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https://www.readbyqxmd.com/read/28226899/nanoporous-membrane-robustness-stability-in-small-form-factor-microfluidic-filtration-system
#1
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/28225832/elevated-bilirubin-levels-are-associated-with-a-better-renal-prognosis-and-ameliorate-kidney-fibrosis
#2
Sehoon Park, Do Hyoung Kim, Jin Ho Hwang, Yong-Chul Kim, Jin Hyuk Kim, Chun Soo Lim, Yon Su Kim, Seung Hee Yang, Jung Pyo Lee
BACKGROUND: Bilirubin has been reported to protect against kidney injury. However, further studies highlighting the beneficial effects of bilirubin on renal fibrosis and chronic renal function decline are necessary. METHODS: We assessed a prospective cohort with a reference range of total bilirubin levels. The primary outcome was a 30% reduction in the estimated glomerular filtration rate (eGFR) from baseline, and the secondary outcome was a doubling of the serum creatinine levels, halving of the eGFR and the initiation of dialysis...
2017: PloS One
https://www.readbyqxmd.com/read/28224937/telehealth-in-the-delivery-of-home-dialysis-care-catching-up-with-technology
#3
REVIEW
Vinay N Krishna, Kamesha Managadi, Michael Smith, Eric Wallace
Geographic and socioeconomic barriers may pose a significant difficulty in delivering home dialysis care to remote underserved populations leading to low utilization rates and poor outcomes. Telehealth may serve as a solution to overcome geographic barriers in delivering home dialysis care. Although technologic advances in telehealth have progressed rapidly making it accessible and inexpensive, it has been underused by nephrologists. Components of a regular face-to-face visit that can be successfully accomplished remotely using telehealth techniques include physician-patient communication, physical examination, laboratory and treatment data monitoring, nursing and nutrition education...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28223836/dyslipidemia-in-patients-with-chronic-kidney-disease-etiology-and-management
#4
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
#5
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/28222990/establishing-patient-specific-criteria-for-selecting-the-optimal-upper-extremity-vascular-access-procedure
#6
Karen Woo, Jesus Ulloa, Michael Allon, Christopher G Carsten, Eric S Chemla, Mitchell L Henry, Thomas S Huber, Jeffrey H Lawson, Charmaine E Lok, Eric K Peden, Larry Scher, Anton Sidawy, Melinda Maggard-Gibbons, David Cull
OBJECTIVE: The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dramatically, several reports have found that this singular focus on increasing AVFs has resulted in increased AVF nonmaturation/early failure and a high prevalence of catheter dependence...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222985/concurrent-renal-artery-stent-during-endovascular-infrarenal-aortic-aneurysm-repair-confers-higher-risk-for-30-day-acute-renal-failure
#7
Besma Nejim, Isibor Arhuidese, Muhammmad Rizwan, Lana Khalil, Satinderjit Locham, Devin Zarkowsky, Philip Goodney, Mahmoud B Malas
OBJECTIVE: Concurrent renal artery angioplasty and stenting (RAAS) during endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysm (AAA) has been practiced in an attempt to maintain renal perfusion. The aim of this study was to identify the current practice of RAAS during EVAR and its effect on perioperative renal outcome. METHODS: Patients with infrarenal AAA were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP, 2011-2014) database...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222929/magnesium-an-overlooked-electrolyte
#8
Jaya Kala, Ala Abudayyeh
BACKGROUND: Hypermagnesemia is rare and usually iatrogenic. Due to decreased renal function, older patients are generally more susceptible to hypermagnesemia than are younger patients. Because it is not one of the commonly assessed electrolytes in the blood work panel of patients, high levels are usually missed. CASE REPORT: An elderly gentleman with history of leukemia presented with complaints of shortness of breath and extreme weakness while walking. He was diagnosed with severe hypermagnesemia, but unfortunately succumbed to cardiorespiratory arrest...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28222798/fracture-risk-in-dialysis-and-kidney-transplanted-patients-a-protocol-for-systematic-review-and-meta-analysis
#9
Aboubacar Sidibé, Lynne Moore, Sonia Jean, Fabrice Mac-Way
BACKGROUND: Chronic kidney disease (CKD) is associated with an increased risk of fracture and cardiovascular mortality. The risk of fracture in hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT) is higher when compared to the general population. However, uncertainties remain about which group has the highest risk of fracture. We aim to identify the risk of fracture and cardiovascular mortality post-fracture in HD compared to PD or KT and in PD compared to KT population...
February 22, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28222688/vascular-access-conversion-and-patient-outcome-after-hemodialysis-initiation-with-a-nonfunctional-arteriovenous-access-a-prospective-registry-based-study
#10
Natalia Alencar de Pinho, Raphael Coscas, Marie Metzger, Michel Labeeuw, Carole Ayav, Christian Jacquelinet, Ziad A Massy, Bénédicte Stengel
BACKGROUND: Little is known about vascular access conversion and outcomes for patients starting hemodialysis with nonfunctional arteriovenous (AV) access. We assessed mortality risk associated with nonfunctional AV access at hemodialysis initiation, taking subsequent changes in vascular access into account. METHODS: We studied the 53,092 incident adult hemodialysis patients included in the French REIN registry from 2005 through 2012. AV access placed predialysis was considered nonfunctional when dialysis began with a central venous catheter...
February 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28222207/impact-of-the-type-of-dialysis-membranes-on-the-circulating-concentration-of-markers-of-vitamin-d-metabolism
#11
Etienne Cavalier, Pablo U Torres, Bernard E Dubois, Nicole Smelten, Hans Pottel, Jean-Marie Krzesinski, Pierre Delanaye
INTRODUCTION: Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend vitamin D supplementation in hemodialyzed patients to monitor 25(OH)-vitamin D 25(OH)D levels. However, patient-to-patient inconsistency can be observed in response to the treatment. In this study, we aimed to evaluate the impact of the dialysis membrane on 25(OH)D, albumin (Alb) and vitamin D-binding protein (VDBP), the major players of vitamin D transport and storage. MATERIAL AND METHODS: Alb (Cobas), VDBP (R&D) and 25(OH)D (liquid chromatography-tandem mass spectrometry) were measured in 75 patients before and after a 4-hour dialysis session...
February 18, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28222038/evidence-based-ethically-justified-counseling-for-fetal-bilateral-renal-agenesis
#12
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#13
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219597/combined-heart-and-kidney-transplantation-a-23-year-experience
#14
M Awad, L S C Czer, F Esmailian, S Jordan, M A De Robertis, J Mirocha, J Patel, D H Chang, M Kittleson, D Ramzy, F Arabia, J S Chung, J L Cohen, A Trento, J A Kobashigawa
BACKGROUND: We report clinical experience with combined heart and kidney transplantation (HKTx) over a 23-year time period. METHODS: From June 1992 to August 2015, we performed 83 combined HKTx procedures at our institution. We compared the more recent cohort of 53 HKTx recipients (group 2, March 2009 to August 2015) with the initial 30 previously reported HKTx recipients (group 1, June 1992 to February 2009). Pre-operative patient characteristics, peri-operative factors, and post-operative outcomes including survival were examined...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219583/risk-factors-affecting-graft-and-patient-survivals-after-transplantation-from-deceased-donors-in-a-developing-country-a-single-center-experience
#15
Y Ayar, A Ersoy, G Ocakoglu, A Yildiz, A Oruc, H Soyak, M Calapkulu, A B Sahin, N Bolca Topal, E Okeer, B Coskun, O Kaygisiz, Y Kordan, H Vuruskan
AIM: The aim of this study was to evaluate risk factors affecting graft and patient survival after transplantation from deceased donors. METHODS: We retrospectively analyzed the outcomes of 186 transplantations from deceased donors performed at our center between 2006 and 2014. The recipients were divided into two groups: Group I (141 recipients without graft loss) and Group II (45 recipients with graft loss). Kaplan-Meier, log-rank test, and Cox proportional hazard regressions were used...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28218647/diabetes-mellitus-and-younger-age-are-risk-factors-for-hyperphosphatemia-in-peritoneal-dialysis-patients
#16
Rameez Imtiaz, Steven Hawken, Brendan B McCormick, Simon Leung, Swapnil Hiremath, Deborah L Zimmerman
Hyperphosphatemia has been associated with adverse outcomes in patients with end stage kidney disease (ESKD). The purpose of this study was to determine risk factors for hyperphosphatemia in ESKD patients treated with peritoneal dialysis (PD). This information will be used to develop a patient specific phosphate binder application to facilitate patient self-management of serum phosphate. Adult PD patients documented their food, beverage, and phosphate binder intake for three days using a dietitian developed food journal...
February 17, 2017: Nutrients
https://www.readbyqxmd.com/read/28218361/arteriovenous-fistula-maturation-in-patients-with-permanent-access-created-prior-to-or-after-hemodialysis-initiation
#17
Juan C Duque, Laisel Martinez, Marwan Tabbara, Denise Dvorquez, Sushil K Mehandru, Arif Asif, Roberto I Vazquez-Padron, Loay H Salman
INTRODUCTION: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#18
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
February 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#19
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216442/a-seven-day-course-of-trimethoprim-sulfamethoxazole-may-be-as-effective-as-a-seven-day-course-of-ciprofloxacin-for-the-treatment-of-pyelonephritis
#20
Miriam T Fox, Michael T Melia, Rebecca G Same, Anna T Conley, Pranita D Tamma
INTRODUCTION: The Infectious Diseases Society of America guidelines recommend either 14 days of trimethoprim-sulfamethoxazole (TMP-SMX) or 7 days of ciprofloxacin for the treatment of pyelonephritis. Antibiotic courses of 7 days of TMP-SMX versus 7 days of ciprofloxacin for pyelonephritis have not been previously compared. We evaluated the odds of a subsequent, symptomatic urinary tract infection (UTI) for women with E. coli pyelonephritis receiving a 7-day course of TMP-SMX versus a 7-day course of ciprofloxacin...
February 16, 2017: American Journal of Medicine
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