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Pulmonary ESRD

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https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#1
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28869934/typical-hemodialysis-in-india-a-case-report
#2
Georgi Abraham, Madhusudan Vijayan, Milly Mathew
We report here a typical case of a patient on hemodialysis (HD) for end-stage renal disease (ESRD) in India that highlights some of the management issues encountered in a country with an enormous burden of ESRD and major challenges of underdialysis and management of comorbidities. The patient, a 42-year-old multiparous woman with chronic kidney disease (CKD) stage V, type 2 diabetes mellitus, and hypertension is a homemaker from a middle-class family, living in a large city, with no family history of CKD. From May 2013 to December 2016, she has been receiving twice-weekly maintenance HD for 4 h (intermittent HD); access was via an internal jugular line initially and then via a left brachiocephalic arteriovenous fistula (AVF) from late June 2013...
2017: Blood Purification
https://www.readbyqxmd.com/read/28865972/high-dose-melphalan-and-stem-cell-transplantation-in-patients-on-dialysis-due-to-al-amyloidosis-and-monoclonal-immunoglobulin-deposition-disease
#3
Felipe Batalini, Laura Econimo, Karen Quillen, J Mark Sloan, Shayna Sarosiek, Dina Brauneis, Andrea Havasi, Lauren Stern, Laura Dember, Vaishali Sanchorawala
The kidney is the most common organ affected by immunoglobulin light-chain (AL) amyloidosis and monoclonal immunoglobulin deposition disease (MIDD), often leading to end stage renal disease (ESRD). High-dose melphalan and stem cell transplantation (HDM/SCT) is effective for selected patients with AL amyloidosis, with high rates of complete hematologic responses and potential for improvement in organ dysfunction. Data on tolerability and response to HDM/SCT in patients with ESRD due to AL amyloidosis and MIDD are limited...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28845472/a-clinical-prediction-score-to-guide-referral-of-elderly-dialysis-patients-for-kidney-transplant-evaluation
#4
Ling-Xin Chen, Michelle A Josephson, Donald Hedeker, Kellie Hunter Campbell, Nicole Stankus, Milda R Saunders
INTRODUCTION: Dialysis patients aged ≥70 years derive improved life expectancy through kidney transplantation compared to their waitlisted counterparts, but guidelines are not clear about how to identify appropriate transplantation candidates. We developed a clinical prediction score to identify elderly dialysis patients with expected 5-year survival appropriate for kidney transplantation (>5 years). METHODS: Incident dialysis patients in 2006-2009 aged ≥70 were identified from the United States Renal Data System database and divided into derivation and validation cohorts...
July 2017: KI Reports
https://www.readbyqxmd.com/read/28730376/lower-urinary-tract-obstruction-fetal-intervention-based-on-prenatal-staging
#5
Rodrigo Ruano, Timothy Dunn, Michael C Braun, Joseph R Angelo, Adnan Safdar
The authors present an overview of lower urinary tract obstruction (LUTO) in the fetus with a particular focus on the insult to the developing renal system. Diagnostic criteria along with the challenges in estimating long-term prognosis are reviewed. A proposed prenatal LUTO disease severity classification to guide management decisions with fetal intervention to maintain or salvage in utero and neonatal pulmonary and renal function is also discussed. Stage I LUTO (mild form) is characterized by normal amniotic fluid index after 18 weeks, normal kidney echogenicity, no renal cortical cysts, no evidence of renal dysplasia, and favorable urinary biochemistries when sampled between 18 and 30 weeks; prenatal surveillance is recommended...
July 21, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28680564/kidney-dysfunction-in-patients-with-pulmonary-arterial-hypertension
#6
REVIEW
N P Nickel, J M O'Leary, E L Brittain, J P Fessel, R T Zamanian, J D West, E D Austin
Pulmonary arterial hypertension (PH) and chronic kidney disease (CKD) both profoundly impact patient outcomes, whether as primary disease states or as co-morbid conditions. PH is a common co-morbidity in CKD and vice versa. A growing body of literature describes the epidemiology of PH secondary to chronic kidney disease and end-stage renal disease (ESRD) (WHO group 5 PH). But, there are only limited data on the epidemiology of kidney disease in group 1 PH (pulmonary arterial hypertension [PAH]). The purpose of this review is to summarize the current data on epidemiology and discuss potential disease mechanisms and management implications of kidney dysfunction in PAH...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28555652/reducing-the-costs-of-chronic-kidney-disease-while-delivering-quality-health-care-a-call-to-action
#7
REVIEW
Raymond Vanholder, Lieven Annemans, Edwina Brown, Ron Gansevoort, Judith J Gout-Zwart, Norbert Lameire, Rachael L Morton, Rainer Oberbauer, Maarten J Postma, Marcello Tonelli, Wim Van Biesen, Carmine Zoccali
The treatment of chronic kidney disease (CKD) and of end-stage renal disease (ESRD) imposes substantial societal costs. Expenditure is highest for renal replacement therapy (RRT), especially in-hospital haemodialysis. Redirection towards less expensive forms of RRT (peritoneal dialysis, home haemodialysis) or kidney transplantation should decrease financial pressure. However, costs for CKD are not limited to RRT, but also include nonrenal health-care costs, costs not related to health care, and costs for patients with CKD who are not yet receiving RRT...
July 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28497088/pulmonary-hypertension-among-patients-undergoing-hemodialysis
#8
Fatemeh Hayati, Seyed Seifollah Beladi Mousavi, Seyed Majid Mousavi Movahed, Maryam Mofrad Bushehri
Introduction: The epidemiology of pulmonary hypertension (PHT) among long-term hemodialysis patients has been described in relatively small studies in Iran. Objectives: The purpose of this study was to evaluate the prevalence of PHT and its relationship among end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD). Patients and Methods: In a cross-sectional study, patients with ESRD treated with HD for at least 3 months in the Imam hospital enrolled for the study. PHT was defined as an estimated systolic pulmonary artery pressure (PAP) equal to or higher than 25 mm Hg using echocardiograms performed by cardiologist...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28492295/elderly-versus-non-elderly-patients-with-intra-abdominal-candidiasis-in-the-icu
#9
George Dimopoulos, Dimitrios K Matthaiou, Elda Righi, Maria Merelli, Matteo Bassetti
BACKGROUND: Intra-abdominal candidiasis (IAC) has a considerable cost in terms of mortality and morbidity. We sought to study the epidemiology, characteristics and outcome of elderly (>75 years old) versus non-elderly patients with IAC and risk factors for mortality in elderly patients. METHODS: Post-hoc analysis of a retrospective multinational cohort study over a 3- year period (2011-2013). RESULTS: Of 482 patients, 124 (25.7%) were elderly and 358 (74...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28457746/comparing-the-palliative-care-needs-of-those-with-cancer-to-those-with-common-non-cancer-serious-illness
#10
Doran Bostwick, Steven Wolf, Greg Samsa, Janet Bull, Donald H Taylor, Kimberly S Johnson, Arif H Kamal
BACKGROUND: Historically, palliative care has been focused on those with cancer. Although these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature informing palliative care practices stems from the care of cancer patients. OBJECTIVES: We compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD)...
June 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#11
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28143672/echocardiographic-measures-and-estimated-gfr-decline-among-african-americans-the-jackson-heart-study
#12
Leila R Zelnick, Ronit Katz, Bessie A Young, Adolfo Correa, Bryan R Kestenbaum, Ian H de Boer, Nisha Bansal
BACKGROUND: Cardiac structural abnormalities, common in African Americans, are associated with adverse clinical outcomes. Associations between echocardiography-measured subclinical heart failure and kidney function decline are unknown and may identify novel risk factors for kidney disease in this population. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 2,418 Jackson Heart Study participants with baseline echocardiograms and longitudinal measures of estimated glomerular filtration rate (eGFR) calculated from the CKD-EPI creatinine equation...
August 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28120425/kidney-transplantation-in-patients-with-systemic-sclerosis-a-nationwide-multicentre-study
#13
MULTICENTER STUDY
Dominique Bertrand, Julien Dehay, Julien Ott, Rebecca Sberro, Charlotte Brunelle, Nassim Kamar, Charlotte Colosio, Valérie Chatelet, Laetitia Albano, Sophie Girerd, Vincent Audard, Christelle Barbet, Jacques Dantal, Didier Ducloux, Antoine Durrbach, Valérie Garrigue, Marc Hazzan, Anne-Elisabeth Heng, Christophe Mariat, Pierre Merville, Jean-Philippe Rerolle, Bruno Moulin, Dominique Guerrot
Kidney transplantation is one of the therapeutic options for end-stage renal disease (ESRD) in systemic sclerosis (SS). Current evidence demonstrates poorer patient and graft survival after transplantation in SS than in other primary kidney diseases. All the patients presenting ESRD associated with SS who had received a kidney allograft between 1987 and 2013 were systematically included from 20 French kidney transplantation centres. Thirty-four patients received 36 kidney transplants during the study period...
March 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28043083/lung-ultrasound-in-the-management-of-fluid-volume-in-dialysis-patients-potential-usefulness
#14
EDITORIAL
Carmine Zoccali
Volume overload is a hidden, pervasive complication in dialysis patients with dyspnea and pulmonary edema being its main clinical manifestations. Measuring lung water has clinical potential because it allows timely treatment of lung congestion at a preclinical stage. Chest ultrasound (US) is a novel, well-validated technique that allows reliable estimates of lung water in clinical practice. The application of this technique in dialysis patients has shown that an unsuspectedly high proportion of these patients have moderate to severe lung congestion which is usually asymptomatic...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/27989049/infective-endocarditis-in-hemodialysis-patients
#15
Rahul Vasudev, Priyank Shah, Supreet Kaur, Chandrika Chitturi, Sundermurthy Yamini, Ashesha Mechineni, Chandra Chandran, Mahesh Bikkina, Fayez Shamoon
BACKGROUND: Infective endocarditis (IE) is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). The study aim was to evaluate the demographic, clinical, microbiological and inpatient mortality data of IE in hemodialysis patients. METHODS: Data were analyzed for all IE patients admitted to the authors' 800-bed tertiary care hospital between January 2001 and December 2014. These data included demographics, comorbidities, clinical and microbiological characteristics, echocardiographic findings, complications, outcomes, and in-patient mortality...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27909682/case-report-of-invasive-disseminated-candidiasis-with-peripheral-nodular-cavitary-lesions-in-the-lung
#16
Hafiza Arshad, Silvia Garcia, Misbahuddin Khaja
We report a case of invasive candidiasis presenting as multiple lung nodules and cavitary lesions with minimal pleural effusion. Candida infections of the lung are rare but can occur after hematologic dissemination of the yeast from other body sites, such as the skin and the gastrointestinal and genitourinary tracts. Here, we describe the case of a 56-year-old female with a history of end-stage renal disease (ESRD) who presented with fever, productive cough, and pulmonary nodules and cavitary lesions seen on a chest computed tomography (CT)...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27660305/the-agreement-between-auscultation-and-lung-ultrasound-in-hemodialysis-patients-the-lust-study
#17
Claudia Torino, Luna Gargani, Rosa Sicari, Krzysztof Letachowicz, Robert Ekart, Danilo Fliser, Adrian Covic, Kostas Siamopoulos, Aristeidis Stavroulopoulos, Ziad A Massy, Enrico Fiaccadori, Alberto Caiazza, Thomas Bachelet, Itzchak Slotki, Alberto Martinez-Castelao, Marie-Jeanne Coudert-Krier, Patrick Rossignol, Faikah Gueler, Thierry Hannedouche, Vincenzo Panichi, Andrzej Wiecek, Giuseppe Pontoriero, Pantelis Sarafidis, Marian Klinger, Radovan Hojs, Sarah Seiler-Mussler, Fabio Lizzi, Dimitrie Siriopol, Olga Balafa, Linda Shavit, Rocco Tripepi, Francesca Mallamaci, Giovanni Tripepi, Eugenio Picano, Gérard Michel London, Carmine Zoccali
BACKGROUND AND OBJECTIVES: Accumulation of fluid in the lung is the most concerning sequela of volume expansion in patients with ESRD. Lung auscultation is recommended to detect and monitor pulmonary congestion, but its reliability in ESRD is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a subproject of the ongoing Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial, we compared a lung ultrasound-guided ultrafiltration prescription policy versus standard care in high-risk patients on hemodialysis...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27660303/anxiety-in-patients-treated-with-hemodialysis
#18
Scott D Cohen, Daniel Cukor, Paul L Kimmel
Anxiety is a common yet frequently overlooked psychiatric symptom in patients with ESRD treated with hemodialysis (HD). Anxiety is characterized by disruptive feelings of uncertainty, dread, and fearfulness. A variety of common medical complaints may be manifestations of an anxiety disorder, including palpitations, tremors, indigestion, numbness/tingling, nervousness, shortness of breath, diaphoresis, and fear. It is essential for the clinician to rule out specific medical conditions, including cardiovascular, pulmonary, and neurologic diseases, before ascribing these symptoms to an anxiety disorder...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27574402/pharmacokinetic-profile-of-defibrotide-in-patients-with-renal-impairment
#19
Paola Tocchetti, Elena Tudone, Jean-Francois Marier, Thomas C Marbury, Katie Zomorodi, Mark Eller
Hepatic veno-occlusive disease, also called sinusoidal obstruction syndrome (VOD/SOS), is an unpredictable, potentially life-threatening complication of hematopoietic stem cell transplant conditioning. Severe VOD/SOS, generally associated with multiorgan dysfunction (pulmonary or renal dysfunction), may be associated with >80% mortality. Defibrotide, recently approved in the US, has demonstrated efficacy treating hepatic VOD/SOS with multiorgan dysfunction. Because renal impairment is prevalent in patients with VOD/SOS, this Phase I, open-label, two-part study in adults examined the effects of hemodialysis and severe or end-stage renal disease (ESRD) on defibrotide pharmacokinetics (PK)...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27499694/predictive-value-of-echocardiographic-abnormalities-and-the-impact-of-diastolic-dysfunction-on-in-hospital-major-cardiovascular-complications-after-living-donor-kidney-transplantation
#20
Eun Jung Kim, Suyon Chang, So Yeon Kim, Kyu Ha Huh, Soojeong Kang, Yong Seon Choi
Patients with end-stage renal disease (ESRD) show characteristic abnormalities in cardiac structure and function. We evaluated the influence of these abnormalities on adverse cardiopulmonary outcomes after living donor kidney transplantation in patients with valid preoperative transthoracic echocardiographic evaluation. We then observed any development of major postoperative cardiovascular complications and pulmonary edema until hospital discharge. In-hospital major cardiovascular complications were defined as acute myocardial infarction, ventricular fibrillation/tachycardia, cardiogenic shock, newly-onset atrial fibrillation, clinical pulmonary edema requiring endotracheal intubation or dialysis...
2016: International Journal of Medical Sciences
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