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https://www.readbyqxmd.com/read/29147997/drug-eluting-balloon-angioplasty-for-assisted-maturation-of-failing-fistulae
#1
Alexandros Mallios, Jeffrey Hull, Benoit Boura, Alessandro Costanzo, Myriam Combes
OBJECTIVE: To present our experience of balloon-assisted maturation with drug-eluting balloon dilation in patients with recurrent failing arteriovenous fistulae. CASE SERIES: Three patients (all males, mean age 71 years) with a complex history of failed attempts at native fistula creation underwent surgical creation of arteriovenous fistulae. Two patients had a two-stage brachio-brachial fistula and 1 had a brachio-cephalic fistula that also required subsequent elevation...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#2
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29142382/capillary-leak-syndrome-following-snakebite-envenomation
#3
REVIEW
V Udayabhaskaran, E T Arun Thomas, Bhagya Shaji
Capillary leak syndrome is a unique complication that follows Russell's viper envenomation. This syndrome has a very high fatality rate and is characterized by parotid swelling, chemosis, periorbital edema, hypotension, albuminuria, hypoalbuminemia, and hemoconcentration. This syndrome is frequently recognized from the southern parts of India, especially from the state of Kerala. It has been postulated that a vascular apoptosis inducing component of Russell's viper venom that is not neutralized by the commercially available anti-snake venom (ASV) is responsible for this complication as it occurs even after adequate doses of ASV administration in most cases...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#4
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29132945/uric-acid-and-the-risks-of-kidney-failure-and-death-in-individuals-with-ckd
#5
Anand Srivastava, Arnaud D Kaze, Ciaran J McMullan, Tamara Isakova, Sushrut S Waikar
BACKGROUND: Serum uric acid concentrations increase in chronic kidney disease (CKD) and may lead to tubular injury, endothelial dysfunction, oxidative stress, and intrarenal inflammation. Whether uric acid concentrations are associated with kidney failure and death in CKD is unknown. STUDY DESIGN: Prospective observational cohort study. SETTINGS & PARTICIPANTS: 3,885 individuals with CKD stages 2 to 4 enrolled in the Chronic Renal Insufficiency Cohort (CRIC) between June 2003 and September 2008 and followed up through March 2013...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#6
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29103152/barriers-for-implementation-of-intensified-hemodialysis-survey-results-from-the-international-pediatric-dialysis-network
#7
Julia Thumfart, Dominik Müller, Steffen Wagner, Anuradha Jayanti, Dagmara Borzych-Duzalka, Franz Schaefer, Bradley Warady, Claus Peter Schmitt
BACKGROUND: In patients on conventional hemodialysis (HD), morbidity is high and quality of life is poor. Intensified HD programs have been developed to help overcome these shortcomings, , but very few pediatric dialysis centers have reported the implementation of such a HD program. METHODS: An online survey was sent to all 221 pediatric dialysis centers which participate in the International Pediatric Dialysis Network (IPDN). The aim of the survey was to assess the attitude of pediatric nephrologists towards intensified HD, the penetrance of intensified HD into their clinical practice and barriers to implementation...
November 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29094800/low-protein-diet-for-conservative-management-of-chronic-kidney-disease-a-systematic-review-and-meta-analysis-of-controlled-trials
#8
Connie M Rhee, Seyed-Foad Ahmadi, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: Recent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low-protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein-energy wasting or cachexia. We aimed to systematically review and meta-analyse the controlled clinical trials with adequate participants in each trial, providing rigorous contemporary evidence of the impact of a low-protein diet in the management of uraemia and its complications in patients with CKD...
November 2, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/29072166/effect-of-an-intradialytic-protein-rich-meal-intake-in-nutritional-and-body-composition-parameters-on-hemodialysis-patients
#9
Cristina Caetano, Ana Valente, Francisco Jorge Silva, Jorge Antunes, Cristina Garagarza
BACKGROUND AND AIMS: Protein intake is a key point to maintain an adequate nutritional status in hemodialysis (HD) patients. There are some studies that confirm the positive influence of intradialytic oral nutritional supplementation in several nutritional parameters in HD patients. The aim of this study was to evaluate the effect of an intradialytic protein rich meal in nutritional and body composition parameters on HD patients. METHODS: This was a 6-months single center non-randomized study with 99 patients in HD from one Nephrocare dialysis unit in Portugal...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29070040/care-of-the-dialysis-patient-primary-provider-involvement-and-resource-utilization-patterns-a-cohort-study
#10
Bjorg Thorsteinsdottir, Priya Ramar, LaTonya J Hickson, Megan S Reinalda, Robert C Albright, Jon C Tilburt, Amy W Williams, Paul Y Takahashi, Molly M Jeffery, Nilay D Shah
BACKGROUND: Efficient and safe delivery of care to dialysis patients is essential. Concerns have been raised regarding the ability of accountable care organizations to adequately serve this high-risk population. Little is known about primary care involvement in the care of dialysis patients. This study sought to describe the extent of primary care provider (PCP) involvement in the care of hemodialysis patients and the outcomes associated with that involvement. METHODS: In a retrospective cohort study, patients accessing a Midwestern dialysis network from 2001 to 2010 linked to United States Renal Database System and with >90 days follow up were identified (n = 2985)...
October 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29069040/predictive-validity-of-the-acs-nsqip-surgical-risk-calculator-in-geriatric-patients-undergoing-lumbar-surgery
#11
Xiao Wang, Yanting Hu, Binjiang Zhao, Yue Su
The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29067650/ckd-complications-in-kidney-transplanted-patients-going-back-to-dialysis-impact-on-patients-outcomes
#12
Julien Aniort, Saleh Kaysi, Cyril Garrouste, Mohamed Hadj Abdelkader, Myriam Isnard, Didier Aguilera, Youssef Ali, Marc Bouiller, Aurelien Mulliez, Anne Elisabeth Heng
AIMS: The management of chronic kidney disease (CKD) complications is not always adequate in patients with a failed kidney transplant. We aimed to evaluate the frequency of CKD complications and assess whether they may lead to worse outcomes in this patient population. METHOD: We analyzed 49 kidney transplant recipients with a failed transplant (T+) and matched non-transplanted patients (T-) starting dialysis between 2000 and 2010 in five dialysis centers in France...
October 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29066641/adverse-reaction-with-suvorexant-for-insomnia-acute-worsening-of-depression-with-emergence-of-suicidal-thoughts
#13
Jeremy Petrous, Kevin Furmaga
A 59-year-old woman on daily peritoneal dialysis for end-stage renal failure received care at an outpatient psychiatric clinic for her diagnoses that include major depressive disorder, generalised anxiety disorder and insomnia disorder. Although there was partial improvement in the patient's mood and anxiety symptoms with antidepressant treatment, insomnia remained a persistent complaint despite adequate trials of different sleep medications. The novel hypnotic, suvorexant (Belsomra, Merck & Co.) was then initiated at the recommended bedtime dose of 10 mg and was followed by a 15 mg dose the following night...
October 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29064141/the-role-of-dietary-phosphate-restriction-in-chronic-kidney-disease
#14
Grahame J Elder, Avya Malik, Kelly Lambert
BACKGROUND AND OBJECTIVES: Patients with progressive chronic kidney disease (CKD) develop positive phosphate balance that is associated with increased cardiovascular risk and mortality. Modification of dietary phosphate is a commonly used strategy to improve outcomes but is complicated by the need for adequate dietary protein. Surprisingly, the evidence for patient-level benefits from phosphate restriction is tenuous, and the justification for using any phosphate binder for pre-dialysis patients is questionable...
October 24, 2017: Nephrology
https://www.readbyqxmd.com/read/29058165/clinical-characteristics-and-risk-factors-associated-with-mortality-in-calcific-uremic-arteriolopathy
#15
Peter W Santos, Jianghua He, Ahmad Tuffaha, James B Wetmore
BACKGROUND: Calcific uremic arteriolopathy (CUA) is an often-fatal condition in dialysis patients. The clinical descriptions and treatments of CUA patients have been confined mostly to case reports. We report a comprehensive characterization of CUA and its associated diagnosis, treatment patterns, and outcome. METHODS: An internet-based registry collected information about CUA in dialysis patients. Univariate analysis using Cox proportional hazards models estimated hazard ratios of the association between clinical characteristics, laboratory values, and treatments with all-cause mortality...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29045916/suicide-deaths-among-patients-with-end-stage-renal-disease-receiving-dialysis-a-population-based-retrospective-cohort-study-of-64-000-patients-in-taiwan
#16
I-Ming Chen, Po-Hsien Lin, Vin-Cent Wu, Chi-Shin Wu, Jia-Chi Shan, Shu-Sen Chang, Shih-Cheng Liao
BACKGROUND: Patients with end-stage renal disease (ESRD) who receive dialysis may experience increased distress and risk of suicide. METHODS: This population-based retrospective cohort study linked Taiwan's national register of ESRD patients on dialysis and the cause-of-death mortality data file. A separate multiple-cause-of-death data file was used to investigate the detailed suicide methods used. Standardized mortality ratios (SMRs) were calculated for the overall patient group and by sex, age, year of initiating dialysis, method of suicide, and time since initiation of dialysis...
October 9, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#17
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29040687/mortality-risk-in-patients-on-hemodiafiltration-versus-hemodialysis-a-real-world-comparison-from-the-dopps
#18
Francesco Locatelli, Angelo Karaboyas, Ronald L Pisoni, Bruce M Robinson, Joan Fort, Raymond Vanholder, Hugh C Rayner, Werner Kleophas, Stefan H Jacobson, Christian Combe, Friedrich K Port, Francesca Tentori
Background: With its convective component, hemodiafiltration (HDF) provides better middle molecule clearance compared with hemodialysis (HD) and is postulated to improve survival. A previous analysis of Dialysis Outcomes and Practice Patterns Study (DOPPS) data in 1998-2001 found lower mortality rates for high replacement fluid volume HDF versus HD. Randomized controlled trials have not shown uniform survival advantage for HDF; in secondary (non-randomized) analyses, better outcomes were observed in patients receiving the highest convection volumes...
October 11, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29031705/laparoscopic-repair-of-large-hiatal-hernia-without-the-need-for-esophageal-lengthening-with-low-morbidity-and-rare-symptomatic-recurrence
#19
Farzaneh Banki, Chandni Kaushik, David Roife, Kyle G Mitchell, Charles C Miller
The aim of this study was to assess symptomatic recurrence in patients who underwent a laparoscopic repair of large hiatal hernia without an esophageal lengthening procedure. Patients who underwent a laparoscopic repair of a large hiatal hernia from September 2009 to September 2015 by a single surgeon were identified in the retrospective review. The patients were followed up prospectively by the operating surgeon using a structured questionnaire, administered by telephone, to assess the symptoms. Symptomatic recurrence was defined as the requirement for a reoperative procedure for symptomatic recurrent hiatal hernia...
May 29, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29018183/a-case-of-left-renal-vein-ligation-in-a-patient-with-solitary-left-kidney-undergoing-liver-transplantation-to-control-splenorenal-shunt-and-improve-portal-venous-flow
#20
Rodrigo B Martino, Eserval Rocha Júnior, Valdano Manuel, Vinicius Rocha-Santos, Luis Augusto C D'Albuquerque, Wellington Andraus
BACKGROUND Adequate portal venous flow is required for successful liver transplantation. Reduced venous flow and blood flow 'steal' by collateral vessels are a concern, and when there is a prominent splenorenal shunt present, ligation of the left renal vein has been recommended to improve portal venous blood flow. CASE REPORT A 51-year-old man who had undergone right nephrectomy in childhood required liver transplantation for liver cirrhosis and hepatocellular carcinoma due to hepatitis C virus (HCV) infection...
October 11, 2017: American Journal of Case Reports
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