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https://www.readbyqxmd.com/read/28230617/acute-kidney-injury-following-efavirenz-tenofovir-disoproxil-fumarate-emtricitabine-atripla%C3%A2-overdose
#1
Thomas Havenith, David Burger, Maarten Visschers, Jolanda Schippers, Astrid Oude Lashof
We describe a patient with acute renal failure and irreversible kidney damage after an overdose with the fixed dose combination of efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla). The acute kidney injury was most probably caused by tenofovir. Efavirenz and emtricitabine seemed relatively safe in overdose. The pharmacokinetics in overdose of all three drugs and the effect of hemodialysis on the tenofovir clearance were studied by measuring the plasma concentrations and by the use of clinical pharmacokinetic software...
February 20, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#2
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28229289/clinical-aspects-of-hantavirus-infections-in-bulgaria
#3
I Christova, M Pishmisheva, I Trifonova, N Vatev, M Stoycheva, M Tiholova, D Igova, M Baev, R Karagyaurova, U Prokopova
BACKGROUND: Hantaviruses cause two distinct human diseases: hemorrhagic fever with renal syndrome (HFRS) in Asia and Europe and hantavirus pulmonary syndrome (HPS) in America. In Europe, mainly Puumala, Dobrava and Seoul viruses cause HFRS. A total of 23 cases of HFRS were detected in Bulgaria over a 2‑year period 2013-2014. The aim of the study was to present epidemiology, clinical manifestations and laboratory findings of these patients. METHODS: Patients with HFRS were diagnosed using PCR, ELISA and immunoblotting tests...
February 22, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28228889/application-of-hong-s-technique-for-removal-of-stuck-hemodialysis-tunneled-catheter-to-pacemaker-leads
#4
Chaudhry Adeel Ebad, Stephen Davitt, Ramal Gnanasekaran, Amjad Khan, Anne-Marie Moran
The term "stuck catheter" refers to situations where a central venous catheter cannot be removed from the central veins or right atrium using standard technique, usually due to development of a fibrin sheath leading to adherence to SVC or right atrial wall. Endoluminal dilatation is an interventional radiology technique that has been previously reported in the removal of stuck hemodialysis catheters, and to the best of our knowledge, this case describes the first application of the technique to remove a hemodialysis catheter that was adherent to SVC wall and transvenous pacemaker leads...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228795/bone-scintigraphy-of-severe-hypercalcemia-following-simvastatin-induced-rhabdomyolysis
#5
Zubair B Mirza, Sophia Hu, Louis F Amorosa
Simvastatin induced rhabdomyolysis with renal failure is a well reported clinical entity with hyperkalemia recognized as a life threatening risk. The risk of delayed hypercalcemia during the recovery of renal function is not well appreciated as this varies in severity and can be caused by multiple mechanisms. We present a patient with high dose simvastatin induced rhabdomyolysis leading to late onset of severe hypercalcemia due to calcium phosphate deposition in muscles diagnosed by distinctive bone scintigraphy...
September 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28228057/intravenous-chlorothiazide-versus-enteral-metolazone-to-augment-loop-diuretic-therapy-in-the-intensive-care-unit
#6
Christopher J Michaud, Kendall C Mintus
BACKGROUND: In cases of loop diuretic resistance in the intensive care unit (ICU), recommendations for a specific second-line thiazide agent are lacking. OBJECTIVE: To compare the effects of intravenous chlorothiazide (CTZ) and enteral metolazone (MET) on urine output (UOP) when added to furosemide monotherapy therapy in critically ill adults. METHODS: This was a retrospective cohort study conducted in the medical, surgical, and cardiothoracic ICUs of a quaternary medical center...
April 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28227681/wearable-impedance-monitoring-system-for-dialysis-patients
#7
S Bonnet, A Bourgerette, S Gharbi, C Rubeck, W Arkouche, B Massot, E McAdams, A Montalibet, P Jallon, S Bonnet, A Bourgerette, S Gharbi, C Rubeck, W Arkouche, B Massot, E McAdams, A Montalibet, P Jallon, A Bourgerette, B Massot, P Jallon, C Rubeck, S Gharbi, A Montalibet, W Arkouche, S Bonnet, E McAdams
This paper describes the development and the validation of a prototype wearable miniaturized impedance monitoring system for remote monitoring in home-based dialysis patients. This device is intended to assess the hydration status of dialysis patients using calf impedance measurements. The system is based on the low-power AD8302 component. The impedance calibration procedure is described together with the Cole parameter estimation and the hydric volume estimation. Results are given on a test cell to validate the design and on preliminary calf measurements showing Cole parameter variations during hemodialysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226899/nanoporous-membrane-robustness-stability-in-small-form-factor-microfluidic-filtration-system
#8
Dean G Johnson, Sabrina Pan, Andrew Hayden, James L McGrath, Dean G Johnson, Sabrina Pan, Andrew Hayden, James L McGrath, Andrew Hayden, Sabrina Pan, Dean G Johnson, James L McGrath
The development of wearable hemodialysis (HD) devices that replace center-based HD holds the promise to improve both outcomes and quality-of-life for patients with end-stage-renal disease (ERD). A prerequisite for these devices is the development of highly efficient membranes that can achieve high toxin clearance in small footprints. The ultrathin nanoporous membrane material developed by our group is orders of magnitude more permeable than conventional HD membranes. We report on our progress making a prototype wearable dialysis unit...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226474/estimation-of-arterio-venous-access-blood-flow-in-hemodialysis-patients-using-video-image-processing-technique
#9
Fansan Zhu, Schantel Williams, Hannah Putnam, Israel Campos, Jie Ma, Camille Johnson, Franz Kappel, Peter Kotanko, Fansan Zhu, Schantel Williams, Hannah Putnam, Israel Campos, Jie Ma, Camille Johnson, Franz Kappel, Peter Kotanko, Jie Ma, Israel Campos, Peter Kotanko, Schantel Williams, Franz Kappel, Fansan Zhu, Hannah Putnam, Camille Johnson
Assessment of arterio-venous fistula (AVF) blood flow (ABF) is vital in hemodialysis (HD) patients. Currently, no non-invasive and contact-free technique is available to accurately measure ABF in routine clinical practice. In this study, we developed a novel approach using video image processing (VIP) to measure the change in optic flow in the skin. We the tested the hypothesis that the change in optical flow, expressed as the change in pixels between consecutive frames, is related to ABF. We recorded AVF videos in 40 HD patients using a digital camera and processed them by VIP technique...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226325/lung-ultrasound-in-hemodialysis-a-card-to-be-played
#10
Pierpaolo Di Nicolò, Giacomo Magnoni, Antonio Granata
The end-stage renal disease is characterized by a profound impairment in the regulation of body fluid distribution, and volume assessment in hemodialysis is one of the challenging goals for the nephrologist. To determine a state of euvolemia, different validated techniques have been employed and among them lung ultrasonography (LUS) has recently attracted growing attention on account of its capacity to estimate accurately extra vascular lung water and to detect lung edema even in its early asymptomatic stage, that is, hidden lung congestion...
February 23, 2017: Blood Purification
https://www.readbyqxmd.com/read/28226039/educational-nursing-intervention-to-reduce-the-hyperphosphatemia-in-patients-on-hemodialysis
#11
Eniva Miladi Fernandes Stumm, Rosane Maria Kirchner, Laura de Azevedo Guido, Eliane Raquel Rieth Benetti, Angélica Gonçalves Silva Belasco, Ricardo de Castro Cintra Sesso, Dulce Aparecida Barbosa
Objective: to evaluate the effectiveness of an educational nursing intervention to reduce hyperphosphataemia in chronic renal patients on hemodialysis. Method: quasi-experimental study with 63 hyperphosphatemic patients on hemodialysis. The intervention consisted of developing and providing a printed and illustrated manual to patients containing information on disease control. The participant was asked to complete a daily checklist with the aim to reinforce aspects provided in the manual...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28224036/clinical-results-of-biologic-prosthesis-a-systematic-review-and-meta-analysis-of-comparative-studies
#12
REVIEW
Chumpon Wilasrusmee, Boonying Siribumrungwong, Suthas Horsirimanont, Napaphat Poprom, Jakrapan Jirasiritham, Ammarin Thakkinstian
BACKGROUND: Biologic prosthesis (BP) has been reported as a safe alternative to polytetrafluoroethylene (PTFE) in vascular reconstruction. However, efficacy of BP remains controversial. We, therefore, conducted a systematic review to summarize previous available evidences comparing the BP and PTFE in terms of clinical outcomes. MATERIALS AND METHODS: A literature search of the MEDLINE and Scopus was performed to identify comparative studies reporting outcomes of BP, PTFE, and/or autologous veins graft (VG) in vascular access for hemodialysis or femoropopliteal bypass...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28223837/efficacy-of-low-dose-cinacalcet-on-alternate-days-for-the-treatment-of-secondary-hyperparathyroidism-in-hemodialysis-patients-a-single-center-study
#13
Pongsathorn Gojaseni, Dolnapa Pattarathitinan, Anutra Chittinandana
INTRODUCTION: Cinacalcet is effective in reducing serum parathyroid hormone (PTH) in patients with secondary hyperparathyroidism (HPT). This study focused on testing whether a prescription of low-dose cinacalcet on alternate days could be an option for treatment of secondary HPT. MATERIALS AND METHODS: A retrospective clinical study was conducted on chronic maintenance hemodialysis patients. Patients with secondary HPT who received cinacalcet at a starting dose of 25 mg on alternate days were reviewed (low-dose group)...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28223836/dyslipidemia-in-patients-with-chronic-kidney-disease-etiology-and-management
#14
REVIEW
Ivana Mikolasevic, Marta Žutelija, Vojko Mavrinac, Lidija Orlic
Patients with chronic kidney disease (CKD), including those with end-stage renal disease, treated with dialysis, or renal transplant recipients have an increased risk for cardiovascular disease (CVD) morbidity and mortality. Dyslipidemia, often present in this patient population, is an important risk factor for CVD development. Specific quantitative and qualitative changes are seen at different stages of renal impairment and are associated with the degree of glomerular filtration rate declining. Patients with non-dialysis-dependent CKD have low high-density lipoproteins (HDL), normal or low total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol, increased triglycerides as well as increased apolipoprotein B (apoB), lipoprotein(a) (Lp (a)), intermediate- and very-low-density lipoprotein (IDL, VLDL; "remnant particles"), and small dense LDL particles...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#15
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28223289/when-all-you-have-is-a-hammer-the-need-for-tools-to-define-and-apply-patient-centered-outcomes-in-hemodialysis
#16
EDITORIAL
C Barrett Bowling, Laura C Plantinga
No abstract text is available yet for this article.
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28223040/red-blood-cell-exchange-as-an-approach-for-treating-a-case-of-severe-tacrolimus-overexposure
#17
Valentina Spallanzani, Lucia Bindi, Irene Bianco, Arianna Precisi, Paolo DeSimone, Alessandro Mazzoni, Gianni Biancofiore
Immunosuppressive medication dosing errors are not unfrequent and may present a number of challenges to transplant clinicians. Tacrolimus (TAC) is a widely used immunosuppressant with a narrow therapeutic index and potential severe side effects, including neurotoxicity and kidney injury. We herein report a case of 60-year-old woman who underwent deceased-donor liver transplantation at our center and due to inadvertent TAC overexposure was admitted to the Intensive Care Unit because of severe neurologic impairment, kidney injury and arterial hypotension...
February 2, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28223004/sudden-cardiac-death-among-hemodialysis-patients
#18
Melissa S Makar, Patrick H Pun
Hemodialysis patients carry a large burden of cardiovascular disease; most onerous is the high risk for sudden cardiac death. Defining sudden cardiac death among hemodialysis patients and understanding its pathogenesis are challenging, but inferences from the existing literature reveal differences between sudden cardiac death among hemodialysis patients and the general population. Vascular calcifications and left ventricular hypertrophy may play a role in the pathophysiology of sudden cardiac death, whereas traditional cardiovascular risk factors seem to have a more muted effect...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28223003/treatment-of-metformin-intoxication-complicated-by-lactic-acidosis-and-acute-kidney-injury-the-role-of-prolonged-intermittent-hemodialysis
#19
Giuseppe Regolisti, Riccardo Antoniotti, Filippo Fani, Paolo Greco, Enrico Fiaccadori
Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#20
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
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