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Risk sepsis dialysis

Fabio Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Mariana Nadal Cardoso, Gledson Luiz Picharski, Gregory Jaeger, Marion Burger
OBJECTIVE: To evaluate risk factors associated with death due to bloodstream infection caused by Candida spp. in pediatric patients and evaluate the resistance to the main anti-fungal used in clinical practice. METHODS: This is a cross-sectional, observational, analytical study with retrospective collection that included 65 hospitalized pediatric patients with bloodstream infection by Candida spp. A univariate analysis was performed to estimate the association between the characteristics of the candidemia patients and death...
October 3, 2016: Jornal de Pediatria
Samih Z Thalji, Anai N Kothari, Paul C Kuo, Michael J Mosier
OBJECTIVE: To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND: Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventing AKI after burn injury. Expanding our understanding of the burden AKI has on the clinical course of burn patients would highlight the need for standardized protocols...
September 8, 2016: Annals of Surgery
T Sahutoglu, K Atay, Y Caliskan, E Kara, H Yazici, A Turkmen
BACKGROUND: Amyloid A (AA) amyloidosis is a multisystemic, progressive, and severe disease. Renal involvement is a prominent feature of the disease, and the outcome of patients on dialysis is poor. We aimed to analyze the outcomes of kidney transplantation in patients with AA amyloidosis in comparison with chronic glomerulonephritis (CGN). METHODS: Charts of patients who underwent kidney transplantation between 1988 and 2012 were reviewed; 41 patients with AA amyloidosis were identified, and 41 age- and sex-matched control patients with chronic CGN were included...
July 2016: Transplantation Proceedings
Sérgio Aparecido Cleto, Camila Eleutério Rodrigues, Ceila Maria Malaque, Jaques Sztajnbok, Antônio Carlos Seguro, Lúcia Andrade
BACKGROUND: Leptospirosis is a health problem worldwide. Its most severe form is a classic model of sepsis, provoking acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI), with associated mortality that remains unacceptably high. We previously demonstrated that early initiation of sustained low-efficiency dialysis (SLED) followed by daily SLED significantly decreases mortality. However, the mode of clearance can also affect dialysis patient outcomes. Therefore, the objective of this study was to compare the effects of SLED with traditional (diffusive) clearance, via hemodialysis, and SLED with convective clearance, via hemodiafiltration (SLEDf), in patients with severe leptospirosis...
2016: PloS One
Mei Gao, Jianzhong Sun, Nilas Young, Douglas Boyd, Zane Atkins, Zhongmin Li, Qian Ding, James Diehl, Hong Liu
OBJECTIVES: Body mass index (BMI) commonly is used in obesity classification as a surrogate measure, and obesity is associated with a cluster of risk factors for cardiovascular disease. The aim of this study was to investigate the impact of BMI on short-term outcomes after cardiac surgery. DESIGN: A retrospective cohort study. SETTING: University teaching hospital, 2 centers. PARTICIPANTS: The study comprised 4,740 patients who underwent cardiac surgery at 2 hospitals-from July 1, 2001, to June 30, 2013, in 1 hospital and from September 1, 2003, to August 31, 2014, in a second hospital...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Nicholas Carlson, Kristine Hommel, Jonas Bjerring Olesen, Anne-Merete Soja, Tina Vilsbøll, Anne-Lise Kamper, Christian Torp-Pedersen, Gunnar Gislason
BACKGROUND: Dialysis-requiring acute kidney injury (AKI) is associated with substantial mortality and risk of end-stage renal disease (ESRD). Despite considerable growth in incidence of severe AKI, information pertaining to trends in outcomes remains limited. We evaluated time trends in one year risks of ESRD and death in patients with dialysis-requiring AKI over an eight year period in Denmark. METHODS: In a retrospective nationwide study based on national registers, all adults requiring acute renal replacement therapy between 2005 and 2012 were identified...
2016: PloS One
Lawrence Kingi, Roger Grech, Michael Lam, Ajith Dissanayake, Simon Otter
This case history describes a rare complaint - Calciphylaxis, seen in a New Zealand Maori patient undergoing renal dialysis. This condition causes non-healing tissue ulceration, typically with sepsis and is associated with a very high mortality rate. The need for vigilance among health professionals is highlighted, including the risk factors that may faciliate an early diagnosis; together with the value associated with a multi-disciplinary team approach to management.
July 5, 2016: Journal of Tissue Viability
Pramod K Guru, Tarun D Singh, Abbasali Akhoundi, Kianoush B Kashani
BACKGROUND: Both acute kidney injury (AKI) requiring dialysis and thrombocytopenia are very common and have been independently associated with mortality and morbidity in critically ill patients. Thrombocytopenia is an independent risk factor for AKI and also a marker of disease severity. There is a paucity of literature on the prevalence, incidence, and outcome of thrombocytopenia in patients receiving continuous renal replacement therapy (CRRT). We aimed at identifying the impact of thrombocytopenia on patients in the intensive care unit (ICU) with AKI requiring CRRT...
2016: Nephron
Marcia C Riyuzo, Liciana V de A Silveira, Célia S Macedo, José R Fioretto
OBJECTIVE: To evaluate the prognosis factors of children with sepsis and acute kidney injury. METHODS: This was a retrospective study of children with sepsis and acute kidney injury that were admitted to the pediatric intensive care unit (PICU) of a tertiary hospital. A multivariate analysis was performed to compare risk factors for mortality. RESULTS: Seventy-seven children (47 males) were retrospectively studied, median age of 4 months. Mean length of hospital stay was 7...
July 2, 2016: Jornal de Pediatria
Jianmin Chen, Julius E Kieswich, Fausto Chiazza, Amie J Moyes, Thomas Gobbetti, Gareth S D Purvis, Daniela C F Salvatori, Nimesh S A Patel, Mauro Perretti, Adrian J Hobbs, Massimo Collino, Muhammad M Yaqoob, Christoph Thiemermann
Patients with CKD requiring dialysis have a higher risk of sepsis and a 100-fold higher mortality rate than the general population with sepsis. The severity of cardiac dysfunction predicts mortality in patients with sepsis. Here, we investigated the effect of preexisting CKD on cardiac function in mice with sepsis and whether inhibition of IκB kinase (IKK) reduces the cardiac dysfunction in CKD sepsis. Male C57BL/6 mice underwent 5/6 nephrectomy, and 8 weeks later, they were subjected to LPS (2 mg/kg) or sepsis by cecal ligation and puncture (CLP)...
May 6, 2016: Journal of the American Society of Nephrology: JASN
Chris Lata, Louis Girard, Michael Parkins, Matthew T James
PURPOSE OF THE REVIEW: Patients with end-stage renal disease (ESRD) are at a high risk of bacterial infection. We reviewed publications on risk factors, prevention, and treatment paradigms, as well as outcomes associated with bacterial infection in end-stage kidney disease. We focused in particular on studies conducted in Canada where rates of haemodialysis catheter use are high. SOURCES OF INFORMATION: We included original research articles in English text identified from MEDLINE using search terms 'chronic kidney failure', 'renal dialysis', or 'chronic renal insufficiency', and 'bacterial infection'...
2016: Canadian Journal of Kidney Health and Disease
Lokman Ustyol, Erdal Peker, Nihat Demir, Kemal Agengin, Oguz Tuncer
BACKGROUND To evaluate the efficacy, complications, and mortality rate of acute peritoneal dialysis (APD) in critically ill newborns. MATERIAL AND METHODS The study included 31 newborns treated in our center between May 2012 and December 2014. RESULTS The mean birth weight, duration of peritoneal dialysis, and gestational age of the patients were determined as 2155.2 ± 032.2 g (580-3900 g), 4 days (1-20 days), and 34 weeks (24-40 weeks), respectively. The main reasons for APD were sepsis (35.5%), postoperative cardiac surgery (16%), hypoxic ischemic encephalopathy (13%), salting of the newborn (9...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Ying Wang, Jessica N Ivany, Vlado Perkovic, Martin P Gallagher, Mark Woodward, Meg J Jardine
BACKGROUND: Catheter malfunction, including thrombosis, is associated with reduced dialysis adequacy, as well as an increased risk of catheter-related bacteraemia and mortality. The role of anticoagulants in the prevention of catheter malfunction remains uncertain. OBJECTIVES: This review aimed to compare the prophylactic effect of different anticoagulant agents, preparations, doses and administration on the incidence of central venous haemodialysis catheter-related malfunction and sepsis in patients with end-stage kidney disease (ESKD)...
April 4, 2016: Cochrane Database of Systematic Reviews
Natalia O Glebova, Michael Bronsert, Karl E Hammermeister, Mark R Nehler, Douglas R Gibula, Mahmoud B Malas, James H Black, William G Henderson
OBJECTIVE: Postoperative readmissions are frequent in vascular surgery patients, but it is not clear which factors are the main drivers of readmissions. Specifically, the relative contributions of patient comorbidities vs those of operative factors and postoperative complications are unknown. We sought to study the multiple potential drivers of readmission and to create a model for predicting the risk of readmission in vascular patients. METHODS: The 2012-2013 American College of Surgeons National Surgical Quality Improvement Program data set was queried for unplanned readmissions in 86,238 vascular patients...
July 2016: Journal of Vascular Surgery
Yusuke Minematsu, Masafumi Yamato, Yuta Ikemiya, Takahito Ito
BACKGROUND: The most frequent cause of acute kidney injury (AKI) needing renal replacement therapy is sepsis, with the prognosis of patients with septic AKI worse than for other causes of this disease. Recent studies have shown that fibroblast growth factor-23 (FGF-23) levels, one of the phosphaturic and prognostic factors in chronic kidney disease, are also elevated in patients with AKI and correlate with an increased risk of death or a need for dialysis. In addition, FGF-23 was found to inhibit the extra-renal synthesis of 1,25-dihydroxyvitamin D by human monocytes...
2016: Clinical Laboratory
Rashmi Mishra, Nupur Sinha, Richard Duncalf
Clostridium perfringens bacteremia is associated with adverse outcomes. Known risk factors include chronic kidney disease, malignancy, diabetes mellitus, and gastrointestinal disease. We present a 74-year-old man admitted with confusion, vomiting, and abdominal pain. Exam revealed tachycardia, hypotension, lethargy, distended abdomen, and cold extremities. He required intubation and aggressive resuscitation for septic shock. Laboratory data showed leukocytosis, metabolic acidosis, acute kidney injury, and elevated lipase...
2016: Case Reports in Critical Care
Francesco Rapisarda, Roberta Aliotta, Barbara Pocorobba, Grazia Portale, Silvia Ferrario, Luca Zanoli, Pasquale Fatuzzo
Fungal infections have a high incidence in patients receiving peritoneal dialysis. (1)
Peritoneal dialysis is often complicated by peritonitis which has only minimally mycotic etiology, but nonetheless it is associated with 15-45% mortality (8).
 The opportunistic pathogens such as Candida can cause infection in immunocompromised conditions. Even the Acinetobacter tends to infect immunocompromised individuals and it has the same risk factors for infection as Candida: immunosuppression, malignancy, HIV positivity and all the other conditions of immunosuppression, central venous catheterization, mechanical ventilation and prolonged antibiotic therapy...
November 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Jared Feyko, Hannah Hazard, Jon Cardinal, Alan Thomay, Sung Cho
Chronic renal impairment causes profound physiologic and metabolic changes. Its impact on surgical outcome after pancreatectomy is not well established. We sought to quantify complication rates of pancreatectomy in patients with chronic renal impairment. Database from the American College of Surgeons National Surgical Quality Improvement Project (2005-2011) was queried to identify patients with chronic renal impairment who underwent pancreatectomy. The study population consisted of 16,708 patients of whom 16,649 patients were not on dialysis and 59 patients were on dialysis...
January 2016: American Surgeon
Barbara A Clark, Liliana Osadchuk, Jones John, Thuyanh Culver, Richard Marcus
BACKGROUND: Little is known about benefit versus risk in treating iron deficiency anemia with intravenous (IV) iron in patients with acute kidney injury (AKI). Concerns about adverse outcomes may dissuade use and could contribute to greater use of red blood cell (RBC) transfusion. STUDY DESIGN AND METHODS: We performed a retrospective case-control study of patients with AKI who received IV iron (cases) compared to those with AKI without IV iron (controls). RESULTS: We identified 67 cases and 67 controls matched for age, stage of chronic kidney disease, and severity of anemia (hemoglobin [Hb], 7...
April 2016: Transfusion
Nelson Leung, Shaji K Kumar, Siobhan V Glavey, Angela Dispenzieri, Martha Q Lacy, Francis K Buadi, Suzanne R Hayman, David Dingli, Prashant Kapoor, Steven R Zeldenrust, Stephen J Russell, John A Lust, William J Hogan, S Vincent Rajkumar, Dennis A Gastineau, Taxiarchis V Kourelis, Yi Lin, Wilson I Gonsalves, Ronald S Go, Morie A Gertz
BACKGROUND: Acute renal failure requiring dialysis is associated with high mortality during autologous stem cell transplantation (ASCT). This study examined the association between acute renal failure and mortality in immunoglobulin light chain (AL) amyloidosis during ASCT. METHODS: Between 1996 and 2010, 408 ASCT patients were evaluated. Data were collected from electronic medical records. RESULTS: Dialysis was performed on 72 (17.6%) patients...
August 2016: Nephrology, Dialysis, Transplantation
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