A fixed protocol for outpatient clinic routines in the care of patients with severe renal failure

Hadimeri, Henrik; Frisenette‐Fich, Carsten; Deurell, S. I.; Svensson, Lars G.; Carlsson-Bjering, Lena; Fernström, Anders; Almroth, Gabriel; Melander, Stefan; Andersson, Per‐Olof; Cassel, Agneta; Mauritz, Nils-Johan; Ståhl-Nilsson, Agneta; Wilske, Jan; Nordström, Kataryna; Oruda, Pavel; Eriksson, Marie; Larsson, Annelie Inghilesi; Stegmayr, Bernd

doi:10.3109/0886022x.2013.794661

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…A recent study of HD patients performed in our region suggested that unknown factors affect the outcome in this category of patients . In a previous study, we compared the levels of inflammatory markers and growth factors in 84 haemodialysis (HD) patients with those in 68 healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Sclerostin, TNF‐alpha and Interleukin‐18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients

et al. 2015

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Patients with chronic renal failure are known to have renal osteodystrophy (bone disease) and increased calcification of vessels. A new marker of bone disease, sclerostin, the two pro-inflammatory cytokines tumour necrosis factor-alpha (TNF-alpha) and interleukin-18 (IL-18), and the fibroblast growth factor-23 (FGF-23) receptor-associated marker Klotho were tested in 84 haemodialysis (HD) patients and in healthy controls. The patients had significantly higher levels of the three former markers than of the controls while Klotho was significantly higher in the controls. Low level, but significant, correlations were observed in the patient group when the levels of these four markers were compared to each other and to those of 5 cytokines and growth factors tested earlier; high-sensitive CRP (hsCRP), interleukin-6 (IL-6), hepatocyte growth factor (HGF), fibroblast growth factor-23 (FGF-23) and soluble urokinase plasminogen activator (suPAR). Ln sclerostin correlated positively to Ln hsTNFalpha, Ln HGF and Ln suPAR. Ln hsTNF-alpha correlated positively to Ln sclerostin, Ln hsCRP, Ln IL-6, Ln FGF-23, Ln suPAR and Ln IL-18. Ln IL-18 correlated positively to Ln suPAR and Ln TNF-alpha. Ln Klotho correlated negatively to Ln hsCRP but did not correlate to Ln FGF-23. The markers studied here may be involved in the calcification of vessels seen in HD patients due to a combination of inflammation and bone disease. The mechanisms are still not fully known but may be of importance for future therapeutic possibilities in this group of patients.

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Section: Introductionmentioning

confidence: 99%

Sclerostin, TNF‐alpha and Interleukin‐18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients

et al. 2015

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“…The consequence is that many patients already suffer from severe cardiovascular disease when entering the HD program and, consequently, a worse outcome for them . During the period of progressive decline in renal function in outpatient clinics, approximately 30% of the patients die before they need to enter a dialysis program . Once entering the dialysis program, despite abnormal blood lipids, patients have no or limited benefit in overall survival using statins , treatment with cinacalcet , or hemodiafiltration , while calcium‐free phosphate binder may offer some benefit .…”

Section: Distribution Of Variables Based On Data From Various Studiesmentioning

confidence: 99%

Sources of Mortality on Dialysis with an Emphasis on Microemboli

Stegmayr

2016

Seminars in Dialysis

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Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, excessive interdialytic weight gain, high-flow arteriovenous fistulae, and impaired lipid break down by anticoagulation administered during HD. Another risk factor, not well appreciated, is the occurrence of microemboli of air (microbubbles) during HD. Such microemboli are not effectively removed by the venous air trap and the safety system provides no warning when these small microbubbles enter the venous bloodline of the extra corporeal circuit and then the venous circulation of the patient. Data indicate that the gas emboli are not fully adsorbed and become embedded by fibrin resulting in a combined clot that causes microemboli in the lung. In addition, these microbubbles (of the size of blood corpuscles) can pass the pulmonary circulation into the left heart and then into the general arterial circulation explaining their detection not only in the lungs but also in the brain and heart of patients. Risk factors for such microbubble appearance include the high blood pump speed associated with high-efficiency dialyses. This review will discuss these various issues in relation to the better outcome of patients in Japan and also how to reduce some of these risk factors.

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2013

Journal of Renal Nursing

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A fixed protocol for outpatient clinic routines in the care of patients with severe renal failure

Abstract: However, the time to renal replacement therapy was significantly shorter in the intervention group, indicating that other variables than guideline achievements are important for the patient.

Cited by 3 publications

References 29 publications

Sclerostin, TNF‐alpha and Interleukin‐18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients

Sclerostin, TNF‐alpha and Interleukin‐18 Correlate and are Together with Klotho Related to Other Growth Factors and Cytokines in Haemodialysis Patients

Sources of Mortality on Dialysis with an Emphasis on Microemboli

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