Turning Human Pluripotent Stem Cells Into Mesoderm That Forms Kidney Tubules

Hemodialysis.com Interview with: Albert Q. Lam, MD Harvard Medical School, Boston, MA More »

ACEIs/ARBs Lowered Dialysis Risk in CKD Hypertensive Patients

Hemodialysis.com Interview with: Dr. Der-Cherng Tarng and Dr. Chih-Cheng Hsu. More »

Kidney Stones: Value of Weekly Exercise

Hemodialysis.com Interview with: Mathew Sorensen, MD, MS More »

Albuminuria and Exposure to Phthaltes

Hemodialysis.com Interview with: Dr. Howard Trachtman MD More »

Dialysis Patients Have Higher Risk of Cardiac Injury Even If LV Function Normal

Shih-Han Susan Huang, Assistant Professor, MD FRCPC Department of Medicine, Division of Nephrology, Western University A2-344 Commissioners Road East, London, OntarioHemodialysis.com Interview with:
Shih-Han Susan Huang, Assistant Professor, MD FRCPC
Department of Medicine, Division of Nephrology, Western University
A2-344 Commissioners Road East, London, Ontario

Hemodialysis.com: What are the main findings of the study?

Dr. Huang: Two-dimensional speckle tracked imaging (STI) echocardiography can be used to asses global and regional left ventricular function and it has been shown to be a sensitive method in patients with normal ventricular function. We applied this new method to 104 of our hemodialysis patients. In our prospective observational study, we found that the left ventricular global and segmental strain values were higher than in healthy individuals. In patients who had more segments (>80%) that were affected and/or worse global function measured by STI, they had lower survival rate.

PD vs Hemodialysis: Differences In Infection Risk

Anouk van Diepen Division of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Hemodialysis.com Interview with:
Anouk van Diepen
Division of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

Hemodialysis.com: What are the main findings of the study?

Answer: The main finding of the study is that peritoneal dialysis patients carry a high overall infection risk when compared to hemodialysis patients. However, when infections are stratified into infections that are related to the dialysis technique (peritonitis, catheter infections, iv access associated sepsis) and those that are not related to the dialysis technique, it becomes evident that the dialysis technique induces infections in peritoneal dialysis patients, while deficient immunological function appears to be more important in hemodialysis patients.

Does Buttonhole Cannulation Really Reduce Dialysis Access Pain?

Hemodialysis.com Interview with:
Dr. Ben Wong MD
Division of Nephrology and Transplant Immunology
University of Alberta, Edmonton, Alberta, Canada.

Hemodialysis.com: What are the main findings of the study?

Dr. Wong: Reduction in patient-reported cannulation pain, which is one of the purported benefits of buttonhole cannulation, was only demonstrated among pooled observational studies, but not among randomized controlled trials.  This suggests that the buttonhole cannulation technique as a means to reduce needling discomfort is likely overly-stated and over-emphasized in parts of the renal community.  Also, compared to the traditional rope-ladder cannulation technique, there appeared to be a signal towards increased risk of local and systemic infections with the buttonhole technique – this result simply confirms what others have already reported.

HDL Function Remains Compromised After Kidney Transplantation

Dr. Marcus D. Säemann Division of Nephrology and Dialysis Department of Internal Medicine III Medical University of Vienna, Austria.
Hemodialysis.com Interview with:

Dr. Marcus D. Säemann
Division of Nephrology and Dialysis
Department of Internal Medicine III
Medical University of Vienna, Austria.

 

Hemodialysis.com: What are the main findings of the study?

Dr. Säemann: The main focus of our study was to describe HDL quality after renal transplantation to provide information on characteristic lipid
disturbances in this population due to limited information on the high  cardiovascular risk in renal disease patients. We could previously show
that HDL is rendered dysfunctional in hemodialysis patients, including  alterations on the molecular level and wondered whether the impaired HDL quality is recovered after renal transplantation. The major finding of our study is that functional properties of HDL remain compromised after renal transplantation, shown by substantially reduced HDL functions in transplant patients and importantly, which was independent of graft function.

Remarkably, we detected a profound suppression of key  cardioprotective HDL metrics, such as cholesterol efflux capacity and
anti-oxidative activity, along with a characteristic protein composition  across the transplant population which was similar to ESRD patients.

Contast-Induced AKI: Using Renal Function–Adjusted Contrast Volume Before PCI

Giuseppe Andò, MD PhD University of Messina Messina, Italy.Hemodialysis.com Interview with:
Giuseppe Andò, MD PhD
University of Messina
Messina, Italy.

Hemodialysis.com: What are the main findings of the study?

Dr. Andò: The volume of contrast media remains a key factor for developing acute
kidney injury after percutaneous coronary intervention for acute myocardial
infarction across the whole spectrum of baseline risk estimation that, in
turn, is based on clinical presentation. Indeed, age, renal function and
left ventricular function are pre-procedural independent predictors of
acute kidney injury and can be combined in a statistical model for risk
estimation which has high discriminative power and calibration. The
addition of the adjusted volume of contrast media (namely, the ratio
contrast volume/estimated glomerular filtration rate) to the model improves
its statistical performance and demonstrates a significant net
reclassification improvement, largely driven by a correct decrease in risk
estimates for patients not experiencing acute kidney injury.

Kidney and Cardiac Function Interplay Begins Prior To Symptomatic Heart or Kidney Disease

 

Elisabet Nerpin PhD. Department of Public Health and Caring Sciences Uppsala University, SwedenHemodialysis.com Interview with:
Elisabet Nerpin PhD.
Department of Public Health and Caring Sciences
Uppsala University, Sweden

Hemodialysis.com: What are the main findings of the study?

Dr. Nerpin: We investigated cross-sectional associations between eGFR (cystatin C-based) and ventricular functional in two community-based samples of elderly, free from a clinical heart failure and with a left ventricular ejection function >40%. Our data suggest that the interplay between kidney and the heart function begins prior to the development of symptomatic heart failure and kidney disease.

Temporal Association Between Warfarin and Aortic Stiffness Progression

Hemodialysis.com Interview with:
Dr. Mohsen Agharazi

CHU de Québec Research Center, L’Hôtel-Dieu de Québec Hospital
Division of Nephrology, Faculty of Medicine, Université Laval
Québec , Canada

Hemodialysis.com: What are the main findings of the study?

Dr. Agharazii: This is the first study to show that there is a temporal association between the use of warfarin and accelerated progression of aortic stiffness. This accelerated progression of aortic stiffness was also associated with increased risk of mortality. Our results also support that subclinical vitamin K deficiency, which is common in dialysis population, may be deleterious to the vascular health in the procalcifying uremic milieu.

Latest update: 24-9-2014 . Thank you for visitng Hemodialysis.com

Not for specific medical advice. Please consult your physician for recommendations and questions. Editor: Marie Benz info@hemodialysis.com