Depressive Symptoms & Hospitalization Risk in Incident Hemodialysis Patients
Eduardo Lacson, Jr., MD, MPH, FACP, FASN Vice President Clinical Science, Epidemiology, and Research Fresenius Medical Care, North America More »
Ultraviolet Index and All-Cause Mortality in Dialysis Patients
Hemodialysis.com eInterview with Bryan B. Shapiro More »
Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy.
Hemodialysis.com Author Interview: Csaba P. Kovesdy MD FASN. More »
Geographic Variation in Black–White Differences in End-of-Life Care for Patients with ESRD
Hemodialysis.com eInterview with
Bernadette Thomas MD
University of Washington
Department of Nephrology
Seattle, Washington
Written Interview conducted with author by Editor Marie Benz, MD
Hemodialysis.com: What are the major findings of your study?
Dr. Thomas: The major findings of the study are:
1. There are pronounced black-white differences in end-of-life outcomes among patients with ESRD.
2. These differences vary substantially across regions of the United States.
3. Geography plays a role in differences in end-of-life outcomes for both whites and blacks.
Marie Benz, MD on Google+Pharmacometric Characterization of Dabigatran Hemodialysis
Hemodialysis.com eInterview with: Karl-Heinz Liesenfeld
Pharmacometrician
Pharmacometrics/Translational Medicine
Boehringer Ingelheim Pharma GmbH & Co. KG
mailto:karl-heinz.liesenfeld@boehringer-ingelheim.com
Hemodialysis.com: What are the main findings of the study?
Answer: The results have shown that a four-hour haemodialysis session can rapidly and effectively eliminate up to 60% of dabigatran etexilate from the plasma, concomitantly reducing its anticoagulation activity. Simulations of various haemodialysis settings (e.g., type of filter, dialysis flow rate and blood flow rate), variations in renal function and duration of dialysis showed that dialysis duration had the strongest impact on dabigatran elimination. The observations for dabigatran also showed that the average redistribution effect after dialysis was low.
Type of arteriovenous vascular access and association with patency and mortality.
Hemodialysis.com eInterview with Gürbey Ocak,
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Written Interview conducted with author by Editor Marie Benz, MD
Hemodialysis.com: What are the main findings of the study?
Answer: We prospectively followed 919 incident hemodialysis patients in our study. We investigated risk factors for primary patency loss in patients with a graft or fistula. Furthermore, we investigated the association between graft versus fistula use and two-year primary patency loss and two-year mortality. Cardiovascular disease, prior catheter use, albumin, hsCRP, and fetuin-A are risk factors for patency loss. Graft use as compared with fistula use was associated with an increased risk of patency loss and mortality.
Hyponatremia, Mineral Metabolism, and Mortality in Incident Maintenance Hemodialysis Patients: A Cohort Study
Hemodialysis.com eInterview with Dr. Sagar Nigwekar, MD
Dr. Nigwaker is currently a Clinical and Research Fellow in the Joint Nephrology Fellowship Program at the Brigham and Women’s Hospital and Massachusetts GeneralHospital. His areas of research include calciphylaxis, cardiovascular disease in patients with kidney disease and vascular calcification.
Hemodialysis.com: What are the main finding of the study?
Dr. Nigwekar: In this large cohort study, we investigated associations between hyponatremia, mineral bone disease, and mortality in incident hemodialysis patients. We observed that hyponatremia at the time of hemodialysis initiation is associated with hypercalcemia, increased alkaline phosphatase and hypoparathyroidism suggesting that hyponatremia may have a potential role in bone turnover in hemodialysis patients. Hyponatremia was also associated with increased one-year mortality. Although, causality of these associations could not be determined in this observational study, it provides a platform for future studies to address the role of hyponatremia, a common and potentially modifiable abnormality, in mineral bone disease in dialysis patients.
Chronic kidney disease and dialysis access in women
Hemodialysis.com eInterview with Dr. Victoria J. Teodorescu
Associate Professor of Surgery
Mt. Sinai Hospital, New York
Hemodialyisis.com: What are the main findings of your review?
Dr. Teodorescu: This review article highlights some of the differences between men and women in progression to renal failure as well as creation of dialysis access. The diagnosis of chronic kidney disease (CKD) is based on low kidney function which may be estimated taking serum creatinine, age, race and sex. Sex is important because men have a higher level of kidney function at the same level of serum creatinine. This is important to recognize as clinicians who refer patients for dialysis access at a fixed level of creatinine, 4 mg/dL for example, would be systematically referring women at a more advanced stage.
Impact of non-dialysis chronic kidney disease on survival in patients with septic shock
Hemodialysis.com Author Interview: Julien Maizel, MD
Medical Intensive Care Unit, Department of Nephrology,
Amiens University Medical Center
Amiens, France and INSERM U-1088, Jules Verne University of Picardie
Amiens, France
Hemodialysis.com: What are the main findings of the study?
Answer: The key finding from this retrospective study is that CKD (not on dialysis) is an independent factor of mortality after septic shock.
Predictors of cardiovascular events in hemodialysis patients after stress myocardial perfusion imaging
Hemodialysis.com: eInterview with Tatsuhiko Furuhashi
Division of Cardiovascular Medicine
Toho University Ohashi Medical Center
153-8515
2-17-6 Ohashi Meguro-ku Tokyo
Hemodialysis.com: What are the main findings of the study?
Answer: In hemodialysis patients, normal stress myocardial perfusion imaging (MPI) alone cannot guarantee good prognosis in terms of cardiovascular events.
Hemodialysis.com: Were any of the findings unexpected?
Withdrawal from dialysis and palliative care for severely ill dialysis patients in terms of patient-centered medicine
Hemodialysis.com Author Interview: M.D. Hideaki Ishikawa
Tokai Central Hospital of Japan Mutual Aid Association of Public School Teachers
Hemodialysis.com: What are the main findings of the study?
Answer: In daily works for our dialysis patients, we occasionally have some difficulty in diagnosis of severely ill patients. Although dialysis is life-sustaining therapy, however, it can no longer be helpful to improve their life expectancy in that situation.
Moreover, we feel that dialysis itself may be burdensome for these seriously ill patients such as terminal phase of cancer, severe heart failure, sepsis due to infectious diseases and so on.
So, in our hospital, we sometimes recommend or propose “withdrawal from dialysis (WD) ” for them as an optional treatment. As a result, we believe that the patients can die with peace and dignity.
