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Renal replacement therapy

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https://www.readbyqxmd.com/read/28913589/estimating-renal-function-in-old-people-an-in-depth-review
#1
REVIEW
Maharajan Raman, Rachel J Middleton, Philip A Kalra, Darren Green
Estimates of glomerular filtration rate (eGFR) should provide accurate measure of an individual's kidney function because important clinical decisions such as timing of renal replacement therapy and drug dosing may be dependent on eGFR. Formulae from which eGFR is derived are generally based on serum creatinine measurement, such as Cockcroft-Gault, MDRD and CKD-EPI. More recently, calculation of eGFR using other laboratory biomarkers such as cystatin C has emerged with apparent greater accuracy. In old people, there is age-related physiological change in the kidney, which could lead to reduced GFR...
September 15, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28912860/effects-of-hv-crrt-on-pct-tnf-%C3%AE-il-4-il-6-il-8-and-il-10-in-patients-with-pancreatitis-complicated-by-acute-renal-failure
#2
Changbo Liu, Mu Li, Shixiong Cao, Jianzhong Wang, Xiaoqiong Huang, Weizhen Zhong
The aim of the study was to investigate the effects of high-volume continuous renal replacement therapy (HV-CRRT) on procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, IL-8 and IL-10 in acute pancreatitis complicated by acute renal failure. Eighty-six patients with acute pancreatitis complicated with acute renal failure were selected from September 2014 to September 2016 in our hospital, and were treated by continuous veno-venous hemofiltration (CVVH). The patients were randomly divided into the observation group, treated by the HV-CVVH model with a displacement rate of 4 l/h, and the control group, treated by the normal capacity model with a displacement rate of 2 l/h...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28912532/chronic-kidney-disease-is-associated-with-poorer-in-hospital-outcomes-in-patients-hospitalized-with-infections-electronic-record-analysis-from-china
#3
Guobin Su, Hong Xu, Gaetano Marrone, Bengt Lindholm, Zehuai Wen, Xusheng Liu, Juan-Jesus Carrero, Cecilia Stålsby Lundborg
Predominantly based on studies from high-income countries, reduced estimated glomerular filtration rate (eGFR) has been associated with increased risk of infections and infection-related hospitalizations (IRHs). We here explore in-hospital outcomes of IRHs in patients with different kidney function. A total of 6,283 adults, not on renal replacement therapy, with a discharge diagnosis of infection, and with an eGFR 1-12 months before index hospitalization, were included from four hospitals in China. We compared in-hospital outcomes (death, intensive care unit (ICU) admission, length of hospital stay (LOHS) and medical expenses), between patients with and without chronic kidney disease (CKD, defined as eGFR ≤ 60 ml/min per 1...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28910794/membrane-innovation-in-dialysis
#4
Adriana Boschetti-de-Fierro, Werner Beck, Helmut Hildwein, Bernd Krause, Markus Storr, Carina Zweigart
Despite advances in renal replacement therapy, the adequate removal of uremic toxins over a broad molecular weight range remains one of the unmet needs in hemodialysis. Therefore, membrane innovation is currently directed towards enhanced removal of uremic toxins and increased membrane permeability. This chapter presents a variety of opportunities where innovation is brought into dialysis membranes. It covers the membrane formation from solution, describing different approaches to control the phase inversion process through additives that either swell in the polymer solution or influence the pore shrinkage during the membrane drying process...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910789/end-stage-renal-disease-inflammation-and-cardiovascular-outcomes
#5
Lu Dai, Edyta Golembiewska, Bengt Lindholm, Peter Stenvinkel
Despite marked improvements in renal replacement therapy during the last 30 years, the age-adjusted mortality rate in end-stage renal disease (ESRD) patients is still unacceptably high and comparable to that of many malignancies. Cardiovascular disease (CVD) remains the major cause of morbidity and mortality in ESRD patients. However, traditional risk factors can only partially explain the high premature cardiovascular burden in this population. Nontraditional risk factors, including persistent low-grade inflammation, are critical in the pathogenesis of atherosclerosis, vascular calcification, and other causes of CVD and may also contribute to protein-energy wasting and other complications in chronic kidney disease (CKD) patients...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28906404/ticagrelor-induced-life-threatening-bleeding-via-the-cyclosporine-mediated-drug-interaction-a-case-report
#6
Chi Zhang, Long Shen, Min Cui, Xiaoyan Liu, Zhichun Gu
RATIONALE: Ticagrelor has become one of the first-line antiplatelet agents in acute coronary syndrome (ACS) patients recommend by the guideline due to its more potent and predictable antiplatelet effect. However, bleeding is still a severe drug adverse reaction of ticagrelor therapy. We report a first case on ticagrelor-induced life-threatening bleeding via the cyclosporine-mediated drug interaction. PATIENT CONCERNS: A 58-year-old Chinese male who received cyclosporine 200 mg daily 5 years after renal transplantation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906362/are-we-ever-too-old-characteristics-and-outcome-of-octogenarians-admitted-to-a-medical-intensive-care-unit
#7
Johanna Maria Muessig, Maryna Masyuk, Amir Movahed Nia, Marcus Franz, Bjoern Kabisch, Malte Kelm, Christian Jung
The aging population increases the demand of intensive care unit (ICU) treatments. However, the availability of ICU beds is limited. Thus, ICU admission of octogenarians is considered controversial. The population above 80 years is a very heterogeneous group though, and age alone might not be the best predictor. Aim of this study was to analyze resource consumption and outcome of octogenarians admitted to a medical ICU to identify reliable survival predictors in a senescent society.This retrospective observational study analyzes 930 octogenarians and 5732 younger patients admitted to a medical ICU...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28904876/heart-rate-is-associated-with-mortality-in-patients-undergoing-continuous-renal-replacement-therapy
#8
Soojin Lee, Yeonhee Lee, Heejoon Jang, Hongran Moon, Dong Ki Kim, Seung Seok Han
BACKGROUND: Heart rate (HR) is an essential vital sign based on the finding that HR beyond its normal range is associated with several conditions or diseases, including high mortality in several clinical settings. Nevertheless, the clinical implications of HR remain unresolved in patients undergoing continuous renal replacement therapy (CRRT). METHODS: This retrospective cohort study included 828 patients who underwent CRRT due to acute kidney injury between 2010 and 2014...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28904875/the-influence-of-hypophosphatemia-on-outcomes-of-low-and-high-intensity-continuous-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#9
Soo Young Kim, Ye Na Kim, Ho Sik Shin, Yeonsoon Jung, Hark Rim
BACKGROUND: The purpose of this study was to assess the role of hypophosphatemia in major clinical outcomes of patients treated with low- or high-intensity continuous renal replacement therapy (CRRT). METHODS: We performed a retrospective analysis of data collected from 492 patients. We divided patients into two CRRT groups based on treatment intensity (greater than or equal to or less than 40 mL/kg/hour of effluent generation) and measured serum phosphate level daily during CRRT...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28904487/hemodialysis-for-lactic-acidosis
#10
N Karthiraj, Nagarajan Ramakrishnan, Ashwin K Mani
Lactic acidosis (Type A) is common in critically ill patients and usually treated by correcting the underlying etiology. We present the case of a young female who presented with life-threatening lactic acidosis secondary to hematological malignancy. Timely initiation of hemodialysis was lifesaving. The case highlights the importance of considering Type B lactic acidosis (in this case secondary to a hematological malignancy) and also initiating renal replacement therapy when routine measures are ineffective.
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904443/to-compare-acute-peritoneal-dialysis-with-sustained-low-efficiency-dialysis-in-critically-ill-patients-requiring-renal-replacement-therapy
#11
B Datt, R Ramachandran, N Sharma, V Kumar, M Rathi, H S Kohli, V Jha, K L Gupta
No abstract text is available yet for this article.
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#12
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
September 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28901791/determinants-of-1-year-survival-in-critically-ill-acute-leukemia-patients-a-grrr-oh-study
#13
Márcio Tavares, Virginie Lemiale, Djamel Mokart, Frédéric Pène, Etienne Lengliné, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Anne-Pascale Meert, Dominique Benoit, Michael Darmon, Elie Azoulay
Acute leukemia (AL) is the most common hematological malignancy requiring intensive care unit (ICU) management. Data on long-term survival are limited. This is a post hoc analysis of the prospective multicenter data from France and Belgium: A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique [A Research Group on Acute Respiratory Failure in Onco-Hematological Patients (French)] Study, to identify determinants of 1-year survival in critically ill AL patients. A total of 278 patients were admitted in the 17 participating ICUs...
September 13, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28900774/readmission-rate-after-ultrafiltration-in-acute-decompensated-heart-failure-a-systematic-review-and-meta-analysis
#14
REVIEW
Waqas Javed Siddiqui, Andrew R Kohut, Syed F Hasni, Jesse M Goldman, Benjamin Silverman, Ellie Kelepouris, Howard J Eisen, Sandeep Aggarwal
Significance of ultrafiltration in acute decompensated heart failure remains unclear. We performed meta-analysis to determine its role in reducing readmissions after acute decompensated heart failure. MEDLINE was searched using PUBMED from inception to March 22, 2017 for prospective randomized control trials comparing ultrafiltration to diuretics in acute decompensated heart failure. Five hundred ninety studies were found; nine studies with 820 patients were included. Studies with renal replacement therapy bar ultrafiltration, chronic decompensated heart failure, and non-English language were excluded...
September 13, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28899601/baclofen-toxicity-in-kidney-disease
#15
Erin Wolf, Niraj R Kothari, John K Roberts, Matthew A Sparks
Baclofen, a commonly prescribed muscle relaxant, is primarily excreted via the kidneys; toxicity is a potentially serious adverse outcome in patients with decreased kidney function. We describe a patient with end-stage kidney disease receiving hemodialysis who developed neurotoxicity and hemodynamic instability after receiving baclofen for muscle spasms. In this case, prompt recognition of baclofen toxicity and urgent hemodialysis were effective in reversing this toxicity. This case is used to examine the pharmacokinetics and pathophysiology of baclofen toxicity and discuss appropriate diagnosis and management of baclofen toxicity...
September 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28898616/the-calcium-phosphorus-homeostasis-in-chronic-kidney-disease-from-clinical-epidemiology-to-pathophysiology
#16
Ana Pires, Luis Sobrinho, Hugo Gil Ferreira
INTRODUCTION: A simple data filtering process together with some basic concepts of control theory applied to electronically stored clinical data were used to identify some of the pathophysiological mechanisms underlying the perturbations of the calcium/phosphorus homeostasis in chronic kidney disease. MATERIAL AND METHODS: Retrospective data (a set per patient of serum single value concentrations of creatinine, calcium, phosphorus, parathormone, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D) from 2507 patients with stable chronic kidney disease not on renal replacement therapy were studied...
June 30, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28898482/impact-of-renal-replacement-therapy-on-survival-in-patients-with-kdigo-stage-3-acute-kidney-injury-a-propensity-score-matched-analysis
#17
Hoi-Ping Shum, King-Chung Chan, Catherine Wing-Yan Tam, Wing-Wa Yan, Tak Mao Chan
PURPOSE: To investigate the impact of renal replacement therapy (RRT) on 90-day mortality in critically ill patients suffering from KDIGO stage 3 acute kidney injury (AKI) with or without life-threatening complications using propensity score matching analysis. MATERIAL AND METHODS: We conducted a retrospective analysis of critically ill adult patients with KDIGO Stage 3 AKI with or without RRT during ICU stay between 1/1/2011-31/12/2013. Cox regression analysis and propensity score matching methods were used to determine predictors for 90-day mortality...
September 12, 2017: Nephrology
https://www.readbyqxmd.com/read/28895871/type-i-interferons-in-the-pathogenesis-and-treatment-of-canine-diseases
#18
REVIEW
Daniela Klotz, Wolfgang Baumgärtner, Ingo Gerhauser
Type I interferons (IFNs) such as IFN-α, IFN-β, IFN-ε, IFN-κ, and IFN-ω represent cytokines, which are deeply involved in the regulation and activation of innate and adaptive immune responses. They possess strong antiviral, antiproliferative, and immunomodulatory activities allowing their use in the therapy of different viral diseases, neoplasms, and immune-mediated disorders, respectively. Initially, treatment strategies were based on nonspecific inducers of type I IFNs, which were soon replaced by different recombinant proteins...
September 2017: Veterinary Immunology and Immunopathology
https://www.readbyqxmd.com/read/28895161/therapeutic-drug-monitoring-of-antitubercular-agents-for-disseminated-mycobacterium-tuberculosis-during-intermittent-haemodialysis-and-continuous-venovenous-haemofiltration
#19
J H Sin, R H Elshaboury, R M Hurtado, A R Letourneau, R G Gandhi
WHAT IS KNOWN AND OBJECTIVE: There is a lack of data regarding therapeutic drug monitoring (TDM) of antitubercular agents in the setting of continuous venovenous haemofiltration (CVVH). We describe TDM results of numerous antitubercular agents in a critically ill patient during CVVH and haemodialysis. CASE SUMMARY: A 49-year-old man was initiated on treatment for disseminated Mycobacterium tuberculosis. During hospital admission, the patient developed critical illness and required renal replacement therapy...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28894410/life-threatening-dyskalaemia-after-barbiturate-coma-therapy-the-strategy-of-management
#20
Yeap Boon Tat, Wan Mohd Nazaruddin Wan Hassan, Ting Yung Chuen, Abdul Rahman Izaini Ghani
Barbiturate coma therapy (BCT) is a treatment option that is used for refractory intracranial hypertension after all other options have been exhausted. Although BCT is a brain protection treatment, it also has several side effects such as hypotension, hepatic dysfunction, renal dysfunction, respiratory complications and electrolyte imbalances. One less concerning but potentially life-threatening complication of BCT is dyskalaemia. This complication could present as severe refractory hypokalaemia during the therapy with subsequent rebound hyperkalaemia after cessation of the therapy...
March 2017: Malaysian Journal of Medical Sciences: MJMS
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