Seminars in Dialysis最新文献_第4页

A Cost-Effective Approach to Resistant AV Fistula Stenosis: Successful Treatment Using Coronary OPN NC® Balloon in a Low-Income Setting. 治疗耐药房室瘘狭窄的经济有效方法：在低收入地区使用冠状动脉 OPN NC® 球囊成功治疗。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-02-28 DOI: 10.1111/sdi.13196

Kanhai Lalani, M Sudhakar Rao, M Harsha Sagar, Padmakumar R

引用次数: 0

Hypersensitive Reactions During Hemodialysis Treatment: What Do We Need to Know? 血液透析治疗过程中的过敏反应：我们需要知道什么？

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-04 DOI: 10.1111/sdi.13197

Baris Afsar, Rengin Elsurer Afsar

{"title":"Hypersensitive Reactions During Hemodialysis Treatment: What Do We Need to Know?","authors":"Baris Afsar, Rengin Elsurer Afsar","doi":"10.1111/sdi.13197","DOIUrl":"10.1111/sdi.13197","url":null,"abstract":"Kidney replacement therapies (KRTs) including hemodialysis (HD) are one of the treatment options for most of the patients with end-stage kidney disease. Although HD is vital for these patients, it is not hundred percent physiological, and various adverse events including hypersensitivity reactions may occur. Fortunately, these reactions are rare in total and less when compared to previous decades, but it is still very important for at least two reasons: First, the number of patients receiving kidney replacement treatment is increasing globally; and the cumulative number of these reactions may be substantial. Second, although most of these reactions are mild, some of them may be very severe and even lead to mortality. Thus, it is very important to have basic knowledge and skills to diagnose and treat these reactions. Hypersensitivity reactions can occur at any component of dialysis machinery (access, extracorporeal circuit, medications, etc.). The most important preventive measure is to avoid the allergen. However, even with very specific test, sometimes the allergen cannot be found. In mild conditions, HD can be contained with non-specific treatment (topical creams, antihistaminics, corticosteroids). In more severe conditions, treatment must be stopped immediately, blood should not be returned to patient, drugs must be stopped, and rules of general emergency treatment must be followed.","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":"140022556","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 Phosphate Clearance: Determinants and Association With Mortality. 腹膜磷酸盐清除率：决定因素及其与死亡率的关系

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-20 DOI: 10.1111/sdi.13205

Jinping Li, Wenyu Zhang, Xichao Wang, Na Sun, Lei Li, Wenxiu Chang

{"title":"Peritoneal Phosphate Clearance: Determinants and Association With Mortality.","authors":"Jinping Li, Wenyu Zhang, Xichao Wang, Na Sun, Lei Li, Wenxiu Chang","doi":"10.1111/sdi.13205","DOIUrl":"10.1111/sdi.13205","url":null,"abstract":"Background: Dialytic phosphate removal is a cornerstone of the management of hyperphosphatemia in peritoneal dialysis (PD) patients, but the influencing factors on peritoneal phosphate clearance (PPC) are incompletely understood. Our objective was to explore clinically relevant factors associated with PPC in patients with different PD modality and peritoneal transport status and the association of PPC with mortality.Methods: This is a cross-sectional and prospective observational study. Four hundred eighty-five PD patients were enrolled and divided into 2 groups according to PPC. All-cause mortality was evaluated after followed-up for at least 3 months.Results: High PPC group showed lower mortality compared with Low PPC group by Kaplan-Meier analysis and log-rank test. Both multivariate linear regression and multivariate logistic regression revealed that high transport status, total effluent dialysate volume per day, continuous ambulatory PD (CAPD), and protein in total effluent dialysate volume appeared to be positively correlated with PPC; body mass index (BMI) and the normalized protein equivalent of total nitrogen appearance (nPNA) were negatively correlated with PPC. Besides PD modality and membrane transport status, total effluent dialysate volume showed a strong relationship with PPC, but the correlation differed among PD modalities.Conclusions: Higher PPC was associated with lower all-cause mortality risk in PD patients. Higher PPC correlated with CAPD modality, fast transport status, higher effluent dialysate volume and protein content, and with lower BMI and nPNA.","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":"140176322","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

An Improvised Cost-Effective Repair Technique for Management of Broken Luer Connections of Tunneled Dialysis Catheter and Salvage Existing Catheter. 一种用于处理隧道式透析导管鲁尔接头断裂并挽救现有导管的经济高效的改良修复技术。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-03 DOI: 10.1111/sdi.13199

Vineet Behera, Giddaluru Gireesh Reddy, C G Shreedhara, A Kishan, Kapil Kalra, R Ananthakrishnan, J Subramaniam, J Balasubramaniam

引用次数: 0

Enhancing Plasmapheresis Efficacy in Waldenstrom Macroglobulinemia: Overcoming Circuit Clotting Challenges. 增强Waldenstrom巨球蛋白血症患者的血浆置换疗效：克服回路凝血难题。

IF 1.4 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-20 DOI: 10.1111/sdi.13206

Urvashi Khan, Sourabh Sharma, Pallavi Prasad, Anupam Agarwal, Ankur Jain, Aditi Jain, Himanshu Verma

引用次数: 0

Comparison of Unplanned/Urgent-Start Versus Conventional-Start Peritoneal Dialysis: A Systematic Review and Meta-Analysis. 计划外/紧急启动与常规启动腹膜透析的比较：系统综述与元分析》。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-05-01 Epub Date: 2024-03-13 DOI: 10.1111/sdi.13198

Yunfen Xu, Weizhong Jiang

{"title":"Comparison of Unplanned/Urgent-Start Versus Conventional-Start Peritoneal Dialysis: A Systematic Review and Meta-Analysis.","authors":"Yunfen Xu, Weizhong Jiang","doi":"10.1111/sdi.13198","DOIUrl":"10.1111/sdi.13198","url":null,"abstract":"The timing of peritoneal dialysis (PD) initiation, whether conventional-start (planned) or urgent-start (unplanned), may impact the outcomes of PD and the rate of associated complications in individuals with chronic kidney disease (CKD). The goal of this study was to evaluate the effects of unplanned/urgent-start PD versus conventional-start PD in this cohort of patients. Electronic search of MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases was done from inception until July 2023 for studies reporting outcomes of unplanned/urgent-start and conventional-start PD in CKD patients. Outcomes of interest included mechanical complications, post-procedure infections, mortality, and transfer to hemodialysis. Heterogeneity, publication bias, and the influence of individual studies on the pooled odds ratio (OR) with 95% confidence interval (CI) were evaluated. Twenty-seven studies were finally included in the review. The overall risk of post-procedure infectious was comparable for both PD initiation methods (OR: 1.05; 95% CI: 0.83-1.34). Similarly, the risks for peritonitis and exit site infections did not differ significantly. However, urgent-start PD correlated with a significantly higher risk of overall mechanical complications (OR: 1.70; 95% CI: 1.23-2.34). Specifically, the risk for leaks was notably higher (OR: 2.47; 95% CI: 1.67-3.65) in the urgent-start group compared to the conventional-start PD group. Urgent-start PD correlated with significantly increased mortality rates (OR: 1.83; 95% CI: 1.39-2.41). There was no difference in the likelihood of technique survival and transfer to hemodialysis. Both urgent-start and conventional-start PD correlated with similar risks of overall infectious complications. Urgent-start PD resulted in significantly increased risks of mechanical complications and mortality. Our findings emphasize the need for meticulous planning and consideration when opting for PD initiation.","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":"140111336","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

Risk Factors of the Occurrence and Treatment Failure of Refractory Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Retrospective Study From China 难治性腹膜透析相关腹膜炎发生和治疗失败的风险因素：一项来自中国的单中心回顾性研究

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-04-03 DOI: 10.1111/sdi.13202

Qichen Liang, Huiping Zhao, Bei Wu, Qingyu Niu, Lixia Lu, Jie Qiao, Chuncui Men, Yuting He, Xinxin Chu, Li Zuo, Mei Wang

{"title":"Risk Factors of the Occurrence and Treatment Failure of Refractory Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Retrospective Study From China","authors":"Qichen Liang, Huiping Zhao, Bei Wu, Qingyu Niu, Lixia Lu, Jie Qiao, Chuncui Men, Yuting He, Xinxin Chu, Li Zuo, Mei Wang","doi":"10.1111/sdi.13202","DOIUrl":"https://doi.org/10.1111/sdi.13202","url":null,"abstract":"BackgroundThis study aimed to investigate the clinical characteristics and prognosis of refractory peritoneal dialysis (PD)‐associated peritonitis as well as the risk factors of its occurrence and treatment failure.MethodsA single‐center retrospective cohort study was conducted among 519 patients undergoing PD from January 2007 to October 2021. According to the International Society for Peritoneal Dialysis guidelines, all episodes occurred in our center were divided into two groups: refractory and nonrefractory. Demographic, biochemical, and pathogenic bacteria and treatment outcome data were collected.ResultsDuring the 15‐year period, 282 episodes of peritonitis occurred in 166 patients undergoing PD. The refractory rate was 34.0% (96/282). Gram‐positive organisms were the leading cause of peritonitis (47.9%); however, gram‐negative organisms were predominant in refractory peritonitis (34.4%, p = 0.002). Multiple logistic regression revealed that gram‐negative organism‐based peritonitis, longer PD duration, and female sex were the significant independent predictors of refractory peritonitis. Among 96 refractory episodes, white blood cell (WBC) count, dialysate WBC on Day 3, and PD duration ≥5 years were the independent risk factors of treatment failure.ConclusionsGram‐negative organism‐based peritonitis, longer PD duration, and female sex were the independent risk factors of refractory peritonitis. Refractory peritonitis with higher WBC count, higher dialysate WBC on Day 3, and PD duration ≥5 years increased treatment failure risk and required immediate PD catheter removal. The timely identification of refractory peritonitis with high risk of treatment failure as well as timely PD catheter removal is important.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140567228","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

The Revival of Sorbents in Chronic Dialysis Treatment. 吸附剂在慢性透析治疗中的复兴。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-03-20 DOI: 10.1111/sdi.13203

Jeroen Peter Kooman

{"title":"The Revival of Sorbents in Chronic Dialysis Treatment.","authors":"Jeroen Peter Kooman","doi":"10.1111/sdi.13203","DOIUrl":"https://doi.org/10.1111/sdi.13203","url":null,"abstract":"Interest in the use of sorbents in chronic dialysis treatment has undergone a revival in the last decades, for which two major factors are responsible. The first is the potential of sorbents as adjunct therapy for the removal of substances that are difficult to remove by conventional dialysis therapies. The second is their use in regeneration of dialysate, which is of pivotal importance in the design of portable or even wearable treatments, next to the potential for reducing water use during conventional dialysis treatment. Sorbent-enhanced dialysis with synthetic polymers was associated with a reduction in inflammatory parameters as compared to hemodialysis and even associated with improved survival in smaller studies, although this needs to be confirmed in large randomized trials. Incorporation of sorbents within a dialysis membrane (mixed matrix membrane) appears a promising way forward to reduce the complexity and costs of a dual therapy but needs to be tested in vivo. For regeneration of dialysate, at present, a combination of urease, zirconium-based sorbents, and activated charcoal is used. Next to sodium release by the sorbent in exchange for ammonium and the CO2 release by the hydrolysis of urea has been a bottleneck in the design of wearable devices, although short-term trials have been performed. Still, for widespread and flexible application of sorbent-assisted portable or wearable devices, a direct urea sorbent would be a major asset. In the near future, it will likely become apparent whether sorbent-assisted dialysis techniques are feasible for routine implementation in clinical practice.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176323","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

Hemodialysis vascular access coordinator: Three-level model for access management. 血液透析血管通路协调员：血管通路管理的三级模式。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-03-01 Epub Date: 2023-04-07 DOI: 10.1111/sdi.13153

Clemente Neves Sousa, Paulo Teles, Rui Sousa, Filipa Cabrita, Olga Maria Pimenta Lopes Ribeiro, Elisabete Delgado, Sara Coutinho, Sandra Cristina Mendo Moura, Millena Freire Delgado, João Filipe Costa, Tiago Gomes Sá, Sílvia Mónica Pereira Teixeira, Ana Elza Oliveira Mendonça, Nurten Ozen

引用次数: 0

Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital. 聚集性泛球菌：一种罕见的感染性疫情，影响三级护理医院的维持性血液透析患者。

IF 1.6 4区医学

Seminars in Dialysis Pub Date : 2024-03-01 Epub Date: 2023-10-01 DOI: 10.1111/sdi.13182

Danyal Hassan, Nida Saleem, Muhammad Haneef, Merina Khan, Maliha Aziz, Muhammad Usman

{"title":"Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital.","authors":"Danyal Hassan, Nida Saleem, Muhammad Haneef, Merina Khan, Maliha Aziz, Muhammad Usman","doi":"10.1111/sdi.13182","DOIUrl":"10.1111/sdi.13182","url":null,"abstract":"Background: Pantoea agglomerans is an environmental pathogen known to cause infection in immunocompromised individuals, particularly after thorn injuries. However, previous data showed few cases of human disease caused by contaminated medical products such as parenteral nutrition, anesthetic agents, blood, and peritoneal dialysis solutions. Infection in hemodialysis patients is rare. In this study, we presented a detailed account of several hemodialysis patients infected with this contagious pathogen and compared them with noninfected dialysis patients.Methods: We retrospectively reviewed the hospital records of 105 hemodialysis patients. Seventeen of 105 patients were diagnosed with P. agglomerans infection. We carefully analyzed their entire in-hospital course.Results: Among infected patients, 52.9% were male with a median age of 49 (IQR: 32-66) years. Compared to the noninfected patients, age below 50 years, prior kidney transplantation, prior immunosuppression and antibiotics use, and dialysis via a tunneled vascular catheter were the significant epidemiological features. Despite negative microbiological investigations, we suspect the possible infectious spread via infected central venous catheter was the likely infectious source. Most importantly, all patients responded well to intravenous antibiotics. Only two patients required the removal of the tunneled catheter. Their mortality rate was 0%.Conclusion: P. agglomerans infection, although considered rare, is becoming increasingly prevalent among dialysis patients. Its occurrence must be appraised as an infectious outbreak rather than mere contamination. Prompt treatment, source identification, and early implementation of preventive strategies should always be the goal to curtail this infection at an early stage.","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41129338","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