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dose adjustment in renal failure

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https://www.readbyqxmd.com/read/29140472/uric-acid-predicts-adverse-outcomes-in-chronic-kidney-disease-a-novel-insight-from-trajectory-analyses
#1
Ching-Wei Tsai, Hsien-Tsai Chiu, Han-Chun Huang, I-Wen Ting, Hung-Chieh Yeh, Chin-Chi Kuo
Background: Very little is known about longitudinal trajectories of serum uric acid (SUA) over the course of chronic kidney disease (CKD). We aimed to determine whether longitudinal SUA trajectories are associated with the risk of end-stage renal disease (ESRD) and all-cause mortality among CKD patients. Methods: We conducted a prospective cohort study from a 13-year multidisciplinary pre-ESRD care registry. The final study population consisted of 5090 CKD patients aged 20-90 years between 2003 and 2015...
November 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29109576/baseline-competency-assessment-of-pharmacists-prescribing-and-managing-vancomycin-therapy-in-the-regina-qu-appelle-health-region
#2
Kirsten Tangedal, Jennifer Bolt, Suzanne Len, Ali Bell
Background: Pharmacists in the Regina Qu'Appelle Health Region (RQHR), Saskatchewan, independently dose, monitor, and adjust vancomycin therapy. No framework exists for ongoing competency assessment of pharmacists. Objectives: The primary objective was to determine pharmacists' overall level of competency for all components of the vancomycin prescribing procedure. The secondary objectives were to determine competency for individual prescribing phases, to stratify overall competency in relation to pharmacist and patient factors, and to identify the 3 most frequent errors...
September 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29104841/a-unique-case-of-drug-interaction-between-ticagrelor-and-statin-leading-to-acute-renal-failure
#3
Gbeminiyi Samuel, Adebayo C Atanda, Alex Onyemeh, Ahmad Awan, Oyintayo Ajiboye
Dual antiplatelet agents and high-intensity statins are frequently used in combination after myocardial infarction. Ticagrelor has the potential of causing acute kidney injury. Rosuvastatin is excreted through the kidneys and dose adjustment is needed in patients with kidney disease. When used in combination, they can potentiate the toxic effects of each other. We report a case of drug interaction between rosuvastatin and ticagrelor resulting in rhabdomyolysis and acute renal failure necessitating dialysis...
August 31, 2017: Curēus
https://www.readbyqxmd.com/read/29064811/-the-risk-of-epileptic-seizures-during-antibiotic-therapy
#4
Ewa Czapińska-Ciepiela
Numerous antibiotics may trigger epileptic seizures or status epilepticus by decreasing inhibitory transmission in the brain, thus lowering the seizure threshold. The most potent seizurogenic effect is exerted by penicillins, cephalosporins, fluorochinolons and carbapenems. Predisposing factors that facilitate development of epileptic seizures in the course of antibiotic therapy comprise all conditions accompanied by damage to the blood-brain barrier (including cerebral trauma and encephalitis), a high dose of an antibiotic or lack of adequate dose adjustment in patients with renal failure...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28983844/the-role-of-vildagliptin-in-the-therapy-of-type-2-diabetic-patients-with-renal-dysfunction
#5
REVIEW
Roberto Trevisan
Diabetes is the leading cause of chronic kidney disease, and even in the absence of albuminuria, decreased renal function in type 2 diabetes mellitus (T2DM) patients increases the risk for major adverse cardiovascular events and death. The evidence derived from recent studies suggests that intensive glucose control not only reduces the risk for microalbuminuria and macroalbuminuria but may also decrease the rate of decline of glomerular filtration rate (GFR). Although insulin therapy is widely used in patients with T2DM and renal disease, metabolic control is particularly difficult to achieve and manage because of the limited therapeutic options and the frequent comorbidities seen in this population...
December 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28978898/therapeutic-drug-monitoring-simulator-for-antibiotic-dosage-for-methicillin-resistant-staphylococcus-aureus-sepsis-in-a-patient-with-primary-immunodeficiency-on-peritoneal-dialysis
#6
Hidehiko Narazaki, Yusuke Terada, Kiyohiko Kaizu, Toyo Jitsukawa, Yasuhiko Ito, Takeshi Asano
Bacterial infections often cause fatal systemic infections in patients with primary immunodeficiency. To prevent unfortunate results, the selection, dose, and dosage of antibiotics are extremely important. Here, we report a case of Wiskott-Aldrich syndrome in a patient undergoing peritoneal dialysis because of chronic renal failure in whom methicillin-resistant Staphylococcus aureus sepsis developed. Because of the primary disease and complications, teicoplanin was the only chosen anti-S. aureus drug to prevent side effects...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28937522/ambulatory-high-dose-methotrexate-administration-in-pediatric-osteosarcoma-patients-at-a-single-institution-in-argentina
#7
Jose A Villegas Rubio, Walter Cacciavillano, Adriana Rose, Pedro Zubizarreta, Marcelo Scopinaro
BACKGROUND: The purpose of this study was to evaluate the feasibility and safety of ambulatory high-dose methotrexate (HDMTX) administration with oral hydration, alkalinization, and leucovorin rescue. HDMTX (12 g/m) was given intravenously over 4 hours after urine alkalinization. Families and patients were instructed to continue ambulatory oral hydration and alkalinization to monitor urine pH and to adjust bicarbonate according to our institution's treatment algorithm. Clinical status and MTX levels were controlled every 24 hours, and oral leucovorin dose was adjusted accordingly...
October 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28904326/intravenous-polymyxins-revival-with-puzzle
#8
Yun Yu, Aihua Fei, Zengbin Wu, Chengjin Gao, Shuming Pan
With the increasing incidence of multi-drug resistant strains, especially carbapenem resistant strains, polymyxsins (mainly colistin and polymyxin B) based regimens seem to be a revival as an effective treatment of last resort in these infections. Evidence from 47 clinical trials or case series we reviewed showed that polymyxins based regimens are effective and have less toxicity compared with previous trials. When used alone, the mortality of intravenous polymyxsins ranged from 0% to 74.3%, clinical response (cure and improvement) rate was 7-82...
2017: Bioscience Trends
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#9
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
September 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28775205/therapy-related-hematological-malignancies-after-peptide-receptor-radionuclide-therapy-with-177-lu-dota-octreotate-incidence-course-predicting-factors-in-patients-with-gep-nets
#10
Hendrik Bergsma, Kirsten van Lom, Mark Konijnenberg, Boen Kam, Jaap Teunissen, Wouter de Herder, Eric Krenning, Dik Kwekkeboom
Peptide Receptor Radionuclide Therapy (PRRT) may induce long-term toxicity to the bone marrow (BM). The aim of this study was to analyze persistent dysfunction of the hematopoietic system after PRRT with (177)Lu-DOTATATE in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Methods: The incidence and course of persistent hematological dysfunction (PHD) was analyzed in 274 (=GEP-NET) out of 367 patients with somatostatin receptor-positive tumors. PHD was defined as diagnosis of Myelodysplastic Syndrome (MDS), Acute Myeloid Leukemia (AML), Myeloproliferative Neoplasms (MPN), Myelodysplastic/Myeloproliferative neoplasms (MDS/MPN) or otherwise unexplained cytopenia (for more than 6 months)...
August 3, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28766263/a-phase-ii-study-of-combination-therapy-with-oral-s-1-and-cisplatin-in-elderly-patients-with-advanced-gastric-cancer
#11
Yusuke Sasaki, Satoru Iwasa, Shunsuke Okazaki, Masahiro Goto, Yasushi Kojima, Atsushi Naganuma, Kengo Nagashima, Yushi Nagai, Hidekazu Hirano, Yoshitaka Honma, Atsuo Takashima, Ken Kato, Tetsuya Hamaguchi
BACKGROUND: A combination of S-1 and cisplatin is recognized as one of the standard first-line chemotherapy regimens for patients with advanced gastric cancer. However, demographic analyses of pivotal phase III studies have showed that only a minority of treated patients were aged 76 years or older. The purpose of this phase II study was to evaluate the safety and efficacy of combination therapy with S-1 and cisplatin in elderly patients with chemotherapy-naive advanced gastric cancer...
August 1, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28761677/comparison-of-the-chronic-kidney-disease-epidemiology-collaboration-the-modification-of-diet-in-renal-disease-study-and-the-cockcroft-gault-equation-in-patients-with-heart-failure
#12
Karolina Szummer, Marie Evans, Juan Jesus Carrero, Urban Alehagen, Ulf Dahlström, Lina Benson, Lars H Lund
BACKGROUND: It is unknown how the creatinine-based renal function estimations differ for dose adjustment cut-offs and risk prediction in patients with heart failure. METHOD AND RESULTS: The renal function was similar with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (median 59 mL/min/1.73 m(2), IQR 42 to 77) and Modification of Diet in Renal Disease Study (MDRD) (59 mL/min/1.73 m(2), IQR 43 to 75) and slightly lower with the Cockcroft-Gault (CG) equation (57 mL/min, IQR 39 to 82)...
2017: Open Heart
https://www.readbyqxmd.com/read/28739270/discrepancies-between-the-use-of-mdrd-4-idms-and-ckd-epi-equations-instead-of-the-cockcroft-gault-equation-in-the-determination-of-the-dosage-of-direct-oral-anticoagulants-in-patients-with-non-valvular-atrial-fibrillation
#13
Alejandro Isidoro Pérez Cabeza, Pedro Antonio Chinchurreta Capote, Jose Antonio González Correa, Francisco Ruiz Mateas, Gabriel Rosas Cervantes, Francisco Rivas Ruiz, Almudena Valle Alberca, Rafael Bravo Marqués
BACKGROUND AND OBJECTIVE: Direct oral anticoagulants (DOACs) require dose adjustment according to estimated clearance creatinine (eClCr) using the Cockcroft-Gault (CG) equation. There are discrepancies with the equations that estimate glomerular filtration rate (eGFR). We analyse how the use of the CKD-EPI and MDRD-4 IDMS equations affect the recommended dosage for ACODs. PATIENTS AND METHODS: Retrospective study of patients with non-valvular atrial fibrillation seen at a cardiology clinic between November 2012 and August 2014...
July 21, 2017: Medicina Clínica
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
#14
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
#15
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...
September 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
#16
Domenico Capone, Mauro Cataldi, Mauro Vinciguerra, 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
#17
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
#18
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
#19
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
#20
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
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