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https://www.readbyqxmd.com/read/29037311/therapeutic-plasma-exchange-in-rheumatic-diseases-a-university-hospital-experience
#1
Juan Pablo Córdoba, Carolina Larrarte, Cristina Estrada, Daniel G Fernández-Ávila
INTRODUCTION: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting. METHODS: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013...
September 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/29037159/bowel-perforation-by-a-peritoneal-dialysis-catheter-report-of-two-cases
#2
Maki Fujiwara, Takeshi Soda, Takuya Okada, Hiroshi Kanamaru, Takahiro Inoue, Osamu Ogawa
BACKGROUND: Complications of peritoneal dialysis (PD) such as pain and catheter leakage are frequently reported. Delayed bowel perforation of a PD catheter is a rare adverse event but a serious complication associated with significant mortality. Bowel perforation of a PD catheter is difficult to differentiate from PD-related peritonitis and likely to result in a delay in diagnosis. Here, we report two cases of bowel perforation after PD catheter insertion by the stepwise initiation of PD using the Moncrief and Popovich technique (SMAP) and peritoneal wall anchor technique (PWAT)...
October 16, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29027687/filter-adsorption-of-anidulafungin-to-a-polysulfone-based-hemofilter-during-cvvhd-in-vitro
#3
Peter Kolbinger, Michael Gruber, Gabriel Roth, Bernhard M Graf, Karl-Peter Ittner
Candidemia is frequent in critically ill patients, especially in combination with an acute kidney injury (AKI). Echinocandins generally are recommended for therapy of such infections. Recent studies found no need for dosage adjustment in patients with end-stage renal disease receiving hemodialysis, or patients with AKI receiving continuous venovenous hemofiltration. The aim of this in vitro study was to examine the adsorption of anidulafungin to the surface of the hemofilter during continuous venovenous hemodialysis (CVVHD) and its effect on anidulafungin concentrations...
October 13, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29027212/complexity-of-intravenous-iron-nanoparticle-formulations-implications-for-bioequivalence-evaluation
#4
REVIEW
Amy Barton Pai
Intravenous iron formulations are a class of complex drugs that are commonly used to treat a wide variety of disease states associated with iron deficiency and anemia. Venofer® (iron-sucrose) is one of the most frequently used formulations, with more than 90% of dialysis patients in the United States receiving this formulation. Emerging data from global markets outside the United States, where many iron-sucrose similars or copies are available, have shown that these formulations may have safety and efficacy profiles that differ from the reference listed drug...
October 13, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29026877/prolonged-delayed-renal-graft-function-secondary-to-venous-hypertension
#5
Suraj Mishra, Gaurav Gupta, I Moinuddin, Brian Strife, Uma Prasad, D Massey, Anne King, Dhiren Kumar, Chandra S Bhati
The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months. Antibody-mediated rejection occurred in the immediate postoperative period. This resolved after treatment, and resolution was confirmed by repeat biopsy...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28993507/dialysate-potassium-dialysate-magnesium-and-hemodialysis-risk
#6
Patrick H Pun, John P Middleton
One of the fundamental goals of the hemodialysis prescription is to maintain serum potassium levels within a narrow normal range during both the intradialytic and interdialytic intervals. Considering the extraordinarily high rate of cardiovascular mortality in the hemodialysis population, clinicians are obligated to explore whether factors related to dialytic potassium removal can be modified to improve clinical outcomes. Observational studies and circumstantial evidence suggest that extreme concentrations of serum and dialysate potassium can trigger cardiac arrest...
October 9, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28992335/how-to-set-the-stage-for-a-full-fledged-clinical-trial-testing-incremental-haemodialysis
#7
Francesco Gaetano Casino, Carlo Basile
Most people who make the transition to maintenance haemodialysis (HD) therapy are treated with a fixed dose of thrice-weekly HD (3HD/week) regimen without consideration of their residual kidney function (RKF). The RKF provides an effective and naturally continuous clearance of both small and middle molecules, plays a major role in metabolic homeostasis, nutritional status and cardiovascular health, and aids in fluid management. The RKF is associated with better patient survival and greater health-related quality of life...
July 21, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992258/risk-and-complications-of-venous-thromboembolism-in-dialysis-patients
#8
Amber O Molnar, Sarah E Bota, Eric McArthur, Ngan N Lam, Amit X Garg, Ron Wald, Deborah Zimmerman, Manish M Sood
Background: Contemporary data on venous thromboembolism (VTE) risk in dialysis patients are limited. Our objective was to determine the risk and complications of VTE among incident maintenance dialysis patients. Methods: We performed a retrospective cohort study using administrative databases. We included adult incident dialysis patients from 2004 to 2010 ( n  = 13 315). Dialysis patients were age- and sex-matched to individuals of the general population using a 1:4 ratio ( n  = 53 260)...
July 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28983897/left-axillary-to-right-atrium-anterior-chest-wall-graft-using-bovine-carotid-artery-conduit
#9
Muhammad Mujeeb Zubair, Matthew E Bennett, Eric K Peden
INTRODUCTION: Central venous occlusive (CVO) disease involving the superior vena cava (SVC) and inferior vena cava (IVC) can occur frequently in patients with end-stage renal disease (ESRD) on chronic dialysis. Dialysis access is essential for the survival of these patients. CASE DESCRIPTION: We report a case of a chest wall graft creation using bovine carotid artery conduit in a patient who was experiencing life-threatening loss of dialysis access secondary to her SVC and IVC occlusion along with a hypercoagulable state...
October 3, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28983694/incomplete-vaccination-coverage-in-european-children-with-end-stage-kidney-disease-prior-to-renal-transplantation
#10
Britta Höcker, Martin Aguilar, Paul Schnitzler, Lars Pape, Luca Dello Strologo, Nicholas J A Webb, Martin Bald, Gurkan Genc, Heiko Billing, Jens König, Anja Büscher, Markus J Kemper, Stephen D Marks, Martin Pohl, Marianne Wigger, Rezan Topaloglu, Susanne Rieger, Kai Krupka, Thomas Bruckner, Alexander Fichtner, Burkhard Tönshoff
BACKGROUND: Because infections constitute a major cause of morbidity and mortality in paediatric renal allograft recipients, avoidance of preventable systemic infections by vaccination before transplantation is of utmost importance. However, data on the completeness of vaccinations and factors associated with incomplete vaccination coverage are scarce. METHODS: Within the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN), we therefore performed a multi-centre, multi-national, retrospective study investigating the vaccination coverage before transplantation of 254 European children with end-stage renal disease (mean age 10...
October 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28972690/on-line-hemodiafiltration-at-home
#11
Almudena Vega, Soraya Abad, Nicolás Macías, Inés Aragoncillo
Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC(©) ) monitor, and the Acqua C(©) (Fresenius Medical Care) for water treatment...
October 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28967233/overhydration-underhydration-and-total-body-sodium-a-tricky-m%C3%A3-nage-a-trois-in-dialysis-patients
#12
EDITORIAL
Luminita Voroneanu, Cristina Gavrilovici, Adrian Covic
Overhydration is a frequent complication in dialysis patients. It has been linked with hypertension, left ventricular hypertrophy, arterial stiffness, atherosclerosis uremic cardiomyopathy, and all-cause mortality or cardiovascular morbidity. In addition, predialysis underhydration is also associated with increased risk of death in ESRD patients. In this context, the optimal evaluation of hydration status is a must. However, this mission is not easy or accurate. In the last 10 years, several new methods have been tested in dialysis patients, particularly bioimpedance and lung ultrasonography...
October 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28963827/-iron-deficiency-in-nd-ckd-from-diagnosis-to-treatment
#13
REVIEW
Maria Elena Liberti, Carlo Garofalo, Adelia Sagliocca, Silvio Borrelli, Giuseppe Conte, Luca De Nicola, Roberto Minutolo
In non-dialysis-chronic kidney disease (CKD), iron deficiency is a frequent nutritional disorder due to either the greater tendency to occult gastrointestinal bleeding or to the chronic inflammatory state resulting in a reduced intestinal iron reabsorption through an increased synthesis of hepcidin. These phenomenon are responsible for a negative iron balance that compromises erythropoiesis and contributes to the pathogenesis of anemia in CKD. Several laboratory tests are now available to allow an adequate diagnosis of iron deficiency...
September 28, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28957803/troponin-i-levels-in-asymptomatic-hemodialysis-patients
#14
Diego Castini, Simone Persampieri, Riccardo Floreani, Andrea Galassi, Maria Luisa Biondi, Stefano Carugo, Mario Cozzolino
BACKGROUND: End-stage renal disease (ESRD) represents a situation in which persistently elevated levels of cardiac troponins I (cTnI) are frequently found in the absence of clinically evident cardiac disease. Moreover, the effect of hemodialysis (HD) on cTnI levels is not definitively elucidated. The aim of this study was to investigate the effects of HD on cTnI levels in ESRD patients. METHODS: We enrolled 30 asymptomatic ESRD patients on maintenance HD. All the patients were dialyzed thrice weekly...
September 29, 2017: Blood Purification
https://www.readbyqxmd.com/read/28941604/current-risk-of-contrast-induced-acute-kidney-injury-after-coronary-angiography-and-intervention-a-reappraisal-of-the-literature
#15
REVIEW
Lorenzo Azzalini, Luciano Candilio, Peter A McCullough, Antonio Colombo
Contrast-induced acute kidney injury (CI-AKI) is the acute impairment of renal function further to the intravascular administration of iodinated contrast media, and occurs most frequently after coronary angiography, percutaneous coronary intervention, and contrast-enhanced computed tomography. CI-AKI has been associated with the development of acute renal failure, worsening of chronic kidney disease, requirement for dialysis, prolonged hospital stay, and higher mortality rates and health care costs. Recently, a number of studies suggested that contrast media exposure might not be the causative agent in the occurrence of acute kidney injury, particularly in stable patients who receive small to moderate amounts of contrast media...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28937074/clinicoepidemiological-profile-of-peritonitis-complicating-acute-peritoneal-dialysis-a-single-center-experience
#16
Kunal Gandhi, Dharmendra Prasad, Vinay Malhotra, Dhananjai Agrawal, Pankaj Beniwal, Amith Vijay Leon Dsouza
A prospective observational study examining the incidence and microbiological aspects of peritonitis complicating acute intermittent peritoneal dialysis (IPD) was performed. A total of 145 acute IPD treatments were included involving 112 patients. The majority of patients suffered from acute kidney injury (72.3%) secondary to sepsis. Peritonitis occurred in 31 treatment sessions, giving a frequency of 21.4% of procedures performed. The mean interval between starting dialysis and the first sign of peritonitis was 2...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28937071/insomnia-in-hemodialysis-patients-a-multicenter-study-from-morocco
#17
Mohamed Amine Hamzi, Kawtar Hassani, Mohamed Asseraji, Driss El Kabbaj
Previous studies have shown that insomnia is a common sleep disorder in patients with end-stage renal disease. This study aims to determine the prevalence and risk factors of insomnia in our chronic hemodialysis (HD) patients. This is a cross-sectional study conducted in three HD units in Morocco. To assess the prevalence of insomnia, we used a specific questionnaire. Patients complaining of difficulty in falling asleep and/or nocturnal awakenings occurring seven nights a week during the last month were included in the group "insomnia;" the other patients were used as controls...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28932305/the-effect-of-treatment-on-short-term-outcomes-in-elderly-patients-with-acute-kidney-injury
#18
Zvezdana Petronijevic, Gjulsen Selim, Lidija Petkovska, Ljubica Georgievska-Ismail, Goce Spasovski, Liljana Tozija
BACKGROUND: Elderly population (≥ 65) are more prone to develop acute kidney injury (AKI) compared to younger, also elderly with AKI have an increased requirement for dialysis treatment and an elevated risk of short-term and long-term mortality. AIM: The objectives of this study were to examine the effect of treatment of short-term outcomes and mortality in elderly patients with AKI. MATERIAL AND METHODS: Seventy elderly AKI patients, that filled one of the criteria of AKI definition and had hospitalization over 24 hours, were enrolled in the study...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#19
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. METHODS: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#20
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
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