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https://www.readbyqxmd.com/read/28745926/safety-and-efficacy-of-empirical-interleukin-1-inhibition-using-anakinra-in-aa-amyloidosis-of-uncertain-aetiology
#1
Thirusha Lane, Ashutosh D Wechalekar, Julian D Gillmore, Philip N Hawkins, Helen J Lachmann
OBJECTIVE: AA amyloidosis is a serious complication of persistent inflammation, which, untreated will progress to renal failure and death. Effective suppression of the underlying inflammatory disease is the focus of treatment. However, in approximately 20% of cases the underlying condition remains uncertain, presenting a dilemma as to choice of treatment. METHODS: We conducted a retrospective study of a cohort of 11 patients diagnosed with AA amyloidosis of unknown aetiology, who had been empirically treated with anakinra...
July 26, 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/28735994/kidney-transplantation-using-gonadal-vein-for-venous-anastomosis-in-patients-with-iliac-vein-thrombosis-or-stenosis-a-series-of-cases
#2
J B G de Cerqueira, C M C de Oliveira, B G B Silva, L C O Santos, A G Fernandes, P F C B C Fernandes, E L Maia
BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The standard surgery uses the recipient's iliac vessels for vascular anastomosis. Thrombosis and/or stenosis of the iliac vein, which are possible complications of multiple vascular access points for dialysis, can be detected intraoperatively, constituting a surgical challenge. An infrequently reported option is the use of the gonadal vein. OBJECTIVES: This study aims to evaluate the outcomes of venous anastomosis in the gonadal vein in patients with iliac vein thrombosis and/or stenosis submitted to kidney transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28730555/intermittent-versus-continuous-renal-replacement-therapy-in-acute-methanol-poisoning-comparison-of-clinical-effectiveness-in-mass-poisoning-outbreaks
#3
Sergey Zakharov, Jan Rulisek, Olga Nurieva, Katerina Kotikova, Tomas Navratil, Martin Komarc, Daniela Pelclova, Knut Erik Hovda
BACKGROUND: Intermittent hemodialysis (IHD) is the modality of choice in the extracorporeal treatment (ECTR) of acute methanol poisoning. However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown. During an outbreak of mass methanol poisoning, we therefore studied the effect of IHD versus CRRT on mortality and the prevalence of visual/central nervous system (CNS) sequelae in survivors. METHODS: The study was designed as prospective observational cohort study...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28729965/fluid-overload-as-a-major-target-in-management-of-cardiorenal-syndrome-implications-for-the-practice-of-peritoneal-dialysis
#4
REVIEW
Amir Kazory
Congestion is an integral component of cardiorenal syndrome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability of modulating the interactions between the kidney and the heart in this setting. Peritoneal dialysis (PD) is a home-based therapeutic modality that is not only offered to patients with end-stage renal disease to provide solute clearance and ultrafiltration, but it has also been used in patients with refractory heart failure and fluid overload to help optimize volume status...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28721509/maintaining-patency-of-vascular-access-for-haemodialysis
#5
Nicholas Inston, J Al Shakarchi, A Khawaja, R Jones
All types of vascular access, a necessity for haemodialysis, are prone to thrombosis and if untreated this results in failure. Thrombosis results from the combination of impaired blood flow, endothelial and vessel wall injury and a propensity towards pro-coagulative states, either intrinsic or aggravated by dialysis or dehydration. The treatment of access thrombosis relies on removal of the clot (thrombectomy) and treatment of the underlying problem. In most cases this is stenosis secondary to neointimal hyperplasia which can occur early (failure to mature) or later...
July 18, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28714644/-dialysis-implementation-in-elderly-patients-a-difficult-clinical-choice
#6
Silesia Da Graca, Patrick Saudan
Prevalence of elderly patients with end-stage kidney disease has increased. Implementation of dialysis does not offer a clear advantage in terms of life expectancy and quality of life compared to a conservative treatment in these patients, especially in emergency and in those with severe comorbidities. The choice between dialysis and supportive care should be based on a shared decision-making process between the patient, his family and the caregivers.
February 22, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28706984/the-uk-national-registry-of-abo-and-hla-antibody-incompatible-renal-transplantation-pretransplant-factors-associated-with-outcome-in-879-transplants
#7
Laura Pankhurst, Alex Hudson, Lisa Mumford, Michelle Willicombe, Jack Galliford, Olivia Shaw, Raj Thuraisingham, Carmelo Puliatti, David Talbot, Sian Griffin, Nicholas Torpey, Simon Ball, Brendan Clark, David Briggs, Susan V Fuggle, Robert M Higgins
BACKGROUND: ABO and HLA antibody incompatible (HLAi) renal transplants (AIT) now comprise around 10% of living donor kidney transplants. However, the relationship between pretransplant factors and medium-term outcomes are not fully understood, especially in relation to factors that may vary between centers. METHODS: The comprehensive national registry of AIT in the United Kingdom was investigated to describe the donor, recipient and transplant characteristics of AIT...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28701770/racial-and-social-disparities-in-the-access-to-automated-peritoneal-dialysis-results-of-a-national-pd-cohort
#8
Roberto Pecoits-Filho, Silvia Carreira Ribeiro, Adam Kirk, Helder Sebastião da Silva, Arthur Pille, Ricardo Sprenger Falavinha, Sandro Scolari Filho, Ana Elizabeth Figueiredo, Pasqual Barretti, Thyago Proença de Moraes
The prevalence of patients on automated peritoneal dialysis (APD) is increasing worldwide and may be guided by clinical characteristics, financial issues and patient option. Whether socioeconomic factors at the patient level may influence the decision for the initial peritoneal dialysis (PD) modality is unknown. This is a prospective cohort study. The primary outcome of interest was the probability to start PD on APD. The inclusion criteria were adult patients incident in PD. Exclusion criteria were missing data for either race or initial PD modality...
July 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28700983/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#9
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28676510/peritoneal-dialysis-in-very-low-birth-weight-neonates
#10
Vesna D Stojanović, Svetlana S Bukarica, Jelena B Antić, Aleksandra D Doronjski
BACKGROUND: The aim of this retrospective study is to evaluate clinical characteristics and outcomes of very low birth weight (VLBW) neonates with acute kidney injury (AKI) treated with peritoneal dialysis (PD). METHODS: This retrospective study included 10 VLBW neonates treated with PD. Intravenous (IV) cannula and umbilical venous catheter were used for the peritoneal access. RESULTS: Mean age at the moment of starting PD was 14.9 ± 9.3 days...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28676037/challenges-and-outcomes-of-haemodialysis-among-patients-presenting-with-kidney-diseases-in-dodoma-tanzania
#11
Alfred J Meremo, David P Ngilangwa, Masumbuko Y Mwashambwa, Matobogolo B Masalu, Janet Kapinga, Rehema Tagalile, Issa Sabi
BACKGROUND: Kidney Diseases contribute a significant proportion to the global burden of non-communicable diseases. Haemodialysis services as the main modality of renal replacement therapy in most resource limited countries is only available in few cities and at higher costs. The aim of this study was to determine the challenges and outcomes of patients who were on haemodialysis at the University of Dodoma (UDOM) haemodialysis unit in Tanzania. METHODS: In this retrospective study; we reviewed haemodialysis registers and charts of 116 patients dialyzed from January 2013 to June 2015 at The UDOM haemodialysis unit...
July 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28666072/special-situations-intradialytic-hypertension-chronic-hypertension-and-intradialytic-hypotension
#12
Peter Noel Van Buren, Jula K Inrig
Hypertension is a comorbidity that is present in the majority of end-stage renal disease patients on maintenance hemodialysis. This population is particularly unique because of the dynamic nature of blood pressure (BP) during dialysis. Modest BP decreases are expected in most hemodialysis patients, but intradialytic hypotension and intradialytic hypertension are two special situations that deviate from this as either an exaggerated or paradoxical response to the dialysis procedure. Both of these phenomena are particularly important because they are associated with increased mortality risk compared to patients with modest decreases in BP during dialysis...
June 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28659813/human-peritoneal-mesothelial-cell-death-induced-by-high-glucose-hypertonic-solution-involves-ca-2-and-na-ions-and-oxidative-stress-with-the-participation-of-pkc-nox2-and-pi3k-akt-pathways
#13
Felipe Simon, Pablo Tapia, Ricardo Armisen, Cesar Echeverria, Sebastian Gatica, Alejandro Vallejos, Alejandro Pacheco, Maria E Sanhueza, Miriam Alvo, Erico Segovia, Rubén Torres
Chronic peritoneal dialysis (PD) therapy is equally efficient as hemodialysis while providing greater patient comfort and mobility. Therefore, PD is the treatment of choice for several types of renal patients. During PD, a high-glucose hyperosmotic (HGH) solution is administered into the peritoneal cavity to generate an osmotic gradient that promotes water and solutes transport from peritoneal blood to the dialysis solution. Unfortunately, PD has been associated with a loss of peritoneal viability and function through the generation of a severe inflammatory state that induces human peritoneal mesothelial cell (HPMC) death...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28651309/the-pattern-of-choosing-dialysis-modality-and-related-mortality-outcomes-in-korea-a-national-population-based-study
#14
Hyung Jong Kim, Jung Tak Park, Seung Hyeok Han, Tae-Hyun Yoo, Hyeong-Cheon Park, Shin-Wook Kang, Kyoung Hoon Kim, Dong-Ryeol Ryu, Hyunwook Kim
BACKGROUND/AIMS: Since comorbidities are major determinants of modality choice, and also interact with dialysis modality on mortality outcomes, we examined the pattern of modality choice according to comorbidities and then evaluated how such choices affected mortality in incident dialysis patients. METHODS: We analyzed 32,280 incident dialysis patients in Korea. Patterns in initial dialysis choice were assessed by multivariate logistic regression analyses. Multivariate Poisson regression analyses were performed to evaluate the effects of interactions between comorbidities and dialysis modality on mortality and to quantify these interactions using the synergy factor...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28615054/end-stage-kidney-disease-in-patient-with-epidermolysis-bullosa-what-are-the-treatment-options-case-report
#15
Michał Małecki, Maciej Domański, Kazimierz Ciechanowski
BACKGROUND: Epidermolysis bullosa is a group of diseases caused by mutations in genes for proteins responsible for cells' anchorage at the dermo-epidermal junction. Their common feature are dysfunctional or even absent connections between cells. The typical clinical sign is the formation of blisters, with possible excessive scarring, in response to minimal skin irritation. End stage renal disease may be one of the comorbidities in patients with epidermolysis bullosa. The implementation of renal replacement therapy may be very difficult in this population...
June 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28579291/successful-use-of-partial-aneurysmectomy-and-repair-approach-for-managing-complications-of-arteriovenous-fistulas-and-grafts
#16
Shouwen Wang, Michele S Wang
OBJECTIVE: Arteriovenous fistulas and grafts may often be associated with localized complications related to aneurysms/pseudoaneurysms, buttonholes, or structural defects that require proper management to ensure continued access functionality for hemodialysis. Partial aneurysmectomy and repair (PAR) is a targeted surgical approach specifically designed for managing these complications. The basic concepts of PAR include resecting unhealthy or excessive tissue over an access, reconstructing the vascular access lumen using in situ vascular wall or tissue when possible, and closing overlying skin with healthy margins to promote reliable healing...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28573315/pediatric-renal-transplant-biopsy-with-ultrasound-guidance-the-core-essentials
#17
REVIEW
Aris Oates, Saveen Ahuja, Marsha M Lee, Andrew S Phelps, John D Mackenzie, Jesse L Courtier
This review provides a comprehensive and practical approach to pediatric percutaneous renal transplant biopsies, highlighting techniques and strategies to optimize adequate sample yield and ensure patient safety. In children with end-stage renal disease, transplantation is the preferred choice of therapy, providing for overall lower long-term morbidity and mortality compared with dialysis. In the ongoing management of renal transplant patients, core tissue sampling via a percutaneous renal biopsy remains the gold standard when transplant dysfunction is suspected...
June 1, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28572219/is-replacement-modality-choice-knowledge-important-in-the-non-renal-multidisciplinary-team-experience-from-a-single-uk-centre
#18
Fatima Abdelaal, Hatem Ali, Jyoti Baharani
Dialysis remains the mainstay treatment for patients with end stage renal disease. In the UK, there has been a significant decline in home dialysis despite its benefits and cost effectiveness. Patients with chronic kidney disease (CKD) are often known to other specialties who they may continue to consult when approaching dialysis. We wished to assess the knowledge of the non-renal multidisciplinary team (MDT) regarding home dialysis and establish whether further education was warranted. This was assessed using an online survey sent to specialties likely to deal with CKD patients...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28571995/is-peritoneal-dialysis-feasible-after-laparotomy-in-children-a-case-control-series-to-compare-outcomes
#19
A Bouty, A Faure, L Shaw, J Ah Toy, E Dobremez, M O'Brien, Y Heloury
OBJECTIVES: Peritoneal dialysis (PD) is the modality of choice for children with end-stage renal disease (ESRD) awaiting renal transplant; however, this option is sometimes avoided for those with previous laparotomy. The goal of this study was to compare the outcomes of PD in patients with and without previous laparotomy. PATIENTS AND METHODS: Twenty-four patients who had been started on peritoneal dialysis were retrospectively analysed. Group LAP consisted of six patients with previous laparotomy, and Group NO-LAP of 18 controls with either retroperitoneal or no abdominal surgery...
May 12, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28557999/treatment-of-aki-in-developing-and-developed-countries-an-international-survey-of-pediatric-dialysis-modalities
#20
Rupesh Raina, Abigail M Chauvin, Timothy Bunchman, David Askenazi, Akash Deep, Michael J Ensley, Vinod Krishnappa, Sidharth Kumar Sethi
HYPOTHESIS: Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD) and hemodialysis (HD). It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability...
2017: PloS One
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