Ramipril and Cardiovascular Outcomes in Patients on Maintenance Hemodialysis: The ARCADIA Multicenter Randomized Controlled Trial.

Background And Objectives: Renin-angiotensin system (RAS) inhibitors reduce cardiovascular morbidity and mortality in patients with CKD. We evaluated the cardioprotective effects of the angiotensin-converting enzyme inhibitor ramipril in patients on maintenance hemodialysis.

Design, Setting, Participants, & Measurements: In this phase 3, prospective, randomized, open-label, blinded end point, parallel, multicenter trial, we recruited patients on maintenance hemodialysis with hypertension and/or left ventricular hypertrophy from 28 Italian centers.

Thyroid micro-carcinoma: only a diagnostic epidemic?

Background: The incidence of thyroid carcinoma ranges from 0.5 to 10 cases every 100,000, depending on the country, the context and purpose of the study. The high incidence of differentiated thyroid tumor is continuously growing.

Hybrid simultaneous treatment of thrombosed prosthetic grafts for hemodialysis.

Purpose: The aim of the study was to evaluate our experience in the hybrid simultaneous treatment (open and endovascular) of acute thrombosis of prosthetic grafts for hemodialysis.

Methods: Between January 2011 and June 2013, 23 patients with acute thrombosis of a prosthetic graft for hemodialysis were urgently treated with a hybrid simultaneous treatment in order to obtain a prompt restoration of the flow. A new puncture of the graft was scheduled after 24 hours.

Oral anticoagulant therapy in hemodialysis patients: do the benefits outweigh the risks?

Managing oral anticoagulation may be difficult in hemodialysis patients because the antithrombotic effect can be counterbalanced by an increased risk of hemorrhagic complications. There is insufficient evidence to recommend the routine use of warfarin for thrombosis prophylaxis of the vascular access in all patients. If a decision for anticoagulation is made, dosing warfarin to a "therapeutic" level is suggested, although the most appropriate target INR range remains unclear.

Thrice-weekly in-center nocturnal hemodialysis: an effective strategy to optimize chronic dialysis therapy.

Objectives: Daily nocturnal hemodialysis (NHD) has been proposed as a valuable strategy to improve outcomes for patients on conventional hemodialysis (CHD), but it is burdened by high costs and logistic issues. Thrice NHD might represent a more affordable approach to improve hemodialysis patient outcome.

Methods: Here we retrospectively analyzed the data on blood pressure, body weight, and hematochemical parameters in a cohort of 7 patients (mean age 50.