Archive for the ‘Hemodialysis’ Category

May 1, 2017

A Clinical Risk Prediction Tool for 6-Month Mortality After Dialysis Initiation Among Older Adults

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This study derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment using linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada. A 19-point risk score was developed for 6-month mortality that […]

No Comments Posted in Clinical Nephrology, Hemodialysis
May 1, 2017

The Effect of Predialysis Fistula Attempt on Risk of All-Cause and Access-Related Death

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This study was designed to determine the proportion of access-related deaths in a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. There was significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt […]

No Comments Posted in Chronic Kidney Disease, Hemodialysis, Vascular Access
February 9, 2017

Association between Preoperative Vascular Function and Postoperative Arteriovenous Fistula Development

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Arteriovenous fistula (AVF) maturation failure is the primary cause of dialysis vascular access dysfunction. To evaluate whether preoperative vascular functional properties predict postoperative AVF measurements, patients enrolled in the Hemodialysis Fistula Maturation Study underwent up to five preoperative vascular function tests (VFTs): flow-mediated dilation (FMD), nitroglycerin-mediated dilation (NMD), carotid-femoral pulse wave velocity, carotid-radial pulse wave […]

No Comments Posted in Clinical Nephrology, Hemodialysis, Vascular Access
February 9, 2017

Residual Kidney Function Decline and Mortality in Incident Hemodialysis Patients

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This is a longitudinal cohort study of 6538 patients who started maintenance hemodialysis over a 4-year period (January 2007 through December 2010) and had available renal urea clearance (CLurea) data at baseline and 1 year after hemodialysis initiation.  This study  examined the association of annual change in renal CLurea rate with subsequent survival. The median (interquartile […]

No Comments Posted in Clinical Nephrology, Hemodialysis
February 9, 2017

The Effect of Predialysis Fistula Attempt on Risk of All-Cause and Access-Related Death

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This is a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. The authors observed significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt in patients aged <65 years and in the first […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, Hemodialysis, Vascular Access
November 11, 2016

Hospitalization Rates for Patients on Assisted Peritoneal Dialysis Compared with In-Center Hemodialysis

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This multicenter, retrospective cohort study by linked a quality assurance dataset to administrative health data in Ontario, Canada. The study included 872 patients in the in-center hemodialysis group and 203 patients in the assisted peritoneal dialysis group. Using an intention to treat approach, patients on assisted peritoneal dialysis had a similar hospitalization rate of 11.1 d/yr (95% confidence interval, 9.4 to 13.0) compared with 12.9 d/yr (95% confidence interval, 10.3 to 16.1) in the hemodialysis group (P=0.19). […]

No Comments Posted in Clinical Nephrology, Hemodialysis, Peritoneal Dialysis
November 11, 2016

Continuous Dialysis Therapies: Core Curriculum 2016

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This edition of the core curriculum nicely summarizes continuous dialysis therapies.        

No Comments Posted in AJKD Core Curriculum, Hemodialysis
November 11, 2016

A new model to predict acute kidney injury requiring renal replacement therapy after cardiac surgery

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The authors of this study developed and validated a risk prediction model for acute kidney injury requiring renal replacement therapy within 14 days after cardiac surgery.  They identified 8 independent predictors of acute kidney injury requiring renal replacement therapy in the derivation model(adjusted odds ratio, 95% confidence interval [CI]): congestive heart failure (3.03, 2.00-4.58), Canadian Cardiovascular Society angina class III or higher (1.66, […]

No Comments Posted in Acute Kidney Injury, Clinical Nephrology, Hemodialysis
May 29, 2016

Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury The ELAIN Randomized Clinical Trial

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This single-center randomized clinical trial of 231 critically ill patients with AKI KDIGO stage 2 looked at early (within 8 hours of diagnosis of KDIGO stage 2; n = 112) or delayed (within 12 hours of stage 3 AKI or no initiation; n = 119) initiation of RRT.  The results show that early initiation of RRT significantly reduced 90-day mortality (39.3% vs 54.7%).  More patients in the early group recovered renal function by day 90 (53.6% vs 38.7%) in the delayed group.  Furthermore, duration of […]

No Comments Posted in Acute Kidney Injury, Clinical Trial Results, Hemodialysis
May 29, 2016

Bioengineered human acellular vessels for dialysis access in patients with end-stage renal disease: two phase 2 single-arm trials

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This phase 2 trial looked at bioengineered human acellular vessel as an option for dialysis access in 60 patients that were not candidates for arteriovenous fistulas.  The results show that onne vessel became infected during 82 patient-years of follow-up. There were no vessels with dilatation and there was rarely any post-cannulation bleeding. At 12 months, […]

No Comments Posted in Hemodialysis, Vascular Access
November 30, 2015

Performance of Temporary Hemodialysis Catheter Insertion by Nephrology Fellows and Attending Nephrologists

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This pre- post-intervention study with a pretest-only comparison group was conducted at the University of Toronto in September of 2014. Participants were nephrology fellows and attending nephrologists from three university-affiliated academic hospitals who underwent baseline assessment of internal jugular temporary hemodialysis catheter insertion skills using a central venous catheter simulator. A total of 19 attending nephrologists and 20 nephrology fellows participated in the study. Mean attending nephrologist checklist scores (46.1%; SD=29.5%) were similar to baseline scores […]

No Comments Posted in Clinical Nephrology, Clinical Trial Results, Hemodialysis
November 30, 2015

The mortality and hospitalization rates associated with the long interdialytic gap in thrice-weekly hemodialysis patients.

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This article aimed to identify factors associated with mortality and hospitalization events in England from 2002-2006 comparing the 2 day vs 3 day intradialytic gap. Higher admission rates were seen after the 2-day gap irrespective of whether thrice-weekly dialysis sequence commenced on a Monday or Tuesday (2.4 per year after the 2-day gap vs. 1.4 […]

No Comments Posted in Clinical Nephrology, Clinical Trial Results, Hemodialysis
September 21, 2015

An Incident Cohort Study Comparing Survival on Home Hemodialysis and Peritoneal Dialysis (Australia and New Zealand Dialysis and Transplantation Registry)

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This Australia and New Zealand Dialysis and Transplantation Registry database study compared patient and technique survival between patients on home hemodialysis with those on peritoneal dialysis.  Overall, on every level that was assessed home hemodialysis was associated with better outcomes than peritoneal dialysis, including 5 year survival (85% vs 44%, respectively; log-rank P<0.001).  Patients eligible for both modalities may benefit from this […]

No Comments Posted in Clinical Nephrology, Clinical Trial Results, Hemodialysis, Peritoneal Dialysis