Seminars in Dialysis最新文献_第3页

Successful Application of a Hemoperfusion Machine in Separated System CRRT: Evaluating Effectiveness and Safety in Critically Ill Patients With AKI in Resource-Limited Settings. 血液灌流机在分离式系统 CRRT 中的成功应用：评估在资源有限的环境中对 AKI 重症患者的有效性和安全性。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-21 DOI: 10.1111/sdi.13210

Atthaphong Phongphithakchai, Thiti Sirisuksan, Sirihatai Konwai, Suntornwit Praditau-Krit, Ussanee Boonsrirat

{"title":"Successful Application of a Hemoperfusion Machine in Separated System CRRT: Evaluating Effectiveness and Safety in Critically Ill Patients With AKI in Resource-Limited Settings.","authors":"Atthaphong Phongphithakchai, Thiti Sirisuksan, Sirihatai Konwai, Suntornwit Praditau-Krit, Ussanee Boonsrirat","doi":"10.1111/sdi.13210","DOIUrl":"https://doi.org/10.1111/sdi.13210","url":null,"abstract":"Background: It is imperative to note that integrated system continuous renal replacement therapy (CRRT) necessitates a sophisticated and costly apparatus, potentially limiting its availability within resource-limited settings. The introduction of a separated system for continuous veno-venous hemofiltration (CVVH), characterized by uncomplicated setup procedures with a hemoperfusion machine, holds promise as a feasible alternative to CRRT for critically ill patients with acute kidney injury (AKI).Methods: We aimed to retrospectively analyze the effectiveness and safety of separated CRRT applied from a hemoperfusion machine in critically ill patients with AKI during the January 2015 to December 2021 period. We also examine the in-hospital mortality rate and multivariate logistic regression analysis to uncover the factors that affect mortality.Results: We included a total of 129 critically ill patients who received separated system CRRT. The SOFA score at CRRT initiation was 12.6 ± 3.8. The fluid accumulation at the day of CRRT initiation was 3900 mL (622-8172 mL) All patients received pre- and postdilution CVVH. The mean prescribed CRRT dose was 22.4 ± 3.1 mL/kg/h. We found no serious complications including circuit explosion and air embolism. The in-hospital mortality rate was 68.9%. High SOFA score and positive fluid accumulation at CRRT initiation serve as predictors of survival.Conclusions: Separated system CRRT using a hemoperfusion machine provides a simplified system to operate and is proven to be effective and safe in real-life practice, especially in resource-limited areas.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071430","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}

引用次数: 0

Green Dialysate. 绿色透析液

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-21 DOI: 10.1111/sdi.13208

Héctor Raúl Ibarra-Sifuentes, Gustavo Abraham Canales-Azcona

引用次数: 0

Proximalization of Arterial Inflow for the Treatment of Limb Ischemia in a Transposed Femoral Arteriovenous Fistula-A Case Report. 为治疗经股动静脉瘘的肢体缺血而进行动脉导流近端化--病例报告。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-21 DOI: 10.1111/sdi.13209

Carlos Filipe Pinho Veterano, Paulo Jorge Carvalho de Almeida, Duarte Nuno Cunha Rego, Luís Pedro Martins Macedo Alvarenga Loureiro, Pedro Jorge Sá Pinto, Rui Manuel Vieira Mota Machado

{"title":"Proximalization of Arterial Inflow for the Treatment of Limb Ischemia in a Transposed Femoral Arteriovenous Fistula-A Case Report.","authors":"Carlos Filipe Pinho Veterano, Paulo Jorge Carvalho de Almeida, Duarte Nuno Cunha Rego, Luís Pedro Martins Macedo Alvarenga Loureiro, Pedro Jorge Sá Pinto, Rui Manuel Vieira Mota Machado","doi":"10.1111/sdi.13209","DOIUrl":"https://doi.org/10.1111/sdi.13209","url":null,"abstract":"Introduction: Femoral vein transposition is one of the final resorts for vascular access in patients with exhaustion of upper limb venous patrimony and central venous occlusive disease. Its major pitfalls include hemodialysis access-induced distal ischemia and infection. Surgical procedures may be warranted to preserve vascular access if ischemia develops. Several techniques are reported in the literature for femoral vein transposition.Case report: We expose an endoscopic femoral vein harvesting as an alternative to the single thigh incision in order to avoid its associated complications. In the setting of ischemia, proximalization of arterial inflow was used to manage femoral vein transposition associated limb ischemia.Conclusion: This case report aims to expose the aforementioned unreported surgical techniques for lower limb arteriovenous fistula, its advantages, and pitfalls, as well as considerations on its future use.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076330","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}

引用次数: 0

Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome to Hemodialysis Polysulfone Membrane. 血液透析聚砜膜引起的嗜酸性粒细胞增多症和全身症状（DRESS）药物反应综合征。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-21 DOI: 10.1111/sdi.13207

Masatoshi Inoue, Momoko Sasamoto, Ryosuke Ichihara

{"title":"Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome to Hemodialysis Polysulfone Membrane.","authors":"Masatoshi Inoue, Momoko Sasamoto, Ryosuke Ichihara","doi":"10.1111/sdi.13207","DOIUrl":"https://doi.org/10.1111/sdi.13207","url":null,"abstract":"Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe and potentially life-threatening hypersensitivity reaction. Although commonly associated with specific drugs, there have been no reports of DRESS syndrome caused by medical devices. We report a unique case of DRESS syndrome linked to a particular hemodialysis membrane during treatment. An 83-year-old man on hemodialysis exhibited fever, rash, and elevated eosinophils. Despite medication changes and consultations with specialists, his condition persisted. A drug-induced lymphocyte stimulation test revealed a positive response to the dialysis membrane. His symptoms and lab results met DRESS syndrome diagnostic criteria. After substituting the membrane and administering glucocorticoids, the patient displayed early improvement. Diagnosing DRESS syndrome is complex due to its varied presentation and lack of specific benchmarks. This instance underscores the need to consider medical devices as potential DRESS syndrome triggers. Enhanced physician awareness can facilitate prompt detection and proper management, ultimately refining patient outcomes.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075684","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}

引用次数: 0

Safety and Feasibility of Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy With Calcium-Containing Solutions: A Randomized Controlled Trial. 使用含钙溶液进行连续性肾脏替代治疗时区域性枸橼酸盐抗凝剂的安全性和可行性：随机对照试验

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-05 DOI: 10.1111/sdi.13200

Shan Huang, Guangfeng Sun, Penglong Wu, LinJing Wu, Hongfei Jiang, Xixing Wang, Liyuan Li, Lingling Gao, Fanqi Meng

{"title":"Safety and Feasibility of Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy With Calcium-Containing Solutions: A Randomized Controlled Trial.","authors":"Shan Huang, Guangfeng Sun, Penglong Wu, LinJing Wu, Hongfei Jiang, Xixing Wang, Liyuan Li, Lingling Gao, Fanqi Meng","doi":"10.1111/sdi.13200","DOIUrl":"10.1111/sdi.13200","url":null,"abstract":"Background: Calcium-free (Ca-free) solutions are theoretically the most ideal for regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT). However, the majority of medical centers in China had to make a compromise of using commercially available calcium-containing (Ca-containing) solutions instead of Ca-free ones due to their scarcity. This study was designed to probe into the potential of Ca-containing solution as a secure and efficient substitution for Ca-free solutions.Methods: In this prospective, randomized single-center trial, 99 patients scheduled for CRRT were randomly assigned in a 1:1:1 ratio to one of three treatment groups: continuous veno-venous hemodialysis Ca-free dialysate (CVVHD Ca-free) group, continuous veno-venous hemodiafiltration calcium-free dialysate (CVVHDF Ca-free) group, and continuous veno-venous hemodiafiltration Ca-containing dialysate (CVVHDF Ca-containing) group at cardiac intensive care unit (CICU). The primary endpoint was the incidence of metabolic complications. The secondary endpoints included premature termination of treatment, thrombus of filter, and bubble trap after the process.Results: The incidence of citrate accumulation (18.2% vs. 12.1% vs. 21.2%) and metabolic alkalosis (12.1% vs. 0% vs. 9.1%) did not significantly differ among three groups (p > 0.05 for both). The incidence of premature termination was comparable among the groups (18.2% vs. 9.1% vs. 9.1%, p = 0.582). The thrombus level of the filter and bubble trap was similar in the three groups (p > 0.05 for all).Conclusions: In RCA-CRRT for CICU population, RCA-CVVHDF with Ca-containing solutions and traditional RCA with Ca-free solutions had a comparable safety and feasibility.Trial registration: ChiCTR2100048238 in the Chinese Clinical Trial Registry.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028836","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}

引用次数: 0

Deep learning-based prediction of coronary artery calcium scoring in hemodialysis patients using radial artery calcification. 基于深度学习的桡动脉钙化预测血液透析患者冠状动脉钙化评分。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-01-04 DOI: 10.1111/sdi.13191

Yuankai Xu, Wen Li, Yanli Yang, Shiyi Dong, Fulei Meng, Kaidi Zhang, Yuhuan Wang, Lin Ruan, Lihong Zhang

{"title":"Deep learning-based prediction of coronary artery calcium scoring in hemodialysis patients using radial artery calcification.","authors":"Yuankai Xu, Wen Li, Yanli Yang, Shiyi Dong, Fulei Meng, Kaidi Zhang, Yuhuan Wang, Lin Ruan, Lihong Zhang","doi":"10.1111/sdi.13191","DOIUrl":"10.1111/sdi.13191","url":null,"abstract":"Objective: This study used random forest model to explore the feasibility of radial artery calcification in prediction of coronary artery calcification in hemodialysis patients.Material and methods: We enrolled hemodialysis patients and performed ultrasound examinations on their radial arteries to evaluate the calcification status using a calcification index. All involved patients received coronary artery computed tomography scans to generate coronary artery calcification scores (CACS). Clinical variables were collected from all patients. We constructed both a random forest model and a logistic regression model to predict CACS. Logistic regression model was used to identify the risk factors of radial artery calcification.Results: One hundred eighteen patients were included in our analysis. In random forest model, the radial artery calcification index, age, serum C-reactive protein, body mass index (BMI), diabetes, and hypertension history were related to CACS based on the average decrease of the Gini coefficient. The random forest model achieved a sensitivity of 76.9%, specificity of 75.0%, and area under receiver operating characteristic of 0.869, while the logistic regression model achieved a sensitivity of 75.2%, specificity of 68.7%, and area under receiver operating characteristic of 0.742 in prediction of CACS. Sex, BMI index, smoking history, hypertension history, diabetes history, and serum total calcium were all the risk factors related to radial artery calcification.Conclusions: A random forest model based on radial artery calcification could be used to predict CACS in hemodialysis patients, providing a potential method for rapid screening and prediction of coronary artery calcification.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098599","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}

引用次数: 0

Influence of renin-angiotensin system blockades on vascular access survival in patients on maintenance hemodialysis. 肾素-血管紧张素系统阻断剂对维持性血液透析患者血管通路存活率的影响。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2023-12-22 DOI: 10.1111/sdi.13189

Seok Hui Kang, Bo Yeon Kim, Eun Jung Son, Gui Ok Kim, Jun Young Do

{"title":"Influence of renin-angiotensin system blockades on vascular access survival in patients on maintenance hemodialysis.","authors":"Seok Hui Kang, Bo Yeon Kim, Eun Jung Son, Gui Ok Kim, Jun Young Do","doi":"10.1111/sdi.13189","DOIUrl":"10.1111/sdi.13189","url":null,"abstract":"Introduction: Results on the association between the use of renin-angiotensin system blockades (RASBs) and vascular access-related outcomes are inconsistent. We aimed to compare vascular access-related outcomes according to the use of RASBs in hemodialysis patients.Methods: This study used data from a national hemodialysis quality assessment program of the Republic of Korea (n = 54,903). Group 1 was not prescribed any blood pressure-lowering drugs (n = 28,521). Group 2 was prescribed other blood pressure-lowering agents except for RASBs (n = 9571). Group 3 was prescribed RASBs (n = 16,811). Vascular access-related outcomes were classified into intervention-free survival (IFS), thrombosis-free survival (TFS), and vascular access survival (VAS).Results: No significant difference in the three access survival rates was identified among the three groups. The multivariate Cox regression analyses indicated that Group 3 had better outcomes in IFS and TFS than Group 1. The numbers of angioplasties performed were significantly greater in Group 1 than in the other two groups. The numbers of thrombectomies performed were significantly the lowest in Group 3 among all the groups.Conclusions: Our study revealed different results according to types of access survival in univariate or multivariate analyses. The association of RASBs with favorable outcomes in vascular access remains unclear.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138885940","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}

引用次数: 0

Paradoxical Embolic Stroke Following Percutaneous Transluminal Angioplasty in a Hemodialysis Patient. 血液透析患者经皮腔内血管成形术后发生栓塞性中风。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-09 DOI: 10.1111/sdi.13201

Xun Luo, Jie Yu, Hailang Xiao, Lang Dai, Yang Jiang, Xiaohui Xia, Wenjian Shi, Fan Zhang

引用次数: 0

Minimizing early catheter failure using a risk stratification model for peritoneal dialysis. 利用腹膜透析风险分层模型最大限度地减少导管早期失效。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2023-12-06 DOI: 10.1111/sdi.13187

Lulu Sun, Chuan Cheng, Yuqin Wang, Changqing Luo, Mingzhu Ye, Jing Sun, Chun Zhang, Lijun Yao, Huajun Jiang

{"title":"Minimizing early catheter failure using a risk stratification model for peritoneal dialysis.","authors":"Lulu Sun, Chuan Cheng, Yuqin Wang, Changqing Luo, Mingzhu Ye, Jing Sun, Chun Zhang, Lijun Yao, Huajun Jiang","doi":"10.1111/sdi.13187","DOIUrl":"10.1111/sdi.13187","url":null,"abstract":"Background: Early catheter failure is the main reason for peritoneal dialysis (PD) failure, which often causes patients to withdraw from PD. Reducing the early catheter failure is critical to increase the acceptance of PD. The purpose of our study was to establish a risk stratification model to minimize early catheter failure.Methods: A retrospective study with patients underwent PD catheter placement from January 2013 to March 2022 was conducted. The primary outcome event was early catheter failure. Univariate and multivariable logistic regression were performed to select potential risk predictors. A risk stratification model and a clinical procedure were established. The effectiveness of the model was evaluated by external validation.Results: A total of 432 patients were finally enrolled in the study. The risk for early catheter failure was associated with younger age (odds ratio [OR], 0.930; 95% confidence interval [95% CI], 0.884 to 0.972; p = 0.002), lower body mass index (BMI) (OR, 0.797; 95% CI, 0.629 to 0.964; p = 0.036), and lower albumin (ALB) levels (OR, 0.881; 95% CI, 0.782 to 0.985; p = 0.036). The risk stratification model was established and performed great discrimination capability with AUC of 0.832 (cut-off value: 0.061, sensitivity: 0.853, specificity: 0.812). The model proved to be effective in external validation; the rate of early catheter failure was dropped off from 4.1% to 0%.Conclusions: We established an effective risk stratification model, by which patients with high risk of early catheter failure could be precisely identified. The clinical procedure based on the model was proved to be helpful to minimize early catheter failure.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488408","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}

引用次数: 0

Peritoneal Protein Loss With Time in Peritoneal Dialysis. 腹膜透析过程中腹膜蛋白质随时间流失的情况。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1111/sdi.13194

Anabela Malho Guedes, Roberto Calças Marques, Ana Teresa Domingos, Céu Laranjo, Ana Paula Silva, Anabela Rodrigues, Raymond T Krediet

{"title":"Peritoneal Protein Loss With Time in Peritoneal Dialysis.","authors":"Anabela Malho Guedes, Roberto Calças Marques, Ana Teresa Domingos, Céu Laranjo, Ana Paula Silva, Anabela Rodrigues, Raymond T Krediet","doi":"10.1111/sdi.13194","DOIUrl":"10.1111/sdi.13194","url":null,"abstract":"Longitudinal evolution of peritoneal protein loss (PPL), a reflection of hydrostatic pressure-driven leak of plasma proteins through the large-pore pathway, is not clear. Time on PD causes loss of mesothelial cells, vasculopathy, and increased thickness of the submesothelial fibrous layer. Are these structural changes associated with progressive increase of PPL, in a parallel with the rise in the D/P creatinine? The aim of the present study was to identify longitudinal changes of PPL over time. This single-center, longitudinal study included 52 peritoneal dialysis (PD) patients with a median follow-up of 26.5 months, evaluated at two different time points with a minimum interval of 6 months. Repeated measures analysis was performed using paired sample t-test or the nonparametric Wilcoxon signed-rank test, depending on the distribution. After a median interval of 15.5 months, lower levels of residual renal function and urine volume, lower Kt/V, and creatinine clearance were found. D/P creatinine and PPL were stable, but a decrease in ultrafiltration was present. Systemic inflammation, nutrition, and volume overload showed no significant change with time on PD. Analysis of a subpopulation with over 48 months between initial and subsequential assessment (n = 11) showed again no difference in inflammation, nutritional and hydration parameters from baseline, but importantly PPL decreased after more than 4 years on PD (mean difference 1.2 g/24, p = 0.033). D/P creatinine and dip of sodium remained unchanged. The absence of deleterious effects of time on PD is reassuring, pointing to the benefit of updated PD prescription, including the standard use of more biocompatible solutions towards membrane preservation and adjusted prescription avoiding overhydration and inflammation while maintaining nutritional status. After controlling for confounders, PPL may act as a biomarker of acquired venous vasculopathy, even if small pore fluid transport rates and free water transport are preserved.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991048","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}

引用次数: 0