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Dialysis sirs

Maria Hortlund, Laila Sara Arroyo Mühr, Hans Storm, Gerda Engholm, Joakim Dillner, Davit Bzhalava
Immunosuppression involves an inability to control virus infections and increased incidence of virus-associated cancers. Some cancers without known viral etiology are also increased, but data on exactly which cancer forms are increased has been inconsistent. To provide a reliable and generalizable estimate, with high statistical power and long follow-up time, we assessed cancer risks using comprehensive, population-based registries in two different countries and from two different immunosuppressed patient groups (solid organ transplant recipients (OTRs) and long-term dialysis patients (LDPs))...
March 1, 2017: International Journal of Cancer. Journal International du Cancer
Jasmohan S Bajaj, Jacqueline G O'Leary, Puneeta Tandon, Florence Wong, Guadalupe Garcia-Tsao, Patrick S Kamath, Benedict Maliakkal, Scott W Biggins, Paul J Thuluvath, Michael B Fallon, Ram M Subramanian, Hugo E Vargas, Jennifer Lai, Leroy R Thacker, K Rajender Reddy
BACKGROUND & AIMS: Although survival times have increased for patients with cirrhosis, hepatic encephalopathy (HE) remains a major complication and its relative contribution toward mortality in North America is unclear. We investigated whether HE is associated with mortality independent of extrahepatic organ failures (EHOFs). METHODS: We collected data from the North American Consortium for Study of End-stage Liver Disease database of hospitalized patients with cirrhosis at tertiary-care centers...
October 5, 2016: Clinical Gastroenterology and Hepatology
Weifeng Shang, Liu Huang, Li Li, Xiaojuan Li, Rui Zeng, Shuwang Ge, Gang Xu
It has been reported that patients receiving renal replacement therapy (RRT), including dialysis and kidney transplantation, tend to have an increased risk of cancer; however, studies on the degree of this risk have remained inconclusive. The present meta-analysis was therefore performed to quantify the cancer risk in patients with RRT. Cohort studies assessing overall cancer risk in RRT patients published before May 29, 2015 were included following systematic searches with of PubMed, EMBASE and the reference lists of the studies retrieved...
September 2016: Molecular and Clinical Oncology
Rosalind Ramsey-Goldman, Amarpali Brar, Carrie Richardson, Moro O Salifu, Ann Clarke, Sasha Bernatsky, Dimitre G Stefanov, Rahul M Jindal
OBJECTIVE: We investigated malignancy risk after renal transplantation in patients with and without systemic lupus erythematosus (SLE). METHODS: Using the United States Renal Data System from 2001 to 2009, 143 652 renal transplant recipients with and without SLE contributed 585 420 patient-years of follow-up to determine incident cancers using Medicare claims codes. We calculated standardised incidence ratios (SIRs) of cancer by group using age, sex, race/ethnicity-specific and calendar year-specific cancer rates compared with the US population...
2016: Lupus Science & Medicine
S Karami, E L Yanik, L E Moore, R M Pfeiffer, G Copeland, L Gonsalves, B Y Hernandez, C F Lynch, K Pawlish, E A Engels
Renal cell carcinoma (RCC) is a common malignancy following kidney transplantation. We describe RCC risk and examine RCC risk factors among US kidney recipients (1987-2010). The Transplant Cancer Match Study links the US transplant registry with 15 cancer registries. Standardized incidence ratios (SIRs) were used to compare RCC risk (overall and for clear cell [ccRCC] and papillary subtypes) to the general population. Associations with risk factors were assessed using Cox models. We identified 683 RCCs among 116 208 kidney recipients...
May 10, 2016: American Journal of Transplantation
Chi Yuen Cheung, Gary C W Chan, Siu Kim Chan, Flora Ng, Man Fai Lam, Sunny S H Wong, Wai Leung Chak, Ka Foon Chau, Sing Leung Lui, Wai Kei Lo, Sydney C W Tang
BACKGROUND: Different studies in the past have shown that the risk of cancer development is increased in chronic dialysis patients. However, data concerning the cancer risk in Asian dialysis patients was scarce. More importantly, there was lack of information about the cancer-specific mortality in dialysis patients. METHODS: A multicenter retrospective cohort study of 6,254 patients who started either chronic peritoneal dialysis or hemodialysis between 1994 and 2014 in 4 renal units in Hong Kong...
2016: American Journal of Nephrology
I Jahan, M Hanif, M A Ali, M M Hoque
This case control study was aimed to identify the predictive risk factors for frequent relapse idiopathic nephrotic syndrome (INS) and conducted in Sir Salimullah Medical College & Mitford Hospital, Dhaka and at Renal and Dialysis Unit of Dhaka Shishu Hospital and Bangladesh Institute of Child Health (BICH), Dhaka, from January 2006 to December 2006. We examined retrospectively the clinical course of fifty cases of frequent relapse nephrotic syndrome (FRNS) as cases and fifty cases of infrequent relapse nephrotic syndrome (IRNS) as control who met the predefined enrollment criteria, followed for at least one year after initial onset of disease...
October 2015: Mymensingh Medical Journal: MMJ
Salvatore Torre, Elisa Biondani, Tiziano Menon, Diego Marchi, Mauro Franzoi, Daniele Ferrarini, Rocco Tabbì, Stiljan Hoxha, Luca Barozzi, Giuseppe Faggian, Giovanni Battista Luciani
Cardiopulmonary bypass (CPB) in infants is associated with morbidity due to systemic inflammatory response syndrome (SIRS). Strategies to mitigate SIRS include management of perfusion temperature, hemodilution, circuit miniaturization, and biocompatibility. Traditionally, perfusion parameters have been based on body weight. However, intraoperative monitoring of systemic and cerebral metabolic parameters suggest that often, nominal CPB flows may be overestimated. The aim of the study was to assess the safety and efficacy of continuous metabolic monitoring to manage CPB in infants during open-heart repair...
January 2016: Artificial Organs
Toms Augustin, Eric Schneider, Diya Alaedeen, Matthew Kroh, Ali Aminian, David Reznick, Matthew Walsh, Stacy Brethauer
AIM: Patients undergoing emergency surgery for paraesophageal hernia (PEH) repair have a higher adjusted mortality risk based on Nationwide Inpatient Sample (NIS). We sought to examine this relationship in the National Surgical Quality Improvement Program (NSQIP), which adjusts for patient-level risk factors, including factors contributing to patient frailty. METHODS: This is a retrospective analysis of the NSQIP from 2009 through 2011. A modified frailty index was created based on previously validated methodology...
December 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
Rafael Baez, Jose Betancourt, Hector J Diaz, Javier Monserrate, Tania Ramírez, Martin Gorrochategui, Carlos Rivera Bermudez, Francisco Torre Leon, Jose L Cangianoa
Puerto Rico is one of the most prevalent areas covered by Medicare in need of renal replacement therapy for which interventional procedures are performed. A cumulative analysis of this management is reported in patients during the period between June 2007 and August 2010. Experience accumulated with 3755 surgical patients revealed that 58% had intravascular catheters, 28% had arteriovenous fistulas, 15% had arteriovenous grafts, and 2% without vascular access. Procedures performed in these patients were: catheter introduction in 1990 cases (33%), angioplasty in 751 cases (20%), angiography in 450 cases (12%), thrombectomy in 413 cases (11%) and venous mapping in 151 cases (4%)...
January 2015: Boletín de la Asociación Médica de Puerto Rico
Luca De Nicola, Michele Provenzano, Paolo Chiodini, Graziella D'Arrigo, Giovanni Tripepi, Lucia Del Vecchio, Giuseppe Conte, Francesco Locatelli, Carmine Zoccali, Roberto Minutolo
BACKGROUND AND AIMS: The prognostic role of LDL in non-dialysis chronic kidney disease (CKD) is still undefined. We addressed this question in a multicenter prospective study including patients referred to nephrologist for management. METHODS AND RESULTS: 1306 patients with CKD stage III-V were studied at basal visit in 79 Italian nephrology clinics in 2004-2006, and then followed for survival analyses. Study endpoints were incident cardiovascular -CV events (fatal and major non-fatal) and renal events (start of renal replacement therapy or eGFR halving)...
August 2015: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
F Lee, E Ohanian, J Rheem, L Laine, K Che, J J Kim
BACKGROUND: Predictors of organ failure and the impact of early endoscopic retrograde cholangiopancreatography (ERCP) on outcomes in patients with acute cholangitis are unclear. AIM: To identify factors associated with persistent organ failure and assess the impact of early ERCP on outcomes in hospitalised patients with cholangitis. METHODS: Consecutive hospitalised patients who received ERCP at two centres for cholangitis from 4/2005-3/2013 were retrospectively reviewed...
July 2015: Alimentary Pharmacology & Therapeutics
Donal J Sexton, Scott Reule, Craig A Solid, Shu-Cheng Chen, Allan J Collins, Robert N Foley
Management of hemolytic uremic syndrome (HUS) has evolved rapidly, and optimal treatment strategies are controversial. However, it is unknown whether the burden of end-stage renal disease (ESRD) from HUS has changed, and outcomes on dialysis in the United States are not well described. We retrospectively examined data for patients initiating maintenance renal replacement therapy (RRT) (n = 1,557,117), 1995-2010, to define standardized incidence ratios (SIRs) and outcomes of ESRD from HUS) (n = 2241)...
October 2015: Hemodialysis International
Anne M Butler, Andrew F Olshan, Abhijit V Kshirsagar, Jessie K Edwards, Matthew E Nielsen, Stephanie B Wheeler, M Alan Brookhart
BACKGROUND: Patients with end-stage renal disease (ESRD) receiving dialysis have been reported to have increased risk of cancer. However, contemporary cancer burden estimates in this population are sparse and do not account for the high competing risk of death characteristic of dialysis patients. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: US adult patients enrolled in Medicare's ESRD program who received in-center hemodialysis...
May 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Anupama Vasudevan, Amartya Mukhopadhyay, Jialiang Li, Eugene Goh Yu Yuen, Paul Ananth Tambyah
BACKGROUND: The widespread use of empiric broad spectrum antibiotics has contributed to the global increase of Resistant Gram-Negative Bacilli (RGNB) infections in intensive care units (ICU). The aim of this study was to develop a tool to predict nosocomial RGNB infections among ICU patients for targeted therapy. METHODS: We conducted a prospective observational study from August'07 to December'11. All adult patients who were admitted and stayed for more than 24 hours at the medical and surgical ICU's were included...
2014: BMC Infectious Diseases
Alison G Abraham, Keri N Althoff, Yuezhou Jing, Michelle M Estrella, Mari M Kitahata, C William Wester, Ronald J Bosch, Heidi Crane, Joseph Eron, M John Gill, Michael A Horberg, Amy C Justice, Marina Klein, Angel M Mayor, Richard D Moore, Frank J Palella, Chirag R Parikh, Michael J Silverberg, Elizabeth T Golub, Lisa P Jacobson, Sonia Napravnik, Gregory M Lucas
BACKGROUND: Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks. METHODS: Using data from the North American AIDS Cohort Collaboration for Research and Design from January 2000 to December 2009, we validated 286 incident ESRD cases using abstracted medical evidence of dialysis (lasting >6 months) or renal transplant...
March 15, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
T Clark Powell, Stephen L Powell, Bryant K Allen, Russell L Griffin, David G Warnock, Henry E Wang
OBJECTIVE: Acute kidney injury (AKI) is a sequela of sepsis associated with increased morbidity and mortality. We sought to determine if individuals with elevated baseline levels of inflammation and endothelial cell activation are at increased risk for future AKI after sepsis. METHODS: We conducted an analysis of individuals developing sepsis in the national 30,239 subject REGARDS cohort. Biomarkers measured at the beginning of an 8-year observation period included high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), E-selectin, inter-cellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and urinary Albumin-to-creatinine ratio (ACR)...
2014: SpringerPlus
I Stefanidis, A Vainas, E Dardiotis, C D Giannaki, P Gourli, D Papadopoulou, P Vakianis, E Patsidis, T Eleftheriadis, V Liakopoulos, S Pournaras, G K Sakkas, E Zintzaras, G M Hadjigeorgiou
BACKGROUND: Restless legs syndrome (RLS) is a sensorimotor disorder characterized by an uncontrolled need to move extremities accompanied by unpleasant sensations, which frequently leads to sleep disturbances. In hemodialysis (HD) patients, the previously reported RLS prevalence varied enormously, between 6% and 60%. In our study, we investigated the RLS prevalence in HD patients for the first time in Greece. METHODS: A continuous sample of HD patients was studied between January and September of 2010 in six dialysis units in Greece...
December 2013: Sleep Medicine
(no author information available yet)
The American College of Cardiology Foundation (ACCF), in partnership with key specialty and subspecialty societies, conducted a review of common clinical scenarios where noninvasive vascular testing (venous ultrasound and physiological testing) is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of the original appropriate use criteria (AUC)...
August 2013: Vascular Medicine
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