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https://www.readbyqxmd.com/read/29776755/neutral-ph-and-low-glucose-degradation-product-dialysis-fluids-induce-major-early-alterations-of-the-peritoneal-membrane-in-children-on-peritoneal-dialysis
#1
Betti Schaefer, Maria Bartosova, Stephan Macher-Goeppinger, Peter Sallay, Peter Vörös, Bruno Ranchin, Karel Vondrak, Gema Ariceta, Ariane Zaloszyc, Aysun K Bayazit, Uwe Querfeld, Rimante Cerkauskiene, Sara Testa, Christina Taylan, Johan VandeWalle, YokChin Yap, Rafael T Krmar, Rainer Büscher, Anne K Mühlig, Dorota Drozdz, Salim Caliskan, Felix Lasitschka, Sahar Fathallah-Shaykh, Enrico Verrina, Günter Klaus, Klaus Arbeiter, Raj Bhayadia, Anette Melk, Philipp Romero, Bradley A Warady, Franz Schaefer, Akos Ujszaszi, Claus Peter Schmitt
The effect of peritoneal dialysates with low-glucose degradation products on peritoneal membrane morphology is largely unknown, with functional relevancy predominantly derived from experimental studies. To investigate this, we performed automated quantitative histomorphometry and molecular analyses on 256 standardized peritoneal and 172 omental specimens from 56 children with normal renal function, 90 children with end-stage kidney disease at time of catheter insertion, and 82 children undergoing peritoneal dialysis using dialysates with low-glucose degradation products...
May 15, 2018: Kidney International
https://www.readbyqxmd.com/read/29742659/anhydramnios-in-the-setting-of-renal-malformations-the-national-institutes-of-health-workshop-summary
#2
Marva Moxey-Mims, Tonse N K Raju
Anhydramnios in the setting of severe malformations of the fetal kidney and urinary tract is associated with a high incidence of stillbirths and life-threatening complications, including severe pulmonary hypoplasia, umbilical cord compression, and perinatal asphyxia. To prevent such adverse outcomes, some centers in the United States and elsewhere are offering amniotic fluid restoration for women diagnosed with anhydramnios in the setting of fetal renal malformations. The procedures include infusions of amniotic fluid substitutes (normal saline), percutaneously or through an amnioport-an implanted system for serial or continuous infusion of normal saline to maintain the desired amniotic fluid volume...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29731287/controversies-in-management-of-hyperkalemia
#3
Brit Long, Justin R Warix, Alex Koyfman
BACKGROUND: Hyperkalemia is a common electrolyte disorder that can result in morbidity and mortality if not managed appropriately. OBJECTIVES: This review evaluates the classic treatments of hyperkalemia and discusses controversies and new medications for management. DISCUSSION: Potassium (K+) plays a key role in determining the transmembrane potentials of "excitable membranes" present in nerve and muscle cells. K+ is the predominant intracellular cation, and clinical deterioration typically ensues when patients develop sufficiently marked elevation in extracellular fluid concentrations of K+ (hyperkalemia)...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29688512/greater-fluid-overload-and-lower-interdialytic-weight-gain-are-independently-associated-with-mortality-in-a-large-international-hemodialysis-population
#4
Manfred Hecking, Ulrich Moissl, Bernd Genser, Hugh Rayner, Indranil Dasgupta, Stefano Stuard, Andrea Stopper, Charles Chazot, Franklin W Maddux, Bernard Canaud, Friedrich K Port, Carmine Zoccali, Peter Wabel
Background: Fluid overload and interdialytic weight gain (IDWG) are discrete components of the dynamic fluid balance in haemodialysis patients. We aimed to disentangle their relationship, and the prognostic importance of two clinically distinct, bioimpedance spectroscopy (BIS)-derived measures, pre-dialysis and post-dialysis fluid overload (FOpre and FOpost) versus IDWG. Methods: We conducted a retrospective cohort study on 38 614 incident patients with one or more BIS measurement within 90 days of haemodialysis initiation (1 October 2010 through 28 February 2015)...
April 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29456216/the-cardiovascular-risk-factor-profiles-among-end-stage-renal-failure-patients-treated-with-continuous-ambulatory-peritoneal-dialysis-and-intermittent-hemodialysis
#5
S A K Sharifah Zamiah, Che Rosle Draman, Mohd Ramli Seman, A Fariz Safhan, R Rozalina, N I Nik Ruzni
Cardiovascular (CV) event is the most common cause of death in dialysis patients. Both traditional and nontraditional CV risk factors related to malnutrition, inflammation, and anemia are commonly found in this population. This study was conducted to evaluate the burden factors of CV risk factors and its management in our regularly dialyzed patients. It was a single-center, cross-sectional analysis of prevalent intermittent hemodialysis (IHD) and continuous ambulatory peritoneal dialysis (CAPD) patients followed up in our hospital...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29386307/a-retrospective-analysis-of-etiology-and-outcomes-of-refractory-capd-peritonitis-in-a-tertiary-care-center-from-north-india
#6
Venkatesh Thammishetti, Anupama Kaul, Dharmendra S Bhadauria, Karthikeyan Balasubramanian, Narayan Prasad, Amit Gupta, Raj K Sharma
BACKGROUND: Refractory peritonitis is defined as failure of clearance of peritoneal fluid despite 5 days of appropriate antibiotic therapy. Catheter removal decreases morbidity and mortality. Data on the outcomes of refractory peritonitis and of reinitiation of peritoneal dialysis (PD) in this group of patients are sparse. The present study analyzed etiology, outcomes, and prognostic factors of refractory peritonitis as well as survival of the reinitiation of the technique. METHODS: This was a single-center retrospective study that included 90 patients of refractory continuous ambulatory PD (CAPD) peritonitis at a tertiary care center in North India...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29378860/dorsal-raphe-serotonin-neurons-mediate-co-2-induced-arousal-from-sleep
#7
Haleigh R Smith, Nicole K Leibold, Daniel A Rappoport, Callie M Ginapp, Benton S Purnell, Nicole M Bode, Stephanie L Alberico, Young-Cho Kim, Enrica Audero, Cornelius T Gross, Gordon F Buchanan
Arousal from sleep in response to CO2 is a critical protective phenomenon. Dysregulation of CO2 -induced arousal contributes to morbidity and mortality from prevalent diseases, such as obstructive sleep apnea and sudden infant death syndrome. Despite the critical nature of this protective reflex, the precise mechanism for CO2 -induced arousal is unknown. Because CO2 is a major regulator of breathing, prevailing theories suggest that activation of respiratory chemo- and mechano-sensors is required for CO2 -induced arousal...
February 21, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment-relational-potential-revisited
#8
Aaron Wightman, Jennifer Cobelli Kett, Benjamin S Wilfond
No abstract text is available yet for this article.
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29174672/-aluminic-intoxication-in-chronic-hemodialysis-a-diagnosis-rarely-evoked-nowadays-clinical-case-and-review-of-the-literature
#9
Alexandre Seidowsky, Emmanuel Dupuis, Tilman Drueke, Serge Dard, Ziad A Massy, Bernard Canaud
Aluminum intoxication in chronic hemodialysis patients has virtually vanished over the last decade. Therefore, the diagnosis is rarely advocated at present. Aluminum intoxication in dialysis patients associates to different degrees with dialysis encephalopathy, bone disorders and microcytic anemia. We report here the observation of a patient receiving intermittent hemodialysis therapy who presented with acute encephalopathy. It turned out to be caused by aluminum intoxication secondary to a defect in dialysis water treatment...
February 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29148130/a-pseudo-one-compartment-model-of-phosphorus-kinetics-during-hemodialysis-further-supporting-evidence
#10
John K Leypoldt, Baris U Agar, Alfred K Cheung, Angelito A Bernardo
A pseudo-one compartment model has been proposed to describe phosphorus kinetics during hemodialysis and the immediate post-dialysis period. This model assumes that phosphorus mobilization from tissues is proportional to the difference between the pre-dialysis serum concentration (a constant) and the instantaneous serum concentration. The current study is exploratory and evaluated the ability of a pseudo-one compartment model to describe the kinetics of phosphorus during two short hemodialysis treatments separated by a 60-min inter-treatment period without dialysis; the latter is the post-dialysis rebound period for the first short hemodialysis treatment...
November 2017: Artificial Organs
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#11
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29040687/mortality-risk-in-patients-on-hemodiafiltration-versus-hemodialysis-a-real-world-comparison-from-the-dopps
#12
Francesco Locatelli, Angelo Karaboyas, Ronald L Pisoni, Bruce M Robinson, Joan Fort, Raymond Vanholder, Hugh C Rayner, Werner Kleophas, Stefan H Jacobson, Christian Combe, Friedrich K Port, Francesca Tentori
Background: With its convective component, hemodiafiltration (HDF) provides better middle molecule clearance compared with hemodialysis (HD) and is postulated to improve survival. A previous analysis of Dialysis Outcomes and Practice Patterns Study (DOPPS) data in 1998-2001 found lower mortality rates for high replacement fluid volume HDF versus HD. Randomized controlled trials have not shown uniform survival advantage for HDF; in secondary (non-randomized) analyses, better outcomes were observed in patients receiving the highest convection volumes...
October 11, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28919596/outcome-of-pregnancy-related-acute-kidney-injury-observed-in-a-tertiary-care-hospital
#13
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28805365/removal-of-cells-from-body-fluids-by-magnetic-separation-in-batch-and-continuous-mode-influence-of-bead-size-concentration-and-contact-time
#14
Nils Bohmer, Nino Demarmels, Elena Tsolaki, Lukas Gerken, Kerda Keevend, Sergio Bertazzo, Marco Lattuada, Inge K Herrmann
The magnetic separation of pathogenic compounds from body fluids is an appealing therapeutic concept. Recently, removal of a diverse array of pathogens has been demonstrated using extracorporeal dialysis-type devices. The contact time between the fluid and the magnetic beads in such devices is limited to a few minutes. This poses challenges, particularly if large compounds such as bacteria or cells need to be removed. Here, we report on the feasibility to remove cells from body fluids in a continuous dialysis type of setting...
August 22, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28740213/functional-and-transcriptomic-characterization-of-peritoneal-immune-modulation-by-addition-of-alanyl-glutamine-to-dialysis-fluid
#15
Rebecca Herzog, Lilian Kuster, Julia Becker, Tobias Gluexam, Dietmar Pils, Andreas Spittler, Manoj K Bhasin, Seth L Alper, Andreas Vychytil, Christoph Aufricht, Klaus Kratochwill
Peritonitis remains a major cause of morbidity and mortality during chronic peritoneal dialysis (PD). Glucose-based PD fluids reduce immunological defenses in the peritoneal cavity. Low concentrations of peritoneal extracellular glutamine during PD may contribute to this immune deficit. For these reasons we have developed a clinical assay to measure the function of the immune-competent cells in PD effluent from PD patients. We then applied this assay to test the impact on peritoneal immune-competence of PD fluid supplementation with alanyl-glutamine (AlaGln) in 6 patients in an open-label, randomized, crossover pilot trial (EudraCT 2012-004004-36), and related the functional results to transcriptome changes in PD effluent cells...
July 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28666072/special-situations-intradialytic-hypertension-chronic-hypertension-and-intradialytic-hypotension
#16
Peter Noel Van Buren, Jula K Inrig
Hypertension is a comorbidity that is present in the majority of end-stage renal disease patients on maintenance hemodialysis. This population is particularly unique because of the dynamic nature of blood pressure (BP) during dialysis. Modest BP decreases are expected in most hemodialysis patients, but intradialytic hypotension and intradialytic hypertension are two special situations that deviate from this as either an exaggerated or paradoxical response to the dialysis procedure. Both of these phenomena are particularly important because they are associated with increased mortality risk compared to patients with modest decreases in BP during dialysis...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28583554/enterobacter-cloacae-related-necrotizing-fasciitis-after-peritoneal-dialysis-in-delayed-graft-function-a-case-report
#17
Y-M Choe, K-M Park, Y S Jeon, S G Cho, K C Hong, W Y Shin, J H Song
INTRODUCTION: Necrotizing fasciitis is an uncommon soft-tissue infection that involves the superficial fascia, subcutaneous fat, and deep fascia. Herein, we report the first case of Enterobacter cloacae-related necrotizing fasciitis after peritoneal dialysis in delayed graft function. CASE: A 58-year-old man, who was a hepatitis B-viral carrier and had atrial fibrillation, received cadaveric renal transplantation with peritoneal dialysis and encountered delayed graft function...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28535530/mathematical-model-of-potassium-profiling-in-chronic-dialysis
#18
Mauro Ursino, Gabriele Donati
Potassium balance is a difficult task in hemodialysis: low potassium in the dialysate is associated with a high risk of sudden cardiac death, whereas excessive dialysate potassium may provoke insufficient removal and hyperkalemia. A better understanding of the problem can be achieved with the use of mathematical models of solute kinetics. This study is aimed at presenting an improved model of solute kinetics and fluid shifts during hemodialysis. It comprises a 2-compartment (intracellular and extracellular) description of sodium, potassium, and urea, including volume fluid shifts induced by osmotic forces...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28421299/compared-effects-of-calcium-and-sodium-polystyrene-sulfonate-on-mineral-and-bone-metabolism-and-volume-overload-in-pre-dialysis-patients-with-hyperkalemia
#19
Yosuke Nakayama, Kaoru Ueda, Sho-Ichi Yamagishi, Miki Sugiyama, Chika Yoshida, Yuka Kurokawa, Nao Nakamura, Tomofumi Moriyama, Goh Kodama, Tomohisa Minezaki, Sakuya Ito, Akiko Nagata, Kensei Taguchi, Junko Yano, Yusuke Kaida, Kazutaka Shibatomi, Kei Fukami
BACKGROUND: Hyperkalemia is prevalent in end-stage renal disease patients, being involved in life-threatening arrhythmias. Although polystyrene sulfonate (PS) is commonly used for the treatment of hyperkalemia, direct comparison of effects between calcium and sodium PS (CPS and SPS) on mineral and bone metabolism has not yet been studied. METHODS: In a randomized and crossover design, 20 pre-dialysis patients with hyperkalemia (>5 mmol/l) received either oral CPS or SPS therapy for 4 weeks...
February 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28131489/risk-of-acute-kidney-injury-after-intravenous-contrast-media-administration
#20
Jeremiah S Hinson, Michael R Ehmann, Derek M Fine, Elliot K Fishman, Matthew F Toerper, Richard E Rothman, Eili Y Klein
STUDY OBJECTIVE: The study objective was to determine whether intravenous contrast administration for computed tomography (CT) is independently associated with increased risk for acute kidney injury and adverse clinical outcomes. METHODS: This single-center retrospective cohort analysis was performed in a large, urban, academic emergency department with an average census of 62,179 visits per year; 17,934 ED visits for patients who underwent contrast-enhanced, unenhanced, or no CT during a 5-year period (2009 to 2014) were included...
May 2017: Annals of Emergency Medicine
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