Tag Archives: hemodialysis
Air Quality Index and All-Cause Mortality in Maintenance Dialysis Patients
Hemodialysis.com eInterview with: Elani Streja
Doctoral StudentHarold Simmons Center for Chronic Disease Research & Epidemiology
University of California Irvine Medical Center, Irvine, CA, USA
Hemodialysis.com: What is the Rationale for the study?
Answer: Air quality is considered an important modifier of health in the general population, as poor air quality have been associated with increased risk of heart disease, lung cancer, and respiratory infection. We explored how residential air quality correlates with mortality outcomes in maintenance hemodialysis (MHD) patients, for whom pulmonary infections and cardiovascular mortality occur far more frequently as compared to the general population. The “Air Quality Index,” a scale developed by Environmental Protection Agency (EPA) to assess ambient air quality, measures levels of five major air pollutants: ground-level ozone, particulate matter, carbon monoxide, nitrogen dioxide, and sulfur dioxide. In high amounts, these pollutants are associated with several adverse health effects in the general population, including increased risk of heart disease, lung cancer, and respiratory infections.
Marie Benz, MD on Google+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.
Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients
Hemodialysis.com eInterview with Giuseppe Enia MD
Dr. Giuseppe Enia, Nephrology, Dialysis, Hypertension, and Renal Transplantation Unit,
Azienda Ospedaliera and CNR-IBIM, via vallone Petrara, 89124 Reggio Calabria, Italy.
Hemodialysis.com: What are the main findings of the study?
Dr. Enia: While it is well known that symptomatic central volume overload (shortness of breath) is related to poor physical functioning, the present study highlights the negative impact of “silent” pulmonary congestion (i.e. not clinically apparent to the patient or physician according to the NYHA classification) on physical functioning of hemodialysis patients.
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 PICC Epidemic and the Kidney Patient
Hemodialysis.com eInterview: Rita McGill MD
Allegheny General Hospital
Pittsburgh, PA USA
The major finding of this study is that more than 20% of hospital inpatients have PICC lines. Compared to hospital patients in general, PICC patients are sicker and have more chronic kidney disease. This is particularly unfortunate, since national ASDIN guidelines advise against PICC placement in kidney patients. Despite this recommendation, CKD patients actually bear a disproportionate brunt of the PICC ‘epidemic, with a PICC rate of 30%, which is higher than other patients.
Candidate Gene Analysis of Arteriovenous Fistula Failure in Hemodialysis Patients
Hemodialysis.com Author Interview: Dr. Joris I. Rotmans, MD PhD
Department of Nephrology, Leiden University Medical Center,
PO Box 9600, 2300 RC Leiden, The Netherlands
The Einthoven Laboratory
Experimental Vascular Medicine is the workshop of the theme Vascular Medicine
Leiden University Medical Center (LUMC).
Hemodialysis.com: What was the rationale for the study?
Dr. Rotmans: Vascular access dysfunction is currently the Achilles’ heel of hemodialysis therapy. The vast majority of arteriovenous access failure is caused by thrombosis, secondary to disproportionate intimal hyperplasia and impaired outward remodeling of the venous outflow tract. Currently, it is unknown why AVF failure occurs in some individuals but not in others. We investigated whether genetic risk factors might play a role in AVF failure.
Cost implications of switching from sevelamer to lanthanum carbonate within a bundled reimbursement scenario
Interview with Dr. Michael S Keith Shire Pharmaceuticals, Wayne, PA, USA
Hemodialysis.com: What are the main findings of the study?
Dr. Keith: The key finding from this post hoc analysis is that phosphate control was similar regardless of the prior sevelamer dose a patient received. Overall mean phosphate binder doses were SH 7703 mg/day and LC 2800 mg/day. Drug cost-savings were realized when applying clinically utilized doses of lanthanum carbonate (LC) 3000 mg/day ($26.46/day) and sevelamer hydrochloride (SH) from doses of 6400 mg/day ($29.68/day) and above. Cost savings were as high as $18/day when converting patients from SH 9600 mg/day to LC 3000 mg/day.
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.
