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timing of renal replacement therapy

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https://www.readbyqxmd.com/read/28817669/the-association-between-renal-recovery-after-acute-kidney-injury-and-long-term-mortality-after-transcatheter-aortic-valve-replacement
#1
Charat Thongprayoon, Wisit Cheungpasitporn, Narat Srivali, Wonngarm Kittanamongkolchai, Ankit Sakhuja, Kevin L Greason, Kianoush B Kashani
BACKGROUND: This study aimed to examine the association between renal recovery status at hospital discharge after acute kidney injury (AKI) and long-term mortality following transcatheter aortic valve replacement (TAVR). METHODS: We screened all adult patients who survived to hospital discharge after TAVR for aortic stenosis at a quaternary referral medical center from January 1, 2008, through June 30, 2014. An AKI was defined as an increase in serum creatinine level of 0...
2017: PloS One
https://www.readbyqxmd.com/read/28816298/-multiple-endoscopy-for-the-treatment-of-upper-urinary-tract-calculi-following-ileal-conduit-a-case-report-and-literature-review
#2
B Wang, J F Ye, L Zhao, H Bi, J Lu, L L Ma
Upper urinary tract calculi with infection is a quite difficult acute urologic emergency. And what is more, upper urinary tract obstruction after radical cystectomy following urinary diversion may be fatal in the vulnerable patients with this kind of situation. Postoperative anatomy and other factors affect the upper urinary tract calculi, and urinary tract infection greatly increased the risk. But it is particularly difficult to handle with patients with poor general condition and septic shock treatment, so how to optimize the selection program is worth further studying...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28811533/plasma-metabolomics-profiling-of-maintenance-hemodialysis-based-on-capillary-electrophoresis-time-of-flight-mass-spectrometry
#3
Shuxin Liu, Lichao Wang, Chunxiu Hu, Xin Huang, Hong Liu, Qiuhui Xuan, Xiaohui Lin, Xiaojun Peng, Xin Lu, Ming Chang, Guowang Xu
Uremia has been a rapidly increasing health problem in China. Hemodialysis (HD) is the main renal replacement therapy for uremia. The results of large-scale clinical trials have shown that the HD pattern is crucial for long-term prognosis of maintenance hemodialysis (MHD) in uremic patients. Plasma metabolism is very important for revealing the biological insights linked to the therapeutic effects of the HD pattern on uremia. Alteration of plasma metabolites in uremic patients in response to HD therapy has been reported...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28803033/the-risk-of-tumour-recurrence-in-patients-undergoing-renal-transplantation-for-end-stage-renal-disease-after-previous-treatment-for-a-urological-cancer-a-systematic-review
#4
REVIEW
Romain Boissier, Vital Hevia, Harman Max Bruins, Klemens Budde, Arnaldo Figueiredo, Enrique Lledó-García, Jonathon Olsburgh, Heinz Regele, Claire Fraser Taylor, Rhana Hassan Zakri, Cathy Yuhong Yuan, Alberto Breda
CONTEXT: Renal transplantation is the gold standard renal replacement therapy in end-stage renal disease owing to its superior survival and quality of life compared with dialysis. When the potential recipient has a history of cancer, the waiting period before radiotherapy is usually based on the Cincinnati Registry. OBJECTIVE: To systematically review all available evidence on the risk of cancer recurrence in end-stage renal disease patients with a history of urological cancer...
August 9, 2017: European Urology
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#5
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28797896/predictors-of-mortality-in-adults-with-sickle-cell-disease-admitted-to-intensive-care-unit-in-bahrain
#6
Sana Abdulaaziz Al Khawaja, Zainab Mahdi Ateya, Ridha Abdulla Al Hammam
OBJECTIVE: Sickle cell disease (SCD) is one of the most common genetic blood disorders in Bahrain. However, there is a paucity of data regarding the clinical presentation of SCD patients who require ICU admission. This study aimed to describe the epidemiological data of SCD patients admitted to the ICU and to identify predictors of mortality in order to help intensivists identify patients at most risk. METHOD: This study used a retrospective, descriptive, and correlational design...
July 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28794844/a-case-series-on-simultaneous-liver-and-kidney-transplantation-do-we-need-intraoperative-renal-replacement-therapy
#7
Wongook Wi, Tae Soo Hahm, Gaab-Soo Kim
Since the implementation of the model for end-stage liver disease (MELD) scoring system in 2002, the liver transplantation (LT) society has observed a substantial increase in the number of recipients with renal dysfunction. Intraoperative renal replacement therapy (ioRRT) has emerged as one of the solutions available to manage high-MELD score recipients; however, its usefulness has not yet been proven. To date, we have experienced five cases of simultaneous liver and kidney transplantation (SLKT). Recipients of SLKT tend to have a lower pre-transplant kidney function and the longer operation time mandates a larger amount of fluid than LT alone...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#8
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
https://www.readbyqxmd.com/read/28792165/acute-stylet-peritoneal-dialysis-in-acute-kidney-injury-the-soul-never-dies
#9
Amith Vijay Leon D'Souza, Nishad Raveendran, Rajendra Singh Tanwar, Piyush Kimmatkar, Pankaj Beniwal, Dhananjai Agarwal, Vinay Vinay
BACKGROUND: Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28761233/measured-glomerular-filtration-rate-at-dialysis-initiation-and-clinical-outcomes-of-indian-peritoneal-dialysis-patients
#10
N Prasad, M R Patel, A Chandra, D Rangaswamy, A Sinha, D Bhadauria, R K Sharma, A Kaul, A Gupta
The optimal time for dialysis initiation remains controversial. Studies have failed to show better outcomes with early initiation of hemodialysis; even a few had shown increased adverse outcomes including poorer survival. Few studies have examined the same in patients on peritoneal dialysis (PD). Measured glomerular filtration rate (mGFR) not creatinine-based estimated GFR is recommended as the measure of kidney function in end-stage renal disease (ESRD) patients. The objective of this observational study was to compare the outcomes of Indian patients initiated on PD with different residual renal function (RRF) as measured by 24-h urinary clearance method...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28751432/severe-hypokalaemia-as-a-cause-of-acute-transient-quadriparesis
#11
Martin Bell Lybecker, Henrik Bjørnsgaard Madsen, Jens Meldgaard Bruun
Hypokalaemic paralysis covers a heterogeneous group of disorders caused either by an enhanced shift of potassium into the cells or following a significant renal or gastrointestinal loss of potassium. We present the case of a 48-year-old Caucasian man with paralysis of both upper and lower extremities. ECG showed sinus rhythm and characteristic changes of hypokalaemia with depression of the ST segment, prolonged QTc interval of 581ms and U waves seen as a small positive deflection at the T wave in the middle precordial leads...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28748886/clinical-and-histological-correlation-of-diabetic-nephropathy
#12
Tameem Afroz, Radha Sagar, Sandeep Reddy, Sridhar Gandhe, K G Rajaram
Renal failure in diabetes is a common cause of renal replacement therapy. The affected kidney goes through various changes in all compartments progressively. The classification of diabetic nephropathy is based on glomerular lesions and displays a heterogeneous morphology. Abnormalities in tubulointerstitial and vascular compartments are important in assessing the outcome of these patients. We applied the new pathologic classification of diabetic nephropathy by Tervaert et al to classify the renal damage in diabetes...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28745687/-nephrological-aspects-of-complement-mediated-thrombotic-microangiopathy
#13
A V Smirnov, A V Karunnaya, V A Dobronravov
AIM: To analyze cases of complement-mediated thrombotic microangiopathy (C-TMA) in the daily practice of a hospital nephrology department, relative to the general aspects of the clinical course, therapy, and short-term outcomes. SUBJECTS AND METHODS: The prospective study conducted in the period June 1, 2015 to June 1, 2016 included 10 patients with C-TMA newly diagnosed during hospitalization. Standard demographic parameters, generally accepted clinical data showing the severity of TMA and the involvement of vital organs were recorded at admission...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28743566/mortality-prediction-in-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-after-cardiac-surgery
#14
Inga Skarupskienė, Dalia Adukauskienė, Jurgita Kuzminskienė, Laima Rimkutė, Vilma Balčiuvienė, Edita Žiginskienė, Vytautas Kuzminskis, Agnė Adukauskaitė, Daiva Pentiokinienė, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. MATERIALS AND METHODS: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT...
July 14, 2017: Medicina
https://www.readbyqxmd.com/read/28730555/intermittent-versus-continuous-renal-replacement-therapy-in-acute-methanol-poisoning-comparison-of-clinical-effectiveness-in-mass-poisoning-outbreaks
#15
Sergey Zakharov, Jan Rulisek, Olga Nurieva, Katerina Kotikova, Tomas Navratil, Martin Komarc, Daniela Pelclova, Knut Erik Hovda
BACKGROUND: Intermittent hemodialysis (IHD) is the modality of choice in the extracorporeal treatment (ECTR) of acute methanol poisoning. However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown. During an outbreak of mass methanol poisoning, we therefore studied the effect of IHD versus CRRT on mortality and the prevalence of visual/central nervous system (CNS) sequelae in survivors. METHODS: The study was designed as prospective observational cohort study...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28729905/an69st-membranes-adsorb-nafamostat-mesylate-and-affect-the-management-of-anticoagulant-therapy-a-retrospective-study
#16
Takahiro Hirayama, Nobuyuki Nosaka, Yasumasa Okawa, Soichiro Ushio, Yoshihisa Kitamura, Toshiaki Sendo, Toyomu Ugawa, Atsunori Nakao
BACKGROUND: In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the management of anticoagulant therapy. However, the adsorbed amount has not yet been quantitatively assessed. Therefore, in this study, we evaluated the pre- and post-hemofilter prolongation of the activated clotting time (ACT) in patients with AN69ST and PS membranes. We also measured the adsorption of NM in three types of CRRT membranes using an experimental model...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28729034/prolonged-renal-survival-in-light-chain-amyloidosis-speed-and-magnitude-of-light-chain-reduction-is-the-crucial-factor
#17
Tamer Rezk, Helen J Lachmann, Marianna Fontana, Sajitha Sachchithanantham, Shameem Mahmood, Aviva Petrie, Carol J Whelan, Jennifer H Pinney, Darren Foard, Thirusha Lane, Taryn Youngstein, Ashutosh D Wechalekar, Paul Bass, Philip N Hawkins, Julian D Gillmore
Renal involvement causing progressive chronic kidney disease (CKD) is present in 70% of patients with systemic Ig light-chain (AL) amyloidosis at diagnosis. Chemotherapy that substantially suppresses free light chain production is associated with improved patient survival, but its benefit in delaying the onset of renal replacement therapy among patients who present with established advanced CKD has not been studied. To evaluate this, we studied 1000 patients enrolled in the prospective UK AL amyloidosis chemotherapy study (ALchemy)...
July 17, 2017: Kidney International
https://www.readbyqxmd.com/read/28723748/clinical-characteristics-and-mutation-spectrum-of-gla-in-korean-patients-with-fabry-disease-by-a-nationwide-survey-underdiagnosis-of-late-onset-phenotype
#18
Jin-Ho Choi, Beom Hee Lee, Sun Hee Heo, Gu-Hwan Kim, Yoo-Mi Kim, Dae-Seong Kim, Jung Min Ko, Young Bae Sohn, Yong Hee Hong, Dong-Hwan Lee, Hoon Kook, Han Hyuk Lim, Kyung Hee Kim, Woo-Shik Kim, Geu-Ru Hong, Su-Hyun Kim, Sang Hyun Park, Chan-Duck Kim, So Mi Kim, Jeong-Sook Seo, Han-Wook Yoo
Fabry disease is a rare X-linked lysosomal storage disorder caused by an α-galactosidase A deficiency. The progressive accumulation of globotriaosylceramide (GL-3) results in life-threatening complications, including renal, cardiac, and cerebrovascular diseases. This study investigated the phenotypic and molecular spectra of GLA mutations in Korean patients with Fabry disease using a nationwide survey.This study included 94 patients from 46 independent pedigrees: 38 adult males, 46 symptomatic females, and 10 pediatric males...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28717377/appropriate-blood-component-therapy-can-reduce-postcardiac-surgery-acute-kidney-injury-through-packed-cell-transfusion-reduction
#19
Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Gholam Reza Massoumi
BACKGROUND: Acute kidney injury (AKI) can happen due to different factors such as anemia. Packed cell (PC) transfusion is an important cause of AKI occurrence. The aim of the study is to investigate whether appropriate blood component (BC) therapy can reduce blood transfusion and it would result in AKI decreasing. MATERIALS AND METHODS: We conducted a cohort study of 1388 patients who underwent cardiac surgery in one university hospital. A serum creatinine higher than 2 mg/dl, renal disease history, renal replacement therapy (chronic dialysis) were our exclusion criteria...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28709919/morbidity-after-cardiac-surgery-in-patients-with-adult-congenital-heart-disease-in-comparison-with-acquired-disease
#20
Dimos Karangelis, Amine Mazine, Sreekanth Narsupalli, Shamarli Mendis, Gruschen Veldtman, Nicolas Nikolaidis
BACKGROUND: Due to the advancements in congenital cardiac surgery and interventional cardiology in the last five decades, more than 85% of congenital heart patients now survive to adulthood. METHODS: This retrospective study included 135 Adult Congenital Heart Disease (ACHD) patients, who had cardiac surgery at Southampton General Hospital over three consecutive years. We also included 42 patients with a structurally normal heart who had cardiac surgery for acquired cardiac conditions as a control group...
June 28, 2017: Heart, Lung & Circulation
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