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dialysis in end stage renal failure

Sudabeh Alatab, Iraj Najafi, Gholamreza Pourmand, Mostafa Hosseini, Soroosh Shekarchian
Peritoneal dialysis (PD) offers the healthiest way for starting renal replacement therapy (RRT) in End Stage Renal Disease patients, however exposes long-term PD patients to a dangerous complication named encapsulating peritoneal sclerosis (EPS). In this study, we searched for possible risk factors of EPS. Data were collected from two PD centers covering period 1995-2012 and comprised 464 patients. Control group defined as PD patients stayed on PD >42 month (n = 122), and case group was 12 confirmed EPS patients...
October 24, 2016: Renal Failure
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Je Hoon Jeong, Hee Kyung Kim, Soo Bin Im
BACKGROUND: Atlantoaxial spondyloarthropathy is most often resulted from rheumatoid arthritis, cancer metastasis and basilar invagination. Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy at the atlantoaxial joint. We report two long-term hemodialysis patients who presented with atlantoaxial spondyloarthropathy. CASE DESCRIPTION: Two patients with end-stage renal failure (ESRD) presented with history of progressively worsening neck pain and motion limitation, and gait disturbance...
October 19, 2016: World Neurosurgery
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Paolo Angeli, Dimitri Bezinover, Gianni Biancofiore, Anja Bienholz, James Findlay, Catherine Paugam Burtz, Koen Reyntjens, Tetsuro Sakai, Fuat H Saner, Dana Tomescu, Gebhard Wagener, Emmanuel Weiss
Acute kidney injury (AKI) is associated with high perioperative mortality. A series of AKI research breakthroughs are worth mentioning. First, in 2003, serum and urine biomarkers specific to AKI were identified. These biomarkers have contributed to early detection, prevention, and treatment of AKI. In 2004, AKI severity was defined with the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, which was developed by the International Consensus Conference Workgroup of the Acute Dialysis Quality Initiative...
October 19, 2016: Minerva Anestesiologica
Vishal Dey, Audrey Jones, Elaine M Spalding
INTRODUCTION: Telehealth technologies are being widely adopted across the globe for management of long-term conditions. There are limited data on its use, effectiveness and patient experience in end-stage renal disease. The aim of this pilot project was to explore patient acceptability of technology and evaluate its effect on clinical interventions and quality of life in patients undergoing peritoneal dialysis. METHODS: Peritoneal dialysis patients were provided with computer tablets (PODs)...
2016: SAGE Open Medicine
Joo Hoon Lee, Jae Suk Baek, Jeong Jin Yu, Young-Hwue Kim, Jae-Kon Ko, Young Seo Park
OBJECTIVE: To evaluate the relationship between B-type natriuretic peptide (BNP) and cardiac parameters on echocardiography. DESIGN AND METHOD: Echocardiography was checked at 6 months ∼ 1 year interval in children with end-stage renal disease on peritoneal dialysis, which was more frequently done in patients with hypertension or any heart problems. We reviewed blood pressure (BP) and echocardiographic findings of those children (since February 2005). Data were presented as mean ± standard deviation (median, minimum ∼ maximum)...
September 2016: Journal of Hypertension
Gergely Becs, Renáta Hudák, Zsolt Fejes, Ildikó Beke Debreceni, Harjit Pal Bhattoa, József Balla, János Kappelmayer
BACKGROUND: Mortality in patients with end-stage renal disorders is often a consequence of cardiovascular complications. Renal replacement therapies may contribute to this morbidity by promoting cellular activation. In renal failure patients peripheral blood samples were investigated for platelet and endothelial cell activation markers to compare the effects of haemodiafiltration (HDF) and haemodialysis (HD). METHODS: Overall 28 patients were included in the study...
October 13, 2016: BMC Nephrology
Yu Bin Shin, Jong Hoon Park
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is one of the most common inherited disorders. It is the fourth leading cause of renal replacement and renal failure worldwide. Mutations in PKD1 or PKD2 cause ADPKD. Patients with ADPKD show progressive growth of renal cysts filled with cystic fluid, leading to end-stage renal disease (ESRD) and renal failure by their sixth decade of life. Currently, there are no curative treatments for ADPKD. Therefore, patients require dialysis or kidney transplantation...
2016: Advances in Experimental Medicine and Biology
Jasmohan S Bajaj, Jacqueline G O'Leary, Puneeta Tandon, Florence Wong, Guadalupe Garcia-Tsao, Patrick S Kamath, Benedict Maliakkal, Scott W Biggins, Paul Thuluvath, Michael B Fallon, Ram M Subramanian, Hugo E Vargas, Jennifer Lai, Leroy R Thacker, K Rajender Reddy
: While survival of patients with cirrhosis has improved, hepatic encephalopathy (HE) remains a major complication and its relative contribution towards mortality in North America is unclear. AIM: To determine whether HE is associated with mortality independent of extra-hepatic organ failures (EHOF). METHODS: North American Consortium for Study of End-stage Liver Disease (NACSELD) consists of non-electively hospitalized patients with cirrhosis...
October 5, 2016: Clinical Gastroenterology and Hepatology
Mohammed Rafique Moosa, Jonathan David Maree, Maxwell T Chirehwa, Solomon R Benatar
Universal access to renal replacement therapy is beyond the economic capability of most low and middle-income countries due to large patient numbers and the high recurrent cost of treating end stage kidney disease. In countries where limited access is available, no systems exist that allow for optimal use of the scarce dialysis facilities. We previously reported that using national guidelines to select patients for renal replacement therapy resulted in biased allocation. We reengineered selection guidelines using the 'Accountability for Reasonableness' (procedural fairness) framework in collaboration with relevant stakeholders, applying these in a novel way to categorize and prioritize patients in a unique hierarchical fashion...
2016: PloS One
Joo Myung Lee, Jeehoon Kang, Euijae Lee, Doyeon Hwang, Tae-Min Rhee, Jonghanne Park, Hack-Lyoung Kim, Sang Eun Lee, Jung-Kyu Han, Han-Mo Yang, Kyung Woo Park, Sang-Hoon Na, Hyun-Jae Kang, Bon-Kwon Koo, Hyo-Soo Kim
OBJECTIVES: The purpose of this study was to evaluate the clinical impact of chronic kidney disease (CKD) on clinical outcomes in contemporary practice of percutaneous coronary intervention (PCI) using second-generation drug-eluting stents (DES). BACKGROUND: Although second-generation DES have improved the safety and efficacy issues in PCI, data regarding the performance of second-generation DES in patients with CKD are still limited. METHODS: We performed a patient-level pooled analysis on 12,426 patients undergoing PCI using second-generation DES from the Korean Multicenter Drug-Eluting Stent Registry...
October 24, 2016: JACC. Cardiovascular Interventions
Tahseen A Chowdhury, Danushan Srirathan, Georgi Abraham, Elizabeth L Oei, Stanley L Fan, Kieran McCafferty, M Magdi Yaqoob
Diabetes is an important cause of end stage renal failure worldwide. As renal impairment progresses, managing hyperglycaemia can prove increasingly challenging, as many medications are contra-indicated in moderate to severe renal impairment. Whilst evidence for tight glycaemic control reducing progression to renal failure in patients with established renal disease is limited, poor glycaemic control is not desirable, and is likely to lead to progressive complications. Metformin is first line therapy in patients with Type 2 diabetes, as it appears to be effective in reducing diabetes related end points and mortality in overweight patients...
September 30, 2016: Diabetes, Obesity & Metabolism
Oscar Swift, Enric Vilar, Belinda Rahman, Lucy Side, Daniel P Gale
AIMS: No recommendations currently exist regarding implementation of both prenatal diagnosis and preimplantation genetic diagnosis (PGD) for autosomal dominant polycystic kidney disease (ADPKD). This study evaluated attitudes in ADPKD patients with either chronic kidney disease (CKD) stages I-IV or end-stage renal failure (ESRF) toward prenatal diagnosis and PGD. METHODS: Ninety-six ADPKD patients were recruited from an outpatient clinic, wards, and dialysis units...
September 30, 2016: Genetic Testing and Molecular Biomarkers
Hannelore Sprenger-Mähr, Emanuel Zitt, Karl Lhotta
INTRODUCTION: The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. METHODS: We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015...
2016: PloS One
Yee C Lau, Marco Proietti, Elisa Guiducci, Andrew D Blann, Gregory Y H Lip
A bidirectional relationship exists between atrial fibrillation (AF) and chronic renal disease. Patients with AF have a higher incidence of renal dysfunction, and the latter predisposes to incident AF. The coexistence of both conditions results in a higher risk for thromboembolic-related adverse events but a paradoxical increased hemorrhagic risk. Oral anticoagulants (both vitamin K antagonists [VKAs] and non-VKA oral anticoagulants [NOACs]) have been demonstrated to be effective in mild to moderate renal dysfunction...
September 27, 2016: Journal of the American College of Cardiology
Joo Hoon Lee, Jae Suk Baek, Jeong Jin Yu, Young-Hwue Kim, Jae-Kon Ko, Young Seo Park
OBJECTIVE: To evaluate the relationship between B-type natriuretic peptide (BNP) and cardiac parameters on echocardiography. DESIGN AND METHOD: Echocardiography was checked at 6 months ∼ 1 year interval in children with end-stage renal disease on peritoneal dialysis, which was more frequently done in patients with hypertension or any heart problems. We reviewed blood pressure (BP) and echocardiographic findings of those children (since February 2005). Data were presented as mean ± standard deviation (median, minimum ∼ maximum)...
September 2016: Journal of Hypertension
Tammy Hod, Alexander S Goldfarb-Rumyantzev, Bhanu K Patibandla, Akshita Narra, Robert S Brown
BACKGROUND: In patients with failure of an initial arteriovenous fistula (AVF), a subsequent vascular access is needed before hemodialysis (HD) initiation. METHODS: To assess the optimal access strategy after a failed AVF, we linked data from the US Renal Data System with Medicare claims data identifying 21,436 patients ≥ 67 years old who started HD between January 1, 2005, and December 31, 2008, with an AVF placed as their first predialysis access. Of the 10,568 subjects whose AVF failed, 1,796 patients had an AVF placed as a second access predialysis (AVF2 group) and 399 patients had an arteriovenous graft placed as a second access predialysis (AVG2 group)...
November 2016: Clinical Nephrology
Thomas A Mavrakanas, David M Charytan
PURPOSE OF REVIEW: This review article focuses on the most significant cardiovascular complications in dialysis patients [sudden cardiac death (SCD), acute coronary syndromes, heart failure, and atrial fibrillation]. RECENT FINDINGS: Current and ongoing research aims to quantify the rate and pattern of significant arrhythmia in dialysis patients and to determine the predominant mechanism of SCD. Preliminary findings from these studies suggest a high rate of atrial fibrillation and that bradycardia and asystole may be more frequent than ventricular arrhythmia as a cause of sudden death...
November 2016: Current Opinion in Nephrology and Hypertension
Gautam R Shroff, Paolo Raggi
Extensive myocardial fibrosis is known to occur in patients undergoing dialysis due to a variety of mechanisms not necessarily restricted to coronary artery disease. Fibrosis may predispose to reentry arrhythmias and long-term myocardial dysfunction, and sudden death and congestive heart failure are the most frequent causes of death in patients undergoing renal replacement therapy. Despite the high accuracy of magnetic resonance for imaging of myocardial fibrosis, its use has been restricted by the risk of inducing nephrogenic systemic sclerosis with the injection of gadolinium...
October 2016: Kidney International
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