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https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#1
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27905888/medicare-program-end-stage-renal-disease-prospective-payment-system-coverage-and-payment-for-renal-dialysis-services-furnished-to-individuals-with-acute-kidney-injury-end-stage-renal-disease-quality-incentive-program-durable-medical-equipment-prosthetics-orthotics
#2
(no author information available yet)
This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27898433/transcatheter-aortic-valve-implantation-in-nonagenarians
#3
Adam Penkalla, Joerg Kempfert, Axel Unbehaun, Semih Buz, Thorsten Drews, Miralem Pasic, Volkmar Falk
OBJECTIVE: In this report, we assess the outcome of transcatheter aortic valve implantation (TAVI) in nonagenarians at our institution during a 6-year period. METHODS: Between April 2008 and July 2014, 40 patients with a mean ± SD age of 91.8 ± 2.3 years (range, 90-98 years) underwent TAVI. Thirty-three patients (82.5%) received transapical TAVI, and seven patients (17.5%) received transfemoral TAVI. Baseline characteristics were as follows: mean ± SD EuroSCORE II, 23...
November 28, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27895019/nephrotoxicity-during-vancomycin-therapy-in-combination-with-piperacillin-tazobactam-or-cefepime
#4
W Cliff Rutter, Jessica N Cox, Craig A Martin, Donna R Burgess, David S Burgess
BACKGROUND: Recent reports have demonstrated that vancomycin (VAN) may lead to an increase in acute kidney injury (AKI) when combined with anti-pseudomonal beta-lactams. This study compared the incidence of AKI associated with VAN plus piperacillin-tazobactam (TZP) or cefepime (FEP). METHODS: This was a retrospective, matched cohort study at an academic medical center between September 2010 and September 2014 including adult patients receiving TZP-VAN or FEP-VAN for at least 48 hours and without severe chronic or structural kidney disease, dialysis, pregnancy, cystic fibrosis, or hospital transfer...
November 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#5
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin Gonzalez, Jonathan Sobocinski, Stéphan Haulon
OBJECTIVE: To describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27886156/conformity-scores-differentiate-older-hemodialyzed-patients-and-patients-with-continuous-peritoneal-dialysis
#6
Zbigniew Nowak, Krzysztof Laudanski
BACKGROUND Conformity is a psychological variable related to the propensity of an individual to match his or her behavior and opinion to the perceived social and cultural norm, even if these do not represent the true beliefs of the person. The aim of the present study was to investigate whether the psychological variable of conformity is different in two distinct modes of renal replacement therapy (RRT) in end-stage renal disease (ESRD). MATERIAL AND METHODS A total of 56 hemodialyzed patients (HD group), 45 continuous ambulatory peritoneal dialysis patients (CAPD group) and 62 healthy volunteers (CONTR group) were enrolled in the study...
November 25, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27885564/hepatitis-e-virus-infection-in-patients-on-dialysis-and-in-solid-organ-transplant-recipients-in-argentina-exploring-associated-risk-factors
#7
María Belén Pisano, Domingo Balderramo, Maribel Martínez Wassaf, Martín Lotto, Yanina Carlino, Viviana Elizabeth Ré, José D Debes
Infection with hepatitis E virus (HEV) leads to acute hepatitis infection in immunocompetent hosts. HEV genotype 3 can present with high frequency and lead to chronic infection in individuals with a compromised immune system. The risk factors related to increased seroprevalence or chronicity in this population are not entirely understood. Moreover, most studies addressing risk factors for HEV in non-endemic areas come from developed areas such as North America and Europe. In this study we evaluated seroprevalence, chronicity and risk factors for HEV in 120 transplant recipients and 88 patients on dialysis in Argentina...
November 25, 2016: Archives of Virology
https://www.readbyqxmd.com/read/27879188/the-sustainable-kidney-care-foundation-s-contribution-to-the-improvement-of-aki-management-in-developing-countries-using-peritoneal-dialysis
#8
Mary Carter, Nathan W Levin, Calvin S Carter, John Callegari
Professional organizations, such as kidney foundations, have been active for over half a century in the field of nephrology, serving as the basic institutions for advocacy, disease education, prevention, and treatment. These organizations have focused efforts in four areas: supporting the training of clinical specialists, raising awareness about kidney disease, improving patient outcomes, and organizing continuing medical education. These activities, while essential for the success of nephrology organizations, do not usually initiate renal service programs in the neediest of places...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27876521/increased-risk-of-renal-dysfunction-with-percutaneous-mechanical-thrombectomy-compared-with-catheter-directed-thrombolysis
#9
Katherine L Morrow, Ann H Kim, Steven A Plato, Andrew J Shevitz, Jerry Goldstone, Henry Baele, Vikram S Kashyap
OBJECTIVE: Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus. METHODS: This study is a retrospective review of all patients in a single institution with a Current Procedural Terminology code for PMT or CDT from January 2009 through December 2014...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27869432/-massive-hydrothorax-in-a-ease-of-hemolytic-uremic-syndrome-conservative-treatment-without-interruption-of-peritoneal-dialysis
#10
Gustavo R Marin
: The hydrothorax is a known but rare complication of acute and chronic peritoneal dialysis. Patients with hemolytic uremic syndrome seem to be more prone to this complication. Usually discontinuation of treatment is necessary due to the lack of resolution or recurrence of hydrothorax and transfer to hemodialysis, but some patients can continue dialysis with modification of technique and with resolution of hydrothorax. CASE REPORT: a child with hemolytic uremic syndrome presented a massive hydrothorax during acute peritoneal dialysis which resolved with dialysis schema modification without interruption of treatment...
December 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27865711/use-of-an-eptfe-covered-nitinol-self-expanding-stent-graft-for-the-treatment-off-pre-closure-device-failure-during-transcatheter-aortic-valve-replacement
#11
Arie Steinvil, Nelson Bernardo, Toby Rogers, Edward Koifman, Kyle Buchanan, M Chadi Alraies, Christian Shults, Rebecca Torguson, Petros G Okubagzi, Augusto D Pichard, Lowell F Satler, Itsik Ben-Dor, Ron Waksman
OBJECTIVES: Our aim was to describe our experience with the use of an ePTFE-covered nitinol self-expanding stent graft (GORE® VIABAHN® Endoprosthesis, Gore Medical, USA) placed in the common femoral artery for the treatment of suture-mediated pre-closure device failure following transcatheter aortic valve replacement (TAVR). BACKGROUND: Access site-related vascular complications (VC) following sheath removal related to pre-closure device failure during TAVR are common and treatment options may vary...
October 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27865637/increased-risk-of-mortality-after-lower-extremity-bypass-in-individuals-with-acute-kidney-injury-in-the-vascular-quality-initiative
#12
Erica Flores, Juan Pablo Lewinger, Vincent L Rowe, Karen Woo, Fred A Weaver, David Shavelle, Leonardo Clavijo, Parveen K Garg
OBJECTIVE: The development of acute kidney injury (AKI) and its effect on prognosis after lower extremity bypass (LEB) surgery have not been well described. We determined risk factors associated with AKI in patients undergoing infrainguinal LEB surgery and whether individuals with AKI are at increased risk for cardiovascular events and mortality. METHODS: Data for 12,907 operations entered in the Vascular Quality Initiative (VQI) registry from January 2012 through April 2015 were retrospectively reviewed...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27864708/thyroid-dysfunction-and-kidney-disease-an-update
#13
REVIEW
Pedro Iglesias, María Auxiliadora Bajo, Rafael Selgas, Juan José Díez
Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible with treatment...
November 18, 2016: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#14
Bailey E Sparks, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter)...
October 7, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27863352/ultrafiltration-for-acute-decompensated-cardiac-failure-a-systematic-review-and-meta-analysis
#15
Chun Shing Kwok, Chun Wai Wong, Claire A Rushton, Fozia Ahmed, Colin Cunnington, Simon J Davies, Ashish Patwala, Mamas A Mamas, Duwarakan Satchithananda
BACKGROUND: Ultrafiltration is a method used to achieve diuresis in acute decompensated heart failure (ADHF) when there is diuretic resistance, but its efficacy in other settings is unclear. We therefore conducted a systematic review and meta-analysis to evaluate the use of ultrafiltration in ADHF. METHODS: We searched MEDLINE and EMBASE for studies that evaluated outcomes following filtration compared to diuretic therapy in ADHF. The outcomes of interest were body weight change, change in renal function, length of stay, frequency of rehospitalization, mortality and dependence on dialysis...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27860413/development-of-a-wearable-bioartificial-kidney-using-the-bioartificial-renal-epithelial-cell-system-brecs
#16
Kimberly A Johnston, Angela J Westover, Alvaro Rojas-Pena, Deborah A Buffington, Christopher J Pino, Peter L Smith, H David Humes
Cell therapy for the treatment of renal failure in the acute setting has proved successful, with therapeutic impact, yet development of a sustainable, portable bioartificial kidney for treatment of chronic renal failure has yet to be realized. Challenges in maintaining an anticoagulated blood circuit, the typical platform for solute clearance and support of the biological components, have posed a major hurdle in advancement of this technology. This group has developed a Bioartificial Renal Epithelial Cell System (BRECS) capable of differentiated renal cell function while sustained by body fluids other than blood...
November 18, 2016: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/27856091/a-clinical-risk-prediction-tool-for-6-month-mortality-after-dialysis-initiation-among-older-adults
#17
James P Wick, Tanvir C Turin, Peter D Faris, Jennifer M MacRae, Robert G Weaver, Marcello Tonelli, Braden J Manns, Brenda R Hemmelgarn
BACKGROUND: Information on an individual's risk for death following dialysis therapy initiation may inform the decision to initiate maintenance dialysis for older adults. We derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment. STUDY DESIGN: Prediction model using retrospective administrative and clinical data. SETTING & PARTICIPANTS: We linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada, who initiated maintenance dialysis therapy (excluding acute kidney injury) in May 2003 to March 2012...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27851743/effect-of-the-obesity-epidemic-on-kidney-transplantation-obesity-is-independent-of-diabetes-as-a-risk-factor-for-adverse-renal-transplant-outcomes
#18
Jennifer M Kwan, Zahraa Hajjiri, Ahmed Metwally, Patricia W Finn, David L Perkins
BACKGROUND: Obesity is a growing epidemic in most developed countries including the United States resulting in an increased number of obese patients with end-stage renal disease. A previous study has shown that obese patients with end-stage renal disease have a survival benefit with transplantation compared with dialysis. However, due to serious comorbidities, many centers place restrictions on the selection of obese patients for transplantation. Further, due to obese patients having an increased risk of diabetes, it is unclear whether obesity can be an independent risk, independent of diabetes for increasing adverse renal transplant outcomes...
2016: PloS One
https://www.readbyqxmd.com/read/27846860/purtscher-s-retinopathy-and-renal-cortical-necrosis-two-rare-vaso-occlusive-complications-in-a-patient-with-acute-pancreatitis-a-case-report
#19
Wasim Md Mohosin Ul Haque, Mehruba Alam Ananna, Hasna Fahmima Haque, Muhammad Abdur Rahim, Tabassum Samad, Sarwar Iqbal
BACKGROUND: Purtscher's retinopathy and renal cortical necrosis are two rare vaso-occlusive complications of acute pancreatitis. Purtscher's retinopathy causes sudden impairment of vision, which was first reported in a patient with head trauma. Subsequently, it was also reported as a complication of acute pancreatitis and few other clinical conditions. Acute pancreatitis also rarely causes renal cortical necrosis leading to acute kidney injury. However, the simultaneous presence of both complications is rarely reported...
November 15, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27846001/unexpected-diffuse-18f-naf-uptake-in-the-lung-parenchyma-in-a-patient-with-severe-hypercalcemia-due-to-myelomatosis
#20
Ali Asmar, Lene Simonsen, Birgitte Svolgaard, Jens Bülow
An 84-year-old man was admitted to the intensive care unit because of hypercalcemic crisis leading to acute renal failure needing dialysis. The patient had no other history of illness. However, because prostate-specific antigen levels were increased, the patient was referred to F-NaF PET/CT on suspicion of active skeletal metastases. The patient was finally diagnosed with myelomatosis. Although the skeletal uptake of F-NaF was without signs of focal metastasis, the F-NaF PET/CT scanning surprisingly revealed diffuse high accumulation of F-NaF in the lung parenchyma, possibly because of calcium deposition in the lung parenchyma associated to amyloidosis seen in patients with myelomatosis...
November 11, 2016: Clinical Nuclear Medicine
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