15 Years of Experience with Renal Replacement Therapy in Patients Starting Therapy before Age 20

1988 ◽  
Vol 11 (5) ◽  
pp. 335-339 ◽  
Author(s):  
J. Rubin ◽  
J.D. Bower ◽  
R. Krueger
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Pediatric Patient ◽  
Hospitalization Rate ◽  
University Of Mississippi ◽  
Free Standing ◽  
Home Hemodialysis ◽  
Survival Plot ◽  
Living Related ◽  
The University

This study retrospectively evaluates the survival on renal replacement therapy among patients starting dialysis before their twentieth birthday. The cohort included all patients starting therapy from 1972 through August, 1987 at the University of Mississippi or Kidney Care, Inc. Fifty-five patients, median age 17 years, range 5-19 years, underwent 335 patient years of therapy. Nineteen initially received CAPD; 12 home hemodialysis, 2 were transplanted prior to dialysis, and the remaining 22 patients were entered into dialysis in a free standing facility. Thirty-one patients received a cadaveric transplant and four patients received a living related transplant. The median transplant survival was 1360 days. There were 10 patients on renal replacement therapy over 10 years and a survival plot projected a 70% survival at 10 years. Nine patients died. Three percent of the time on renal replacement therapy was spent hospitalized. Although the hospitalization rate is significant, the pediatric patient may be expected to have a long survival on renal replacement therapy.

Daily Home Hemodialysis Is an Available Option for Renal Replacement Therapy in Spain

2016 ◽  
Vol 20 (4) ◽  
pp. 408-412 ◽  
Author(s):  
Almudena Vega ◽  
María José Sequí ◽  
Soraya Abad ◽  
Claudia Yuste ◽  
Alba Santos ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Home Hemodialysis

The Use of Nocturnal Home Hemodialysis as Salvage Therapy for Patients Experiencing Peritoneal Dialysis Failure

2007 ◽  
Vol 27 (6) ◽  
pp. 669-674 ◽  
Author(s):  
Joseph H.S. Wong ◽  
Andreas Pierratos ◽  
Dimitrios G. Oreopoulos ◽  
Reem Mohammad ◽  
Fatima Benjamin–Wong ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Salvage Therapy ◽  
Primary Objective ◽  
Home Hemodialysis ◽  
Creatinine Concentration ◽  
Suitable Alternative ◽  
Humber River ◽  
Esrd Patients

Background Failure of peritoneal dialysis (PD) results in poor quality of life and worsening morbidity in patients with end-stage renal disease (ESRD). Traditionally, hospital-based conventional hemodialysis has been the only option for this patient population. We hypothesized that nocturnal home hemodialysis (NHD), 3 – 6 sessions per week, 6 – 8 hours per session, is a suitable alternative salvage therapy for this vulnerable patient group. Methods This is a descriptive cohort study of all consecutive ESRD patients failing PD that were converted to NHD at the University Health Network and Humber River Regional Hospital from 2003 to 2005. Our primary objective was to describe the changes in clinical and biochemical indices before and after conversion from PD to NHD. Results 69 patients required transfer from PD to another form of renal replacement therapy during the period of interest. Our pilot cohort included 8 ESRD patients (5 males, 3 females; age 53 ± 7 years). Mean duration on PD was 4.8 ± 4.6 years. NHD delivered a higher dose of dialysis, as reflected by lower plasma creatinine concentration 1 year after beginning NHD (from 1107 ± 312 μmol/L with PD to 649 ± 309 μmol/L, p = 0.01) and a rise in standardized Kt/V (from 2.21 ± 0.73 with PD to 4.49 ± 1.92 after 6 months of NHD, to 4.51 ± 1.77 after 1 year of NHD; p < 0.001). There was a progressive and sustained rise in plasma albumin after conversion to NHD (from 31 ± 4 g/L with PD to 36 ± 4 g/L after 6 months of NHD, to 39 ± 2 g/L after 1 year of NHD; p = 0.001). Hemoglobin concentrations increased (from 102 ± 13 to 125 ± 7 g/L, p = 0.03), while erythropoietin requirement tended to fall (from 17500 ± 8669 to 9197 ± 7573 U/week). Plasma phosphate fell (from 2.1 ± 0.6 to 1.1 ± 0.3 mmol/L, p = 0.01) despite a decrease in phosphate binder requirement. Blood pressure profile also tended to improve after conversion to NHD. Conclusion Nocturnal HD represents a promising, viable, alternative renal replacement therapy for patients experiencing PD failure. The clinical impact of transferring ESRD patients failing PD to NHD deserves further investigation.

Hypokalemia in a pediatric patient on continuous renal replacement therapy: Questions

2019 ◽  
Vol 34 (12) ◽  
pp. 2551-2552
Author(s):  
Alexandra Idrovo ◽  
Ayse Akcan-Arikan ◽  
Rossana Malatesta-Muncher ◽  
Leyat Tal
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Pediatric Patient

scholarly journals FP539DAILY HOME HEMODIALYSIS IS AN AVAILABLE OPTION OF RENAL REPLACEMENT THERAPY IN SPAIN

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii253-iii253
Author(s):  
Almudena Vega ◽  
Soraya Abad ◽  
Claudia Yuste ◽  
Alba Santos ◽  
Nicolás Macías ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Home Hemodialysis

scholarly journals The Evolution of Critical Care Nephrology in Edmonton

2016 ◽  
Vol 41 (4) ◽  
pp. I-V ◽  
Author(s):  
Sean M. Bagshaw ◽  
R.T. Noel Gibney
Keyword(s):  
Critical Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Task Force ◽  
Solid Organ Transplantation ◽  
Critical Care Medicine ◽  
Solid Organ ◽  
University Of Alberta ◽  
Extracorporeal Blood Purification ◽  
The University

The University of Alberta (UofA) in Edmonton, Canada has a rich and productive history supporting the development of critical care medicine, nephrology and the evolving subspecialty of critical care nephrology. The first hemodialysis program for patients with chronic renal failure in Canada was developed at the University of Alberta Hospital. The UofA is also recognized for its early pioneering work on the diagnosis, etiology and outcomes associated with acute kidney injury (AKI), the development of a diagnostic scheme renal allograft rejection (Banff classification), and contributions to the Renal Disaster Relief Task Force. Edmonton was one of the first centers in Canada to provide continuous renal replacement therapy. This has grown into a comprehensive clinical, educational and research center for critical care nephrology. Critical care medicine in Edmonton now leads and participates in numerous critical care nephrology initiatives dedicated to AKI, renal replacement therapy, renal support in solid organ transplantation, and extracorporeal blood purification. Critical care medicine in Edmonton is recognized across Canada and across the globe as a leading center of excellence in critical care nephrology, as an epicenter for research innovation and for training a new generation of clinicians with critical care nephrology expertise.

scholarly journals Clinical Outcome of Home Hemodialysis in Patients with Previous Peritoneal Dialysis Exposure: Evaluation of the Integrated Home Dialysis Model

2015 ◽  
Vol 35 (3) ◽  
pp. 316-323 ◽  
Author(s):  
Annie-Claire Nadeau-Fredette ◽  
Joanne M. Bargman ◽  
Christopher T. Chan
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Home Hemodialysis ◽  
Home Dialysis ◽  
Technique Survival ◽  
Home Based

BackgroundHome dialysis is a cost-effective modality of renal replacement therapy associated with excellent outcomes. Peritoneal dialysis (PD) is the most common home-based modality, but technique failure remains a problem. Transfer from PD to home hemodialysis (HHD) allows the patient to continue with a home-based modality, but the outcomes of patients transitioning to HHD after PD are largely unknown.MethodsIn a retrospective cohort study, including all consecutive HHD patients between January 1996 and December 2011, we evaluated the outcomes of patients with previous PD exposure compared to those without. The primary outcome was the cumulative patient and technique survival. Secondary outcomes included time to first hospitalization and hospitalization rate. Data were compared using the log-rank test and a multivariable Cox proportional hazards model.ResultsAmong our cohort of 207 consecutive HHD patients, 35 (17%) had previous exposure to PD. Median renal replacement therapy (RRT) vintage (12.3 years, interquartile range (IQR) 8.5 – 18.9 vs 0.9 years, IQR 0.2 – 7.5, p < 0.001) and Charlson comorbidity index (CCI) (4, IQR 2 – 6 vs 3, IQR 2 – 4, p = 0.044) were higher among patients with PD exposure than those without. Despite the difference in vintage, cumulative patient and technique survival was similar in the two groups, in both unadjusted (log-rank p = 0.893) and Cox adjusted models (hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.51 – 2.59) for patients with PD exposure compared to those without. The time to first hospitalization was shorter in patients with previous PD exposure compared to PD-naïve patients (log-rank p = 0.021). This association was preserved in the Cox proportional model (HR 1.65, 95% CI 1.08 – 2.54).ConclusionDespite a higher burden of comorbidity, patients with previous PD exposure had similar cumulative patient and technique survival on HHD compared to those without PD exposure. Whenever possible, HHD should be considered in PD patients in need of a new dialysis modality.

scholarly journals Results in Assisted Peritoneal Dialysis: A Ten-Year Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sara Querido ◽  
Patrícia Quadros Branco ◽  
Elisabete Costa ◽  
Sara Pereira ◽  
Maria Augusta Gaspar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Retrospective Study ◽  
Renal Replacement Therapy ◽  
Home Care ◽  
Replacement Therapy ◽  
Clinical Outcomes ◽  
Patient Survival ◽  
Hospitalization Rate ◽  
Technique Survival ◽  
Assisted Peritoneal Dialysis

Background/Aims. Peritoneal dialysis is a successful renal replacement therapy (RRT) for old and dependent patients. We evaluated the clinical outcomes of an assisted peritoneal dialysis (aPD) program developed in a Portuguese center.Methods. Retrospective study based on 200 adult incident patients admitted during ten years to a PD program. We included all 17 patients who were under aPD and analysed various parameters, including complications with the technique, hospitalizations, and patient and technique survival.Results. The global peritonitis rate was lower in helped than in nonhelped patients: 0.4 versus 0.59 episodes/patient/year. The global hospitalization rate was higher in helped than in nonhelped patients: 0.67 versus 0.45 episodes/patient/year (p=NS). Technique survival in helped patients versus nonhelped patients was 92.3%, 92.3%, 83.1%, and 72.7% versus 91.9%, 81.7%, and 72.1%, and 68.3%, at 1, 2, 3, and 4 years, respectively (p=NS), and patient survival in helped patients versus nonhelped patients was 93.3%, 93.3%, 93.3%, and 74.7% versus 95.9% 93.7%, 89%, and 82% at 1, 2, 3, and 4 years, respectively (p=NS).Conclusions. aPD offers an opportune, reliable, and effective home care alternative for patients with no other RRT options.

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