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https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#1
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28527110/a-review-of-the-hemodynamic-factors-believed-to-contribute-to-vascular-access-dysfunction
#2
Connor V Cunnane, Eoghan M Cunnane, Michael T Walsh
A vascular access (VA) is used to facilitate hemodialysis in patients that suffer from end-stage renal disease. However, they suffer from high failure rates due to non-maturation and venous stenosis, with intimal hyperplasia (IH) the underlying cause of both conditions. Abnormal hemodynamic profiles, which arise following VA creation, are believed to lead to the development of IH. However, the exact physiological response that initiates this process is unknown. This review evaluates the different hemodynamic parameters that are hypothesised to correlate with the development of IH...
May 19, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28522650/examining-the-association-between-hemodialysis-access-type-and-mortality-the-role-of-access-complications
#3
Pietro Ravani, Robert Quinn, Matthew Oliver, Bruce Robinson, Ronald Pisoni, Neesh Pannu, Jennifer MacRae, Braden Manns, Brenda Hemmelgarn, Matthew James, Marcello Tonelli, Brenda Gillespie
BACKGROUND AND OBJECTIVES: People receiving hemodialysis to treat kidney failure need a vascular access (a fistula, a graft, or a central venous catheter) to connect to the blood purification machine. Higher rates of access complications are considered the mechanism responsible for the excess mortality observed among catheter or graft users versus fistula users. We tested this hypothesis using mediation analysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied incident patients who started hemodialysis therapy from North America, Europe, and Australasia (the Dialysis Outcomes and Practice Patterns Study; 1996-2011)...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28509350/high-sodium-continuous-veno-venous-hemodialysis-with-regional-citrate-anticoagulation-and-online-dialysate-generation-in-patients-with-acute-liver-failure-and-cerebral-edema
#4
Tamim Hamdi, Lenar Yessayan, Jerry Yee, Balazs Szamosfalvi
INTRODUCTION: Acute liver failure is associated with a high mortality rate. Induction of plasma hypertonicity with mannitol or hypertonic saline remains the cornerstone in the management of resultant cerebral edema. Significant disadvantages of this approach include poor or unpredictable control of serum sodium concentration and volume expansion, among others. METHODS: We used high sodium continuous veno-venous hemodialysis with regional citrate anticoagulation and online dialysate generation to accurately control the serum sodium in eleven patients with acute liver failure, renal failure, and cerebral edema...
May 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28509133/denosumab-for-treatment-of-immobilization-related-hypercalcemia-in-a-patient-with-end-stage-renal-disease
#5
Atsuko Uehara, Masahiko Yazawa, Atsumi Kawata, Rina Hachisuka, Yugo Shibagaki
The efficacy and safety of denosumab for the treatment of immobilization-related hypercalcemia in end-stage renal disease remain uncertain. We describe the case of a hemodialysis patient with immobilization-related hypercalcemia who was successfully treated with denosumab. A 79-year-old man admitted for hemodialysis after sustaining an acute kidney injury developed immobilization-related hypercalcemia due to the impairment resulting from an acute myocardial infarction, acute heart failure, and catheter-related bloodstream infection...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28508968/dialysis-disequilibrium-leading-to-posterior-reversible-encephalopathy-syndrome-in-chronic-renal-failure
#6
Pratim Sengupta, Sumanta Biswas
Dialysis disequilibrium syndrome is a neurological adverse effect of acute hemodialysis in advanced uremic patients. Dialysis disequilibrium has a wide spectrum of clinical manifestations starting from subtle uneasiness, confusion, to florid and complex life threatening neurological deficit. In this case study, we present a patient who developed sudden cortical blindness following hemodialysis due to posterior reversible encephalopathy, which is a rare presentation of dialysis disequilibrium syndrome.
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28508538/prognostic-value-of-predialysis-indices-for-technique-failure-and-mortality-in-peritoneal-dialysis-patients
#7
Masaru Matsui, Yasuhiro Akai, Ken-Ichi Samejima, Hideo Tsushima, Kaori Tanabe, Katsuhiko Morimoto, Miho Tagawa, Yoshihiko Saito
Technique failure remains a frequent cause of peritoneal dialysis (PD) withdrawal. Many post-commencement predictors of PD technique failure have been identified, while predialysis predictors have remained unclear. The aim of this study was to identify predialysis indices for technique failure in PD patients. We recruited 206 consecutive PD patients who were treated at Nara Medical University Hospital between 1 April 1997 and 31 December 2012. Forty-eight patients were excluded because of transition from hemodialysis (HD) or withdrawal from PD within 3 months, leaving 158 patients for analysis...
May 15, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28507910/penile-calciphylaxis-the-use-of-radiological-investigations-in-the-management-of-a-rare-and-challenging-condition
#8
Rebecca A Campbell, Laith M Alzweri, Nikolai A Sopko, Katarzyna J Macura, Arthur L Burnett
Penile calciphylaxis is a rare phenomenon of penile necrosis observed in patients with hemodialysis-dependent end-stage renal failure. Multiple treatments have been proposed including conservative management, surgical debridement and penectomy; yet, the prognosis remains extremely poor. Here, we describe a patient with protracted resolution of dry gangrene of the glans, which failed conservative management of wound care and pain management. Radiological studies revealed extensive calcification of abdominal aorta and branching vessels including the penile arteries...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#9
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28497450/the-role-of-hemodialysis-in-treatment-of-acute-acetic-acid-poisonings
#10
Andon Chibishev, Lidija Petkovska, Liljana Tozija, Milka Zdravkovska, Emilija Shikole
INTRODUCTION: The aim of this study is to show the importance of hemodialysis as an active method in treatment of acute acetic acid poisonings. Its main role is to support the renal function during the state of the intoxication when patients develop acute renal failure. METHODS: We analyzed data from a 10-year period, a total of 71 patients who ingested acetic acid, either intentionally or accidentally. Patients with a need of hemodialysis (HD) treatment underwent 3- to 4-hour HD sessions every day or every second day, according to clinical assessment, as needed, until recovery of kidney function...
May 10, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28497092/the-relationship-between-dialysis-adequacy-and-serum-uric-acid-in-dialysis-patients-a-cross-sectional-multi-center-study-in-iranian-hemodialysis-centers
#11
Eghlim Nemati, Arezoo Khosravi, Behzad Einollahi, Mehdi Meshkati, Mehrdad Taghipour, Shahin Abbaszadeh
Introduction: Uric acid is one of the most significant uremic toxins accumulating in chronic renal failure patients treated with standard dialysis. Its clearance has not any exact relation with urea and creatinine clearance. Objectives: The aim of this study was to investigate the relationship between adequacy of dialysis and serum level of uric acid in dialysis patients of some dialysis centers in Iran. Patients and Methods: In this study 1271 hemodialysis patients who have been treated for more than 3 months were evaluated...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#12
Niloufar Zadeh Saraji, Maryam Hami, Reza Boostani, Mohammad Javad Mojahedi
Introduction: Restless leg syndrome (RLS) is a sensory motor disorder. Patients with this syndrome have serious and uncontrollable desire to move their legs, which is mostly due to an uncomfortable feeling intensified when they are motionless. It may be a genetic disorder or secondary to iron deficiency, neurodegenerations, pregnancy, some drugs and severe kidney diseases. Objectives: This study was designed to find out the prevalence and its risk factors of RLS in hemodialysis patients. Patients and Methods: This multicenter cross-sectional study was done on 260 hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28497088/pulmonary-hypertension-among-patients-undergoing-hemodialysis
#13
Fatemeh Hayati, Seyed Seifollah Beladi Mousavi, Seyed Majid Mousavi Movahed, Maryam Mofrad Bushehri
Introduction: The epidemiology of pulmonary hypertension (PHT) among long-term hemodialysis patients has been described in relatively small studies in Iran. Objectives: The purpose of this study was to evaluate the prevalence of PHT and its relationship among end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD). Patients and Methods: In a cross-sectional study, patients with ESRD treated with HD for at least 3 months in the Imam hospital enrolled for the study. PHT was defined as an estimated systolic pulmonary artery pressure (PAP) equal to or higher than 25 mm Hg using echocardiograms performed by cardiologist...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28495210/3-tesla-23-na-magnetic-resonance-imaging-during-acute-kidney-injury
#14
Matthias Hammon, Susan Grossmann, Peter Linz, Hannes Seuss, Rebecca Hammon, Daniela Rosenhauer, Rolf Janka, Alexander Cavallaro, Friedrich C Luft, Jens Titze, Michael Uder, Anke Dahlmann
RATIONALE AND OBJECTIVES: Sodium and proton magnetic resonance imaging ((23)Na/(1)H-MRI) have shown that muscle and skin can store Na(+) without water. In chronic renal failure and in heart failure, Na(+) mobilization occurs, but is variable depending on age, dialysis vintage, and other features. Na(+) storage depots have not been studied in patients with acute kidney injury (AKI). MATERIALS AND METHODS: We studied 7 patients with AKI (mean age: 51.7 years; range: 25-84) and 14 age-matched and gender-matched healthy controls...
May 8, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28492143/a-direct-assay-for-measuring-free-25-hydroxyvitamin-d
#15
Heureux Nicolas, Ernst Lindhout, Leon Swinkels
Recent studies suggest that the concentration and genotype of vitamin D binding protein (VDBP) are important factors that determine the bioavailability of 25-hydroxyvitamin D [25(OH)D] in blood. Accumulating data indicate that, e.g., in pregnant women, hemodialysis patients, chronic kidney disease, liver failure, and bladder and pancreatic cancers, the measurement of free 25(OH)D in serum provides more relevant diagnostic information than measurement of total 25(OH)D. The aim of this study was to develop and validate an ELISA for direct measurement of free 25(OH)D in serum...
May 11, 2017: Journal of AOAC International
https://www.readbyqxmd.com/read/28491851/pemetrexed-induced-acute-kidney-failure-following-irreversible-renal-damage-two-case-reports-and-literature-review
#16
Tito Zattera, Francesco Londrino, Matteo Trezzi, Roberto Palumbo, Antonio Granata, Paola Tatangelo, Valentina Corbani, Valeria Falqui, Nadia Chiappini, Lisa Mathiasen, Marco Cavallini, Davide Rolla
BACKGROUND: Pemetrexed (PEM) is a new-generation multitargeted antifolate agent with a demonstrated broad-spectrum activity in several types of human cancers, including non-small cell lung cancer (NSCLC) and mesothelioma. Major side effects include dose-limiting hematologic toxicities. PEM nephrotoxicity is well known; however, its frequency is considered to be low. CASE PRESENTATION: Here we report two cases of acute kidney injury (AKI) related to PEM administration (500 mg/m2) in patients with NSCLC...
March 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28487153/prognostic-factors-of-infective-endocarditis-in-patients-on-hemodialysis-a-case-series-from-a-national-multicenter-registry
#17
Antonio Ramos-Martínez, Fernado Roque, Maria Carmen Fariñas, Patricia Muñoz, Eduardo Verde, Gregorio Pablo Cuerpo, Arístides de Alarcón, José Antonio Lepe, José María Miró, Antonio Plata, Miguel Ángel Goenaga, Dácil García-Rosado, Amparo Martínez-Monzonis, Javier de la Torre, Pablo García-Pavía
BACKGROUND: Infective endocarditis (IE) is a severe complication associated with high mortality. OBJECTIVES: To examine the clinical characteristics of IE in hemodialysis (HD) patients and to determine prognostic factors related to HD. METHODS: From January 2008 to April 2015, 2488 consecutive patients with definite IE were included. Clinical characteristics of IE patients on HD were compared with those of IE patients who were not on HD. RESULTS: A total of 126 patients (63% male, median age: 66years; IQR: 54-74years) with IE (5...
April 29, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28486776/ultrasound-guided-cannulation-of-the-hemodialysis-arteriovenous-access
#18
Frank Ward, Rose Faratro, Rory F McQuillan
Successful cannulation of the arteriovenous access for patients with end-stage kidney failure to allow catheter-free hemodialysis is associated with superior patient outcomes. With an increasing rate of arteriovenous access creation, coupled with increasing dialysis patient age, the "difficult-to-cannulate" access is becoming more commonplace. Ultrasound-guided cannulation aims to improve first-time successful cannulations and minimize cannulation-associated complications such as infiltration and hematoma formation, minimizing delays in access use and reducing catheter dependency...
May 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28483919/ambulatory-pulse-wave-velocity-is-a-stronger-predictor-of-cardiovascular-events-and-all-cause-mortality-than-office-and-ambulatory-blood-pressure-in-hemodialysis-patients
#19
Pantelis A Sarafidis, Charalampos Loutradis, Antonios Karpetas, Georgios Tzanis, Alexia Piperidou, Georgios Koutroumpas, Vasilios Raptis, Christos Syrgkanis, Vasilios Liakopoulos, Georgios Efstratiadis, Gérard London, Carmine Zoccali
Arterial stiffness and augmentation of aortic blood pressure (BP) measured in office are known cardiovascular risk factors in hemodialysis patients. This study examines the prognostic significance of ambulatory brachial BP, central BP, pulse wave velocity (PWV), and heart rate-adjusted augmentation index [AIx(75)] in this population. A total of 170 hemodialysis patients underwent 48-hour ambulatory monitoring with Mobil-O-Graph-NG during a standard interdialytic interval and followed-up for 28.1±11.2 months...
May 8, 2017: Hypertension
https://www.readbyqxmd.com/read/28480823/clinical-course-of-hemodialysis-access-after-initial-endovascular-intervention-for-stenosis-in-asian-renal-failure-patients
#20
Dewahar Senthoor, Kyi Zin Thant, Tze-Kiat Ng, Pei Ho
BACKGROUND: Arteriovenous fistula (AVF) and arteriovenous fistula graft (AVG) access for hemodialysis can develop stenosis, eventually leading to thrombosis and access failure. Prompt endovascular intervention can salvage the access but restenosis does occur. Clinical course, restenosis pattern, and risk factors associated with initial stenosis of AVFs/AVGs in Asian hemodialysis patients were studied. METHOD: A retrospective study was conducted (January 2009-June 2012) on consecutive patients with renal failure who developed the first-time stenosis in the vascular access and were managed with endovascular intervention...
January 1, 2017: Vascular and Endovascular Surgery
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