Hemodialysis International最新文献

{"title":"Is hemodiafiltration superior to high-flow hemodialysis in reducing all-cause and cardiovascular mortality in kidney failure patients? A meta-analysis of randomized controlled trials","authors":"Paulo Roberto Bignardi,&nbsp;Vinicius Daher Alvares Delfino","doi":"10.1111/hdi.13136","DOIUrl":"10.1111/hdi.13136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hemodiafiltration (HDF) and high-flux hemodialysis (hf-HD) are different methods of kidney replacement therapy (KRT) used for the treatment of kidney failure patients. A debate has raged over the last decade about the survival benefit of patients with the use of HDF compared with hf-HD, but with divergent results from randomized controlled trials. Therefore, this study aimed to perform a meta-analysis to compare HDF and hf-HD regarding all-cause and cardiovascular mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed and Cochrane databases were searched until July 19, 2023, for randomized clinical trials comparing HDF and hf-HD in patients on maintenance dialysis. A meta-analysis was performed using Stata 16.1, applying fixed or random effect models according to the heterogeneity between studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of the 496 studies found, five met the inclusion criteria. Compared with the hf-HD group, the risk ratio (RR) for all-cause mortality with HDF use was 0.76 (95% CI: 0.67–0.88, <i>I</i>² = 0%). HDF was associated with lower cardiovascular mortality, although the sensitivity analysis showed that the result differed between scenarios. Subgroup analysis showed lower all-cause mortality among patients without diabetes in the HDF group compared with hf-HD (RR 0.66, 95% CI: 0.51–0.81, <i>I</i>² = 0%), but not in diabetic patients (RR = 0.89, 95% CI: 0.65–1.12, <i>I</i>² = 0.0%). A subgroup analysis considering convection volumes was not performed, but the studies with the highest weight in the meta-analysis described convection volume as more than 20 L/session.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>More clinical studies considering critical risk factors, such as advanced age and preexisting cardiovascular disease, are needed to confirm the supremacy of HDF over hf-HD on the survival of patients treated by these two forms of kidney replacement therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 2","pages":"139-147"},"PeriodicalIF":1.3,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139901086","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":"Success is just running out of mistakes: a lifelong quest to make hemodialysis simple, safe, and effective. Ash SR. Pittsburgh, PA: Dorrance Publishing; 2023","authors":"Fokko P. Wieringa","doi":"10.1111/hdi.13132","DOIUrl":"10.1111/hdi.13132","url":null,"abstract":"","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 2","pages":"225-228"},"PeriodicalIF":1.3,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139928640","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":"Successful twin pregnancy in a woman undergoing alternate diurnal and nocturnal hemodialysis","authors":"Geoffroy Desbuissons,&nbsp;Liliane Ngango,&nbsp;Christophe Baudeau,&nbsp;Philippe Fournier","doi":"10.1111/hdi.13134","DOIUrl":"10.1111/hdi.13134","url":null,"abstract":"<p>Although pregnancy has become more frequent in patients undergoing hemodialysis, it remains a relatively rare event and carries a high risk of complications for both the mother and the fetus. In parallel, multiple pregnancies are also associated with a high risk of complications for the mother and the fetus, even in healthy women. The presence of a twin pregnancy in a woman with chronic renal failure undergoing hemodialysis is an even rarer event and is considered a very high-risk situation. We describe the case of a 31-year-old hemodialysis patient who successfully gave birth to twins at 29 weeks after a period of alternate diurnal and nocturnal hemodialysis.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 2","pages":"233-235"},"PeriodicalIF":1.3,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736908","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":"Longitudinal changes in diffusion tensor imaging in hemodialysis patients","authors":"Wesley T. Richerson,&nbsp;Brian D. Schmit,&nbsp;Dawn F. Wolfgram","doi":"10.1111/hdi.13133","DOIUrl":"10.1111/hdi.13133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hemodialysis patients have increased white matter and gray matter pathology in the brain relative to controls based on MRI. Diffusion tensor imaging is useful in detecting differences between hemodialysis and controls but has not identified the expected longitudinal decline in hemodialysis patients. In this study we implemented specialized post-processing techniques to reduce noise to detect longitudinal changes in diffusion tensor imaging parameters and evaluated for any association with changes in cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We collected anatomical and diffusion MRIs as well as cognitive testing from in-center hemodialysis patients at baseline and 1 year later. Gray matter thickness, white matter volume, and white matter diffusion tensor imaging parameters were measured to identify longitudinal changes. We analyzed the diffusion tensor imaging parameters by averaging the whole white matter and using a pothole analysis. Eighteen hemodialysis patients were included in the longitudinal analysis and 15 controls were used for the pothole analysis. We used the NIH Toolbox Cognition Battery to assess cognitive performance over the same time frame.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Over the course of a year on hemodialysis, we found a decrease in white matter fractional anisotropy across the entire white matter (<i>p</i> &lt; 0.01), and an increase in the number of white matter fractional anisotropy voxels below pothole threshold (<i>p</i> = 0.03). We did not find any relationship between changes in whole brain structural parameters and cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>By employing noise reducing techniques, we were able to detect longitudinal changes in diffusion tensor imaging parameters in hemodialysis patients. The fractional anisotropy declines over the year indicate significant decreases in white matter health. However, we did not find that declines in fractional anisotropy was associated with declines in cognitive performance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 2","pages":"178-187"},"PeriodicalIF":1.3,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139731243","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":"Adrenal insufficiency in hemodialysis patients—An under-recognized problem: A case series","authors":"Krupa Shah,&nbsp;Jeffrey Wong,&nbsp;Kathy Mac,&nbsp;Namson S. Lau,&nbsp;Vincent M. Wong,&nbsp;Angela Makris","doi":"10.1111/hdi.13131","DOIUrl":"10.1111/hdi.13131","url":null,"abstract":"<p>Adrenal insufficiency is an uncommon disorder and presents with non-specific symptoms. Identifying adrenal insufficiency in patients with chronic kidney disease requiring dialysis is increasingly difficult as there is a significant overlap of the signs and symptoms of adrenal insufficiency with those seen in chronic kidney failure. We highlight this diagnostic uncertainty in a case series of three patients with chronic kidney disease requiring hemodialysis as renal replacement therapy from a single center identified as hypoadrenal. Steroid replacement improved symptoms and hemodynamic parameters. Increased vigilance for adrenal insufficiency in dialysis patients is necessary. It is likely under recognized in hemodialysis patients given their multi-morbidity.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 2","pages":"229-232"},"PeriodicalIF":1.3,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704274","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":"We are moving to online only","authors":"","doi":"10.1111/hdi.13129","DOIUrl":"10.1111/hdi.13129","url":null,"abstract":"","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"3"},"PeriodicalIF":1.3,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428096","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":"Effect of conventional hemodialysis on the apixaban plasma concentration","authors":"Tim Poel,&nbsp;Nikki de Rouw,&nbsp;Nathalie C. V. Péquériaux,&nbsp;Daan van de Kerkhof,&nbsp;Annemieke M.A. Vermeulen Windsant,&nbsp;Rob J. van Marum,&nbsp;Angele P. M. Kerckhoffs","doi":"10.1111/hdi.13127","DOIUrl":"10.1111/hdi.13127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Apixaban is a factor Xa inhibitor used in patients undergoing hemodialysis treatment. The objective of this study is to investigate the effect of hemodialysis on apixaban plasma concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study is on patients treated with apixaban 2.5 mg twice daily on conventional hemodialysis with standard low-molecular-weight heparin (LMWH) anticoagulation (nadroparin 3800–7600 IU). Plasma blood samples were collected before starting dialysis (t1), 2 h after starting dialysis (t2), and directly after dialysis (t3). Apixaban concentration was measured before and after dialysis. Anti-Xa activity was measured for all three samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant difference was observed between the apixaban concentration before and after dialysis (mean before dialysis 141.03 ng/mL; mean after dialysis 102.71 ng/mL; <i>p</i> = 0.003). Nonetheless, both apixaban plasma concentrations and anti-Xa levels remained within the reference range. Anti-Xa levels had a strong correlation with the apixaban concentrations (<i>r</i> = 0.935, <i>p</i> = 0.000). Thus, anti-Xa activity might be used as a surrogate for apixaban plasma concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There seems to be no need for dose adjustments of apixaban; co-administration of LMWH next to apixaban might also be unnecessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"72-76"},"PeriodicalIF":1.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92158102","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":"Chronic kidney disease and value-based care: Lessons from innovation, iteration, and ideation in primary care","authors":"Matthew E. Berman,&nbsp;Joshua E. Lowentritt","doi":"10.1111/hdi.13126","DOIUrl":"10.1111/hdi.13126","url":null,"abstract":"<p>Value-based primary care has reduced health care costs, improved the quality of rendered care, and enhanced the patient experience. Value-based care emphasizes prevention, outreach, follow-up, patient engagement, and comprehensive, whole-person health. Primary care Accountable Care Organizations have leveraged technology-enabled workflows, practice transformation, and cutting-edge data and analytics to achieve success. These efforts are increasingly aided by predictive modeling used in the context of patient identification and prioritization algorithms. Value-based kidney care programs can glean salient takeaways from successful value-based primary care methods and models. The kidney care community is experiencing unprecedented transformation as novel payer programs and financial models burgeon. The authors contend these efforts can be accelerated by the adoption of techniques honed in value-based primary care. To optimize value-based kidney care, though, nephrology thought leaders must transcend the archetype of value-based primary care. To do so, the nephrology community must: (1) impel behavioral change among fee-for-service adherents; (2) harness emerging policy, guidelines, and quality measures; (3) adopt innovative tools, technologies, and therapies. In aggregating lessons from value-based primary care—and leveraging novel methodologies and approaches—the kidney care community will be better equipped to achieve the quadruple aim for kidney care.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"6-16"},"PeriodicalIF":1.3,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490395","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":"Age-associated effects of intradialytic exercise on physical function and nutritional status in patients receiving ambulatory hemodialysis: A multicenter cohort study","authors":"Ren Takahashi,&nbsp;Hiroki Yabe,&nbsp;Hideaki Ishikawa,&nbsp;Takashi Hibino,&nbsp;Tomoya Yamaguchi,&nbsp;Sayumi Morishita,&nbsp;Kenichi Kono,&nbsp;Yoshifumi Moriyama,&nbsp;Tetsuya Yamada","doi":"10.1111/hdi.13128","DOIUrl":"10.1111/hdi.13128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Intradialytic exercise is essential for improving physical function for older patients. This study aimed to examine the relationship between the effects of exercise therapy and aging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter cohort study included 1176 patients aged 40–89 years, who participated in an intradialytic exercise program, comprising stretching and resistance training, three times per week for 12 months. Isometric knee extension strength (IKES), 10-m walking speed, Short Physical Performance Battery (SPPB), and Geriatric Nutritional Risk Index (GNRI) were measured at baseline and after 12 months. The patients were divided according to age as follows: 40–59, 60–69, 70–79, and 80–89 years. A linear mixed-effects model examined the improvement within-group and between-control differences, as the 40–59 age group was the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The 40–59, 60–69, 70–79, and 80–89 age groups comprised 180, 317, 466, and 213 participants, respectively. Within-group differences, all the age groups significantly improved IKES and SPPB. The 10-m walking speed [0.02 (0.02) m/s] and GNRI [0.38 (0.33)] did not improved only in the 80–89 age group despite other age groups significantly improved. Between-control differences, IKES of the 70–79 age group [−0.24 (−0.42 to −0.06) %] was significantly lower improvement than control. GNRI of all the older groups were significantly smaller improvement than control (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The older group demonstrated difficulty in improving walking ability and nutritional status compared with the younger groups. Clinicians need to consider the difference in effectiveness due to age and prescribe intradialytic exercises accordingly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"117-124"},"PeriodicalIF":1.3,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490382","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":"Dr. Andreas Pierratos, MD, FRCPC","authors":"Christopher T. Chan","doi":"10.1111/hdi.13119","DOIUrl":"10.1111/hdi.13119","url":null,"abstract":"","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"4-5"},"PeriodicalIF":1.3,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159577","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}