Maintenance hemodialysis patients suffer from multiple comorbidities and treatment-related complications. A personalized approach to hemodialysis prescription could reduce some of these burdens by preventing complications such as excessive changes in blood pressure, arrhythmias, post-dialysis fatigue and decreased quality of life. A patient-centered approach to dialysate electrolyte concentrations represents one such opportunity. In addition to modifications in dialysate electrolyte concentrations, consideration of individual factors such as patients' serum concentrations, medication profiles, nutritional status and comorbidities is critical to tailoring hemodialysis prescriptions to optimize patient outcomes. The development of personalized dialysis treatment depends on the collection of comprehensive patient data, advances in technology, resource allocation and patient involvement in decision-making. This review discusses how the treatment of maintenance hemodialysis patients could benefit from individualized changes in certain dialysis fluid components.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10768751 | PMC |
http://dx.doi.org/10.1093/ckj/sfad210 | DOI Listing |
Clin Ther
January 2025
Pharmacy Department, Alice Springs Hospital, Alice Springs, Australia; Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Alice Springs, NT, Australia.
Purpose: To determine the incidence of therapeutic target attainment using a three-times per week protocol for vancomycin therapy given during the last hour of intermittent hemodialysis (HD).
Methods: A single-center retrospective cohort study was conducted of patient medical records in a remote dialysis center from January 2017 to July 2023. Adult patients with chronic kidney disease stage 5 on ≥3 months of intermittent HD who had received a course of vancomycin therapy with ≥1 serum vancomycin concentration recorded were included.
Indian J Nephrol
July 2024
Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
The simultaneous occurrence of vasculitic glomerulonephritis and membranous nephropathy is unusual. We report two cases that presented to our outpatient department with rapidly progressive renal failure. On evaluation, in one patient, anti-myeloperoxidase (MPO) titers were high, and renal biopsy was suggestive of concurrent necrotizing and diffuse crescentic anti-MPO anti-neutrophil cytoplasmic antigen-associated glomerulonephritis with the circumferential cellular crescent formation and membranous glomerulopathy.
View Article and Find Full Text PDFIndian J Nephrol
June 2024
Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Mansoura, Egypt.
Background: It has been claimed that tacrolimus may have harmful effects on the auditory system, where it has been linked to ototoxicity and sensorineural hearing loss (SNHL). We evaluated silent SNHL in kidney transplant recipients (KTRs) receiving tacrolimus and the different factors affecting it compared to healthy controls.
Materials And Methods: In this case control study, hearing functions were studied in 42 KTRs receiving tacrolimus as maintenance immunosuppressive therapy for more than 3 months in comparison to 27 age- and gender-matched healthy subjects using tympanometry, pure-tone audiometry (PTA), extended high frequency audiometry (EHFA), and transient evoked oto-acoustic emissions (TEOAEs).
Indian J Nephrol
July 2024
Department of Clinical Chemistry, Theodor Bilharz Research Institute, Giza, Egypt.
Background: The low-density lipoprotein receptor () is essential for regulating intracellular cholesterol levels. Mutations in the gene can cause a increase in LDL cholesterol levels in the blood, elevating the vulnerability to cardiovascular disease (CVD). This study evaluated the correlation between the rs688 polymorphism and CVD risk in chronic kidney disease (CKD).
View Article and Find Full Text PDFPLoS One
January 2025
Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Bursa, Turkey.
Background: End-stage renal disease (ESRD) patients frequently experience protein-energy wasting (PEW), which increases their morbidity and mortality rates.
Objective: This study explores the effects of nutritional status and pulmonary function on the short- and long-term mortality of ESRD patients undergoing hemodialysis.
Materials And Methods: 67 consecutive ESRD patients on maintenance hemodialysis were included in the study.
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