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Infection risk end stage renal disease

Samuel J Rednor, Michael J Ross
HIV-associated nephropathy (HIVAN) is an important cause of secondary focal glomerulosclerosis that occurs primarily in persons of African ancestry with advanced HIV disease. Although HIVAN is characterized by severe proteinuria and rapid progression to end stage renal disease without treatment, the phenotype is markedly attenuated by treatment with antiretroviral medications. HIV infection of glomerular and tubular epithelial cells and subsequent viral gene expression is a key contributor to HIVAN pathogenesis and the kidney can serve as reservoir for HIV strains that differ those in blood...
2018: Frontiers in Medicine
Emmanuel Ademola Anigilaje
BACKGROUND: Although urinary tract infection (UTI) resolves with prompt treatment in a majority of children, some children, especially those aged less than 5 years, also develop renal parenchymal scarring (RPS). RPS causes high blood pressure that may lead to severe chronic kidney disease and end-stage renal disease (ESRD). Although the risk of UTI is higher in white children than in black children, it is unknown whether RPS is more common in white children than in black children as data are scarce in this regard...
June 14, 2018: JMIR Research Protocols
George Kaysen, Xiaoling Ye, Jochen G Raimann, Yuedong Wang, Alice Topping, Len A Usvyat, Stefano Stuard, Bernard Canaud, Frank M van der Sande, Jeroen P Kooman, Peter Kotanko
Cardiovascular events (CV) are increased 36 fold in patients with end stage renal disease. However, randomized controlled trials to lower LDL-C and TC have not shown significant mortality improvements. An inverse association of serum total cholesterol (TC) and LDL cholesterol (LDL-C) with all-cause and cardiovascular (CV) mortality has been observed in patients on chronic dialysis. Lipoproteins also may protect against infectious diseases. We used data from 37,250 patients in the international Monitoring Dialysis Outcomes (MONDO) database to evaluate the association between lipids and infection-related or CV mortality...
June 12, 2018: Journal of Lipid Research
Rajiv Ranjan Singh, Rama Walia, Naresh Sachdeva, Ashish Bhalla, Akash Singh, Virendra Singh
AIM: Relative adrenal insufficiency (RAI) has been reported in critically ill patients with cirrhosis. We evaluated the prevalence of RAI and its relationship to clinical course in non-septic cirrhosis patients with ascites. METHODS: The study included 66 consecutive non-septic cirrhosis patients with ascites. RAI was defined by a delta cortisol lower than 9 μg/dL and/or a peak cortisol lower than 18 μg/dL. RESULTS: Sixty-six patients with cirrhosis and ascites were studied...
May 23, 2018: Digestive and Liver Disease
Carl D Langefeld, Mary E Comeau, Maggie C Y Ng, Meijian Guan, Latchezar Dimitrov, Poorva Mudgal, Mitzie H Spainhour, Bruce A Julian, Jeffrey C Edberg, Jennifer A Croker, Jasmin Divers, Pamela J Hicks, Donald W Bowden, Gary C Chan, Lijun Ma, Nicholette D Palmer, Robert P Kimberly, Barry I Freedman
African Americans carrying two apolipoprotein L1 gene (APOL1) renal risk variants have a high risk for nephropathy. However, only a minority develops end-stage renal disease (ESRD). Hence, modifying factors likely contribute to initiation of kidney disease such as endogenous (HIV infection) or exogenous (interferon treatment) environmental modifiers. In this report, genome-wide association studies and a meta-analysis were performed to identify novel loci for nondiabetic ESRD in African Americans and to detect genetic modifiers in APOL1-associated nephropathy...
June 6, 2018: Kidney International
Jing Fang, Wenge Li, Min Tan, Xiangxin Peng, Zhao Tan, Wenbo Wang
AIM: To analyze whether different hepatitis B virus (HBV) infection status influenced the prognosis of patients with lupus nephritis (LN) under immunosuppressive therapy. METHODS: A retrospective study enrolled 177 adults with active LN (Classes III, IV, V or mixed), and divided them into three groups: (i) HBV-free group (n = 93), antibodies to hepatitis B surface antigen positive only or all items negative; (ii) occult HBV infection group (n = 68), hepatitis B surface antigen (HBsAg) negative and antibody to hepatitis B core antigen positive with undetectable HBV DNA; and (iii) HBV infection group (n = 16), HBsAg-positive...
May 2018: International Journal of Rheumatic Diseases
Xu Qian, Duc T Nguyen, Jianxin Lyu, Andreas E Albers, Xiaohong Bi, Edward A Graviss
Many environmental, host, and microbial characteristics have been recognized as risk factors for dissemination of extrapulmonary tuberculosis (EPTB). However, there are few population-based studies investigating the association between the primary sites of tuberculosis (TB) infection and mortality during TB treatment. De-identified population-based surveillance data of confirmed TB patients reported from 2009 to 2015 in Texas, USA, were analyzed. Regression analyses were used to determine the risk factors for EPTB, as well as its subsite distribution and mortality...
June 6, 2018: Emerging Microbes & Infections
Chun-Lin Su, Chang-Cheng Chang, Yun-Shing Peng, Mei-Yen Chen
OBJECTIVE: The aim of this study is to investigate the preexisting predictive factors associated with comorbidities for diabetic foot ulcer (DFU) in King classification III at an outpatient clinic. METHOD: This prospective study included 100 patients with DFU in King classification III treated at outpatient clinics in Chiayi Chang Gung Memorial Hospital from January 2011 to December 2011. The least follow-up time was 1 year. Medical documentations were in respect of patient's baseline characteristics, associated history, presence of comorbidities, follow-up time, and condition of wounds...
May 30, 2018: Annals of Plastic Surgery
Saritha Ranabothu, Ari P Bernstein, Beth A Drzewiecki
Compared to adults, urolithiasis is less common in children, with a definite rise in incidence, especially among young adults (Tasian et al. in Clin J Am Soc Nephrol 11:488, 2016). In the last 25 years, the incidence in children has increased by approximately 6-10% annually, for reasons still unknown, with an associated significant increase in related health care-related expenditures (Hyams and Matlaga in Transl Androl Urol 3(3):278-83, 2014). It has been shown that there is twice as high a risk of chronic kidney disease (CKD) or end stage renal disease (ESRD) in stone formers compared to non-stone formers (Tasian et al...
May 30, 2018: International Urology and Nephrology
Qiang Xiao, Jinlong Li, Kai Zhou, Tingxian Ling, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
Objective: To evaluate the safety and efficacy of total hip arthroplasty (THA) in patients with end stage renal disease (ESRD). Methods: Between December 2009 and May 2016, 30 THAs were performed in 28 patients with dialysis-dependent renal failure (18 patients) or renal transplantation (10 patients). A retrospective case control study was carried out to compare these 28 ESRD patients (ESRD group) with a matched cohort of 28 nonrenal patients (control group). There was no significant difference in gender, age, hip side, American Society of Anesthesiology (ASA) classification, comorbidities, and preoperative Harris score and hemoglobin (Hb) level between 2 groups ( P >0...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Maristela Pinheiro Freire, Clara Mendes, Affonso C Piovesan, Flavio Jota de Paula, Fernanda Spadão, Willian C Nahas, Elias David-Neto, Ligia Camera Pierrotti
The incidence of urinary tract infection (UTI) after kidney transplantation (KT) caused by multidrug-resistant (MDR) bacteria is growing. The aim of this study was to analyze the impact of UTI caused by carbapenem-resistant Gram-negative bacteria (CR-GNB) in the survival of graft and recipients following KT. This was a retrospective cohort study involving patients who underwent KT between 2013 and 2016. Patients were followed since the day of the KT until loss of graft, death or end of the follow-up period (31th December 2016)...
May 24, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Thomas Jouve, Johan Noble, Lionel Rostaing, Paolo Malvezzi
BACKGROUND: The prevalence of end-stage renal disease is increasing worldwide. The best treatment is kidney transplantation, although life-long immunosuppressive therapy is then mandatory. Currently, the cornerstone immunosuppressive therapy relies on tacrolimus, a calcineurin inhibitor that is nephrotoxic but whose exposition can be minimized in a delicate balance. Area covered: We addressed whether, in the setting of kidney transplantation, tacrolimus-based therapy can be tailored to medical needs: to achieve this, we searched for suitable articles in PubMed...
May 19, 2018: Expert Review of Clinical Pharmacology
Chenchen Zhou, Yaodong Gu, Changlin Mei, Bing Dai, Yi Wang, Cheng Xue
INTRODUCTION: Identifying the appropriate modality between hemodialysis (HD) and peritoneal dialysis (PD) is an unresolved issue in polycystic kidney disease (PKD) patients. This study aims to illustrate whether the mortality and survival are different among individuals receiving HD comparing PD. METHODS: We searched PubMed, EMBASE, and China National Knowledge Infrastructure about cohort studies involving PKD patients with end stage renal disease and comparing HD with PD...
May 18, 2018: Hemodialysis International
Sung Bum Kim, Kook Hyun Kim, Tae Nyeun Kim
BACKGROUND AND AIM: Previous studies evaluating the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with end-stage renal disease (ESRD) undergoing hemodialysis reported an increased risk of post-procedural bleeding. We investigated the safety and efficacy of ERCP for the treatment of choledocholithiasis in patients with ESRD undergoing long-term dialysis. METHODS: A total of 3466 patients who underwent ERCP due to choledocholithiasis between January 2000 and Feb 2018 were reviewed and analyzed retrospectively...
May 16, 2018: Digestive Diseases and Sciences
So Jin Park, Na Ri Lim, Hyo Jung Park, Jae Wook Yang, Min-Ji Kim, Kyunga Kim, Yong Won In, Young Mee Lee
Background Vancomycin is a glycopeptide antibiotic of choice for the treatment of serious infections caused by multi-resistant Gram-positive bacteria. However, vancomycin-associated nephrotoxicity (VAN) often limits its use. Previous data suggested a few risk factors of VAN, including higher mean vancomycin trough level, higher daily doses, old age, long duration of vancomycin therapy, and concomitant nephrotoxins. Objective To evaluate the incidence and risk factors of VAN and determine whether higher vancomycin trough concentrations were associated with a greater risk for VAN...
May 9, 2018: International Journal of Clinical Pharmacy
N Masaki, K Iwadoh, A Kondo, I Koyama, I Nakajima, S Fuchinoue
BACKGROUND: Even if a living donor candidate exists, there are some cases that do not result in kidney transplantation (KTx) due to problems on the recipient side. The aim of this study was to clarify causes of ineligibility for KTx in these cases, so as to make RTx more applicable for patients. METHODS: We targeted 470 patients with end-stage renal disease who applied for the primary kidney KTx from 2010 to 2012. Then we selected those who were not applicable for KTx and investigated recipient causes of ineligibility for KTx or not receiving KTx...
May 2018: Transplantation Proceedings
Magdalena Harris, Rachel Brathwaite, Jenny Scott, Gail Gilchrist, Dan Ciccarone, Vivian Hope, Catherine R McGowan
BACKGROUND AND AIMS: Chronic skin and soft tissue infections (SSTI) among people who inject drugs (PWID) can lead to AA amyloidosis: a serious, yet neglected, multi-organ disease. We aim to synthesize findings on the epidemiology, risk factors, clinical outcomes, screening recommendations and challenges to treatment for AA amyloidosis among PWID. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
April 26, 2018: Addiction
Abraham Cohen-Bucay, Jean M Francis, Craig E Gordon
Hepatitis C virus (HCV) infection is prevalent in patients with kidney disease including transplant candidates and recipients. It is associated with increased morbidity and mortality in end-stage renal disease patients and also increases the risk of allograft rejection and decreases allograft and patient survival post-transplant. Newly developed direct acting antivirals have revolutionized the way HCV is treated. Whether patients are treated before or after kidney transplantation, the cure rates with direct acting antivirals are >90%...
April 2018: Hemodialysis International
Susan Taylor, Tricia Francisco, Janet A Munroe, Hadyn T Williams
Extracardiac uptake on SPECT MPI, seen with physiologic radiotracer distribution, benign or malignant neoplasm, infection, inflammation, or granulomatous disease, may confound the accuracy of MPI or lead to unsuspected pathology. A 38-year-old woman with end-stage renal disease on hemodialysis had SPECT MPI for renal transplant preoperative risk stratification, showing left anterior descending artery ischemia and an intense extracardiac soft tissue focus adjacent to the diaphragmatic right ventricle concerning for focal infection related to prior coronary or gastric surgeries or tumor...
June 2018: Clinical Nuclear Medicine
Rajesh Kumar Wadhva, Muhammad Manzoorul Haque, Nasir Hassan Luck, Abbas Ali Tasneem, Zaigham Abbas, Muhammad Mubarak
Objectives: The aim was to assess the diagnostic accuracy of APRI and FIB-4 in assessing the stage of liver fibrosis in end stage renal disease (ESRD) patients with chronic viral hepatitis and to compare the two tests with standard tru-cut liver biopsy. Material and Methods: The study was conducted at Sindh Institute of Urology and Transplantation Karachi (SIUT) from May 2010 to May 2014. All ESRD patients, being considered as candidates for renal transplantation and in whom liver biopsy was performed were included...
March 2018: Journal of Translational Internal Medicine
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