Hemodialysis international. International Symposium on Home Hemodialysis最新文献

{"title":"Trends in the Prevalence and Incidence of Chronic Dialysis in Brazil (2006-2024) With Projections to 2039.","authors":"Helbert do N Lima, Fabiana B Nerbass, Jocemir R Lugon, Ricardo C Sesso","doi":"10.1111/hdi.70032","DOIUrl":"https://doi.org/10.1111/hdi.70032","url":null,"abstract":"<p><strong>Introduction: </strong>Brazil is the third country in the world with the highest number of dialysis patients. The increasing number of dialysis patients may reflect the state of renal care in the country. We analyzed and reported trends in the prevalence and incidence of chronic dialysis in Brazil since 2006, and projected estimates for 2039.</p><p><strong>Methods: </strong>We compared trends in the prevalence and incidence rates of the Brazilian Dialysis annual Surveys since 2006. Monotonic trends were evaluated using the Mann-Kendall test, and forecasting trends were performed using classical and exponential smoothing techniques until 2039.</p><p><strong>Findings: </strong>The incidence and prevalence rates of dialysis in Brazil have shown an upward trend over the past 19 years. Prevalence rates have increased across all five regions of the country. Regarding incidence rates, only the northeast region of Brazil did not show a significant upward trend over the period. The projected incidence and prevalence rates for 2039 are 338 patients per million population (95% CI: 306-370) and 1225 per million population (95% CI: 1179-1271), respectively. This represents an increase of 35.8% and 50.9% over 15 years, respectively.</p><p><strong>Discussion: </strong>The projected rise in the incidence and prevalence of chronic dialysis in Brazil over the next decade is worrisome. It underscores the need for more vigorous measures to manage the burden of chronic kidney disease in the country, aiming to mitigate its impact on health care and associated costs.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Commentary on \"Exploring Oral Candidiasis in Hemodialysis Patients: Candida Species and Associated Risk Factor\".","authors":"Abdol Sattar Pagheh, Maryam Erfaninejad, Aynaz Ghojoghi, Vajehallah Raeesi, Eisa Nazar, Mahnaz Fatahinia, Nafiseh Ramezani, Parvin Askari, Seydeh Fereshte Mohammadi, Masood Ziaee","doi":"10.1111/hdi.70028","DOIUrl":"https://doi.org/10.1111/hdi.70028","url":null,"abstract":"","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of B. Braun Machines to Provide Home Hemodialysis: Technical Aspects.","authors":"Rachid Daoui, Joseph Saccucci, Diane Fountain, Loay Salman","doi":"10.1111/hdi.70025","DOIUrl":"https://doi.org/10.1111/hdi.70025","url":null,"abstract":"<p><strong>Background: </strong>In previous work, we demonstrated that using the B. Braun hemodialysis (HD) machine for home HD typically delivers higher single treatment Kt/V (spKt/V), weekly standard Kt/V, and urea reduction ratio (URR) compared to the NxStage home HD machine.</p><p><strong>Methods: </strong>We reviewed the technical requirements and home modifications necessary to implement the B. Braun HD machine for home HD based on our 5 years of experience with 40 patients.</p><p><strong>Results: </strong>Successful home use of the B. Braun machine at home required a larger dedicated space, installation of a dedicated reverse osmosis water treatment system, specialized plumbing and electrical connections, and tailored machine-specific patient training.</p><p><strong>Conclusions: </strong>Despite these home requirements, most of our patients found these modifications manageable and the machine easy and intuitive to operate. Our experience supports the B. Braun machine as another practical option for home HD, including nocturnal HD treatments.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Use of Continuous Glucose Monitoring to Adjust Glucose-Lowering Therapy in Hemodialysis Patients: A Case Series.","authors":"Christine L Meyer-Olesen, Merete B Christensen, Dea H Kofod, Mads Hornum, Kirsten Nørgaard, Tobias Bomholt","doi":"10.1111/hdi.70024","DOIUrl":"https://doi.org/10.1111/hdi.70024","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes management in hemodialysis patients is complicated by limited treatment options and challenges in glycemic monitoring. Continuous glucose monitoring (CGM) provides detailed glucose profiles, enabling tailored glucose-lowering therapy.</p><p><strong>Methods: </strong>This case series presents three insulin-treated hemodialysis patients with type 1 or type 2 diabetes.</p><p><strong>Findings: </strong>Each case reveals significant glycemic abnormalities, including excessive hyperglycemia with nocturnal glucose drops, unrecognized hypoglycemia, and extreme glucose variability. We propose specific personalized insulin adjustments based on CGM readings to optimize treatment across these different clinical scenarios.</p><p><strong>Conclusions: </strong>The case series highlights the potential to rethink glucose monitoring in hemodialysis patients with diabetes and underlines the need for future studies evaluating CGM use in this population.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Center Dialysis Patients' and Staff Perspectives of Assisted Home Hemodialysis: A Three-Phase Feasibility Study.","authors":"Vikram Mitra, Victoria Jackson, John Woods, Sandip Mitra, Kunaal Kharbanda","doi":"10.1111/hdi.70027","DOIUrl":"https://doi.org/10.1111/hdi.70027","url":null,"abstract":"<p><strong>Background: </strong>The majority of growth in the rising dialysis population remains within in-center hemodialysis, stretching capacity. Despite national strategies promoting home hemodialysis, uptake remains low. Assisted home hemodialysis may overcome challenges by supporting patients who wish to dialyse at home but require assistance. This study aimed to evaluate the feasibility, interest, and operational implications of assisted home HD through multi-modal data collection amongst prevalent in-center HD patients and staff members.</p><p><strong>Methods: </strong>A feasibility study incorporating patient surveys, focus groups, and care model development was conducted recruiting from three renal centers in the United Kingdom. Outcomes measured utilized structured patient questionnaires to assess patient perspectives, interest in assisted home HD, and assistance needs. Focus groups explored barriers and concerns regarding delivery. Hypothetical cost modeling was estimated.</p><p><strong>Findings: </strong>Four hundred and sixty-five in-center hemodialysis patients from three UK centers participated, with a median age of 66 years. 34% of patients, a significantly younger (p < 0.01) group with higher disability (p < 0.05), answered \"yes\" when asked if they would consider a switch to assisted home HD, compared with 44% who answered \"no\", and 22% were unsure. Patients expressed varying degrees of assistance needs across dialysis tasks, with cannulation (65%), machine connection (51%), and set-up (38%). Patients voiced concerns about safety during home treatment and missing social aspects of in-center care, though many also expressed a desire for greater autonomy. Five key themes emerged around staffing practices in implementing assisted home HD, which included (i) boundaries of care, (ii) staff training and supervision, (iii) staff responsibility, (iv) back-up and support requirements, and (v) implementation strategies.</p><p><strong>Conclusions: </strong>Assisted home HD demonstrates a feasible and desirable option for in-center dialysis patients. Assisted home HD presents as a potential model for overcoming barriers to home HD adoption by prevalent HD patients. Assisted home HD care models should explore varying levels of assistance at home. The findings of this study merit further exploration through implementation pilots and outcomes-based studies.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Progress in Double Filtration Plasmapheresis.","authors":"Dan Li, Xiaoqiang Liu, Yuhan Wang, Wenxuan Ji","doi":"10.1111/hdi.70026","DOIUrl":"https://doi.org/10.1111/hdi.70026","url":null,"abstract":"<p><p>Double-filtration plasmapheresis is an advanced extracorporeal blood purification technique that selectively removes pathogenic macromolecules based on molecular weight. Unlike conventional plasma exchange, double-filtration plasmapheresis uses a two-step filtration process to retain beneficial plasma components such as albumin, while eliminating harmful substances, thereby reducing the need for exogenous plasma replacement. Over the last few decades, double-filtration plasmapheresis has gained prominence in the management of refractory autoimmune, neurological, metabolic, and renal diseases. This review systematically examines the therapeutic mechanisms, recent clinical advances, safety, limitations, and prospects of double-filtration plasmapheresis.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Among Serum Transferrin Levels, Markers of Malnutrition, and Mortality in Hemodialysis Patients.","authors":"Sonoo Mizuiri, Yoshiko Nishizawa, Toshiki Doi, Aiko Okubo, Kenichi Morii, Kenichiro Shigemoto, Kazuomi Yamashita, Tetsuji Arakawa, Takao Masaki","doi":"10.1111/hdi.70018","DOIUrl":"https://doi.org/10.1111/hdi.70018","url":null,"abstract":"<p><strong>Introduction: </strong>A serum transferrin (transferrin) level below 200 mg/dL has been suggested as an indicator of malnutrition in hemodialysis (HD) patients. We investigated the relationships among transferrin levels, various markers of malnutrition, and 1-year mortality in this patient population.</p><p><strong>Methods: </strong>We assessed transferrin, ferritin, and transferrin saturation (TSAT) five times over 1 year. We also measured baseline serum albumin, C-reactive protein (CRP), geriatric nutritional risk index (GNRI), Kt/Vurea, post-dialysis body composition (using bioimpedance analysis), and 1-year mortality.</p><p><strong>Findings: </strong>Our study included 431 HD patients (mean age: 67 ± 11 years; median dialysis duration: 67 [35-138] months; diabetes prevalence: 45%). Patients with baseline transferrin ≥ 200 mg/dL had consistently and significantly higher transferrin concentrations throughout the study (p < 0.001). Compared to patients with baseline transferrin < 200 mg/dL (n = 285), those with baseline transferrin ≥ 200 mg/dL (n = 146) showed significantly higher serum albumin (3.7 [3.4-3.9] vs. 3.4 [3.1-3.7] g/dL), GNRI (95 [90-98] vs. 90 [85-95]), and lean tissue index (11.2 [9.5-13.3] vs. 10.3 [9.0-12.1] kg/m²). Conversely, they had significantly lower TSAT (22% ± 12% vs. 27% ± 14%), ferritin (74 ± 79 vs. 172 ± 148 ng/mL), and CRP (p < 0.01 for all). Baseline serum albumin, Kt/Vurea, and the presence of diabetes were significant determinants of having a baseline transferrin level ≥ 200 mg/dL (p < 0.05). Over the 1-year period, 45 all-cause deaths occurred among the 431 patients. Patients with baseline transferrin ≥ 200 mg/dL had a significantly higher cumulative 1-year survival rate (p < 0.05). Furthermore, baseline transferrin was a significant predictor of 1-year all-cause mortality in HD patients (hazard ratio: 0.99; p < 0.05).</p><p><strong>Discussion: </strong>Our findings indicate that HD patients with baseline transferrin ≥ 200 mg/dL exhibit a better nutritional status than those with transferrin < 200 mg/dL. Moreover, baseline transferrin serves as a significant predictor for 1-year mortality in HD patients.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Exploring Oral Candidiasis in Hemodialysis Patients: Candida Species and Associated Risk Factors\".","authors":"Sahar Sadr Moharerpour, Mohammad Barary, Soheil Ebrahimpour","doi":"10.1111/hdi.70022","DOIUrl":"https://doi.org/10.1111/hdi.70022","url":null,"abstract":"","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Two Low-Frequency Intradialytic Cycling Training Programs on Functional Capacity in Subjects Undergoing Hemodialysis: A Randomized Controlled Trial.","authors":"Ahmad Mahdi Ahmad, Mona Mohammed Ghareeb, Ahmed Ezzat Mansour, Heba Ahmed Mousa","doi":"10.1111/hdi.70017","DOIUrl":"https://doi.org/10.1111/hdi.70017","url":null,"abstract":"<p><strong>Introduction: </strong>Functional capacity deteriorates over time in patients on hemodialysis, which is associated with increased mortality risk. This study aimed to assess the effects of two low-frequency (i.e., twice weekly) intradialytic cycling exercise training programs-low- to moderate-intensity continuous training (L-MICT) versus moderate- to high-intensity interval training (M-HIIT) - on functional capacity in patients undergoing hemodialysis.</p><p><strong>Methods: </strong>Sixty-seven out of sixty-nine patients undergoing hemodialysis of both sexes (44 men and 23 women), aged 35-55 years, completed this study. Patients were randomly assigned to three groups: L-MICT group (n = 23), M-HIIT group (n = 21), and nonexercise control group (n = 23). Patients in the L-MICT group performed intradialytic cycling exercise continuously at a low-to moderate-intensity for 20-30 min. Patients in the M-HIIT group performed 3 × 3-min moderate- to high-intensity cycling exercise, separated by 4-min low-intensity active breaks. The intradialytic cycling programs were scheduled twice a week for 8 weeks. The outcome measure was the functional capacity assessed by the 6-min walk test (6MWT).</p><p><strong>Findings: </strong>The 6-min walk distance (6MWD) increased significantly in the L-MICT group [p = 0.004, the change score (Δ) = 18.2 meters (m)], in the M-HIIT group (p = 0.001, Δ = 17.6 m), and in the control group (p = 0.014, Δ = 11.4 m) compared to baseline. However, no significant differences were found between groups.</p><p><strong>Discussion: </strong>Low-frequency intradialytic cycling training programs, either L-MICT or M-HIIT, twice a week for 8 weeks, could similarly induce statistically significant improvements in the 6MWD in people receiving hemodialysis. Nevertheless, the 6MWD changes did not exceed the minimally detectable change previously reported in this population.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Visfatin Level and Cardiac Valve Calcifcation in Hemodialysis Patients.","authors":"Xiaoqi Wang, Dan Yuan, Feng Shao, Conghui Liu, Xiao Zhang, Zhongxin Li","doi":"10.1111/hdi.70019","DOIUrl":"https://doi.org/10.1111/hdi.70019","url":null,"abstract":"<p><strong>Background: </strong>Cardiac valve calcification is a serious complication in patients with cardiovascular disease. This study investigated the relationship between visfatin levels and cardiac valve calcification in individuals undergoing hemodialysis.</p><p><strong>Methods: </strong>We conducted a cross-sectional study at Beijing Luhe Hospital of Capital Medical University, enrolling 339 maintenance hemodialysis patients between June 2023 and May 2024. We collected baseline data including sex, age, underlying diseases, electrolyte levels, and parathyroid hormone levels. Patients were categorized into cardiac valve calcification and non-cardiac valve calcification groups based on echocardiogram findings; we analyzed associations between valve calcification and clinical data.</p><p><strong>Results: </strong>Of the 339 hemodialysis patients, 186 (55.8%) were male, with an average age of 66.1 ± 12.5 years and a mean dialysis duration of 58.7 ± 45.3 months. Cardiac valve calcification was present in 36.7% of patients. Compared to the non-cardiac valve calcification group, patients with cardiac valve calcification were significantly older, had longer dialysis durations, a higher prevalence of coronary heart disease, longer histories of hypertension, elevated intact parathyroid hormone levels, and increased visfatin levels (p < 0.05). Logistic regression analysis identified advanced age, prolonged dialysis duration, an extended hypertension history, and elevated serum visfatin as factors associated with valve calcification.</p><p><strong>Conclusion: </strong>Our findings indicate that cardiac valve calcification is significantly linked to advanced age and higher visfatin concentrations in hemodialysis patients. Calcium and phosphate levels did not show significant group differences in this study.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}