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https://www.readbyqxmd.com/read/28515156/anti-glomerular-basement-membrane-disease
#1
Stephen P McAdoo, Charles D Pusey
Anti-glomerular basement membrane (anti-GBM) disease is a rare small vessel vasculitis that affects the capillary beds of the kidneys and lungs. It is an archetypic autoimmune disease, caused by the development of directly pathogenic autoantibodies targeting a well characterized autoantigen expressed in the basement membranes of these organs, although the inciting events that induce the autoimmune response are not fully understood. The recent confirmation of spatial and temporal clustering of cases suggests that environmental factors, including infection, may trigger disease in genetically susceptible individuals...
May 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28514783/dialysis-access-as-an-area-of-improvement-in-elderly-incident-hemodialysis-patients-results-from-a-cohort-study-from-the-international-monitoring-dialysis-outcomes-initiative
#2
Jochen G Raimann, Claudia Barth, Len A Usvyat, Priscila Preciado, Bernard Canaud, Michael Etter, Xiaoqi Xu, Adrian Guinsburg, Christina Marelli, Neill Duncan, Albert Power, Frank M van der Sande, Jeroen P Kooman, Stephan Thijssen, Yuedong Wang, Peter Kotanko
BACKGROUND: Commencing hemodialysis (HD) using a catheter is associated with a higher risk of adverse outcomes, and early conversion from central-venous catheter (CVC) to arteriovenous fistula/graft (non-CVC) improves outcomes. We investigated CVC prevalence and conversion, and their effects on outcomes during the first year of HD in a multinational cohort of elderly patients. METHODS: Patients ≥70 years from the MONDO Initiative who commenced HD between 2000 and 2010 in Asia-Pacific, Europe, North-, and South-America and survived at least 6 months were included in this investigation...
May 17, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28506760/patients-double-seropositive-for-anca-and-anti-gbm-antibodies-have-varied-renal-survival-frequency-of-relapse-and-outcomes-compared-to-single-seropositive-patients
#3
Stephen P McAdoo, Anisha Tanna, Zdenka Hrušková, Lisa Holm, Maria Weiner, Nishkantha Arulkumaran, Amy Kang, Veronika Satrapová, Jeremy Levy, Sophie Ohlsson, Vladimir Tesar, Mårten Segelmark, Charles D Pusey
Co-presentation with both ANCA and anti-GBM antibodies is thought to be relatively rare. Current studies of such 'double-positive' cases report small numbers and variable outcomes. To study this further we retrospectively analyzed clinical features and long-term outcomes of a large cohort of 568 contemporary patients with ANCA-associated vasculitis, 41 patients with anti-GBM disease, and 37 double-positive patients with ANCA and anti-GBM disease from four European centers. Double-positive patients shared characteristics of ANCA-associated vasculitis (AAV), such as older age distribution and longer symptom duration before diagnosis, and features of anti-GBM disease, such as severe renal disease and high frequency of lung hemorrhage at presentation...
May 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28486627/re-exploration-due-to-bleeding-is-not-associated-with-severe-postoperative-complications
#4
Sandeep P Tambe, Hans-Henrik Kimose, Jakob Raben Greisen, Carl-Johan Jakobsen
OBJECTIVES: In cardiac surgery, postoperative bleeding remains a frequent complication with various possible adverse outcomes. Re-exploration due to bleeding is frequent in this type of patient. Sternal wound infection is an infrequent but serious and devastating complication. Whether re-exploration due to bleeding significantly affects the incidence of sternal wound infection is uncertain. There is no consensus on allowed severity of bleeding and timing of intervention. METHODS: A retrospective, observational cohort study of 15 350 consecutive patients who underwent cardiac surgical procedures from 1 April 2006 through 31 December 2013 in 3 different university hospitals in Denmark was performed...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28467527/association-of-transcatheter-aortic-valve-replacement-with-30-day-renal-function-and-1-year-outcomes-among-patients-presenting-with-compromised-baseline-renal-function-experience-from-the-partner-1-trial-and-registry
#5
Nirat Beohar, Darshan Doshi, Vinod Thourani, Hanna Jensen, Susheel Kodali, Feifan Zhang, Yiran Zhang, Charles Davidson, Patrick McCarthy, Michael Mack, Samir Kapadia, Martin Leon, Ajay Kirtane
Importance: The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. Objective: To determine the effect of TAVR among patients with baseline renal impairment. Design, Setting, and Participants: This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada...
May 3, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28444445/acquired-cystic-kidney-disease-an-under-recognized-condition-in-children-with-end-stage-renal-disease
#6
Eugene Y H Chan, Bradley A Warady
Acquired cystic kidney disease (ACKD) is a condition that occurs predominantly in patients with end-stage renal disease (ESRD). In contrast to hereditary cystic kidney disease, ACKD is characterized by the presence of multiple small cysts in bilaterally small kidneys. Limited pediatric data suggest a high incidence (21.6-45.8%) of ACKD in children on dialysis, comparable to that in adults, with an increased frequency associated with a longer duration of dialysis. Recent research has shed light on the pathogenesis of ACKD, such as activation of proto-oncogenes...
April 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28432691/tenapanor-administration-and-the-activity-of-the-h-coupled-transporter-pept1-in-healthy-volunteers
#7
Susanne Johansson, David P Rosenbaum, Johan Palm, Bergur Stefansson, Mikael Knutsson, Eleanor A Lisbon, Constanze Hilgendorf
AIM: Tenapanor (RDX5791/AZD1722), an inhibitor of gastrointestinal Na(+) /H(+) exchanger NHE3, is being evaluated for the treatment of patients with constipation-predominant irritable bowel syndrome and the treatment of hyperphosphataemia in patients with chronic kidney disease on dialysis. By reducing intestinal H(+) secretion, inhibition of NHE3 by tenapanor could indirectly affect H(+) -coupled transporter activity, leading to drug-drug interactions. We investigated the effect of tenapanor on the activity of the H(+) -coupled peptide transporter PepT1 via assessment of the pharmacokinetics of cefadroxil - a compound transported by PepT1 - in healthy volunteers...
April 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28425578/survival-comparisons-of-intensive-vs-conventional-hemodialysis-pitfalls-and-lessons
#8
REVIEW
Amanda J Miller, Jeff Perl, Karthik K Tennankore
The optimal dose of hemodialysis (HD) has not yet been established. As a means of better approximating the physiology of native kidney function, there has been a growing interest in intensive HD (an increase in dialysis frequency and/or duration). Although many studies have demonstrated a survival benefit with intensive dialysis, results have been conflicting. This controversy stems from the challenges of randomizing patients to conventional vs. intensive HD modalities and, therefore, the reliance on observational comparisons that have been limited by varying definitions for intensive dialysis, differences in dialysis location and prescription, unavoidable treatment selection bias, and a potential lack of generalizability...
April 20, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28419668/prevalence-and-associated-variables-of-postdialysis-fatigue-results-of-a-prospective-multicenter-study
#9
Maurizio Bossola, Emanuele Marzetti, Enrico Di Stasio, Tania Monteburini, Stefano Cenerelli, Katia Mazzoli, Emanuele Parodi, Vittorio Sirolli, Stefano Santarelli, Fabio Ippoliti, Pier Eugenio Nebiolo, Mario Bonomini, Roberta Melatti, Carlo Vulpio
AIMS: Little is known about postdialysis fatigue (PDF), a debilitating symptom of hemodialysis patients. METHODS: In 5 hemodialysis units of northern-centre Italy, patients were regarded to suffer from PDF if they spontaneously offered this complaint when asked the open-ended question: Do you feel better or worse after dialysis? If worse, please specify in which way. A complaint of fatigue would be probed further with questions directed at its duration, frequency and intensity, allowing creation of a fatigue index of severity (one third of the sum of these three parameters, each rated from 1 to 5)...
April 17, 2017: Nephrology
https://www.readbyqxmd.com/read/28407876/more-frequent-hemodialysis-does-not-effectively-clear-protein-bound-azotemic-solutes-derived-from-gut-microbiome-metabolism
#10
Andrew Davenport
The 5-year survival rate for hemodialysis patients remains lower than that for some of the more common solid organ cancers. Trials of increasing urea clearance by hemodialysis have failed to demonstrate improved patient survival. Accumulating evidence suggests that protein-bound azotemic solutes derived from gut microbiome metabolism have greater potential for toxicity than urea. The Frequent Hemodialysis Network Trials group now report that increasing dialysis frequency to 6 times a week did not effectively improve clearance of these protein-bound azotemic solutes compared with standard thrice weekly sessions...
May 2017: Kidney International
https://www.readbyqxmd.com/read/28401120/estimating-patient-borne-water-and-electricity-costs-in-home-hemodialysis-a-simulation
#11
Matthew Nickel, Wes Rideout, Nikhil Shah, Frances Reintjes, Justin Z Chen, Robert Burrell, Robert P Pauly
BACKGROUND: Home hemodialysis is associated with lower costs to the health care system compared with conventional facility-based hemodialysis because of lower staffing and overhead costs, and by transferring the treatment cost of utilities (water and power) to the patient. The purpose of this study was to determine the utility costs of home hemodialysis and create a formula such that patients and renal programs can estimate the annual patient-borne costs involved with this type of treatment...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28398983/effectiveness-of-educational-or-behavioral-interventions-on-adherence-to-phosphate-control-in-adults-receiving-hemodialysis-a-systematic-review
#12
Molly Milazi, Ann Bonner, Clint Douglas
BACKGROUND: People with end-stage kidney disease (ESKD) develop impaired excretion of phosphate. Hyperphosphatemia develops in ESKD as a result of the kidney's reduced ability to excrete ingested phosphate load and is characterized by high bone turnover and increased musculoskeletal morbidity including bone pain and muscle weakness. Increased serum phosphate levels are also associated with cardiovascular disease and associated mortality. These effects are significant considering that cardiovascular disease is the leading cause of death in ESKD, making phosphate control a crucial treatment goal...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28395286/heart-failure-with-preserved-and-reduced-ejection-fraction-in-hemodialysis-patients-prevalence-disease-prediction-and-prognosis
#13
Marlies Antlanger, Stefan Aschauer, Chantal Kopecky, Manfred Hecking, Johannes J Kovarik, Johannes Werzowa, Julia Mascherbauer, Bernd Genser, Marcus D Säemann, Diana Bonderman
BACKGROUND/AIMS: Heart failure (HF) is a main cause of mortality of hemodialysis (HD) patients. While HF with reduced ejection fraction (HFrEF) is known to only affect a minority of patients, little is known about the prevalence, associations with clinical characteristics and prognosis of HF with preserved ejection fraction (HFpEF). METHODS: We included 105 maintenance HD patients from the Medical University of Vienna into this prospective single-center cohort study and determined the prevalence of HFpEF (per the 2013 criteria of the European Society of Cardiology) and HFrEF (EF <45%), using standardized post-HD transthoracic echocardiography...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28389745/short-frequent-5-days-per-week-in-center-hemodialysis-versus-3-days-per-week-treatment-a-randomized-crossover-pilot-trial-through-the-midwest-pediatric-nephrology-consortium
#14
Benjamin L Laskin, Guixia Huang, Eileen King, Denis F Geary, Christoph Licht, Joshua P Metlay, Susan L Furth, Tom Kimball, Mark Mitsnefes
BACKGROUND: No controlled trials in children with end-stage kidney disease have assessed the benefits of more frequently administered hemodialysis (HD). METHODS: We conducted a multicenter, crossover pilot trial to determine if short, more frequent (5 days per week) in-center HD was feasible and associated with improvements in blood pressure compared with three conventional HD treatments per week. Because adult studies have not controlled for the weekly duration of dialysis, we fixed the total treatment time at 12 h a week of dialysis during two 3-month study periods; only frequency varied from 5 to 3 days per week between study periods...
April 8, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28377908/the-usefulness-of-duplex-ultrasound-for-hemodialysis-access-selection
#15
Jeong Won Choi, Jin Hyun Joh, Ho-Chul Park
PURPOSE: A native vessel is preferable to an artificial graft for dialysis access. Duplex ultrasound (DUS) is noninvasive, cost-effective modality to evaluate the vessels for dialysis. The purpose of this study was to compare the rates of utilization of native vessels after preoperative imaging with DUS and contrast venography (CV). MATERIALS AND METHODS: A retrospective review was performed on patients who received an arteriovenous fistula (AVF) or arteriovenous graft (AVG) between June 2006 and July 2010...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28367165/frequency-of-hepatitis-c-in-hospitalized-patients-with-chronic-kidney-disease
#16
Salman Tahir Shafi, Muhammad Zaigham Hassan, Mohammed Saleem, Roshina Anjum, Wajid Abdullah, Tahir Shafi
BACKGROUND AND OBJECTIVES: Hepatitis C and chronic kidney disease (CKD) are major global health problems and are highly prevalent in Pakistan. There is limited information on prevalence of hepatitis C in patients with CKD not yet on dialysis. The objective of this study was to determine the frequency of hepatitis C in hospitalized chronic kidney disease patients at a tertiary care center in Pakistan. METHODS: The study design was cross-sectional in nature. Patients between ages of 20-80 years with CKD not previously on renal replacement therapy and who were admitted to nephrology ward at a tertiary care facility were included...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28366609/no-evidence-of-increased-ocular-involvement-in-candidemic-patients-initially-treated-with-echinocandins
#17
P Muñoz, A Vena, B Padilla, M Valerio, M I Sanchez, M Puig-Asensio, J Fortún, M Fernández-Ruiz, P Merino, J E Losa, A Loza, R A Rivas, E Bouza
Candins are commonly used as initial therapy in patients with candidemia and are known to diffuse poorly into ocular tissue. The aim of our multicenter study was to assess whether eye involvement was more common in patients initially treated with echinocandins. We performed a post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program implemented in Spain during 2010-2011 (CANDIPOP project). Eye involvement was detected in 13 of 168 patients with candidemia (7.7%) who underwent ophthalmoscopy...
February 27, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28359658/unrecognized-fibrinogen-a-%C3%AE-chain-amyloidosis-results-from%C3%A2-targeted-genetic-testing
#18
Isabel Tavares, João Paulo Oliveira, Ana Pinho, Luciana Moreira, Liliana Rocha, Josefina Santos, Joaquim Pinheiro, Paulo Pinho Costa, Luísa Lobato
BACKGROUND: Fibrinogen A α-chain (AFib) amyloidosis results from autosomal-dominant mutations in the gene encoding AFib (FGA). Patients with this disorder typically present with proteinuria. Isolated cases of AFib amyloidosis, carrying the FGA p.Glu545Val variant, were identified in the district of Braga, in northwest Portugal. This observation led us to hypothesize that this disorder might be an unrecognized cause of kidney disease in that region and prompted us to carry out targeted genetic testing for the p...
March 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28353612/the-effectiveness-and-safety-of-angiotensin-converting-enzyme-inhibition-or-receptor-blockade-in-vascular-diseases-in-patients-with-hemodialysis
#19
Kuang-Ming Liao, Hui-Teng Cheng, Yi-Hsuan Lee, Chung-Yu Chen
Patients with end-stage renal disease (ESRD) who are on hemodialysis have high risk of vascular diseases. Our study sought to examine whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin type 1 receptor blockers (ARBs) could reduce the frequencies of cardiovascular and cerebrovascular events in patients receiving hemodialysis using the medication possession ratio (MPR) method of analysis.This retrospective cohort study identified cases of ESRD with dialysis from the National Health Insurance Research Database between 1999 and 2006, and used Cox-regression methods to evaluate risk of poor outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28340192/prediction-equation-for-calculating-residual-kidney-urea-clearance-using-urine-collections-for-different-hemodialysis-treatment-frequencies-and-interdialytic-intervals
#20
Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Elani Streja, John T Daugirdas
Background.: The purpose of the study was to explore the precision of an equation designed to estimate residual kidney urea clearance (K RU ) from interdialytic urine collection data and pre-hemodialysis (HD) serum urea nitrogen (SUN) in different hemodialysis treatment schedules. Methods.: The generalizability of the proposed equation was tested in 32 731 HD treatments where urine was collected prior to a dialysis session, mostly for 24 h but sometimes longer, in patients being dialyzed 1-4 times/week...
March 15, 2017: Nephrology, Dialysis, Transplantation
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