Hemodialysis Access | Peritoneal Access | Dialysis Access |
Dialysis Grafts, Catheter and Fistula Research Publications
Hemodialysis Stents |Dialysis Catheter | Hemodialysis Grafts and Fistula Research Publications
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. |
1Department of Transplant Surgery, Western Infirmary, Glasgow, UK |
Aristeidis Stavroulopoulos, Vasiliki Aresti, and Christos Zounis
Dial. Transplant. first published online December 20, 2011 doi:10.1093/ndt/gfr739
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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. |
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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. |
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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. |
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Schuman E, Ronfeld A.
J Vasc Surg. 2011 Apr 15.
Legacy Oregon Surgical, Portland, Ore. |
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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 |
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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. |
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. |
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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. |
Lynch JR, Wasse H, Armistead NC, McClellan WM.
Mid-Atlantic Renal Coalition, Midlothian, VA. |
Clin J Am Soc Nephrol. 2010 Oct 28.
Allon M, Lok CE.
University of Alabama at Birmingham, Birmingham, Alabama; |
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. |
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. |
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.
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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 |
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 |
Schenk WG 3rd.
Department of Surgery, University of Virginia, Charlottesville, Virginia 22908, USA
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Vasc Endovascular Surg. 2010 Sep 9.
Wasinrat J, Siriapisith T, Thamtorawat S, Tongdee T.
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Caridi J, Ross E, Aspilcueta A, Wiley S.
J Vasc Interv Radiol. 2010 Aug 27.
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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.
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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.
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J Am Soc Nephrol. 2010 Aug 12.
Hurst FP, Abbott KC, Raj D, Krishnan M, Palant CE, Agodoa LY, Jindal RM.
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J Am Soc Nephrol. 2010 Aug 5.
McClellan WM, et al
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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.
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Vasquez JC, et al
Vasc Endovascular Surg. 2010 Jul 30.
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J Vasc Access. 2010 Jul 21.
Chan MR, Yevzlin AS.
Division of Nephrology, Department of Medicine, University of Wisconsin, Madison, W
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J Vasc Surg. 2010 Jul 8.
Hsiao JF,
Cardiovascular Division, Department of Internal Medicine
Chia-Yi Chang Gung Memorial Hospital.
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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.
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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 |
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Hemodialysis Research Interview of the Week |
Author Interview: Dr. Len Usvyat PhD
Clinical Systems Database Senior Analyst
Renal Research Institute
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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.
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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.
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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.
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What should clinicians and patients take away from this study? |
These findings are particularly important in designing studies -- taking season into account is key.
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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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