Hemodialysis International最新文献

{"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}

{"title":"Higher NT-proBNP levels and the risk of intradialytic hypotension at hemodialysis initiation","authors":"Katherine A. Curtis,&nbsp;Sushrut S. Waikar,&nbsp;Finnian R. Mc Causland","doi":"10.1111/hdi.13125","DOIUrl":"10.1111/hdi.13125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Elevated N-terminal pro B-type natriuretic peptide (NT-proBNP) is a potent predictor of adverse outcomes in hemodialysis initiation. These patients often experience intradialytic hypotension, which may partially reflect cardiac dysfunction, but the association of NT-proBNP with intradialytic hypotension is not clear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a post hoc analysis of a randomized trial that tested mannitol versus placebo in 52 patients initiating hemodialysis (NCT01520207). NT-proBNP was measured prior to the first and third sessions (<i>n</i> = 87). Mixed-effects models (adjusting for randomized treatment, sex, race, age, diabetes, heart failure, catheter use, pre-dialysis systolic blood pressure, pre-dialysis weight, ultrafiltration volume, serum sodium, bicarbonate, urea nitrogen, phosphate, albumin, hemoglobin, and session length) were fit to examine the association of NT-proBNP with systolic blood pressure decline (pre-dialysis minus nadir systolic blood pressure). Additionally, mixed-effects Poisson models were fit to examine the association with intradialytic hypotension (≥20 mmHg decline in systolic blood pressure).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Mean age was 55 ± 16 years; 33% had baseline heart failure. The median NT-proBNP was 5498 [25th-75th percentile 2011, 14,790] pg/mL; 26 sessions (30%) were complicated by intradialytic hypotension. In adjusted models, each unit higher log-NT-proBNP was associated with 6.0 mmHg less decline in systolic blood pressure (95%CI −9.2 to −2.8). Higher pre-dialysis NT-proBNP, per log-unit, was associated with a 52% lower risk of intradialytic hypotension (IRR 0.48, 95%CI 0.23–0.97), without evidence for effect modification by randomized treatment (<i>P</i>-interaction = 0.17).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In patients initiating hemodialysis, higher NT-proBNP is associated with less decline in intradialytic systolic blood pressure and lower risk of intradialytic hypotension. Future studies should investigate if higher pre-dialysis NT-proBNP levels may identify patients who might tolerate more aggressive ultrafiltration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"77-84"},"PeriodicalIF":1.3,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159578","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 phase 3b, multicenter, open-label, single-arm study of roxadustat within a US dialysis organization: The DENALI study","authors":"John Larkin,&nbsp;Jeffrey Hymes,&nbsp;Marcus L. Britton,&nbsp;Yemmie Oluwatosin,&nbsp;Jacqueline Nolen,&nbsp;Lixia Zhu,&nbsp;Arnold Silva","doi":"10.1111/hdi.13122","DOIUrl":"10.1111/hdi.13122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor approved in several regions for the treatment of anemia of chronic kidney disease (CKD). DENALI, a phase 3b study, evaluated the efficacy, safety, and feasibility of roxadustat in patients with anemia of CKD receiving in-center or home dialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible patients received open-label roxadustat, dosed three times weekly for 24 weeks, with an optional extension of ≤1 year. Initial dosing depended on erythropoiesis-stimulating agent (ESA) dose at screening for patients receiving ESAs (≥6 weeks) and weight-based for those not (total &lt;6 weeks). Primary efficacy endpoints were proportion of patients with mean hemoglobin (Hb) ≥10.0 g/dL averaged over Weeks 16–24, and mean Hb change from baseline to the average during Weeks 16–24. Treatment-emergent adverse events (TEAEs) and treatment-emergent serious adverse events (TESAEs) were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of 281 patients screened, 203 were treated and 201 included in the full analysis set. Overall, 166 patients completed the 24-week treatment period and 126 continued into the extension period. Mean baseline Hb was 10.4 g/dL and 82.6% received in-center hemodialysis. Overall, 84.6% of patients achieved a mean Hb ≥ 10.0 g/dL averaged Weeks 16–24. Mean (standard deviation) Hb change from baseline averaged Weeks 16–24 was 0.5 (1.0) g/dL. Prespecified subgroup analyses were consistent with primary analyses. Dosing adherence was 94%. Overall, 3.0% of patients received a red blood cell transfusion at up to Week 24. TEAEs and TESAEs were reported by 71.4% and 25.6% of patients, respectively. The most frequently reported TESAEs were COVID-19 (<i>n</i> = 5; 2.5%), and acute myocardial infarction, pneumonia, and sepsis (each <i>n</i> = 4; 2.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Roxadustat effectively achieved and/or maintained mean Hb levels ≥10.0 g/dL in patients receiving dialysis. The feasibility of incorporating oral roxadustat into dialysis organizations was successfully demonstrated with high dosing adherence. No new safety signals were identified.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"59-71"},"PeriodicalIF":1.3,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159576","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":"Myocardial markers are highly altered by higher rates of fluid removal during hemodialysis","authors":"Junko Goto,&nbsp;Michael Ott,&nbsp;Bernd Stegmayr","doi":"10.1111/hdi.13124","DOIUrl":"10.1111/hdi.13124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although hemodialysis is lifesaving in patients with kidney failure extensive interdialytic weight gain (IDWG) between dialyses worsens the prognosis. We recently showed a strong correlation between IDWG and predialytic values of cardiac markers. The aim of the present study was to evaluate if the cardiac markers N-terminal pro-B-type natriuretic peptide (proBNP) and troponin T were influenced by IDWG and speed of fluid removal (ultrafiltration-rate).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty hemodialysis patients performed in total 60 hemodialysis (three each). Predialytic values of proBNP and troponin T and changes from predialysis to 180 min hemodialysis (180–0 min) were compared with the IDWG calculated in percent of body weight. The ultrafiltration-rate was adjusted (UF-rate_adj) to IDWG: (100 × weight gain between dialysis [kg])/(estimated body dry weight [kg] × length of hemodialysis session [hours]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UF-rate_adj correlated (Spearman) with (1) predialytic values of IDWG (<i>r</i> = 0.983, <i>p</i> &lt; 0.001), proBNP (<i>r</i> = 0.443, <i>p</i> &lt; 0.001), and troponin T (<i>r</i> = 0.296, <i>p</i> = 0.025); and (2) differences in proBNP_180–0min (<i>r =</i> 0.572, <i>p</i> &lt; 0.001) and troponin T_180–0min (<i>r</i> = 0.400, <i>p</i> = 0.002). UF-rates_adj above a breakpoint of 0.60 caused more release of proBNP_180–0min (<i>p</i> = 0.027). Remaining variables in multiple regression analysis with ProBNP_180–0min as dependent factor were predialytic proBNP (<i>p</i> &lt; 0.001) and the ultrafiltration-rate (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher UF-rate_adj during dialysis was correlated to increased levels of cardiac markers. Data support a UF-rate_adj lower than 0.6 to limit such increase. Further studies may confirm if limited fluid intake and a lower UF-rate_adj should be recommended to prevent cardiac injury during dialysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"17-23"},"PeriodicalIF":1.3,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159579","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":"Elevated intraneural vascularization of the median nerve proximal to the arteriovenous fistula in hemodialysis patients suspected of carpal tunnel syndrome: A case series","authors":"Carina N. Bagge,&nbsp;Kristine Lindhard,&nbsp;Ylian S. Liem,&nbsp;Janus Kaufmann Lindquist,&nbsp;Eszter Balazs-Becsi,&nbsp;Nils Wolfram","doi":"10.1111/hdi.13123","DOIUrl":"10.1111/hdi.13123","url":null,"abstract":"<p>Patients with end-stage kidney disease may require creation of an arteriovenous fistula in order to receive hemodialysis treatment. The creation may result in several complications, including carpal tunnel syndrome. Early diagnosis and treatment are essential to relieve symptoms, prevent permanent nerve damage, and improve quality of life. However, the sensory and motor disturbances resembling carpal tunnel syndrome could be related to other etiologies than external compression of the median nerve underneath the transverse ligament. This case report presents eight patients with a radiocephalic arteriovenous fistula, who all had symptoms of carpal tunnel syndrome. Ultrasonographic examination showed a segmental intraneural hypervascularization of a large vessel inside the median nerve proximal to the wrist and arteriovenous fistula anastomosis with garland-like course as well as multiple flow velocities. The neurophysiological findings showed a significant decreased velocity in the ipsilateral forearm to the arteriovenous fistula.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"125-129"},"PeriodicalIF":1.3,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49695371","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 vitamin D supplementation on management of anemia in hemodialysis patients with vitamin D deficiency: A double-blind, randomized, controlled trial","authors":"Sameh Mohamed Emarah,&nbsp;Mohamed Abd El Rahman Ahmed,&nbsp;Ghada Mohamed El Kannishy,&nbsp;Ahmed Elsaeed Abdulgalil","doi":"10.1111/hdi.13121","DOIUrl":"10.1111/hdi.13121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Anemia and vitamin D deficiency are common problems among hemodialysis (HD) patients. This study aimed to assess the impact of correction of vitamin D deficiency with vitamin D supplementation on the improvement of anemia in patients with end-stage renal disease (ESRD) on maintenance HD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This double-blind, randomized, controlled study included 100 anemic HD patients with vitamin D deficiency who were randomly divided using the closed envelop method into two groups (1:1). The first group received vitamin D (50,000 IU) monthly for 6 months, and the other group received a placebo for the same period. 25-Hydroxyvitamin D (25(OH)D) levels were measured for both groups at the beginning of the study and after 6 months at the end of the study. Hemoglobin (Hb) concentrations were recorded monthly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Vitamin D supplementation during the period of the study increased 25(OH)D levels in the vitamin D group more than the placebo group (<i>p</i> &gt; 0.001). Serum ferritin, serum iron, and transferrin saturation did not differ significantly between both groups during the period of the study. Hb concentration in the vitamin D group increased more than that in the other group over the period of the study, and there was a statistically significant difference between the two groups in all durations of follow-up. Erythropoietin (EPO) dosage requirements were found to be lower in the vitamin D group than in the placebo group, and this was statistically significant (<i>p</i> &gt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Vitamin D supplementation in anemic ESRD patients on HD with vitamin D deficiency or insufficiency is safe and effective in improving anemia and decreasing EPO dosage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"51-58"},"PeriodicalIF":1.3,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686622","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 role of calcitonin gene-related peptide and substance P in the pathogenesis of dialysis headache","authors":"Gizem Gürsoy,&nbsp;Serhat Karadağ,&nbsp;Şennur Köse,&nbsp;Tamer Şakacı,&nbsp;Sibel Yücel Koçak,&nbsp;Yasemin Erdoğan Döventaş,&nbsp;Ayla Çulha Oktar,&nbsp;Muhammet Duran Bayar","doi":"10.1111/hdi.13120","DOIUrl":"10.1111/hdi.13120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The present study aims to establish the role of serum CGRP and SP levels in the disease pathophysiology in patients with dialysis headache not accompanied by primary or secondary headaches, and also whether there is a correlation between these vasoactive peptides and the severity of headache.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study was designed as prospective and multicenter. A total of 30 dialysis headache patients and 30 patients without headache as the control group in the Nephrology outpatient clinics which implement similar dialysis procedures were included in the study. Blood samples were taken from all the patients before hemodialysis, and post-hemodialysis samples were collected. CGRP and SP contents in serum samples were measured using the ELISA method with detection kits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 60 patients were included in the study with 17 female and 13 male patients in the dialysis headache group and 18 female and 12 male patients in the control group, and there were no significant differences in sex and age between the groups. CGRP levels in the headache group were found to be significantly higher compared with the control group both before and after hemodialysis. Furthermore, pre-hemodialysis CGRP levels were significantly higher than post-hemodialysis CGRP levels in both the headache and control groups. Serum SP levels in the headache group were found to be higher compared with the control group both before and after hemodialysis, there was no significant difference between the groups. Even though SP levels in both groups decreased after hemodialysis, there was again no significant difference between the groups. No correlation was found between the patients' severity of headache and serum CGRP and SP levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study concludes that CGRP and SP, even though the latter is not statistically significant, play a role in the pathophysiology of the dialysis headache, and further studies with a larger and more specific patient population may reveal the relationship between the neuropeptides and dialysis headache more clearly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"85-91"},"PeriodicalIF":1.3,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686623","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":"Intravascular volumes and the influence on anemia assessed by a carbon monoxide rebreathing method in patients undergoing maintenance hemodialysis","authors":"Vårin Vinje,&nbsp;Tobias Bomholt,&nbsp;Carsten Lundby,&nbsp;Peter Oturai,&nbsp;Marianne Rix,&nbsp;Kristine Lindhard,&nbsp;Mads Hornum","doi":"10.1111/hdi.13118","DOIUrl":"10.1111/hdi.13118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fluid overload is a major challenge in hemodialysis patients and might cause hypervolemia. We speculated that hemodialysis patients reaching dry weight could have undetected hypervolemia and low hemoglobin (Hb) concentration (g/dL) due to hemodilution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included hemodialysis patients (<i>n</i> = 22) and matched healthy controls (<i>n</i> = 22). Blood volume, plasma volume, red blood cell volume, and total Hb mass were determined using a carbon monoxide (CO)-rebreathing method in hemodialysis patients reaching dry weight and controls. Blood volume measurements were also obtained by a dual-isotope labeling technique in a subgroup for validation purposes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>In the hemodialysis group, the median specific blood volume was 89.3 mL/kg (interquartile range [IQR]: 76.7–95.4 mL/kg) and was higher than in the control group (79.9 mL/kg [IQR: 70.4–88.0 mL/kg]; <i>p</i> &lt; 0.037). The median specific plasma volume was 54.7 mL/kg (IQR: 47.1–61.0 mL/kg) and 44.0 mL/kg (IQR: 38.7–49.5 mL/kg) in the hemodialysis and control groups, respectively (<i>p</i> &lt; 0.001). Hb concentration was lower in hemodialysis patients (<i>p</i> &lt; 0.001), whereas no difference in total Hb mass was observed between groups (<i>p</i> = 0.11). A correlation was found between blood volume measured by the CO-rebreathing test and the dual-isotope labeling technique in the control group (<i>r</i> = 0.83, <i>p</i> = 0.015), but not the hemodialysis group (<i>r</i> = 0.25, <i>p</i> = 0.60).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The hemodialysis group had increased specific blood volume at dry weight due to high plasma volume, suggesting a hypervolemic state. However, correlation was not established against the dual-isotope labeling technique underlining that the precision of the CO-rebreathing test should be further validated. The total Hb mass was similar between hemodialysis patients and controls, unlike Hb concentration, which emphasizes that Hb concentration is an inaccurate marker of anemia among hemodialysis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"40-50"},"PeriodicalIF":1.3,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223977","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 relationship between skeletal muscle mass and exercise capacity in patients undergoing hemodialysis: An exploratory secondary-analysis","authors":"Xuanrui Zhang,&nbsp;Yan Zhuang,&nbsp;Wen Qin,&nbsp;Lun Yang,&nbsp;Yan Song","doi":"10.1111/hdi.13115","DOIUrl":"10.1111/hdi.13115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Protein-energy wasting is commonly observed in patients undergoing hemodialysis, leading to reduced muscle mass and, in severe cases, sarcopenia, which significantly impacts the patients' quality of life and clinical outcomes. Exercise interventions are frequently employed to address muscle loss in these patients. However, the relationship between exercise capacity and skeletal muscle mass in this context remains uncertain. In this study, researchers conducted a series of body composition analysis and exercise capacity test to explore the relationship between exercise capacity and skeletal muscle mass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study recruited 32 patients undergoing hemodialysis and analyzed their demographic and clinical parameters. To assess aerobic exercise capacity, the incremental shuttle walking test (ISWT) was conducted, while the handgrip strength test was used to evaluate muscle strength. The patients' body compositions were assessed using the Fresenius Body Composition Monitor, and the appendicular skeletal muscle was scanned using a GE Healthcare Lunar iDXA scanner. Three sequential linear models were employed to model the relationship between ISWT and skeletal muscle mass. Model 1 regressed ISWT against gender and age; Model 2 added handgrip strength, fat tissue index, and Davies comorbidity scores as additional predictors; and Model 3 further included the appendicular skeletal muscle index (appendicular skeletal muscle/height).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>After controlling for age and gender (Model 1: <i>R</i>² = 0.373), and subsequently including handgrip strength, fat tissue index, and Davies comorbidity score effects (Model 2: <i>R</i>² = 0.581), the impact of appendicular skeletal muscle on ISWT was found to be non-significant (Model 3: <i>R</i>² = 0.600).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was no significant correlation observed between exercise capacity and skeletal muscle mass in patients undergoing hemodialysis, indicating the factors influencing exercise capacity in this patient population are complex and that increasing skeletal muscle mass may not necessarily involve solely addressing the improvement of exercise capacity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"98-106"},"PeriodicalIF":1.3,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223978","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}