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Pulmonary hypertension in hemodialysis patients

Masato Nishimura, Toshiko Tokoro, Satoru Yamazaki, Tetsuya Hashimoto, Hiroyuki Kobayashi, Toshihiko Ono
BACKGROUND: We examined the prevalence, prognosis, and effect of endothelin receptor antagonists on survival in end-stage kidney disease patients with idiopathic pre-capillary pulmonary hypertension. METHODS: We investigated 1988 end-stage kidney disease patients in Toujinkai Hospital from January 1, 2001 to December 31, 2014. Pulmonary hypertension was screened by symptoms (dyspnea, hypotension, or near syncope) and echocardiography, and diagnosed by computed tomography with enhancement, pulmonary flow scintigraphy, and right heart catheterization...
October 19, 2016: Clinical and Experimental Nephrology
Amin S I Banaga, Nihad K Siddiq, Randa T Alsayed, Rasha Babiker, Khalifa Elmusharaf
Tuberculosis (TB) is a major health problem in the developing countries. There are limited data about the prevalence of TB patients on maintenance hemodialysis (HD) in Sudan. The aim of this study is to identify the prevalence and presentation of TB among Sudanese maintenance HD patients. This is a hospital-based descriptive study. The participants of the study are all HD patients distributed in 13 HD centers in Khartoum and Khartoum North Provinces in Sudan. All patients attended the HD centers from November 1, 2014 to February 1, 2015, were interviewed by a questionnaire focused on personal and clinical data...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Fabio Rosario Salerno, Grace Parraga, Christopher William McIntyre
Dyspnea is one of the most common symptoms associated with CKD. It has a profound influence on the quality of life of CKD patients, and its underlying causes are often associated with a negative prognosis. However, its pathophysiology is poorly understood. While hemodialysis may address fluid overload, it often does not significantly improve breathlessness, suggesting multiple and co-existing alternative issues exist. The aim of this article is to discuss the main pathophysiologic mechanisms and the most important putative etiologies underlying dyspnea in CKD patients...
September 28, 2016: Seminars in Dialysis
Mu-Yang Hsieh, Tsung-Yan Chen, Lin Lin, Min-Tsun Liao, Ren-Huei Wang, Ruei-Cheng Kuo, Chao-Lun Lai, Chih-Cheng Wu
OBJECTIVES: Right heart catheterization is an important diagnostic tool but carries risks of adverse events. Little is known about the feasibility and safety of using dialysis arteriovenous (AV) shunts. We aim to evaluate the feasibility and safety of using dialysis AV shunts for access in right heart catheterization. METHODS: Hemodialysis patients who required right heart catheterization were prospectively enrolled. A 7 Fr sheath was inserted and a balloon-tipped pulmonary artery catheter was advanced for right heart catheterization...
September 15, 2016: Journal of Invasive Cardiology
Loheetha Ragupathi, Drew Johnson, Gregary D Marhefka
Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites...
August 2016: Texas Heart Institute Journal
Chung-Kuan Wu, Jyh-Gang Leu, Cheng-Chun Wei, Shih-Chung Hsieh
BACKGROUND: Acute thrombosis of a transplanted renal artery is a serious vascular complication following renal allograft transplantation, which usually occurs within the first month after transplantation and often results in graft loss. It rarely occurs beyond the first month, except in a rejected kidney or in a kidney with high-grade transplant renal artery stenosis. RESULT: A 65-year-old male with a history of type 2 diabetes mellitus, hypertension, pulmonary tuberculosis, and end-stage renal disease was previously treated with hemodialysis (HD)...
July 2016: Medicine (Baltimore)
Yi-Chih Hung, Che-Chen Lin, Wei-Lun Huang, Man-Ping Chang, Ching-Chu Chen
The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio...
2016: Scientific Reports
Hui-Ting Wang, Yung-Lung Chen, Chiung-Jen Wu
BACKGROUND: Patients with chronic kidney disease (CKD) experience poor outcomes after acute myocardial infarction. This study investigated how CKD affects clinical outcomes in patients with non-ST segment elevation myocardial infarction (NSTEMI) receiving PCI. METHODS: This retrospective study analyzed record-linked data for 314 patients who had received PCI for NSTEMI between January 2008 and September 2010. The 141 patients with advanced CKD were compared with 173 patients who had mild or no CKD...
October 1, 2016: International Journal of Cardiology
Cheng-Huang Shen, Cai-Mei Zheng, Kee-Thai Kiu, Hsin-An Chen, Chia-Chang Wu, Kuo-Cheng Lu, Yung-Ho Hsu, Yuh-Feng Lin, Yuan-Hung Wang
End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. We used the Taiwan National Health Insurance Research Database to determine the incident AF among peritoneal dialysis (PD) and hemodialysis (HD) patients in Taiwan.Our ESRD cohort include Taiwan National Health Insurance Research Database, we identified 15,947 patients, who started renal replacement therapy between January 1, 2002 and December 31, 2003...
June 2016: Medicine (Baltimore)
T E Rudenko, M P Vasil'eva, N I Solomakhina, I M Kutyrina
AIM: To investigate the incidence and risk factors of pulmonary hypertension (PH) in patients with chronic kidney disease (CKD). SUBJECTS AND METHODS: 86 patients (53% men, 47% women; mean age, 45±13 years) with nondiabetic CKD were examined. According to the magnitude of glomerular filtration rate (GFR) decrease, all the patients were divided into 3 groups: 1) 33 patients with a GFR of 89--45 ml/min; 2) 33 with a GFR of 44--15 ml/min; 3) 20 with a GFR of <15 ml/min who were treated with hemodialysis...
2016: Terapevticheskiĭ Arkhiv
Mu-Yang Hsieh, Lin Lin, Tsung-Yan Chen, Ren-Huei Wang, Su-Chin Huang, HsiuChiao Liu, Chao-Lun Lai, Shih-Yen Pu, Kuei-Chin Tsai, Chih-Cheng Wu
BACKGROUND: The prevalence of pulmonary hypertension is unusually high in Taiwanese patients with end-stage renal disease. Thrombosis of hemodialysis grafts is common and pulmonary embolism has been reported after endovascular thrombectomy. The aim of this study was to evaluate the relationship between pulmonary hypertension and endovascular thrombectomy of hemodialysis grafts. METHODS: One hundred and ten patients on hemodialysis via arteriovenous grafts were enrolled in our study...
May 2016: Acta Cardiol Sin
Jun Miyahara, Masaki Yamamoto, Kyoko Motoshige, Naoya Fujita, Shigeru Ohki
Recent advances in neonatal cardiorespiratory management and neonatal renal replacement therapy have led to occasional reports of favorable short-term and long-term outcomes for Potter sequence, once thought to be fatal. The present patient was a girl born at a gestational age of 34 weeks 4 days with a birthweight of 1398 g. She was diagnosed with Potter sequence complicated by pulmonary hypoplasia due to left renal agenesis and small right kidney. Hemodialysis was started because anuria persisted even after persistent pulmonary hypertension receded and cardiorespiratory status improved...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Christopher Lau, Padraic O'Malley, Mario Gaudino, Douglas S Scherr, Leonard N Girardi
BACKGROUND: Intraabdominal malignancies with cavoatrial extension can be resected using cardiopulmonary bypass and deep hypothermic circulatory arrest (DHCA). METHODS: Twenty-five consecutive patients underwent resection of intraabdominal tumor with cavoatrial thrombectomy using DHCA at a single tertiary center. Recurrence-free survival, cancer-specific survival, and overall survival were estimated using Kaplan-Meier analysis. RESULTS: All patients had renal artery embolization preoperatively...
September 2016: Annals of Thoracic Surgery
Noha Hassanin, Alkhateeb Alkemary
BACKGROUND: Pulmonary hypertension (PH) is one of the most important comorbidities in patients undergoing hemodialysis (HD). The goal of the present work is to determine the possible etiologic factors for its occurrence. METHODS: The prevalence of PH was estimated by Doppler echocardiography in a cohort of 100 patients aged 49.3 ± 13.9 years on regular HD. Mean pulmonary artery pressure was estimated from pulmonary acceleration time by Mahan's regression equation...
April 2016: Journal of the Saudi Heart Association
Ottavio Bosello, Maria Pia Donataccio, Massimo Cuzzolaro
Obesity is still defined on the basis of body mass index (BMI) and BMI in itself is generally accepted as a strong predictor of overall early mortality. However, an inverse association between BMI and mortality has been reported in patients with many disease states and in several clinical settings: hemodialysis, cardiovascular diseases, hypertension, stroke, diabetes, chronic obstructive pulmonary disease, surgery, etc. This unexpected phenomenon is usually called obesity-survival paradox (OP). The contiguous concepts of metabolically healthy obesity (MHO, a phenotype having BMI ≥ 30 but not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance, HOMA, <2...
June 2016: Eating and Weight Disorders: EWD
Huang-Pin Wu, Chien-Ming Chu, Chun-Yao Lin, Chung-Chieh Yu, Chung-Ching Hua, Teng-Jen Yu, Yu-Chih Liu
BACKGROUND: The risk factors for Staphylococcus aureus (S. aureus) pneumonia are not fully identified. The aim of this work was to find out the clinical characteristics associated with S. aureus infection in patients with healthcare-associated pneumonia (HCAP) and hospital-acquired pneumonia (HAP), which may be applicable for more appropriate selection of empiric antibiotic therapy. METHODS: From July 2007 to June 2010, patients who were admitted to the intensive care unit with severe HCAP/HAP and severe sepsis were enrolled in this study...
2016: Pulmonary Medicine
Edward G Clark, Ayub Akbari, Brett Hiebert, Swapnil Hiremath, Paul Komenda, Charmaine E Lok, Louise M Moist, Michael E Schachter, Navdeep Tangri, Manish M Sood
BACKGROUND: Non-tunneled (temporary) hemodialysis catheters (NTHCs) are the least-optimal initial vascular access for incident maintenance hemodialysis patients yet little is known about factors associated with NTHC use in this context. We sought to determine factors associated with NTHC use and examine regional and facility-level variation in NTHC use for incident maintenance hemodialysis patients. METHODS: We analyzed registry data collected between January 2001 and December 2010 from 61 dialysis facilities within 12 geographic regions in Canada...
2016: BMC Nephrology
Süreyya Yılmaz, Yasar Yildirim, Mahsuk Taylan, Melike Demir, Zülfükar Yilmaz, Ali Veysel Kara, Fatma Aydin, Hadice Selimoglu Sen, Aziz Karabulut, Fusun Topcu
BACKGROUND Pulmonary arterial hypertension (PAH) is common disease among hemodialysis (HD) patients and is associated with increased morbidity and mortality. However, its pathogenesis has not been completely elucidated. We aimed to evaluate the frequency of PAH in HD patients, as well as the relationship between fluid status and PAH. MATERIAL AND METHODS We enrolled 77 HD patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status. BIA was performed before and 30 min after the midweek of HD...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Radosław Grabysa, Zofia Wańkowicz
In recent years, increasing attention has been paid to pulmonary hypertension (PH) as a strong and independent risk factor for adverse outcome in the population of patients on long-term dialysis. Published results of observational studies indicate that the problem of PH refers mostly to patients on long-term hemodialysis and is less common in peritoneal dialysis patients. The main cause of this complication is proximal location of the arteriovenous fistula, causing chronically increased cardiac output. This paper presents the usefulness of transthoracic echocardiography (TTE) for measurement of the Tricuspid Annular Plane Systolic Excursion (TAPSE) in the early diagnosis of PH in dialysis patients...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Javier Reque, Borja Quiroga, Caridad Ruiz, Maria Teresa Villaverde, Almudena Vega, Soraya Abad, Nayara Panizo, J Manuel López-Gómez
BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is a progressive disorder that can be caused by several underlying conditions or an intrinsic alteration of the pulmonary vasculature. Chronic increased pressure in the pulmonary vasculature leads to changes in the architecture of the vessels that can perpetuate PH and produce right ventricular dysfunction. These structural and functional alterations can decrease survival and quality of life of patients on hemodialysis; however, there is a lack of evidence about this problem in this population...
February 19, 2016: Medicina Clínica
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