasive procedures. Our study aimed to identify clinical and analytical risk factors for primary AVF failure or delay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective study (October 2022–March 2023) included adult patients scheduled for AVF creation. In all patients, a preoperative ultrasound mapping was conducted and AVF maturation assessed at least 6 weeks post-surgery. Clinical, analytical, and demographic data were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Eighty patients were included, 62.5% male, and mean age 66.3 years. For distal anastomosis, preoperative vein (3.8 ± 1.2 vs. 2.8 ± 0.6 mm; <i>p</i> 0.002) and supply artery (2.5 ± 0.4 vs. 2.0 ± 0.3 mm; <i>p</i> 0.001) diameters were significant factors impacting primary failure. Also, for proximal anastomosis, the artery diameter (2.4 ± 0.4 vs. 2.0 ± 0.4 mm; <i>p</i> 0.01) had an impact on AVF maturation. ROC curves established for distal AVF a vein diameter cutoff of 3.25 mm (AUC 77.2%) and artery cut-off of 2.35 mm (AUC 74.6%) and for proximal AVF an artery cutoff of 2.25 mm (AUC 76.5%). Distal AVF creation correlated with higher primary failure risk (<i>p</i> &lt; 0.001). No correlation was found between the primary failure rate and the presence of central venous catheter or serum results. In a sub analysis, we found that patients with central venous catheter had higher levels of inflammatory markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our study highlights the importance of preoperative evaluation, ultrasound mapping, and careful AVF site selection. Recognizing vein and artery diameter thresholds for optimal outcomes is crucial. Avoiding central venous catheters in suitable patients can positively impact AVF results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"24-30"},"PeriodicalIF":1.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of acute kidney injury due to recurrent rhabdomyolysis: Carnitine palmitoyltransferase 2 deficiency","authors":"Pervin Ozkan Kurtgoz,&nbsp;Suleyman Karakose,&nbsp;Ibrahim Guney","doi":"10.1111/hdi.13195","DOIUrl":"10.1111/hdi.13195","url":null,"abstract":"<p>The most common cause of rhabdomyolysis is trauma. In the presence of rhabdomyolysis attacks triggered by heavy exercise and fever, hereditary causes should be investigated. In our study, a case was presented that developed rhabdomyolysis and acute kidney injury due to carnitine palmitoyltransferase 2 (CPT2) deficiency and then required hemodialysis treatment. We wanted to draw attention to hereditary rhabdomyolysis in this case. A 25-year-old male patient was hospitalized with pneumonia and acute kidney injury. On examination, muscle enzymes, creatinine, and potassium levels were high. The patient, who was evaluated as having rhabdomyolysis and acute kidney injury, underwent three sessions of hemodialysis treatment due to the indication for renal replacement therapy. He had a history of rhabdomyolysis and acute kidney injury 5 years ago. The only trigger for both attacks was febrile infection. There was a history of acute kidney injury in two of his siblings in family history. In the gene analysis requested due to suspicion of hereditary causes, homozygous mutation was detected in CPT2 whole gene sequence analysis. Medium-chain triglycerides, low-fat diet, and L-carnitine capsules were given for treatment. Carnitine palmitoyltransferase 2 deficiency is the most common form of muscle fatty acid metabolism disorder. The phenotype of the patients can vary from severe infantile form to milder muscle form characterized by rhabdomyolysis. Cases requiring hemodialysis are very rare, so we wanted to present this case. Detection of hereditary rhabdomyolysis is important for preventing new attacks and preventive treatments.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"130-133"},"PeriodicalIF":1.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialysis Jeopardy!","authors":"Shreepriya Mangalgi,&nbsp;Madhukar Misra","doi":"10.1111/hdi.13192","DOIUrl":"10.1111/hdi.13192","url":null,"abstract":"<p>Dialysis Jeopardy! was a fun and innovative dialysis quiz for conference attendees at the Annual Dialysis Conference 2024 held in San Diego. The event saw active participation from nephrology fellows, faculty, and allied health care professionals. The event provided an excellent opportunity for nephrology fellows to interact with faculty in a nonformal setting.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"3-5"},"PeriodicalIF":1.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of death anxiety on diet-fluid restriction non-adherence in hemodialysis patients","authors":"Gülcan Bahçecioğlu Turan,&nbsp;Zülfünaz Özer,&nbsp;Seda Başak","doi":"10.1111/hdi.13191","DOIUrl":"10.1111/hdi.13191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The study was performed to examine the effects of death anxiety on diet-fluid restriction non-adherence in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive, cross-sectional, and correlational study was performed with 118 hemodialysis patients who received treatment in the dialysis unit of a university hospital and a state hospital in Elazığ, eastern Turkey. The study data were obtained with the “Descriptive Data Form”, “Death Anxiety Scale”, and “Dietary and Fluid Restriction Non-Adherence Scale”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The average Death Anxiety Scale total score of the patients was 10.00 ± 4.75. The “Duration of non-adherence with diet” mean score was 1.66 ± 1.70, “Degree of non-adherence with diet” mean score was 1.24 ± 1.19, “Duration of non-adherence with fluid restriction” mean score was 1.61 ± 1.71, and “Degree of non-adherence with fluid restriction” mean score was 1.16 ± 1.13. The independent variable Death Anxiety Scale significantly and negatively affected the dependent variable “Duration of non-adherence with diet”, “Degree of non-adherence with diet”, “Duration of non-adherence with fluid restriction”, and “Degree of non-adherence with fluid restriction”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Hemodialysis patients face serious death anxiety, their degree of non-adherence with diet-fluid restriction was low as death anxiety scores increased, and the degree of non-adherence with diet-fluid restriction decreased.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"108-115"},"PeriodicalIF":1.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of using a local skin cooling device on arteriovenous fistula cannulation pain and comfort level of patients on hemodialysis: A single-blind randomized controlled study","authors":"Hatice Demırağ,&nbsp;Nurşen Kulakaç","doi":"10.1111/hdi.13190","DOIUrl":"10.1111/hdi.13190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The study aimed to investigate the impact of the using local skin cooling on arteriovenous fistula cannulation pain and the comfort levels of hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The single-blind randomized controlled trial was formed with 50 patients between June 20, 2023, and July 31, 2023, in the hemodialysis units of two state hospitals in Turkey. Patients were randomly assigned to either the experimental group (<i>n</i> = 25) or the control group (<i>n</i> = 25) using the block randomization method. This data were collected through the use of the CoolSense device, the “Patient Information Form,” the “Verbal Category Scale,” and the “General Comfort Scale.” Patients in the experimental group received the local skin cooling for five seconds during arteriovenous fistula cannulation, while the control group followed the standard hospital protocol. The study was registered on Clinical Trials (NCT06144801).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The study revealed that the application of the local skin cooling during arteriovenous fistula cannulation significantly reduced pain and increased patients’ comfort levels, demonstrating an anesthetic effect (<i>p</i> &lt; 0.001). Furthermore, it was observed that as pain levels decreased, patient comfort levels increased (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>It is concluded that the using lokal skin cooling is an effective tool for reducing pain and enhancing comfort during arteriovenous fistula cannulation in hemodialysis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"47-55"},"PeriodicalIF":1.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prior central venous catheter placement and age are associated with earlier intervention after permanent hemodialysis access creation","authors":"Ramtin Talebi,&nbsp;Ramin Talebi,&nbsp;Joshua Chen,&nbsp;Angela Yang,&nbsp;Sanath Patil,&nbsp;Paul J. DiMuzio,&nbsp;Babak Abai,&nbsp;Dawn M. Salvatore,&nbsp;Michael J. Nooromid","doi":"10.1111/hdi.13180","DOIUrl":"10.1111/hdi.13180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Arteriovenous fistulas (AVFs) and grafts are essential for long-term hemodialysis access in patients with end-stage renal disease. However, complications and access failure often necessitate re-intervention. In this study, we aim to delineate the factors associated with earlier failure of permanent hemodialysis access warranting revision procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study aimed to identify factors associated with increased revision rates in AVFs and arteriovenous grafts, using multivariate survival analysis. A cohort of 136 patients who underwent initial arteriovenous access creation between 2005 and 2022 was analyzed. Patient characteristics, including age, comorbidities, access type, and vascular anatomy, were extracted, and hazard ratios (HR) were calculated to identify independent predictors of needing revision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 119 patients were included in the final cohort, with a mean age of 55.2 years. Over 40% of patients had a previous central venous catheter placement, while 15% had a previous AVF. The majority of procedures were performed on the left side (74%), and brachiocephalic fistulas were most commonly created (41%). Univariate and multivariate Cox regression revealed that age (adjusted HR = 1.02, <i>p</i> = 0.01) and prior central venous catheter placement (adjusted HR = 1.77, <i>p</i> = 0.01) were independent predictors of earlier revision, while other variables such as sex, hypertension, and diabetes did not show significant associations. Patients with prior central venous catheter placement had a 77% increased risk of revision, even when adjusted for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Understanding predictors of successful long-term access outcomes can guide decision-making regarding access type and alternative strategies. In our cohort, increased age and prior central venous catheter placement are associated with a shorter time to failure of permanent hemodialysis access and an increased risk of needing revision.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"17-23"},"PeriodicalIF":1.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between trace elements and cognitive function among hemodialysis patients in Turkey","authors":"Meric Oruc,&nbsp;Furkan Asan,&nbsp;Selda Mercan,&nbsp;Sennur Kose,&nbsp;Mehmet Murat Kirpinar,&nbsp;Burc Cagri Poyraz,&nbsp;Sinan Trabulus,&nbsp;Feray Karaali Savrun,&nbsp;Mehmet Riza Altiparmak","doi":"10.1111/hdi.13188","DOIUrl":"10.1111/hdi.13188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cognitive impairment is common among patients with hemodialysis. Hemodialysis patients have theoretical risks for both deficiency and accumulation of trace elements. We aimed to investigate the relationship between cognitive dysfunction and whole blood levels of trace elements in hemodialysis patients. We also aimed to examine the effect of baseline trace element status and cognitive dysfunction on mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Maintenance hemodialysis patients and age-and sex-matched controls were included. The whole blood levels of trace elements were measured by inductively coupled plasma mass spectrometry. Cognitive impairment was defined as a score of ≤24 points on the Montreal Cognitive Assessment test. Executive dysfunction was also defined as Trails A score of more than 75 s and Trails B score of more than 180 s.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Forty-two patients and 35 controls were included. Cognitive impairment was detected in 69% of the patients and 45.7% of the controls (<i>p</i> = 0.039). Cognitively impaired patients had lower education years (<i>p</i> = 0.003) and higher whole blood levels of manganese (Mn) and lead (Pb) (<i>p</i> = 0.026, <i>p</i> = 0.019, respectively) compared to patients without cognitive impairment. Mn levels were also found statistically higher in patients with executive dysfunction compared to patients without executive dysfunction (<i>p</i> = 0.005). Lower education years and higher Pb levels were independent risk factors for cognitive impairment in hemodialysis patients (odds ratio [OR] 0.589 [95% confidence interval, CI 0.400–0.866, <i>p</i> = 0.007] and OR 1.047 [95% CI 1.001–1.096, <i>p</i> = 0.047, respectively]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Cognitive impairment, especially impaired executive function, is common among patients with hemodialysis patients. Cognitive impairment is not found to be associated in cross-sectional analysis with several modifiable end-stage renal disease- and dialysis-associated factors. The accumulation of trace elements especially Mn and Pb might exacerbate the cognitive dysfunction in hemodialysis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"93-107"},"PeriodicalIF":1.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing use of an electronic medical record system for quality improvement initiatives in hemodialysis: Review of a single center experience","authors":"Noémie Laurier,&nbsp;Jorane-Tiana Robert,&nbsp;Alexander Tom,&nbsp;Jerrica McKinnon,&nbsp;Nancy Filteau,&nbsp;Laura Horowitz,&nbsp;Murray Vasilevsky,&nbsp;Catherine Weber,&nbsp;Tiina Podymow,&nbsp;Andrey V. Cybulsky,&nbsp;Rita S. Suri,&nbsp;Emilie Trinh","doi":"10.1111/hdi.13178","DOIUrl":"10.1111/hdi.13178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The complexity of managing patients with end-stage kidney disease on hemodialysis underscores the importance of implementing quality improvement (QI) initiatives to enhance patient safety and prioritize patient-centered care. To address this, we established a QI committee at our tertiary academic center focusing on evidence-based practices, patient-centered approaches, and cost efficiency. To facilitate the seamless implementation of QI initiatives, we leveraged the capabilities of our electronic medical record (EMR) system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review details effective strategies for optimizing use of an EMR system to successfully implement QI efforts. Drawing from our experience, we provide detailed descriptions and practical insights that can be applied to other EMRs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The creation of a secure and accessible dashboard, offering real-time data on quality metrics, stands out as the most notable feature. This dashboard operates through an algorithm that merges data from both our dialysis and hospital EMR systems. Its primary objectives are to streamline the identification of high-priority patients, enhance team communication, and facilitate tracking of quality indicators. Additionally, we integrated clinical pathways, checklists, and standardized protocols into the renal EMR to ensure smooth implementation of QI interventions. Notable examples of these interventions include an incremental hemodialysis protocol, a new hemodialysis start checklist, vaccination care plans, and personalized kidney transplant workups. Programmed electronic automatic reminders have proven invaluable in ensuring timely follow-ups of assigned tasks. The EMR has also contributed to medication optimization and deprescribing by generating patient lists based on specific medication classes. Finally, the EMR's capability to swiftly generate lists of patients with specific features has significantly facilitated targeted QI interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Leveraging the capabilities of an EMR system can be crucial for enhancing care of hemodialysis patients and implementing effective QI initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"74-82"},"PeriodicalIF":1.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of sucroferric oxyhydroxide versus sevelamer carbonate: A systematic review and meta-analysis","authors":"Christos Georgopoulos,&nbsp;Anila Duni,&nbsp;Eleni Stamellou,&nbsp;Athanasios Kitsos,&nbsp;Charikleia Gouva,&nbsp;Evangelia Dounousi","doi":"10.1111/hdi.13187","DOIUrl":"10.1111/hdi.13187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Phosphate binders are commonly used in patients receiving kidney replacement therapy (KRT), aiming to reduce and maintain serum phosphorus. Chronic kidney disease-mineral and bone disorder has been linked to reduced lifespan and worsened quality of life. This study aims to examine the efficacy and safety of sucroferric oxyhydroxide versus sevelamer carbonate in patients receiving KRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data sources examined were MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Clinical Trials with a search deadline of October 2023. We examined randomized controlled trials that compared sucroferric oxyhydroxide versus sevelamer carbonate in the adult population receiving KRT. We performed a meta-analysis combining the data from trials, using R-studio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Inclusion criteria were met by five randomized trials. There was no statistically significant difference in the reduction of serum phosphorus between the two groups (MD: −0.07 mmol/L, 95% CI-random effects: −0.15 to 0.02). In the same line, a non-statistically significant difference was observed in serum i-PTH reduction between the two drugs (MD = −1.53 mg/dL, 95% CI = (−4.45, 1.4), <i>p</i> = 0.26, random effects model). No statistically significant difference was observed in all adverse events between the two groups (odds ratio: 1.11, 95% CI: 0.65–1.88, random effects model). Further analysis of gastrointestinal adverse events revealed that sevelamer carbonate increases gastrointestinal adverse events by up to 60% (odds ratio: 1.60, 95% CI: 1.31–1.97, common (fixed) effect model).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This meta-analysis of randomized trials showed that both drugs, sucroferric oxyhydroxide and sevelamer equally and effectively controlled serum phosphorus levels, whereas sucroferric oxyhydroxide revealed a better profile in terms of gastrointestinal adverse events. Sucroferric oxyhydroxide is a valuable option for patients receiving KRT when sevelamer carbonate is more difficult to tolerate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"6-16"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}