The hemodialysis procedure is thought to be a physical stressor in the majority of hemodialyzed patients. Previous studies suggest that elevated salivary amylase level may correlate with increased plasma norepinephrine level under psychological and physical stress conditions. In this study, we investigated biological stress reactivity during hemodialysis treatment using salivary amylase activit...

BACKGROUND A higher sodium gradient (dialysate sodium minus pre-dialysis plasma sodium) during hemodialysis (HD) has been associated with sodium loading; however, its role is not well studied. We hypothesized that a sodium dialysate prescription resulting in a higher sodium gradient is associated with increases in interdialytic weight gain (IDWG), blood pressure (BP) and thirst. METHODS We co...

A literature search completed over the period of 1980-1999 identified studies on the prevalence of thirst in hemodialysis (HD) patients and the relationship between thirst and interdialytic weight gain, as well as intervention studies in which thirst was used as an outcome variable. Twenty-three studies fulfilled the selection criteria and were included in the analysis. The prevalence of thirst...

BACKGROUND Regional citrate anticoagulation is a very effective anticoagulation method for haemodialysis. However, it is not widely used, primarily due to the risk of hypocalcaemia. We studied citrate and calcium kinetics to better understand safety aspects of this anticoagulation method. METHODS During 15 haemodialysis treatments with a calcium-free dialysis solution, citrate was infused pre...

BACKGROUND Although low magnesium levels have been associated with an increased mortality in dialysis patients, they are kept low by routinely-used dialysates containing 0.50 mmol/L magnesium. Thus, we investigated the impact of a higher dialysate magnesium concentration on mortality. METHODS 25 patients on high dialysate magnesium (HDM) of 0.75 mmol/L were 1:2 matched to 50 patients on low d...

Dialysis fluids are real ‘drugs’ and as a consequence they need pharmacological preparation in order to meet the criteria of quality and standarization. Modern dialysis machines permit accurate proportioning of treated water and salts and also guarantee a continuous monitoring of the accuracy of the final composition and maintenance of the desired proportions. However, errors with dialysate con...

A 67-year-old man with chronic hemodialysis (HD), who had end-stage renal disease secondary to diabetic nephropathy and had been on HD for 9 years with ultrapure dialysis solution, is presented with recurrent transient loss of consciousness during HD.

BACKGROUND Intradialytic hypotension (IDH) is a frequent complication of haemodialysis. Reducing the temperature of the dialysis fluid is a simple therapeutic strategy but is relatively underused. This may be due to concerns regarding its effects on symptoms and dialysis adequacy. We performed a systematic review of the literature to examine the effects of cool dialysis on intradialytic blood p...

The purpose of this three-group quasi-experimental research study was to describe the relationship between hemodialysis knowledge and perceived medical adherence to a prescribed treatment regimen in African Americans diagnosed with end stage renal disease and to determine if an educational intervention improved hemodialysis knowledge and medical adherence. Eighty-five African Americans particip...

We describe a case of recurrent pulmonary edema after hemodialysis despite the patient being at ideal dry weight. Coronary-subclavian steal syndrome can cause serious complications in end-stage renal disease patients on hemodialysis. This is a case of subclavian steal, made worse by hemodialysis, using an upper limb hemodialysis fistula. Complete resolution of symptoms followed percutaneous ste...