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https://www.readbyqxmd.com/read/29782356/acute-neurologic-complications-during-extracorporeal-membrane-oxygenation-a-systematic-review
#1
Raoul Sutter, Kai Tisljar, Stephan Marsch
OBJECTIVES: We determine the frequency, risk factors, and mortality of neurologic complications in adults on extracorporeal membrane oxygenation and propose an algorithm for preventive strategies. DATA SOURCES: PubMed, Embase, and Cochrane databases. STUDY SELECTION: Screening was performed using predefined search terms to identify cohort studies reporting neurologic complications in adults during extracorporeal membrane oxygenation from 1990 to 2017...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29746711/a-monte-carlo-simulation-approach-for-beta-lactam-dosing-in-critically-ill-patients-receiving-prolonged-intermittent-renal-replacement-therapy
#2
Soo Min Jang, Katherine N Gharibian, Susan J Lewis, William H Fissell, Ashita J Tolwani, Bruce A Mueller
Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta-lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from critically ill patients was used to evaluate multiple dosing regimens in 4 different prolonged intermittent renal replacement therapy effluent rates and prolonged intermittent renal replacement therapy duration combinations (4 L/h × 10 hours or 5 L/h × 8 hours in hemodialysis and hemofiltration modes)...
May 10, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29735308/grazoprevir-plus-elbasvir-in-hcv-genotype-1-or-4-infected-patients-with-stage-4-5-severe-chronic-kidney-disease-is-safe-and-effective
#3
Laurent Alric, Isabelle Ollivier-Hourmand, Emilie Bérard, Sophie Hillaire, Maeva Guillaume, Anais Vallet-Pichard, Brigitte Bernard-Chabert, Veronique Loustaud-Ratti, Marc Bourlière, Victor de Ledinghen, Isabelle Fouchard-Hubert, Valerie Canva, Anne Minello, Eric Nguyen-Khac, Vincent Leroy, David Saadoun, Dominique Trias, Stanislas Pol, Nassim Kamar
Patients with advanced chronic kidney disease who receive direct-acting antiviral drugs require special consideration regarding comorbid conditions. Here we assessed the efficacy and safety of grazoprevir plus elbasvir in 93 patients infected with HCV genotype 1 or 4 and with advanced chronic kidney disease in a non-randomized, multicenter, nationwide observational survey. Twenty patients with HCV genotype 1a, 51 patients with 1b, four unclassified genotype 1, 17 with genotype 4 and one with genotype 6 received grazoprevir plus elbasvir (100/50 mg) once daily...
May 5, 2018: Kidney International
https://www.readbyqxmd.com/read/29725639/dialysis-case-volume-associated-with-in-hospital-mortality-in-maintenance-dialysis-patients
#4
Shintaro Mandai, Hidehiko Sato, Soichiro Iimori, Shotaro Naito, Takayasu Mori, Daiei Takahashi, Moko Zeniya, Naohiro Nomura, Eisei Sohara, Tomokazu Okado, Shinichi Uchida, Kiyohide Fushimi, Tatemitsu Rai
Introduction: Accumulating evidence suggests that a large hospital volume (HV) is associated with favorable outcomes in various diseases or surgical procedures. The aim of this study is to clarify the correlation of HV and dialysis case volume (DCV) with in-hospital death in patients on maintenance dialysis. Methods: The study cohort was derived from the Diagnosis Procedure Combination database, a national inpatient database in Japan, from 2012 to 2014. We included 382,689 admissions of maintenance dialysis patients over the age of 20 years in the analysis...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29703633/oral-versus-intravenous-iron-supplementation-for-the-treatment-of-iron-deficiency-anemia-in-patients-on-maintenance-hemodialysis-effect-on-fibroblast-growth-factor-23-metabolism
#5
Wataru Fukao, Yukiko Hasuike, Tomo Yamakawa, Kazuhiro Toyoda, Makoto Aichi, Satoko Masachika, Mari Kantou, Shoko Ikeda Takahishi, Takahide Iwasaki, Mana Yahiro, Masatoshi Nanami, Yasuyuki Nagasawa, Takahiro Kuragano, Takeshi Nakanishi
OBJECTIVE: Iron administration affects serum levels of intact (I-) fibroblast growth factor-23 (FGF23) and its cleavage product C-terminal (C-) FGF23 in iron-deficient patients on maintenance hemodialysis (MHD). The objective of this study was to compare the effect of oral or intravenous iron administration on serum levels of I-FGF23 and C-FGF23 in iron-deficient patients on MHD. DESIGN AND METHODS: A prospective randomized study. SUBJECTS: Participants on MHD with severe iron deficiency (n = 61)...
April 24, 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29682748/successful-practice-transitioning-between-hemodialysis-and-hemodiafiltration-in-outpatient-units-ten-key-issues-for-physicians-to-remember
#6
Tibor Fülöp, Mihály B Tapolyai, Lajos Zsom, Miklos Z Molnar, Sohail Abdul Salim, László Újhelyi, Gergely Becs, József Balla, Mehrdad Hamrahian
Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks...
April 22, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29674340/opioid-analgesics-and-adverse-outcomes-among-hemodialysis-patients
#7
Julie H Ishida, Charles E McCulloch, Michael A Steinman, Barbara A Grimes, Kirsten L Johansen
BACKGROUND AND OBJECTIVES: Patients on hemodialysis frequently experience pain and may be particularly vulnerable to opioid-related complications. However, data evaluating the risks of opioid use in patients on hemodialysis are limited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the US Renal Data System, we conducted a cohort study evaluating the association between opioid use (modeled as a time-varying exposure and expressed in standardized oral morphine equivalents) and time to first emergency room visit or hospitalization for altered mental status, fall, and fracture among 140,899 Medicare-covered adults receiving hemodialysis in 2011...
April 19, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29672740/effects-of-vadadustat-on-hemoglobin-concentrations-in-patients-receiving-hemodialysis-previously-treated-with-erythropoiesis-stimulating-agents
#8
Volker H Haase, Glenn M Chertow, Geoffrey A Block, Pablo E Pergola, Emil M deGoma, Zeeshan Khawaja, Amit Sharma, Bradley J Maroni, Peter A McCullough
Background: Vadadustat, an inhibitor of hypoxia-inducible factor prolyl-4-hydroxylase domain dioxygenases, is an oral investigational agent in development for the treatment of anemia secondary to chronic kidney disease. Methods: In this open-label Phase 2 trial, vadadustat was evaluated in 94 subjects receiving hemodialysis, previously maintained on epoetin alfa. Subjects were sequentially assigned to one of three vadadustat dose cohorts by starting dose: 300 mg once daily (QD), 450 mg QD or 450 mg thrice weekly (TIW)...
April 16, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29661469/successful-7-year-eculizumab-treatment-of-plasmapheresis-resistant-recurrent-atypical-hemolytic-uremic-syndrome-due-to-complement-factor-h-hybrid-gene-a-case-report
#9
K Vondrák, T Seeman
Atypical hemolytic-uremic syndrome (aHUS) is an extremely rare disease, and up to 70% of the patients have a genetic mutation in the encoding components of complement activation or anti-complement factor H autoantibodies. The risk of recurrence after kidney transplantation is 10% to 80%. Eculizumab, a monoclonal antibody that binds complement protein C5, has shown to be highly effective in patients with aHUS; however, there are only few reports on the efficacy and safety of long-term eculizumab treatment in children with recurrent aHUS...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29628022/vitamin-e-supplementation-improves-high-densitiy-lipoprotein-and-endothelial-functions-in-end-stage-kidney-disease-patients-undergoing-hemodialysis
#10
Masatoshi Mune, Harumi Uto-Kondo, Iwao Iteya, Yoshiyuki Fujii, Saiko Ikeda, Katsunori Ikewaki
BACKGROUND AND AIMS: Patients with end-stage kidney disease (ESKD) undergoing hemodialysis (HD) have been shown to be at increased risk for cardiovascular disease (CVD). Decreased high-density lipoprotein cholesterol (HDL-C) and impaired cholesterol efflux capacity (CEC) have been reported in such patients, and effects of vitamin E supplementation on HDL functions are poorly understood. Therefore, the present study aimed to investigate effects of vitamin E supplementation on HDL and endothelial functions in ESKD patients undergoing HD...
April 9, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29624853/impact-of-salt-reduction-in-meals-consumed-during-hemodialysis-sessions-on-interdialytic-weight-gain-and-hemodynamic-stability
#11
Arthur Colson, Anita Brinkley, Philippe Braconnier, Nadia Ammor, Michel Burnier, Menno Pruijm
INTRODUCTION: Patients on hemodialysis (HD) are advised to limit daily water- and salt intake to reduce interdialytic weight gain (IDWG). To counterbalance protein-losses, protein-rich meals are sometimes provided during HD sessions, but their salt content is not always taken into account. The aim of this study was to assess the influence of a lower salt content of meals provided during HD sessions on IDWG, blood pressure (BP), and hemodynamic stability during dialysis. METHODS: This monocentric, interventional study was proposed to all the patients treated with three weekly HD sessions...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29617976/the-effects-of-tenapanor-on-serum-fibroblast-growth-factor-23-in-patients-receiving-hemodialysis-with-hyperphosphatemia
#12
Geoffrey A Block, David P Rosenbaum, Andrew Yan, Peter J Greasley, Glenn M Chertow, Myles Wolf
Background: Elevated serum fibroblast growth factor 23 (FGF23) is strongly associated with cardiovascular risk and mortality. Tenapanor, an inhibitor of gastrointestinal sodium/hydrogen exchanger isoform 3, decreased serum phosphate in a randomized, double-blind, placebo-controlled Phase 2 trial (ClinicalTrials.gov identifier NCT02081534) of patients receiving hemodialysis with hyperphosphatemia. Here, we report a secondary analysis of effects on serum FGF23 during that study. Methods: After 1-3 weeks of washout of phosphate binders, 162 patients were randomized to receive 4 weeks of treatment with placebo or one of six tenapanor regimens (3 or 30 mg once daily, or 1, 3, 10 or 30 mg twice daily)...
April 3, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29611144/treatment-dose-and-the-elimination-rates-of-electrolytes-vitamins-and-trace-elements-during-continuous-veno-venous-hemodialysis-cvvhd
#13
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/29588811/effect-of-low-dose-aspirin-and-dipyridamole-on-primary-patency-of-arteriovenous-grafts-in-hemodialysis-patients-a-randomized-double-blind-placebo-controlled-trial
#14
Pouya Tayebi, Gholamhosein Kazemzadeh, Azin Banihashem, Hassan Ravari
Background: There is some evidence for the efficacy of antiplatelet therapies in increasing the vascular access patency duration or decreasing the thrombosis of arteriovenous grafts. Objective: To determine the effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients. Methods: This randomized, double-blind, placebo-controlled trial was done at Imam Reza Hospital in Mashhad, Iran from September 10, 2015 to July 05, 2016...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29587251/pregnancy-outcomes-in-french-hemodialysis-patients
#15
Gabrielle Normand, Xiaoli Xu, Marine Panaye, Anne Jolivot, Sandrine Lemoine, Fitsum Guebre-Egziabher, Evelyne Decullier, Sylvie Bin, Muriel Doret, Laurent Juillard
BACKGROUND: Pregnancy in hemodialysis (HD) women is a rare event and often associated with maternal and fetal complications. Scarcity of available data from large cohorts impedes fair medical counseling. METHODS: This is a descriptive, retrospective, multi-centric study. Pregnant women on HD during the period from 1985 to 2015 in France were included. The primary outcome was a living infant discharged from hospital, while secondary outcomes included gestational age and birth weight...
March 27, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29548779/dialysis-as-a-treatment-option-for-a-patient-with-normal-kidney-function-and-familial-tumoral-calcinosis-due-to-a-compound-heterozygous-fgf23-mutation
#16
Patrícia T Goldenstein, Precil D Neves, Bruno E Balbo, Rosilene M Elias, Alexandre C Pereira, Luiz F Onuchic, Harald Jüppner, Vanda Jorgetti, Hugo Abensur, Rosa Maria Moysés
Primary tumoral calcinosis is a rare autosomal recessive disorder characterized by ectopic calcified tumoral masses. Mutations in 3 genes (GALNT3, FGF23, and KL) have been linked to this human disorder. We describe a case of a 28-year-old man with a history of painful firm masses over his right and left gluteal region, right clavicle region, knees, and left elbow. Biochemical analysis disclosed hyperphosphatemia (phosphate, 9.0 mg/dL) and normocalcemia (calcium, 4.8 mg/dL), with normal kidney function and fractional excretion of phosphate of 3%...
March 14, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29535526/role-of-resilience-and-social-support-in-alleviating-depression-in-patients-receiving-maintenance-hemodialysis
#17
Yueh-Min Liu, Hong-Jer Chang, Ru-Hwa Wang, Li-King Yang, Kuo-Cheng Lu, Yi-Chou Hou
Background: Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD)...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29530855/elimination-of-doripenem-during-dialysis-and-pharmacokinetic-evaluation-of-posthemodialysis-dosing-for-patients-undergoing-intermittent-renal-replacement-therapy
#18
M G Vossen, L Ehmann, S Pferschy, A Maier-Salamon, M Haidinger, C Weiser, J M Wenisch, K Saria, C Kajahn, S Jilch, R Lemmerer, M Bécède, M Zeitlinger, C Kloft, W Jäger, F Thalhammer
Doripenem is a broad-spectrum parenteral carbapenem with enhanced activity against Pseudomonas aeruginosa and Enterobacteriaceae Current dosing regimens recommend the administration of 0.25 to 0.5 g once daily in patients undergoing intermittent renal replacement therapy. As patients are usually dialyzed thrice weekly, we aimed to investigate a 1-g posthemodialysis regimen, thus reducing treatment costs and enhancing patient compliance. A second objective of this trial was to describe the pharmacokinetics of intradialytic doripenem...
May 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29525810/glucocorticoid-induced-myopathy-in-a-patient-with-systemic-lupus-erythematosus-sle-a-case-report-and-review-of-the-literature
#19
Elliot M Silver, William Ochoa
BACKGROUND Chronic intake of high-dose corticosteroids is associated with multiple adverse clinical effects, including hypertension, insulin resistance, impaired wound healing, immunosuppression, myopathy, and osteoporosis. In cases of autoimmune disease, use of steroid-sparing treatment modalities is preferred over chronic steroid therapy to limit these side effects. Glucocorticoid-induced myopathy is a less common side effect of chronic steroid use in patients treated with <10 mg/day of prednisone. However, doses exceeding 40-60 mg/day can induce clinically significant myopathy and weakness...
March 11, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29524230/transfusion-transmitted-malaria-masquerading-as-sickle-cell-crisis-with-multisystem-organ-failure
#20
Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
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