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Procalcitonin dialysis

Robert Zant, Christian Stocker, Luregn Jan Schlapbach, Sara Mayfield, Tom Karl, Andreas Schibler
OBJECTIVE: Procalcitonin has emerged as a promising infection marker, but previous reports from small-sized studies suggest nonspecific elevation of procalcitonin after pediatric heart surgery. As procalcitonin is increasingly used as a marker for infection in the PICU, the aim of this study was to identify factors associated with postoperative procalcitonin elevation and to investigate the role of procalcitonin as an early marker of outcome after cardiac surgery. DESIGN: Prospective observational study...
July 2016: Pediatric Critical Care Medicine
Francesca Martino, Elisa Scalzotto, Davide Giavarina, Maria Pia Rodighiero, Carlo Crepaldi, Sonya Day, Claudio Ronco
BACKGROUND: Peritoneal dialysis (PD) is frequently complicated by high rates of peritonitis, which result in hospitalization, technique failure, transfer to hemodialysis, and increased mortality. Early diagnosis, and identification of contributing factors are essential components to increasing effectiveness of care. In previous reports, neutrophil gelatinase-associated lipocalin (NGAL), a lipocalin which is a key player in innate immunity and rapidly detectable in peritoneal dialysis effluent (PDE), has been demonstrated to be a useful tool in the early diagnosis of peritonitis...
September 2015: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Eddie Grace, R Mackenzie Turner
Procalcitonin (PCT) has been shown to be a useful surrogate marker in identifying patients with various bacterial infections. PCT has been studied as a diagnostic marker in differentiating bacterial pneumonia from other respiratory conditions such as chronic obstructive pulmonary disease exacerbations or viral pneumonia. Differentiating bacterial from nonbacterial pneumonia using PCT has shown to reduce antibiotic usage, length of stay, and antibiotic-related adverse effects. PCT has also been studied in patients with sepsis in an effort to reduce unnecessary antibiotic usage and decrease the length of antibiotic therapy...
December 15, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Adriana M Hung, Cindy Booker, Charles D Ellis, Edward D Siew, Amy J Graves, Ayumi Shintani, Naji N Abumrad, Jonathan Himmelfarb, Talat Alp Ikizler
BACKGROUND: Chronic systemic inflammation is common in patients with chronic kidney disease on dialysis (CKD5D) and has been considered a key mediator of the increased cardiovascular risk in this patient population. In this study, we tested the hypothesis that supplementation of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) will attenuate the systemic inflammatory process in CKD5D patients. METHODS: The design was a randomized, double-blinded, placebo controlled pilot trial (NCT00655525)...
February 2015: Nephrology, Dialysis, Transplantation
Borja Quiroga, Maite Villaverde, Almudena Vega, Soraya Abad, Javier Reque, Juan M López-Gómez
BACKGROUND AND AIMS: Hemodialysis patients have a greater risk of infection than individuals not on dialysis. Procalcitonin has been shown to rise in bacterial from but widely studied in hemodialysis patients. The present study evaluates procalcitonin as an early predictor of infection in this population. METHODS: A historical cohorts study was made of 211 prevalent hemodialysis patients (median age 73 years [range 60-80], 58% males) covering the period 2005-2012...
May 21, 2014: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
M Yaroustovsky, M Abramyan, N Krotenko, D Popov, M Plyushch, E Rogalskaya, H Nazarova
INTRODUCTION: Sepsis still represents an obstacle in modern medicine. The aim of this study was to evaluate the effectiveness and safety of the combined use of lipopolysaccharide adsorption and haemodialysis (HD) with high cut-off haemofilters as part of the complex intensive care of patients with severe sepsis after cardiac surgery. METHODS: The study group included 26 patients, 57 (48-62) years of age, with severe sepsis. The inclusion criteria were clinical signs of severe sepsis (systemic inflammatory response syndrome + infection site + failure of two or more organs) together with endotoxin activity assay (EAA) ≥0...
2014: Blood Purification
Hernán Trimarchi, Mariana Dicugno, Alexis Muryan, Fernando Lombi, Leticia Iturbe, María S Raña, Pablo Young, Karin Nau, Romina Iriarte, Vanesa Pomeranz, Mariano Forrester, Alejandra Karl, Mirta Alonso
UNLABELLED: Procalcitonin (PCT) has emerged as a marker of infection, a frequent complication in hemodialysis (HD). We analyzed PCT levels in chronic non-acutely infected HD subjects, assessed its correlation with inflammatory and nutritional markers and propose a PCT reference value for non-infected HD patients. In an observational cross-sectional study, 48 chronic HD patients and 36 controls were analyzed. VARIABLES: age, gender, time on HD; diabetes; vascular access, PCT, C-reactive protein (CRP), albumin, malnutrition inflammatory score (MIS), hematocrit, leukocyte count, and body mass index (BMI)...
2013: Medicina
Damien Contou, Géraldine d'Ythurbide, Jonathan Messika, Christophe Ridel, Antoine Parrot, Michel Djibré, Alexandre Hertig, Eric Rondeau, Muriel Fartoukh
OBJECTIVES: To describe the spectrum of infection and multidrug-resistant bacterial colonization, and to identify early predictors of infection in patients with chronic kidney disease (CKD) admitted to the critical care unit (CCU). METHODS: A 7-month observational prospective single-centre study in a French university hospital. RESULTS: 791 patients were admitted to the CCU, 135 of whom (17%) had severe CKD. Among these, 41 (30%) were infected on admission...
February 2014: Journal of Infection
Raluca Dumea, Dimitrie Siriopol, Simona Hogas, Irina Mititiuc, Adrian Covic
PURPOSE: Although procalcitonin (PCT) has been described as a marker of infection and inflammation, it has not been extensively studied in patients with chronic kidney disease (CKD), end stage renal disease, or renal transplant. METHODS: PCT was routinely tested in 82 (56 dialyzed patients and 28 renal transplant recipients) consecutive cases with a strong clinical suspicion of infection, during a 6-month period, in a single referral unit. RESULTS: During the study period, 58/82 cases had confirmed infections as per definition...
February 2014: International Urology and Nephrology
Sawako Kato, Bengt Lindholm, Peter Stenvinkel, Tomas J Ekström, Karin Luttropp, Yukio Yuzawa, Yoshinari Yasuda, Yoshinari Tsuruta, Shoichi Maruyama
BACKGROUND/AIMS: Inflammation is an established mortality risk factor in chronic kidney disease (CKD) patients. Although a previous report showed that uremic Caucasian patients with inflammation had signs of global DNA hypermethylation, it is still unknown whether DNA hypermethylation is linked to inflammatory markers including a marker of bacterial infections in Japanese CKD patients. METHODS: In 44 consecutive incident dialysis patients (26 males, mean age 59 ± 12 years) without clinical signs of infection, global DNA methylation was evaluated in peripheral blood DNA using the HpaII/MspI ratio by the luminometric methylation assay method...
January 2012: Nephron Extra
Bambang Purwanto, Diding H Prasetyo
AIM: to determine the effect of oral N-acetylcysteine (NAC) on plasma levels of inflammatory markers in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. METHODS: we performed a placebo-controlled study over 8 weeks in 32 patients on regular CAPD. The patients were divided into 2 groups of 16 patients matched for age and gender. The first group was given NAC 2x600 mg/day for 8 weeks and inflammatory parameter was compared with control group. The immune system is determined from the average levels of Procalcitonin, IL-6, IL-1, C3, SICAM, hsCRP, and TNF- before and after treatment with NAC...
April 2012: Acta Medica Indonesiana
Sadie van Esch, Raymond T Krediet, Dirk G Struijk
Despite advances in treatment and prevention, peritonitis remains a major problem in peritoneal dialysis (PD) patients with often technique failure as a consequence. The last decades the focus of PD peritonitis has changed from lowering peritonitis incidence to improvement of peritonitis outcome. Prognostic factors for peritonitis outcome can influence decision making during the treatment of peritonitis, for example to take out the PD catheter early in the time course of peritonitis and prevent further damage to the peritoneal membrane...
2012: Contributions to Nephrology
Maciej Drozdz, Andrzej Kraśniak, Piotr Podolec, Grzegorz Chmiel, Martyna Kowalczyk-Michałek, Mieczysław Pasowicz, Małgorzata Konieczyńska, Ewa Wicher-Muniak, Wiesława Tracz, Władysław Sułowicz
The very high cardiovascular mortality and morbidity in hemodialyzed patients (HD) is strongly associated with cardiovascular calcification. The aim of the study was to find the predictors of mortality in HD patients during 5-years observation period. The study group was composed of 64 patients (35 F, 29 M) aged 25-75 years (mean 48.9) hemodialyzed three times a week for 12-275 months (mean 77.8). The levels of hemoglobin, total protein, albumin, Ca, P, Ca x P, iPTH, cholesterol, triglycerides, fibrinogen, insulin, homocysteine, leptin, procalcitonin, CRP, IL-6, TGF-beta, PDGF were assessed and all patients underwent Calcium Score (CS) of coronary arteries (CACS) calculation using MSCT and B-mode ultrasound of carotid arteries for intima-media thickness (CCA-IMT), as well as echocardiographic assessment with LVMI calculation and heart valves evaluation at the start of observation...
2011: Przegla̧d Lekarski
Bernardo A Lavín-Gómez, Rosa Palomar-Fontanet, Maria Gago-Fraile, José A Quintanar-Lartundo, Estefanía Gómez-Palomo, Domingo González-Lamuño, Maria T García-Unzueta, Manuel A Arias-Rodríguez, Juan A Gómez-Gerique
Chronic kidney disease (CKD) is associated with a proinflammatory state and an excess of cardiovascular risk. In this work, we describe changes in inflammatory markers-C-reactive protein (CRP), pentraxin 3 (PTX3), serum component of amyloid A (SAA), and procalcitonin (PCT)--in CKD patients compared with a control group of subjects with a normal estimated glomerular filtration rate (eGFR). Blood samples were obtained from 69 healthy individuals (GP) and 70 end-stage CKD patients--25 not yet on dialysis, 22 on peritoneal dialysis (PD), and 23 on hemodialysis (HD)...
2011: Advances in Peritoneal Dialysis
Rosa Palomar-Fontanet, Bernardo A Lavin-Gómez, José A Quintanar-Lartundo, Maria T García-Unzueta, María Gago-Fraile, Mónica I Torrealba-Rodríguez, Manuel A Arias-Rodriguez, Juan A Gómez-Gerique
In this study, we compared changes in inflammatory markers-C-reactive protein (CRP), pentraxin 3 (PTX3), serum component of amyloid A (SAA), and procalcitonin (PCT)-in 182 subjects: 69 from the general population (GP), 47 with CKD, 19 with an implanted intra-abdominal catheter for peritoneal dialysis ("prePD"), and 47 on peritoneal dialysis (PD). These were the results [median (95% confidence interval)] for the GP CKD, prePD, and PD groups respectively: CRP: 1.40 mg/L (1.15-2.10 mg/L), 5.30 mg/L (3.04-8.06 mg/L), 3...
2011: Advances in Peritoneal Dialysis
Gordon P Otto, Maik Sossdorf, Ralf A Claus, Jürgen Rödel, Katja Menge, Konrad Reinhart, Michael Bauer, Niels C Riedemann
INTRODUCTION: Recent models capturing the pathophysiology of sepsis and ex-vivo data from patients are speculating about immunosuppression in the so-called late phase of sepsis. Clinical data regarding survival and microbiological burden are missing. The aim of this study was to determine the clinical significance of the 'late phase' of sepsis with respect to overall survival and occurrence of microbiological findings. METHODS: In a retrospective trial, 16,041 patient charts from a university intensive care unit were screened, and 999 patients with severe sepsis or septic shock were identified...
2011: Critical Care: the Official Journal of the Critical Care Forum
Iu A Petrovich, I V Iarema, N A Terekhina, S M Kichenko
New data on etiology, pathogenesis, clinics, quantity estimation, treatment and complications of peritoneal dialysis are observed. The role of aquaporine, nitric oxide, NO-synthase, inflammation and sepsis markers (procalcitonine, C-reactive protein) in pathochemical mechanism of peritoneal dialysis is discussed.
January 2010: Patologicheskaia Fiziologiia i èksperimental'naia Terapiia
Karin Malícková, Helena Brodská, Jana Lachmanová, Sylvie Dusilová Sulková, Ivana Janatková, Helena Marecková, Vladimír Tesar, Tomás Zima
OBJECTIVE: The current study aimed to evaluate plasma calprotectin levels and clearance end-stage renal disease (ESRD) patients with and without acute infection undergoing chronic hemodialysis (HD). MATERIALS AND METHODS: Blood samples from 54 HD patients were obtained before and after the HD and 42 healthy blood donors were examined as controls. The blood levels of calprotectin, procalcitonin, C-reactive protein (CRP), and intracellular production of interleukins 10 and 12 in monocytes were determined in both groups...
April 2010: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
Katalin Szakszon, István Csízy, Tamás Szabó
OBJECTIVES: Acute renal failure is a serious complication of sepsis and is associated with a very high mortality. Recent evidence suggests that proinflammatory cytokines (interleukins 1 and 6 and tumor necrosis factor alpha) released into the circulation in response to sepsis can be removed from the blood via hemofiltration and appear in the dialysate in times of peritoneal dialysis as well. METHODS: An infant who developed acute renal failure in full-blown sepsis is presented...
September 2009: Pediatric Emergency Care
M Yaroustovsky, M Abramyan, Z Popok, E Nazarova, O Stupchenko, D Popov, M Plushch, N Samsonova
AIMS: The purpose of this publication is to evaluate the first experiences with the supplemental use of selective endotoxin adsorption cartridges in the treatment of critically ill patients complicated by severe sepsis after cardiac surgery. METHODS: Thirteen patients with Gram-negative sepsis underwent the procedure of selective lipopolysaccharide (LPS) adsorption using Alteco adsorber (group I) or Toraymyxin columns (polymyxin-B-immobilized fiber) (group II). RESULTS: This therapy positively influenced the course of sepsis...
2009: Blood Purification
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