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https://www.readbyqxmd.com/read/29597214/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvement
#1
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29510919/improving-incident-esrd-care-via-a-transitional-care-unit
#2
Brendan Bowman, Sijie Zheng, Alex Yang, Brigitte Schiller, José A Morfín, Melvin Seek, Robert S Lockridge
Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29458366/inequity-in-dialysis-related-practices-and-outcomes-in-aotearoa-new-zealand-a-kaupapa-m%C3%A4-ori-analysis
#3
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29429947/hospital-readmission-rates-and-risk-factors-for-readmission-following-cytoreductive-surgery-crs-and-hyperthermic-intraperitoneal-chemotherapy-hipec-for-peritoneal-surface-malignancies
#4
Yael Dreznik, Aviad Hoffman, Tamar Hamburger, Almog Ben-Yaacov, Yossi Dux, Harel Jacoby, Yaniv Berger, Aviram Nissan, Mordechai Gutman
BACKGROUND: Cytoreductive surgery and Hyperthermic intra-peritoneal chemotherapy (CRS/HIPEC) for peritoneal surface malignancies is associated with high morbidity. The increased numbers of patients undergoing CRS/HIPEC in recent years mandates risk analysis and quality assurance. However, only scarce data exist regarding causative parameters for readmission. The aim of this study was to assess readmission rates and risk factors associated with readmission. METHODS: A retrospective-cohort study including patients from two high-volume centers who underwent CRS/HIPEC surgery between the years 2007-2016 was performed...
February 8, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29314253/peritoneal-dialysis-education-challenges-and-innovation
#5
Rajnish Mehrotra
Peritoneal dialysis is the most common modality for home dialysis and to ensure patients have access to dialysis at home, training programs have to ensure that the fellows attain clinical competency in the care of such patients. The limited data available however are sobering; about 10 years ago, 44% of nephrologists reported that they did not feel competent in the care of patients undergoing peritoneal dialysis. There are recognizable challenges in ensuring clinical competency of trainees that may need creative solutions...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#6
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
February 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29192721/haemodialysis-vascular-access-current-practices-amongst-indian-nephrologists
#7
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29160975/peritoneal-dialysis-access-management-more-than-skin-deep
#8
Susan Bridger
Providing care and education for a patient on peritoneal dialysis (PD) requires that the nephrology nurse have knowledge and expertise in the PD access. This article provides information on types and placement of PD catheters, pre-placement and post-placement education and care, how to assess PD catheter exit site healing, and initial use of the PD catheter for access.
September 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29142474/clinical-features-of-alcoholic-hepatitis-in-latinos-and-caucasians-a-single-center-experience
#9
Rogelio Pinon-Gutierrez, Blythe Durbin-Johnson, Charles H Halsted, Valentina Medici
AIM: To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians. METHODS: We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29137810/technique-for-precaval-and-laterocaval-nodes-excision-at-extraperitoneal-paraaortic-lymphadenectomy
#10
M Gorostidi, C Villalain, R Ruiz, I Jaunarena, A Lekuona
STUDY OBJECTIVE: To describe our technique for excision of the pre-caval and laterocaval nodes using an extraperitoneal approach. This technique was developed to make the dissection and excision of the less accessible nodes in an easier and safer way by minimizing the risk of great vessels injury and bleeding. DESIGN: Step-by-step description of the surgical procedure using video (Canadian Task Force classification III). SETTING: The procedure was performed at a teaching hospital, Hospital Universitario Donostia (Spain)...
January 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29124391/implementing-a-digital-real-time-hydrocephalus-and-shunt-registry-to-evaluate-contemporary-pattern-of-care-and-surgical-outcome-in-pediatric-hydrocephalus
#11
Hans Christoph Bock, Maximilian Kanzler, Ulrich-Wilhelm Thomale, Hans Christoph Ludwig
OBJECTIVE: Treatment monitoring and outcome evaluation in pediatric hydrocephalus require gapless documentation regarding surgical and clinical follow-up data beginning from day 1 of treatment in order to apply high quality of care. Endoscopic procedures, shunt insertion and revision surgeries, and individual modifications of valve hardware or pressure settings during follow-up as well as established outcome measurements are highly relevant for complete illustration of the patient's hydrocephalus histories...
November 9, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28797473/biomarker-research-to-improve-clinical-outcomes-of-peritoneal-dialysis-consensus-of-the-european-training-and-research-in-peritoneal-dialysis-eutripd-network
#12
REVIEW
Christoph Aufricht, Robert Beelen, Matthias Eberl, Michel Fischbach, Donald Fraser, Achim Jörres, Klaus Kratochwill, Manuel LópezCabrera, Peter Rutherford, Claus-Peter Schmitt, Nicholas Topley, Janusz Witowski
Peritoneal dialysis (PD) therapy substantially requires biomarkers as tools to identify patients who are at the highest risk for PD-related complications and to guide personalized interventions that may improve clinical outcome in the individual patient. In this consensus article, members of the European Training and Research in Peritoneal Dialysis Network (EuTRiPD) review the current status of biomarker research in PD and suggest a selection of biomarkers that can be relevant to the care of PD patients and that are directly accessible in PD effluents...
October 2017: Kidney International
https://www.readbyqxmd.com/read/28795012/chronic-kidney-disease-and-sports-participation-by-children-and-adolescents
#13
REVIEW
Vimal Master Sankar Raj, Dilip R Patel, Lakshmi Ramachandran
Individuals suffering from chronic kidney disease (CKD) deal with major morbidity and mortality including poor exercise tolerance. A variety of factors including anemia, poor muscle mass, cardiovascular changes and limited physical activity contribute to exercise intolerance. Studies suggest that early initiation of aerobic and resistance training improves the muscle function, ability to tolerate exercise and quality of life in CKD patients. A thorough medical examination and exercise testing are recommended before initiating an exercise regimen in individuals with CKD...
July 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/28741138/trans-splenic-access-for-portal-venous-interventions-in-children-do-benefits-outweigh-risks
#14
Sheena Pimpalwar, Ponraj Chinnadurai, Alberto Hernandez, Kamlesh Kukreja, Shakeel Siddiqui, Henri Justino
BACKGROUND: The primary concern of trans-splenic access for portal interventions is the risk of life-threatening intraperitoneal bleeding. OBJECTIVE: To review the clinical indications and efficacy and evaluate the risk factors for intraperitoneal bleeding during trans-splenic portal interventions in children. MATERIALS AND METHODS: A retrospective review of consecutive patients who underwent trans-splenic portal interventions at a tertiary care pediatric institution between March 2011 and April 2017 was performed...
July 24, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28689655/robotic-resection-of-a-symptomatic-parasitic-leiomyoma-from-the-obturator-fossa
#15
Gulden Menderes, Belinda Nhundu, Karen Levy, Dan-Arin Silasi
STUDY OBJECTIVE: To demonstrate a technique for robotically resecting a parasitic leiomyoma from the obturator fossa. DESIGN: Case report and a step-by-step video demonstration of resection of a symptomatic parasitic leiomyoma (Canadian Task Force classification III). SETTING: Tertiary referral center in New Haven, Connecticut. INTERVENTIONS: This 48-year-old Caucasian female had undergone a previous total abdominal hysterectomy for uterine leiomyomas...
January 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28560726/payment-reform-and-health-disparities-changes-in-dialysis-modality-under-the-new-medicare-dialysis-payment-system
#16
Marc Turenne, Regina Baker, Jeffrey Pearson, Chad Cogan, Purna Mukhopadhyay, Elizabeth Cope
OBJECTIVE: To evaluate the effect of the Medicare dialysis payment reform on potential disparities in the selection of peritoneal dialysis (PD) for the treatment of end-stage renal disease (ESRD). DATA SOURCES: Centers for Medicare & Medicaid Services (CMS) ESRD Medical Evidence Form, Medicare claims, and other CMS data for 2008-2013. STUDY DESIGN: We examined the association of patient age, race/ethnicity, urban/rural location, pre-ESRD care, comorbidities, insurance, and other factors with the selection of PD as initial dialysis modality across prereform (2008-2009), interim (2010), and postreform (2011-2013) time periods...
May 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/28557999/treatment-of-aki-in-developing-and-developed-countries-an-international-survey-of-pediatric-dialysis-modalities
#17
Rupesh Raina, Abigail M Chauvin, Timothy Bunchman, David Askenazi, Akash Deep, Michael J Ensley, Vinod Krishnappa, Sidharth Kumar Sethi
HYPOTHESIS: Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD) and hemodialysis (HD). It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability...
2017: PloS One
https://www.readbyqxmd.com/read/28540833/registries-on-peritoneal-surface-malignancies-throughout-the-world-their-use-and-their-options
#18
Victor J Verwaal, Beate Rau, Faek Jamali, François Noël Gilly, Ignace de Hingh, Heikki Takala, Ingvar Syk, Jorg Pelz, Jurgen Mulsow, Kurt van der Speeten, Kusamura Shigeki, Lene H Iversen, Faheez Mohamed, Olivier Glehen, Rami Younan, Roman Yarema, Santiago Gonzalez-Moreno, Sarah O'Dwyer, Yukata Yonemura, Paul Sugarbaker
AIM: The treatment of peritoneal surface malignancies ranges from palliative care to full cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy, HIPEC. Ongoing monitoring of patient recruitment and volume is usually carried out through dedicated registries. With multiple registries available worldwide, we sought to investigate the nature, extent and value of existing worldwide CRS and HIPEC registries. METHODS: A questionnaire was sent out to all known major treatment centres...
August 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28532557/pd-first-policy-thailand-s-response-to-the-challenge-of-meeting-the-needs-of-patients-with-end-stage-renal-disease
#19
REVIEW
Piyatida Chuengsaman, Vijj Kasemsup
Providing dialysis for end-stage kidney disease (ESKD) patients nationwide in a developing country such as Thailand is challenging. Even after roll-out of the Thai Universal Coverage Scheme in 2002, treatment for ESKD was not covered and patients struggled to afford dialysis. There was an urgent need to improve financial risk protection for patients with ESKD. Advocacy by nephrologists, health economists, and civil society seeking equity in access to dialysis, and responsiveness from policy makers, led to the methodical development of the Peritoneal Dialysis (PD) First policy and marked a turning point in ESKD care in Thailand...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28508021/examining-the-roles-and-experiences-of-fathers-of-children-with-chronic-kidney-disease
#20
David B Nicholas
This study examined roles and experiences of fathers of children with chronic kidney disease (CKD). Based on interpretive description, semistructured interviews were conducted with 22 fathers of children receiving a range of treatments (transplant, peritoneal dialysis, hemodialysis, and CKD not requiring renal replacement therapy). Fathers described various experiences and means of adjusting to shifts associated with pediatric CKD. These included loss of personal control, a sense of personal isolation, and a stance of remaining strong amidst personal suffering...
January 2017: Global Qualitative Nursing Research
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