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renal replacement treatment

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https://www.readbyqxmd.com/read/29652913/ventilator-associated-pneumonia-in-patients-assisted-by-veno-arterial-extracorporeal-membrane-oxygenation-support-epidemiology-and-risk-factors-of-treatment-failure
#1
Adrien Bouglé, Camille Bombled, Dimitri Margetis, Guillaume Lebreton, Charles Vidal, Marine Coroir, David Hajage, Julien Amour
INTRODUCTION: Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. METHODS: To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#2
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652109/an-aspirational-diet-for-dialysis-patients-evidence-and-theory
#3
REVIEW
Jaime Uribarri
Dialytic renal replacement therapy is now entering into its sixth decade in the United States. Despite major advances in dialysis technology, regimens and protocols, and pharmacological treatments, patients' restricted dietary intake remains the lynchpin to their well-being and success. Herein, we review current guidelines that limit dietary intake of nutrients and minerals in dialysis patients and explore potential ways to use them in designing a daily food intake that is not only healthy, but also easy to implement and therefore patient friendly...
April 13, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29644072/do-kidney-transplantations-save-money-a-study-using-a-before-after-design-and-multiple-register-based-data-from-sweden
#4
Johan Jarl, Peter Desatnik, Ulrika Peetz Hansson, Karl Göran Prütz, Ulf-G Gerdtham
Background: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. Method: A before-after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29644070/intravenous-drug-users-who-require-dialysis-causes-of-renal-failure-and-outcomes
#5
Jemima K Scott, Dominic M Taylor, Chris R K Dudley
Background: Intravenous drug use is associated with progressive kidney disease of several aetiologies. It is associated with behavioural and lifestyle characteristics that make the provision of renal replacement therapies (RRTs) challenging. We observed that patients who use intravenous drugs [people who inject drugs (PWID)] present late to renal services and struggle to engage with treatment. We describe the experience of a UK centre providing renal services to a mixed city and rural population...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#6
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29624594/a-systematic-scoping-review-on-the-consequences-of-stress-related-hyperglycaemia
#7
Elena Olariu, Nicholas Pooley, Aurélie Danel, Montserrat Miret, Jean-Charles Preiser
BACKGROUND: Stress-related hyperglycaemia (SHG) is commonly seen in acutely ill patients and has been associated with poor outcomes in many studies performed in different acute care settings. We aimed to review the available evidence describing the associations between SHG and different outcomes in acutely ill patients admitted to an ICU. Study designs, populations, and outcome measures used in observational studies were analysed. METHODS: We conducted a systematic scoping review of observational studies following the Joanna Briggs methodology...
2018: PloS One
https://www.readbyqxmd.com/read/29623210/new-onset-insulin-dependent-diabetes-due-to-nivolumab
#8
Ali A Zaied, Halis K Akturk, Richard W Joseph, Augustine S Lee
Nivolumab, a monoclonal antibody against programmed cell death-1 receptor, is increasingly used in advanced cancers. While nivolumab use enhances cancer therapy, it is associated with increased immune-related adverse events. We describe an elderly man who presented in ketoacidosis after receiving nivolumab for metastatic renal cell carcinoma. On presentation, he was hyperpneic and laboratory analyses showed hyperglycemia and anion-gapped metabolic acidosis consistent with diabetic ketoacidosis. No other precipitating factors, besides nivolumab, were identified...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29618309/genetics-and-gene-therapy-of-anderson-fabry-disease
#9
Irene Simonetta, Antonino Tuttolomondo, Tiziana Di Chiara, Salvatore Miceli
Fabry's disease is a genetic disorder of X-linked inheritance caused by mutations in the alpha galactosidase A gene resulting in deficiency of this lysosomal enzyme. The progressive accumulation of glycosphingolipids, caused by the inadequate enzymatic activity, is responsible of organ dysfunction and thus of clinical manifestations. In presence of a high clinical suspicion, a careful physical examination and specific laboratory tests are required, finally diagnosis of Fabry's disease is confirmed by demonstration of absence or reduced alpha galactosidase A enzyme activity in hemizygous men and gene typing in heterozygous females; in fact the performance of enzymatic activity assay alone in women is inconclusive...
April 4, 2018: Current Gene Therapy
https://www.readbyqxmd.com/read/29617839/outcomes-of-aortic-valve-replacement-via-partial-upper-sternotomy-versus-conventional-aortic-valve-replacement-in-obese-patients
#10
Henryk A Welp, Isabell Herlemann, Sven Martens, Heinz Deschka
OBJECTIVES: Excellent outcomes after minimally invasive aortic valve replacement (mini-AVR) have been reported. Therefore, mini-AVR has become a popular treatment option in many cardiac surgery centres. However, whether obese patients particularly benefit from mini-AVR remains unclear. The aim of the present study was to evaluate outcomes of AVR performed through partial upper sternotomy compared to AVR through a full sternotomy (full-AVR) in obese patients. METHODS: We retrospectively reviewed the medical records of all patients who underwent isolated AVR at our institution, and 217 consecutive obese [body mass index (BMI) >30 kg/m2] patients were identified...
March 30, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29617494/transcatheter-aortic-valve-replacement-the-experience-of-one-brazilian-health-care-center
#11
Fabiula Schwartz Azevedo, Marcelo Goulart Correa, Débora Holanda Gonçalves Paula, Alex Dos Santos Felix, Luciano Herman Juaçaba Belém, Ana Paula Chedid Mendes, Valeria Gonçalves Silva, Bruno Miranda Marques, Andrey José de Oliveira Monteiro, Clara Weksler, Alexandre Siciliano Colafranceschi, Daniel Arthur Barata Kasal
OBJECTIVE: Transcatheter aortic valve replacement has been an alternative to invasive treatment for symptomatic severe aortic stenosis in high risk patients. The primary endpoint was 30-day and 1-year mortality from any cause. Secondary endpoints were to compare the clinical and echocardiographic variation pre-and post- transcatheter aortic valve replacement, and the occurrence of complications throughout a 4-year follow-up period. METHODS: This prospective cohort, nestled to a multicenter study (Registro Brasileiro de Implante de Bioprótese por Cateter), describes the experience of a public tertiary center in transcatheter aortic valve replacement...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29611144/treatment-dose-and-the-elimination-rates-of-electrolytes-vitamins-and-trace-elements-during-continuous-veno-venous-hemodialysis-cvvhd
#12
Thomas Datzmann, Karl Träger, Bernd Schröppel, Helmut Reinelt, Philipp von Freyberg
INTRODUCTION: During continuous renal replacement therapy, achievement of recommended treatment dose is important. However, relevant substrate loss may occur and recommended nutrition during critical illness could not be sufficient for higher dialysis doses. We investigated the correlation of dialysis dose and substrate loss for a broad range of dialysis doses. METHODS: Forty critically ill patients with acute kidney injury undergoing citrate CVVHD were included in this prospective study...
April 2, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29611002/current-and-emerging-therapeutic-targets-for-metastatic-renal-cell-carcinoma
#13
REVIEW
Kevin Zarrabi, Shenhong Wu
PURPOSE OF REVIEW: The treatment of advanced renal cell carcinoma has evolved dramatically over recent years. In this review, we will summarize current and emerging therapies based on molecular targets and provide insight into treatment strategy for metastatic renal cell carcinoma. RECENT FINDINGS: We have witnessed a paradigm shift in the therapeutic landscape as treatment was formerly reliant on cytokine-based agents which have now been replaced with therapies targeting angiogenesis, mammalian target of rapamycin pathways, and immune responses...
April 2, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29610664/hypomagnesemia-in-critically-ill-patients
#14
REVIEW
Bent-Are Hansen, Øyvind Bruserud
Background: Magnesium (Mg) is essential for life and plays a crucial role in several biochemical and physiological processes in the human body. Hypomagnesemia is common in all hospitalized patients, especially in critically ill patients with coexisting electrolyte abnormalities. Hypomagnesemia may cause severe and potential fatal complications if not timely diagnosed and properly treated, and associate with increased mortality. Main body: Mg deficiency in critically ill patients is mainly caused by gastrointestinal and/or renal disorders and may lead to secondary hypokalemia and hypocalcemia, and severe neuromuscular and cardiovascular clinical manifestations...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29606256/-renal-toxicity-of-high-dose-methotrexate
#15
Hugo Garcia, Véronique Leblond, François Goldwasser, Didier Bouscary, Emmanuel Raffoux, Nicolas Boissel, Sophie Broutin, Dominique Joly
INTRODUCTION: High-dose methotrexate (at least 1g/m2 ) is used to treat haematologic malignancies and osteosarcomas. Acute kidney injury is a well-known adverse-event after high-dose methotrexate and may lead to delayed drug elimination. Besides usual therapeutics (hyperhydration, urine alkalinisation, leucovorin rescue, renal replacement therapy), a costly specific enzymatic treatment (glucarpidase) is now available but its clinical impact remains elusive. PATIENTS AND METHODS: We analysed high-dose methotrexate prescription charts in 11 clinical centres during the last 15 years to identify and describe adult patients who developed acute kidney injury (according to KDIGO classification)...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29605557/nitrolipids-in-kidney-physiology-and-disease
#16
REVIEW
Soma Jobbagy, Roderick J Tan
The kidneys are vital organs responsible for maintaining body fluid homeostasis within proper physiologic ranges. Kidney disease is an epidemic clinical problem causing significant morbidity and mortality, and current treatments are limited to renin-angiotensin system blockade or renal replacement therapy for the majority of affected individuals. There is a critical, unmet need for novel pharmacological agents to improve the outcome of patients with kidney disease. Nitro-oleic acid (NO2 -OA) is an endogenously generated electrophilic compound with the capacity to modify thiols in proteins, altering their function...
March 29, 2018: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/29603885/synchronous-nephron-sparing-approaches-for-bilateral-renal-masses-perioperative-and-renal-functional-outcomes
#17
Ross J Mason, Thomas Atwell, Christine Lohse, Bimal Bhindi, Grant Schmit, John Schmitz, Bradley C Leibovich, Stephen A Boorjian, R Houston Thompson
OBJECTIVES: To evaluate the perioperative and renal functional outcomes of patients undergoing synchronous bilateral partial nephrectomy (PN) or percutaneous cryoablation (PCA). PATIENTS AND METHODS: We retrospectively reviewed our institutional nephrectomy and renal mass ablation registries to identify all patients with synchronous bilateral renal masses who underwent simultaneous bilateral PN (n = 76) or PCA (n = 13) between 1974 and 2013. Changes in estimated glomerular filtration rates as well as perioperative complications are descriptively reported for each procedure...
March 31, 2018: BJU International
https://www.readbyqxmd.com/read/29597227/from-continuous-renal-replacement-therapies-to-multiple-organ-support-therapy
#18
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco, Gaetano La Manna
The incidence of the multiple organ dysfunction syndrome (MODS) is rapidly increasing in intensive care units (ICU). It usually combines with sepsis and is the most frequent cause of death in the ICU patients. The nature of the ICU patients has changed in the last years. It includes a variety of patients with severe cases due to major surgical interventions, trauma, hemodynamic instability, sepsis, and so on but also older people than previous times. All these situations can easily lead to MODS. In the prior years, the only available and efficient therapy was renal replacement therapy (RRT) for treating acute renal failure, but the development of technology also gives us devices to support the other systems...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597224/ensuring-quality-of-care-through-monitoring-of-continuous-renal-replacement-therapies
#19
Mitchell H Rosner
The continuous renal replacement therapy (CRRT) has offered life-saving treatment for kidney failure. Technological advances coupled with findings from clinical trials have allowed for refinements both in the therapy and in the way it is applied to patients. However, outcomes for patients requiring CRRT remain suboptimal. The use of information technology coupled with structured quality improvement programs offers a methodology for studying the delivery of CRRT with an eye toward improving outcomes. Furthermore, integration of information from the CRRT treatment can be combined with real-time data from other patient-monitoring sources to create "feedback" loops where more timely changes in the CRRT prescription can occur...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597221/technical-complications-of-continuous-renal-replacement-therapy
#20
Zaccaria Ricci, Stefano Romagnoli
Continuous renal replacement therapy (CRRT) is commonly applied in critically ill patients affected by severe acute kidney injury for solute and volume control and to optimize acid-base and electrolytes balance. Although CRRT represents a life-saving procedure for these patients, it is a representation of a non-physiologic artificial kidney and the potential benefits of the treatment could be hampered by clinical and technical side effects. Different parts of the CRRT system can be a source of technical complications...
2018: Contributions to Nephrology
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