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Acute Kidney Injury Dialysis

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https://www.readbyqxmd.com/read/28224940/telemedicine-to-promote-patient-safety-use-of-phone-based-interactive-voice-response-system-to-reduce-adverse-safety-events-in-pre-dialysis-ckd
#1
REVIEW
Shoshana Weiner, Jeffery C Fink
CKD patients have several features conferring on them a high risk of adverse safety events, which are defined as incidents with unintended harm related to processes of care or medications. These characteristics include impaired kidney function, polypharmacy, and frequent health system encounters. The consequences of such events in CKD can include new or prolonged hospitalization, accelerated kidney function loss, acute kidney injury, ESRD, and death. Health information technology administered via telemedicine presents opportunities for CKD patients to remotely communicate safety-related findings to providers for the purpose of improving their care...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28223003/treatment-of-metformin-intoxication-complicated-by-lactic-acidosis-and-acute-kidney-injury-the-role-of-prolonged-intermittent-hemodialysis
#2
Giuseppe Regolisti, Riccardo Antoniotti, Filippo Fani, Paolo Greco, Enrico Fiaccadori
Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28213620/post-contrast-acute-kidney-injury-in-intensive-care-unit-patients-a-propensity-score-adjusted-study
#3
Jennifer S McDonald, Robert J McDonald, Eric E Williamson, David F Kallmes, Kianoush Kashani
PURPOSE: To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examination. METHODS: All ICU patients at our institution who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) CT scan from January 2006 to December 2014 were identified...
February 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28193605/potential-deaths-averted-and-serious-adverse-events-incurred-from-adoption-of-the-sprint-intensive-blood-pressure-regimen-in-the-u-s-projections-from-nhanes
#4
Adam P Bress, Holly Kramer, Rasha Khatib, Srinivasan Beddhu, Alfred K Cheung, Rachel Hess, Vinod K Bansal, Guichan Cao, Jerry Yee, Andrew E Moran, Ramon A Durazo-Arvizu, Paul Muntner, Richard S Cooper
Background -The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated a 27% reduction in all-cause mortality with a systolic blood-pressure (SBP) goal of <120 mmHg versus <140 mmHg among U.S. adults at high cardiovascular disease (CVD) risk but without diabetes, stroke, or heart failure. To quantify the potential benefits and risks of SPRINT intensive goal implementation, we estimated the deaths prevented and excess serious adverse events (SAEs) incurred if the SPRINT intensive SBP treatment goal was implemented in all eligible U...
February 13, 2017: Circulation
https://www.readbyqxmd.com/read/28182800/cost-of-acute-kidney-injury-in-hospitalized-patients
#5
Samuel A Silver, Jin Long, Yuanchao Zheng, Glenn M Chertow
BACKGROUND: The economic burden of acute kidney injury (AKI) is not well understood. OBJECTIVE: To estimate the effects of AKI on hospitalization costs and length of stay (LOS). DESIGN: Using data from the 2012 National Inpatient Sample, we compared hospitalization costs and LOS with and without AKI. We used a generalized linear model with a gamma distribution and a log link fitted to AKI to adjust for demographics, hospital differences, and comorbidities...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28176909/outcomes-of-renal-function-in-elderly-patients-with-acute-kidney-injury
#6
Qinglin Li, Meng Zhao, Jing Du, Xiaodan Wang
OBJECTIVES: The aim of this study was to explore the prognostic impact of clinical factors on the short-term outcomes of renal function (RF) in very elderly patients with acute kidney injury (AKI). PATIENTS AND METHODS: We carried out a retrospective cohort study of only very elderly patients who developed AKI at the geriatric department of a tertiary medical center during the period 2007-2015. All patients with AKI were followed up for 90 days after AKI diagnosis or until death...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#7
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28173756/a-clinical-score-to-predict-mortality-in-septic-acute-kidney-injury-patients-requiring-continuous-renal-replacement-therapy-the-helenicc-score
#8
Rogério da Hora Passos, João Gabriel Rosa Ramos, Evandro Jose Bulhoes Mendonça, Eva Alves Miranda, Fábio Ricardo Dantas Dutra, Maria Fernanda R Coelho, Andrea C Pedroza, Luis Claudio L Correia, Paulo Benigno Pena Batista, Etienne Macedo, Margarida M D Dutra
BACKGROUND: This study aimed to identify predictors of early (7-day) mortality in patients with septic acute kidney injury (AKI) who required continuous renal replacement therapy (CRRT). METHODS: Prospective cohort of 186 septic AKI patients undergoing CRRT at a tertiary hospital, from October 2005 to November 2010. RESULTS: After multivariate adjustment, five variables were associated to early mortality: norepinephrine utilization, liver failure, medical condition, lactate level, and pre-dialysis creatinine level...
February 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28164512/critical-deviations-of-ionized-calcium-measurements-when-using-blood-gas-analyzers-to-monitor-citrate-dialysis
#9
Thorsten Feldkamp, Norbert Weiler, Michael Marx, Peter B Luppa, Ralf Junker
BACKGROUND: During the course of acute kidney injury (AKI) patients may require renal replacement therapy (RRT). The preferred therapeutic measure for such patients is continuous RRT (CRRT). Anticoagulation is required to prevent clotting of the extracorporeal circuit. The actual KDIGO guidelines recommend citrate as the first line anticoagulant. METHODS: Citrate dose infused into the extracorporeal circuit should achieve an extracorporeal calcium concentration of 0...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28156631/survival-benefits-among-patients-with-end-stage-renal-disease-receiving-dialysis-versus-no-dialysis
#10
Maen Abdelrahim, Valda D Page, Shouhao Zhou, Chan Shen, Sriram Yennu, Bo Zhao, Joanna-Grace Mayo Manzano, Marina Ciny George, Joseph L Nates, Alvin Howard Moss, Rima Pai, Ala Abudayyeh
: 55 Background: Retrospective study of the outcomes of Stage IV Cancer Patients with End Stage Renal disease Receiving Dialysis and comparing the survival benefits among the patients who received Hemodialysis versus who didn't at a Comprehensive Cancer Center. METHODS: Retrospectively review all patients admitted to MDACC from 2005-2014 and diagnosed with stage IV solid tumor admitted with Acute kidney injury and a nephrology consult were included (N = 903) 19...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#11
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28151965/prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-cardiovascular-procedures-a-systematic-review-and-network-meta-analysis
#12
Eliano P Navarese, Paul A Gurbel, Felicita Andreotti, Michalina Marta Kołodziejczak, Suetonia C Palmer, Sofia Dias, Antonino Buffon, Jacek Kubica, Mariusz Kowalewski, Tomasz Jadczyk, Michał Laskiewicz, Marek Jędrzejek, Maximillian Brockmeyer, Flavio Airoldi, Marinella Ruospo, Stefano De Servi, Wojciech Wojakowski, Christopher O' Connor, Giovanni F M Strippoli
BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovascular events, and prolonged hospitalization. The aim of this study was to investigate the efficacy of pharmacological and non-pharmacological treatments for CIAKI prevention in patients undergoing cardiovascular invasive procedures with iodinated contrast...
2017: PloS One
https://www.readbyqxmd.com/read/28149647/hepatitis-c-and-kidney-disease-a-narrative-review
#13
REVIEW
Rashad S Barsoum, Emad A William, Soha S Khalil
Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28149027/sustained-low-efficiency-dialysis-in-septic-shock-hemodynamic-tolerability-and-efficacy
#14
Shakti Bedanta Mishra, Ratender Kumar Singh, Arvind Kumar Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
AIM OF THE STUDY: Acute kidney injury (AKI) in septic shock has poor outcomes. Sustained low-efficiency dialysis (SLED) is increasingly replacing continuous renal replacement therapy as the preferred modality in Intensive Care Units (ICUs). However, the essential aspects of hemodynamic tolerability and efficacy of SLED in septic shock AKI has been minimally studied. PATIENTS AND METHODS: We describe hemodynamic tolerability using modified vasopressor index (VI) and vasopressor dependency (VD) and efficacy using a combination of Kt/v, correction of acidosis, electrolyte, and fluid overload...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#15
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28135776/long-term-renal-outcome-after-allogeneic-haemopoietic-stem-cell-transplant-a-comprehensive-analysis-of-risk-factors-in-an-asian-patient-population
#16
Wei Zhou, Rehena Sultana, Colin Diong, Yeow-Tee Goh, Sathish Gopalakrishnan, Aloysius Ho, William Hwang, Liang-Piu Koh, Mickey Koh, Yvonne Loh, Patrick Tan, Yeh-Ching Linn
Allogeneic haemopoietic stem cell transplantation (allo-HSCT) poses a significant challenge to renal function due to multiple drug- and complication-related renal toxicity. In this single center series of 216 adult Asian patients with a long and complete follow up, 41 developed chronic kidney disease (CKD) giving a cumulative incidence of 19.0% at 25 years (median follow up duration 7.84 years, range 2.0 - 27.7 years), but only 2 of the 41 patients reaching stage 4 CKD and another 2 requiring dialysis. In contrast, acute kidney injury occurred in most patients, where glomerular filtration rate (GFR) suffered a mean fall of 50ml/min/1...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28134407/-metformin-associated-lactic-acidosis-and-acute-kidney-injury
#17
Paolo Greco, Giuseppe Regolisti, Riccardo Antoniotti, Caterina Maccari, Elisabetta Parenti, Silvia Corrado, Enrico Fiaccadori
Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because of its efficacy, general tolerability and low cost. Recent guidelines have extended the use of metformin to patients with Chronic Kidney Disease (CKD) up to stage III. However, in the recent literature, cases of MALA (metformin-associated lactic acidosis) are increasingly reported. MALA is the most dangerous side effect of the drug, with an incidence rate of 2-9 cases per 100000 person-years of exposure. We report on two patients with accidental metformin overdose, severe lactic acidosis and acute kidney injury...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28131489/risk-of-acute-kidney-injury-after-intravenous-contrast-media-administration
#18
Jeremiah S Hinson, Michael R Ehmann, Derek M Fine, Elliot K Fishman, Matthew F Toerper, Richard E Rothman, Eili Y Klein
STUDY OBJECTIVE: The study objective was to determine whether intravenous contrast administration for computed tomography (CT) is independently associated with increased risk for acute kidney injury and adverse clinical outcomes. METHODS: This single-center retrospective cohort analysis was performed in a large, urban, academic emergency department with an average census of 62,179 visits per year; 17,934 ED visits for patients who underwent contrast-enhanced, unenhanced, or no CT during a 5-year period (2009 to 2014) were included...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28128881/the-effect-of-sustained-low-efficient-dialysis-versus-continuous-renal-replacement-therapy-on-renal-recovery-after-acute-kidney-injury-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#19
REVIEW
Bernadett Kovacs, Katrina J Sullivan, Swapnil Hiremath, Rakesh V Patel
Acute kidney injury (AKI) is a significant contributing factor to the morbidity and mortality of critically ill adults, yet there remains controversy on the optimal renal replacement therapy mode for these patients. The aim of our systematic review was to determine the effect of sustained low-efficiency dialysis or continuous renal replacement therapy on patient outcomes in critically ill patients with AKI. A systematic search of Medline, Embase, CINAHL, and the Cochrane Library was conducted in February 2015...
January 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28127437/effect-of-extracorporeal-cytokine-removal-on-vascular-barrier-function-in-a-septic-shock-patient
#20
Sascha David, Kristina Thamm, Bernhard M W Schmidt, Christine S Falk, Jan T Kielstein
BACKGROUND: Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient...
2017: Journal of Intensive Care
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