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https://www.readbyqxmd.com/read/29161686/impact-of-an-in-hospital-patient-education-program-on-choice-of-renal-replacement-modality-in-unplanned-dialysis-initiation
#1
Moritz Schanz, Markus Ketteler, Markus Heck, Juergen Dippon, Mark Dominik Alscher, Martin Kimmel
BACKGROUND/AIMS: Up to 50% patients requiring dialysis receive an urgent, unplanned start (UPS) to renal replacement therapy (RRT). Most of these are initiated with an intravenous catheter and commenced and maintained on hemodialysis (HD). Although peritoneal dialysis (PD) could be an equipotent initial modality for RRT, it is used less frequently as long-term RRT in UPS patients. This multicenter-study aimed to evaluate the impact of a structured, in-hospital education program and factors influencing PD rates, especially in UPS patients...
November 21, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29159719/effect-of-a-real-time-electronic-dashboard-on-a-rapid-response-system
#2
Grant S Fletcher, Barry A Aaronson, Andrew A White, Reena Julka
A rapid response system (RRS) may have limited effectiveness when inpatient providers fail to recognize signs of early patient decompensation. We evaluated the impact of an electronic medical record (EMR)-based alerting dashboard on outcomes associated with RRS activation. We used a repeated treatment study in which the dashboard display was successively turned on and off each week for ten 2-week cycles over a 20-week period on the inpatient acute care wards of an academic medical center. The Rapid Response Team (RRT) dashboard displayed all hospital patients in a single view ranked by severity score, updated in real time...
November 20, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#3
Flávio de Oliveira Marques, Saulo Aires Oliveira, Priscila Ferreira de Lima E Souza, Wandervânia Gomes Nojoza, Maiara da Silva Sena, Taynara Muniz Ferreira, Bruno Gabriele Costa, Alexandre Braga Libório
BACKGROUND: Although significant advances have been achieved in acute kidney injury (AKI) research following its classification, potential pitfalls can be identified in clinical practice. The nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) could add clinical and prognostic information in critically ill patients beyond the current AKI classification system. METHODS: This was a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II project...
November 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#4
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29148022/hemodialysis-versus-peritoneal-dialysis-an-observational-study-in-two-international-centers
#5
Renhua Lu, Carla Estremadoyro, Xiaohuan Chen, Mingli Zhu, Leonardo C Ribeiro, Yucheng Yan, Alessandra Brendolan, Wei Fang, Carlo Crepaldi, Zhaohui Ni, Leyi Gu, Claudio Ronco
INTRODUCTION: Given that it is difficult to randomize end-stage renal disease (ESRD) patients to either hemodialysis (HD) or peritoneal dialysis (PD), differences between these renal replacement therapy (RRT) modalities are of major interest and remain controversial. METHODS: All data on maintenance dialysis patients during 2009 to 2013 in the Renji Hospital in Shanghai, China and in the San Bortolo Hospital in Vicenza, Italy were selected. Patients who changed their therapy from HD to PD or PD to HD during this study were excluded...
November 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29147999/selective-placement-of-autogenous-arteriovenous-fistulae-in-an-over-80-year-old-population
#6
Keagan Werner-Gibbings, Liesl Ischia, William Butcher, Richard Ward-Harvey, Jonathan Stewart, Mark J Jackson
INTRODUCTION: With improved life expectancy and quality of life, elderly patients constitute a progressively larger fraction of consumers utilising renal replacement therapy (RRT). Although substantial data exist for younger cohorts, minimal evidence exists for outcomes of arteriovenous fistula (AVF) and central catheters (CVC) placed in those patients over 80 years. We examined outcomes of primary AVF placement in this cohort to ascertain durability and benefits of AVF in the over 80-year-old population...
November 9, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29145723/statin-initiation-and-renal-outcomes-following-isolated-coronary-artery-bypass-grafting-a-meta-analysis
#7
Yushu Wang, Sui Zhu, Rongsheng DU, Juteng Zhou, Yucheng Chen, Qing Zhang
BACKGROUND: The effects of preoperative statin therapy (PST) on renal outcomes in patients with isolated coronary artery bypass grafting (CABG) are in controversial. This study aimed to assess the effects of preoperative statin use on postoperative renal outcomes in patients undergoing isolated CABG. METHODS: PubMed, EMBASE, and Cochrane Library were searched for studies published up to February 2017. Pooled odds ratio (OR) and its corresponding 95% confidence interval (95% CI) were calculated...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29142938/epidemiological-transition-of-end-stage-kidney-disease-in-oman
#8
Faisal Al Ismaili, Issa Al Salmi, Yaqoub Al Maimani, Abdul Massiah Metry, Humood Al Marhoobi, Alan Hola, Ronald L Pisoni
Introduction: The number of persons receiving renal replacement therapy (RRT) is estimated at more than 2.5 million worldwide, and is growing by 8% annually. Registries in the developing world are not up to standards compared to the United States Renal Data System (USRDS). Herein we examine the causes, progression, and magnitude of end-stage kidney disease (ESKD) over 3 decades in Oman. Methods: We examined ESKD data from 1983 to 2013. Data from 1998 to 2013 were obtained through an Information Management System...
January 2017: KI Reports
https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#9
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29133019/frequency-and-significance-of-qsofa-criteria-during-adult-rapid-response-team-reviews-a-prospective-cohort-study
#10
Maurice LeGuen, Yvonne Ballueer, Richard McKay, Glenn Eastwood, Rinaldo Bellomo, Daryl Jones
AIM: A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes. METHODS: We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia RESULTS: Over a one-month period, there were 282 RRT reviews, 258 of which were included...
November 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29132411/an-isolated-elevation-in-blood-urea-level-is-not-uraemia-and-not-an-indication-for-renal-replacement-therapy-in-the-icu
#11
EDITORIAL
Jack Mackenzie, Bobby Chacko
The decision to initiate renal replacement therapy (RRT) and the optimal timing for commencement is a difficult decision faced by clinicians when treating acute kidney injury (AKI) in the intensive care setting. Without clinically significant ureamic symptoms or emergent indications (electrolyte abnormalities, volume overload) the timing of RRT initiation remains contentious and inconsistent across health providers. Current trends of initiating RRT in the ICU are often based on isolated blood urea levels without clear guidelines demonstrating an upper limit for treatment...
November 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#12
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
https://www.readbyqxmd.com/read/29124905/rapid-and-simple-detection-of-foot-and-mouth-disease-virus-evaluation-of-a-cartridge-based-molecular-detection-system-for-use-in-basic-laboratories
#13
K V Goller, V Dill, M Madi, P Martin, Y Van der Stede, V Vandenberge, B Haas, S Van Borm, F Koenen, C J Kasanga, N Ndusilo, M Beer, L Liu, V Mioulet, B Armson, D P King, V L Fowler
Highly contagious transboundary animal diseases such as foot-and-mouth disease (FMD) are major threats to the productivity of farm animals. To limit the impact of outbreaks and to take efficient steps towards a timely control and eradication of the disease, rapid and reliable diagnostic systems are of utmost importance. Confirmatory diagnostic assays are typically performed by experienced operators in specialized laboratories, and access to this capability is often limited in the developing countries with the highest disease burden...
November 9, 2017: Transboundary and Emerging Diseases
https://www.readbyqxmd.com/read/29124060/avian-influenza-virus-surveillance-in-south-central-spain-using-fecal-samples-of-aquatic-birds-foraging-at-landfills
#14
Andreia Bárbara, Olalla Torrontegi, Maria-Cruz Camacho, Marta Barral, Jose-Manuel Hernández, Ursula Höfle
Aquatic wild birds have been intensively studied to better understand their role in avian influenza virus (AIV) maintenance and spread. To date, AIV surveillance has primarily focused on natural aquatic environments where different bird species aggregate and viral survival is enhanced. However, artificial habitats such as landfills are attracting substantial numbers of wild birds, AIV reservoir species included. The use of landfills as a predictable food source has significantly influenced population size, migratory traits, and feeding behavior of white storks (Ciconia ciconia) and black-headed gulls (Chroicocephalus ridibundus) among others...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29122911/prognosis-of-patients-with-cirrhosis-and-aki-who-initiate-rrt
#15
Andrew S Allegretti, Xavier Vela Parada, Nwamaka D Eneanya, Hannah Gilligan, Dihua Xu, Sophia Zhao, Jules L Dienstag, Raymond T Chung, Ravi I Thadhani
BACKGROUND AND OBJECTIVES: Literature on the prognosis of patients with cirrhosis who require RRT for AKI is sparse and is confounded by liver transplant eligibility. An update on outcomes in the nonlisted subgroup is needed. Our objective was to compare outcomes in this group between those diagnosed with hepatorenal syndrome and acute tubular necrosis, stratifying by liver transplant listing status. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective cohort study of patients with cirrhosis acutely initiated on hemodialysis or continuous RRT at five hospitals, including one liver transplant center...
November 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29113733/development-and-evaluation-of-a-novel-real-time-rt-pcr-to-detect-foot-and-mouth-disease-viruses-from-the-emerging-a-asia-g-vii-lineage
#16
Meruyert A Saduakassova, Akhmetzhan A Sultanov, Lespek B Kutumbetov, Jemma Wadsworth, Britta A Wood, Nick J Knowles, Donald P King, Katarzyna Bachanek-Bankowska
A new lineage of foot-and-mouth disease virus (FMDV), called A/ASIA/G-VII, emerged from the Indian subcontinent in 2015 and continues to spread in Western Asia. Currently, the distribution of viruses belonging to this lineage is defined using sequencing approaches, but other cheaper and faster diagnostic methods are urgently needed. Thus, this study describes the development and validation of a novel A/ASIA/G-VII lineage-specific real-time RT-PCR (rRT-PCR). Diagnostic sensitivity and specificity were evaluated using representative field specimens and isolates from the A/ASIA/G-VII lineage, as well as samples comprising other FMDV lineages that co-circulate in Asia (n=54)...
November 4, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/29112632/prediction-of-60-day-case-fatality-in-critically-ill-patients-receiving-renal-replacement-therapy-external-validation-of-a-prediction-model
#17
Gloria Maria Custodio de Carvalho, Tacyano Tavares Leite, Alexandre Braga Libório
BACKGROUND: A recent prognostic model, predicting 60-day case fatality in critically-ill patients requiring RRT has been developed (Acute Renal Failure Trial Network - ATN study). Because many prognostic models are suggested in literature, but just a few have found its way into clinical practice, we aimed to externally validate this prediction model in an independent cohort. METHODS: 1,053 critically-ill patients requiring RRT from the MIMIC-III database were analyzed...
November 6, 2017: Shock
https://www.readbyqxmd.com/read/29106631/effect-of-renin-angiotensin-aldosterone-system-blockade-in-adults-with-diabetes-mellitus-and-advanced-chronic-kidney-disease-not-on-dialysis-a-systematic-review-and-meta-analysis
#18
Ionut Nistor, Johan De Sutter, Christiane Drechsler, David Goldsmith, Maria Jose Soler, Charles Tomson, Andrzej Wiecek, Mihaela-Dora Donciu, Davide Bolignano, Wim Van Biesen, Adrian Covic
The presumed superiority of renin-angiotensin-aldosterone system (RAAS)-blocking agents over other antihypertensive agents in patients with diabetes to delay development of end-stage kidney disease (ESKD) has recently been challenged. In addition, there is ongoing uncertainty whether RAAS-blocking agents reduce mortality and/or delay ESKD in patients with diabetes and chronic kidney disease (CKD) stages 3-5. In this subgroup, there might be an expedited need for renal replacement therapy (RRT) when RAAS-blocking agents are used...
July 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29102102/bluetongue-virus-infection-in-na%C3%A3-ve-cattle-identification-of-circulating-serotypes-and-associated-culicoides-biting-midge-species-in-trinidad
#19
T Brown-Joseph, C Batten, L E Harrup, L Frost, J Flannery, H Hicks, V Ramkissoon, R Ramdeen, C V Carrington, C A L Oura
To better understand risks associated with trading cattle, it is important to know which serotypes of Bluetongue virus (BTV) are circulating within the exporting and importing country. Hence, this study was conducted to identify the circulating serotypes of BTV in Trinidad. Blood samples were collected monthly from sixty BTV- naïve imported cattle over a six month period after their arrival in the country. Virological (PCR and virus isolation) and serological (ELISA) analyses were carried out on the samples and CDC light traps were placed near the cattle enclosure to trap and identify the species of Culicoides biting midges that were present...
November 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/29097448/using-simulation-to-develop-care-models-for-rapid-response-and-code-teams-at-a-satellite-facility
#20
Amy R L Rule, Julie Snider, Cheryl Marshall, Kathleen Kramer, Gary L Geis, Ken Tegtmeyer, Craig H Gosdin
BACKGROUND: Our institution recently completed an expansion of an acute care inpatient unit within a satellite hospital that does not include an on-site ICU or PICU. Because of expected increases in volume and acuity, new care models for Rapid Response Teams (RRTs) and Code Blue Teams were necessary. OBJECTIVES: Using simulation-based training, our objectives were to define the optimal roles and responsibilities for team members (including ICU physicians via telemedicine), refine the staffing of RRTs and code Teams, and identify latent safety threats (LSTs) before opening the expanded inpatient unit...
November 2, 2017: Hospital Pediatrics
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