Seminars in Dialysis最新文献

{"title":"Targeted Temporary Tunnel Compression Suture: A Precision Method for Localizing and Controlling Postimplantation Bleeding in Tunneled Dialysis Catheter.","authors":"Subrahmanian Sathiavageesan","doi":"10.1111/sdi.70021","DOIUrl":"10.1111/sdi.70021","url":null,"abstract":"<p><strong>Background: </strong>Tunneled dialysis catheters (TDCs) remain the mainstay of unplanned and urgent start hemodialysis. TDCs are implanted by interventional radiologists, surgeons, or nephrologists, and these clinicians must be familiar with the management of TDC-related complications. Postimplantation bleeding at the exit site of a TDC poses diagnostic and therapeutic challenges.</p><p><strong>Methods: </strong>In this case report, we describe a simple bedside method for precise localization of the bleeding spot and targeted placement of a compression suture to arrest exit site bleeding from a TDC.</p><p><strong>Discussion: </strong>Bleeding at the exit site may be the result of bleeding from a venotomy wound or the tunnel tract or the exit wound itself. Precise localisation of the bleeding spot is an essential first step in achieving secure hemostasis. Currently recommended measures like application of manual compression, compressive dressing, local infiltration of hemostatic agents, and suturing of the exit site are limited by their empirical nature and failure to specifically target the bleeding vessel.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"48-52"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616472","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":"Advancing Postdilution Hemodiafiltration for Global Sustainability: A Japanese Blueprint.","authors":"Kenji Sakurai, Ikuto Masakane, Akihiro C Yamashita, Hideki Kawanishi, Bernard Canaud","doi":"10.1111/sdi.70018","DOIUrl":"10.1111/sdi.70018","url":null,"abstract":"<p><strong>Background: </strong>Japan leads globally in HDF adoption, with online predilution HDF used in the majority of HDF treatments. Although associated with excellent outcomes, predilution HDF requires large substitution volumes and high dialysate production, raising sustainability concerns.</p><p><strong>Methods: </strong>This study employed a narrative review integrating expert consensus, Japanese registry data (JSDT), dialysis system specifications, and comparative clinical and kinetic literature to contrast predilution and postdilution strategies and derive an implementation pathway.</p><p><strong>Results: </strong>Postdilution HDF provides higher convective efficiency and solute removal per liter of fluid than predilution HDF, enabling comparable performance with lower total fluid requirements when prescriptions are optimized. A stepwise transition strategy is proposed: (1) progressive blood flow optimization; (2) selection of HDF-appropriate dialyzers with strict albumin permeability control; (3) anticoagulation optimization for higher filtration fractions; (4) gradual introduction and escalation of postdilution convection with automated fluid control; (5) dialysate-to-blood flow alignment allowing reduction of total dialysate flow while preserving clearance; and (6) iterative monitoring of efficacy and tolerance using clinical targets and biomarker response.</p><p><strong>Conclusions: </strong>A pragmatic transition toward optimized postdilution HDF can preserve Japan's high-quality dialysis care while improving resource efficiency. Registry-based evaluations and targeted randomized studies are needed to confirm clinical outcomes and quantify economic and environmental benefits.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"33-43"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271799","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":"Blood Hemoglobin Change During Maintenance Hemodialysis Sessions.","authors":"Hiroyuki Koike, Masayuki Tanemoto","doi":"10.1111/sdi.70020","DOIUrl":"10.1111/sdi.70020","url":null,"abstract":"<p><strong>Background: </strong>Blood hemoglobin (Hb) levels typically increase during maintenance hemodialysis (MHD) sessions. This intradialytic Hb change (ID-HbC) may increase thrombotic risks depending on its magnitude. This study investigated the magnitude.</p><p><strong>Methods: </strong>In 115 MHD sessions with standard hemodialysis modality, relative-ID-HbC, which was calculated from pre- and post-dialysis Hb values, was examined in relation to ultrafiltration volume normalized to dry weight (UFV/DW).</p><p><strong>Results: </strong>Relative-ID-HbC ranged from -0.037 to 0.324, with a median (interquartile range) of 0.104 (0.070-0.177). A significant positive correlation was observed between relative-ID-HbC and UFV/DW (r = 0.50, p < 0.001), with a least-squares regression slope of 3.1. In about 1/3 sessions with UFV/DW > 0.05, relative-ID-HbC exceeded 0.2.</p><p><strong>Conclusion: </strong>More than 20% increase in Hb can occur in sessions with UFV/DW > 0.05, whereas the typical increase is around 3% per 1% increase in UFV/DW. To reduce thrombotic risks, anemia therapy raising pre-dialysis Hb > 10.5 g/dL should preferably be avoided in MHD patients who require UFV/DW > 0.05.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"44-47"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504698","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":"Value-Based Model for Vascular Access Management in the End-Stage Kidney Disease Population.","authors":"Daniel Raskin, Tushar J Vachharajani, Sasan Partovi, Abdullah Khan, Sean P Lyden, Levester Kirksey","doi":"10.1111/sdi.70024","DOIUrl":"10.1111/sdi.70024","url":null,"abstract":"<p><strong>Background: </strong>Value-based medicine (VBM) seeks to maximize patient-relevant outcomes per unit cost. In end-stage kidney disease (ESKD), vascular access (VA) is a dominant, modifiable driver of morbidity, mortality, and expenditure.</p><p><strong>Methods: </strong>We performed a narrative review of published studies and gray literature on VA creation, maintenance, and salvage in ESKD, focusing on clinical outcomes, patient experience, and economic impact. Findings were synthesized within a VBM framework relevant to clinicians, health-system leaders, and policymakers.</p><p><strong>Results: </strong>Contemporary data confirm that tunneled dialysis catheters (TDCs) are associated with high rates of bloodstream infection, central venous injury, and mortality, and substantially higher costs than autogenous access. Arteriovenous fistulas (AVFs) offer the best long-term value when creation is risk-based, maturation is supported, and the access is actually used; nonmaturation, nonuse, and prolonged catheter dependence erode this advantage. Endovascular AVF and external support devices improve technical success and early patency but have uncertain cost-effectiveness at current device prices. Arteriovenous grafts (AVGs) can provide greater net value than AVFs in selected patients (older, frail, or with poor veins) by shortening catheter exposure, at the expense of higher reintervention rates and maintenance costs. Across access types, circuit failure and recurrent interventions drive a substantial share of hemodialysis admissions and Medicare spending. Selective preoperative imaging, targeted duplex ultrasound in response to clinical findings, and ultrasound-guided cannulation can improve access selection, maturation, and salvage while avoiding low-value routine surveillance. Peritoneal dialysis remains underutilized despite comparable outcomes in many cohorts and lower average per-patient costs than in-center hemodialysis. Site-of-service optimization (office-based/ASC vs. hospital) and multidisciplinary, life-plan-based access programs further reduce admissions, catheter days, and per-patient costs.</p><p><strong>Conclusions: </strong>A value-based VA strategy for ESKD should prioritize minimizing catheter exposure, tailoring AVF versus AVG use to patient risk, integrating PD where feasible, using selective imaging and monitoring, matching site of service to case complexity, and organizing multidisciplinary access teams aligned with quality and cost metrics.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"15-25"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646462","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":"Tuberculous Peritonitis Diagnosed by Metagenomic Next-Generation Sequencing Progressing to Fatal Encapsulating Peritoneal Sclerosis in a Peritoneal Dialysis Patient: A Case Report.","authors":"Tianjiao Cui, Mingcheng Huang","doi":"10.1111/sdi.70022","DOIUrl":"10.1111/sdi.70022","url":null,"abstract":"<p><p>A 40-year-old woman on peritoneal dialysis for 3 years presented with febrile peritonitis. Metagenomic next-generation sequencing (mNGS) confirmed Mycobacterium tuberculosis complex in ascitic fluid, leading to prompt anti-tuberculosis therapy. She initially improved but developed ultrafiltration failure 15 months later and transitioned to hemodialysis. At 18 months, she developed bowel obstruction, bloody ascites, and characteristic imaging and laparoscopic findings of encapsulating peritoneal sclerosis (EPS). Despite supportive care, she deteriorated and died 30 months after tuberculosis peritonitis diagnosis. This case highlights that mNGS enables rapid diagnosis of tuberculous peritonitis when conventional tests are inconclusive, and that tuberculosis peritonitis may serve as a potent inflammatory trigger for EPS even after peritoneal dialysis cessation. Early recognition and timely intervention may improve outcomes.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"53-56"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646322","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 Renal Replacement Therapy on FeNO Levels and Pulmonary Function in End-Stage Renal Disease Patients.","authors":"Buğra Kerget, İsmail Çınar, Eda Çelik, Can Sevinç, Edip Erkuş","doi":"10.1111/sdi.70011","DOIUrl":"10.1111/sdi.70011","url":null,"abstract":"<p><strong>Background: </strong>Renal replacement therapy (RRT) is crucial for end-stage renal disease, yet its pulmonary effects remain unclear. Fractional exhaled nitric oxide (FeNO) serves as a biomarker for airway inflammation. This study evaluates FeNO levels in hemodialysis (HD) and peritoneal dialysis (PD) patients and their relationship with pulmonary function.</p><p><strong>Methods: </strong>RRT patients aged 18-65, followed for at least 2 years in our nephrology clinic, were included. FeNO tests were performed after routine blood sampling. The study comprised 110 patients: 50 HD, 30 PD, and 30 controls.</p><p><strong>Results: </strong>FeNO levels before and after dialysis were statistically significantly higher in HD patients compared to PD patients (p = < 0.001 for both). Exhaled NO levels measured in the control group were 7.6 ± 5.2 ppb and were statistically significantly lower compared to HD patients before and after dialysis (p = < 0.001 for both). A negative correlation was observed between FeNO and FEV1 and FVC percent (R = -0.807, p = 0.01; R = -0.801, p = 0.01, respectively). A positive correlation was observed between exhaled NO levels before and after dialysis and ΔFVC, ΔFEV1, and ΔPEF25-75 (R = 0.74, p = 0.01; R = 0.74, p = 0.01; R = 0.89, p = 0.01, respectively).</p><p><strong>Conclusion: </strong>This study showed that FeNO levels were significantly higher in HD patients before and after RRT compared to PD and healthy controls, suggesting a greater impact of HD on airway inflammation. FeNO measurement may serve as a biomarker for monitoring pulmonary health in RRT patients.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"340-346"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701549","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":"Hemodialysis Patients' Needs for Self-Care Structured Teaching Programs: A Pre- and Post-Test Study.","authors":"Radhe Shyam, Himanshu Verma, Daisy Thomas, Harindarjeet Goyal, Sourabh Sharma","doi":"10.1111/sdi.70013","DOIUrl":"10.1111/sdi.70013","url":null,"abstract":"<p><strong>Background: </strong>Patients on hemodialysis need to have sufficient knowledge, skill, and ability to carry out their treatment regimen. The aim of this study was to identify factors that affect adherence to hemodialysis and to assess the role of a structured teaching program on self-care in terms of knowledge and practice.</p><p><strong>Methods: </strong>This was a pre-experimental one-group pre-test post-test design study conducted at a tertiary care center in India, from January 10, 2022, to March 30, 2022, involving 50 participants by convenience sampling. Electronic training (self-care structured teaching program), structured knowledge interview, ESRD-AQ tool, and structured 4-point Likert-practice rating scale were implied.</p><p><strong>Results: </strong>Most patients (38/50; 76%) were non-adherent. Educational status (p = 0.0002), occupation (p = 0.0006), monthly income (p = 0.0017), dialysis frequency (p = 0.019), transportation mode (p = 0.0003), education frequencies (p = 0.0006), and perceived relative importance of hemodialysis (p = 0.0001) were statistically significantly associated with adherence. The mean pre-test knowledge score was 10.82 while the mean post-test knowledge score was 19.50. The mean difference between the pre-test and post-test score was 8.68 ± 0.12 and the difference was clinically significant (p = 0.001). Similarly, the mean pre-test practice rating scale was 23.70 while the mean post-test practice rating scale was 42.36. The mean difference between the pre-test and post-test score was 18.66 ± 0.95 and the difference was clinically significant (p = 0.001). There was a significant association between the post-test knowledge and practice scores on the self-care and educational status of patients.</p><p><strong>Conclusion: </strong>Most patients were non-adherent and were deficient in knowledge and practices regarding self-care. Patient education and self-care teaching are beneficial in improving adherence.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"347-356"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865272","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":"Comparing Concurrent and Countercurrent Dialysate Flow in Hemodialysis: A Pilot Study on Hyponatremic Patients.","authors":"Amandeep Singh, Lalit Pursnani, Himansu Sekhar Mahapatra, Muthukumar Balakrishna, Sanket Patil, Manoj Prabhakaran, Abhishek Gautam, Anubhav Chakraborty","doi":"10.1111/sdi.70008","DOIUrl":"10.1111/sdi.70008","url":null,"abstract":"<p><strong>Background: </strong>In hyponatremic patients, concurrent dialysate flow during hemodialysis may be an ideal option to mitigate complications such as osmotic demyelination syndrome (ODS).</p><p><strong>Methods: </strong>Present randomized controlled trial enrolled dialysis-requiring chronic kidney disease (CKD) and acute kidney injury (AKI) patients with serum sodium levels < 125 mEq/L during January 2020 over 16 months. Hemodynamically unstable patients, as well as those with a history of seizures and neurological conditions, were excluded. All were randomized to concurrent and countercurrent dialysate flow groups during two-h dialysis session. Hydration status was evaluated by Body Composition Monitor BCMTM and hourly sodium was estimated to guide ultrafiltration. Comparative analysis of sodium correction rates (meq/L/h) during dialysis, neurological deterioration via Mini-Mental State Examination (MMSE) scores, and ODS during 1 week and 1 month in both groups was done. Two-way repeated measures ANOVA was used to compare sodium correction trends.</p><p><strong>Results: </strong>A total of 44 hyponatremic patients of AKI (17.39%), CKD (56.52%) and acute on CKD (26.09%) were randomized to concurrent (n = 23) and countercurrent (n = 21) dialysate groups. Postdialysis sodium correction rate was nonsignificantly slower in the concurrent group (45.45%) vs. the countercurrent group (36.36% group, p = 0.44). Neurological deterioration, measured via MMSE scores, and ODS incidence were absent in both groups. The concurrent group exhibited a higher proportion of patients without neurological deterioration (73.91%) compared to the countercurrent group (57.14%, p = 0.241). Comparable survival between the two groups was seen at 10, 20, and 30 days. No significant risk factors for mortality were identified in either group.</p><p><strong>Conclusion: </strong>Concurrent dialysate flow demonstrates a slower but nonsignificant rate of sodium correction, making it a safer alternative for managing severe hyponatremia during hemodialysis by reducing the risk of rapid neurological shifts.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"326-332"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016185","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":"Effects of Insulin Dosage Adjustment on Hemodialysis Day for Blood Glucose Levels, Glycated Albumin, Interleukin-6, and TNF-α in Patients With Type 2 Diabetes Mellitus and End-Stage Renal Disease.","authors":"Hendra Zufry, Krishna Wardhana Sucipto, Agustia Sukri Ekadamayanti, Sarah Firdausa, Maulina Debbyousha","doi":"10.1111/sdi.70007","DOIUrl":"10.1111/sdi.70007","url":null,"abstract":"<p><strong>Background: </strong>Previous studies suggested adjusting insulin doses during hemodialysis to reduce intra- and post-hemodialysis hypoglycemia. However, the impact of insulin adjustment on cardiovascular morbidity and mortality in diabetic patients with end-stage renal disease (ESRD) remains unclear. Although reducing hypoglycemia is a well-documented benefit of insulin dose modification in this population, the broader metabolic and inflammatory consequences-particularly those related to cardiovascular risk-are not well understood. This study aimed to investigate the effects of a 25% reduction in total daily insulin dose on hemodialysis days in T2DM patients with ESRD, focusing on daily blood glucose profiles, glycated albumin, IL-6, and TNF-α.</p><p><strong>Methods: </strong>A multicenter study with clinical trials was designed in five hemodialysis centers. It was a 4-week clinical trial involving 17 eligible type 2 diabetic patients with ESRD on insulin therapy and regular hemodialysis. Self-monitoring blood glucose was performed seven times a day before, during, and 1 month after the intervention. Blood samples were collected before and after the intervention. The Wilcoxon test was used to assess differences in daily glucose profiles, glycated albumin, IL-6, and TNF-α before and after insulin dose adjustment.</p><p><strong>Results: </strong>After 1 month of adjusting total daily insulin dose during hemodialysis, no statistically significant difference was observed in daily blood glucose, IL-6, and TNF-α levels. However, glycated albumin levels increased both before and after the insulin dosage modification.</p><p><strong>Conclusions: </strong>Reducing the total daily insulin dose by 25% during hemodialysis day effectively reduces hypoglycemia incidence intra- and post-hemodialysis in T2DM patients with ESRD without impacting pro-inflammatory factors IL-6 and TNF-α, which are associated with increased cardiovascular morbidity and mortality risk.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"316-325"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967340","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":"Utility of Adding Once-Weekly Hemoadsorption to High-Volume Hemodiafiltration for Refractory Restless Legs Syndrome: A Clinical Case Report.","authors":"Cristian Pedreros-Rosales, Gonzalo Ramírez-Guerrero, Hans Müller-Ortiz, Jonathan Alarcón-Fuentes, Beatriz Calderón-Salazar","doi":"10.1111/sdi.70014","DOIUrl":"10.1111/sdi.70014","url":null,"abstract":"<p><p>Dialysis improves survival in kidney failure but does not effectively remove larger uremic toxins, contributing to persistent symptoms like restless legs syndrome (RLS). High-volume hemodiafiltration (HDF) has improved these issues, but refractory cases may require combined therapies with hemoadsorption (HA). We present a patient with refractory RLS treated with HDF plus hemoadsorption using Jafron HA130 cartridges. The β2 microglobulin (β2M) reduction ratio was higher during HDF+HA (76.4% [75.8-77.8] vs. 72.9% [71.1-73.2]), with further improvement at Q_B > 400 ml/min (77.6% [77.2-79.4]). Despite similar baseline β2M levels, the patient's RLS score dropped from 32 to 0 points. Adding once-weekly hemoadsorption to high-volume HDF using HA130 adsorption may enhance refractory uremic symptom management, particularly at higher Q_B values. Given the scarce literature on this approach, our case highlights its potential benefits for dialysis patients with persistent uremic symptoms.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"357-360"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906675","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}