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https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#1
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28092113/hemodialysis-treatment-time-as-important-as-it-seems
#2
John T Daugirdas
Hemodialysis treatment time and Kt/V can both be considered to be primary measures of hemodialysis adequacy, because when either goes to zero, mortality is certain in patients without residual kidney function. Treatment time is important, but it needs to be adjusted based on surface-area-normalized Kt/V, residual kidney function, and expected ultrafiltration rate. Rescaling dose of dialysis measured as Kt/V to body surface area prevents ultrashort dialysis in small patients, women, and children with minimal residual kidney function...
January 16, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28090764/incremental-and-infrequent-hemodialysis-a-new-paradigm-for-both-dialysis-initiation-and-conservative-management
#3
Connie M Rhee, Mehrdad Ghahremani-Ghajar, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Registry or national dialysis data show that a sizeable proportion of contemporary dialysis patients have substantial levels of residual kidney function especially upon transitioning to dialysis therapy. However, among incident hemodialysis patients, the prevailing paradigm has been to initiate "full-dose" thrice-weekly treatment schedules irrespective of native kidney function in most developed countries. Recognizing the benefits of residual kidney function upon the health and survival of dialysis patients, there has been growing interest in incremental hemodialysis, in which dialysis frequency and dose are tailored according to the degree of patients' residual kidney function...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28066881/short-acting-erythropoiesis-stimulating-agents-for-anaemia-in-predialysis-patients
#4
REVIEW
Deirdre Hahn, Christopher I Esezobor, Noha Elserafy, Angela C Webster, Elisabeth M Hodson
BACKGROUND: The benefits of erythropoiesis-stimulating agents (ESA) for chronic kidney disease (CKD) patients have been previously demonstrated. However, the efficacy and safety of short-acting epoetins administered at larger doses and reduced frequency as well as of new epoetins and biosimilars remains uncertain. OBJECTIVES: This review aimed to evaluate the benefits and harms of different routes, frequencies and doses of epoetins (epoetin alpha, epoetin beta and other short-acting epoetins) for anaemia in adults and children with CKD not receiving dialysis...
January 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28058704/safety-and-efficacy-of-placing-internal-jugular-dialysis-catheter-tip-in-the-inferior-vena-cava
#5
Michael A M Mayer, Vinaya Soundararajan, Ramesh Soundararajan
PURPOSE: To assess the efficacy and safety of placing the tip of the internal jugular (IJ) hemodialysis catheter in the inferior vena cava (IVC) in situations where it does not work well when placed in the right atrium. METHODS: The medical records of chronic hemodialysis patients at an outpatient vascular intervention facility were retrospectively reviewed. Out of the 831 patients who had dialysis catheters exchanged over a 4-year period, 13 patients were identified who underwent catheter exchanges where the tip of the catheter was placed in the IVC via the IJ approach...
January 3, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28027794/intraperitoneal-vancomycin-plus-either-oral-moxifloxacin-or-intraperitoneal-ceftazidime-for-the-treatment-of-peritoneal-dialysis-related-peritonitis-a-randomized-controlled-pilot%C3%A2-study
#6
Rong Xu, Zhikai Yang, Zhen Qu, Huan Wang, Xue Tian, David W Johnson, Jie Dong
BACKGROUND: Intraperitoneal administration of antibiotics is recommended as a first treatment for managing peritoneal dialysis (PD)-related peritonitis. However, the efficacy of oral administration of quinolones has not been well studied. STUDY DESIGN: Randomized controlled pilot study. SETTING & PARTICIPANTS: 80 eligible patients with PD-related peritonitis from Peking University First Hospital (40 in each arm). INTERVENTION: Intraperitoneal vancomycin, 1g, every 5 days plus oral moxifloxacin, 400mg, every day (treatment group) versus intraperitoneal vancomycin, 1g, every 5 days plus intraperitoneal ceftazidime, 1g, every day (control group)...
December 24, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28001026/keto-analogues-and-essential-amino-acids-and-other-supplements-in-the-conservative-management-of-chronic-kidney-disease
#7
Adamasco Cupisti, Piergiorgio Bolasco
The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with an aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of CKD patients...
December 21, 2016: Panminerva Medica
https://www.readbyqxmd.com/read/27991478/hemodialysis-delivery-dialysis-dose-achievement-and-vascular-access-types-in-hemodialysis-patients-from-the-gulf-cooperation-council-countries-enrolled-in-the-dialysis-outcomes-and-practice-patterns-study-phase-5-2012-2015
#8
Anas AlYousef, Sumaya AlGhareeb, Jamal Al Wakeel, Saeed M G Al-Ghamdi, Brian A Bieber, Mohamad Hassan, Yacoub Al Maimani, Naser Alkandari, Haroun Z Ahmed, Ashraf Fawzy, Ronald L Pisoni
The prospective observational Dialysis Outcomes and Practice Patterns Study (DOPPS) was initiated in late 2012 in national samples of hemodialysis (HD) units (n = 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates). For many years, guidelines have recommended single pool Kt/V ≥1.2 as the minimum adequate dose for chronic HD patients. Here, we report initial DOPPS results regarding HD practices related to dialysis dose achievement in the GCC...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27988790/pharmacokinetics-of-lenalidomide-during-high-cut-off-dialysis-in-a-patient-with-multiple-myeloma-and-renal-failure
#9
Kim Dao, Yimin Lu, Cody J Peer, William D Figg, Raphael Stadelmann, Michel Burnier, Thierry Buclin, Sebastien Kissling
INTRODUCTION: High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy. METHODS: The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in order to develop a pharmacokinetic model accounting for lenalidomide concentrations in this setting...
December 17, 2016: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27965919/results-of-protocol-based-perioperative-management-in-off-pump-coronary-artery-bypass-grafting-for-patients-with-non-dialysis-dependent-chronic-kidney-disease
#10
Jeong-Won Kim, Hyung Tae Sim, Jae Suk Yoo, Dong Jin Kim, Kwang Ree Cho
BACKGROUND: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. METHODS: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27951574/clinical-performance-assessment-of-cordiax-filters-in-hemodialysis-and-hemodiafiltration
#11
Jacky Potier, Sudhir Bowry, Bernard Canaud
In this study, we evaluate the in vivo clinical performances of CorDiax FX 100 and CorDiax FX 1000 filters incorporating a high-flux membrane (Helixone Plus) designed for use in high-flux hemodialysis (HD) as well as in hemodiafiltration (HDF) in 6 stable end-stage kidney disease patients. In the HDF mode, various substitution modalities (post-, pre-, and mixed) were compared. In addition to conventional markers of efficacy of dialysis dose (urea, ionic dialysance, Kt/V), several additional middle- and large-size solute (β2-microglobulin, myoglobin, serum-free light-chain kappa and lambda, α1-microglobulin, and FGF23) compounds were explored in order to cover the spectrum of uremic toxins that are involved in uremia...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951560/new-dialysis-technology-and-biocompatible-materials
#12
Andrew Davenport
Although haemodialysis is an established treatment for patients with end-stage kidney disease, sustaining life for more than 2 million patients world-wide, the mortality of dialysis patients remains high and is greater than that for some of the more common solid organ cancers. As such, the question arises as to whether more efficient clearance of the waste products of metabolism which accumulate would improve outcomes. Recent reports of an association between improved patient survivals with higher-volume on-line haemodiafiltration exchanges would support this hypothesis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951551/what-is-the-best-dialysis-therapy-in-developed-and-developing-countries-peritoneal-dialysis-and-or-hemodialysis-the-trend-in-korea
#13
Yong-Lim Kim
In Korea, peritoneal dialysis (PD) penetration peaked around 2005 at 23%, after which it declined and has remained at 10.5%. Two factors possibly explain the decrease: more favorable physician incentives to perform hemodialysis (HD) and disincentives for private clinics to perform PD, even though they account for a large percentage of dialysis centers in Korea. Early referral to nephrologists has been shown to be associated with better survival and lower medical costs than late referral, highlighting a possible role for systemic intervention to encourage early referrals...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27939593/dietary-patterns-and-clinical-outcomes-in-chronic-kidney-disease-the-ckd-qld-nutrition-study
#14
Shu Ning Wai, Jaimon T Kelly, David W Johnson, Katrina L Campbell
OBJECTIVE: Emerging evidence suggests that dietary patterns are associated with survival in people with chronic kidney disease (CKD). This study evaluated the relationship between dietary habits and renal-related clinical outcomes in an established CKD cohort. DESIGN: Prospective cohort study. SETTING: Three outpatient nephrology clinics in Queensland, Australia. SUBJECTS: A total of 145 adult patients with Stage 3 or 4 CKD (estimated glomerular filtration rate 15-59 mL/minute/1...
December 8, 2016: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/27935536/evaluation-of-a-12-month-pilot-of-long-term-and-temporary-assisted-peritoneal-dialysis
#15
Micheli U Bevilacqua, Linda Turnbull, Sushila Saunders, Lee Er, Helen Chiu, Penny Hill, Rajinder S Singh, Adeera Levin, Michael A Copland, Abeed Jamal, Catherine Brumby, Orla Dunne, Paul A Taylor
♦ Background: Peritoneal dialysis (PD) is challenging for patients with functional limitations, and assisted PD can support these patients, but previous reports of assisted PD have not examined the role of temporary assisted PD and had difficulty identifying adequate comparator cohorts. ♦ Methods: Peritoneal Dialysis Assist (PDA), a 12-month pilot of long-term and temporary assisted PD was completed in multiple PD centers in British Columbia, Canada. Continuous cycler PD (CCPD) patients were identified for PDA by standardized criteria, and service could be long-term or temporary/respite...
December 1, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27902586/neurological-psychological-and-cognitive-disorders-in-patients-with-chronic-kidney-disease-on-conservative-and-replacement-therapy
#16
Silvia Lai, Oriano Mecarelli, Patrizia Pulitano, Roberto Romanello, Leonardo Davi, Alessia Zarabla, Amalia Mariotti, Maria Carta, Giorgia Tasso, Luca Poli, Anna Paola Mitterhofer, Massimo Testorio, Nicla Frassetti, Paola Aceto, Alessandro Galani, Carlo Lai
Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy.Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27896453/management-of-phosphorus-load-in-ckd-patients
#17
REVIEW
Yutaka Taketani, Fumihiko Koiwa, Keitaro Yokoyama
Disturbances in mineral and bone metabolism play a critical role in the pathogenesis of cardiovascular complications in patients with chronic kidney disease (CKD). The term "renal osteodystrophy" has recently been replaced with "CKD-mineral and bone disorder (CKD-MBD)", which includes vascular calcification as well as bone abnormalities. In Japan, proportions of the aged and long-term dialysis patients are increasing which makes management of vascular calcification and parathyroid function increasingly more important...
November 28, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#18
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27876561/tip-design-of-hemodialysis-catheters-influences-thrombotic-events-and-replacement-rate
#19
C Petridis, M Nitschke, W Lehne, E Smith, J P Goltz, H Lehnert, M Meier
OBJECTIVE/BACKGROUND: Central venous tunnelled hemodialysis catheters (CVTC) are used for initial vascular access in patients with renal failure. Tip design of the CVTC may play an important role in catheter function and complication rates, influencing adequate hemodialysis treatment of these patients. METHODS: This prospective, observational cohort study compared the function and complication rates of two CVTCs in patients with end stage renal disease (ESRD) within a follow-up period of 24 months...
November 19, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27801685/dietary-protein-intake-and-chronic-kidney-disease
#20
Gang Jee Ko, Yoshitsugu Obi, Amanda R Tortorici, Kamyar Kalantar-Zadeh
PURPOSE OF REVIEW: High-protein intake may lead to increased intraglomerular pressure and glomerular hyperfiltration. This can cause damage to glomerular structure leading to or aggravating chronic kidney disease (CKD). Hence, a low-protein diet (LPD) of 0.6-0.8 g/kg/day is often recommended for the management of CKD. We reviewed the effect of protein intake on incidence and progression of CKD and the role of LPD in the CKD management. RECENT FINDINGS: Actual dietary protein consumption in CKD patients remains substantially higher than the recommendations for LPD...
January 2017: Current Opinion in Clinical Nutrition and Metabolic Care
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