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https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#1
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#2
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28098109/visceral-leishmaniasis-in-adults-with-nephropathy
#3
H Kaaroud El Jeri, A Harzallah, S Barbouch, M M Bacha, R Kheder, S Turki, S Trabelsi, E Abderrahim, F Ben Hamida, T Ben Abdallah
The aim of this study is to evaluate the features of visceral leishmaniasis (VL) in adults with nephropathy, who were not infected with the human immunodeficiency virus. This is a retrospective study of 14 adults hospitalized between 2000 and 2014, with VL and renal involvement. Clinical, biological, and therapeutic data were collected from the patients' medical files. Eleven women and three men, most of whom were from the North of the country, with a mean age of 40.5 years were studied. Lupus was present in five cases, the Sicca syndrome in three cases, diabetes in one case, renal failure on dialysis in two cases, and there were three renal transplant recipients...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28098099/the-evaluation-of-the-relationship-between-serum-levels-of-interleukin-6-and-interleukin-10-and-metabolic-acidosis-in-hemodialysis-patients
#4
Narges Sadat Zahed, Saghar Chehrazi
Chronic kidney disease is defined as progressive kidney dysfunction. The levels of various cytokines increase in hemodialysis (HD) patients. High levels of interleukins (ILs) and presence of metabolic acidosis are described as independent risk factors for morbidity and mortality in these patients. This study was designed to evaluate the relationship between IL-6 and IL-10 and serum bicarbonate and metabolic acidosis in HD patients. In this analytical crosssectional study, patients referred to the HD units of Loghman Hakim and Shahid Ashrafi Esfahani Hospitals were randomly selected...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28098098/a-study-of-clinical-assessment-of-frailty-in-patients-on-maintenance-hemodialysis-supported-by-cashless-government-scheme
#5
Manjusha Yadla, Jyothi Priyadarshini John, Mahesh Mummadi
This is a prospective cohort study to assess the prevalence of frailty in patients undergoing maintenance hemodialysis (HD) under the government-funded scheme at our center and to assess the relationship between frailty and falls, hospitalizations, and mortality. This was done at our center which is completely supported by the government, which provides HD to all the patients under poverty line. Epidemiological data, anthropometric measurements, comorbidities assessment, frailty assessment using Fried criteria, subsequent hospitalizations, falls, and mortality were recorded in our prevalent dialysis population at our center between October 2014 and October 2015...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097800/inception-and-utility-of-a-renal-replacement-registry-using-administrative-health-data-in-north-east-italy
#6
Francesca Valent, Anna Busolin, Giuliano Boscutti
BACKGROUND: Disease registries are useful tools for public health planning, evaluating clinical practice and providing information on cohorts of patients. METHODS: The administrative databases of the regional health information system of Friuli Venezia Giulia, Italy were used to build a regional registry of the resident population in renal replacement therapy (including dialysis and renal transplantation), through an algorithm taking into account hospital discharge and outpatient ambulatory care data...
January 18, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28096439/the-24-month-changes-in-body-fat-mass-and-adipokines-in-patients-starting-peritoneal-dialysis
#7
Soo Jeong Choi, Moo Yong Park, Jin Kuk Kim, Seung Duk Hwang
♦ Background: Peritoneal dialysis (PD) is characterized by a gain in fat mass. The fat tissue is a complex endocrine organ that releases various adipokines. In this study, we prospectively examined serial changes of fat composition and adipokines in patients undergoing PD. ♦ Methods: Body composition was assessed by computed tomography (CT). Nutrition status and adipokines (leptin, adiponectin, interleukin [IL]-6, and tumor necrosis factor [TNF]-α) were assessed on the 7th day and 6 months, 12 months, and 24 months after the start of PD...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#8
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#9
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#10
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28081061/vital-signs-decrease-in-incidence-of-diabetes-related-end-stage-renal-disease-among-american-indians-alaska-natives-united-states-1996-2013
#11
Ann Bullock, Nilka Ríos Burrows, Andrew S Narva, Karen Sheff, Israel Hora, Akaki Lekiachvili, Hannah Cain, David Espey
BACKGROUND: American Indians and Alaska Natives (AI/AN) have the highest diabetes prevalence among any racial/ethnic group in the United States. Among AI/AN, diabetes accounts for 69% of new cases of end-stage renal disease (ESRD), defined as kidney failure treated with dialysis or transplantation. During 1982-1996, diabetes-related ESRD (ESRD-D) in AI/AN increased substantially and disproportionately compared with other racial/ethnic groups. METHODS: Data from the U...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28077806/low-protein-diet-for-the-prevention-of-renal-failure
#12
Shaw Watanabe
The prevalence of chronic kidney disease (CKD) is estimated to be 8-16% worldwide, and it is increasing. CKD is a risk factor for heart attack and stroke, and it can progress to kidney failure requiring dialysis or transplantation. Recently, diabetic nephropathy has become the most common cause of CKD. In Japan, the cumulative probability of requiring hemodialysis by the age 80 years is 1/50 in males and 1/100 in females. The number of patients under hemodialysis in Japan exceeded 320,000 in 2014, among which 38,000 were newcomers and 27,000 died...
2017: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
https://www.readbyqxmd.com/read/28077410/health-policies-on-dialysis-modality-selection-a-nationwide-population-cohort-study
#13
Yi-Chun Lin, Yen-Chung Lin, Chih-Chin Kao, Hsi-Hsien Chen, Chih-Cheng Hsu, Mai-Szu Wu
OBJECTIVES: In Taiwan, peritoneal dialysis (PD) and haemodialysis are fully accessible to patients with end-stage renal disease. However, the usage of PD is considered low in Taiwan. Since 2005, 4 major policies have been implemented by Taiwan's Ministry of Health and Welfare, namely a multidisciplinary predialysis care programme and usage increasing the PD incidence as a key performance indicator (KPI) for hospital accreditation, both of which were implemented in 2006; reimbursement of the glucose-free dialysate, icodextrin that was implemented in 2007; and insurance reimbursement for renting automated PD machines that was implemented in 2008...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28073668/drug-eluting-stenting-for-femoropopliteal-lesions-followed-by-cilostazol-treatment-reduces-stent-restenosis-in-patients-with-symptomatic-peripheral-artery-disease
#14
Kan Zen, Mitsuyoshi Takahara, Osamu Iida, Yoshimitsu Soga, Daizo Kawasaki, Shinsuke Nanto, Hiroyoshi Yokoi, Satoaki Matoba
BACKGROUND: Cilostazol improves clinical endovascular therapy outcomes for femoropopliteal (FP) lesions in patients with symptomatic peripheral arterial disease, but whether it also has clinical benefits for patients after drug-eluting stent implantation remains unclear. METHODS: This study is a subanalysis of the ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy (ZEPHYR) study, a prospective multicenter study investigating FP lesions treated with the Zilver (Cook Medical, Bloomington, Ind) paclitaxel-eluting stent...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28068455/variation-in-access-to-kidney-transplantation-across-renal-programs-in-ontario-canada
#15
K L Naylor, S N Dixon, A X Garg, S J Kim, P G Blake, G E Nesrallah, M K McCallum, C D'Antonio, A H Li, G A Knoll
In the United States, kidney transplant rates vary significantly across end-stage renal disease (ESRD) networks. We conducted a population-based cohort study to determine whether there was variability in kidney transplant rates across renal programs in a health care system distinct from the United States. We included incident chronic dialysis patients in Ontario, Canada, from 2003 to 2013 and determined the 1-, 5-, and 10-year cumulative incidence of kidney transplantation in 27 regional renal programs (similar to U...
January 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28057772/clot-structure-a-potent-mortality-risk-factor-in-patients-on-hemodialysis
#16
Katharina Schuett, Anna Savvaidis, Sebastian Maxeiner, Katharina Lysaja, Vera Jankowski, Stephan H Schirmer, Nada Dimkovic, Peter Boor, Nadine Kaesler, Friedo W Dekker, Jürgen Floege, Nikolaus Marx, Georg Schlieper
Patients with CKD on hemodialysis exhibit increased cardiovascular risk. Fibrin clot structure and clot lysis are crucially involved in development of cardiovascular events, but little is known about the influence of clot density on outcome in patients on hemodialysis. We determined fibrin clot structure parameters and effect on mortality in a prospective cohort of 171 patients on chronic hemodialysis (mean±SD age =59±11 years old; 54% men) using a validated turbidimetric assay. Kaplan-Meier analysis revealed that patients on hemodialysis with a denser clot structure had increased all-cause and cardiovascular mortality risks (log rank P=0...
January 5, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#17
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28049587/response-to-active-hepatitis-b-vaccination-and-mortality-in-incident-dialysis-patients
#18
Emanuel Zitt, Hildegard Hafner-Giessauf, Birgitta Wimmer, Alexander Herr, Sabine Horn, Claudia Friedl, Hannelore Sprenger-Mähr, Reinhard Kramar, Alexander R Rosenkranz, Karl Lhotta
All patients with advanced chronic kidney disease or on renal replacement therapy should receive active hepatitis B vaccination. The aim of this retrospective cohort study was to investigate the association between the immune response to hepatitis B vaccination and all-cause, cardiovascular or infection-related mortality in incident dialysis patients starting dialysis between 2001 and 2008 (n=426) in two Austrian dialysis centers. Vaccination response was defined as follows: absent anti-HBs antibody titer or a titer <10IU/L was classified as non-response, seroconversion (SC) was defined as a titer ⩾10IU/L, and seroprotection (SP) as a titer ⩾100IU/L...
December 31, 2016: Vaccine
https://www.readbyqxmd.com/read/28049235/the-prevalence-and-management-of-anemia-in-chronic-kidney-disease-patients-result-from-the-korean-cohort-study-for-outcomes-in-patients-with-chronic-kidney-disease-know-ckd
#19
Sang Ryol Ryu, Sue K Park, Ji Yong Jung, Yeong Hoon Kim, Yun Kyu Oh, Tae Hyun Yoo, Suah Sung
Anemia is a common and significant complication of chronic kidney disease (CKD). However, its prevalence and current management status has not been studied thoroughly in Korea. We examined the prevalence of anemia, its association with clinical and laboratory factors, and utilization of iron agents and erythropoiesis stimulating agents using the baseline data from the large-scale CKD cohort in Korea. We defined anemia when hemoglobin level was lower than 13.0 g/dL in males and 12.0 g/dL in females, or received by erythropoiesis stimulating agents...
February 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28044236/vascular-adhesion-protein-1-in-hemodialysis-and-hemodiafiltration-patients-effect-of-single-hemodialysis-session-on-its-level-in-regard-to-type-of-anticoagulant
#20
Jolanta Malyszko, Ewa Koc-Zorawska, Piotr Kozminski, Jacek S Malyszko
PURPOSE: Traditional anticoagulants used in intermittent hemodialysis (HD) are unfractionated heparin (UFH) and increasingly low molecular weight heparins (LMWHs). Repeated and prolonged exposure to UFH and/or LMWHs may further disturb hemostasis in uremic patients. Vascular adhesion protein-1 (VAP-1) is secreted by vascular smooth muscle cells, adipocytes and endothelial cells with functional monoamine oxidase activity and is elevated in atherosclerosis, diabetes mellitus and obesity...
January 2, 2017: International Urology and Nephrology
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