Supporting and maintaining the frail patient on long-term renal replacement therapy

Ryan, Louise; Brown, Edwina A.

doi:10.7861/clinmed.2019-0416

Cited by 5 publications

(6 citation statements)

References 20 publications

(21 reference statements)

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“…Diabetic nephropathy is a serious complication of diabetes, and is characterized by high incidence and poor prognosis, representing an important cause of death in patients with diabetes. 7 Diabetic nephropathy has become a major cause of end-stage renal disease. At the end stage of DN, patients often develop serious complications.…”

Section: Discussionmentioning

confidence: 99%

Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy

Xu¹,

Han²,

Yi³

et al. 2020

Pak J Med Sci

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Objective: Diabetic nephropathy is a serious threat to human health, and its incidence is on the rise. End-stage diabetic nephropathy (ESDN) requires extra investigation due to its complexity and severity, as well as serious concurrent diseases. Our objective was to compare the efficacy of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of ESDN. Methods: Clinical data of 84 patients with ESDN admitted to our hospital from June 2016 to June 2018 were retrospectively analyzed. The patients were divided into an HD group that received hemodialysis and a PD group that received peritoneal dialysis. Their general conditions, biochemical indicators, residual renal function and incidence of complications were recorded and compared between the two groups. Results: (1) No significant difference in diastolic blood pressure, systolic blood pressure, body weight, or urine output was detected between the two groups at the beginning of dialysis (P>0.05). (2) Compared to the PD group, the HD group had significantly lower total cholesterol (TC) and triglyceride (TG) (P<0.05), and significantly higher total protein (TP) and albumin (ALB) after treatment (P<0.05). (3) The two groups also showed significant difference in residual renal function after treatment (P<0.05). (4) The HD group had significantly higher systolic pressure than the PD group after treatment (P<0.05). And more cases of infection were observed in the PD group than the HD group (P<0.05). Conclusion: Both HD and PD are used for treatment of ESDN, and can achieve similar calcium and phosphorus control. Compared to HD, PD has less adverse effect on hemodynamics and better preserves residual renal function, but is more likely to cause malnutrition and disorders of lipid metabolism. Therefore, choice of dialysis method should be based on specific conditions of each patient. doi: https://doi.org/10.12669/pjms.36.7.2901 How to cite this:Xu XD, Han X, Yang Y, Li X. Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2901 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy

Xu¹,

Han²,

Yi³

et al. 2020

Pak J Med Sci

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“…A far as we know, it is of note that the number of frail patients reaching end-stage kidney disease is increasing [ 145 ]. In addition, frailty has been associated with an increased risk of CVD [ 27 , 150 ]. However, patients who reverse the frailty state also prevent the development of CVD [ 144 ].…”

Section: Unraveling Underlying Mechanisms: Therapeutical Approachesmentioning

confidence: 99%

Exploring New Kingdoms: The Role of Extracellular Vesicles in Oxi-Inflamm-Aging Related to Cardiorenal Syndrome

et al. 2021

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The incidence of age associated chronic diseases has increased in recent years. Although several diverse causes produce these phenomena, abundant evidence shows that oxidative stress plays a central role. In recent years, numerous studies have focused on elucidating the role of oxidative stress in the development and progression of both aging and chronic diseases, opening the door to the discovery of new underlying mechanisms and signaling pathways. Among them, senolytics and senomorphics, and extracellular vesicles offer new therapeutic strategies to slow the development of aging and its associated chronic diseases by decreasing oxidative stress. In this review, we aim to discuss the role of extracellular vesicles in human cardiorenal syndrome development and their possible role as biomarkers, targets, or vehicles of drugs to treat this syndrome.

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“…The survival of patients undergoing hemodialysis has been improved by advances in hemodialysis therapy, standard expert practice, and affordable national healthcare support [ 1 ]. However, hemodialysis patients still experience physical and psychosocial burdens from living with chronic kidney disease [ 2 ]. Despite the life-saving benefits of adequate dialysis, the uremic milieu continues to impair bodily functions and structures, leading to exercise intolerance, impaired mobility, and disability among hemodialysis patients [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, it does have the drawbacks of adding to the workload of dialysis care providers, and its adoption into routine care has been slow [ 4 , 6 , 7 ]. The coexistence of frailty and dialysis markedly aggravates functional declines and health in all age groups [ 2 ]. Low physical activity contributes directly and indirectly to the development of frailty, and increased physical activity can prevent or reverse frailty, a non-permanent progressive condition that reflects physical performance and QoL [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Despite the life-saving benefits of adequate dialysis, the uremic milieu continues to impair bodily functions and structures, leading to exercise intolerance, impaired mobility, and disability among hemodialysis patients [3]. Those burdens predispose hemodialysis patients to adverse behaviors, such as a lack of motivation, sedentary lifestyle, and reduced physical activity, which can translate into frailty, which is known to affect approximately one-half of hemodialysis patients [2][3][4]. Frailty is a geriatric syndrome characterized as a multidimensional construct (slow gait speed, muscle weakness, exhaustion, weight loss, and low physical activity) [5].…”

Section: Introductionmentioning

confidence: 99%

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An intradialytic aerobic exercise program ameliorates frailty and improves dialysis adequacy and quality of life among hemodialysis patients: a randomized controlled trial

Kim

Park

Yang

2022

Kidney Res Clin Pract

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Background: Hemodialysis patients with chronic kidney disease exhibit impaired exercise tolerance and functional decline. Despite the life-saving benefits of adequate dialysis, those declines translate into frailty and deteriorating quality of life (QoL). This study evaluated the effects of an intradialytic aerobic exercise program on frailty, dialysis adequacy, and QoL among hemodialysis patients. Methods: Patients at an university hospital-affiliated hemodialysis center were randomly assigned to an exercise group (n = 18) or a control group (n = 21). The 12-week aerobic exercise program comprised 40 to 70 minutes of ergometer cycling 3 times/wk and a single education session. The control group completed only the education session. Outcomes were assessed at the time of enrollment, week 4, week 8, and week 12 using Fried’s frailty phenotype measures (gait speed, grip strength, vitality, body mass index, and physical activity), the short physical performance battery (SPPB), Kt/V urea, and the Short Form-36 questionnaire. Results: There were significant interactions between groups and follow-up times in the frailty score (p < 0.001), gait speed (p < 0.001), SPPB (p < 0.001), and mental QoL (p = 0.03). The intention-to-treat and per-protocol analyses revealed that the exercise group exhibited significant improvements in frailty score (p < 0.001), gait speed (p < 0.001), grip strength (p < 0.001), exhaustion (p = 0.02), SPPB (p = 0.01), dialysis adequacy (p = 0.01), and physical QoL (p = 0.003). Conclusion: An intradialytic aerobic exercise program could be a safe, feasible, and appropriate additional strategy to routine care among hemodialysis patients for improvements in frailty, dialysis adequacy, and QoL.

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Supporting and maintaining the frail patient on long-term renal replacement therapy

Cited by 5 publications

References 20 publications

Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy

Comparative study on the efficacy of peritoneal dialysis and hemodialysis in patients with end-stage diabetic nephropathy

Exploring New Kingdoms: The Role of Extracellular Vesicles in Oxi-Inflamm-Aging Related to Cardiorenal Syndrome

An intradialytic aerobic exercise program ameliorates frailty and improves dialysis adequacy and quality of life among hemodialysis patients: a randomized controlled trial

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