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Infective dialysis

Ali Riza Ucar, Erol Demir, Mehmet Sukru Sever
Progress in patient care and immunosuppressive medications has resulted in improved allograft survival in the early posttransplant period; however, substantial graft loss continues in the long term. Therefore, the number of dialysis patients with failed allografts is increasing progressively. These patients have a worse prognosis than naive dialysis patients. Cardiovascular causes are the leading cause of death, followed by infections and malignancies. Delay in return to dialysis, a chronic inflammatory state, infections, and cancer are contributing factors to mortality, whereas type of dialysis modality does not have a significant effect on outcomes...
March 2018: Experimental and Clinical Transplantation
Therese Adrian, Mads Hornum, Frank Eriksson, Jesper M Hansen, Katrine Pilely, Peter Garred, Bo Feldt-Rasmussen
Background: Patients with end-stage renal disease (ESRD) have high morbidity and mortality rates, with cardiovascular diseases and infections being the major causes of death. Mannose-binding lectin (MBL) has been suggested to play a protective role in this regard. The aim of this study was to investigate a possible clinical association of MBL genotypes (MBL2) with outcome among patients on dialysis or with a functioning graft. Methods: A total of 98 patients with ESRD accepted for living-donor renal transplantation or on the waiting list for transplantation were included and prospectively followed for an average of 9 years (range 7...
March 3, 2018: Nephrology, Dialysis, Transplantation
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
Mehmet Sarıer, İbrahim Duman, Meltem Demir, Yücel Yüksel, Mestan Emek, Erdal Kukul
Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods: Between February 2009 and March 2016, 38 male patients underwent TURP/TUIP due to BOO within the first 30 days of renal transplantation...
March 2018: Turkish Journal of Urology
Christine M Durand, Mary G Bowring, Diane M Brown, Michael A Chattergoon, Guido Massaccesi, Nichole Bair, Russell Wesson, Ashraf Reyad, Fizza F Naqvi, Darin Ostrander, Jeremy Sugarman, Dorry L Segev, Mark Sulkowski, Niraj M Desai
Background: Given the high mortality rate for patients with end-stage kidney disease receiving dialysis and the efficacy and safety of hepatitis C virus (HCV) treatments, discarded kidneys from HCV-infected donors may be a neglected public health resource. Objective: To determine the tolerability and feasibility of using direct-acting antivirals (DAAs) as prophylaxis before and after kidney transplantation from HCV-infected donors to non-HCV-infected recipients (that is, HCV D+/R- transplantation)...
March 6, 2018: Annals of Internal Medicine
Jenny H C Chen, David W Johnson, Carmel Hawley, Neil Boudville, Wai H Lim
Technique failure is a frequent complication of peritoneal dialysis (PD), but the association between causes of death-censored technique failure and mortality remains unclear. Using Australian and New Zealand Dialysis and Transplant (ANZDATA) registry data, we examined the associations between technique failure causes and mortality in all incident PD patients who experienced technique failure between 1989-2014. Of 4663 patients, 2415 experienced technique failure attributed to infection, 883 to inadequate dialysis, 836 to mechanical failure and 529 to social reasons...
March 5, 2018: Scientific Reports
Shokoufeh Savaj, Seyedeh Ghazal Hosseini, Ahad J Ghods
INTRODUCTION: Non-human leukocyte antigen antibodies are an independent risk factor for acute rejection in kidney transplant recipients. Among them, angiotensin II receptor type 1 (ART1) antibodies can induce various effects, but their clinical importance in kidney transplant recipients has not been properly explained. This study aimed to evaluate the effect of ART1 antibodies on allograft function and hypertension in stable kidney transplant recipients. MATERIALS AND METHODS: Eighty-one kidney recipients from non- human leukocyte antigen antibodies-matched donors with stable allograft function were examined for estimated glomerular filtration rate (Chronic Kidney Disease-Epidemiology Collaboration formula) and ART1 antibodies (measured using an enzyme-linked immunosorbent assay method)...
March 2018: Iranian Journal of Kidney Diseases
Alan S Kliger
No abstract text is available yet for this article.
March 5, 2018: Journal of the American Society of Nephrology: JASN
Yu-Tsung Huang, Chun-Hsing Liao, Shey-Ying Chen, Hsin-Sui Hsu, Lee-Jene Teng, Po-Ren Hsueh
Clinical data related to bacteraemia caused by mecA-positive borderline-oxacillin resistant (minimum inhibitory concentrations, 0.5-4 mg/L) Staphylococcus aureus (BORSA) isolates are limited. Patients (age >15 years) with bacteraemia due to BORSA who were admitted to the emergency department in a tertiary hospital between January 2001 and December 2015 were evaluated. Clinical characteristics of patients with bacteraemia caused by BORSA, methicillin-susceptible S. aureus and MRSA were compared. Minimum inhibitory concentrations of 12 antibiotics were determined using the agar dilution method...
March 2, 2018: International Journal of Antimicrobial Agents
Chien-Fang Fu, Jiun-Da Huang, Jann-Tay Wang, Shu-Wen Lin, Chien-Chih Wu
BACKGROUND: Vancomycin is a standard treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and its efficacy is closely linked to the recommended serum trough concentration of 15-20 mg/L. However, it is unknown how the pre-dialysis trough serum concentration (Cpre-HD) correlates with MRSA eradication in renal failure patients undergoing intermittent hemodialysis (HD). OBJECTIVE: To evaluate the relationship between Cpre-HD and the treatment outcomes in this population...
2018: PloS One
Atish Chopra, Amir F Azarbal, Enjae Jung, Cherrie Z Abraham, Timothy K Liem, Gregory J Landry, Gregory L Moneta, Erica L Mitchell
OBJECTIVE: Major lower extremity amputations (MLEAs) remain a significant source of disability. It is unknown whether postamputation functional outcomes and outcome predictability have changed with a population of increasingly aging and obese patients. Accordingly, we sought to evaluate contemporary trends. METHODS: A retrospective chart review was performed to identify patients undergoing MLEA using Current Procedural Terminology codes in a university hospital...
March 1, 2018: Journal of Vascular Surgery
Arjun Agrawal, Rachael Snow, Erik Lehman, Faisal Aziz
OBJECTIVE: Despite advances in surgical techniques, ruptured abdominal aortic aneurysm (rAAA) remains associated with extremely high mortality. Several preoperative risk factors have been shown to predict poor prognosis after rAAA repair. Notably, a preoperative dependent functional status has previously been shown to be associated with poor outcomes after several vascular surgery procedures. The purpose of this study was to examine the effect of preoperative functional status on postoperative outcomes for patients undergoing repair of rAAA...
March 1, 2018: Journal of Vascular Surgery
S J Jin, K H Seo, Y M Wi
Management of Clostridium difficile infection (CDI) involves discontinuation of the offending antibiotic agent as soon as possible. However, the ongoing infection does not allow discontinuation of the offending antibiotic. We aimed to retrospectively investigate the predictors of treatment failure and impact of the concomitant use of systemic antibiotics in patients receiving metronidazole therapy. This study was conducted among patients hospitalised at a second care academic hospital from January 2013 to December 2014...
March 1, 2018: Epidemiology and Infection
Yi-Chun Chen, Chung-Yi Li, Shiang-Jiun Tsai, Yen-Chun Chen
AIM: To investigate the risk of end-stage renal disease (ESRD) in hepatitis B virus (HBV)-infected patients with chronic kidney disease (CKD) with and without nucleos(t)ide analogue (NA) therapy. METHODS: This nationwide cohort study included 103444 Taiwanese CKD adults without hepatitis C virus infection from the Taiwan Longitudinal Health Insurance Database 2005 between 1997 and 2012. We identified 2916 CKD patients who acquired HBV infection and did not receive NAs (untreated cohort), and they were propensity-matched 1:4 with 11664 uninfected counterparts...
February 28, 2018: World Journal of Gastroenterology: WJG
Jawad Salman, Felix Fleißner, Jamshid Naqizadah, Murat Avsar, Malakh Shrestha, Gregor Warnecke, Issam Ismail, Stefan Rümke, Serghei Cebotari, Axel Haverich, Igor Tudorache
BACKGROUND:  Minimally invasive mitral valve surgery (MIMVS) is superior to "classical" mitral valve surgery via a sternotomy regarding wound healing and postoperative pain. It is however a more challenging procedure. Patients' preference is leading clearly toward minimally invasive approaches, and surgeons are driven by upcoming new technologies in interventional procedures such as the MitraClip. Especially in re-do cases, the access via right mini-thoracotomy, as previously non-operated situs, is a possible advantage over a re-sternotomy...
February 28, 2018: Thoracic and Cardiovascular Surgeon
George Kuo, Wei-Chiao Sun, Yueh-An Lu, Chao-Yu Chen, Huang-Kai Kao, Yu Lin, Yung-Chang Chen, Cheng-Chieh Hung, Ya-Chung Tian, Hsiang-Hao Hsu
Purpose: Infectious spondylodiscitis is a serious disease that can lead to permanent neurological deficit. Because there were only a few case reports or series featuring infectious spondylodiscitis in chronic dialysis patients, we investigated the epidemiology and outcome in the chronic dialysis patients versus general population. Materials and methods: We retrospectively identified chronic dialysis patients admitted for infectious spondylodiscitis between January 2002 and December 2015...
2018: Therapeutics and Clinical Risk Management
Sarah J Swartz, Alicia Neu, Amy Skversky Mason, Troy Richardson, Jonathan Rodean, John Lawlor, Bradley Warady, Michael J G Somers
BACKGROUND: The Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative is a quality improvement initiative to reduce dialysis-associated infections. The frequency of peritoneal dialysis (PD) catheter exit site infection (ESI) and variables influencing its development and end result are unclear. We sought to determine ESI rates, to elucidate the epidemiology, risk factors, and outcomes for ESI, and to assess for association between provider compliance with care bundles and ESI risk...
February 26, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Dalia E Yousif, Alice R Topping, Maha F Osman, Jochen G Raimann, Elfadil M Osman, Peter Kotanko, Omar I Abboud
BACKGROUND: The burden of acute kidney injury (AKI) is high in Africa. While there are no reliable statistics about AKI in Africa, the Global Snapshot Study of the 0by25 initiative of the International Society of Nephrology has determined dehydration, infections, animal envenomation, and complications during pregnancy as the main causes. METHODS: This study was conducted at the Soba University Hospital (SUH), Khartoum, Sudan, a tertiary referral center. We included all hemodialysis patients treated for AKI at SUH between -January 1, 2013 and December 31, 2014 in the study...
January 26, 2018: Blood Purification
Kelsey Gray, Abraham Korn, Joshua Zane, Hamid Alipour, Amy Kaji, Nina Bowens, Christian de Virgilio
INTRODUCTION: Current guidelines recommend preoperative antibiotics in all vascular surgery cases. However, we hypothesize that patients undergoing arteriovenous fistula (AVF) and arteriovenous graft (AVG) creation have low rates of postoperative surgical site infection (SSI) and that preoperative antibiotic prophylaxis in these patients may not be necessary. METHODS: This is a retrospective review of all patients who underwent AVF and AVG creation from November 2014 through July of 2016 at a single institution...
February 22, 2018: Annals of Vascular Surgery
Nese Saltoglu, Onder Ergonul, Necla Tulek, Mucahit Yemisen, Ayten Kadanali, Gul Karagoz, Ayse Batirel, Oznur Ak, Cagla Sonmezer, Haluk Eraksoy, Atahan Cagatay, Serkan Surme, Salih A Nemli, Tuna Demirdal, Omer Coskun, Derya Ozturk, Nurgul Ceran, Filiz Pehlivanoglu, Gonul Sengoz, Turan Aslan, Yasemin Akkoyunlu, Oral Oncul, Hakan Ay, Lutfiye Mulazımoglu, Buket Erturk, Fatma Yilmaz, Gulsen Yoruk, Nuray Uzun, Funda Simsek, Taner Yildirmak, Kadriye Kart Yaşar, Meral Sonmezoglu, Yasar Küçükardali, Nazan Tuna, Oguz Karabay, Nail Ozgunes, Fatma Sargın
OBJECTIVES: We described the clinical outcome of the diabetic patients who had foot infections with multidrug resistant organisms. METHODS: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. RESULTS: In total, 791 patients with DFI were included, 531(67%) was male, median age was 62 (19-90)...
February 21, 2018: International Journal of Infectious Diseases: IJID
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