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Sepsis ESRD

S Sebastian, H F Jordaan, J W Schneider, M R Moosa, M R Davids
BACKGROUND: Calcific uraemic arteriolopathy (calciphylaxis) is an unusual and potentially fatal condition characterised by small-vessel calcification and ischaemic skin necrosis. It mainly affects patients with end-stage renal disease (ESRD) on haemodialysis, but may rarely occur in the absence of ESRD in conditions such as primary hyperparathyroidism, malignancy, alcoholic liver disease and connective tissue disease. METHODS: We reviewed the records of all patients diagnosed with calciphylaxis while on renal replacement therapy at Tygerberg Hospital, Cape Town, South Africa, between 1990 and 2014, to describe its presentation, course and final outcome...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Amit R Patel, Viktor Y Dombrovskiy, Todd R Vogel
Objectives Chronic kidney disease (CKD) has been identified as a significant risk factor for poor post-surgical outcomes. This study was designed to provide a contemporary analysis of carotid endarterectomy (CEA) outcomes in patients with CKD, end-stage renal disease (ESRD), and normal renal function (NF). Methods The Nationwide Inpatient Sample data 2006-2012 was queried to select patients aging 40 years old and above who underwent CEA during two days after admission and had a diagnosis of ESRD on long-term hemodialysis, patients with non-dialysis-dependent CKD, or NF...
January 1, 2017: Vascular
Tanushree Banerjee, Timothy W Meyer, Tariq Shafi, Thomas H Hostetter, Michal Melamed, Yunnuo Zhu, Neil R Powe
The uremic syndrome is attributed to progressive retention of compounds that, under normal conditions, are excreted by the healthy kidneys. p-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. Recent studies have identified relations between increased levels of PCS and indoxyl sulfate (IS) and adverse clinical outcomes in hemodialysis patients. We explored the relationship between free and total PCS and IS with infection-related hospitalizations (IH) and septicemia in 2 cohorts, Choices for Healthy Outcomes in Caring for end-stage renal disease (ESRD) Study (CHOICE) and Hemodialysis Study (HEMO)...
February 2017: Medicine (Baltimore)
M Surendra, S B Raju, N Raju, S Chandragiri, K K Mukku, M S Uppin
Antibody-mediated rejection (AMR) is not uncommon after renal transplantation and is harder to handle compared to cell-mediated rejection. When refractory to conventional therapies, rituximab is an attractive option. This study aims to examine the effectiveness of rituximab in refractory late acute AMR. This is a retrospective study involving nine renal transplant recipients. Four doses of rituximab were administered at weekly interval for 4 weeks, at a dose of 375 mg/m(2). The mean age of patients was 35.3 ± 7...
September 2016: Indian Journal of Nephrology
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
November 2017: Renal Failure
J Prakash, P Pant, S Prakash, M Sivasankar, R Vohra, P K Doley, L K Pandey, U Singh
The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10...
July 2016: Indian Journal of Nephrology
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
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
Niranjan Jeganathan, Neha Ahuja, Stephen Yau, Dara Otu, Brian Stein, Robert A Balk
PURPOSE: To report the characteristics and outcomes of patients with sepsis in the intensive care unit (ICU) with end-stage renal disease (ESRD) and acute kidney injury (AKI) compared to patients with nonkidney injury (non-KI). METHODS: Retrospective study of all patients with sepsis admitted to the ICU of a university hospital within a 12-month time period. Data were obtained from the University Health Consortium database and a chart review of the electronic medical records...
May 4, 2016: Journal of Intensive Care Medicine
Xosé L Pérez, Kathleen D Liu
With improvements in supportive care, mortality from sepsis and the acute respiratory distress syndrome has declined over the past 20 years. However, mortality associated with these conditions is still high. We will review the latest clinical trial findings in these fields, along with implications for the nephrologist. Very recently, there have been significant changes with regard to the management of anterior ischemic strokes; given the high rate of cerebrovascular disease in patients with CKD or ESRD, we will review those studies here...
May 2016: Advances in Chronic Kidney Disease
Nathalie Le Clef, Anja Verhulst, Patrick C D'Haese, Benjamin A Vervaet
Acute kidney injury (AKI) is an underestimated, yet important risk factor for development of chronic kidney disease (CKD). Even after initial total recovery of renal function, some patients develop progressive and persistent deterioration of renal function and these patients are more likely to progress to end-stage renal disease (ESRD). Animal models are indispensable for unravelling the mechanisms underlying this progression towards CKD and ESRD and for the development of new therapeutic strategies in its prevention or treatment...
2016: PloS One
Jessica Hui Fen Goh, Siok Ying Lee, Say Tat Ooi, Lawrence Lee Soon-U, Kim-Hor Hee, Claude J Renaud
Ceftazidime is a cost-effective antimicrobial against Gram-negative pathogens associated with sepsis in end-stage renal disease (ESRD) hemodialysis patients with potential for wider use with the advent of ceftazidime-avibactam. Dosing ceftazidime post-hemodialysis appears attractive and convenient, but limited in vivo data on pharmacodynamic efficacy (PE) attainment, defined as >70% of the interdialytic period drug concentrations exceed susceptible pathogens minimal inhibitory concentrations (MICs) (%TMIC), warrants further assessment...
April 2016: Hemodialysis International
Gilbert Abou Dagher, Elie Harmouche, Elsy Jabbour, Rana Bachir, Dina Zebian, Ralphe Bou Chebl
BACKGROUND: Bacterial infections are very common in End Stage Renal Disease (ESRD) patients. The diagnosis of sepsis in such patients is often challenging and requires a high index of suspicion. The aim of this study is to report on a series of patient with ESRD on hemodialysis (HD) diagnosed with sepsis. METHODS: Single center retrospective study looking at ESRD on HD who presented to our tertiary hospital were retrieved. Inclusion criteria included a discharge diagnosis of sepsis, septic shock or bacteremia...
October 14, 2015: BMC Emergency Medicine
Anupma Kaul, R Dharshan, Dharmendra Bhadhuaria, Narayan Prasad, Amit Gupta, R K Sharma
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease, with 50-75% of these patients requiring renal replacement therapy (RRT). The outcome of peritoneal dialysis (PD) in ADPKD with end-disease renal disease (ESRD) is not clearly defined, more so in developing countries. We conducted a retrospective analysis of the outcomes and economics of PD in these ESRD patients and compared them with other causes of ESRD on PD. Data were reviewed of all the PD patients who were followed-up at our institute from January 2007 to December 2011...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
Mikael Eriksson, Olof Brattström, Johan Mårtensson, Emma Larsson, Anders Oldner
BACKGROUND: The trauma patient sustains numerous potentially harmful insults that may contribute to a notable risk of acute kidney injury (AKI). The aim of this study was to investigate the incidence of and to identify risk factors for AKI in severely injured trauma patients admitted to the intensive care unit (ICU). The patients were followed up for 1 year with respect to survival and end-stage renal disease. METHODS: Trauma patients admitted to the ICU for more than 24 hours at a Level I trauma center were included...
September 2015: Journal of Trauma and Acute Care Surgery
Renato A Caires, Regina C R M Abdulkader, Verônica T Costa E Silva, Gillene S Ferreira, Emmanuel A Burdmann, Luis Yu, Etienne Macedo
BACKGROUND: Single-pass batch dialysis (SBD) is a well-established system for treatment of end-stage renal disease. However, little evidence is available on sustained low-efficiency extended dialysis (SLED) performed with SBD in patients with acute kidney injury (AKI) in the intensive care unit (ICU). METHODS: All SLED-SBD sessions conducted on AKI patients in nine ICUs between March and June 2010 were retrospectively analyzed regarding the achieved metabolic and fluid control...
June 2016: Journal of Nephrology
Christopher Lau, Mario Gaudino, Andreas R de Biasi, Monica Munjal, Leonard N Girardi
BACKGROUND: The purpose of this study was to evaluate the short- and intermediate-term outcomes of open repair of mycotic thoracic and thoracoabdominal aneurysms. Contemporary surgical and perioperative techniques were utilized. METHODS: From November 1997 to May 2014, 14 consecutive patients underwent open repair of descending thoracic (n = 9, 64.3%) and thoracoabdominal (n = 5, 35.7%) mycotic aortic aneurysms. All procedures were performed through the left side of the chest...
November 2015: Annals of Thoracic Surgery
Ying Qian, Xiao-Nong Chen, Hao Shi, Jingyuan Xie, Nan Chen
Nonocclusive mesenteric ischemia (NOMI) is a rare disorder. Failure of an early diagnosis may cause progressive intestinal ischemia, leading to abdominal pain, sepsis, and death. Patients with end-stage renal disease are among the highest risk populations for developing this lethal complication. The key to a correct diagnosis at an early stage is a high index of suspicion in predisposed patients. In our case, we present a 62-year-old female undergoing maintenance hemodialysis for 8 years; she complained of abdominal pain after hemodialysis in the last 3 months; NOMI was suspected after a CT angiography...
May 2015: Case Reports in Nephrology and Dialysis
Eymen Gazel, Gazel Açıkgöz, Yusuf Kasap, Metin Yiğman, Zeki Ender Güneş
Nontraumatic spontaneous splenic rupture (NSSR) has been encountered much more rarely compared with the traumatic splenic rupture. Although NSSR generally emerges in dialysis patients on account of such causes as the use of heparin during hemodialysis, uremic coagulopathy, infections, and secondary amyloidosis. Herein, we aimed to present a case of spontaneous splenic rupture which had developed soon after the inclusion of the case suffering from end-stage renal disease in routine hemodialysis program in the absence of any trauma or other prespecified risk factors for splenic rupture...
April 2015: International Journal of Critical Illness and Injury Science
Mansoor Mehmood, Faisal A Khasawneh
A 57-year-old end stage renal disease patient on hemodialysis (HD) presented with sepsis secondary to right buttock abscess and overlying cellulitis. She was started on broad-spectrum antibiotic therapy and underwent incision and drainage with marked improvement. Her cultures grew methicillin-resistant Staphylococcus lugdunensis. This bacterium is more virulent than other coagulase negative staphylococci and has been implicated in causing a variety of serious infections but it has been underreported as a cause of skin infections in HD patients and possible other patient populations...
January 28, 2015: Clinics and Practice
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