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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
#1
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/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#2
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28414662/weil-s-disease-from-a-local-new-orleans-bar
#3
H P Kahn, L Bateman
INTRODUCTION: Leptospirosis is a zoonotic infection that typically presents with fever, myalgias, nausea, and vomiting after contact with contaminated waters or infected animals (typically rodents); and their excrements. Conditions favorable to the transmission of leptospirosis are common in LA and, without treatment, leptospirosis can lead to both liver and renal failure, meningitis, pulmonary hemorrhage and ultimately death. CASE: A 56 year old woman with no past medical history presented to the Emergency Department with weakness, myalgias, jaundice and decreased urine output for one week...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#4
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28391314/continued-monitoring-of-acute-kidney-injury-survivors-might-not-be-necessary-in-those-regaining-an-estimated-glomerular-filtration-rate-60%C3%A2-ml-min-at-1-year
#5
Sokratis Stoumpos, Patrick B Mark, Emily P McQuarrie, Jamie P Traynor, Colin C Geddes
Background.: Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods.: All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28356667/hemophagocytic-lymphohistiocytosis-secondary-to-hemodialysis-catheter-related-blood-stream-infection
#6
U Anandh, S Johari, B Vaswani
A 57-year-old man on dialysis presented with fever due to Pseudomonas septicemia. Workup revealed very high triglycerides and serum ferritin levels. A bone marrow examination showed hemophagocytosis. A diagnosis of hemophagocytic lymphohistiocytosis (HLH) was made and steroids were started. He was put on automated peritoneal dialysis. Patients' condition continued to deteriorate and he succumbed to his illness. This case illustrates the development of HLH secondary to infections which are increasingly being recognized in the literature...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#7
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#8
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28279408/declotting-the-thrombosed-access
#9
Keith B Quencer, Tamir Friedman
Because a patent access is the lifeline for a dialysis patient, access declotting is extremely important. Before embarking on a declot, it is important to evaluate the patient for potential contraindications such as pulmonary hypertension, right-to-left shunts and access infection in order to be able to avoid potential complications such as symptomatic pulmonary embolism, stroke, and sepsis. Multiple methods to perform a percutaneous declot exist. Four common methods are described here. We also discuss how to avoid causing an arterial embolism and how to treat it if it does occur...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28270643/charlson-comorbidity-index-for-prediction-of-outcome-of-acute-kidney-injury-in-critically-ill-patients
#10
Sumaira Talib, Fatima Sharif, Sidra Manzoor, Sonia Yaqub, Waqar Kashif
INTRODUCTION: This study aimed to determine predictors of outcomes in critically ill patients with acute kidney injury (AKI), and to study the impact of the Charlson Comorbidity Index (CCI) as a prognostic indicator. MATERIALS AND METHODS: This retrospective study included critically ill patients who were admitted with AKI or developed AKI during their hospital stay. The impact of comorbidity was evaluated by the CCI, while severity of AKI was assessed by the RIFLE criteria...
March 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28265980/outcomes-in-elderly-patients-admitted-to-the-intensive-care-unit-with-solid-tumors
#11
Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb, Nadia Aissaoui
BACKGROUND: As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS: We conducted a retrospective study. The primary endpoint was ICU mortality. Resumption of anticancer therapy in patients who survived the ICU stay and 90-day mortality were secondary endpoints...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28238919/characteristics-management-and-outcomes-of-surgically-treated-arteriovenous-fistula-aneurysm-in-patients-on-regular-hemodialysis
#12
Hassan Al-Thani, Ayman El-Menyar, Noora Al-Thani, Mohammad Asim, Ahmed Hussein, Ahmed Sadek, Ahmed Sharaf, Amr Fares
BACKGROUND: To investigate the clinical characteristics, surgical interventions and outcomes of arteriovenous fistula (AVF) aneurysms, we retrospectively analyzed patients on regular hemodialysis (HD). METHODS: We conducted a cohort study of all patients with HD access who presented with AVF aneurysms and underwent operative procedures over a 11-year period. Patients' demographics, comorbidities, vascular access characteristics, management of aneurysms, complications and outcomes were analyzed...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28220742/calcific-uraemic-arteriolopathy-calciphylaxis-in-patients-on-renal-replacement-therapy
#13
S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28209134/first-clinical-experience-in-14-patients-treated-with-advos-a-study-on-feasibility-safety-and-efficacy-of-a-new-type-of-albumin-dialysis
#14
Wolfgang Huber, Benedikt Henschel, Roland Schmid, Ahmed Al-Chalabi
BACKGROUND: Liver failure (LF) is associated with prolonged hospital stay, increased cost and substantial mortality. Due to the limited number of donor organs, extracorporeal liver support is suggested as an appealing concept to "bridge to transplant" or to avoid transplant in case of recovery. ADVanced Organ Support (ADVOS) is a new type of albumin dialysis, that provides rapid regeneration of toxin-binding albumin by two purification circuits altering the binding capacities of albumin by biochemical (changing of pH) and physical (changing of temperature) modulation of the dialysate...
February 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28181855/a-contemporary-evaluation-of-carotid-endarterectomy-outcomes-in-patients-with-chronic-kidney-disease-in-the-united-states
#15
Amit R Patel, Viktor Y Dombrovskiy, Todd R Vogel
Objectives Chronic kidney disease (CKD) has been identified as a significant risk factor for poor post-surgical outcomes. This study was designed to provide a contemporary analysis of carotid endarterectomy (CEA) outcomes in patients with CKD, end-stage renal disease (ESRD), and normal renal function (NF). Methods The Nationwide Inpatient Sample data 2006-2012 was queried to select patients aging 40 years old and above who underwent CEA during two days after admission and had a diagnosis of ESRD on long-term hemodialysis, patients with non-dialysis-dependent CKD, or NF...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28178155/complement-mediated-thrombotic-microangiopathy-secondary-to-sepsis-induced-disseminated-intravascular-coagulation-successfully-treated-with-eculizumab-a-case-report
#16
Tomohiro Abe, Akira Sasaki, Taichiro Ueda, Yoshitaka Miyakawa, Hidenobu Ochiai
Secondary thrombotic microangiopathies (TMAs) are induced by several underlying conditions; most are resolved by treating background disease. Eculizumab is a human monoclonal antibody that blocks the final stage of the complement system and effectively treats atypical hemolytic uremic syndrome (aHUS). In this report, we present a patient with TMA secondary to sepsis- induced coagulopathy, who was successfully treated with eculizumab.A 44-year-old woman, who had no special medical history or familial history of TMAs, was admitted on suspicion of septic shock...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28178126/free-and-total-p-cresol-sulfate-levels-and-infectious-hospitalizations-in-hemodialysis-patients-in-choice-and-hemo
#17
RANDOMIZED CONTROLLED TRIAL
Tanushree Banerjee, Timothy W Meyer, Tariq Shafi, Thomas H Hostetter, Michal Melamed, Yunnuo Zhu, Neil R Powe
The uremic syndrome is attributed to progressive retention of compounds that, under normal conditions, are excreted by the healthy kidneys. p-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. Recent studies have identified relations between increased levels of PCS and indoxyl sulfate (IS) and adverse clinical outcomes in hemodialysis patients. We explored the relationship between free and total PCS and IS with infection-related hospitalizations (IH) and septicemia in 2 cohorts, Choices for Healthy Outcomes in Caring for end-stage renal disease (ESRD) Study (CHOICE) and Hemodialysis Study (HEMO)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28152540/vancomycin-during-the-last-hour-of-the-hemodialysis-session-a-pharmacokinetic-analysis
#18
Lila Ghouti-Terki, Elodie Chasseuil, Nolwenn Rabot, Gilles Paintaud, Maud François, Béatrice Birmelé, François Darrouzain, Matthias Büchler, Jean-Michel Halimi, David Ternant
BACKGROUND: Vancomycin is usually administered after the dialysis sessions to patients undergoing hemodialysis. Administration of vancomycin during (as opposed to after) sessions would save time, and would be more acceptable to patients and staff, but may lead to vancomycin underexposure. The aim of this study was to propose a new dosing regimen of vancomycin taking into account the dialysis-related losses of vancomycin when administered during dialysis. METHODS: In this monocentric prospective study, vancomycin was infused to dialyzed patients during the last hour of the dialysis session at increased doses...
2017: Nephron
https://www.readbyqxmd.com/read/28149647/hepatitis-c-and-kidney-disease-a-narrative-review
#19
REVIEW
Rashad S Barsoum, Emad A William, Soha S Khalil
Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#20
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
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