Archive for the ‘Hemodialysis’ Category
July 20, 2010
Van Wert R, Friedrich JO, Scales DC, Wald R, Adhikari NK, University of Toronto Acute Kidney Injury Research Group. Crit Care Med. 2010 May;38(5):1360-9
This meta-analysis examining high-dose renal replacement therapy in acute kidney injury did not show any improvement in patient survival or recovery of renal function.
June 27, 2010
This landmark clinical trial randomized CKD patients to a strategy of early (GFR 10-14 ml/min) vs late (GFR 5-7 ml/min) initiation of dialysis. After a median follow-up of 3.6 years, no difference was seen in mortality, cardiovascular events, infections, or complications of dialysis. Careful note should be made that the majority of patient randomized to late [...]
June 27, 2010
This editorial provides insight into the interpretation of the article ‘A Randomized, Controlled Trial of Early versus Late Initiation of Dialysis‘.
March 23, 2010
Weinhandl ED, Foley RN, Gilbertson DT, Arneson TJ, Snyder JJ, Collins AJ. J Am Soc Nephrol. 2010 Mar;21(3):499-506
Since an RCT comparing survival on hemodialysis vs peritoneal dialysis will likely never be done, this article warrants highlighting. This matched-pair cohort study compared survival of incident hemodialysis and peritoneal dialysis patients by intention-to-treat analysis. 6337 patient pairs from a retrospective cohort of 98,875 adults who initiated dialysis in 2003 in the United States were [...]
March 23, 2010
Prabhu MV, Juneja D, Gopal PB, Sathyanarayanan M, Subhramanyam S, Gandhe S, Nayak KS. Clin J Am Soc Nephrol. 2010 Feb;5(2):235-9
While a small, single study trial, this RCT suggests that when inserting a femoral line for hemodialysis, ultrasound-guided insertion was superior and safer than the anatomical landmark-guided technique. Full text kindly provided by the American Society of Nephrology.
February 12, 2010
Haskal ZJ, Trerotola S, Dolmatch B, Schuman E, Altman S, Mietling S, Berman S, McLennan G, Trimmer C, Ross J, Vesely T. N Engl J Med. 2010 Feb 11;362(6):494-503
This important RCT concludes that in treatment of venous anastomotic stenosis of hemodialysis grafts, angioplasty plus placement of a stent provides better longer-term patency and freedom from repeat interventions than balloon angioplasty.
February 12, 2010
Shurraw S, Tonelli M. Am J Kidney Dis. 2010 Feb;55(2):237-40
This review discusses the role of statins in dialysis patients and offers insight into the interpretation of AURORA and the 4D study.
January 11, 2010
Kikić Z, Lorenz M, Sunder-Plassmann G, Schillinger M, Regele H, Györi G, Mühlbacher F, Winkelmayer WC, Böhmig GA. Transplantation. 2009 Dec 27;88(12):1377-85
Previous studies have suggested that hemodialysis immediately before transplant surgery may increase the risk of delayed graft function. In this RCT, patients were randomized to be dialyzed or not pre-transplant; patients with a potassium > 5.0 were randomized to citrate or heparin anticoagulation. There were no differences in the incidence of DGF, acute rejection or [...]
December 14, 2009
Perl J, Chan CT. Am J Kidney Dis. 2009 Dec;54(6):1171-84
This next addition to the AJKD Core Curriculum series provides a detailed overview of the topic of “Home Hemodialysis, Daily Hemodialysis and Nocturnal Hemodialysis”.
November 22, 2009
de Jager DJ, Grootendorst DC, Jager KJ, van Dijk PC, Tomas LM, Ansell D, Collart F, Finne P, Heaf JG, De Meester J, Wetzels JF, Rosendaal FR, Dekker FW. JAMA. 2009 Oct 28;302(16):1782-9
This study evaluated whether the high overall mortality in patients starting dialysis is a consequence of increased cardiovascular mortality risk only or whether noncardiovascular mortality is equally increased. In this analysis, patients starting dialysis were found to have an increased risk of death not specifically caused by excess cardiovascular mortality.
November 22, 2009
Kurella Tamura M, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE. N Engl J Med. 2009 Oct 15;361(16):1539-47
This paper demonstrates that among nursing home residents with ESRD, the initiation of dialysis is associated with a substantial and sustained decline in functional status.
October 18, 2009
Wald R, Quinn RR, Luo J, Li P, Scales DC, Mamdani MM, Ray JG, University of Toronto Acute Kidney Injury Research Group. JAMA. 2009 Sep 16;302(11):1179-85
The purpose of this Canadian population-based cohort study was to assess the risk of chronic dialysis and all-cause mortality in individuals who experienced an episode of acute kidney injury requiring dialysis. The authors concluded that acute kidney injury necessitating in-hospital dialysis was associated with an increased risk of chronic dialysis but not all-cause mortality.
September 13, 2009
Pauly RP, Gill JS, Rose CL, Asad RA, Chery A, Pierratos A, Chan CT. Nephrol Dial Transplant. 2009 Sep;24(9):2915-9
This paper compared the results of nocturnal hemodialysis patients at two centres with matched deceased and liver donor transplant patients. Patient survival on nocturnal hemodialysis was similar to deceased donor transplantation, but inferior to live-donor transplantation. This is only a registry analysis and not a RCT. In addition, the dialysis patients were Canadian, while the [...]
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