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HEMODIALYSIS Edited by Hiromichi Suzuki Hemodialysis http://dx.doi.org/10.5772/45929 Edited by Hiromichi Suzuki Contributors Roland E. Winkler, M.B.A., Peter Ahrenholz, Wolfgang Paetow, Grit Waitz, Hartmut Wolf, Andrea Mahrova, Klara Svagrova, Guy Rostoker, Paulo Roberto Santos, Gülsüm Özkan, Şükrü Ulusoy, Masahiro Kohzuki, Miroslaw Dziekiewicz, Grzegorz Kade, Zofia Wańkowicz, Marek Maruszynski, Marlies Ostermann, Melanie Chan, Seyed Reza Mousavi, Hossam Elwakeel, Lucian Florin Dorobantu, Konstantinos Pantelias, Eirini Grapsa, Yasuo Imanishi, Yoshiki Nishizawa, Masaaki Inaba, Michčle Kessler, Hervé Boccaccini, Sylvie Béot, Joëlle Cridlig, Hiromichi Suzuki, Naushad Ali Junglee, Mahdi Jibani, Anna Owen, Dean Williams, Ayman Karkar, Dr. Pornanong Aramwit, Bancha Satirapoj, Kyungsoo Lee, Octavio J. Salgado, Masaki Fujioka, Alexandre Liborio, Hernan Trimarchi, Andrew Forauer, Robert Percarpio, Elizabeth Chorney, Rodolfo Amilcar Valtuille, Elmer Andres Fernandez, Manuel Sztejnberg, Wang, Emanuele Gatti, Ciro Tetta, Elísio Costa, Stanislaw P. A. Stawicki, Laura Peterson, Hooman Khabiri, Maria Litzendorf, Fabio Grandi, Marialuisa Caiazzo, Piergiorgio Bolasco, Giuseppe Palladino, Luisa Sereni, Paolo Maria Ghezzi, Mauro Atti, Pierpaolo Di Cocco, Katia Clemente, Vinicio Rizza, Linda De Luca, Francesco Pisani, Antonio Famulari, Mukadder Mollaoglu, Yoshiaki Kawaguchi, Ane Claudia Fernandes Nunes, Fernanda Messias, Elvino Barros, Ufuk Saadet Yurdalan, Esra Fatma Güneş Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2013 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. 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Publishing Process Manager Iva Simcic Technical Editor InTech DTP team Cover InTech Design team First published March, 2013 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Hemodialysis, Edited by Hiromichi Suzuki p. cm. ISBN 978-953-51-0988-4 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface XI Section 1 Complications in Dialysis Therapy 1 Chapter 1 Cardiovascular Disease in Hemodialysis Patients 3 Han Li and Shixiang Wang Chapter 2 Medical Nutrition Therapy for Hemodialysis Patients 21 F. Esra Güneş Chapter 3 Rare Inherited Diseases Among Hemodialysis Patients 45 Ane Cláudia Fernandes Nunes, Fernanda de Souza Messias and Elvino José Guardão Barros Chapter 4 Bleeding Diathesis in Hemodialysis Patients 59 Gülsüm Özkan and Şükrü Ulusoy Chapter 5 Pathogenesis and Treatment of Chronic Kidney Disease- Mineral and Bone Disorder 81 Yasuo Imanishi, Yoshiki Nishizawa and Masaaki Inaba Chapter 6 Lipid Abnormalities in Hemodialysis Patients 101 Şükrü Ulusoy and Gülsüm Özkan Chapter 7 Remnant Proteinuria in Chronic Hemodialysis 127 Hernán Trimarchi Chapter 8 Glycemic Control in Diabetic Patients on Long-Term Maintenance Dialysis 153 Pornanong Aramwit and Bancha Satirapoj Chapter 9 Epidemiology of Chronic Dialysis Patients in the Intensive Care Unit 193 Melanie Chan and Marlies Ostermann Chapter 10 Disturbances in Acid-Base Balance in Patients on Hemodialysis 211 Alexandre Braga Libório and Tacyano Tavares Leite Chapter 11 More than Half of Patients Receiving Hemodialysis with Leg Ulcer Require Amputation 231 Masaki Fujioka Chapter 12 Helicobacterpylori Infection for Hemodialysis Patients 241 Yoshiaki Kawaguchi and Tetsuya Mine Chapter 13 Site and Size of Vascular Calcifications Are Different in Dialysis Patients with Various Underlying Diseases 249 H. Suzuki, T. Inoue, H. Okada, T. Takenaka, Kunihiko Hayashi, Jyunnichi Nishiyama, Takashi Yamazaki, Yuji Nishiyama and Keiko Kaneko Chapter 14 Colloids in Dialytic Refractory Hypotension 259 Guy Rostoker Section 2 Pathogenesis and Management of Anemia 273 Chapter 15 Current Anemia Treatment in Hemodialysis Patients: The Challenge for Secure Use of Erythropoietin-Stimulating Agents 275 Paulo Roberto Santos Chapter 16 rhEPO for the Treatment of Erythropoietin Resistant Anemia in Hemodialysis Patients – Risks and Benefits 291 Sandra Ribeiro, Elísio Costa, Luís Belo, Flávio Reis and Alice Santos- Silva Chapter 17 Management of Anemia on Hemodialysis 315 Konstantinos Pantelias and Eirini Grapsa ContentsVI Section 3 New Developments in Dialysis Focused on Methods and Instruments 357 Chapter 18 Analysis of the Dialysis Dose in Different Clinical Situations: A Simulation-Based Approach 359 Rodolfo Valtuille, Manuel Sztejnberg and Elmer. A. Fernandez Chapter 19 Adsorption in Extracorporeal Blood Purification: How to Enhance Solutes Removal Beyond Diffusion and Convection 381 Fabio Grandi, Piergiorgio Bolasco, Giuseppe Palladino, Luisa Sereni, Marialuisa Caiazzo, Mauro Atti and Paolo Maria Ghezzi Chapter 20 Advances in Hemodialysis Techniques 409 Ayman Karkar Chapter 21 Implementation and Management of Strategies to Set and to Achieve Clinical Targets 439 Bernard Canaud, Ciro Tetta, Daniele Marcelli, Guido Giordana, Stefano Stuard, Katrin Koehler, Flavio Mari, Carlo Barbieri, Miryana Dobreva, Andrea Stopper and Emanuele Gatti Chapter 22 Push/Pull Based Renal Replacement Treatments 455 Kyungsoo Lee Chapter 23 Select Ion and Preparation of Patients for Dialysis 475 Pierpaolo Di Cocco, Antonio Famulari, Francesco Pisani, Linda De Luca, Vinicio Rizza and Katia Clemente Chapter 24 Reduction of Heparin and Oxidative Potential by Means of Citrasate® in High-Flux Dialysis (HFD) and Online Hemodiafiltration (olHDF) in Pre and Postdilution 491 Roland E. Winkler, Peter Ahrenholz, Wolfgang Paetow, Grit Waitz and Hartmut Wolf Section 4 Vascular Access 515 Chapter 25 The Controversial Vascular Access for Hemodialysis – Own Experience 517 M. Dziekiewicz, G. Kade, Z. Wańkowicz and M. Maruszyński Contents VII Chapter 26 Vascular Access With or Without Synthetic GOR-TEX 523 Seyed Reza Mousavi Chapter 27 A Holistic Approach to Vascular Access in Hemodialysis 533 Naushad Junglee, Anna Owen, Mahdi Jibani and Dean Williams Chapter 28 Vascular Access for Hemodialysis - How to Maintain in Clinical Practice 565 Hossam Elwakeel and Khaled Elalfy Chapter 29 Single-Needle Hemodialysis on Native Fistulae 607 Guy Rostoker Chapter 30 Complications of Autogenous Arteriovenous Fistulas 621 Lucian Florin Dorobanţu, Ovidiu Ştiru, Cristian Bulescu, Şerban Bubenek and Vlad Anton Iliescu Chapter 31 Hemodialysis Access: Initial Considerations and the Difficult Patient 635 Laura A. Peterson, Maria Litzendorf, Hooman Khabiri and Stanislaw P. A. Stawicki Chapter 32 Vascular Access for Hemodialysis - Overview and Emphasis on Complications 663 Octavio J. Salgado Chapter 33 Catheter-Related Sheaths (CRS): Pathophysiology and Treatment Strategies 699 Robert Percarpio, Elizabeth T. Chorney and Andrew R. Forauer Chapter 34 Arteriovenous Fistula or Catheter: Creating an Optimal Vascular Access for Hemodialysis 719 Joëlle Cridlig, Michèle Kessler and Thanh Cao-Huu Section 5 Quality of Life and Exercise 741 Chapter 35 Renal Rehabilitation: Present and Future Perspectives 743 Masahiro Kohzuki Chapter 36 Exercise Therapy – Additional Tool for Managing Physical and Psychological Problems on Hemodialysis 753 Andrea Mahrova and Klara Svagrova ContentsVIII Chapter 37 Quality of Life in Patients Undergoing Hemodialysis 823 Mukadder Mollaoğlu Chapter 38 Physiotherapy in the Patients on Hemodialysis 845 S. Ufuk Yurdalan Contents IX [...]... dialysis patients 11 12 Hemodialysis 4.4.2 Angina during the hemodialysis session For patients whose angina manifests primarily during hemodialysis session, a number of therapeutic options available Nasal oxygen should be given routinely If the anginal epi‐ sode is associated with hypotension, then initial treatment should include raising the blood pressure by elevating the feet and by cautiously administering... programmes, such as increasing the dialysis or hemodialysisfiltrition frequency or be changed to daily dialysis for atrial fibrillation with frequent seizure Regular monitoring of serum potassium levels before and post dialysis, ad‐ justing dialysate concentration of potassium ions in a timely manner, using different pre‐ scription of individualized dialysate for hemodialysis treatment (2)Behavioral interventions,... metabolism in hemodialysis patients Tunis Med 2012 ;90:537-41 [27] Fukushima M, Miura S, Mitsutake R, Fukushima T, Fukushima K, Saku K Cholester‐ ol metabolism in patients with hemodialysis in the presence or absence of coronary artery disease Circ J 2012;76:1980-1986 15 16 Hemodialysis [28] Blankestijn PJ, Vos PF, Rabelink TJ, et al High-flux dialysis membranes improve lip‐ id profile in chronic hemodialysis. .. (http://creativecommons.org/licenses /by/ 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited 22 Hemodialysis The results of studies indicate that hemodialysis patients are at risk of malnutrition The evaluation methods used in the nutritional status showed that 18-75% prevalence of malnu‐ trition in hemodialysis patients, malnutrition... I thank Ms Iva Simcic, who carried out an exceptional secretarial task of collecting and editing the manuscripts Professor Hiromichi Suzuki, Department of Nephrology, Saitama Medical College, Japan Section 1 Complications in Dialysis Therapy Chapter 1 Cardiovascular Disease in Hemodialysis Patients Han Li and Shixiang Wang Additional information is available at the end of the chapter http://dx.doi.org/10.5772/53071... ointment may be of benefit when applied 1 hour prior to a hemodialysis session, assuming that the blood pressure will tolerate this intervention 5 Heart failure Heart failure is the commonest manifestation of cardiac dysfunction in patients on mainte‐ nance dialysis According to the cross-sectional survey by Harnett and coworkers, which in‐ cluded both hemodialysis and peritoneal dialysis patients, nearly... risk factor for cardiovascular disease in MHD patients Foley et al [3] found that with each 10 mm Hg increase of BP in MHD patients, the risk of LVH increased by 48%, ischemic heart disease increased by 39% and congestive cardiac failure increased by 44% The causes of hypertension in MHD patients are miscellaneous, including volume overload [4], activation of the RAS [5], sympathetic hyperactivity [6]... practical) serum lipid panel that includes total and HDL cholesterol as well as triglycerides a LDL cholesterol LDL cholesterol is commonly computed by subtracting the serum tri‐ glyceride level divided either by 5 (when TGs are measured in mg/dL) or by 2.19 (when TGs are measured in mmol/L) as well as the HDL cholesterol level from the total choles‐ terol b Atherogenic, remnant lipoproteins and non-HDL... practices associated with sudden death among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study Clin J Am Soc Nephrol 2012;7(5):765-774 19 Chapter 2 Medical Nutrition Therapy for Hemodialysis Patients F Esra Güneş Additional information is available at the end of the chapter http://dx.doi.org/10.5772/53473 1 Introduction Nutrition in hemodialysis is very important in decreasing... lowest tertile 3.4 Oxidant stress Numerous factors in the dialysis patient increase o xidative stress (OxStress) These include inflammation (as marked by elevated C-reactive protein), malnutrition (by reducing antioxi‐ dant defenses), uremic toxins, and, potentially, the dialysis procedure itself Many protective mechanisms are impaired, including reduced plasma protein-associated free thiols such as glutathione . HEMODIALYSIS Edited by Hiromichi Suzuki Hemodialysis http://dx.doi.org/10.5772/45929 Edited by Hiromichi Suzuki Contributors Roland E. Winkler, M.B.A.,. www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Hemodialysis, Edited by Hiromichi Suzuki p. cm. ISBN 978-953-51-0988-4 free online editions of InTech Books and Journals. Disease in Hemodialysis Patients 3 Han Li and Shixiang Wang Chapter 2 Medical Nutrition Therapy for Hemodialysis Patients 21 F. Esra Güneş Chapter 3 Rare Inherited Diseases Among Hemodialysis