scholarly journals Effects of Arterial Needle Placement in Arteriovenous Fistula on Dialysis Adequacy of End-Stage Renal Disease Patients Undergoing Maintenance Hemodialysis

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Intervention Group ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Needle Placement ◽  
Dialysis Adequacy ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Objective: The arterial needle placement in arteriovenous fistula (AVF) can either be antegrade (in the direction of blood flow or pointing towards the heart) or retrograde (against the direction of blood flow) while venous needle placement should always be in the same direction as the blood flow. This study determined the effects of arterial needle placement in the arteriovenous fistula on dialysis adequacy of End-Stage Renal Disease (ESRD) patients undergoing maintenance hemodialysis in United Candelaria Doctors Hospital - Nephro Synergies Inc. (UCDHNSI) Hemodialysis Center. Methods: A randomized controlled trial design was used in the study. A total of 20 non-diabetic, non-cardiac patients on maintenance hemodialysis for more than 6 months were randomized either to the intervention group (patients’ AVF were cannulated in a retrograde manner) or the control group (patients’ AVF were cannulated in an antegrade manner). Urea reduction ratio (URR) and Kt/V as well as access recirculation percentage were used to determine dialysis adequacy. Pre-dialysis, in the first 30 minutes of dialysis initiation and post-dialysis blood samples were obtained in each patient in 6 succeeding hemodialysis considering dialyzer reuse up to fifth reuse. Means were compared by independent t-test. Results: The findings of the study revealed that the mean URR and Kt/V of the subjects cannulated in retrograde manner and antegrade manner were 69.35% and 1.45, and 74.65% and 1.70, respectively. The mean access recirculation percentage of the subjects was 4.65% in the intervention group and 3.02% in the control group. There was a significant difference on URR and Kt/V of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. There was no significant difference on access recirculation percentage of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. Conclusions: Antegrade arterial needle placement provides more adequate hemodialysis than retrograde arterial needle placement in terms of URR and Kt/V values among non-diabetic, non-cardiac patients undergoing maintenance hemodialysis in 6 succeeding hemodialysis sessions. The directions of the arterial needle either retrograde and antegrade did not have significant effects on access recirculation.

scholarly journals Effects of Heparin on Early Patency of Arteriovenous Fistula in Angioaccess Surgery of Patients with End-Stage Renal Disease

2018 ◽  
Vol 3 (1) ◽  
pp. 36
Author(s):  
Mohamamd Mozafar ◽  
Fatemeh Hoseinzadegan ◽  
Saran Lotfollahzadeh ◽  
Maryam Baikpour ◽  
Razie Amraei ◽  
...  
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Post Surgery ◽  
Significant Difference ◽  
Systemic Anticoagulation ◽  
Stage Renal Disease ◽  
End Stage

Background: Arteriovenous fistula (AVF) is now the optimal method of obtaining vascular access for dialysis. Measures such as systemic anticoagulation have been proposed as means of increasing patency rates but enough evidence does not exist to support their application. We aimed to evaluate the efficacy of preoperative heparin injection on patency of AVF during the first 24 hours after surgery and to determine whether such measure can be used to prevent early thrombosis of the vascular access.Methods: The study was carried out on 150 patients admitted to Shohada-e-Tajrish hospital for permanent vascular access placement during 2011-2012. 75 patients were randomly assigned to receive 100 units/kg of heparin intraoperatively and at 24 hours post-surgery AVF patency rate was assessed and compared to the control group. Results: All the 75 patients who had received heparin intraoperatively had a patent arteriovenous fistula 24 hours post-surgery which showed a statistically significant difference compared to the control group among which only 69 (92%) patients had a functioning AV fistula (p-value= 0.028).Conclusions: Our results show that systemic anticoagulation with heparin can be considered as an effective option in preventing vascular access failure. However, considering the contradictory data on the usefulness of heparin injection, larger trials are needed to evaluate efficacy and adverse effects of systemic intraoperative anticoagulation in End-Stage Renal Disease (ESRD) patients before qualifying it as a method of increasing AVF patency in these patients

Serum Thiamine Values in End-Stage Renal Disease Patients under Maintenance Hemodialysis

2015 ◽  
Vol 85 (5-6) ◽  
pp. 348-355 ◽  
Author(s):  
Masamitsu Ubukata ◽  
Nobuyuki Amemiya ◽  
Kosaku Nitta ◽  
Takashi Takei
Keyword(s):  
Thiamine Deficiency ◽  
Risk Index ◽  
Nutritional Risk ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Significant Difference ◽  
Nutritional Risk Index ◽  
Serum Aspartate Aminotransferase ◽  
Stage Renal Disease ◽  
End Stage

Abstract. Objective: Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients. Methods: To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis. Results: Average thiamine levels were not low in both pre-hemodialysis (50.1 ± 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 ± 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (Δthiamine/pre thiamine < 0; - 0.13 ± 0.11) group (n = 18) and the increase (Δthiamine/pre thiamine> 0; 0.32 ± 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group (≥ 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 ± 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group (≥ 35.4 ng/ml; 73.5 ± 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate. Conclusion: In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.

scholarly journals Effect of Auricular Acupressure on Uremic Pruritus in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Cui-na Yan ◽  
Wei-guo Yao ◽  
Yi-jie Bao ◽  
Xiao-jing Shi ◽  
Hui Yu ◽  
...  
Keyword(s):  
Intervention Group ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Common Symptom ◽  
Uremic Pruritus ◽  
Auricular Acupressure ◽  
Significant Difference ◽  
Vas Scores ◽  
And Control

Background. Uremic pruritus (UP) is a common symptom in patients undergoing maintenance hemodialysis for end-stage renal disease (ESRD).Objective. To determine the clinical efficacy of auricular acupressure therapy on pruritus in hemodialysis patients and to explore possible underlying mechanisms.Methods. Patients receiving maintenance hemodialysis at a referral medical center were recruited and assigned to intervention (n=32) and control (n=30) groups. The intervention group underwent auricular acupressure treatment three times a week for six weeks. Auricular acupressure was not applied to patients in the control group. However, tape withoutVaccariaseeds was applied to the same six auricular acupoints as the intervention group. Pruritus scores were assessed using VAS scores, and enzyme-linked immunosorbent assays (ELISA) were used to measure levels of other possible contributory biochemical factors.Results. There was a significant difference in mean VAS scores between the postintervention and control groups during follow-up (3.844 ± 1.687 versus 5.567 ± 2.285,F=22.32,P<0.0001). Compared to the control group, serum histamine levels in the postintervention group at the six-week follow-up had decreased significantly (F=5.01,P=0.0290).Conclusion. Our findings suggest that auricular acupressure may be a useful treatment in the multidisciplinary management of UP in ESRD patients.

Long-Term Protective Effect of N-Acetylcysteine against Amikacin-Induced Ototoxicity in End-Stage Renal Disease: A Randomized Trial

2018 ◽  
Vol 38 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Alperen Vural ◽  
İsmail Koçyiğit ◽  
Furkan Şan ◽  
Eray Eroğlu ◽  
İbrahim Ketenci ◽  
...  
Keyword(s):  
Protective Effect ◽  
Pure Tone Audiometry ◽  
The Other ◽  
Control Group ◽  
Tnf Α ◽  
Significant Difference ◽  
Hearing Test ◽  
Stage Renal Disease ◽  
End Stage

Background The aim of the study is to evaluate the long-term protective effect of N-acetylcysteine (NAC), an antioxidant agent, against aminoglycoside (AG)-induced ototoxicity. Methods A total of 40 patients receiving continuous ambulatory peritoneal dialysis (CAPD) and having their first peritonitis attacks and planned to be treated with AGs were enrolled in the study. They were randomized into 2 groups: 1 group received additional NAC and the other did not. All patients underwent hearing tests with pure tone audiometry (PTA) after the diagnosis, at 1 month and 12 months and at the same time the tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were measured. Results Patients taking NAC had better hearing test results in both ears at 1 month except 2,000 Hz for the left ear, which wasn't significantly different between the 2 groups. Although patients taking NAC had generally better PTA results at 12 months, differences between the 2 groups were not statistically significant. Baseline IL-6 level was significantly higher in the NAC group than the control group. Both TNF-α and IL-6 levels at 1 month were significantly lower in the NAC group than in the control group. On the other hand, there was no significant difference between the 2 groups in terms of TNF-α and IL-6 levels at 12 months. Conclusions The results of the current study showed that NAC, a potent anti-inflamatory drug, may be otoprotective, but that the effect is not long-lasting.

scholarly journals Raloxifene in the Treatment of Osteoporosis in Postmenopausal Women with End-Stage Renal Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 730-737
Author(s):  
Hao-Yang Ma ◽  
Shuang Chen ◽  
Ling-Ling Lu ◽  
Wei Gong ◽  
Ai-Hua Zhang
Keyword(s):  
Lumbar Spine ◽  
Renal Disease ◽  
Postmenopausal Women ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

AbstractAs a selective estrogen receptor modulator (SERM), raloxifene is used in healthy postmenopausal women to prevent bone loss and reduce fractures. However, the benefit of raloxifene is uncertain in the treatment of osteoporosis among patients with end-stage renal disease (ESRD) or those who require maintenance dialysis. We assessed the safety and efficacy of raloxifene in this particular population. Studies were selected from PubMed, Springer, CNKI (Chinese National Knowledge Infrastructure) and Wanfang Database. Randomized controlled trials (RCTs) and prospective studies with control/placebo groups were included. Five studies were included with a total of 244 participants (121 patients in the raloxifene group and 123 patients in the placebo/control group). The median duration of treatment was 12 months. The incidence rate of side effects of raloxifene was 0/121 (0%). There was a significant improvement of lumbar spine bone mineral density (BMD) levels in the raloxifene group compared with the placebo group (MD: 33.88, 95% CI: 10.93, 56.84, p=0.004). There was no significant difference concerning the improvement of femoral neck BMD (MD: 8.42, 95% CI: –10.21, 27.04, p=0.38), intact parathyroid hormone (iPTH) (MD: –12.62, 95% CI: –35.36, 10.13, p=0.28), calcium (MD: -0.08, 95% CI: –0.61, 0.44, p=0.76), phosphorus (MD: 0.18, 95% CI: –0.12, 0.48, p=0.23) or bone alkaline phosphatase (BAP) (MD: –4.33, 95% CI: –14.44, 5.79, p=0.40). Raloxifene seems to be effective in improving the lumbar spine BMD in postmenopausal women with ESRD. More large RCTs are necessary to evaluate the long-term safety of raloxifene in uremic patients.

scholarly journals A Comparative Study on the Effects of Acupressure at SP6 and ST36 Acupoints on the Pain Caused by Fistula Needle Placement in Hemodialysis Patients

2021 ◽  
Vol 10 (4) ◽  
pp. 354-367
Author(s):  
Tahereh Baloochi Beydokhti ◽  
Keyword(s):  
Arteriovenous Fistula ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Needle Placement ◽  
Chi Square ◽  
Double Blind ◽  
Significant Difference ◽  
Chi Square Test ◽  
Vas Scores ◽  
And Control

Objective: Hemodialysis is one of the most common treatment methods in kidney patients. To do this, repeated insertion of the needle into the vessel is necessary. Patients treated with hemodialysis are exposed to stress and pain caused by perforation of their arteriovenous fistula about 300 times a year. More than 1/5 of hemodialysis patients express this pain as unbearable. This study aims to evaluate the effect of acupressure at SP6 and ST36 acupoints on the pain caused by fistula needle placement in hemodialysis patients. Methods: This study is a double-blind randomized clinical trial conducted in 2016 on 90 hemodialysis patients with arteriovenous fistula in Mashhad, Iran. They were randomly divided into three groups of SP6, ST36, and control. Data were collected after obtaining a written informed consent by a demographic form and the Visual Analog Scale (VAS). Data analysis was performed in SPSS v.16 software by using Kolmogorov-Smirnov test, Kruskal-Wallis test, one-way ANOVA, paired t-test, and Chi-square test. Results: There was a statistically significant difference between VAS scores after the intervention in all three group (P<0.001). The Mean±SD VAS scores before the intervention in SP6, ST36, control groups were 54.47±18.93, 51.5±22.83, 46.6±17.73, respectively which changed to 45.63±20.53, 40.2±20.01, and 51.87±19.05 after the intervention, indicating that acupressure at SP6 and ST36 acupoints reduced pain in patients, while the pain increased in the control group. Conclusion: Acupressure at SP6 and ST36 acupoints is an effective method in relieving pain caused by the insertion of a needle into the arteriovenous fistula in hemodialysis patients.

Effects of Kidney Transplantation on Cognitive Performance in a Pediatric Population

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 273-278 ◽  
Author(s):  
Robert S. Fennell ◽  
Wiley C. Rasbury ◽  
Eileen B. Fennell ◽  
Mary K. Morris
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Cognitive Performance ◽  
End Stage Renal Disease ◽  
Pediatric Population ◽  
Control Group ◽  
Memory And Attention ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

The cognitive functioning of 20 children and adolescents with end-stage renal disease was assessed 1 to 3 weeks prior to the onset of hemodialysis, and at 1 month and 1 year after successful kidney transplantation, and results were compared with those of a matched control group. A battery of intelligence, achievement, problem solving, learning, memory, and attention tasks were administered. Both groups had significantly improved scores over time on most measures. The group with renal disease exhibited significantly greater improvement than the control group from initial testing to 1 month after transplantation on the performance IQ and full-scale IQ as well as in mathematics achievement. This significant difference was not maintained, however, at 1 year after transplantation. Cognitive performance was less impaired the later the onset of renal failure or the fewer the years in end-stage renal disease. BUN nitrogen, serum creatinine levels, and BP did not consistently correlate with any of the cognitive or academic achievement measures.

scholarly journals Effect of local papaverine on arteriovenous fistula maturation in patients with end-stage renal disease

2019 ◽  
Vol 41 (2) ◽  
pp. 185-192 ◽  
Author(s):  
Reza Manani ◽  
Gholamreza Kazemzadeh ◽  
Ali Saberi ◽  
Fatemeh Sadeghipour ◽  
Asghar Rahmani
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Case Group ◽  
Maturation Time ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Control ◽  
Fistula Maturation

Abstract Background: Arteriovenous fistula (AVF) maturation is one of the main concerns in patients with end-stage renal disease (ESRD) and finding a strategy for increasing success rate and accelerating fistula maturation is valuable. The aim of this study was to evaluate the effects of papaverine injection on AVF maturation and success rate. Method: This study was a randomized clinical trial that involved 110 patients with ESRD that were referred for AVF construction. Patients were allocated in papaverine group and control group with block randomization according to age and sex. In the case group, papaverine (0.1 or 0.2 cc) was injected locally within the subadventitia of artery and vein after proximal and distal control during AVF construction and in the control group, AVF construction was done routinely without papaverine injection. Results: Maturation time in case and control groups was 37.94 ± 11.49 and 44.23 ± 9.57 days, respectively (p=0.004). Hematoma was not seen in the case group but occurred in one patient in the control group. One patient of the case group developed venous hypertension. Four functional fistulas, 1 (1.8%) in the case group and 3 (5.5%) in the control group, failed to mature (p=0.618). Maturation rate did not differ between the two groups statistically (p=0.101). Conclusion: Local papaverine injection increased vessel diameter and blood flow, increasing shearing stress in both arterial and venous segment of recently created AVF. In this way, papaverine probably can decrease AVF maturation time without an increase in complications.

scholarly journals Effects of Peer Support Program on Self-Management in Patients with End-Stage Renal Disease Undergoing Hemodialysis

2020 ◽  
Vol 10 (2) ◽  
pp. 171-181 ◽  
Author(s):  
Fida' Husain ◽  
Henni Kusuma ◽  
Andrew Johan
Keyword(s):  
Peer Support ◽  
End Stage Renal Disease ◽  
Intervention Group ◽  
Support Programs ◽  
Self Management ◽  
Control Group ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End-stage renal disease (ESRD) patients undergoing hemodialysis require essential self-management to lifestyle changes to minimize the risk of complications, morbidity, and mortality. Efforts made to improve self-management of hemodialysis patients in previous studies were carried out by health workers that may not provide 'real' knowledge, while peer support programs carried out by patients as peers to share their experiences may provide more benefits.Purpose: The purpose of this study was to determine the effects of peer support programs on improving self-management in patients with ESRD undergoing hemodialysis.Methods: This study employed a quasi-experimental design and involved a total of 33 patients in the control group and 32 patients in the intervention group, who met the inclusion and exclusion criteria. The samples were recruited consecutively. The intervention of peer support programs was implemented through information support, emotional support, and mutual reciprocity in groups of 10-12 people to share experiences related to their self-management. The intervention was given for six sessions; each lasted for 30-45 minutes. The data were collected using the Indonesian version of the hemodialysis self-management instrument (HDSMI) and analyzed using a paired-sample t-test and independent-sample t-test.Results: The results showed that after the intervention, the mean score of self-management in the intervention group increased from 79.47±7.919 to 90.75±7.089, and in the control group, the mean increased from 81.88±8.291 to 82.12±7.692. After the implementation of peer support programs, there was a significant difference in the score of self-management between the intervention and control groups (p<0.001).Conclusion: Peer support programs gave an effect on increasing self-management in patients with ESRD undergoing hemodialysis. Peer support programs should be introduced early to ESRD patients undergoing hemodialysis so that they can learn about self-management from other patients.  

scholarly journals Influence of hemoglobin level and dose of administered recombinant human beta erythropoietin on survival of hemodialysis patients

2011 ◽  
Vol 68 (9) ◽  
pp. 749-755
Author(s):  
Violeta Knezevic ◽  
Aleksandra Milosevic ◽  
Slavenka Vodopivec ◽  
Dusan Bozic ◽  
Ivana Budosan ◽  
...  
Keyword(s):  
Function Analysis ◽  
Underlying Disease ◽  
Hemodialysis Patients ◽  
Hemoglobin Level ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Dialysis Duration ◽  
Significant Difference ◽  
The Difference ◽  
Stage Renal Disease

Background/Aim. In patients with end-stage renal disease, treatment with erythropoietin lowers cardiovascular morbidity, improves quality of life and patient survival. The aim of this study was to determine the difference in survival of hemodialysis patients treated with recombinant human beta erythropoietin and patients without this treatment, and to determine the influence of hemoglobin level and erythropoietin dose on the survival of these patients. Method. The study included 291 patients undergoing maintenance hemodialysis, 122 were on erythropoietin therapy, 169 patients formed control group. The study was performed at the Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, during a 69-month period. We analyzed basic demographic parameters, dialysis duration, underlying disease, comorbidities, death causes, bloodwork parameters and erythropoietin dosage. Descriptive statistics, Anova, Manova, discriminant function analysis, Cox regressional model and Kaplan Meier survival curves were used as statistical methods. Results. Average age and dialysis duration in the experimental group were 47.88 ? 13.32 years, and 45.76 ? 46.73 months, respectively and in the control group 58.73 ? 12.67 years and 62.80 ? 55.23 months, respectively. Average level of hemoglobin and hematocrit in the group in which erythropoietin had been administered was 11.40 ? 8.39 g/dL and 0.35 ? 0.04/L, while the control group these values were 8.52 ? 7.73 g/dL and 0.26 ? 0.04/L, respectively. Average monthly dosage of erythropoietin was 21 587 ? 10 183.36 IJ/month. Significant difference in survival was determined (p < 0,05) between the stated patient groups. A significant difference (p < 0,05) was found in survival of the patients in which erythropoietin was administered regarding hemoglobin level (< 100 g/L/100-110 g/L/110-120 g/L/ > 120 g/L), as well as in regard of erythropoietin dose applied (< 20 000 IJ/20 000-40 000 IJ/ > 40 000 IJ/month). Conclusion. Best survival was noted in patients with hemoglobin > 120 g/L and erythropoietin dose < 20 000 IJ/month.

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