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https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#1
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28525779/systematic-review-and-meta-analysis-of-renal-replacement-therapy-modalities-for-acute-kidney-injury-in-the-intensive-care-unit
#2
Danielle M Nash, Sebastian Przech, Ron Wald, Daria O'Reilly
PURPOSE: To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). MATERIALS AND METHODS: We completed a systematic review and meta-analysis of studies published in 2015 or earlier using MEDLINE®, EMBASE®, Cochrane databases and grey literature. Eligible studies included randomized clinical trials (RCTs) or prospective cohort studies comparing outcomes of mortality, dialysis dependence or length of stay among critically ill adults receiving CRRT, IHD or SLED to treat AKI...
May 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28515746/veno-arterial-extracorporeal-membrane-oxygenation-as-cardiogenic-shock-therapy-support-in-adult-patients-after-heart-surgery
#3
Robert Musiał, Krystyna Ochońska, Andrzej Proc, Jarosław Stoliński, Dariusz Plicner, Bogusław Kapelak, Rafał Drwiła
INTRODUCTION: The authors present their personal experience in qualifying and treating adult patients using veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in postcardiotomy cardiogenic shock. AIM: The aim of this study was to analyze the results of VA ECMO in patients with postcardiotomy cardiogenic shock. An analysis of the risk factors of postoperative mortality was also performed. MATERIAL AND METHODS: We analyzed the perioperative results of survivors and non-survivors of treatment using VA ECMO...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28515613/secondary-sjogren-s-syndrome-presenting-with-distal-tubular-acidosis-and-quadriparesis
#4
Kartik Munta, Manimala Rao Surath, K Seshikiran
A 52-year-old female patient was admitted to Intensive Care Unit with complaints of quadriparesis. Investigations revealed distal renal tubular acidosis (DRTA) secondary to Sjogren's syndrome with involvement of the parotid and thyroid glands. Laboratory investigations showed hyperchloremic metabolic acidosis and an alkaline urine pH with clinical signs of sicca syndrome. Sjogren's syndrome is associated with DRTA and occurrences of quadriparetic hypokalemia, nephrolithiasis, and osteomalacia can be prevented with early diagnosis and lifelong treatment with potassium and alkali replacement...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28508984/successful-treatment-of-myeloma-cast-nephropathy-using-bortezomib-based-chemotherapy-plus-selective-plasma-exchange
#5
Mayuko Kawabe, Izumi Yamamoto, Ai Katsuma, Naomi Hayashi, Yo Komatsuzaki, Yasuyuki Nakada, Akihiro Shimizu, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Kazuhito Suzuki, Takaki Shimada, Yoji Ogasawara, Katsuki Sugiyama, Keisuke Aiba, Takashi Yokoo
Myeloma cast nephropathy is a major complication of multiple myeloma. Recent evidence has demonstrated that the earlier induction of bortezomib-based chemotherapy with plasma exchange (PE) provides better results for kidney function and patient survival. Due to its non-selectivity, PE with albumin replacement carries the risk of fibrinogen loss, leading to bleeding. We herein report a case of successful treatment of myeloma cast nephropathy using bortezomib-based chemotherapy and selective PE. A 61-year-old woman who had a 20-year history of type II diabetes mellitus was admitted to our hospital for the evaluation of hypercalcemia, severe kidney dysfunction, and anemia...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28508132/survival-in-children-requiring-chronic-renal-replacement-therapy
#6
Nicholas C Chesnaye, Karlijn J van Stralen, Marjolein Bonthuis, Jérôme Harambat, Jaap W Groothoff, Kitty J Jager
Survival in the pediatric end-stage renal disease (ESRD) population has improved substantially over recent decades. Nonetheless, mortality remains at least 30 times higher than that of healthy peers. Patient survival is multifactorial and dependent on various patient and treatment characteristics and degree of economic welfare of the country in which a patient is treated. In this educational review, we aim to delineate current evidence regarding mortality risk in the pediatric ESRD population and provide pediatric nephrologists with up-to-date information required to counsel affected families...
May 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28508021/examining-the-roles-and-experiences-of-fathers-of-children-with-chronic-kidney-disease
#7
David B Nicholas
This study examined roles and experiences of fathers of children with chronic kidney disease (CKD). Based on interpretive description, semistructured interviews were conducted with 22 fathers of children receiving a range of treatments (transplant, peritoneal dialysis, hemodialysis, and CKD not requiring renal replacement therapy). Fathers described various experiences and means of adjusting to shifts associated with pediatric CKD. These included loss of personal control, a sense of personal isolation, and a stance of remaining strong amidst personal suffering...
January 2017: Global Qualitative Nursing Research
https://www.readbyqxmd.com/read/28507907/effectiveness-of-enzyme-replacement-therapy-in-fabry-disease-long-term-experience-in-argentina
#8
Gustavo Cabrera, Juan Politei, Norberto Antongiovani, Hernán Amartino
Evidence regarding long term effectiveness of enzyme replacement therapy (ERT) in Fabry disease (FD) is needed. The aim of this study was to analyze in a cohort of FD patients in Argentina, the long term effectiveness of ERT on renal, cardiac and cerebrovascular parameters. METHODS: Patients with genetically proven FD were included from GADYTEF (Argentinean group for the treatment of FD) between 2001 and 2014. Renal, cardiac, and cerebral outcomes were prospectively studied in patients treated with ERT...
June 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28507581/long-term-outcomes-in-children-with-chronic-kidney-disease-stage-5-over-the-last-40-years
#9
Dominika Adamczuk, Maria Roszkowska-Blaim
INTRODUCTION: We evaluated outcomes in children with chronic kidney disease stage 5 (CKD 5) treated in the first pediatric dialysis unit in Poland during 1973-2012. MATERIAL AND METHODS: The retrospective analysis included 208 children with CKD 5 undergoing renal replacement therapy (RRT), stratified into four decades of treatment: 1973-1982, 1983-1992, 1993-2002, and 2003-2012. RESULTS: The most common causes of CKD 5 included glomerulonephritis in 27...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28505627/endothelial-damage-signals-refractory-acute-kidney-injury-in-critically-ill-patients
#10
Theis S Itenov, Jens-Ulrik Jensen, Sisse R Ostrowski, Pär I Johansson, Katrin M Thormar, Jens D Lundgren, Morten H Bestle
Critically ill patients with acute kidney injury (AKI) are heterogeneous on pathophysiology and prognosis. The role of endothelial damage in the pathogenesis of refractory AKI has not been clarified. The aim was to determine if biomarkers of endothelial damage, independently of the inflammatory insult on the kidney, can predict recovery of acute kidney injury. METHODS: From the "Procalcitonin And Survival Study" multicenter intensive care unit cohort, followed for 28 days after admission, we included patients without chronic kidney disease, who survived >24 h after admission and with plasma samples at admission available for biomarker analysis...
June 2017: Shock
https://www.readbyqxmd.com/read/28504015/laparoscopic-surgery-in-patients-on-peritoneal-dialysis-a-review-of-the-literature
#11
Giulio Mari, Renzo Scanziani, Sara Auricchio, Jacopo Crippa, Dario Maggioni
Peritoneal dialysis (PD) is an effective renal replacement therapy for the treatment of end-stage renal disease. Patients on PD undergoing abdominal open surgery often fail to resume PD. Laparoscopic surgery has recently become a serious alternative to open surgery in patients on PD to treat different abdominal pathologies. However, only a few studies have reported successful procedures without Tenckhoff catheter removal. The aim of this review is to describe how a laparoscopic technique can allow PD patients to deal with abdominal surgery without shifting to hemodialysis...
May 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28495592/mir-21-promotes-fibrogenesis-in-peritoneal-dialysis
#12
Melisa Lopez-Anton, Mark Lambie, Manuel Lopez-Cabrera, Claus P Schmitt, Vicente Ruiz-Carpio, Maria Bartosova, Betti Schaefer, Simon Davies, Timothy Stone, Robert Jenkins, Philip R Taylor, Nicholas Topley, Timothy Bowen, Donald Fraser
Peritoneal dialysis (PD) is a life-saving form of renal replacement therapy for those with end-stage kidney disease. Mesothelial cells (MCs) line the peritoneal cavity and help define peritoneal response to treatment-associated injury, a major reason for treatment failure. miRNAs are important regulators, but their roles in peritoneal fibrosis are largely unknown. In this study, miR-21 was one of the most abundant miRNAs in primary MCs, and was up-regulated by the profibrotic cytokine transforming growth factor-β1 and in PD effluent-derived MCs exhibiting mesenchymal phenotypic change...
May 8, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28491851/pemetrexed-induced-acute-kidney-failure-following-irreversible-renal-damage-two-case-reports-and-literature-review
#13
Tito Zattera, Francesco Londrino, Matteo Trezzi, Roberto Palumbo, Antonio Granata, Paola Tatangelo, Valentina Corbani, Valeria Falqui, Nadia Chiappini, Lisa Mathiasen, Marco Cavallini, Davide Rolla
BACKGROUND: Pemetrexed (PEM) is a new-generation multitargeted antifolate agent with a demonstrated broad-spectrum activity in several types of human cancers, including non-small cell lung cancer (NSCLC) and mesothelioma. Major side effects include dose-limiting hematologic toxicities. PEM nephrotoxicity is well known; however, its frequency is considered to be low. CASE PRESENTATION: Here we report two cases of acute kidney injury (AKI) related to PEM administration (500 mg/m2) in patients with NSCLC...
March 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28491339/the-clinical-epidemiology-and-30-day-outcomes-of-emergency-department-patients-with-acute-kidney-injury
#14
Frank Xavier Scheuermeyer, Eric Grafstein, Brian Rowe, Jay Cheyne, Brian Grunau, Aaron Bradford, Adeera Levin
BACKGROUND: Acute kidney injury (AKI) is associated with increased mortality and dialysis in hospitalized patients but has been little explored in the emergency department (ED) setting. OBJECTIVE: The objective of this study was to describe the risk factors, prevalence, management, and outcomes in the ED population, and to identify the proportion of AKI patients who were discharged home with no renal-specific follow-up. DESIGN: This is a retrospective cohort study using administrative and laboratory databases...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28487869/a-curious-case-of-persistently-relapsing-hyperkalemia-in-an-esrd-patient-on-maintenance-hemodialysis-following-bioprosthetic-aortic-valve-replacement-a-potential-case-for-the-use-of-the-new-agent-patiromer-for-hyperkalemia-management
#15
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi, Fidelis Oguejiofor, Charles Odenigbo
Hyperkalemia is not uncommon in patients with end-stage renal disease (ESRD) on maintenance hemodialysis, often related to dietary indiscretion, following the prolonged inter-dialytic weekend interval in patients on thrice weekly hemodialysis treatments, and sometimes the adverse effects of medications such as RAAS blocking agents. Moreover, hyperkalemia following extended cardiac surgery can result from the use of high-potassium containing cardioplegic solutions used during cardiopulmonary bypass. Nevertheless, different from the foregoing, in the nephrology literature, there have been very rare reports of potentially life-threatening hyperkalemia following cardiac valve replacement procedure...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28487864/non-dialytic-management-of-acute-kidney-injury-in-newborns
#16
REVIEW
Vishal Pandey, Deepak Kumar, Prashant Vijayaraghavan, Tushar Chaturvedi, Rupesh Raina
Treating acute kidney injury (AKI) in newborns is often challenging due to the functional immaturity of the neonatal kidney. Because of this physiological limitation, renal replacement therapy (RRT) in this particular patient population is difficult to execute and may lead to unwanted complications. Although fluid overload and electrolyte abnormalities, as seen in neonatal AKI, are indications for RRT initiation, there is limited evidence that RRT initiated in the first year of life improves long-term outcome...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28485326/clarifications-on-continuous-renal-replacement-therapy-and-hemodynamics
#17
REVIEW
Xiao-Ting Wang, Cui Wang, Hong-Min Zhang, Da-Wei Liu
OBJECTIVE: Continuous renal replacement therapy (CRRT) is a continuous process of bedside blood purification which is widely used in the treatment of acute kidney injury (AKI) and for fluid management. However, since AKI and fluid overload are often found to be associated with hemodynamic abnormalities, determining the relationship between CRRT and hemodynamics remains a challenge in the treatment of critically ill patients. The aim of this review was to summarize key points in the relationship between CRRT and hemodynamics and to understand and monitor renal hemodynamics in critically ill patients, especially those with AKI...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28481830/dose-prescription-and-delivery-in-neonates-with-congenital-heart-diseases-treated-with-continuous-veno-venous-hemofiltration
#18
Zaccaria Ricci, Francesco Guzzi, Germana Tuccinardi, Luca Di Chiara, William Clark, Stuart L Goldstein, Claudio Ronco
OBJECTIVES: Renal replacement therapy may be required for acute kidney injury treatment in neonates with complex cardiac conditions. Continuous veno-venous hemofiltration is applied safely in this population but no published recommendations for dose prescription in neonates currently exist. The aim of our study was to evaluate the effects of a relatively small dialysis dose on critically ill neonates. DESIGN: Retrospective analysis of clinical charts. SETTING: Pediatric Cardiac ICU...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28472927/renal-replacement-therapy-in-acute-kidney-injury-from-a-chinese-cross-sectional-study-patient-clinical-socioeconomic-and-health-service-predictors-of-treatment
#19
Fang Wang, Daqing Hong, Yafang Wang, Yunlin Feng, Li Wang, Li Yang
BACKGROUND: Renal replacement therapy (RRT) is important to support critically ill patients with acute kidney injury (AKI). This study, a part of a nation-wide survey for AKI conducted by the ISN AKF 0 by 25 China Consortium, aims to study the current RRT practical situation and problems in China. METHODS: The current study is a part of a nation-wide survey for AKI conducted by ISN AKF 0 by 25 China Consortium. The survey included 44 sites all over the country, including 22 academic hospitals in big cities and 22 local hospitals in smaller cities or rural areas...
May 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28466293/-renal-replacement-therapy-in-acute-kidney-injury
#20
REVIEW
S J Klein, M Joannidis
Acute kidney injury is still a common complication in intensive care units and is associated with a significantly increased risk for morbidity and mortality. Various treatment concepts, like continuous renal replacement therapy (RRT) or (modified) intermittent procedures, as well as different methods of anticoagulation and the general decision of when and if to initiate RRT have to be considered by the treating physician. While giving vital input on when to initiate RRT, the German ELAIN (Early versus late initiation of renal replacement therapy in critically ill patients) trial and the French AKIKI (The artificial kidney initiation in kidney injury) trial raised many more questions...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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