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Marion M Mafham, Natalie Staplin, Jonathan Emberson, Richard Haynes, William Herrington, Christina Reith, Christoph Wanner, Robert Walker, Alan Cass, Adeera Levin, Bengt Fellström, Lixin Jiang, Hallvard Holdaas, Bertram Kasiske, David C Wheeler, Martin J Landray, Colin Baigent
BACKGROUND: Estimated albumin excretion rate (eAER) provides a better estimate of 24-h albuminuria than albumin:creatinine ratio (ACR). However, whether eAER is superior to ACR in predicting end-stage renal disease (ESRD), vascular events (VEs) or death is uncertain. METHODS: The prognostic utility of ACR and eAER (estimated from ACR, sex, age and race) to predict mortality, ESRD and VEs was compared using Cox proportional hazards regression among 5552 participants with chronic kidney disease in the Study of Heart and Renal Protection, who were not on dialysis at baseline...
January 14, 2017: Nephrology, Dialysis, Transplantation
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
Binxian Ye, Li Zhao, Wei Shen, Yan Ren, Bo Lin, Maosheng Chen, Junda Tang, Xinxin Jiang, Yiwen Li, Qiang He
Objective: To investigate the changes of aortic stiffness and its influencing factors in patients with chronic kidney diseases (CKD). Methods: Eightyfour patients with CKD from Department of Nephrology, Zhejiang Provincial People's Hospital were divided into the dialysis group (CKD stage 5, n=48) and non-dialysis group (CKD stage 3-5, n=36). Clinical data, biochemical parameters and echocardiography findings were collected. SphygmoCor pulse wave analysis system was used to obtain pulse wave analysis (PWA) parameters including central aortic systolic blood pressure (CSP), central pulse pressure (CPP), augmented pressure (AP), augmentation index (AIX), and heart rate 75-adjusted augmentation index (HR75AIX)...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
Daniel Zickler, Ralf Schindler, Kevin Willy, Peter Martus, Michael Pawlak, Markus Storr, Michael Hulko, Torsten Boehler, Marcus A Glomb, Kristin Liehr, Christian Henning, Markus Templin, Bogusz Trojanowicz, Christof Ulrich, Kristin Werner, Roman Fiedler, Matthias Girndt
BACKGROUND: To increase the removal of middle-sized uremic toxins a new membrane with enhanced permeability and selectivity, called Medium Cut-Off membrane (MCO-Ci) has been developed that at the same time ensures the retention of albumin. Because many middle-sized substances may contribute to micro-inflammation we hypothesized that the use of MCO-Ci influences the inflammatory state in hemodialysis patients. METHODS: The randomized crossover trial in 48 patients compared MCO-Ci dialysis to High-flux dialysis of 4 weeks duration each plus 8 weeks extension phase...
2017: PloS One
Sunny Eloot, Harlinde Peperstraete, Filip De Somer, Eric Hoste
PURPOSE: Lung protective ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) needing mechanical ventilation. This can however be associated with hypercapnia and respiratory acidosis, such that extracorporeal CO2 removal (ECCO2R) can be applied. The aim of this study was to derive optimal operating parameters for the ECCO2R Abylcap® system (Bellco, Italy). METHODS: We included 4 ARDS patients with a partial arterial oxygen tension over the fraction of inspired oxygen (PaO2/FiO2) lower than 150 mmHg, receiving lung-protective ventilation and treated with the Abylcap® via a double lumen 13...
January 12, 2017: International Journal of Artificial Organs
Makoto Fukuda, Kengo Yoshimura, Koki Namekawa, Kiyotaka Sakai
The objective of the present study is to evaluate the effect of filtration coefficient and internal filtration on dialysis fluid flow and mass transfer coefficient in dialyzers using dimensionless mass transfer correlation equations. Aqueous solution of vitamin B12 clearances were obtained for REXEED-15L as a low flux dialyzer, and APS-15EA and APS-15UA as high flux dialyzers. All the other design specifications were identical for these dialyzers except for filtration coefficient. The overall mass transfer coefficient was calculated, moreover, the exponents of Reynolds number (Re) and film mass transfer coefficient of the dialysis-side fluid (k D) for each flow rate were derived from the Wilson plot and dimensionless correlation equation...
January 13, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
P Pavlakou, E Liberopoulos, E Dounousi, M Elisaf
PURPOSE: Chronic kidney disease (CKD) is accompanied by a number of secondary metabolic dysregulations, such as lipid abnormalities, presenting with unique characteristics. Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors have been introduced as the new era in the management of dyslipidemia with promising results in groups with refractory lipid abnormalities. Increasing number of studies investigate the possible association of PCSK9 levels with kidney function, especially with nephrotic range proteinuria, as well as its role as a prognostic cardiovascular risk marker in CKD...
January 13, 2017: International Urology and Nephrology
S Teege, T Wiech, O M Steinmetz
We report on a 75-year old woman who presented with acute oliguric renal failure. The kidney biopsy revealed calcium oxalate depositions in the tubular lumen, caused by an overload of intravenous ascorbic acid (cumulative dose of 240 g). Due to a lack of specific therapeutic interventions, the patient remained dialysis-dependent. Iatrogenic causes of kidney failure play an important role in the pathogenesis of kidney diseases and should always be considered in patients with acute renal failure. Detailed evaluation of the patient history is often suggestive, while renal biopsy can establish the diagnosis...
January 13, 2017: Der Internist
Juan C Duque, Marwan Tabbara, Laisel Martinez, Jose Cardona, Roberto I Vazquez-Padron, Loay H Salman
The arteriovenous fistula (AVF) is the preferred hemodialysis access type because it has better patency rates and fewer complications than other access types. However, primary failure remains a common problem impeding AVF maturation and adding to patients' morbidity and mortality. Juxta-anastomotic (or inflow) stenosis is the most common reason leading to primary failure, and percutaneous transluminal angioplasty continues to be the gold-standard treatment with excellent success rates. Intimal hyperplasia (IH) has been traditionally blamed as the main pathophysiologic culprit, but new evidence raises doubts regarding the contribution of IH alone to primary failure...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Mauricio A Villavicencio, Ernesto Larraín, Ricardo Larrea, Juan Pablo Peralta, Jong S Lim, Pamela Rojo, Erika Donoso, Francesca Gajardo, Margarita Hurtado, Víctor Rossel
Background Durable mechanical support devices are prohibitively expensive in our health system and may be unsuitable for critically ill patients. CentriMag is an alternative bridge to transplantation or recovery. Methods We retrospectively reviewed 28 patients (23 males) aged 13-60 years who received CentriMag support. The etiology was ischemic in 13 (46%), dilated cardiomyopathy in 8 (29%), and others in 7 (25%). All patients were in Interagency Registry for Mechanically Assisted Circulatory Support class I, and 27 (96%) had multiorgan failure; 2 (7%) were post-cardiotomy and 12 (43%) had a previous cardiac arrest (mean arrest time 21 ± 17 min)...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
John C Stivelman
The FDA first licensed erythropoiesis stimulating agents (ESA) for use in patients with ESRD in 1989. Hemoglobin targets for treatment with ESAs were established at the outset on the basis of descriptive pre-ESA literature and Phase I-III data in patients with ESRD. Postrelease literature in ESA-treated patients accumulating over time initially supported improvement in indices of both cardiovascular and other organ function as well as quality of life with therapy. Recommended treatment targets for hemoglobin would evolve further in the United States from four iterations of evidence- and opinion-based practice guidelines appearing between 1997 and 2007...
January 12, 2017: Seminars in Dialysis
Jente Boelaert, Frédéric Lynen, Griet Glorieux, Eva Schepers, Nathalie Neirynck, Raymond Vanholder
A typical characteristic of chronic kidney disease (CKD) is the progressive loss in renal function over a period of months or years with the concomitant accumulation of uremic retention solutes in the body. Known biomarkers for the kidney deterioration, such as serum creatinine or urinary albumin, do not allow effective early detection of CKD, which is essential towards disease management. In this work, a hydrophilic interaction liquid chromatography time-of-flight mass spectrometric (HILIC-TOF MS) platform was optimized allowing the search for novel uremic retention solutes and/or biomarkers of CKD...
January 12, 2017: Analytical and Bioanalytical Chemistry
Serkan Bakirdogen, Necmi Eren, Sibel Gokcay Bek, Ozgur Mehtap, Mustafa Baki Cekmen
OBJECTIVE: Serum leptin levels of chronic kidney disease patients have been detected higher than normal population. The aim of this study was to investigate the effects of serum leptin levels on thrombocyte aggregation in peritoneal dialysis patients. METHODS: Fourty three peritoneal dialysis patients were included in the study. Thrombocyte aggregation was calculated from the whole blood subsequently the effects of different concentrations of human recombinant leptin on thrombocyte aggregations were investigated...
November 2016: Pakistan Journal of Medical Sciences Quarterly
Louis-Mathieu Stevens, Nicolas Noiseux, Alvaro Avezum, Dharma Rakshak Ayapati, Xin Chen, Fernando Antonio Lucchese, Horacio Cacheda, Sirish Parvathaneni, Yongning Ou, André Lamy
OBJECTIVES: Emergent and late conversions form OFF-to-ON pump coronary artery bypass grafting (CABG) have been associated with worse outcomes, however, it remains unclear as to which risk factors are associated with conversion and how to prevent them. METHODS: Among 4718 patients who randomly underwent off- or on-pump CABG, the incidence of off-pump to on-pump cross-over, or 'OFF-to-ON conversion', was 7.9% (186/2356). The primary outcome was a composite of death, stroke, myocardial infarction, or new renal failure requiring dialysis...
January 12, 2017: European Journal of Cardio-thoracic Surgery
Bong Gu Yi, Ok Kyu Park, Myeong Seon Jeong, Seung Hae Kwon, Jae In Jung, Seongsoo Lee, Sungwoo Ryoo, Sung Eun Kim, Jin Won Kim, Won-Jin Moon, Kyeongsoon Park
Scavenger receptors (SRs) expressed on the activated macrophages in inflammation sites have been considered as the most interesting and important target biomarker for targeted drug delivery, imaging and therapy. In the present study, we fabricated the scavenger receptor-A (SR-A) targeted-photoactivatable nanoagents (termed as Ce6/DS-DOCA) by entrapping chlorin e6 (Ce6) into the amphiphilic dextran sulfate-deoxycholic acid (DS-DOCA) conjugates via physically hydrophobic interactions. Insoluble Ce6 was easily encapsulated into DS-DOCA nanoparticles by a dialysis method and the loading efficiency was approximately 51...
January 9, 2017: International Journal of Biological Macromolecules
Evangelia Zampeli, Dennis M Klinman, M Eric Gershwin, Haralampos M Moutsopoulos
Systemic lupus is the prototypic human autoimmune disease. It is a kaleidoscope of autoreactivities, with clear indications of both a genetic and environmental basis. Indeed, it is a disease that can manifest in virtually every tissue and organ and can also be found spontaneously in a number of animal species, including dogs, cats and horses. Moreover, there are multiple murine models of lupus, the first of which, New Zealand Black (NZB) mice, were discovered in 1959. Despite an enormous effort from scientists in multiple disciplines, the etiology of lupus remains elusive and the introduction of new therapies has been disappointing...
January 9, 2017: Journal of Autoimmunity
Barbara Kot, Jolanta Wicha, Agata Grużewska, Małgorzata Piechota, Katarzyna Wolska, Maria Obrębska
BACKGROUND/AIM: Escherichia coli is the most frequent cause of urinary tract infections. We investigated the possible associations between the origin of strains, antimicrobial resistance, the presence of urovirulence factors, and biofilm-forming ability. MATERIALS AND METHODS: Antibiotic susceptibility of E. coli strains was tested by disk diffusion method. Hemagglutination assays were performed for phenotypic characterization of the cell surface. Multiplex PCR was used for detection of virulence genes and for determination of phylogenetic relationships...
December 20, 2016: Turkish Journal of Medical Sciences
Ann Bullock, Nilka Ríos Burrows, Andrew S Narva, Karen Sheff, Israel Hora, Akaki Lekiachvili, Hannah Cain, David Espey
BACKGROUND: American Indians and Alaska Natives (AI/AN) have the highest diabetes prevalence among any racial/ethnic group in the United States. Among AI/AN, diabetes accounts for 69% of new cases of end-stage renal disease (ESRD), defined as kidney failure treated with dialysis or transplantation. During 1982-1996, diabetes-related ESRD (ESRD-D) in AI/AN increased substantially and disproportionately compared with other racial/ethnic groups. METHODS: Data from the U...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
Tian A Qiu, Marco D Torelli, Ariane M Vartanian, Nathan B Rackstraw, Joseph T Buchman, Lisa M Jacob, Catherine J Murphy, Robert J Hamers, Christy L Haynes
Polyelectrolyte (PE) wrapping of colloidal nanoparticles (NPs) is a standard method to control NP surface chemistry and charge. Because excess polyelectrolytes are usually employed in the surface modification process, it is critical to evaluate different purification strategies to obtain a clean final product and thus avoid ambiguities in the source of effects on biological systems. In this work, 4 nm diameter gold nanoparticles (AuNPs) were wrapped with 15 kDa poly(allylamine hydrochloride) (PAH), and three purification strategies were applied: (a) diafiltration or either (b) one round or (c) two rounds of centrifugation...
January 10, 2017: Analytical Chemistry
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