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renal haemodynamics

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https://www.readbyqxmd.com/read/28340239/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#1
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles J Ferro, Jean-Michel Halimi, Gunnar H Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verhaar, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival...
March 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28332265/antidiuretic-and-antinatriuretic-response-to-high-salt-load-in-normotensive-wistar-kyoto-rats-role-of-alpha-1a-adrenoreceptors
#2
R N Kazi, M A Sattar, E J Johns
Altered renal adrenergic responses have been recognized as pathophysiological responses to high salt intake. This study aims to investigate the influence of 6 weeks of high salt diet on α1A -adrenoceptor regulation of renal tubular antinatriuretic and antidiuretic response in normal Wistar Kyoto rats. To achieve the above objective, antinatriuretic and antidiuretic response to phenylephrine was measured in the absence and presence of 5-methylurapidil (5-MeU) using the inulin clearance method. Systemic mean arterial blood pressure and renal haemodynamics were also measured simultaneously...
January 2017: Autonomic & Autacoid Pharmacology
https://www.readbyqxmd.com/read/28329161/surgery-for-prosthetic-valve-endocarditis-a-retrospective-study-of-a-national-registry%C3%A2
#3
Alessandro Della Corte, Michele Di Mauro, Guglielmo Actis Dato, Fabio Barili, Diego Cugola, Sandro Gelsomino, Pasquale Santè, Antonio Carozza, Ester Della Ratta, Lorenzo Galletti, Roger Devotini, Riccardo Casabona, Francesco Santini, Antonio Salsano, Roberto Scrofani, Carlo Antona, Carlo De Vincentiis, Andrea Biondi, Cesare Beghi, Giangiuseppe Cappabianca, Michele De Bonis, Alberto Pozzoli, Francesco Nicolini, Filippo Benassi, Davide Pacini, Roberto Di Bartolomeo, Andrea De Martino, Uberto Bortolotti, Roberto Lorusso, Enrico Vizzardi, Gabriele Di Giammarco, Daniele Marinelli, Emmanuel Villa, Giovanni Troise, Domenico Paparella, Vito Margari, Francesco Tritto, Girolamo Damiani, Giuseppe Scrascia, Salvatore Zaccaria, Attilio Renzulli, Giuseppe Serraino, Giovanni Mariscalco, Daniele Maselli, Alessandro Parolari, Giannantonio Nappi
OBJECTIVES: We described clinical-epidemiological features of prosthetic valve endocarditis (PVE) and assessed the determinants of early surgical outcomes in multicentre design. METHODS: Data regarding 2823 patients undergoing surgery for endocarditis at 19 Italian Centers between 1979 and 2015 were collected in a database. Of them, 582 had PVE: in this group, the determinants of early mortality and complications were assessed, also taking into account the different chronological eras encompassed by the study...
March 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28325445/nonlinear-model-on-pulsatile-flow-of-blood-through-a-porous-bifurcated-arterial-stenosis-in-the-presence-of-magnetic-field-and-periodic-body-acceleration
#4
R Ponalagusamy, S Priyadharshini
BACKGROUND AND OBJECTIVE: Background and Objective: The motivation of cardiovascular modeling is to understand the haemodynamic and mechanical factors in the diagnosis and treatment of cardiovascular diseases. Several investigations have been carried out by many authors to understand the flow properties of blood in modelling blood flows in the circulatory system. In the present article, the pulsatile flow of Herschel-Bulkley fluid through a bifurcated arterial stenosis in a porous medium with magnetic field and periodic body acceleration has been investigated in view of understanding the role of rheological behaviour of blood, stenotic height, bifurcation angle, magnetic field and porosity of wall in the initiation and proliferation of cardiovascular diseases...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28294557/double-blind-randomized-controlled-trial-of-the-routine-peri-operative-use-of-terlipressin-in-adult-living-donor-liver-transplantation
#5
Mettu Srinivas Reddy, Ilankumaran Kaliamoorthy, Akila Rajakumar, Selvakumar Malleeshwaran, Ellango Appuswamy, Sukanya Lakshmi, Joy Varghese, Mohamed Rela
BACKGROUND: Peri-operative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intra-operative portal pressures and improve renal function. Its role and safety profile has never been evaluated in a double-blinded RCT. AIM: To evaluate the haemodynamic effects, clinical benefits and safety of peri-operative terlipressin infusion in adult LDLT. METHODS: This was a single centre double-blind RCT. Consenting adults with chronic liver disease and low risk of post-transplant renal dysfunction (PTRD) undergoing their first LDLT were randomized...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#6
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28263343/percutaneous-endovascular-treatment-to-salvage-non-maturing-arteriovenous-fistulas-in-a-multiethnic-asian-population
#7
Wei Ping Tham, Mark C Burgmans, Bien Soo Tan, Kiang Hong Tay, Farah G Irani, Apoorva Gogna, Ankur Patel, Richard Hg Lo, Siew Ping Chng, Hui Lin Choong, Shaun Xjm Chan
INTRODUCTION: An arteriovenous fistula (AVF) is the preferred method for haemodialysis in patients with end-stage renal failure. Previous studies have shown value in attempting percutaneous transluminal angioplasty (PTA) to salvage AVFs that fail to mature, but they are relatively small in size and mainly reported in Western populations. We reviewed our data of PTA in non-maturing AVFs to establish whether this technique is translatable to our local multiethnic population. MATERIALS AND METHODS: We retrospectively reviewed the medical records and procedural images of 105 patients who had PTA for non-maturing AVFs performed at our department from January 2008 to January 2011...
February 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28250484/effect-of-discontinuing-morning-dose-of-antihypertensive-for-renal-transplant-surgery-on-haemodynamic-and-early-graft-functioning-a-prospective-double-blind-randomised-study
#8
Vinod Kumar, Virendra Kumar Arya, Rakesh V Sondekoppam, Suman Arora, Mukut Minz, Rakesh Garg, Nishkarsh Gupta
BACKGROUND AND AIMS: Antihypertensive drugs are continued until the day of renal transplant surgery. These are associated with increased incidence of hypotension and bradycardia. Hence, this study was designed to evaluate perioperative haemodynamic and early graft functioning in renal recipients with discontinuation of antihypertensive drugs on the morning of surgery. METHODS: This prospective, randomised, double-blind study recruited 120 patients. Group 1 patients received placebo tablet while Group 2 patients received usual antihypertensive drugs on the day of surgery...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28212603/effects-of-renal-denervation-on-cardiac-oxidative-stress-and-local-activity-of-the-sympathetic-nervous-system-and-renin-angiotensin-system-in-acute-myocardial-infracted-dogs
#9
Qiaoli Feng, Chengzhi Lu, Li Wang, Lijun Song, Chao Li, Ravi Chandra Uppada
BACKGROUND: This study sought to evaluate the therapeutic effects of renal denervation (RDN) on acute myocardial infarction (MI) in canines and explore its possible mechanisms of action. METHODS: Eighteen healthy mongrel dogs were randomly assigned to either the control group, the MI group or the MI + RDN group. To assess cardiac function, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD) and fraction shortening (FS) were recorded...
February 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28208979/evaluation-of-the-efficacy-of-bupivacaine-0-5-alone-or-with-clonidine-1%C3%AE-g-kg-versus-control-in-a-single-level-paravertebral-blockin-patients-undergoing-pcnl-procedure
#10
Trupti S Kamble, Charulata Mahesh Deshpande
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is a widely used procedure to remove complex upper tract renal calculi by means of a nephroscope. Although less invasive, PCNL is associated with significant pain owing to soft tissue injury. Most of these patients have mild to moderately compromised renal function. An anaesthesia plan that reduces intraoperative requirement of anaesthetics, analgesics, muscle relaxants and postoperative requirement of systemic analgesics is essential...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28188168/metformin-associated-lactic-acidosis-treated-with-continuous-renal-replacement-therapy
#11
Akihide Nakamura, Kei Suzuki, Hiroshi Imai, Naoyuki Katayama
Metformin-associated lactic acidosis (MALA) is a rare but life-threatening complication. We report a case of MALA in a man aged 71 years who was treated with continuous renal replacement therapy (CRRT). The patient was brought to the hospital for prolonged and gradual worsening gastrointestinal symptoms. Although he received intravenous treatment, he developed catecholamine-resistant shock, and blood gas analysis revealed lactic acidosis. Bicarbonate and antibiotics for possible sepsis were initiated, but with no clear benefit...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28181735/the-innervation-of-the-kidney-in-renal-injury-and-inflammation-a-cause-and-consequence-of-deranged-cardiovascular-control
#12
REVIEW
Mohammed H Abdulla, Edward J Johns
Extensive investigations have revealed that renal sympathetic nerves regulate renin secretion, tubular fluid reabsorption and renal haemodynamics which can impact on cardiovascular homoeostasis normally and in pathophysiological states. The significance of the renal afferent innervation and its role in determining the autonomic control of the cardiovascular system is uncertain. The transduction pathways at the renal afferent nerves have been shown to require pro-inflammatory mediators and TRPV1 channels. Reno-renal reflexes have been described, both inhibitory and excitatory, demonstrating that a neural link exists between kidneys and may determine the distribution of excretory and haemodynamic function between the two kidneys...
February 9, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28153377/effects-of-reducing-blood-pressure-on-renal-outcomes-in-patients-with-type-2-diabetes-focus-on-sglt2-inhibitors-and-empa-reg-outcome
#13
REVIEW
A J Scheen, P Delanaye
Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin-angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function...
January 30, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28148536/impact-of-rapid-ultrafiltration-rate-on-changes-in-the-echocardiographic-left-atrial-volume-index-in-patients-undergoing-haemodialysis-a-longitudinal-observational-study
#14
Jwa-Kyung Kim, Young Rim Song, GunHa Park, Hyung Jik Kim, Sung Gyun Kim
OBJECTIVE: Optimal fluid management is essential when caring for a patient on haemodialysis (HD). However, if the fluid removal is too rapid, the resultant higher ultrafiltration rate (UFR) disadvantageously promotes haemodynamic instability and cardiac injury. We evaluated the effects of a rapid UFR on changes in the echocardiographic left atrial volume index (LAVI) over a period of time. DESIGN: Longitudinal observational study. SETTING AND PARTICIPANTS: A total of 124 new patients on HD...
February 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#15
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#16
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#17
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#18
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#19
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28052944/acute-traumatic-renal-arteriocalyceal-fistula-selective-angioembolisation-for-haemodynamic-instability
#20
Adam Carl Philipoff, Duncan Ramsay, Dieter G Weber
Abdominal angiography with selective arteriography and subsequent embolisation is an accepted management modality in the treatment of selected solid organ injuries following blunt abdominal trauma. This management practice is well established in the haemodynamically stable patient; however, this remains more controversial in haemodynamically compromised patients, though warrants consideration in both cases due to the associated benefits of non-operative management. This case report describes the successful non-operative management of a severe renal injury in a young polytraumatised patient following a high-speed motor vehicle crash...
January 4, 2017: BMJ Case Reports
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