Hemodialysis International最新文献

{"title":"Blood Flow Restriction Training in Hemodialysis Patients: Clinical Benefits, Challenges, and Future Perspectives","authors":"Yu Li,&nbsp;Chaozheng Li,&nbsp;Xiaoyan Liu,&nbsp;Yan Yang,&nbsp;Liying Zhu,&nbsp;Yufeng Zou,&nbsp;Li Rao,&nbsp;Shujie Ding,&nbsp;Jing Wang","doi":"10.1111/hdi.70077","DOIUrl":"10.1111/hdi.70077","url":null,"abstract":"<div>\u0000 \u0000 <p>Blood flow restriction training uses cuffs to partially restrict blood flow to the limbs during low-intensity exercise. Compared with traditional high-load training, this approach can improve muscle strength and endurance with lighter loads, making it a potentially suitable strategy for hemodialysis patients who suffer from muscle wasting, weakness, and impaired quality of life. However, optimal protocols for blood flow restriction training in this population remain unclear, and further research is needed to evaluate its long-term effects on muscle mass, strength, and quality of life. This narrative review summarizes the available clinical evidence and recent advances in blood flow restriction training for hemodialysis patients. Based on literature retrieved from major databases, the review presents the historical background of blood flow restriction training, its key methodological parameters (including cuff pressure and exercise selection), underlying physiological mechanisms, and emerging clinical outcomes in dialysis patients.</p>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"508-524"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847960","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 Music-Repeating Robotic Parrot Therapy and Different Instrumental Live Music Therapies on Anxiety and Fatigue Levels in Hemodialysis Patients: A Randomized Controlled Trial","authors":"Hatice Demirağ,&nbsp;Aynur Cin,&nbsp;Dilan Aktepe Coşar,&nbsp;Sevda Uzun,&nbsp;Osman Oğulcan Türkmen","doi":"10.1111/hdi.70075","DOIUrl":"10.1111/hdi.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the effects of three different music-based interventions on anxiety and fatigue levels in patients undergoing hemodialysis, compared to a concurrent control group receiving standard care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomized controlled trial involved 64 patients receiving maintenance hemodialysis. They were randomly assigned to four equal groups (<i>n</i> = 16 each): live music, live ney sound therapy (using a traditional reed flute known for its soothing, breath-like tones), a music-repeating robotic parrot therapy (an interactive robotic parrot that repeats music or sounds provided by the patient), or a control group (no intervention). The experimental groups received 30-min sessions 3 days per week for 2 months. The “Beck Anxiety Scale” and “Fatigue Severity Scale” were used to measure anxiety and fatigue, respectively. Assessments were performed before the intervention, immediately after the 2-month intervention period, and at 2 months after the end of the intervention period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before the intervention, there were no significant differences in anxiety or fatigue scores across the four groups (<i>p</i> &gt; 0.05). After the interventions, all three groups exposed to music therapy showed significant reductions in both anxiety and fatigue scores compared to the control group (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All three therapies were effective in managing anxiety and fatigue symptoms in hemodialysis patients. Among them, music-repeating robotic parrot therapy demonstrated the most superior and longest-lasting effects in reducing both anxiety and fatigue levels.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT07238374</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"605-616"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944412","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 and Pregnancy: Optimizing Therapy for Best Maternal and Fetal Outcomes","authors":"Shreepriya Mangalgi,&nbsp;Silvi Shah","doi":"10.1111/hdi.70062","DOIUrl":"10.1111/hdi.70062","url":null,"abstract":"<p>Pregnancy in women with end-stage kidney disease (ESKD) requiring dialysis remains high risk, with significant maternal and fetal complications. While fertility rates are markedly reduced in this population, advances in dialysis care and obstetric management have led to increasing reports of successful pregnancies. Important maternal adverse outcomes include early pregnancy loss, preeclampsia, polyhydramnios, and cesarean delivery, while common adverse fetal outcomes are preterm birth, low birth weight, and high neonatal intensive care utilization. Evidence consistently demonstrates that dialysis intensification—achieving longer treatment hours or targeting lower maternal blood urea nitrogen levels—correlates with improved gestational age and birth weight, thereby enhancing live birth rates. Optimizing therapy further requires individualized dialysis prescriptions, careful volume and blood pressure management, and timely adjustment of dialysate composition. A multidisciplinary approach involving nephrology, maternal-fetal medicine, obstetrics, gynecology, and neonatology is critical for care coordination. Despite these advances, significant disparities persist, particularly in access to intensive dialysis and specialized care worldwide. Future directions include strengthening obstetric nephrology training, expanding research in peritoneal and home hemodialysis during pregnancy, and establishing integrated care models. With careful planning and optimization of renal replacement therapy, maternal and fetal outcomes in this high-risk population can continue to improve. This review aims to synthesize current evidence on fertility, dialysis strategies, and maternal–fetal outcomes in pregnant women with ESKD on dialysis, while highlighting practical considerations for dialysis optimization and multidisciplinary care, thereby addressing gaps in consolidated guidance for clinicians managing this increasingly encountered high-risk population.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"499-507"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373669","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":"Clinical Efficacy of Vitamin D Supplements for the Treatment of Anemia in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis","authors":"Xiaodong Wanyan,&nbsp;Jiayun Xu","doi":"10.1111/hdi.70078","DOIUrl":"10.1111/hdi.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To conduct a meta-analysis of clinical randomized controlled studies related to vitamin D supplements for the treatment of anemia in patients with chronic kidney disease (CKD), to evaluate the clinical efficacy of vitamin D supplements for CKD patients complicated with anemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature review of the published literature in both English and Chinese was searched from the Cochrane Library, PubMed, Web of Science, CNKI and Wanfang Data that were published from the inception date to January 2018. Randomized controlled trials (RCTs) eligible for the inclusion and exclusion criteria were selected. The quality of eligible studies was assessed by the Cochrane Risk of Bias tool. Meta-analysis was performed by using Revman 5.3 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 RCTs comprising 779 patients were included in this meta-analysis, including 383 patients in the experimental group (with vitamin D supplementation) and 396 patients in the control group (without vitamin D supplementation). Meta-analysis showed that vitamin D supplements could significantly increase the hemoglobin (<i>p</i> &lt; 0.01, SMD = 1.24, 95% CI: 1.02–1.45) and lower the dosage of erythropoietin required (<i>p</i> &lt; 0.01, SMD = −0.76, 95% CI: −1.09 to −0.43).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Use of vitamin D supplements can significantly elevate the hemoglobin concentration and reduce the dosage of erythropoietin. However, these findings remain to be validated by large-scale, multi-center, prospective RCTs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"478-485"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201780","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":"Associations Between a Combined Baseline Inflammation—Malnutrition Risk Score and Future Late Arteriovenous Fistula Occlusion in Hemodialysis Patients","authors":"Tolga O. Badak,&nbsp;Ferid Cereb","doi":"10.1111/hdi.70063","DOIUrl":"10.1111/hdi.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Late arteriovenous fistula (AV fistula) occlusion is a major cause of morbidity in hemodialysis patients. The Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), and Geriatric Nutritional Risk Index (GNRI) have emerged as candidate prognostic biomarkers. This study aimed to compare their predictive accuracy, evaluate their independent prognostic value, and develop a combined risk score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 750 hemodialysis patients undergoing primary AV fistula creation. Baseline Systemic Immune-Inflammation Index, Neutrophil-to-Lymphocyte Ratio, and Geriatric Nutritional Risk Index were collected preoperatively. The primary outcome was late AV fistula occlusion (&gt; 90 days). Predictive performance was assessed using ROC analysis and Cox proportional hazards regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Over a median follow-up of 48 months, 38.0% of patients developed late AV fistula occlusion. Systemic Immune-Inflammation Index demonstrated the highest predictive accuracy (AUC: 0.79), significantly outperforming Geriatric Nutritional Risk Index (<i>p</i> &lt; 0.001). In multivariate analysis, Systemic Immune-Inflammation Index &gt; 850 (Hazard ratios 3.15, 95% CI: 2.28–4.35), Neutrophil-to-Lymphocyte Ratio &gt; 4.5 (Hazard ratios 2.78, 95% CI: 2.02–3.82), and Geriatric Nutritional Risk Index &lt; 92 (Hazard ratios 1.92, 95% CI: 1.41–2.62) were independent predictors. A combined risk score integrating these biomarkers achieved superior discrimination (AUC: 0.83). Baseline vascular diameters were not independently associated with occlusion risk in this cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The synergistic interaction between inflammation and malnutrition identifies a distinct high-risk phenotype. The combined risk score is a readily implementable tool that may support personalized surveillance strategies to improve long-term AV fistula outcomes in hemodialysis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"534-548"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379700","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":"Changes in Cardiac Functional Parameters After Discontinuation of Sacubitril/Valsartan in Hemodialysis Patients: Insights From Left Ventricular End-Diastolic Diameter in Real-World Observational Data","authors":"Ruibin He,&nbsp;Lingling Zhu,&nbsp;Li Qin,&nbsp;Qianling Wu,&nbsp;Jingyan Tian,&nbsp;Na Jiang,&nbsp;Jiangzi Yuan","doi":"10.1111/hdi.70076","DOIUrl":"10.1111/hdi.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Data on the efficacy and safety of sacubitril/valsartan in hemodialysis patients with heart failure and preserved left ventricular ejection fraction (≥ 50%, HFpEF) or mildly reduced left ventricular ejection fraction (41%–49%, HFmrEF) were analyzed, as well as cardiac functional parameters and safety after withdrawal of sacubitril/valsartan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety-eight maintenance hemodialysis patients with heart failure with preserved or mildly reduced ejection fraction were included in the present study. Patients were divided into sacubitril/valsartan and control groups according to whether they had been, or were being, treated with sacubitril/valsartan. Patients were further divided into continuation and discontinuation groups based on whether sacubitril/valsartan was discontinued at the end of follow-up. Laboratory examination results, echocardiographic parameters, and the occurrence of major adverse cardiac events were recorded and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 50 patients in the control group and 48 in the sacubitril/valsartan group. The median follow-up time was 14.5 months. Compared with the control group, the serum B-type natriuretic peptide levels and echocardiographic parameters in the sacubitril/valsartan group significantly decreased from baseline at 6-month follow-up (<i>p</i> &lt; 0.05). In the sacubitril/valsartan group, there were 28 patients in the continuation group and 20 in the discontinuation group. The reduction in left ventricular end-diastolic diameter in the sacubitril/valsartan group reversed in the discontinuation group (by 10%) after drug withdrawal, whereas it was stable in the continuation group (change 0.66%, <i>p</i> = 0.030). Patients with lower left ventricular end-diastolic diameters at the end follow-up (≤ 50 mm) exhibited a lower incidence of major adverse cardiac events compared to those with higher diameters (&gt;50 mm; <i>p</i> = 0.012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sacubitril/valsartan improved cardiac function in patients on hemodialysis with heart failure and preserved or mildly reduced left ventricular ejection fraction. Long-term continuous use of sacubitril/valsartan may reduce left ventricular end-diastolic diameter and positively impact prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"582-590"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847976","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":"Comparison of the Effect of Valsalva Maneuver and Rhythmic Breathing on Pain Intensity During Vascular Needle Insertion in Hemodialysis Patients: A Randomized Controlled Clinical Trial","authors":"Sajad Salehipour,&nbsp;Zeynab Voloei,&nbsp;Setayesh Hasanabadi,&nbsp;Fatemeh Mohseni,&nbsp;Hassan Babamohamadi","doi":"10.1111/hdi.70066","DOIUrl":"10.1111/hdi.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Over 20% of patients undergoing hemodialysis are unable to tolerate the discomfort associated with vascular needle insertion, and nearly half (47%) report a fear of these needles, often identifying this step as the most distressing aspect of their treatment. Currently, no universally accepted method exists to alleviate this pain effectively. The objective of the present investigation was to assess and contrast the analgesic efficacy of the Valsalva maneuver and rhythmic breathing techniques in hemodialysis patients undergoing vascular access cannulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety participants undergoing hemodialysis at Semnan University's Kosar Hospital were randomly divided into three study arms (rhythmic breathing, Valsalva maneuver, control) in this clinical trial, using convenience sampling for enrollment. The rhythmic breathing intervention group performed controlled, rhythmic respiration cycles (lasting 1 min every 5 min) during the 20 min preceding vascular access needle insertion. Patients assigned to the Valsalva group executed the technique for 16–20 s just prior to vascular access needle placement. Participants in the control arm received routine clinical care and no supplementary interventions. Numerical pain rating scale measurements were obtained two minutes following needle insertion to quantify pain levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Significantly lower pain scores were observed in both Valsalva maneuver (3.06 ± 2.39) and rhythmic breathing (3.03 ± 2.48) groups relative to controls (6.20 ± 1.49; <i>p</i> &lt; 0.001). Subsequent analysis showed that both the Valsalva maneuver and rhythmic breathing groups experienced a markedly higher reduction in pain levels compared to the control group (<i>p</i> &lt; 0.001). However, the two interventions demonstrated comparable effectiveness, with no observable statistical difference between them (<i>p</i> = 0.99).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that the Valsalva maneuver is equally effective as rhythmic breathing in minimizing pain during arteriovenous fistula (AV fistula) cannulation, and both methods can be recommended as non-pharmacological pain relief strategies in hemodialysis patients.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> Iranian Registry of Clinical Trials, Trial No: IRCT20120109008665N16. Registered 14 March 2024</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"549-556"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792888","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 Body Mass Index and Clinical Outcomes Stratified by Age in Patients Undergoing Maintenance Hemodialysis","authors":"Seok Hui Kang,&nbsp;So Young Park,&nbsp;Yu Jeong Lim,&nbsp;Bo Yeon Kim,&nbsp;Ji Young Choi,&nbsp;Jun Young Do","doi":"10.1111/hdi.70081","DOIUrl":"10.1111/hdi.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Our study aimed to investigate the association between body mass index and clinical outcomes by age group in a population-based cohort of patients having HD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data collected by the Health Insurance Review and Assessment Service during HD quality assessment programs and the claims and death data were retrospectively analyzed (<i>n</i> = 71,382). The patients were divided into four groups according to their age. Each group was further divided into four groups in accordance with previous guidelines: underweight group; normal group; overweight group; and obese group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The age groups were composed of the following: 41,395 patients aged &lt; 65 years, 18,329 patients aged 65–74 years, 10,354 patients aged 75–84 years, and 1304 patients aged ≥ 85 years. In all age groups, the all-cause mortality of the underweight group was higher than that of the normal group. Multivariable Cox regression analyses revealed that the cardiovascular event outcomes of the patients aged &lt; 65 years and those aged 65–74 years in the overweight and obese groups were better than those in the normal group. However, in patients aged ≥ 75 years, the association between body mass index and cardiovascular event outcomes was attenuated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Low body mass index was associated with poor patient survival irrespective of age. Conversely, patients in overweight or obese groups had modestly lower or comparable all-cause mortality relative to those with normal body mass index. In patients aged <i>&lt;</i> 65 years, patients with low body mass index showed a higher risk of cardiovascular event compared with those with normal body mass index.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"624-634"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950370","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":"Risk Factors for Falls in Patients on Hemodialysis: A 12-Month Prospective Study","authors":"Luciana Angélica da Silva de Jesus,&nbsp;Bruno Valle Pinheiro,&nbsp;Ana Clara Cattete Bainha,&nbsp;Rodrigo Schinniger Assun Garcia,&nbsp;Letícia Maria do Carmo Corrêa,&nbsp;Helena Faria Mucci,&nbsp;Erich Vidal Carvalho,&nbsp;Pelagia Koufaki,&nbsp;Leda Marília Fonseca Lucinda,&nbsp;Cristino Carneiro Oliveira,&nbsp;Maycon Moura Reboredo","doi":"10.1111/hdi.70068","DOIUrl":"10.1111/hdi.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients on hemodialysis have comorbidities and malnutrition and are subject to polypharmacy, which contributes to disability and sarcopenia. These conditions increase the risk of falls and are associated with fractures, morbidities, substantial costs, nursing home admissions, hospitalization, and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This prospective study evaluated the association of physical function, postural balance, frailty, fear of falling, and quality of life with the occurrence and number of falls within a 12-month interval in patients on hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were assessed for physical function (gait speed over 15 ft., timed up and go [TUG] test, 5-repetition sit-to-stand [5-STS] test, and handgrip strength), postural balance (Mini-Balance Evaluation Systems Test [Mini-BESTest]), frailty, fear of falling (Falls Efficacy Scale-International [FES-I]), and quality of life (36-Item Short Form Health Survey [SF-36]). Interviews were conducted for 12 months to monitor falls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred twelve patients were included and the incidence rate was 1.62 falls/person-years. The occurrence of falls was associated with the TUG (OR: 1.24; 95% CI: 1.01–1.53) and 5-STS (OR: 1.11, 95% CI: 1.02–1.21) performance and frailty (OR: 7.22, 95% CI: 1.71–30.50). The number of falls was associated with the gait speed (OR: 0.22; 95% CI: 0.06–0.77), TUG test results (OR: 1.37; 95% CI: 1.16–1.62), handgrip strength (OR: 0.95; 95% CI: 0.91–0.99), Mini-BESTest (OR: 0.87; 95% CI: 0.78–0.96), frailty (OR: 4.43; 95% CI: 1.87–10.51), FES-I score (OR: 1.11; 95% CI: 1.06–1.17), and SF-36 scores in the physical functioning (OR: 0.98; 95% CI: 0.96–0.99), physical role (OR: 0.99; 95% CI: 0.98–0.99), and physical component summary (OR: 0.96; 95% CI: 0.92–0.99) domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients undergoing hemodialysis have a higher incidence of falls. Falls are associated with physical function, postural balance, frailty, and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"591-599"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391345","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":"Effect of Hemodiafiltration and Hemodialysis on Postoperative Mortality in Patients With Kidney Failure","authors":"Dharmenaan Palamuthusingam,&nbsp;Carmel M. Hawley,&nbsp;Elaine M. Pascoe,&nbsp;David Wayne Johnson,&nbsp;Martin Wolley,&nbsp;Stephen McDonald,&nbsp;Neil Boudville,&nbsp;Matthew D. Jose,&nbsp;Girish Talaulikar,&nbsp;Nicholas B. Cross,&nbsp;Magid Fahim","doi":"10.1111/hdi.70072","DOIUrl":"10.1111/hdi.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Hypothesis</h3>\u0000 \u0000 <p>Patients receiving chronic dialysis have increased risks of postoperative mortality and morbidity. Studies have suggested that patients receving hemodiafiltration (HDF) compared to hemodialysis (HD) may benefit from improved cardiovascular health, reduced infections and better overall survival. This study aimed to determine if patients receving HDF had improved postoperative outcomes after elective surgery compared to patients receiving HD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Bi-national population cohort study evaluated all incident and prevalent patients receiving chronic hemodialysis in Australia and New Zealand. Surgeries included upper gastrointestinal, anorectal, hernia surgery, cholecystectomy and appendectomy. The primary outcome was 30-day all-cause mortality. Secondary outcomes included cardiovascular and infective outcomes. As there was potential for data to be correlated with multiple surgeries clustered at the patient and centre level, a multi-level mixed effects logistic regression model was used, with patient level covariates as fixed effects and dialysis centre as random intercepts, whereby patients were nested within centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, there were 1750 surgeries in 1669 patients, of which 416 (23.8%) were receiving HDF. The median age was similar in both groups, as was the prevalence of comorbidities. Patients receiving HDF had received dialysis for a shorter period (0.9 vs. 2.3 years, <i>p</i> &lt; 0.001). The 30-day mortality rate was lower in patients receiving HDF than in those receiving HD (1.9 vs. 3.3%, <i>p</i> &lt; 0.005). Using multi-level mixed effects logistic regression, HDF was not associated with reduced mortality odds (OR 0.84, 95% CI 0.37–1.93) compared to patients receiving HD. Patients on HDF experienced a lower rate of a composite of infections (5.5 vs. 9.8%, <i>p</i> = 0.012), and required less blood transfusions (7.7 vs. 12.4%, <i>p</i> = 0.009). The occurrence of cardiovascular complications was not significantly different between the two groups (1.4 vs. 2.3%, <i>p</i> = 0.280).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of HDF was not associated with lower postoperative mortality odds but lower rates of infective complications compared to HD were observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 3","pages":"573-581"},"PeriodicalIF":1.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597371","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}