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Hiroyuki Yoshihara, Daisuke Yoneoka
STUDY DESIGN: A retrospective analysis of population-based national hospital discharge data collected for the nationwide inpatient sample (NIS). OBJECTIVES: To examine the in-hospital outcomes of patients with advanced chronic kidney disease (CKD), dialysis, and kidney transplant undergoing spinal fusion on a national level. SUMMARY OF BACKGROUND DATA: Patients with advanced CKD have been living longer with the support and improvement of medical treatment, dialysis, and organ transplant...
July 17, 2018: Clinical Spine Surgery
Derrick Y Tam, Thin X Vo, Harindra C Wijeysundera, Danny Dvir, Jan O Friedrich, Stephen E Fremes
OBJECTIVE: To determine the safety and efficacy of valve-in-valve transcatheter aortic valve replacement (ViV) versus redo surgical aortic valve replacement (SAVR) for the treatment of previously failed aortic bioprostheses. BACKGROUND: Valve-in-valve has emerged as a treatment option for patients with a failed aortic bioprosthesis. Evidence for safety and efficacy remains limited to small studies. METHODS: Medline and Embase were searched to 2017 for studies that directly compared ViV to redo SAVR...
July 19, 2018: Catheterization and Cardiovascular Interventions
Hongjian Ye, Peiyi Cao, Xiaodan Zhang, Jianxiong Lin, Qunying Guo, Haiping Mao, Xueqing Yu, Xiao Yang
The aim of this study was to explore the association between serum Mg and cardiovascular mortality in the peritoneal dialysis (PD) population. This prospective cohort study included prevalent PD patients from a single centre. The primary outcome of this study was cardiovascular mortality. Serum Mg was assessed at baseline. A total of 402 patients (57 % male; mean age 49·3±14·9 years) were included. After a median of 49·9 months (interquartile range: 25·9-68·3) of follow-up, sixty-two patients (25·4 %) died of CVD...
July 19, 2018: British Journal of Nutrition
Gabor Cs Nagy, Reiner Verwiebe, Matthias Wunsch
BACKGROUND: In obese patients with end stage renal disease, puncturing matured arteriovenous fistulas (AVF) that run deep under the skin surface may prove difficult. To achieve reliable puncturability, there are several surgical solutions. Superficialization with mobilization is common. With some newer options (lipectomy and liposuction) subcutaneous adipose tissue is surgically reduced. There are only a few authors who have published their experience with liposuction and we want to add our own results...
July 19, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Tadao Akizawa, Hiroyuki Okumura, Ana Filipa Alexandre, Ayako Fukushima, Grace Kiyabu, Julie Dorey
Anemia is a common complication for patients with chronic kidney disease (CKD) and is associated with cardiovascular comorbidities and reduced quality of life. The incidence of anemia increases as kidney function declines and affects approximately 32% of Japanese patients with stage 3-5 CKD. This review examined the current literature on anemia in CKD patients in Japan to provide an overview of the burden of anemia in CKD. Medline, Embase, and Igaku Chuo Zasshi databases were searched to identify relevant manuscripts and abstracts published from 2004 onward...
July 18, 2018: Therapeutic Apheresis and Dialysis
Taniya Kaewarpai, Visith Thongboonkerd
Secretory products from infiltrating macrophages have been thought to play crucial roles in development and progression of diabetic complications in various tissues/organs. Nevertheless, diabetes-induced changes in macrophage secretory products remained largely unknown. We thus analyzed high-glucose (HG)-induced changes in secretome of human macrophages derived from U937 human monocytic cell line after phorbol 12-myristate 13-acetate (PMA) activation. Serum-free culture supernatants were collected from macrophages exposed to 5...
July 18, 2018: Molecular and Cellular Biochemistry
Denis Fouque, Marc Vervloet, Markus Ketteler
Management of hyperphosphatemia in patients with dialysis-dependent chronic kidney disease remains a major challenge, requiring a multifaceted approach that includes dietary phosphate restriction, dialysis, and phosphate binders. However, these treatments fail to meet serum phosphate targets in many patients, potentially further exacerbating the significant morbidity and mortality burden associated with the disease. Recent advances in our understanding of the mechanisms underlying phosphate homeostasis have shed new light on the issue and suggest that gastrointestinal transport proteins may be promising targets for new hyperphosphatemia treatments...
July 18, 2018: Drugs
Alain Beaudry, Thomas W Ferguson, Claudio Rigatto, Navdeep Tangri, Sandi Dumanski, Paul Komenda
BACKGROUND AND OBJECTIVES: The prevalence of ESKD is increasing worldwide. Treating ESKD is disproportionately costly in comparison with its prevalence, mostly due to the direct cost of dialysis therapy. Here, we aim to provide a contemporary cost description of dialysis modalities, including facility-based hemodialysis, peritoneal dialysis, and home hemodialysis, provided with conventional dialysis machines and the NxStage System One. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We constructed a cost-minimization model from the perspective of the Canadian single-payer health care system including all costs related to dialysis care...
July 18, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Alexander Meyer, Anne Schilling, Magdalena Kott, Ulrich Rother, Werner Lang, Susanne Regus
BACKGROUND: Evaluation of below-the-knee open revascularization (OR) versus endovascular revascularization (EVT) in patients with end-stage renal disease and critical limb ischemia (CLI) was performed. PATIENTS AND METHODS: Seventy-seven dialysis patients with CLI and infrapopliteal involvement from 2007 to 2017 were included. Thirty-five patients received OR and 42 patients were treated with EVT. Survival, amputation-free survival (AFS) and wound-healing were evaluated...
January 1, 2018: Vascular and Endovascular Surgery
Lindsay R Kosinski, Joseph A Gil, Wesley M Durand, Steven F DeFroda, Brett D Owens, Alan H Daniels
OBJECTIVES: The purpose of this study is to identify patient characteristics that increase risk for unplanned readmission within 30 days of an initial hospital stay after outpatient rotator cuff repair (RCR). METHODS: A retrospective cohort study was performed utilizing the National Surgical Quality Improvement Program (ACS NSQIP) datasets from 2012-2015. Patients were preliminarily included in the study based on the presence of a primary Common Procedural Terminology (CPT) code for rotator cuff repair (23410, 23412, 23420, and 29827)...
July 18, 2018: Physician and Sportsmedicine
Monica Coll, Carles Ferrer-Costa, Sara Pich, Catarina Allegue, Emilio Rodrigo, Gema Fernández-Fresnedo, Paloma Barreda, Jesus Mates, Angel Luis Martinez de Francisco, Israel Ortega, Anna Iglesias, Oscar Campuzano, Eduardo Salas, Manuel Arias, Ramon Brugada
BACKGROUND: Patients with end-stage renal disease have very high mortality. In individuals on hemodialysis, cardiovascular deaths account for ~50% of all deaths in this population, mostly due to arrhythmia. To determine the causes of these arrhythmic deaths is essential in order to adopt preventive strategies. The main objective of this study was to investigate whether, the presence of QTc interval alterations, from electrolyte abnormalities or presence of rare genetic variants, could have a relationship with sudden arrhythmogenic deaths in end-stage renal disease patients...
2018: PloS One
Julie R Ingelfinger
We chatted as the dialysis shift began. She was a young nursing student whose name and face I still remember five decades later, but I will just call her "Jane Roe." She was from the Virgin Islands and had come to New York for nursing school. She was nearly done — justifiably proud, since she had..
July 18, 2018: New England Journal of Medicine
Kateryna Karimova, Lorenz Uhlmann, Marc Hammer, Corina Guethlin, Ferdinand M Gerlach, Martin Beyer
OBJECTIVES: To compare the development of diabetes complications, measured in terms of clinical end points, of patients enrolled in general practitioner (GP)-centered healthcare (Hausarztzentrierte Versorgung [HZV]) and patients in usual GP care (non-HZV) over 4 years. STUDY DESIGN: Retrospective closed cohort study based on German claims data. METHODS: The main end points in our evaluation were dialysis, blindness, amputation, stroke, myocardial infarction, cardiovascular disease, hypoglycemia, and mortality...
July 2018: American Journal of Managed Care
A Gunness, A Pazderska, M Ahmed, A McGowan, N Phelan, G Boran, A E Taylor, M W O'Reilly, W Arlt, K Moore, L A Behan, M Sherlock, J Gibney
STUDY QUESTION: What information does androgen profiling using liquid chromatography tandem mass spectrometry (LC-MS/MS) provide in reproductive-age women with Type 1 diabetes (T1D)? SUMMARY ANSWER: In T1D women, androstenedione proved most useful of the measured androgens in differentiating subgroups based on clinical phenotypes of hyperandrogenism (HA) and polycystic ovary syndrome (PCOS). WHAT IS KNOWN ALREADY: The prevalence of HA and PCOS are increased in women with T1D...
July 18, 2018: Human Reproduction
Federica Picariello, Sam Norton, Rona Moss-Morris, Iain C Macdougall, Joseph Chilcot
Background: Fatigue affects between 49% and 92% of dialysis patients with considerable repercussions on their functioning and quality of life. Purpose: To evaluate whether fatigue severity and its impact on functioning predict survival (all-cause mortality) and time to transplantation among in-centre haemodialysis patients. Methods: As part of a prospective study of fatigue among in-centre haemodialysis patients, survival data were collected between April 2014 and August 2017...
July 17, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
Philip A Kalra, Alexandru Burlacu, Charles J Ferro, Adrian Covic
PURPOSE OF REVIEW: Non-valvular atrial fibrillation is common in patients with severe chronic kidney disease (CKD) and historically patients have been treated with vitamin K antagonists (VKA). However, these agents have questionable efficacy and are associated with increased bleeding risk. Non-vitamin K oral anticoagulants (NOAC) have advantages over VKA in early stage CKD. In this review, we sought to establish evidence for best practice in patients with severe CKD (creatinine clearance <30 ml/min including dialysis patients) and nonvalvular atrial fibrillation...
July 16, 2018: Current Opinion in Nephrology and Hypertension
Karl A Nath, Daniel R O'Brien, Anthony J Croatt, Joseph P Grande, Allan W Ackerman, Meryl C Nath, Satsuki Yamada, Andre Terzic, Tamara Tchkonia, James L Kirkland, Zvonimir S Katusic
There is no therapy that promotes maturation and functionality of a dialysis arteriovenous fistula (AVF). The search for such therapies largely relies on evaluating vascular responses and putative therapies in experimental AVFs. We studied an AVF in mice with chronic kidney disease (CKD). We demonstrate numerous stressors in the vein of the AVF-CKD group, including pathologic shear, mitogenic, inflammatory, and hypoxia-reoxygenation stress. Because stress promotes premature senescence, we examined whether senescence is induced in the vein of the AVF-CKD model...
July 18, 2018: American Journal of Physiology. Renal Physiology
Jesse D Schold, Susana Arrigain, Stuart M Flechner, Joshua J Augustine, John R Sedor, Alvin Wee, David A Goldfarb, Emilio D Poggio
Over the past decades, numerous clinical advances and policy changes have affected outcomes for candidates of kidney transplantation in the United States. We examined national Scientific Registry for Transplant Recipients for adult(18+) solitary kidney transplant candidates placed on the waiting list for primary listing from 2001-2015. We evaluated rates of mortality, transplantation and waitlist removal. Among 340,115 candidates there were significant declines in mortality(52 deaths/1000 patient years in 2001-04 vs...
July 18, 2018: American Journal of Transplantation
M A Lantinga, R G L de Sévaux, T J G Gevers, W J G Oyen, J W de Fijter, D Soonawala, R Zietse, M Salih, N F Casteleijn, E M Spithoven, E Meijer, R T Gansevoort, J P H Drenth On Behalf Of The Dipak Consortium
BACKGROUND: Cyst infection may occur in autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (ADPLD). Antimicrobial agents often fail to control infection, leading to invasive action. We aimed to identify factors predicting escalation of care. METHODS: ADPKD and ADPLD patients were identified from local/national databases (2001-2013). Records were screened for patients meeting criteria for cyst infection (positive cyst aspirate and/or clinical findings)...
July 2018: Netherlands Journal of Medicine
Goki Suda, Masayuki Kurosaki, Jun Itakura, Namiki Izumi, Yoshihito Uchida, Satoshi Mochida, Chitomi Hasebe, Masami Abe, Hiroaki Haga, Yoshiyuki Ueno, Ikuto Masakane, Kazumichi Abe, Atsushi Takahashi, Hiromasa Ohira, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Tomoe Kobayashi, Atsuhiko Kawakami, Kenichi Kumagai, Katsumi Terasita, Masatsugu Ohara, Naoki Kawagishi, Machiko Umemura, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
BACKGROUND: The prevalence of hepatitis C virus (HCV) infection in hemodialysis patients is high and results in a poor prognosis. Thus, safer and more effective treatment regimens are required. In this prospective multicenter study, we investigated the efficacy and safety of the novel HCV-NS5A-inhibitor, elbasvir, and protease inhibitor, grazoprevir in Japanese hemodialysis patients with genotype 1b HCV infection. METHODS: This study is registered at the UMIN Clinical Trials Registry as UMIN00002578...
July 17, 2018: Journal of Gastroenterology
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