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BMC Nephrology

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https://www.readbyqxmd.com/read/29351783/simple-citrate-anticoagulation-protocol-for-low-flux-haemodialysis
#1
Eng Kuang Lim, Ying-Ying T Seow, Shun E Chen, Gao Yang, Min Er Liaw, Shimi Isaac
BACKGROUND: For patients unable to receive heparin anticoagulation during haemodialysis, saline flushes to reduce circuit clotting are often the norm. Regional citrate anticoagulation (RCA) although effective is not used by many centres including in Singapore. We wanted to demonstrate the superiority and safety of a simple regional citrate anticoagulation regime, compared to saline flushes, for heparin-free low flux haemodialysis. METHODS: This is a prospective, open label, cross over study on 25 sequential haemodialysis sessions for inpatients receiving heparin-free haemodialysis...
January 19, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334938/therapeutic-plasma-exchange-in-a-tertiary-care-center-185-patients-undergoing-912-treatments-a-one-year-retrospective-analysis
#2
Julius J Schmidt, Firas Asper, Gunilla Einecke, Gabriele Eden, Carsten Hafer, Jan T Kielstein
BACKGROUND: Therapeutic plasma exchange (TPE) is increasingly used throughout the world. Although the procedure itself is fairly standardized, it is yet unknown how the underlying disease entities influence the key coordinates of the treatment. METHODS: Retrospective chart review. The treatment indications were clustered into four categories. Data are presented as median and interquartile (25-75%) range [IQR]. RESULTS: Within 1 year, 912 TPE treatments were performed in 185 patients (90 female, 48...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334930/safety-and-adequacy-of-percutaneous-kidney-biopsy-performed-by-nephrology-trainees
#3
Vittoria Esposito, Giulia Mazzon, Paola Baiardi, Massimo Torreggiani, Luca Semeraro, Davide Catucci, Marco Colucci, Alice Mariotto, Fabrizio Grosjean, Giacomo Bovio, Ciro Esposito
BACKGROUND: Recently there has been a progressive loss of specialty related skills for nephrologists. Among the skills we find the kidney biopsy that has a central role in diagnosis of renal parenchymal disease. One of the causes might be the belief that the kidney biopsy should be performed only in larger Centers which can rely on the presence of a renal pathologist and on nephrologists with a large experience. This trend may increase in the short term procedural safety but may limit the chance of in training nephrologists to become confident with the technique...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334929/chronic-kidney-disease-in-sugarcane-workers-in-cameroon-a-cross-sectional-study
#4
Martin E Ekiti, Jean-Berthelot Zambo, Felix K Assah, Valirie N Agbor, Krystel Kekay, Gloria Ashuntantang
BACKGROUND: Agricultural workers especially in sugarcane plantations have a high risk of chronic kidney disease (CKD). Little is known about CKD among sugarcane plantation workers in Cameroon. This study sought to evaluate the prevalence and identify factors associated with CKD in sugarcane plantation workers in Cameroon. METHODS: We conducted an analytic cross-sectional study including 204 adult workers at the sugarcane plantation complex in Mbandjock, Cameroon; over 500 m above sea level...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334912/estimating-the-total-prevalence-and-incidence-of-end-stage-kidney-disease-among-aboriginal-and-non-aboriginal-populations-in-the-northern-territory-of-australia-using-multiple-data-sources
#5
Lin Li, Steven Guthridge, Shu Qin Li, Yuejen Zhao, Paul Lawton, Alan Cass
BACKGROUND: Most estimates for End Stage Kidney Disease (ESKD) prevalence and incidence are based on renal replacement therapy (RRT) registers. However, not all people with ESKD will commence RRT and estimates based only on RRT registry data will underestimate the true burden of ESKD in the community. This study estimates the total number of Northern Territory (NT) residents with ESKD including: those receiving RRT, those diagnosed but not receiving RRT and an estimate of "undiagnosed" cases...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334904/association-of-kidney-disease-quality-of-life-kdqol-36-with-mortality-and-hospitalization-in-older-adults-receiving-hemodialysis
#6
Rasheeda K Hall, Alison Luciano, Carl Pieper, Cathleen S Colón-Emeric
BACKGROUND: For older adults receiving dialysis, health-related quality of life is not often considered in prognostication of death or future hospitalizations. To determine if routine health-related quality of life measures may be useful for prognostication, the objective of this study is to determine the extent of association of Kidney Disease Quality of Life (KDQOL-36) subscales with adverse outcomes in older adults receiving dialysis. METHODS: This is a longitudinal study of 3500 adults aged ≥75 years receiving dialysis in the United States in 2012 and 2013...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29334900/process-evaluation-of-the-radiant-community-study-a-dialysis-facility-level-intervention-to-increase-referral-for-kidney-transplantation
#7
Reem E Hamoda, Jennifer C Gander, Laura J McPherson, Kimberly J Arriola, Loren Cobb, Stephen O Pastan, Laura Plantinga, Teri Browne, Erica Hartmann, Laura Mulloy, Carlos Zayas, Jenna Krisher, Rachel E Patzer
BACKGROUND: The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities. METHODS: To assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January-December 2014)...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29329521/treating-c3-glomerulopathy-with-eculizumab
#8
Thomas Welte, Frederic Arnold, Julia Kappes, Maximilian Seidl, Karsten Häffner, Carsten Bergmann, Gerd Walz, Elke Neumann-Haefelin
BACKGROUND: C3 glomerulopathy (C3G) is a rare, but severe glomerular disease with grim prognosis. The complex pathogenesis is just unfolding, and involves acquired as well as inherited dysregulation of the alternative pathway of the complement cascade. Currently, there is no established therapy. Treatment with the C5 complement inhibitor eculizumab may be a therapeutic option. However, due to rarity of the disease, parameters predicting treatment response remain largely unknown. METHODS: Seven patients with C3G (five with C3 glomerulonephritis and two with dense deposit disease) were treated with eculizumab...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29329518/the-use-of-eculizumab-in-gemcitabine-induced-thrombotic-microangiopathy
#9
Vinod Krishnappa, Mohit Gupta, Haikoo Shah, Abhijit Das, Natthavat Tanphaichitr, Robert Novak, Rupesh Raina
BACKGROUND: Thrombotic microangiopathy (TMA) secondary to gemcitabine therapy (GiTMA) is a very rare pathology that carries a poor prognosis, with nearly half of the cases progressing to end stage renal disease. GiTMA is most commonly associated with adenocarcinomas, most notably pancreatic cancers. The mainstay of management is withdrawal of the offending drug and supportive care. Plasmapheresis has a limited role and hemodialysis may help in the management of fluid overload secondary to renal failure...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29329515/engaging-clinicians-and-patients-to-assess-and-improve-frailty-measurement-in-adults-with-end-stage-renal-disease
#10
Sarah Van Pilsum Rasmussen, Jonathan Konel, Fatima Warsame, Hao Ying, Brian Buta, Christine Haugen, Elizabeth King, Sandra DiBrito, Ravi Varadhan, Leocadio Rodríguez-Mañas, Jeremy D Walston, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: The Fried frailty phenotype, a measure of physiologic reserve defined by 5 components (exhaustion, unintentional weight loss, low physical activity, slow walking speed, and poor grip strength), is associated with poor outcomes among ESRD patients. However, these 5 components may not fully capture physiologic reserve in this population. We aimed to ascertain opinions of ESRD clinicians and patients about the usefulness of the Fried frailty phenotype and interventions to improve frailty in ESRD patients, and to identify novel components to further characterize frailty in ESRD...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29320993/distribution-of-glomerular-diseases-in-taiwan-preliminary-report-of-national-renal-biopsy-registry-publication-on-behalf-of-taiwan-society-of-nephrology
#11
Hsien-Fu Chiu, Hung-Chun Chen, Kuo-Cheng Lu, Kuo-Hsiung Shu
BACKGROUND: Despite the development of biomarkers and noninvasive imaging tools, biopsy remains the only method for correctly diagnosing patients with unexplained hematuria, proteinuria and renal failure. Renal biopsy has been performed for several decades in Taiwan; however, a national data registry is still lacking until 2013. METHODS: The Renal Biopsy Registry Committee was established within the Taiwan Society of Nephrology in January 2013. A biopsy registry format, including basic demographic data, baseline clinical features, laboratory data, and clinical and pathological diagnosis was developed...
January 10, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29316901/dialysis-facility-staff-perceptions-of-racial-gender-and-age-disparities-in-access-to-renal-transplantation
#12
Kristie J Lipford, Laura McPherson, Reem Hamoda, Teri Browne, Jennifer C Gander, Stephen O Pastan, Rachel E Patzer
BACKGROUND: Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States...
January 10, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29310600/warfarin-anticoagulation-in-hemodialysis-patients-with-atrial-fibrillation-comparison-of-nephrologist-led-and-anticoagulation-clinic-led-management
#13
Hamad Bahbahani, Ahmed AlTurki, Ahmed Dawas, Mark L Lipman
BACKGROUND: There is conflicting evidence of benefit versus harm for warfarin anticoagulation in hemodialysis patients with atrial fibrillation. This equipoise may be explained by suboptimal Time in Therapeutic Range (TTR), which correlates well with thromboembolic and bleeding complications. This study aimed to compare nephrologist-led management of warfarin therapy versus that led by specialized anticoagulation clinic. METHODS: In a retrospective cohort of chronic hemodialysis patients from two institutions (Institution A: Nephrologist-led warfarin management, Institution B: Anticoagulation clinic-led warfarin management), we identified patients with atrial fibrillation who were receiving warfarin for thromboembolic prophylaxis...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29310598/assessing-cardiovascular-risk-in-chronic-kidney-disease-patients-prior-to-kidney-transplantation-clinical-usefulness-of-a-standardised-cardiovascular-assessment-protocol
#14
Robin Ramphul, Maria Fernandez, Sam Firoozi, Juan C Kaski, Rajan Sharma, Debasish Banerjee
BACKGROUND: Despite pre-kidney-transplant cardiovascular (CV) assessment being routine care to minimise perioperative risk, the utility of such assessment is not well established. The study reviewed the evaluation and outcome of a standardised CV assessment protocol. METHODS: Data were analysed for 231 patients (age 53.4 ± 12.9 years, diabetes 34.6%) referred for kidney transplantation between 1/2/2012-31/12/2014. One hundred forty-three patients were high-risk (age > 60 years, diabetes, CV disease, heart failure, peripheral vascular disease) and offered dobutamine stress echocardiography (DSE); 88 patients were low-risk and offered ECG and echocardiography with/without exercise treadmill test...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29310591/uncontrolled-donation-after-circulatory-death-comparison-of-two-kidney-preservation-protocols-on-graft-outcomes
#15
Claire Delsuc, Alexandre Faure, Julien Berthiller, Didier Dorez, Xavier Matillon, Vannary Meas-Yedid, Bernard Floccard, Guillaume Marcotte, Vanessa Labeye, Maud Rabeyrin, Ricardo Codas, Cécile Chauvet, Philip Robinson, Emmanuel Morelon, Lionel Badet, William Hanf, Thomas Rimmelé
BACKGROUND: Kidney transplantation following uncontrolled donation after circulatory death (uDCD) presents a high risk of delayed graft function due to prolonged warm ischemia time. In order to minimise the effects of ischemia/reperfusion injury during warm ischemia, normothermic recirculation recently replaced in situ perfusion prior to implantation in several institutions. The aim of this study was to compare these preservation methods on kidney graft outcomes. METHODS: The primary endpoint was the one-year measured graft filtration rate (mGFR)...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29304774/assessment-of-the-association-between-increasing-membrane-pore-size-and-endotoxin-permeability-using-a-novel-experimental-dialysis-simulation-set-up
#16
Eva Schepers, Griet Glorieux, Sunny Eloot, Michael Hulko, Adriana Boschetti-de-Fierro, Werner Beck, Bernd Krause, Wim Van Biesen
BACKGROUND: Membranes with increasing pore size are introduced to enhance removal of large uremic toxins with regular hemodialysis. These membranes might theoretically have higher permeability for bacterial degradation products. In this paper, permeability for bacterial degradation products of membranes of comparable composition with different pore size was investigated with a new in vitro set-up that represents clinical flow and pressure conditions. METHODS: Dialysis was simulated with an AK200 machine using a low-flux, high-flux, medium cut-off (MCO) or high cut-off (HCO) device (n = 6/type)...
January 5, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29287591/systematic-review-of-nephrotoxicity-of-drugs-of-abuse-2005-2016
#17
Kanaan Mansoor, Murad Kheetan, Saba Shahnawaz, Anna P Shapiro, Eva Patton-Tackett, Larry Dial, Gary Rankin, Prasanna Santhanam, Antonios H Tzamaloukas, Tibor Nadasdy, Joseph I Shapiro, Zeid J Khitan
BACKGROUND: The United States is faced with an unprecedented epidemic of drug abuse. Every year thousands of Americans visit the emergency departments all over the country with illicit drug related complaints. These drugs have been known to be associated with a range of renal pathologies, from reversible acute kidney injuries to debilitating irreversible conditions like renal infarction. So far, no comprehensive study or systematic review has been published that includes the commonly used street drugs and designer drugs with potential nephrotoxic outcomes...
December 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29287589/rapid-clinical-improvement-of-amyloid-a-amyloidosis-following-treatment-with-tocilizumab-despite-persisting-amyloid-deposition-a-case-report
#18
Akira Yamagata, Takahiro Uchida, Yuji Yamada, Takashi Nakanishi, Kazue Nagai, Toshihiko Imakiire, Naoki Oshima, Hiroo Kumagai
BACKGROUND: Amyloid A amyloidosis is one of the most common forms of amyloidosis. It is secondary to rheumatoid arthritis, which is difficult to manage and has a poor prognosis. We present a patient with rheumatoid arthritis and amyloid A amyloidosis who was treated with tocilizumab, a humanized monoclonal antibody against interleukin 6 receptor, resulting in improvement in both proteinuria and gastrointestinal symptoms; however, amyloid deposition remained. CASE PRESENTATION: A 67-year-old woman who had previously been treated for rheumatoid arthritis presented with abdominal pain and diarrhea...
December 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29287588/relation-between-duration-of-the-prodromal-phase-and-renal-damage-in-anca-associated-vasculitis
#19
Eline Houben, Stefanie L Groenland, Joost W van der Heijden, Alexandre E Voskuyl, Hiëronymus J Doodeman, Erik L Penne
BACKGROUND: In ANCA-associated vasculitis the acute phase of the disease is often preceded by prodromal symptoms. The aim of the present study was to analyze the relation between the duration of the prodromal phase and renal damage. METHODS: Patients with ANCA-associated vasculitis and renal involvement from a retrospective single-center cohort were divided into two equal groups based on the duration of the prodromal phase. The prodromal phase was defined as the time between first vasculitis related symptoms and the date of diagnosis...
December 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29287586/the-impact-of-intravenous-methylprednisolone-pulses-on-renal-survival-in-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-with-severe-renal-injury-patients-a-retrospective-study
#20
Yanhong Ma, Fei Han, Liangliang Chen, Hongya Wang, Haidongqing Han, Binfeng Yu, Ying Xu, Jianghua Chen
BACKGROUND: High-dose methylprednisolone pulses were one of the main treatments for anti-neutrophil cytoplasmic autoantibody (ANCA) associated vasculitides (AAV) but had obvious side effects. We aimed to know the impact on renal survival and identify the prognostic factors of this treatment in Chinese AAV patients with severe renal involvement. METHODS: One hundred and eleven AAV patients with an estimated glomerular filtration rate (eGFR) of 10ml/min/1.73 m2 or less at admission were included...
December 29, 2017: BMC Nephrology
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