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Infectious complications hemodialysis

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https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#1
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#2
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215666/expansion-of-polymorphonuclear-myeloid-derived-suppressor-cells-in-patients-with-end-stage-renal-disease-may-lead-to-infectious-complications
#3
Yan-Fang Xing, Rui-Ming Cai, Qu Lin, Qing-Jian Ye, Jian-Hua Ren, Liang-Hong Yin, Xing Li
Myeloid-derived suppressor cells (MDSCs) are recently identified immune suppressive cells in multiple chronic inflammations. Here, we investigated MDSCs in patients with end-stage renal disease (ESRD) and their clinical significance in these patients and healthy individuals (49 each). Polymorphonuclear and mononuclear MDSCs were investigated by flow cytometry. Patients with ESRD before hemodialysis presented a significantly higher level of polymorphonuclear MDSCs. Depletion of polymorphonuclear-MDSCs resolved T cell IFN-γ responses...
February 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28203564/neurotoxicity-following-the-ingestion-of-bilimbi-fruit-averrhoa-bilimbi-in-an-end-stage-renal-disease-patient-on-hemodialysis
#4
Camille Pereira Caetano, Cinara Barros de Sá, Bruno Antônio Paixão Faleiros, Marcelo Fonseca Coutinho Fernandes Gomes, Edna Regina Silva Pereira
INTRODUCTION: The toxic effects of the ingestion of star fruit (Averrhoa carambola) in chronic kidney disease patients are well described in the literature. Recently, the compound caramboxin has been isolated, explaining the mechanisms of its neurotoxicity. Bilimbi fruit belongs to the family Oxalidaceae, Averrhoa bilimbi species, and exhibits similar biochemical characteristics to star fruit. OBJECTIVE: To report the case of a patient with chronic kidney disease who developed a seizure disorder after the ingestion of bilimbi fruit...
January 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#5
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28143967/the-effect-of-predialysis-fistula-attempt-on-risk-of-all-cause-and-access-related-death
#6
Robert R Quinn, Matthew J Oliver, Daniel Devoe, Krishnan Poinen, Rameez Kabani, Fareed Kamar, Priyanka Mysore, Adriane M Lewin, Swapnil Hiremath, Jennifer MacRae, Matthew T James, Lisa Miller, Brenda R Hemmelgarn, Louise M Moist, Amit X Garg, Tanvir T Chowdhury, Pietro Ravani
Whether the lower risk of mortality associated with arteriovenous fistula use in hemodialysis patients is due to the avoidance of catheters or if healthier patients are simply more likely to have fistulas placed is unknown. To provide clarification, we determined the proportion of access-related deaths in a retrospective cohort study of patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. A total of 3168 patients initiated dialysis at the participating centers; 2300 met our inclusion criteria...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#7
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28068970/quadriplegia-caused-by-an-epidural-abscess-occurring-at-the-same-level-of-cervical-destructive-spondyloarthropathy-a-case-report
#8
Jun-Seok Lee, Ji-Hyun Ryu, Jong-Tae Park, Ki-Won Kim
BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level...
January 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28001173/patient-in-chronic-hemodialysis-with-right-atrial-mass-thrombus-fungal-endocarditis-or-atrial-myxoma
#9
Talita G Salani, Cynthia de Moura Borges, Carolina S Urbini, Patrícia Schincariol, Kélcia Rosana da Silva Quadros, Maria Almerinda Ribeiro-Alves, Rodrigo Bueno de Oliveira
We present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD) by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA). The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI) indicated for the diagnosis of myxoma in RA...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27795628/swan-neck-versus-straight-peritoneal-dialysis-catheter-long-term-effect-on-patient-and-method-survival
#10
V Filiopoulos, D Biblaki, L Takouli, A Dounavis, D Hadjiyannakos, D Vlassopoulos
Peritoneal dialysis (PD) is limited mainly by a higher technique failure rate as compared to hemodialysis (HD), catheter malfunction being an important reason. Intra- and extra-peritoneal catheter configuration may be associated with mechanical and infectious complications affecting method survival. We report our experience with two extra-peritoneal catheter configurations: the straight and the swan-neck (SN) catheters. A total of 85 consecutive patients, 58 males and 27 females were included in the study. Among them, 26 were diabetics; 52 were treated with automated PD (APD) and 33 with continuous ambulatory PD (CAPD)...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27772644/intensive-hemodialysis-and-potential-risks-with-increasing%C3%A2-treatment
#11
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27694081/tuberculosis-in-hemodialysis
#12
M El Amrani, M Asserraji, A Bahadi, D El Kabbaj, M Benyahia
Chronic uremia puts patients at increased risk of infectious complications, in particular, tuberculosis. In this prospective study, we analyzed the clinical, paraclinical, and therapeutic features as well as outcome for all patients on chronic hemodialysis with tuberculosis from January 2010 through August 2012. Sixty-one patients were admitted for bacterial infections, 23% of them for tuberculosis. Fever was present in 71% of cases, and CRP elevated in all cases. The tuberculin skin test was positive in only 2 of 9 cases, and Mycobacterium tuberculosis isolated in 2 of 10 cases...
August 1, 2016: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/27599416/efficacy-and-adverse-events-of-azacitidine-in-the-treatment-of-hemodialysis-patients-with-high-risk-myelodysplastic-syndrome
#13
REVIEW
Tomoyasu Yoshihiro, Tsuyoshi Muta, Kenichi Aoki, Syo Shimamoto, Yasuhisa Tamura, Ryosuke Ogawa
We describe two hemodialysis patients with high-risk myelodysplastic syndrome (MDS) treated with azacitidine. A 65-year-old woman (case 1) received azacitidine at 75 mg/m(2) for 7 days, and a 52-year-old man (case 2) with liver cirrhosis received a 70% dose of azacitidine. Both cases developed grade 4 cytopenia, but they achieved transfusion independence after 3 and 2 courses, and the durations of remission were 10 and 11 months, respectively. Case 1 had the complication of febrile neutropenia (FN) twice during the 1(st) and 2(nd) courses, but continued to receive azacitidine treatment thereafter...
August 2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27536676/peritoneal-dialysis-in-western-countries
#14
REVIEW
Dirk G Struijk
BACKGROUND: Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. SUMMARY: First the major events in the history of the development of PD are described...
December 2015: Kidney Diseases
https://www.readbyqxmd.com/read/27444362/a-comparison-of-patency-and-interventions-in-thigh-versus-hemodialysis-reliable-outflow-grafts-for-chronic-hemodialysis-vascular-access
#15
Evan R Brownie, Clark D Kensinger, Irene D Feurer, Derek E Moore, David Shaffer
OBJECTIVE: With improvements in medical management and survival of patients with end-stage renal disease, maintaining durable vascular access is increasingly challenging. This study compared primary, assisted primary, and secondary patency, and procedure-specific complications, and evaluated whether the number of interventions to maintain or restore patency differed between prosthetic femoral-femoral looped inguinal access (thigh) grafts and Hemodialysis Reliable Outflow (HeRO; Hemosphere Inc, Minneapolis, Minn) grafts...
July 18, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27342656/venous-window-needle-guide-for-deep-vessels-and-difficult-arteriovenous-fistula-cannulation
#16
Giacomo Forneris, Marco Trogolo, Pasqualina Cecere, Daniele Savio, Dario Roccatello
The Venous Window Needle Guide (VWING™) has recently been proposed for patients with difficult arteriovenous fistula (AVF) access for hemodialysis due to deep vessels or other cannulation-related problems. This totally subcutaneous titanium device is sutured onto the upper wall of the matured fistula and may facilitate cannulation by the button-hole technique. We describe our initial experience with nine implants in six patients with a cumulative follow-up of 83 months, and make some experience-based technical suggestions for implant and surveillance radiological imaging...
June 24, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27312766/hemodialysis-patients-satisfaction-and-perspectives-on-complications-associated-with-vascular-access-related-interventions-are-we-listening
#17
Sarah D Kosa, Cynthia Bhola, Charmaine E Lok
PURPOSE: To understand the patient's perspective on complications associated with vascular access-related interventions. METHODS: A multi-stage comprehensive questionnaire of over 150 items was administered to 140 in-center hemodialysis patients in a large, Toronto-based academic-based facility from May 1, 2011 until July 1, 2014. The questionnaire was divided into three domains: physical complications, disruption to routine, and infection. For each of the 12 prespecified vascular access interventions, there were 9 items about the associated complications...
July 12, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27296391/scrub-typhus-in-a-tertiary-care-hospital-in-north-india
#18
Navneet Sharma, Manisha Biswal, Abhay Kumar, Kamran Zaman, Sanjay Jain, Ashish Bhalla
Scrub typhus, a zoonotic disease caused by the bacterium Orientia tsutsugamushi, has become endemic in many parts of India. We studied the clinical profile of this infection in 228 patients that reported to this tertiary care center from July 2013 to December 2014. The median age of patients was 35 years (interquartile range = 24.5-48.5 years), and 111 were males and 117 females. A high-grade fever occurred in 85%, breathlessness in 42%, jaundice in 32%, abdominal pain in 28%, renal failure in 11%, diarrhea in 10%, rashes in 9%, and seizures in 7%...
August 3, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27249387/the-tunneled-catheter-for-haemodialysis-about-52-cases
#19
Badreddine Ben Kaab, Rania Kheder, Héla Jbali, Wided Smaoui, Madiha Krid, Lamia Raies, Lilia Ben Fatma, Souméya Béji, Med Karim Zouaghi, Fatma Ben Moussa
BACKGROUND: Vascular access is a basic and essential tool required for performing renal replacement therapy in end stage renal disease. AIM: To study the indications of tunneled catheter (KTT) in hemodialysis (HD), identify complications related to the use of KTT and contributing factors, assess the survival and performance of the technique. INTRODUCTION: The making of a vascular access is an angular piece for adequate HD and in good conditions...
December 2015: La Tunisie Médicale
https://www.readbyqxmd.com/read/27197427/-risk-factors-of-death-occurrence-in-patients-with-acute-kidney-injury-in-the-course-of-severe-cardio-vascular-complications
#20
Ewa Ignacak, Grażyna Wyrwicz-Zielińska, Izabela Krzysztonek-Weber, Władysław Sułowicz
INTRODUCTION: Acute kidney injury (AKI) is a frequent and serious complication in patients with cardiovascular disease. The aim of the study was to evaluate the risk of death in patients with AKI complicating severe cardiovascular diseases. MATERIAL AND METHODS: A retrospective analysis of 246 patients surveys (157 men and 89 women aged 67.9 ± 14.8 years) with AKI in the course of severe cardiovascular diseases, hospitalized in intensive care units and words of nephrological profile in years 2000-2011 were performed...
2016: Przegla̧d Lekarski
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