Hemodialysis Procedures for Stable Incident and Prevalent Patients Optimize Hemodynamic Stability, Dialysis Dose, Electrolytes, and Fluid Balance.

The demographic profile of patients transitioning from chronic kidney disease to kidney replacement therapy is changing, with a higher prevalence of aging patients with multiple comorbidities such as diabetes mellitus and heart failure. Cardiovascular disease remains the leading cause of mortality in this population, exacerbated by the cardiovascular stress imposed by the HD procedure. The first year after transitioning to hemodialysis is associated with increased risks of hospitalization and mortality, particularly within the first 90-120 days, with greater vulnerability observed among the elderly. Based on data from clinics in Fresenius Medical Care Europe, Middle East, and Africa NephroCare, this review aims to optimize hemodialysis procedures to reduce mortality risk in stable incident and prevalent patients. It addresses critical aspects such as treatment duration, frequency, choice of dialysis membrane, dialysate composition, blood and dialysate flow rates, electrolyte composition, temperature control, target weight management, dialysis adequacy, and additional protocols, with a focus on mitigating prevalent intradialytic complications, particularly intradialytic hypotension prevention.

[Additional measures of treatment in patients with renal anemia]. / Dodatne mjere lijecenja u bolesnika s bubreznom anemijom.

UNLABELLED: Treatment of renal anemia with erythropoiesis-stimulating agents (ESA) is performed with the addition of iron, and other drugs and adjuvants to epoetin therapy to reach target hemoglobin. In achieving the ultimate goal should be to provide adequate dialysis, monitor the nutritional status of patients, improve patient response to treatment with adjuvants to epoetin therapy (vitamins, androgens, antioxidants) and in exceptional circumstances a transfusion of red blood cells. The article discussed several elements of the additional measures for the treatment of patients with renal anemia. CONCLUSIONS: Additional measures of treatment in patients with renal anemia affect the improvement of anemia in patients with chronic kidney failure, but not in respectable extent. They can reduce the required dose of erythropoiesis-stimulating agents (ESA) and improve the effectiveness of iron. Some measures are strictly defined indications and application of targeted patients (e.g., reduced response to the ESA). For most measures is not recommended as a routine application. Some measures must be implemented to strengthen the supervision of serious side effects.

Frequency of ventricular premature beats and ventricular tachycardia in STEMI treated with fibrinolytics.

To determine in acute myocardial infarction with an ST elevation (STEMI) treated with fibrinolytics frequency of ventricular premature beats (VPBs) and ventricular tachycardia (VT) according to the damaged area and residual cardiac function. With anterolateral infarction with ejection fraction (EF) < 45%, incidence of VPBs < 10/h was statistically significantly reduced (p < 0.001) while incidence of VPBs > or = 10/h as well as VPBs in a pair and VT was increased (p < 0.001). With anteroseptal infarction with EF < 45%, incidence of VPBs < 10/h was statistically reduced (p = 0.06) and incidence of VPBs > 10/h, VPBs in a pair and VT was increased (p = 0.06). With inferior and inferoposterior infarction with EF < 45%, incidence of VPBs < 10/h was reduced and incidence of VPBs > or = 10/h, VPBs in a pair and VT was increased. However, such difference was not statistically significant. Along with reduced residual cardiac function, one can also expect increase in frequency of VPBs and VT in all forms of STEMI regardless the area of damage. Such frequency is significant with all forms of anterior infarction, that is to say, slightly more with anterolateral infarction in relation to anteroseptal one. However, with inferior and inferoposterior infarction this frequency of VPBs i VT is not significant.