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https://www.readbyqxmd.com/read/28931542/cumulative-kidney-complication-risk-by-50-years-of-type-1-diabetes-the-effects-of-sex-age-and-calendar-year-at-onset
#1
Tina Costacou, Trevor J Orchard
OBJECTIVE: A common belief is that only a minority of patients with type 1 diabetes (T1D) develop advanced kidney disease and that incidence is higher among men and lower in those diagnosed at a younger age. However, because few patients with T1D survived to older ages until recently, long-term risks have been unclear. RESEARCH DESIGN AND METHODS: We examined the 50-year cumulative kidney complication risk in a childhood-onset T1D cohort diagnosed during 1950-80 (n = 932; mean baseline age 29 years, duration 19 years)...
September 20, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28931089/advanced-glycation-end-products-dietary-restriction-effects-on-bacterial-gut-microbiota-in-peritoneal-dialysis-patients-a-randomized-open-label-controlled-trial
#2
Rabi Yacoub, Melinda Nugent, Weijin Cai, Girish N Nadkarni, Lee D Chaves, Sham Abyad, Amanda M Honan, Shruthi A Thomas, Wei Zheng, Sujith A Valiyaparambil, Mark A Bryniarski, Yijun Sun, Michael Buck, Robert J Genco, Richard J Quigg, John C He, Jaime Uribarri
The modern Western diet is rich in advanced glycation end products (AGEs). We have previously shown an association between dietary AGEs and markers of inflammation and oxidative stress in a population of end stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD). In the current pilot study we explored the effects of dietary AGEs on the gut bacterial microbiota composition in similar patients. AGEs play an important role in the development and progression of cardiovascular (CVD) disease. Plasma concentrations of different bacterial products have been shown to predict the risk of incident major adverse CVD events independently of traditional CVD risk factors, and experimental animal models indicates a possible role AGEs might have on the gut microbiota population...
2017: PloS One
https://www.readbyqxmd.com/read/28927285/impact-of-a-basal-bolus-insulin-regimen-on-metabolic-control-and-risk-of-hypoglycemia-in-patients-with-diabetes-undergoing-peritoneal-dialysis
#3
Ana María Gómez, Santiago Vallejo, Freddy Ardila, Oscar M Muñoz, Álvaro J Ruiz, Mauricio Sanabria, Alfonso Bunch, Elly Morros, Laura Kattah, Maira García-Jaramillo, Fabián León-Vargas
INTRODUCTION: Clinical interventional studies in diabetes mellitus usually exclude patients undergoing peritoneal dialysis (PD). This study evaluates the impact of an educational program and a basal-bolus insulin regimen on the blood glucose level control and risk of hypoglycemia in this population. METHODS: A before-and-after study was conducted in type 1 and type 2 DM patients undergoing PD at the Renal Therapy Services (RTS) clinic network, Bogota, Colombia. An intervention was instituted consisting of a three-month educational program and a basal-bolus detemir (Levemir, NovoNordisk) and aspart (Novorapid, NovoNordisk) insulin regimen...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28924630/role-of-in-vitro-release-methods-in-liposomal-formulation-development-challenges-and-regulatory-perspective
#4
Deepak Solomon, Nilesh Gupta, Nihal S Mulla, Snehal Shukla, Yadir A Guerrero, Vivek Gupta
In the past few years, measurement of drug release from pharmaceutical dosage forms has been a focus of extensive research because the release profile obtained in vitro can give an indication of the drug's performance in vivo. Currently, there are no compendial in vitro release methods designed for liposomes owing to a range of experimental challenges, which has created a major hurdle for both development and regulatory acceptance of liposome-based drug products. In this paper, we review the current techniques that are most often used to assess in vitro drug release from liposomal products; these include the membrane diffusion techniques (dialysis, reverse dialysis, fractional dialysis, and microdialysis), the sample-and-separate approach, the in situ method, the continuous flow, and the modified United States Pharmacopeia methods (USP I and USP IV)...
September 18, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28918595/successful-pregnancy-in-a-ckd-patient-on-a-low-protein-supplemented-diet-an-opportunity-to-reflect-on-ckd-and-pregnancy-in-mexico-an-emerging-country
#5
Julia Nava, Silvia Moran, Veronica Figueroa, Adriana Salinas, Margy Lopez, Rocio Urbina, Abril Gutierrez, Jose Luis Lujan, Alejandra Orozco, Rafael Montufar, Giorgina B Piccoli
Pregnancy is probably the most important challenge in young women with chronic kidney disease (CKD). The challenge is greater in developing countries, in which access to dialysis is uneven, and prenatal care for CKD patients is not uniformly available. This case report summarizes some of the challenges faced by pregnant CKD women in a developing country. A 35-year-old woman, affected by an undiagnosed kidney disease, experienced preeclampsia at 24 years of age, and started dialysis in emergency at age 31 in the context of severe preeclampsia in her second pregnancy...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28917008/peritoneal-dialysis-catheter-function-and-survival-are-not-adversely-affected-by-obesity-regardless-of-the-operative-technique-used
#6
Monika A Krezalek, Nicolas Bonamici, Kristine Kuchta, Brittany Lapin, JoAnn Carbray, Woody Denham, John Linn, Michael Ujiki, Stephen P Haggerty
BACKGROUND: Obesity has been considered a relative contraindication to peritoneal dialysis (PD). Surprisingly, PD catheter dysfunction rates and longevity have not been studied in the growing obese ESRD population. The aim of this study was to determine the effect of patient weight on PD catheter survival in the three insertion technique categories of advanced laparoscopy (AL), basic laparoscopy (BL), and open. METHODS: We examine retrospectively collected data on 231 consecutive PD catheter insertions at the NorthShore University HealthSystem between 2004 and 2014...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28912982/severe-thyrotoxicosis-secondary-to-povidone-iodine-from-peritoneal-dialysis
#7
Kirstie Lithgow, Christopher Symonds
A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#8
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28904881/numerical-expression-of-volume-status-using-the-bioimpedance-ratio-in-continuous-ambulatory-peritoneal-dialysis-patients-a-pilot-study
#9
Mun Jang, Won Hak Kim, Jung Hee Lee, Mi Soon Kim, Eun Kyoung Lee, So Mi Kim, Jai Won Chang
BACKGROUND: Volume overload results in higher mortality rates in patients on continuous ambulatory peritoneal dialysis (CAPD). The ratio of bioimpedance (RBI) might be a helpful parameter in adjusting dry body weight in CAPD patients. This study examined whether it is possible to distinguish between non-hypervolemic status and hypervolemic status in CAPD patients by using only RBI. METHODS: RBI was calculated as follows: RBI = impedance at 50 kHz/impedance at 500 kHz...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28893206/efficacy-of-blood-flow-restriction-exercise-during-dialysis-for-end-stage-kidney-disease-patients-protocol-of-a-randomised-controlled-trial
#10
Matthew J Clarkson, Steve F Fraser, Paul N Bennett, Lawrence P McMahon, Catherine Brumby, Stuart A Warmington
BACKGROUND: Exercise during haemodialysis improves strength and physical function. However, both patients and clinicians are time poor, and current exercise recommendations add an excessive time burden making exercise a rare addition to standard care. Hypothetically, blood flow restriction exercise performed during haemodialysis can provide greater value for time spent exercising, reducing this time burden while producing similar or greater outcomes. This study will explore the efficacy of blood flow restriction exercise for enhancing strength and physical function among haemodialysis patients...
September 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28885379/risk-stratification-of-patients-with-current-generation-continuous-flow-left-ventricular-assist-devices-being-bridged-to-heart-transplantation
#11
Ashrith Guha, Duc Nguyen, Ana S Cruz-Solbes, Javier Amione-Guerra, Robert C Schutt, Arvind Bhimaraj, Barry H Trachtenberg, Myung H Park, Edward A Graviss, Osama Gaber, Eva Montane, Guillermo Torre-Amione, Jerry D Estep
Patients bridged to transplant (BTT) with continuous-flow left ventricular assist devices (CF-LVADs) have increased in the past decade. Decision support tools for these patients are limited. We developed a risk score to estimate prognosis and guide decision-making. We included heart transplant recipients bridged with CF-LVADs from the United Network for Organ Sharing (UNOS) database and divided them into development (2,522 patients) and validation cohorts (1,681 patients). Univariate and multivariate Cox proportional hazards models were performed...
September 5, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28883535/mechanisms-of-silver-nanoparticle-toxicity-to-the-coastal-marine-diatom-chaetoceros-curvisetus
#12
Pablo Lodeiro, Thomas J Browning, Eric P Achterberg, Aurélie Guillou, Mohammad S El-Shahawi
Inputs of silver nanoparticles (AgNPs) to marine waters continue to increase yet mechanisms of AgNPs toxicity to marine phytoplankton are still not well resolved. This study reports a series of toxicity experiments on a representative coastal marine diatom species Chaetoceros curvisetus using the reference AgNP, NM-300K. Exposure to AgNPs resulted in photosynthetic impairment and loss of diatom biomass in proportion to the supplied AgNP dose. The underlying mechanism of toxicity was explored via comparing biological responses in parallel experiments...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28882029/clinical-observation-of-umbilical-cord-mesenchymal-stem-cell-transplantation-for-treating-patients-receiving-peritoneal-dialysis
#13
Hong-Ying Jiang, Jia-Ping Wang, Yi-Hua Bai, Min Yang, Yi Zeng, Yun-Juan Liao, Zhen-Kun He
BACKGROUND: This study aims to observe the outcome and safety of umbilical cord-mesenchymal stem cell (UC-MSC) treatment for continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: A total of 24 CAPD patients, who underwent UC-MSC treatment from June 2011 to December 2012, were selected for this study. These patients were followed-up until June 2015. RESULTS: Results revealed a significant increase in HB, EPO and ALB levels, a decrease in CRP levels, and marked improvement in cystatin C and urine volume within three months after UC-MSC transplantation; and the difference was statistically significant (P<0...
September 7, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28877926/effectiveness-of-quality-improvement-strategies-for-the-management-of-ckd-a-meta-analysis
#14
Samuel A Silver, Chaim M Bell, Glenn M Chertow, Prakesh S Shah, Kaveh Shojania, Ron Wald, Ziv Harel
BACKGROUND AND OBJECTIVES: Quality improvement interventions have enhanced care for other chronic illnesses, but their effectiveness for patients with CKD is unknown. We sought to determine the effects of quality improvement strategies on clinical outcomes in adult patients with nondialysis-requiring CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a systematic review of randomized trials, searching Medline and the Cochrane Effective Practice and Organization of Care database from January of 2003 to April of 2015...
September 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28874122/doxycycline-treatment-in-dialysis-related-amyloidosis-discrepancy-between-antalgic-effect-and-inflammation-studied-with-fdg-positron-emission-tomography-a-case-report
#15
Giorgina Barbara Piccoli, Mammar Hachemi, Ida Molfino, Jean Philippe Coindre, Charles Boursot
BACKGROUND: No effective treatment is currently available and dialysis related amyloidosis continues to be invalidating in long-term dialysis patients. A recent case series reported reduction of osteoarticular pain on doxycycline treatment, extending the indications of this drug, used in other uncommon forms of amyloidosis, to dialysis patients. Explanations of the antalgic effect were the anti-inflammatory properties and anti-coiling effects of tetracycline. CASE PRESENTATION: Our report regards a 54-year-old woman, who was never transplanted and has been on hemodialysis and hemodiafiltration for overall 37 years, due to renal hypoplasia...
September 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28871391/hemofiltration-induces-generation-of-leukocyte-derived-cd31-cd41-microvesicles-in-sepsis
#16
Georg Franz Lehner, Ulrich Harler, Clemens Feistritzer, Viktoria Maria Haller, Julia Hasslacher, Romuald Bellmann, Michael Joannidis
BACKGROUND: Microvesicles (MV) are extracellular vesicles known to be associated with cellular activation and inflammation. Hemofiltration is an effective blood purification technique for patients with renal failure and possibly also eliminates inflammatory mediators in the setting of sepsis. On the other hand, proinflammatory stimuli are induced by blood contacting the artificial membrane during extracorporeal blood purification. In chronic dialysis patients a systemic increase in MV has been described...
September 4, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28858868/association-between-testosterone-and-mortality-risk-among-u-s-males-receiving-dialysis
#17
Jerry Yu, Vanessa A Ravel, Amy S You, Elani Streja, Matthew B Rivara, Praveen K Potukuchi, Steven M Brunelli, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Connie M Rhee
BACKGROUND: Among the general population, low circulating testosterone levels are associated with higher risk of cardiovascular disease and death. While testosterone deficiency is common in dialysis patients, studies of testosterone and mortality in this population are ambiguous and overlapping. We hypothesized that lower testosterone levels are associated with higher mortality in male dialysis patients. METHODS: We examined a nationally representative cohort of male dialysis patients from a large US dialysis organization who underwent one or more total testosterone measurements from 1/2007 to 12/2011...
September 1, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28840494/ultrapure-dialysis-water-obtained-with-additional-ultrafilter-may-reduce-inflammation-in-patients-on-hemodialysis
#18
Biagio Di Iorio, Lucia Di Micco, Dario Bruzzese, Luca Nardone, Luigi Russo, Pietro Formisano, Vittoria D'Esposito, Domenico Russo
BACKGROUND: Patients on standard dialysis, in particular those on high-flux and high-efficiency dialysis, are exposed to hundreds of liters of dialysis-water per week. The quality of dialysis-water is a factor responsible for inflammation in dialysis patients. Inflammation is a potent trigger of atherosclerosis and a pathogenetic factor in anemia, increasing mortality and morbidity in dialysis patients. Current systems for water treatment do not completely eliminate bacteria and endotoxins...
August 23, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28835982/effects-of-paricalcitol-on-cardiovascular-outcomes-and-renal-function-in-patients-with-chronic-kidney-disease-a-meta-analysis
#19
REVIEW
X Hu, J Shang, W Yuan, S Zhang, Y Jiang, B Zhao, Y Duan, J Xiao, Z Zhao
BACKGROUND: Paricalcitol, a selective activator of the vitamin D receptor (VDR), influences calcium and phosphorus homeostasis and bone metabolism. Whether paricalcitol reduces cardiovascular risk and protects renal function remains unclear. To systematically evaluate this in patients with chronic kidney disease (CKD), we conducted a meta-analysis of published randomized controlled trials (RCTs). METHODS: We searched MEDLINE, Embase, the Cochrane Library, and reference lists for RCTs comparing paricalcitol with placebo in stage 2-5 CKD (including pre-dialysis and renal replacement patients)...
August 23, 2017: Herz
https://www.readbyqxmd.com/read/28815812/association-of-left-ventricular-systolic-dysfunction-with-mortality-in-incident-peritoneal-dialysis-patients
#20
Yating Wang, Liping Xiong, Qingdong Xu, Wei Li, Xuan Peng, Jiani Shen, Yagui Qiu, Xueqing Yu, Haiping Mao
AIM: Cardiovascular disease is associated with morbidity and mortality in peritoneal dialysis patients but the relationship between left ventricular ejection fraction (LVEF) and outcomes is unclear. This study aimed to explore the association between LVEF and mortality in incident continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS: The patients were divided into three groups according to LVEF levels (>0.6, 0.5 to 0.6, and <0.5). Kaplan-Meier analysis and the Cox proportional hazards models were used to evaluate association of LVEF with mortality...
August 16, 2017: Nephrology
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