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timing of renal replacement therapy

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https://www.readbyqxmd.com/read/29044336/the-impact-of-body-mass-index-bmi-variation-on-mortality-of-incident-elderly-patients-on-peritoneal-dialysis-a-joint-model-analysis
#1
Marcia Regina Gianotti Franco, Fernando Antonio Basile Colugnati, Abdul Rashid Qureshi, José Carolino Divino-Filho, Natália Maria Da Silva Fernandes
INTRODUCTION: Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time. METHODS: Prospective multicenter cohort study (December / 2004-October/2007) with 674 patients. Socio-demographic and clinical data evaluated with patients followed until death, transfer to hemodialysis (HD), recovery of renal function, loss of follow-up or transplant...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29039628/early-versus-late-initiation-of-renal-replacement-therapy-in-patients-with-acute-kidney-injury-a-meta-analysis-of-randomised-clinical-trials
#2
Thomas A Mavrakanas, D Ezra Aurian-Blajeni, David M Charytan
AIMS OF THE STUDY: The optimal timing of renal replacement therapy (RRT) initiation in acute kidney injury (AKI) remains a matter of debate. A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to better estimate the effects of early initiation of RRT compared with late initiation of RRT among patients with AKI and in patients at risk for AKI. METHODS: A Medline literature research was conducted in PubMed for RCTs in adult patients with AKI that compared different RRT initiation strategies (early vs late)...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29027706/regional-citrate-anticoagulation-with-calcium-replacement-in-pediatric-apheresis
#3
Katie Sigler, Ji Lee, Poyyapakkam Srivaths
PURPOSE: The objective of this retrospective analysis was to present our single-center experience with intravenous (IV) calcium replacement and regional citrate anticoagulation in pediatric apheresis therapy with the aim of developing a standard operating procedure to minimize symptomatic hypocalcemia. METHODS: We analyzed apheresis procedures in patients <18 years of age over a 2-year time period (Jan 2012 to Dec 2014). Procedures in tandem with other extracorporeal therapies, including continuous renal replacement therapy, extracorporeal liver support, and extracorporeal membrane oxygenation, were excluded...
October 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29021348/early-right-ventricular-assist-device-use-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation-incidence-and-risk-factors-from-the-interagency-registry-for-mechanically-assisted-circulatory-support
#4
Michael S Kiernan, E Wilson Grandin, Marshall Brinkley, Navin K Kapur, Duc Thinh Pham, Robin Ruthazer, J Eduardo Rame, Pavan Atluri, Edo Y Birati, Guilherme H Oliveira, Francis D Pagani, James K Kirklin, David Naftel, Robert L Kormos, Jeffrey J Teuteberg, David DeNofrio
BACKGROUND: To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. METHODS AND RESULTS: Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression...
October 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28992348/location-of-glomerular-immune-deposits-not-codeposition-of-immunoglobulin-g-influences-definitive-renal-outcomes-in-immunoglobulin-a-nephropathy
#5
Anthony S Alvarado, Nicole K Andeen, Sergey Brodsky, Alice Hinton, Tibor Nadasdy, Charles E Alpers, Christopher Blosser, Behzad Najafian, Brad H Rovin
Background: It has been suggested that the prognosis of immunoglobulin (IgA) nephropathy (IgAN) is adversely affected if there is codeposition of IgG in the glomeruli or if immune deposits are present in the glomerular capillary walls. We sought to understand how these variables affect clinical outcome. Methods: A total of 80 IgAN biopsies were retrospectively divided into groups: (i) IgA without IgG deposition versus IgA + IgG and (ii) immune deposits restricted to the mesangium versus mesangium and peripheral capillary walls (PCWs)...
August 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992218/long-term-consequences-of-renal-insufficiency-in-children-lessons-learned-from-the-dutch-leric-study
#6
Jaap W Groothoff, Martin Offringa, Martha Grootenhuis, Kitty J Jager
Few data exist on the prospects in adulthood for children on chronic renal replacement therapy (RRT). This article summarizes the results of a comprehensive Dutch long-term follow-up study performed in 2000 and 2010 of patients with RRT onset at age <15 years between 1972 and 1992. After a median of 25.5 RRT years, patients had stayed 23% of RRT time on dialysis. We observed a 30 times greater mortality risk compared with age-matched peers with cardiovascular disease (CVD) as the main cause of death during 1972-2000 and infections during 2000-10...
July 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28979782/elderly-patients-with-chronic-kidney-disease-do-they-really-need-referral-to-the-nephrology-clinic
#7
Mark McClure, Thomas Jorna, Laura Wilkinson, Joanne Taylor
INTRODUCTION: Chronic kidney disease (CKD) is becoming increasingly common, especially in the elderly. In the UK, there has been a marked increase in the awareness and detection of CKD over the last decade. This is largely attributable to the introduction of automated estimated glomerular filtration rate (eGFR) reporting and renal indicators in the primary care Quality and Outcomes Framework (QOF) initiative, both of which were introduced in 2006. These two initiatives have had a significant impact on referral patterns to renal services...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28978157/the-optimal-time-of-initiation-of-renal-replacement-therapy-in-acute-kidney-injury-a-meta-analysis
#8
Kaiping Luo, Shufang Fu, Weidong Fang, Gaosi Xu
BACKGROUND: The impact on the timing of renal replacement therapy (RRT) initiation on clinical outcomes for patients with acute kidney injury (AKI) remains controversial. MATERIALS AND METHODS: We searched the Cochrane Library, EMBASE, Global Health, MEDLINE, PubMed, the International Clinical Trials Registry Platform, and Web of Science. RESULTS: We included 49 studies involving 9698 patients. Pooled analysis of 5408 critically ill patients with AKI showed that early RRT was significantly associated with reduced mortality compared to late RRT [odds ratio (OR), 0...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28969597/the-effect-of-regional-citrate-anti-coagulation-on-the-coagulation-system-in-critically-ill-patients-receiving-continuous-renal-replacement-therapy-for-acute-kidney-injury-an-observational-cohort-study
#9
Richard Fisher, Katie Lei, Mike J Mitchell, Gary W Moore, Helen Dickie, Linda Tovey, Siobhan Crichton, Marlies Ostermann
BACKGROUND: Regional anticoagulation with citrate is the recommended first line treatment for patients receiving continuous renal replacement therapy (CRRT). There is wide variability in filter patency which may be due to differences in patient characteristics and local practice. It is also possible that citrate has effects on primary and secondary haemostasis, fibrinolysis and platelet function that are still unknown. The primary aim of the study is to describe the effect of citrate on coagulation and fibrinolysis pathways in both the patient and the haemodialysis circuit...
October 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28953045/perioperative-acute-kidney-injury-an-under-recognized-problem
#10
Melanie Meersch, Christoph Schmidt, Alexander Zarbock
The incidence of perioperative acute kidney injury (AKI) is more common than previously recognized, especially in high-risk patients undergoing higher risk procedures. The growing number of patients who develop perioperative AKI is related, in part, to the aging population and increase in the number of individuals with chronic comorbidities, particularly those with premorbid chronic kidney disease. Despite the acceptance of standardization in the definition of AKI, clinicians routinely underdiagnose it and fail to appreciate that it is associated with considerable morbidity and mortality...
August 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28953042/critically-ill-patients-with-the-middle-east-respiratory-syndrome-a-multicenter-retrospective-cohort-study
#11
Yaseen M Arabi, Awad Al-Omari, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Basem Alraddadi, Sarah Shalhoub, Abdullah Almotairi, Kasim Al Khatib, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Ghaleb A Al Mekhlafi, Abdulrahman Al Harthy, Ayman Kharaba, Mashael Al Ahmadi, Musharaf Sadat, Hanan Al Mutairi, Eman Al Qasim, Jesna Jose, Maliha Nasim, Abdulaziz Al-Dawood, Laura Merson, Robert Fowler, Frederick G Hayden, Hanan H Balkhy
OBJECTIVES: To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. DESIGN: Retrospective cohort study. SETTING: Patients admitted to ICUs in 14 Saudi Arabian hospitals...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28947349/contribution-of-inflammatory-pathways-to-fabry-disease-pathogenesis
#12
REVIEW
Paula Rozenfeld, Sandro Feriozzi
Lysosomal storage diseases are usually considered to be pathologies in which the passive deposition of unwanted materials leads to functional changes in lysosomes. Lysosomal deposition of unmetabolized glycolipid substrates stimulates the activation of pathogenic cascades, including immunological processes, and particularly the activation of inflammation. In lysosomal storage diseases, the inflammatory response is continuously being activated because the stimulus cannot be eliminated. Consequently, inflammation becomes a chronic process...
September 13, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28946965/testosterone-deficiency-in-dialysis-patients-difference-between-dialysis-techniques
#13
Secundino Cigarrán, Francisco Coronel, Enrique Florit, Jesús Calviño, Juan Villa, Lourdes Gonzalez Tabares, José Antonio Herrero, Juan Jesús Carrero
Testosterone deficiency is a prevalent condition in male patients with chronic kidney disease. However, it is not known whether the type of renal replacement therapy has an impact on testosterone deficiency that accompanies loss of renal function. METHODS: The cross-sectional study enrolled 79 prevalent male patients on dialysis; 43 on haemodialysis (HD) and 36 on peritoneal dialysis (PD). The median age was 69 years and 31.6% were diabetics. Endogenous testosterone levels were measured by immunoluminescence assay (normal range 3-10...
September 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28940550/evaluation-of-combined-extracorporeal-life-support-and-continuous-renal-replacement-therapy-on-hemodynamic-performance-and-gaseous-microemboli-handling-ability-in-a-simulated-neonatal-ecls-system
#14
Kaitlyn R Shank, Elizabeth Profeta, Shigang Wang, Christian O'Connor, Allen R Kunselman, Karl Woitas, John L Myers, Akif Ündar
The objective of this study was to evaluate the hemodynamic performance and gaseous microemboli (GME) handling ability of a simulated neonatal extracorporeal life support (ECLS) circuit with an in-line continuous renal replacement therapy (CRRT) device. The circuit consisted of a Maquet RotaFlow centrifugal pump or HL20 roller pump, Quadrox-iD Pediatric diffusion membrane oxygenator, 8-Fr arterial cannula, 10-Fr venous cannula, and Better-Bladder (BB) with "Y" connector. A second Quadrox-I Adult oxygenator was added postarterial cannula for GME experiments...
September 21, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28937077/practice-pattern-of-hemodialysis-among-end-stage-renal-disease-patients-in-rural-south-india-a-single-center-experience
#15
R Hemachandar
Hemodialysis (HD) is the most common mode of renal replacement therapy for end-stage renal disease (ESRD) patients in India. However, the practice and pattern of dialysis in a hospital serving rural population is largely unknown. A prospective study of 127 ESRD patients initiated on HD between January 2013 and December 2014 was done. The study included 101 males and 26 females, with a mean age of 50.05 ± 13.80 years. Native kidney disease was unknown in 45.67% of patients as they presented very late in their disease course...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#16
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28930541/molecular-mechanisms-of-disorders-of-lipid-metabolism-in-chronic-kidney-disease
#17
Hamid Moradi, Nosratola D Vaziri
Chronic kidney disease (CKD) is a progressive condition marked by protracted kidney damage which over time can lead to end stage renal disease (ESRD). CKD can be categorized into different stages based on the extent of renal damage and degree of renal dysfunction with ESRD requiring renal replacement therapy considered the final stage. It is important to note that CKD in all of its forms is associated with accelerated atherosclerosis, cardiovascular (CV) disease and poor CV outcomes. While a number of factors contribute to the high risk of CV mortality in this patient population, dyslipidemia is considered to be a key player in the pathogenesis of CV disease in CKD...
January 1, 2018: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28913589/estimating-renal-function-in-old-people-an-in-depth-review
#18
REVIEW
Maharajan Raman, Rachel J Middleton, Philip A Kalra, Darren Green
Estimates of glomerular filtration rate (eGFR) should provide accurate measure of an individual's kidney function because important clinical decisions such as timing of renal replacement therapy and drug dosing may be dependent on eGFR. Formulae from which eGFR is derived are generally based on serum creatinine measurement, such as Cockcroft-Gault, MDRD and CKD-EPI. More recently, calculation of eGFR using other laboratory biomarkers such as cystatin C has emerged with apparent greater accuracy. In old people, there is age-related physiological change in the kidney, which could lead to reduced GFR...
November 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28912860/effects-of-hv-crrt-on-pct-tnf-%C3%AE-il-4-il-6-il-8-and-il-10-in-patients-with-pancreatitis-complicated-by-acute-renal-failure
#19
Changbo Liu, Mu Li, Shixiong Cao, Jianzhong Wang, Xiaoqiong Huang, Weizhen Zhong
The aim of the study was to investigate the effects of high-volume continuous renal replacement therapy (HV-CRRT) on procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, IL-8 and IL-10 in acute pancreatitis complicated by acute renal failure. Eighty-six patients with acute pancreatitis complicated with acute renal failure were selected from September 2014 to September 2016 in our hospital, and were treated by continuous veno-venous hemofiltration (CVVH). The patients were randomly divided into the observation group, treated by the HV-CVVH model with a displacement rate of 4 l/h, and the control group, treated by the normal capacity model with a displacement rate of 2 l/h...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28904876/heart-rate-is-associated-with-mortality-in-patients-undergoing-continuous-renal-replacement-therapy
#20
Soojin Lee, Yeonhee Lee, Heejoon Jang, Hongran Moon, Dong Ki Kim, Seung Seok Han
BACKGROUND: Heart rate (HR) is an essential vital sign based on the finding that HR beyond its normal range is associated with several conditions or diseases, including high mortality in several clinical settings. Nevertheless, the clinical implications of HR remain unresolved in patients undergoing continuous renal replacement therapy (CRRT). METHODS: This retrospective cohort study included 828 patients who underwent CRRT due to acute kidney injury between 2010 and 2014...
September 2017: Kidney Research and Clinical Practice
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