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https://www.readbyqxmd.com/read/29150231/diagnosis-of-hyperferritinemia-in-routine-clinical-practice
#1
Bernard Lorcerie, Sylvain Audia, Maxime Samson, Aurélie Millière, Nicolas Falvo, Vanessa Leguy-Seguin, Sabine Berthier, Bernard Bonnotte
The discovery of hyperferritinemia is often fortuitous, revealed in results from a laboratory screening or follow-up test. The aim of the diagnostic procedure is therefore to identify its cause and to identify or rule out hepatic iron overload, in a three-stage process. In the first step, clinical findings and several simple laboratory tests are sufficient to detect four of the most frequent causes of high ferritin concentrations: alcoholism, inflammatory syndrome, cytolysis, and metabolic syndrome. None of these causes is associated with substantial hepatic iron overload...
November 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29148024/blue-planet-dialysis-novel-water-sparing-strategies-for-reducing-dialysate-flow
#2
Alejandra Molano-Triviño, Benjamin Wancjer, Mauro M Neri, Akash N Karopadi, Mitchell Rosner, Claudio Ronco
INTRODUCTION: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. METHODS: We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux...
November 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29145251/renal-osteodystrophy-presenting-as-a-metabolic-superscan-on-f-18-fdg-pet-ct-a-case-report
#3
Ismaheel Lawal, Alfred Ankrah, Kehinde Ololade, Moshe Modiselle, Mike Sathekge
RATIONALE: F-18 Fluoro Deoxyglucose positron emission tomography and computed tomography (F-18 FDG PET/CT) is a useful modality in the evaluation of patients with malignancies. Increased incidence of lympho-proliferative disorders has been reported in individuals with long-standing end-stage renal disorders treated with renal replacement therapy. PATIENT CONCERNS: A 30-year-old male on peritoneal dialysis on account of end-stage renal disease. He had acute rejection of an earlier transplanted renal allograft...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142938/epidemiological-transition-of-end-stage-kidney-disease-in-oman
#4
Faisal Al Ismaili, Issa Al Salmi, Yaqoub Al Maimani, Abdul Massiah Metry, Humood Al Marhoobi, Alan Hola, Ronald L Pisoni
Introduction: The number of persons receiving renal replacement therapy (RRT) is estimated at more than 2.5 million worldwide, and is growing by 8% annually. Registries in the developing world are not up to standards compared to the United States Renal Data System (USRDS). Herein we examine the causes, progression, and magnitude of end-stage kidney disease (ESKD) over 3 decades in Oman. Methods: We examined ESKD data from 1983 to 2013. Data from 1998 to 2013 were obtained through an Information Management System...
January 2017: KI Reports
https://www.readbyqxmd.com/read/29135295/-re-engineering-of-glucose-exposure-in-peritoneal-dialysis
#5
Emília Mácsai, István Kiss
The significance of peritoneal dialysis in kidney replacement therapy is expected to increase, so it is important to reconsider glucose exposure to minimize the adverse effects. The first step was to develop biocompatible modern PD solutions to reduce the local and systemic adverse effects of current conventional glucose-based ones. According to the limited clinical experience, there are no clear data on better clinical outcome. Besides this there is a suspected theoretical correlation between development of encapsulating peritoneal sclerosis and chronic local irritation of peritoneal surface by glucose...
October 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29132990/beneficiary-characteristics-and-vaccinations-in-the-end-stage-renal-disease-medicare-beneficiary-population-an-analysis-of-claims-data-2006-2015
#6
Angela K Shen, Jeffrey A Kelman, Rob Warnock, Weiwei Zhang, Stephaeno Brereton, Stephen McKean, Michael Wernecke, Steve Chu, Bruce G Gellin
BACKGROUND: The Advisory Committee on Immunization Practices (ACIP) routinely recommends three vaccines - influenza, hepatitis B, and pneumococcal vaccines - for End-Stage Renal Disease (ESRD) dialysis patients. METHODS: We sought to assess vaccination coverage among fee-for-service (FFS) Medicare beneficiaries with ESRD who received Part B dialysis services at any point from January 1, 2006 through December 31, 2015 (through June 30, 2016 for influenza). To assess influenza vaccination rates in a given influenza season, we restricted the population to beneficiaries who were continuously enrolled in Medicare Parts A and B throughout all twelve months of that season...
November 10, 2017: Vaccine
https://www.readbyqxmd.com/read/29132946/an-interview-study-of-patient-and-caregiver-perspectives-on-advance-care-planning-in-esrd
#7
Marcus Sellars, Josephine M Clayton, Rachael L Morton, Tim Luckett, William Silvester, Lucy Spencer, Carol A Pollock, Rowan G Walker, Peter G Kerr, Allison Tong
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, it can be an emotionally charged process for patients with kidney disease and their caregivers. This study aimed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and their caregivers toward ACP. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Patients with ESRD (n=24) and their caregivers (n=15) aged 36 to 91 years at various stages of ACP ("not commenced," "in progress," or "completed") from 3 renal services...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29131451/what-we-do-and-do-not-know-about-women-and-kidney-diseases-questions-unanswered-and-answers-unquestioned-reflection-on-world-kidney-day-and-international-woman-s-day
#8
EDITORIAL
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
Chronic Kidney Disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health and specifically their kidney health, on the community, and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly...
November 13, 2017: Nephrology
https://www.readbyqxmd.com/read/29127652/dapagliflozin-as-a-cause-of-acute-tubular-necrosis-with-heavy-consequences-a-case-report
#9
Christos Pleros, Elisavet Stamataki, Antonia Papadaki, Nikolaos Damianakis, Rafaela Poulidaki, Charikleia Gakiopoulou, Ioannis Tzanakis
A 50-year-old man with type II diabetes, hypertension and dyslipidemia, presented with non-oliguric acute kidney injury (AKI) and anemia. Renal biopsy showed acute tubular necrosis (ATN) with extensive cytoplasmic vacuolization and areas of tubulitis. These findings were ultimately attributed to dapagliflozin, which he started 3 months earlier due to poor glycemic control. ATN with similar microscopic findings has been described with larger doses of dapagliflozin in non-clinical trials. Our patient was started on dialysis and remained dialysis-dependent for 4 weeks while his renal function improved gradually thereafter...
November 10, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29125879/spironolactone-is-effective-in-treating-hypokalemia-among-peritoneal-dialysis-patients
#10
Amit Langote, Swapnil Hiremath, Marcel Ruzicka, Brendan B McCormick
BACKGROUND: Hypokalemia is common in peritoneal dialysis (PD) patients and is associated with increased cardiovascular and all-cause mortality. The management approach for such patients routinely includes spironolactone at our centre. We undertook this study to assess the efficacy of spironolactone for the treatment of hypokalemia in PD patients. METHODS: Retrospective chart review of PD patients at a single centre. Serum potassium was compared prior to initiation of spironolactone and two months afterwards...
2017: PloS One
https://www.readbyqxmd.com/read/29122793/developing-a-classification-system-for-haemoglobin-management-in-patients-with-end-stage-renal-disease-on-haemodialysis-a-secondary-data-analysis
#11
Tibor Kesztyüs, Ulrich Simonsmeier, Dorothea Kesztyüs
BACKGROUND: Ongoing discussion on anaemia management and target haemoglobin (Hb) levels in patients on haemodialysis with erythropoietin treatment require a systematic approach in evaluating current practice. Aim of the present study was to develop a new classification system to easily monitor Hb trajectories and categorise patients on haemodialysis. METHODS: Routine data from five dialysis centres in the USA collected between 2010 and 2016. Data were anonymised and only those from patients with fortnightly Hb values were included in the analysis...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29110796/long-term-outcomes-and-management-of-the-heart-transplant-recipient
#12
REVIEW
Sharon L McCartney, Chetan Patel, J Mauricio Del Rio
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#13
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29097487/long-term-protective-effect-of-n-acetylcysteine-against-amikacin-induced-ototoxicity-in-end-stage-renal-disease-a-randomized-trial
#14
Alperen Vural, Ismail Kocyigit, Furkan Şan, Eray Eroglu, İbrahim Ketenci, Aydin Unal, Bulent Tokgoz, Yaşar Ünlü
BACKGROUND: The aim of the study is to evaluate the long-term protective effect of N-acetylcysteine (NAC), an antioxidant agent, against aminoglycoside (AG)-induced ototoxicity. METHODS: A total of 40 patients receiving continuous ambulatory peritoneal dialysis (CAPD) and having their first peritonitis attacks and planned to be treated with AGs were enrolled in the study. They were randomized into 2 groups: 1 group received additional NAC and the other did not. All patients underwent hearing tests with pure tone audiometry (PTA) after the diagnosis, at 1 month and 12 months and at the same time the tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were measured...
November 2, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29095800/incidence-of-end-stage-renal-disease-attributed-to-diabetes-among-persons-with-diagnosed-diabetes-united-states-and-puerto-rico-2000-2014
#15
Nilka Rios Burrows, Israel Hora, Linda S Geiss, Edward W Gregg, Ann Albright
During 2014, 120,000 persons in the United States and Puerto Rico began treatment for end-stage renal disease (ESRD) (i.e., kidney failure requiring dialysis or transplantation) (1). Among these persons, 44% (approximately 53,000 persons) had diabetes listed as the primary cause of ESRD (ESRD-D) (1). Although the number of persons initiating ESRD-D treatment each year has increased since 1980 (1,2), the ESRD-D incidence rate among persons with diagnosed diabetes has declined since the mid-1990s (2,3). To determine whether ESRD-D incidence has continued to decline in the United States overall and in each state, the District of Columbia (DC), and Puerto Rico, CDC analyzed 2000-2014 data from the U...
November 3, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29092961/maternal-olmesartan-exposure-causing-neonatal-failure
#16
Antonio Pérez-Iranzo, Ana Nos Ferreres, Aranzazu Jarque Bou
Although angiotensin II receptor blockers (ARBs) are contraindicated during pregnancy, new cases are currently being reported.A 32-week preterm neonate was admitted after C-section due to maternal oligohydramnios. He presented with Potter phenotype, pulmonary hypoplasia with pneumothorax, systemic hypotension and anuria. He required chest drain insertion and continuous positive airway pressure (CPAP), volume expansion plus inotropic support with persistent renal failure. Mother confirmed olmesartan intake during entire pregnancy...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29092740/preoperative-aldosterone-receptor-blockade-and-outcomes-of-cardiac-surgery-in-patients-with-chronic-kidney-disease%C3%A2
#17
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND AND AIMS: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown. MATERIALS AND METHODS: This is an observational study that included adult CKD patients undergoing cardiac surgery...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29092738/optimizing-the-use-of-darbepoetin-%C3%AE-with-a-split-strategy-a-concept-change%C3%A2
#18
Marco Mendes, Ana Carina Ferreira, David Navarro, Bruno Pinto, Fernanda Gomes, Patrícia Matias, Cristina Jorge, Inês Aires, Aníbal Ferreira
As erythropoiesis is a continuous process, we hypothesized that a new approach with smaller doses of darbepoetin-α administered more regularly could result in fewer variations of its serum levels and be more effective. In a prevalent hemodialysis population, we evaluated the effects of the darbepoetin splitting in "mini-doses". A 34-month prospective study was performed in a cohort of 110 patients, with a mean age of 66.6 ± 14.2 years, median dialysis vintage of 63.6 months (IQ range: 27 - 86), 46.4% (n = 51) male gender, 36...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29091730/probing-the-interaction-of-aspergillomarasmine-a-with-metallo-%C3%AE-lactamases-ndm-1-vim-2-and-imp-7
#19
Alexander Bergstrom, Andrew Katko, Zach Adkins, Jessica Hill, Zishuo Cheng, Mia Burnett, Hao Yang, Mahesh Aitha, M Rachel Mehaffey, Jennifer S Brodbelt, Kamaleddin H M E Tehrani, Nathaniel I Martin, Robert A Bonomo, Richard C Page, David L Tierney, Walter Fast, Gerard D Wright, Michael W Crowder
Metallo-β-lactamases (MBLs) are a growing threat to the continued efficacy of β-lactam antibiotics. Recently, aspergillomarasmine A (AMA) was identified as an MBL inhibitor, but the mode of inhibition was not fully characterized. Equilibrium dialysis and metal analysis studies revealed that 2 equiv of AMA effectively removes 1 equiv of Zn(II) from MBLs NDM-1, VIM-2, and IMP-7 when the MBL is at micromolar concentrations. Conversely, (1)H NMR studies revealed that 2 equiv of AMA remove 2 equiv of Co(II) from Co(II)-substituted NDM-1, VIM-2, and IMP-7 when the MBL/AMA are at millimolar concentrations...
November 9, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29080304/high-resolution-computational-fluid-dynamic-simulation-of-haemodialysis-cannulation-in-a-patient-specific-arteriovenous-fistula
#20
David Fulker, Bogdan Ene-Iordache, Tracie J Barber
Arteriovenous fistulae are the preferred choice of vascular access in hemodialysis patients, however complications such as stenosis can lead to access failure or recirculation, which reduces dialysis efficiency. This study utilized computational fluid dynamics on a patient specific radio-cephalic fistula under hemodialysis treatment to determine the dynamics of access recirculation and identify the presence of disturbed flow. Metrics of transverse wall shear stress and oscillatory shear index were used to characterize the disturbed flow acting on the blood vessel wall, whilst a power spectral density analysis was used to calculate the any turbulence within the access...
October 28, 2017: Journal of Biomechanical Engineering
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