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https://www.readbyqxmd.com/read/28207287/thiamine-as-a-renal-protective-agent-in-septic-shock-a-secondary-analysis-of-a-randomized-double-blind-placebo-controlled-trial
#1
Ari Moskowitz, Lars W Andersen, Michael N Cocchi, Mathias Karlsson, Parth V Patel, Michael W Donnino
RATIONALE: Acute kidney injury (AKI) is common in patients with sepsis and has been associated with high mortality rates. The provision of thiamine to septic patients may reduce the incidence and severity of sepsis-related AKI and thereby prevent renal failure requiring renal replacement therapy (RRT). OBJECTIVES: To test the hypothesis that thiamine supplementation mitigates kidney injury in septic shock. METHODS: This was a secondary analysis of a single-center, randomized, double-blind trial comparing thiamine to placebo in patients with septic shock...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28202048/chemotherapy-for-primary-mediastinal-yolk-sac-tumor-in-a-patient-undergoing-chronic-hemodialysis-a-case-report
#2
Haruki Hirakawa, Chiho Nakashima, Tomomi Nakamura, Masanori Masuda, Taro Funakoshi, Shunsaku Nakagawa, Takahiro Horimatsu, Kazuo Matsubara, Manabu Muto, Shinya Kimura, Naoko Sueoka-Aragane
BACKGROUND: The safety and efficacy of chemotherapy for patients undergoing concomitant hemodialysis have not been fully established and optimal doses of anti-cancer drugs and best timing of hemodialysis remains unclear. Although chemosensitive cancers, such as germ cell tumors, treated with chemotherapy should have sufficient dose intensity maintained to achieve the desired effect, many patients with cancer undergoing hemodialysis might be under-treated because the pharmacokinetics of anti-cancer drugs in such patients remains unknown...
February 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28198403/noninvasive-quantification-of-blood-potassium-concentration-from-ecg-in-hemodialysis-patients
#3
Cristiana Corsi, Marilisa Cortesi, Giulia Callisesi, Johan De Bie, Carlo Napolitano, Antonio Santoro, David Mortara, Stefano Severi
Blood potassium concentration ([K(+)]) influences the electrocardiogram (ECG), particularly T-wave morphology. We developed a new method to quantify [K(+)] from T-wave analysis and tested its clinical applicability on data from dialysis patients, in whom [K(+)] varies significantly during the therapy. To elucidate the mechanism linking [K(+)] and T-wave, we also analysed data from long QT syndrome type 2 (LQT2) patients, testing the hypothesis that our method would have underestimated [K(+)] in these patients...
February 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28185299/incremental-hemodialysis-a-european-perspective
#4
Kamonwan Tangvoraphonkchai, Andrew Davenport
Most patients initiating hemodialysis have residual renal function (RRF). Whereas RRF is monitored prior to commencing hemodialysis, once dialysis is started most centres simply rely on dialyzer urea clearance to determine adequate uremic toxin clearance and disregard the effect of RRF. However sustaining RRF is important for the dialysis patient, as RRF reduces inter-dialytic weight gains, increases middle molecule and protein bound toxin clearances and is associated with better quality of life assessments...
February 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28182071/fibroblast-growth-factor-23-levels-in-maintenance-hemodialysis-patients-in-india
#5
U Anandh, P Mandavkar, B Das, S Rao
Fibroblast growth factor-23 (FGF-23) levels start rising early in patients with chronic kidney disease and is implicated in cardiovascular and overall mortality of hemodialysis patients. We conducted a prospective observational cohort study in stable dialysis patients looking into the levels of FGF-23 in hemodialysis patients and its association with various demographic and biochemical variables and mortality. A total of 91 patients were enrolled in the study. The mean FGF-23 levels were very high (1152.7 pg/ml)...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28160763/the-use-of-complementary-and-alternative-medicine-by-patients-undergoing-hemodialysis
#6
Özlem Ceyhan, Songul Göris, Nevin Dogan, Sevda Korkut Bayındır
Context • Hemodialysis (HD) is a frequently used method for the treatment of chronic renal failure. Patients show many symptoms and problems, depending on the success of HD and the disease. Today, one of the most commonly used methods, in addition to pharmacological treatments, for ensuring symptom control and reinforcing a patient's well-being is complementary and alternative medicine (CAM). Objectives • The study was conducted to determine the benefits of the use of CAM for patients undergoing HD. Design • The study was descriptive...
January 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28152637/l-arginine-in-the-treatment-of-valproate-overdose-five-clinical-cases
#7
Verena Schrettl, Norbert Felgenhauer, Christian Rabe, Malkanthi Fernando, Florian Eyer
BACKGROUND: Valproic acid and its metabolites - particularly valproyl-CoA - are inhibitors of the enzyme N-acetylglutamate synthetase. The amino acid l-arginine can stimulate N-acetylglutamate synthetase activity and could be potentially used therapeutically to correct hyperammonemia caused by valproate therapy or overdose. Severely valproic-acid-poisoned patients are usually treated with l-carnitine or hemodialysis in order to decrease hyperammonemia. We herein report of five cases, in which l-arginine was administered...
February 3, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#8
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28134396/-metabolic-acidosis
#9
Giuseppe Regolisti, Filippo Fani, Riccardo Antoniotti, Giuseppe Castellano, Elena Cremaschi, Paolo Greco, Elisabetta Parenti, Santo Morabito, Alice Sabatino, Enrico Fiaccadori
Metabolic acidosis is frequently observed in clinical practice, especially among critically ill patients and/or in the course of renal failure. Complex mechanisms are involved, in most cases identifiable by medical history, pathophysiology-based diagnostic reasoning and measure of some key acid-base parameters that are easily available or calculable. On this basis the bedside differential diagnosis of metabolic acidosis should be started from the identification of the two main subtypes of metabolic acidosis: the high anion gap metabolic acidosis and the normal anion gap (or hyperchloremic) metabolic acidosis...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28128729/do-patients-receiving-hemodialysis-regret-starting-dialysis-a-survey-of-affected-patients%C3%A2
#10
Elizabeth A Gilman, Molly A Feely, Daniel Hildebrandt, Jithinraj Edakkanambeth Varayil, Elisa Y Chong, Amy W Williams, Paul S Mueller
AIMS: End-stage renal disease (ESRD) is associated with high morbidity and mortality. A prior study showed that many Canadian patients regretted their decision to start dialysis. We sought to determine if US patients also regretted dialysis. MATERIALS AND METHODS: We surveyed hemodialysis patients within 55 miles of Rochester, MN, with a 25-question survey about their perceptions of their health, preparedness for dialysis, advance care planning, and regrets about starting dialysis...
January 27, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28126707/acceptance-of-antidepressant-treatment-by-patients-on-hemodialysis-and-their-renal-providers
#11
Julio E Pena-Polanco, Maria K Mor, Fadi A Tohme, Michael J Fine, Paul M Palevsky, Steven D Weisbord
BACKGROUND AND OBJECTIVES: Depression is common in patients receiving chronic hemodialysis but seems to be ineffectively treated. We investigated the acceptance of antidepressant treatment by patients on chronic hemodialysis and their renal providers. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: As part of a clinical trial of symptom management in patients on chronic hemodialysis conducted from 2009 to 2011, we assessed depression monthly using the Patient Health Questionnaire 9...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28122320/revisional-bariatric-surgery-in-a-transplant-patient
#12
Salman Al Sabah, Eliana Al Haddad
INTRODUCTION: A BMI of over 35-45kg/m2 is deemed the upper limit for considering a patient for a renal transplant. Voluntary weight loss attempts are a major concern for patients while on hemodialysis, however, bariatric surgeries have opened up a new door to notable weight loss results, even demonstrating significant improvements of patients' diabetic profile and hypertension. CASE REPORT: Case of a 52-year-old male with a BMI of 42 in end-stage renal disease, that needed a kidney transplant but was ineligible to be placed on the waiting list due to his weight...
January 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28110327/mortality-after-renal-allograft-failure-and-return-to-dialysis
#13
Amarpali Brar, Mariana Markell, Dimitre G Stefanov, Edem Timpo, Rahul M Jindal, Robert Nee, Nabil Sumrani, Devon John, Fasika Tedla, Moro O Salifu
INTRODUCTION: The outcomes of patients who fail their kidney transplant and return to dialysis (RTD) has not been investigated in a nationally representative sample. We hypothesized that variations in management of transplant chronic kidney disease stage 5 leading to kidney allograft failure (KAF) and RTD, such as access, nutrition, timing of dialysis, and anemia management predict long-term survival. METHODS: We used an incident cohort of patients from the United States Renal Data System who initiated hemodialysis between January 1, 2003 and December 31, 2008, after KAF...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#14
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28090226/more-use-of-peritoneal-dialysis-gives-significant-savings-a-systematic-review-and-health-economic-decision-model
#15
Eva Pike, Vida Hamidi, Tove Ringerike, Torbjorn Wisloff, Marianne Klemp
BACKGROUND: Patients with end-stage renal disease (ESRD) are in need of renal replacement therapy as dialysis and/or transplantation. The prevalence of ESRD and, thus, the need for dialysis are constantly growing. The dialysis modalities are either peritoneal performed at home or hemodialysis (HD) performed in-center (hospital or satellite) or home. We examined effectiveness and cost-effectiveness of HD performed at different locations (hospital, satellite, and home) and peritoneal dialysis (PD) at home in the Norwegian setting...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#16
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28078814/life-threatening-nutritional-deficiencies-in-a-dialysis-patient
#17
Fahad Aziz, Kunal Chaudhary
Nutritional deficiencies are very common among the patient on chronic hemodialysis. But they can be easily overlooked or misdiagnosed. Deficiencies of trace elements and phosphorous is rare among this patient population but if neglected can lead to catastrophic effects. We describe a case report of a patient with ESRD recently started on outpatient maintenance hemodialysis, who presented with life threatening muscular weakness with respiratory failure requiring prolonged mechanical ventilation. On initial workup, it was unclear what the cause of her weakness was, however, further investigations showed undetectable phosphorous levels as well as very low levels of trace elements...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28057453/association-of-anril-gene-polymorphisms-with-major-adverse-cardiovascular-events-in-hemodialysis-patients
#18
A Arbiol-Roca, A Padró-Miquel, M Hueso, E Navarro, P Alía-Ramos, M T González-Álvarez, I Rama, J Torras, J M Grinyó, J M Cruzado, N Lloberas
BACKGROUND: Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD). Single nucleotide polymorphisms (SNPs) in ANRIL gene have been associated with higher cardiovascular morbidity and mortality in general population. The main objective was to ascertain whether ANRIL polymorphisms could identify risk of major adverse cardiovascular event (MACE) in patients starting on hemodialysis (HD). METHODS: This was a prospective observational cohort study...
January 2, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#19
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#20
Luciene P Magalhães, Luciene M Dos Reis, Fabiana G Graciolli, Benedito J Pereira, Rodrigo B de Oliveira, Altay A L de Souza, Rosa M Moyses, Rosilene M Elias, Vanda Jorgetti
BACKGROUND: Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality...
2017: PloS One
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