Nocturnal home hemodialysis with low‐flow dialysate: Retrospective analysis of the first European patients

Abstract Background Real-world data on safety and clinical outcomes of remdesivir in COVID-19 management is scant. We present findings of data analysis conducted for assessing the safety and clinical outcomes of remdesivir treatment for COVID-19 in India. Methods This retrospective analysis used data from an active surveillance programme database of hospitalised patients with COVID-19 who were receiving remdesivir. Results Of the 2329 patients included, 67.40% were men. Diabetes (29.69%) and hypertension (20.33%) were the most common comorbidities. At remdesivir initiation, 2272 (97.55%) patients were receiving oxygen therapy. Remdesivir was administered for 5 days in 65.38% of patients. Antibiotics (64.90%) and steroids (47.90%) were the most common concomitant medications. Remdesivir was overall well tolerated, and total 119 adverse events were reported; most common were nausea and vomiting in 45.40% and increased liver enzymes in 14.28% patients. 84% of patients were cured/improved, 6.77% died and 9.16% showed no improvement in their clinical status at data collection. Subgroup analyses showed that the mortality rate was significantly lower in patients < 60 years old than in those > 60 years old. Amongst patients on oxygen therapy, the cure/improvement rate was significantly higher in those receiving standard low-flow oxygen than in those receiving mechanical ventilation, non-invasive ventilation, or high-flow oxygen. Factors that were associated with higher mortality were age > 60 years, cardiac disease, diabetes high flow oxygen, non-invasive ventilation and mechanical ventilation. Conclusion Our analysis showed that remdesivir is well tolerated and has an acceptable safety profile. The clinical outcome of cure/improvement was 84%, with a higher improvement in patients < 60 years old and on standard low-flow oxygen.

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FP440NOCTURNAL HOME HEMODIALYSIS WITH LOW-FLOW DIALYSATE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy104.fp440 ◽

2018 ◽

Vol 33 (suppl_1) ◽

pp. i183-i183

Author(s):

Kristine Kubisiak ◽

Eric Weinhandl ◽

Allan Collins

Keyword(s):

Low Flow ◽

Home Hemodialysis

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Characterisation of aortic stenosis severity: a retrospective analysis of echocardiography reports in a clinical laboratory

Open Heart ◽

10.1136/openhrt-2020-001331 ◽

2020 ◽

Vol 7 (2) ◽

pp. e001331

Author(s):

Michael A Raddatz ◽

Holly M Gonzales ◽

Eric Farber-Eger ◽

Quinn S Wells ◽

Brian R Lindman ◽

...

Keyword(s):

Aortic Stenosis ◽

Retrospective Analysis ◽

Clinical Laboratory ◽

Left Ventricular ◽

Low Flow ◽

Left Ventricular Ejection ◽

Aortic Valve Area ◽

Academic Medical Centre ◽

Ventricular Ejection Fraction ◽

Stenosis Severity

ObjectiveTo evaluate how common echocardiographic metrics of aortic stenosis (AS) influence the proportion of patients who may be categorised as having severe stenosis and therefore considered for valve replacement.MethodsRetrospective analysis was performed of all echocardiograms with aortic valve area (AVA) ≤1.2 cm2 and peak jet velocity (Vmax) ≥3 m/s from 1 December 2014 through 30 October 2017 at a single academic medical centre. Echocardiographic indices collected include AVA, Vmax, left ventricular ejection fraction, stroke volume and annotated aortic stenosis severity.ResultsAmong 807 patients with AVA ≤1.2 cm2 and Vmax ≥3 m/s (44.0% female, median age 74 years (IQR: 66–81)), 45.6% had Vmax ≥4 m/s, while 75.8% had AVA ≤1 cm2. 40.0% of patients had concordant indices (Vmax ≥4 m/s and AVA ≤1 cm2), and 35.8% had discordant indices (Vmax <4 m/s and AVA ≤1 cm2) of severe AS. Compared with those with concordant indices, patients with discordant indices were more commonly female (54.0% vs 44.3%, p<0.05) and less commonly characterised as severe (42.6% vs 93.8%, p<0.001). Patients with paradoxical low-flow, low-gradient severe AS by echocardiography were disproportionately female (61.5% vs 41.8%, p<0.001), and their disease was characterised as severe only 49.5% of the time.ConclusionsPatients with discordant indices, who are disproportionately female, are commonly described in clinical echocardiography reports as having less than severe AS. Given the potential benefit of AVR in patients with AVA ≤1 cm2 regardless of Vmax, this could have important clinical implications.

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Home hemodialysis treatment and outcomes: retrospective analysis of the Knowledge to Improve Home Dialysis Network in Europe (KIHDNEy) cohort

BMC Nephrology ◽

10.1186/s12882-018-1059-2 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

Shashidhar Cherukuri ◽

Maria Bajo ◽

Giacomo Colussi ◽

Roberto Corciulo ◽

Hafedh Fessi ◽

...

Keyword(s):

Retrospective Analysis ◽

Home Hemodialysis ◽

Home Dialysis ◽

Hemodialysis Treatment

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Efficacy and Safety of Remdesivir in COVID-19 Patients: A Retrospective Analysis of Active Surveillance Database

10.21203/rs.3.rs-366384/v1 ◽

2021 ◽

Author(s):

Vaishali Gupte ◽

Rashmi Hegde ◽

Sandesh Sawant ◽

Kabil Kalathingal ◽

Sonali Jadhav ◽

...

Keyword(s):

Mechanical Ventilation ◽

Retrospective Analysis ◽

Active Surveillance ◽

Oxygen Therapy ◽

Clinical Status ◽

Low Flow ◽

Real World Data ◽

Improvement Rate ◽

Hospitalised Patients ◽

High Flow Oxygen

Abstract Background: Real-world data on safety and efficacy of remdesivir in COVID‑19 management is scant. We present findings of data analysis conducted for assessing the clinical outcomes of remdesivir treatment for COVID-19 in India. Methods: This retrospective analysis used data from an active surveillance programme database of hospitalised patients with COVID-19 who were receiving remdesivir. Results: Of the 2329 patients included, 67.4% were men. Diabetes (29.69%) and hypertension (20.33%) were the most common comorbidities. At remdesivir initiation, 2272 (97.55%) patients were receiving oxygen therapy. Remdesivir was administered for 5 days in 65.38% of patients. Antibiotics (64.9%) and steroids (47.9%) were the most common concomitant medications. Remdesivir was overall well tolerated: 13% of patients reported 119 adverse events; most common were nausea and vomiting in 45.4% and increased liver enzymes in 14.28% patients. 84% of patients were cured/improved, 6.02% died, and 9.16% showed no improvement in their clinical status at data collection. Subgroup analysis showed that the mortality rate was significantly lower in patients < 60 years old than in those > 60 years old. Amongst patients on oxygen therapy, the cure/improvement rate was significantly higher in those receiving standard low-flow oxygen than in those receiving mechanical ventilation, non-invasive ventilation, or high-flow oxygen. Risk factors for higher mortality were age > 60 years, hypertension, cardiac disease, diabetes, and mechanical ventilation. Conclusion: Our analysis showed that remdesivir is well tolerated and has an acceptable safety profile. The cure/improvement rate was 84%, with a higher improvement in patients < 60 years old and on standard low-flow oxygen.

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Birth, Rise, Decline and Revival of Home Hemodialysis – French experience

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v1i3.56 ◽

2018 ◽

Vol 1 (3) ◽

pp. 99-103

Author(s):

Alain Meyrier

Keyword(s):

Electrolyte Solutions ◽

Low Flow ◽

Maintenance Hemodialysis ◽

Steady Increase ◽

Rapid Decline ◽

Home Hemodialysis ◽

Daily Hemodialysis ◽

Number Of Patients ◽

Public Health Authorities ◽

At Home

The first publication in 1960 on maintenance hemodialysis was followed in 1963 by some reports on dialysis in the home. The introduction of proportioning pumps and concentrated electrolyte solutions led to developing single-patient machines and safety devices that made home hemodialysis possible. It was demonstrated in 1964 that home hemodialysis can be done overnight, unattended. This led to a steady rise in the number of patients treated at home. The percentage in France was ≈20% by the end of the seventies, out of a total of ≈ 6 000. The decline began when Public Health authorities authorized a program of ‘’limited – care’’ units. A loophole in the regulations led to a massive transfer of patients to these units and a rapid decline of home HD. The revival can be dated to 2012 with the development of disposable dialysate bags that make low flow daily home HD feasible. Efficacy and tolerability are such that the total number of patients treated at home rose from 307 in 2014 to 374 in 2016, owing to those on daily hemodialysis - an increase from 55 in 2014 to 374 in 2016 and 448 by the end of 2018. Currently, ≈46 000 patients are hemodialyzed in France. The % of those treated at home is very low but the trend is to a steady increase.

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A retrospective analysis of the treatment on abdominal aortic balloon occlusion-related thrombosis by continuous low-flow diluted heparin

Medicine ◽

10.1097/md.0000000000018446 ◽

2019 ◽

Vol 98 (51) ◽

pp. e18446 ◽

Cited By ~ 1

Author(s):

Rongguang Luo ◽

Fen Wang ◽

Yanxing Guan ◽

Junhui Wan ◽

Wentao Zhang ◽

...

Keyword(s):

Retrospective Analysis ◽

Balloon Occlusion ◽

Low Flow ◽

Aortic Balloon Occlusion ◽

Abdominal Aortic

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Long nocturnal home hemodialysis : An old therapy brought up to date

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v2i1.19113 ◽

2019 ◽

Vol 2 (1) ◽

pp. 11-16

Author(s):

Eric Laruelle

Keyword(s):

Adverse Event ◽

Graft Failure ◽

Alternative Therapy ◽

Low Flow ◽

Salt Balance ◽

Home Hemodialysis ◽

Daily Dialysis ◽

First Results ◽

Therapy Orientation ◽

Water And Salt Balance

Home hemodialysis therapy orientation is rising since 2011 in France due to technical progress in dialysis machines, with a simplified use, an ultrapure and sparing dialysate delivery. The most frequent therapy is short daily dialysis sessions with performing results in terms of water and salt balance, depuration and mainly on autonomy and flexibility. In this article, we describe the organization of an alternative therapy with long nocturnal low flow hemodialysis in a dialyzed patient since 2006 after a graft failure. We discuss the benefits of this therapy, first results, eventual barriers to this method specially the occurrence of an adverse event, security and benefit of a telemonitoring and teleassistance that we develop for this occasion.

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