It is unlikely that any single treatment option will significantl

It is unlikely that any single treatment option will significantly alter patient outcomes, but rather incremental

gains will be achieved with an integrated, multidisciplinary approach. BVM devices have had a moderate effect on the reduction of the incidence of IDH; however, its effects are limited to an at-risk population. The expansion and integration of these technologies to create an individual patient dialysis profile may prove more successful. The role of cool temperature dialysis shows greater promise in reducing IDH; however, there is still uncertainty about the necessary reduction in temperature to achieve optimal results. With the technologies available today, BTM technology is more mature and offers a relatively simple and effective means of combating IDH in susceptible patients. The widespread use of BVM and BTM monitoring in the general HD population, not prone to IDH, cannot be supported with the evidence MLN2238 currently available. Ultimately, these technologies will need to be trialled in combination, in a way that demonstrates a mortality and morbidity benefit, and to effectively allow the determination of an individualized HD profile that can account for the multitude of dialysis and patient factors that contribute to IDH. “
“The BLOCADE Feasibility Study aims to determine the feasibility of a large-scale randomised controlled trial with clinical endpoints comparing Fer-1 concentration the beta-blocking

agent carvedilol to placebo in patients receiving dialysis. The BLOCADE Feasibility Study is a randomised, double blind, placebo-controlled, parallel group feasibility study comparing the beta-blocking agent carvedilol to placebo. Patients receiving dialysis for ≥3 months and who are aged ≥50 years, or who are ≥18 years and have diabetes or cardiovascular disease, are eligible. The primary outcome is the proportion of participants who complete Meloxicam a 6-week Run-in phase in which all participants receive carvedilol titrated from 3.125mg twice daily to 6.25mg twice daily. Other measures include how many patients

are screened, the proportion recruited, the overall recruitment rate, the proportion of participants who remain on study drug for 12 months and the incidence of intra-dialytic hypotension while on randomised treatment. The BLOCADE Feasibility Study commenced recruiting in May 2011 and involves 11 sites in Australia and New Zealand. The BLOCADE Feasibility Study will inform the design of a larger clinical endpoint study to determine whether beta-blocking agents provide benefit to patients receiving dialysis, and define whether such a study is feasible. “
“1. Targets Patients with diabetes, hypertension Those with family history of chronic kidney disease (CKD) Individuals receiving potentially nephrotoxic drugs, herbs or substances or taking indigenous medicine Patients with past history of acute kidney injury Individuals older than 65 years 2.

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