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https://www.readbyqxmd.com/read/29334366/modified-colistin-regimen-for-critically-ill-patients-with-acute-renal-impairment-and-continuous-renal-replacement-therapy
#1
Pierantonio Menna, Emanuela Salvatorelli, Alessia Mattei, Dario Cappiello, Giorgio Minotti, Massimiliano Carassiti
Colistin is a last resort antibiotic to treat multidrug-resistant Gram-negative bacteria infections. Colistin is administered intravenously in the form of its inactive prodrug colistin methanesulfonate (CMS). For patients with acute kidney impairment and continuous renal replacement therapy high extracorporeal clearance may cause a substantial removal of active colistin from the bloodstream, eventually decreasing its antibacterial efficacy. Currently recommended doses of CMS may therefore be inadequate for these patients...
December 22, 2017: Chemotherapy
https://www.readbyqxmd.com/read/29334234/is-there-an-association-between-severity-of-illness-and-psychiatric-symptoms-in-patients-with-chronic-renal-failure
#2
D Guenzani, M Buoli, G S Carnevali, M Serati, P Messa, S Vettoretti
Chronic renal failure (CRF) is a frequent condition in elderly subjects, and it is associated with psychiatric comorbidity, especially depressive symptoms. Purpose of the present research was to compare patients with different severity of chronic kidney disease (CKD) in terms of psychiatric symptoms. One hundred CKD subjects were randomly selected among those attending the Department of Nephrology, University of Milan. The patients were evaluated through the following rating scales: Mini-Mental State Examination (MMSE), Beck Depression Inventory (BDI), Symptom Checklist (SCL-90), Kidney Disease Quality of Life- Short Form (KDQOL-SF) and Cumulative Illness Rating Scale (CIRS)...
January 15, 2018: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#3
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29332911/impact-of-continuous-administration-of-tolvaptan-on-preventing-medium-term-worsening-renal-function-and-long-term-adverse-events-in-heart-failure-patients-with-chronic-kidney-disease
#4
Yusuke Nakano, Tomofumi Mizuno, Toru Niwa, Kentaro Mukai, Hirokazu Wakabayashi, Atsushi Watanabe, Hirohiko Ando, Hiroaki Takashima, Kenta Murotani, Katsuhisa Waseda, Tetsuya Amano
Tolvaptan (TLV) has an inhibiting effect for worsening renal function (WRF) in acute decompensated heart failure (HF) patients. However, there are limited data regarding the effect of continuous TLV administration on medium-term WRF.This was a retrospective observational study in hospitalized HF patients with chronic kidney disease (CKD). TLV was administered to those patients with fluid retention despite standard HF therapy. We compared 34 patients treated with TLV (TLV group) to 33 patients treated with conventional HF therapy with high-dose loop diuretics (furosemide ≥ 40 mg) (Loop group)...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29329521/treating-c3-glomerulopathy-with-eculizumab
#5
Thomas Welte, Frederic Arnold, Julia Kappes, Maximilian Seidl, Karsten Häffner, Carsten Bergmann, Gerd Walz, Elke Neumann-Haefelin
BACKGROUND: C3 glomerulopathy (C3G) is a rare, but severe glomerular disease with grim prognosis. The complex pathogenesis is just unfolding, and involves acquired as well as inherited dysregulation of the alternative pathway of the complement cascade. Currently, there is no established therapy. Treatment with the C5 complement inhibitor eculizumab may be a therapeutic option. However, due to rarity of the disease, parameters predicting treatment response remain largely unknown. METHODS: Seven patients with C3G (five with C3 glomerulonephritis and two with dense deposit disease) were treated with eculizumab...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29329305/evaluating-the-efficacy-of-switching-from-lamivudine-plus-adefovir-to-tenofovir-disoproxil-fumarate-monotherapy-in-lamivudine-resistant-stable-hepatitis-b-patients
#6
Heon Ju Lee, Sang Jin Kim, Young Oh Kweon, Soo Young Park, Jeong Heo, Hyun Young Woo, Jae Seok Hwang, Woo Jin Chung, Chang Hyeong Lee, Byung Seok Kim, Jeong Ill Suh, Won Young Tak, Byoung Kuk Jang
BACKGROUND: The efficacy of switching to tenofovir disoproxil fumarate (TDF) monotherapy from lamivudine (LAM) plus adefovir dipivoxil (ADV) combination therapy (stable switching) in patients with LAM-resistant chronic hepatitis B (CHB) and undetectable hepatitis B virus (HBV) DNA is not clear. METHODS: In this non-inferiority trial, patients with LAM-resistant CHB and undetectable serum HBV DNA (<20 IU/mL) for >6 months after initiating LAM+ADV combination therapy were randomized (1:2) either to continue the combination therapy (LAM+ADV group, n = 58) or switched to TDF monotherapy (TDF group, n = 111)...
2018: PloS One
https://www.readbyqxmd.com/read/29327565/durability-of-fenestrated-endovascular-aortic-repair-for-juxta-renal-abdominal-aortic-aneurysm-repair
#7
Konstantinos Spanos, George Α Antoniou, Athanasios D Giannoukas, Fiona Rohlffs, Nikolaos Tsilimparis, Sebastian E Debus, Tilo Kölbel
BACKGROUND: The aim of this study was to evaluate the long term durability of fenestrated endovascular aortic aneurysm repair (F-EVAR) of juxta-renal aortic aneurysms (JAAAs) in terms of mortality, target visceral vessel (TVV) patency and re-intervention rates. EVIDENCE ACQUISITION: A systematic review and meta-analysis was performed. MEDLINE, CENTRAL, and Cochrane databases were searched with PRISMA methodology for studies reporting on F-EVAR of JAAA presenting follow up > 36 months...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29325951/shunt-nephritis-an-increasingly-unfamiliar-diagnosis
#8
Tessa A Harland, Ken R Winston, Anna J Jovanovich, Richard J Johnson
BACKGROUND: Shunt nephritis is a rare, reversible immune-complex mediated complication of CSF shunt infection that can progress to end-stage renal disease and even death if diagnosis is delayed. CASE DESCRIPTION: The present case report details the manifestation and clinical course of shunt nephritis in a 50-year old patient who presented with symptoms of nephrotic syndrome 30 years after ventriculo-jugular shunt placement. Diagnosis was delayed due to initial negative CSF and blood cultures but later a CSF culture was positive for Propionibacterium acnes...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325761/trends-in-utilization-of-robotic-and-open-partial-nephrectomy-for-management-of-ct1-renal-masses
#9
Mahmoud Alameddine, Tulay Koru-Sengul, Kevin J Moore, Feng Miao, Luís Felipe Sávio, Bruno Nahar, Nachiketh Soodana Prakash, Vivek Venkatramani, Joshua S Jue, Sanoj Punnen, Dipen J Parekh, Chad R Ritch, Mark L Gonzalgo
BACKGROUND: Partial nephrectomy is widely used for surgical management of small renal masses. Use of robotic (RPN) versus open partial nephrectomy (OPN) among various populations is not well characterized. OBJECTIVE: To analyze trends in utilization of RPN and disparities that may be associated with this procedure for management of cT1 renal masses in the USA. DESIGN, SETTING, AND PARTICIPANTS: Patients who underwent RPN or OPN for clinical stage T1N0M0 renal masses in the USA from 2010 to 2013 were identified in the National Cancer Data Base...
January 8, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29325738/the-effect-of-patient-and-surgical-characteristics-on-renal-function-after-partial-nephrectomy
#10
Andrew G Winer, Emily C Zabor, Michael J Vacchio, A Ari Hakimi, Paul Russo, Jonathan A Coleman, Edgar A Jaimes
BACKGROUND: The purpose of the study was to identify patient and disease characteristics that have an adverse effect on renal function after partial nephrectomy. PATIENTS AND METHODS: We conducted a retrospective review of 387 patients who underwent partial nephrectomy for renal tumors between 2006 and 2014. A line plot with a locally weighted scatterplot smoothing was generated to visually assess renal function over time. Univariable and multivariable longitudinal regression analyses incorporated a random intercept and slope to evaluate the association between patient and disease characteristics with renal function after surgery...
December 6, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29324487/renal-replacement-therapy-in-critically-ill-patients-who-when-why-and-how
#11
Melanie Meersch, Alexander Zarbock
PURPOSE OF REVIEW: The increasing incidence of acute kidney injury has the immediate effect of a growing need for renal replacement therapy (RRT). Shedding light on the questions of who, when, why, and how RRT should be performed is difficult to accomplish because of ambiguous study results, poor quality evidence, and low standardization. RECENT FINDINGS: Critically ill patients are exposed to multiple factors known to deteriorate kidney function. Especially severe fluid overload is strongly associated with worse outcome and may be considered as a trigger for initiating RRT...
January 10, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29323719/the-multifaceted-link-between-inflammation-and-human-diseases
#12
Peramaiyan Rajendran, Ya-Fang Chen, Yu-Feng Chen, Li-Chin Chung, Shanmugam Tamilselvi, Chia-Yao Shen, Cecilia Hsuan Day, Ray-Jade Chen, Vijaya Padma Viswanadha, Wei-Wen Kuo, Chih-Yang Huang
Increasing reports on epidemiological, diagnostic and clinical studies suggest that dysfunction of the inflammatory reaction results in chronic illnesses such as cancer, arthritis, arteriosclerosis, neurological disorders, liver diseases, and renal disorders. Chronic inflammation might progress if injurious agent persists; however, more typically than not, the response is chronic from the start. Distinct to most changes in acute inflammation, chronic inflammation is characterized by the infiltration of damaged tissue by mononuclear cells like macrophages, lymphocytes, and plasma cells, in addition to tissue destruction and attempts to repair...
January 11, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29323077/epidermoid-cyst-of-the-renal-pelvis-masquerading-as-malignancy
#13
Dinesh Pradhan, Gabriela Quiroga-Garza, Ronald Hrebinko, Rajiv Dhir, Anil V Parwani
Epidermoid cyst of the renal pelvis is exceptionally rare. The histogenetic mechanism has not been well characterized. Herein, we report a case of intrarenal epidermoid cyst in a 62-year-old woman who had undergone left nephrolithotomy for a staghorn calculus. She was being followed up for bilateral renal cysts when a complex mass was noted arising from the lower pole of the left kidney. Renal ultrasound showed a small left kidney with a solid vascular echogenic mass. A laparoscopic radical nephrectomy was performed...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29322215/-assessment-of-kidney-function-creatinine-is-not-the-whole-story
#14
REVIEW
U Huynh-Do, M Fiedler, B Vogt
Chronic renal insufficiency has a high prevalence and leads not only to a severe impairment in the quality of life but also to a higher mortality, mainly due to cardiovascular complications; however, in the early stages where there is still a chance for a therapeutic intervention, it is often underestimated because depending on endogenous factors (e.g. age and muscle mass), serum creatinine could falsely remain in the normal range while kidney function is already impaired. An exact measurement of the glomerular filtration rate (GFR) using radionuclide techniques is cumbersome and usually confined to rare cases, such as in clinical studies...
January 10, 2018: Der Internist
https://www.readbyqxmd.com/read/29322206/-perioperative-handling-of-anticoagulation
#15
REVIEW
J F Lock, J Wagner, V Luber, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms...
January 10, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29319767/variables-associated-with-lung-congestion-as-assessed-by-chest-ultrasound-in-diabetics-undergoing-hemodialysis
#16
Paulo Roberto Santos, José Antonio de Lima Neto, Raimundo Aragão Aires Carneiro, Antônio Igor Taumaturgo Dias Soares, Wanessa Ribeiro de Oliveira, Juliana Oliveira Figueiredo, Narcélio Menezes Silva Filho, Thais Oliveira Silva
INTRODUCTION: Ultrasound is an emerging method for assessing lung congestion but is still seldom used. Lung congestion is an important risk of cardiac events and death in end-stage renal disease (ESRD) patients on hemodialysis (HD). OBJECTIVE: We investigated possible variables associated with lung congestion among diabetics with ESRD on HD, using chest ultrasound to detect extracellular lung water. METHODS: We studied 73 patients with diabetes as the primary cause of ESRD, undergoing regular HD...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319618/effect-of-conversion-to-ctla4ig-treatment-on-tacrolimus-induced-diabetic-rats
#17
Long Jin, Sun Woo Lim, Jian Jin, Kang Luo, Eun Jeong Ko, Byung Ha Chung, Hong Li Lin, Chul Woo Yang
BACKGROUND: The effect of conversion to cytotoxic T-lymphocyte-associated protein 4 immunoglobulin (CTLA4Ig) treatment on tacrolimus (TAC)-induced renal dysfunction is well known, but its effect on TAC-induced diabetes mellitus (DM) is still undetermined. In the present study, we tested the diabetogenicity of CTLA4Ig and evaluated the effect of conversion to CTLA4Ig treatment on TAC-induced diabetic rats. METHODS: We tested diabetogenicity of CTLA4Ig by escalating doses (0...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29319492/risk-of-complications-with-use-of-aspirin-during-renal-biopsy-a-systematic-review
#18
Vinayak Kumar, Matthew D Mitchell, Craig A Umscheid, Jeffrey S Berns, Jonathan J Hogan
BACKGROUND: Bleeding is a well-known complication of percutaneous renal biopsy (PRB). Thus, antiplatelet agents are routinely held for most patients undergoing elective PRB to decrease bleeding risk. MATERIALS AND METHODS: In this systematic review, we examine the association between antiplatelet use and bleeding during PRB. MEDLINE and EMBASE were searched from inception to December 2016 using terms that included "renal biopsy", "antiplatelet","aspirin", and "bleeding"...
January 10, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29319234/comparative-pharmacokinetics-of-trandolapril-its-active-metabolite-and-verapamil-in-human-plasma-of-egyptian-population-using-hplc-ms-ms
#19
Ragaa Magdy, Ahmed H El-Khatib, Ahmed Hemdan, Omar Abd Elaziz, Maha Farouk, Michael W Linscheid
Trandolapril and verapamil are commonly used antihypertensive drugs. However, there is a lack of available data on the change of their pharmacokinetics in patients with liver or kidney impairment and hence the need for dose adjustment. In the presented work, a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed and validated for the monitoring of trandolapril, its active metabolite trandolaprilat, and verapamil in human plasma of patients with renal impairment and/or liver insufficiency...
January 10, 2018: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29318214/urinary-calcium-excretion-and-risk-of%C3%A2-chronic-kidney-disease-in-the-general%C3%A2-population
#20
Jacob M Taylor, Lyanne M Kieneker, Martin H de Borst, Sipke T Visser, Ido P Kema, Stephan J L Bakker, Ron T Gansevoort
Introduction: High urinary calcium excretion (UCaE) has been shown to lead to accelerated renal function decline in individuals with renal tubular diseases. It is not known whether this association also exists in the general population. Therefore, we investigated whether high UCaE is associated with risk of developing chronic kidney disease (CKD) in community-dwelling subjects. Methods: Urine samples of 5491 subjects who were free of CKD at baseline and participated in the Prevention of Renal and Vascular End-Stage Disease study (a prospective, observational, general population-based cohort of Dutch men and women aged 28-75 years) were examined for UCaE...
May 2017: KI Reports
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