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Intermittent hemodialysis

Rebecca Maxson, Julia Pate, Jessica Starr
BACKGROUND: Current vancomycin dosing guidelines recommend targeting trough concentrations of 15-20 mg/L in complicated infections to avoid treatment failure and resistance. How to accomplish this in the intermittent hemodialysis (IHD) population has not been adequately described. A weight-based vancomycin dosing protocol for IHD patients was developed to provide standardization of vancomycin dosing for this patient population. Prior to implementation of this protocol, clinical pharmacists used their individual judgment for dosing and monitoring...
October 19, 2016: Renal Failure
R T Noel Gibney
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Sajni I Khemchandani
INTRODUCTION: Classic bladder exstrophy (BE) is a rare malformation of the genito-urinary tract affecting 1:50,000 to 1:100,000 live births. The surgical reconstruction of the BE-epispadias complex is challenging for the most experienced pediatric urologists, surgeons, and orthopedists. PURPOSE: To assess the success of staged reconstruction of the BE and long-term effects on the upper urinary tract, renal function, and continence. MATERIALS AND METHODS: This is retrospective study; between 1994 and 2013, 30 patients with BE have undergone stage 1 repair at the institute...
October 2016: Journal of Indian Association of Pediatric Surgeons
Bogusz Trojanowicz, Christof Ulrich, Roman Fiedler, Markus Storr, Torsten Boehler, Peter Martus, Michael Pawlak, Marcus A Glomb, Christian Henning, Markus Templin, Kristin Werner, Daniel Zickler, Kevin Willy, Ralf Schindler, Matthias Girndt
Introduction Patients with chronic kidney disease maintained on intermittent hemodialysis suffer from systemic chronic inflammation which is causally associated with high mortality. Inflammation mediators of 15-45 kDa range cannot be effectively removed by conventional dialysis membranes. In this study, we tested the influence of serum and dialysates obtained from patients maintained on High cut-off or High flux membranes on the inflammation profile of THP-1 monocytes. Methods THP-1 monocytes were treated with serum or dialysates obtained from patients maintained on High cut-off and High flux membranes within a randomized crossover pilot trial...
September 26, 2016: Hemodialysis International
Amy E McAlister, Kira Geile, Carmen M Halabi, T Keefe Davis
We describe the successful treatment of a pediatric transplant patient with simultaneous intermittent hemodialysis and therapeutic plasma exchange (TPE). The patient presented with kidney graft failure. He had life threatening electrolyte disturbances and fluid overload due to antibody-mediated rejection. Therefore, he was in need of both emergent kidney replacement therapy and TPE. Both extracorporeal circuits were set up, established, and maintained safely and effectively without difficulty or alarms. Running intermittent hemodialysis and TPE simultaneously significantly reduced therapy time, allowed both needed therapies priority, and provided a superior pediatric patient experience in an acute situation...
October 2016: Hemodialysis International
Louise E Ross, Pauline A Swift, Sandra M Newbold, Kate Bramham, Anne Hurley, Hugh Gallagher
Pregnancy outcomes in patients with end-stage renal disease (ESRD) on dialysis are improving. Recent literature supports intensive hemodialysis (HD) as the modality of choice during pregnancy in ESRD. We report the successful delivery of a healthy infant at full term in a patient with ESRD by supplementing peritoneal dialysis (PD) with intermittent HD to achieve adequate dialysis intensity.
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Daniel Kraus, Christoph Wanner
Critically ill patients who are treated in an intensive care unit are at increased risk of developing acute renal failure. Every episode of renal failure decreases life expectancy. However, acute renal failure is no longer an immediate cause of death because renal function can be substituted medically and mechanically, by the use of renal replacement therapy. Hemodialysis and hemofiltration are the 2 fundamental modalities of renal replacement therapy and may be performed intermittently or continuously. The decision for one particular therapy has to be made for each patient individually...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Daniela Pelclová, Sergey Zakharov
UNLABELLED: Methanol mass poisoning occurs across the world quite frequently, but the complete clinical and laboratory data of the patients are only rarely available. Approximately 138 cases of poisoning were documented in the Czech Republic, 107 patients were hospitalized. Another 31 persons died out of hospital. About 60 % of the hospitalized patients survived intoxication without consequences, one half of the remaining 40 % died and the other half survived with the CNS and/or sight impaired...
2016: Vnitr̆ní Lékar̆ství
Jessica M Rosselot, James N Mansfield, Cody R Hill, Nirmala Tumarada, Shane E Sanne, Fred A Lopez
A 54 year-old woman with diabetes mellitus type two and end-stage renal disease on hemodialysis presented to the emergency department with a four day history of generalized malaise, fever, and chills. Her symptoms were also associated with occasional dyspnea without a cough. She reported intermittent chronic diarrhea with hemodialysis which was currently unchanged. On the day of admission, she could not tolerate hemodialysis due to her symptoms. Over the past year she admitted to night sweats and a 40 pound weight loss...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Malin Skagerlind, Bernd Stegmayr
Introduction Intermittent hemodialysis (IHD) is sometimes necessary in patients with a bleeding risk, i.e., before/after surgery or brain hemorrhage. In such case IHD has to be modified to limit the conventional anticoagulation used to avoid clotting of the extracorporeal circuit (ECC). We evaluated if priming using a heparin and albumin (HA) mixture could minimize the exposure to heparin. Methods Retrospective data from 1995 to 2013 were collected from 1408 acute dialysis treatment protocols that included 321 patients...
August 31, 2016: Hemodialysis International
Hayato Mitaka, Yuji Yamada, Osamu Hamada, Shintaro Kosaka, Naoki Fujiwara, Yoshitaka Miyakawa
A 49-year-old man with malignant hypertension, acute kidney injury and mental deterioration was referred to our hospital. We initially observed microangiopathic hemolytic anemia, thrombocytopenia and kidney damage, indicating he had thrombotic microangiopathy (TMA). We considered TMA was caused by malignant hypertension and therefore did not start plasma therapy. The French TMA reference center reported that platelet counts and serum creatine levels have high values for predicting severe ADAMTS13 deficiency...
2016: Internal Medicine
Anne-Sophie Truche, Michael Darmon, Sébastien Bailly, Christophe Clec'h, Claire Dupuis, Benoit Misset, Elie Azoulay, Carole Schwebel, Lila Bouadma, Hatem Kallel, Christophe Adrie, Anne-Sylvie Dumenil, Laurent Argaud, Guillaume Marcotte, Samir Jamali, Philippe Zaoui, Virginie Laurent, Dany Goldgran-Toledano, Romain Sonneville, Bertrand Souweine, Jean-Francois Timsit
No abstract text is available yet for this article.
July 22, 2016: Intensive Care Medicine
Marc Ghannoum, Monique Cormier, Amélie Bernier-Jean, Dave Brindamour, Clément Déziel, Josée Bouchard
INTRODUCTION: Intentional dapsone intoxication can be life-threatening. There is limited data on the clinical effect of extracorporeal treatments (ECTRs) on dapsone elimination. We describe a case of severe dapsone toxicity treated with different ECTRs. CASE DETAILS: A 23-year-old woman was admitted 2.5 h after ingesting 2.2 g of dapsone. She developed methemoglobinemia (39.9%) and showed signs of toxicity (hemodynamic instability and altered mental status) despite multiple-activated charcoal, methylene blue, vasopressors and endotracheal intubation...
July 18, 2016: Clinical Toxicology
Tonci Brkovic, Eliana Burilovic, Livia Puljak
OBJECTIVES: Understanding the epidemiology of pain in patients on hemodialysis (HD) is crucial for further improvement in managing pain. The aim of this study was to systematically review available evidence on the prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent HD. MATERIALS AND METHODS: We carried out a systematic review of the literature and developed a comprehensive search strategy based on search terms on pain and HD...
2016: Patient Preference and Adherence
Shota Okuno, Osamu Iida, Tatsuya Shiraki, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Mitsuyoshi Takahara, Masaaki Uematsu
PURPOSE: To investigate whether the severity of lesion calcification assessed by the novel peripheral artery calcification scoring system (PACSS) was associated with clinical outcomes after endovascular therapy (EVT) for superficial femoral artery (SFA) lesions. METHODS: A retrospective analysis was conducted of 394 consecutive patients (mean age 72±8 years; 290 men) with intermittent claudication [223 (57%) with diabetes, 81 (21%) on hemodialysis] who underwent successful EVT for de novo SFA lesions [length 152...
October 2016: Journal of Endovascular Therapy
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Jadranka Buturovic-Ponikvar
Citrate has many characteristics of the ideal anticoagulant for hemodialysis. In addition to immediate and complete anticoagulation in the dialysis circuit, citrate has important effects beyond anticoagulation, mainly in reducing inflammatory response induced by hemodialysis. Citrate has already become the standard anticoagulant in acute kidney injury requiring continuous renal replacement therapy (CRRT), both for adults and children, with the citrate module being a part of modern CRRT monitors. Although the citrate module is not yet available for intermittent hemodialysis, precise infusion pumps, point-of-care ionometers and high citrate clearance from high flux dialyzers increase safety while reducing the risk of metabolic complications, both in adult and pediatric patients...
June 2016: Therapeutic Apheresis and Dialysis
S Y Byun, J W Jeong, J H Choi, K P Lee, H Y Youn, H J Maeng, K H Song, T S Koo, K W Seo
Meropenem, a second carbapenem antimicrobial agent with a broad spectrum of activity, is used to treat sepsis and resistant-bacterial infections in veterinary medicine. The objective of this study was to identify the pharmacokinetics of meropenem in dogs receiving intermittent hemodialysis (IHD) and to determine the proper dosing in renal failure patients receiving IHD. Five healthy beagle dogs were given a single i.v. dose of 24 mg/kg of meropenem and received IHD. The blood flow rate, dialysate flow, and ultrafiltration rate were maintained at 40 mL/min, 300 mL/min, and 40 mL/h, respectively...
June 15, 2016: Journal of Veterinary Pharmacology and Therapeutics
David Berger, Jukka Takala
Hypotension during intermittent hemodialysis is common, and has been attributed to acute volume shifts, shifts in osmolarity, electrolyte imbalance, temperature changes, altered vasoregulation, and sheer hypovolemia. Although hypovolemia may intuitively seem a likely cause for hypotension in intensive care patients, its role in the pathogenesis of intradialytic hypotension may be overestimated.
2016: Critical Care: the Official Journal of the Critical Care Forum
Anne-Sophie Truche, Michael Darmon, Sébastien Bailly, Christophe Clec'h, Claire Dupuis, Benoit Misset, Elie Azoulay, Carole Schwebel, Lila Bouadma, Hatem Kallel, Christophe Adrie, Anne-Sylvie Dumenil, Laurent Argaud, Guillaume Marcotte, Samir Jamali, Philippe Zaoui, Virginie Laurent, Dany Goldgran-Toledano, Romain Sonneville, Bertrand Souweine, Jean-Francois Timsit
PURPOSE: The best renal replacement therapy (RRT) modality remains controversial. We compared mortality and short- and long-term renal recovery between patients treated with continuous RRT and intermittent hemodialysis. METHODS: Patients of the prospective observational multicenter cohort database OUTCOMEREA™ were included if they underwent at least one RRT session between 2004 and 2014. Differences in patients' baseline and daily characteristics between treatment groups were taken into account by using a marginal structural Cox model, allowing one to substantially reduce the bias resulting from confounding factors in observational longitudinal data analysis...
September 2016: Intensive Care Medicine
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