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https://www.readbyqxmd.com/read/28810244/increasing-haemodialytic-clearances-as-residual-renal-function-declines-an-incremental-approach
#1
Kamonwan Tangvoraphonkchai, Andrew Davenport
Many patients with chronic kidney disease start undergoing thrice-weekly haemodialysis (HD), aiming for an HD sessional dialyzer urea clearance target, irrespective of whether they have residual renal function (RRF). While increasing sessional dialyzer urea clearance above a target of 1.2 has not been shown to improve patient survival, it has been shown that the preservation of RRF improves patient self-reported outcomes and survival. Observational studies have suggested that initiating twice-weekly HD schedules leads to greater preservation of RRF...
August 16, 2017: Blood Purification
https://www.readbyqxmd.com/read/28794599/beware-a-simple-renal-cyst-could-be-a-hydatid-cyst
#2
Nidhi Sehgal, Vinod Priyadarshi
Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock...
July 2017: Urology Annals
https://www.readbyqxmd.com/read/28766494/resting-energy-expenditure-a-valuable-predictor-for-kt-vurea-in-peritoneal-dialysis-patients%C3%A2
#3
Tian Xu, Jingyuan Xie, Weiming Wang, Hong Ren, Nan Chen
OBJECTIVE: The objective of this study was to identify an effective method for predicting small-molecule solute removal at the commencement of or before peritoneal dialysis (PD). METHODS: The PD patients with a dialysis delivery of 8 L/d and a residual kidney function (RKF) ≤ 5 mL/min were enrolled in the study. Fat-free lean body mass (FFM) and resting energy expenditure (REE) were measured using bioelectrical impedance (BIA). A receiver operating characteristic (ROC) curve was drawn to determine the threshold value for REE...
September 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28761233/measured-glomerular-filtration-rate-at-dialysis-initiation-and-clinical-outcomes-of-indian-peritoneal-dialysis-patients
#4
N Prasad, M R Patel, A Chandra, D Rangaswamy, A Sinha, D Bhadauria, R K Sharma, A Kaul, A Gupta
The optimal time for dialysis initiation remains controversial. Studies have failed to show better outcomes with early initiation of hemodialysis; even a few had shown increased adverse outcomes including poorer survival. Few studies have examined the same in patients on peritoneal dialysis (PD). Measured glomerular filtration rate (mGFR) not creatinine-based estimated GFR is recommended as the measure of kidney function in end-stage renal disease (ESRD) patients. The objective of this observational study was to compare the outcomes of Indian patients initiated on PD with different residual renal function (RRF) as measured by 24-h urinary clearance method...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28758559/small-for-size-syndrome-bridging-the-gap-between-liver-transplantation-and-graft-recovery
#5
Akila Rajakumar, Ilankumaran Kaliamoorthy, Mohamed Rela, M Susan Mandell
In living donor liver transplantation, optimal graft size is estimated from values like graft volume/standard liver volume and graft/recipient body weight ratio but the final functional hepatic mass is influenced by other donor and recipient factors. Grafts with insufficient functional hepatic mass can produce a life-threatening condition with rapidly progressive liver failure called small-for-size syndrome (SFSS). Diagnosis of SFSS requires careful surveillance for signs of inadequate hepatocellular function, residual portal hypertension, and systemic inflammation that suggest rapidly progressive liver failure...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28742337/gallium-complexation-stability-and-bioconjugation-of-1-4-7-triazacyclononane-derived-chelators-with-azaheterocyclic-arms
#6
Alexander Schmidtke, Tilman Läppchen, Christian Weinmann, Lorenz Bier-Schorr, Manfred Keller, Yvonne Kiefer, Jason P Holland, Mark D Bartholomä
We have recently introduced a 1,4,7-triazacyclononane (TACN) based chelating system with additional five-membered azaheterocyclic substituents for complexation of radioactive Cu(2+) ions. In this work, we investigated the complexation properties of these novel chelators with Ga(3+). In labeling experiments, we could show that the penta- and hexadentate imidazole derivatives NODIA-Me 4 and NOTI-Me 1 can be labeled with (68)Ga in specific activities up to ∼30 MBq nmol(-1), while the corresponding thiazole derivative NOTThia 2 did not label satisfactorily under identical conditions...
August 7, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28738355/impact-of-renin-angiotensin-aldosterone-system-inhibition-on-serum-potassium-levels-among-peritoneal-dialysis-patients
#7
Silvia Carreira Ribeiro, Ana Elizabeth Figueiredo, Pasqual Barretti, Roberto Pecoits-Filho, Thyago Proença de Moraes
BACKGROUND: The chronic use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker has been associated with hyperkalemia in patients with reduced renal function even after the initiation of hemodialysis. Whether such medications may cause a similar effect in peritoneal dialysis patients is not well established. So, the aim of our study was to analyze the impact of renin-angiotensin-aldosterone inhibitors on the serum levels of potassium in a national cohort of peritoneal dialysis patients...
July 22, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28728829/short-term-double-natural-orifice-catheterization-nonoperative-management-of-hydrocolpos-in-persistent-cloaca-patients-case-series
#8
Stjepan Višnjić, Mislav Bastić, Mateja Marčec, Marko Mesić
PURPOSE: Management of hydrocolpos in cloaca patients is of clinical importance. We report a nonoperative method for the management of hydrocolpos in the form of initial catheter decompression, followed by an endoscopy with catheters placement into both the bladder and vagina, and leaving these catheters for 9 and 14days respectively. METHODS: The medical records of six cloaca patients with hydrocolpos in the last 12years were reviewed. The outcomes measured were the renal function, bladder emptying, the presence/resolution of hydronephrosis, and the recurrence of hydrocolpos...
June 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28727739/survival-analysis-of-heart-failure-patients-a-case-study
#9
Tanvir Ahmad, Assia Munir, Sajjad Haider Bhatti, Muhammad Aftab, Muhammad Ali Raza
This study was focused on survival analysis of heart failure patients who were admitted to Institute of Cardiology and Allied hospital Faisalabad-Pakistan during April-December (2015). All the patients were aged 40 years or above, having left ventricular systolic dysfunction, belonging to NYHA class III and IV. Cox regression was used to model mortality considering age, ejection fraction, serum creatinine, serum sodium, anemia, platelets, creatinine phosphokinase, blood pressure, gender, diabetes and smoking status as potentially contributing for mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28722276/identification-and-functional-analysis-of-an-adamtsl1-variant-associated-with-a-complex-phenotype-including-congenital-glaucoma-craniofacial-and-other-systemic-features-in-a-three-generation-human-pedigree
#10
Kathryn Hendee, Lauren Weiping Wang, Linda M Reis, Gregory M Rice, Suneel S Apte, Elena V Semina
Developmental glaucoma can occur as an isolated or syndromic condition and is genetically heterogeneous. We describe a three-generation family affected with developmental glaucoma, myopia, and/or retinal defects associated with variable craniofacial/dental, auditory, brain, renal, and limb anomalies. Whole exome sequencing identified a heterozygous c.124T> C, p.(Trp42Arg) allele in ADAMTSL1; co-segregation analysis confirmed the presence of this allele in four affected family members. The mutation affects a highly conserved residue and is strongly predicted to have a deleterious effect on protein function...
July 19, 2017: Human Mutation
https://www.readbyqxmd.com/read/28714271/influence-of-residual-renal-function-in-carotid-modeling-as-a-marker-of-early-atherosclerosis-in-dialysis-patients
#11
Merita Rroji, Nereida Spahia, Saimir Seferi, Myftar Barbullushi, Goce Spasovski
Atherosclerosis is frequently present in patients with chronic kidney disease (CKD) treated with dialysis. We evaluated the association between residual renal function (RRF), phosphate level, inflammation and other risk factors in carotid modeling as a marker of early atherosclerosis in peritoneal dialysis (PD) compared with hemodialysis (HD) patients. We studied 39 stable PD and 53 HD patients on renal replacement therapy (RRT) for 3 to 36 months duration. B-mode ultrasonography was used to determine carotid artery intima media thickness (CIMT)...
July 17, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28705579/melamine-poisoning-pediatric-urolithiasis-treatment-in-gansu-china-5-yrfollow-up-analysis
#12
Hong Chang, Gongjin Wu, Zhongjin Yue, Junhai Ma, Ze Qin
OBJECTIVES: To investigate the clinical characteristics of urolithiasis children retrospectively who ingested melamine-poisoned formula as infants and report a five-year follow-up analysis. METHODS: Clinical data on 207 patients (mean±SD, 13.6±8.0months) with melamine-induced urolithiasis were retrospectively analyzed. Patients were subdivided into two groups according to treatment. A five-year follow-up study was conducted with 95.7% (198/207) of the children...
July 10, 2017: Urology
https://www.readbyqxmd.com/read/28698733/chronic-renal-failure-secondary-to-unrecognized-neurogenic-bladder-in-a-child-with-myelodysplasia
#13
Shameem Ahmed, Siba Prosad Paul
Myelodysplasia includes a group of developmental anomalies resulting from defects that occur during neural tube closure. Urological morbidity in patients with myelodysplasia is significant and if not treated appropriately in a timely manner can potentially lead to progressive renal failure, requiring dialysis or transplantation. We report the case of a 13-year old girl with neurogenic bladder who presented chronic renal failure secondary to lipomyelomeningocele with retethering of cord. She was managed with urinary indwelling catheterization until optimization of renal function and then underwent detethering of cord with excision and repair of residual lipomeningomyelocele...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28693252/clinical-outcomes-of-percutaneous-radiofrequency-ablation-for-small-renal-cancer
#14
Keiichi Ito, Shigeyoshi Soga, Kenji Seguchi, Yusuke Shinchi, Ayako Masunaga, Shinsuke Tasaki, Kenji Kuroda, Akinori Sato, Junichi Asakuma, Akio Horiguchi, Hiroshi Shinmoto, Tatsumi Kaji, Tomohiko Asano
Partial nephrectomy is the treatment of choice for small renal cell carcinoma (RCC) from the perspective of cancer management and renal function. However, when patients with RCC are of advanced age, exhibit severe comorbidities, including cardiovascular and pulmonary diseases, or have hereditary RCC, ablative therapies, including radiofrequency ablation (RFA) and cryoablation are useful treatment options. In the present study, the clinical outcomes of percutaneous RFA for treating small RCC were evaluated. Between December 2005 and March 2015, 40 patients (41 renal tumors in total) underwent RFA and a total of 50 sessions of RFA were performed...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28691402/osmolality-and-blood-pressure-stability-during-hemodialysis
#15
Anika T Singh, Finnian R Mc Causland
Homeostatic regulation of plasma osmolality (POsm) is critical for normal cellular function in humans. Arginine vasopressin (AVP) is the major hormone responsible for the maintenance of POsm and acts to promote renal water retention in conditions of increased POsm. However, AVP also exerts pressor effects, and its release can be stimulated by the development of effective arterial blood volume depletion. Patients with end-stage renal disease on hemodialysis, particularly those with minimal or no residual renal function, have impaired ability to regulate water retention in response to AVP...
July 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28682031/-the-peritoneal-ultrafiltration-in-patients-with-cardio-renal-disease
#16
Roberto Corciulo, Simone Corciulo
In Italy, the congestive heart failure is the leading cause of hospitalization and despite advances in therapy, the long-term prognosis is poor. Congestive heart failure is associated with advanced varying degrees of chronic renal disease that identify the cardio-renal syndrome type 2. High-dose diuretic therapy often fail to solve the water overload that is frequently the cause of death. The resistance to diuretics aggravates the state of the patient's edema and consequently morbidity and mortality. In the acute stage, the extracorporeal ultrafiltration unable to repair over hydration but needs frequent access weekly or midweek at the dialysis center...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28676514/rapid-change-in-residual-renal-function-decline-is-associated-with-lower-survival-and-worse-residual-renal-function-preservation-in-peritoneal-dialysis-patients
#17
Susie L Hu, Priyanka Joshi, Mark Kaplan, Judy Lefkovitz, Andreea Poenariu, Lance D Dworkin, Dominique S Michaud
The survival advantage observed among peritoneal dialysis patients early on after dialysis initiation has been largely attributed to residual renal function (RRF) preservation due to higher baseline residual function and fewer comorbidities. We hypothesize that a rapid decline in RRF is associated with higher risk of anuria and mortality. In a retrospective cohort study of 581 subjects on peritoneal dialysis with longitudinal prevalent data, we assessed whether RRF change over time, in addition to baseline RRF, increased risk of mortality and anuria using Kaplan-Meier analysis and Cox proportional hazard analysis to control for known risk factors...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28674854/icodextrin-and-peritoneal-dialysis-advantages-and-new-applications
#18
REVIEW
Periklis Dousdampanis, Carlos Guido Musso, Konstantina Trigka
The impact of icodextrin (ico) on peritoneal dialysis (PD) extension and patient survival is well established. Predominantly, ico-based solutions were prescribed in high-transporter PD patients. Advantages of the ico-based solutions include increased biocompatibility, avoidance of glucotoxicity, enhanced ultrafiltration failure (UF), sodium removal rates, better metabolic and blood pressure control. Bimodal solutions and twice daily exchanges of ico-based solutions are two newly introduced strategies to avoid glucose exposure and/or enhance UF in PD patients with UF failure...
July 3, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28666993/digoxin-use-and-subsequent-clinical-outcomes-in-patients-with-atrial-fibrillation-with-or-without-heart-failure-in-the-engage-af-timi-48-trial
#19
Alon Eisen, Christian T Ruff, Eugene Braunwald, Rose A Hamershock, Basil S Lewis, Christian Hassager, Tze-Fan Chao, Jean Yves Le Heuzey, Michele Mercuri, Howard Rutman, Elliott M Antman, Robert P Giugliano
BACKGROUND: Digoxin is widely used in patients with atrial fibrillation despite the lack of randomized controlled trials. Observational studies report conflicting results regarding its association with mortality, perhaps because of residual confounding by the presence of heart failure (HF). METHODS AND RESULTS: In the ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) trial, clinical outcomes of patients with atrial fibrillation with and without HF were examined by baseline digoxin use during a median follow-up of 2...
June 30, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28666408/effects-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-on-cardiovascular-events-and-residual-renal-function-in-dialysis-patients-a-meta-analysis-of-randomised-controlled-trials
#20
Youxia Liu, Xinxin Ma, Jie Zheng, Junya Jia, Tiekun Yan
BACKGROUND: The role of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) reducing risk of cardiovascular events (CVEs) and preserving kidney function in patients with chronic kidney disease is well-documented. However, the efficacy and safety of these agents in dialysis patients is still a controversial issue. METHODS: We systematically searched MEDLINE, Embase, Cochrane Library and Wanfang for randomized trials. The relative risk (RR) reductions were calculated with a random-effects model...
June 30, 2017: BMC Nephrology
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