Impact of a change in vascular access flow volume after percutaneous transluminal angioplasty on cardiac function.

Vascular access (VA) is necessary for patients on hemodialysis, and percutaneous transluminal angioplasty (PTA) is a useful treatment for maintaining VA function. PTA immediately increases the VA flow volume, which can affect cardiac function. We investigated the relationship between changes in VA flow volume and cardiac function in patients who underwent PTA.

Features of high flow access in the elderly.

Introduction: The number of elderly hemodialysis patients continues to grow. The aim of this study was to investigate differences in elderly high flow access patients compared with middle-aged and young patients.

Methods: We performed a retrospective study to determine the characteristics of elderly patients (aged >60 years) following blood flow suppression procedures.

Outcomes of blood flow suppression methods of treating high flow access in hemodialysis patients with arteriovenous fistula.

Purpose: A high flow access (HFA) may cause heart failure in patients with an arteriovenous fistula (AVF) undergoing hemodialysis (HD) and is associated with poor prognosis. There are a variety of blood flow suppression techniques for treating HFA; however, the therapeutic outcome is still unclear.

Methods: The following three different blood flow suppression methods were performed on 74 patients with HFA: proximal artery banding with distal artery ligation (A-ban with A-lig: 12 cases); shunt vein banding (V-ban: 37 cases); and anastoplasty (Ana: 25 cases).

Serum sulfatide abnormality is associated with increased oxidative stress in hemodialysis patients.

Sulfatides are major glycosphingolipids of lipoproteins that influence atherosclerosis and blood coagulation. Our previous cross-sectional study of hemodialysis patients showed that serum sulfatide levels decreased markedly with increasing duration of hemodialysis treatment, which may contribute to the development of cardiovascular disease. However, this past study could not demonstrate the time-dependent change in serum sulfatide levels in each patient, and the underlying mechanism is unknown.

Survey of the effects of a column for adsorption of β2-microglobulin in patients with dialysis-related amyloidosis in Japan.

Dialysis-related amyloidosis is a serious complication of long-term hemodialysis. Its pathogenic mechanism involves accumulation of β2-microglobulin in the blood, which then forms amyloid fibrils and is deposited in tissues, leading to inflammation and activation of osteoclasts. Lixelle, a direct hemoperfusion column for adsorption of β2-microglobulin, has been available since 1996 to treat dialysis-related amyloidosis in Japan.

[Estimation of glomerular filtration rate by inulin clearance: comparison with creatinine clearance].

Inulin clearance (Cin) is widely believed to be the gold standard of the glomerular filtration rate (GFR). However, in Japan, Cin has not been officially recognized by the Ministry of Health, Labour and Welfare of Japan for clinical use. Creatinine clearance (Ccr) has been used to estimate the renal function of patients, but there have been many studies in which Ccr estimates were GFR falsely high because the metabolism and tubular excretion of creatinine widely varied according to the pathophysiological state of the patient.