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https://www.readbyqxmd.com/read/29221978/influence-of-6-hydroxyethyl-starch-130-0-4-versus-crystalloid-solution-on-structural-renal-damage-markers-after-coronary-artery-bypass-grafting-a-post-hoc-subgroup-analysis-of-a-prospective-trial
#1
Thomas Datzmann, Markus Hoenicka, Helmut Reinelt, Andreas Liebold, Hagen Gorki
OBJECTIVE: The restriction of hydroxyethyl starch (HES) has mandated changes in volume management based on data of critically ill patients. Reliable data of structural renal damage after HES treatment in cardiac surgical patients are lacking. The influence of 6% HES 130/0.4 was investigated in this study. DESIGN: An exploratory post hoc subgroup analysis of a prospective trial was performed. SETTING: The study was carried out at a university hospital...
May 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#2
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29214330/oxidative-stress-in-kidney-diseases-the-cause-or-the-consequence
#3
REVIEW
Natalia Krata, Radosław Zagożdżon, Bartosz Foroncewicz, Krzysztof Mucha
Exaggerated oxidative stress (OS) is usually considered as a disturbance in regular function of an organism. The excessive levels of OS mediators may lead to major damage within the organism's cells and tissues. Therefore, the OS-associated biomarkers may be considered as new diagnostic tools of various diseases. In nephrology, researchers are looking for alternative methods replacing the renal biopsy in patients with suspicion of chronic kidney disease (CKD). Currently, CKD is a frequent health problem in world population, which can lead to progressive loss of kidney function and eventually to end-stage renal disease...
December 6, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/29214049/latent-autoimmune-diabetes-of-adulthood-case-report
#4
Cristen P Page, Brian Fitzgerald, Emily M Hawes
Background: Primary care clinicians will see a higher incidence of type 2 diabetes in adult patients, and the diagnosis and management of an initial presentation of type 1 diabetes can pose challenges to clinicians who see it less frequently. Symptoms of hyperglycemia and risk of ketoacidosis may be missed. Further, endocrine autoimmune disease can run together in patients and families. Case presentation: A 49-year-old Caucasian female with history of pituitary adenoma and Graves' disease with history of thyroid ablation presented in the outpatient setting due to hand tingling of her right middle finger that was worse in the mornings and improved throughout the day...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29212080/clinical-evaluation-of-continuous-renal-replacement-therapy-in-combination-with-ultrasound-guided-percutaneous-transhepatic-gallbladder-drainage-for-acute-severe-biliary-pancreatitis-a-retrospective-study
#5
Qingyun Zhu, Xinting Pan, Yongxian Cao, Hongqiao Wang, Ning Yu, Fuguo Liu, Shigang Yang, Yunlong Wang, Yunbo Sun, Zhengbin Wang
BACKGROUND/AIMS: This study aimed to report the clinical efficacy of continuous renal replacement therapy (CRRT) in combination with ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) (CRRT+PTGD) in the treatment of acute severe biliary pancreatitis (ASBP). METHODS: Between January 2010 and January 2016, 40 cases of patients with ASBP who received routine CRRT (CRRT group) and 40 of those who received CRRT+PTGD (CRRT+PTGD group) at the Affiliated Hospital of Qingdao University (Qingdao, China) were retrospectively reviewed...
November 30, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#6
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29209836/accuracy-of-cystatin-c-for-the-detection-of-abnormal-renal-function-in-children-undergoing-chemotherapy-for-malignancy-a-systematic-review-using-individual-patient-data
#7
Penny Whiting, Kate Birnie, Jonathan A C Sterne, Catherine Jameson, Rod Skinner, Bob Phillips
PURPOSE: We conducted a systematic review and individual patient data (IPD) meta-analysis to examine the utility of cystatin C for evaluation of glomerular function in children with cancer. METHODS: Eligible studies evaluated the accuracy of cystatin C for detecting poor renal function in children undergoing chemotherapy. Study quality was assessed using QUADAS-2. Authors of four studies shared IPD. We calculated the correlation between log cystatin C and GFR stratified by study and measure of cystatin C...
December 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29208752/effects-of-alanyl-glutamine-treatment-on-the-peritoneal-dialysis-effluent-proteome-reveal-pathomechanism-associated-molecular-signatures
#8
Rebecca Herzog, Michael Boehm, Markus Unterwurzacher, Anja Wagner, Katja Parapatics, Peter Majek, André C Mueller, Anton Lichtenauer, Keiryn L Bennett, Seth L Alper, Andreas Vychytil, Christoph Aufricht, Klaus Kratochwill
Peritoneal dialysis (PD) is a modality of renal replacement therapy in which the high volumes of available PD effluent (PDE) represents a rich source of biomarkers for monitoring disease and therapy. Although this information could help guide the management of PD patients, little is known about the potential of PDE to define pathomechanism-associated molecular signatures in PD.</p> <p>We therefore subjected PDE to a high-performance multiplex proteomic analysis after depletion of highly-abundant plasma proteins and enrichment of low-abundance proteins...
December 4, 2017: Molecular & Cellular Proteomics: MCP
https://www.readbyqxmd.com/read/29206655/pathophysiology-clinical-presentation-and-treatment-of-coma-and-acute-kidney-injury-complicating-falciparum-malaria
#9
Katherine Plewes, Gareth D H Turner, Arjen M Dondorp
PURPOSE OF REVIEW: Cerebral impairment and acute kidney injury (AKI) are independent predictors of mortality in both adults and children with severe falciparum malaria. In this review, we present recent advances in understanding the pathophysiology, clinical features, and management of these complications of severe malaria, and discuss future areas of research. RECENT FINDINGS: Cerebral malaria and AKI are serious and well recognized complications of severe malaria...
December 4, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29189958/surgical-treatment-of-spinal-metastases-from-renal-cell-carcinoma-effects-of-preoperative-embolization-on-intraoperative-blood-loss
#10
Matthias Reitz, Klaus Christian Mende, Christopher Cramer, Theresa Krätzig, ZSuzsanna Nagy, Eik Vettorazzi, Sven Oliver Eicker, Marc Dreimann
The objective of this paper is analyzing the effects of preoperative embolization on intraoperative blood loss in spinal surgery for renal cell carcinoma (RCC) metastasis and identifying factors contributing to an increased blood loss in the surgical procedure. A retrospective analysis was performed in patients who were treated in for spinal metastasis from RCC between 2011 and 2016. Factors analyzed were reduction of tumor blush, timing of embolization, selective vs. superselective approach, surgical factors, and tumor volume and localization...
November 30, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29186865/role-of-vitamin-d-in-maintaining-renal-epithelial-barrier-function-in-uremic-conditions
#11
Milos Mihajlovic, Michele Fedecostante, Miriam J Oost, Sonja K P Steenhuis, Eef G W M Lentjes, Inge Maitimu-Smeele, Manoe J Janssen, Luuk B Hilbrands, Rosalinde Masereeuw
As current kidney replacement therapies are not efficient enough for end-stage renal disease (ESRD) treatment, a bioartificial kidney (BAK) device, based on conditionally immortalized human proximal tubule epithelial cells (ciPTEC), could represent an attractive solution. The active transport activity of such a system was recently demonstrated. In addition, endocrine functions of the cells, such as vitamin D activation, are relevant. The organic anion transporter 1 (OAT-1) overexpressing ciPTEC line presented 1α-hydroxylase (CYP27B1), 24-hydroxylase (CYP24A1) and vitamin D receptor (VDR), responsible for vitamin D activation, degradation and function, respectively...
November 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29186572/hydroxycloroquine-blood-concentration-in-lupus-nephritis-a-determinant-of-disease-outcome
#12
Cátia Cunha, Suceena Alexander, Damien Ashby, Janet Lee, Gary Chusney, Tom D Cairns, Liz Lightstone
Background: Hydroxychloroquine (HCQ) is a recommended drug in systemic lupus erythematosus (SLE). It has a long terminal half-life, making it an attractive target for therapeutic drug monitoring. The aim of this study was to establish a relationship between blood HCQ concentration and lupus nephritis activity. Methods: We conducted a retrospective observational study with data collected from clinical and laboratory records. Inclusion criteria were patients followed in the lupus clinic with biopsy-proven International Society of Nephrology/Renal Pathology Society Classes III, IV or V lupus nephritis on HCQ for at least 3 months (200-400 mg daily) and with HCQ levels measured during treatment...
November 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29184602/-giant-lithiasis-due-to-urinary-stasis-related-to-ileo-caecal-bladder
#13
Hamza Dergamoun, Zayd El Boukili El Makhoukhi
Bladder exstrophy is a malformation characterized by subumbilical anterior abdominal wall and anterior bladder wall deishence. It affects nearly 30.000-40.000 births per year, with a higher prevalence in boys. External continent urinary diversion creates a long-term outcome. However, it is not devoid of complications. We report the case of a 30-year old female patient who had undergone cystectomy with bladder replaced with ileo-caecal segment for bladder exstrophy 13 years earlier. She was followed up for 5 years and then lost to follow up...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29181437/clinical-features-of-patients-treated-by-peritoneal-dialysis-for-over-a-decade
#14
Mengli Tong, Yuhui Wang, Jun Ni, Ning Weng, Chuanxia Chen, Hongyu Chen, Lindholm Bengt
BACKGROUND: Peritoneal dialysis (PD) is well-established as renal replacement therapy in end stage renal disease and has survival rates similar or better than hemodialysis (HD) for the initial years on dialysis therapy. However retention rate is lower due to higher technique failure rates than in HD and few patients stay on PD for more than 10 years (PD>10 yrs). Here we investigated clinical features characterizing PD>10 yrs patients. PATIENTS AND METHODS: In a single center study of 450 prevalent PD patients, 35 PD>10 yrs patients (n=35) were compared with patients (n=415) who had been on PD for shorter periods of time in terms of clinical characteristics...
2017: American Journal of Clinical and Experimental Urology
https://www.readbyqxmd.com/read/29179767/rhabdomyolysis-lactic-acidosis-and-multiple-organ-failure-during-telbivudine-treatment-for-hepatitis-b-a-case-report-and-review-of-the-literature
#15
Jinxin Zheng, Minggui Deng, Xiaoliang Qiu, Zhong Chen, Duoyun Li, Xiangbin Deng, Qiwen Deng, Zhijian Yu
BACKGROUND: Telbivudine can cause severe side effects, including myositis, neuritis, rhabdomyolysis, and lactic acidosis. However, reported cases of telbivudine leading to multiple organ failure are rare. Here, we report a case of telbivudine-induced severe polymyositis, lactic acidosis, and multiple organ failure. CASE PRESENTATION: A 30-year-old Chinese man with hepatitis B virus infection received antiviral treatment with 600 mg of telbivudine daily for more than 11 months...
November 27, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29178943/high-volume-hemofiltration-in-adult-burn-patients-with-septic-shock-and-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#16
Kevin K Chung, Elsa C Coates, David J Smith, Rachel A Karlnoski, William L Hickerson, Angela L Arnold-Ross, Michael J Mosier, Marcia Halerz, Amy M Sprague, Robert F Mullins, Daniel M Caruso, Marlene Albrecht, Brett D Arnoldo, Agnes M Burris, Sandra L Taylor, Steven E Wolf
BACKGROUND: Sepsis and septic shock occur commonly in severe burns. Acute kidney injury (AKI) is also common and often results as a consequence of sepsis. Mortality is unacceptably high in burn patients who develop AKI requiring renal replacement therapy and is presumed to be even higher when combined with septic shock. We hypothesized that high-volume hemofiltration (HVHF) as a blood purification technique would be beneficial in this population. METHODS: We conducted a multicenter, prospective, randomized, controlled clinical trial to evaluate the impact of HVHF on the hemodynamic profile of burn patients with septic shock and AKI involving seven burn centers in the United States...
November 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29178124/high-cut-off-membranes-in-acute-kidney-injury-and-continuous-renal-replacement-therapy
#17
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
Innovation in continuous renal replacement therapies (CRRT) utilized to treat acute kidney injury (AKI) and sepsis, has brought new machines and techniques. Part of these new advances are due to the availability of innovative biomaterials and the construction of membranes with larger pores and wide distribution of pore sizes. This includes the creation of a new generation of high cut-off membranes whose utilization in clinical practice is promising for the wide spectrum of solutes that are removed during extracorporeal therapies...
November 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29171682/in-hospital-outcomes-of-transcatheter-versus-surgical-aortic-valve-replacement-in-end-stage-renal-disease
#18
Ahmad Alkhalil, Shervin Golbari, David Song, Harveen Lamba, Anas Fares, Amer Alaiti, Salil Deo, Guilherme F Attizzani, Homam Ibrahim, Carlos E Ruiz
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at intermediate and high risk for surgery. Commercial use of TAVR has expanded to patients with end stage renal disease (ESRD). OBJECTIVES: Compare in-hospital outcomes of TAVR versus SAVR in ESRD patients requiring hemodialysis (HD). METHODS: ESRD patients on HD undergoing TAVR (n = 328) or SAVR (n = 697) between 2012 and 2014 were identified in the National Inpatient Sample (NIS)...
November 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29171000/applying-pharmacokinetic-pharmacodynamic-principles-for-optimizing-antimicrobial-therapy-during-continuous-renal-replacement-therapy
#19
Patrick M Honore, Rita Jacobs, Elisabeth De Waele, Herbert D Spapen
Continuous renal replacement therapy (CRRT) is progressively supplanting intermittent hemodialysis (IHD) in critically ill patients. CRRT indeed offers more appropriate hemodynamic, fluid, and metabolic stability but concern is rising about its impact on concomitant drug, and in particular antimicrobial, treatment. Antimicrobial dose recommendations have been elaborated to avoid drug accumulation and toxicity in patients undergoing IHD. However, these dosing regimens resulted in significant underdosing in patients undergoing CRRT thereby increasing the risk of treatment failure and development of resistance...
November 24, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29169332/how-does-pre-dialysis-education-need-to-change-findings-from-a-qualitative-study-with-staff-and-patients
#20
Gill Combes, Kim Sein, Kerry Allen
BACKGROUND: Pre-dialysis education (PDE) is provided to thousands of patients every year, helping them decide which renal replacement therapy (RRT) to choose. However, its effectiveness is largely unknown, with relatively little previous research into patients' views about PDE, and no research into staff views. This study reports findings relevant to PDE from a larger mixed methods study, providing insights into what staff and patients think needs to improve. METHODS: Semi-structured interviews in four hospitals with 96 clinical and managerial staff and 93 dialysis patients, exploring experiences of and views about PDE, and analysed using thematic framework analysis...
November 23, 2017: BMC Nephrology
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