Seminars in Dialysis最新文献

{"title":"Caffeine intoxication treated with hemodialysis.","authors":"Saad Khan, Kavita Babu, Rohan Sidhu, Matthew Niemi","doi":"10.1111/sdi.13169","DOIUrl":"10.1111/sdi.13169","url":null,"abstract":"<p><strong>Introduction: </strong>Caffeine overdose, while uncommon, can be life threatening with hemodynamic and neurological complications and often requires intensive monitoring and critical management.</p><p><strong>Case report: </strong>We report a case of a 23-year-old male who ingested approximately 24 g of caffeine in a suicidal attempt and developed cardiopulmonary complications. He was resuscitated, and hemodialysis was performed with successful recovery.</p><p><strong>Conclusion: </strong>Hemodialysis appears to effectively remove caffeine from the blood system and can be lifesaving in severe caffeine overdose.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"414-418"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156241","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":"Impacts of cognition of exercise on physical activity participation in hemodialysis patients.","authors":"Mei Huang, Aili Lv, Feng Yang, Yuning Tang, Yang Li, Yan Hua, Julin Gao, Chunping Ni","doi":"10.1111/sdi.13138","DOIUrl":"10.1111/sdi.13138","url":null,"abstract":"<p><strong>Introduction: </strong>Physical inactivity is a strong predictor of mortality in hemodialysis patients. Although regular physical activity reduces mortality, patients remain inactive. Comparing the cognition of exercise in hemodialysis patients with different physical activity status could highlight domains where inactive people experience heightened barriers to physical activity. We therefore assessed patients' perceived benefits and barriers to exercise using a standardized way, thereby informing future exercise interventions to address these barriers experienced by inactive patients.</p><p><strong>Methods: </strong>ESRD patients undergoing hemodialysis were recruited and asked to complete a human activity profile, wear a pedometer for seven consecutive days, and complete the Dialysis Patient-perceived Exercise Benefits and Barriers Scale (DPEBBS). Binominal Logistic regression analysis was conducted to determine which benefits and barriers are associated with physical activity. This cross-sectional observational study was registered as NCT05189795.</p><p><strong>Results: </strong>A total of 505 patients completed the survey, most of whom were male (67.1%), with an average age of 49.69 ± 13.96 years. And 52.67-76.63% patients on HAP questionnaire were inactive. The co-benefits in active patients were improving mood and prevention of muscle wasting but did not reach significance in physical activity level. Tiredness, muscle fatigue, and lack of knowledge of exercise were common barriers to patients, and all have a significant impact on a patient's physical activity level.</p><p><strong>Conclusions: </strong>For inactive patients, exercise during hemodialysis can not only improve physical activity but also reduce family burden. And improving physical activity is a long-term project that cannot be separated from the support of hemodialysis medical staff.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"366-373"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159276","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":"Dialysis modality, humoral response to vaccine, and SARS-CoV-2 infection risk: Comparative prospective evaluation.","authors":"Alon Bnaya, Naomi Nacasch, Yael Einbinder, Linda Shavit, Daniel Erez, Moshe Shashar, Ayelet Grupper, Sydney Benchetrit, Ori Wand, Keren Cohen-Hagai","doi":"10.1111/sdi.13155","DOIUrl":"10.1111/sdi.13155","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 vaccinations have a central role in decreasing severe SARS-CoV-2 disease complications. This study investigated the long-term humoral immune response to BNT162b2 vaccine among hemodialysis (HD) versus peritoneal dialysis (PD) patients, and their relative risk for COVID-19 infection.</p><p><strong>Methods: </strong>This prospective, observational study included maintenance HD and PD patients who had received at least two BNT162b2 vaccine doses. Levels of antibodies targeting SARS-CoV-2 spike protein were measured 6 and 12 months after the first vaccine dose, and 2-3 weeks after the third and fourth vaccine doses. Patients were divided according to dialysis modality (HD or PD). Humoral response was evaluated at different time points among different vaccine regimens (two vs. three vs. four doses of vaccine). An adjusted multivariate model was used to assess cumulative risk for SARS-CoV-2 infection.</p><p><strong>Results: </strong>Eighty-seven HD and 36 PD patients were included. Among them, 106 (86%) received at least three vaccine doses. Both HD and PD patients demonstrated marked increases in humoral response 2-3 weeks after the third dose (mean anti-S antibody increased from 452 ± 501 AU/mL to 19,556 ± 14,949 AU/mL, p < 0.001). By 6 months after the third dose, antibody titers had declined significantly (mean anti-S antibody 9841 ± 10,493 AU/mL, p < 0.001). HD patients had higher risk for SARS-CoV-2 infection than PD patients (OR 4.4 [95% CI 1.4-13.6], p = 0.006). In multivariate analysis, the most important predictor for SARS-CoV-2 infection was dialysis modality.</p><p><strong>Conclusion: </strong>This study found a high antibody response rate after the third and fourth doses of BNT162b2 vaccine among dialysis patients. Hemodialysis as dialysis modality is an important predictor of COVID-19 infection, despite similar humoral responses to vaccine in peritoneal dialysis.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"382-389"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159817","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":"Computational fluid dynamics simulation of hemodynamic changes in a hemodialysis patient with central venous stenosis treated with stent.","authors":"Biyun Teng, Qining Fu, Zhe Wang","doi":"10.1111/sdi.13170","DOIUrl":"10.1111/sdi.13170","url":null,"abstract":"<p><p>We comment on the recently published to investigate hemodynamic changes in central venous stenosis patients before and after stent placement. Through the evidence, we believe that the boundary conditions in computational models and simulations of this study are incorrect in three points.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"357"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156735","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":"Novel method for laparoscopic rectus sheath tunneling with Lin's tube in peritoneal dialysis catheter implantation.","authors":"Yuntzu Chang, Wei-Jung Chang, Huang Cheng-Yen, Ping-Fang Chiu, Kuo-Hua Lin","doi":"10.1111/sdi.13165","DOIUrl":"10.1111/sdi.13165","url":null,"abstract":"<p><p>Laparoscopic implantation of a catheter through rectus sheath tunnel minimizes the risks of catheter failure and reduces some complications like catheter migration, hernias, and leaks. We described a novel method for laparoscopic catheter rectus sheath tunneling using an aspiration tube and a silk tie (Lin's tube). This material is easily available and yields a small fascial defect with an equivalent cannula size to minimize tissue disruption. The technique is feasible, reproducible and it may reduce the risks of postoperative leakage and hemorrhage.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"419-422"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10158550","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":"Neutrophil reactive oxygen formation, bacterial infections and mortality in malnourished hemodialysis patients: Evaluation of clinical outcomes.","authors":"Hadar Mudrik-Zohar, Danny Alon, Naomi Nacasch, Aviad Sternschuss, Meidad Greenberg, Sydney Benchetrit, Ronit Gavrieli, Tali Zitman-Gal, Keren Cohen-Hagai","doi":"10.1111/sdi.13168","DOIUrl":"10.1111/sdi.13168","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with end stage kidney disease undergoing maintenance hemodialysis (MHD) are prone to malnutrition and infections.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the effect of polymorphonuclear (PMN) cell dysfunction on clinical outcomes of MHD patients, in association with nutritional status.</p><p><strong>Methods: </strong>This prospective study investigated 39 MHD patients by evaluating the oxidative activity of their PMN cells using Phorbol 12-Myristate-13-Acetate (PMA) stimulation. Blood samples were taken from each participant at dialysis initiation. Demographics, laboratory data, and clinical outcomes during a 24-month follow-up period were obtained from electronic medical records.</p><p><strong>Results: </strong>Phagocytic activity was described in percentiles of mean fluorescence intensity (MFI) of PMA levels. There were no differences in comorbidities between patients with low or high MFI-PMA percentiles. Patients in the lowest (25th) MFI-PMA percentile (N = 10) had poorer nutritional status and more frequent severe infections compared to the other 29 patients (4.3 ± 3.4 events versus 2 ± 2.2 events, p = 0.017). Furthermore, they had more frequent hospitalizations (>3) due to infections (70% versus 41%, p = 0.073) and their mortality rate was higher (80% versus 31%, p = 0.007). The odds ratio for all-cause mortality was 8.85. In multivariate analysis, the MFI-PMA percentile and ischemic heart disease were the strongest predictors of all-cause mortality (p = 0.02 and p = 0.005, respectively).</p><p><strong>Conclusions: </strong>Low MFI-PMA levels were associated with poor nutritional status and adverse clinical outcomes and might serve as a prognostic biomarker, predicting severe infections and mortality among malnourished MHD patients.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"399-406"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10512468","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":"Incidence and risk factors of cognitive dysfunction in hemodialysis patients: A systematic review and meta-analysis.","authors":"Jun Liu, Kehong Chen, Jia Chen, Lili Fu, Weiwei Zhang, Jing Lin, Jingfang Wan","doi":"10.1111/sdi.13171","DOIUrl":"10.1111/sdi.13171","url":null,"abstract":"<p><strong>Background: </strong>The study aims to explore the incidence and risk factors of cognitive dysfunction in hemodialysis patients.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science databases were searched for clinical studies on the association between hemodialysis and cognitive dysfunction from the database's inception to 1 December 2022. Two researchers independently completed data extraction and risk of bias assessments for the included studies. All statistical analyses were performed using STATA15.0 software.</p><p><strong>Results: </strong>Ten studies were included in this meta-analysis, with a total of 5535 hemodialysis patients, that is, 2033 patients with cognitive dysfunction and 3502 patients with normal cognitive function. The Newcastle-Ottawa Scale scores of the included studies were greater than 5. Meta-analysis results suggested that the incidence of cognitive dysfunction in hemodialysis patients was (effect size = 51%, 95% confidence interval [CI] [0.33, 0.69]), and hemodialysis patients with cognitive dysfunction were often older than those with normal cognition (standard mean difference [SMD] = 0.49, 95% CI [0.31, 0.68]). Female gender was a risk factor for cognitive dysfunction in hemodialysis patients (relative risk [RR] = 1.21, 95% CI [1.04, 1.41]); diabetes (RR = 1.33, 95% CI [1.04, 1.71]) and stroke (RR = 1.66, 95% CI [1.08, 2.55]) increased the incidence of cognitive dysfunction in hemodialysis patients.</p><p><strong>Conclusions: </strong>The most important risk factors for cognitive dysfunction associated with hemodialysis might be female gender, old age, diabetes, and stroke. Close attention should be paid to such patients for early prevention.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"358-365"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215670","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":"Manual compression technique improves the success rate in the treatment of thrombosed aneurysmal arteriovenous fistula: A single-center experience.","authors":"Cheng-Yu Ko,&nbsp;Li-Ying Yu,&nbsp;Po-Wei Chen,&nbsp;Chih-Chang Ko,&nbsp;Tian-Xi Lin,&nbsp;Cheng-Han Lee,&nbsp;Ping-Yen Liu,&nbsp;Hsien-Yuan Chang","doi":"10.1111/sdi.13127","DOIUrl":"https://doi.org/10.1111/sdi.13127","url":null,"abstract":"<p><strong>Objective: </strong>Endovascular intervention for thrombosed aneurysmal arteriovenous fistula (AVF) is still a challenge. Manual compression technique (MCT)-assisted angioplasty may be helpful, but there is no evidence or data to support it.</p><p><strong>Methods: </strong>From January 2018 to May 2021, patients with thrombosed aneurysmal AVFs were retrospectively enrolled. The patients were separated into the MCT group or the traditional group according to the procedure received. Technical failure, clinical failure, 90-day patency, and safety were analyzed.</p><p><strong>Results: </strong>A total of 159 cases (64 ± 12 years old, 60% male) were enrolled, of which 87 cases received MCT and 72 underwent traditional angioplasty. No technical failure was observed in the MCT group, while five technical failures were observed in the traditional group (0% vs. 7%, p = 0.02). There were no differences in the clinical failure rate (3% vs. 7%, p = 0.30), 90-day patency rate, or procedure time between the MCT group and the traditional group. There was no symptomatic pulmonary embolism or other complication in the two groups.</p><p><strong>Conclusion: </strong>MCT is a low-cost, less invasive, and safe procedure for thrombosed aneurysmal AVF, and it achieves a higher technical success rate than traditional angioplasty.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 5","pages":"374-381"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10510419","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":"Combined aerobic and resistance exercise in maintenance hemodialysis patients: A meta-analysis.","authors":"Yixiu Liu, Xiju Luo, Siyan Deng, Jing Chen, Lu Zhang, Ying Huang, Huagang Hu","doi":"10.1111/sdi.13162","DOIUrl":"10.1111/sdi.13162","url":null,"abstract":"<p><p>Exercise brings many benefits to patients undergoing maintenance hemodialysis (MHD), but the effect of combined aerobic and resistance exercise remains unclear. English and Chinese databases (PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP, Wan Fang, and CBM) were searched from inception to January 2023 to retrieve qualified randomized controlled trials. The literature selection, data extraction, and risk of bias assessment of included studies were conducted independently by two reviewers. Meta-analysis was performed using RevMan 5.3 software. A total of 23 studies with 1214 participants were included, and 17 of the interventions were conducted during dialysis. Results showed that combined aerobic and resistance exercise (CARE) improved the peak oxygen uptake, six-minute walking test, 60 s sit-to-stand test (STS), 30 s STS, dialysis adequacy, five (out of eight) domains and physical component summary of health-related quality of life (HRQOL) measured by the Medical Outcomes Study Short Form-36, blood pressure, and hemoglobin for MHD patients compared with usual care. No significant changes were found in the mental component summary of HRQOL, C-reactive protein, creatinine, potassium, sodium, calcium, and phosphate. Subgroup analysis showed that intradialytic CARE ameliorated more outcomes, except for handgrip strength and hemoglobin, than non-intradialytic ones. CARE is an effective way to improve physical function, aerobic capacity, dialysis adequacy, and HRQOL for MHD patients. Strategies should be implemented by clinicians and policymakers to motivate patients to do more exercise. Well-designed clinical trials are warranted to explore the effectiveness of non-intradialytic CARE.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 4","pages":"278-293"},"PeriodicalIF":1.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9835303","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":"Early start hemodialysis with a catheter may be associated with greater mortality: A propensity score analysis.","authors":"Gustavo Laham, Gervasio Soler Pujol, Jenny Guzman, Natalia Boccia, Anabel Abib, Carlos H Diaz","doi":"10.1111/sdi.13157","DOIUrl":"10.1111/sdi.13157","url":null,"abstract":"<p><strong>Introduction: </strong>Deciding when and how to initiate hemodialysis (HD) is still controversial. An early start (ES) seems to show a lack of benefit. \"Lead time bias\" and comorbidities have been associated with different outcomes in ES groups. On the other hand, it is well accepted that the impact the type of vascular access (VA) has on patient survival. Our aim was to evaluate survival with early start (ES) versus late start (LS) on HD, taking into account the vascular access (VA) used.</p><p><strong>Methods: </strong>Between 01/1995 and 06/2018, 503 incidental patients initiated HD at our Dialysis Unit. eGFR was estimated by the CKD-EPI equation. Diabetes mellitus (DM), coronary disease (CD), and peripheral vascular disease (PVD) were considered comorbid conditions. According to eGFR and VA, patients were divided into four groups: G1: ES (eGFR > 7 mL/min) with catheter (ES + C), G2: ES with fistula or graft (F/G) (ES + F/G), G3: LS (eGFR< 7 mL/min) with catheter (LS + C), and G4: LS with F/G (LS + F/G). The cut-off value to define ES or LS was based on median eGFR for these 503 patients. We compared patient's survival rates by Kaplan-Meier and log-rank test. The four groups were compared before and after matching with propensity scores (PS). Cox analysis was performed to determine the impact of predictors of mortality.</p><p><strong>Results: </strong>Median eGFR was 7 (5.3-9.5) mL/min/1.73 m² , median follow-up time was 30.9 (13-50) months, 52.1% had F/G access at entry, and 46.9% died during the observation period. Among the four groups, the ES + C were significantly older, and there were more diabetics and comorbid conditions, while phosphatemia, iPTH, albumin, and hemoglobin were significantly higher in the LS groups. Before propensity score (PS) matching, the ES + C group had a poor survival rate (p < 0.0001), while LS + F/G access had the best survival. After PS, a total of 180 patients were selected in the same four groups and ES + C kept showing a statistically significant poorer survival. Multivariate analysis revealed that ES + C was an independent predictor of mortality.</p><p><strong>Conclusion: </strong>In this retrospective study, ES + C on HD was associated with a higher mortality rate than LS. This association persisted after PS matching.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":"36 4","pages":"294-302"},"PeriodicalIF":1.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9837050","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}