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https://www.readbyqxmd.com/read/28736562/brain-natriuretic-peptide-is-a-marker-of-fluid-overload-in-incident-hemodialysis-patients
#1
Charles Chazot, Margaux Rozes, Cyril Vo-Van, Patrik Deleaval, Jean-Marc Hurot, Christie Lorriaux, Brice Mayor, Eric Zaoui, Guillaume Jean
BACKGROUND/AIMS: Brain natriuretic peptide (BNP) is secreted by cardiomyocytes under stretch condition. High blood levels are associated with decreased patient survival in heart failure patients and in hemodialysis (HD) patients. We report the monthly BNP change in the first months of HD therapy in incident patients and its relationship with fluid removal and cardiac history (CH). METHODS: All patients starting HD therapy in our unit from May 2008 to December 2012 were retrospectively analyzed...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28729965/fluid-overload-as-a-major-target-in-management-of-cardiorenal-syndrome-implications-for-the-practice-of-peritoneal-dialysis
#2
REVIEW
Amir Kazory
Congestion is an integral component of cardiorenal syndrome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability of modulating the interactions between the kidney and the heart in this setting. Peritoneal dialysis (PD) is a home-based therapeutic modality that is not only offered to patients with end-stage renal disease to provide solute clearance and ultrafiltration, but it has also been used in patients with refractory heart failure and fluid overload to help optimize volume status...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28710094/perspectives-from-the-kidney-health-initiative-on-advancing-technologies-to-facilitate-remote-monitoring-of-patient-self-care-in-rrt
#3
Mitchell H Rosner, Susie Lew, Paul Conway, Jennifer Ehrlich, Robert Jarrin, Uptal D Patel, Karen Rheuban, R Brooks Robey, Neal Sikka, Eric Wallace, Patrick Brophy, James Sloand
Telehealth and remote monitoring of a patient's health status has become more commonplace in the last decade and has been applied to conditions such as heart failure, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. Conversely, uptake of these technologies to help engender and support home RRTs has lagged. Although studies have looked at the role of telehealth in RRT, they are small and single-centered, and both outcome and cost-effectiveness data are needed to inform future decision making...
July 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28706868/tricuspid-valve-endocarditis
#4
Syed T Hussain, James Witten, Nabin K Shrestha, Eugene H Blackstone, Gösta B Pettersson
Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5-10% of cases of IE. Ninety percent of RSIE involves the tricuspid valve (TV). Given the relatively small numbers of TVIE cases operated on at most institutions, the purpose of this review is to highlight and discuss the current understanding of IE involving the TV. RSIE and TVIE are strongly associated with intravenous drug use (IVDU), although pacemaker leads, defibrillator leads and vascular access for dialysis are also major risk factors...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#5
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#6
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28682031/-the-peritoneal-ultrafiltration-in-patients-with-cardio-renal-disease
#7
Roberto Corciulo, Simone Corciulo
In Italy, the congestive heart failure is the leading cause of hospitalization and despite advances in therapy, the long-term prognosis is poor. Congestive heart failure is associated with advanced varying degrees of chronic renal disease that identify the cardio-renal syndrome type 2. High-dose diuretic therapy often fail to solve the water overload that is frequently the cause of death. The resistance to diuretics aggravates the state of the patient's edema and consequently morbidity and mortality. In the acute stage, the extracorporeal ultrafiltration unable to repair over hydration but needs frequent access weekly or midweek at the dialysis center...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28682030/-hemodialysis-and-cardiovascular-outcome
#8
Laura Panicali, Fabiana Brigante, Elena Mancini
Hemodialysis patients often present multiple comorbidities and have a high mortality rate (15-20% per year), mostly due to cardiovascular events. Besides predisposing pathological conditions related to uremia (heart failure, coronary heart disease, left ventricular hypertrophy, arrhythmias), they also have specific risk factors linked to the hemodialysis (HD) treatment in itself: chronic inflammation, fluid overload, autonomic nervous system dysfunction, arterovenous fistula. These factors may affect the hemodynamic compensatory systems (vascular refilling, arteriolar and venous tone, autonomic nervous system response) to fluid removal, with high risk of intra-dialysis hypotension (IDH) episodes or arrhythmic events...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28676035/white-matter-damage-in-maintenance-hemodialysis-patients-a-diffusion-tensor-imaging-study
#9
David A Drew, Bang-Bon Koo, Rafeeque Bhadelia, Daniel E Weiner, Sarah Duncan, Maria Mendoza-De la Garza, Aditi Gupta, Hocine Tighiouart, Tammy Scott, Mark J Sarnak
BACKGROUND: Patients treated with dialysis have high rates of brain infarcts, brain atrophy, and white matter disease. There are limited data regarding the presence of more subtle damage to brain white matter. METHODS: In the Cognition and Dialysis Study, we compared brain structure using diffusion tensor imaging in hemodialysis (HD) patients to individuals without known kidney disease, using tract based spatial statistics (TBSS) to compare Fractional Anisotropy (FA) and Mean Diffusivity (MD)...
July 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28674854/icodextrin-and-peritoneal-dialysis-advantages-and-new-applications
#10
REVIEW
Periklis Dousdampanis, Carlos Guido Musso, Konstantina Trigka
The impact of icodextrin (ico) on peritoneal dialysis (PD) extension and patient survival is well established. Predominantly, ico-based solutions were prescribed in high-transporter PD patients. Advantages of the ico-based solutions include increased biocompatibility, avoidance of glucotoxicity, enhanced ultrafiltration failure (UF), sodium removal rates, better metabolic and blood pressure control. Bimodal solutions and twice daily exchanges of ico-based solutions are two newly introduced strategies to avoid glucose exposure and/or enhance UF in PD patients with UF failure...
July 3, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28674037/blood-pressure-and-risk-of-cardiovascular-events-in-patients-on-chronic-hemodialysis-the-cric-study-chronic-renal-insufficiency-cohort
#11
Nisha Bansal, Charles E McCulloch, Feng Lin, Arnold Alper, Amanda H Anderson, Magda Cuevas, Alan S Go, Radhakrishna Kallem, John W Kusek, Claudia M Lora, Eva Lustigova, Akinlolu Ojo, Mahboob Rahman, Cassianne Robinson-Cohen, Raymond R Townsend, Jackson Wright, Dawei Xie, Chi-Yuan Hsu
We recently reported a linear association between higher systolic blood pressure (SBP) and risk of mortality in hemodialysis patients when SBP is measured outside of the dialysis unit (out-of-dialysis-unit-SBP), despite there being a U-shaped association between SBP measured at the dialysis unit (dialysis-unit-SBP) with risk of mortality. Here, we explored the relationship between SBP with cardiovascular events, which has important treatment implications but has not been well elucidated. Among 383 hemodialysis participants enrolled in the prospective CRIC study (Chronic Renal Insufficiency Cohort), multivariable splines and Cox models were used to study the association between SBP and adjudicated cardiovascular events (heart failure, myocardial infarction, ischemic stroke, and peripheral artery disease), controlling for differences in demographics, cardiovascular disease risk factors, and dialysis parameters...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28666408/effects-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-on-cardiovascular-events-and-residual-renal-function-in-dialysis-patients-a-meta-analysis-of-randomised-controlled-trials
#12
Youxia Liu, Xinxin Ma, Jie Zheng, Junya Jia, Tiekun Yan
BACKGROUND: The role of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) reducing risk of cardiovascular events (CVEs) and preserving kidney function in patients with chronic kidney disease is well-documented. However, the efficacy and safety of these agents in dialysis patients is still a controversial issue. METHODS: We systematically searched MEDLINE, Embase, Cochrane Library and Wanfang for randomized trials. The relative risk (RR) reductions were calculated with a random-effects model...
June 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#13
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28655387/hemodialysis-treatment-of-cardiorenal-syndrome
#14
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje
AIMS: We evaluated the impact of hemodialysis on mortality and hospital readmission in patients with cardiorenal syndrome. METHODS: All patients were NYHA IV functional class and underwent laboratory testing, echocardiography, and cardiac functional testing. Hemodialysis was indicated in patients with progressive decline of kidney function and consequent failure to titrate heart failure medication as well as in patients with hypervolemia that was resistant to conservative treatment with more than 4 annual hospitalizations due to heart failure and/or concomitant chronic kidney disease stage III - IV...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28651309/the-pattern-of-choosing-dialysis-modality-and-related-mortality-outcomes-in-korea-a-national-population-based-study
#15
Hyung Jong Kim, Jung Tak Park, Seung Hyeok Han, Tae-Hyun Yoo, Hyeong-Cheon Park, Shin-Wook Kang, Kyoung Hoon Kim, Dong-Ryeol Ryu, Hyunwook Kim
BACKGROUND/AIMS: Since comorbidities are major determinants of modality choice, and also interact with dialysis modality on mortality outcomes, we examined the pattern of modality choice according to comorbidities and then evaluated how such choices affected mortality in incident dialysis patients. METHODS: We analyzed 32,280 incident dialysis patients in Korea. Patterns in initial dialysis choice were assessed by multivariate logistic regression analyses. Multivariate Poisson regression analyses were performed to evaluate the effects of interactions between comorbidities and dialysis modality on mortality and to quantify these interactions using the synergy factor...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#16
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28633804/protective-effect-of-n-acetylcysteine-on-progression-to-end-stage-renal-disease-necessity-for-prospective-clinical-trial
#17
Chen-Yi Liao, Chi-Hsiang Chung, Chai-Chao Wu, Fu-Huang Lin, Chang-Huei Tsao, Chih-Chiang Wang, Wu-Chien Chien
BACKGROUND: We aimed to evaluate the potential benefits of N-acetylcysteine (NAC) on the risk of chronic kidney disease (CKD) progression to dialysis-requiring end-stage renal disease (ESRDd). METHODS: In a population-based cohort study of 145,062 individuals, 123,608 CKD patients who were followed up for 10years were included, and CKD patients treated with NAC (ICD-9-CM) were compared with those who were not treated. Using propensity score matching, we analyzed the predictors of CKD progression to ESRDd by Cox proportional hazards regression with adjustments for sex, age, and comorbidities, and evaluated the effect of NAC using cumulative defined daily dose (cDDD)...
June 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28612323/risk-assessment-and-outcomes-of-vasoplegia-after-cardiac-surgery
#18
Athanasios Tsiouris, Lynn Wilson, Ala S Haddadin, James J Yun, Abeel A Mangi
OBJECTIVE: The aim of this study was to analyze risk factors and outcomes of vasoplegia after cardiac surgery based on our experience with almost 2000 cardiac operations performed at our institution. METHODS: We retrospectively analyzed patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between 2011 and 2013. Data were available for a total of 1992 patients. We defined vasoplegia as hypotension with persistently low systemic vascular resistance (<800 dyn/s/cm) and preserved Cardiac Index (>2...
June 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28602210/renal-allograft-outcome-after-simultaneous-heart-and-kidney-transplantation
#19
Avishay Grupper, Ayelet Grupper, Richard C Daly, Naveen L Pereira, Matthew A Hathcock, Walter K Kremers, Fernando G Cosio, Brooks S Edwards, Sudhir S Kushwaha
Chronic kidney disease frequently accompanies end-stage heart failure and may result in consideration of simultaneous heart and kidney transplantation (SHKT). In recent years, there has been a significant increase in SHKT. This single-center cohort consisted of 35 patients who underwent SHKT during 1996 to 2015. The aim of this study was to review factors that may predict better long-term outcome after SKHT. Thirteen patients (37%) had delayed graft function (DGF) after transplant (defined as the need for dialysis during the first 7 days after transplant), which was significantly associated with mechanical circulatory support device therapy and high right ventricular systolic pressure before transplant...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28599901/esrd-after-heart-failure-myocardial-infarction-or-stroke-in-type%C3%A2-2-diabetic-patients-with-ckd
#20
David M Charytan, Scott D Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E Cooper, Janet B McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K Singh, Emmanuel A Burdmann, Andrew S Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J V McMurray, Brian Claggett, Eldrin F Lewis, Marc A Pfeffer
BACKGROUND: How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). PREDICTOR: Postrandomization CV events. OUTCOMES: ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event...
June 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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