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More frequent dialysis

Ross Lynds, Brock Hansen, Preston H Blomquist, V Vinod Mootha
PURPOSE: To examine the outcomes of resident-performed manual small-incision cataract surgery (SICS) in an urban academic setting. SETTING: Parkland Memorial Hospital, Dallas, Texas, USA. DESIGN: Retrospective case series. METHODS: Manual SICS was used only in selected cases for which phacoemulsification was expected to be difficult, namely for mature or brunescent cataracts, traumatic cataracts, and pseudoexfoliation syndrome or other causes of zonular weakness...
January 2018: Journal of Cataract and Refractive Surgery
Alexander J Gallan, W James Chon, Michelle A Josephson, Patrick N Cunningham, Kammi J Henriksen, Anthony Chang
Acute T cell-mediated rejection (TCMR) is an important cause of renal allograft loss. The Banff classification for tubulointerstitial (type I) rejection is based on the extent of both interstitial inflammation and tubulitis. Lymphocytes may also be present between parietal epithelial cells and Bowman capsules in this setting, which we have termed "capsulitis." We conducted this study to determine the clinical significance of capsulitis. We identified 42 patients from the pathology archives at the University of Chicago with isolated Banff type I TCMR from 2010-2015...
February 28, 2018: Human Pathology
Holger Eggebrecht, Kurt Bestehorn, Tienush Rassaf, Maike Bestehorn, Thomas Voigtländer, Eckhard Fleck, Volker Schächinger, Axel Schmermund, Rajendra H Mehta
AIMS: Randomised trials comparing transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) have included mainly elderly patients >80 years. The authors investigated comparative in-hospital outcomes of younger patients <75 years undergoing transfemoral (TF) TAVR or isolated SAVR. METHODS AND RESULTS: A total of 6,972 patients aged 65-74 years undergoing TF-TAVR or SAVR between 2013 and 2014 were identified from the observational German Quality Assurance Registry on Aortic Valve Replacement (AQUA), which comprises all TAVR and SAVR procedures performed in Germany...
February 27, 2018: EuroIntervention
Jessica Tangren, Molly Nadel, Michelle A Hladunewich
Pregnancy is uncommon in women with end-stage renal disease (ESRD). Fertility rates are low in women on dialysis, and physicians still frequently counsel women with ESRD against pregnancy. Advancements in the delivery of dialysis and obstetric care have led to improved live birth rates in women on dialysis, so pregnancy for young women with ESRD is now more feasible and safer. However, these pregnancies remain high-risk for both maternal and fetal complications, necessitating experienced multidisciplinary care...
January 26, 2018: Blood Purification
Frank M van der Sande, Marijke J Dekker, Karel M L Leunissen, Jeroen P Kooman
BACKGROUND: Intradialytic hypotension (IDH) is a common complication of haemodialysis (HD) and associated with adverse outcomes, especially when a nadir definition (systolic blood pressure <90 mm Hg) is used. The pathogenesis of IDH is directly linked to the discontinuous nature of the HD treatment, in combination with patient-related factors such as age, diabetes mellitus and cardiac failure. SUMMARY: Although the decline in blood volume due to removal of fluid by ultrafiltration is the prime mover, thermally induced reflex vasodilation compromises the haemodynamic response to hypovolemia...
January 26, 2018: Blood Purification
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
Nada Dimkovic, Georg Schlieper, Aleksandar Jankovic, Zivka Djuric, Marcus Ketteler, Tatjana Damjanovic, Petar Djuric, Jelena Marinkovic, Zoran Radojcic, Natasa Markovic, Jürgen Floege
PURPOSE: Cardiovascular calcifications (CVC) are present in up to 70% of non-diabetic dialysis patients. Sparse data are available on predictors of very long-term outcomes of such patients. The Belgrade Aachen Study on Calcification in Hemodialysis patients (BASCH study) aimed to study this using a comprehensive CVC assessment. METHODS: We prospectively analyzed 220 hemodialysis patients followed for a mean of 76 months (median 73 months, range 6-160 months). We compared patients deceased from cardiovascular diseases (CVD) and survivors...
February 13, 2018: International Urology and Nephrology
Keith A Riccardi, Sangwoo Ryu, Jian Lin, Phillip Yates, David A Tess, Rui Li, Dhirender Singh, Brian R Holder, Brendon Kapinos, George Chang, Li Di
Fraction unbound (fu) of liver tissue, hepatocytes and other cell types is an essential parameter used to estimate unbound liver drug concentration and intracellular free drug concentration. Fu,liver and fu,cell are frequently measured in multiple species and cell types in drug discovery and development for various applications. A comparison study of 12 matrices for fu,liver and fu,cell of hepatocytes in five different species (mouse, rat, dog, monkey and human), as well as fu,cell of Huh7 and HEK-293 cell lines, was conducted for 22 structurally diverse compounds with the equilibrium dialysis method...
February 2, 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
Chen-Wei Pan, Yin Wu, Hui-Jun Zhou, Bin-Xian Xu, Pei Wang
BACKGROUND: To identify factors of health-related quality of life (HRQOL) of Chinese end-stage renal disease patients undergoing hemodialysis (HD). METHODS: In all, 315 HD patients were recruited from a tertiary hospital in Suzhou, -China. Each patient completed the Kidney Disease Quality of Life Short Form. It generated 4 types of HRQOL scores: PCS score, MCS score, kidney disease component summary (KDCS) score, and SF-6D index score. Multiple linear regressions were conducted to identify the factors associated with each of the scores...
February 8, 2018: Blood Purification
Wei Deng, Xiaojun Tan, Qian Zhou, Zhen Ai, Wenting Liu, Wei Chen, Xueqing Yu, Qiongqiong Yang
BACKGROUND: The prognostic effect of gender on immunoglobulin A nephropathy (IgAN) is not clear. We explored gender-related differences in clinicopathological features and renal outcomes in IgAN. METHODS: This was a single-centre retrospective study. Patients were divided into two groups according to gender. The clinicopathological features at biopsy and renal outcomes during the follow-up were collected and analysed. Renal outcomes were defined as the doubling of baseline serum creatinine and end-stage renal disease (ESRD) (estimated glomerular filtration rate < 15 mL/min/1...
February 7, 2018: BMC Nephrology
Ying Zhou, Peiran Yin, Bin Li, Jianying Li, Naya Huang, Haishan Wu, Habib Ullah, Xiao Yang, Xueqing Yu
BACKGROUND: Sedative-hypnotic medication is widely used among continuous ambulatory peritoneal dialysis (CAPD) patients with sleep disorders; however, its effect on mortality has rarely been investigated. METHODS: Logistic regression was employed to identify factors associated with sedative-hypnotic medication, whose effect on mortality was evaluated by Cox proportional hazards models. RESULTS: A total of 146 CAPD patients with sleep disorders were recruited, of which 46 patients (31...
December 12, 2017: Blood Purification
Prabir Roy-Chaudhury, Jim A Tumlin, Bruce A Koplan, Alexandru I Costea, Vijay Kher, Don Williamson, Saurabh Pokhariyal, David M Charytan
Sudden death is one of the more frequent causes of death for hemodialysis patients, but the underlying mechanisms, contribution of arrhythmia, and associations with serum chemistries or the dialysis procedure are incompletely understood. To study this, implantable loop recorders were utilized for continuous cardiac rhythm monitoring to detect clinically significant arrhythmias including sustained ventricular tachycardia, bradycardia, asystole, or symptomatic arrhythmias in hemodialysis patients over six months...
January 27, 2018: Kidney International
Eva Rodríguez, Carlos Arias-Cabrales, Sheila Bermejo, Adriana Sierra, Carla Burballa, María José Soler, Clara Barrios, Julio Pascual
BACKGROUND/AIMS: Recurrent acute kidney injury (AKI) is common among patients after a first hospitalized AKI. However, little is known about the prognosis of recurrent AKI episodes in chronic kidney disease (CKD) development, cardiovascular events and mortality. METHODS: A retrospective study included patients admitted to our Hospital from 2000 to 2010. AKI was defined according to the Acute Dialysis Quality Initiative criteria. In the follow-up period after the first AKI episode, clinical, laboratory data and the number of repeated AKI episodes, etiology and severity were recorded...
January 23, 2018: Kidney & Blood Pressure Research
Premal S Trivedi, Kimberly E Lind, Charles E Ray, Paul J Rochon, Robert K Ryu
PURPOSE: To determine whether utilization and outcomes of dialysis access maintenance interventions vary by patient race or sex. MATERIALS AND METHODS: Data for this retrospective cohort study of first-time arteriovenous (AV) access recipients were drawn from a 5% sample of Medicare beneficiaries, containing claims from all clinical settings (2009-2014) in 2,693 patients who received their first AV fistula/graft in 2009. Maintenance interventions-angiography, angioplasty, thrombolysis, stent placement, and venous embolization-were identified by corresponding Current Procedural Terminology codes...
January 17, 2018: Journal of Vascular and Interventional Radiology: JVIR
Marion Haubitz
In patients with ANCA-associated vasculitis renal involvement is frequently seen and the severity of renal manifestation is very important for therapeutic strategies and prognosis. Clinically rapid loss of renal function, nephritic sediment and proteinuria in a non-nephrotic range are characterizing a focal segmental necrotizing pauci-immune glomerulonephritis with extrarenal proliferations. Induction treatment depends on the severity of manifestations. With a normal renal function methotrexate can be used in combination with steroids...
January 2018: Deutsche Medizinische Wochenschrift
Allison Meisner, Kathleen F Kerr, Heather Thiessen-Philbrook, Francis Perry Wilson, Amit X Garg, Michael G Shlipak, Peter Kavsak, Richard P Whitlock, Steven G Coca, Chirag R Parikh
Background: Acute kidney injury (AKI) is a frequent complication of cardiac surgery. We sought prognostic combinations of postoperative biomarkers measured within 6 h of surgery, potentially in combination with cardiopulmonary bypass time (to account for the degree of insult to the kidney). We used data from a large cohort of patients and adapted methods for developing biomarker combinations to account for the multicenter design of the study. Methods: The primary endpoint was sustained mild AKI, defined as an increase of 50% or more in serum creatinine over preoperative levels lasting at least 2 days during the hospital stay...
2018: Biomarker Research
Susan P Y Wong, Margaret K Yu, Pamela K Green, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare
BACKGROUND: Little is known about patterns of end-of-life care for patients with advanced kidney disease not treated with maintenance dialysis. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: A sample of 14,071 patients with sustained estimated glomerular filtration rates < 15mL/min/1.73m2 treated in the US Veterans Affairs health care system who died during 2000 to 2011. Before death, 12,756 of these patients had been treated with dialysis, 503 had been discussing and/or preparing for dialysis therapy, and for 812, there had been a decision not to pursue dialysis therapy...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Bilal Mohsin
BACKGROUND: Catheter related blood stream infections (CRBSI) are the leading cause of morbidity in HD patients. The majority of these infections relate to haemodialysis catheters. There is a paucity of local data on microbial agents responsible for CRBSI in our region. This prompted our study. METHODS: This Prospective observatory survey was conducted in Department of Nephrology, King Fahd Hospital, Hofuf KSA from Nov 2014 to Jan 2017 (26 months). It was performed on dialysis patients with HD catheters who developed features of CRBSI...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
Kei Yabuki, Joji Haratake, Yojiro Tsuda, Eisuke Shiba, Hiroshi Harada, Kenji Yorita, Kazuyoshi Uchihashi, Atsuji Matsuyama, Keiji Hirata, Masanori Hisaoka
Lanthanum (La) carbonate (LC) is one of the most potent phosphate binders that prevents the elevation of serum phosphate levels in patients with end-stage renal diseases undergoing dialysis. LC binds strongly to dietary phosphate and forms insoluble complexes that pass through the gastrointestinal tract. La deposition in patients treated with LC is a recently documented finding particularly observed in gastric mucosa. We herein describe the detailed gastric mucosal lesions in 45 LC-treated patients and address the potential underlying pathologic mechanism using oral LC administration in rats...
January 4, 2018: Biological Trace Element Research
Jun-Jun Zhang, Liu Yang, Jun-Wen Huang, Yu-Jie Liu, Jin-Wei Wang, Lu-Xia Zhang, Ming-Hui Zhao, Zhang-Suo Liu
Although the prevalence of chronic kidney disease (CKD) and diabetes mellitus (DM) is increasing globally, information on Chinese CKD patients with DM is lacking. A total of 3499 pre-dialysis CKD patients from across China were enrolled in the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) between November 2011 and April 2016. We divided the C-STRIDE patients into CKD with DM and CKD without DM groups and compared their clinical, demographic, and laboratory data in this cross-sectional study. CKD patients with DM were older, had a higher male-to-female ratio, and had more complications than CKD patients without DM...
December 5, 2017: Oncotarget
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