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dose adjustment in renal failure

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https://www.readbyqxmd.com/read/28693440/serum-lactate-level-and-mortality-in-metformin-associated-lactic-acidosis-requiring-renal-replacement-therapy-a-systematic-review-of-case-reports-and-case-series
#1
Hung-Chieh Yeh, I-Wen Ting, Ching-Wei Tsai, Jenn-Yu Wu, Chin-Chi Kuo
BACKGROUND: The current practice concerning timing, mode, and dose of renal replacement therapy (RRT) in patients with metformin-associated lactic acidosis (MALA) with renal failure remains unknown. To investigate whether serum lactate level and prescription pattern of RRT are associated with mortality in patients with MALA requiring RRT. METHODS: We searched PubMed/Medline and EMBASE from inception to Sep 2014 and applied predetermined exclusion criteria. Case-level data including case's demographics and clinical information related to MALA were abstracted...
July 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28675584/does-secretory-clearance-follow-glomerular-filtration-rate-in-chronic-kidney-diseases-reconsidering-the-intact-nephron-hypothesis
#2
A Chapron, D D Shen, B R Kestenbaum, C Robinson-Cohen, J Himmelfarb, C K Yeung
Drug-dose modification in chronic kidney disease (CKD) utilizes glomerular filtration rate (GFR) with the implicit assumption that multiple renal excretory processes decline in parallel as CKD progresses. We compiled published pharmacokinetic data to evaluate if GFR predicts renal clearance changes as a function of CKD severity. For each drug, we calculated ratio of renal clearance to filtration clearance (Rnf). Of 21 drugs with Rnf >0.74 in subjects with GFR >90 mL/min (implying filtration and secretion), 13 displayed significant change in Rnf vs...
July 4, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28652444/reticulocyte-hemoglobin-content-helps-avoid-iron-overload-in-hemodialysis-patients-a-retrospective-observational-study
#3
Domenico Capone, Mauro Cataldi, Mauro Viniguerra, Teresa Mosca, Salvatore Barretta, Annalisa Ragosta, Aniello Sorrentino, Alessandra Vecchione, Luca Barretta, Giovanni Tarantino
BACKGROUND/AIM: Anemia in patients suffering from end-stage renal failure is currently treated with Erythropoiesis-Stimulating Agents (ESA). This treatment needs sufficient iron supplementation to avoid an inadequate dosage of ESA. Nowadays modern analytical instruments allow to accurately calculate the content of Hemoglobin (Hb) in reticulocytes (CHr), that can be used as a guide for prescribing patients with the appropriate amount of iron. PATIENTS AND METHODS: Patients, undergoing hemodialysis, were retrospectively selected from the database and were divided in two groups: group A received intravenous (IV) iron and subcutaneously ESA, and their dosages were adjusted on the basis of the following parameters: Hb, Mean corpuscular haemoglobin (MCH), CHr with consequent MCH/CHr ratio and reticulocyte count determined by the ADVIA 120 Hematology System of Siemens; group B patients were administered IV iron and ESA monitoring iron storage, Hb and ferritin...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28633804/protective-effect-of-n-acetylcysteine-on-progression-to-end-stage-renal-disease-necessity-for-prospective-clinical-trial
#4
Chen-Yi Liao, Chi-Hsiang Chung, Chai-Chao Wu, Fu-Huang Lin, Chang-Huei Tsao, Chih-Chiang Wang, Wu-Chien Chien
BACKGROUND: We aimed to evaluate the potential benefits of N-acetylcysteine (NAC) on the risk of chronic kidney disease (CKD) progression to dialysis-requiring end-stage renal disease (ESRDd). METHODS: In a population-based cohort study of 145,062 individuals, 123,608 CKD patients who were followed up for 10years were included, and CKD patients treated with NAC (ICD-9-CM) were compared with those who were not treated. Using propensity score matching, we analyzed the predictors of CKD progression to ESRDd by Cox proportional hazards regression with adjustments for sex, age, and comorbidities, and evaluated the effect of NAC using cumulative defined daily dose (cDDD)...
June 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28532770/changes-in-loop-diuretic-dose-and-outcome-after-cardiac-resynchronization-therapy-in-patients-with-heart-failure-and-reduced-left-ventricular-ejection-fractions
#5
Pieter Martens, Frederik H Verbrugge, Petra Nijst, Matthias Dupont, Wilfried Mullens
Cardiac resynchronization therapy (CRT) improves cardiac hemodynamics. Therefore, the maintenance dose of loop diuretic therapy might be reduced. Consecutive patients who underwent CRT (n = 648) were retrospectively evaluated. Loop diuretic dose was recorded at baseline before implantation and 6 months later with patients classified into 4 groups: (1) no loop diuretic, (2) down-titration, (3) unchanged dose, and (4) up-titration. Afterward total loop diuretic exposure was calculated. Renal function trajectories were evaluated as the difference between implantation and censoring serum creatinine (Cr) value...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28515811/first-line-sunitinib-or-pazopanib-in-metastatic-renal-cell-carcinoma-the-canadian-experience
#6
Aly-Khan A Lalani, Haocheng Li, Daniel Y C Heng, Lori Wood, Austin Kalirai, Georg A Bjarnason, Hao-Wen Sim, Christian K Kollmannsberger, Anil Kapoor, Sebastien J Hotte, Marie Vanhuyse, Piotr Czaykowski, M Neil Reaume, Denis Soulieres, Peter Venner, Scott North, Naveen S Basappa
INTRODUCTION: Clinical trial data has shown pazopanib to be non-inferior in overall survival (OS) compared to sunitinib as first-line treatment for metastatic renal cell carcinoma (mRCC). The purpose of this study was to evaluate outcomes and compare dose-modifying toxicities of mRCC patients treated with suntinib or pazopanib in the real-world setting. METHODS: Data were collected on mRCC patients using the prospective Canadian Kidney Cancer Information System (CKCis) database from January 2011 to November 2015...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28511545/fosfomycin-tromethamine-for-the-treatment-of-cystitis-in-abdominal-solid-organ-transplant-recipients-with-renal-dysfunction
#7
Luiza Kerstenetzky, Margaret R Jorgenson, Jillian L Descourouez, Glen Leverson, Warren E Rose, Robert R Redfield, Jeannina A Smith
BACKGROUND: Urinary tract infection (UTI) after abdominal solid organ transplantation (SOT) is associated with significant morbidity and mortality. Fosfomycin tromethamine (FOS), a uroselective antibiotic, is FDA approved for uncomplicated UTIs in women and is used off-label for complicated UTIs and prostatitis in men. Literature supporting the use of FOS in the SOT population is limited, and efficacy is questioned in the setting of renal dysfunction. OBJECTIVE: To evaluate the success of FOS for the treatment of cystitis in SOT patients with renal dysfunction...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28487576/risk-factors-for-nephrotoxicity-associated-with-cisplatin
#8
Karine Almanric, Nathalie Marceau, Ariane Cantin, Émilie Bertin
BACKGROUND: Cisplatin-induced nephrotoxicity occurs in about one-third of patients who receive this chemotherapy drug. In late 2012, the study institution began measuring serum creatinine on day 7 after administration of cisplatin to identify patients with acute renal failure. OBJECTIVE: To evaluate the extent of nephrotoxicity associated with cisplatin and the influence of risk factors for nephrotoxicity. METHODS: This retrospective study involved patients who received a first cycle of cisplatin-based chemotherapy between November 1, 2012, and November 1, 2013...
March 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28459916/direct-oral-anticoagulants-doacs-current-status-among-distinct-patient-subgroups
#9
Peter Riley, Abhishek Maan, Kenneth S Korr
The landscape of anticoagulant therapy for atrial fibrillation and deep-vein thrombosis has evolved considerably in the last decade with the advent of Novel or Direct-Acting Oral Antiocoagulants (DOACs). The initial phase III randomized controlled trials established the individual DOACs as viable alternatives to warfarin for thromboprophylaxis but generalizations to the larger population were limited by the small number of protocol subjects with renal insufficiency, congestive heart failure, advanced age and other comorbidities...
May 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28456704/outpatient-treatment-of-osteomyelitis-with-telavancin
#10
Claudia P Schroeder, Lucinda J Van Anglen, Robin H Dretler, John S Adams, Richard C Prokesch, Quyen Luu, Andrew H Krinsky
Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres...
July 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#11
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28443283/vascular-access-site-for-renal-replacement-therapy-in-acute-kidney-injury-a-post-hoc-analysis-of-the-atn-study
#12
Yue-Harn Ng, Kavitha Ganta, Herbert Davis, V Shane Pankratz, Mark Unruh
BACKGROUND: Acute kidney injury requiring renal replacement therapy (RRT) in the intensive care unit portends a poor prognosis. The decisions regarding dialysis catheter placement is based mainly on physician discretion with little evidence to support the choice of dialysis catheter location. METHODS: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive vs. less intensive RRT in critically ill patients with AKI...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28439485/treatment-of-atypical-hemolytic-uremic-syndrome-in-the-era-of-eculizumab
#13
Rawaa Ebrahem, Salam Kadhem, Quoc Truong
Hemolytic-uremic syndrome (HUS) is the triad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI); the main cause of multi-organ failure is related to thrombotic microangiopathy (TMA). Atypical HUS (aHUS) is a disease of uncontrolled complement activation associated with a high mortality rate and most cases progress to end-stage renal disease. About 50% of patients with this syndrome carry mutations in genes that encode complement proteins. Also, aHUS constitutes an over-activation of the complement pathway which is either inherited, acquired, or both...
March 23, 2017: Curēus
https://www.readbyqxmd.com/read/28433216/implications-of-alternative-hepatorenal-prognostic-scoring-systems-in-acute-heart-failure-from-dose-ahf-and-rose-ahf
#14
Justin L Grodin, Dianne Gallup, Kevin J Anstrom, G Michael Felker, Horng H Chen, W H Wilson Tang
Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28370487/contrast-induced-nephropathy-in-patients-undergoing-endovascular-peripheral-vascular-intervention-incidence-risk-factors-and-outcomes-as-observed-in-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium
#15
P Michael Grossman, Syed S Ali, Herbert D Aronow, Michael Boros, Timothy J Nypaver, Theodore L Schreiber, Yeo Jung Park, Peter K Henke, Hitinder S Gurm
BACKGROUND: The incidence, risk factors, and outcomes associated with Contrast-induced nephropathy (CIN) after Percutaneous Vascular Intervention (PVI) in contemporary medical practice are largely unknown. METHODS: A total of 13 126 patients undergoing PVI were included in the analysis. CIN was defined as an increase in serum creatinine from pre-PVI baseline to post-PVI peak Cr of ≥0.5 mg/dL. RESULTS: CIN occurred in 3% (400 patients) of the cohort, and 26 patients (6...
April 3, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28341412/dorsal-muscle-attenuation-may-predict-failure-to-respond-to-interleukin-2-therapy-in-metastatic-renal-cell-carcinoma
#16
Bamidele Otemuyiwa, Brian A Derstine, Peng Zhang, Sandra L Wong, Michael S Sabel, Bruce G Redman, Stewart C Wang, Ajjai S Alva, Matthew S Davenport
RATIONALE AND OBJECTIVES: To explore whether the sarcopenia body type can help predict response to interleukin-2 (IL-2) therapy in metastatic renal cell carcinoma (RCC). MATERIALS AND METHODS: Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant retrospective cohort study of 75 subjects with metastatic RCC who underwent pretreatment contrast-enhanced computed tomography within 1 year of initiating IL-2 therapy...
March 21, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28336157/-prescription-of-acetaminophen-in-five-french-hospitals-what-are-the-practices
#17
Jean-Baptiste Pace, Viviane Nave, Mélanie Moulis, Magali Bourdelin, Sandra Coursier, Élodie Jean-Bart, Bertrand Leroy, Jean-Louis Bonnefous, Hervé Bontemps, Jérôme Coutet, Carine Eyssette, Emmanuelle Pont
AIM: Acetaminophen is widely used in hospital settings and often considered as nontoxic. We conducted a multicentric study in order to evaluate its proper use. METHOD: Prescriptions from five general hospitals were analyzed, according to dose adjustments required in renal or liver failure, weight or chronic alcoholism, determined using a literature review. Other criteria have been assessed: indication for parenteral access, accuracy of administration time and pain assessment...
February 22, 2017: Thérapie
https://www.readbyqxmd.com/read/28275227/halogenated-volatile-anesthetics-in-the-intensive-care-unit-current-knowledge-on-an-upcoming-practice
#18
Pascal L Langlois, Frederick D'Aragon, William Manzanares
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28273997/teneligliptin-in-management-of-diabetic-kidney-disease-a-review-of-place-in-therapy
#19
REVIEW
Mohammed Abubaker, Preetesh Mishra, Onkar C Swami
Diabetes is a global health emergency of this century. Diabetic nephropathy is the most common microvascular complication associated with Type 2 Diabetes Mellitus (T2DM). T2DM has been reported as a major etiological factor in almost 45% of patients undergoing dialysis due to kidney failure. Lifestyle modifications; cessation of smoking, optimum control of blood glucose, blood pressure and lipids are required to reduce the progression of Diabetic Kidney Disease (DKD). Presently, Dipeptidyl peptidase-4 (DPP-4) inhibitors are preferred in the management of T2DM due to their established efficacy; favorable tolerability including, low risk of hypoglycaemia; weight neutrality and convenient once-a-day dosage...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203342/optimizing-current-and-emerging-therapies-in-multiple-myeloma-a-guide-for-the-hematologist
#20
REVIEW
Shahzad Raza, Rachael A Safyan, Evan Rosenbaum, Alex S Bowman, Suzanne Lentzsch
Multiple myeloma (MM) is the second most common hematologic malignancy. The diagnosis of MM requires ⩾10% clonal plasma cells in the bone marrow or biopsy-proven plasmacytoma, plus evidence of end-organ damage (hypercalcemia, renal failure, anemia, and lytic bone lesions). The definition of MM has recently been expanded to include a ⩾60% clonal plasma cell burden in the bone marrow, serum involved/uninvolved light chain ratio of ⩾100, or more than one focal lesion on magnetic resonance imaging ⩾5 mm in the absence of end-organ damage...
February 2017: Therapeutic Advances in Hematology
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