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Intermittent hemodialysis

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https://www.readbyqxmd.com/read/29202728/non-tunneled-versus-tunneled-dialysis-catheters-for-acute-kidney-injury-requiring-renal-replacement-therapy-a-prospective-cohort-study
#1
Mallika L Mendu, Megan F May, Arnaud D Kaze, Dionne A Graham, Salena Cui, Margaret E Chen, Naomi Shin, Ayal A Aizer, Sushrut S Waikar
BACKGROUND: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is associated with high morbidity, mortality and resource utilization. The type of vascular access placed for AKI-RRT is an important decision, for which there is a lack of evidence-based guidelines. METHODS: We conducted a prospective cohort study over a 16-month period with 154 patients initiated on AKI-RRT via either a non-tunneled dialysis catheter (NTDC) or a tunneled dialysis catheter (TDC) at an academic hospital...
December 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29190861/-outcome-of-acute-kidney-injury-in-critically-ill-patients-treated-with-intermittent-hemodialysis-versus-crrt
#2
Mariana Ávalos-López, María Juana Pérez-López, Carolina Aguilar-Martínez, Ana María Del Carmen Díaz-Franco, Alejandro Esquivel-Chávez, José Angel Baltazar-Torres
BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients and it is associated with poor outcome. Some patients require renal replacement therapy (RRT), and the most frequently used are intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT). Current evidence is insufficient to conclude which modality is most appropriate to treat critically ill patients with AKI. METHODS: We reviewed the clinical records of critically ill patients with stage 3 AKI treated with RRT...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29179699/gastrointestinal-tuberculosis-following-renal-transplantation-accompanied-with-septic-shock-and-acute-respiratory-distress-syndrome-a-survival-case-presentation
#3
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29174672/-aluminic-intoxication-in-chronic-hemodialysis-a-diagnosis-rarely-evoked-nowadays-clinical-case-and-review-of-the-literature
#4
Alexandre Seidowsky, Emmanuel Dupuis, Tilman Drueke, Serge Dard, Ziad A Massy, Bernard Canaud
Aluminum intoxication in chronic hemodialysis patients has virtually vanished over the last decade. Therefore, the diagnosis is rarely advocated at present. Aluminum intoxication in dialysis patients associates to different degrees with dialysis encephalopathy, bone disorders and microcytic anemia. We report here the observation of a patient receiving intermittent hemodialysis therapy who presented with acute encephalopathy. It turned out to be caused by aluminum intoxication secondary to a defect in dialysis water treatment...
November 22, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29171099/regional-citrate-anticoagulation-for-intermittent-hemodialysis-in-dogs
#5
T Francey, A Schweighauser
BACKGROUND: The traditional systemic heparinization used for anticoagulation in extracorporeal therapies may cause fatal complications in animals at risk of bleeding. HYPOTHESIS/OBJECTIVES: To develop and validate a protocol of regional citrate anticoagulation (RCA) for intermittent hemodialysis in dogs. ANIMALS: A total of 172 dogs treated with hemodialysis for acute kidney injury. METHODS: In vitro titration was performed, adding trisodium citrate and calcium chloride to heparinized canine blood...
November 24, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29171000/applying-pharmacokinetic-pharmacodynamic-principles-for-optimizing-antimicrobial-therapy-during-continuous-renal-replacement-therapy
#6
Patrick M Honore, Rita Jacobs, Elisabeth De Waele, Herbert D Spapen
Continuous renal replacement therapy (CRRT) is progressively supplanting intermittent hemodialysis (IHD) in critically ill patients. CRRT indeed offers more appropriate hemodynamic, fluid, and metabolic stability but concern is rising about its impact on concomitant drug, and in particular antimicrobial, treatment. Antimicrobial dose recommendations have been elaborated to avoid drug accumulation and toxicity in patients undergoing IHD. However, these dosing regimens resulted in significant underdosing in patients undergoing CRRT thereby increasing the risk of treatment failure and development of resistance...
November 24, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29089579/transfemoral-transcatheter-aortic-valve-implantation-in-patients-with-end-stage-renal-disease-and-kidney-transplant-recipients
#7
Fadi Al-Rashid, Anja Bienholz, Heike Annelie Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Andreas Kribben, Daniel Wendt, Heinz Jakob, Alexander Lind, Rolf Alexander Jánosi, Tienush Rassaf, Philipp Kahlert
Transcatheter aortic valve implantation (TAVI) has evolved to a treatment of choice in high-risk patients and is therefore ideal for patients with advanced chronic kidney disease, as patients with end-stage renal disease and kidney transplant recipients. Especially, outcome of this special patient group is very important. 22 patients with chronic kidney disease stage 5 undergoing intermittent hemodialysis treatment (CKD 5D) and 8 kidney transplant recipients (KT) with severe aortic valve stenosis underwent transfemoral TAVI...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29065404/urgent-start-peritoneal-dialysis-the-first-year-of-brazilian-experience
#8
Dayana Bitencourt Dias, Marcela Lara Mendes, Vanessa Burgugi Banin, Pasqual Barretti, Daniela Ponce
BACKGROUND: This study aimed to evaluate mechanical and infectious complications associated with urgent-start peritoneal dialysis (PD) and patients and technique survival in the first 180 days. METHODS: It was a prospective study that evaluated chronic patients who started unplanned PD using high-volume PD (HVPD) right after (<72 h) PD catheter placement. After hospital discharge, patients were treated with intermittent PD on alternate days in a dialysis unit until family training was provided...
October 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/29052790/efficacy-and-safety-of-glecaprevir-pibrentasvir-in-hcv-infected-japanese-patients-with-prior-daa-experience-severe-renal-impairment-or-genotype-3-infection
#9
Hiromitsu Kumada, Tsunamasa Watanabe, Fumitaka Suzuki, Kenji Ikeda, Ken Sato, Hidenori Toyoda, Masanori Atsukawa, Akio Ido, Akinobu Takaki, Nobuyuki Enomoto, Koji Kato, Katia Alves, Margaret Burroughs, Rebecca Redman, David Pugatch, Tami J Pilot-Matias, Preethi Krishnan, Rajneet K Oberoi, Wangang Xie, Kazuaki Chayama
BACKGROUND: Once-daily, orally administered, co-formulated glecaprevir (NS3/4A protease inhibitor) and pibrentasvir (NS5A inhibitor) (G/P) demonstrated pangenotypic activity and high sustained virologic response (SVR) rates in studies outside Japan. Here we report safety and efficacy in a subset of Japanese patients with chronic HCV infection who received G/P 300/120 mg in a phase 3, open-label, multicenter study (CERTAIN-1). METHODS: This analysis focuses on three difficult-to-treat subgroups: HCV GT1/2-infected patients who failed to achieve SVR after treatment with a direct acting antiviral (DAA)-containing regimen; GT1/2-infected patients with severe renal impairment (estimated glomerular filtration rate < 30 mL/min/1...
October 20, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28905389/the-first-reported-case-of-concurrent-trimethoprim-sulfamethoxazole-induced-immune-hemolytic-anemia-and-thrombocytopenia
#10
Yevgeniy A Linnik, Edison W Tsui, Isabella W Martin, Zbigniew M Szczepiorkowski, Gregory A Denomme, Jerome L Gottschall, John M Hill, Nancy M Dunbar
BACKGROUND: Drug-induced immune hemolytic anemia (DIIHA) and drug-induced immune thrombocytopenia (DIIT) are rare but dangerous complications of pharmacotherapy that may be underrecognized in hematopoietic stem cell transplant (HSCT) patients due to overlap of signs and symptoms with those of more common disease processes. CASE REPORT: A 61-year-old woman with NK-cell deficiency and GATA-2-associated myelodysplastic syndrome, status post-recent allogeneic HSCT (Day +58), presented with 3 days of acute-onset severe back pain, muscle cramps, and increasingly dark urine...
September 14, 2017: Transfusion
https://www.readbyqxmd.com/read/28869940/severe-secondary-hyperparathyroidism-in-a-hemodialysis-patient-a-case-report-from-mongolia
#11
Saruultuvshin Adiya, Khurtsbayar Damdinsuren, Chuluuntsetseg Dorj
Secondary hyperparathyroidism (SHPT) occurs in patients with chronic renal failure complicated with renal bone disease and soft tissue/vascular calcification. In dialysis patients with severe SHPT, medical treatment may fail and parathyroidectomy (PTX) is indicated for definitive treatment. Severe hypocalcemia from hungry bone disease or postoperative hypoparathyroidism may occur during the postoperative period. We report here a case of severe SHPT in a hemodialysis patient treated with phosphate binders, calcitriol, and calcimimetics but who still required PTX...
2017: Blood Purification
https://www.readbyqxmd.com/read/28869934/typical-hemodialysis-in-india-a-case-report
#12
Georgi Abraham, Madhusudan Vijayan, Milly Mathew
We report here a typical case of a patient on hemodialysis (HD) for end-stage renal disease (ESRD) in India that highlights some of the management issues encountered in a country with an enormous burden of ESRD and major challenges of underdialysis and management of comorbidities. The patient, a 42-year-old multiparous woman with chronic kidney disease (CKD) stage V, type 2 diabetes mellitus, and hypertension is a homemaker from a middle-class family, living in a large city, with no family history of CKD. From May 2013 to December 2016, she has been receiving twice-weekly maintenance HD for 4 h (intermittent HD); access was via an internal jugular line initially and then via a left brachiocephalic arteriovenous fistula (AVF) from late June 2013...
2017: Blood Purification
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#13
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28856008/when-crrt-on-ecmo-is-not-enough-for-potassium-clearance-a-case-report
#14
Janice A Tijssen, Guido Filler
BACKGROUND: Continuous renal replacement therapy (CRRT) is an excellent method used to remove fluid and solutes. It may also reduce the systemic inflammatory response for patients on extracorporeal membrane oxygenation (ECMO) support. The objective of this report is to describe a case where CRRT in combination with ECMO was insufficient to control hyperkalemia. METHODS: We report the case of an adolescent patient with refractory symptomatic hyperkalemia due to substantial rhabdomyolysis in which CRRT insufficiently cleared the patient's excess potassium...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28828726/levetiracetam-pharmacokinetics-in-a-critically-ill-anephric-patient-on-intermittent-hemodialysis
#15
Patrick M Wieruszewski, Kianoush B Kashani, Alejandro A Rabinstein, Erin Frazee
BACKGROUND: In patients requiring hemodialysis, the extracorporeal circuit is expected to remove the majority of serum levetiracetam. The preferred levetiracetam dosing regimen in critically ill patients exhibiting complex pharmacokinetic profiles undergoing hemodialysis is unknown. The objective of this case is to describe levetiracetam pharmacokinetics in a critically ill anephric patient receiving intermittent hemodialysis. METHODS: This is a case report of a single patient...
August 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28812394/the-use-of-sustained-low-efficiency-dialysis-sled-in-massive-paracetamol-overdose
#16
Anselm Wong, Roger L K Tong, Liam Ryan, Tim Crozier, Andis Graudins
CONTEXT: Massive paracetamol ingestion causing mitochondrial dysfunction is uncommon. Use of sustained low-efficiency dialysis (SLED) to improve acidaemia and enhance paracetamol elimination has not been previously described. CASE DETAILS: A 44-year-old male presented to the emergency department 2.5 hours post overdose of 200 g (2.5 g/kg) of paracetamol. Examination revealed a BP 85/60 mmHg, pulse 112 bpm, temperature 33.9 °C and blood glucose of 13...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28796408/use-of-the-anion-gap-and-intermittent-hemodialysis-following-continuous-hemodiafiltration-in-extremely-high-dose-acute-on-chronic-lithium-poisoning-a-case-report
#17
Yohei Komaru, Ryota Inokuchi, Yoshihiro Ueda, Masaomi Nangaku, Kent Doi
A 35-year-old woman intentionally took 40,000 mg of lithium carbonate, and she was transferred to our hospital with nausea, vomiting, and diarrhea. She was diagnosed as having bipolar disorder 10 years ago and was receiving oral lithium therapy. Blood test results on arrival were remarkable for a negative anion gap of -2.1 and later, the serum lithium level turned out to be as high as 15.4 mEq/L. Intubation was required because of disrupted consciousness, and continuous hemodiafiltration (CHDF) was immediately started in the intensive care unit to obtain constant removal of lithium...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28779790/management-of-renal-dysfunction-in-patients-with-liver-cirrhosis-role-of-pretransplantation-hemodialysis-and-outcomes-after-liver-transplantation
#18
REVIEW
Ashok Thorat, Long-Bin Jeng
Patients with end-stage liver disease (ESLD) who develop hepatorenal syndrome (HRS) have very high mortality rates. For patients with HRS type I, median survival without specific therapy is only 2 weeks. Due to worsening clinical condition in such patients secondary to uremia and hepatic disease, some form of renal replacement therapy (RRT), either intermittent hemodialysis IHD or continuous veno-venous hemodialysis (CVVHD), must be instituted. However, the literature regarding the survival benefits of the hemodialysis for the worsening renal failure in liver cirrhotic patients remains limited...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28762237/aminoglycoside-impregnated-cement-spacer-precipitating-acute-kidney-injury-requiring-hemodialysis
#19
Sohail Abdul Salim, Jessica Everitt, Aaron Schwartz, Mohit Agarwal, Jorge Castenada, Tibor Fülöp, Luis A Juncos
The current standard of care for prosthetic joint infection includes two-stage arthroplasty, with antibiotic-impregnated cement spacers (ACS) utilized between the stages. We report a 75-year-old woman with previously normal renal function, who developed acute kidney injury (AKI) secondary to biopsy-proven acute tubular necrosis and acute interstitial nephritis after ACS placement containing tobramycin and vancomycin. Peak tobramycin level measured 25.3 mcg/mL, the highest value reported in the literature after ACS placement...
July 31, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28730555/intermittent-versus-continuous-renal-replacement-therapy-in-acute-methanol-poisoning-comparison-of-clinical-effectiveness-in-mass-poisoning-outbreaks
#20
Sergey Zakharov, Jan Rulisek, Olga Nurieva, Katerina Kotikova, Tomas Navratil, Martin Komarc, Daniela Pelclova, Knut Erik Hovda
BACKGROUND: Intermittent hemodialysis (IHD) is the modality of choice in the extracorporeal treatment (ECTR) of acute methanol poisoning. However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown. During an outbreak of mass methanol poisoning, we therefore studied the effect of IHD versus CRRT on mortality and the prevalence of visual/central nervous system (CNS) sequelae in survivors. METHODS: The study was designed as prospective observational cohort study...
December 2017: Annals of Intensive Care
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