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Lawrence A Lavery, David C Lavery, Nathan A Hunt, Javier La Fontaine, Ryan D Lavery
BACKGROUND: Dialysis therapy is associated with an increased incidence of lower-extremity wounds and amputations. We compared the incidence of foot ulcers and amputations before and after the start of dialysis. METHODS: We evaluated 150 consecutive diabetic patients receiving dialysis and compared the incidence of foot complications 30 months before and after initiation of hemodialysis. We used claims data for diabetes, ulceration, and dialysis and abstracted medical records to verify diagnoses and dates of ulcers and amputations...
January 2018: Journal of the American Podiatric Medical Association
Nikolaos Papadopoulos, Ioannis Griveas, Eirini Sveroni, Vasiliki Argiana, Antonios Kalliaropoulos, Beatriz Martinez-Gonzalez, Melanie Deutsch
BACKGROUND: Hepatitis C virus (HCV) infection is still common among dialysis patients, but the natural history of HCV in this group is not completely understood. The KDIGO HCV guidelines of 2009 recommend that chronic haemodialysis patients be screened for HCV antibody upon admission to the dialysis clinic and every 6 months thereafter if susceptible to HCV infection. However, previous studies have shown the presence of HCV viraemia in anti-HCV-negative haemodialysis patients as up to 22%...
March 2018: International Journal of Artificial Organs
Panagiotis M Kitrou, Konstantinos Katsanos, Panagiotis Papadimatos, Stavros Spiliopoulos, Dimitris Karnabatidis
Thrombosis is the most important access-related complication. Several declotting procedures have been suggested falling mainly into two categories; thrombolysis-dependent and thrombectomy dependent. Areas Covered: Seventeen studies after 2001 have been published on percutaneous treatment of thrombosed vascular access. Authors performed a systematic review of these studies together with a parametric meta-analysis of data available investigating clinical success, postintervention assisted primary patency (PAPP) and independent factors that could influence outcome measures...
March 16, 2018: Expert Review of Medical Devices
Alexandros Mallios, William Jennings, Benoit Boura, Alessandro Costanzo, Myriam Combes
Skin necrosis overlying an arteriovenous fistula at the cannulation site is a common and potentially life-threatening problem, often associated with underlying aneurysm formation. Arteriovenous fistula-skin necrosis generally requires resection of surrounding skin margins and the underlying aneurysmal vessel wall, allowing repair with healthy tissue of the arteriovenous fistula in addition to closure of soft tissue and skin. In patients with insufficient fistula length, salvage of these arteriovenous fistulas may result in difficult or insurmountable cannulation issues leading to attempts at one-needle cannulation dialysis or, most often, catheter placement...
March 1, 2018: Journal of Vascular Access
Manuel Kussmann, Stefan Hauer, Petra Pichler, Gottfried Reznicek, Heinz Burgmann, Wolfgang Poeppl, Markus Zeitlinger, Martin Wiesholzer
Peritonitis is still the main infectious complication among patients on peritoneal dialysis. For treatment of peritoneal dialysis-related peritonitis, the intraperitoneal administration of antibiotics admixed to peritoneal dialysis fluids (PDFs) should be preferred. However, the influence of diverse PDFs on the activity of frequently used antibiotics has been investigated insufficiently. Thus, the present study set out to investigate the in vitro activity of fosfomycin against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus epidermidis, and Staphylococcus aureus in commercially available PDFs...
March 15, 2018: European Journal of Clinical Microbiology & Infectious Diseases
V Schwenger, D Kindgen-Milles, C Willam, A Jörres, W Druml, D Czock, S J Klein, M Oppert, M Schmitz, J T Kielstein, A Zarbock, M Joannidis, S John
BACKGROUND: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients. The incidence of AKI in ICU patients exceeds 50% and the associated morbidity and mortality rates increase with severity of AKI. In addition, long-term consequences of AKI are underestimated and several studies show impaired long-term outcome after AKI. In about 5-25% of ICU patients with AKI renal replacement therapy (RRT) is required. OBJECTIVES: To assist in indication, timing, modality and application of renal replacement therapy of adult patients, current recommendations from the renal sections of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
March 15, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Berdien E Oortgiesen, Roshna Azad, Marc H Hemmelder, Robby E Kibbelaar, Nic J G M Veeger, Joost C de Vries, Eric N van Roon, Mels Hoogendoorn
No abstract text is available yet for this article.
March 15, 2018: Haematologica
Pablo Antonio Ureña-Torres, Mario Cozzolino, Jordi Bover
Secondary hyperparathyroidism (SHPT) is one of the most frequent and deleterious complication of chronic kidney disease (CKD). SHPT is also one of the principal components of the now called CKD-mineral and bone disorders (MBD) syndrome. It is usually prevented and treated by vitamin D derivatives. However, the rationale for the prescription of vitamin D sterols in those patients is still a matter of hotly debates, mainly because of unsatisfactory results from numerous observational and not well-controlled studies...
March 12, 2018: Néphrologie & Thérapeutique
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
Chronic Kidney Disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health and specifically their kidney health, on the community, and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly...
March 15, 2018: BMC Nephrology
Wendy L St Peter, Haifeng Guo, Shaum Kabadi, David T Gilbertson, Yi Peng, Trudy Pendergraft, Suying Li
BACKGROUND: Anemia is common in non-dialysis-dependent chronic kidney disease (NDD-CKD) patients, but detailed information on prevalence and treatment is lacking. METHODS: We evaluated anemia prevalence and treatment using two datasets: the Medicare 20% random sample (ages 66-85 years), and the Truven Health MarketScan database (ages 18-63 years). We selected stage 3-5 NDD-CKD patients with and without anemia from both databases during 2011-2013. We evaluated anemia prevalence and treatment (erythropoietin stimulating agents [ESAs], intravenous [IV] iron, red blood cell [RBC] transfusions) following anemia diagnosis during a 1-year baseline period, and healthcare utilization during a 1-year follow-up period...
March 15, 2018: BMC Nephrology
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
Tereza Kmentova, Anna Valerianova, Lucie Kovarova, Jana Lachmanova, Zuzana Hladinova, Jan Malik
BACKGROUND: Creation of vascular access leads to considerable local haemodynamic changes with decreased hand perfusion. Distal limb tissues then represent a model of hand ischaemia effect on muscles. The aim of our study was to investigate how the presence of vascular access influences the hand muscle strength in end-stage renal disease patients. METHODS: We included 52 chronically haemodialysed patients with upper limb access without clinical signs of hand ischaemia...
March 1, 2018: Journal of Vascular Access
Franck Maunoury, Aurore Clément, Chizoba Nwankwo, Laurie Levy-Bachelot, Armand Abergel, Vincent Di Martino, Eric Thervet, Isabelle Durand-Zaleski
OBJECTIVE: To assess the cost-effectiveness of the elbasvir/grazoprevir (EBR/GZR) regimen in patients with genotype 1 chronic hepatitis C virus (HCV) infection with severe and end-stage renal disease compared to no treatment. DESIGN: This study uses a health economic model to estimate the cost-effectiveness of treating previously untreated and treatment experienced chronic hepatitis C patients who have severe and end stage renal disease with the elbasvir-grazoprevir regimen versus no treatment in the French context...
2018: PloS One
Meda E Pavkov, Jessica L Harding, Nilka R Burrows
Acute kidney injury is a sudden decrease in kidney function with or without kidney damage, occurring over a few hours or days. Diabetes, hypertension, and advanced age are primary risk factors for acute kidney injury. It is increasingly recognized as an in-hospital complication of sepsis, heart conditions, and surgery (1,2). Its most severe stage requires treatment with dialysis. Acute kidney injury is also associated with higher likelihood of long-term care, incidence of chronic kidney disease and hospital mortality, and health care costs (1,2)...
March 16, 2018: MMWR. Morbidity and Mortality Weekly Report
Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Brianna Kim, Robyn Araujo, Marissa Howard, Ruben Magni, Lance Liotta, Alessandra Luchini
Mass spectrometry (MS) is the premier tool for discovering novel disease-associated protein biomarkers. Unfortunately, when applied to complex body fluid samples, MS has poor sensitivity for the detection of low abundance biomarkers (≪10 ng/mL), derived directly from the diseased tissue cells or pathogens. Areas covered: Herein we discuss the strengths and drawbacks of technologies used to concentrate low abundance analytes in body fluids, with the aim to improve the effective sensitivity for MS discovery...
March 15, 2018: Expert Review of Proteomics
Per Jonsson, Lorentz Lindmark, Jan Axelsson, Lars Karlsson, Lennart Lundberg, Bernd Stegmayr
We were encouraged to investigate the reasons for large amounts of foam observed in bloodlines during hemodialysis (HD). Foam was visible in the venous air trap within the Artis Gambro dialysis device. Estimates of the extent of foam were graded (0-no foam, 10-extensive foam) by two persons that were blind to the type of dialyzer used. Thirty-seven patients were involved in the dialysis procedures. Consecutive dialyses were graded using dialyzers from Fresenius Medical Care (CorDiax dialyzers that were used for high flux HD-FX80 and FX100, and for hemodiafiltration-FX1000)...
March 15, 2018: Artificial Organs
Zackary M Herbst, Sayaka Shibata, Erkang Fan, Michael H Gelb
An inexpensive, in-house made microdialysis device is described that is suitable for measuring the binding of small molecules including drug candidates to serum proteins or other macromolecules. The device is based on the standard equilibrium dialysis method to measure the fraction of low molecular weight compound bound to proteins. It is constructed from a standard polypropylene 96-well plate, dialysis tubing, and low viscosity epoxy resin. The device can be readily prepared for a small fraction of the cost of a commercial, multichamber microdialysis device...
March 8, 2018: ACS Medicinal Chemistry Letters
Masaki Okazaki, Daijo Inaguma, Takahiro Imaizumi, Akiko Kada, Takaaki Yaomura, Naotake Tsuboi, Shoichi Maruyama
BACKGROUND: Patients with late referral and positive history of volume overload may have a poor prognosis after initiating dialysis due to insufficient and/or inadequate management of complications of renal failure and the lack of better dialysis preparation. Little is known about the influence of the relationship between history of volume overload and late referral on prognosis. METHODS: We analyzed 1475 patients who had initiated dialysis for the first time from October 2011 to September 2013...
March 14, 2018: BMC Nephrology
Nicole A Pilch, Vinayak Rohan, Vinaya Rao, Patrick D Mauldin, Zemin Su, Derek A Dubay, Thomas A Morinelli, David J Taber
BACKGROUND: Several studies have been performed to evaluate surrogate markers of long-term allograft function in renal transplant recipients. These include serum creatinine, estimated glomerular filtration rate (eGFR), slope of eGFR, and more recently eGFR variability. The aim of this study was to measure eGFR slope while assessing the variability of this slope and if high variability occurring at any time post-transplant was predictive of poorer long-term outcomes in a large cohort of kidney transplant recipients...
March 14, 2018: American Journal of Nephrology
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