The Effect of Increasing Blood Flow Rate on Severity of Uremic Pruritus in Hemodialysis Patients: A Single Clinical Trial

Aliasgharpour, Mansooreh; Zabolypour, Soheila; Haghani, Hamid; Lesanpezeshki, M

doi:10.1016/j.jnma.2017.04.008

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Various methods are used to increase dialysis adequacy to avoid the symptoms of uremic syndrome. A 25% increase in blood flow has been noted to be effective in increasing dialysis adequacy (Aliasgharpour et al, 2018). However, patients often experience negative effects during dialysis such as fatigue, dyspnea, restless leg, and nausea, although vascular access also needs to be considered (El-Sheikh & El-Ghazaly, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Intradialytic Range of Motion Exercise on Dialysis Adequacy and Fatigue in Hemodialysis Patients

Malini

Forwaty²,

Cleary

et al. 2022

Journal of Nursing Research

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Background: Many hemodialysis patients experience fatigue as a result of not achieving dialysis adequacy.Purpose: This study was designed to determine the effect of intradialytic range-of-motion exercises on dialysis adequacy and fatigue in patients undergoing hemodialysis.Methods: In this two-arm experimental study with repeated measures, participants were allocated to treatment (n = 25, 23 completed) and control (n = 25, 24 completed) groups using computerized simple random sampling. Participants in the treatment group performed 30-minute weekly intradialytic exercise sessions in addition to receiving standard care, whereas those in the control group received standard care only.Results: Fatigue and dialysis characteristics were reported at baseline, at the midpoint (end of Week 4), and at the end of Week 8. Whereas mean Kt/V (dialysis adequacy) and urea reduction ratio increased and the fatigue level decreased in the treatment group, these variables did not change in the control group. Significant mean differences in Kt/V, urea reduction ratio, and fatigue between the groups were observed at the end of Week 8.Conclusions: Intradialytic range-of-motion exercises are recommended for patients undergoing hemodialysis to increase dialysis adequacy and reduce fatigue.

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Section: Introductionmentioning

confidence: 99%

The Effect of Intradialytic Range of Motion Exercise on Dialysis Adequacy and Fatigue in Hemodialysis Patients

Malini

Forwaty²,

Cleary

et al. 2022

Journal of Nursing Research

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“…The BFR during HD is associated with dialysis adequacy; an increasing BFR will improve the removal of uremic toxins, such as urea and β2-microglobulin [ 24 ], thereby improving patient quality of life [ 25 ]. Moreover, an elevated BFR within the range of 200 to 300 mL/min was independently linked to a reduced risk of all-cause mortality, with a more pronounced effect observed in male and non-diabetic patients [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Time-Dependent Factors Influencing Cardiocerebral Vascular Events in Chronic Hemodialysis Patients: Insights from a Longitudinal Study

Zhong,

Zhang,

et al. 2023

Med Sci Monit

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Background Cardiocerebral vascular events (CVCs) are significant complications in patients undergoing hemodialysis (HD). Given the increased morbidity and mortality associated with CVCs in this population, understanding the factors influencing CVC occurrence over time is crucial. This study aimed to investigate these time-dependent factors in HD patients. Material/Methods A total of 228 HD patients from 2 dialysis centers, with at least 3 months of treatment between 2017 and 2021, were included. Annual clinical data were collected, and patients were monitored until CVC development. Kaplan-Meier analysis and a time-dependent Cox regression model were used for data analysis. Results The mean age of 228 patients was 55.0±15.0 years, and 64.76% were male. For 5 years of monitoring, the mean follow-up interval was 3.1±1.0 years for patients to develop CVCs. The 1-year, 3-year, and 5-year CVC-free rates were 97.47%, 81.31%, and 70.71%, respectively. Time-dependent Cox regression revealed that C-reactive protein was an independent time-dependent risk factor in HD patients and blood flow rate was an independent time-dependent protective factor. The male subgroup and non-diabetic subgroup had these same results. The following were was the independent time-dependent risk factors: white blood cell count for the female subgroup; blood flow rate for the non-elderly subgroup; and C-reactive protein for the diabetic subgroup. None were risk factors for the elderly subgroup. Conclusions It took an average of 3.1±1.0 years for patients with HD to develop CVCs. C-reactive protein and blood flow rate emerged as key time-dependent influencing factors for CVCs in this population.

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“…Two sessions before the intervention, the mean pump velocity was examined and was raised by 25 rounds per minute (rpm) in the first two weeks and 50 rpm in the final two weeks. The frequency of pruritus in the experimental group showed a significant difference after four weeks, while the severity of pruritus between two hemodialysis sessions showed earlier improvement at two weeks [56]. The study participants were matched on age and gender, but the differences in hemoglobin, calcium, CRP, and other biochemical markers were not mentioned.…”

Section: Dialysis Alterationmentioning

confidence: 99%

Chronic Kidney Disease-Associated Pruritus: A Glance at Novel and Lesser-Known Treatments

Elhag¹,

Rivas²,

Tejovath³

et al. 2022

Cureus

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Chronic kidney disease-associated pruritus (CKD-aP), also known as uremic pruritus, has been associated with increased mortality and lower quality of life among patients with chronic kidney disease (CKD). The relentless nature of the condition is mainly due to its diverse and complex etiologies, which are still being studied. Despite the introduction of many agents to treat it, the resolution rates of CKD-aP still remain unsatisfactory. This study sought to review the lesser-known/novel treatments and establish a relationship between their mechanism of action and the proposed etiologies implicated in CKD-aP. We also discuss the role of dialysis modification in managing CKD-aP.A decent proportion of the reviewed studies have proposed that the agents analyzed in them act through hampering inflammation. Interestingly, the results of two agents alluded to the role of dysbiosis in CKD-aP. The addition of hemoperfusion to the dialysis regimen of patients with CKD-aP improved the severity of their symptoms.The featured treatments could be tried in patients with intractable symptoms. However, additional research is needed to confirm the findings reported in these studies. A better understanding of the pathologic mechanisms is required to help guide the development of agents that can better treat CKD-aP.

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The Effect of Increasing Blood Flow Rate on Severity of Uremic Pruritus in Hemodialysis Patients: A Single Clinical Trial

Cited by 9 publications

References 11 publications

The Effect of Intradialytic Range of Motion Exercise on Dialysis Adequacy and Fatigue in Hemodialysis Patients

The Effect of Intradialytic Range of Motion Exercise on Dialysis Adequacy and Fatigue in Hemodialysis Patients

Time-Dependent Factors Influencing Cardiocerebral Vascular Events in Chronic Hemodialysis Patients: Insights from a Longitudinal Study

Chronic Kidney Disease-Associated Pruritus: A Glance at Novel and Lesser-Known Treatments

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