scholarly journals SAT-342 LONG TERM OUTCOMES OF LOWERING DIALYSATE FLOW (QD) IN A POPULATION OF CHRONIC HEMODIALYSIS IN RTS COLOMBIA

2019 ◽  
Vol 4 (7) ◽  
pp. S151-S152
Author(s):  
A. Molano Trivino ◽  
Á. Galván ◽  
B. Wancjer Meid ◽  
J. Vesga ◽  
A. Suárez ◽  
...  
Keyword(s):  
Chronic Hemodialysis ◽  
Long Term Outcomes ◽  
Dialysate Flow

scholarly journals Quantification of Internal Filtration in Hollow Fiber Hemodialyzers with Medium Cut-Off Membrane

2018 ◽  
Vol 46 (3) ◽  
pp. 196-204 ◽  
Author(s):  
Anna Lorenzin ◽  
Mauro Neri ◽  
Andrea Lupi ◽  
Martina Todesco ◽  
Monica Santimaria ◽  
...  
Keyword(s):  
Nuclear Imaging ◽  
Chronic Hemodialysis ◽  
Transmembrane Pressure ◽  
Hydraulic Permeability ◽  
Dialysate Flow ◽  
New Class ◽  
Inner Diameter ◽  
Marker Molecule

Background: Inadequate removal of molecules between 5 and 50 KDa may cause long-term complication in chronic hemodialysis. Medium cut-off (MCO) is a new class of membranes with enhanced sieving properties and negligible albumin loss. MCO membrane makes it possible to perform expanded hemodialysis (HDx), a technique based on high internal filtration (IF).The present study is designed to quantify IF in 2 MCO dialyzers (Theranova 400 and 500, Baxter, Deerfield, USA) using a nuclear imaging technique previously validated. Methods: Blood and dialysate compartment pressure drop along with transmembrane pressure; they were measured in a closed in vitro circuit with human blood (blood flow [QB] = 300 and 400 mL/min; dialysate flow 500 mL/min; net ultrafiltration rate 0 mL/min). A non-diffusible marker molecule (albumin macro-aggregates labeled with 99Tc metastable) was injected in the blood compartment and nuclear emission was recorded by a gamma camera. Relative variations in the concentration of the marker molecule along the length of the filter were used to calculate local cross filtration. Results: Based on marker concentration profiles, IF was estimated. For Theranova 400, IF were 29.7 and 41.6 mL/min for QB of 300 and 400 mL/min. For Theranova 500, IF were 31.6 and 53.1 mL/min for QB of 300 and 400 mL/min respectively. Conclusions: MCO membrane provides significant amounts of IF due to the particular combination between hydraulic permeability of the membrane and reduced inner diameter of the fibers. High IF combined with enhanced sieving profile of MCO membrane leads to improved removal of a wider spectrum of uremia retention molecules in HDx, without requiring complex equipment.

scholarly journals Cardiac Troponin T Predicts Long-Term Outcomes in Hemodialysis Patients

2001 ◽  
Vol 47 (3) ◽  
pp. 412-417 ◽  
Author(s):  
Daylily S Ooi ◽  
Deborah Zimmerman ◽  
Janet Graham ◽  
George A Wells
Keyword(s):  
Troponin I ◽  
Troponin T ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Peripheral Vascular ◽  
Long Term Outcomes ◽  
All Cause Mortality ◽  
End Stage

Abstract Background: Increased plasma troponin T (cTnT), but not troponin I (cTnI), is frequently observed in end-stage renal failure patients. Although generally considered spurious, we previously reported an associated increased mortality at 12 months. Methods: We studied long-term outcomes in 244 patients on chronic hemodialysis for up to 34 months, correlating the outcomes to plasma cTnT in routine predialysis samples. In addition, subsequent plasma samples at least 1 year later and within 6 months of data analysis were available in 97 patients and were used to identify patients with increasing plasma cTnT. The endpoints used were death and new or worsening coronary, cerebro-, and peripheral vascular disease and neuropathy. Results: Transplantation occurred more frequently in patients with low initial cTnT: 31%, 13%, and 3% in the groups with cTnT <0.010, 0.010–0.099, and ≥0.100 μg/L, respectively. In the same groups, total deaths occurred in 6%, 43%, and 59% and cardiac deaths in 0%, 14%, and 24% of patients. In patients with follow-up samples, the group with increasing cTnT had a significantly increased death (relative risk, 2.0; P = 0.028). The increase was mainly in cardiac and sudden deaths. Conclusions: Higher plasma cTnT predicts long-term all-cause mortality in hemodialysis patients, even at concentrations <0.100 μg/L, as does an increasing cTnT concentration over time.

scholarly journals Short- and long-term outcomes in patients undergoing valve surgery with end-stage renal failure receiving chronic hemodialysis

2012 ◽  
Vol 144 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Vinod H. Thourani ◽  
Eric L. Sarin ◽  
Patrick D. Kilgo ◽  
Omar M. Lattouf ◽  
John D. Puskas ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Hemodialysis ◽  
Valve Surgery ◽  
Long Term Outcomes ◽  
End Stage Renal Failure ◽  
Short And Long Term ◽  
End Stage

Abstract 102: Carotid Endarterectomy versus Stenting in Patients on Chronic Hemodialysis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Isibor Arhuidese ◽  
Tammam Obeid ◽  
Besma Nejim ◽  
Kanhua Yin ◽  
Sophie Wang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Carotid Endarterectomy ◽  
Cox Regression ◽  
The United States ◽  
Chronic Hemodialysis ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Perioperative Stroke ◽  
Angioplasty And Stenting

Introduction: There has been an increase in the number of hemodialysis (HD) patients seeking treatment for carotid artery stenosis in recent times. These patients suffer from a unique course of cardiac and vascular disease and are often considered high risk for surgery. In this study, we compare long-term outcomes after carotid endarterectomy (CEA) versus angioplasty and stenting (CAS) in a large contemporary cohort of HD patients. Methods: We studied all HD patients who underwent CEA and CAS in the United States Renal Disease System (USRDS) database between January 2006 and December 2011. Patient data were linked to the Medicare database to capture long-term outcomes. Univariable, multivariable cox regression, and propensity score matched analyses were employed to compare perioperative (stroke, death, MI) and long-term (stroke and death) outcomes following CAS vs. CEA. Results: There were 6183 (CEA: 5121; CAS: 1062) carotid revascularizations performed in this cohort with a mean age of 67 (S.D 10.1) years. The majority of patients were male (60%), white (76%) and asymptomatic (CEA: 83%; CAS: 83%). Mean follow-up was of 1.6±1.3 years. Thirty day stroke (3.2 vs 5.5%) and death (4.6 vs 5.5%) were significantly lower after CEA. However, 30-day MI was similar between groups (3.2 vs 3.5%). Propensity score matched analysis showed a significantly higher risk of perioperative stroke after CAS compared to CEA (Table 1). Symptomatic status was a significant predictor of perioperative stroke (OR: 1.92; 95%CI: 1.33-2.77; P<0.001). Stroke-free survival for CEA vs CAS was 92% vs 90% at 1 year, 87% vs 85% at 2 years, and 81% vs 76% at 4 years. Conclusions: This is the first study to compare long-term outcomes after CEA and CAS in a large cohort of HD patients. CAS is associated with a significantly higher risk of perioperative stroke compared to CEA. Long term stroke free survival is similar between groups, and differences appear to be largely driven by perioperative stroke rates.

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