Seminars in Dialysis最新文献_第7页

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 1.4 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":" ","pages":"234-241"},"PeriodicalIF":1.4,"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

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 1.4 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":" ","pages":"249-258"},"PeriodicalIF":1.4,"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

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 1.4 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":" ","pages":"211-219"},"PeriodicalIF":1.4,"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

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 1.4 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":" ","pages":"220-227"},"PeriodicalIF":1.4,"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 1.4 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

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 1.4 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":" ","pages":"242-248"},"PeriodicalIF":1.4,"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

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 1.4 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 1.4 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":" ","pages":"189-199"},"PeriodicalIF":1.4,"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 1.4 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":" ","pages":"259-268"},"PeriodicalIF":1.4,"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

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