Hypersensitivity reactions to acetate in the bicarbonate dialysate in a patient undergoing pre-dilution online hemodiafiltration.

A 63-year-old male patient first experienced recurrent hypotensive episode during the dialysis session just after switching the mode from hemodialysis to online hemodiafiltration (OL-HDF) with infusion in pre-dilution of the bicarbonate dialysate containing 9.2 mEq/L of acetate. Peripheral eosinophil count and serum IgE were both elevated to 16,440/μL and 2000 IU/L.

Effects of change in the formulation of lanthanum carbonate on laboratory parameters.

Lanthanum carbonate (LC) is available in the two formulations of chewable tablets and granules. In this study, we changed the formulation of LC from chewable tablet to granules, and compared the laboratory parameters for 3 months before and after changing formulation in 58 hemodialysis (HD) patients. We also surveyed patients about their preferences for the two formulations.

A comparison of systemic inflammation-based prognostic scores in patients on regular hemodialysis.

Background/aims: Systemic inflammation-based prognostic scores have prognostic power in patients with cancer, independently of tumor stage and site. Although inflammatory status is associated with mortality in hemodialysis (HD) patients, it remains to be determined as to whether these composite scores are useful in predicting clinical outcomes.

Methods: We calculated the 6 prognostic scores [Glasgow prognostic score (GPS), modified GPS (mGPS), neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic index (PI) and prognostic nutritional index (PNI), which have been established as a useful scoring system in cancer patients.

Association of serum total testosterone concentration with skeletal muscle mass in men under hemodialysis.

Purpose: Although skeletal muscle wasting can occur in chronic kidney diseases, its relationship with the serum testosterone concentration remains uncertain. This study investigates the relationship between serum testosterone and skeletal muscle mass in men under hemodialysis (HD).

Methods: Sixty men aged between 41 and 89 years undergoing HD for 15.

Association of HCV core antigen seropositivity with long-term mortality in patients on regular hemodialysis.

Anti-hepatitis C virus (HCV) antibody seropositivity is independently associated with poor prognosis in hemodialysis (HD) patients. However, anti-HCV antibody cannot distinguish between patients with active infection and those who have recovered from infection. We therefore aimed in this study to examine the association of HCV core antigen (HCVcAg) seropositivity with mortality in HD patients.

Brachial-ankle pulse wave velocity and the cardio-ankle vascular index as a predictor of cardiovascular outcomes in patients on regular hemodialysis.

Brachial-ankle pulse wave velocity (baPWV) and the cardio-ankle vascular index (CAVI) are both used to evaluate arterial stiffness. The aim of the present study is to determine whether baPWV or CAVI is superior as a marker of arterial stiffness in hemodialysis (HD) patients. Of 194 patients, 59 patients had been excluded from the study due to advanced age over 76 years old (n = 29), or abnormal ankle-brachial pressure index (ABI) (<0.

Influence of the assay for measuring serum albumin on corrected total calcium in chronic hemodialysis patients.

The Japanese Society for Dialysis Therapy guideline for secondary hyperparathyroidism recommends the use of albumin-corrected serum Ca as a therapeutic target in chronic hemodialysis patients; however, the assay used for albumin measurement may affect the corrected Ca level. In this study, we examined the impact of the albumin assay on corrected Ca levels in hemodialysis patients. We measured serum albumin using bromocresol green (BCG) and modified bromocresol purple (BCP) assays, and corrected Ca for albumin using Payne's formula in 422 hemodialysis patients (age 66±13 years; time on hemodialysis 116±111 months).

Association of abdominal visceral adiposity and thigh sarcopenia with changes of arteriosclerosis in haemodialysis patients.

Background: In haemodialysis (HD) patients, abdominal visceral fat is accumulated while lean body mass is decreased irrespective of their body mass indexes (BMI). However, it is poorly understood which changes of fat and muscle masses are more associated with changes of arteriosclerosis. We aimed at examining the associations of abdominal visceral fat and thigh muscle masses with markers of arteriosclerosis in chronic HD patients in a cross-sectional fashion.

Relationship between an increased serum kynurenine/tryptophan ratio and atherosclerotic parameters in hemodialysis patients.

Essential amino acid tryptophan (Trp) is mainly catabolized by indoleamine 2,3-dioxygenase, which leads to the formation of kynurenine (Kyn). In this study, we reexamined whether an increased indoleamine 2,3-dioxygenase activity, as estimated by the Kyn/Trp ratio (μM/mM), is associated with atherosclerotic parameters in hemodialysis (HD) patients. Serum Trp and Kyn were measured in 243 HD patients by liquid chromatography/electrospray ionization tandem mass spectrometry.

Comparison of serum albumin, C-reactive protein and carotid atherosclerosis as predictors of 10-year mortality in hemodialysis patients.

Serum albumin, C-reactive protein (CRP), and the intima-medial thickness of the common carotid artery (CA-IMT) are associated with clinical outcomes in hemodialysis (HD) patients. However, it remains unclear which parameters are more reliable as predictors of long-term mortality. We measured serum albumin, CRP, and CA-IMT in 206 HD patients younger than 80 years old, and followed them for the next 10 years.

A small reduction in the ankle-brachial index is associated with increased mortality in patients on chronic hemodialysis.

Background: High pulse wave velocity (PWV) and a low ankle-brachial index (ABI) are associated with mortality in hemodialysis (HD) patients. Recently, the cardio-ankle vascular index (CAVI) was developed as a novel index of arterial stiffness independent of blood pressure.

Methods: We compared brachial-ankle PWV (baPWV), the ABI and the CAVI as predictors of mortality in 194 HD patients (age 64 +/- 12 years; time on HD 111 +/- 96 months) during a follow-up period of 39 +/- 4 months (range 31-46).

Blood monocyte count is a predictor of total and cardiovascular mortality in hemodialysis patients.

An increase in white blood cell (WBC) count is an independent predictor of mortality in hemodialysis (HD) patients. However, few studies have assessed the association of specific WBC subtypes with mortality. We prospectively studied the predictive value of WBC subtypes for total and cardiovascular death in 333 HD patients (age 63 +/- 12 years; HD duration 129 +/- 109 months) during a 40-month of follow-up.

Association of homocysteine and asymmetric dimethylarginine with atherosclerosis and cardiovascular events in maintenance hemodialysis patients.

Background: Homocysteine (Hcy) and asymmetric dimethylarginine (ADMA) recently were recognized as potential risk factors for atherosclerosis in the general population, and the metabolism of each of these substances seems to be closely related. This study investigates the association between these substances and whether elevated serum Hcy and ADMA levels are related to high risk for atherosclerosis and cardiovascular events in maintenance hemodialysis (HD) patients.

Methods: A study was made of 197 HD patients (132 men, 65 women; mean age, 56.

Association between seroprevalence of anti-chlamydial antibodies and long-term cardiovascular mortality in chronic hemodialysis patients.

Chlamydial infection has been suspected in the pathogenesis of ischemic heart disease. However, it remains undetermined if persistent chlamydial infection is related to cardiovascular mortality in regular hemodialysis (HD) patients. We measured Chlamydia pneumoniae (Cp) antibody seropositivity in 154 HD subjects (age 59 +/- 11 years, time on HD 13 +/- 7 years, male/female = 101/53), and prospectively examined an association between Cp antibody status and cardiovascular death for 56 months of follow-up.

Pro-oxidative effect of alpha-tocopherol in the oxidation of LDL isolated from co-antioxidant-depleted non-diabetic hemodialysis patients.

The association between the antioxidants in LDL and the oxidizability of LDL assessed by the oxidation lag time during copper ion-catalyzed oxidation was investigated in 69 non-diabetic hemodialysis patients and 23 healthy volunteers. The concentrations of co-antioxidants, including ubiquinol-10, lycopene and beta-carotene, in LDL were significantly lower in the hemodialysis patients than in the healthy volunteers, while there was no difference in the alpha-tocopherol concentration between the groups. The lag time showed a significantly positive correlation with the alpha-tocopherol level (r = 0.

Chlamydial infection and progression of carotid atherosclerosis in patients on regular haemodialysis.

Background: Recent findings have suggested a possible contribution of chlamydial infection to the pathogenesis of atherosclerosis in the general population. However, the role that chlamydial antibody status plays in atherosclerosis generation in haemodialysis (HD) patients remains uncertain.

Methods: We measured carotid artery intima medial thickness (IMT) over 4 years in 100 HD subjects (age: 58+/-10 years; time on HD: 13+/-7 years; male/female: 67/33) and examined potential associations between Chlamydia pneumoniae (Cp) antibody seropositivity and changes in carotid artery IMT.

Impact of serum parathyroid hormone concentration and its regulatory factors on arterial stiffness in patients undergoing maintenance hemodialysis.

Background: Cardiovascular mortality is extremely high in patients on hemodialysis. Among a variety of pathophysiological conditions, deranged calcium homeostasis including secondary hyperparathyroidism may be one of the factors contributing to cardiovascular disease in patients on hemodialysis. This study was designed to evaluate the role of the serum parathyroid hormone (PTH) concentration and its regulatory factors in serum on arterial stiffness in patients on maintenance hemodialysis.

Impact of carotid atherosclerosis on long-term mortality in chronic hemodialysis patients.

Background: Cardiovascular event is the major cause of mortality in patients on maintenance hemodialysis. We prospectively tested the predictive values of atherosclerotic parameters for all-cause and cardiovascular outcomes in 219 hemodialysis patients (age, 58 +/- 13 years; time on hemodialysis, 13 +/- 7 years; male/female, 144/75).

Methods: We measured blood homocysteine (Hcy), ultrasound carotid artery intima media thickness (IMT) and % aortic wall calcification at L2/3 region [% of calcification index in the abdominal aortic wall (%ACI)] by computed tomography (CT) scan, and followed all patients for 5 years.

Role of soluble receptors for tumor necrosis factor alpha in the development of hypoalbuminemia in hemodialysis patients.

Background: Hypoalbuminemia is a significant predictor of mortality in patients on hemodialysis (HD). The cause of hypoalbuminemia in HD patients, however, remains to be clarified. Recent studies have demonstrated that high blood concentrations of soluble receptors for tumor necrosis factor (sTNFRs) are associated with malnutrition in a variety of diseases and that the blood sTNFRs concentrations are elevated in HD patients.

Association between interleukin-6 and carotid atherosclerosis in hemodialysis patients.

Background: Interleukin-6 (IL-6) is associated with cardiovascular complications in general subjects. Although blood IL-6 is greatly elevated in hemodialysis (HD) patients, the role of IL-6 in the advance of atherosclerosis remains to be determined.

Methods: We conducted a cross-sectional study to investigate the relationship between circulating IL-6 and carotid atherosclerotic changes in 156 HD patients (age 58 +/- 1 years; time on HD treatment 13 +/- 1 years; 97 males and 59 females).