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Sensing Savvy

The Cardiovascular Effects of Arteriovenous Fistulas: A Cause for Concern?

Posted by Deborah Brouwer-Maier RN, CNN on Nov 16, 2016 6:30:00 AM

Jennifer MacRae and her colleagues from the University of Calgary, Calgary, Alberta, Canada, reviewed the hemodynamic and cardiovascular consequences of arteriovenous fistulas. Their findings were published in a 2006 paper in Seminars in Dialysis.

MacRae identified three periods when the presence of an AV fistula influences a patient's hemodynamics.

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Topics: Clinical Trends, Hemodialysis

High School Student Sparks Development of First Portable Dialysis Machine

Posted by Susan Eymann, MS on Nov 9, 2016 7:00:00 AM

The first hemodialysis machines at the University of Washington weighed about 1,000 pounds. They were bulky and could only treat one patient at a time. Using them cost about $10,000 annually.

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Topics: Hemodialysis

The Maytag and Nose-Cone Artificial Kidneys

Posted by Susan Eymann, MS on Nov 7, 2016 7:00:00 AM

During the early days of dialysis, in the 1960s, only a few patients could be treated, and even then at great cost. This was unacceptable to W.J. Kolff, the inventor of the first artificial kidney.

As head of the Department of Artificial Organs at the Cleveland Clinic, Kolff wanted to make dialysis so reasonable that anyone could afford it. In his biography, Inventor for Life, The Story of W.J. Kolff, Father of Artificial Organs, Herman Broers relates how Kolff went in search of a way to allow kidney patients to dialyze at home to relieve the pressure of limited beds in dialysis centers. In 1966, Kolff and his team arrived at a solution.

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Topics: Clinical Trends, Hemodialysis

Kidney Care News to Know for November

Posted by Deborah Brouwer-Maier RN, CNN on Nov 2, 2016 6:30:00 AM

Lower Mortality and Dialysis Patients

Researchers found a fistula attempt could be a “surrogate marker for a healthy patient who has had good care prior to starting dialysis,” while catheters were preferred for patients who had a short life expectancy, an acute kidney injury or poor blood vessels.

The researchers also discovered that excess mortality rates in dialysis patients with catheters do not appear to be due to access-related complications but rather the result of “residual confounding, unmeasured comorbidity, or treatment selection bias.”

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Topics: Hemodialysis

Scribner Shunt Ushers In New Era for End-stage Kidney Disease Treatment

Posted by Susan Eymann, MS on Oct 31, 2016 7:00:00 AM

Before 1960, end-stage kidney disease was always fatal. According to a University of Washington research study: “Use of the artificial kidney—or kidney dialysis—to cleanse the blood of toxic products meant that an artery and a vein were damaged every time the patient was hooked up to the machine. A patient could receive perhaps five to seven treatments before doctors would literally run out of places to connect the machine to the patient and the patient would ultimately succumb to the disease.”

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Topics: Hemodialysis

Causes of Sudden Death in Hemodialysis Patients

Posted by Susan Eymann, MS on Oct 26, 2016 6:30:00 AM

Up to one in four hemodialysis patients will die suddenly. These deaths occur most often during the 12 hours immediately following the hemodialysis session or toward the end of the long 72-hour weekend interval between dialysis sessions.

The causes of sudden death in hemodialysis patients are not known. Many patients do not seem to have the typical high-risk factors such as coronary artery disease and heart failure that are associated with sudden death (SCD) in the general population. Their sudden deaths may be related to symptoms associated with chronic kidney disease itself such as vascular calcification, left ventricular hypertrophy, electrolyte/fluid abnormalities, autonomic dysfunction or inflammation.

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Topics: Hemodialysis

Kidney Care News to Know from September

Posted by Deborah Brouwer-Maier RN, CNN on Oct 7, 2016 7:00:00 AM

Frenovia Renal Research will be opening an office in Durham, North Carolina. The company is a subsidiary of Fresenius Medical Care North America and will also expand staff at its locations in New York, Illinois, Florida and Louisiana in addition to North Carolina.

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Topics: Hemodialysis

W.J. Kolff’s First Artificial Kidney Faces Opposition

Posted by Susan Eymann, MS on Sep 14, 2016 7:00:00 AM

Seventy years ago, renal failure meant certain death. The toxins that the kidney normally cleanses from the blood would build up and poison a person until they would fall into a coma and die. Hemodialysis to cleanse the blood did not exist. The artificial kidney invented by W.J. Kolff in Nazi-occupied Netherlands was in its infancy.

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Topics: Hemodialysis

First Artificial Kidney Built in War-Torn Netherlands by W.J. Kolff

Posted by Susan Eymann, MS on Sep 12, 2016 6:30:00 AM

Conditions were harsh. When the Netherlands was attacked and occupied by Nazi Germany in May, 1940, the lives of a young doctor, Willem Johann Kolff, and his family were to irrevocably change. Kolff was a resident at the University of Groningen. There, he had watched a young man slowly die of kidney failure. The 22-year-old’s agonizing death ignited a resolve in Kolff to do something to help patients with renal failure. He was going to build an artificial kidney.

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Topics: Hemodialysis

Nephrologists Need Experience in Cardiac Care

Posted by Susan Eymann, MS on Sep 7, 2016 6:30:00 AM

In 1998, the American Journal of Kidney Disease sounded a clarion call with the following title on the cover of their journal, “Cardiovascular Disease, An ESRD Epidemic.” 1 Their call was well grounded because cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with end-stage renal disease (ESRD).1-2 It accounts for half of the deaths and a third of hospitalizations of dialysis patients.4

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Topics: Cardiac Function during Dialysis, Hemodialysis