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Dialysis cardiac disease

Toshihide Hayashi, Yuri Tanaka, Masaki Iwasaki, Hiroki Hase, Hiroyuki Yamamoto, Yasuhiro Komatsu, Ryoichi Ando, Masato Ikeda, Daijo Inaguma, Toshifumi Sakaguchi, Toshio Shinoda, Fumihiko Koiwa, Shigeo Negi, Toshihiko Yamaka, Takashi Shigematsu, Nobuhiko Joki
OBJECTIVES: High prevalence of iron deficiency (ID) and cardiomyopathy have been observed in patients with end-stage kidney disease (ESKD). Our objective was to clarify associations between ID and cardiac remodeling in patients with ESKD. DESIGN AND METHODS: A cross-sectional study was conducted using 1974 Japanese patients with ESKD at the initiation of maintenance dialysis. Levels of hemoglobin (Hb), iron status, and cardiac enlargement as assessed by the cardiothoracic ratio (CTR) were determined immediately before the first hemodialysis session...
August 7, 2018: Journal of Renal Nutrition
Chieh-Li Yen, Kun-Hua Tu, Ming-Shyan Lin, Su-Wei Chang, Pei-Chun Fan, Ching-Chung Hsiao, Chao-Yu Chen, Hsiang-Hao Hsu, Ya-Chun Tian, Chih-Hsiang Chang
BACKGROUND: A beneficial effect of a ketoanalogue-supplemented low-protein diet (sLPD) in postponing dialysis has been demonstrated in numerous previous studies. However, evidence regarding its effect on long-term survival is limited. Our study assessed the long-term outcomes of patients on an sLPD after commencing dialysis. METHODS: This retrospective study examined patients with new-onset end-stage renal disease with permanent dialysis between 2001 and 2013, extracted from Taiwan's National Health Insurance Research Database...
August 8, 2018: Nutrients
Tiago Lemos Cerqueira, Armando Fartolino Guerrero, Clara Krystal Pérez Fermin, Ricardo Wang, Evelin Elfriede Balbino, Janis L Breeze, Paola Gonzalez Mego, Daniele Argentina Silva, Walid Ezzeldin Omer, Nathalie Monique Vandevelde
BACKGROUND: End-stage renal disease (ESRD) is the last stage of chronic kidney disease, mainly caused by type 2 diabetes mellitus and characterized by an increased mortality risk related to cardiovascular disease. Low-dose aspirin (acetylsalicylic acid or ASA) seems to effectively prevent cardiovascular events in patients with ESRD. However, the number of interventional studies in this population remains limited and the mechanisms of aspirin-related bleeding remain poorly understood. Aspirin's efficacy and safety may be modified by the presence of type 2 diabetes mellitus or platelet hyperreactivity...
August 9, 2018: JMIR Research Protocols
Frederic Sacher, Laurence Jesel, Claire Borni-Duval, Valerie De Precigout, Frédéric Lavainne, Jean-Philippe Bourdenx, Atman Haddj-Elmrabet, Bruno Seigneuric, Adrien Keller, Julien Ott, Helene Savel, Yahsou Delmas, Dorothée Bazin-Kara, Nicolas Klotz, Sylvain Ploux, Sébastien Buffler, Philippe Ritter, Virginie Rondeau, Pierre Bordachar, Claire Martin, Antoine Deplagne, Sylvain Reuter, Michel Haissaguerre, Jean-Baptiste Gourraud, Cécile Vigneau, Philippe Mabo, Philippe Maury, Thierry Hannedouche, Antoine Benard, Christian Combe
OBJECTIVES: The aim of this study was to identify using implantable loop recorder (ILR) monitoring the mechanisms leading to sudden death (SD) in patients undergoing hemodialysis (HD). BACKGROUND: SD accounts for 11% to 25% of death in HD patients. METHODS: Continuous rhythm monitoring was performed using the remote monitoring capability of the ILR device in patients undergoing HD at 8 centers. Clinical, biological, and technical HD parameters were recorded and analyzed...
March 2018: JACC. Clinical Electrophysiology
Paulo G de Albuquerque Suassuna, Helady Sanders-Pinheiro, Rogério B de Paula
Cardiovascular diseases are the main cause of death in chronic kidney disease (CKD) patients. In dialysis patients, sudden cardiac death accounts for 40% of all deaths. In these patients, sudden cardiac death is usually secondary to an underlying cardiomyopathy, which is clinically identified by the high prevalence of left ventricular hypertrophy and the resultant mechanical and electrical dysfunction. CKD-related cardiomyopathy has a multifactorial pathophysiology. Recent evidence has highlighted the central pathophysiological role of chronic kidney disease-mineral and bone disorder (CKD-MBD) with hyperphosphatemia and high fibroblast growth factor 23 (FGF23) levels in these patients...
2018: Frontiers in Medicine
Lefeng Zhang, Yongqiang Jin, Fuqiang Zhang, Hongyin Li, Qingyu Wu
BACKGROUND: Acute kidney injury (AKI) is one of the common complications in infants and children after complex congenital heart surgery. Peritoneal dialysis (PD) is usually applied for renal replacement therapy (RRT), especially in infants. We investigated the efficacy and safety of modified PD for the treatment of acute renal failure and congestive heart failure after cardiac surgery for congenital heart disease in infants. METHODS: We retrospectively analyzed five consecutive patients from October 2015 to February 2017...
June 25, 2018: Heart Surgery Forum
Akira Mukai, Koichi Suehiro, Yohei Fujimoto, Tadashi Matsuura, Katsuaki Tanaka, Tomoharu Funao, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
OBJECTIVES: To assess whether a tissue Doppler imaging (TDI)-based parameter consisting of the sum of early diastolic velocities of the mitral annulus (Me') and tricuspid annulus (Te') can serve as a predictor of adverse outcomes after cardiac surgery. DESIGN: Prospective, observational study. SETTING: University hospital. PARTICIPANTS: The study comprised 100 patients undergoing cardiac surgery. INTERVENTIONS: None...
May 28, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Mohammed Shurrab, Dennis T Ko, Yazan Zayed, Sankar D Navaneethan, Nour Yadak, Abeer Yaseen, Anna Kaoutskaia, Waad Qamhia, Zakaria Hamdan, Saleem Haj-Yahia, Douglas S Lee, David Newman, Jeff S Healey, Paula Harvey, Eugene Crystal
PURPOSE: The efficacy of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) in patients with chronic kidney disease (CKD) remains unclear. The aim of this meta-analysis is to explore the association between ICD/CRT and mortality in CKD patients. METHODS: An electronic search was conducted using MEDLINE. We included studies that reported outcomes of interest in CKD patients stratified by the presence of ICD, CRT, or none. The primary outcome was all-cause mortality...
July 30, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
K Komorowska-Jagielska, Z Heleniak, A Dębska-Ślizień
BACKGROUND: Cytomegalovirus (CMV) infection is associated with an increased risk of cardiac complications in kidney transplant recipients (KTRs). Some data suggest that CMV may be involved in atherogenesis. The aim of the study was the analysis of CMV medical history in KTRs and its influence on cardiovascular (CV) incidents. MATERIALS AND METHODS: The study observed 254 patients (165 male/89 female) with mean age of 47.2 (range, 15-81) years and duration of dialysis before transplantation 29...
July 2018: Transplantation Proceedings
Peter T Moore, Christian Janssen, Aengus Murphy, Eric Fretz, Imad J Nadra, Anthony Della Siega, Simon D Robinson
BACKGROUND: Coronary artery bypass grafting (CABG) is established treatment for subsets of coronary artery disease (CAD). Observational data have characterised significant progression of native coronary as well as graft vessel disease during longer-term follow-up, potentially reducing the benefit of CABG. We sought to assess longer-term outcomes following CABG by determining rates of repeat coronary angiography, revascularization procedures, and survival. METHODS: Data for all patients undergoing isolated CABG in British Columbia between 2001 and 2009 inclusive, and with follow-up until the end of 2013, were retrieved from the British Columbia Cardiac Registry...
August 2018: Canadian Journal of Cardiology
Christopher C Mayer, Julia Matschkal, Pantelis A Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C Braunisch, Marcus Baumann, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer
BACKGROUND: Evidence on the utility of ambulatory BP monitoring for risk prediction has been scarce and inconclusive in patients on hemodialysis. In addition, in cardiac diseases such as heart failure and atrial fibrillation (common among patients on hemodialysis), studies have found that parameters such as systolic BP (SBP) and pulse pressure (PP) have inverse or nonlinear (U-shaped) associations with mortality. METHODS: In total, 344 patients on hemodialysis (105 with atrial fibrillation, heart failure, or both) underwent ambulatory BP monitoring for 24 hours, starting before a dialysis session...
July 25, 2018: Journal of the American Society of Nephrology: JASN
Nobuhiko Joki, Masanori Tokumoto, Nobuyuki Takahashi, Masato Nishimura
BACKGROUND: Recent lines of evidence suggest that, as in other countries, sudden cardiac death (SCD) is more common in the Japanese dialysis clinical setting than we previously thought. SUMMARY: Three specific important findings may underlie the increased incidence of SCD in dialysis patients. Even after successful coronary revascularization, hemodialysis (HD) patients continue to have a higher incidence of SCD than the general population. Second, about 70% or more of end-stage kidney disease patients have concentric and eccentric left ventricular hypertrophy, which predisposes many dialysis patients to interstitial fibrosis, decreased coronary perfusion reserve, and decreased ischemia tolerance...
2018: Contributions to Nephrology
Michael Saul Lundin, Subash Bastakoti, Daniel Havlichek, Heather Laird-Fick
An 18-year-old woman presented to clinic with acute pharyngitis with 4/4 Centor criteria. Rapid streptococcal antigen test was negative. The patient, who was allergic to penicillin, was prescribed azithromycin. Ultimately, after 5 days and without any corticosteroids, she presented to the emergency department with 10/10 chest pain and was admitted to the intensive care unit. CT showed nodular lung disease and blood cultures on admission grew Fusobacterium, likely Fusobacterium nucleatum. She sustained two cardiac arrests, three tube thoracostomies, acute kidney injury requiring dialysis and ventilatory failure requiring tracheostomy...
July 19, 2018: BMJ Case Reports
Rachel Joffe, Mohammed Al Aklabi, Sudeshna Bhattacharya, Dominic Cave, Thomas Calleja, Daniel Garros, Nicholas Majesic, Lindsay Ryerson, Catherine Morgan
OBJECTIVES: Cardiac surgery-associated acute kidney injury is common in children and associates with negative outcomes. Novel interventions to reduce cardiac surgery-associated acute kidney injury require knowledge of its pathophysiology. States of altered perfusion, oxygen delivery, and energy consumption occur during cardiopulmonary bypass and could protect against or contribute to renal cellular injury and recovery. Near-infrared spectroscopy is noninvasive technology for monitoring regional blood flow and tissue oxygenation...
July 19, 2018: Pediatric Critical Care Medicine
Alexander Meyer, Anne Schilling, Magdalena Kott, Ulrich Rother, Werner Lang, Susanne Regus
BACKGROUND: Evaluation of below-the-knee open revascularization (OR) versus endovascular revascularization (EVT) in patients with end-stage renal disease and critical limb ischemia (CLI) was performed. PATIENTS AND METHODS: Seventy-seven dialysis patients with CLI and infrapopliteal involvement from 2007 to 2017 were included. Thirty-five patients received OR and 42 patients were treated with EVT. Survival, amputation-free survival (AFS) and wound-healing were evaluated...
January 1, 2018: Vascular and Endovascular Surgery
Monica Coll, Carles Ferrer-Costa, Sara Pich, Catarina Allegue, Emilio Rodrigo, Gema Fernández-Fresnedo, Paloma Barreda, Jesus Mates, Angel Luis Martinez de Francisco, Israel Ortega, Anna Iglesias, Oscar Campuzano, Eduardo Salas, Manuel Arias, Ramon Brugada
BACKGROUND: Patients with end-stage renal disease have very high mortality. In individuals on hemodialysis, cardiovascular deaths account for ~50% of all deaths in this population, mostly due to arrhythmia. To determine the causes of these arrhythmic deaths is essential in order to adopt preventive strategies. The main objective of this study was to investigate whether, the presence of QTc interval alterations, from electrolyte abnormalities or presence of rare genetic variants, could have a relationship with sudden arrhythmogenic deaths in end-stage renal disease patients...
2018: PloS One
K H D Thilini Hemachandra, M B Kavinda Chandimal Dayasiri, Thamara Kannangara
Background: Acute flaccid paralysis is an uncommon, but potentially life threatening, sequel of severe hyperkalemia. Reported primary aetiologies include renal failure, Addison's disease, potassium sparing diuretics, potassium supplements, and dietary excess. Coconut water, when consumed in excess, has been reported to cause severe hyperkalemia. We report the case of acute ascending flaccid paralysis secondary to hyperkalemia induced by multiple trigger factors-king coconut water, renal failure, diabetes, metabolic acidosis, and potassium sparing diuretics...
2018: Case Reports in Neurological Medicine
Ho Jin Kim, You Na Oh, Min Ho Ju, Joon Bum Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee, Suk Jung Choo
Background: We reviewed our experience with on-pump beating (OPB) heart coronary artery bypass grafting (CABG) to evaluate the impacts of obviating aortic cross-clamping and cardioplegic arrest on clinical outcomes compared with conventional CABG (C-CABG). Methods: Between 2006 and 2012, elective isolated cardiopulmonary bypass (CPB)-assisted CABG was consecutively performed in 645 patients (mean patient age 63.3±9.1 years, 471 women) with 254 (39.4%) undergoing OPB-CABG and 391 (60...
May 2018: Journal of Thoracic Disease
Peter Schnuelle, Urs Benck, Bernhard K Krämer, Benito A Yard, Andreas Zuckermann, Florian Wagner, Gabor Szabo, Martin Borggrefe, Matthias Karck, Jan Gummert
BACKGROUND: A previous donor intervention trial found that induction of mild therapeutic hypothermia in the brain-dead donor reduced the dialysis requirement after kidney transplantation. Consequences on the performance of cardiac allografts after transplantation were not explored to date. METHODS: Cohort study investigating 3-year heart allograft survival according to spontaneous core body temperature (CBT) assessed on the day of organ procurement. The study is nested in the database of the randomized trial of donor pretreatment with low-dose dopamine (ClinicalTrials...
July 10, 2018: Transplantation
Sergey Karamnov, Ethan Y Brovman, Katherine J Greco, Richard D Urman
PURPOSE: Sepsis causes significant morbidity and mortality after cardiac surgery and carries a significant burden on health care costs. There is a general association of increased risk of post-cardiac surgery sepsis in patients with postoperative complications. We sought to investigate significant patient and procedural risk factors and outcomes associated with sepsis after cardiac surgery. MATERIALS AND METHODS: In this retrospective study, we analyzed 531 coronary artery bypass grafting and open heart valve surgery cases that developed postoperative sepsis in the National Surgical Quality Improvement Program database between 2007 and 2014...
July 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
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