Publications by authors named "Allen M Kaufman"
Key Points: Prior efficacy study—established that more frequent dialysis achieved better outcomes than CONVENTIONAL dialysis in outpatients. We undertook an effectiveness observational on-site nursing home study (=195) comparing on-site more frequent dialysis with CONVENTIONAL dialysis. More frequent dialysis patients, despite being sicker at baseline, returned home faster than CONVENTIONALLY dialyzed patients without worsened death or hospitalization.
View Article and Find Full Text PDFIntroduction: For end-stage renal disease (ESRD) patients residing in skilled nursing facilities (SNFs), the logistics and physical exhaustion of life-saving hemodialysis therapy often conflict with rehabilitation goals. Integration of dialysis care with rehabilitation programs in a scalable and cost-efficient manner has been a significant challenge. SNF-resident ESRD patients receiving onsite, more frequent hemodialysis (MFD) have reported rapid post-dialysis recovery.
View Article and Find Full Text PDFIntroduction: Post-dialysis recovery time (DRT) has an important relationship to quality of life and survival, as identified in studies of ESRD patients on conventional dialysis. ESRD patients are often discharged from hospitals to skilled nursing facilities (SNFs) where on-site treatment using home hemodialysis technology is increasingly offered, but nothing is known about DRT in this patient population.
Methods: From November 4, 2019 to June 11, 2021, within a dialysis organization providing service across 12 states and 154 SNFs, patients receiving in-SNF, more frequent dialysis (MFD) (modeled to deliver 14 treatment hours minimum per week and stdKt/V ≥2.
Introduction: Dialysis patients are often discharged from hospitals to skilled nursing facilities (SNFs), but little has been published about their natural history.
Methods: Using electronic medical record data, we conducted a retrospective cohort study of nursing home patients treated with in-SNF hemodialysis from January 1, 2018 through June 20, 2020 within a dialysis organization across eight states. A dialytic episode began with the first in-SNF dialysis and was ended by hospitalization, death, transfer, or cessation of treatment.
Article Synopsis
- Intradialytic blood pressure (BP) is primarily used to monitor patients during hemodialysis (HD), but knowing details about cardiac output and resistance could offer better insights.
- A study employed a non-invasive bio-impedance system to assess multiple hemodynamic parameters in chronic HD patients, examining changes before, during, and after dialysis across various hemodynamic profiles.
- The findings indicated that most patients did not remain hemodynamically stable during dialysis, with higher mortality rates observed in those with low cardiac power and total peripheral resistance, suggesting that enhanced monitoring could improve patient safety during HD treatments.
Background: Infection is a common cause of mortality and morbidity in haemodialysis patients. Few prospective studies have examined the clinical consequences of infection-related hospitalizations in haemodialysis patients or the risk factors predictive of clinical outcomes.
Methods: The outcomes of all first infection-related hospitalizations of patients enrolled in the HEMO Study were categorized in terms of mortality, requirement for intensive care unit (ICU) stay and length of hospitalization.
Low access blood flow is considered the most important cause of peripheral vascular access thrombosis, particularly with grafts. The measurement of access flow is time consuming, operator dependent, and may affect the efficiency of dialysis so that it cannot be done with every treatment. The measurement of recirculation, however, is possible with every treatment and can be done automatically when using the thermodilution offered by the blood temperature monitor (BTM).
View Article and Find Full Text PDFInfection is the second most common cause of death among hemodialysis patients. A predefined secondary aim of the HEMO study was to determine if dialysis dose or flux reduced infection-related deaths or hospitalizations. The effects of dialysis dose, dialysis membrane, and other clinical parameters on infection-related deaths and first infection-related hospitalizations were analyzed using Cox regression analysis.
View Article and Find Full Text PDFBackground: Both hypovolemia and heat accumulation act as powerful perturbations of blood pressure control. In hemodialysis, hypovolemia and heat accumulation often develop simultaneously, and the question arises of whether and to what extent these perturbations are linked.
Methods: Heat accumulation was measured by the amount of thermal energy (E) removed from a patient during prescribed ultrafiltration under isothermic hemodialysis conditions, ie, constant patient temperature.