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https://www.readbyqxmd.com/read/28812394/the-use-of-sustained-low-efficiency-dialysis-sled-in-massive-paracetamol-overdose
#1
Anselm Wong, Roger L K Tong, Liam Ryan, Tim Crozier, Andis Graudins
CONTEXT: Massive paracetamol ingestion causing mitochondrial dysfunction is uncommon. Use of sustained low-efficiency dialysis (SLED) to improve acidaemia and enhance paracetamol elimination has not been previously described. CASE DETAILS: A 44-year-old male presented to the emergency department 2.5 hours post overdose of 200 g (2.5 g/kg) of paracetamol. Examination revealed a BP 85/60 mmHg, pulse 112 bpm, temperature 33.9 °C and blood glucose of 13...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28805365/removal-of-cells-from-body-fluids-by-magnetic-separation-in-batch-and-continuous-mode-influence-of-bead-size-concentration-and-contact-time
#2
Nils Bohmer, Nino Demarmels, Elena Tsolaki, Lukas Gerken, Kerda Keevend, Sergio Bertazzo, Marco Lattuada, Inge K Herrmann
The magnetic separation of pathogenic compounds from body fluids is an appealing therapeutic concept. Recently, removal of a diverse array of pathogens has been demonstrated using extracorporeal dialysis-type devices. The contact time between the fluid and the magnetic beads in such devices is limited to a few minutes. This poses challenges, particularly if large compounds, such as bacteria or cells need to be removed. Here, we report on the feasibility to remove cells from body fluids in a continuous dialysis type of setting...
August 14, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28801959/outcomes-of-patients-with-atypical-hemolytic-uremic-syndrome-with-native-and-transplanted-kidneys-treated-with-eculizumab-a-pooled-post-hoc-analysis
#3
Christophe M Legendre, Josep M Campistol, Thorsten Feldkamp, Giuseppe Remuzzi, John F Kincaid, Åsa Lommelé, Jimmy Wang, Laurent E Weekers, Neil S Sheerin
Atypical hemolytic uremic syndrome (aHUS) often leads to end-stage renal disease (ESRD) and kidney transplantation; graft loss rates are high due to disease recurrence. A post hoc analysis of four prospective clinical trials in aHUS was performed to evaluate eculizumab, a terminal complement inhibitor, in patients with native or transplanted kidneys. The trials included 26-week treatment and extension periods. Dialysis, transplant, and graft loss were evaluated. Study endpoints included complete thrombotic microangiopathy (TMA) response, TMA event-free status, hematologic and renal parameters, and adverse events...
August 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28799694/patient-with-a-total-artificial-heart-maintained-on-outpatient-dialysis-while-listed-for-combined-organ-transplant-a-single-center-experience
#4
Ramy M Hanna, Huma Hasnain, Mohammad Kamgar, Mina Hanna, Raffi Minasian, James Wilson
Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28795537/proteomics-investigations-into-serum-proteins-adsorbed-by-high-flux-and-low-flux-dialysis-membranes
#5
Shuai Han, Kaiguang Yang, Jingdi Sun, Jianhui Liu, Lihua Zhang, Jiuyang Zhao
PURPOSE: Hemodialysis is one of the most important therapies for patients with uremia, and the dialysis membrane is the predominant factor that impacts the efficiency of dialysis. Here, we investigated protein adsorption on two different membranes to provide a basis for improving dialysis materials. METHODS: Two cases treated with the Polyflux 14L low-flux dialyzer and the Polyflux 140H high-flux dialyzers during two continuous therapies were selected. Four used dialyzers from selected patients were infused with C12Im-Cl to elute the adsorbed proteins...
August 10, 2017: Proteomics. Clinical Applications
https://www.readbyqxmd.com/read/28795535/update-on-postdialysis-rebound-by-a-new-technology-in-hemodialysis
#6
Alicia García Testal, David Hervás Marín, Rafael García Maset, Pilar Royo Maicas, Inmaculada Soledad Rico Salvador, Pau Olagüe Díaz, Jose Enrique Fernández Najera, Eduardo Torregrosa De Juan, Caterina Benedito Carrera
After dialysis ends, urea continued movement causes rebound postdialysis, with values at about 20%. New techniques have been incorporated into hemodialysis, but their relationship with rebound has not yet been studied. This study aimed to quantify urea rebound at 30-min postdialysis during sessions using polysulfone filters and high-flow versus online hemodiafiltration, and to define its correlation with body composition measured by bioimpedance by a cross-sectional study with 69 patients (December 2015 to January 2016)...
August 9, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28795380/peritoneal-dialysis-associated-catheter-infection-caused-by-mycobacterium-abscessus-in-an-elderly-patient-who-was-successfully-treated-with-catheter-removal
#7
Arata Hibi, Takahisa Kasugai, Keisuke Kamiya, Keisuke Kamiya, Chiharu Ito, Satoru Kominato, Ken Mizuguchi, Toshiyuki Miura, Katsushi Koyama
An 89-year-old Japanese man on peritoneal dialysis (PD) was suspected of having a PD-associated catheter infection. He visited the hospital because of the discharge of pus from the exit site of his catheter. Gram staining of the pus showed Gram-positive bacilli, but these were acid-fast bacilli. The rapidly growing nontuberculous mycobacteria, Mycobacterium abscessus, was isolated. PD catheter removal and debridement were immediately performed. The patient received combination antibiotic therapy. His clinical course was good, but he required hemodialysis due to the discontinuation of PD...
August 9, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28794295/foreign-body-reaction-to-dialysis-chatheter-and-peritoneal-fluid-eosinophilia-in-a-child-on-continuous-ambulatory-peritoneal-dialysis
#8
Nuran Cetin, Nadide Melike Sav, Evrim Ciftci, Bilal Yildiz
Foreign body reaction is a tissue response against implanted materials. We described for the first time the eosinophilic peritonitis and foreign body giant cell reaction to dialysis catheter in a nonatopic child on continuous ambulatory peritoneal dialysis. We found tenderness, redness, and swelling without purulent discharge around the peritoneal catheter; increased eosinophil count in cloudy dialysis fluid; and blood and hyperechoic granulomatous formation appearance surrounding the peritoneal catheter on ultrasonography and foreign body giant cell reaction to dialysis catheter in pathologic examination of granulomatous lesionin in our patient...
July 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28793394/tranexamic-acid-induced-acute-renal-cortical-necrosis-in-post-endoscopic-papillectomy-bleeding
#9
Doo Hyun Ko, Tae Hyung Kim, Jong Wook Kim, Ja Joong Gu, Baek Hyun Yoon, Ji Hong Oh, Seung Goun Hong
Acute renal failure can be the result of acute renal cortical necrosis (RCN), which commonly occurs from complications occurring during pregnancy. RCN is rarely caused by medications, although tranexamic acid, which is used in patients with acute bleeding for its antifibrinolytic effects, reportedly causes acute RCN in rare cases. An 82-year-old woman experienced gastrointestinal bleeding after endoscopic papillectomy of an ampullary adenoma. The bleeding was controlled with tranexamic acid administration; however, 4 days later, her urine volume decreased and she developed pulmonary edema and dyspnea...
August 9, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#10
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
https://www.readbyqxmd.com/read/28783094/ability-to-work-among-patients-with-eskd-relevance-of-quality-care-metrics
#11
Nancy G Kutner, Rebecca Zhang
Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated...
August 7, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28782299/continuous-erythropoiesis-receptor-activator-cera-for-the-anaemia-of-chronic-kidney-disease
#12
REVIEW
Valeria M Saglimbene, Suetonia C Palmer, Marinella Ruospo, Patrizia Natale, Jonathan C Craig, Giovanni Fm Strippoli
BACKGROUND: Continuous erythropoiesis receptor activator (CERA) is a newer, longer acting ESA which might be preferred to other ESAs (epoetin or darbepoetin) based on its lower frequency of administration. Different dosing requirements and molecular characteristics of CERA compared with other ESAs may lead to different health outcomes (mortality, cardiovascular events, quality of life) in people with anaemia and chronic kidney disease (CKD). OBJECTIVES: To assess benefits and harms of CERA compared with other epoetins (darbepoetin alfa and epoetin alfa or beta) or placebo/no treatment or CERA with differing strategy of administration for anaemia in individuals with CKD...
August 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28777393/hemodialysis-membrane-coated-with-a-polymer-having-a-hydrophilic-blood-contacting-layer-can-enhance-diffusional-performance
#13
Masashi Tagaya, Saki Nagoshi, Morihiro Matsuda, Shunsuke Takahashi, Shinya Okano, Kazunobu Hara
PURPOSE: Currently, the foreign surfaces of various extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPA), which creates a hydrophilic blood-contacting layer to reduce thrombogenicity, while the membranes in hemodialyzers are not. We aimed to clarify other side effects of BPA-coated membranes by examining the diffusion performance in in vitro experiments. METHODS: We used a polyethersulfone membrane (sieving coefficient of albumin is ≤0...
August 2, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28768271/long-term-outcomes-and-associated-risk-factors-of-post-hospitalization-dialysis-dependent-acute-kidney-injury-patients
#14
Ajay S Rathore, Tushar Chopra, Jennie Z Ma, Wenjun Xin, Emaad M Abdel-Rahman
BACKGROUND/AIMS: Acute kidney injury requiring dialysis (AKI-D) is associated with poor outcomes. Centers for Medicare and Medicaid Services have reversed their clarification allowing AKI-D patients to be dialyzed at outpatient dialysis units. Data assessing long-term outcomes of AKI-D patients and their predictors is needed to adopt guidelines to ensure adequate management. We assessed long-term outcomes and associated risk factors of AKI-D patients who survived 90 days post-hemodialysis (HD) initiation...
July 29, 2017: Nephron
https://www.readbyqxmd.com/read/28766493/evaluation-of-the-safety-and-immunogenicity-of-subcutaneous-hx575-epoetin-alfa-in-the-treatment-of-anemia-associated-with-chronic-kidney-disease-in-predialysis-and-dialysis-patients%C3%A2
#15
Nicole Casadevall, Vladimir Dobronravov, Kai-Uwe Eckardt, Sehsuvar Ertürk, Liliya Martynyuk, Susanne Schmitt, Gregor Schaffar, Anita Rudy, Andriy Krendyukov, Marité Ode
AIM: To assess the safety and immunogenicity of subcutaneous (SC) HX575 (epoetin-α) in dialysis- and nondialysis-dependent adult patients with chronic kidney disease (CKD). METHODS: Open-label, single-arm, multicenter study in patients (n = 416) from Germany, Italy, Poland, Romania, Russia, Turkey, and Ukraine. RESULTS: Mean (standard deviation (SD)) age was 52.3 (15.8) years, all patients were Caucasian, and similar proportions were male/female...
August 2, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28762611/pregnancy-on-short-daily-home-hemodialysis-using-low-dialysate-flow-rate-a-new-hope-for-the-end-stage-renal-disease-patients
#16
Vincent Leduc, Maxence Ficheux, Clémence Bechade, Michel Dreyfus, Thierry Lobbedez, Patrick Henri
INTRODUCTION: In France in 2014, there were approximately 1500 patients of reproductive age treated by dialysis. Pregnancy in these patients remains rare, however, the incidence has increased since the 2000s, with a parallel increase in the fetal survival rate. We report 2 cases of pregnancy in short-daily home hemodialysis using low dialysate flow rate. METHODS: Short-daily hemodialysis was continued at the request of the patients. The treatment consisted in an increase of frequency and duration of hemodialysis sessions, an independent blood pressure and dry weight control supervised by nephrological monitoring twice a month and a regular obstetrics follow-up...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28755052/usp-apparatus-4-a-valuable-in-vitro-tool-to-enable-formulation-development-of-long-acting-parenteral-lap-nanosuspension-formulations-of-poorly-water-soluble-compounds
#17
William P Forrest, Kevin G Reuter, Vivek Shah, Irina Kazakevich, Michael Heslinga, Siddhi Dudhat, Sanjaykumar Patel, Claudia Neri, Yun Mao
Long-acting or extended release parenteral dosage forms have attracted extensive attention due to their ability to maintain therapeutic drug concentrations over long periods of time and reduce administration frequency, thus improving patient compliance. It is essential to have an in vitro release (IVR) testing method that can be used to assure product quality during routine production as well as predict and understand the in vivo performance of a formulation. The purpose of this work was to develop a discriminatory in vitro release method to guide formulation and process development of long-acting parenteral (LAP) nanosuspension formulations composed of poorly water-soluble drugs (BCS class II)...
July 28, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28752387/vitamin-and-trace-element-deficiencies-in-the-pediatric-dialysis-patient
#18
Lyndsay A Harshman, Kathy Lee-Son, Jennifer G Jetton
Pediatric dialysis patients are at risk of nutritional illness secondary to deficiencies in water-soluble vitamins and trace elements. Unlike 25-OH vitamin D, most other vitamins and trace elements are not routinely monitored in the blood and, consequently, the detection of any deficiency may not occur until significant complications develop. Causes of vitamin and trace element deficiency in patients on maintenance dialysis patient are multifactorial, ranging from diminished nutritional intake to altered metabolism as well as dialysate-driven losses of water-soluble vitamins and select trace elements...
July 27, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28748880/incident-elderly-patients-on-peritoneal-dialysis-epidemiological-characteristics-and-modality-impact-on-survival-time
#19
Marcia R G Franco, Marcus G Bastos, Abdul R Qureshi, Alyne Schreider, Kleyton de Andrade Bastos, Jose C Divino-Filho, Natalia M S Fernandes
Aging of the population and the increased prevalence of diseases such as diabetes and arterial hypertension result in an increasing need of dialysis treatment. Herein we describe a cohort of elderly patients on peritoneal dialysis (PD) and assess the influence of the modality on the long-term survival. Out of a multicenter prospective cohort of 2,144 BRAZPD PD incident patients during a period from December 2004 to October 2007, 762 elderly adults, defined as patients ≥65-year-old, were eligible for the study, 413 started on automated PD (APD) and 349 on continuous ambulatory PD (CAPD)...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28742229/association-between-obesity-with-low-muscle-mass-and-dialysis-mortality
#20
Hung-Chieh Wu, Shih-Fen Tseng, Wei-Jie Wang, Hsin-Jen Chen, Lin-Chien Lee
AIMS: This study examines the association between body composition and dialysis mortality. METHODS: Adult patients who initiated hemodialysis in Taoyuan General Hospital from 2012 to 2016 were enrolled. We reviewed baseline characteristics and followed over 5 years after dialysis. Patients with body mass index > 25 Kg/m(2) were defined as obesity. High or low muscle mass were classified by skeletal muscle mass index (SMMI) based on consensus from Chinese population...
July 25, 2017: Internal Medicine Journal
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