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multiple renal failure

Lisa B VanWagner, Samantha Montag, Lihui Zhao, Norrina B Allen, Donald M Lloyd-Jones, Arighno Das, Anton I Skaro, Samuel Hohmann, John J Friedewald, Josh Levitsky
BACKGROUND: In the general population, even mild renal disease is associated with increased cardiovascular (CV) complications. Whether this is true in liver transplant recipients (LTR) is unknown. METHODS: This was a retrospective cohort study of 671 LTR (2002-2012) from a large urban tertiary care center and 37,322 LTR using Vizient hospitalization data linked to the United Network for Organ Sharing. The MDRD4 equation estimated GFR (eGFR). Outcomes were 1-year CV complications (death/hospitalization from myocardial infarction, heart failure, atrial fibrillation, cardiac arrest, pulmonary embolism or stroke) and mortality...
March 20, 2018: Transplantation
Yanhua Wu, Yuanhan Chen, Shaowen Li, Wei Dong, Huaban Liang, Miaoyi Deng, Yingnan Chen, Shixin Chen, Xinling Liang
PURPOSE: To investigate the application value of "electronic alerts" ("e-alerts") for acute kidney injury (AKI) among high-risk wards of hospitals. METHODS: A prospective, randomized, controlled study was conducted. We developed an e-alert system for AKI and ran the system in intensive care units and divisions focusing on cardiovascular disease. The e-alert system diagnosed AKI automatically based on serum creatinine levels. Patients were assigned randomly to an e-alert group (467 patients) or non-e-alert group (408 patients)...
March 19, 2018: International Urology and Nephrology
Pankti A Gheewala, Gregory M Peterson, Syed Tabish R Zaidi, Matthew D Jose, Ronald L Castelino
BACKGROUND: Screening programs may help to address the burden of chronic kidney disease (CKD) in Australia. Public awareness is an important determinant of the uptake of screening programs. However, data on the public knowledge of CKD in Australia is lacking. The aim of this study was to develop a validated questionnaire and assess the Australian public knowledge of CKD. METHODS: A CKD knowledge questionnaire was developed after reviewing the literature and discussions with nephrology experts...
March 20, 2018: BMC Public Health
Maroua Eid, Olivier Fouquet, Cédric Darreau, Marc Pierrot, Achille Kouatchet, Alain Mercat, Christophe Baufreton
INTRODUCTION: Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. METHODS: A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure...
March 2018: International Journal of Artificial Organs
Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
Chang-Hua Li, Wen-Liang Chen, Guang-Mao Lin
OBJECTIVE: To study the risk factors of perioperative heart failure in the elderly patients with femoral shaft fracture by the regression analysis, so as to provide relevant clinical reference. METHODS: From July 2012 to April 2017, 143 elderly patients with femoral shaft fracture who underwent surgical treatment in our hospital were retrospectively studied. Among them, 25 patients with perioperative heart failure included 10 males and 15 females with a mean age of (77...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Saishree Pradhan, Sriram Krishnamurthy, Barath Jagadisan, Nachiappa G Rajesh, Subashini Kaliaperumal, Suryaprakash Ramasamy, Nandeeswari Subramanian
A 12-year-old girl born to third-degree consanguineous parents presented with recurrent episodes of haematuria for 8 months in association with peri-orbital and lower limb oedema for 20 days. There was no jaundice, hepatomegaly or neurological abnormality at presentation. An older brother had died following jaundice at 10 years of age. Urinalysis showed multiple dysmorphic erythrocytes without proteinuria and there was leucopenia, thrombocytopenia and hypo-albuminaemia (23 g/L). C3 component of complementaemia was low and anti-nuclear antibodies and anti-double-stranded DNA antibodies were strongly positive by immunofluorescence...
March 12, 2018: Paediatrics and International Child Health
Amir A Ghaffarian, Ragheed Al-Dulaimi, Larry W Kraiss, Mark Sarfati, Claire L Griffin, Brigitte K Smith, Graham Donald, Benjamin S Brooke
OBJECTIVE: Arteriovenous (AV) fistulas are the preferred hemodialysis access for patients with end-stage renal disease, although multiple interventions are typically needed to maintain patency. When AV fistulas thrombose, however, there is debate as to whether open thrombectomy should be attempted, particularly for salvage of upper arm fistulas. This study was designed to evaluate outcomes after open thrombectomy of upper arm and forearm AV fistulas compared with AV grafts. METHODS: We identified all patients who underwent an open thrombectomy procedure for a thrombosed AV fistula or graft at a single academic medical center between January 2006 and March 2017...
March 8, 2018: Journal of Vascular Surgery
Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
Karine Augeul-Meunier, Marie-Lorraine Chretien, Anne-Marie Stoppa, Lionel Karlin, Lofti Benboubker, Jose Miguel Torregrosa Diaz, Mohamad Mohty, Ibrahim Yakoub-Agha, Jacques-Olivier Bay, Aurore Perrot, Claude-Eric Bulabois, Anne Huynh, Mélanie Mercier, Laurent Frenzel, Hervé Avet-Loiseau, Régis Peffault de Latour, Jérôme Cornillon
Renal impairment is a common complication of multiple myeloma (MM), accounting for 20-30% of MM patients at diagnosis and 40-50% of patients during the course of their disease. This feature is associated with poor prognosis and shorter survival as compared to patients with normal renal function (NRF). Therefore, therapeutic management is challenging as autologous stem cell transplantation (ASCT) is often not considered as a valuable strategy, mainly due to concerns of toxicity. In this retrospective and multicenter study, we included 55 MM patients with dialysis-dependent or independent renal failure who underwent high-dose melphalan-based ASCT in order to assess the efficacy outcomes and toxicities of this strategy...
March 9, 2018: Bone Marrow Transplantation
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
Sanda Mrabet, Narjess Ben Aicha, Nihed Abdessayed, Moncef Mokni, Abdellatif Achour
BACKGROUND: Membranous nephropathy (MN), the leading cause of nephrotic syndrome in adults, is characterized by the deposition of subepithelial immune deposits. Most of the cases are primary, while only approximately 25% of the cases are secondary to some known diseases. Recently, MN has been considered to be a possible presentation of chronic graft-versus-host disease (GVHD) of the kidney in allogeneic hematopoietic stem cell transplantation (HSCT) patients. In autologous HSCT populations, there have been scarce reports of associated MN, as a result of immune dysregulation leading to systemic autoimmunity and miming chronic GVHD...
March 9, 2018: BMC Nephrology
Michitaka Funayama, Taketo Takata, Akihiro Koreki, Satoyuki Ogino, Masaru Mimura
OBJECTIVE: Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications following catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia...
March 8, 2018: Psychosomatic Medicine
David F Pinal-García, Carlos M Nuño-Guzmán, Audrey Gómez-Abarca, Jorge L Corona, Ismael Espejo
Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography...
January 2018: Case Reports in Gastroenterology
Yin-Wu Bao, Yuan Yuan, Jiang-Hua Chen, Wei-Qiang Lin
Acute kidney injury (AKI) and chronic kidney disease (CKD) are worldwide public health problems affecting millions of people and have rapidly increased in prevalence in recent years. Due to the multiple causes of renal failure, many animal models have been developed to advance our understanding of human nephropathy. Among these experimental models, rodents have been extensively used to enable mechanistic understanding of kidney disease induction and progression, as well as to identify potential targets for therapy...
March 18, 2018: Zoological Research
Timothy D Girard, Jennifer L Thompson, Pratik P Pandharipande, Nathan E Brummel, James C Jackson, Mayur B Patel, Christopher G Hughes, Rameela Chandrasekhar, Brenda T Pun, Leanne M Boehm, Mark R Elstad, Richard B Goodman, Gordon R Bernard, Robert S Dittus, E W Ely
BACKGROUND: Delirium during critical illness results from numerous insults, which might be interconnected and yet individually contribute to long-term cognitive impairment. We sought to describe the prevalence and duration of clinical phenotypes of delirium (ie, phenotypes defined by clinical risk factors) and to understand associations between these clinical phenotypes and severity of subsequent long-term cognitive impairment. METHODS: In this multicentre, prospective cohort study, we included adult (≥18 years) medical or surgical ICU patients with respiratory failure, shock, or both as part of two parallel studies: the Bringing to Light the Risk Factors and Incidence of Neuropsychological Dysfunction in ICU Survivors (BRAIN-ICU) study, and the Delirium and Dementia in Veterans Surviving ICU Care (MIND-ICU) study...
March 2018: Lancet Respiratory Medicine
Lorraine Sheena Kasaven, Anastasia Goumenou, Kenneth Adegoke
Ovarian hyperstimulation syndrome (OHSS) is a well-recognised iatrogenic complication following controlled ovarian stimulation (COS). Mild to moderate cases are mostly managed conservatively. Severe cases of OHSS can be potentially fatal. For this reason, UK clinics providing licensed fertility treatment are obliged to follow Human Fertilisation and Embryology Authority guidelines for reporting severe incidents. We present an unusually severe complication of OHSS resulting in significant morbidity. A nulligravida woman aged 25, with a 4-year history of subfertility and multiple risk factors for the development of OHSS, underwent COS...
March 5, 2018: BMJ Case Reports
Akash Deep, Romit Saxena, Bipin Jose
Acute kidney injury (AKI) is a common accompaniment in patients with liver disease. The causes, risk factors, manifestations and management of AKI in these patients vary according to the liver disease in question (acute liver failure, acute-on-chronic liver failure, post-liver transplantation or metabolic liver disease). There are multiple causes of AKI in patients with liver disease-pre-renal, acute tubular necrosis, post-renal, drug-induced renal failure and hepatorenal syndrome (HRS). Definitions of AKI in liver failure are periodically revised and updated, but pediatric definitions have still to see the light of the day...
March 1, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Jun Lai, Gael Akindavyi, Qiang Fu, Zhi-Liang Li, Hui-Min Wang, Li-Hua Wen
Objective: Coronary artery calcification (CAC) is thought to be a controlled metabolic process that is very similar to the formation of new bone. In patients with chronic renal failure (CRF), CAC is very common, and CAC severity correlates with the deterioration of renal function. We summarized the current understanding and emerging findings of the relationship between CAC and CRF. Data Sources: All studies were identified by systematically searching PubMed, Embase, and CNKI databases for the terms "coronary calcification", "chronic renal failure", "vascular smooth muscle cell", and their synonyms until September 2017...
March 5, 2018: Chinese Medical Journal
Hyun-Wook Lee, Gunars Osis, Autumn N Harris, Lijuan Fang, Michael F Romero, Mary E Handlogten, Jill W Verlander, I David Weiner
Renal ammonia metabolism is the primary mechanism through which the kidneys maintain acid-base homeostasis, but the molecular mechanisms regulating renal ammonia generation are unclear. In these studies, we evaluated the role of the proximal tubule basolateral plasma membrane electrogenic sodium bicarbonate cotransporter 1 variant A (NBCe1-A) in this process. Deletion of the NBCe1-A gene caused severe spontaneous metabolic acidosis in mice. Despite this metabolic acidosis, which normally causes a dramatic increase in ammonia excretion, absolute urinary ammonia concentration was unaltered...
February 26, 2018: Journal of the American Society of Nephrology: JASN
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