Kidney Dialysis
From MedicalXpress
For asymptomatic adults with chronic kidney disease who will need dialysis, an intent-to-defer approach is recommended over an earlier start, according to a new guideline from the Canadian Society of Nephrology published in CMAJ (Canadian Medical Association Journal).
The guideline panel recommends an "intent-to-defer" strategy over an "intent-to-start" early approach, in which patients with an estimated glomerular filtration rate (eGFR) below 15 mL/ min per 1.73 m2 are closely monitored by a nephrologist. Dialysis is initiated when clinical indications emerge or the eGFR is 6 mL/min per 1.73 m2 or less, whichever of these occurs first.
The recommendation is based on evidence from 23 studies, including the Initiating Dialysis Early and Late (IDEAL) study, a large recent clinical trial that looked at survival rates, costs and other factors in early versus deferred start of dialysis. The study also found that there were substantially higher costs per patient with early initiation of dialysis.
"There was no detectable evidence of benefit with intent-to-start-early as compared with intent-to-defer dialysis for mortality, quality of life or hospital admission in either the RCT or the observational studies," writes Dr. Louise Moist, guideline chair, professor of medicine and epidemiology at the Schulich School of Medicine & Dentistry at Western University and a scientist with the Lawson Health Research Institute, London, Ontario. "Time on dialysis and associated resource use were significantly greater in the intent-to-start-early group. For an asymptomatic patient, an intent-to-defer approach avoids the burden and inconvenience of an early start."
Chronic kidney disease impairs patients' quality of life, and dialysis places substantial burdens on both the patient and the health care system. "This later start of dialysis will place less burden on [patients and their families] as it can delay the start of dialysis in asymptomatic patients for approximately six months," states Dr. Moist. [Read more]
From MarketWatch.com, News Release
Nipro Medical Corporation Introduces State-of-the-Art ELISIO(TM) Polynephron(TM) Dialyzer
MIAMI, FL, Feb 06, 2014 (Marketwired via COMTEX) -- Nipro Medical Corporation, a subsidiary for North & South America Sales and Marketing of Nipro Corporation in Japan, a world leader in dialyzer design and manufacturing, today announced the introduction of the ELISIO(TM) Polynephron(TM) Single Use, High-Flux, Hollow-Fiber Dialyzer. The ELISIO(TM) features a state-of-the-art Polynephron(TM) membrane similar in function to that of a human kidney delivering outstanding biocompatibility, hemocompatibility, and solute-removal performance, resulting in superior clearances for better patient outcomes. The ELISIO(TM) Polynephron Dialyzer has received 510(K) clearance from the U.S. Food and Drug Administration (FDA). The product is designed for the renal market, targeting those involved in care and procedures for kidney disease and dialysis.
"Nipro dialyzers have been the preferred product for dialysis around the globe for the past 30 years," said Joe Dawson, Senior Vice President, Nipro North America. "The introduction of the ELISIO(TM) dialyzer builds on our strategy of becoming a complete and cost-effective dialysis solutions leader, offering blood tubing lines, fistulas needles, and now dialyzers to our dialysis market partners in the U.S. market. ELISIO(TM) is designed to deliver an elevated benefits platform to the market, especially in clearance performance of small to middle molecules, and it delivers on these objectives."
The sophisticated ELISIO(TM) membrane provides thousands of fibers where each fiber acts like a nephron -- the functional unit of the kidney, responsible for the actual purification and filtration of the blood. A 3D chemical structure affords an ideal mixture of hydrophilic and hydrophobic domains, while reducing membrane fouling and maximizing membrane performance. [Read more]
From Canton Rep, Canton, Ohio by Jim Hillibish
Editor's note: Black History Month is a time for schools, churches and the media to remember the contributions of African-Americans in all walks of life. People without a history are never whole. Many of the stories are often told but worth repeating. This is a story about an African-American woman known dearly to a small community of people at a frightful time of their lives. She convinced them that every day is a gift of light.
Part of the orientation of new patients starting kidney dialysis was to sit a spell with Veronica Thomas, a living legend (but never call her that to her face) at Aultman Hospital. We needed her, desperately.
"She was our first patient. She was here for so long, it was 'been there, done that' when she talked to our new patients. If something went wrong, she always understood," said Kathy Sirean, receptionist at the Dialysis Center.
Veronica was Aultman's first and longest-living kidney dialysis patient. Her 32-year career (we view dialysis as a job) on the blood-cleansing machines spanned much of the modern history of this life-giving treatment. Veronica was the pathfinder for thousands of patients to come. Even though she passed nearly a decade ago, my memory of her hasn't faded. [Read more]
Gift of Life
From Donaldsonville Chief, Donaldsonville, LA, by DERON TALLEY, EDITOR
In 1999 Tamiko Garrison found out she had a polycystic kidney disease that was hereditary from her father who had a transplant that year. She only found out when she tried to donate her kidney to save her father’s life. At that moment she knew at some point in her life she’d be asking for a donor. The time came in 2012 when she got sick. She went to her nephrologists in January of 2013 and she learned it was time for dialysis. After a couple of procedures in March, she began dialysis at home – also known as peritoneal. She was put on a transplant list in June. While waiting, from August to Jan. 21, 2014, Garrison did dialysis five times a day – until her hero arrived. Doctors found a kidney match, a perfect match.
“I kind of put the word out to my family, but some of them couldn’t do it because they had medical issues,” Garrison said, who works as the Executive Director of AMIKids in Baton Rouge. “So I had two potential donors that were a perfect match: my brother and another lady in Baton Rouge who decided that she was going to do it.”
Doctors pick the best match for organ donations, which is usually a family member. Garrison’s younger brother, Bernard Francis, Jr., was selected to be the donor to save Garrison’s life.
After Francis passed all the tests and doctors cleared him, it was only a matter of time to pick a date and time to go to Tulane Medical Center to have the surgery.
Francis, who works as the District Manager for Assumption Waterworks, declined to comment on the story, he didn’t want the publicity.
“That’s not why I wanted to do this, it was done out of love and for nothing else,” Francis said.
Garrison said having her younger brother save her life is good and bad.
“You don’t want anybody you know to suffer because if he’s feeling what I’m feeling right now, oh Lord,” Garrison said. “But I’m glad he did. I’m happy that he did it because it’s a better match having a family member.”
“If I could’ve chose I wouldn’t have chose him because I don’t want to see him suffer but I’m glad he did.”
“Needless to say, no more dialysis, thank you Jesus because that was a pain in the butt,” Garrison said at home resting after the procedure. [Read more]
PKD News
From PKD Foundation of Canada
Upcoming Webinar: Straight Talk About Transplantation
What happens when you are told you need a kidney transplant? Melissa Blevins, RN, MS, will walk us through the process beginning when your physician tells you it is time to consider a kidney transplant. Learn more about what to look for in a transplant centre, the medical professional team that will be answering your questions and helping you navigate the process, tests and evaluations required for transplant recipients and living donors, transplant costs, insurance coverage and much more. Transplant recipients will also share their experience and an expert panel will answer questions following the presentation.
PKD Health Notes
We all know drinking water is good for us, but are flavored waters just as good as plain water? Are they better in some cases? This month in PKD Health Notes, Renal Dietician Kelly Welsh helps us to understand what to watch out for when getting our daily water intake. [Read more]
No comments:
Post a Comment