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https://www.readbyqxmd.com/read/29045980/-anti-neutrophil-cytoplasmic-antibodies-associated-vasculitis-with-lung-hemorrhage-in-the-patient-on-maintenance-haemodialysis-a-case-report
#1
J X Ding, M Wang
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is usually a multisystem disorder, and pulmonary renal syndrome is a common presentation. Patients with AAV are less likely to experience relapse when they progress to end-stage renal disease (ESRD). We report a rare case of diffuse alveolar hemorrhage (DAH) in relapsing AAV after eight years of haemodialysis. A 58-year-old woman was admitted to our hospital with the chief complaints of dyspnea and hemoptysis accompanied by anemia, fever, fatigue, and weight loss...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29026846/intracranial-hemorrhage-in-methanol-toxicity-challenging-the-probable-heparin-effect-during-hemodialysis
#2
Hossein Hassanian-Moghaddam, Hooman Bahrami-Motlagh, Nasim Zamani, Seyed Amirhossein Fazeli, Behdad Behnam
Brain hemorrhages are rare complications of acute methanol poisoning. There is a debate on association of brain hemorrhage in methanol toxicity and application of systemic anticoagulation during hemodialysis (HD). A 70-year-old male presented to us with severe metabolic acidosis and a methanol level of 7.6 mg/dL. Ethanol and folinic acid were administered, and HD was performed. Brain computed tomography (CT) scan which was normal on presentation showed extensive bilateral subcortical supratentorial hypodensities on the 3(rd) day after commencing the treatment...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28894790/aortic-dissection-and-severe-renal-failure-6-years-after-kidney-transplantation
#3
Amaury Dujardin, Awena Le Fur, Diego Cantarovich
We report the case of a patient with long-term history of hypertension, presenting with transient neurological disorders and severe graft failure several years after kidney transplantation. Cause of end-stage renal disease was hypertensive nephrosclerosis. Chronic hemodialysis lasted for 1 year. After transplantation and throughout follow-up, serum creatinine ranged from 200 to 230 μmol/L and maintenance immunosuppression included sirolimus and low-dose steroids. Six years after transplantation, the patient presented with right hip pain radiating to the lower back, transient aphasia, confusion, and hemiparesis...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#4
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#5
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28836163/blood-glutamate-reducing-effect-of-hemofiltration-in-critically-ill-patients
#6
Evgeni Brotfain, Ruslan Kutz, Julia Grinshpun, Benjamin F Gruenbaum, Shaun E Gruenbaum, Amit Frenkel, Agzam Zhumadilov, Vladimir Zeldetz, Yoav Bichovsky, Matthew Boyko, Moti Klein, Alexander Zlotnik
Glutamate toxicity plays a well-established role in secondary brain damage following acute and chronic brain insults. Previous studies have demonstrated the efficacy of hemodialysis and peritoneal dialysis in reducing blood glutamate levels. However, these methods are not viable options for hemodynamically unstable patients. Given more favorable hemodynamics, longer treatment, and less needed anticoagulation, we investigated whether hemofiltration could be effective in lowering blood glutamate levels. Blood samples were taken from 10 critically ill patients immediately before initiation of hemofiltration and after 1, 2, 4, 6, and 12 h, for a total of 6 blood samples...
August 23, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28802549/diffuse-renal-cortical-hemorrhage-in-the-setting-of-subcapsular-hematoma-diagnosis-and-treatment-with-embolization
#7
Marta Burrel, Marta Barrufet, Maria Carme Sebastia, Jonathan Joudanin, Laura Buñesch, Patricia Bermudez, Jordi Blasco, Rosa Gilabert
PURPOSE: To describe radiologic findings, embolization technique, and clinical outcomes in patients with renal subcapsular hematoma and diffuse cortical hemorrhage. MATERIALS AND METHODS: Ten patients with renal subcapsular hematoma and diffuse cortical hemorrhage were reviewed. Nine of the 10 had undergone procedures (nephrostomy, n = 4; biopsy, n = 4; embolization of a cerebral aneurysm, n = 1) and 1 patient was receiving oral anticoagulation. Computed tomography (CT), angiography, and embolization of bleeding sites were performed in all patients...
November 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28766495/pulmonary-embolism-with-endovascular-thrombolysis-for-thrombosed-hemodialysis-arteriovenous-access%C3%A2
#8
Yogeshwar Singh Rajaram, Thong Le, Maree Ross-Smith, Andrew Owen, Jason Chuen, Peter F Mount
AIMS: Acute thrombosis of hemodialysis (HD) arteriovenous access is an urgent problem for HD patients and is commonly managed by endovascular thrombolysis. Pulmonary embolism (PE) is a recognized complication of HD access thrombosis and thrombolysis but the risk and outcomes are unclear. This study aims to determine the incidence, predictors, and outcomes of PE after endovascular thrombolysis of HD arteriovenous access in patients presenting with acute thrombosis. MATERIALS AND METHODS: A single-center retrospective study was performed for all adult chronic kidney disease patients undergoing arteriovenous access thrombolysis between January 1, 2012, and December 31, 2014...
September 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28762633/platelet-activation-and-clotting-cascade-activation-by-dialyzers-designed-for-high-volume-online-hemodiafiltration
#9
Kamonwan Tangvoraphonkchai, Anne Riddell, Andrew Davenport
INTRODUCTION: Hemodialysis patients are pro-thrombotic. Higher volume online postdilutional hemodiafiltration (OL-HDF), with increasing hematocrit increases the risk of clotting in the extracorporeal circuit (ECC). We wished to determine whether OL-HDF increased platelet activation and ECC clotting. METHODS: Coagulation parameters, platelet, white cell, and endothelial activation markers were measured at the start and end of dialysis sessions in 10 patients and also pre- and post-dialyzer after 15 minutes using two different dialyzers designed for high volume OL-HDF; cellulose triacetate (TAGP) and polysulphone (PS), and polyvinylpyrrolidone (PVP)...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28736561/recent-advances-in-stroke-prevention-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#10
REVIEW
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28692694/renal-replacement-therapy-practices-for-patients-with-acute-kidney-injury-in-china
#11
William R Clark, Xiaoqiang Ding, Haibo Qiu, Zhaohui Ni, Ping Chang, Ping Fu, Jiarui Xu, MinMin Wang, Li Yang, Jing Wang, Claudio Ronco
Recent data indicate AKI is very common among hospitalized Chinese patients and continuous renal replacement therapy (CRRT) is increasingly offered for treatment. However, only anecdotal information regarding CRRT's use in relation to other modalities and the specific manner in which it is prescribed exists currently. This report summarizes the results of a comprehensive physician survey designed to characterize contemporary dialytic management of AKI patients in China, especially with respect to the utilization of CRRT...
2017: PloS One
https://www.readbyqxmd.com/read/28652058/repeated-paradoxical-brain-infarctions-in-a-patient-on-self-managed-home-hemodialysis-using-a-long-term-indwelling-catheter
#12
Takuya Kiyohara, Tadataka Mizoguchi, Junya Kuroda, Yoshinobu Wakisaka, Aya Irie, Chie Kitaoka, Kiichiro Fujisaki, Udai Nakamura, Kazuhiko Tsuruya, Takanari Kitazono, Tetsuro Ago
We describe the case of a 51-year-old Japanese man with an end-stage kidney disease caused by a 30-year history of type 1 diabetes mellitus. The patient had suffered repeated bilateral multiple brain infarctions within a short period of time after the initiation of a self-managed daily home hemodialysis regimen using a long-term indwelling catheter inserted into the right atrium. Despite extensive examinations, we could not find any embolic causes except for the catheter and a patent foramen ovale (PFO). The patient had experienced repeated brain infarctions under antiplatelet and anticoagulation therapies, but suffered no further brain infarctions after the removal of the catheter and the alteration of vascular access from the catheter to an arteriovenous fistula in the forearm...
September 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28643524/a-multicenter-analysis-of-factors-associated-with-apixaban-related-bleeding-in-hospitalized-patients-with-end-stage-renal-disease-on-hemodialysis
#13
Taylor D Steuber, Dane L Shiltz, Alex C Cairns, Qian Ding, Katie J Binger, Julia R Courtney
BACKGROUND: In 2014, the United States Food and Drug Administration approved a labeling change for apixaban to include recommendations for patients with severe renal impairment and patients with end-stage renal disease (ESRD) on hemodialysis (HD), though these recommendations are largely based on pharmacokinetic and pharmacodynamic data. OBJECTIVE: Identify variables associated with bleeding events in hospitalized patients with ESRD on HD receiving apixaban. METHODS: This retrospective, multicenter cohort study evaluated hospitalized patients with ESRD on HD receiving apixaban from January 1, 2013, through March 31, 2016...
November 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28607611/report-of-periprocedural-oral-anticoagulants-in-catheter-ablation-for-atrial-fibrillation-the-japanese-catheter-ablation-registry-of-atrial-fibrillation-j-caraf
#14
Yuji Murakawa, Akihiko Nogami, Morio Shoda, Koichi Inoue, Shigeto Naito, Koichiro Kumagai, Yasushi Miyauchi, Teiichi Yamane, Norishige Morita, Hideo Mitamura, Ken Okumura, Kenzo Hirao
BACKGROUND: To obtain a perspective of the current status of catheter ablation for the cure of atrial fibrillation, the Japanese Heart Rhythm Society conducted a nationwide survey: the Japanese Catheter Ablation Registry of Atrial Fibrillation. In this report, we aimed to evaluate the periprocedural use of direct oral anticoagulants with respect to thromboembolic or bleeding complications. METHODS: Using an online questionnaire, the Japanese Heart Rhythm Society requested electrophysiology centers in Japan to register the relevant data of patients who underwent atrial fibrillation ablation over selected five-months from 2011 to 2014...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28592259/safety-of-low-molecular-weight-heparin-compared-to-unfractionated-heparin-in-hemodialysis-a-systematic-review-and-meta-analysis
#15
Hind Harrak Lazrak, Émilie René, Naoual Elftouh, Martine Leblanc, Jean-Philippe Lafrance
BACKGROUND: Low molecular weight heparins (LMWH) have been extensively studied and became the treatment of choice for several indications including pulmonary embolism. While their efficacy in hemodialysis is considered similar to unfractionated heparin (UFH), their safety remains controversial mainly due to a risk of bioaccumulation in patients with renal impairment. The aim of this systematic review was to evaluate the safety of LMWH when compared to UFH for extracorporeal circuit (ECC) anticoagulation...
June 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28569990/prospective-randomized-multicenter-controlled-trial-triathron-1-on-a-new-antithrombogenic-hydrophilic-dialysis-membrane
#16
Claudio Ronco, Alessandra Brendolan, Federico Nalesso, Monica Zanella, Massimo De Cal, Valentina Corradi, Grazia M Virzì, Fiorenza Ferrari, Francesco Garzotto, Anna Lorenzin, Aakash N Karopadi, Marco Sartori, Silvia De Rosa, Sara Samoni, Faeq Husain-Syed, Alessandra Spinelli, Mauro Neri, Gianluca Villa, Alberta Alghisi
INTRODUCTION: Hemodialysis treatment requires anticoagulation to prevent thrombosis of the dialyzer. The Hydrolink® (NV series; Toray) has been designed to reduce thrombotic complications by increasing membrane hydrophilic properties. Previous studies have confirmed reduced platelet activation, improved removal of β2-microglobulin and excellent small-solute removal. METHODS: We designed a prospective, multi-centered, randomized clinical study to compare the antithrombogenic effects (platelet count) of NV dialyzers versus conventional treatment...
May 29, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28554992/dialysis-procedures-alter-metabolic-conditions
#17
REVIEW
Bernd Stegmayr
A progressive chronic kidney disease results in retention of various substances that more or less contribute to dysfunction of various metabolic systems. The accumulated substances are denominated uremic toxins. Although many toxins remain undetected, numerous newly defined toxins participate in the disturbance of food breakdown. In addition, toxic effects may downregulate other pathways, resulting in a reduced ability of free fatty acid breakdown by lipoprotein lipase (LPL) and hepatic lipase (HL). Dialysis may even worsen metabolic functions...
May 27, 2017: Nutrients
https://www.readbyqxmd.com/read/28549534/dabigatran-reversal-in-a-patient-with-end-stage-liver-disease%C3%A2-and-acute-kidney-injury
#18
James E Novak, Khalid Alamiri, Jerry Yee
Dabigatran, a direct thrombin inhibitor and one of the new class of direct oral anticoagulants, is increasingly used in preference to warfarin because of its efficacy and ease of administration. However, because the drug is cleared by the kidneys, it can accumulate in plasma and increase the risk for bleeding in patients with decreased kidney function. We report a patient with end-stage liver disease who developed life-threatening hemorrhage and acute kidney injury while taking dabigatran, 150mg, twice daily...
May 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28538441/hyperlactatemia-lactate-kinetics-and-prediction-of-citrate-accumulation-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation
#19
Dmytro Khadzhynov, Annette Dahlinger, Christin Schelter, Harm Peters, Detlef Kindgen-Milles, Klemens Budde, Lukas Johannes Lehner, Fabian Halleck, Oliver Staeck, Torsten Slowinski
OBJECTIVES: Citrate accumulation is a major complication of regional citrate anticoagulation during continuous renal replacement therapy. We studied the prediction of citrate accumulation during continuous veno-venous hemodialysis with regional citrate anticoagulation by initial lactate concentrations and lactate kinetics. DESIGN: A retrospective follow-up analysis from a cohort of critically ill patients. SETTING: Mixed medical-surgical ICUs at a university hospital...
September 2017: Critical Care Medicine
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
#20
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
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