TUESDAY, March 1 (HealthDay News) -- The incidence of central line-associated blood stream infections (CLABSIs) in intensive care units (ICUs) has decreased by more than half since 2001, but the infections continue to occur in substantial numbers in inpatient wards and outpatient hemodialysis centers, according to research published in the March 1 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
Arjun Srinivasan, M.D., of the CDC in Atlanta, and colleagues multiplied central-line utilization and CLABSI rates by the total number of patient-days in ICUs, inpatient wards, and outpatient hemodialysis facilities to estimate the number of CLABSIs in each setting.
In ICU patients, the number of CLABSIs fell dramatically from an estimated 43,000 in 2001 to 18,000 in 2009. The researchers note that reductions in CLABSIs due to Staphylococcus aureus were more pronounced than declines in infections caused by gram-negative rods, Candida spp., and Enterococcus spp. Numbers for inpatient wards in 2009 and outpatient hemodialysis in 2008 remained fairly high, at 23,000 and 37,000, respectively. According to the report, the reduction in CLABSIs in ICUs represents as many as 6,000 lives saved and $414 million in potential excess health care costs in 2009 as well as approximately $1.8 billion in cumulative excess health care costs since 2001.
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Showing posts with label Dialysis Updates. Show all posts
Showing posts with label Dialysis Updates. Show all posts
Friday, March 11, 2011
Sunday, March 6, 2011
Cheaper peritoneal dialysis as safe as hemodialysis, research says
By Mary Ann Roser | Thursday, March 3, 2011, 02:33 PM
New research says that less costly peritoneal dialysis causes no more infections than hemodialysis and is much easier on the body.
The study, done by the University of Texas Southwestern Medical Center at Dallas, found no increased risk of catheter infections and greater flexibility for patients on peritoneal dialysis.
Peritoneal dialysis involves inserting a catheter, or tube, into the abdomen to sweep away wastes produced by the kidneys. It can be done at home, while the person sleeps. In hemodialysis, which is done at a dialysis center, the waste products are filtered from the blood and the cleansed blood is returned to the body. The catheter is placed in the person’s arm.
“Patients actually survive better on peritoneal dialysis, have a better quality of life and the procedure is cheaper,” Dr. Ramesh Saxena, at right, an associate professor of internal medicine at UT Southwestern and a senior author of the study, said in a news release on the school’s website. “Factors such as obesity, age and previous abdominal surgeries should not be considered as barriers in selecting patients for peritoneal dialysis.”
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New research says that less costly peritoneal dialysis causes no more infections than hemodialysis and is much easier on the body.
The study, done by the University of Texas Southwestern Medical Center at Dallas, found no increased risk of catheter infections and greater flexibility for patients on peritoneal dialysis.
Peritoneal dialysis involves inserting a catheter, or tube, into the abdomen to sweep away wastes produced by the kidneys. It can be done at home, while the person sleeps. In hemodialysis, which is done at a dialysis center, the waste products are filtered from the blood and the cleansed blood is returned to the body. The catheter is placed in the person’s arm.
“Patients actually survive better on peritoneal dialysis, have a better quality of life and the procedure is cheaper,” Dr. Ramesh Saxena, at right, an associate professor of internal medicine at UT Southwestern and a senior author of the study, said in a news release on the school’s website. “Factors such as obesity, age and previous abdominal surgeries should not be considered as barriers in selecting patients for peritoneal dialysis.”
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Hemodialysis should be made affordable, say doctors
New Delhi, March 4 (IANS) Doctors attending the fourth Congress of the International Society for Hemodialysis here opined that Hemodialysis, a method to remove waste from blood when the kidneys fail to filter toxins, should be made affordable for the poor.
The three-day event that commenced Thursday is being held in collaboration with the Indian Society for Hemodialysis. Former president A.P.J. Abdul Kalam was the special guest at the inaugural ceremony.
A patient needs to shell out around Rs.25,000 per month for Hemodialysis treatment.
'Hemodialysis is an expensive treatment and can cost anywhere between Rs.600 to Rs.3,000 per sitting. Despite their exponential growth over the years, it has not benefitted the poor as around 90 percent of these treatment centres are confined to the private sector,' said D.S. Rana, secretary, Indian Society of Hemodialysis.
Madhukar Misra, president of International Society for Hemodialysis, said: 'Two decades ago, there were half a million patients on dialysis but today the number has increased to more than two million. Sadly, not enough steps have been taken to curtail this hike.'
The doctors also advised people to lead a healthy lifestyle to avoid diseases which may lead to kidney failure.
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The three-day event that commenced Thursday is being held in collaboration with the Indian Society for Hemodialysis. Former president A.P.J. Abdul Kalam was the special guest at the inaugural ceremony.
A patient needs to shell out around Rs.25,000 per month for Hemodialysis treatment.
'Hemodialysis is an expensive treatment and can cost anywhere between Rs.600 to Rs.3,000 per sitting. Despite their exponential growth over the years, it has not benefitted the poor as around 90 percent of these treatment centres are confined to the private sector,' said D.S. Rana, secretary, Indian Society of Hemodialysis.
Madhukar Misra, president of International Society for Hemodialysis, said: 'Two decades ago, there were half a million patients on dialysis but today the number has increased to more than two million. Sadly, not enough steps have been taken to curtail this hike.'
The doctors also advised people to lead a healthy lifestyle to avoid diseases which may lead to kidney failure.
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Sunday, September 19, 2010
Relationship between Hypertension and Kidney Failure: High Blood Pressure and Kidney Disease
High blood pressure is a major cause of kidney disease and kidney failure (end-stage renal disease). Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult
Definition
Renal failure (kidney failure) is caused primarily by chronic high blood pressure (hypertension) over many years. Hypertension is the second major cause, after diabetes, of end stage renal disease (ESRD) and is responsible for 25–30% of all reported cases. In addition, many people with diabetes also have hypertension, thus high blood pressure plays an even larger role in kidney failure.
Description
About 398,000 people were diagnosed with end-stage renal disease in 1998. Of these, about 83,000 had hypertension and about 133,000 had diabetes. That same year, approximately 63,000 people with ESRD passed away. Most people with ESRD have had symptoms for a long time and may have had kidney disease (nephropathy) for as many as 20 years or more prior to experiencing kidney failure.
Genetic profile
It is believed that most cases of hypertension leading to kidney failure have a genetic element. Finding a genetic link is complicated by the fact that nearly half of all people with renal failure have three or more serious disorders, such as diabetes. Animal studies have been done to find genetic linkages to hypertension and kidney failure, but genetic studies on humans are in their infancy. A recent breakthrough came in a study of African American subjects with hypertensive end-stage renal disease. Researchers found a significant association between severe hypertension and mutations on the HSD11B2 gene. This is a gene that plays a role in sodium retention and related factors. Their data suggested that the 16q22.1 chromosome region was the location of the mutation.
In another study, researchers studied an Israeli family of Iraqi-Jewish origin whose members suffered from hypertension and renal failure. The researchers found a genetic locus at 1q21 that was autosomal dominant. They also hypothesized that the gene encoding atrial natriutetic peptide receptor-1 (NPR1) was the disease gene that led to the hypertension/renal failure.
Other families with high rates of hypertension have also been studied. For example, researchers observed a family of Old Order Amish in Lancaster, Pennsylvania and found a genetic link for hypertension to chromosome 2q31-34. The subjects were not experiencing kidney failure, thus, further study would be needed to determine if the identified genetic locus also coded for ESRD.
What Are the Symptoms of Kidney Disease?
The symptoms of kidney disease include:
As with high blood pressure, you may not realize that you have kidney disease. Certain laboratory tests can indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and blood urea nitrogen (BUN); elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.
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| Image Source: intelihealth.com |
Definition
Renal failure (kidney failure) is caused primarily by chronic high blood pressure (hypertension) over many years. Hypertension is the second major cause, after diabetes, of end stage renal disease (ESRD) and is responsible for 25–30% of all reported cases. In addition, many people with diabetes also have hypertension, thus high blood pressure plays an even larger role in kidney failure.
Description
About 398,000 people were diagnosed with end-stage renal disease in 1998. Of these, about 83,000 had hypertension and about 133,000 had diabetes. That same year, approximately 63,000 people with ESRD passed away. Most people with ESRD have had symptoms for a long time and may have had kidney disease (nephropathy) for as many as 20 years or more prior to experiencing kidney failure.
Genetic profile
It is believed that most cases of hypertension leading to kidney failure have a genetic element. Finding a genetic link is complicated by the fact that nearly half of all people with renal failure have three or more serious disorders, such as diabetes. Animal studies have been done to find genetic linkages to hypertension and kidney failure, but genetic studies on humans are in their infancy. A recent breakthrough came in a study of African American subjects with hypertensive end-stage renal disease. Researchers found a significant association between severe hypertension and mutations on the HSD11B2 gene. This is a gene that plays a role in sodium retention and related factors. Their data suggested that the 16q22.1 chromosome region was the location of the mutation.
In another study, researchers studied an Israeli family of Iraqi-Jewish origin whose members suffered from hypertension and renal failure. The researchers found a genetic locus at 1q21 that was autosomal dominant. They also hypothesized that the gene encoding atrial natriutetic peptide receptor-1 (NPR1) was the disease gene that led to the hypertension/renal failure.
Other families with high rates of hypertension have also been studied. For example, researchers observed a family of Old Order Amish in Lancaster, Pennsylvania and found a genetic link for hypertension to chromosome 2q31-34. The subjects were not experiencing kidney failure, thus, further study would be needed to determine if the identified genetic locus also coded for ESRD.
What Are the Symptoms of Kidney Disease?
The symptoms of kidney disease include:
- High blood pressure.
- Decrease in amount of urine or difficulty urinating.
- Edema (fluid retention), especially in the lower legs.
- A need to urinate more often, especially at night.
As with high blood pressure, you may not realize that you have kidney disease. Certain laboratory tests can indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and blood urea nitrogen (BUN); elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.
READ MORE
Sunday, September 5, 2010
Patients Are Injured Due to Missed or Delayed Diagnosis Analysis Shows
Studies show that diagnostic errors cause twice as many adverse events as medication errors, but the subject has received little attention; Pennsylvania Patient Safety Authority reviews 100 events related to diagnostic error
HARRISBURG, Pa., Sept. 1 /PRNewswire-USNewswire/ -- Errors related to missed or delayed diagnosis are frequently a cause of patient injury and therefore an underlying cause of patient safety related events. Autopsy analysis spanning several decades show error rates at four to 50 percent, according to an article released today by the Pennsylvania Patient Safety Authority and published in its September Pennsylvania Patient Safety Advisory.
Diagnostic error is a diagnosis that is missed, incorrect, or delayed as detected by a subsequent definitive test or finding. Not all misdiagnosis results in harm and harm may be due to either disease or intervention.
Diagnostic errors are encountered in every specialty and are generally lowest (less than five percent) for certain specialties that rely on visual pattern recognition and interpretation (e.g., radiology, pathology, dermatology). Error rates in specialties that rely more on data gathering and the combination of different elements for a conclusive diagnosis are higher (10 to 15 percent).
"Diagnostic errors are often the first or second leading cause of medical malpractice claims in the United States," Dr. John Clarke, clinical director of the Pennsylvania Patient Safety Authority said. "They account for twice as many ongoing and settled claims as medication errors."
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HARRISBURG, Pa., Sept. 1 /PRNewswire-USNewswire/ -- Errors related to missed or delayed diagnosis are frequently a cause of patient injury and therefore an underlying cause of patient safety related events. Autopsy analysis spanning several decades show error rates at four to 50 percent, according to an article released today by the Pennsylvania Patient Safety Authority and published in its September Pennsylvania Patient Safety Advisory.
Diagnostic error is a diagnosis that is missed, incorrect, or delayed as detected by a subsequent definitive test or finding. Not all misdiagnosis results in harm and harm may be due to either disease or intervention.
Diagnostic errors are encountered in every specialty and are generally lowest (less than five percent) for certain specialties that rely on visual pattern recognition and interpretation (e.g., radiology, pathology, dermatology). Error rates in specialties that rely more on data gathering and the combination of different elements for a conclusive diagnosis are higher (10 to 15 percent).
"Diagnostic errors are often the first or second leading cause of medical malpractice claims in the United States," Dr. John Clarke, clinical director of the Pennsylvania Patient Safety Authority said. "They account for twice as many ongoing and settled claims as medication errors."
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Friday, September 3, 2010
Effect of hemodialysis and peritoneal dialysis on redox status in chronic renal failure patients: a comparative study
ObjectiveTo investigate the effects of hemodialysis (HD) and periotoneal dialysis (PD) on oxidative stress in chronic renal failure patients (CRF).
Methods: 20 HD patients and 20 PD patients were compared with 20 end stage renal failure patients (CRF).
Results: Thiobarbituric acid reactive substances (TBARS) values were elevated in HD and decreased in PD compared to CRF (P<0.05). TBARS-VLDL and TBARS-HDL2 were decreased in HD and PD, compared to CRF (p<0.05). TBARS-LDL were higher in HD compared to CRF (p<0.05). No significant difference in TBARS- HDL3 values between the three groups. Carbonyls were increased in HD (p<0.05) and PD (p<0.01) compared to CRF. Plasma superoxide dismutase activity (SOD) was decreased in HD compared to CRF and PD (P<0.05). Glutathion peroxidase activity (GSH-Px) was decreased in HD and PD (P<0.005), compared to CRF. Decrease in catalase activity was noted only in PD compared to CRF (P<0.05). An increase in nitric oxide was noted in HD compared to CRF (p<0.05). Albumin concentrations were higher in HD and PD compared to CRF (P<0.001). READ MORE
Methods: 20 HD patients and 20 PD patients were compared with 20 end stage renal failure patients (CRF).
Results: Thiobarbituric acid reactive substances (TBARS) values were elevated in HD and decreased in PD compared to CRF (P<0.05). TBARS-VLDL and TBARS-HDL2 were decreased in HD and PD, compared to CRF (p<0.05). TBARS-LDL were higher in HD compared to CRF (p<0.05). No significant difference in TBARS- HDL3 values between the three groups. Carbonyls were increased in HD (p<0.05) and PD (p<0.01) compared to CRF. Plasma superoxide dismutase activity (SOD) was decreased in HD compared to CRF and PD (P<0.05). Glutathion peroxidase activity (GSH-Px) was decreased in HD and PD (P<0.005), compared to CRF. Decrease in catalase activity was noted only in PD compared to CRF (P<0.05). An increase in nitric oxide was noted in HD compared to CRF (p<0.05). Albumin concentrations were higher in HD and PD compared to CRF (P<0.001). READ MORE
Tuesday, August 31, 2010
Redsense Alarm Ascertains Blood Leakage During Hemodialysis
The Redsense alarm, developed by the Veteran Affairs National Center for Patient Safety, will be used in Veteran Affairs' dialysis centers for monitoring blood leakage in the course of hemodialysis.
The Veteran Affairs National Center for Patient Safety had already monitored 47 bleeding cases from the year 2002 to 2010. A Redsense(R) Dialysis Alarm was installed on July 7, 2010, by the Veterans Affairs Central Office for patients subjected to needle access treatment methods (AL-1013).
By November 1, 2010, most of the VA centers will be utilizing the Redsense warning system outside the clinics, for all the patients under hemodialysis treatment. The outer areas cover ICUs or in-hospital wards where bedside treatment is provided and isolation rooms or side rooms in the hemodialysis chambers that do not permit direct view of the patients and the hemodialysis machine.
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The Veteran Affairs National Center for Patient Safety had already monitored 47 bleeding cases from the year 2002 to 2010. A Redsense(R) Dialysis Alarm was installed on July 7, 2010, by the Veterans Affairs Central Office for patients subjected to needle access treatment methods (AL-1013).
By November 1, 2010, most of the VA centers will be utilizing the Redsense warning system outside the clinics, for all the patients under hemodialysis treatment. The outer areas cover ICUs or in-hospital wards where bedside treatment is provided and isolation rooms or side rooms in the hemodialysis chambers that do not permit direct view of the patients and the hemodialysis machine.
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Daily Hemodialysis Improves Depression, Recovery Time
Posted in News, NxStage, Home Dialysis, Home Hemodialysis, National Kidney Foundation (NKF), American Journal Of Kidney Diseases (AJKD), Clinical & Pharma, Practice Management
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NEW YORK—Patients who transitioned from in-center to daily home dialysis regimens experienced significant improvements in depressive symptoms and post-dialysis recovery times, according to a new report published in the Sept. 1 American Journal of Kidney Diseases.
Patients who made the switch from the normal, thrice weekly in-center treatment regimen to a daily schedule, defined as six times per week, reported more than a 30 percent decline in depressive symptoms and an 87 percent drop in post-dialysis recovery time over a 12-month period.
The research team assessed 128 patients making the treatment regimen switch. Patients were assessed upon enrollment and then again four months and 12 months afterward. The average training period to complete the transition was 27 days
“Depression and post-dialysis fatigue are important concerns for patients with kidney failure,” said Kerry Willis, PhD, National Kidney Foundation’s senior vice president of Scientific Activities. “These findings suggest that increasing the number of times a patient dialyzes can improve their quality of life, which has been linked to fewer trips to the hospital and a lower mortality rate.”
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NEW YORK—Patients who transitioned from in-center to daily home dialysis regimens experienced significant improvements in depressive symptoms and post-dialysis recovery times, according to a new report published in the Sept. 1 American Journal of Kidney Diseases.
Patients who made the switch from the normal, thrice weekly in-center treatment regimen to a daily schedule, defined as six times per week, reported more than a 30 percent decline in depressive symptoms and an 87 percent drop in post-dialysis recovery time over a 12-month period.
The research team assessed 128 patients making the treatment regimen switch. Patients were assessed upon enrollment and then again four months and 12 months afterward. The average training period to complete the transition was 27 days
“Depression and post-dialysis fatigue are important concerns for patients with kidney failure,” said Kerry Willis, PhD, National Kidney Foundation’s senior vice president of Scientific Activities. “These findings suggest that increasing the number of times a patient dialyzes can improve their quality of life, which has been linked to fewer trips to the hospital and a lower mortality rate.”
READ MORE
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