scholarly journals Hemodynamic and Laboratory Changes during Incremental Transition from Twice to Thrice-Weekly Hemodialysis

2020 ◽  
Vol 10 (2) ◽  
pp. 97-107
Author(s):  
Inkyong Hur ◽  
Cachet Wenziger ◽  
Yoshitsugu Obi ◽  
Hamid Moradi ◽  
Elani Streja ◽  
...  
Keyword(s):  
Body Weight ◽  
Treatment Frequency ◽  
Interdialytic Weight Gain ◽  
Weekly Treatment ◽  
Before And After ◽  
Incremental Hemodialysis ◽  
Baseline Values ◽  
Stage Renal Disease ◽  
End Stage ◽  
Laboratory Changes

Objective: Incremental hemodialysis (HD) is a strategy utilized to gradually intensify dialysis among patients with incident end-stage renal disease. However, there are scarce data about which patients’ clinic status changes by increasing treatment frequency. Methods: We retrospectively examined statistically de-identified data from 569 patients who successfully transitioned from twice- to thrice-weekly HD (2007–2011) and compared the differences in monthly-averaged values of hemodynamic and laboratory indices during the 3 months before and after the transition with the values at 1 month prior to transition serving as the reference. Results: At 3 months after transitioning from twice- to thrice-weekly HD, ultrafiltration volume decreased by 0.5 (95% CI 0.3–0.6) L/session among 189 patients (33%) with weekly interdialytic weight gain (IDWG) ≥5.4 kg/week, and increased by 0.4 (95% CI 0.3–0.5) L/session among 186 patients (33%) with weekly IDWG <3.3 kg/week. Weekly IDWG consistently increased after the transition irrespective of baseline values (1.7 [95% CI 1.5–1.9] kg/week). Pre-HD systolic blood pressure (SBP) decreased by 12 (95% CI 9–14) mm Hg among 177 patients (31%) with baseline pre-HD SBP ≥160 mm Hg, which coincided with a decreasing trend in post-HD body weight (1.3 [95% CI 0.8–1.7] kg). Discussion: In conclusion, patients who increased HD frequency from twice to thrice weekly treatment experienced increased weekly IDWG and better pre-HD SBP control with lower post-HD body weight.

scholarly journals The Effects of Hemodialysis on Tear Osmolarity

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Muhittin Taskapili ◽  
Kubra Serefoglu Cabuk ◽  
Rukiye Aydin ◽  
Kursat Atalay ◽  
Ahmet Kirgiz ◽  
...  
Keyword(s):  
Body Weight ◽  
Weight Changes ◽  
Biochemical Tests ◽  
Sodium Potassium ◽  
Glucose Levels ◽  
Blood Biochemical ◽  
Before And After ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Aim. To determine the effects of hemodialysis (HD) on tear osmolarity and to define the blood biochemical tests correlating with tear osmolarity among patients with end stage renal disease (ESRD).Material-Method. Tear osmolarity of ESRD patients before and after the hemodialysis program was determined as well as the blood biochemical data including glucose, sodium, potassium, calcium, urea, and creatinine levels.Results. Totally 43 eyes of 43 patients (20 females and 23 males) with a mean age of53.98±18.06years were included in the study. Tear osmolarity of patients was statistically significantly decreased after hemodialysis (314.06±17.77versus301.88±15.22 mOsm/L,p=0.0001). In correlation analysis, pre-HD tear osmolarity was negatively correlated with pre-HD blood creatinine level (r=-0.366,  p=0.016). Post-HD tear osmolarity was statistically significantly correlated with the post-HD glucose levels (r=0.305  p=0.047). Tear osmolarity alteration by HD was negatively correlated with creatinine alteration, body weight alteration, and ultrafiltration (r=-0.426,  p=0.004;r=-0.365,  p=0.016; andr=-0.320,p=0.036, resp.). There was no correlation between tear osmolarity and Kt/V and URR values.Conclusion. HD effectively decreases tear osmolarity to normal values and corrects the volume and composition of the ocular fluid transiently. Tear osmolarity alteration induced by HD is correlated with body weight changes, creatinine alterations, and ultrafiltration.

scholarly journals Hemodialysis exacerbates proteolytic imbalance and pro-fibrotic platelet dysfunction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aaron J. Velasquez-Mao ◽  
Mark A. Velasquez ◽  
Zhengxiong Hui ◽  
Denise Armas-Ayon ◽  
Jingshen Wang ◽  
...  
Keyword(s):  
Blood Flow Rate ◽  
Mode Switching ◽  
Platelet Dysfunction ◽  
Compensatory Mechanisms ◽  
Before And After ◽  
Basal Plasma ◽  
Stage Renal Disease ◽  
End Stage ◽  
Plasma Factors ◽  
Esrd Patients

AbstractMulti-organ fibrosis among end stage renal disease (ESRD) patients cannot be explained by uremia alone. Despite mitigation of thrombosis during hemodialysis (HD), subsequent platelet dysfunction and tissue dysregulation are less understood. We comprehensively profiled plasma and platelets from ESRD patients before and after HD to examine HD-modulation of platelets beyond thrombotic activation. Basal plasma levels of proteolytic regulators and fibrotic factors were elevated in ESRD patients compared to healthy controls, with isoform-specific changes during HD. Platelet lysate (PL) RNA transcripts for growth and coagulative factors were elevated post-HD, with upregulation correlated to HD vintage. Platelet secretome correlations to plasma factors reveal acutely induced pro-fibrotic platelet phenotypes in ESRD patients during HD characterized by preferentially enhanced proteolytic enzyme translation and secretion, platelet contribution to inflammatory response, and increasing platelet dysfunction with blood flow rate (BFR) and Vintage. Compensatory mechanisms of increased platelet growth factor synthesis with acute plasma matrix metalloproteinase (MMP) and tissue inhibitor of MMPs (TIMP) increases show short-term mode-switching between dialysis sessions leading to long-term pro-fibrotic bias. Chronic pro-fibrotic adaptation of platelet synthesis were observed through changes in differential secretory kinetics of heterogenous granule subtypes. We conclude that chronic and acute platelet responses to HD contribute to a pro-fibrotic milieu in ESRD.

scholarly journals Thiamine Diphosphate Status and Dialysis-Related Losses in End-Stage Kidney Disease Patients Treated with Hemodialysis

2017 ◽  
Vol 44 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Magdalena Jankowska ◽  
Paweł Rudnicki-Velasquez ◽  
Hanna Storoniak ◽  
Przemysław Rutkowski ◽  
Bolesław Rutkowski ◽  
...  
Keyword(s):  
Body Weight ◽  
Kidney Disease ◽  
Dietary Intake ◽  
Whole Blood ◽  
Vitamin B1 ◽  
Thiamine Diphosphate ◽  
End Stage Kidney Disease ◽  
Before And After ◽  
End Stage ◽  
The Impact

Aim: (1) To describe the whole blood content of thiamine diphosphate (TDP), a biologically active form of vitamin B1 in end-stage kidney disease patients treated with hemodialysis (HD); (2) to establish the impact of a single HD procedure on TDP blood concentrations; and (3) to describe potential explanatory variables influencing TDP dialysis related losses, including dialysis prescription, vitamin B1 dietary intake and supplementation. Methods: Single-center, cross-sectional study in 50 clinically stable maintenance HD patients. The assessment of whole blood TDP with the High Performance Liquid Chromatography method, before and after a single, middle-week dialysis session and analysis of clinical and laboratory parameters potentially influencing TDP status Results: We report a significant difference in TDP levels before and after HD sessions - 42.5 (95% CI 38.7-46.2) μg/L and 23.6 (95% CI 18.9-28.2) μg/L, respectively (p = 0.000). The magnitude of intradialytic TDP changes is highly variable among individuals and is negatively associated only with the body weight of the patients (p < 0.013). Vitamin B1 dietary intake and supplementation do not influence whole blood TDP and dialysis-related loss of TDP. Conclusions: TDP, a bioactive compound of vitamin B1, is substantially lost during the HD procedure, and the magnitude of its loss is associated with the patient's body weight but it is not influenced by vitamin B1 dietary intake and standard supplementation dose.

L-Carnitine Consecutively Administered to Patients on Hemodialysis Improves Beta-Cell Response

2003 ◽  
Vol 26 (4) ◽  
pp. 304-307 ◽  
Author(s):  
E. Vazelov ◽  
A-M. Borissova ◽  
G. Kirilov ◽  
B. Assenova ◽  
M. Tchetirska ◽  
...  
Keyword(s):  
Beta Cell ◽  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Carnitine Level ◽  
Peripheral Tissues ◽  
Before And After ◽  
Oxidative Processes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Beta Cell Response

Eight patients with end stage renal disease (ESRD) on chronic hemodialysis (CHD) treatment were supplemented with 1 g L-carnitine intravenously (i.v.) after each dialysis session for one month. A Tolbutamide test was done and blood sugar (BS), serum C-peptide (CP) were measured at 0, 20 and 60 minutes, as well as the plasma L-carnitine level before and after treatment. Delta CP and the area under CP curve were ascertained. After L-carnitine application delta CP was significantly increased (1.33 ± 0.63 vs. 2.24 ± 1.0 nmol/L; p <0.05) and also the area of the stimulated secretion under the CP curve (14.93 ± 11.11 vs. 36.88 ± 25.36 nmol/L × 60 min.; p <0.05). The fasting BS-level was significantly lower after the treatment - 3.85 ± 0.43 vs. 4.76 ± 1.02 mmol/L; p <0.05 and plasma L-carnitine level significantly increased (72.8 ± 43.2 vs. 35.2 ± 18.3 mcmol/L; p <0.05) Improving the oxidative processes in peripheral tissues, L-carnitine increases the peripheral effectiveness of insulin and relieves the overstretched beta-cell apparatus.

Abacavir/lamivudine/dolutegravir single tablet regimen in patients with human immunodeficiency virus and end-stage renal disease on hemodialysis

2018 ◽  
Vol 30 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Sarah M Michienzi ◽  
Christopher A Schriever ◽  
Melissa E Badowski
Keyword(s):  
Human Immunodeficiency Virus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Case Series ◽  
Drug Discontinuation ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Clinically Significant ◽  
Stage Renal Disease ◽  
End Stage

No single-tablet antiretroviral (ARV) regimens (STRs) are approved for patients with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) on hemodialysis (HD). Based on known pharmacokinetic (PK) properties, abacavir (ABC)/lamivudine (3TC)/dolutegravir (DTG) STR may represent a promising option. This case series presents the safety and efficacy of ABC/3TC/DTG STR in patients with HIV and ESRD on HD. Patients were included if they were HIV-positive, maintained on intermittent HD for ESRD, switched to an ARV regimen containing ABC/3TC/DTG, and had at least one set of virologic data before and after the switch. Average age (±standard deviation) was 59 (±8) years. The majority of patients were cis-gender male and non-Hispanic Black. Only one demonstrated clinically significant resistance at baseline. All were on multiple-tablet regimens prior to the switch. Five patients (83%) achieved undetectable HIV-RNA after the switch while only four patients (46%) were undetectable immediately prior. No decline in immune function was noted. ABC/3TC/DTG STR was well tolerated. Only one patient self-reported an adverse event (nausea), which resolved without drug discontinuation. Based on these data, it appears that ABC/3TC/DTG may be a safe and effective ARV-STR option for patients with HIV and ESRD on HD. A larger trial including a PK analysis is needed to confirm these findings.

scholarly journals CHILDRENONHEMODIALYSIS: A RETROSPECTIVESTUDYIN BENGHAZI PEDIATRIC HOSPITAL

2020 ◽  
Vol 8 (12) ◽  
pp. 827-832
Author(s):  
Narges M. Kablan ◽  
◽  
Khadija A. Ali ◽  
Kamlah J. Said ◽  
Mabroka A. Ali ◽  
...  
Keyword(s):  
Body Weight ◽  
White Blood Cells ◽  
Life Quality ◽  
Pediatric Hospital ◽  
Dialysis Unit ◽  
Major Health Problem ◽  
Drug History ◽  
Male Patients ◽  
Stage Renal Disease ◽  
End Stage

End stage renal disease (ESRD) is a major health problem worldwide. In Libya, limited studies are available on children with ESRD.Regular assessment of laboratory parameters is the only way to reduce their risk of mortality.This study aimed to determinethe demographic characteristics and evaluate the hematological profile of children on hemodialysis (HD) admitted to the dialysis unit in Benghazi Pediatric hospital, Benghazi, Libya during the period 3rd of December, 2017 to 15th of January 2018.A structured form was used to record data collected from patients files. Data includedage, gender, body weight, treatment history, drug history, duration and frequency of HD and laboratory tests results, specifically white blood cells (WBC), hemoglobin (HB), blood urea, glucose, Albumin, uric acid, serum creatinine, serum iron, calcium, phosphate, sodium and potassium.Number of patients on HD includedin this study was seven with average age of 11years,the majority (71%)were males.Average body weight of female patients was24.2kg,while male patients averagebody weight was25.52kg. Most of the patients(57%)hadhigh BP.71%of patientsstarted dialysis sincemore than one year.Patients underwentdialysisthree times a week represented(86%),while the rest of patients underwent dialysis four times a weekrepresented(14%).All patients had anemia and highcreatininelevel.Providing an appropriate care for children on maintenance dialysis in Libya is quitedifficult. Increasing the awareness ofparents about ESRD is necessary to improve the life quality of children with ESRD.

scholarly journals RELATIONSHIP BETWEEN INTERDIALYTIC WEIGHT GAIN AND PRE HEMODIALYSIS BLOOD PRESSURE IN HEMODIALYSIS PATIENTS

2020 ◽  
pp. 169-171
Author(s):  
M Manasa ◽  
Aravind Reddy. Gangula
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Water Retention ◽  
Salt Intake ◽  
Hemodialysis Patients ◽  
Interdialytic Weight Gain ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Interdialytic weight gain in patients with hemodialysis depends on fluid, salt intake in interdialytic period and compliance of dialysis patients. In end stage renal disease(ESRD) patients due to decreased and absent residual urine output there is salt and water retention in body which leads to interdialytic weight gain. Overhydration and IDWG is assumed to be the main cause of pre hemodialysis raised blood pressure(BP) in ESRD patients. Here the relationship between IDWG and pre HD blood pressure is studied in 40 hemodialysis patients. We recorded pre HD BP and IDWG in four subsequent hemodialysis sessions for each patient during the period of 2 weeks in patients who are on twice weekly hemodialysis. so, in total we studied 160 hemodialysis sessions. Mean of four pre HD BP is compared with mean of four IDWG for each patient. Then correlation between 40 mean IDWG and 40 mean pre HD BP is studied and also correlation between IDWG and pre HD blood pressure during 160 hemodidlysis sessions studied individually.

scholarly journals P1356PACLITAXEL-COATED BALLOON ANGIOPLASTY FOR STENOSIS OF ARTERIOVENOUS FISTULA IN PATIENTS UNDER HEMODIALYSIS: 18TH MONTH FOLLOW-UP

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
IOANNIS GRIVEAS ◽  
GEORGIOS VOURLIOTAKIS ◽  
IOANNIS KANDOUNAKIS
Keyword(s):  
Clinical Course ◽  
Therapeutic Option ◽  
Minimal Invasive ◽  
Arteriovenous Fistulas ◽  
Day Clinic ◽  
Before And After ◽  
Vascular Stenosis ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims The recording of the experience of the use of paclitaxel-coated balloons in patients with End Stage Renal Disease under hemodialysis (HD) exhibiting narrowing in arteriovenous fistulas (AVF). Method 20 patients with ultrasonographically confirmed AVF dysfunction were subjected after angiographic screening to prosthesis with a simple angioplasty balloon, and then a balloon drug gradually released the drug paclitaxel. After the damage was restored (one-day clinic), arteriovenous communication was used immediately. The degree of vascular stenosis, blood flow to it and kt / V before and after recovery were assessed by ultrasound. At the same time, the clinical course of the patient and the vestibule of the vessel were monitored for 18 months. Results In the 20 patients of the study, since the damage was recovered, AVF was immediately treated without any problems. After angioplasty the degree of stenosis of the responsible vessel was statistically significantly reduced from 69.85% to 27.38% (p &lt;0.05). Flow volume increased statistically significantly from 690.47 mils / min to 942.67 mils / min (p &lt;0.05). The kt / v of patients improved from 1.25 to 1.6. During the 18th -month follow-up, the clinical course of the patients was stable, no problems related to vascular access appeared. Restenosis occurred to two patients, one of each received another successful angioplasty. Conclusion Drug-releasing balloons can be a useful therapeutic option for patients with AVF stenosis due to accelerated endothelial hyperplasia. The use of paclitaxel-coated balloons helps reduce the risk of restenosis of arteriovenous anastomoses and is a safe, time consuming, minimal invasive and immediate solution to AVF management.

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