Hemodialysis International最新文献

{"title":"Analysis of the Relationship Between Self-Efficacy, Adherence With Diet Therapy and Fluid Control in Patients Receiving Hemodialysis Treatment: A Structural Equation Analysis","authors":"Gülcan Bahçecioğlu Turan,&nbsp;Ceren Karabulutlu,&nbsp;Zülfünaz Özer","doi":"10.1111/hdi.70004","DOIUrl":"10.1111/hdi.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Hemodialysis treatment presents physical, emotional, and social challenges for patients, impacting their overall well-being and daily life. Successful management requires adherence to fluid restrictions, dietary guidelines, and regular medication intake. This study explored the associations between self-efficacy, dietary adherence, and fluid control in patients undergoing hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional, descriptive study was conducted from 15 April 2024 to 15 June 2024, involving 197 patients receiving hemodialysis at a public hospital and a private dialysis center in Erzurum, eastern Turkey. Data were collected using a Personal Information Form, the General Self-Efficacy Scale, the Fluid Control in Hemodialysis Patients Scale, and the Attitude Scale for Dietary Therapy of Hemodialysis Patients. Descriptive statistics and structural equation modeling were used for analysis. A Bayesian estimator assessed direct and indirect relationships between variables. The model's reliability and validity were assessed using various statistical tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants had an average age of 53.3 years and an average duration on dialysis of 6.7 years. Of the participants, 91.4% regularly monitored their weight, and 65% regularly monitored edema. The average scores were 28.35 (5.92, SD) on the General Self-Efficacy Scale, 45.8 (8.12) on the Attitude Scale for Dietary Therapy, and 49.0 (9.05) on the Fluid Control Scale. Self-efficacy had a significant positive indirect association with fluid control through dietary adherence (β = 0.126, 95% confidence interval [0.008, 0.277]). The total association between self-efficacy and fluid control was also significant (β = 0.624, 95% confidence interval [0.483, 0.755]), with dietary adherence partially mediating this relationship. Self-efficacy accounted for 31% of the variance in dietary adherence, and the overall model explained 41% of the variance in fluid control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher self-efficacy was associated with better dietary adherence and improved fluid control. Dietary adherence partially mediated the association between self-efficacy and fluid control. Healthcare providers may consider strategies to enhance self-efficacy in hemodialysis patients to support dietary adherence and fluid control, potentially improving treatment outcomes, and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 1","pages":"234-241"},"PeriodicalIF":1.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediating Effects of Fatigue and Sleep Quality on Uremic Pruritus and Quality of Life Among Hemodialysis Patients: A Cross-Sectional Study","authors":"Yongjun Ji,&nbsp;Hye-Ja Park,&nbsp;Sunki Kim","doi":"10.1111/hdi.70003","DOIUrl":"10.1111/hdi.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Uremic pruritus is a common and distressing symptom among patients undergoing hemodialysis, frequently accompanied by fatigue and poor sleep quality. These symptoms collectively impair quality of life (QoL), yet their interrelationships remain unclear. To examine whether fatigue and sleep quality mediate the relationship between uremic pruritus and QoL in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study using quantitative mediation analysis. A total of 175 hemodialysis patients from three hospital-affiliated dialysis centers in South Korea completed validated self-report measures assessing uremic pruritus, fatigue, sleep quality, and QoL. Mediation analysis was conducted using Baron and Kenny's framework, Sobel test, and bootstrapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Uremic pruritus was significantly correlated with fatigue (<i>r</i> = 0.30, <i>p</i> &lt; 0.001) and sleep quality (<i>r</i> = 0.53, <i>p</i> &lt; 0.001), and negatively correlated with QoL (r = −0.29, <i>p</i> &lt; 0.001). Fatigue (<i>B</i> = −0.3, 95% CI: −0.5 to −0.1) and sleep quality (<i>B</i> = −0.2, 95% CI: −0.4 to −0.1) were significantly associated with both uremic pruritus and QoL. The final model accounted for 40% of the variance in QoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Uremic pruritus indirectly affects QoL through its impact on fatigue and sleep quality. This suggests that its influence operates via interconnected symptoms rather than directly. The findings support the need for integrated symptom management approaches in dialysis care. Interventions targeting fatigue and sleep quality may be effective in reducing the burden of pruritus and improving daily functioning and well-being in patients undergoing hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Preprint Statement</h3>\u0000 \u0000 <p>This manuscript has not been previously published and is not under consideration elsewhere. If the manuscript is posted on a preprint server, the authors will update it with a link to the final published version.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Statistical Compliance Statement</h3>\u0000 \u0000 <p>The statistics were checked prior to submission by an expert statistician, Ilhyun Lee, Email: <span>[email protected]</span>.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 1","pages":"224-233"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Strategies for Prevention of Catheter-Related Bloodstream Infections (CRBSI) in United States Hemodialysis Facilities","authors":"Leslie P. Wong","doi":"10.1111/hdi.70005","DOIUrl":"10.1111/hdi.70005","url":null,"abstract":"<div>\u0000 \u0000 <p>Hemodialysis (HD) patients are at high risk for infection owing to the necessity of vascular access to the bloodstream for treatments. Despite widespread efforts to promote early establishment of arteriovenous fistula or graft (AVF/G) for HD, 70%–80% of patients initiate dialysis with a central venous catheter (CVC). Catheter-related bloodstream infections (CRBSIs) are a known risk of central venous catheter use, accounting for 70% of HD access-related bloodstream infections. Given the significant morbidity, mortality, and cost associated with central venous catheter use, prevention of CRBSIs is a major priority for nephrologists, dialysis facilities, and kidney care organizations attempting to improve quality and deliver safe care to dialysis patients. Recent strategies for prevention of CRBSI in HD have broadened focus to pre-dialysis education and planning and a growing armamentarium of evidence-based interventions to avoid or mitigate the consequences of central venous catheter use. New commercially available products containing chlorhexidine and taurolidine promise to augment core interventions to prevent CRBSI in dialysis facilities. This manuscript reviews selected topics and recent advances in knowledge related to preventing CRBSI in HD, with emphasis on dialysis care in United States.</p>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 1","pages":"10-17"},"PeriodicalIF":1.2,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Extracorporeal Therapies to Treat Severe Caffeine Poisoning","authors":"Saeko Kohara,&nbsp;Yoshito Kamijo,&nbsp;Michiko Takai,&nbsp;Ryoko Kyan,&nbsp;Eiju Hasegawa,&nbsp;Takuya Shimane","doi":"10.1111/hdi.70002","DOIUrl":"10.1111/hdi.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reflecting on recent reports suggesting the efficacy of extracorporeal blood purification, including hemodialysis, for severe caffeine poisoning, we conducted a retrospective 5-year follow-up study on acute caffeine poisoning in Japan particularly focusing on extracorporeal blood purification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients transported to emergency facilities between April 2016 and March 2021 after consuming large or excessive amounts of over-the-counter drugs and energy drinks containing caffeine as a primary ingredient were included. We collected information on demographic characteristics, medical history, the caffeine-containing products consumed, clinical and laboratory findings, treatments, and outcomes using a questionnaire. We compared the data of patients who were treated with and without extracorporeal blood purification (blood purification vs. nonblood purification group). We also compared our findings with those of a previous related study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Seventy-six patients were included. Patients in the blood purification group (<i>n</i> = 22) were significantly older (<i>p</i> = 0.02), ingested higher estimated doses of caffeine (<i>p</i> &lt; 0.01), demonstrated higher pulse rates (<i>p</i> = 0.01), respiratory rates (<i>p</i> = 0.03), and serum glucose levels (<i>p</i> = 0.05) on admission, resulting in longer hospital stays (<i>p</i> &lt; 0.01) than those in the nonblood purification group (<i>n</i> = 54). However, their backgrounds, clinical features on arrival, and clinical signs and symptoms during the clinical course were similar between this and the previous study. Compared to the previous study, this study had a higher percentage of patients who underwent extracorporeal blood purification (16.8% vs. 28.9%; <i>p</i> = 0.07), including hemodialysis (10.9% vs. 22.4%; <i>p</i> = 0.06); nevertheless, no statistically significant differences were observed in the prognoses between the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Currently, the use of extracorporeal blood purification including hemodialysis for the treatment of caffeine poisoning is being promoted in Japan; however, the decision to administer it mostly depends on the patients' ingested doses or vital signs, and not on the serum caffeine levels. Further studies are warranted to confirm whether extracorporeal blood purification improves the prognoses of patients with severe caffeine poisoning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 1","pages":"73-79"},"PeriodicalIF":1.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Single Cannulaton Technique for Puncturing Arteriovenous Fistulas: Randomized Comparison With Rope Ladder Technique Cannulation","authors":"Fang Xu,&nbsp;Jun Qiu,&nbsp;Shanshan Huo,&nbsp;Haitao Bai,&nbsp;Xia Wang,&nbsp;Peng Shu","doi":"10.1111/hdi.70000","DOIUrl":"10.1111/hdi.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to evaluate the impact of multiple single cannulation technique (MuST) on complications associated with arteriovenous fistulas (AV fistulas) in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who initiated hemodialysis using AV fistulas at our hospital between August 2023 and December 2023 were selected using convenience sampling. Participants were randomly assigned to either the control group or the experimental group using a random number table, with odd-numbered patients placed in the control group and even-numbered patients in the experimental group. The experimental group received MuST, while the control group received the rope ladder cannulation technique. After 12 months of follow-up, we assessed the incidence of aneurysms, thrombosis, infiltration, and stenosis, along with the cannulation success rate. Pain levels were evaluated using the Visual Analogue Scale (VAS) for pain, and cannulation difficulty was rated using Likert's five-point scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The experimental group exhibited significantly lower incidences of aneurysms (3.44% vs. 15.3%), thrombus (1.72% vs. 13.6%), and stenosis (1.72% vs. 11.7%) compared to the control group (<i>p</i> &lt; 0.05). The cannulation success rate was also significantly higher in the experimental group (99.5% vs. 99.0%) (<i>p</i> &lt; 0.05). Moreover, the experimental group reported significantly lower cannulation difficulty scores (1.41 ± 0.54 vs. 2.24 ± 1.04) and pain scores (1.82 ± 0.93 vs. 3.29 ± 0.77) (<i>p</i> &lt; 0.05). However, the incidence of infiltration was significantly higher in the experimental group (19.0% vs. 6.78%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MuST was associated with reduced pain and higher success rate of cannulation, and fewer complications compared to the standard rope ladder method. However, it was linked with a higher rate of infiltration. These findings suggest that MuST may be a promising alternative and warrants further investigation and broader clinical adoption.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"30 1","pages":"58-65"},"PeriodicalIF":1.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Dimensional Speckle Tracking Echocardiography in Hemodialysis Patients","authors":"Serap Yadigar,&nbsp;Gülümser Sevgin Halil,&nbsp;Pınar Özdemir,&nbsp;Erman Özdemir,&nbsp;Ezgi Gültekin Güner,&nbsp;Abdurrahman Engin Demir,&nbsp;Sukru Hakan Gunduz,&nbsp;Banu Şahin Yıldız,&nbsp;Mustafa Yıldız","doi":"10.1111/hdi.13272","DOIUrl":"10.1111/hdi.13272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It has been suggested that ventricular strain measurements may be impaired in chronic hemodialysis patients despite having no history of heart disease. The aim of this study is to investigate whether ventricular strain parameters can be used to detect subclinical cardiac dysfunction in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In our study, 47 patients under the age of 65 years with no known history of cardiac or valvular disease and receiving chronic hemodialysis treatment for at least 1 year were compared with an age- and sex-matched control group of 29 healthy individuals. Transthoracic echocardiography was used to evaluate parameters such as global longitudinal strain, right ventricular global longitudinal strain, and left ventricular diastolic diameter. Differences between groups were analyzed by Student's <i>t</i>-test and Mann–Whitney <i>U</i> test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The global longitudinal strain values of the hemodialysis group were significantly lower than those of the control group (−13.2 ± 3.91 vs. −22.1 ± 1.59, <i>p</i> &lt; 0.001). Right ventricular global longitudinal strain (RV GLS) and left ventricular diastolic diameter were also significantly impaired in the hemodialysis group (<i>p</i> &lt; 0.05). These results indicate the presence of subclinical cardiac dysfunction in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ventricular strain measurements may be impaired in chronic hemodialysis patients without a history of cardiovascular disease. Therefore, it is considered that ventricular strain measurements can be a useful method for the early detection of cardiac dysfunction in hemodialysis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 4","pages":"588-598"},"PeriodicalIF":1.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Green Dialysis Review: Reducing Water, Energy, and Waste","authors":"Kyle J. Backston,&nbsp;Cole J. Thompson,&nbsp;Manya Raina,&nbsp;Nafees R. Sathik,&nbsp;Lydia S. Noh,&nbsp;Pooja P. Lokkur,&nbsp;Shyam B. Bansal","doi":"10.1111/hdi.13251","DOIUrl":"10.1111/hdi.13251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hemodialysis is a lifesaving therapy but imposes a significant environmental burden due to its excessive consumption of water and energy and the generation of non-recyclable medical waste. The emerging Green Dialysis movement aims to mitigate these environmental impacts by promoting sustainable practices in nephrology. We summarize current knowledge on the environmental challenges associated with hemodialysis and highlight innovative strategies for reducing its ecological footprint through the Green Dialysis framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review synthesized recent literature on water use, energy consumption, and waste generation in dialysis, evaluating practical and technological innovations, including water recycling, reduced dialysate flow, renewable energy integration, and sorbent-based systems, that aim to improve sustainability in nephrology care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key environmental challenges of hemodialysis include excessive water and energy consumption and substantial waste generation. Hemodialysis facilities consume vast quantities of water, with up to 60 percent of treated water being discarded, while energy demands produce considerable carbon emissions. Waste production, particularly plastic waste, poses additional environmental challenges, as much of it is non-recyclable and poorly managed. Through the Green Dialysis movement, there is a concerted effort to promote sustainable practices in nephrology. Innovative solutions such as water recycling, reduced dialysate flow rates, adoption of renewable energy sources, and advanced hemodialysis machine designs may minimize resource use and waste.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Green Dialysis movement offers a comprehensive and actionable approach to improving the environmental sustainability of dialysis care. By integrating these strategies, the Green Dialysis movement aims to mitigate the environmental footprint of hemodialysis, fostering a sustainable and resilient future for nephrology care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 4","pages":"463-471"},"PeriodicalIF":1.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Hemorrhagic Rectal Ulcer in a Uremic Patient: A Case Report and Literature Review","authors":"Dongdong Liu,&nbsp;Xingbing Han,&nbsp;Min Li,&nbsp;Lingyan Li,&nbsp;Yi Huang,&nbsp;Jingmei Song","doi":"10.1111/hdi.13273","DOIUrl":"10.1111/hdi.13273","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute hemorrhagic rectal ulcer (AHU) is a rare but severe cause of painless lower GI bleeding, mainly in elderly patients with comorbidities. Uremia increases bleeding risk due to platelet dysfunction and hemodialysis anticoagulation, but AHU in dialysis patients is underreported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To report a case of AHU in a uremic hemodialysis patient and analyze management challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A 78-year-old female with ESRD presented with rectal bleeding. Colonoscopy showed a 3 × 4 cm ulcer, managed with clips, injections, and adhesives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient experienced recurrent bleeding, requiring multiple endoscopic interventions (titanium clip placement, methylene blue-polydocanol injection, tissue adhesive). Despite initial hemostasis, she developed worsening heart failure and multi-organ failure, dying at home after ICU admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Uremia, anticoagulation, and comorbidities fueled bleeding. Endoscopic therapy was key, but systemic decline dominated. Multidisciplinary care is vital for high-risk patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case instills awareness of the exigency regarding continuous observation and tailored management in this population of patients with high risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 4","pages":"730-736"},"PeriodicalIF":1.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Artificial Intelligence in Scientific Writing. The Danger of Trying Too Hard to Please","authors":"John T. Daugirdas","doi":"10.1111/hdi.13270","DOIUrl":"10.1111/hdi.13270","url":null,"abstract":"<p>The author describes his experience using several artificial intelligence programs to assist in the process of editing or preparing manuscripts for publication. While the programs were very useful to increase clarity and optimize the English of previously written text, problems arose when asked to review the literature to describe or expand on concepts, and then to cite references to support those statements. Citations were sometimes fabricated. The artificial intelligence program would even provide PubMed identification (PMID) numbers for references cited, which sometimes pointed to completely different publications. In references that were correctly cited, a request to extract data from their abstracts yielded data that were completely fabricated or incorrect. The newer versions of these artificial intelligence programs appear to be enormously helpful in helping with the process of scientific writing, but one needs to assiduously verify every statement made with regard to their interpretation of the medical literature and double-check any citations by retrieving and reading those references. Because statements made by these agents are proffered with great confidence and using excellent writing skills, the resulting errors can be difficult to anticipate. The motivations behind such errors are unknown, but appear to be related to a desire of AI to please the user at any cost. Programmers who create these tools somehow managed to allow such errors, and this issue must be addressed in future versions of AI. Also, it would help greatly if AI had access to the full text of medical scientific articles, which might be achieved by contractual agreements with the main medical publishers.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 4","pages":"430-433"},"PeriodicalIF":1.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Distress in Hemodialysis: Impact of Life Events, Illness Perception, and Difficulty Processing Emotions (Alexithymia)","authors":"Weihuan Sun,&nbsp;Yanshuang Chang","doi":"10.1111/hdi.13269","DOIUrl":"10.1111/hdi.13269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Depression and anxiety in individuals undergoing hemodialysis (HD) significantly impair daily functioning and hinder renal rehabilitation efforts. Various factors, including negative life events, illness perceptions, and difficulty processing emotions (alexithymia), have been associated with these psychological challenges; however, their specific impact on HD-related psychological distress remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 246 individuals receiving HD were assessed using self-administered questionnaires, including the Life Events Scale (LES), Illness Perceptions Questionnaire (IPQ-R), Toronto Alexithymia Scale (TAS-20), and the Hospital Anxiety and Depression Scale (HADS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that 32.5% and 41.5% of HD patients exhibited symptoms of depression and anxiety, respectively. Logistic regression analyses revealed significant correlations between negative life events, illness perceptions, and alexithymia with both depression and anxiety. Specifically, higher scores on the “Negative Emotional Representation about Illness” subscale were associated with an increased risk of depression (adjusted odds ratio [OR], 1.302; 95% confidence interval [CI], 1.118–1.544; <i>p</i> &lt; 0.001). Conversely, lower scores on “Personal Control” were linked to a heightened risk of depression (adjusted OR, 0.796; 95% CI, 0.683–0.927; <i>p</i> = 0.003). For anxiety, elevated scores in “Negative Emotional Representation about Illness” (adjusted OR, 1.185; 95% CI, 1.014–1.261; <i>p</i> = 0.015) and “difficulty identifying feelings” (adjusted OR, 1.210; 95% CI, 1.031–1.411; <i>p</i> = 0.016) indicated increased risk, while lower scores in “Personal Control” were similarly associated with heightened anxiety risk (adjusted OR, 0.852; 95% CI, 0.734–0.983; <i>p</i> = 0.042).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that negative life events, specific illness perceptions, and alexithymia are significant predictors of depression and anxiety among HD patients. Addressing maladaptive illness perceptions and emotional regulation deficits could offer novel strategies to enhance mental health outcomes in this population, highlighting the need for further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 4","pages":"626-638"},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}