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Mortality esrd

Mark Hensey, John G Webb
In patients with end stage renal disease on hemodialysis, TAVR resulted in reduced length of stay, hospitalization cost, complication rate and higher rates of home discharge compared to SAVR. In-hospital mortality and complication rates were high in both groups. Careful patient selection and further research is required to identify patients with end-stage renal disease who might, or might not, benefit from intervention.
October 1, 2018: Catheterization and Cardiovascular Interventions
Anthony J Nastasi, Tyler S Bryant, Jimmy T Le, Jennifer Schrack, Hao Ying, Christine E Haugen, Marlís González Fernández, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: Few objective tests can be performed at admission for kidney transplantation [KT] to discern risk of increased length of stay [LOS], which is important for patient counseling and is associated with increased costs and mortality. The short physical performance battery [SPPB] is an easily administered, potentially modifiable, 3-part test of lower extremity function. SPPB score is associated with longer hospital LOS in older adults, and may provide similar utility in KT recipients given that ESRD is a disease of accelerated aging...
October 19, 2018: BMC Geriatrics
Kinsuk Chauhan, Yorg Azzi, Geovani Faddoul, Luz Liriano-Ward, Paul Chang, Girish Nadkarni, Veronica Delaney, Scott Ames, Neha Debnath, Nandita Singh, Vinita Sehgal, Graciela Di Boccardo, Felipe Garzon, Vinay Nair, Rebecca Kent, Susan Lerner, Steven Coca, Ron Shapiro, Sander Florman, Thomas Schiano, Madhav C Menon
SLK allocation protocols allocate dual-organs based on a sustained eGFR of 30 ml/min or less. A 2017-UNOS update includes CKD3 as dual organ candidates but only when the listing eGFR is less than 30 ml/min while recommending a "safety net" for prioritized kidney listing post-LT. We retrospectively reviewed adult LTs examine whether the UNOS proposal captured the LT population at highest risk for developing post-LT ESRD. Among 290 LT-recipients, 67 had pre-LT CKD3, 141 had AKI, of whom 47 required dialysis (<4 weeks)...
October 19, 2018: Clinical Transplantation
Marisa Danielle Juarez
Children with end-stage renal disease (ESRD) on hemodialysis are at increased risk for malnutrition. Aggressive nutrition intervention such as intradialytic parenteral nutrition (IDPN) should be considered to prevent further co-morbidities and mortality associated with malnutrition when other interventions fail. IDPN is a non-invasive method of providing nutrition to malnourished hemodialysis (HD) patients via the HD access throughout the HD treatment. Although the evidence on the long-term benefits of IDPN is scant in pediatrics, there is evidence that it improves metabolic parameters and nutritional status...
2018: Frontiers in Pediatrics
Tatsuya Suwabe, Francisco J Barrera-Flores, Rene Rodriguez-Gutierrez, Yoshifumi Ubara, Kenmei Takaichi
BACKGROUND: End-stage renal disease (ESRD) is related to high morbidity, mortality, and impaired health-related quality of life. While hemodialysis (HD) is the current life-saving standard of treatment for patients with ESRD, their quality of life (QoL) remains far from desirable. Online HDF (OL-HDF), due to its convenience, could improve the QoL of patients with ESRD, however, this remains uncertain. OBJECTIVE: We aimed to assess the body of evidence of OL-HDF compared to HD regarding QoL in patients with ESRD...
2018: PloS One
Catherine R Lesko, Bryan Lau, Geetanjali Chander, Richard D Moore
OBJECTIVE: Describe all-cause mortality associated with history of injection drug use (IDU) after a validated diagnosis of four non-communicable disease (NCD) diagnoses: 1) end-stage liver disease (ESLD); 2) end-stage renal disease (ESRD); 3) cancer; or 4) myocardial infarction (MI) or stroke. DESIGN: We followed 4 cohorts of persons in continuity HIV care in the Johns Hopkins HIV Clinic with a validated diagnosis of ESLD (n = 67), ESRD (n = 187), cancer (n = 424), and MI or stroke (n = 213) from 1996 through approximately 2014...
October 15, 2018: AIDS
Peter W Crooks, Christopher O Thomas, Amy Compton-Phillips, Wendy Leith, Alvina Sundang, Yi Yvonne Zhou, Linda Radler
OBJECTIVES: To assess the association between optimal end-stage renal disease (ESRD) starts and clinical and utilization outcomes in an integrated healthcare delivery system. STUDY DESIGN: Retrospective observational cohort study in 6 regions of an integrated healthcare delivery system, 2011-2013. METHODS: Propensity score techniques were used to match 1826 patients who experienced an optimal start of renal replacement therapy (initial therapy of hemodialysis via an arteriovenous fistula or graft, peritoneal dialysis, or pre-emptive transplant) to 1826 patients who experienced a nonoptimal start (hemodialysis via a central venous catheter)...
October 1, 2018: American Journal of Managed Care
Anawin Sanguankeo, Sikarin Upala
Context: Metabolic syndrome (MetS) is documented to increase the risk of mortality in the general population. However, there are reports of lower mortality in end stage renal disease (ESRD) patients with obesity. Since obesity is a major component of MetS, this meta-analysis was conducted to determine the risk of all-cause mortality, cardiovascular disease (CVD) mortality, and cardiovascular disease events (CVE) associated with MetS in ESRD subjects. Evidence Acquisition: Eligible studies from inception to March 2017 assessing the clinical outcome of MetS in ESRD subjects were comprehensively searched in MEDLINE, EMBASE, and CENTRAL...
April 2018: International Journal of Endocrinology and Metabolism
Ting-Yun Lin, Jia-Sin Liu, Szu-Chun Hung
Background: Obesity is a risk factor for de novo chronic kidney disease (CKD) in the general population. Obesity has been increasingly prevalent in patients with CKD and may lead to further progression of pre-existing CKD. However, whether obesity is associated with the development of end-stage renal disease (ESRD) in patients with CKD is not well understood. Objective: We investigated the impact of obesity on ESRD (needing chronic dialysis treatment or pre-emptive renal transplantation) or all-cause mortality in patients with moderate to advanced CKD...
October 13, 2018: American Journal of Clinical Nutrition
Patrick Ahearn, Kirsten L Johansen, Charles E McCulloch, Barbara A Grimes, Elaine Ku
RATIONALE & OBJECTIVE: In the general population, girls have lower mortality risk compared with boys. However, few studies have focused on sex differences in survival and in access to kidney transplantation among children with end-stage kidney disease. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Children aged 2 to 19 years registered in the US Renal Data System who started renal replacement therapy (RRT) between 1995 and 2011...
October 11, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Cheng-Yang Hsieh, Chia-Cheng Lai, Jung-Shun Lee, Chin-Chung Tseng
PURPOSE: Patients with end-stage renal disease (ESRD) have higher risks of subdural hemorrhage (SDH) and subsequent 30-day mortality. However, evidences regarding optimal mode of dialysis therapy during acute management are sparse. We aimed to compare the outcomes of ESRD patients who received continuous peritoneal dialysis (CPD) or extended hemodialysis (EHD) after SDH and determined factors associated with 30-day mortality. METHODS: We retrospectively reviewed consecutive patients with SDH and ESRD in a medical center...
March 15, 2018: Acta Neurologica Taiwanica
Amy S You, John J Sim, Csaba P Kovesdy, Elani Streja, Danh V Nguyen, Gregory A Brent, Kamyar Kalantar-Zadeh, Connie M Rhee
Background: Advanced chronic kidney disease (CKD) patients, including those receiving dialysis, have a high prevalence of thyroid dysfunction. Although hypothyroidism is associated with higher death risk in end-stage renal disease (ESRD) patients, no studies have examined whether thyroid status in the pre-ESRD period impacts mortality after dialysis initiation. Methods: Among US veterans with CKD identified from the national Veterans Affairs database that transitioned to dialysis over the period from October 2007 to September 2011, we examined the association of pre-ESRD serum thyrotropin (TSH) levels averaged over the 1-year pre-dialysis ('prelude') period with all-cause mortality in the first year following dialysis initiation...
October 8, 2018: Nephrology, Dialysis, Transplantation
George Kuo, Szi-Wen Chen, Jeng-Yi Huang, Chao-Yi Wu, Chung-Ming Fu, Chih-Hsiang Chang, Su-Hsun Liu, Yi-Hsin Chan, I-Wen Wu, Huang-Yu Yang
BACKGROUND: Heart rate variability (HRV), a non-invasive measurement of the sympathetic-vagal balance, has been demonstrated as a predictor of long-term survival in various patient populations. However, its predictive value in patients with end-stage renal disease (ESRD) has not been evaluated in a long-term follow-up study. METHODS: Prospective data collected for 41 patients with chronic hemodialysis (age 59 ± 10 years, men 51.3%, diabetes mellitus 31%, and duration of dialysis 64 ± 50 months) who underwent a 5-minute electrocardiogram (ECG) recording as a baseline for frequency domain HRV analysis...
October 5, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Sanjay Vikrant
INTRODUCTION: Tuberculosis (TB) is a significant health problem in developing countries. There are limited data on TB among end stage renal disease (ESRD) patients on maintenance dialysis in India. Clinical profile and outcome of TB in dialysis were studied. METHODS: Retrospective study of ESRD patients who were on maintenance dialysis (either peritoneal dialysis [PD] or hemodialysis (HD]) and diagnosed to have TB over a period of 11 years. FINDINGS: Thirty-two patients had a diagnosis of TB...
October 5, 2018: Hemodialysis International
Claire Harris, Mercedeh Kiaii, Wynnie Lau, Myriam Farah
Background: Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare but life-threatening condition predominately occurring in patients with end-stage renal disease on dialysis. In the absence of randomized clinical trials to guide management, clinicians must rely on observational data. We have previously reported the outcomes of our multi-intervention management in seven patients and now present a larger series of patients with extended follow-up. Methods: We performed a retrospective analysis of all patients diagnosed with CUA at a single academic center between 2008 and 2017...
October 2018: Clinical Kidney Journal
Tao Zhang, Yitian Dou, Xuejun Wang, Jing Li, Shili Cao
BACKGROUND/AIMS: Mounting clinical experience and evidence from scale observational studies have suggested that polycystic kidney disease (PKD) was not a contraindication for peritoneal dialysis (PD). Recent studies have reported that PD may be associated with a better prognosis in PKD than that of non-PKD patients. To solve the problem, we performed a systematic review and comprehensive meta-analysis to compare the outcomes between PKD and non-PKD patients on PD and the all-cause mortality between patients with PKD on PD and hemodialysis (HD)...
October 4, 2018: Kidney & Blood Pressure Research
Mario Cozzolino, Michela Mangano, Andrea Stucchi, Paola Ciceri, Ferruccio Conte, Andrea Galassi
Cardiovascular disease (CVD) is a highly common complication and the first cause of death in patients with end-stage renal disease (ESRD) on haemodialysis (HD). In this population, mortality due to CVD is 20 times higher than in the general population and the majority of maintenance HD patients have CVD. This is likely due to ventricular hypertrophy as well as non-traditional risk factors, such as chronic volume overload, anaemia, inflammation, oxidative stress, chronic kidney disease-mineral bone disorder and other aspects of the 'uraemic milieu'...
October 1, 2018: Nephrology, Dialysis, Transplantation
Gabriela Cobo, Bengt Lindholm, Peter Stenvinkel
Under normal conditions, inflammation is a protective and physiological response to various harmful stimuli. However, in several chronic debilitating disorders, such as chronic kidney disease, inflammation becomes maladaptive, uncontrolled and persistent. Systemic persistent inflammation has, for almost 20 years, been recognized as a major contributor to the uraemic phenotype (such as cardiovascular disease, protein energy wasting, depression, osteoporosis and frailty), and a predictor of cardiovascular and total mortality...
October 1, 2018: Nephrology, Dialysis, Transplantation
Arbey Aristizabal-Alzate, John Fredy Nieto-Rios, Catalina Ocampo-Kohn, Lina Maria Serna-Higuita, Diana Carolina Bello-Marquez, Gustavo Adolfo Zuluaga-Valencia
Methotrexate is an effective medication to control several diseases; however, it can be very toxic, being myelosuppression one of its main adverse effects, which increases in severity and frequency in patients with renal failure. We present the case of a 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis, under treatment with peritoneal dialysis, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis...
September 21, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
B Sangeetha Lakshmi, N Harini Devi, M M Suchitra, P V L N Srinivasa Rao, V Siva Kumar
BACKGROUND: Cardiovascular disease (CVD) is a common cause of morbidity and mortality in end-stage renal disease (ESRD) patients on hemodialysis (HD) among whom it is 5-20 times higher than in the general population. Some of the nontraditional risk factors such as oxidative stress and inflammation are related to the progress of CVD in HD patients. Several, but not all studies, reported that inflammatory and oxidative stress markers are increased during a single session of HD, mimicking changes that occur during acute immune activation...
November 2018: Renal Failure
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