Tag Archives: dialysis
Dialysis Facility Profit Status and Compliance With a Black Box Warning
Hemodialysis.com eInterview with:
Dr. Julie H. Ishida MD
University of California at San Francisco
Hemodialysis.com What are the main findings of the study?
Dr. Ishida: Despite a black box warning from the FDA advising use of the minimum necessary dose of erythropoiesis-stimulating agents, for-profit dialysis providers used more of these agents than non-profit dialysis providers after controlling for patient characteristics. This was also the case even among patients with a hematocrit above the recommended range and in patients who switched from a non-profit to for-profit dialysis facility.
Marie Benz, MD on Google+Report on the Hemodialysis Reliable Outflow (HeRO) experience in dialysis patients with central venous occlusions.
Hemodialysis.com eInterview with Justin Wallace MD
General Surgery and Vascular Labs
T32 Trainee 4th Year Resident
University of Pittsburgh Medical Center, Pittsburgh, Pa
Written Interview conducted with author by Marie Benz, MD
Hemodialysis.com: What are the main findings of the study?
Dr. Wallace: Our experience with the HeRO graft thus far does not reflect the overwhelmingly positive reports (although few) previously published. Successful placement rates were high and infection rates were low, but 22% of successful placements resulted in steal syndrome that required removal in the immediate postoperative period. Interestingly, all four incidences of steal syndrome occurred in females and each met the HeRO IFU placement requirements. Additionally, the observed 12-month primary and secondary patency rates of 11% and 37%, respectively, are significantly lower than the rates of prior reports and should temper provider and patient expectations.
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.
Increased Blood Loss From Access Cannulation Site During Hemodialysis Is Associated With Anemia and Arteriovenous Graft Use
Hemodialysis.com eInterview with Dr Yen-Ling Chiu
Department of Nephrology
No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 220, Taiwan
Hemodialysis.com: What are the main findings of the study?
A: We found that a significant percentage of patients will experience excessive blood loss from the fistula/graft cannulation sites during treatment. Such excessive bleeding is more common among graft users, the elderly and is associated with anemia. These patients are in general less healthy.
The Relationship of Age, Race, and Ethnicity with Survival in Dialysis Patients
Hemodialysis.com Interview with Prof. Guofen Yan, Ph.D.
Associate Professor
Department of Public Health Sciences, School of Medicine
University of Virginia Charlottesville, Virginia 22908-0717
Email: guofen.yan@virginia.edu
Hemodialysis.com: What are the main findings of the study?
Prof. Yan: Reports on the racial and ethnic differences in dialysis patient survival rates have been inconsistent. The literature suggests these survival differences may be modified by age as well as categorizing white race as inclusive of Hispanic ethnicity. We sought to better understand these associations by examining survival among U.S. dialysis patients by age and both ethnicity and race.
The MONitoring Dialysis Outcomes (MONDO) initiative.
Hemodialysis.com Interview with
Dr.Len Usvyat PhD
Director, Integrated Care Analytics Renal Research Institute
Fresenius Medical Care
Dr. Peter Kotanko, MD
Research Director Renal Research Institute
New York, NY 10128
Hemodialysis.com: What are the main findings of the study?
Dr. Usvyat: MONDO (MONitoring Dialysis Outcomes) is an international consortium of dialysis providers who contribute both patient data and analytical resources to study this global database with aims of understanding and improving outcomes in patients with end stage kidney disease world-wide. While its initial focus was on studying “trajectories of patient parameters before death,” it has much expanded since then. MONDO comprises of longitudinal, patient specific data from 5 continents, 38 countries, ~1200 clinics, ~150,000 patients, and ~30,000,000 hemodialysis treatments between 2000 and 2012. Its data is updated annually and will soon include PD patients as well.
Experience of HeRO Dialysis Graft Placement in a Challenging Population
Hemodialysis.com Interview with: Harry Schanzer, M.D., F.A.C.S.
Clinical Professor of Surgery
Division of Vascular Surgery
Mount Sinai School of Medicine
Hemodialysis.com: What are the main findings of the study?
Dr. Schanzer: Eleven patients with central venous occlusive disease underwent 12 HeRO placements as a last ditch effort for long-term hemodialysis access. At one year, primary and secondary patencies were 9.1% and 45.5%. Four HeRO grafts were never cannulated, and the remaining 11 had a functional patency of an average of 14 months
Disentangling the Ultrafiltration Rate–Mortality Association: The Respective Roles of Session Length and Weight Gain
Hemodialysis.com Author Interview: Dr. Jennifer E. Flythe
Renal Division, Department of Medicine, Brigham and Women’s Hospital
75 Francis Street, MRB-4, Boston, MA 02115
Hemodialysis.com: What are the main findings of the study?
Dr. Flythe: High ultrafiltration rates during hemodialysis (HD) have been associated with increased all-cause and cardiovascular mortality. The ultrafiltration rate, however, is determined by both dialysis session length (DSL) and interdialytic weight gain (IDWG). Both short DSL and high IDWG have been linked to increased mortality, but these variables are often collinear so their independent associations with mortality have not been adequately investigated. We undertook this study to determine the associations of DSL and IDWG (independently of each other) with mortality in a population of chronic HD patients with adequate clearance.
