Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy最新文献

{"title":"Lower time-averaged serum uric acid was associated with increased mortality in peritoneal dialysis patients.","authors":"Lu Li, Hongxia Zhang, Botao Zhang, Fangyuan Yang, Mengting Wang, Wenlong Qiu, Lina Fu, Menghua Chen, Na Tian","doi":"10.1111/1744-9987.14252","DOIUrl":"https://doi.org/10.1111/1744-9987.14252","url":null,"abstract":"<p><strong>Background: </strong>The relationship between time-averaged serum uric acid (TA-SUA) levels and prognosis in peritoneal dialysis (PD) patients are rarely discussed.</p><p><strong>Methods: </strong>This was a retrospective cohort study. PD patients recruited from January 1, 2011, to December 31, 2020, were included. Baseline and follow-up uric acid levels over 1 year were collected to calculate time-averaged serum uric acid (TA-SUA) levels. Patients were divided into four groups based on TA-SUA quartiles: Q1 (<5.1 mg/dl), Q2 (5.1-5.8 mg/dl), Q3 (5.8-6.8 mg/dl), and Q4 (>6.8 mg/dl).</p><p><strong>Results: </strong>A total 487 PD patients with a mean age of 52.0 ± 14.2 were enrolled, including114 (23.4%) diabetes. Q1 (n = 121, 24.8%), Q2 (n = 118, 24.2%), Q3 (n = 125, 25.7%), and Q4 (n = 123, 25.3%). The Q1 group exhibited characteristics of increased age, malnutrition, and a higher prevalence of diabetes. During the 48.1 months follow-up time, 197 (35.8%) died, 109 (55.3%) cardiovascular disease (CVD), 38 (19.3%) infections. Kaplan-Meier analysis revealed that both all-cause mortality and cardiovascular mortality were significantly higher in the Q1 and Q4 groups (log-rank = 24.373, p < 0.001). COX regression analysis showed that decreased TA-SUA level was an independent risk factor for all-cause mortality in PD patients after adjustment for confounding factors. Each 1 mg/dl decrease in TA-SUA level was associated with a 23.46% increase in all-cause mortality (HR = 0.81, 95% CI, 0.71-0.94; p = 0.004*). Lower serum albumin level was associated with increased all-cause mortality.</p><p><strong>Conclusion: </strong>PD patients with lower TA-SUA were older and had a higher proportion of diabetes and malnourishment than those with higher TA-SUA. Long-term exposure to low TA-SUA levels was an independent predictor of all-cause and cardiovascular mortality in PD patients.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191241","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":"Frequent, perseverant therapy with plasma exchange in Japanese patients with rapidly progressive interstitial lung disease caused by anti-MDA5 antibody-positive dermatomyositis: A report of two cases.","authors":"Tomomi Motohashi, Yukihiro Wada, Yasuo Takeuchi","doi":"10.1111/1744-9987.14258","DOIUrl":"https://doi.org/10.1111/1744-9987.14258","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191240","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":"Clinical outcomes of endovascular treatment in hemodialysis patients with central venous stenosis: A retrospective analysis.","authors":"Ran Tian, Zhengya Yu, Tao Luo","doi":"10.1111/1744-9987.14249","DOIUrl":"https://doi.org/10.1111/1744-9987.14249","url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular treatment is one of treatment options for hemodialysis patients with central venous stenosis (CVS), but clinical outcomes and risk factors remain inadequately studied. This study seeks to investigate the occurrence and risk factors associated with CVS.</p><p><strong>Methods: </strong>This retrospective study analyzed the distribution and causes of 385 lesions in 309 hemodialysis patients with symptomatic CVS. We particularly examined patients with single-segment lesions treated with endovascular treatment to explore patency rates and related factors.</p><p><strong>Results: </strong>The proportion of catheter-related superior vena cava (SVC) lesions was 100%. In the subgroup of single-segment lesions (from 205 patients) 187 patients successfully treated with endovascular treatment (technical success was 91.22%) and Cox analysis revealed that age over 50 years (HR = 2.057, 95% CI: 1.174-3.603, p = 0.012), upper-arm arteriovenous fistula (HR = 1.832, 95% CI: 1.127-2.977, p = 0.015), and presence of preoperative collateral circulation (HR = 1.924, 95% CI: 1.241-2.982, p = 0.003) were prognostic factors influencing the 1-year primary patency rate of subclavian veins, while age over 50 years (HR = 3.618, 95% CI: 1.465-8.933, p = 0.005), upper-arm arteriovenous fistula (HR = 1.972, 95% CI: 1.116-3.482, p = 0.019), high pressure to efface waist at the stenotic site (HR = 2.343, 95% CI: 1.106-4.961, p = 0.026), and diabetes (HR = 1.953, 95% CI: 1.042-3.661, p = 0.037) were prognostic factors for brachiocephalic veins. Due to the small sample size, comprehensive analysis of risk factors for restenosis could not be performed.</p><p><strong>Conclusion: </strong>Central venous balloon angioplasty is an effective treatment for central venous stenosis in hemodialysis patients, with satisfactory technical and clinical success rates. Age, upper arm fistula and collateral circulation are important factors affecting the treatment outcome for subclavian veins. Similarly, the corresponding factors for the brachiocephalic veins include age, upper-arm fistula, high pressure to efface waist and diabetes.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124291","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":"Lower dry weight is associated with post-hemodialysis hypokalemia.","authors":"Daigo Sunagawa, Yoshihiko Imamura, Saeko Matsumura, Hiromitsu Inoue, Hayato Wakabayashi, Toshihide Hayashi, Yasunori Takahashi, Nobuhiko Joki","doi":"10.1111/1744-9987.14256","DOIUrl":"https://doi.org/10.1111/1744-9987.14256","url":null,"abstract":"<p><strong>Introduction: </strong>Serum potassium levels <3 mEq/L at post-hemodialysis (HD) are closely associated with poor prognosis. This study aimed to identify high-risk patients with post-HD hypokalemia after regular HD using potassium (2 mEq/L) dialysate solution.</p><p><strong>Methods: </strong>A total of 129 patients receiving HD and 1121 HD sessions were enrolled in this single-center retrospective cross-sectional study. The association of post-HD hypokalemia less than 3 mEq/L with patient background, as well as each dialysis session was investigated.</p><p><strong>Results: </strong>Approximately 16% of 129 patients and 10% of 1121 sessions showed post-HD hypokalemia. In per-patient analysis, more inpatients and lower dry weight were found in the hypokalemia group compared with the non-hypokalemia group. Logistic regression analysis indicated that lower dry weight was significantly associated with higher risk of hypokalemia independent of inpatients (p < 0.01). To determine the best cut-off value of pre-HD potassium for identifying post-HD hypokalemia, receiver operating curve analysis was performed in per-session analysis. The results showed that the optimal pre-HD potassium cut-off value was 4.2 mEq/L. In the 250 sessions below the optimal cut-off value for post-HD hypokalemia development, 28.8% of sessions with potassium correction showed post-HD hypokalemia, compared to 40.8% of sessions without potassium correction. Although numerically lower, the difference did not reach statistical significance (p = 0.125).</p><p><strong>Conclusion: </strong>Our results indicated that a relatively lower dry weight was more likely to complicate post-HD hypokalemia. Potassium supplementation for high-risk patients during HD sessions may be needed to prevent post-HD hypokalemia.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124296","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":"Shared decision-making in selecting modality of renal replacement therapy confers better patient prognosis after the initiation of dialysis.","authors":"Kaori Kohatsu, Shigeki Kojima, Yugo Shibagaki, Tsutomu Sakurada","doi":"10.1111/1744-9987.14192","DOIUrl":"10.1111/1744-9987.14192","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of shared decision-making (SDM) regarding the choice of renal replacement therapy (RRT) for chronic kidney disease (CKD) patients on their mortality after the induction of dialysis therapy has not been adequately investigated.</p><p><strong>Methods: </strong>Patients who initiated dialysis at our hospital were divided into two groups according to whether they participated in SDM in the outpatient clinic, and survival analysis was performed. We also examined the effect of SDM in the outpatient clinic on mortality.</p><p><strong>Results: </strong>Of the 554 patients, 123 (22.2%) were in the SDM group. The survival rate was significantly higher in the SDM group (p = 0.001, log-rank test). Multivariate analysis excluding ADL, which competed with SDM, showed that SDM was significantly associated with mortality (HR 0.593, 95% CI: 0.353-0.997, p = 0.049).</p><p><strong>Conclusion: </strong>SDM regarding RRT selection in the outpatient clinic may be associated with a better patient prognosis after dialysis induction.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899317","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":"Comparison of the efficacy of drug-coated balloon angioplasty and conventional balloon angioplasty in the endovascular treatment of thrombosed arteriovenous dialysis fistulas.","authors":"Mustafa Ozdemir, Onur Taydas","doi":"10.1111/1744-9987.14197","DOIUrl":"10.1111/1744-9987.14197","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the efficacy and safety of paclitaxel-coated balloon angioplasty in the treatment of thrombosed arteriovenous fistulas.</p><p><strong>Methods: </strong>This prospective, randomized, controlled study investigated the use of drug-eluting balloons in the treatment of the thrombosis of arteriovenous fistulas (AVFs) at our center between January 2018 and January 2023. A total of 246 patients were included in the study. The mean age of the patients was 61.3 ± 11.5 years. Of the patients, 150 (61%) were male and 96 (39%) were female. Angioplasty was performed using a plain balloon (PB) in 126 patients (51.2%) and a drug-coated balloon (DCB) in 120 (48.8%). The control images of the patients were obtained at the sixth and 12th months. Patency was evaluated during the follow-up.</p><p><strong>Results: </strong>There was no significant difference between the two groups in terms of age, gender, hypertension, hyperlipidemia, diabetes, fistula location, or stenosis length. No significant difference was observed between the groups regarding the number of complications observed during and after the procedure. At the end of the sixth month, the patency rate was found to be 86.7% in the DCB group and 78.6% in the PB group. The 12th-month patency rate was 77.5% in the DCB group and 57.9% in the PB group. A significant difference was detected between the two groups in relation to the 6th- and 12th-month patency rates (p = 0.034 and p = 0.046, respectively).</p><p><strong>Conclusion: </strong>Drug-coated balloon angioplasty is an effective approach to the treatment of thrombosed AVFs, especially in terms of prolonging primary patency and reducing the need for secondary procedures.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"70-78"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010176","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":"Considering kidney replacement therapy initiation based on acute encephalopathy in severe acute kidney injury.","authors":"Henry H L Wu, Shaw Kang Liew, Arvind Ponnusamy","doi":"10.1111/1744-9987.14225","DOIUrl":"10.1111/1744-9987.14225","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"144-145"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635648","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":"Machine learning-based prediction of vancomycin concentration after abdominal administration in patients with peritoneal dialysis-related peritonitis.","authors":"Bo Lv, Wenxiu Liu, Ying Lu, Zhi Wang, Aiming Shi","doi":"10.1111/1744-9987.14188","DOIUrl":"10.1111/1744-9987.14188","url":null,"abstract":"<p><strong>Introduction: </strong>Peritonitis is a serious complication of peritoneal dialysis (PD), in which insufficient control of antibacterial drug concentrations poses a significant risk for poor outcomes. Predicting antibacterial drug concentrations is crucial in clinical practice. The limitations imposed by compartment models have presented a considerable challenge.</p><p><strong>Methods: </strong>In this study, we employed machine learning as model-free methods to circumvent the constraints of compartment models. We collected data from 68 observations from 38 patients with peritoneal dialysis-related peritonitis who were treated with vancomycin from the EHR system. This data included information about drug administration, demographic details, and experimental indicators as predictors. We constructed models using Genetic Adaptive Supporting Vector Regression (GA-SVR), KNN-regression, GBM, XGBoost, and a stacking ensemble model. Additionally, we used RMSE loss and partial-dependence profiles to elucidate the effects of these predictors.</p><p><strong>Results: </strong>GA-SVAR outperformed other large-scale models. In 10-fold cross-validation, the RMSE ratio and R-squared values for direct concentration prediction were 23.5% and 0.633, respectively. The ROC AUC for predicting concentrations below 15 and exceeding 20 μg/mL were 0.890 and 0.948, respectively. Notably, the most influential predictors included times of drug administration and weight. These predictors were also influenced by residual kidney function.</p><p><strong>Conclusion: </strong>To assist in controlling vancomycin concentrations for patients with PD-related peritonitis in clinical practice, we developed GA-SVR and a corresponding explainer model. Our study improves the controlling of vancomycin in clinical settings by enhancing our understanding of vancomycin concentration in patients with PD-related peritonitis.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"106-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736260","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 effect of listening to the sound of running water on pain and anxiety experienced during cannulation by hemodialysis patients: A randomized, controlled, open-label study.","authors":"Samet Sayilan, Aylin Aydin Sayilan, Zeynep Temiz, Didem Kandemir","doi":"10.1111/1744-9987.14200","DOIUrl":"10.1111/1744-9987.14200","url":null,"abstract":"<p><strong>Introduction: </strong>This study was conducted to determine the effect of the sound of running water, which we had not previously encountered being used in dialysis patients, on invasive pain and anxiety experienced during cannulation.</p><p><strong>Methods: </strong>The research was conducted as a randomized, controlled study. A descriptive form, a VAS pain scale, and state-trait anxiety scales were used as a data collection form. The data were analyzed on SPSS version 22.00 for Windows software. The independent groups t-test was applied to compare descriptive statistics such as mean, standard deviation, number, and percentage in independent groups, while categorical data were compared using the chi-square test. The effect of an independent variable on a dependent variable was tested using linear regression analysis. p values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>The study was completed with 32 experimental and 33 control group patients. There was no significant difference in pre-intervention pain and anxiety between the groups. The pain levels of the patients after the first and 12th cannulations were significantly lower in the experimental group (p < 0.05). State and trait anxiety levels were also significantly lower in the experimental group at the 12th session (p < 0.05).</p><p><strong>Conclusion: </strong>We conclude that the sound of running water has a significant positive effect on pain and anxiety experienced during cannulation by dialysis patients. We recommend that clinicians apply such a simple method as listening to the sound of running water for reducing pain and anxiety during invasive procedures.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"42-51"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116715","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":"Successful introduction and maintenance of denosumab treatment through close monitoring of serum calcium levels in a hemodialysis patient with prostate cancer and multiple bone metastases.","authors":"Shunsuke Yamada, Kanako Yamada, Hiroshi Nishida","doi":"10.1111/1744-9987.14231","DOIUrl":"10.1111/1744-9987.14231","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"141-142"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635649","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}