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https://www.readbyqxmd.com/read/27932111/hepatitis-c-virus-in-kidney-transplant-recipients-a-problem-on-the-path-to-eradication
#1
A Suarez Benjumea, C Gonzalez-Corvillo, J M Sousa, G Bernal Blanco, M Suñer Poblet, M A Perez Valdivia, F M Gonzalez Roncero, P Acevedo, M A Gentil Govantez
BACKGROUND: Hepatitis C virus (HCV) still has significant prevalence in kidney transplant (KT) recipients and is related to poor recipient and graft survival. New direct-acting antivirals (DAA) are leading to a radical change in the problem. METHODS: We studied HCV prevalence at the time of transplantation and in follow-up patients, the way cases are handled, and the results of DAA. RESULTS: A total of 2,001 KT had been performed in our center since 1978...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27916890/indoxyl-sulfate-review-of-toxicity-and-therapeutic-strategies
#2
REVIEW
Sheldon C Leong, Tammy L Sirich
Indoxyl sulfate is an extensively studied uremic solute. It is a small molecule that is more than 90% bound to plasma proteins. Indoxyl sulfate is derived from the breakdown of tryptophan by colon microbes. The kidneys achieve high clearances of indoxyl sulfate by tubular secretion, a function not replicated by hemodialysis. Clearance by hemodialysis is limited by protein binding since only the free, unbound solute can diffuse across the membrane. Since the dialytic clearance is much lower than the kidney clearance, indoxyl sulfate accumulates to relatively high plasma levels in hemodialysis patients...
November 30, 2016: Toxins
https://www.readbyqxmd.com/read/27908905/mortality-hospitalization-and-quality-of-life-among-patients-with-hepatitis-c-infection-on-hemodialysis
#3
David A Goodkin, Brian Bieber, Michel Jadoul, Paul Martin, Eiichiro Kanda, Ronald L Pisoni
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is widely prevalent among patients on hemodialysis (HD), but very rarely treated. The aim of our study is to evaluate the burdens of HCV suffered by patients on HD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Dialysis Outcomes and Practice Patterns Study is an international, prospective, cohort study of patients on HD. We reviewed the HCV status of 76,689 adults enrolled between 1996 and 2015. We compared HCV-positive (HCV+) with HCV-negative (HCV-) patients for risk of mortality, hospitalization, decline in hemoglobin concentration <8...
December 1, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#4
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27903998/survival-benefit-of-hemodiafiltration-compared-with-prolonged-high-flux-hemodialysis
#5
Petar S Djuric, Aleksandar Jankovic, Jovan Popovic, Jelena Tosic Dragovic, Ana Bulatovic, Zivka Djuric, Milos Mitrovic, Nada Dimkovic
INTRODUCTION:  Patients on dialysis have a high rate of death, mainly of cardiovascular cause. Nephrologists are actively looking for ways to improve patients' outcomes, and alternative dialysis strategies, such as long conventional hemodialysis and hemodiafiltration, are currently being investigated. The aim of this study was to compare anemia, nutrition, inflammation, mineral metabolism, and 3-year survival rates between patients treated with hemodiafiltration and prolonged high-flux hemodialysis (HFH)...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27900978/penile-calcific-uremic-arteriolopathy-occurring-postparathyroidectomy-in-a-hemodialysis-patient
#6
Salah Omar Bashir, Mahmoud A Aamer, Hayder A Omer, Mohamed D Morsy
Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare condition most frequently seen in patients with advanced chronic kidney disease. The clinical picture is characterized by painful skin lesions and ulcerations. The underlying pathology is medial calcification and intimal proliferation with microthrombi of small arteries. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. This article reports an atypical case where CUA developed after parathyroidectomy and in the course of treatment of hungry bone syndrome...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900966/infective-endocarditis-in-chronic-hemodialysis-a-transition-from-left-heart-to-right-heart
#7
Y Bentata, I Haddiya, N Ismailli, N El Ouafi, A Benzirar, O El Mahi, A Azzouzi
Infective endocarditis (IE) of the left heart is the most frequent type of IE in chronic hemodialysis (CHD) (in 90% of cases) whereas involvement of the right heart is rare. The aim of this study was to determine the clinical, biological, and echocardiographic characteristics, as well as the prognosis of IE in CHD. This is a retrospective study conducted at the Center of Nephrology and Hemodialysis in Oujda, Morocco. Over a period of 56 months, we compiled data on a series of 11 CHD patients with IE. Their mean age was 40...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900441/successful-afatinib-treatment-of-advanced-non-small-cell-lung-cancer-patients-undergoing-hemodialysis
#8
Hisao Imai, Kyoichi Kaira, Ichiro Naruse, Hideki Hayashi, Hirotoshi Iihara, Yutaro Kita, Naoki Mizusaki, Takayuki Asao, Yoshinori Itoh, Tadashi Sugiyama, Koichi Minato, Masanobu Yamada
The treatment for patients with lung cancer undergoing hemodialysis, who are frequently elderly and have poor performance status, becomes a more important subject. However, the feasibility of afatinib in patients with chronic renal failure undergoing hemodialysis has not, so far, been reported. Here, afatinib was administered to three patients with NSCLC harboring EGFR mutation and chronic renal failure undergoing hemodialysis. Pharmacokinetic (PK) data of afatinib supported the safety of afatinib treatment...
November 29, 2016: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27899108/geographic-variation-of-parathyroidectomy-in-patients-receiving-hemodialysis-a-retrospective-cohort-analysis
#9
James B Wetmore, Jiannong Liu, Paul J Dluzniewski, Areef Ishani, Geoffrey A Block, Allan J Collins
BACKGROUND: Secondary hyperparathyroidism (SHPT) is associated with adverse outcomes in patients receiving maintenance dialysis. Parathyroidectomy is a treatment for SHPT; whether parathyroidectomy utilization varies geographically in the US is unknown. METHODS: A retrospective cohort analysis was undertaken to identify all patients aged 18 years or older who were receiving in-center hemodialysis between 2007 and 2009, were covered by Medicare Parts A and B, and had been receiving hemodialysis for at least 1 year...
November 29, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27880852/clinical-characteristics-and-outcomes-of-patients-with-high-ankle-brachial-index-from-the-impact-abi-study
#10
Hitoshi Nishimura, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Naoyuki Abe, Naoto Hashizume, Tomoaki Mochidome, Mikiko Harada, Kunihiko Shimizu, Wataru Shoin, Koji Yoshie, Yasutaka Oguchi, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda, Koichiro Kuwahara
BACKGROUND: Reduced ankle-brachial index (ABI) is a predictor of cardiovascular events. However, the significance of high ABI remains poorly understood. This study aimed to assess the characteristics and outcomes of patients with high ABI. METHODS: The IMPACT-ABI study was a retrospective cohort study that enrolled and examined ABI in 3,131 patients hospitalized for cardiovascular disease between January 2005 and December 2012. From this cohort, 2,419 patients were identified and stratified into two groups: high ABI (> 1...
2016: PloS One
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#11
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27863531/effects-of-continuous-renal-replacement-therapy-on-linezolid-pharmacokinetic-pharmacodynamics-a-systematic-review
#12
Gianluca Villa, Paola Di Maggio, A Raffaele De Gaudio, Andrea Novelli, Riccardo Antoniotti, Enrico Fiaccadori, Chiara Adembri
BACKGROUND: Major alterations in linezolid pharmacokinetic/pharmacodynamic (PK/PD) parameters might be expected in critically ill septic patients with acute kidney injury (AKI) who are undergoing continuous renal replacement therapy (CRRT). The present review is aimed at describing extracorporeal removal of linezolid and the main PK-PD parameter changes observed in critically ill septic patients with AKI, who are on CRRT. METHOD: Citations published on PubMed up to January 2016 were systematically reviewed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement...
November 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27856087/hemodialysis-hospitalizations-and-readmissions-the-effects-of-payment-reform
#13
Kevin F Erickson, Wolfgang C Winkelmayer, Glenn M Chertow, Jay Bhattacharya
BACKGROUND: In 2004, the Centers for Medicare & Medicaid Services changed reimbursement for physicians and advanced practitioners caring for patients receiving hemodialysis from a capitated to a tiered fee-for-service system, encouraging increased face-to-face visits. This early version of a pay-for-performance initiative targeted a care process: more frequent provider visits in hemodialysis. Although more frequent provider visits in hemodialysis are associated with fewer hospitalizations and rehospitalizations, it is unknown whether encouraging more frequent visits through reimbursement policy also yielded these benefits...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27832647/extracellular-volume-overload-and-increased-vasoconstriction-in-patients-with-recurrent-intradialytic-hypertension
#14
Peter Noel Van Buren, Yunyun Zhou, Javier A Neyra, Guanghua Xiao, Wanpen Vongpatanasin, Jula Inrig, Robert Toto
BACKGROUND/AIMS: Intradialytic hypertension (IH) occurs frequently in some hemodialysis patients and increases mortality risk. We simultaneously compared pre-dialysis, post-dialysis and changes in extracellular volume and hemodynamics in recurrent IH patients and controls. METHODS: We performed a case-control study among prevalent hemodialysis patients with recurrent IH and hypertensive hemodialysis controls. We used bioimpedance spectroscopy and impedance cardiography to compare pre-dialysis, post-dialysis, and intradialytic change in total body water (TBW) and extracellular water (ECW), as well as cardiac index (CI) and total peripheral resistance index (TPRI)...
November 11, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27830398/relationships-between-vitreous-levels-of-soluble-receptor-for-advanced-glycation-end-products-srage-and-renal-function-in-patients-with-diabetic-retinopathy
#15
Makiko Katagiri, Jun Shoji, Satoshi Kato, Shigehiko Kitano, Yasuko Uchigata
PURPOSE: We investigated the relationship between vitreous levels of soluble receptor for advanced glycation end products (sRAGE) and vascular endothelial growth factor (VEGF) and renal function, and correlations between vitreous sRAGE levels and proliferative diabetic retinopathy (PDR) activity. METHODS: We examined 33 eyes from 33 patients with diabetes mellitus who underwent a vitrectomy (eight patients in the non-PDR [NPDR] group and 25 in the PDR group). Serum creatinine levels and estimated glomerular filtration rate (eGFR) were measured and classified according to the chronic kidney disease (CKD)-staging method...
November 9, 2016: International Ophthalmology
https://www.readbyqxmd.com/read/27819399/cytomegalovirus-encephalitis-in-a-hemodialysis-patient-a-rare-association
#16
Alberto Vera, Pablo Ruano, Esther Ortega, Borja Quiroga
Haemodialysis patients are at greater risk of infections than individuals not on dialysis due to their immunosuppressive state caused by several factors (uraemia, vascular access, inflammation, malnutrition). However, infections affecting the central nervous system are not frequent in this population. We present the case of a 77-year-old man with end-stage renal disease who was admitted to the emergency department for a decreased level of consciousness and fever. Although the initial clinical suspicion oriented to a urinary infection, the lack of improvement forced us to perform a lumbar puncture...
November 7, 2016: New Microbiologica
https://www.readbyqxmd.com/read/27805342/management-of-sitagliptin-and-metformin-combination-toxic-overdose
#17
Sudhish Sehra, Shalini Jaggi, Devindra Sehra, Rajesh Aggarwal, Vikas Saraswat, Deven Juneja
Metformin and Sitagliptin are often used in combination in the management of non-insulin dependent diabetes mellitus. Though toxicity is rare, but occurs more frequently in cases of intentional or unintentional overdose of these drugs. Here, we present a case of an intentional overdose of a metformin- sitagliptin combination (70g metformin and 3500mg sitagliptin) in a suicide attempt by a young non-diabetic female who presented with severe lactic acidosis and was successfully treated with prompt hemodialysis and bicarbonate therapy...
November 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27801488/peritoneal-dialysis-experience-of-the-department-of-pediatrics-of-the-hospital-charles-nicolle-of-tunis
#18
Manel Jellouli, Meriem Ferjani, Amal Oueslati, Kamel Abidi, Ouns Naija, Yousra Hammi, Taieb Ben Abdallah, Tahar Gargah
Introduction Peritoneal dialysis (PD) is still the most common modality used in treatment for children with End Stage Renal Disease (ESRD). The objective of this study was to identify the epidemiological, clinical, and microbiological factors affecting the outcome of PD. Methods In this study, we retrospectively reviewed the records of 85 patients who were treated with DP for the last ten years (from January 2004 to December 2013) in the Department of Pediatrics in Charles Nicolle hospital, Tunis. Results The mean duration of PD was 18...
May 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27795374/pharmacokinetic-pharmacodynamic-modeling-and-simulation-of-cefiderocol-a-parenteral-siderophore-cephalosporin-for-dose-adjustment-based-on-renal-function
#19
Takayuki Katsube, Toshihiro Wajima, Toru Ishibashi, Juan Camilo Arjona Ferreira, Roger Echols
The novel parenteral siderophore cephalosporin, cefiderocol, exhibits potent efficacy against most Gram-negative bacteria including carbapenem-resistant strains. Since cefiderocol is primarily excreted via the kidneys, this study was conducted to develop a population pharmacokinetic (PK) model to determine dose adjustment based on renal function.Population PK models were developed based on cefiderocol concentration data in plasma, urine and dialysate with a non-linear mixed effects model approach. Monte-Carlo simulations were conducted to calculate the probability of target attainment (PTA) of fraction of time during the dosing interval where the free drug concentration in plasma exceeds the minimum inhibitory concentration (MIC) (Tf>MIC) for a MIC range of 0...
October 17, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27786416/does-guidewire-exchange-influence-infection-rate-related-to-catheters-used-for-vascular-access-in-children-on-chronic-hemodialysis
#20
Rina R Rus, Nina Battelino, Rafael Ponikvar, Vladimir Premru, Gregor Novljan
A central venous catheter (CVC) can either be inserted "de novo" or placed by guidewire exchange (GWE). From September 1998 to September 2015, 32 children (19 boys, 13 girls) were hemodialyzed in our unit by using a CVC. The mean age at CVC insertion was 12.6 ± 0.5 years. A total of 121 uncuffed catheters were placed, either "de novo" or by GWE in 64 (52.9%) and 57 (47.1%) cases, respectively. The most frequent cause for line revision was catheter dysfunction in 40/121 (33.1%) patients. The overall incidence of bacteremia was 1...
October 27, 2016: Therapeutic Apheresis and Dialysis
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