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https://www.readbyqxmd.com/read/29774464/eculizumab-in-stec-hus-need-for-a-proper-randomized-controlled-trial
#1
Sebastian Loos, Jun Oh, Markus J Kemper
Hemolytic uremic syndrome caused by Shiga toxin-producing E. coli (STEC-HUS) is often associated with a severe morbidity including neurological involvement and a mortality of 1-5%. Although STEC-HUS is often self-limited, improvement of treatment strategies is needed for cases with complications and, among others, plasma exchange/plasmapheresis and use of antibiotics have been advocated. With the availability of the complement blocker eculizumab, now a standard treatment of atypical HUS, several series have addressed its use in STEC-HUS, with variable response; randomized controlled trials are lacking...
May 17, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29739260/timing-of-renal-replacement-therapy-for-acute-kidney-injury
#2
Nithin Karakala, Ashita J Tolwani
Acute kidney injury (AKI) is common in critically ill patients and associated with increased morbidity and mortality. With the increased use of renal replacement therapy (RRT) for severe AKI, the optimal time for initiation of RRT has become one of the most probed and debated topic in the field of nephrology and critical care. There appears to be an increased trend toward earlier initiation of RRT to avoid life-threatening complications associated with AKI. Despite the presence of a plethora of studies in this field, the lack of uniformity in study design, patient population types, definition of early and late initiation, modality of RRT, and results, the optimal time for starting RRT in AKI still remains unknown...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29705734/treatment-of-end-stage-renal-disease-with-continuous-ambulatory-peritoneal-dialysis-in-rural-guatemala
#3
Jillian Moore, Pablo Garcia, Peter Rohloff, David Flood
A 42-year-old indigenous Maya man presented to a non-profit clinic in rural Guatemala with signs, symptoms and laboratory values consistent with uncontrolled diabetes. Despite appropriate treatment, approximately 18 months after presentation, he was found to have irreversible end-stage renal disease (ESRD) of uncertain aetiology. He was referred to the national public nephrology clinic and subsequently initiated home-based continuous ambulatory peritoneal dialysis. With primary care provided by the non-profit clinic, his clinical status improved on dialysis, but socioeconomic and psychological challenges persisted for the patient and his family...
April 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29703177/functional-status-pre-dialysis-health-and-clinical-outcomes-among-elderly-dialysis-patients
#4
Silvi Shah, Anthony C Leonard, Charuhas V Thakar
BACKGROUND: Elderly patients comprise the fastest growing population initiating dialysis in United States. The impact of poor functional status and pre-dialysis health status on clinical outcomes in elderly dialysis patients is not well studied. METHODS: We studied a retrospective cohort of 49,645 incident end stage renal disease patients that initiated dialysis between January 1, 2008 and December 31, 2008 from the United States Renal Data System with linked Medicare data covering at least 2 years prior to dialysis initiation...
April 27, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29692934/a-web-based-platform-to-collect-data-from-esrd-patients-undergoing-dialysis-methods-and-preliminary-results-from-the-brazilian-dialysis-registry
#5
Jocemir R Lugon, Pedro A Gordan, Fernando S Thomé, Antonio A Lopes, Yoshimi J A Watanabe, Carmen Tzanno, Ricardo C Sesso
Introduction: The methods and initial results of a web-based platform to collect data from patients receiving maintenance dialysis in Brazil are reported. Methods: Companies providing management software for dialysis centers adapted their system to comply with a formulary of the Brazilian Society of Nephrology. Baseline and follow-up individual patients' data were transmitted via Internet on monthly bases to the coordinating center from 2011 to 2017. Results: 73 dialysis centers provided information of 24,930 patients: 57% were male, 28% were 64 years old or older, and 13% were overweight/obese...
2018: International Journal of Nephrology
https://www.readbyqxmd.com/read/29679398/application-of-instant-messaging-software-in-the-follow-up-of-patients-using-peritoneal-dialysis-a-randomized-controlled-trial
#6
Fang Cao, Lanfei Li, Miao Lin, Qinyu Lin, Yiping Ruan, Fuyuan Hong
AIMS AND OBJECTIVES: This study aims to investigate the application value of Internet-based instant messaging software in the follow-up of patients using peritoneal dialysis(PD). BACKGROUND: PD is an effective renal replacement treatment for end-stage renal disease. The clinical usefulness of Internet-based instant messaging software in the follow-up of PD patients, including the incidence of peritonitis and exit-site infection, the levels of albumin and electrolytes and the degree of patients' satisfaction, remains unknown...
April 20, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29669046/nephrology-comanagement-and-the-quality-of-antibiotic-prescribing-in-primary-care-for-patients-with-chronic-kidney-disease-a-retrospective-cross-sectional-study
#7
Justin X G Zhu, Danielle M Nash, Eric McArthur, Alexandra Farag, Amit X Garg, Arsh K Jain
Background: In primary care, patients with chronic kidney disease (CKD) are frequently prescribed excessive doses of antibiotics relative to their kidney function. We examined whether nephrology comanagement is associated with improved prescribing in primary care. Methods: In a retrospective propensity score-matched cross-sectional study, we studied the appropriateness of antibiotic prescriptions by primary care physicians to Ontarians ≥66 years of age with CKD Stages 4 and 5 (estimated glomerular filtration rate <30 mL/min/1...
April 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29657197/adamts-13-level-in-children-with-severe-diarrhea-associated-hemolytic-uremic-syndrome-unmasking-new-association
#8
Naglaa A Khalifa, Heba H Gawish, Noora A Khalifa, Doaa M Tawfeek, Saed M Morsy
Severe deficiency of ADAMTS-13 leads to thrombotic thrombocytopenic purpura. Few studies have reported reduced activity of ADAMTS-13 in patients with atypical and typical hemolytic uremic syndrome (HUS). We hypothesized that ADAMTS-13 deficiency might play a role in the pathogenesis of severe HUS. This study aimed to evaluate the ADAMTS-13 level in severe typical HUS. This prospective case-control study was carried out in the Pediatric Nephrology Unit and Clinical Pathology Department, Faculty of Medicine, Zagazig University from February 2013 to February 2014...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29656848/the-discipline-of-epidemiology-engaging-in-the-full-breadth-of-population-health-science
#9
Harold I Feldman
This address was delivered by Harold I. Feldman, MD, MSCE, at the Annual Meeting of the American College of Epidemiology in New Orleans, Louisiana, on September 26, 2017. Dr. Feldman is George S. Pepper Professor of Public Health and Preventive Medicine, Professor of Epidemiology and Medicine, and Chair, Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine at the University of Pennsylvania. He is recognized nationally and internationally for his expertise in kidney disease epidemiology...
March 21, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29651696/diversity-of-the-midstream-urine-microbiome-in-adults-with-chronic-kidney-disease
#10
Holly Kramer, Gina Kuffel, Krystal Thomas-White, Alan J Wolfe, Kavitha Vellanki, David J Leehey, Vinod K Bansal, Linda Brubaker, Robert Flanigan, Julia Koval, Anuradha Wadhwa, Michael J Zilliox
PURPOSE: To examine the characteristics of the midstream urine microbiome in adults with stage 3-5 non-dialysis-dependent chronic kidney disease (CKD). METHODS: Patients with non-dialysis-dependent CKD (estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m2 ) and diuretic use were recruited from outpatient nephrology clinics. Midstream voided urine specimens were collected using the clean-catch method. The bacterial composition was determined by sequencing the hypervariable (V4) region of the bacterial 16S ribosomal RNA gene...
April 12, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29644061/interstitial-inflammation-and-interstitial-fibrosis-and-tubular-atrophy-predict-renal-survival-in-lupus-nephritis
#11
Parker C Wilson, Michael Kashgarian, Gilbert Moeckel
Background: This study examines the effect of interstitial inflammation and interstitial fibrosis and tubular atrophy on renal survival in lupus nephritis. Methods: Baseline characteristics, initial ( n = 301) and repeat biopsies ( n = 94) and clinical outcomes for patients with biopsy-proven lupus nephritis from 1998 to 2014 were retrospectively collected from the medical record. Clinical and morphologic variables were evaluated using a Cox proportional hazards model and multiple imputation to address missing data...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29644056/lung-ultrasonography-in-end-stage-renal-disease-moving-from-evidence-to-practice-a-narrative-review
#12
Daniel W Ross, Mohammed M Abbasi, Kenar D Jhaveri, Mala Sachdeva, Ilene Miller, Richard Barnett, Mangala Narasimhan, Paul Mayo, Massini Merzkani, Anna T Mathew
Traditionally, point of care ultrasonography in nephrology has been used for renal biopsies and dialysis line placement. However, there is an emerging literature supporting the value of point of care lung ultrasonography in the assessment of volume status for dialysis patients. We conducted a review and identified 12 studies that examined the utility of lung ultrasonography in assessing volume status in patients with end-stage renal disease. We conclude that lung ultrasonography can be used to determine volume status in chronic dialysis patients by identifying lung congestion using the B-line score...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29644053/the-dialysis-orders-objective-structured-clinical-examination-osce-a-formative-assessment-for-nephrology-fellows
#13
Lisa K Prince, Ruth C Campbell, Sam W Gao, Jessica Kendrick, Christopher J Lebrun, Dustin J Little, David L Mahoney, Laura A Maursetter, Robert Nee, Mark Saddler, Maura A Watson, Christina M Yuan
Background: Few quantitative nephrology-specific simulations assess fellow competency. We describe the development and initial validation of a formative objective structured clinical examination (OSCE) assessing fellow competence in ordering acute dialysis. Methods: The three test scenarios were acute continuous renal replacement therapy, chronic dialysis initiation in moderate uremia and acute dialysis in end-stage renal disease-associated hyperkalemia. The test committee included five academic nephrologists and four clinically practicing nephrologists outside of academia...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29629274/current-characteristics-of-dialysis-therapy-in-korea-2016-registry-data-focusing-on-diabetic-patients
#14
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park, Yong-Kyun Kim
Diabetic nephropathy is the most frequent cause of end-stage renal disease worldwide. Dialysis patients with diabetes mellitus (DM) have more complications and shorter survival duration than non-DM dialysis patients, requiring more clinical attention and difficult management. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an on-line registry program and analyzed the characteristics of patients. A survey of dialysis patients in 2016 showed that 50...
March 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29617835/patient-and-transplant-outcome-in-infants-starting-renal-replacement-therapy-before-2-years-of-age
#15
Julien Hogan, Justine Bacchetta, Marina Charbit, Gwenaelle Roussey, Robert Novo, Michel Tsimaratos, Joelle Terzic, Tim Ulinski, Arnaud Garnier, Elodie Merieau, Jérôme Harambat, Isabelle Vrillon, Olivier Dunand, Denis Morin, Etienne Berard, Francois Nobili, Cécile Couchoud, Marie-Alice Macher
Background: Despite major technical improvements in the care of children requiring renal replacement therapy (RRT) before 2 years of age, the management of those patients remains challenging and transplantation is generally delayed until the child weighs 10 kg or is 2 years old. In this national cohort study, we studied patient and graft survival in children starting RRT before 2 years of age to help clinicians and parents when deciding on RRT initiation and transplantation management...
March 29, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29615173/outcome-of-chronic-kidney-disease-patients-on-the-basis-of-referral-to-nephrologist-a-one-year-follow-up-study
#16
Muhammad Anees, Yasir Hussain, Muhammad Ibrahim, Irfan Ilahi, Sajjad Ahmad, Khushbakht Isma Asif, Amina Jameel
OBJECTIVE: To determine the outcome of chronic kidney disease (CKD) patients presenting for dialysis on the basis of referral to nephrologist. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Nephrology Department of King Edward Medical University/Mayo Hospital, Lahore, from January 2014 to January 2016. METHODOLOGY: All patients who were presented in nephrology outpatients department and with the indication of dialysis were included in study...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29615168/reasons-for-removal-of-non-tunneled-double-lumen-catheters-in-incident-dialysis-patients
#17
Ruqaya Qureshi, Beena Salman, Salman Imtiaz, Murtaza F Drohlia, Aasim Ahmad
OBJECTIVE: To evaluate the reasons of removal of non-tunneled double lumen catheters (NTDLC) in incident hemodialysis (HD) patients in a tertiary renal care hospital. STUDY DESIGN: Observational retrospective study. PLACE AND DURATION OF STUDY: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKC PGTI), Karachi, from June 2015 to May 2016. METHODOLOGY: All patients were selected who had naive NTDLC placement at TKC PGTI either in Emergency Room (ER) or Intensive Care Unit (ICU) during the study period...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29606989/conservative-care-as-a-treatment-option-for-patients-aged-75-years-and-older-with-ckd-stage-v-a-national-survey-in-the-netherlands
#18
Christopher Susanto, J Kooman, A M Courtens, C J A M Konings
Background and objectives: Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. Design setting participants and measurement: A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Results: Twenty-one medical managers (35%) completed the survey...
2018: European Geriatric Medicine
https://www.readbyqxmd.com/read/29606094/can-increased-vigilance-for-chronic-kidney-disease-in-hospitalised-patients-decrease-late-referral-and-improve-dialysis-free-survival
#19
M De Wilde, M Speeckaert, W Van Biesen
BACKGROUND: Insufficient vigilance for renal insufficiency is associated with late referral, increased morbidity and mortality. The present study examines whether increased vigilance for chronic kidney disease (CKD) leads to quicker referral to and better follow-up by a nephrologist, and whether it is associated with an improved outcome. METHODS: Patients with an eGFR < 45 ml/min/1.73 m2 during hospitalisation at the Ghent University Hospital were enrolled during a period of 100 days...
April 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29597214/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvement
#20
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2018: Contributions to Nephrology
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