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Chronic kidney disease Pulmonary embolism

Liang-Tseng Kuo, Su-Ju Lin, Chi-Lung Chen, Pei-An Yu, Wei-Hsiu Hsu, Tien-Hsing Chen
Diabetes and chronic kidney disease (CKD) are associated with a higher rate of complications in patients undergoing total knee arthroplasty (TKA). The purpose of this study was to determine the effects of CKD and diabetes in patients after TKA. Diabetic patients who received unilateral primary TKA between January 2008 and December 2011 were enrolled. The follow-up period was more than 6 months. The primary outcome was a TKA-related infection and the secondary outcome was all-cause mortality. The study cohort included 13844 patients who were followed for a mean period of 2 years, of whom 1459 (10...
November 21, 2017: Oncotarget
Sara Colella, Federica Fioretti, Chiara Massaccesi, Gian L Primomo, Gianluca Panella, Vittorio D'Emilio, Riccardo Pela
INTRODUCTION: Although pleural effusion (PE) can be caused by several pathologies like congestive heart failure, infections, malignancies, and pulmonary embolism, it is also a common finding in chronic kidney disease (CKD). Diagnostic thoracentesis is of limited value in the differential diagnosis, and the role of more invasive investigations like medical thoracoscopy (MT) is still unclear. AIM: To evaluate the usefulness of MT in unexplained PE in CKD. MATERIALS AND METHODS: In the electronic database of our Institution, we retrospectively searched for patients with CKD who underwent MT for unexplained PE between January 2008 and August 2016...
October 2017: Journal of Bronchology & Interventional Pulmonology
Brijesh Patel, Naveen Sablani, Mahek Shah, Lohit Garg, Manyoo Agarwal, Sahil Agrawal, Susan Steigerwalt, Raman Dusaj
To assess the safety of thrombolytic therapy in chronic kidney disease (CKD) patients who present with pulmonary embolism (PE). We used the Nationwide Inpatient Sample Database to identify patients who underwent thrombolysis for PE between 2010 and 2014. The patients were divided into two groups: (1) No CKD and (2) CKD. Patients with and without CKD were matched using 1:1 propensity score matching and a caliper width of 0.01. The primary outcomes were in-hospital mortality and hemorrhagic events. The secondary outcomes were blood transfusions, length of stay and total hospitalization charge...
October 2017: Journal of Thrombosis and Thrombolysis
Yogeshwar Singh Rajaram, Thong Le, Maree Ross-Smith, Andrew Owen, Jason Chuen, Peter F Mount
AIMS: Acute thrombosis of hemodialysis (HD) arteriovenous access is an urgent problem for HD patients and is commonly managed by endovascular thrombolysis. Pulmonary embolism (PE) is a recognized complication of HD access thrombosis and thrombolysis but the risk and outcomes are unclear. This study aims to determine the incidence, predictors, and outcomes of PE after endovascular thrombolysis of HD arteriovenous access in patients presenting with acute thrombosis. MATERIALS AND METHODS: A single-center retrospective study was performed for all adult chronic kidney disease patients undergoing arteriovenous access thrombolysis between January 1, 2012, and December 31, 2014...
September 2017: Clinical Nephrology
Janice Schwartz, Steve Merrill, Noelle de Leon, Ashley Thompson, Margaret Fang
BACKGROUND/OBJECTIVE: Direct-acting oral anticoagulants (DOACs) are increasingly used to prevent or treat thromboembolism. We conducted a study to compare how well initial DOAC prescribing for adult inpatients adhered to dosing recommendations approved by the US Food and Drug Administration (FDA). DESIGN: Retrospective analysis. SETTING: Single academic medical center, July 1, 2014 to June 30, 2015. PATIENTS: 508 adult inpatients...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Chih-Hsiang Chang, Chung-Ming Fu, Pei-Chun Fan, Shao-Wei Chen, Su-Wei Chang, Chun-Tai Mao, Ya-Chung Tian, Yung-Chang Chen, Pao-Hsien Chu, Tien-Hsing Chen
Acute kidney injury (AKI) is overlooked in patients with pulmonary embolism (PE). Risk factors for and long-term outcomes of this complication remain unknown. This study evaluated the predictors and prognosis of AKI in patients with PE.This retrospective cohort study used Taiwan's National Health Insurance Research Database. We enrolled a total of 7588 patients who were admitted to a hospital for PE from January1997 to December 2011 and administered anticoagulation or thrombolytic agents. All demographic data, risk factors, and outcomes were analyzed...
March 2017: Medicine (Baltimore)
Tsung-Hang Kuo, Hsin-Yang Li, Sheng-Hsiang Lin
INTRODUCTION: Chronic kidney disease (CKD) increases risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). However, few studies have investigated the relationship between acute kidney injury (AKI) and risk of DVT and PE. Therefore, we conducted a nationwide longitudinal cohort study to determine whether patients with AKI are associated with increased risk of developing DVT and PE. METHODS: We included >30years-old inpatients (n=4734) receiving the diagnosis of AKI from 2000 to 2006 and their age-and sex-matched non-AKI inpatients using medical service in the same year (n=47...
March 2017: Thrombosis Research
N Janus, I Mahé, V Launay-Vacher, J-P Laroche, G Deray
Anticoagulant agents have been approved by international regulatory agencies to prevent and treat venous thromboembolism (VTE). However, chronic kidney disease (CKD) is: (1) highly frequent in VTE patients; (2) strongly linked to VTE; and (3) a risk factor for cardiovascular morbidity/mortality and fatal pulmonary embolism. Therefore, an increasing number of patients are presented with CKD and VTE and more and more physicians must face the questions of the management of these patients and that of the handling of anticoagulant agents in CKD patients because of the pharmacokinetic modifications of these drugs in this population...
December 2016: Journal des Maladies Vasculaires
P W Franks, N Atabaki-Pasdar
Obesity is a risk factor for a plethora of severe morbidities and premature death. Most supporting evidence comes from observational studies that are prone to chance, bias and confounding. Even data on the protective effects of weight loss from randomized controlled trials will be susceptible to confounding and bias if treatment assignment cannot be masked, which is usually the case with lifestyle and surgical interventions. Thus, whilst obesity is widely considered the major modifiable risk factor for many chronic diseases, its causes and consequences are often difficult to determine...
March 2017: Journal of Internal Medicine
Oluseye Ogunmoroti, Norrina B Allen, Mary Cushman, Erin D Michos, Tatjana Rundek, Jamal S Rana, Ron Blankstein, Roger S Blumenthal, Michael J Blaha, Emir Veledar, Khurram Nasir
BACKGROUND: The American Heart Association introduced the Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health. We examined the association between the LS7 metrics and noncardiovascular disease. METHODS AND RESULTS: We studied 6506 men and women aged between 45 and 84 years, enrolled in the Multi-Ethnic Study of Atherosclerosis. Median follow-up time was 10.2 years. Each component of the LS7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was assigned points, 0 indicates "poor" category; 1, "intermediate," and 2, "ideal...
October 20, 2016: Journal of the American Heart Association
Anair Beverly, Ethan Y Brovman, Raymond J Malapero, Robert W Lekowski, Richard D Urman
OBJECTIVES: To determine the incidence, timing, risk factors for, and outcomes after unplanned reintubation following cardiac surgery in adults. DESIGN: Retrospective analysis of admission data from the American College of Surgeons National Surgical Quality Improvement Project Database, 2007-2013, inclusive. Univariate and multivariate analyses of risk factors and outcomes. PARTICIPANTS: A total of 18,571 patients, over 18 years of age, undergoing cardiac surgery...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
Salah A M Said, Rogier Nijhuis, Anita Derks, Herman Droste
BACKGROUND Cardiac resynchronization therapy (CRT) has been demonstrated to reduce morbidity and mortality in patients with advanced, drug-refractory heart failure. Procedure-related mortality is less than 1% in larger studies. Approximately10% of CRT patients have to undergo surgical revision because of infections, dislocations, or unacceptable electrical behavior manifested as high threshold, unstable sensing, or unwanted phrenic nerve stimulation. CASE REPORT A 70-year-old man with symptomatic congestive heart failure underwent implantation of a biventricular pacemaker on the left anterior chest wall in 2003 and pulse generator exchange in August 2009...
July 20, 2016: American Journal of Case Reports
Bülent Altınsoy, İbrahim İlker Öz, Tacettin Örnek, Fatma Erboy, Hakan Tanrıverdi, Fırat Uygur, Nejat Altintas, Figen Atalay, Müge Meltem Tor
INTRODUCTION: Glomerular filtration rate (GFR) and blood urea nitrogen (BUN) are important prognostic indicators for cardiovascular disease. However, data on the relationship between renal dysfunction (RD) and prognosis in patients with acute pulmonary embolism (APE) are limited. The estimated-GFR (eGFR), based on the Modification of Diet in Renal Disease (MDRD) equation, has been suggested as a possible prognostic marker in patients with APE; however, at present, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is thought to be more accurate than the MDRD equation for the estimation of RD...
September 2017: Clinical and Applied Thrombosis/hemostasis
Catherine E Handy, Chintan S Desai, Zeina A Dardari, Mouaz H Al-Mallah, Michael D Miedema, Pamela Ouyang, Matthew J Budoff, Roger S Blumenthal, Khurram Nasir, Michael J Blaha
OBJECTIVES: This study sought to determine if coronary artery calcium (CAC) is associated with incident noncardiovascular disease. BACKGROUND: CAC is considered a measure of vascular aging, associated with increased risk of cardiovascular and all-cause mortality. The relationship with noncardiovascular disease is not well defined. METHODS: A total of 6,814 participants from 6 MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10...
May 2016: JACC. Cardiovascular Imaging
Hanane Khoury, Louis Lavoie, Sharon Welner, Kerstin Folkerts
BACKGROUND: Patients with a history of a cardiovascular (CV) disease are at high risk of suffering secondary major adverse cardiac events (MACE), namely death, nonfatal myocardial infarction (MI), stroke, symptomatic pulmonary embolism, CV and all-cause hospitalization, and bleeding. METHODS: A comprehensive review of the literature was conducted to review the epidemiology and burden of MACE in patients with coronary or peripheral arterial disease (CAD or PAD) in Europe and other ex-US regions...
April 2016: Cardiovascular Therapeutics
Farzin Ghiasi, Amin Ahmadpoor, Babak Amra
BACKGROUND: Pulmonary embolism (PE) is the most life-threatening form of venous thrombosis which causes the majority of mortalities in this category. Obstructive sleep apnea (OSA) has been indicated as one of the risk factors for thromboembolism because of hemostatic alterations. The present study was designed to seek for the relationship between OSA and 30-day mortality of patients with PE. MATERIALS AND METHODS: This prospective cohort study was conducted among 137 consecutive patients referred to hospital with symptoms of PE and preliminary stable hemodynamic...
July 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Brett J Carroll, Ravi V Shah, Venkatesh Murthy, Stephen A McCullough, Nosheen Reza, Sunu S Thomas, Tae H Song, Christopher H Newton-Cheh, Janice M Camuso, Thomas MacGillivray, Thoralf M Sundt, Marc J Semigran, Gregory D Lewis, Joshua N Baker, José P Garcia
Extracorporeal membrane oxygenation (ECMO) is an increasingly used supportive measure for patients with refractory cardiogenic shock (CS). Despite its increasing use, there remain minimal data regarding which patients with refractory CS are most likely to benefit from ECMO. We retrospectively studied all patients (n = 123) who underwent initiation of ECMO for CS from February 2009 to September 2014 at a single center. Baseline patient characteristics, including demographics, co-morbid illness, cause of CS, available laboratory values, and patient outcomes were analyzed...
November 15, 2015: American Journal of Cardiology
Jean Triscott, Susan Mercer, Peter George Jaminal Tian, Bonnie Dobbs
An 81-year-old woman with chronic kidney disease was on enoxaparin (1 mg/kg subcutaneously two times a day) for 4 months to manage pulmonary embolism. While admitted for diagnostic evaluation of frequent falls, transient ischaemic attacks and pain management, she developed vomiting, diarrhoea, melena and hypotension. Her estimated glomerular filtration rate decreased from an admission value of 34 mL/min/1.73 m2 to 13 mL/min/1.73 m2. CT scan showed retroperitoneal haematoma. She was placed in intensive care and stabilised with aggressive fluid replacement, blood transfusion, and discontinuation of enoxaparin and concomitant aspirin...
October 5, 2015: BMJ Case Reports
Radovan Malý, Jaroslav Malý
Venous thromboembolic disease which includes both venous thrombosis and pulmonary embolism, is a frequent and potentially fatal disease. Based on the introduction of low-molecular-weight heparins (LMWH) into practice it has been proved that outpatient treatment of venous thrombosis is effective and safe for a large number of patients with VTE. The growing volume of data on LMWH outpatient treatment in recent years shows that up to 50 % of patients with clinically stable pulmonary embolism can be treated at home...
May 2015: Vnitr̆ní Lékar̆ství
Elif Küpeli, Gaye Ulubay, Ilgaz Doğrul, Özlem Birben, Pınar Seyfettin, Aylin Özsancak Uğurlu, Füsun Öner Eyüboğlu, Mehmet Haberal
OBJECTIVES: Solid-organ transplant recipients can develop chronic hypercoagulation that increases the incidence of pulmonary embolism. Here, we evaluate the frequency of pulmonary embolism in solid-organ transplant recipients during the first 10 years after transplantation and evaluate the risk factors for its development. MATERIALS AND METHODS: The medical records of solid-organ transplant recipients who were treated between 2003 and 2013 were retrospectively reviewed...
April 2015: Experimental and Clinical Transplantation
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