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Citrasate® is an acid concentrate for bicarbonate-based dialysis that uses citric acid, a known anticoagulant, instead of acetic acid as the primary acidifying agent.  Citrasate® is an acid concentrate for bicarbonate-based dialysis that uses citric acid, a known anticoagulant, instead of acetic acid as the primary acidifying agent. 

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  hemodialysis News and hemodialysis Current Topics
NEWS: Hemodialysis - Dialysis - ESRD - CKD News & Research Interviews
Depressive symptoms associate with high mortality risk & dialysis withdrawal in incident hemodialysis patients:
Dr. Lacson
Nephrology Dialysis Transplant
Global Trends in Rates of Peritoneal Dialysis: Dr. Jain JASN
Structural Equation Modeling Highlights the Potential of Kim-1 as CKD Biomarker: Dr. Gardiner Am J Nephrology
Protective effects of PPARγ agonist in acute nephrotic syndrome: Dr. Fogo Nephrology Dialysis Transplant
A Computerized Treatment Algorithm Trial to Optimize Mineral Metabolism in ESRD: Dr. Spiegel CJASN
Development/Validation of Expedited 10g Protein Counter for Dietary Protein Intake : SL Lim J.Renal Nutrition
IL-6-independent risk factor for ESAs resistance in hemodialysis pts without iron deficiency: Dr. Kim Hemodialysis Int'l
Troponin I & Postoperative Myocardial Infarction after Renal Transplantation : Dr. Shroff Amer J Nephrology
Longitudinal Progression Trajectory of GFR in CKD: Dr. Li : AJ Kidney Disease

Hemodialysis Access | Peritoneal Access | Dialysis Access |
Dialysis Grafts, Catheter and Fistula Research Publications

Hemodialysis Stents |Dialysis Catheter | Hemodialysis Grafts and Fistula Research Publications

Author Interview: Jesse Goldman, MD

Tenecteplase for the improvement of blood flow rate in dysfunctional hemodialysis catheters.

Goldman J, Fishbane S, Oliver MJ, Blaney M, Jacobs JR, Begelman SM.
Temple University, Philadelphia, PA, Winthrop-University Hospital, Mineola, NY, USA, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, and Genentech, Inc., South San Francisco, CA, USA.
Clin Nephrol. 2012 Jan;77(1):55-61.

Author Interview: Andrew J. Jackson MD

Pharmacotherapy to improve outcomes in vascular access surgery: a review of current treatment strategies

Andrew J. Jackson, Paul Coats, and David B. Kingsmore
Nephrol. Dial. Transplant. first published online January 13, 2012 doi:10.1093/ndt/gfr552

1Department of Transplant Surgery, Western Infirmary, Glasgow, UK

Author Interview: Dr Aristeidis Stavroulopoulos

Right atrial thrombi complicating haemodialysis catheters. A meta-analysis of reported cases and a proposal of a management algorithm


Aristeidis Stavroulopoulos, Vasiliki Aresti, and Christos Zounis
Dial. Transplant. first published online December 20, 2011 doi:10.1093/ndt/gfr739

Isometric Handgrip Exercises Improve Success Rates in Arteriovenous Fistula (AVF) Placement in Unsuitable Candidates

ASN 2011 Abstract: [FR-PO1938]

Alice L. Uy, MD, Christina M. Yuan, MD, Rahul Jindal, Frank P. Hurst, MD. Medicine (Nephrology), Walter Reed Army Medical Center, Washington, DC; Surgery (Organ Transplant), Walter Reed Army Medical Center, Washington, DC.

Hemodialysis.com Author Interview: Dr. Luís Coentrão

Physical examination of dysfunctional arteriovenous fistulae by non-interventionalists: a skill worth teaching
Luís Coentrão, Bernardo Faria, and Manuel Pestana


Nephrol. Dial. Transplant. (2011)first published online September 21, 2011
doi:10.1093/ndt/gfr532

Author Interview: Dr. Laurie Solomon

Observational Study of Need for Thrombolytic Therapy and Incidence of Bacteremia using Taurolidine-Citrate-Heparin, Taurolidine-Citrate and Heparin Catheter Locks in Patients Treated with Hemodialysis

Solomon, L. R., Cheesbrough, J. S., Bhargava, R., Mitsides, N., Heap, M., Green, G. and Diggle, P.
Seminars in Dialysis.
doi: 10.1111/j.1525-139X.2011.00951.x 2011

Author Interview: Drs. André de Smet MD PhD and Ninos Ayez MD

Secondary interventions in patients with autologous arteriovenous fistulas strongly improve patency rates.

Ayez N, Fioole B, Aarts RA, Dorpel MA, Akkersdijk GP, Dinkelman MK, de Smet AA.
Department of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
J Vasc Surg. 2011 Aug 11

Author Interview: Tara I Chang, MD, MS
Intradialytic Hypotension and Vascular Access Thrombosis


Chang TI, Paik J, Greene T, Desai M, Bech F, Cheung AK, Chertow GM.
Division of Nephrology, Stanford University School of Medicine,
J Am Soc Nephrol. 2011 Aug;22(8):1526-33
Author Interview: Dr. YanQing Tong
Effect of Chinese Herbal Fomentation on Arteriovenous Fistula Maturation


The Journal of Alternative and Complementary Medicine
YanQing Tong, Yue Jing and ZhengPing Qu.
The Journal of Alternative and Complementary Medicine. - doi:10.1089/acm.2010.0565.

Independent prediction factors for primary patency loss in arteriovenous grafts within six months.

J Vasc Access. 2011 Jun 15. pii: 8077EF7C-99E1-4E06-905E-4A58A48EAB4E.
doi: 10.5301/JVA.2011.8425.

Monroy-Cuadros M, Yilmaz S, Salazar-Bañuelos A, Doig C.
Division of Transplantation, Department of Surgery, Faculty of Medicine, University of Calgary, Calgary AB, Foothills Medical Center, Calgary, AB - Canada.

Johns Hopkins’ Hemova Dialysis Access Port Receives Innovation Award
Author Interview: Eric K. Peden, MD and Javier E. Anaya-Ayala, MD
Efficacy of covered stent placement for central venous occlusive disease in hemodialysis patients.

Anaya-Ayala JE, Smolock CJ, Colvard BD, Naoum JJ, Bismuth J, Lumsden AB, Davies MG, Peden EK.


J Vasc Surg. 2011 Jun 8
Department of Cardiovascular Surgery, Methodist DeBakey Heart & Vascular Center; The Methodist Hospital Research Institute, The Methodist Hospital, Houston, Tex.
Author Interview Dr. Patty Quinan
A three-step approach to conversion of prevalent catheter-dependent hemodialysis patients to arteriovenous access.


Quinan P, Beder A, Berall MJ, Cuerden M, Nesrallah G, Mendelssohn DC.
CANNT J. 2011 Jan-Mar;21(1):22-33.
Department of Nephrology, Humber River Regional Hospital, Toronto, Ontario.
Author Interview: Dr. Michael Allon
Arteriovenous Graft Infection: A Comparison of Thigh and Upper Extremity Grafts

Abha Harish and Michael Allon
CJASN June 2011 CJN.00490111
Author Interview: Dr. Eduardo Lacson, Jr. NKF Poster Spring 2011
HEPARIN LOCK DOSE & HD CATHETER DYSFUNCTION

Eduardo Lacson, Jr., Weiling Wang, Michael Lazarus, Raymond Hakim, Fresenius Medical Care,
North America, Waltham, MA
Author Interview: Dr. Chia-Ter Chao
Letter to the Editor
Chronic haemodialysis: the access determines the outcome?


Chia-Ter Chao
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan, China

Author Interview: Daniel Schneditz, Ph.D
More may be less: increasing extracorporeal blood flow in an axillary arterio-arterial access decreases effective clearance.

Nephrol Dial Transplant. 2011 May 4
Krisper P, Martinelli E, Zierler E, Schilcher G, Tiesenhausen K, Schneditz D

Author Interview: Dr. Jacob A Akoh 
Vascular Access Infections: Epidemiology, Diagnosis, and Management


Akoh JA.
Curr Infect Dis Rep. 2011 Apr 26.

Author Interview Dr. Earl Schuman
Early use conversion of the HeRO dialysis graft.

Schuman E, Ronfeld A.
J Vasc Surg. 2011 Apr 15.
Legacy Oregon Surgical, Portland, Ore.

Author Interview: Dr. Laura Labriola
Infectious complications following conversion to buttonhole cannulation of native arteriovenous fistulas: a quality improvement report.

Labriola L, Crott R, Desmet C, André G, Jadoul M.
Am J Kidney Dis. 2011 Mar;57(3):442-8.
Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

Author Interview: Dr. Charmaine Lok Seeing eye to eye: the key to reducing catheter use.

J Vasc Access. 2011 Feb 28.
pii: 33CD128A-6888-4BD8-82D8-C4A5D14B1657

Chaudhry M, Bhola C, Joarder M, Zimmerman D, Quinan P, Mendelssohn D, Lok CE.University Health Network-Toronto General Hospital and the University of Toronto, Toronto, Ontario - Canada.

Author Interview: Drs. Javier E. Anaya Ayala, MD. and Eric K. Peden, MD.

Methodist DeBakey Heart & Vascular Center Houston, Texas

Surgical management of hemodialysis-related central venous occlusive disease: a treatment algorithm.

Annals of Vascular Surgery 2011 Jan;25(1):108-19.
Anaya-Ayala JE, Bellows PH, Ismail N, Cheema ZF, Naoum JJ, Bismuth J, Lumsden AB, Reardon MJ, Davies MG, Peden EK.
Department of Cardiovascular Surgery, Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, TX 77030, USA.

Gore Receives CE Mark for GORE® PROPATEN® Vascular Graft for Hemodialysis Access

FLAGSTAFF, Ariz.--(BUSINESS WIRE February 22, 20)--W. L. Gore & Associates (Gore) announced the GORE® PROPATEN® Vascular Graft for hemodialysis access has received CE Mark. Arteriovenous (AV) Grafts are used to create a conduit for repeated blood access during hemodialysis, allowing blood to be withdrawn from the body and cleansed when a patient has End Stage Renal Disease (ESRD), commonly referred to as kidney failure.

Prevention of Dialysis Catheter Malfunction with Recombinant Tissue Plasminogen Activator

Brenda R. Hemmelgarn, M.D., Ph.D., Louise M. Moist, M.D., Charmaine E. Lok, M.D., Marcello Tonelli, M.D., S.M., Braden J. Manns, M.D., Rachel M. Holden, M.D., Martine LeBlanc, M.D., Peter Faris, Ph.D., Paul Barre, M.D., Jianguo Zhang, M.Sc., and Nairne Scott-Douglas, M.D., Ph.D. for the Prevention of Dialysis Catheter Lumen Occlusion with rt-PA versus Heparin (PreCLOT) Study Group
N Engl J Med 2011; 364:303-312 January 27, 2011

Vascular access for hemodialysis in the elderly.

J Vasc Surg. 2011 Jan 5. Swindlehurst N, Swindlehurst A, Lumgair H, Rebollo Mesa I, Mamode N, Cacciola R, Macdougall I.

Abstract

OBJECTIVE: The number of elderly patients needing hemodialysis is constantly increasing year by year. Elderly patients with end-stage renal failure represent a challenge for the surgeons who create vascular accesses. The aim of this study was to analyze the outcome of conduit creation in the elderly in our institution and to compare it with the outcome of a cohort of patients aged <65 years.

WHY DOES DIALYSIS ACCESS FAIL?

MCP-1 May Be 'Critical Contributor' to Problems with AV Fistulas

Washington, DC (December 22, 2010) — A protein implicated in the development of
vascular diseases may also contribute to the failure of arteriovenous (AV) fistulas created for vascular access in dialysis patients, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Catheter Reduction Reduces Hospitalization and Mortality

Renee Jg Arnold, David Madigan, John A. Robertson, Abbe Volz. DaVita Inc., Denver, CO
Date: Friday, November 19, 2010

Introduction: Use of central venous catheters (CVC) in hemodialysis patients is associated with increased hospitalization and mortality. Published data have shown that an aggressive catheter reduction initiative (CathAway™) can decrease both catheter incidence and duration. We examined the impact of CathAway™ on hospitalization and mortality in the last 15 months of this program.
Read the Author Interview:
Catheter Reduction Reduces Hospitalization and Mortality

Hemodialysis Vascular Access Type and Bloodstream Infection Rates

Eduardo K. Lacson, Weiling Wang, J. Michael Lazarus, Raymond M. Hakim. Fresenius Medical Care, North America, Waltham, MA
November 19, 2010  

Introduction: We evaluated bloodstream infection (BSI) rates based on positive blood cultures by type of vascular access in a national cohort of incident hemodialysis (HD) patients during their first year.
Evolution and Clinical Course of First (EVER) Fistulas and Grafts

Eduardo K. Lacson, Weiling Wang, J. Michael Lazarus, Raymond M. Hakim. Fresenius Medical Care, North America, Waltham, MA


Introduction: The evolution and clinical course of arteriovenous (AV) access placement in patients new to hemodialysis (HD) are reported mainly as single center experiences. We describe results from a nationally distributed cohort for the first (ever) constructed AV accesses in the 1st year of HD.

Achieving the Goal of the Fistula First Breakthrough Initiative for Prevalent Maintenance Hemodialysis Patients.

Am J Kidney Dis. 2010 Nov 29.

Lynch JR, Wasse H, Armistead NC, McClellan WM.
Mid-Atlantic Renal Coalition, Midlothian, VA.

Dialysis Fistula or Graft: The Role for Randomized Clinical Trials.

Clin J Am Soc Nephrol. 2010 Oct 28.

Allon M, Lok CE.
University of Alabama at Birmingham, Birmingham, Alabama;

Hemodialysis patients' experience with and attitudes toward the buttonhole technique for arteriovenous fistula cannulation.

Clin Nephrol. 2010 Nov;74(5):346-50.

Hashmi A, Cheema MQ, Moss AH.
Section of Nephrology, Department of Medicine, West Virginia University School of Medicine (AH,MQC, AHM), and the Center for Health Ethics and Law (AHM), Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA.

Traditional and non-traditional strategies to optimize catheter function: go with more flow.

Kidney Int. 2010 Sep 29.

Mokrzycki MH, Lok CE.
Division of Nephrology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA.

Choice of Vascular Access among Incident Hemodialysis Patients: A Decision and Cost-Utility Analysis.

Clin J Am Soc Nephrol. 2010 Sep 28.

Xue H, Lacson E Jr, Wang W, Curhan GC, Brunelli SM.
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and.

Effective Ionic Dialysance/Blood Flow Rate Ratio: An Indicator of Access Recirculation in Arteriovenous Fistulae

Mohan, Sumit; Madhrira, Machaiah; Mujtaba, Muhammad; Agarwala, Rajesh; Pogue, Velvie; Cheng, Jen-Tse
ASAIO Journal. 56(5):427-433, September/October 2010.
doi: 10.1097/MAT.0b013e3181e743eb

Previous PICC Placement May Be Associated With Catheter-Related Infections in Hemodialysis Patients.

Cardiovasc Intervent Radiol. 2010 Sep 21

Butler PJ, Sood S, Mojibian H, Tal MG.
Department of Diagnostic Radiology, Yale University School of Medicine, P.O. Box 208042 (SP2-323), New Haven, CT

Improving dialysis access:
regional anesthesia improves arteriovenous fistula prevalence
.

Am Surg. 2010 Sep;76(9):938-42.

Schenk WG 3rd.
Department of Surgery, University of Virginia, Charlottesville, Virginia 22908, USA

64-Slice MDCT Angiography of Upper Extremity in Assessment of Native Hemodialysis Access.

Vasc Endovascular Surg. 2010 Sep 9.

Wasinrat J, Siriapisith T, Thamtorawat S, Tongdee T.

The Cannon Catheter-A Prospective Analysis.

Caridi J, Ross E, Aspilcueta A, Wiley S.
J Vasc Interv Radiol. 2010 Aug 27.

Prosthetic lower extremity hemodialysis access grafts have satisfactory patency despite a high incidence of infection.

J. Vasc Surg. 2010 Aug 21.

Geenen IL, Nyilas L, Stephen MS, Makeham V, White GH, Verran DJ.
Transplantation and Vascular Surgical Services, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; General Surgery, Maastricht University Medical Centre, Maastricht, Maastricht, The Netherlands.

Automated Intravascular Access Pressure Surveillance Reduces Thrombosis Rates.

Semin Dial. 2010 Aug 13.

Zasuwa G, Frinak S, Besarab A, Peterson E, Yee J.
Division of Nephrology and Hypertension, Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan.

Arteriovenous Fistulas among Incident Hemodialysis Patients in Department of Defense and Veterans Affairs Facilities.

J Am Soc Nephrol. 2010 Aug 12.

Hurst FP, Abbott KC, Raj D, Krishnan M, Palant CE, Agodoa LY, Jindal RM.

Vascular access using the superficial femoral vein.

Scollay JM, et al On Behalf of the East of Scotland Vascular Network.
J Vasc Access. 2010 Aug 3.
Department of Vascular Surgery, Ninewells Hospital and Medical School, Dundee - UK.

Antibiotic lock solutions for the prevention of catheter-related bacteraemia in haemodialysis patients.

Hong Kong Med J. 2010 Aug;16(4):269-74.
Chow KM,
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

Clinical outcome of overlapping stents in hemodialysis access.

J Vasc Access. 2010 Jul 21.
Chan MR, Yevzlin AS.
Division of Nephrology, Department of Medicine, University of Wisconsin, Madison, W

Hemodialysis vascular access ultrasonography: tips, tricks, pitfalls and a quiz.

J Vasc Access. 2010 Jul 20.
Van Hooland S, Malik J.
Department of Nephrology, AZ St Lucas, Ghent - Belgium.

Outpatient surgeries of patients with arteriovenous fistulas for hemodialysis. Integrated activity in a general surgery unit.

Nefrologia. 2010;30(4):452-457 [Article in Spanish, English]
Jiménez-Almonacid P, et al

Vascular changes at the puncture segments of arteriovenous fistula for hemodialysis access.

J Vasc Surg. 2010 Jul 8.

Hsiao JF,
Cardiovascular Division, Department of Internal Medicine
Chia-Yi Chang Gung Memorial Hospital.

Patients' Perspectives of Constant-Site (Buttonhole) Cannulation for Haemodialysis Access.

Nephron Clin Pract. 2010 May 21;116(2):c123-c127.
Ward J, Shaw K,  Davenport A.
Barnet Dialysis Centre, Royal Free Hospital, London, UK.

Epidemiology, Surveillance, and Prevention of Bloodstream Infections in Hemodialysis Patients.
Am J Kidney Dis. 2010 Jun 14.
Patel PR et al
National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.

Fistula First: myth vs. fact.
Nephrol News Issues. 2010 Apr;24(4):36, 39-41.
Wish JB.

Vascular access for hemodialysis and cardiovascular complications.
Minerva Urol Nefrol. 2010 Mar;62(1):81-5.
Santoro D, et al

Statin Therapy Is Not Associated with Improved Vascular Access Outcomes
Clin J Am Soc Nephrol. 2010 May 27.
Pisoni R, Barker-Finkel J, Allon M.

Buttonhole cannulation in hemodialysis: improved outcomes and increased expense--is it worth it?
CANNT J. 2010 Jan-Mar;20(1):29-37.
Ludlow V.
Patient Research Centre, Memorial University, St. John's, Newfoundland. vludlow@nl.rogers.com

Status of research in vascular access for dialysis.
Nephrol Dial Transplant. 2010 May 19.
Kian K, Asif A.
Denver Nephrology, 950 E Harvard Ave, Ste 240 Denver, CO, USA.

Early vascular access blood flow as a predictor of long-term vascular access patency in incident hemodialysis patients.

J Korean Med Sci. 2010 May;25(5):728-33.
Kim HS, Park JW, et al
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.

Is it possible to create a "mechanical" arteriovenous fistula in hemodialysis patients?

Artificial Organs. 2010 Mar;34(3):239-41.
Lo Monte AI, Buscemi G.
General Surgery and Organ Transplantation, University of Palermo, School of Medicine, Palermo, Italy. ailomonte@unipa.it

Vascular access for hemodialysis: Thrills and thrombosis.
J Vasc Nurs. 2010 Jun;28(2):78-83.
Gilpin V, Nichols WK.

Association of serum pentosidine with arterial stiffness in hemodialysis patients.
Artificial Organs. 2010 Mar;34(3):193-9.
Zhou Y, Yu Z, Jia H, Sun F, Ma L, Guo R, Peng L, Cui T.
Department of Nephrology, ChaoYang Hospital, Capital Medical University, Beijing, China.




 

 

 
Author Interviews: hemodialysis - Dialysis - ESRD - CKD
Predictors of eGFR Decline in Type 2 Diabetes & Preserved Kidney Function: Dr. Chonchol CJASN
Tenecteplase for improvement of blood flow in dysfunctional hemodialysis catheters: Dr. Goldman Clin Neph
Religious coping, psychological distress and quality of life in hemodialysis: Dr. Carvalho J Psychosom Res. 
Effect of captopril on recuperation from ischemia/reperfusion-induced AKI Nephrology Dialysis Transplant
Restless legs syndrome in dialysis: comparison of hemodialysis & CAPD: Dr. Merlino Neurol Sci.
International practice patterns & non-conventional hemodialysis utilization : Dr. Sood BMC Nephrology 
Decreased PON1 in hemodialyzed & renal transplanted patients. Dr. Paragh Nephrol. Dial. Transplant
Preoperative Proteinuria & Long-Term Progression to Chronic Dialysis & Mortality after CABG: Drs. Chao & Ko : PLoS ONE
Creatinine generation is reduced in CVHD & predicts mortality: Dr. Wilson: Nephrology Dialysis Transplant
Importance of normohydration for the long-term survival in hemodialysis : Dr. Wabel
Nephrology Dialysis Transplant
Local Tissue Renin-Angiotensin System Activation in Cardiorenal Metabolic Syndrome & Type 2 Diabetes: Dr.Hayden Cardiorenal Med
Group I nonreciprocal inhibition in restless legs syndrome secondary to CKD : Dr. Marconi Parkinsonism & Related Disorders 
Low-Dose ESAs and CV Geometry in CKD: Is Darbepoetin-α More Effective than Expected? Dr. Di Lullo
Cardiorenal Med
Pharmacotherapy to improve outcomes in vascular access surgery: Dr. Jackson
Nephrology Dialysis Transplant
Parathyroidectomy for the attainment of NKF-K/DOQI™ and KDIGO recommended values for bone & mineral metabolism in dialysis with uncontrollable secondary hyperparathyroidism. Langenbecks Arch Surg
Bisphosphonate Therapy, Death, and Cardiovascular Events Among Female Patients With CKD: Dr. Perkins
Losartan prevents the development of the pro-inflammatory monocytes CD14+CD16+ in hemodialysis : Dr. Merino Nephrology Dialysis Transplant
Does Dialysis Modality Influence the Oxidative Stress of Uremia? Dr. Capusa  Kidney Blood Press Res
Treatment of Periodontal Diseases Reduces Inflammation in Hemodialysis : Dr. Siribamrungwong
Declining Rates of Deceased Donor Renal Transplantation in the US Over Successive Years of Listing: Dr. Trivedi
When Is the Best Moment to Assess the Ankle Brachial Index: Pre- or Post-Hemodialysis?Dr. RM Elias
Role of Race and Poverty on Steps to Kidney Transplantation in the Southeastern US
Validity & Reliability of the MUST and MST Nutrition Screening Tools in Renal Inpatients : C. Lawson
Target-Orientated Algorithm for Regional Citrate-Calcium Anticoagulation in Extracorporeal Therapies: Dr. Brandl
Evaluation of bone microarchitecture by HR-pQCT in hemodialysis : Dr. Negri
Erectile Dysfunction in Chronic Hemodialysis : Dr. Strippoli
Have Renal Dietitians Successfully Implemented Evidence-Based Guidelines Into Practice? E. Joy
Regional Citrate Versus Heparin Anticoagulation for CRRT: Drs. Tam & Wu
von Willebrand factor predicts mortality in CRRT : Dr. Péquériaux
Clinical Outcome of Twice-Weekly Hemodialysis Patients in Shanghai | Dr. Qian
Persistently low intact PTH levels predict aortic arch calcification progression in hemodialysis patients : Dr. Song
Lack of Awareness among Future Medical Professionals about the Risk of Consuming Hidden Phosphate-Containing Processed Food & Drinks : Dr. Razzaque
51Cr-EDTA plasma & urinary clearance as a measure of residual renal function in dialysis :Dr. Kjaergaard
Obesity and Mortality Risk among Younger Dialysis Patients: Dr. Hoogeveen
Solar-Assisted Hemodialysis: Dr. Agar
Hydrogen sulfide inhibits high glucose-induced matrix protein synthesis by activating AMP-activated protein kinase in renal epithelial cells Drs. Lee & Kasinath
Mineral, bone disorders, survival in hemodialysis with & without PKD : Drs. Molnar & Kalantar-Zadeh
Hydrogen sulfide inhibits high glucose-induced matrix protein synthesis by activating AMP-activated protein kinase in renal epithelial cells Drs. Lee & Kasinath
Mineral, bone disorders, survival in hemodialysis with & without PKD : Drs. Molnar & Kalantar-Zadeh
Downregulation of the renal & hepatic hydrogen sulfide-producing enzymes and capacity in CKD - Dr. Vaziri
A predictive algorithm for management of anemia in hemodialysis based on ESA pharmacodynamics : Dr. Lines
Factors Associated With Intradialytic Systolic Blood Pressure Variability: Dr. Flythe
Safety and predictors of complications of renal biopsy in the outpatient setting : Dr. Jiang
Heparin induced antibodies in chronic hemodialysis patients and cardiac surgery patients: Dr. Shavit
Atrial Fibrillation in Medicare/Medicaid-eligible dialysis patients: Dr. Wetmore
Newly identified anorexigenic adipokine nesfatin-1 in hemodialysis patients: J. Saldanha
Correction of Post kidney Transplant Anemia Reduces Progression of Allograft Nephropathy: Dr. Choukrou
Mild and moderate pre-dialysis CKD is associated with increased coronary artery calcium: Dr. Budoff
Endogenous factors modified by hemodialysis and accuracy of blood glucose-measuring device: Dr. Ogawa
Narrow-band UVV increases serum vitamin D levels in hemodialysis patients Dr. Ala-Houhala
Predicting hospital cost in CKD patients through blood chemistry values: Dr. Bessette
Nutritional vitamin D supplementation in hemodialysis: a potential vascular benefit? D. Mason
Volume excess in chronic hemodialysis effects of treatment frequency & treatment spacing : Dr. Schneditz
Acid reduction with fruits/veges or bicarb attenuates kidney injury in hypertensive nephropathy with reduced GFR
Predicting Number of US Medical Graduates Entering Adult Nephrology Fellowships
Using Search Terms Dr. Desai
Potential influence of sevelamer hydrochloride on responsiveness to ESAs in hemodialysis patients: Dr. Ikee
Anemia Management in Dialysis : ESAs vs Transfusions: Clinical & Economic Consequences :Dr. Naci
Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury: Dr. Perkins
Filtration Markers May Have Prognostic Value Independent of Glomerular Filtration Rate : Dr. Tangri
Stopping Renin-Angiotensin System Inhibitors in Chronic Kidney Disease: Predictors of Response
Insights into nephrologist training, clinical practice, and dialysis choice: Dr. Mehrotra
Early ACE inhibition in Alport syndrome delays renal failure and improves life expectancy: Dr. Gross
Blunted insulinemia using high dialysate glucose concentration during hemodialysis : Dr. Schneditz
Prevalence of Inadequate Platelet Inhibition by Clopidogrel in Patients Receiving Hemodialysis: Dr. Alexopoulos
Live kidney donation: attitudes towards donor approach, motives and factors promoting donation: Dr. Mazaris
High-dose ESAs, inflammatory biomarkers, and soluble erythropoietin receptors : Dr. Inrig
Association of AKI with Adverse Outcomes in Burned Military Casualties : Dr. Stewart
Sodium Intake, ACE Inhibition, and Progression to ESRD Dr. Ruggenenti
DOPPS Practice Monitor: Update on Trends in US Hemodialysis Care Following Launch of Bundled Payment System and Revisions to ESA Labels January 6 2011

Emerging trends in hemodialysis care through August 2011, based on a sample of US dialysis facilities, are included in the latest update to the DOPPS Practice Monitor (DPM, at http://www.dopps.org/DPM), run by the Dialysis Outcomes and Practice Patterns Study (DOPPS) at Arbor Research Collaborative for Health.

Ongoing Changes in the US Dialysis Environment – Recent changes in dialysis payment and regulatory guidance are expected to affect hemodialysis practice. In January 2011, the Centers for Medicare & Medicaid Services (CMS) launched a new Prospective Payment System (PPS) with the intent to control dialysis costs through bundled payments. In June 2011, the FDA approved revised prescribing information for erythropoiesis-stimulating agents (ESAs), used to treat anemia in most dialysis patients. Previously, the label recommended a hemoglobin target range of 10-12 g/dL. The June 2011 update removed the target range, advising instead to start ESA therapy for dialysis patients at hemoglobin less than 10 g/dL, and to reduce or interrupt the dose when the hemoglobin approaches or exceeds 11 g/dL.

Most Recent Trends in Care – Over the August 2010 to August 2011 time period, many hemodialysis practices have remained stable; examples include nutrition measures and hemodialysis treatment time and dose. There have been notable trends in the following practice areas:

  • Anemia: Hemoglobin levels have decreased since the June 2011 ESA label update. While the mean hemoglobin level declined by 0.12 g/dL over 12 months from August 2010 to July 2011, it declined in August 2011 by another 0.10 g/dL to 11.26 g/dL. The percentage of patients with hemoglobin levels greater than 12 g/dL declined sharply (from 28% to 23%) in July/August 2011, while the percentage with hemoglobin levels less than 10 g/dL increased slightly from 8.5% to 10% and the percentage with hemoglobin levels less than 9 g/dL remained under 3%.

Mean prescribed epoetin dose (among patients receiving epoetin) decreased by 15%, from 21,100 units/wk to 17,900 units/wk, from August 2010 to August 2011, with the greatest decline in June-August 2011. Epoetin doses at the higher end of the dose range have decreased most notably. IV iron use increased from August 2010 to August 2011 though has recently stabilized. In keeping with greater IV iron use, serum ferritin levels (indicative of iron stores) continue to rise. Serum ferritin concentration exceeded 500 ng/mL in 65% of patients, 800 ng/mL in 34% of patients, and 1,200 ng/mL in 11% of patients in August 2011.

  • Mineral & Bone Disorder: In our last report, we noted a 29% increase in serum parathyroid hormone (PTH) levels through April 2011, and differences by race were described. Since then, PTH levels have remained stable or declined slightly in both black and non-black patients. In August 2011, 22% of black patients and 12% of non-black patients had very high PTH values (defined here as PTH >600 pg/mL). The percentage of hemodialysis patients for whom PTH is measured has declined slightly since August 2010. There have been no clear changes in serum calcium or serum phosphorus levels.
  • Clinical Outcomes: Preliminary data indicate that the 30-day hospitalization rate has increased somewhat from August 2010 to August 2011. The DPM does not report yet on trends in red blood cell transfusions, as dialysis units are often unaware of transfusions occurring in the inpatient setting. Additional efforts to comprehensively monitor trends in transfusions are warranted. To date mortality rate has not changed appreciably, though further follow-up time is necessary as we continue to track this outcome.

Future monitoring of these trends, confirmation with national data when eventually available, and understanding their effect on clinical outcomes, if any, is required.

DPM data are aggregated across dialysis organizations and facilities. Aggregated trends may not reflect trends in individual dialysis organizations or facilities, and are not intended to provide oversight of performance in individual dialysis organizations or facilities.

Read the rest of the DOPPS Practice Monitor: Update on Trends in US Hemodialysis Care Following Launch of Bundled Payment System and Revisions to ESA Labels Press Release

 
Hemodialysis Patient: Calciphylaxis after skin biopsy - Joerg Latus

Early Stages of Calciphylaxis:
Are Skin Biopsies the Answer?

Joerg Latus, MD
Open Access

Case Rep Dermatol 2011;3:201-205


 

Hemodialysis Research Interview of the Week

Author Interview: Dr. Len Usvyat PhD
Clinical Systems Database Senior Analyst
Renal Research Institute

Seasonal Variations in Mortality, Clinical, and Laboratory Parameters in Hemodialysis Patients: A 5-Year Cohort Study.

Usvyat LA, Carter M, Thijssen S, Kooman JP, van der Sande FM, Zabetakis P,
Balter P, Levin NW, Kotanko P.
 Clin J Am Soc Nephrol. 2011 Nov 17.

What are the main findings of the study?

We found that mortality of hemodialysis patients followed a seasonal pattern over a five year period with the highest mortality in the winter and lowest mortality in the summer months.

We also observed that many clinical and laboratory parameters follow a seasonal pattern in our patient population.

For example, pre-dialysis systolic blood pressures are highest in winter and lowest in summer months; pre-dialysis body temperatures are highest in summer and lowest in winter months.

Neutrophils are highest in winter and lowest in summer suggesting higher inflammatory markers in the winter.

This phenomena was observed in various geographic regions in US.

Were any of the findings unexpected?

It has been previously shown that mortality follows seasonal trends in healthy population however these findings were never extended to dialysis patients.

While it was shown that blood pressures tend to follow a seasonal pattern, to the best of our knowledge, it has not been shown that neutrophils or interdialytic weight gains also follow a seasonal pattern.

Additionally, we applied a cosinor analysis to show whether these patterns are statistically significant.

What should clinicians and patients take away from this study?

These findings are particularly important in designing studies -- taking season into account is key.

What recommendations do you have for future studies as a result of your study?

Further research into understanding the biologic factors that contribute to this seasonality is important.

 


 
 
 
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