Independent External Validation and Comparison of Death and Kidney Replacement Therapy Prediction Models in Advanced CKD.

Rationale & Objective: The Kidney Failure Risk Equation (KFRE) is widely used to predict the risk of kidney replacement therapy (KRT) initiation in chronic kidney disease (CKD) stages G3-G5. The new Grams calculator developed for advanced CKD (stage G4+) predicts KRT initiation, cardiovascular events, and death by uniquely incorporating the competing risk of death. We aimed to validate this tool in a stage G4+ cohort for death and KRT.

Polycythemia due to obstructive sleep apnea in a patient on hemodialysis.

Both anemia and sleep disordered breathing are common in patients with dialysis-dependent stage 5 chronic kidney disease. Erythrocytosis resulting from obstructive sleep apnea (OSA) is rare in the general population and has never been described in the hemodialysis population. We present a case of asymptomatic isolated erythrocytosis and elevated serum erythropoietin level in an otherwise well and previously erythropoietin-dependent chronic hemodialysis patient with chronic kidney disease secondary to ischemic nephropathy.

Oral intake during hemodialysis: is there an association with intradialytic hypotension?

Oral intake (OI) of food and fluid has been associated with hypotension during hemodialysis (HD). Trials evaluating this relationship are small. The objective of this study was to quantify OI and to examine its association with hypotension during HD.

Adequacy of glycemic control in hemodialysis patients with diabetes.

Objective: We sought to measure the prevalence of inadequate glycemic control in prevalent hemodialysis patients with diabetes and to examine independent predictors of inadequate glycemic control in these patients.

Research Design And Methods: This is a cross-sectional study of prevalent hemodialysis patients with diabetes in southeastern Ontario (n = 100). Data were collected by chart review and interview.

Quality of sleep in patients with chronic kidney disease.

Background: Sleep disorders are common in patients with renal failure on dialysis; however, the prevalence of "poor sleep" in patients with chronic kidney disease (CKD) not yet on dialysis is not known. This study aimed to measure the prevalence of "poor sleep" in CKD patients and to examine the association between quality of sleep and the degree of renal impairment in this population.

Methods: Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) in 120 prevalent CKD patients.

Quality of sleep and health-related quality of life in haemodialysis patients.

Background: Sleep complaints are common in haemodialysis patients. In the general population, insomnia impacts negatively on health-related quality of life (HRQoL). The objective of this study was to examine the association between quality of sleep and HRQoL in haemodialysis patients independent of known predictors of HRQoL.

Apolipoprotein(a) phenotype and lipoprotein(a) level predict peritoneal dialysis patient mortality.

Objective: To examine the associations between lipoprotein(a) [Lp(a)] level, apolipoprotein(a) [apo(a)] phenotype, and patient mortality in peritoneal dialysis (PD) patients.

Design: Observational prospective study of prevalent PD patients.

Setting: Tertiary-care health sciences center.