2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T585,In patients with incident end-stage kidney disease (ESKD), hyperkalemia (HyperK) is a common indication for initiating kidney replacement therapy (KRT). Hemodialysis (HD) and peritoneal dialysis (PD) both effectively reduce serum potassium, but HD is often considered superior due to its perceived faster efficiency. However, evidence supporting this perception remains limited. We hypothesized that HD and PD would be equally effective for the management of severe HyperK during hospitalization. We conducted a prospective cohort study at the Nephrology Department of Hospital Civil de Guadalajara. Consecutive, dialysis-naïve patients hospitalized with ESKD and severe HyperK (serum potassium >6.5 mEq/L at admission) between 2022 and 2024 were included. The modality of KRT (HD vs PD) was determined by the treating nephrology team. The primary outcome was the trajectory of serum potassium reduction between groups. Secondary outcomes included daily potassium trajectory, catheter dysfunction, length of stay and mortality. Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups ( In this prospective cohort of ESKD patients with severe HyperK, both PD and HD achieved comparable potassium reduction and clinical outcomes, supporting PD as an effective alternative for urgent-start KRT.31:Tb3b,ABSTRACT Introduction In patients with incident end-stage kidney disease (ESKD), hyperkalemia (HyperK) is a common indication for initiating kidney replacement therapy (KRT). Hemodialysis (HD) and peritoneal dialysis (PD) both effectively reduce serum potassium, but HD is often considered superior due to its perceived faster efficiency. However, evidence supporting this perception remains limited. We hypothesized that HD and PD would be equally effective for the management of severe HyperK during hospitalization. Methods We conducted a prospective cohort study at the Nephrology Department of Hospital Civil de Guadalajara. Consecutive, dialysis-naïve patients hospitalized with ESKD and severe HyperK (serum potassium >6.5 mEq/L at admission) between 2022 and 2024 were included. The modality of KRT (HD vs PD) was determined by the treating nephrology team. The primary outcome was the trajectory of serum potassium reduction between groups. Secondary outcomes included daily potassium trajectory, catheter dysfunction, length of stay and mortality. Results Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups (P > .05). Median age was 65 years [interquartile range (IQR) 53–74], with diabetes in 33% and hypertension in 53%. Median admission potassium was 6.99 mEq/L (6.7–7.6), serum creatinine 15.9 mg/dL (11.5–23.1) and estimated glomerular filtration rate 2.91 mL/min/1.73 m² (1.80–4.09). The PD group underwent a mean of 45 (±15) exchanges during hospitalization, and the HD group received 4.6 (±1) sessions. Serum potassium decreased similarly in both groups (P > .05), with substantial reductions on Day 1 (PD 6.03 mEq/L; HD 5.90 mEq/L) and stabilization by Day 5 through Day 15. Catheter dysfunction occurred in 11% of patients, with similar rates between groups, hospitalization median was 5 days (IQR 3–8) and 12-month mortality was 26.8%, without differences between modalities. Conclusions In this prospective cohort of ESKD patients with severe HyperK, both PD and HD achieved comparable potassium reduction and clinical outcomes, supporting PD as an effective alternative for urgent-start KRT. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Hemodialysis: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Hemodialysis (modality). Clinician-written summaries and actionable practice insights. 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On multivariate analysis, PTDD ≥2 years was an independent risk factor for allograft loss (HR 2.61, 95% CI 1.58–4.38); 10-year allograft survival was 91.8% for PTDD <2 years vs. 82.0% for PTDD ≥2 years. Male sex (HR 2.35) and diabetic nephropathy (HR 2.94) were also independent risk factors.","limitations":"Single-country (Japanese) cohort with favorable dialysis management limits generalizability to other health systems. Study is retrospective and observational, so unmeasured confounders may affect results. Exclusion of pediatric and repeat transplant recipients narrows applicability.","practice_takeaway":"When PEKT is not possible, transplanting after a short dialysis period (<2 years) preserves allograft survival at near-PEKT levels. Clinicians should prioritize timely referral and transplantation to minimize dialysis exposure before living donor KT."}},{"doi":"10.1681/asn.0000001225","pmid":"42593876","title":"Hemodiafiltration versus High-flux Hemodialysis and Risk of Mortality","journal_title":"Journal of the American Society of Nephrology","journal_issn":"1046-6673","published_at":"2026-08-13T00:00:00.000Z","url":"https://doi.org/10.1681/asn.0000001225","source_score":24,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-30T06:20:01.184Z","updated_at":"2026-08-30T06:20:01.184Z","tags":[{"paper_doi":"10.1681/asn.0000001225","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"condition","value":"End-Stage Kidney Disease","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"modality","value":"Hemodiafiltration","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"modality","value":"Hemodialysis","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"sample_size","value":"n=19539","value_numeric":19539},{"paper_doi":"10.1681/asn.0000001225","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"study_design","value":"Target Trial Emulation (Observational Cohort)","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"warning","value":"The convective volume dose-response finding is explicitly flagged by the authors as potentially non-causal and should not be used to set volume targets without further evidence.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"warning","value":"The 'impact_flag' is tagged as 'confirms_prior' because the findings align with existing RCT evidence (e.g., CONVINCE trial), though this study adds real-world, multinational generalizability.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001225","tag_type":"warning","value":"The study design is a target trial emulation using registry data, not a true RCT — causal inference is limited by potential unmeasured confounding.","value_numeric":null}],"summaries":{"what_studied":"This target trial emulation compared sustained high-volume post-dilution hemodiafiltration (HDF) versus high-flux hemodialysis (HD) in adults receiving thrice-weekly in-center dialysis across eight European countries (2014–2019), using the EuCliD® registry with follow-up starting 91 days after dialysis initiation.","key_result":"HDF was associated with a 28% lower risk of all-cause mortality (HR 0.72; 95% CI 0.67–0.77); at 2 years, cumulative mortality was 20.6% (HDF) vs. 22.3% (HD), an absolute risk reduction of 1.7 percentage points across 4,282 deaths in a weighted pseudo-population of 19,758 patients.","limitations":"- As an observational emulation, residual confounding cannot be excluded — higher convective volumes may reflect patient stability or center expertise rather than a true dose-response effect.\n- The study is restricted to European centers in the EuCliD® registry, limiting generalizability to other regions.\n- Sustained treatment strategies (≥90% session adherence) were required, which may not reflect real-world prescribing patterns.","practice_takeaway":"For patients on thrice-weekly in-center dialysis, prioritizing sustained high-volume post-dilution HDF over high-flux HD may reduce mortality, with the greatest relative benefit in those with pre-existing cardiovascular disease. Clinicians should advocate for HDF access where feasible, while recognizing that center expertise and patient selection influence achievable convective volumes."}},{"doi":"10.1093/ckj/sfag270","pmid":null,"title":"Ten tips for the first hemodialysis sessions","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-08-12T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag270","source_score":43,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-08-19T06:28:53.913Z","updated_at":"2026-08-19T06:28:53.913Z","tags":[{"paper_doi":"10.1093/ckj/sfag270","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"condition","value":"End-Stage Kidney Disease","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"modality","value":"Hemodialysis","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"study_design","value":"Expert Opinion / Narrative Review","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"warning","value":"No original patient data are presented; this is expert opinion only and should not be interpreted as evidence-based guidelines.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"warning","value":"Sample size tag omitted as this is not an empirical study.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag270","tag_type":"warning","value":"Study design classified as 'Expert Opinion / Narrative Review' based on author framing; the journal may categorize it differently.","value_numeric":null}],"summaries":{"what_studied":"This expert opinion piece offers 10 practical tips for nephrologists managing patients during the early hemodialysis phase, covering consent, transplant candidacy, medication review, vaccination, exercise, nutrition, volume management, modality selection, anticoagulation, and incremental hemodialysis.","key_result":"The authors frame the initiation of hemodialysis as a high-risk, high-opportunity period — early mortality is elevated, functional decline is common, and patients are often underprepared — and argue that individualized, proactive prescription decisions made at the start can shape long-term outcomes.","limitations":"Self-described as incomplete: vascular access, anemia management, mineral bone disorder, patient-reported symptoms, and dialysate composition are not addressed. Tips are expert opinion ('suggestions for colleagues'), not guideline-level recommendations, and no original data are presented.","practice_takeaway":"Treat the first hemodialysis sessions as a clinical window to optimize the full care package — review medications, confirm vaccination status, assess transplant candidacy early, and consider incremental hemodialysis or tailored anticoagulation from day one. Individualization at initiation, rather than defaulting to a standard prescription, may reduce early morbidity."}},{"doi":"10.1007/s43678-026-01197-0","pmid":"42324426","title":"Just the facts: tumour lysis syndrome","journal_title":"Canadian Journal of Emergency Medicine","journal_issn":"1481-8035","published_at":"2026-06-21T00:00:00.000Z","url":"https://doi.org/10.1007/s43678-026-01197-0","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-25T13:25:19.349Z","updated_at":"2026-06-25T13:25:19.349Z","tags":[{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"condition","value":"Acute Lymphocytic Leukemia","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"condition","value":"Acute Myeloid Leukemia","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"condition","value":"Burkitt Lymphoma","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"condition","value":"Non-Hodgkin Lymphoma","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"condition","value":"Tumour Lysis Syndrome","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"generic","value":"furosemide","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"generic","value":"rasburicase","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"modality","value":"Hemodialysis","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"modality","value":"Intravenous Fluid Resuscitation","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"modality","value":"Urate Oxidase","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"modality","value":"Xanthine Oxidase Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"warning","value":"Rasburicase dosing range cited (3–6 mg IV flat dose in adults) is based on a single meta-analysis and may differ from institutional or weight-based protocols.","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"warning","value":"The case vignette features a pediatric/young adult patient (age 23), but the review covers adults broadly; age-specific dosing nuances are not fully addressed.","value_numeric":null},{"paper_doi":"10.1007/s43678-026-01197-0","tag_type":"warning","value":"This is a narrative clinical review, not a systematic review or primary study; no original patient data are presented and no formal evidence grading is applied.","value_numeric":null}],"summaries":{"what_studied":"This is a clinical review (\"Just the Facts\" format) covering the diagnosis, risk factors, presentation, and emergency management of tumour lysis syndrome (TLS), using a case of a 23-year-old male with Burkitt lymphoma presenting 2 days after chemotherapy.","key_result":"TLS in-hospital mortality is ~21%, and up to 69% of patients experience at least one major complication. Incidence ranges from 4–42% depending on cancer type; non-Hodgkin lymphoma carries the highest risk (~30%). Rasburicase (3–6 mg IV) is the treatment of choice for uric acid >75 mg/L; allopurinol is for prevention only, not active TLS.","limitations":"- Narrative/expert review format with no original data; key management recommendations (e.g., IV fluid composition) are based on expert consensus rather than high-quality trials.\n- No systematic literature search or GRADE-level evidence appraisal reported.","practice_takeaway":"In cancer patients on chemotherapy with AKI, hyperkalemia, hyperphosphatemia, hyperuricemia, or hypocalcemia, apply the Cairo-Bishop criteria early and consult hematology/oncology.\n\nUse rasburicase (not allopurinol) for established TLS with uric acid >75 mg/L, avoid urinary alkalinization and thiazides, and have a low threshold for hemodialysis in refractory cases."}},{"doi":"10.1093/ckj/sfag171","pmid":null,"title":"Dialysis disequilibrium syndrome: an underdiagnosed condition? results from a monocentric observational study","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-05-27T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag171","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-02T13:27:29.698Z","updated_at":"2026-06-02T13:27:29.698Z","tags":[{"paper_doi":"10.1093/ckj/sfag171","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"condition","value":"Dialysis Disequilibrium Syndrome","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"condition","value":"End-Stage Renal Disease","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"condition","value":"Intradialytic Hypertension","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"modality","value":"Hemodialysis","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"sample_size","value":"n=48","value_numeric":48},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"study_design","value":"Prospective Observational Study","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"warning","value":"DDS was defined by a symptom-based score increase (Δ≥1) without neuroimaging confirmation; this may over- or under-estimate true DDS incidence.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"warning","value":"Median age of 67 years with 70.8% male limits applicability to younger or female-predominant populations.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag171","tag_type":"warning","value":"Small single-center sample (n=48) means multivariate estimates — especially the wide CI on the OR for intradialytic hypertension (1.38–18.15) — should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This prospective observational study (Feb 2021–Feb 2022) followed 48 adults starting hemodialysis, assessing Dialysis Disequilibrium Syndrome (DDS) incidence and risk factors across the first four sessions using a standardized 0–3 severity score.","key_result":"DDS occurred in 22.9% of patients (11/48). Intradialytic hypertension was the sole independent risk factor on multivariate analysis (OR 4.43, 95% CI 1.38–18.15), present in 78.6% of DDS sessions vs. 40.0% of non-DDS sessions. Pre-dialysis urea was **not** associated with DDS (P = 0.15).","limitations":"- Single-center study with only 48 patients limits generalizability and statistical power.\n- DDS diagnosis relied on a symptom-based severity score rather than objective neuroimaging or electrophysiological endpoints.\n- Short observation window (first 4 sessions only); longer-term or chronic DDS not captured.","practice_takeaway":"Monitor for intradialytic hypertension during hemodialysis initiation — it is a stronger DDS predictor than pre-dialysis urea, challenging the traditional solute-gradient model. Patients on centrally acting agents and those with fluid overload or severe acidosis may warrant closer neurological surveillance at dialysis start."}},{"doi":"10.1093/ckj/sfaf343","pmid":"41333670","title":"Urgent initiation of hemodialysis versus peritoneal dialysis in severe hyperkalemia: a prospective study","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2025-12-03T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfaf343","source_score":38,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-10","doi":"10.1093/ckj/sfaf343","days":"30","issn":"2048-8505","rank":"5","field":"Clinical Medicine","score":"38","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1093/ckj/sfaf343","title":"Urgent initiation of hemodialysis versus peritoneal dialysis in severe hyperkalemia: a prospective study.","journal":"Clinical kidney journal","methods":"","results":"Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups (","abstract":"$30","keywords":["ESRD","chronic hemodialysis","hyperkalemia","peritoneal dialysis","uremic 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