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https://www.readbyqxmd.com/read/29688442/impact-of-residual-kidney-function-on-hemodialysis-adequacy-and-patient-survival
#1
Mengjing Wang, Yoshitsugu Obi, Elani Streja, Connie M Rhee, Jing Chen, Chuanming Hao, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
Background: Both dialysis dose and residual kidney function (RKF) contribute to solute clearance and are associated with outcomes in hemodialysis patients. We hypothesized that the association between dialysis dose and mortality is attenuated with greater RKF. Methods: Among 32 251 incident hemodialysis patients in a large US dialysis organization (2007-11), we examined the interaction between single-pool Kt/V (spKt/V) and renal urea clearance (rCLurea) levels in survival analyses using multivariable Cox proportional hazards regression model...
April 23, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29594137/artificial-intelligence-for-the-artificial-kidney-pointers-to-the-future-of-a-personalized-hemodialysis-therapy
#2
REVIEW
Miguel Hueso, Alfredo Vellido, Nuria Montero, Carlo Barbieri, Rosa Ramos, Manuel Angoso, Josep Maria Cruzado, Anders Jonsson
Background: Current dialysis devices are not able to react when unexpected changes occur during dialysis treatment or to learn about experience for therapy personalization. Furthermore, great efforts are dedicated to develop miniaturized artificial kidneys to achieve a continuous and personalized dialysis therapy, in order to improve the patient's quality of life. These innovative dialysis devices will require a real-time monitoring of equipment alarms, dialysis parameters, and patient-related data to ensure patient safety and to allow instantaneous changes of the dialysis prescription for the assessment of their adequacy...
February 2018: Kidney Diseases
https://www.readbyqxmd.com/read/29529914/percutaneous-transluminal-angioplasty-for-central-venous-stenosis-or-occlusion-in-hemodialysis-patients
#3
Yuki Horita
The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29417389/vocational-activity-and-health-insurance-type-among-patients-with-end-stage-renal-disease-association-with-outcomes
#4
Jiacong Luo, Andrew Lee, Dena E Cohen, Carey Colson, Steven M Brunelli
It is widely thought that patients with end-stage renal disease who remain vocationally active and/or commercially insured following dialysis initiation have better clinical outcomes and higher quality of life than those who do not. However, scientifically robust data are lacking. Here, we examined whether vocational status (active, N = 1848; inactive, N = 10,001) and, separately, insurance status (commercial, N = 4858; Medicare/self-pay, N = 13,329; Medicaid, N = 3528) were associated with clinical outcomes and Kidney Disease Quality of Life (KDQOL) scores among a cohort of patients who initiated dialysis at a large US dialysis organization during 2015-2016...
February 7, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29405139/microbiology-clinical-spectrum-and-outcome-of-peritonitis-in-patients-undergoing-peritoneal-dialysis-in-india-results-from-a-multicentric-observational-study
#5
Georgi Abraham, Amit Gupta, Kashi Nath Prasad, Anusha Rohit, Anil Kumar Bhalla, Vishwanath Billa, Rajasekhar Chakravati, Tonmoy Das, Thadakanathan Dhinakaran, Arup Ratan Dutta, Padmanabhan Giri, Tarun Jeloka, Sampath Kumar, Ajay Marwaha, Radha Vijay Raghavan, Rajan Ravichandran, Roshan Rohit, Chandra Nath Sarkar, Naorem Sharat Kumar Singh
BACKGROUND: Peritoneal dialysis (PD)-related peritonitis is a major risk factor for drop out of patients on continuous ambulatory PD (CAPD) and automated PD (APD). Factors affecting PD-related peritonitis and centre-specific microbiological data are lacking in India. A multicentric prospective observational study was designed to overcome the gaps in the existing data regarding causative organism and outcome. METHODOLOGY: The present study was a prospective, uncontrolled, open-label; observational study conducted in 21 centres representing all the four geographical regions (North, South, East and West) of India between April 2010 and December 2011...
October 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29356335/pediatric-patient-with-end-stage-kidney-disease-secondary-to-eagle-barrett-syndrome-and-metastatic-unresectable-hepatoblastoma-treated-successfully-with-chemotherapy-and-liver-kidney-transplant
#6
Daniel Ortiz, Avis Harden, Fernando F Corrales-Medina, Gaurav Saigal, Akin Tekin, Jennifer Garcia
HBL is the most common malignant liver neoplasm in children. The etiology of HBL is largely unknown but there are certain syndromes, such as Beckwith-Wiedemann syndrome, that have been clearly associated with an increased incidence of this malignancy. EBS, also known as prune belly syndrome, is a congenital anomaly characterized by lax abdominal musculature, bilateral cryptorchidism requiring, in some cases, hemodialysis due to significant kidney and urinary tract dysfunctions. Despite an improvement on the survival rates of patients with advanced-stage HBL, the presence of concomitant end-stage renal disease that occurs in patients with EBS constitutes a therapeutic challenge for the clinician not only due to the use of nephrotoxic chemotherapy but also due to the potential need for multi-organ transplant...
March 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29315693/nacseld-acute-on-chronic-liver-failure-nacseld-aclf-score-predicts-30-day-survival-in-hospitalized-patients-with-cirrhosis
#7
Jacqueline G O'Leary, K Rajender Reddy, Guadalupe Garcia-Tsao, Scott W Biggins, Florence Wong, Michael B Fallon, Ram M Subramanian, Patrick S Kamath, Paul Thuluvath, Hugo E Vargas, Benedict Maliakkal, Puneeta Tandon, Jennifer Lai, Leroy R Thacker, Jasmohan S Bajaj
The North American Consortium for the Study of End-Stage Liver Disease's definition of acute-on-chronic liver failure (NACSELD-ACLF) as two or more extrahepatic organ failures has been proposed as a simple bedside tool to assess the risk of mortality in hospitalized patients with cirrhosis. We validated the NACSELD-ACLF's ability to predict 30-day survival (defined as in-hospital death or hospice discharge) in a separate multicenter prospectively enrolled cohort of both infected and uninfected hospitalized patients with cirrhosis...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29241184/peritonitis-in-children-on-chronic-peritoneal-dialysis-the-experience-of-a-large-national-pediatric-cohort
#8
Daniela Ponce, Thyago Proença de Moraes, Roberto Pecoits-Filho, Ana Elizabeth Figueiredo, Pasqual Barretti
BACKGROUND: We performed this study to evaluate the incidence, risk factors, microbiology, treatment, and outcome of peritonitis in pediatric Peritoneal dialysis (PD) patients at a nationwide prospective study. METHODOLOGY: Patients younger than 18 years recruited in the BRAZPD II study from 2004 to 2011, who presented their first peritonitis episode, were included in the study. RESULTS: We found 125 first episodes of peritonitis in 491 children PD patients (0...
December 14, 2017: Blood Purification
https://www.readbyqxmd.com/read/29223620/impact-of-obesity-on-modality-longevity-residual-kidney-function-peritonitis-and-survival-among-incident-peritoneal-dialysis-patients
#9
Yoshitsugu Obi, Elani Streja, Rajnish Mehrotra, Matthew B Rivara, Connie M Rhee, Melissa Soohoo, Daniel L Gillen, Wei-Ling Lau, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: The prevalence of severe obesity, often considered a contraindication to peritoneal dialysis (PD), has increased over time. However, mortality has decreased more rapidly in the PD population than the hemodialysis (HD) population in the United States. The association between obesity and clinical outcomes among patients with end-stage kidney disease remains unclear in the current era. STUDY DESIGN: Historical cohort study. SETTING & PARTICIPANTS: 15,573 incident PD patients from a large US dialysis organization (2007-2011)...
December 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29221626/effects-of-oral-nutritional-supplements-on-mortality-missed-dialysis-treatments-and-nutritional-markers-in-hemodialysis-patients
#10
Debbie Benner, Steven M Brunelli, Becky Brosch, Jane Wheeler, Allen R Nissenson
OBJECTIVE: Protein-energy wasting is common in end-stage renal disease patients undergoing dialysis and is strongly associated with mortality and adverse outcomes. Intradialytic oral nutritional supplements (ONS) reduce risk of mortality in these patients. Large studies characterizing the impact of ONS on other outcomes are lacking. We assessed the associations between administration of ONS and clinical and nutritional outcomes. DESIGN: Retrospective evaluation of a pilot program providing ONS to patients at a large dialysis organization in the United States...
December 6, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29173691/clinical-outcomes-and-survival-in-aa-amyloidosis-patients
#11
Yavuz Ayar, Alparslan Ersoy, Mustafa Ferhat Oksuz, Gokhan Ocakoglu, Berna Aytac Vuruskan, Abdülmecit Yildiz, Emel Isiktas, Aysegül Oruc, Sedat Celikci, Ismail Arslan, Ahmet Bilgehan Sahin, Mustafa Güllülü
AIM: Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. METHODS: A total of 81 patients (51 males, 30 females) with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results...
November 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/29142964/impact-of-the-end-stage-renal-disease-prospective-payment-system-on-the-use-of-peritoneal-dialysis
#12
Qian Zhang, Mae Thamer, Onkar Kshirsagar, Yi Zhang
Introduction: The End Stage Renal Disease (ESRD) Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services in January 2011, encouraged use of peritoneal dialysis (PD) through various financial incentives. Our goal was to determine whether PPS effectively increased PD use in incident dialysis patients. Methods: Our study used the United States Renal Data System (USRDS) to identify 430,927 adult patients who initiated dialysis between 2009 and 2012...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29130984/lymphocyte-cell-ratios-and-mortality-among-incident-hemodialysis-patients
#13
Christina Catabay, Yoshitsugu Obi, Elani Streja, Melissa Soohoo, Christina Park, Connie M Rhee, Csaba P Kovesdy, Takayuki Hamano, Kamyar Kalantar-Zadeh
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been previously suggested as oncologic prognostication markers. These are associated with malnutrition and inflammation, and hence, may provide benefit in predicting mortality among hemodialysis patients. METHODS: Among 108,548 incident hemodialysis patients in a large U.S. dialysis organization (2007-2011), we compared the mortality predictability of NLR and PLR with baseline and time-varying covariate Cox models using the receiver operating characteristic curve (AUROC), net reclassification index (NRI), and adjusted R2...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29077786/intradialytic-hypertension-frequency-and-short-term-clinical-outcomes-among-individuals-receiving-maintenance-hemodialysis
#14
Magdalene M Assimon, Lily Wang, Jennifer E Flythe
BACKGROUND: Intradialytic hypertension occurs in 5-20% of hemodialysis treatments. Observational data support an association between intradialytic hypertension and long-term mortality. However, the short-term consequences of recurrent intradialytic hypertension are unknown. METHODS: Data were taken from a cohort of prevalent hemodialysis patients receiving treatment at a large United States dialysis organization on 1 January 2010. A retrospective cohort design with a 180-day baseline, 30-day exposure assessment, and 30-day follow-up period was used to estimate the associations between intradialytic hypertension frequency and 30-day outcomes...
February 9, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29057097/a-short-discourse-on-vascular-tissue-engineering
#15
William G Chang, Laura E Niklason
Vascular tissue engineering has significant potential to make a major impact on a wide array of clinical problems. Continued progress in understanding basic vascular biology will be invaluable in making further advancements. Past and current achievements in tissue engineering of microvasculature to perfuse organ specific constructs, small vessels for dialysis grafts, and modified synthetic and pediatric large caliber-vessel grafts will be discussed. An emphasis will be placed on clinical trial results with small and large-caliber vessel grafts...
2017: NPJ Regenerative Medicine
https://www.readbyqxmd.com/read/28992343/serum-to-dialysate-potassium-gradient-and-its-association-with-short-term-outcomes-in-hemodialysis-patients
#16
Steven M Brunelli, David M Spiegel, Charles Du Mond, Nina Oestreicher, Wolfgang C Winkelmayer, Csaba P Kovesdy
Background: A high serum-to-dialysate potassium (K + ) gradient at the start of dialysis leads to rapid lowering of serum K + and may confer a greater risk of adverse events. Here, we examined the near-term association of K + gradient with clinical outcomes. Methods: This retrospective (2010-11) event-based study considered 830 741 patient-intervals, each defined by a pre-dialysis measurement of serum K + made among adult Medicare Parts A and B enrollees who received in-center hemodialysis on a Monday/Wednesday/Friday schedule at a large US dialysis organization...
August 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28915253/persistence-of-marine-fish-environmental-dna-and-the-influence-of-sunlight
#17
Elizabeth A Andruszkiewicz, Lauren M Sassoubre, Alexandria B Boehm
Harnessing information encoded in environmental DNA (eDNA) in marine waters has the potential to revolutionize marine biomonitoring. Whether using organism-specific quantitative PCR assays or metabarcoding in conjunction with amplicon sequencing, scientists have illustrated that realistic organism censuses can be inferred from eDNA. The next step is establishing ways to link information obtained from eDNA analyses to actual organism abundance. This is only possible by understanding the processes that control eDNA concentrations...
2017: PloS One
https://www.readbyqxmd.com/read/28910802/effects-of-expanded-hemodialysis-therapy-on-clinical-outcomes
#18
Sandip Mitra, Kunaal Kharbanda
The invention of dialysis has been a phenomenal advance in the treatment of kidney failure. The introduction of artificial kidneys in clinical care remains one of the most successful lifesaving interventions in modern medicine. Its glory, however, has been tempered by poor long-term outcomes and a negative qualitative impact on the lives of patients who suffer from an extremely complex, burdensome, and restricted life on dialysis. There remains a huge gap in patient well-being and outcomes between artificial kidney treatments and kidney transplantation...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28905254/use-of-eculizumab-in-a-systemic-lupus-erythemathosus-patient-presenting-thrombotic-microangiopathy-and-heterozygous-deletion-in-cfhr1-cfhr3-a-case-report-and-systematic-review
#19
REVIEW
Maria Izabel de Holanda, Luis Cristóvão Pôrto, Teresa Wagner, Luis Fernando Christiani, Lilian M P Palma
The association of thrombotic microangiopathy (TMA) with systemic lupus erythematosus (SLE) has been described in 0.5 to 10% of cases, and patients present worse outcome. TMA is described as the association of microangiopathic hemolytic anemia, thrombocytopenia, and an organ injury, frequently the kidney. This study describes a successful case of use of eculizumab in a patient with SLE and TMA refractory to standard therapy, and provides a literature review. Case description and search in PubMed and MEDLINE using systemic lupus erythemathous and/or antiphospholipid syndrome (APS) and eculizumab retrieved 15 case reports...
December 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28893419/telenephrology-current-perspectives-and-future-directions
#20
Rajeev Rohatgi, Michael J Ross, Sandawana W Majoni
There is increasing interest in telemedicine among physicians and patients; however, the evidence regarding the quality of care delivered by telemedicine, and telenephrology in particular, compared with in-person care is limited. In this review, different electronic modalities used to deliver nephrology care are reviewed and critiqued, with a focused analysis from the Australian and United States perspectives. Both countries are geographically expansive with significant rural populations where access to nephrology care is limited...
December 2017: Kidney International
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