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Continuous dialysis therapies

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https://www.readbyqxmd.com/read/29765590/a-case-of-rhabdomyolysis-after-kidney-transplantation-successfully-managed-with-intensive-continuous-dialysis
#1
Rauf Shahbazov, Michael Fox, Jennifer L Alejo, Malik A Anjum, Feredun Azari, Alden Doyle, Avinash Agarwal, Kenneth L Brayman
Rhabdomyolysis is characterized by muscle cell death which can result in acute kidney injury from pigment nephropathy. We present a patient who developed rhabdomyolysis immediately after deceased donor kidney transplantation surgery and was managed with continuous renal replacement therapy that resulted in successful salvage of the kidney allograft. Patients who develop acute kidney failure requiring renal replacement therapy generally have a poor prognosis. It is worth noting that while continuous veno-venous hemofiltration (CVVHF) offers greater volume support and continuous clearance compared to hemodialysis (HD), recent studies have demonstrated no clinically significant improvement in clinical outcome between the two...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29750039/impact-of-an-inline-extracorporeal-membrane-oxygenation-hemofilter-system-in-neonatal-acute-kidney-injury
#2
Mohammed Azar, Abdulrahman Alamir, Abdullah Thabet Al Qahtani, Al Mokali Khamisa, Khalid Alfakeeh
Extracorporeal membrane oxygenation (ECMO) is considered a recognized lifesaving support for patients with cardiorespiratory failure. Acute kidney injury (AKI) and fluid overload are significant morbidity factors resulting in serious complications. The inline hemofilter system (IHS) and the continuous renal replacement therapy (CRRT) machine are different methods of renal replacement therapy for patients with ECMO. IHS is the alternate, safe dialysis modality of choice because it is user-friendly, inexpensive, and efficiently removes fluid overload and renal diffusive clearance...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29737362/-regional-citrate-anticoagulation-in-renal-replacement-therapy-in-the-intensive-care-station-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#3
REVIEW
M Schmitz, M Joannidis, D Czock, S John, A Jörres, S J Klein, M Oppert, V Schwenger, J Kielstein, A Zarbock, D Kindgen-Milles, C Willam
BACKGROUND: Regional citrate anticoagulation (RCA) in continuous renal replacement therapy can effectively anticoagulate dialysis circuits without having adverse effects on systemic heparin application. In particular, in continuous renal replacement therapy RCA is well established and represents a safe procedure with longer filter lifetimes and fewer bleeding complications. OBJECTIVES: To provide guidance on the indications, advantages and disadvantages, and use of RCA, current recommendations from the renal section of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
May 8, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29725650/effect-of-frequent-dialysis-on-renal-recovery-results-from-the-acute-renal-failure-trial-network-study
#4
Anitha Vijayan, Rowena B Delos Santos, Tingting Li, Charles W Goss, Paul M Palevsky
Introduction: The optimal frequency of intermittent hemodialysis (IHD) in the treatment of acute kidney injury (AKI) remains unclear. Increasing the frequency of IHD, while offering the possible advantage of reduced ultrafiltration requirement and less hemodynamic instability per session, amplifies patient contact with an extracorporeal circuit with possible deleterious cardiovascular and immunological consequences. A recent study suggested that intensive renal replacement therapy (RRT) is associated with a decrease in urine output during AKI...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29720873/the-impact-on-quality-of-life-of-dialysis-patients-with-renal-insufficiency
#5
Marta Dąbrowska-Bender, Grażyna Dykowska, Wioletta Żuk, Magdalena Milewska, Anna Staniszewska
Aim: The aim of the study was the subjective assessment of the quality of life (QoL) of 140 patients treated with dialysis (peritoneal dialysis and hemodialysis). Background: Chronic kidney disease and the methods of its treatment play an important part in shaping the QoL of patients receiving dialysis. As a result, kidney failure causes many limitations in patients' physical, mental, and social activities. Methods: The instrument to measure the QoL was the authors' own questionnaire made on the basis of Kidney Disease and Quality of Life Short Form version 1...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29705734/treatment-of-end-stage-renal-disease-with-continuous-ambulatory-peritoneal-dialysis-in-rural-guatemala
#6
Jillian Moore, Pablo Garcia, Peter Rohloff, David Flood
A 42-year-old indigenous Maya man presented to a non-profit clinic in rural Guatemala with signs, symptoms and laboratory values consistent with uncontrolled diabetes. Despite appropriate treatment, approximately 18 months after presentation, he was found to have irreversible end-stage renal disease (ESRD) of uncertain aetiology. He was referred to the national public nephrology clinic and subsequently initiated home-based continuous ambulatory peritoneal dialysis. With primary care provided by the non-profit clinic, his clinical status improved on dialysis, but socioeconomic and psychological challenges persisted for the patient and his family...
April 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29669237/current-practice-of-diagnosis-and-management-of-acute-kidney-injury-in-intensive-care-unit-in-resource-limited-settings
#7
Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29664506/continuous-venovenous-hemofiltration-in-neonates-with-hyperammonemia-a-case-series
#8
Felipe Cavagnaro Santa María, Jorge Roque Espinosa, Pamela Guerra Hernández
INTRODUCTION: Neonatal hyperammonemia secondary due to inborn errors of metabolism is a rare condition with a high rate of neurological sequelae and mortality. Initial medical management is often insufficient to stop the progressive increase of ammonia, with the consequent deterioration of the patient. For this reason, depurative techniques have been implemented, including peritoneal dialysis, intermittent hemodialysis and continuous renal replacement therapy (CRRT). OBJECTIVE: To describe our experience with continuous extracorporeal dialysis in severely ill neonates with hyperammonemia...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#9
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29651510/-vomiting-and-collapse-of-a-28-year-old-male-long-distance-runner-in-middle-european-summer
#10
J Herold, A Mitrasch, E Lorenz, U Lodes, I Tanev, R Braun-Dullaeus, F Meyer
BACKGROUND: Hyperthermia often ends fatally and must therefore be promptly recognized and adequately treated. CASE: A 28-year-old man participated in a long-distance race (3 km) on a hot summer day (28 °C). The runner collapsed, had to vomit but continued the run and reached the finish. Neurologically, the patient presented with intermittent cerebral seizures. External cooling batteries were immediately applied and cold infusions were started. The patient was admitted to the intensive care unit of the university hospital (body temperature 40...
April 12, 2018: Der Internist
https://www.readbyqxmd.com/read/29650864/-a-case-of-home-care-for-heart-failure
#11
Haruhiko Tohyama
A female in her 80s with a history of cerebral infarction and atrial fibrillation had repeated hospitalizations because of heart failure caused by ischemic myocardiopathy. She lived alone and received home care and support for self-care with involvement of multiple providers, enabling early detection of disease exacerbation and subsequent intervention. A new ischemic event was managed with percutaneous coronary intervention. With deterioration of renal function, her response to diuretics decreased, and dialysis was initiated...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29644072/do-kidney-transplantations-save-money-a-study-using-a-before-after-design-and-multiple-register-based-data-from-sweden
#12
Johan Jarl, Peter Desatnik, Ulrika Peetz Hansson, Karl Göran Prütz, Ulf-G Gerdtham
Background: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. Method: A before-after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29644065/frailty-and-chronic-kidney-disease-current-evidence-and-continuing-uncertainties
#13
Andrew C Nixon, Theodoros M Bampouras, Neil Pendleton, Alexander Woywodt, Sandip Mitra, Ajay Dhaygude
Frailty, the state of increased vulnerability to physical stressors as a result of progressive and sustained degeneration in multiple physiological systems, is common in those with chronic kidney disease (CKD). In fact, the prevalence of frailty in the older adult population is reported to be 11%, whereas the prevalence of frailty has been reported to be greater than 60% in dialysis-dependent CKD patients. Frailty is independently linked with adverse clinical outcomes in all stages of CKD and has been repeatedly shown to be associated with an increased risk of mortality and hospitalization...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29644053/the-dialysis-orders-objective-structured-clinical-examination-osce-a-formative-assessment-for-nephrology-fellows
#14
Lisa K Prince, Ruth C Campbell, Sam W Gao, Jessica Kendrick, Christopher J Lebrun, Dustin J Little, David L Mahoney, Laura A Maursetter, Robert Nee, Mark Saddler, Maura A Watson, Christina M Yuan
Background: Few quantitative nephrology-specific simulations assess fellow competency. We describe the development and initial validation of a formative objective structured clinical examination (OSCE) assessing fellow competence in ordering acute dialysis. Methods: The three test scenarios were acute continuous renal replacement therapy, chronic dialysis initiation in moderate uremia and acute dialysis in end-stage renal disease-associated hyperkalemia. The test committee included five academic nephrologists and four clinically practicing nephrologists outside of academia...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29629282/effects-of-12-months-of-continuous-positive-airway-pressure-therapy-on-cognitive-function-sleep-mood-and-health-related-quality-of-life-in-a-peritoneal-dialysis-patient-with-obstructive-sleep-apnea
#15
Kyoung Sook Park, Jung Hyun Chang, Ea Wha Kang
This report describes the case of a hypertensive 51-year-old male with a 3-year history of peritoneal dialysis. We followed the patient through his diagnosis of severe obstructive sleep apnea (OSA) and treatment with continuous positive airway pressure (CPAP). Therapeutic use of CPAP led to the improvement of not only sleep-related problems, but also cognitive function and quality of life. To our knowledge, this is the first paper describing the benefits of long-term CPAP treatment in an OSA patient undergoing dialysis...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29629280/effectiveness-of-group-cognitive-behavioral-therapy-with-mindfulness-in-end-stage-renal-disease-hemodialysis-patients
#16
Bo Kyung Sohn, Yun Kyu Oh, Jung-Seok Choi, Jiyoun Song, Ahyoung Lim, Jung Pyo Lee, Jung Nam An, Hee-Jeong Choi, Jae Yeon Hwang, Hee-Yeon Jung, Jun-Young Lee, Chun Soo Lim
Background: Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. Methods: We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29611144/treatment-dose-and-the-elimination-rates-of-electrolytes-vitamins-and-trace-elements-during-continuous-veno-venous-hemodialysis-cvvhd
#17
Thomas Datzmann, Karl Träger, Bernd Schröppel, Helmut Reinelt, Philipp von Freyberg
INTRODUCTION: During continuous renal replacement therapy, achievement of recommended treatment dose is important. However, relevant substrate loss may occur and recommended nutrition during critical illness could not be sufficient for higher dialysis doses. We investigated the correlation of dialysis dose and substrate loss for a broad range of dialysis doses. METHODS: Forty critically ill patients with acute kidney injury undergoing citrate CVVHD were included in this prospective study...
April 2, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29611117/intestinal-perforation-by-a-peritoneal-dialysis-catheter-in-which-fungal-peritonitis-led-to-diagnosis-a-rare-case-report
#18
Hisato Shima, Shogo Mizoguchi, Yuji Morine, Manabu Tashiro, Kazuyoshi Okada, Jun Minakuchi, Shu Kawashima
Intestinal perforation by a peritoneal catheter is an uncommon, but serious, complication that has a high mortality rate. Intestinal perforation in peritoneal dialysis (PD) patients is difficult to diagnose using symptoms and radiological findings, which may result in a delay in diagnosis. Moreover, intestinal perforation complicated with fungal peritonitis is reportedly a severe condition with a poor prognosis. Herein, we report the case of a 78-year-old man on PD, whose diagnosis of perforative peritonitis was difficult to diagnose preoperatively...
April 2, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29602067/the-use-of-computed-tomography-in-the-diagnosis-of-abdominal-cocoon
#19
Ujjwal Gorsi, Pankaj Gupta, Harshal S Mandavdhare, Harjeet Singh, Usha Dutta, Vishal Sharma
BACKGROUND: Literature on the diagnosis of abdominal cocoon using computed tomography (CT) outside the setting of continuous ambulatory peritoneal dialysis is sparse. METHODS: We did a retrospective analysis of contrast enhanced CT done for patients treated for abdominal cocoon. The clinical features, radiological findings, underlying etiology and outcomes were recorded. RESULTS: Of the 22 patients analyzed, 19 had tuberculosis, 2 had malignancy and 1 was idiopathic...
March 26, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29597223/discontinuation-of-continuous-renal-replacement-therapy-and-dialysis-dependence
#20
Gregorio Romero-González, Anna Lorenzin, Mauro Neri, Fiorenza Ferrari, Alejandra Molano-Triviño, Alessandra Brendolan, Claudio Ronco
Renal replacement therapy (RRT) is a form of extracorporeal support for critical patients, especially for those with acute kidney injury. This therapy enables to gain adequate control over the great metabolic and fluids demand when kidneys are not able to do so; this condition is habitually present in patients who are admitted to intensive care units. However, it is also clear that these patients present a higher mortality rate and, in some cases, complications associated with the therapy. Therefore, it is fundamental to optimize and customize different aspects of RRT that range from the ideal timing including the modality and the dose until its suspension or ending...
2018: Contributions to Nephrology
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