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Hemodialysis pictures

Yassamine Bentata, F Hamdi, A Chemlal, I Haddiya, N Ismaili, N El Ouafi
The prevalence of uremic pericarditis (UP) used to range from 3% to 41%. More recently, it has decreased to about 5%-20% and to <5% in the last decades, as hemodialysis techniques have become widely used and dialysis quality improved. The objective of this work is to determine the initial clinical picture and the prognosis of patients presenting End Stage Renal Disease (ESRD) with UP. MATERIALS: This is a retrospective study (May 2015-September 2017). Inclusion criteria targeted patients who had uremic pericarditis defined as pericarditis occurring in a patient with ESRD before initiation of renal replacement therapy, or within eight weeks of its initiation...
March 2018: American Journal of Emergency Medicine
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...
July 2017: Hemodialysis International
Salah Omar Bashir, Mahmoud A Aamer, Hayder A Omer, Mohamed D Morsy
Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare condition most frequently seen in patients with advanced chronic kidney disease. The clinical picture is characterized by painful skin lesions and ulcerations. The underlying pathology is medial calcification and intimal proliferation with microthrombi of small arteries. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. This article reports an atypical case where CUA developed after parathyroidectomy and in the course of treatment of hungry bone syndrome...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
Julia Cordelia Hempel, Felix Poppelaars, Mariana Gaya da Costa, Casper F M Franssen, Thomas P G de Vlaam, Mohamed R Daha, Stefan P Berger, Marc A J Seelen, Carlo A J M Gaillard
BACKGROUND: Intravenous (IV) iron preparations are widely used in the treatment of anemia in patients undergoing hemodialysis (HD). All IV iron preparations carry a risk of causing hypersensitivity reactions. However, the pathophysiological mechanism is poorly understood. We hypothesize that a relevant number of these reactions are mediated by complement activation, resulting in a pseudo-anaphylactic clinical picture known as complement activation-related pseudo allergy (CARPA). METHODS: First, the in-vitro complement-activating capacity was determined for 5 commonly used IV iron preparations using functional complement assays for the 3 pathways...
2017: American Journal of Nephrology
José Ruiz Pardo, Noelia Ibáñez Cánovas, Jesús Abrisqueta Carrión, Juan Antonio Luján Mompeán, Pascual Parrilla Paricio
An 84-year-old woman presented to her local emergency department for abdominal pain. Her medical history included hemodialysis in the treatment of chronic renal failure, Parkinson's disease, chronic atrial fibrillation, chronic constipation, appendicectomy and cholecystectomy. The patient complained of diffuse abdominal pain for 4 days, associated with nausea and vomiting in the last 24 hours. Physical examination revealed a soft and depressible abdomen, diffusely painful, without signs of peritoneal irritation...
June 2016: Revista Española de Enfermedades Digestivas
Aadel A Chaudhuri, Jason T Davis
A 75-year-old male with no prior history of vasculitis or renal deficiency presented with a history of 36 hours of anterior epistaxis, one month of worsening shortness of breath, severe anemia requiring transfusion, thrombocytopenia, coagulopathy with INR 4.9, and renal failure requiring hemodialysis. A peripheral blood smear revealed no evidence of microangiopathic hemolytic anemia. We performed an autoimmune workup, which revealed high levels of serum serine protease 3 antibody (C-ANCA), elevated rheumatoid factor, low serum C3, and normal levels of serum C4...
February 5, 2016: Curēus
Francesco Rapisarda, Roberta Aliotta, Barbara Pocorobba, Grazia Portale, Silvia Ferrario, Luca Zanoli, Pasquale Fatuzzo
Fungal infections have a high incidence in patients receiving peritoneal dialysis. (1)
Peritoneal dialysis is often complicated by peritonitis which has only minimally mycotic etiology, but nonetheless it is associated with 15-45% mortality (8).
 The opportunistic pathogens such as Candida can cause infection in immunocompromised conditions. Even the Acinetobacter tends to infect immunocompromised individuals and it has the same risk factors for infection as Candida: immunosuppression, malignancy, HIV positivity and all the other conditions of immunosuppression, central venous catheterization, mechanical ventilation and prolonged antibiotic therapy...
November 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Luca Di Lullo, Antonio Gorini, Domenico Russo, Alberto Santoboni, Claudio Ronco
Cardiovascular diseases represent the main causes of morbidity and mortality in patients with chronic kidney disease (CKD). According to a well-established classification, cardiovascular involvement in CKD can be set in the context of cardiorenal syndrome type 4. Left ventricular hypertrophy (LVH) represents a key feature to provide an accurate picture of systolic-diastolic left heart involvement in CKD patients. Cardiovascular involvement is present in about 80% of prevalent hemodialysis patients, and it is evident in CKD patients since stage IIIb-IV renal disease (according to the K/DOQI CKD classification)...
October 2015: Cardiorenal Medicine
F Chasset, C Pecquet, K Cury, L Sesé, P Moguelet, C Francès, C Gharbi, P Senet
BACKGROUND: Cutaneous eruption around a peritoneal dialysis (PD) catheter exit site is a rare complication. Herein we report a case of bullous eruption; we discuss the diagnostic approach and the related therapeutic implications. PATIENTS AND METHODS: A 63-year-old man presented a bullous periumbilical eruption two months after initiation of PD. Cultures of laboratory samples ruled out an infectious origin and systemic corticosteroids initiated at 0.5mg/kg for suspected eosinophilic peritonitis produced significant improvement of the cutaneous eruption...
June 2015: Annales de Dermatologie et de Vénéréologie
Mustafa Sevinc, Taner Basturk, Tuncay Sahutoglu, Tamer Sakaci, Yener Koc, Elbis Ahbap, Cuneyt Akgol, Ekrem Kara, Vicky Brocklebank, Tim H J Goodship, David Kavanagh, Abdulkadir Unsal
INTRODUCTION: Thrombotic microangiopathies are a group of diseases presenting as microangiopathic hemolytic anemia, thrombocytopenia and end-organ dysfunction. As the role of the complement system was elucidated in atypical hemolytic uremic syndrome pathogenesis, eculizumab was successfully introduced into clinical practice. We present a large pedigree with multiple individuals carrying a functionally significant novel factor H mutation. We describe the proband's presentation following a presumed infectious trigger requiring plasma exchange and hemodialysis...
2015: Journal of Medical Case Reports
A A Eremenko, N M Minbolatova, M M Kaabak, N N Babenko
BACKGROUND: Early dysfunction of transplanted kidney is a serious complication that can lead to the premature loss of transplant. Ischemic and reperfusion injury of donor kidney leads to the disturbance of the function of the graft, which is a form of post-transplantation acute kidney injury that causes the relevance of search of early markers for diagnosis. OBJECTIVE: Evaluation of the diagnostic value of determination in the urine neutrophilgelatinase-associated lipocalin (u-NGAL) in patients in the early period after kidney transplantation...
September 2014: Anesteziologiia i Reanimatologiia
Masoud Pezeshki Rad, Gholam Hosain Kazemzadeh, Masood Ziaee, Ghodsieh Azarkar
Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis...
March 2015: Saudi Journal of Kidney Diseases and Transplantation
Cristiana Bagnis, S Berutti, C Vitale, N Ravarino, M Marangella
We report a case of hypercalcemia in a female patient who was restarted on hemodialysis 22 years after renal transplantation. Graft biopsy showed chronic post-transplant nephropathy. Treatment with immunosuppressants and steroids was maintained owing to residual graft function. She was then given oral paracalcitol 1 µg/d for secondary hyperparathyroidism (iPTH 850 pg/mL) and her transplant medication was reduced and then discontinued. After this, the patient referred widespread joint pain, especially in the hips and subsequently presented with erythema nodosum...
September 2013: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Michal Drobny, Rudolf Pullmann, Ivan Odalos, Maria Skerenova, Beata Saniova
OBJECTIVES: The goal of this clinical trial was to determine the incidence of undesirable side effects, and to ascertain any occurrence of genetic polymorphisms. MATERIAL AND METHODS: Clinically, we looked for manifestations of a benign myositis and of serious rhabdomyolysis. We observed a group 198 patients treated with statins, primarially fluvastatin and rosuvastatin. There were 126 (mean age = 58.3 ± 4.1; male 91, mean age = 57.4 ± 5.9; female 35, mean age = 60...
2014: Neuro Endocrinology Letters
Yasemin Coskun Yavuz, Safa Ersen Ganidagli, Tugba Yilmaz, Orcun Altunoren, Mustafa Saygin Deniz, Ekrem Dogan
Orofacial digital syndrome type 1 is condition which is characterized with, in addition to oral-facial and digital congenital anomalies, polycystic renal disease in most patient, and the prognosis is dependent on renal involvement in such patients. Our case was a 22-year-old patient who was presented with clinical picture of chronic renal failure, was started on hemodialysis and had took our attention due to oral, facial and digital anomalies in addition to polycystic renal disease.
July 2014: Renal Failure
Dirk M Hermann, Andreas Kribben, Heike Bruck
Cognitive deficits have a high prevalence in elderly patients with chronic kidney disease (CKD). The clinical picture consists of cognitive slowing, executive, memory and language deficits, and is attributed to cerebral white matter disease and clinically often silent brain infarcts. In the meantime, robust evidence exists that low estimated glomerular filtration rate, a measure of CKD severity, predisposes to cognitive deficits, cerebral white matter lesions, and ischemic brain infarcts in addition to demographic factors, vascular risk factors and diseases which also contribute to CKD-related cognitive deficits...
June 2014: Journal of Neural Transmission
Gerardo B Vieregge, Thomas J Harrington, David M Andrews, Maria F Carpintero, Dollie F Green, Ali Nayer
The catastrophic antiphospholipid syndrome (CAPS) is a rare life-threatening form of the antiphospholipid syndrome characterized by disseminated vascular thrombosis resulting in multiorgan failure. On an exceedingly rare occasion, CAPS can be associated with severe hemorrhagic manifestations. We report a young woman with a history of several spontaneous miscarriages who presented with menorrhagia and hemoptysis. The patient developed respiratory failure due to diffuse alveolar hemorrhage. Laboratory tests demonstrated severe hemolytic anemia, profound thrombocytopenia, markedly elevated fibrin degradation products, and renal failure...
2013: Case Reports in Medicine
Rebecca Layman-Amato, Jim Curtis, Glenda M Payne
While nurses may not routinely service the water treatment system or mix the dialysate, they are responsible for understanding all of the clinical ramifications of water treatment and dialysate preparation for hemodialysis as a part of the entire dialysis treatment picture. Although the water treatment system has historically been in the technicians' domain, knowing the technical aspects is important for the entire team to work together to ensure patient safety and well-being. This article describes the composition of water treatment systems for hemodialysis, as well as the monitoring and testing necessary to assure that both water and dialysate are safe for patient use...
September 2013: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
P Dionisio, C Borsetti, M Valenti, E Caramello, R Bergia, I M Berto, R Cravero, B Agostini, E Schillaci, N Chiappini, A Tommiselli, P Bajardi
The persistence of a left superior vena cava is the result of a lack of an embryological involution of the left anterior cardinal vein. This anomaly is very rare: about 0.3% of the general population. Its incidence increases remarkably from 3-10% in those patients affected with congenital heart disease. Described herein is a case of persistent left superior vena cava, discovered by chance, following the placement of a central venous catheter for hemodialysis. A chest X-ray in projection back-forward showed the central venous catheter along the left sternal margin simulating a placement in the aorta artery...
January 2003: Journal of Vascular Access
S L Zharskiĭ, O N Slobodianiuk, S N Slobodianiuk
The aim of the work was to study the possibility of development, clinical picture and outcome of rhabdomyolysis (R) caused by physical activity in young conscript personnel. It included 141 men aged 18-25 years. Group I was comprised of 48 patients treated in a military hospital, group 2 consisted of 98 healthy conscripts examined before and 12 days after regular physical exercises. General clinical examination was supplemented by measuring blood CPK. LDH, AST, ALT, and myoglobin levels. Erroneous diagnosis was made in 32 cases of group 1...
2013: Klinicheskaia Meditsina
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