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Renal replacement therapy

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https://www.readbyqxmd.com/read/28332157/systematic-overdosing-of-oxa-and-cloxacillin-in-severe-infections-treated-in-icu-risk-factors-and-side-effects
#1
Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit, Bruno Mourvillier
BACKGROUND: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects. METHODS: All patients with a therapeutic drug monitoring of oxa- or cloxacillin between 2008 and 2014 were included...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28329336/remote-ischaemic-preconditioning-reduces-acute-kidney-injury-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-meta-analysis
#2
Bin Yi, Xiang Chen, Han Shi, Tiao Lin, Haifeng Lin, Yi Xu, Jian Rong
This article represents the first attempt to perform a pooled analysis about remote ischaemic preconditioning (RIPC) in reduction of acute kidney injury (AKI) of adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A systematic search was performed using PubMed (1966-5 January 2016), the Cochrane Library (1996-5 January 2016), the Web of Science (1986-5 January 2016) and Chinese database (SinoMed) (1978-5 January 2016) to identify studies that have described the effect of RIPC on AKI in adult patients undergoing cardiac surgery with CPB...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329026/the-effect-of-early-versus-late-initiation-of-renal-replacement-therapy-in-patients-with-acute-kidney-injury-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#3
Yan-Mei Feng, Yuan Yang, Xiao-Li Han, Fan Zhang, Dong Wan, Rui Guo
BACKGROUND: The optimal timing for initiating renal replacement therapy (RRT) in patients with acute kidney injury (AKI) remains controversial. METHODS: We conducted a meta-analysis with trial sequential analysis (TSA) of randomized controlled trials (RCTs) using PUBMED, Cochrane Library databases, and Web of Science (from January 1, 1985, to August 21, 2016). Adult patients with AKI who received RRT with different timing were included. The primary outcome was mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28327551/genomic-reprograming-analysis-of-the-mesothelial-to-mesenchymal-transition-identifies-biomarkers-in-peritoneal-dialysis-patients
#4
Vicente Ruiz-Carpio, Pilar Sandoval, Abelardo Aguilera, Patricia Albar-Vizcaíno, María Luisa Perez-Lozano, Guadalupe T González-Mateo, Adrián Acuña-Ruiz, Jesús García-Cantalejo, Pedro Botías, María Auxiliadora Bajo, Rafael Selgas, José Antonio Sánchez-Tomero, Jutta Passlick-Deetjen, Dorothea Piecha, Janine Büchel, Sonja Steppan, Manuel López-Cabrera
Peritoneal dialysis (PD) is an effective renal replacement therapy, but a significant proportion of patients suffer PD-related complications, which limit the treatment duration. Mesothelial-to-mesenchymal transition (MMT) contributes to the PD-related peritoneal dysfunction. We analyzed the genetic reprograming of MMT to identify new biomarkers that may be tested in PD-patients. Microarray analysis revealed a partial overlapping between MMT induced in vitro and ex vivo in effluent-derived mesothelial cells, and that MMT is mainly a repression process being higher the number of genes that are down-regulated than those that are induced...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28326675/utilization-and-outcomes-of-transcatheter-aortic-valve-replacement-in-the-united-states-shortly-after-device-approval
#5
Michael N Young, Sammy Elmariah, Kevin F Kennedy, Ignacio Inglessis, Robert W Yeh
OBJECTIVE: The objective of this study was to assess the national uptake of TAVR, associated in-hospital outcomes, and the effect of procedural experience on outcomes in the first two years following device approval. BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a newly established therapy for high-risk patients with severe aortic stenosis. Evaluating the manner in which TAVR has disseminated into real-world practice is essential for understanding its impact on population health...
March 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28326146/effects-of-continuous-and-intermittent-renal-replacement-therapies-among-adult-patients-with-acute-kidney-injury
#6
Tonio Schoenfelder, Xiaoyu Chen, Hans-Holger Bleß
Background: Dialysis-dependent acute kidney injury (AKI) can be treated using continuous (CRRT) or intermittent renal replacement therapies (IRRT). Although some studies suggest that CRRT may have advantages over IRRT, study findings are inconsistent. This study assessed differences between CRRT and IRRT regarding important clinical outcomes (such as mortality and renal recovery) and cost-effectiveness. Additionally, ethical aspects that are linked to renal replacement therapies in the intensive care setting are considered...
2017: GMS Health Technology Assessment
https://www.readbyqxmd.com/read/28325788/decompression-illness-with-hypovolemic-shock-and-neurological-failure-symptoms-after-two-risky-dives-a-case-report
#7
Sebastian Klapa, Johannes Meyne, Wataru Kähler, Frauke Tillmans, Henning Werr, Andreas Binder, Andreas Koch
Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28322169/potential-therapeutic-strategies-of-regenerative-medicine-for-renal-failure
#8
Monica Maribel Mata-Miranda, Raul Jacobo Delgado-Macuil, Marlon Rojas-Lopez, Ricardo Martinez-Flores, Gustavo Jesus Vazquez-Zapien
Kidney diseases are a public health problem worldwide; the mortality rate is between 50 and 80%. Available therapies include replacement function by dialysis or transplant, associated with a high morbidity and mortality; kidney transplantation is limited by the shortage of donor organs, immune rejection and lifelong treatment with immunosuppressive. Likewise, none of these treatments compensates all kidney functions. There is a great concern in developing more effective therapies with the ability to replace the wide range of renal functions, so that, new researches on developing therapeutic strategies have focused on regenerative medicine, science that includes artificial creation of tissues and organs, in order to repair or replace a tissue or organ function...
March 17, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28321803/prognosis-of-cirrhotic-patients-admitted-to-intensive-care-unit-a-meta-analysis
#9
Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier, Vincent Di Martino
BACKGROUND: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. METHODS: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28320366/cardiovascular-risk-is-similar-in-patients-with-glomerulonephritis-compared-to-other-types-of-chronic-kidney-disease-a-matched-cohort-study
#10
Holly L Hutton, Adeera Levin, Jagbir Gill, Ognjenka Djurdjev, Mila Tang, Sean J Barbour
BACKGROUND: Patients with chronic kidney disease (CKD) due to glomerulonephritis (GN) are thought to be at high risk for cardiovascular disease (CVD). However, no study has examined whether GN directly contributes to CV risk beyond the effects conferred by pre-existing traditional risk factors and level of renal function. METHODS: Matched cohort study using the previously described prospective CanPREDDICT study cohort. 2187 patients with CKD (eGFR 15-45 ml/min/m(2)) from 25 Canadian centres were divided into GN vs non-GN cause of CKD...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28320333/delta-neutrophil-index-is-an-independent-predictor-of-mortality-in-septic-acute-kidney-injury-patients-treated-with-continuous-renal-replacement-therapy
#11
In Mi Han, Chang-Yun Yoon, Dong Ho Shin, Youn Kyung Kee, Seung Gyu Han, Young Eun Kwon, Kyoung Sook Park, Mi Jung Lee, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Tae-Hyun Yoo
BACKGROUND: Delta neutrophil index (DNI), representing an elevated fraction of circulating immature granulocytes in acute infection, has been reported as a useful marker for predicting mortality in patients with sepsis. The aim of this study was to evaluate the prognostic value of DNI in predicting mortality in septic acute kidney injury (S-AKI) patients treated with continuous renal replacement therapy (CRRT). METHOD: This is a retrospective analysis of consecutively CRRT treated patients...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28320238/early-renal-replacement-therapy-versus-standard-care-in-the-icu
#12
Dipayan Chaudhuri, Brent Herritt, Daren Heyland, Louis-Philippe Gagnon, Kednapa Thavorn, Daniel Kobewka, Kwadwo Kyeremanteng
OBJECTIVE: Renal replacement therapy (RRT) is the treatment of choice for severe acute kidney injury, but there are no firm guidelines as to the time of initiation of RRT in the critically ill. The primary objective of this study is to determine 1-month mortality rates of early versus late dialysis in critical care. As secondary end points, we provide a cost analysis of early versus late RRT initiation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and number of patients on dialysis at day 60 postrandomization...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28319494/heparin-binding-protein-hbp-a-causative-marker-and-potential-target-for-heparin-treatment-of-human-sepsis-induced-acute-kidney-injury
#13
Jane Fisher, James A Russell, Peter Bentzer, Devyn Parsons, Stefano Secchia, Matthias Mörgelin, Keith R Walley, John H Boyd, Adam Linder
RATIONALE: Sepsis-induced acute kidney injury (AKI) is a common condition with high morbidity and mortality. Neutrophil-derived heparin-binding protein (HBP) induces vascular leakage and is a promising biomarker of sepsis-induced organ dysfunction. It remains unknown if HBP is prognostic of AKI in septic shock and if HBP could play a role in the pathophysiology of sepsis-induced AKI. OBJECTIVES: To determine the association of plasma HBP levels with development of AKI, investigate the role of HBP in the pathophysiology of sepsis-induced AKI, and test the effect of blocking HBP using heparin derivatives...
March 17, 2017: Shock
https://www.readbyqxmd.com/read/28318663/dipeptidyl-peptidase-iv-in-chronic-heart-failure-with-reduced-ejection-fraction
#14
Patrícia Lourenço, Sérgio Silva, Filipe Cunha, Joana Pereira, Ana Ribeiro, Nuno Silva, João Tiago Guimarães, José Paulo Araújo, Paulo Bettencourt
BACKGROUND: An association between dipeptidyl peptidase-IV (DPP-IV) inhibitors with worse prognosis in HF has been suggested. We aimed to assess the serum DPP-IV levels in chronic stable HF patients and determine their association with prognosis. METHODS AND RESULTS: Chronic stable HF patients with optimized prognostic-modifying therapy were prospectively recruited. EXCLUSION CRITERIA: 1) ejection fraction>50%, 2) hospitalizations or therapeutic adjustments in the previous 2months; 3) patients on renal replacement therapy, and 4) use of DPP-IV inhibitors...
March 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318621/early-peritoneal-dialysis-reduces-lung-inflammation-in-mice-with-ischemic-acute-kidney-injury
#15
Chris Altmann, Nilesh Ahuja, Carol M Kiekhaefer, Ana Andres Hernando, Kayo Okamura, Rhea Bhargava, Jane Duplantis, Lara A Kirkbride-Romeo, Jill Huckles, Benjamin M Fox, Kashfi Kahn, Danielle Soranno, Hyo-Wook Gil, Isaac Teitelbaum, Sarah Faubel
Although dialysis has been used in the care of patients with acute kidney injury (AKI) for over 50 years, very little is known about the potential benefits of uremic control on systemic complications of AKI. Since the mortality of AKI requiring renal replacement therapy (RRT) is greater than half in the intensive care unit, a better understanding of the potential of RRT to improve outcomes is urgently needed. Therefore, we sought to develop a technically feasible and reproducible model of RRT in a mouse model of AKI...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28316276/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery
#16
Rajendra H Mehta, Jeffrey D Leimberger, Sean van Diepen, James Meza, Alice Wang, Rachael Jankowich, Robert W Harrison, Douglas Hay, Stephen Fremes, Andra Duncan, Edward G Soltesz, John Luber, Soon Park, Michael Argenziano, Edward Murphy, Randy Marcel, Dimitri Kalavrouziotis, Dave Nagpal, John Bozinovski, Wolfgang Toller, Matthias Heringlake, Shaun G Goodman, Jerrold H Levy, Robert A Harrington, Kevin J Anstrom, John H Alexander
Background Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. Methods In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the efficacy and safety of levosimendan in patients with a left ventricular ejection fraction of 35% or less who were undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients were randomly assigned to receive either intravenous levosimendan (at a dose of 0...
March 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28315623/a-case-report-of-cholinergic-crisis-evolved-from-myasthenia-gravis-due-to-the-tumor-in-trigone-of-bladder
#17
(no author information available yet)
Cholinergic crisis has rarely been reported as a complication of myasthenia gravis, wherein it mainly occurs as a result of the improper accumulation of anticholinesterase agents. In this report, we present one such case. The nature of the patient's clinical manifestations suggested that the main reason for the cholinergic crisis was the abnormal accumulation of pyridostigmine bromide due to renal failure, which was secondary to a tumor in trigeon of bladder. To the best of our knowledge, this is the first report of myasthenia gravis leading to cholinergic crisis caused by acute postrenal renal failure arising from the bladder neoplasm...
November 19, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28302661/severe-co-trimoxazole-induced-hypoglycaemia-in-a-patient-with-microscopic-polyangiitis
#18
Thomas Edward Conley, Atif Mohiuddin, Noshaba Naz
A 69-year-old man presented to the emergency department with lower respiratory tract infection and febrile neutropaenia. He was recently discharged following a 50-day hospital stay with newly diagnosed microscopic polyangiitis, complicated by pulmonary haemorrhage and severe renal dysfunction requiring renal replacement therapy, plasma exchange and immunosuppression (cyclophosphamide and methylprednisolone). High risk of pneumocystis pneumonia (PCP) led to an escalation in treatment from prophylactic to therapeutic oral co-trimoxazole, alongside broad-spectrum antibiotics...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#19
Matthew W Semler, Wesley H Self, Li Wang, Daniel W Byrne, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Avinash B Kumar, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown. METHODS: The Isotonic Solutions and Major Adverse Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28298669/veno-venous-extracorporeal-membrane-oxygenation-for-continuous-renal-replacement-in-a-neonate-with-propionic-acidemia
#20
Jeffrey W Gander, Erika T Rhone, William G Wilson, John P Barcia, Melissa J Sacco
The usual indications for extra corporeal membrane oxygenation (ECMO) are for respiratory or cardiac failure. Although continuous renal replacement therapy (CRRT) is frequently used when patients are on ECMO, the need for CRRT as the primary indication for ECMO is rare. A case of a neonate placed onto veno-venous ECMO for the use of CRRT to treat hyperammonemia from propionic acidemia is presented.
March 2017: Journal of Extra-corporeal Technology
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