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Dialysis sirs

Andrea Angioi, Gianfranca Cabiddu, Maura Conti, Gianfranco Pili, Alice Atzeni, Valeria Matta, Riccardo Cao, Matteo Floris, Marco Songini, Maria Franca Mulas, Mitchell Rosner, Antonello Pani
BACKGROUND: Metformin associated lactic acidosis (MALA) is a well-known serious side effect of biguanides. However, the best treatment strategy remains a matter of debate. In the last 14 years, we observed a significant increase in hospitalizations for MALA to our Center. We report the outcomes of our clinical and therapeutic approach. METHODS: This is a single-center case series. Twenty-eight patients affected with MALA and acute kidney failure admitted between January 2000 and September 2014 were included...
April 2, 2018: BMC Nephrology
Anna Francis, David W Johnson, Armando Teixeira-Pinto, Jonathan C Craig, Germaine Wong
Background: Differences in the epidemiology of post-transplant lymphoproliferative disease (PTLD) between adult and paediatric kidney transplant recipients remain unclear. Methods: Using the Australian and New Zealand Dialysis and Transplant Registry (1963-2015), the cumulative incidences of PTLD in children (age <20 years) and adults were calculated using a competing risk of death model and compared with age-matched population-based data using standardized incidence ratios (SIRs)...
January 12, 2018: Nephrology, Dialysis, Transplantation
Jonas Söderholm, Charlotta Millbourn, Katharina Büsch, Jan Kövamees, Robert Schvarcz, Karin Lindahl, Annette Bruchfeld
BACKGROUND & AIMS: Several studies have shown that chronic hepatitis C (CHC) infection has a negative impact on kidney function, as well as survival, in patients with chronic kidney disease (CKD) or on hemodialysis. The aim of this nationwide registry study was to describe renal disease in Swedish patients with CHC. METHODS: In the present study, patients were identified for CHC (B18.2) and CKD (N18) according to the International Classification of Diseases (ICD)-10 in the nationwide Swedish inpatient care day surgery (1997-2013) and non-primary outpatient care (2001-2013) patient registries...
May 2018: Journal of Hepatology
Chia-Chen Wang, Chao-Hsiun Tang, Siao-Yuan Huang, Kuan-Chih Huang, Yuh-Mou Sue
This study investigated the risk of non-melanoma skin cancer (NMSC) in pre-dialysis patients with chronic kidney disease (CKD) and explored associated risk factors. A population-based cohort of 1,515,858 Taiwanese CKD patients was included. The standardized incidence ratio (SIR) for incident NMSC was determined. Compared with the general population, a 1.14-fold risk of NMSC was found in the CKD cohort. NMSC risk was significant in patients with pre-dialysis stage 5 CKD and anaemia (1.48-fold), and in those with uraemic pruritus after long-term antihistamine treatment (1...
November 15, 2017: Acta Dermato-venereologica
Kyung Don Yoo, Jung Pyo Lee, Su Mi Lee, Jae Yoon Park, Hajeong Lee, Dong Ki Kim, Shin-Wook Kang, Chul Woo Yang, Yong-Lim Kim, Chun Soo Lim, Kwon Wook Joo, Yon Su Kim
BACKGROUND: The effectiveness of dialysis on the incidence of cancer in patients with end-stage renal disease (ESRD) remains to be clarified. In this study, we evaluated the incidence rate and type of cancer among patients with ESRD, compared to the general population, through a prospective 7-year follow-up. We also calculated the cumulative incidence rate of cancer associated with ESRD, with stratification to control for the competing risk of death. METHODS: This prospective observational cohort study was conducted using data from a nationwide study on patients with ESRD in Korea...
2017: PloS One
A Francis, D W Johnson, J C Craig, G Wong
Cancer risk is increased substantially in adult kidney transplant recipients, but the long-term risk of cancer in childhood recipients is unclear. Using the Australian and New Zealand Dialysis and Transplant Registry, the authors compared overall and site-specific incidences of cancer after transplantation in childhood recipients with population-based data by using standardized incidence ratios (SIRs). Among 1734 childhood recipients (median age 14 years, 57% male, 85% white), 289 (16.7%) developed cancer (196 nonmelanoma skin cancers, 143 nonskin cancers) over a median follow-up of 13...
October 2017: American Journal of Transplantation
Valentina Mazzucotelli, Pierluca Piselli, Diana Verdirosi, Claudia Cimaglia, Giovanni Cancarini, Diego Serraino, Silvio Sandrini
BACKGROUND: Kidney transplant recipients (KTR) are known to have a higher risk of cancer than the general population, especially of malignancies related to oncogenic viral infections. This study assessed the incidence of de novo malignancies (DNMs) in patients receiving kidney transplantation and in dialysis patients (DP) on the waiting list for transplantation at the same centre. The aim was to quantify the contribution of post-transplant immunosuppression to the underlying risk of developing a DNM in dialysis patients on the waiting list for kidney transplant...
December 2017: Journal of Nephrology
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...
April 2017: 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...
December 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
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