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https://www.readbyqxmd.com/read/28638839/broken-heart-syndrome-in-a-patient-on-maintenance-hemodialysis
#1
Sukhdeep Bhogal, Vatsal Ladia, Puja Sitwala, Kailash Bajaj, Vijay Ramu, Timir Paul
Context:Broken heart syndrome or Takotsubo cardiomyopathy (TC) is a disorder characterized by transient left ventricular apical ballooning that almost invariably precedes emotional or physical stress. Although the patients with chronic kidney disease on hemodialysis have shown to exhibit sustained activity of sympathetic nervous system, the presentation of TC in these patients is a rare entity with few case reports in the literature. Case Report: A 75-year-old female with past medical history of end-stage renal disease presented with chest pressure and heaviness that started during her maintenance hemodialysis session...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28627747/spontaneous-intercostal-artery-bleeding-in-a-hemodialysis-patient
#2
Areum Durey, Young Sam Kim, Ah Jin Kim
Spontaneous rupture of an intercostal artery (ICA) is a rare but could be a life-threatening emergency requiring prompt diagnosis and intervention for optimal outcome. We report a patient presented with swelling in his right-side back which started immediately after scheduled hemodialysis and continued to increase in size. Contrast computed tomography scan revealed soft tissue attenuated lesion with internal enhancing dots which suggested expanding hematoma with active bleeding. Arteriography detected focal contrast extravasation from seventh ICA, and transcatheter arterial embolization was successfully done...
June 19, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28604988/efficacy-of-statin-on-vascular-access-patency-in-diabetic-hemodialysis-patients
#3
Satoru Sanada, Yasunori Miyasaka, Atsuhiro Kanno, Kozo Sato, Mitsuhiro Sato, Hisako Sugai, Hiroshi Kitamura, Toshinobu Sato, Yoshio Taguma
INTRODUCTION: An effective approach to prevent hemodialysis vascular access dysfunction is still unclear despite previous studies, which have shown conflicting results of several drugs on vascular access outcomes. In this study, we focused on diabetic hemodialysis patients with native arteriovenous fistula and evaluated the impact of statin treatment on vascular access patency. METHODS: A retrospective cohort study of 268 consecutive patients who newly started hemodialysis due to diabetic nephropathy between January 2011 and December 2013 at Japan Community Health Care Organization Sendai Hospital was performed and the patients were followed for two years...
June 7, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28601125/hyperuricemia-and-long-term-survival-in-patients-with-chronic-kidney-disease-undergoing-hemodialysis
#4
Tadej Petreski, Sebastjan Bevc, Robert Ekart, Radovan Hojs
INTRODUCTION: Uric acid (UA), a breakdown product of purines, has been associated with mortality in different populations. Less is known about associations between hyperuricemia and mortality in chronic kidney disease (CKD) patients, later undergoing hemodialysis (HD), during a long observation period. The aim of this study was to determine the impact of elevated UA levels on long-term (19.5 years) survival of CKD patients. METHODS: 120 CKD patients (49 female, 71 male) enrolled in our study were observed from their first visit at the patients' nephrology outpatient clinic (NOC)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28600736/blood-pressure-management-in-children-on-dialysis
#5
F Paglialonga, S Consolo, A Edefonti, G Montini
Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM)...
June 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28579603/rapamycin-treatment-for-benign-multicystic-peritoneal-mesothelioma-a-rare-disease-with-a-difficult-management
#6
Giovanni Stallone, Barbara Infante, Luigi Cormio, Luca Macarini, Giuseppe Grandaliano
BACKGROUND Benign multicystic peritoneal mesothelioma (BMPM) is a rare intra-abdominal tumor. Although considered by many to be benign, this tumor has a high local recurrence rate. Because of its rarity, preoperative diagnosis is difficult and its origin and pathogenesis are uncertain. There are no evidence-based treatment strategies for BMPM. It is agreed that the best treatment strategy for BMPM is the combination of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). An increasing body of evidence supports a pivotal role of the cytoplasmic serine/threonine kinase mTOR in the development and progression of several neoplastic diseases and specific mTOR inhibitors, including rapamycin, have been suggested as potential therapeutic options for different cancers...
June 5, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28575124/seasonal-variation-in-hemodialysis-initiation-a-single-center-retrospective-analysis
#7
Yujiro Maeoka, Takayuki Naito, Taisuke Irifuku, Yuka Shimizu, Takahiko Ogawa, Takao Masaki
The number of new dialysis patients has been increasing worldwide, particularly among elderly individuals. However, information on seasonal variation in hemodialysis initiation in recent decades is lacking, and the seasonal distribution of patients' conditions immediately prior to starting dialysis remains unclear. Having this information could help in developing a modifiable approach to improving pre-dialysis care. We retrospectively investigated the records of 297 patients who initiated hemodialysis at Hiroshima Prefectural Hospital from January 1st, 2009 to December 31st, 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28552124/application-of-genetic-algorithm-for-hemodialysis-schedule-optimization
#8
Jin Woo Choi, Hajeong Lee, Jung Chan Lee, Saram Lee, Yon Su Kim, Hyung-Jin Yoon, Hee Chan Kim
BACKGROUND: The conventional hemodialysis (HD) schedule has been used for decades, even though new modalities have been introduced. Many reasons limit practices of frequent dialysis, such as patients' environments and unknown optimal schedules for each patient. This research provides a theoretical recommendation of HD schedule through genetic algorithm (GA). METHODS: An end-stage renal disease (ESRD) with various dialysis conditions was modeled through a classic variable-volume two-compartment kinetic model to simulate an anuric patient, and GA was implemented to search for an optimal HD schedule for each individual considering and ignoring burden consumption of each dialysis session...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28546813/a-case-of-urachal-carcinoma-of-the-abdominal-wall-in-a-kidney-transplant-recipient
#9
Takuya Yamazaki, Yasushi Nagaba, Yoshitaka Shimada, Yoshinori Taoka, Satoru Minamida, Dai Koguchi, Masahiro Hagiwara, Sho Watanuki, Hide Nagaba, Kazunari Yoshida, Yasuo Takeuchi
Urachal carcinoma is an extremely rare malignant tumor arising from the urachus in the fetus. We report a patient who developed urachal carcinoma 18 years after kidney transplantation. A 59-year-old man was admitted because of abdominal pain and massive ascites. He had undergone kidney transplantation 18 years earlier and had end-stage renal disease requiring dialysis. Abdominal CT showed massive ascites and an abdominal wall cystic mass separated from the peritoneal cavity. Hemodialysis was started, and paralytic ileus was diagnosed and treated...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28531901/a-comparison-between-intermittent-peritoneal-dialysis-and-automatic-peritoneal-dialysis-on-urgent-peritoneal-dialysis
#10
Chang Wang, Xiao Fu, Yuan Yang, Jun Deng, Hong-Qing Zhang, Hong-Mei Deng, Jia Lu, Youming Peng, Hong Liu, Fu-You Liu, Yinghong Liu
BACKGROUND: Urgent-start dialysis is a major problem for incident dialysis population. Urgent start on hemodialysis is associated with an increased risk of infectious or mechanical complications, and its mortality is equal to or higher than that of urgent start on peritoneal dialysis (PD). However, compared to patients starting PD in a planned setting, those on urgent-started PD have an increased risk of mechanical complications and lower technique survival. METHODS: In this study, 101 adult incident dialysis patients (≥18 years old) who underwent Tenckhoff catheter implantation were enrolled...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28522650/examining-the-association-between-hemodialysis-access-type-and-mortality-the-role-of-access-complications
#11
Pietro Ravani, Robert Quinn, Matthew Oliver, Bruce Robinson, Ronald Pisoni, Neesh Pannu, Jennifer MacRae, Braden Manns, Brenda Hemmelgarn, Matthew James, Marcello Tonelli, Brenda Gillespie
BACKGROUND AND OBJECTIVES: People receiving hemodialysis to treat kidney failure need a vascular access (a fistula, a graft, or a central venous catheter) to connect to the blood purification machine. Higher rates of access complications are considered the mechanism responsible for the excess mortality observed among catheter or graft users versus fistula users. We tested this hypothesis using mediation analysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied incident patients who started hemodialysis therapy from North America, Europe, and Australasia (the Dialysis Outcomes and Practice Patterns Study; 1996-2011)...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#12
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
May 18, 2017: Nephron
https://www.readbyqxmd.com/read/28508978/acute-tumoral-calcinosis-due-to-severe-hyperphosphatemia-in-a-maintenance-hemodialysis-patient
#13
Keizo Nishime, Hiroki Takahashi
We report the case of a maintenance hemodialysis patient with severe hyperphosphatemia (26.6 mg/dL) who developed acute tumoral calcinosis. The patient started receiving maintenance hemodialysis after being diagnosed with type 2 diabetes mellitus. The patient's phosphate levels suddenly increased. He had not taken the prescribed phosphate binders for the past 5 years. He noticed swelling of the palmar aspects of his right thumb, which was diagnosed as tumoral calcinosis. His serum phosphate level reached 26...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28508968/dialysis-disequilibrium-leading-to-posterior-reversible-encephalopathy-syndrome-in-chronic-renal-failure
#14
Pratim Sengupta, Sumanta Biswas
Dialysis disequilibrium syndrome is a neurological adverse effect of acute hemodialysis in advanced uremic patients. Dialysis disequilibrium has a wide spectrum of clinical manifestations starting from subtle uneasiness, confusion, to florid and complex life threatening neurological deficit. In this case study, we present a patient who developed sudden cortical blindness following hemodialysis due to posterior reversible encephalopathy, which is a rare presentation of dialysis disequilibrium syndrome.
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28491228/-survival-among-chronic-hemodialysed-patient-in-cameroon
#15
MULTICENTER STUDY
Hermine Fouda, Gloria Ashuntantang, François Kaze, Marie-Patrice Halle
INTRODUCTION: Haemodialysis is the only renal replacement therapy available in Cameroon; 95% of patients has received subsidies by the State since 2002 and the number of dialysis centers is growing. However, since the opening of the first center in 1990, there are no data on survival in chronic dialysis patients. METHODS: We conducted a multicenter prospective cohort study of 15 months in order to assess mortality rates and factors that influence the survival of chronic hemodialysis patients in Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28468005/noninvasive-blood-pressure-measurement-in-maintenance-hemodialysis-patients-comparison-of-agreement-between-oscillometric-and-finger-cuff-methods
#16
Gaetano Alfano, Francesco Fontana, Gianni Cappelli
BACKGROUND: The Nexfin monitor is a device used for measuring arterial blood pressure (BP) continuously and noninvasively through finger-cuff technology. Since it was validated against the auscultatory method using a sphygmomanometer, the aim of this study was to test the ability of the Nexfin to evaluate brachial arterial pressure (BAP) in maintenance hemodialysis patients, quantifying accuracy and precision. METHODS: Forty hemodynamically stable hemodialysis patients underwent serial measurements of Nexfix arterial pressure (NAP) and BAP, respectively, through Nexfin and oscillometric devices...
May 4, 2017: Nephron
https://www.readbyqxmd.com/read/28464924/frailty-in-end-stage-renal-disease-comparing-patient-caregiver-and-clinician-perspectives
#17
David A Clark, Usman Khan, Bryce A Kiberd, Colin C Turner, Alison Dixon, David Landry, Heather C Moffatt, Paige A Moorhouse, Karthik K Tennankore
BACKGROUND: Frailty is associated with poor outcomes for patients on dialysis and is traditionally measured using tools that assess physical impairment. Alternate measurement tools highlight cognitive and functional domains, requiring clinician, patient, and/or caregiver input. In this study, we compared frailty measures for incident dialysis patients that incorporate patient, clinician, and caregiver perspectives with an aim to contrast the measured prevalence of frailty using tools derived from different conceptual frameworks...
May 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28457030/evaluation-of-effect-of-vitamin-d-deficiency-on-anemia-and-erythropoietin-hyporesponsiveness-in-patients-of-chronic-kidney-disease
#18
N Nand, R Mittal
BACKGROUND: The role of vitamin D deficiency and inflammation levels in renal anemia has been documented. However, no study is available in India where the role of vitamin D supplementation in patients with hyporesponsiveness to increased doses of erythropoietin is available. Hence this study. MATERIAL AND METHODS: This study was conducted on 50 adult patients of CKD, on regular, twice weekly hemodialysis. It included 38 cases in group A with deficient serum vitamin D levels (<30 ng/ml) and 12 cases in group B with sufficient vitamin D levels (>30 ng/ml)...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28446125/soluble-transferrin-receptor-as-a-marker-of-erythropoiesis-in-patients-undergoing-high-flux-hemodialysis
#19
Pei Yin, Jijun Li, Yan Song
Anemia is a common complication in chronic kidney disease (CKD) patients receiving hemodialysis. The effect of high-flux dialysis (HFD) on anemia remains unclear. This prospective study aimed to evaluate the effect of HFD on anemia, and the potential of soluble transferrin receptor (sTfR) as a marker of iron status and erythropoiesis in CKD patients on hemodialysis. Forty patients, who switched from conventional low-flux dialysis to HFD for 12 months, were enrolled in this study. The levels of sTfR, hemoglobin, iron, and nutritional markers, as well as the dose of recombinant human erythropoietin (rhEPO) and use of chalybeate were determined at 0, 2, 6, and 12 months after starting HFD...
April 27, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28445893/early-mortality-associated-with-inpatient-versus-outpatient-hemodialysis-initiation-in-a-large-cohort-of-us-veterans-with-incident-end-stage-renal-disease
#20
Faisal M Arif, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Jun Ling Lu, Fatima Hassan, Fridtjof Thomas, Omer A Siddiqui, Geeta G Gyamlani, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Mortality in the immediate post-hemodialysis transition period is extremely high. Many end-stage renal disease (ESRD) patients in the US start dialysis in an inpatient setting, but the characteristics of patients starting dialysis as inpatients, and the association of inpatient hemodialysis transition with mortality remain unclear. METHODS: We examined 48,261 US veterans who transitioned to hemodialysis between October 2007 and September 2011. Associations of inpatient hemodialysis starting with all-cause mortality were examined in Cox proportional hazard models, with adjustments for demographics, comorbidities, vascular access type, pre-dialysis nephrology care and medication use, and last pre-ESRD estimated glomerular filtration rate and hemoglobin...
April 27, 2017: Nephron
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