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Mortality esrd

Joshua L Rein, Steven G Coca
Acute kidney injury (AKI) is a major public health problem that complicates 10-40% of hospital admissions. Importantly, AKI is independently associated with increased risk of progression to chronic kidney disease, end stage renal disease, cardiovascular events, and increased risk of in-hospital and long-term mortality. The chloride content of intravenous fluid has garnered much attention over the last decade, and its association with excess use and adverse outcomes including AKI. Numerous studies show that changes in serum chloride concentration, independent of serum sodium and bicarbonate, are associated with increased risk of AKI, morbidity, and mortality...
December 12, 2018: American Journal of Physiology. Renal Physiology
Junho Ahn, Katherine M Raspovic, George T Liu, Lawrence A Lavery, Javier La Fontaine, Paul A Nakonezny, Dane K Wukich
Chronic kidney disease (CKD) is a major concern in patients with foot disease because it is associated with high rates of neuropathy, peripheral vascular disease, and poor wound healing. The purpose of this study was to evaluate renal dysfunction as a risk factor for reamputation after initial transmetatarsal amputation (TMA). Patients who underwent a TMA were retrospectively identified in the American College of Surgeons National Surgical Quality Improvement Program database. Of 2018 patients, reamputation after TMA occurred in 4...
December 12, 2018: Foot & Ankle Specialist
James M Szymanski, Cathy Conry-Cantilena, Kamille A West
Idiopathic membranous nephropathy is the most common cause of nephrotic syndrome in nondiabetic adults. The antibody most often implicated is the M-type phospholipase A2 receptor (PLA2R) antibody, found in >70% of primary membranous nephropathy cases. First-line therapy is immunosuppressive in nature, but for patients who are treatment-resistant there is a significant risk of end-stage renal disease and mortality. Hypercholesterolemia is not only a side effect of nephrotic syndrome, but also its presence may worsen renal function...
December 10, 2018: Journal of Clinical Apheresis
Fabrizio Fabrizi, Piergiorgio Messa
Liver disease in patients with chronic kidney disease (CKD) is most commonly due to hepatitis C virus (HCV) and contributes to increased rates of mortality. Among the pre-dialysis population, the estimated prevalence of anti-HCV positivity is based on few, limited-size studies. In hemodialysis patients however, HCV remains very prevalent despite large declines in seropositivity rates in dialysis facilities in developed countries after preventive measures were adopted in the 1990s. Recent surveys indicate that the HCV seropositivity prevalence ranges from 1...
December 9, 2018: Seminars in Dialysis
Julia Thumfart, Dirk Bethe, Sarah Wagner, Wolfgang Pommer, Cornelia Rheinländer, Dominik Müller
AIM: Children and adolescents with end stage renal disease face a high morbidity and mortality. Palliative care provides a multidisciplinary approach to reduce disease burden and improve quality of life. This study evaluated concepts and current structures of palliative care from the perspective of a multidisciplinary paediatric nephrology team including physicians, nurses and psychosocial health professionals. METHODS: Evaluation was done by an online survey sent to the members of the German Society of Nephrology and to the nurse managers of German paediatric dialysis centres between April 9th 2018 and May 31th 2018...
December 11, 2018: Acta Paediatrica
Hideyuki Mukai, Lu Dai, Zhimin Chen, Bengt Lindholm, Jonaz Ripsweden, Torkel B Brismar, Olof Heimbürger, Peter Barany, Abdul Rashid Qureshi, Magnus Söderberg, Magnus Bäck, Peter Stenvinkel
Background: The coronary artery calcium (CAC) score from cardiac computed tomography (CT) is a composite of CAC volume and CAC density. In the general population, CAC volume is positively and CAC density inversely associated with cardiovascular disease (CVD) events, implying that decreased CAC density reflects atherosclerotic plaque instability. We analysed associations of CAC indices with mortality risk in patients with end-stage renal disease [chronic kidney disease Stage 5 (CKD5)]...
December 7, 2018: Nephrology, Dialysis, Transplantation
Seyed-Ali Sadjadi, Surakshya Regmi, Tony Chau
BACKGROUND The elderly population in the United States and the world is rapidly increasing. With aging, immunity and kidney function decrease, thus predisposing people to viral illnesses for which there is no effective prophylaxis. Herpes zoster afflicts the elderly and other immunocompromised patients, like those with end-stage renal disease, transplant recipients, and cancer patients, causing significant morbidity and sometimes mortality. Treating herpes zoster becomes problematic when the regular pharmacokinetics of the antiviral drugs are disturbed...
December 9, 2018: American Journal of Case Reports
Virginia Wang, Cynthia J Coffman, Karen M Stechuchak, Theodore S Z Berkowitz, Paul L Hebert, David Edelman, Ann M O'Hare, Susan T Crowley, Hollis J Weidenbacher, Matthew L Maciejewski
BACKGROUND: Outcomes of veterans with ESRD may differ depending on where they receive dialysis and who finances this care, but little is known about variation in outcomes across different dialysis settings and financial arrangements. METHODS: We examined survival among 27,241 Veterans Affairs (VA)-enrolled veterans who initiated chronic dialysis in 2008-2011 at ( 1 ) VA-based units, ( 2 ) community-based clinics through the Veterans Affairs Purchased Care program (VA-PC), ( 3 ) community-based clinics under Medicare, or ( 4 ) more than one of these settings ("dual" care)...
December 7, 2018: Journal of the American Society of Nephrology: JASN
Rammah Abohtyra, Yossi Chait, Michael J Germain, Christopher V Hollot, Joseph Horowitz
OBJECTIVE: There are approximately 660,000 end-stage renal disease (ESRD) patients in the USA, with hemodialysis (HD) the primary form of treatment. High ultrafiltration rates (UFRs) are associated with intradialytic hypotension, a complication associated with adverse clinical outcomes including mortality. Individualized UFR profiles could reduce the incidence of intradialytic hypotension. METHODS: The patient's fluid dynamics during HD is described by a nonlinear model comprising intravascular and interstitial pools, whose parameters are given by the patient's estimated nominal parameter values with uncertainty ranges; the output measurement is hematocrit...
December 4, 2018: IEEE Transactions on Bio-medical Engineering
Ching-Wei Tsai, Han-Chun Huang, Ni Tien, Chih-Wei Chung, Hsien-Tsai Chiu, Hung-Chieh Yeh, Chin-Chi Kuo
BACKGROUND: The clinical importance of random urine creatinine concentration in CKD population remains undetermined. Earlier studies found that lower 24-h urine creatinine excretion was associated with the risk of ESRD and all-cause mortality among CKD patients. METHODS: We modeled the longitudinal trajectories of serial random urine creatinine among 4689 CKD patients enrolled in a national registry-based pre-ESRD program between 2003 and 2015 at a tertiary medical center...
December 7, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Vedran Premužić, Vanja Ivković, Ninoslav Leko, Želimir Stipančić, Sandra Karanović, Ana Jelaković, Ivana Vuković Brinar, Živka Dika, Bojan Jelaković
Balkan endemic nephropathy (BEN), an environmental form of aristolochic acid nephropathy is characterized with later onset and milder forms of hypertension (HT). Thus, we hypothesized that arterial stiffness progresses slower in BEN patients resulting in lower CV mortality. A total of 186 hemodialysed (HD) patients (90 BEN, 96 non-BEN; 67.3 + 13.0 years) were enrolled and followed-up for 25 months. Brachial blood pressure (BP) and pulse wave velocity (PWV) were determined before mid-week dialysis. BEN patients were older (72...
2018: Frontiers in Cardiovascular Medicine
Jared M Gollie, Michael O Harris-Love, Samir S Patel, Sholey Argani
Skeletal muscle wasting has gained interest as a primary consequence of chronic kidney disease (CKD) due to the relationship between skeletal muscle mass, mortality and major adverse cardiovascular events in this population. The combination of reductions in physical function, skeletal muscle performance and skeletal muscle mass places individuals with CKD at greater risk of sarcopenia. Therefore the monitoring of skeletal muscle composition and function may provide clinical insight into disease progression...
December 2018: Clinical Kidney Journal
Sorino Claudio, Scichilone Nicola, Pedone Claudio, Negri Stefano, Visca Dina, Spanevello Antonio
A significant interaction between kidneys and lungs has been shown in physiological and pathological conditions. The two organs can both be targets of the same systemic disease (eg., some vasculitides). Moreover, loss of normal function of either of them can induce direct and indirect dysregulation of the other one. Subjects suffering from COPD may have systemic inflammation, hypoxemia, endothelial dysfunction, increased sympathetic activation and increased aortic stiffness. As well as the exposure to nicotine, all the foresaid factors can induce a microvascular damage, albuminuria, and a worsening of renal function...
December 6, 2018: Journal of Nephrology
Jeroen P Kooman, Frank M van der Sande
BACKGROUND: Abnormalities in fluid status in hemodialysis (HD) patients are highly prevalent and are related to adverse outcomes. SUMMARY: The inherent discontinuity of the HD procedure in combination with an often compromised cardiovascular response is a major contributor to this phenomenon. In addition, systemic inflammation and endothelial dysfunction are related to extracellular fluid overload (FO). Underlying this relation may be factors such as hypoalbuminemia and an increased capillary permeability, leading to an altered fluid distribution between the blood volume (BV) and the interstitial fluid compartments, compromising fluid removal during dialysis...
December 5, 2018: Blood Purification
Akshay Bagai, Di Lu, Joseph Lucas, Abhinav Goyal, Charles A Herzog, Tracy Y Wang, Shaun G Goodman, Matthew T Roe
Background We sought to determine temporal trends in use of evidence-based therapies and clinical outcomes among myocardial infarction ( MI) patients with chronic kidney disease ( CKD ). Methods and Results MI patients from the NCDR (National Cardiovascular Data Registry) Chest Pain- MI Registry between January 2007 and December 2015 were categorized into 3 groups by degree of CKD (end-stage renal disease on dialysis, CKD [glomerular filtration rate <60 mL/min per 1.73 m2 ] not requiring dialysis, and no CKD [glomerular filtration rate ≥60 mL/min per 1...
December 18, 2018: Journal of the American Heart Association
Robin Lohse, Michael Ibsen, Jørgen Wiis, Anders Perner, Theis Lange, Mette Brimnes Damholt
BACKGROUND: In ICU patients, we aimed to describe the outcomes of those with end-stage renal disease (ESRD) as compared to those requiring acute renal replacement therapy (RRT). METHODS: Retrospective analysis of all adult patients admitted to a general, university hospital ICU from 2005 to 2012. ESRD was defined as use of chronic RRT >90 days prior to admission. RESULTS: We included 5927 patients of whom 1004 (17%) received acute RRT and 161 (3%) had pre-existing ESRD requiring RRT...
December 3, 2018: Acta Anaesthesiologica Scandinavica
Brian W Powers, Jiali Yan, Jingsan Zhu, Kristin A Linn, Sachin H Jain, Jennifer L Kowalski, Amol S Navathe
BACKGROUND: There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE: To describe a high-cost Medicare Advantage population and identify clinically and operationally significant subgroups of patients. DESIGN: We used a density-based clustering algorithm to group high-cost patients (top 10% of spending) according to 161 distinct demographic, clinical, and claims-based variables...
December 3, 2018: Journal of General Internal Medicine
Syed Rizwan A Bokhari, Faisal Inayat, Mah Jabeen, Zumar Sardar, Sara Saeed, Ayesha M Malik, Sabin Nasir, Amtul Zareen, Hafiz Ijaz Ahmad
Introduction Acute kidney injury (AKI) continues to be a cause of increased morbidity and mortality in pregnant women. While studies have been conducted on the incidence and etiology of this complication, the outcomes of obstetric AKI have not been extensively investigated. The primary focus of this prospective observational study was to analyze the risk factors, etiologies as well as maternal and fetal outcomes of AKI in pregnant females in Pakistan. Methods A total of 56 patients with obstetric AKI were recruited...
September 26, 2018: Curēus
Julius E Kieswich, Jianmin Chen, Samira Alliouachene, Paul W Caton, Kieran McCafferty, Christoph Thiemermann, Muhammad M Yaqoob
BACKGROUND: The end stage renal disease population has a 20 fold higher incidence of cardiovascular mortality compared to the overall population. The development of reno-cardiac syndrome in these patients will result in cardiovascular events to be the cause of 50% of fatalities. There is therefore a need to research improved therapeutic strategies to combat renal cardiac pathologies. Murine in vivo models contribute greatly to such research allowing for specific genetic modification and reduced miscellany, however there is currently no reliable model of reno-cardiac syndrome in the most common genetically modified mouse strain, the C57BL/6...
December 4, 2018: BMC Nephrology
Soojin Lee, Sehoon Park, Min Woo Kang, Hai-Won Yoo, Kyungdo Han, Yaerim Kim, Jung Pyo Lee, Kwon Wook Joo, Chun Soo Lim, Yon Su Kim, Hyeongsu Kim, Dong Ki Kim
PURPOSE: Dialysis-requiring acute kidney injury (AKI-D) after cardiac surgery is a major cause of in-hospital mortality. However, the long-term outcome has not been previously examined. MATERIALS AND METHODS: We performed a nationwide, population-based cohort study using the claims data in the Korean National Health Insurance System. Patients who underwent cardiac surgery between 2006 and 2015 were considered. RESULTS: Among 52,983 patients who underwent cardiac surgery, 1261 underwent dialysis postoperatively...
November 24, 2018: Journal of Critical Care
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