Once-weekly hemodialysis combined with low-protein and low-salt dietary treatment as a favorable therapeutic modality for selected patients with end-stage renal failure: a prospective observational study in Japanese patients

Nakao, Toshiyuki; Kanazawa, Yuki; Takahashi, Toshimasa

doi:10.1186/s12882-018-0941-2

Cited by 15 publications

(17 citation statements)

References 47 publications

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“…Furthermore, the patients enrolled in this program experienced slower declines in RKF, better control of anemia and mineral disorders, and lower hospitalization rates while maintaining a good nutritional status when compared to those who initiated conventional thrice-weekly hemodialysis. Consistent findings were observed in a prospective cohort from Japan [92]. …”

Section: How To Protect Rkfsupporting

confidence: 71%

Individualized Hemodialysis Treatment: A Perspective on Residual Kidney Function and Precision Medicine in Nephrology

Hur

Lee²,

Kalantar-Zadeh³

et al. 2018

Cardiorenal Med

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Background: Residual kidney function (RKF) is often expected to inevitably and rapidly decline among hemodialysis patients and, hence, has been inadvertently ignored in clinical practice. The importance of RKF has been revisited in some recent studies. Given that patients with end-stage renal disease now tend to initiate maintenance hemodialysis therapy with higher RKF levels, there seem to be important opportunities for incremental hemodialysis by individualizing the dose and frequency according to their RKF levels. This approach is realigned with precision medicine and patient-centeredness. Summary: In this article, we first review the available methods to estimate RKF among hemodialysis patients. We then discuss the importance of maintaining and monitoring RKF levels based on a variety of clinical aspects, including volume overload, blood pressure control, mineral and bone metabolism, nutrition, and patient survival. We also review several potential measures to protect RKF: the use of high-flux and biocompatible membranes, the use of ultrapure dialysate, the incorporation of hemodiafiltration, incremental hemodialysis, and a low-protein diet, as well as general care such as avoiding nephrotoxic events, maintaining appropriate blood pressure, and better control of mineral and bone disorder parameters. Key Message: Individualized hemodialysis regimens may maintain RKF, lead to a better quality of life without compromising long-term survival, and ensure precision medicine and patient-centeredness in nephrology practice.

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Section: How To Protect Rkfsupporting

confidence: 71%

Individualized Hemodialysis Treatment: A Perspective on Residual Kidney Function and Precision Medicine in Nephrology

Hur

Lee²,

Kalantar-Zadeh³

et al. 2018

Cardiorenal Med

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“…Moreover, the present study showed that patients with 2 times of hemodialysis per week were more likely to have lower HRQOL in Burden of Kidney disease. It is in the same line that 3 times weekly hemodialysis has been standard way of treatment to control uremia [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Health Related Quality of Life (HRQOL) of Patients With End Stage Kidney Disease (ESKD) on Hemodialysis in Addis Ababa, Ethiopia: A Cross-Sectional Study

Kim

Nigatu

Araya

et al. 2021

Preprint

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Background: Patients with End-Stage Kidney Disease (ESKD) depend on hemodialysis as a lifesaving treatment for the remainder of their lives. However, the health related quality of life (HRQOL) of patients on hemodialysis is much more underappreciated in resource limited countries, since the hemodialysis is mostly unaffordable or unavailable. Methods: A hospital based cross-sectional study was conducted in Addis Ababa, Ethiopia, from August 01 to October 31, 2019. All patients (n = 125) who were on hemodialysis in five selected public and private hospitals were included in the study. Data were administered by trained nurses by using a standardized Kidney Disease Quality of Life (KDQOL™-36) questionnaire. Clinical data were extracted from the patients’ medical charts. HRQOL was categorized as low, if the overall mean score was ≤50, or as high, if the overall mean score was >50. Factors associated with lower HRQOL were identified by Multi-variable binary logistic regression analysis and expressed by adjusted odds ratio (aOR). Results: The mean age of the study participants was 50.33 years (±15.07) and more than two-thirds (68.8%) of the patients were males. The mean score of HRQOL was 49.08±11.09, with 45.4% of them had lower HRQOL. In the multi-variable model, unemployed patients (aOR = 2.40, 95% CI: 1.10 – 5.90; p-value = 0.03) and patients who had hemodialysis 2 times per week (aOR = 1.71, 95% CI: 1.07 – 3.83; p-value = 0.04) were associated with lower HRQOL. In the further sub-group analysis, elderly patients had higher odds of having lower mean score on the burden of kidney disease (BKD) (aOR = 2.07; 95% CI 1.18 – 4.13; p-value = 0.02) as compared to the younger patients.Conclusions: A substantial proportion of the patients with ESKD on hemodialysis in Addis Ababa had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Therefore, not only the clinical treatment but also quality of life of patients with chronic dialysis should be given special attentions during the patients’ care.

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“…Incremental dialysis is of particular interest; the concept, which originated from PD, supports implementing a progressively higher dialysis dose with a progressively reduced residual kidney function [129][130][131][132][133][134][135]. Several schedules are available, whose is beyond the aim of this paper.…”

Section: Choice Of Renal Replacement Therapy Has An Ecologic Impactmentioning

confidence: 99%

“…Several schedules are available, whose is beyond the aim of this paper. In any case these patient-friendly approaches seem to allow preserving kidney function and lowering dialysis related comorbidity, in particular in association with dietary management [129][130][131][132][133][134][135]. From an ecologic point of view, incremental dialysis allows us to limit the carbon footprint, wastes and social costs, although, almost paradoxically, the treatment costs borne by the institutions providing care may be higher [136].…”

Section: Choice Of Renal Replacement Therapy Has An Ecologic Impactmentioning

confidence: 99%

Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology

et al. 2020

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High-technology medicine saves lives and produces waste; this is the case of dialysis. The increasing amounts of waste products can be biologically dangerous in different ways: some represent a direct infectious or toxic danger for other living creatures (potentially contaminated or hazardous waste), while others are harmful for the planet (plastic and non-recycled waste). With the aim of increasing awareness, proposing joint actions and coordinating industrial and social interactions, the Italian Society of Nephrology is presenting this position statement on ways in which the environmental impact of caring for patients with kidney diseases can be reduced. Due to the particular relevance in waste management of dialysis, which produces up to 2 kg of potentially contaminated waste per session and about the same weight of potentially recyclable materials, together with technological waste (dialysis machines), and involves high water and electricity consumption, the position statement mainly focuses on dialysis management, identifying ten first affordable actions: (1) reducing the burden of dialysis (whenever possible adopting an intent to delay strategy, with wide use of incremental schedules); (2) limiting drugs and favouring "natural" medicine focussing on lifestyle and diet; (3) encouraging the reuse of "household" hospital material; (4) recycling paper and glass; (5) recycling non-contaminated plastic; (6) reducing water consumption; (7) reducing energy consumption; (8) introducing environmental-impact criteria in checklists for evaluating dialysis machines and supplies; (9) encouraging well-planned triage of contaminated and non-contaminated materials; (10) demanding planet-friendly approaches in the building of new facilities.

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Once-weekly hemodialysis combined with low-protein and low-salt dietary treatment as a favorable therapeutic modality for selected patients with end-stage renal failure: a prospective observational study in Japanese patients

Cited by 15 publications

References 47 publications

Individualized Hemodialysis Treatment: A Perspective on Residual Kidney Function and Precision Medicine in Nephrology

Individualized Hemodialysis Treatment: A Perspective on Residual Kidney Function and Precision Medicine in Nephrology

Health Related Quality of Life (HRQOL) of Patients With End Stage Kidney Disease (ESKD) on Hemodialysis in Addis Ababa, Ethiopia: A Cross-Sectional Study

Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology

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