Publications by authors named "V Niyyar"
Article Synopsis
- The concept of "venous outflow stenosis" is better understood as "inflow-outflow imbalance," where the outflow capacity of arteriovenous (AV) access can't adequately handle the blood inflow volume (Qa) without increased pressure.
- This imbalance leads to higher outflow resistance and intraluminal pressure, causing various clinical issues that impact patient health.
- The authors suggest that assessing access flow is crucial for treatment planning, advocating for a dual treatment strategy of angioplasty for low or normal Qa cases and flow reduction for those with excessive Qa.
Background: Most patients starting chronic in-center hemodialysis (HD) receive conventional hemodialysis (CHD) with three sessions per week targeting specific biochemical clearance. Observational studies suggest that patients with residual kidney function can safely be treated with incremental prescriptions of HD, starting with less frequent sessions and later adjusting to thrice-weekly HD. This trial aims to show objectively that clinically matched incremental HD (CMIHD) is non-inferior to CHD in eligible patients.
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