scholarly journals Inhibiting the Progression of Arterial Calcification with Vitamin K in HemoDialysis Patients (iPACK-HD) Trial: Rationale and Study Design for a Randomized Trial of Vitamin K in Patients with End Stage Kidney Disease

2015 ◽  
Vol 2 ◽  
pp. 53 ◽  
Author(s):  
Rachel M Holden ◽  
Sarah L Booth ◽  
Andrew G Day ◽  
Catherine M Clase ◽  
Deborah Zimmerman ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Randomized Trial ◽  
Study Design ◽  
Vitamin K ◽  
Hemodialysis Patients ◽  
Arterial Calcification ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Use of QT Prolonging Medications by Hemodialysis Patients and Individuals Without End‐Stage Kidney Disease

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Magdalene M. Assimon ◽  
Lily Wang ◽  
Patrick H. Pun ◽  
Wolfgang C. Winkelmayer ◽  
Jennifer E. Flythe
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Cardiac Death ◽  
Medication Use ◽  
Torsades De Pointes ◽  
Hemodialysis Patients ◽  
Qt Prolongation ◽  
End Stage Kidney Disease ◽  
Drug Induced ◽  
End Stage

Background The rate of sudden cardiac death in the hemodialysis population exceeds that of the general population by >20‐fold. Hemodialysis patients may be particularly susceptible to sudden cardiac death provoked by drug‐induced QT prolongation because of their substantial cardiovascular disease burden, exposure to electrolyte shifts during dialysis, and extensive polypharmacy. However, population‐specific data regarding the frequency and patterns of QT prolonging medication use are limited. Methods and Results We conducted a descriptive drug utilization study using 3 administrative databases, the United States Renal Data System, MarketScan, and Medicare claims. We characterized the extent and patterns of QT prolonging medication use by adult hemodialysis patients and individuals without end‐stage kidney disease annually from 2012 to 2016. We also identified instances of high‐risk QT prolonging medication use among hemodialysis patients. In total, 338 515 hemodialysis patients and 40.7 million individuals without end‐stage kidney disease were studied. Annual utilization rates of QT prolonging medications with known torsades de pointes risk in hemodialysis patients were ~1.4 to ~2.5 times higher than utilization rates in individuals without end‐stage kidney disease. Hemodialysis patients with demographic and clinical risk factors for drug‐induced QT prolongation were exposed to medications with known torsades de pointes risk more often than patients without risk factors. Conclusions Hemodialysis patients use QT prolonging medications with known torsades de pointes risk more extensively than individuals without end‐stage kidney disease. Given the widespread use and instances of high‐risk prescribing, future studies evaluating the cardiac safety of these drugs in the hemodialysis population are needed.

Iliopsoas Abscess in Hemodialysis Patients With End‐Stage Kidney Disease

2019 ◽  
Vol 23 (6) ◽  
pp. 534-541
Author(s):  
Yusuke Kawai ◽  
Masataka Banshodani ◽  
Misaki Moriishi ◽  
Tomoyasu Sato ◽  
Sadanori Shintaku ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Hemodialysis Patients ◽  
End Stage Kidney Disease ◽  
Iliopsoas Abscess ◽  
End Stage

scholarly journals Sevelamer Use in End-Stage Kidney Disease (ESKD) Patients Associates with Poor Vitamin K Status and High Levels of Gut-Derived Uremic Toxins: A Drug–Bug Interaction?

Toxins ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 351
Author(s):  
Lu Dai ◽  
Björn K. Meijers ◽  
Bert Bammens ◽  
Henriette de Loor ◽  
Leon J. Schurgers ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Vitamin K ◽  
Phosphate Binder ◽  
Microbial Metabolism ◽  
Uremic Toxins ◽  
Matrix Gla Protein ◽  
Vitamin K Deficiency ◽  
End Stage Kidney Disease ◽  
K Deficiency ◽  
End Stage

Gut microbial metabolism is not only an important source of uremic toxins but may also help to maintain the vitamin K stores of the host. We hypothesized that sevelamer therapy, a commonly used phosphate binder in patients with end-stage kidney disease (ESKD), associates with a disturbed gut microbial metabolism. Important representatives of gut-derived uremic toxins, including indoxyl sulfate (IndS), p-Cresyl sulfate (pCS), trimethylamine N-oxide (TMAO), phenylacetylglutamine (PAG) and non-phosphorylated, uncarboxylated matrix-Gla protein (dp-ucMGP; a marker of vitamin K status), were analyzed in blood samples from 423 patients (65% males, median age 54 years) with ESKD. Demographics and laboratory data were extracted from electronic files. Sevelamer users (n = 172, 41%) were characterized by higher phosphate, IndS, TMAO, PAG and dp-ucMGP levels compared to non-users. Sevelamer was significantly associated with increased IndS, PAG and dp-ucMGP levels, independent of age, sex, calcium-containing phosphate binder, cohort, phosphate, creatinine and dialysis vintage. High dp-ucMGP levels, reflecting vitamin K deficiency, were independently and positively associated with PAG and TMAO levels. Sevelamer therapy associates with an unfavorable gut microbial metabolism pattern. Although the observational design precludes causal inference, present findings implicate a disturbed microbial metabolism and vitamin K deficiency as potential trade-offs of sevelamer therapy.

scholarly journals Components of quality of life in hemodialysis patients from family caregivers’ perspective: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sima Sadat Hejazi ◽  
Meimanat Hosseini ◽  
Abbas Ebadi ◽  
Hamid Alavi Majd
Keyword(s):  
Quality Of Life ◽  
Content Analysis ◽  
Kidney Disease ◽  
Family Caregivers ◽  
Hemodialysis Patients ◽  
End Stage Kidney Disease ◽  
The Family ◽  
End Stage ◽  
The Impact

Abstract Background Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients’ quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients’ disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers’ perspective. Methods In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas’ method. Results A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). Conclusion Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients’ quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients’ quality of life and even reduce the caregivers’ burden.

Myoglobin Elimination in End Stage Kidney Disease Patients on Renal Replacement Treatment

1993 ◽  
Vol 16 (9) ◽  
pp. 659-661 ◽  
Author(s):  
V. Stefanović ◽  
M. Bogićević ◽  
M. Mitić
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Serum Levels ◽  
Hemodialysis Patients ◽  
Peritoneal Membrane ◽  
End Stage Kidney Disease ◽  
Replacement Treatment ◽  
End Stage ◽  
Hemodialysis Membrane ◽  
Serum Myoglobin

Increased serum myoglobin levels were previously found in patients with chronic renal failure. In this report we have studied the effects of dialysis on myoglobin elimination in patients on CARD, IPD, cuprophan and polyacrylonitrile (PAN) membrane hemodialysis. Peritoneal dialysis removed a significant amount of myoglobin, CAPD 480 ± 65 μg/day, IPD 270 ± 25 μg/12 h treatment, while with cuprophan dialysis none, and with PAN dialysis only an insignificant amount of myoglobin. The serum myoglobin levels were 250 ± 18 and 264 ± 14 μg/l on cuprophan and a 3 month dialysis on PAN membrane, respectively. Markedly increased serum levels were also found in CAPD and IPD patients on peritoneal dialysis, 227 ± 25 and 286 ± 32 μg/l respectively. This study has shown that there is an increased serum myoglobin concentration in end-stage kidney disease patients on dialysis. Although peritoneal membrane is permeable to myoglobin, a relatively small amount is removed, and the serum level in CAPD and IPD patients was not significantly different from the serum myoglobin concentration in hemodialysis patients. Furthermore myoglobin could not be removed by hemodialysis membrane and an analysis of its important extrarenal catabolism level points were analyzed.

scholarly journals End-stage kidney disease in Sidi Bel Abbes, Algeria: Epidemiological profile of hemodialysis patients from 2015 to 2018

2021 ◽  
pp. 100808
Author(s):  
Katia Berkache ◽  
Zohra Bengharez ◽  
Bastien Poitier ◽  
Djamila Ouabdesslam ◽  
Abdelkrim Guerinik ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Hemodialysis Patients ◽  
End Stage Kidney Disease ◽  
Epidemiological Profile ◽  
End Stage
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