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https://www.readbyqxmd.com/read/28718268/oxymorphone-induced-thrombotic-microangiopathy-mimicking-atypical-haemolytic-uremic-syndrome
#1
Amibhen Gandhi, Saad Ullah, Shani Kotadia, Samer Nasser
Atypical Haemolytic Uremic Syndrome (aHUS) is a rare life threatening entity characterized by thrombocytopenia, haemolytic anaemia and renal dysfunction. It is a thrombotic microangiopathy related to genetic mutations in the alternate complement pathway and has a distinct pathophysiology which makes it harder to distinguish from other microangiopathies. We present a case of a 25-year-old male patient with history of polysubstance abuse who presented with chest pain and dyspnoea. He admitted to using injectable oxymorphone (Opana) two weeks before presentation...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717377/appropriate-blood-component-therapy-can-reduce-postcardiac-surgery-acute-kidney-injury-through-packed-cell-transfusion-reduction
#2
Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Gholam Reza Massoumi
BACKGROUND: Acute kidney injury (AKI) can happen due to different factors such as anemia. Packed cell (PC) transfusion is an important cause of AKI occurrence. The aim of the study is to investigate whether appropriate blood component (BC) therapy can reduce blood transfusion and it would result in AKI decreasing. MATERIALS AND METHODS: We conducted a cohort study of 1388 patients who underwent cardiac surgery in one university hospital. A serum creatinine higher than 2 mg/dl, renal disease history, renal replacement therapy (chronic dialysis) were our exclusion criteria...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28716131/rhabdomyolysis-in-an-hiv-cohort-epidemiology-causes-and-outcomes
#3
Sahar H Koubar, Michelle M Estrella, Rugmini Warrier, Richard D Moore, Gregory M Lucas, Mohamed G Atta, Derek M Fine
BACKGROUND: The Literature on rhabdomyolysis in the HIV-positive population is sparse and limited. We aimed to explore the incidence, patient characteristics, etiologies and outcomes of rhabdomyolysis in a cohort of HIV-positive patients identified through the Johns Hopkins HIV clinical registry between June 1992 and April 2014. METHODS: A retrospective analysis of 362 HIV-positive patients with non-cardiac CK elevation ≥1000 IU/L was performed. Both inpatients and outpatients were included...
July 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28708022/is-intravenous-administration-of-iodixanol-associated-with-increased-risk-of-acute-kidney-injury-dialysis-or-mortality-a-propensity-score-adjusted-study
#4
Jennifer S McDonald, Robert J McDonald, Eric E Williamson, David F Kallmes
Purpose To compare the rates of acute kidney injury (AKI), emergent dialysis, and short-term mortality between patients who underwent intravenous administration of the iso-osmolar contrast material (IOCM) iodixanol 320 and patients who underwent a noncontrast computed tomography (CT) examination. Materials and Methods Study design and implementation were overseen by an institutional review board and conformed to HIPAA guidelines on patient data integrity. All patients who underwent an iodixanol-enhanced (IOCM group) or a noncontrast (noncontrast group) CT examination from January 2003 to December 2014 were identified...
July 13, 2017: Radiology
https://www.readbyqxmd.com/read/28702138/prevalence-and-clinical-features-of-cryptosporidium-infection-in-hemodialysis-patients
#5
Mohammad Ali Mohaghegh, Seyed Hossein Hejazi, Mohsen Ghomashlooyan, Hamed Kalani, Farzaneh Mirzaei, Mehdi Azami
AIM: This cross-sectional study aims to assess the prevalence of Cryptosporidium in hemodialysis patients compared with healthy individuals in central Iran from August 2014 to January 2015. BACKGROUND: Cryptosporidiosis is a major cause of acute and persistent diarrhea with significant morbidity and mortality in immunocompromised patients such as those undergoing renal dialysis. METHODS: Three stool samples were collected from 330 hemodialysis patients and 150 healthy individuals on 3 consecutive days...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28701839/a-study-of-continuous-renal-replacement-therapy-and-acute-peritoneal-dialysis-in-hemodynamic-unstable-patients
#6
Ajay Jaryal, Sanjay Vikrant
OBJECTIVE: The objective of the following study was to assess the outcome of continuous renal replacement therapy (CRRT) and acute peritoneal dialysis (PD) in dialysis-requiring renal failure in patients with hemodynamic instability. MATERIALS AND METHODS: A retrospective analysis of all the patients who received CRRT and acute PD over a period of 1 year at our institute, a tertiary care center, was done for diagnosis, type of renal replacement therapy (RRT), and survival outcome...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#7
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28698269/urinary-matrix-metalloproteinase-7-predicts-severe-aki-and-poor-outcomes-after-cardiac-surgery
#8
Xiaobing Yang, Chunbo Chen, Siyuan Teng, Xiaorui Fu, Yan Zha, Huafeng Liu, Li Wang, Jianwei Tian, Xiangyan Zhang, Youhua Liu, Jing Nie, Fan Fan Hou
Urinary matrix metalloproteinase-7 (uMMP-7) levels consistently reflect the activity of intrarenal Wnt/β-catenin, which is activated in AKI models. To test the hypothesis that uMMP-7 is a predictor for severe AKI in patients after cardiac surgery, we performed a prospective, multicenter, two-stage cohort study in 721 patients undergoing cardiac surgery. In stage 1, we enrolled 323 children from three academic medical centers. In stage 2, we enrolled 398 adults at six centers. We analyzed levels of uMMP-7 and other injury biomarkers during the perioperative period...
July 11, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28698251/trpa1-mechanoreceptors-mediate-the-il-6-response-to-a-single-pd-dwell-in-the-rat
#9
Daniel Nilsson, Eva Jennische, Nicola Cavallini, Magnus Braide
BACKGROUND: The development of modern, biocompatible peritoneal dialysis (PD) fluids has not entirely eliminated the local pro-inflammatory effects of PD fluid administration. The present study was performed in order to establish the importance of known signaling pathways connected to mechano-, osmo- and chemo-sensors of the transient receptor potential (TRP) family for the acute inflammatory response to PD. METHODS: Rats were exposed to a single 4-hour dwell of lactate-buffered, 2...
July 11, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28693502/the-role-of-thrombectomy-and-diffusion-weighted-imaging-with-mri-in-post-transplant-renal-vein-thrombosis-a-case-report
#10
Paraish Misra, Anish Kirpalani, General Leung, Paraskevi A Vlachou, Jason Y Lee, Serge Jothy, Jeffrey Zaltzman, Darren A Yuen
BACKGROUND: Surgical thrombectomy in the context of acute renal vein thrombosis (RVT) post-transplantation has had limited success, with considerable variation in the surgical techniques used. Unfortunately, it is usually followed by allograft nephrectomy within a few days if rapid allograft recovery does not ensue. We report a case of acute RVT in which nephrectomy was not performed despite a prolonged requirement for dialysis post-thrombectomy, but with recovery of renal function 2 weeks later...
July 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28692694/renal-replacement-therapy-practices-for-patients-with-acute-kidney-injury-in-china
#11
William R Clark, Xiaoqiang Ding, Haibo Qiu, Zhaohui Ni, Ping Chang, Ping Fu, Jiarui Xu, MinMin Wang, Li Yang, Jing Wang, Claudio Ronco
Recent data indicate AKI is very common among hospitalized Chinese patients and continuous renal replacement therapy (CRRT) is increasingly offered for treatment. However, only anecdotal information regarding CRRT's use in relation to other modalities and the specific manner in which it is prescribed exists currently. This report summarizes the results of a comprehensive physician survey designed to characterize contemporary dialytic management of AKI patients in China, especially with respect to the utilization of CRRT...
2017: PloS One
https://www.readbyqxmd.com/read/28692484/meta-analysis-of-prophylactic-hydration-versus-no-hydration-on-contrast-induced-acute-kidney-injury
#12
Yufeng Jiang, Min Chen, Yiqing Zhang, Nannan Zhang, Huajia Yang, Jialu Yao, Yafeng Zhou
BACKGROUND: Guidelines recommend prophylactic hydration for all patients with compromised renal function undergoing contrast exposure. However, the AMACING study published recently showed a noninferior result of hydration compared with no prophylaxis in high-risk patients and led to a heat discussion. This study aimed to validate the effectiveness of prophylactic hydration in different subsets of patients undergoing a contrast procedure. METHODS: We carried out a meta-analysis of randomized-controlled trials to assess pooled estimates of relative risk (RR) and 95% confidence intervals (CIs) for incidences of contrast-induced acute kidney injury (CI-AKI), in-hospital all-cause mortality, and need for dialysis...
July 7, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28691389/fetal-left-ventricular-non-compaction-cardiomyopathy-with-ascites-a-case-report
#13
Junsuke Muraoka, Yuki Kodama, Hiroshi Sameshima, Kaori Michikata, Satoshi Matsuzawa, Oohashi Masanao, Masatoki Kaneko, Mayumi Akaki, Yuichiro Sato
Here we report a case of fetal left ventricular non-compaction cardiomyopathy with ascites and cardiac dysfunction at a gestational age of 34(+5)  weeks. Laboratory tests did not reveal any sign of viral infection in utero. A female neonate weighing 2436 g was delivered by emergency cesarean section due to non-reassuring fetal status. Postnatal echocardiography confirmed left ventricular non-compaction cardiomyopathy with severe cardiac failure. Although she was treated effectively during the acute period by continuous flow peritoneal dialysis, surgical ligation of a patent ductus arteriosus, and inhaled nitric oxide, she died on day 41 of life...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28689732/applying-preoperative-dipyridamole-thallium-201-scintigraphy-for-preventing-cardiac-mortality-and-complications-for-patients-with-secondary-hyperparathyroidism-undergoing-parathyroidectomy
#14
Shih-Min Yin, Fong-Fu Chou, Shao-Chun Wu, Shun-Yu Chi
BACKGROUND: To evaluate the value of preoperative dipyridamole thallium-201 scintigraphy for reducing cardiovascular complication in secondary hyperparathyroidism (SHPTH) patients. METHODS: Thallium scintigraphy was arranged for all dialysis patients who underwent parathyroidectomy from Jan 2011 to July 2015. Management of defects on thallium scintigraphy included cardiac catheterization and ultrasonography. Analysis includes 30-day mortality, morbidity and the predicting factors for thallium scintigraphy defect...
July 6, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#15
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28685136/bilateral-renal-cortical-necrosis-associated-with-smoking-synthetic-cannabinoids
#16
Kanaan Mansoor, Ashley Zawodniak, Tibor Nadasdy, Zeid J Khitan
Synthetic cannabinoids have become a common drug of abuse in recent years and their toxicities have come to light as well. They are known to be notorious for the kidneys, with acute tubular necrosis, acute interstitial nephritis and rhabdomyolysis induced renal injury being the frequent nephrotoxic outcomes in users. We report a case of bilateral renal cortical necrosis, leading to irreversible renal damage and lifelong dialysis dependency.
June 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28683162/an-observational-study-of-microcirculation-in-dialysis-patients-and-kidney-transplant-recipients
#17
Yu Chang Yeh, Anne Chao, Chih-Yaun Lee, Chen-Tse Lee, Chi-Chuan Yeh, Chih-Min Liu, Meng-Kun Tsai
BACKGROUND: Microcirculatory dysfunction contributes to acute and chronic kidney diseases. To the best of our knowledge, no study has compared differences in microcirculation among healthy volunteers, dialysis patients, and kidney transplant recipients. MATERIALS AND METHODS: Sublingual microcirculation was examined using sidestream dark field imaging and was compared among 90 healthy volunteers, 40 dialysis patients, and 40 kidney transplant recipients. The gender effect on microcirculation and the correlations among the microcirculation parameters, age, body mass index, heart rate, and blood pressure were analyzed...
July 6, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28682569/-nephrologist-and-icu-the-need-of-new-expertise
#18
Filippo Mariano, Marco Pozzato
Episodes of dialytic Acute Kidney Injury (AKI stage III KDIGO) can lead to chronic kidney disease (CKD), even after a long time. Prelimary data indicate that the relationship between AKI and CKD is affected by dialysis technical modalities and factors in part modifiable, such as an early dialysis timing, dose adeguacy, continuous treatment, use of biocompatible membranes and regional citrate anticoagulation. However, in most ICUs involvement of nephrologist consultant is marginal. Of more, nephrological follow-up after discharge, which allows to slow down the progression rate of CKD even just by a correct pharmacological and dietetic approach (sartans, ACEis), is an uncommon practice...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28682031/-the-peritoneal-ultrafiltration-in-patients-with-cardio-renal-disease
#19
Roberto Corciulo, Simone Corciulo
In Italy, the congestive heart failure is the leading cause of hospitalization and despite advances in therapy, the long-term prognosis is poor. Congestive heart failure is associated with advanced varying degrees of chronic renal disease that identify the cardio-renal syndrome type 2. High-dose diuretic therapy often fail to solve the water overload that is frequently the cause of death. The resistance to diuretics aggravates the state of the patient's edema and consequently morbidity and mortality. In the acute stage, the extracorporeal ultrafiltration unable to repair over hydration but needs frequent access weekly or midweek at the dialysis center...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28682027/-pulmonary-congestion-and-hypertension-in-hemodialysis-patients
#20
Francesca Mallamaci, Giovanni Tripepi
Mild to moderate volume expansion is a frequent complication in dialysis patients and acute volume overload, such as acute pulmonary oedema, is one of the most worrying medical emergency in these patients. Estimated systolic blood pressure in the pulmonary artery (ePASP) is an important risk factor of mortality and cardiovascular (CV) events in the general population and in patients on dialysis. Therefore, the assessment of body water in dialysis patients is useful both from the clinical point of view for monitoring fluids as well as for prognostic purposes...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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