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"Renal replacement therapy"

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https://www.readbyqxmd.com/read/29045467/the-dose-of-hydroxyethyl-starch-6-130-0-4-for-fluid-therapy-and-the-incidence-of-acute-kidney-injury-after-cardiac-surgery-a-retrospective-matched-study
#1
Mona Momeni, Lompoli Nkoy Ena, Michel Van Dyck, Amine Matta, David Kahn, Dominique Thiry, André Grégoire, Christine Watremez
The safety of hydroxyethyl starches (HES) is still under debate. No studies have compared different dosing regimens of HES in cardiac surgery. We analyzed whether the incidence of Acute Kidney Injury (AKI) differed taking into account a weight-adjusted cumulative dose of HES 6% 130/0.4 for perioperative fluid therapy. This retrospective cohort study included all adult patients undergoing elective or emergency cardiac surgery with or without cardiopulmonary bypass. Exclusion criteria were patients on renal replacement therapy (RRT), cardiac trauma surgery, heart transplantation, patients with ventricular assist devices, subjects who required a surgical revision for bleeding and those whose medical records were incomplete...
2017: PloS One
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#2
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29044340/renouncement-of-renal-replacement-therapy-withdrawal-and-refusal
#3
José Andrade Moura, Ana Flávia de Souza Moura, José Hermógenes Rocco Suassuna
Renouncement of renal replacement therapy (RRT) is a medical dilemma. This review covers the concept, the magnitude, the prognosis, and discusses strategies and management approaches about this subject in patients with CKD and AKI. Evidence suggests that refusal is more frequent and carries a more guarded prognosis than withdrawal of RRT. When RRT is not expected to be beneficial in terms of survival or quality of life, conservative treatment and palliative care are alternatives. We review the historical evolution of guidelines about renouncement of RRT and palliative care, and highlight the absence of specific recommendations in Brazil...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29044336/the-impact-of-body-mass-index-bmi-variation-on-mortality-of-incident-elderly-patients-on-peritoneal-dialysis-a-joint-model-analysis
#4
Marcia Regina Gianotti Franco, Fernando Antonio Basile Colugnati, Abdul Rashid Qureshi, José Carolino Divino-Filho, Natália Maria Da Silva Fernandes
INTRODUCTION: Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time. METHODS: Prospective multicenter cohort study (December / 2004-October/2007) with 674 patients. Socio-demographic and clinical data evaluated with patients followed until death, transfer to hemodialysis (HD), recovery of renal function, loss of follow-up or transplant...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29041948/effect-of-levosimendan-on-prognosis-in-adult-patients-undergoing-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#5
Qi-Hong Chen, Rui-Qiang Zheng, Hua Lin, Jun Shao, Jiang-Quan Yu, Hua-Ling Wang
BACKGROUND: Small trials suggest that levosimendan is associated with a favorable outcome in patients undergoing cardiac surgery. However, recently published larger-scale trials did not provide evidence for a similar benefit from levosimendan. We performed a meta-analysis to assess the survival benefits of levosimendan in patients undergoing cardiac surgery and to investigate its effects in subgroups of patients with preoperative low-ejection fraction (EF). METHODS: We identified randomized clinical trials through 20 April 2017 that investigated levosimendan therapy versus control in patients undergoing cardiac surgery...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29039628/early-versus-late-initiation-of-renal-replacement-therapy-in-patients-with-acute-kidney-injury-a-meta-analysis-of-randomised-clinical-trials
#6
Thomas A Mavrakanas, D Ezra Aurian-Blajeni, David M Charytan
AIMS OF THE STUDY: The optimal timing of renal replacement therapy (RRT) initiation in acute kidney injury (AKI) remains a matter of debate. A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to better estimate the effects of early initiation of RRT compared with late initiation of RRT among patients with AKI and in patients at risk for AKI. METHODS: A Medline literature research was conducted in PubMed for RCTs in adult patients with AKI that compared different RRT initiation strategies (early vs late)...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29037311/therapeutic-plasma-exchange-in-rheumatic-diseases-a-university-hospital-experience
#7
Juan Pablo Córdoba, Carolina Larrarte, Cristina Estrada, Daniel G Fernández-Ávila
INTRODUCTION: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting. METHODS: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013...
September 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/29035197/drug-induced-kidney-injury-a-large-case-series-from-the-berlin-case-control-surveillance-study%C3%A2
#8
Antonios Douros, Elisabeth Bronder, Andreas Klimpel, Christiane Erley, Edeltraut Garbe, Reinhold Kreutz
OBJECTIVES: Drug-induced kidney injury (DIKI) may affect patients regardless of their baseline kidney function. Therefore, this study evaluated DIKI in patients with or without previous chronic kidney disease (CKD). MATERIALS AND METHODS: Potential DIKI cases were ascertained using the network of the Berlin Case-Control Surveillance Study in all 51 Berlin hospitals from April 2010 until December 2011. Via face-to-face interviews and medical chart reviews, information on all previous drug intake, comorbidities, and demographics was gathered...
October 16, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29034718/the-prognostic-value-of-the-furosemide-stress-test-in-predicting-delayed-graft-function-following-deceased-donor-kidney-transplantation
#9
Blaithin A McMahon, Jay L Koyner, Tessa Novick, Steve Menez, Robert A Moran, Bonnie E Lonze, Niraj Desai, Sami Alasfar, Marvin Borja, William T Merritt, Promise Ariyo, Lakhmir S Chawla, Edward Kraus
OBJECTIVES AND METHODS: The Furosemide Stress Test (FST) is a novel dynamic assessment of tubular function that has been shown in preliminary studies to predict patients who will progress to advanced stage acute kidney injury, including those who receive renal replacement therapy (RRT). The aim of this study is to investigate if the urinary response to a single intraoperative dose of intravenous furosemide predicts delayed graft function (DGF) in patients undergoing deceased donor kidney transplant...
October 16, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29034081/renal-impairment-in-stroke-patients-a-comparison-between-the-haemorrhagic-and-ischemic-variants
#10
Pratyush Shrestha, Shalima Thapa, Shikher Shrestha, Subash Lohani, Suresh Bk, Oscar MacCormac, Lekhjung Thapa, Upendra Prasad Devkota
Background: Renal impairment is regularly seen in hospitalized stroke patients, affecting the outcome of patients, as well as causing difficulties in their management. A prospective cohort study was conducted to assess the trend of renal function in hospitalized ischemic and haemorrhagic stroke patients. The incidence of renal impairment in these subgroups, the contributing factors and the need for renal replacement in renal impaired patients was evaluated. Methods: Alternate day renal function testing was performed in hospitalized stroke patients...
2017: F1000Research
https://www.readbyqxmd.com/read/29034013/cardiovascular-events-in-hemodialysis-patients-challenging-against-vascular-calcification
#11
REVIEW
Shuzo Kobayashi
Particularly in patients with hemodialysis, cardiovascular mortality rate is extremely high. Polyvascular diseases develop at an early stage of chronic kidney disease (CKD). Pathophysiology includes insulin resistance and/or imbalance between nitric oxide (NO) and endothelin bioavailability as well as oxidative stress. The understanding in pathophysiology of vascular calcification and strategic treatment is a critical issue to achieve favorable outcome for the patients with CKD. In this article, we aim to review the cardiovascular disease for the patients with CKD with a particular emphasis on the clinical aspects of polyvascular disease...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29033336/open-abdomen-therapy-with-vacuum-and-mesh-mediated-fascial-traction-after-aortic-repair-an-international-multicentre-study
#12
Stefan Acosta, Arne Seternes, Maarit Venermo, Leena Vikatmaa, Karl Sörelius, Anders Wanhainen, Mats Svensson, Khatereh Djavani, Martin Björck
OBJECTIVES: Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation. METHODS: This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015...
October 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29029967/-10-years-of-external-quality-assurance-in-dialysis-in-germany-results-and-future-prospects
#13
Dorothea Büchtemann, Stefan Meinhold, Peter Follert
BACKGROUND: In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme based on the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres...
October 10, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29027706/regional-citrate-anticoagulation-with-calcium-replacement-in-pediatric-apheresis
#14
Katie Sigler, Ji Lee, Poyyapakkam Srivaths
PURPOSE: The objective of this retrospective analysis was to present our single-center experience with intravenous (IV) calcium replacement and regional citrate anticoagulation in pediatric apheresis therapy with the aim of developing a standard operating procedure to minimize symptomatic hypocalcemia. METHODS: We analyzed apheresis procedures in patients <18 years of age over a 2-year time period (Jan 2012 to Dec 2014). Procedures in tandem with other extracorporeal therapies, including continuous renal replacement therapy, extracorporeal liver support, and extracorporeal membrane oxygenation, were excluded...
October 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29027657/practical-issues-of-nutrition-during-continuous-renal-replacement-therapy
#15
Dariusz Onichimowski, Radosław Goraj, Rakesh Jalali, Jolanta Grabala, Ewa Mayzner-Zawadzka, Mirosław Czuczwar
Continuous renal replacement therapy (CRRT) in critically ill patients has significant impact on one's ability to provide efficient nutritional therapy. CRRT may help in the prevention of intestinal oedema and the maintenance of the proper function of the gastrointestinal tract by enabling strict control of the fluid balance. It facilitates early introduction of nutrition via the enteral route, as well as allowing for the composition of high-volume feeding mixtures. It is necessary to take into consideration that during CRRT, together with blood purification of toxic substances, nutritive elements are also eliminated to some extent (micro- and macronutrients)...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29027193/single-center-experience-with-intraoperative-extracorporeal-membrane-oxygenation-use-in-lung-transplantation
#16
Tugba Cosgun, Sandra Tomaszek, Isabelle Opitz, Markus Wilhelm, Macé M Schuurmans, Walter Weder, Ilhan Inci
BACKGROUND: Studies have shown that survival after lung transplantation is impaired if extracorporeal membrane oxygenation (ECMO) support is implemented. We investigated the outcome and potential independent risk factors on survival in recipients undergoing lung transplantation with intraoperative ECMO support. MATERIALS AND METHODS: Medical records of recipients were retrospectively evaluated (January 2000-December 2014). Retransplantation and bridge to transplantation on ECMO were excluded...
October 9, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29025386/preoperative-cardiac-risk-assessment-in-renal-transplant-recipients-a-single-center-experience
#17
Kerem Can Yilmaz, Arzu Neslihan Akgün, Orcun Ciftci, Haldun Muderrisoglu, Siren Sezer, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Cardiovascular disease is the major cause of morbidity and mortality in patients on renal replacement therapy and in kidney transplant recipients. There are no specific recommendations for preoperative cardiac risk assessment before renal transplant. The aim of our study was to analyze preoperative cardiac test frequencies, test results, patient characteristics, and relations between cardiac stress test results and severe coronary artery disease. MATERIALS AND METHODS: We retrospectively examined patients who underwent renal transplant between December 2011 and December 2016 in our hospital (Ankara, Turkey)...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29025150/collection-and-determinants-of-patient-reported-outcome-measures-in-haemodialysis-patients-in-scotland
#18
Ailish Nimmo, Samira Bell, Carol Brunton, Jacqueline Campbell, Arthur Doyle, Bruce MacKinnon, Robert K Peel, Susan Robertson, Ilona Shilliday, Elaine Spalding, Jamie P Traynor, Wendy Metcalfe
Background: Patient reported outcome measures (PROMs) can evaluate the quality of health in patients with established renal failure. There is limited experience of their use within national renal registries. Aim: To describe the Scottish Renal Registry's (SRR) experience of collecting PROMS in the haemodialysis population and correlate PROMS to demographic and clinical parameters. Design: Retrospective observational cross-sectional study. Methods: Haemodialysis patients in Scotland were invited to complete the KDQOL™-36 questionnaire on the day of the annual SRR census in 2015 and 2016...
September 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29024613/remote-monitoring-of-automated-peritoneal-dialysis-patients-assessing-clinical-and-economic-value
#19
Dilip Makhija, Mark Dominik Alscher, Stefan Becker, Silvia D'Alonzo, Raj Mehrotra, Leslie Wong, Kim McLeod, Judy Danek, Mary Gellens, Todd Kudelka, James A Sloand, Suzanne Laplante
BACKGROUND: For chronic kidney disease patients who progress to end-stage renal disease, survival is dependent on renal replacement therapy in the form of kidney transplantation or chronic dialysis. Peritoneal dialysis (PD), which can be performed at home, is both more convenient and less costly than hemodialysis that requires three 4-h visits per week to the dialysis facility and complicated equipment. Remote therapy management (RTM), technologies that collect medical information and transmit it to healthcare providers for patient management, has the potential to improve the outcomes of patients receiving automated peritoneal dialysis (APD) at home...
October 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29023314/renal-dysfunction-and-cirrhosis
#20
François Durand, Jody C Olson, Mitra K Nadim
PURPOSE OF REVIEW: Hepatorenal syndrome (HRS) does not represent the predominant phenotype of acute kidney injury (AKI) in cirrhosis. Early recognition of HRS helps initiate appropriate therapy. The aims of this review are to present redefinition of AKI, to list new biomarkers, to report recent data on vasopressors in HRS and to propose criteria for simultaneous liver and kidney transplantation (SLKT). RECENT FINDINGS: Urine output, which was not part of the definition of AKI might be reconsidered as it has an independent prognostic value...
October 11, 2017: Current Opinion in Critical Care
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