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https://www.readbyqxmd.com/read/29149967/early-prediction-of-cardiovascular-disease-in-kidney-transplant-recipients
#1
G Bilancio, M Celano, V Cozza, F Zingone, G Palladino, M Cirillo
Cardiovascular disease (CVD) is frequent after kidney transplantation (KT). This study investigated CVD prediction in KT by information available before KT or within 6 months after KT. The study cohort consisted of 629 patients with KT in 2005-10 and with adult age at KT. The end point was incidence up to 2015 of CVD (coronary heart disease, cerebrovascular disease, peripheral artery disease). Graft failure, non-CVD death with functioning graft, and loss to follow-up were considered competing events. CVD prediction was investigated for 34 variables by means of competing-risks regression...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149955/hemodialysis-patients-willingness-to-undergo-kidney-transplantation-an-observational-study
#2
H Alansari, A Almalki, L Sadagah, M Alharthi
BACKGROUND: The number of dialysis patients is increasing, with only 20% undergoing kidney transplantation. In Saudi Arabia, no studies had examined transplantation barriers from the patients' perspectives. We aimed in this study to estimate hemodialysis (HD) patients' willingness to undergo kidney transplantation and to explore its underlying determinants. METHODS: In an observational cross-sectional study involving adult HD patients from King Abdulaziz Medical City and King Abdullah Dialysis Center-Jeddah, patients were interviewed through a pre-tested questionnaire...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29148012/use-of-bovine-carotid-artery-for-buttonhole-technique-hemodialysis
#3
Earl Schuman, Philip Alexander, Amy Ronfeld
PURPOSE: Assess the feasibility of using a bovine carotid artery graft for buttonhole technique hemodialysis in patients who are not candidates for a native fistula. METHODS: Case reports used to demonstrate selection criteria and results for this approach. Criteria include: knowledgeable patient with prior dialysis experience, stable graft in place for 3 months minimum, not a candidate for a native fistula, and able to maintain close follow-up. RESULTS: Both grafts were based on axillary vessels and have been in place for a total of 64 months...
November 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147997/drug-eluting-balloon-angioplasty-for-assisted-maturation-of-failing-fistulae
#4
Alexandros Mallios, Jeffrey Hull, Benoit Boura, Alessandro Costanzo, Myriam Combes
OBJECTIVE: To present our experience of balloon-assisted maturation with drug-eluting balloon dilation in patients with recurrent failing arteriovenous fistulae. CASE SERIES: Three patients (all males, mean age 71 years) with a complex history of failed attempts at native fistula creation underwent surgical creation of arteriovenous fistulae. Two patients had a two-stage brachio-brachial fistula and 1 had a brachio-cephalic fistula that also required subsequent elevation...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147170/clinical-assessment-of-warfarin-therapy-in-patients-with-maintenance-dialysis-clinical-efficacy-risks-and-development-of-calciphylaxis
#5
Hajime Hasegawa
Recent years, multiple studies regarding clinical efficacy and risks of Warfarin therapy in dialysis patients have been reported, and not a few reports conclude that clinical advantage of Warfarin is questionable in dialysis patients. Conversely, its hemorrhagic risk might be a little more serious in dialysis patients comparing to non-dialysis patients. Basically, it is assumed that long-term administration of Warfarin accelerates the development of vascular athelosclerosis because of the abolished anti-calcification effect of Gla-protein activation by decreased vitamin K activity...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147167/validation-of-the-risk-score-of-the-mortality-and-lower-limb-loss-considering-ambulatory-status-after-surgical-revascularization-in-maintaining-patients-with-dialysis
#6
Haruto Yamazaki, Hisae Hayashi, Morio Kawamura, Ayana Sasaki, Eriko Kondo, Shinya Ito, Kenji Wakai
Surgical revascularization is performed to preserve limb and to maintain functional status of patients with critical limb ischemia (CLI). The PREVENT III risk score helps to predict the postoperative course of CLI. However, this score is not available to estimate the risk of amputation or death properly in patients with hemodialysis (HD) and tissue loss (HD: 4 points, Tissue loss: 3 points), because they are classified as a high-risk group. Therefore, we investigated 213 patients with revascularized HD for CLI and proposed prognosis amputation or death for patients with HD risk score (PAD for HD risk score)...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147074/increased-levels-of-srage-in-diabetic-ckd-g5d-patients-a-potential-protective-mechanism-against-age-related-upregulation-of-fibroblast-growth-factor-23-and-inflammation
#7
Elena Dozio, Valentina Corradi, Elena Vianello, Elisa Scalzotto, Massimo de Cal, Massimiliano Marco Corsi Romanelli, Claudio Ronco
Advanced glycation end products (AGEs) may induce cardiac remodeling in kidney disease by promoting fibroblast growth factor 23 (FGF-23) expression. Since AGEs are increased in diabetes mellitus (DM), our first aim was to evaluate the existence of any potential association between AGEs, FGF-23, inflammation, and increased cardiovascular risk in DM patients on dialysis (CKD-G5D). Secondarily, we explored the potential role of the soluble receptor for AGEs (sRAGE) as a marker of heart failure. Levels of glycated albumin (GA), sRAGE, c-terminal FGF-23 (cFGF-23), brain natriuretic peptide (BNP), and inflammatory mediators were compared between DM and non-DM CKD-G5D patients...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#8
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#9
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29132990/beneficiary-characteristics-and-vaccinations-in-the-end-stage-renal-disease-medicare-beneficiary-population-an-analysis-of-claims-data-2006-2015
#10
Angela K Shen, Jeffrey A Kelman, Rob Warnock, Weiwei Zhang, Stephaeno Brereton, Stephen McKean, Michael Wernecke, Steve Chu, Bruce G Gellin
BACKGROUND: The Advisory Committee on Immunization Practices (ACIP) routinely recommends three vaccines - influenza, hepatitis B, and pneumococcal vaccines - for End-Stage Renal Disease (ESRD) dialysis patients. METHODS: We sought to assess vaccination coverage among fee-for-service (FFS) Medicare beneficiaries with ESRD who received Part B dialysis services at any point from January 1, 2006 through December 31, 2015 (through June 30, 2016 for influenza). To assess influenza vaccination rates in a given influenza season, we restricted the population to beneficiaries who were continuously enrolled in Medicare Parts A and B throughout all twelve months of that season...
November 10, 2017: Vaccine
https://www.readbyqxmd.com/read/29131248/body-mass-index-and-metabolic-syndrome-impact-differently-on-major-clinical-events-in-renal-transplant-patients
#11
A De Giorgi, A Storari, S Forcellini, F Manfredini, N Lamberti, P Todeschini, G La Manna, R Manfredini, F Fabbian
OBJECTIVE: Kidney transplant recipients (KTRs) are bound to develop cardiovascular disease (CVD), and obesity represents a well-known risk factor for CVD. It has been reported that the metabolic syndrome (MetS) is a frequent finding in KTRs, and MetS could develop even if body mass index (BMI) is only mildly increased. We compared the impact of BMI and MetS on the development of major clinical events (MCEs) in a cohort of 107 KTRs during a follow-up of 63 ± 31 months. PATIENTS AND METHODS: Clinical characteristics were recorded at the time of enrollment and patients were classified on the basis of MCEs development...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29130991/pre-end-stage-renal-disease-hemoglobin-variability-predicts-post-end-stage-renal-disease-mortality-in-patients-transitioning-to-dialysis
#12
Keiichi Sumida, Charles Dyer Diskin, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Connie M Rhee, Elani Streja, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Hemoglobin variability (Hb-var) has been associated with increased mortality both in non-dialysis dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD) patients. However, the impact of Hb-var in advanced NDD-CKD on outcomes after dialysis initiation remains unknown. METHODS: Among 11,872 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 through September 2011, we assessed Hb-var calculated from the residual SD of at least 3 Hb values during the last 6 months before dialysis initiation (prelude period) using within-subject linear regression models, and stratified into quartiles...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130984/lymphocyte-cell-ratios-and-mortality-among-incident-hemodialysis-patients
#13
Christina Catabay, Yoshitsugu Obi, Elani Streja, Melissa Soohoo, Christina Park, Connie M Rhee, Csaba P Kovesdy, Takayuki Hamano, Kamyar Kalantar-Zadeh
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been previously suggested as oncologic prognostication markers. These are associated with malnutrition and inflammation, and hence, may provide benefit in predicting mortality among hemodialysis patients. METHODS: Among 108,548 incident hemodialysis patients in a large U.S. dialysis organization (2007-2011), we compared the mortality predictability of NLR and PLR with baseline and time-varying covariate Cox models using the receiver operating characteristic curve (AUROC), net reclassification index (NRI), and adjusted R2...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#14
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
Background The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. Methods In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29127652/dapagliflozin-as-a-cause-of-acute-tubular-necrosis-with-heavy-consequences-a-case-report
#15
Christos Pleros, Elisavet Stamataki, Antonia Papadaki, Nikolaos Damianakis, Rafaela Poulidaki, Charikleia Gakiopoulou, Ioannis Tzanakis
A 50-year-old man with type II diabetes, hypertension and dyslipidemia, presented with non-oliguric acute kidney injury (AKI) and anemia. Renal biopsy showed acute tubular necrosis (ATN) with extensive cytoplasmic vacuolization and areas of tubulitis. These findings were ultimately attributed to dapagliflozin, which he started 3 months earlier due to poor glycemic control. ATN with similar microscopic findings has been described with larger doses of dapagliflozin in non-clinical trials. Our patient was started on dialysis and remained dialysis-dependent for 4 weeks while his renal function improved gradually thereafter...
November 10, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29125879/spironolactone-is-effective-in-treating-hypokalemia-among-peritoneal-dialysis-patients
#16
Amit Langote, Swapnil Hiremath, Marcel Ruzicka, Brendan B McCormick
BACKGROUND: Hypokalemia is common in peritoneal dialysis (PD) patients and is associated with increased cardiovascular and all-cause mortality. The management approach for such patients routinely includes spironolactone at our centre. We undertook this study to assess the efficacy of spironolactone for the treatment of hypokalemia in PD patients. METHODS: Retrospective chart review of PD patients at a single centre. Serum potassium was compared prior to initiation of spironolactone and two months afterwards...
2017: PloS One
https://www.readbyqxmd.com/read/29121886/the-strange-case-of-mr-h-starting-dialysis-at-90%C3%A2-years-of-age-clinical-choices-impact-on-ethical-decisions
#17
Giorgina Barbara Piccoli, Andreea Corina Sofronie, Jean-Philippe Coindre
BACKGROUND: Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. CASE PRESENTATION: Mr...
November 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29116212/causes-of-death-in-patients-with-severe-aortic-stenosis-an-observational-study
#18
Eri Minamino-Muta, Takao Kato, Takeshi Morimoto, Tomohiko Taniguchi, Hiroki Shiomi, Kenji Nakatsuma, Shinichi Shirai, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Makoto Miyake, Chisato Izumi, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Eiji Tada, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Toshikazu Jinnai, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Yuko Morikami, Naritatsu Saito, Ryuzo Sakata, Kenji Minatoya, Takeshi Kimura
Whether patients with severe aortic stenosis (AS) die because of AS-related causes is an important issue for the management of these patients. We used data from CURRENT AS registry, a Japanese multicenter registry, to assess the causes of death in severe AS patients and to identify the factors associated with non-cardiac mortality. We enrolled 3815 consecutive patients with a median follow-up of 1176 days; the 1449 overall deaths comprised 802 (55.3%) from cardiac and 647 (44.7%) from non-cardiac causes. Heart failure (HF) (25...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29111224/statin-treatment-in-dialysis-patients-after-acute-myocardial-infarction-improves-overall-mortality
#19
EDITORIAL
Ertugrul Ercan
While statins are widely accepted as a keystone for secondary prevention of cardiovascular disease in the general population, statin treatment in chronic renal failure is still debated. Statins have shown no benefit on cardiovascular outcomes in 4D, AURORA, and SHARP trials conducted in patients on dialysis. However, no study has yet compared statin treatment after acute myocardial infarction in end-stage renal disease (ESRD) patients. Statin treatment significantly decreases overall mortality in ESRD patients with acute myocardial infarction compared to the non-statin group...
October 23, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29108369/nephroureterectomy-increase-5-year-survival-in-patients-on-dialysis-with-upper-urinary-tract-urothelial-carcinoma
#20
Cih-En Huang, Yao-Hsu Yang, Wen-Cheng Chen, Kuo-Tsai Huang, Pau-Chung Chen, Ying-Huang Tsai, Wei-Yu Lin
Background: There is a high incidence rate of upper tract urothelial carcinoma (UTUC) in patients on dialysis. However, the studies about nephroureterectomy (NU) in this high surgical risk group are limited. The aim of this study is to investigate the outcomes of NU in this population. Results: There were total 931 patients enrolled and 218, 582, 131 patients were non-NU, unilateral and one-stage bilateral NU, respectively. NU provided better 5-year overall survival (66% versus 51% in non-NU, P = 0...
October 3, 2017: Oncotarget
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