scholarly journals The renal replacement therapy landscape in 2030: reducing the global cardiovascular burden in dialysis patients

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii51-ii57 ◽  
Author(s):  
Bernard Canaud ◽  
Allan Collins ◽  
Frank Maddux
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Advanced Technology ◽  
Cardiovascular Risks ◽  
Dialysis Patients ◽  
Medical Needs ◽  
End Stage ◽  
New Strategies

Abstract Despite the significant progress made in understanding chronic kidney disease and uraemic pathophysiology, use of advanced technology and implementation of new strategies in renal replacement therapy, the clinical outcomes of chronic kidney disease 5 dialysis patients remain suboptimal. Considering residual suboptimal medical needs of short intermittent dialysis, it is our medical duty to revisit standards of dialysis practice and propose new therapeutic options for improving the overall effectiveness of dialysis sessions and reduce the burden of stress induced by the therapy. Several themes arise to address the modifiable components of the therapy that are aimed at mitigating some of the cardiovascular risks in patients with end-stage kidney disease. Among them, five are of utmost importance and include: (i) enhancement of treatment efficiency and continuous monitoring of dialysis performances; (ii) prevention of dialysis-induced stress; (iii) precise handling of sodium and fluid balance; (iv) moving towards heparin-free dialysis; and (v) customizing electrolyte prescriptions. In summary, haemodialysis treatment in 2030 will be substantially more personalized to the patient, with a clear focus on cardioprotection, volume management, arrhythmia surveillance, avoidance of anticoagulation and the development of more dynamic systems to align the fluid and electrolyte needs of the patient on the day of the treatment to their particular circumstances.

scholarly journals Peritonites in peritoneal dialysis patients

2018 ◽  
Author(s):  
Emanuelle Barbara Dias Tomaz ◽  
Plínio Trabasso ◽  
Gabriela Jorge Trigo Alves ◽  
Rodrigo Bueno de Oliveira
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Dialysis Patients ◽  
Fungal Peritonitis ◽  
Bacteria And Fungi ◽  
Etiological Agents

Peritonitis is one of the most common complications of the population with chronic kidney disease on peritoneal dialysis. The most frequent etiological agents are bacteria and fungi, the latter being responsible for 2 to 5% of the total cases of this type of infection. Fungal peritonitis is severe and its occurrence requires immediate removal of the catheter and transfer of renal replacement therapy for hemodialysis. The present study aimed to retrospectively study the risk factors and clinical outcomes of patients at the Centro Integrado de Nefrologia (CIN) of the Hospital das Clínicas da UNICAMP, who presented bacterial or fungal peritonitis, comparing them to peritoneal dialysis patients who did not present peritonitis.

scholarly journals Prevalence of end stage renal disease in diabetic obese and hypertensive patients and cardiovascular risk in dialysis patients

2016 ◽  
Vol 2 (1) ◽  
pp. 42 ◽  
Author(s):  
Muhammad Hanif ◽  
Hina Javed ◽  
Umair Jallani ◽  
Nazar Muhammad Ranjha
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Kidney Stone ◽  
Cardiovascular Risks ◽  
Dialysis Patients ◽  
Hypertensive Patients ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease(CKD) is the cause of irreversible detoriation of renal function which leads to end stage renal disease(ESRD).incidence of end stage renal disease has increased dramatically during last 30 years and screening for early stages of chronic kidney disease is often suggested as preventive measure.the main cause of end stage renal disease are diabetes, high blood pressure,hyperlipidemia and obesity.obesity and increased BMI are the cause of kidney stone and chronic kidney disease.this reports aim to determine the prevalance of end stage renal disease in diabetic obese individuals and other problems that are more likely to be encountered in the end stage renal disease are cardiovascular risks in dialysis patients.GFR and creatinine clearance are used as the major diagnostic tool to determined the kidney function. calcium level is also used as predictive factor to determine the vascular calcification.

Global Aspects of Chronic Kidney Disease

2019 ◽  
Author(s):  
Gopesh K Modi ◽  
Vivekanand Jha
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Noncommunicable Diseases ◽  
Health Coverage ◽  
Disease Epidemiology ◽  
Number Of Patients ◽  
End Stage

Chronic kidney disease has a high prevalence and a high mortality rate worldwide. Although diabetes and hypertension are common, unique causes of kidney disease may occur driven by infections, exposures, or genetic susceptibilities. Certain agricultural areas in particular have a high incidence of tubulointerstitial kidney disease of unclear etiology. Risk factors may include heat stress, pesticides, heavy metals, and other environmental toxins. Furthermore, countries have disproportionately different prevalence of renal replacement therapy, which seems to correlate in part to the type of health coverage. The future challenges for the nephrology community worldwide will be dealing with the growing number of patients with end-stage kidney disease, the fragmented healthcare in some countries, shortage of kidney transplantation programs, and deficient registries to appropriately assess the prevalence of kidney disease. This review contains 4 figures, 3 tables, and 54 references. Key Words: acute kidney injury, chronic kidney disease, end-stage renal disease, epidemiology, ethnic background, HIV-associated nephropathy, noncommunicable diseases, renal replacement therapy, screening, socioeconomic status

scholarly journals Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (1) ◽  
pp. 326
Author(s):  
Chih-Chien Chiu ◽  
Ya-Chieh Chang ◽  
Ren-Yeong Huang ◽  
Jenq-Shyong Chan ◽  
Chi-Hsiang Chung ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Root Canal ◽  
Dialysis Patients ◽  
Root Canal Therapy ◽  
Risk Of Death ◽  
Stage Renal Disease ◽  
End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

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