Hemodialysis international. International Symposium on Home Hemodialysis最新文献

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Reverse cardiac remodeling after fluid balance optimization in patients with end‐stage renal disease 终末期肾病患者体液平衡优化后的逆向心脏重构
R. Ursi, F. Pesce, M. Albanese, Vittoria Pavone, D. Grande, M. Ciccone, M. Iacoviello
{"title":"Reverse cardiac remodeling after fluid balance optimization in patients with end‐stage renal disease","authors":"R. Ursi, F. Pesce, M. Albanese, Vittoria Pavone, D. Grande, M. Ciccone, M. Iacoviello","doi":"10.1111/hdi.13019","DOIUrl":"https://doi.org/10.1111/hdi.13019","url":null,"abstract":"In patients with end‐stage renal disease (ESRD) undergoing hemodialysis, cardiovascular diseases, and in particular chronic heart failure are the leading causes of morbidity and mortality. Nevertheless, few data are available about the impact of fluid optimization on echocardiographic parameters of cardiac function in patients with ESRD.","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":"3 1","pages":"345 - 350"},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79199193","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}
引用次数: 0
Diagnosis of tuberculosis in dialysis and kidney transplant patients 透析和肾移植患者结核的诊断
Mahrukh Ali, Dhriti Dosani, R. Corbett, L. Johansson, R. Charif, O. Kon, N. Duncan, D. Ashby
{"title":"Diagnosis of tuberculosis in dialysis and kidney transplant patients","authors":"Mahrukh Ali, Dhriti Dosani, R. Corbett, L. Johansson, R. Charif, O. Kon, N. Duncan, D. Ashby","doi":"10.1111/hdi.13010","DOIUrl":"https://doi.org/10.1111/hdi.13010","url":null,"abstract":"In patients with chronic kidney disease the risk of developing Tuberculosis is increased, while the presentation is often atypical making the diagnosis more difficult. The aim of this study is to describe the presentation of Tuberculosis in dialysis and kidney transplant patients, including the range of diagnostic approaches and the utility of different sample types.","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":"78 4 1","pages":"361 - 368"},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89247027","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}
引用次数: 2
Left atrial strain is associated with adverse cardiovascular events in patients with end‐stage renal disease: Findings from the Cardiac, Endothelial Function and Arterial Stiffness in ESRD (CERES) study 终末期肾病患者左心房应变与不良心血管事件相关:ESRD (CERES)研究中心脏、内皮功能和动脉僵硬的发现
Amrita Ayer, Upasana Banerjee, C. Mills, Catherine Donovan, Lauren Nelson, Sanjiv J. Shah, Ruth F Dubin
{"title":"Left atrial strain is associated with adverse cardiovascular events in patients with end‐stage renal disease: Findings from the Cardiac, Endothelial Function and Arterial Stiffness in ESRD (CERES) study","authors":"Amrita Ayer, Upasana Banerjee, C. Mills, Catherine Donovan, Lauren Nelson, Sanjiv J. Shah, Ruth F Dubin","doi":"10.1111/hdi.13008","DOIUrl":"https://doi.org/10.1111/hdi.13008","url":null,"abstract":"We lack cardiovascular (CV) markers for patients with end‐stage renal disease (ESRD), and left atrial (LA) strain has not been studied definitively in this population. We examined associations of LA reservoir, conduit, and booster strain with major adverse cardiovascular events (MACE) among stable patients with ESRD on dialysis.","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":"14 1","pages":"323 - 334"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75224425","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}
引用次数: 4
Reducing blood stream infection in patients on hemodialysis: Incorporating patient engagement into a quality improvement activity. 减少血液透析患者的血流感染:将患者参与纳入质量改进活动。
Lynda K Ball, Cheryl A George, Linda Duval, Niloufar Nellie F Hedrick
{"title":"Reducing blood stream infection in patients on hemodialysis: Incorporating patient engagement into a quality improvement activity.","authors":"Lynda K Ball,&nbsp;Cheryl A George,&nbsp;Linda Duval,&nbsp;Niloufar Nellie F Hedrick","doi":"10.1111/hdi.12463","DOIUrl":"https://doi.org/10.1111/hdi.12463","url":null,"abstract":"<p><p>Introduction Infection in our immunocompromised patients is the second leading cause of death, according to the Centers for Disease Control and Prevention (CDC). In an effort to improve quality of care, engage patients in their own care, and reduce morbidity and mortality secondary to infection, the Network designed a joint quality improvement/patient engagement activity to decrease bloodstream infection (BSI) rates. Methods Dialysis facilities were ranked utilizing 2014 National Healthcare Safety Network (NHSN) data. Selection included 20% of Network 13 facilities (n = 58) with the highest BSI rates, which captured 31% of the patient population. Findings Statistically significant (P < 0.001) improvement was reached in the reduction of BSIs; increasing patient engagement in the infection control process; and, correct completion of hand hygiene audits. Significant (P < 0.01) improvement was reached in correct completion of cannulation audits. There was also improvement in the catheter audits, but results were not significant. Discussion Involving patients in the infection control process contributed to our successful outcomes and could be replicated to meet the needs of the end stage renal disease community as a whole.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":"20 Suppl 1 ","pages":"S7-S11"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686624","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}
引用次数: 15
Non catheter-related bacteremia caused by Pseudomonas oryzihabitans in a patient undergoing hemodialysis. 1例血液透析患者由米氏假单胞菌引起的非导管相关性菌血症。
IF 1.3
Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2014-07-01 Epub Date: 2014-03-10 DOI: 10.1111/hdi.12150
Elias Hellou, Suheil Artul, Sohaib Omari, Mohamad Taha, Zaher Armaly, William Nseir
{"title":"Non catheter-related bacteremia caused by Pseudomonas oryzihabitans in a patient undergoing hemodialysis.","authors":"Elias Hellou,&nbsp;Suheil Artul,&nbsp;Sohaib Omari,&nbsp;Mohamad Taha,&nbsp;Zaher Armaly,&nbsp;William Nseir","doi":"10.1111/hdi.12150","DOIUrl":"https://doi.org/10.1111/hdi.12150","url":null,"abstract":"<p><p>Pseudomonas oryzihabitans (P. orizyhabitans) has already been reported both as a human and a zoonotic pathogen. A few cases of P. orizyhabitans bacteremia have been reported among patients who underwent peritoneal dialysis. P. orizyhabitans bacteremia has never been reported among patients on hemodialysis. We report the first case of P. orizyhabitans bacteremia in a chronic hemodialysis patient; this patient did not have a central venous catheter angioaccess as a potential portal of entry. </p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"711-3"},"PeriodicalIF":1.3,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40296064","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}
引用次数: 8
Evaluation of the oral health status in Chinese hemodialysis patients. 中国血液透析患者口腔健康状况的评价。
IF 1.3
Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2014-07-01 Epub Date: 2014-03-04 DOI: 10.1111/hdi.12149
Tian Xie, Ziliang Yang, Guanyu Dai, Kaixiao Yan, Yuan Tian, Dan Zhao, Huawei Zou, Fei Deng, Xiaolei Chen, Quan Yuan
{"title":"Evaluation of the oral health status in Chinese hemodialysis patients.","authors":"Tian Xie,&nbsp;Ziliang Yang,&nbsp;Guanyu Dai,&nbsp;Kaixiao Yan,&nbsp;Yuan Tian,&nbsp;Dan Zhao,&nbsp;Huawei Zou,&nbsp;Fei Deng,&nbsp;Xiaolei Chen,&nbsp;Quan Yuan","doi":"10.1111/hdi.12149","DOIUrl":"https://doi.org/10.1111/hdi.12149","url":null,"abstract":"<p><p>Chronic kidney disease has become a worldwide public health problem, and it negatively affects oral health. However, the data of the hemodialysis (HD) patients in Chinese population is unknown. This study was aimed to evaluate the dental health status and oral hygiene behavior of the HD patients in China. Patients undergoing HD therapy at two hospitals were asked to finish a questionnaire and receive dental examination (DMF-T). A total of 306 patients, aged 24-88 (58.09 ± 14.06), took part in this study. Although majority of the patients (77.78%) brushed their teeth at least twice a day, few (less than 5%) had ever used dental floss or mouthwash. More than half of the patients have not visited a dentist since the commencement of HD therapy. The dental examination showed that DMF-T was 9.63 ± 7.54, and the number of filled teeth (F-T) was only 0.70 ± 1.48. Moreover, the average caries restoration ratio and replacement index were 17.57% and 32.59%, respectively. HD therapy seems to prevent patients from visiting a dentist, and there is a great need for dental treatment for Chinese HD patients. </p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"668-73"},"PeriodicalIF":1.3,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40281925","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}
引用次数: 24
Hemodialysis-induced changes in the blood composition affect function of the endothelium. 血液透析引起的血液成分改变会影响内皮细胞的功能。
IF 1.3
Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2014-07-01 Epub Date: 2014-02-24 DOI: 10.1111/hdi.12148
Weronika Oleśkowska-Florek, Alicja Połubinska, Ewa Baum, Monika Matecka, Małgorzata Pyda, Krzysztof Pawlaczyk, Andrzej Bręborowicz
{"title":"Hemodialysis-induced changes in the blood composition affect function of the endothelium.","authors":"Weronika Oleśkowska-Florek,&nbsp;Alicja Połubinska,&nbsp;Ewa Baum,&nbsp;Monika Matecka,&nbsp;Małgorzata Pyda,&nbsp;Krzysztof Pawlaczyk,&nbsp;Andrzej Bręborowicz","doi":"10.1111/hdi.12148","DOIUrl":"https://doi.org/10.1111/hdi.12148","url":null,"abstract":"<p><p>Hemodialysis induces oxidative stress causing intravascular inflammation, which may cause endothelial dysfunction. We evaluated how hemodialysis-induced changes in blood affect the function of endothelial cells in in vitro culture. Serum samples were collected from 42 uremic patients treated with hemodialysis, one before the start of dialysis and the other one at the end of session. All patients were dialysed with polysulfone dialyzer. Concentrations of the inflammatory molecules carbonyl protein and metabolites of NO synthesis were measured in blood. Additionally, the effect of the serum obtained before and after dialysis on the function of endothelial cells in in vitro culture was studied. Hemodialysis caused increase of monocyte chemoattractant protein (MCP)-1 (+17%), hepatocyte growth factor (+91%), and pentraxin-3 (+30%) concentration in serum. Concentration of carbonyl protein was decreased by 30%. Decrease of blood level of asymmetric dimethylarginine (-25%) and nitrate/nitrites (-62%) was observed. Serum obtained after hemodialysis stimulated proliferation of endothelial cells (+10%) and synthesis of MCP-1(+11%) in these cells. Hemodialysis-induced intravascular inflammation changes the function of endothelial cells, which may lead to acceleration of atherosclerosis. </p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"650-6"},"PeriodicalIF":1.3,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40297074","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}
引用次数: 19
Anticoagulation, delivered dose and outcomes in CRRT: The program to improve care in acute renal disease (PICARD). CRRT中的抗凝,给药剂量和结果:改善急性肾脏疾病护理的项目(PICARD)。
IF 1.3
Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2014-07-01 Epub Date: 2014-03-12 DOI: 10.1111/hdi.12157
Rolando Claure-Del Granado, Etienne Macedo, Sharon Soroko, YeonWon Kim, Glenn M Chertow, Jonathan Himmelfarb, T Alp Ikizler, Emil P Paganini, Ravindra L Mehta
{"title":"Anticoagulation, delivered dose and outcomes in CRRT: The program to improve care in acute renal disease (PICARD).","authors":"Rolando Claure-Del Granado,&nbsp;Etienne Macedo,&nbsp;Sharon Soroko,&nbsp;YeonWon Kim,&nbsp;Glenn M Chertow,&nbsp;Jonathan Himmelfarb,&nbsp;T Alp Ikizler,&nbsp;Emil P Paganini,&nbsp;Ravindra L Mehta","doi":"10.1111/hdi.12157","DOIUrl":"https://doi.org/10.1111/hdi.12157","url":null,"abstract":"<p><p>Delivered dialysis dose by continuous renal replacement therapies (CRRT) depends on circuit efficacy, which is influenced in part by the anticoagulation strategy. We evaluated the association of anticoagulation strategy used on solute clearance efficacy, circuit longevity, bleeding complications, and mortality. We analyzed data from 1740 sessions 24 h in length among 244 critically ill patients, with at least 48 h on CRRT. Regional citrate, heparin, or saline flushes was variably used to prevent or attenuate filter clotting. We calculated delivered dose using the standardized Kt/Vurea . We monitored filter efficacy by calculating effluent urea nitrogen/blood urea nitrogen ratios. Filter longevity was significantly higher with citrate (median 48, interquartile range [IQR] 20.3-75.0 hours) than with heparin (5.9, IQR 8.5-27.0 hours) or no anticoagulation (17.5, IQR 9.5-32 hours, P < 0.0001). Delivered dose was highest in treatments where citrate was employed. Bleeding complications were similar across the three groups (P = 0.25). Compared with no anticoagulation, odds of death was higher with the heparin use (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.02-3.32; P = 0.033), but not with citrate (OR 1.02 95% CI 0.54-1.96; P = 0.53). Relative to heparin or no anticoagulation, the use of regional citrate for anticoagulation in CRRT was associated with significantly prolonged filter life and increased filter efficacy with respect to delivered dialysis dose. Rates of bleeding complications, transfusions, and mortality were similar across the three groups. While these and other data suggest that citrate anticoagulation may offer superior technical performance than heparin or no anticoagulation, adequately powered clinical trials comparing alternative anticoagulation strategies should be performed to evaluate overall safety and efficacy. </p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"641-9"},"PeriodicalIF":1.3,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40302049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
Enhanced expression of hemoglobin scavenger receptor and heme oxygenase-1 is associated with aortic valve stenosis in patients undergoing hemodialysis. 血红蛋白清道夫受体和血红素加氧酶-1的表达增强与血液透析患者主动脉瓣狭窄有关。
IF 1.3
Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2014-07-01 Epub Date: 2014-02-24 DOI: 10.1111/hdi.12147
Mayumi Inaba, Kenichi Sugioka, Takahiko Naruko, Kei Yunoki, Yasuyuki Kato, Toshihiko Shibata, Takeshi Inoue, Masahiko Ohsawa, Minoru Yoshiyama, Makiko Ueda
{"title":"Enhanced expression of hemoglobin scavenger receptor and heme oxygenase-1 is associated with aortic valve stenosis in patients undergoing hemodialysis.","authors":"Mayumi Inaba,&nbsp;Kenichi Sugioka,&nbsp;Takahiko Naruko,&nbsp;Kei Yunoki,&nbsp;Yasuyuki Kato,&nbsp;Toshihiko Shibata,&nbsp;Takeshi Inoue,&nbsp;Masahiko Ohsawa,&nbsp;Minoru Yoshiyama,&nbsp;Makiko Ueda","doi":"10.1111/hdi.12147","DOIUrl":"https://doi.org/10.1111/hdi.12147","url":null,"abstract":"<p><p>A high prevalence and a rapid progression of aortic valve stenosis (AS) in patients undergoing hemodialysis (HD) has been reported. In these circumstances, intraleaflet hemorrhage of aortic valve may be related to the development of AS in HD patients. We immunohistochemically examined the relationship among intraleaflet hemorrhage, neovascularization, hemoglobin scavenger receptor (CD163), and heme oxygenase-1 (HO-1) using surgically resected aortic valve specimens from AS patients undergoing HD. The study population consisted of 26 HD patients and 25 non-HD patients with severe AS who had undergone aortic valve replacement. Frozen aortic valve samples surgically obtained from AS patients were stained immunohistochemically with antibodies against smooth muscle cells, macrophages, glycophorin-A (a protein specific to erythrocyte membranes), CD31, CD163, and HO-1. Morphometric analysis demonstrated that the CD163-positive macrophage score, the number of CD31-positive microvessels, and the percentage of glycophorin-A and HO-1-positive area were significantly higher in HD patients than in non-HD patients (CD163-positive macrophage score, P < 0.0001; CD31-positive microvessels, P < 0.0001; glycophorin-A, P < 0.0001; HO-1, P < 0.0001). Double immunostaining for CD163 or HO-1 and macrophages revealed that the majority of CD163- or HO-1-positive cells were macrophages. Furthermore, CD163-positive macrophage score was positively correlated with glycophorin-A, HO-1-positive area, and the number of CD31-positive microvessels (glycophorin-A, R = 0.66, P < 0.0001; HO-1, R = 0.50, P < 0.0005; microvessels, R = 0.38, P < 0.01). These findings suggest a positive association among intraleaflet hemorrhage, neovascularization, and enhanced expression of CD163 and HO-1 as a response to intraleaflet hemorrhage in stenotic aortic valves in AS patients undergoing HD. </p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"632-40"},"PeriodicalIF":1.3,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40295818","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}
引用次数: 1
Gender, low Kt/V, and mortality in Japanese hemodialysis patients: opportunities for improvement through modifiable practices. 日本血液透析患者的性别、低Kt/V和死亡率:通过可修改的做法改善的机会
IF 1.3
Hemodialysis international. International Symposium on Home Hemodialysis Pub Date : 2014-07-01 Epub Date: 2014-02-24 DOI: 10.1111/hdi.12142
Naoki Kimata, Angelo Karaboyas, Brian A Bieber, Ronald L Pisoni, Hal Morgenstern, Brenda W Gillespie, Akira Saito, Tadao Akizawa, Shunichi Fukuhara, Bruce M Robinson, Friedrich K Port, Takashi Akiba
{"title":"Gender, low Kt/V, and mortality in Japanese hemodialysis patients: opportunities for improvement through modifiable practices.","authors":"Naoki Kimata,&nbsp;Angelo Karaboyas,&nbsp;Brian A Bieber,&nbsp;Ronald L Pisoni,&nbsp;Hal Morgenstern,&nbsp;Brenda W Gillespie,&nbsp;Akira Saito,&nbsp;Tadao Akizawa,&nbsp;Shunichi Fukuhara,&nbsp;Bruce M Robinson,&nbsp;Friedrich K Port,&nbsp;Takashi Akiba","doi":"10.1111/hdi.12142","DOIUrl":"https://doi.org/10.1111/hdi.12142","url":null,"abstract":"<p><p>Guidelines have recommended single pool Kt/V > 1.2 as the minimum dose for chronic hemodialysis (HD) patients on thrice weekly HD. The Dialysis Outcomes and Practice Patterns Study (DOPPS) has shown that \"low Kt/V\" (<1.2) is more prevalent in Japan than many other countries, though survival is longer in Japan. We examined trends in low Kt/V, dialysis practices associated with low Kt/V, and associations between Kt/V and mortality overall and by gender in Japanese dialysis patients. We analyzed 5784 HD patients from Japan DOPPS (1999-2011), restricted to patients dialyzing for >1 year and receiving thrice weekly dialysis. Logistic regression models estimated the relationships of patient characteristics with Kt/V. Logistic models also were used to estimate the proportion of low Kt/V cases attributable to various treatment practices. Multivariable Cox regression was used to estimate the associations of low Kt/V, blood flow rate (BFR), and treatment time (TT), with all-cause mortality. From 1999 to 2009, the prevalence of low Kt/V declined in men (37-27%) and women (15-10%). BFR <200 mL/min, TT <240 minutes, and dialyzate flow rate (DFR) < 500 mL/min were common (35, 13, and 19% of patients, respectively) and strongly associated with low Kt/V. Fifteen percent of low Kt/V cases were attributable to BFR <200 and 13% to TT <240, compared to only 3% for DFR <500. Lower Kt/V was associated with elevated mortality, more so among women (hazard ratio [HR] = 1.13 per 0.1 lower Kt/V, 95% CI: 1.07-1.20) than among men (HR = 1.06 per 0.1 lower Kt/V, 95% CI: 1.00-1.12). The relatively large proportion of low Kt/V cases in Japanese facilities may potentially be reduced 30% by increasing BFR to 200 mL/min and TT to 4 hours thrice weekly in HD patients. Associations of low Kt/V with elevated mortality suggest that modification of these practices may further improve survival for Japanese HD patients. </p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"596-606"},"PeriodicalIF":1.3,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/hdi.12142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40293730","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}
引用次数: 36
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