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Dialysis, pediatric

Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Allison Redpath Mahon, Alicia M Neu
Peritonitis is a leading cause of hospitalizations, morbidity, and modality change in pediatric chronic peritoneal dialysis (CPD) patients. Despite guidelines published by the International Society for Peritoneal Dialysis aimed at reducing the risk of peritonitis, registry data have revealed significant variability in peritonitis rates among centers caring for children on CPD, which suggests variability in practice. Improvement science methods have been used to reduce a variety of healthcare-associated infections and are also being applied successfully to decrease rates of peritonitis in children...
October 18, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Shatha Hussain Ali, Salman Hussain Assi, Fadhil S Hussien
Hypertension (HTN) is one of the most common sequelae of chronic kidney disease (CKD) in children. Dialysis-related HTN is predominantly caused by chronic volume overload, and as such the blood pressure (BP) can be reduced and/or brought down to normal in a sizable number of patients with improved salt and fluid balance. This study was conducted to assess the prevalence of HTN among children on hemodialysis (HD) and to evaluate the correlation of HTN with some demographic data. This is a prospective study performed on forty pediatric patients with CKD receiving maintenance HD in three centers in Baghdad...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Priya S Verghese
Successful renal transplantation is the optimal treatment for chronic kidney failure, but this was not always so for children. Beginning with the first kidney transplants in the 1950s, children experienced poorer patient and graft survival rates than adult patients. But over the last 6 decades, an improved understanding of the immune system which has steered pediatric multi-center clinical / pharmacokinetic and mechanistic studies that have sculpted our immunosuppression with markedly better patient and graft survivals...
October 12, 2016: Pediatric Research
Fabio Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Mariana Nadal Cardoso, Gledson Luiz Picharski, Gregory Jaeger, Marion Burger
OBJECTIVE: To evaluate risk factors associated with death due to bloodstream infection caused by Candida spp. in pediatric patients and evaluate the resistance to the main anti-fungal used in clinical practice. METHODS: This is a cross-sectional, observational, analytical study with retrospective collection that included 65 hospitalized pediatric patients with bloodstream infection by Candida spp. A univariate analysis was performed to estimate the association between the characteristics of the candidemia patients and death...
October 3, 2016: Jornal de Pediatria
Anne M Kouri, Sharon P Andreoli
BACKGROUND: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a small- and medium-sized vasculitis classically seen in adult patients, with peak onset near the fifth to seventh decade of life. There is little data on ANCA-associated vasculitis in pediatric patients, and most studies have limited follow-up. METHODS: This is a retrospective chart review of 22 patients with ANCA-positive glomerulonephritis in a single institution from 1991 to 2013...
September 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
John Dotis, Antigoni Pavlaki, Nikoleta Printza, Stella Stabouli, Stamatia Antoniou, Chrysa Gkogka, Nikolaos Kontodimopoulos, Fotios Papachristou
BACKGROUND: Progressive chronic kidney disease (CKD), irrespective of the underlying etiology, affects the quality of life (QoL) of children due to the need for regular follow-up visits, a strict medication program and diet intake. METHODS: The Greek version of the KIDSCREEN-52 multidimensional questionnaire was used in children with CKD, renal transplantation (RT) and in a control group (CG) of healthy children. RESULTS: Fifty-five patients between 8 and 18 years, with CKD (n = 25), RT (n = 16) and with end-stage renal disease (ESRD) on peritoneal dialysis (PD) (n = 14) were included...
September 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Janice Crespo-Salgado, V Matti Vehaskari, Tyrus Stewart, Michael Ferris, Qiang Zhang, Guangdi Wang, Eugene E Blanchard, Christopher M Taylor, Mahmoud Kallash, Larry A Greenbaum, Diego H Aviles
BACKGROUND: End-stage renal disease (ESRD) is associated with uremia and increased systemic inflammation. Alteration of the intestinal microbiota may facilitate translocation of endotoxins into the systemic circulation leading to inflammation. We hypothesized that children with ESRD have an altered intestinal microbiota and increased serum levels of bacterially derived uremic toxins. METHODS: Four groups of subjects were recruited: peritoneal dialysis (PD), hemodialysis (HD), post-kidney transplant and healthy controls...
2016: Microbiome
Nuran Cetın, Nadide M Sav, Duran Karabel, Ali Yildirim, Bilal Yıldız
PURPOSE: Cardiovascular diseases are the main causes of morbidity and mortality in children with end-stage renal disease and the relationships among several relevant potential biomarkers were investigated in pediatric peritoneal dialysis patients. METHODS: Serum homocysteine, von Willebrand factor (vWF), apolipoproteins A and B, lipoprotein-a, high sensitive-CRP, hemoglobin, phosphorus and parathyroid hormone (PTH) levels, systolic (SBP) and diastolic (DBP) blood pressure, carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured in 21 pediatric peritoneal dialysis patients and control subjects...
2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Daniella Levy Erez, Irit Krause, Amit Dagan, Roxana Cleper, Yafa Falush, Miriam Davidovits
Objective. Owing to a shortage of kidney donors in Israel, children with end-stage renal disease (ESRD) may stay on maintenance dialysis for a considerable time, placing them at a significant risk. The aim of this study was to understand the causes of mortality. Study Design. Clinical data were collected retrospectively from the files of children on chronic dialysis (>3 months) during the years 1995-2013 at a single pediatric medical center. Results. 110 patients were enrolled in the study. Mean age was 10...
2016: International Journal of Nephrology
Wai H Lim, Stephen P McDonald, Sean E Kennedy, Nicholas Larkins, Germaine Wong
BACKGROUND AND OBJECTIVE: Delayed graft function (DGF) is associated with an increased risk of graft loss in adult kidney transplant recipients but the association remains inconsistent in pediatric recipients. The aim of this study is to examine the association between DGF and graft loss in pediatric and adolescent deceased donor kidney transplant recipients aged ≤21 years using Australia and New Zealand Dialysis and Transplant (ANZDATA) registry. METHODS: The associations between DGF status, overall and death-censored graft loss (DCGL) were examined using adjusted Cox regression analyses...
August 29, 2016: Transplantation
Djalila Mekahli, Karlijn J van Stralen, Marjolein Bonthuis, Kitty J Jager, Ayşe Balat, Elisa Benetti, Nathalie Godefroid, Vidar O Edvardsson, James G Heaf, Augustina Jankauskiene, Larissa Kerecuk, Svetlana Marinova, Flora Puteo, Tomas Seeman, Aleksandra Zurowska, Jacques Pirenne, Franz Schaefer, Jaap W Groothoff
BACKGROUND: The choice for either kidney or combined liver-kidney transplantation in young people with kidney failure and liver fibrosis due to autosomal recessive polycystic kidney disease (ARPKD) can be challenging. We aimed to analyze the characteristics and outcomes of transplantation type in these children, adolescents, and young adults. STUDY DESIGN: Cohort study. SETTING & PARTICIPANTS: We derived data for children, adolescents, and young adults with ARPKD with either kidney or combined liver-kidney transplants for 1995 to 2012 from the ESPN/ERA-EDTA Registry, a European pediatric renal registry collecting data from 36 European countries...
August 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jessica J Geer, Shweta Shah, Eric Williams, Ayse Akcan Arikan, Poyyapakkam Srivaths
BACKGROUND: Intradialytic hypotension and myocardial stunning are proposed as contributing to the pathogenesis of increased cardiovascular disease burden and death in patients receiving maintenance hemodialysis (HD). Noninvasive cardiac output measurements provide a dynamic, real-time assessment of hemodynamic parameters. We investigated intradialytic changes in hemodynamic parameters in pediatric outpatients receiving chronic HD and determined patient and treatment risk factors associated with such intradialytic changes...
August 23, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Katherine Taylor, Wooheon Thomas Kim, Malak Maharramova, Victor Figueroa, Smruthi Ramesh, Armando Lorenzo
INTRODUCTION: Smaller children are presenting for renal transplantation as the treatment of choice for end-stage renal disease. Adult donor organs are more successful than pediatric deceased donor organs. An adult kidney may sequester ~75% of the circulating volume of a 5 year-old child and requires significantly increased cardiac output to maintain renal perfusion. Treatment includes volume, inotropic or vasopressor agents, or central neuroaxial blockade for sympatholysis. We describe the perioperative anesthestic management as a guide to clinical outcomes...
October 2016: Paediatric Anaesthesia
Maria E Linnaus, Crystal S Langlais, Kevin N Johnson, David M Notrica
INTRODUCTION: Hypertrophic pyloric stenosis is a commonly encountered pediatric surgical issue. Initially treated with open surgical techniques, many pediatric surgeons have adopted the minimally invasive approach using laparoscopy. However, some concerns exist that the rate of incomplete pyloromyotomy is elevated in laparoscopy. We propose a new technique to assess the adequacy of laparoscopic pyloromyotomy. METHODS: Adequacy of laparoscopic pyloromyotomy was assessed by confirming that the top of the serosa on one side of the pylorus has adequate freedom to reach the bottom of the muscle on other side...
August 17, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Connie J Wang, James B Wetmore, Ajay K Israni
As demand for kidney transplant continues to grow faster than organ availability, appropriate allocation of deceased donor kidneys is an acute priority. Increased longevity matching is central to this effort. To foster equitable and efficient utilization of deceased donor kidneys, a new kidney allocation system (KAS) was introduced in December 2014. Major achievements in the 1year after its implementation include a reduction in age-mismatch and an increase in access to transplant for historically disadvantaged candidates, such as those with very high levels of panel-reactive antibodies or long dialysis duration...
August 12, 2016: Human Immunology
Mauro Pittiruti, Sergio Bertoglio, Giancarlo Scoppettuolo, Roberto Biffi, Massimo Lamperti, Alberto Dal Molin, Nicola Panocchia, Nicola Petrosillo, Mario Venditti, Carla Rigo, Enrico DeLutio
BACKGROUND: The most appropriate lock solution for central venous access devices is still to be defined. GAVeCeLT - the Italian group for venous access devices - has developed a consensus on the evidence-based criteria for the choice and the clinical use of the most appropriate lock solution for central venous catheters (excluding dialysis catheters). METHOD: After the constitution of a panel of experts, a systematic collection and review of the literature has been performed, focusing on clinical studies dealing with lock solutions used for prevention of occlusion (heparin, citrate, urokinase, recombinant tissue plasminogen activator [r-TPA], normal saline) or for prevention of infection (citrate, ethanol, taurolidine, ethylene-diamine-tetra-acetic acid [EDTA], vancomycin, linezolid and other antibiotics), in both adults and in pediatric patients...
August 1, 2016: Journal of Vascular Access
Roberto Chimenz, Antonio Lacquaniti, Laura Colavita, Valeria Chirico, Claudia Fede, Michele Buemi, Carmelo Fede
BACKGROUND: Peritonitis, the most important limitation of peritoneal dialysis (PD), could be detected by biomarkers in dialysate effluent, representing a noninvasive method to indirectly assess the peritoneum status. The aim of our study was to test high mobility group box 1 (HMGB1) in PD patients, evaluating its role as precocious marker of peritoneum damage during peritonitis. Transforming growth factor (TGF)-β was correlated with peritoneal transport characteristics. METHODS: Six patients, treated by ambulatory PD, were enrolled...
August 8, 2016: Renal Failure
David S Cooper, David M Kwiatkowski, Stuart L Goldstein, Catherine D Krawczeski
OBJECTIVES: The objectives of this review are to discuss the definition, diagnosis, and pathophysiology of acute kidney injury and its impact on immediate, short-, and long-term outcomes. In addition, the spectrum of cardiorenal syndromes will be reviewed including the pathophysiology on this interaction and its impact on outcomes. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: The field of cardiac intensive care continues to advance in tandem with congenital heart surgery...
August 2016: Pediatric Critical Care Medicine
Morgan B Slater, Andrea Gruneir, Paula A Rochon, Andrew W Howard, Gideon Koren, Christopher S Parshuram
OBJECTIVES: Acute kidney injury may be promoted by critical illness, preexisting medical conditions, and treatments received both before and during ICU admission. We aimed to estimate the frequency of acute kidney injury during ICU treatment and to determine factors, occurring both before and during the ICU stay, associated with the development of acute kidney injury. DESIGN: Cohort study of critically ill children. SETTING: University-affiliated PICU...
September 2016: Pediatric Critical Care Medicine
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