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https://www.readbyqxmd.com/read/28430830/assessment-of-global-kidney-health-care-status
#1
Aminu K Bello, Adeera Levin, Marcello Tonelli, Ikechi G Okpechi, John Feehally, David Harris, Kailash Jindal, Babatunde L Salako, Ahmed Rateb, Mohamed A Osman, Bilal Qarni, Syed Saad, Meaghan Lunney, Natasha Wiebe, Feng Ye, David W Johnson
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN...
April 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#2
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#3
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28415054/-hemodialysis-increases-the-incidence-of-post-traumatic-seizure-in-hemodialysis-patients-with-traumatic-intracranial-hemorrhage
#4
Tomoya Oishi, Seiya Takehara, Yasuhiro Yamamura, Mamoru Tomida, Naoki Ikegaya, George Seki, Nobutaka Ohta
BACKGROUND: In Japan, the number of hemodialysis patients increases every year, along with the average age of this patient population. Further, certain complications of hemodialysis make the care of traumatic head injury(THI)patients particularly difficult. OBJECTIVE: This study was aimed at investigating the occurrence of and risk factors for post-traumatic seizures in hemodialysis patients with a history of THI, and determining patient outcomes. METHODS: Subjects were selected from patients who were admitted to Yaizu Municipal Hospital in Shizuoka, Japan for traumatic intracranial hemorrhage(TICH)...
April 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28411480/hemorrhagic-fever-with-renal-syndrome-in-albania-focus-on-predictors-of-acute-kidney-injury-in-hfrs
#5
Elvana Rista, Arben Pilaca, Ilir Akshija, Ariol Rama, Endri Harja, Edmond Puca, Silvia Bino, Vilma Cadri, Majlinda Kota, Thereska Nestor, Harxhi Arjan
BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS) is a rodent borne zoonosis, caused by the members of the family Bunyaviridae, genus Hantavirus. The main clinical features of the infection by this virus family are fever, thrombocytopenia and acute kidney injury. OBJECTIVE: The aim of our study was to identify, for the first time, characteristic features of HFRS in the Albanian population. STUDY DESIGN: The study comprised 33 consecutive patients admitted with suspected HFRS from April 2011-April 2016 at one center...
March 31, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28410645/epidemiology-and-risk-factors-for-early-mortality-after-dialysis-initiation
#6
REVIEW
Robert N Foley
Confronted with the decision to initiate dialysis, patients and caregivers often seek information about how expected survival chances evolve, both initially and afterward, providing the patient survives beyond arbitrary periods of time. Large registry data, used to examine these issues, may be subject to early ascertainment bias, such as those accruing from nonregistration of with end-stage kidney disease who die shortly after dialysis initiation and inclusion of patients with acute kidney injury with slower than typical recovery rates...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28409285/urinary-calprotectin-kidney-injury-molecule-1-and-neutrophil-gelatinase-associated-lipocalin-for-the-prediction-of-adverse-outcome-in-pediatric-acute-kidney-injury
#7
Jens H Westhoff, Felix S Seibert, Sina Waldherr, Frederic Bauer, Burkhard Tönshoff, Alexander Fichtner, Timm H Westhoff
Early identification of patients with acute kidney injury (AKI) being at high risk for adverse outcome can influence medical treatment. This study compares urinary calprotectin, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) for their performance in predicting mortality and need for renal replacement therapy (RRT) in pediatric AKI patients. Urinary biomarker concentrations were assessed prospectively in 141 subjects aged 0-18 years including 55 patients with established AKI according to pediatric Risk, Injury, Failure, Loss, and End-stage kidney disease (pRIFLE) criteria, 27 patients without AKI, and 59 healthy children...
April 14, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28409034/increased-intracranial-pressure-during-hemodialysis-in-a-patient-with-anoxic-brain-injury
#8
Anton Lund, Mette B Damholt, Ditte G Strange, Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#9
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28404663/decoding-acute-myocardial-infarction-among-patients-on-dialysis
#10
EDITORIAL
Charles E Howard, Peter A McCullough
No abstract text is available yet for this article.
April 12, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28404621/longitudinal-risk-of-adverse-events-in-patients-with-acute-kidney-injury-after-percutaneous-coronary-intervention-insights-from-the-national-cardiovascular-data-registry
#11
Javier A Valle, Lisa A McCoy, Thomas M Maddox, John S Rumsfeld, P Michael Ho, Ivan P Casserly, Brahmajee K Nallamothu, Matthew T Roe, Thomas T Tsai, John C Messenger
BACKGROUND: Acute kidney injury (AKI) remains a common complication after percutaneous coronary intervention (PCI) and is associated with adverse in-hospital patient outcomes. The incidence of adverse events after hospital discharge in patients having post-PCI AKI is poorly defined, and the relationship between AKI and outcomes after hospital discharge remains understudied. METHODS AND RESULTS: Using the National Cardiovascular Data Registry CathPCI registry, we assessed the incidence of AKI among Medicare beneficiaries after PCI from 2004 to 2009 and subsequent post-discharge adverse events at 1 year...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#12
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28396740/long-term-outcome-in-biopsy-proven-acute-interstitial-nephritis-treated-with-steroids
#13
Maria Prendecki, Anisha Tanna, Alan D Salama, Frederick W K Tam, Tom Cairns, David Taube, H Terence Cook, Damien Ashby, Neil D Duncan, Charles D Pusey
Background: There are no prospective randomized controlled trials describing the outcome of acute interstitial nephritis (AIN) treated with steroids, and retrospective studies are limited. Methods: We identified adult patients with a diagnosis of AIN without glomerular pathology over a 14-year period. Treated patients all received oral prednisolone and three also recieved IV methylprednisolone. Data were collected retrospectively on estimated glomerular filtration rate (eGFR), change in eGFR from time of biopsy, dependence on renal replacement therapy (RRT) and mortality, and outcomes were analysed according to the treatment prescribed...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28391314/continued-monitoring-of-acute-kidney-injury-survivors-might-not-be-necessary-in-those-regaining-an-estimated-glomerular-filtration-rate-60%C3%A2-ml-min-at-1-year
#14
Sokratis Stoumpos, Patrick B Mark, Emily P McQuarrie, Jamie P Traynor, Colin C Geddes
Background.: Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods.: All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28390405/fam-face-sg-a-score-for-risk-stratification-of-frequent-hospital-admitters
#15
Lian Leng Low, Nan Liu, Kheng Hock Lee, Marcus Eng Hock Ong, Sijia Wang, Xuan Jing, Julian Thumboo
BACKGROUND: An accurate risk stratification tool is critical in identifying patients who are at high risk of frequent hospital readmissions. While 30-day hospital readmissions have been widely studied, there is increasing interest in identifying potential high-cost users or frequent hospital admitters. In this study, we aimed to derive and validate a risk stratification tool to predict frequent hospital admitters. METHODS: We conducted a retrospective cohort study using the readily available clinical and administrative data from the electronic health records of a tertiary hospital in Singapore...
April 8, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28389813/plasma-neutrophil-gelatinase-associated-lipocalin-is-associated-with-iron-status-in-anemic-patients-with-pre-dialysis-chronic-kidney-disease
#16
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak
BACKGROUND: Iron deficiency anemia is common in patients with chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of acute kidney injury, is known to be associated with iron metabolism. We investigated whether plasma NGAL level is associated with iron status in pre-dialysis CKD patients with anemia. METHODS: This study included 419 patients who had anemia. The subjects were into categorized into a pre-dialysis group (estimated glomerular filtration rate [eGFR] <60 ml/min/1...
April 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28388752/-acute-kidney-injury-potentials-to%C3%A2-improve-aki-related-health-care-structure
#17
REVIEW
Christian Nusshag, Konrad Obermann, Markus Weigand, Vedat Schwenger
Since 2005 the AKI numbers nearly increased threefold. The prevailing health care structure for AKI-management in Germany possesses major potential for improvement. Despite a clear advantage regarding mortality and renal recovery, the cost-intensive CRRT is the predominant procedure in AKI-therapy. Conversion of 85 % of the CRRT-procedures to a dialysis procedure (IHD/SLED) enables annual savings in AKI-therapy by 7.3 million Euros. A reinvestment can finance a strengthened collaboration with licensed nephrologists to improve therapy quality and availability of RRT-units in local hospitals...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28385160/dementia-is-a-risk-factor-for-major-adverse-cardiac-and-cerebrovascular-events-in-elderly-korean-patients-initiating-hemodialysis-a-korean-national-population-based-study
#18
Sung Min Jung, Clara Tammy Kim, Ea Wha Kang, Kyoung Hoon Kim, Shina Lee, Hyung Jung Oh, Seung-Jung Kim, Duk-Hee Kang, Kyu Bok Choi, Dong-Ryeol Ryu, Hyunwook Kim
BACKGROUND: Dementia is common in end-stage renal disease (ESRD) patients on hemodialysis (HD) and is associated with worse outcomes. This study aimed to investigate the risk of major adverse cardiac and cerebrovascular event (MACCE) in elderly patients with dementia initiating HD. METHODS: Using the database from the Health Insurance Review & Assessment Service, we analyzed 10,171 patients aged 65 years or older who had initiated dialysis from 2005 to 2008. MACCE was defined as a composite outcome of all-cause mortality, nonfatal acute myocardial infarction, target vessel revascularization, and nonfatal ischemic and hemorrhagic stroke...
April 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28384106/diagnostic-dilemmas-in-hepatitis-c-virus-infection-for-hemodialysis-patients
#19
Radka T Komitova, Maria V Atanasova, Toska A Pavlova, Monica Sh Nyagolov, Aneta V Ivanova
BACKGROUND: Hepatitis C virus (HCV) is a leading cause of chronic hepatitis in dialysis patients. The diagnosis of HCV infection in these patients is predominantly based on laboratory tests because of the specificity of the clinical course of the disease. AIM: The present prospective study aimed at determining very accurately the prevalence rate of HCV infection in patients on dialysis by simultaneously testing them for anti-HCV and for HCV RNA levels. MATERIALS AND METHODS: For the present cross-sectional longitudinal study we recruited and followed up 93 patients from St George University Hospital Hemodialysis Unit between July 2013 and December 2014...
March 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28380638/when-is-a-meta-analysis-conclusive-a-guide-to-trial-sequential-analysis-with-an-example-of-remote-ischemic-preconditioning-for-renoprotection-in-patients-undergoing-cardiac-surgery
#20
Pavel S Roshanov, Brittany B Dennis, Nicholas Pasic, Amit X Garg, Michael Walsh
Regardless of whether a randomized trial finds a statistically significant effect for an intervention or not, readers often wonder if the trial was large enough to be conclusive. To answer this question, we can estimate the required sample size for a trial by considering how commonly the outcome occurs, the smallest effect of clinical importance and the acceptable risk of falsely detecting or rejecting that effect. But when is a meta-analysis conclusive? We explain and illustrate the interpretation of Trial Sequential Analysis (TSA), a method increasingly used to answer this question...
April 1, 2017: Nephrology, Dialysis, Transplantation
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