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Hashmi SA, Hudar SA, Stephen E, Riyami DA, Maawali HA, Abdelhady I, Wahaibi KA, Rizvi S. Factors Affecting the Early Maturation of Arteriovenous Fistulae Created at a Tertiary Centre in Oman. Sultan Qaboos Univ Med J 2024; 24:37-43. [PMID: 38434458 PMCID: PMC10906777 DOI: 10.18295/squmj.9.2023.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives This study aimed to determine the risk factors associated with the failure of arteriovenous fistulae (AVF) maturation. Methods This retrospective cohort study was conducted from January 2014 to December 2018 in Sultan Qaboos University Hospital, Muscat, Oman. Patients were followed-up 3 months after surgery, and their electronic medical records were accessed for demographic and clinical data. Univariate analysis was used to determine the risk factors associated with early AVF maturation and multivariant analysis was used to determine the predictive factors for AVF failure. Results A total of 269 patients were included. Female gender was a significant factor affecting AVF maturity (P = 0.049), while age (P = 0.626), diabetes (P = 0.954), hypertension (P = 0.378), dyslipidaemia (P = 0.907), coronary artery disease (P = 0.576), cerebrovascular accident (P = 0.864), congestive heart failure (P = 0.685), previous central venous catheterisation (P = 0.05), fistula type (P = 0.863) and fistula site (P = 0.861) did not affect AVF maturation. Binary logistic regression showed that all the risk factors were insignificant. Failure of early AVF maturation affected 11.5% in the cohort. Conclusion This study found that the proportion of early AVF maturation at our hospital is at par with that in the international literature. Failure of AVF maturation was significantly associated with the female gender. These findings can help nephrologists and vascular surgeons prognosticate AVF maturation rates. However, a larger study is needed for definitive conclusions.
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Affiliation(s)
| | | | - Edwin Stephen
- Department of Surgery, Sultan Qaboos University, Muscat, Oman
| | - Dawood Al Riyami
- Department of Internal Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | | | | | | | - Syed Rizvi
- Department of Family Medicine & Public Health, Sultan Qaboos University, Muscat, Oman
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Mandelbaum M, Townsend A, Fontana S, Harmaty M, Torina P. Autologous Breast Reconstruction in a Patient With End-Stage Renal Disease and Systemic Lupus Erythematosus. Eplasty 2023; 23:e29. [PMID: 37305011 PMCID: PMC10257201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Patients with end-stage renal disease (ESRD) secondary to systemic lupus erythematosus (SLE) have historically been deterred from free flap breast reconstruction due to perceived complication risks. Numerous studies examining patients with ESRD have cited free flap complications, including increased incidences of infection and wound breakdown, with some surgeons suggesting ESRD is an independent risk factor for flap failure.15 Due to perceived risks, autologous breast reconstruction has not been extensively explored as an option in patients with ESRD on hemodialysis with comorbid connective tissue/autoimmune disorders, such as SLE. To the authors' knowledge, there are currently no published reports of successful free flap breast reconstruction in patients with ESRD due to SLE. Methods This case report describes a patient requiring hemodialysis for ESRD caused by SLE who underwent left mastectomy and immediate autologous breast reconstruction. Deep inferior epigastric perforator flap technique was employed. Conclusions This successful case report suggests the use of free flaps is a feasible option that should be considered for oncologic breast reconstruction in patients with ESRD secondary to SLE who require hemodialysis. The authors believe that further investigation is warranted to evaluate the safety of autologous breast reconstruction as an option for patients with either comorbidity. While ESRD and SLE are not explicit contraindications to free flap reconstruction, careful patient selection and appropriate indication is paramount for immediate surgical and long-term reconstructive success.
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Affiliation(s)
- Max Mandelbaum
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alexandra Townsend
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - Stefani Fontana
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Marco Harmaty
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Philip Torina
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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3
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Almani MU, Zhang Y, Arshad MH, Usman M, Ayub MT. Impact of end stage renal disease on the clinical outcomes of diabetics admitted for heart failure: Analysis of national inpatient sample. J Cardiovasc Thorac Res 2023; 15:37-43. [PMID: 37342662 PMCID: PMC10278196 DOI: 10.34172/jcvtr.2023.30566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 02/11/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction: Patients with diabetes and heart failure (HF) can have varying outcomes depending on whether they also have End Stage Renal Disease (ESRD). This study aimed to compare the outcomes of patients with diabetes and HF with and without ESRD. Methods: Data from the National Inpatient Sample (NIS) 2016-2018 was analyzed to find hospitalizations for patients with HF as the main diagnosis and diabetes as a secondary diagnosis, with and without ESRD. Multivariable logistic and linear regression analysis was used to adjust for confounding factors. Results: In the total cohort of 12215 patients with a principal diagnosis of heart failure and secondary diagnosis of type 2 diabetes, the in-hospital mortality rate was 2.5%. Patients with ESRD had higher odds of in-hospital mortality (1.37x) compared to those without ESRD. The mean difference in length of stay was higher for patients with ESRD (0.49 days) and in total hospital charges (13360 US$). Patients with ESRD had higher odds of developing acute pulmonary edema, cardiac arrest, and requiring endotracheal intubation. However, they had lower odds of developing cardiogenic shock or requiring an intra-aortic balloon pump insertion. Conclusion: The results suggest that ESRD leads to higher in-patient mortality, length of stay, and total hospital charges for patients with diabetes admitted for HF. The lower incidence of cardiogenic shock and intra-aortic balloon pump insertion in patients with ESRD may be due to timely dialysis.
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Affiliation(s)
| | - Yaqi Zhang
- Division of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, IL, USA
| | | | - Muhammad Usman
- Division of Hospital Medicine, University of Wisconsin, Madison, WI, USA
| | - Muhammad Talha Ayub
- Divsion of Cardiology, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA
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Multani EK, Bajwa D, Multani PK, Nobakht E, Raj D, Paul RS, Paul RS. EYE DISEASE IN KIDNEY TRANSPLANTATION: CLINICAL CHALLENGES IN A UNIQUE PATIENT POPULATION. Surv Ophthalmol 2021; 67:1252-1269. [PMID: 34954092 DOI: 10.1016/j.survophthal.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
Eye disease is common among kidney transplant recipients and their management is challenging. Chronic kidney disease is associated with ocular complications, both independently and in the context of various systemic disorders. In addition, chronic immunosuppression predisposes kidney transplant recipients to an array of long-term ocular issues. This may be broadly categorized into infections, malignancies, and other immunosuppression-specific side effects. The interdependence of kidney disease, transplant pharmacotherapy and ocular health therefore requires a multispecialty approach. Although the kidney transplant population has grown along with the burden of associated oculopathies, systematic guidelines targeting this patient group are lacking. This evidenced-based narrative review summarizes the pertinent issues that may present in the ophthalmic and optometric clinical settings, with emphasis on collaborative management and directions for future research.
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Affiliation(s)
- Eisha K Multani
- MY EYE DR OPTOMETRISTS LLC, 1330 CONNECTICUT AVE NW, WASHINGTON DC, 20037, UNITED STATES
| | - Dalvir Bajwa
- THE NEWCASTLE UPON TYNE HOSPITALS, NHS FOUNDATION TRUST, ROYAL VICTORIA INFIRMARY, QUEEN VICTORIA ROAD, NEWCASTLE UPON TYNE NE1 4LP, UNITED KINGDOM
| | - Priyanika K Multani
- INLAND VISION CENTER OPTOMETRY, 473 E CARNEGIE DR, SUITE 100, SAN BERNADINO, CA 92408
| | - Ehsan Nobakht
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Dominic Raj
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Rohan S Paul
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Rohan S Paul
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES.
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Thadhani R, Willetts J, Wang C, Larkin J, Zhang H, Fuentes LR, Usvyat L, Belmonte K, Wang Y, Kossmann R, Hymes J, Kotanko P, Maddux F. Transmission of SARS-CoV-2 considering shared chairs in outpatient dialysis: a real-world case-control study. BMC Nephrol 2021; 22:313. [PMID: 34530746 PMCID: PMC8444531 DOI: 10.1186/s12882-021-02518-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND SARS-CoV-2 can remain transiently viable on surfaces. We examined if use of shared chairs in outpatient hemodialysis associates with a risk for indirect patient-to-patient transmission of SARS-CoV-2. METHODS We used data from adults treated at 2,600 hemodialysis facilities in United States between February 1st and June 8th, 2020. We performed a retrospective case-control study matching each SARS-CoV-2 positive patient (case) to a non-SARS-CoV-2 patient (control) treated in the same dialysis shift. Cases and controls were matched on age, sex, race, facility, shift date, and treatment count. For each case-control pair, we traced backward 14 days to assess possible prior exposure from a 'shedding' SARS-CoV-2 positive patient who sat in the same chair immediately before the case or control. Conditional logistic regression models tested whether chair exposure after a shedding SARS-CoV-2 positive patient conferred a higher risk of SARS-CoV-2 infection to the immediate subsequent patient. RESULTS Among 170,234 hemodialysis patients, 4,782 (2.8 %) tested positive for SARS-CoV-2 (mean age 64 years, 44 % female). Most facilities (68.5 %) had 0 to 1 positive SARS-CoV-2 patient. We matched 2,379 SARS-CoV-2 positive cases to 2,379 non-SARS-CoV-2 controls; 1.30 % (95 %CI 0.90 %, 1.87 %) of cases and 1.39 % (95 %CI 0.97 %, 1.97 %) of controls were exposed to a chair previously sat in by a shedding SARS-CoV-2 patient. Transmission risk among cases was not significantly different from controls (OR = 0.94; 95 %CI 0.57 to 1.54; p = 0.80). Results remained consistent in adjusted and sensitivity analyses. CONCLUSIONS The risk of indirect patient-to-patient transmission of SARS-CoV-2 infection from dialysis chairs appears to be low.
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Affiliation(s)
| | - Joanna Willetts
- Fresenius Medical Care, Global Medical Office, 920 Winter Street, Waltham, MA, USA
| | | | - John Larkin
- Fresenius Medical Care, Global Medical Office, 920 Winter Street, Waltham, MA, USA.
| | | | | | - Len Usvyat
- Fresenius Medical Care, Global Medical Office, 920 Winter Street, Waltham, MA, USA
| | | | - Yuedong Wang
- University of California-Santa Barbara, Santa Barbara, CA, USA
| | - Robert Kossmann
- Fresenius Medical Care North America, Medical Office, Waltham, MA, USA
| | - Jeffrey Hymes
- Fresenius Medical Care, Global Medical Office, 920 Winter Street, Waltham, MA, USA
| | - Peter Kotanko
- Renal Research Institute, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Franklin Maddux
- Fresenius Medical Care AG & Co. KGaA, Global Medical Office, Bad Homburg, Germany
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Lazar AN, Johnson AP, Morrissey NJ. Association of Insurance Status with Timing of Hemodialysis Access Placement. J Vasc Surg 2021; 74:1309-1316.e2. [PMID: 34186164 DOI: 10.1016/j.jvs.2021.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Patients without adequate outpatient follow-up often present requiring emergency hemodialysis and then undergo permanent dialysis access placement at a later time. We sought to examine the relationship between type of insurance and whether a patient was already on dialysis at time of surgery. METHODS The Vascular Quality Initiative Hemodialysis Access registry was queried for all adult patients undergoing first time permanent hemodialysis access between January 2015 and September 2019. Patient and procedural characteristics were examined in patients split by private insurance, Medicare over 65 years, Medicare under 65 years, and Medicaid. Primary Outcome was whether patients were on dialysis at time of surgery. RESULTS There were 19,307 adult patients that underwent first time placement of an arterio-venous fistula or graft. Of these patients, 9,729 (50%) had Medicare, 7,179 (37%) had private insurance, and 2,399 (12%) had Medicaid. The patients with Medicare were sub-grouped by age with 2,968 (31%) being under the age of 65 and 6,761 (69%) being over the age of 65. Patients with Medicare and under 65 were the most likely to be on dialysis at the time of surgical access placement at 67%, while 59% of Medicaid patients were on dialysis, and 53% each group of patients with Medicare and over 65 and private insurance were on dialysis. Following adjustment for patient characteristics, patients with Medicare under 65 and over 65 were both significantly more likely to be on dialysis at time of surgery compared to private insurance with odds ratio of 1.64 (95% confidence interval 1.49-1.80, p <0.001) and odds ratio of 1.11 (95% confidence interval 1.03-1.20, p = 0.007), respectively. After adjustment, patients with Medicaid were no longer significantly more likely to be on dialysis. Secondary outcomes demonstrated, after adjustment, no difference in association with surgical fistula versus graft in any insurance groups, however patients with Medicare and under 65 were more likely to have a non-radial artery used for anastomosis with an odds ratio of 1.18 (95% confidence interval 1.04-1.34, p = 0.011). CONCLUSIONS Certain types of insurance are correlated with being on dialysis at the time of access placement. Although associations were seen between insurance type and surgical access characteristics, these were predominantly insignificant when patient demographics and status of dialysis were controlled for. These potential gaps in care represent an area for improvement that deserves further exploration.
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Affiliation(s)
- Andrew N Lazar
- Division of Vascular Surgery, Columbia University Medical Center, New York, NY.
| | - Adam P Johnson
- Division of Vascular Surgery, NewYork-Presbyterian Hospital, New York, NY
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Alemayehu YH, Seylania K, Bahramnezhad F. The relationship between health literacy and quality of life among hemodialysis patients: An integrative review. Hum Antibodies 2020; 28:75-81. [PMID: 31524153 DOI: 10.3233/hab-190394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Various studies have highlighted the correlates to health literacy and quality of life among patients receiving hemodialysis therapy. However, evidence of how these two outcomes could influence each other is not clear. OBJECTIVE This study aimed to assess the correlation between health literacy and quality of life among patients receiving hemodialysis. METHODS This is an integrative review of correlational studies. This study conforms to the preferred reporting items for integrative reviews described by Whitemore and Knafl. We search for studies reporting on the correlation of health literacy and quality of life among patients receiving hemodialysis in six databases, that is PubMed, Web of Science/Knowledge, Scopus and Embase, Google Scholar and Ovid MEDLINE. RESULTS In this review five studies were included after screening them against the inclusion criteria. Two studies were identified from Iran, and one study was identified each from Australia, Turkey, and the USA. Most studies were descriptive comparative in nature, while two studies were experimental. Shayan's study had the highest number of participants. This study reports on 1,063 patients receiving dialysis. Most studies were conducted at different centers. Findings from three studies showed that there was a significant relationship between health literacy and quality of life among patients receiving hemodialysis. CONCLUSION There is a relationship between health literacy and quality of life among patients receiving hemodialysis. Conclusively, addressing health literacy may improve the quality of life among patients receiving hemodialysis.
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Affiliation(s)
- Yisak Hagos Alemayehu
- Department of Critical Care Nursing, School of Nursing and Midwifery, International Campus, Tehran University of Medical Sciences, Tehran, Iran.,Ayder Comprehensive Specialized Referral Hospital, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Khatereh Seylania
- Department of Critical Care Nursing, School of Nursing and Midwifery, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Department of Critical Care Nursing, School of Nursing and Midwifery, International Campus, Tehran University of Medical Sciences, Tehran, Iran.,Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Conway PT. Nephrology Nomenclature: How to Accelerate Patient Anxiety, Suppress Engagement, and Mire the Advance of Medical Innovation. Clin J Am Soc Nephrol 2020; 15:907-908. [PMID: 32586925 PMCID: PMC7341778 DOI: 10.2215/cjn.08730620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Paul T Conway
- American Association of Kidney Patients, Tampa, Florida
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9
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Lee S, Lee HY, Park Y, Ko EJ, Ban TH, Chung BH, Lee HS, Yang CW. Development of End Stage Renal Disease after Long-Term Ingestion of Chaga Mushroom: Case Report and Review of Literature. J Korean Med Sci 2020; 35:e122. [PMID: 32419395 PMCID: PMC7234858 DOI: 10.3346/jkms.2020.35.e122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/03/2020] [Indexed: 11/23/2022] Open
Abstract
Chaga mushrooms are widely used in folk remedies and in alternative medicine. Contrary to many beneficial effects, its adverse effect is rarely reported. We here report a case of end-stage renal disease after long-term taking Chaga mushroom. A 49-year-old Korean man with end stage renal disease (ESRD) was transferred to our hospital. Review of kidney biopsy finding was consistent with chronic tubulointerstitial nephritis with oxalate crystal deposits and drug history revealed long-term exposure to Chaga mushroom powder due to intractable atopic dermatitis. We suspected the association between Chaga mushroom and oxalate nephropathy, and measured the oxalate content of remained Chaga mushroom. The Chaga mushroom had extremely high oxalate content (14.2/100 g). Estimated daily oxalate intake of our case was 2 times for four years and 5 times for one year higher than that of usual diet. Chaga mushroom is a potential risk factor of chronic kidney disease considering high oxalate content. Nephrologist should consider oxalate nephropathy in ESRD patients exposed to Chaga mushrooms.
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Affiliation(s)
- Sua Lee
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwa Young Lee
- Division of Nephrology, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Yohan Park
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Jeong Ko
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Convergent Research Consortium for Immunologic Disease, Seoul St. Mary's Hospital, The Collage of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae Hyun Ban
- Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Ha Chung
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Convergent Research Consortium for Immunologic Disease, Seoul St. Mary's Hospital, The Collage of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Chul Woo Yang
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Convergent Research Consortium for Immunologic Disease, Seoul St. Mary's Hospital, The Collage of Medicine, The Catholic University of Korea, Seoul, Korea.
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Zhou F, Gillespie A, Gligorijevic D, Gligorijevic J, Obradovic Z. Use of disease embedding technique to predict the risk of progression to end-stage renal disease. J Biomed Inform 2020; 105:103409. [PMID: 32304869 PMCID: PMC9885429 DOI: 10.1016/j.jbi.2020.103409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 02/01/2023]
Abstract
The accurate prediction of progression of Chronic Kidney Disease (CKD) to End Stage Renal Disease (ESRD) is of great importance to clinicians and a challenge to researchers as there are many causes and even more comorbidities that are ignored by the traditional prediction models. We examine whether utilizing a novel low-dimensional embedding model disease2disease (D2D) learned from a large-scale electronic health records (EHRs) could well clusters the causes of kidney diseases and comorbidities and further improve prediction of progression of CKD to ESRD compared to traditional risk factors. The study cohort consists of 2,507 hospitalized Stage 3 CKD patients of which 1,375 (54.8%) progressed to ESRD within 3 years. We evaluated the proposed unsupervised learning framework by applying a regularized logistic regression model and a cox proportional hazard model respectively, and compared the accuracies with the ones obtained by four alternative models. The results demonstrate that the learned low-dimensional disease representations from EHRs can capture the relationship between vast arrays of diseases, and can outperform traditional risk factors in a CKD progression prediction model. These results can be used both by clinicians in patient care and researchers to develop new prediction methods.
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Affiliation(s)
- Fang Zhou
- School of Data Science & Engineering, East China Normal University, Shanghai, China
| | - Avrum Gillespie
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Djordje Gligorijevic
- Center for Data Analytics and Biomedical Informatics, Temple University, Philadelphia, PA
| | - Jelena Gligorijevic
- Center for Data Analytics and Biomedical Informatics, Temple University, Philadelphia, PA
| | - Zoran Obradovic
- Center for Data Analytics and Biomedical Informatics, Temple University, Philadelphia, PA
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Reynaga-Ornelas L, Baldwin CM, Arcoleo K, Quan SF. Impact of Sleep and Dialysis Mode on Quality of Life in a Mexican Population. Southwest J Pulm Crit Care 2019; 18:122-134. [PMID: 31360612 PMCID: PMC6662728 DOI: 10.13175/swjpcc017-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Health-related quality of life (HR-QOL) is reduced with end-stage renal disease (ESRD) but little is known about the impact of sleep disorders, dialysis modality and demographic factors on HR-QOL of Mexican patients with ESRD. METHODS 121 adults with ESRD were enrolled from 4 dialysis units in the state of Guanajuato, Mexico, stratified by unit and dialysis modality (hemodialysis [HD], continuous ambulatory peritoneal dialysis [CAPD] and automated peritoneal dialysis [APD]). Analysis included clinical information and data from the Sleep Heart Health Study Sleep Habits Questionnaire, the Medical Outcomes Study (MOS) short form (SF-36) HR-QOL measure and Epworth Sleepiness Scale. RESULTS Overall, sleep symptoms and disorders were common (e.g., 37.2% insomnia). SF-36 scores were worse versus US and Mexican norms. HD patients reported better, while CAPD patients poorer HR-QOL for Vitality. With multivariate modelling dialysis modality, sleep disorders as a group and lower income were significantly associated with poorer overall SF-36 and mental health HR-QOL. Overall and Mental Composite Summary models showed HR-QOL was significantly better for both APD and HD with small to moderate effect sizes. Cost-effectiveness analysis demonstrated an advantage for APD. CONCLUSIONS Mexican ESRD patients have reduced HR-QOL, and sleep disorders may be an important driver of this finding. APD should be the preferred mode of dialysis in Mexico.
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Affiliation(s)
- Luxana Reynaga-Ornelas
- Division de Ciencias de la Salud. Departamento de Enfermería y Obstetricia Sede León, Universidad de Guanajuato, Sede San Carlos; Blvd. Puente Milenio #1001; Fracción del Predio San Carlos; C.P. 37670; León, Gto, Mexico
| | - Carol M. Baldwin
- Arizona State University, Edson College of Nursing and Health Innovation, PAHO/WHO Collaborating Centre to Advance the Policy on Research for Health, 500 N. 3rd Street, Phoenix, AZ 85004
| | - Kimberly Arcoleo
- University of Rochester School of Nursing, Box SON, Helen Wood Hall, 601 Elmwood Avenue, Rochester, NY 14642
| | - Stuart F. Quan
- Arizona State University, Edson College of Nursing and Health Innovation, PAHO/WHO Collaborating Centre to Advance the Policy on Research for Health, 500 N. 3rd Street, Phoenix, AZ 85004
- Division of Sleep and Circadian Disorders Brigham and Women’s Hospital and Harvard Medical School, 221 Longwood Ave. Boston, MA 02115
- Asthma and Airway Disease Research Center, University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ 85725
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Alatab S, Shekarchian S, Najafi I, Moghadasali R, Ahmadbeigi N, Pourmand MR, Bolurieh T, Jaroughi N, Pourmand G, Aghdami N. Systemic Infusion of Autologous Adipose Tissue-Derived Mesenchymal Stem Cells in Peritoneal Dialysis Patients: Feasibility and Safety. Cell J 2018; 20:483-495. [PMID: 30123994 PMCID: PMC6099152 DOI: 10.22074/cellj.2019.5591] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 01/08/2023]
Abstract
Objective Using mesenchymal stem cells (MSCs) is regarded as a new therapeutic approach for improving fibrotic diseases.
the aim of this study to evaluate the feasibility and safety of systemic infusion of autologous adipose tissue-derived MSCs
(AD-MSCs) in peritoneal dialysis (PD) patients with expected peritoneal fibrosis.
Materials and Methods This study was a prospective, open-label, non-randomized, placebo-free, phase I clinical trial. Case
group consisted of nine eligible renal failure patients with more than two years of history of being on PD. Autologous AD-MSCs
were obtained through lipoaspiration and expanded under good manufacturing practice conditions. Patients received
1.2 ± 0.1×106 cell/kg of AD-MSCs via cubital vein and then were followed for six months at time points of baseline, and then 3
weeks, 6 weeks, 12 weeks, 16 weeks and 24 weeks after infusion. Clinical, biochemical and peritoneal equilibration test (PET)
were performed to assess the safety and probable change in peritoneal solute transport parameters.
Results No serious adverse events and no catheter-related complications were found in the participants. 14 minor
reported adverse events were self-limited or subsided after supportive treatment. One patient developed an episode
of peritonitis and another patient experienced exit site infection, which did not appear to be related to the procedure. A
significant decrease in the rate of solute transport across peritoneal membrane was detected by PET (D/P cr=0.77 vs.
0.73, P=0.02).
Conclusion This study, for the first time, showed the feasibility and safety of AD-MSCs in PD patients and the potentials
for positive changes in solute transport. Further studies with larger samples, longer follow-up, and randomized blind control
groups to elucidate the most effective route, frequency and dose of MSCs administration, are necessary (Registration Number:
IRCT2015052415841N2).
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Affiliation(s)
- Sudabeh Alatab
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soroosh Shekarchian
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Iraj Najafi
- Urology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Moghadasali
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Naser Ahmadbeigi
- Cell-based Therapies Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Pourmand
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tina Bolurieh
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Neda Jaroughi
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Gholamreza Pourmand
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nasser Aghdami
- Department of Regenerative Biomedicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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13
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Zyga S, Alikari V, Sachlas A, Fradelos EC, Stathoulis J, Panoutsopoulos G, Georgopoulou M, Theophilou P, Lavdaniti M. Assessment of Fatigue in End Stage Renal Disease Patients Undergoing Hemodialysis: Prevalence and Associated Factors. Med Arch 2018; 69:376-80. [PMID: 26843728 PMCID: PMC4720468 DOI: 10.5455/medarh.2015.69.376-380] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Fatigue is a common symptom referred by many patients undergoing hemodialysis. Fatigue is associated with poor health-related quality of life (HRQoL) and is an important predictor for survival of hemodialysis patients. Aim: To assess the levels of fatigue and demographic factors affecting it among patients with End Stage Renal Disease undergoing hemodialysis. Methods: This quantitative study was carried out in two Dialysis Units of Hospitals in Athens Region. Between January 2015 and June 2015, 129 hemodialysis patients completed the Greek Version of the Fatigue Assessment Scale (FAS). Demographic data of patients was recorded. For the statistical analysis IBM SPSS Statistics version 20 was used. Results: The mean FAS score was 24.99. 49 patients (38.0%) were non fatigued, 61 patients (47.3%) were fatigued, and 19 patients (13.7%) were extremely fatigued. Higher levels of fatigue were reported among hemodialysis patients residing in urban areas, in those with low educational level and unemployed. Conclusion: The findings of this study can be used in the assessment of fatigue and early identification of high-risk patients (especially of the unemployed, those who occupy with domestic works, those with low educational level and of urban citizens). Use of this knowledge by hemodialysis nurses may lead to a better understanding of the factors of fatigue in ESRD, which in turn may lead to a more effective treatment.
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Affiliation(s)
- Sofia Zyga
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Victoria Alikari
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Athanasios Sachlas
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Evangelos C Fradelos
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - John Stathoulis
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | - Georgios Panoutsopoulos
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Lakonia, Greece
| | | | | | - Maria Lavdaniti
- Department of Nursing, Technological educational institute of Thessaloniki, Thessaloniki, Greece
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14
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Seyyed Majidi M, Sanjari Pirayvatlou P, Rajabikashani M, Firoozabadi M, Seyed Majidi SA, Vafaeimanesh J. Comparison of Helicobacter pylori eradication regimens in patients with end stage renal disease. Gastroenterol Hepatol Bed Bench 2018; 11:15-19. [PMID: 29564060 PMCID: PMC5849113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AIM The aim of this study was to compare the Helicobacter pylori (HP) eradication regimens in patients with end stage renal disease. BACKGROUND In patients undergoing hemodialysis, the pathologic changes seen in the stomach may be the result of high serum levels of gastrin, delayed gastric emptying or HP infection. METHODS Our study was a randomized clinical trial in which 120 patients with ESRD (Patients who undergo hemodialysis) confirmed HP infection, were divided to four groups having 2-week eradication regimens; Group I: LCA (lansoprazole 30 mg-BD,clarithromycin 250 mg-BD, amoxicillin 500 mg-BD), Group II: LCM (lansoprazole 30 mg-BD,clarithromycin 250 mg-BD, metronidazole 500 mg-BD), Group III: LCAM (lansoprazole 30 mg-BD,clarithromycin 250 mg-BD,amoxicillin 500 mg-BD, metronidazole 500 mg-BD) and Group IV: Sequential (lansoprazole 30 mg-BDfor two weeks; first week: amoxicillin 500 mg-BD and second week: clarithromycin 250 mg-BD, metronidazole 500 mg-BD).6 weeks after treatment, Urea Breath Test (UBT) was performed for all patients. RESULTS The mean age of patients was 43.1±11.2 years. 55.8% of patients were male. The success rates of HP eradication in 4 groups were76.7%, 70%, 90% and 90%, respectively. HP eradication rates were not statistically different among the regimens (p=0.11). There were not significant differences among the groups regarding demographic and anthropometric variables. CONCLUSION The results showed there was no significant difference between the success rates of HP eradication regimens for ESRD patients. According to approved regimen for 90% eradication rate, with a lower number of medications and given the less risk of side effects and drug interactions, the sequential regimen is the best.
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Affiliation(s)
- Mohammadreza Seyyed Majidi
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GOUMS), Gorgan, Golestan Province, Iran
| | - Peyman Sanjari Pirayvatlou
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GOUMS), Gorgan, Golestan Province, Iran
| | - Majid Rajabikashani
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GOUMS), Gorgan, Golestan Province, Iran
| | - Mona Firoozabadi
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GOUMS), Gorgan, Golestan Province, Iran
| | - Seyed ali Seyed Majidi
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GOUMS), Gorgan, Golestan Province, Iran
| | - Jamshid Vafaeimanesh
- Gastroenterology &Hepatology Research Center. Qom Univercity of Medical Séances, Qom, Iran,Gastroentrology and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
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15
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Shafiee MA, Chamanian P, Shaker P, Shahideh Y, Broumand B. The Impact of Hemodialysis Frequency and Duration on Blood Pressure Management and Quality of Life in End-Stage Renal Disease Patients. Healthcare (Basel) 2017; 5:E52. [PMID: 28869490 PMCID: PMC5618180 DOI: 10.3390/healthcare5030052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/22/2017] [Accepted: 08/29/2017] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular complications are the most prominent causes of morbidity and mortality among chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients undergoing standard hemodialysis (HD) therapy. Cardiovascular disease risk is increased significantly through persistent hypertension and blood pressure (BP) fluctuation, which are the most common complications of CKD. It was hypothesized that an extended approach with lengthier and more frequent dialysis sessions, referred to in this paper as "extended hemodialysis" (EHD), can potentially lower and stabilize blood pressure, and consequently reduce the rate of morbidity and mortality. A greater reduction of volume (salt and water) with higher frequency can improve patient quality of life (QOL). Eleven papers, including clinical trials and systematic reviews were chosen and analyzed. The extracted data was used to evaluate the change in blood pressure levels between standard HD and EHD. Overall, the studies showed that EHD resulted in improved blood pressure management; therefore, we concluded that there will be a decrease in cardiovascular disease risk, stroke, and morbidity and mortality rate. There will be also an improvement in patient QOL due to beneficial effects of the EHD.
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Affiliation(s)
- Mohammad Ali Shafiee
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, ON M2G 2C4, Canada.
| | - Pouyan Chamanian
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, ON M2G 2C4, Canada.
| | - Pouyan Shaker
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, ON M2G 2C4, Canada.
| | - Yasmin Shahideh
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, ON M2G 2C4, Canada.
| | - Behrooz Broumand
- Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital Department of Nephrology, Iran University of Medical Sciences, Tehran 1449614535, Iran.
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16
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Abstract
OBJECTIVES In Taiwan, peritoneal dialysis (PD) and haemodialysis are fully accessible to patients with end-stage renal disease. However, the usage of PD is considered low in Taiwan. Since 2005, 4 major policies have been implemented by Taiwan's Ministry of Health and Welfare, namely a multidisciplinary predialysis care programme and usage increasing the PD incidence as a key performance indicator (KPI) for hospital accreditation, both of which were implemented in 2006; reimbursement of the glucose-free dialysate, icodextrin that was implemented in 2007; and insurance reimbursement for renting automated PD machines that was implemented in 2008. The aim of this study was to analyse the associations between the PD promotional policies and the actual PD selection rates. SETTING We analysed data within the Taiwan Renal Registry Data System from 2006 to 2013, focusing on the PD incidence in relation to the timings of the 4 PD promotional policies; then we stratified the results according to age, sex and the presence of diabetes mellitus. PARTICIPANTS From 2006 to 2013, 115 565 patients were enrolled in this study. The mean (SD) age of patients on PD was 54.6 (15.7) years. RESULTS During the time frame in which the 4 PD promotional policies were implemented, the PD incidence increased from 12.8% in 2006 to 15.1% in 2009. The PD incidence started to decline in 2010 (13.8%) when the hospital accreditation policy was repealed. The 3 remaining policies were weakly associated with the PD incidence. The observational analysis determined that the patients' ages, sexes and diabetes mellitus incidence rates were relatively stable from 2006 to 2013. CONCLUSIONS Of the 4 health policies intended to promote PD usage, using increasing the PD incidence as a KPI for hospital accreditation had the strongest association with the PD incidence.
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Affiliation(s)
- Yi-Chun Lin
- Division of Endocrinology & Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Chung Lin
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chin Kao
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsi-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Mai-Szu Wu
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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17
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Shukla PA, Kolber MK, Nwoke F, Kumar A, Shams JN, Silberzweig JE. The MILLER banding procedure as a treatment alternative for dialysis access steal syndrome: a single institutional experience. Clin Imaging 2015; 40:569-72. [PMID: 26615898 DOI: 10.1016/j.clinimag.2015.09.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/17/2015] [Accepted: 09/29/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe a single institutional experience with minimally invasive limited ligation endoluminal-assisted revision (MILLER) for treatment of dialysis access steal syndrome (DASS). MATERIALS AND METHODS Twenty patients were retrospectively identified that underwent 30 MILLER band procedures for DASS at our institution from March 2010 to December 2014. Technical success was defined by successful creation of MILLER band with preservation of flow for hemodialysis. Clinical success was defined as complete resolution of signs and symptoms with preservation of dialysis access in a 1-month postprocedural period. Primary MILLER band patency, postintervention-assisted primary access patency, and postprocedure secondary access patency are reported. RESULTS Technical success was achieved in all patients. Clinical success was achieved in 75% of patients after one banding procedure and in 95% of patients after two banding procedures. One patient experienced access thrombosis following the initial banding procedure which was subsequently treated and did not lead to loss of access. MILLER band patency was 83% at 1 month and 77% at 6 months. Postintervention-assisted primary patency was 95%, 93%, and 92% at 3 months, 6 months, and 1 year, respectively. Postintervention secondary patency was 86%, 68%, and 59% at 3 months, 6 months, and 1 year, respectively. CONCLUSIONS MILLER banding offers a less-invasive alternative to surgical therapy that appears to be safe and permits preservation of dialysis access.
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Affiliation(s)
- Pratik A Shukla
- Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003
| | - Marcin K Kolber
- Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003
| | - Franklin Nwoke
- Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003
| | - Abhishek Kumar
- Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003
| | - Joseph N Shams
- Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003
| | - James E Silberzweig
- Division of Vascular and Interventional Radiology, Department of Radiology, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003.
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18
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Li H, Jiang YF, Lin CC. Factors associated with self-management by people undergoing hemodialysis: a descriptive study. Int J Nurs Stud 2014; 51:208-16. [PMID: 23768411 DOI: 10.1016/j.ijnurstu.2013.05.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 05/15/2013] [Accepted: 05/17/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Improving the level of self-management by people undergoing hemodialysis is an effective way to reduce the incidence of mortality and complications and improve quality of life. A better understanding of what influences an individual's level of self-management can help nurses find appropriate ways to improve self-management. OBJECTIVES To examine self-management levels, and discuss the factors influencing self-management, in a sample of patients undergoing hemodialysis in Beijing. DESIGN A descriptive study design was chosen. SETTINGS AND METHODS A convenience sample of 216 patients undergoing hemodialysis was recruited from dialysis centers in three tertiary hospitals in Beijing from September 2010 to January 2011. Questionnaires were used to examine the variables: level of self-management; knowledge of hemodialysis; self-efficacy; anxiety and depression; and social support. Data analysis involved descriptive statistics, including frequency, percentage, mean and standard deviations, while Spearman correlation, non-parametric Z and χ(2) and multiple linear regression were used for comparative purposes. RESULTS The number of returned questionnaires was 198 (91.67% response rate). The overall score of self-management was 56.01 (SD=10.75). The average item scores for each of the four self-management subscales were 3.02 for partnership, 2.98 for problem-solving skills, 2.74 for self-care and 2.47 for emotional management. Multiple linear regression analyses for overall self-management and the four subscales indicated that knowledge, self-efficacy, the availability of social support and depression were the main influencing factors which explained 34.1% of the variance of self-management. CONCLUSION The level of self-management by those undergoing hemodialysis in this study was less than ideal, varying from 'rare' to 'sometimes' for use of self-management behaviors. For the different subscales of self-management, partnership was the most used and emotional management the least used strategy. Patients' knowledge, self-efficacy, the availability of social support and depression were the main factors influencing self-management.
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19
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Chang JH, Rim MY, Sung J, Ko KP, Kim DK, Jung JY, Lee HH, Chung W, Kim S. Early start of dialysis has no survival benefit in end-stage renal disease patients. J Korean Med Sci 2012; 27:1177-81. [PMID: 23091314 PMCID: PMC3468753 DOI: 10.3346/jkms.2012.27.10.1177] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 07/30/2012] [Indexed: 11/20/2022] Open
Abstract
The timing for dialysis initiationis still debated. The aim of this study was to compare mortality rates, using a propensity-score approach, in dialysis patients with early or late starts. From January 2000 to June 2009, incident adult patients (n = 836) starting dialysis for end-stage renal disease (ESRD) were enrolled. The patients were assigned to either an early- or late-start group depending on the initiation time of the dialysis. After propensity-score-basedmatching, 450 patients remained. At the initiation of dialysis, the mean estimated glomerular filtration rate (eGFR) was 11.1 mL/min/1.73 m(2) in the early-start group compared with 6.1 mL/min/1.73 m(2) in the late-start group. There were no significant differences in survival between the patients in the early- and late-start groups (Log rank tests P = 0.172). A higher overall mortality risk was observed in the early-start group than in the late-start group for the patients aged ≥ 70 yr (hazard ratio [HR]: 3.29; P = 0.048) and/or who had albumin levels ≥ 3.5 g/dL (HR: 2.53; P = 0.046). The survival of the ESRD patients was comparable between the patients in the early and late-start groups. The time to initiate dialysis should be determined based on clinical findings as well as the eGFR.
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Affiliation(s)
- Jae Hyun Chang
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Min Young Rim
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Jiyoon Sung
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Kwang-Pil Ko
- Department of Preventive Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ji Yong Jung
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Hyun Hee Lee
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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20
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Chun HJ, Kim SJ, Sun IO, Chung BH, Kim JI, Moon IS, Min WS, Yang CW. Kidney transplantation in a patient with end stage renal disease after complete remission of acute promyelocytic leukemia. J Korean Med Sci 2012; 27:814-7. [PMID: 22787381 PMCID: PMC3390734 DOI: 10.3346/jkms.2012.27.7.814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 04/19/2012] [Indexed: 01/04/2023] Open
Abstract
In general, a 2-yr disease-free duration is recommended before kidney transplantation (KT) in end-stage renal disease (ESRD) patients who also have acute leukemia. However, the optimal disease-free interval has not been specified for all subtypes of acute leukemia. Among these subtypes, acute promyelocytic leukemia (APL) shows a favorable prognosis and low relapse rate compared to other types of leukemia. We here report KT after complete remission (CR) of APL in an ESRD patient. Irreversible kidney injury developed in a 23-yr-old man with APL. First, we induced CR and subsequently performed KT 7 months after the achievement of CR. The patient's clinical course after KT was favorable, without allograft rejection or relapse of APL up to 1 yr after KT. On the basis of our clinical experience, it is suggested that a long wait may not be necessary before KT in patients with ESRD and APL.
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Affiliation(s)
- Hyun Ji Chun
- Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Su Jeong Kim
- Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - In O Sun
- Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Byung Ha Chung
- Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ji-Il Kim
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Department of General Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - In Sung Moon
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Department of General Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Woo-Sung Min
- Catholic Hematopoietic Stem Cell Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chul Woo Yang
- Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Organ Transplantation Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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