scholarly journals Sodium Dialysate Prescription in a New Dialysis Facility

2021 ◽  
Vol 1 (2) ◽  
pp. 164-166
Author(s):  
Charles Chazot
Keyword(s):  
Quality Of Life ◽  
Point Theory ◽  
Medical Director ◽  
Sodium Balance ◽  
Uremic Toxin ◽  
Interdialytic Weight Gain ◽  
Dialysis Facility ◽  
Sodium Diffusion ◽  
Set Point Theory

As the Medical Director of this new dialysis facility, I recommend a fixed sodium dialysate (Nadial) concentration at 138 mEq/L. This relates to my former experience in the Tassin unit in France and the fear of sodium as a powerful uremic toxin. I realize that, according to the Na+ set-point theory, a fixed value of the Nadial may create a plasma–dialysate (P–D) gradient and may favor intradialytic plasma Na+ changes. In cases where this is associated with signs of negative Na+ balance (bad session tolerance/quality of life) or positive Na+ balance (high interdialytic weight gain or high blood pressure), individualization of the Nadial to reduce the P–D gradient and change in plasma Na+ concentration may be useful, even though evidence remains scarce. I look forward to the possibility of using new dialysis machines that allow for the evaluation of sodium balance and tailoring of the sodium diffusion process.

scholarly journals What Is Known and Unknown About Twice-Weekly Hemodialysis

2015 ◽  
Vol 40 (4) ◽  
pp. 298-305 ◽  
Author(s):  
Yoshitsugu Obi ◽  
Rieko Eriguchi ◽  
Shuo-Ming Ou ◽  
Connie M. Rhee ◽  
Kamyar Kalantar-Zadeh
Keyword(s):  
Quality Of Life ◽  
De Novo ◽  
Urine Volume ◽  
Cost Effective ◽  
Standard Of Care ◽  
Treatment Regimens ◽  
Interdialytic Weight Gain ◽  
Cost Effective Treatment ◽  
Incremental Hemodialysis

Background: The 2006 Kidney Disease Outcomes Quality Initiative guidelines suggest twice-weekly or incremental hemodialysis for patients with substantial residual kidney function (RKF). However, in most affluent nations de novo and abrupt transition to thrice-weekly hemodialysis is routinely prescribed for all dialysis-naïve patients regardless of their RKF. We review historical developments in hemodialysis therapy initiation and revisit twice-weekly hemodialysis as an individualized, incremental treatment especially upon first transitioning to hemodialysis therapy. Summary: In the 1960's, hemodialysis treatment was first offered as a life-sustaining treatment in the form of long sessions (≥10 hours) administered every 5 to 7 days. Twice- and then thrice-weekly treatment regimens were subsequently developed to prevent uremic symptoms on a long-term basis. The thrice-weekly regimen has since become the ‘standard of care' despite a lack of comparative studies. Some clinical studies have shown benefits of high hemodialysis dose by more frequent or longer treatment times mainly among patients with limited or no RKF. Conversely, in selected patients with higher levels of RKF and particularly higher urine volume, incremental or twice-weekly hemodialysis may preserve RKF and vascular access longer without compromising clinical outcomes. Proposed criteria for twice-weekly hemodialysis include urine output >500 ml/day, limited interdialytic weight gain, smaller body size relative to RKF, and favorable nutritional status, quality of life, and comorbidity profile. Key Messages: Incremental hemodialysis including twice-weekly regimens may be safe and cost-effective treatment regimens that provide better quality of life for incident dialysis patients who have substantial RKF. These proposed criteria may guide incremental hemodialysis frequency and warrant future randomized controlled trials.

scholarly journals Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ranganathan Natarajan ◽  
Bohdan Pechenyak ◽  
Usha Vyas ◽  
Pari Ranganathan ◽  
Alan Weinberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Statistical Power ◽  
Small Sample Size ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Venous Blood ◽  
Small Sample ◽  
Uremic Toxin ◽  
Double Blind

Background. Primary goal of this randomized, double-blind, placebo-controlled crossover study of Renadyl in end-stage renal disease patients was to assess the safety and efficacy of Renadyl measured through improvement in quality of life or reduction in levels of known uremic toxins. Secondary goal was to investigate the effects on several biomarkers of inflammation and oxidative stress.Methods. Two 2-month treatment periods separated by 2-month washout and crossover, with physical examinations, venous blood testing, and quality of life questionnaires completed at each visit. Data were analyzed with SAS V9.2.Results. 22 subjects (79%) completed the study. Observed trends were as follows (none reaching statistical significance): decline in WBC count(-0.51×109/L,P=0.057)and reductions in levels of C-reactive protein(-8.61 mg/L,P=0.071)and total indoxyl glucuronide(-0.11 mg%,P=0.058). No statistically significant changes were observed in other uremic toxin levels or measures of QOL.Conclusions. Renadyl appeared to be safe to administer to ESRD patients on hemodialysis. Stability in QOL assessment is an encouraging result for a patient cohort in such advanced stage of kidney disease. Efficacy could not be confirmed definitively, primarily due to small sample size and low statistical power—further studies are warranted.

scholarly journals The effect of transportation modality to dialysis facilities on health-related quality of life among hemodialysis patients: results from the Japanese Dialysis Outcomes and Practice Pattern Study

2019 ◽  
Vol 13 (4) ◽  
pp. 640-646 ◽  
Author(s):  
Masahiko Yazawa ◽  
Kenji Omae ◽  
Yugo Shibagaki ◽  
Masaaki Inaba ◽  
Kazuhiko Tsuruya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Practice Pattern ◽  
Dialysis Facility ◽  
Health Related ◽  
Group 3 ◽  
Group 2 ◽  
Mean Differences ◽  
Dialysis Outcomes ◽  
Group 1

Abstract Background For hemodialysis (HD) patients, travel to the dialysis facility is an issue that can affect their quality of life (QOL), both physically and mentally. However, evidence on this association of transportation modality with health-related QOL (HRQOL) is scarce. Methods We conducted a cohort study among maintenance HD patients participating in the Japanese Dialysis Outcomes and Practice Pattern Study Phase 5. The study included patients who were functionally independent and able to walk. The primary exposure was the means of transportation to the dialysis facility, categorized into three groups, namely transportation by other drivers (Group 1), transportation via self-driving (Group 2) and transportation by bicycle or walking with or without public transportation (Group 3). The primary outcomes were physical and mental health composite scores (PCS and MCS) in the 12-item Short Form at 1 year after study initiation. Results Among 1225 eligible patients (Group 1, 34.4%; Group 2, 45.0%; Group 3, 20.7%), 835 were analyzed for the primary outcomes. Linear regression analyses revealed that patients in Groups 2 and 3 had significantly higher PCS and MCS at 1 year than those in Group 1 {adjusted mean differences of PCS 1.42 [95% confidence interval (CI) 0.17–2.68] and 1.94 [95% CI 0.65–3.23], respectively, and adjusted mean differences of MCS 2.53 [95% CI 0.92–4.14] and 2.20 [95% CI 0.45–3.95], respectively}. Conclusions Transportation modality was a significant prognostic factor for both PCS and MCS after 1 year in maintenance HD patients.

scholarly journals Impact of Intestinal Microbiota on Quality of Life (QoL) of Hemodialysis Patients

2021 ◽  
Author(s):  
Ana Shamanadze ◽  
Irma Tchokhonelidze ◽  
Tamar Kandashvili ◽  
David Gordeladze
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bacterial Flora ◽  
Hemodialysis Patients ◽  
Uremic Toxin ◽  
Gut Dysbiosis ◽  
Impact On Survival ◽  
Key Driver

Chronic kidney disease is a global problem. Increasing evidence suggests that interstinal microflore is altered in patients with Chronic Kidney Disease (CKD).The gut microbiome is a key driver of chronic inflammation. Many of uremic retention solutes are produced by dysbiotic intestinal microflore that may have a great impact on survival of the CKD patients. Our sample study consisted of 147 patients (78 female, 69 male age 18-75) undergoing hemodialysis in one dialysis center. Data were collected by the completion of a scpecially designed questionnaire. Patients received hemodialysis therapy for 4-5 hours sessions, three times weekly using polysulfone dialyzers. It was revealed significant alteration of the colonic bacterial flora in hemodialysis patients, with the excess of the uremic toxin producing bacteria. Also, there was strict correlation between gut dysbiosis and HD patent's QoL.

scholarly journals The Physical Indicators of Quality of Life for Hemodyalisis Patients

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Laily Isroin
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Muscle Strength ◽  
Systolic Blood Pressure ◽  
Control Group ◽  
Life Questionnaire ◽  
Upper Arm ◽  
Interdialytic Weight Gain ◽  
Arm Circumference

The measurement of quality of life using physical indicators is required to validate the use of quality of life questionnaire. Physical indicators of quality of life for hemodialysis patients include interdialytic weight gain, edema, muscle strength, upper arm circumference and blood pressure. This study used an experimental research design with pre-test post-test approach. Samples were divided into an intervention group consist of 6 people and a control group consisting of 5 people which were randomly assigned. The study concludes that all physical indicators of quality of life have improved although not all indicators reach significant values. Physical indicators which experience significant improvement are muscle strength, upper arm circumference and systolic blood pressure after hemodialysis. There are significant differences of physical indicators of quality of life of the circumference of the upper arm, ankle circumference, edema and systolic blood pressure after hemodialysis between the experimental group and the control group.

scholarly journals HOW TO CONTROL INTERDIALYTIC WEIGHT GAIN (IDWG) AMONG HEMODIALYSIS PATIENTS?

2021 ◽  
Vol 10 (2) ◽  
pp. 214-221
Author(s):  
Lono Wijayanti ◽  
Priyo Mukti Pribadi Winoto ◽  
Nursalam Nursalam
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Renal Failure ◽  
Weight Gain ◽  
Literature Review ◽  
End Stage Renal Failure ◽  
Risk Of Death ◽  
Interdialytic Weight Gain ◽  
End Stage

Background: Chronic kidney failure is a terminal disease that often affects the patient's quality of life. One of the problems that often occurs in patients with end-stage renal failure is the increase in fluid volume between two dialysis times. The increase in Interdialytic Weight Gain (IDWG) has a serious impact, 60-80% of patients die from excess fluid and food intake during the interdialytic period. Objective: This review aimed to describe the importance of Interdialytic Weight Gain (IDWG) in end-stage renal failure patients undergoing hemodialysis. Design: This study design is a systematic review to search and review article from database and the theory underlying this study or guidance in this systematic literature review using PRISMA. Data Sources: This systematic review was conducted using a database with electronic searches on EBSCO, ProQuest, Scopus, SAGE, and Science Direct published in 2017-2021. Review Methods: The method used in the preparation of the Literature review using the PRISMA checklist and PICOT. Secondary data obtained from the journal with a predetermined discussion. Results: The results of the database search strategy were 1,907 articles were obtained, but 1,340 articles were excluded. There were seven articles that met the inclusion criteria. Two articles identified that uncontrolled IDWG is at risk of death in chronic renal failure patients undergoing hemodialysis. Conclusion: Two articles state that IDWG affects hemoglobin concentration and cardiovascular disorders and triggers complications, two other articles state that the factors that contribute to IDWG are fluid intake, thirst, self-efficacy and dietary behavior, one article states that controlled IDWG will improve the quality of life of patients with end-stage renal failure/End-Stage Renal Disease (ESRD undergoing hemodialysis. Uncontrolled IDWG is at risk of death in patients undergoing hemodialysis. Control of IDWG through adherence to dietary behavior will improve the quality of life of end-stage renal failure patients undergoing hemodialysis.

scholarly journals P1519A TWICE-WEEKLY HEMODIALYSIS : A SINGLE CENTER STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sirine Bchir ◽  
Malek Mojaat ◽  
Mariem Ben salem ◽  
Boukadida Amine ◽  
Insaf Handous ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Function ◽  
University Hospital ◽  
Good Survival ◽  
Biological Parameters ◽  
Medical Reason ◽  
Interdialytic Weight Gain ◽  
Residual Kidney Function ◽  
The Mean

Abstract Background and Aims Conventional hemodialysis consists of a thrice-weekly in-center Hemodialysis with a mean duration of 4 hours per session. The concept of incremental dialysis has allowed a better adjustment of its prescription guided by clinical and biological parameters. Thereby a twice-weekly regimen may maintain a good quality of life, a good survival rate and adequate dialysis in comparison to a thrice-weekly hemodialysis. The aim of our study was to investigate the profile of patients undergoing a twice-weekly regimen in our center. Method It is a monocenter transversal-descriptive study gathering patients on a twice-weekly regimen in the center of hemodialysis of Fattouma Bourguiba University Hospital in Monastir Tunisia. Results We identified 32 patients with a sex ratio of 2.2 (22 men and 10 women) with a mean age of 48,96 +/- 13,74 years. Regarding the intitial nephropathy, a chronic glomerulopathy was seen in 16 patients, a chronic tubulo-interstitial nephritis In 5 patients, and kidney polykystosis among 3 patients and in 8 patients the initial nephropathy remained undetermined. The indications for a twice-weekly HD regimen were: defavourable socio-economic conditions in 9 patients, a medical reason in 17 patients and a rejection of thrice-weekly regimen in 6 patients. The mean diuresis was 850 +/- 560 cc/24h and only one patient with anuria. The mean interdialytic weight gain was 2, 64 +/- 0, 83 Kg. Normal blood pressure and volemia were reported in 27 patients (84, 37 %). The mean number of anti-hypertensive drugs used was 1,5 per patient. The mean percentage of Urea reduction was 68, 8 % and a mean Kt/V of 1.26. The average of both kalemia and calcemia was respectively 5.27 mmol/l and 1, 94 mmol/l and the mean dosage of phosphoremia was 1, 63 mmol/l. The average of PTH and Hemoglobine was respectively 403 pg/ml and 9, 97 g/dl. Conclusion According to these results, a twice-weekly hemodialysis should be guided by the residual kidney function, clinical status (volemia), cardiovascular symptoms and comorbidities, biological parameters (Hemoglobine, potassium, phosphore) and the nutritional state. By meeting the above criteria, many studies have shown that a twice-weekly regimen or incremental dialysis help preserve the residual kidney function with a good quality of life.

scholarly journals Impact of Interdialytic Weight Gain (IDWG) on Nutritional Parameters, Cardiovascular Risk Factors and Quality of Life in Hemodialysis Patients

2015 ◽  
Vol 13 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Aysegul Kahraman ◽  
Hakan Akdam ◽  
Alper Alp ◽  
Mustafa Ahmet Huyut ◽  
Cagdas Akgullu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Hemodialysis Patients ◽  
Nutritional Parameters ◽  
Interdialytic Weight Gain ◽  
Group I ◽  
Sf 36 ◽  
Group Ii

AbstractIntroduction. The amount of interdialytic weight gain (IDWG) considering body weight is of great importance in hemodialysis patients. In general practice, patients are asked to get standard weight between two hemodialysis sessions. However, it should be individualized considering patient’s weight. We aimed to determine the association between the IDWG and the nutritional parameters, cardiovascular risk factors, and quality of life.Methods. Thrity-two patients receiving hemodialysis at least for one year were enrolled into the study. Patients were monitored for 12 consecutive hemodialysis sessions; and the arithmetic mean of IDWG was calculated. IDWG% was calculated in accordance with patients’ dry weight. Data of patients with IDWG<3% (Group I) and IDWG≥3 (Group II) were compared. Sociodemographic variables, laboratory, anthropometric measurements, blood pressure, left ventricular mass index, Subjective Global Assessment Scale and SF-36 Quality of Life Scale were applied to evaluate the patients.Results. 59.4% (n=19) and 40.6% (n=13) of patients were included in Group I and Group II, respectively. In Group II, albumin (p=0.02), potassium (p=0.02), phosphorus (p=0.04), nPCR (p=0.03), physical function (p=0.04), role limitations caused by physical problems (p=0.04), general health (p=0.03), physical quality of life (p=0.04) scores were significantly higher. A significant correlation was detected between IDWG and physical and mental quality of life, total score SF-36, albumin, total protein and the potassium values.Conclusions. Patients with an IDWG ≥ 3% have better nutritional parameters and quality of life scales. The limiting of IDWG to 1-2 kg, ingoring patient weight may give rise to malnutrition and a reduced quality of life.

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