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https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#1
Morgane Commereuc, Emmanuel Guérot, Anais Charles-Nelson, Adrien Constan, Sandrine Katsahian, Frédérique Schortgen
OBJECTIVES: To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. DESIGN: Retrospective pooled analysis of prospectively collected data. SETTING: ICUs of two teaching hospitals in Paris area, France. SUBJECTS: One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. INTERVENTIONS: None...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#2
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28419668/prevalence-and-associated-variables-of-postdialysis-fatigue-results-of-a-prospective-multicenter-study
#3
Maurizio Bossola, Emanuele Marzetti, Enrico Di Stasio, Tania Monteburini, Stefano Cenerelli, Katia Mazzoli, Emanuele Parodi, Vittorio Sirolli, Stefano Santarelli, Fabio Ippoliti, Pier Eugenio Nebiolo, Mario Bonomini, Roberta Melatti, Carlo Vulpio
AIMS: Little is known about postdialysis fatigue (PDF), a debilitating symptom of hemodialysis patients. METHODS: In 5 hemodialysis units of northern-centre Italy, patients were regarded to suffer from PDF if they spontaneously offered this complaint when asked the open-ended question: Do you feel better or worse after dialysis? If worse, please specify in which way. A complaint of fatigue would be probed further with questions directed at its duration, frequency and intensity, allowing creation of a fatigue index of severity (one third of the sum of these three parameters, each rated from 1 to 5)...
April 17, 2017: Nephrology
https://www.readbyqxmd.com/read/28417662/clinician-views-of-patient-decisional-conflict-when-deciding-between-dialysis-and-conservative-management-qualitative-findings-from-the-palliative-care-in-chronic-kidney-disease-packs-study
#4
Helen Noble, Kevin Brazil, Aine Burns, Sarah Hallahan, Charles Normand, Paul Roderick, Colin Thompson, Peter Maxwell, Magdi Yaqoob
BACKGROUND: Only a paucity of studies have addressed clinician perspectives on patient decisional conflict, in making complex decisions between dialysis and conservative management (renal supportive and palliative care). AIM: To explore clinician views on decisional conflict in patients with end-stage kidney disease. DESIGN: Interpretive, qualitative study. SETTING AND PARTICIPANTS: As part of the wider National Institute for Health Research, PAlliative Care in chronic Kidney diSease study, semi-structured interviews were conducted with clinicians (nephrologists n = 12; 7 female and clinical nurse specialists n = 15; 15 female) across 10 renal centres in the United Kingdom...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28413417/the-dialysis-sodium-gradient-a-modifiable-risk-factor-for-fluid-overload
#5
Emilie Trinh, Catherine Weber
BACKGROUND: Fluid overload in patients on conventional hemodialysis is a frequent complication, associated with increased cardiovascular morbidity and mortality. The dialysate sodium prescription is a potential modifiable risk factor. Our primary objective was to describe associations between dialysate-to-serum sodium gradient and parameters of fluid status. A secondary objective was to evaluate the 6-month risk of hospitalization and mortality in relation to sodium gradient. METHODS: We performed a cross-sectional study of 110 prevalent conventional hemodialysis patients at a single center...
January 2017: Nephron Extra
https://www.readbyqxmd.com/read/28412933/beyond-quality-of-life-a-cross-sectional-study-on-the-mental-health-of-patients-with-chronic-kidney-disease-undergoing-dialysis-and-their-caregivers
#6
Beatriz Dos Santos Pereira, Neimar da Silva Fernandes, Nayara Pires de Melo, Renata Abrita, Fabiane Rossi Dos Santos Grincenkov, Natália Maria da Silva Fernandes
BACKGROUND: Patients with terminal chronic kidney disease (CKDT) requiring renal replacement therapies (RRT) undergo important changes in living habits and frequently need caregiving. These patients and their caregivers are risk groups for the development of physical and psychological symptoms. This study aimed to evaluate the prevalence of anxiety, depression, stress, fatigue, social support, and quality of life in patients with CKD and their caregivers. METHOD: This cross sectional study was conducted with 21 patients and their caregivers, from January to September 2015...
April 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28409034/increased-intracranial-pressure-during-hemodialysis-in-a-patient-with-anoxic-brain-injury
#7
Anton Lund, Mette B Damholt, Ditte G Strange, Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28407876/more-frequent-hemodialysis-does-not-effectively-clear-protein-bound-azotemic-solutes-derived-from-gut-microbiome-metabolism
#8
Andrew Davenport
The 5-year survival rate for hemodialysis patients remains lower than that for some of the more common solid organ cancers. Trials of increasing urea clearance by hemodialysis have failed to demonstrate improved patient survival. Accumulating evidence suggests that protein-bound azotemic solutes derived from gut microbiome metabolism have greater potential for toxicity than urea. The Frequent Hemodialysis Network Trials group now report that increasing dialysis frequency to 6 times a week did not effectively improve clearance of these protein-bound azotemic solutes compared with standard thrice weekly sessions...
May 2017: Kidney International
https://www.readbyqxmd.com/read/28396123/unique-hemoglobin-a1c-level-distribution-and-its-relationship-with-mortality-in-diabetic-hemodialysis-patients
#9
Junichi Hoshino, Maria Larkina, Angelo Karaboyas, Brian A Bieber, Yoshifumi Ubara, Kenmei Takaichi, Tadao Akizawa, Takashi Akiba, Shunichi Fukuhara, Ronald L Pisoni, Akira Saito, Bruce M Robinson
Diabetic hemodialysis patients with hemoglobin A1c (HbA1c) levels below 6.5% and over 8.0% face a higher mortality risk. To determine the optimal glycemic control in Japanese patients, we examined the association between HbA1c and mortality in 2,300 Japanese diabetic patients on maintenance hemodialysis with HbA1c levels determined at enrollment in the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS) phases 2-5, using Cox regression analysis with adjustment for baseline age, sex, dialysis vintage, 12 general comorbidities, hemoglobin, albumin and creatinine levels, and insulin use; stratification by JDOPPS phase; and facility clustering taken into account...
April 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28393968/-encapsulating-peritoneal-sclerosis
#10
Rubén Torres, Paula Ebner, María Eugenia Sanhueza, Miriam Alvo, Erico Segovia, Paula Segura
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is a complication of peritoneal dialysis (PD) with a low prevalence but high mortality. It is characterized by peritoneal inflammation and fibrosis with subsequent development of intestinal encapsulation. It is associated with a long lapse on PD, frequent episodes of peritonitis, high glucose solution use, and high peritoneal transport status. AIM: To report the clinical features of patients on PD, who developed EPS...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28391343/cost-effectiveness-of-eculizumab-treatment-after-kidney-transplantation-in-patients-with-atypical-haemolytic-uraemic-syndrome
#11
Jan A J G van den Brand, Jacobien C Verhave, Eddy M Adang, Jack F M Wetzels
Background: Kidney transplantation in patients with atypical haemolytic uraemic syndrome (aHUS) is frequently complicated by recurrence of aHUS, often resulting in graft loss. Eculizumab prophylaxis prevents recurrence, improving graft survival. An alternative treatment strategy has been proposed where eculizumab is administered upon recurrence. We combined available evidence and performed a cost-effectiveness analysis of these competing strategies. Methods: A cost-effectiveness analysis using a decision analytical approach with Markov chain analyses was used to compare alternatives for aHUS patients with end-stage renal disease (ESRD): (i) dialysis treatment, (ii) kidney transplantation, (iii) kidney transplantation with eculizumab therapy upon recurrence of aHUS, (iv) kidney transplantation with eculizumab induction consisting of 12 months of prophylaxis and (v) kidney transplantation with lifelong eculizumab prophylaxis...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28390405/fam-face-sg-a-score-for-risk-stratification-of-frequent-hospital-admitters
#12
Lian Leng Low, Nan Liu, Kheng Hock Lee, Marcus Eng Hock Ong, Sijia Wang, Xuan Jing, Julian Thumboo
BACKGROUND: An accurate risk stratification tool is critical in identifying patients who are at high risk of frequent hospital readmissions. While 30-day hospital readmissions have been widely studied, there is increasing interest in identifying potential high-cost users or frequent hospital admitters. In this study, we aimed to derive and validate a risk stratification tool to predict frequent hospital admitters. METHODS: We conducted a retrospective cohort study using the readily available clinical and administrative data from the electronic health records of a tertiary hospital in Singapore...
April 8, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28389745/short-frequent-5-days-per-week-in-center-hemodialysis-versus-3-days-per-week-treatment-a-randomized-crossover-pilot-trial-through-the-midwest-pediatric-nephrology-consortium
#13
Benjamin L Laskin, Guixia Huang, Eileen King, Denis F Geary, Christoph Licht, Joshua P Metlay, Susan L Furth, Tom Kimball, Mark Mitsnefes
BACKGROUND: No controlled trials in children with end-stage kidney disease have assessed the benefits of more frequently administered hemodialysis (HD). METHODS: We conducted a multicenter, crossover pilot trial to determine if short, more frequent (5 days per week) in-center HD was feasible and associated with improvements in blood pressure compared with three conventional HD treatments per week. Because adult studies have not controlled for the weekly duration of dialysis, we fixed the total treatment time at 12 h a week of dialysis during two 3-month study periods; only frequency varied from 5 to 3 days per week between study periods...
April 8, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28387791/contemporary-results-of-hemiarch-replacement
#14
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Antonino Di Franco, Lucas B Ohmes, Fawad Hameedi, Cristiano Spadaccio, Leonard N Girardi
OBJECTIVES: Our goal was to report on early and midterm outcomes of hemiarch replacement performed in a high-volume centre. METHODS: We extrapolated hemiarch replacements from our institutional aortic database. We also analysed the impact of aortic disease (dissection vs aneurysm) on the outcomes of de novo hemiarch replacement. RESULTS: A total of 756 patients underwent hemiarch replacement between 1997 and 2016. After elimination of cases involving the aortic root/valve and redo cases, we identified 426 cases of de novo -isolated hemiarch replacement (369 aneurysms and 57 dissections)...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28372582/coping-with-kidney-disease-qualitative-findings-from-the-empowering-patients-on-choices-for-renal-replacement-therapy-epoch-rrt-study
#15
Lalita Subramanian, Martha Quinn, Junhui Zhao, Laurie Lachance, Jarcy Zee, Francesca Tentori
BACKGROUND: The highly burdensome effects of kidney failure and its management impose many life-altering changes on patients. Better understanding of successful coping strategies will inform patients and help health care providers support patients' needs as they navigate these changes together. METHODS: A qualitative, cross-sectional study involving semi-structured telephone interviews including open- and closed-ended questions, with 179 U.S. patients with advanced chronic kidney disease (CKD), either not yet on dialysis ([CKD-ND], n = 65), or on dialysis (hemodialysis [HD], n = 76; or peritoneal dialysis [PD], n = 38) recruited through social media and in-person contacts from June to December 2013...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28366609/no-evidence-of-increased-ocular-involvement-in-candidemic-patients-initially-treated-with-echinocandins
#16
P Muñoz, A Vena, B Padilla, M Valerio, M I Sanchez, M Puig-Asensio, J Fortún, M Fernández-Ruiz, P Merino, J E Losa, A Loza, R A Rivas, E Bouza
Candins are commonly used as initial therapy in patients with candidemia and are known to diffuse poorly into ocular tissue. The aim of our multicenter study was to assess whether eye involvement was more common in patients initially treated with echinocandins. We performed a post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program implemented in Spain during 2010-2011 (CANDIPOP project). Eye involvement was detected in 13 of 168 patients with candidemia (7.7%) who underwent ophthalmoscopy...
February 27, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28357590/non-machinery-dialysis-that-achieves-blood-purification-therapy-without-using-full-scale-dialysis-machines
#17
Takaya Abe, Mistutaka Onoda, Tomohiko Matsuura, Jun Sugimura, Wataru Obara, Toshiya Sato, Mihoko Takahashi, Kenta Chiba, Tomiya Abe
An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury...
March 29, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28355409/life-saving-vascular-access-in-vascular-capital-exhaustion-single-center-experience-in-intra-atrial-catheters-for-hemodialysis
#18
Marta Pereira, Noélia Lopez, Iolanda Godinho, Sofia Jorge, Estela Nogueira, Fernando Neves, Alice Fortes, António G Costa
INTRODUCTION: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. OBJECTIVE: To assess the complications of IAC placement, as well as patient and vascular access survival after this procedure. METHODS: The authors retrospectively analyzed all seven patients with vascular capital exhaustion, without immediate alternative renal replacement therapy (RRT), who underwent IAC placement between January 2004 and December 2015 at a single center...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28355399/comparative-analysis-of-primary-and-secondary-glomerulopathies-in-the-northeast-of-brazil-data-from-the-pernambuco-registry-of-glomerulopathies-repeg
#19
Denise Maria do Nascimento Costa, Lucila Maria Valente, Pedro Alves da Cruz Gouveia, Filipe Wanick Sarinho, Gisele Vajgel Fernandes, Maria Alina Gomes de Mattos Cavalcante, Camila Barbosa Lyra de Oliveira, Carolina de Andrade Jordão de Vasconcelos, Emanuel Sávio Cavalcante Sarinho
INTRODUCTION: In Brazil, glomerulopathies are the third leading cause of chronic renal disease, accounting for 11% of dialysis patients. Studies on the prevalence of this disease in Northeastern Brazil are scarce. OBJECTIVE: The aim was to describe the findings of biopsies and to conduct a comparative analysis on the clinical laboratory presentation of primary glomerulopathies (PG) and secondary glomerulopathies (SG). METHODS: This was a retrospective study conducted at two public teaching hospitals in the state of Pernambuco, Northeastern Brazil...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28355264/epidemiology-and-outcomes-of-hypoglycemia-in-patients-with-advanced-diabetic-kidney-disease-on-dialysis-a-national-cohort-study
#20
Yeh-Wen Chu, Hsuan-Ming Lin, Jhi-Joung Wang, Shih-Feng Weng, Chih-Ching Lin, Chih-Chiang Chien
BACKGROUND: Patients with advanced diabetic kidney disease (DKD) behave differently to diabetic patients without kidney disease. We aimed to investigate the associations of hypoglycemia and outcomes after initiation of dialysis in patients with advanced DKD on dialysis. METHODS: Using National Health Insurance Research Database, 20,845 advanced DKD patients beginning long-term dialysis between 2002 and 2006 were enrolled. We investigated the incidence of severe hypoglycemia episodes before initiation of dialysis...
2017: PloS One
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