Hemodialysis International最新文献

{"title":"Variations in Serum Albumin Levels Over Time in Patients Treated With Conventional Hemodialysis or Expanded Hemodialysis: A Cohort Study","authors":"Juan C. Castillo,&nbsp;Jasmin Vesga,&nbsp;Angela Rivera,&nbsp;Peter Rutherford,&nbsp;Ricardo Sanchez,&nbsp;Henry Oliveros,&nbsp;Bengt Lindholm,&nbsp;Mauricio Sanabria,&nbsp;the Colombian Registry of Expanded Hemodialysis Investigators","doi":"10.1111/hdi.13232","DOIUrl":"10.1111/hdi.13232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hypoalbuminemia is a well-established risk factor for mortality in chronic hemodialysis (HD) patients. To evaluate the association of time-varying serum albumin with the type of dialyzer, we analyzed serum albumin over time in two cohorts of HD patients, one receiving HDx therapy enabled by the Theranova dialyzer and the other conventional HD with high-flux dialyzer (HF-HD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cohort study, 1092 prevalent adult HD patients (mean age 61 years; 62% men; 42% had diabetes; 19% had cardiovascular disease) at Renal Care Services Colombia undergoing either HDx therapy enabled by Theranova dialyzer (<i>n</i> = 559) or HF-HD (<i>n</i> = 533) were enrolled between September 1, 2017, and November 30, 2017, and then underwent repeated measurements of serum albumin for up to 48 months. Sociodemographic and clinical, and laboratory characteristics at baseline were recorded, and a repeated-measures analysis of variance (ANOVA) was conducted to examine differences in means of serum albumin at different time points. To evaluate the association between dialysis membrane and albumin levels during the follow-up, a linear panel regression analysis was performed, allowing control for imbalances in the cohorts of baseline clinical and demographic variables, as well as the time-dependent variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean albumin concentration remained above 3.8 g/dL and did not differ over time between HDx and HF-HD (<i>p</i> = 0.789). No association (<i>p</i> = 0.208) between serum albumin levels varying over time and the use of the Theranova dialyzer was found in the linear panel regression model. However, serum albumin was linked to both inflammatory and nutritional markers, including C-reactive protein, ratio of platelets to lymphocytes, and protein-energy wasting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Variations in serum albumin levels over time were associated with protein-energy wasting, inflammation, high age, vascular access, and hospitalizations, but not with the type of dialyzer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"327-334"},"PeriodicalIF":1.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065384","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":"Evaluation of Long-Term Effects of Parathyroidectomy in Patients With Refractory Secondary Hyperparathyroidism","authors":"Liu Yang,&nbsp;Nian-rong Zhang,&nbsp;Hai-feng Wang,&nbsp;Jing-ning Chen,&nbsp;Meng Yang,&nbsp;Xiao-liang Sun,&nbsp;Yong Lv,&nbsp;Yao Lu,&nbsp;Wan-ning Jia,&nbsp;Wen-wen He,&nbsp;Ling Zhang","doi":"10.1111/hdi.13222","DOIUrl":"10.1111/hdi.13222","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Parathyroidectomy is an effective intervention for patients with end-stage renal disease and refractory secondary hyperparathyroidism. This study aimed to assess the long-term clinical outcomes and overall quality of life of patients following parathyroidectomy in real-world clinical practice.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study included 103 patients with refractory secondary hyperparathyroidism treated with parathyroidectomy in a real-world setting (51 males, age 58 ± 10 years). Intact parathyroid hormone (iPTH), serum calcium, and serum phosphorus indices were compared preoperatively and at 6 months, 12 months, and 1 year postoperatively. The proportion of patients with a &gt; 30% decrease in iPTH was evaluated to assess the long-term treatment effect of parathyroidectomy. The EQ-5D-5L scale was utilized to evaluate the long-term postoperative quality of life.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fifty percent of the patients included in the study had a follow-up time of more than 19 months (19.0 [12.0, 24.0]). The median pretreatment iPTH level was 1796.2 (905.5, 2909.8) pg/mL, with 43.7% of patients exceeding 2000 pg/mL and 19.4% exceeding 3000 pg/mL; 19 (18%) patients had an iPTH level of ≤ 800 pg/mL. The preoperative mean serum calcium level was 2.54 (0.22), 95% CI (2.44, 2.68), and the mean serum phosphorus level was 2.09 (0.48), 95% CI (1.81, 2.19). Approximately 50% of patients underwent total parathyroidectomy. The iPTH levels decreased significantly after surgery (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). At 6 months postoperatively, 96.7% of the patients had a decrease in iPTH of more than 30% compared to the preoperative levels, and this percentage was 94.9% at 12 months postoperatively. Mean serum calcium and phosphorus levels decreased significantly after surgery (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). More than 60% of patients achieved target serum calcium levels, and more than 40% achieved target serum phosphorus levels at 6 months postoperatively, demonstrating a statistically significant increase compared to preoperative levels (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). No significant difference in surgical outcomes was observed between the groups with preoperative iPTH levels &gt; 800 and &lt; 800 pg/mL. The utilization of secondary hyperparathyroidism-related medications decreased following surgical intervention. The median health utility value, as measured using the EQ-5D-5L scale, was 0.897 (0.739, 1.0), with a median VAS score of 80 (60, 90).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In clinical practice, parathyroidectomy demonstrates efficacy in reducing iPTH levels and facilitating the ","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"354-362"},"PeriodicalIF":1.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782360","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":"Attitude of Healthcare Professionals and Patients With End-Stage Kidney Disease Towards Home Hemodialysis: A Survey in China","authors":"Junqing Liang,&nbsp;Ying Wang,&nbsp;Hongjie Yang,&nbsp;Yongju Jin,&nbsp;Li Zuo","doi":"10.1111/hdi.13197","DOIUrl":"10.1111/hdi.13197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Home hemodialysis is still in its early stages in mainland China. This survey aimed to assess the perceptions of healthcare professionals and patients towards home hemodialysis and to identify the barriers hindering its uptake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional observational survey was conducted using convenience sampling. Healthcare professionals specializing in nephrology and patients with end-stage kidney disease (ESKD) across mainland China were included. A self-reported questionnaire was administered to gather data on participants' demographics, attitudes, perceived barriers, and facilitating factors related to home hemodialysis. Chi-square tests were used to analyze the association between categorical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A significant majority (80.1%) of healthcare professionals recognized the need for home hemodialysis. However, there was a statistically significant difference in willingness to undertake or receive home hemodialysis between healthcare professionals (53.6%) and patients (63.2%), respectively. Healthcare professionals identified the following as top facilitating factors: patients' needs (6.9 points), higher patient benefits (5.7 points), and shortage of dialysis resources (5.1 points). The primary barriers cited were the absence of relevant policies and regulations (7.5 points), lack of guidelines and management standards (7.0 points), and inadequate treatment technology and knowledge (6.6 points). Patients' willingness to accept home hemodialysis was primarily driven by the potential to save time and travel expenses (70.7%) and reduce infection risk (49.0%). The main barriers identified by patients were the inability to manage acute complications (77.8%), increased risk of vascular access infection (66.1%), and uncertainty about self-cannulation (60.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a clear demand for home hemodialysis in China among both healthcare professionals and patients with ESKD. However, the lack of a supportive system, including policies, standards, and management frameworks, remains a significant obstacle to its widespread adoption.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"284-293"},"PeriodicalIF":1.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756543","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":"Cerebrovascular Reactivity and Cerebral Ischemia During Chronic Hemodialysis","authors":"Dawn F. Wolfgram,&nbsp;Isabelle Grassl,&nbsp;Claire Seigworth,&nbsp;Michael E. Widlansky,&nbsp;Yan Gao","doi":"10.1111/hdi.13233","DOIUrl":"10.1111/hdi.13233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cerebral hypo-perfusion during hemodialysis (HD) may contribute to cerebral ischemic lesions and atrophy in HD patients. Vascular disease and stiffness can impair cerebrovascular reactivity (CVR) in HD patients, placing them at higher risk for cerebral hypo-perfusion during the hemodynamic stress of HD. We evaluated the relationship between CVR and change in cerebral perfusion during HD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a cohort of in-center HD patients, we used hypercapnia to induce a change in cerebral blood flow velocity measured with transcranial Doppler to assess CVR. We used continuous cerebral oximetry during HD to measure a change in cerebral oxygen saturation (ScO₂), calculating overall decline and the largest drop as markers of cerebral perfusion. We used multiple linear regression to assess the relationship between CVR and the ScO₂-associated endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We measured CVR in 42 HD patients and of those, 41 had the ScO₂ measurements completed. The mean age was 58.5 (11.0) years, and most were male (90.5%, <i>N</i> = 38) with diabetes (59.5%, <i>N</i> = 25) and hypertension (87.5%, <i>N</i> = 36). The average CVR was 2.7 (1.6)%/mmHg. The average overall decline in ScO₂ during HD was 2.2 (2.5)% and the average largest drop in ScO₂ was 5.9 (2.8)%. CVR was negatively associated with both the largest drop in ScO₂ (<i>β</i> = −0.67 95% CI [−1.20, −0.15], <i>p</i> = 0.01) and the overall decline in ScO₂ (<i>β</i> = −0.62 95% CI [−1.09, −0.15], <i>p</i> = 0.01). Vascular disease was a risk factor for lower CVR (<i>β</i> = −1.21, 95% CI [−2.16, −0.26] <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A lower CVR increases the risk for cerebral hypo-perfusion during HD. Impaired CVR may be an important part of the pathophysiology of ischemic brain injury and cognitive impairment in HD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"346-353"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744641","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":"Enhancing Postoperative Pain Management: Assessing the Influence of Ultrasound-Guided Stellate Ganglion Block on Arteriovenous Fistula Surgery","authors":"Hashemian Morteza,&nbsp;Bahaadini Azadeh,&nbsp;Aflatoonian Behnaz,&nbsp;Vehedian Mehrdad,&nbsp;Nozarinia Mostafa,&nbsp;Shahdadi Hamed,&nbsp;Abolhasani Zadeh Firoozeh","doi":"10.1111/hdi.13220","DOIUrl":"10.1111/hdi.13220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The effectiveness of stellate ganglion block in managing acute postoperative pain remains uncertain due to limited high-quality evidence. This study evaluates the impact of stellate ganglion block on acute pain following arteriovenous fistula surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized controlled clinical trial was conducted in the Surgery Department of Bahonar and Shafa Hospitals at Kerman University of Medical Sciences, Iran. Patients undergoing arteriovenous fistula surgery were randomly assigned to either the intervention group, which received an ultrasound-guided stellate ganglion block with 5 mL of 5% lidocaine, or the control group, which received no intervention. A total of 60 patients were selected based on age and gender similarity. Pain levels were assessed using the visual analog scale immediately after surgery and at 6 and 12 h postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Pain scores differed significantly between the two groups at all time points (<i>p</i> ≤ 0.05). The intervention group reported lower pain levels at 6 and 12 h postoperatively compared to the control group. Repeated measures analysis confirmed a significant reduction in pain over time in both groups (<i>p</i> ≤ 0.05), with a more pronounced decrease in the intervention group (<i>p</i> ≤ 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative stellate ganglion block effectively reduces acute postoperative pain following arteriovenous fistula surgery. However, its effects beyond the 12-h postoperative period remain unknown. Further research is needed to evaluate its long-term impact.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"303-309"},"PeriodicalIF":1.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712404","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 Impact of Socioeconomic Factors on the Prevalence of Hemodialysis in Mainland China","authors":"Zenghui Xing,&nbsp;Sichen Li,&nbsp;Delong Zhao,&nbsp;Chao Liu,&nbsp;Guangyan Cai,&nbsp;Xiangmei Chen,&nbsp;Xuefeng Sun","doi":"10.1111/hdi.13218","DOIUrl":"10.1111/hdi.13218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The prevalence of hemodialysis varies significantly across countries and regions with different levels of socioeconomic development. This paper aims to analyze the socioeconomic factors influencing hemodialysis in mainland China, providing a basis for formulating reasonable hemodialysis strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All the hemodialysis prevalence data and socioeconomic data were obtained from the National Medical Service and Quality Safety Report and the China Statistical Yearbook. The 31 regions were categorized into low, medium, and high groups based on the per capita gross domestic product, and the changes in hemodialysis prevalence rates and their growth rates were compared. Linear regression analysis was conducted to identify the independent risk factors affecting hemodialysis prevalence rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant differences in hemodialysis prevalence rates were observed across different years and per capita gross domestic product groups (<i>p</i> &lt; 0.001). The prevalence of hemodialysis in the low and medium per capita gross domestic product groups significantly increased from 2011 to 2020 (<i>p</i> &lt; 0.001), while an increase in the high per capita gross domestic product group was not statistically significant (<i>p</i> &gt; 0.05). The growth in hemodialysis prevalence rates over the 10-year period decreased with increasing per capita gross domestic product levels in 2011 (325.2% ± 98.6%, 209.3% ± 61.9%, and 52.6% ± 73.7% for the low, medium, and high per capita gross domestic product groups, respectively). The incidence of hemodialysis, per capita gross domestic product, the proportion of rural–urban population, highway mileage per square kilometer, and the number of beds in medical facilities per 1000 population were identified as independent factors of hemodialysis prevalence rates (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>With the development of the social economy and the enhancement of medical service capabilities, the prevalence of hemodialysis in Mainland China has increased. Compared to economically less developed and moderately developed regions, the increase in hemodialysis prevalence in economically developed areas has been attenuated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"390-397"},"PeriodicalIF":1.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712421","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":"Associations Between Type of Hemodialysis Access and Pulmonary Hypertension: A Single-Center Retrospective Cohort","authors":"Muhammad Umair Jahngir,&nbsp;Christine De Antonis,&nbsp;Rizwan Rabbani,&nbsp;Amir Ashiq,&nbsp;Ajiya Fatima,&nbsp;Rabia Ahmed,&nbsp;Avrum Gillespie","doi":"10.1111/hdi.13231","DOIUrl":"10.1111/hdi.13231","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pulmonary hypertension affects patients with hemodialysis-dependent end-stage kidney failure; however, the estimated prevalence varies greatly due to the underutilization of right heart catheterization and the evolving diagnostic criteria of pulmonary hypertension. Pulmonary hypertension in end-stage kidney failure is often attributed to arteriovenous (AV) access; therefore, we hypothesized that patients with AV fistula/graft would have a greater prevalence of pulmonary hypertension on right heart catheterization compared to those with central venous (CV) catheter accesses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this retrospective single-center cohort study, we identified and randomly sampled patients from July 2012 to August 2022 receiving hemodialysis for ≥ 3 months and who underwent right heart catheterization, using Current Procedural Terminology codes. Pulmonary hypertension was defined as mean pulmonary arterial pressure (mPAP) &gt; 20 mmHg. Our primary outcome was the prevalence of pulmonary hypertension among patients with AV fistula/graft versus CV hemodialysis access, tested with descriptive statistics. We evaluated survival as a secondary outcome using a Cox proportional hazards model.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 3834 patient charts were extracted. Overall, 444 charts were randomly sampled, resulting in 137 subjects meeting the inclusion criteria. The mean age was 63.8 ± 10.5 years, and 62% were male. The most common etiology of end-stage kidney failure was diabetic kidney disease (57.7%). Eighty percent of end-stage kidney failure patients had pulmonary hypertension; however, the type of hemodialysis access was not associated with pulmonary hypertension (85% CV catheter vs. 79.5% AV access, &lt;i&gt;p&lt;/i&gt; = 0.59). Patients with pulmonary hypertension had lower hemoglobin (9.6 ± 0.8 vs. 11.2 ± 1.3 g/dL, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and serum albumin (2.3 ± 0.9 vs. 3.4 ± 0.6 g/dL, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) than those without pulmonary hypertension. Those with pulmonary hypertension had an increased risk of mortality (hazard ratio: 2.2, 95% confidence interval: 1.04–4.61; &lt;i&gt;p&lt;/i&gt; = 0.04).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our findings show a high burden of pulmonary hypertension among this heterogeneous cohort of end-stage kidney failure patients, with no association between pulmonary hypertension and the type of hemodialysis access. This study highlights the need for prospective investigations incorporating current strategies for pulmonary hypertension diagnosis and treatment among the dialysis-dependent population.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"335-345"},"PeriodicalIF":1.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694950","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":"Treatment Strategies for Refractory Catheter-Related Central Venous Occlusive Disorders: Review","authors":"Xiao Ma,&nbsp;Jiehao Chen,&nbsp;Tianqiao Yang,&nbsp;Lan Gao,&nbsp;Yaoxiong Xia","doi":"10.1111/hdi.13229","DOIUrl":"10.1111/hdi.13229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Catheter-related central vein occlusive disease (CVOD) is a frequent complication in hemodialysis patients and significantly affects their prognosis. Current treatment options for catheter-related CVOD include standard guidewire and catheter techniques, radiofrequency ablation, and sharp recanalization. However, large-scale clinical trials evaluating these techniques are lacking, making CVOD management challenging. This article reviews current treatment strategies for catheter-related CVOD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review was conducted via PubMed, focusing on studies evaluating the effectiveness and safety of various treatment modalities for CVOD. The following keywords were used in PubMed: “hemodialysis”, “central vein occlusion”, “central vein stenosis”, and “catheter”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The treatment methods for refractory CVOD in hemodialysis patients are diverse, including sharp recanalization, radiofrequency ablation, and percutaneous superior vena cava puncture. Complications and success rates vary widely across treatments, and evidence is generally limited to small studies or case series. However, a standardized treatment protocol is still lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While several techniques show promise in treating catheter-related CVOD, high-quality clinical studies are necessary to identify the more effective and safe procedure. The choice of treatment should be based on individual patient characteristics, extent of the occlusion, and available resources. Percutaneous SVC puncture may be a feasible alternative after failed sharp recanalization for refractory CVOD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"255-261"},"PeriodicalIF":1.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634478","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":"Oral Sodium Bicarbonate vs. Use of Higher Dialysate Bicarbonate in Hemodialysis Patients With Metabolic Acidosis: A Randomized Controlled Trial","authors":"Hoda M. M. Abdulaziz,&nbsp;Alaa Sabry,&nbsp;Marwa Saleh,&nbsp;Ghada El-Said","doi":"10.1111/hdi.13230","DOIUrl":"10.1111/hdi.13230","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The optimal strategy for correcting metabolic acidosis and maintaining acid–base balance in hemodialysis patients remains unclear. This study aimed to evaluate and compare the effects of oral bicarbonate administration vs. increased dialysate bicarbonate concentration on predialysis serum bicarbonate levels in hemodialysis patients with metabolic acidosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center, open-label, randomized controlled trial. Adult hemodialysis patients with metabolic acidosis (serum bicarbonate &lt; 22 mmol/L) were randomly assigned in a 1:1:1 ratio to one of three treatment groups for 16 weeks: (1) standard dialysate (32 mM bicarbonate plus 3 mM acetate), (2) increased dialysate bicarbonate (34 mM bicarbonate plus 3 mM acetate), or (3) standard dialysate with daily oral sodium bicarbonate supplementation (0.3–0.5 mmol/kg). Of the 75 eligible participants, 66 completed the study. The primary outcome was the difference in predialysis serum bicarbonate levels between the groups at 16 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline predialysis serum bicarbonate levels averaged approximately 19.5 mmol/L across all three groups. At 16 weeks, there was no statistically significant difference in predialysis serum bicarbonate levels among the groups (<i>p</i> = 0.701). The mean levels were 20.1 (SD 2.16) mmol/L in the standard dialysate group, 20.5 (SD 2.04) mmol/L in the increased dialysate bicarbonate group, and 20.8 (SD 2.61) mmol/L in the oral supplementation group. Compared to baseline, predialysis bicarbonate levels significantly increased within the increased dialysate bicarbonate group (<i>p</i> = 0.010) and the oral supplementation group (<i>p</i> = 0.021), but not in the control (standard dialysate, no oral supplementation) group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Oral or dialytic bicarbonate supplementation at the doses used in this study demonstrated equivalent effects on predialysis serum bicarbonate concentrations in acidotic hemodialysis patients. However, the amount of supplemental bicarbonate administered via either route was insufficient to achieve the target correction of acidosis (e.g., predialysis serum bicarbonate ≥ 22 mmol/L).</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"310-318"},"PeriodicalIF":1.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627267","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":"Frequent In-Center Hemodialysis: Who Can Benefit From a Frequent Dialysis Approach?","authors":"Steven G. Achinger,&nbsp;Juan Carlos Ayus","doi":"10.1111/hdi.13225","DOIUrl":"10.1111/hdi.13225","url":null,"abstract":"<div>\u0000 \u0000 <p>Frequent (a.k.a daily hemodialysis) has continued to spark interest in the nephrology community as a way to possibly improve outcomes for the end-stage renal disease population. This is a patient population with a very high disease burden and mortality rate. The concept of dialysis adequacy in its current form has consolidated mainly around three times weekly dialysis, which has become the worldwide accepted standard. The current drive to encourage more home hemodialysis (which is a frequent dialysis regimen) has made the lessons from daily in-center hemodialysis more relevant. Frequent hemodialysis has been shown in both observational and randomized controlled studies to have some cardiovascular, mineral metabolism, and quality of life benefits. Some of what is learned from this body of literature is applicable today with increasing emphasis on home hemodialysis. This review will focus on the benefits and potential harms of daily hemodialysis to assist the practitioner in shared decision making with patients about the expected benefits and drawbacks of frequent in-center dialysis and what the expected goals should be for a frequent dialysis regimen.</p>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"262-274"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627265","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}