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https://www.readbyqxmd.com/read/29034013/cardiovascular-events-in-hemodialysis-patients-challenging-against-vascular-calcification
#1
REVIEW
Shuzo Kobayashi
Particularly in patients with hemodialysis, cardiovascular mortality rate is extremely high. Polyvascular diseases develop at an early stage of chronic kidney disease (CKD). Pathophysiology includes insulin resistance and/or imbalance between nitric oxide (NO) and endothelin bioavailability as well as oxidative stress. The understanding in pathophysiology of vascular calcification and strategic treatment is a critical issue to achieve favorable outcome for the patients with CKD. In this article, we aim to review the cardiovascular disease for the patients with CKD with a particular emphasis on the clinical aspects of polyvascular disease...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29029967/-10-years-of-external-quality-assurance-in-dialysis-in-germany-results-and-future-prospects
#2
Dorothea Büchtemann, Stefan Meinhold, Peter Follert
BACKGROUND: In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme based on the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres...
October 10, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29027706/regional-citrate-anticoagulation-with-calcium-replacement-in-pediatric-apheresis
#3
Katie Sigler, Ji Lee, Poyyapakkam Srivaths
PURPOSE: The objective of this retrospective analysis was to present our single-center experience with intravenous (IV) calcium replacement and regional citrate anticoagulation in pediatric apheresis therapy with the aim of developing a standard operating procedure to minimize symptomatic hypocalcemia. METHODS: We analyzed apheresis procedures in patients <18 years of age over a 2-year time period (Jan 2012 to Dec 2014). Procedures in tandem with other extracorporeal therapies, including continuous renal replacement therapy, extracorporeal liver support, and extracorporeal membrane oxygenation, were excluded...
October 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28992348/location-of-glomerular-immune-deposits-not-codeposition-of-immunoglobulin-g-influences-definitive-renal-outcomes-in-immunoglobulin-a-nephropathy
#4
Anthony S Alvarado, Nicole K Andeen, Sergey Brodsky, Alice Hinton, Tibor Nadasdy, Charles E Alpers, Christopher Blosser, Behzad Najafian, Brad H Rovin
Background: It has been suggested that the prognosis of immunoglobulin (IgA) nephropathy (IgAN) is adversely affected if there is codeposition of IgG in the glomeruli or if immune deposits are present in the glomerular capillary walls. We sought to understand how these variables affect clinical outcome. Methods: A total of 80 IgAN biopsies were retrospectively divided into groups: (i) IgA without IgG deposition versus IgA + IgG and (ii) immune deposits restricted to the mesangium versus mesangium and peripheral capillary walls (PCWs)...
August 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992218/long-term-consequences-of-renal-insufficiency-in-children-lessons-learned-from-the-dutch-leric-study
#5
Jaap W Groothoff, Martin Offringa, Martha Grootenhuis, Kitty J Jager
Few data exist on the prospects in adulthood for children on chronic renal replacement therapy (RRT). This article summarizes the results of a comprehensive Dutch long-term follow-up study performed in 2000 and 2010 of patients with RRT onset at age <15 years between 1972 and 1992. After a median of 25.5 RRT years, patients had stayed 23% of RRT time on dialysis. We observed a 30 times greater mortality risk compared with age-matched peers with cardiovascular disease (CVD) as the main cause of death during 1972-2000 and infections during 2000-10...
July 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28989174/new-treatment-paradigms-for-adpkd-moving-towards-precision-medicine
#6
REVIEW
Matthew B Lanktree, Arlene B Chapman
The natural history of autosomal dominant polycystic kidney disease (ADPKD) is characterized by a variable rate of cyst development and increase in total kidney volume (TKV), variable kidney function decline and age of onset of end-stage renal disease (ESRD), and variable presentation of renal and extrarenal manifestations. Precision medicine is proposed to improve patient outcomes by tailoring therapy to the specific genetic background, pathophysiology, disease burden, prognosis and status of each individual...
October 9, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28982602/the-assessment-of-acute-kidney-injury-in-critically-ill-patients
#7
Sebastjan Bevc, Robert Ekart, Radovan Hojs
Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. The availability of several biomarkers of kidney injury offers new tools for its early recognition and management. The early identification of high-risk patients provides an opportunity to develop strategies for the prevention, early diagnosis and treatment of AKI. Despite progress in critical care medicine over the past decade, the treatment strategies for AKI in critically ill patients, such as when to start renal replacement therapy, remain controversial...
October 2, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#8
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28974524/risk-of-infective-endocarditis-in-patients-with-end-stage-kidney-disease
#9
Mavish S Chaudry, Nicholas Carlson, Gunnar H Gislason, Anne-Lise Kamper, Marianne Rix, Vance G Fowler, Christian Torp-Pedersen, Niels E Bruun
BACKGROUND AND OBJECTIVES: Endocarditis is a serious complication in patients treated with RRT. The study aimed to examine incidence and risk factors of endocarditis in patients with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Danish National Registry on Regular Dialysis and Transplantation contains data on all Danish patients receiving renal replacement (hemodialysis, peritoneal dialysis, or kidney transplantation) for ESRD. Incidence of endocarditis was estimated for each RRT modality...
October 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28972690/on-line-hemodiafiltration-at-home
#10
Almudena Vega, Soraya Abad, Nicolás Macías, Inés Aragoncillo
Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC(©) ) monitor, and the Acqua C(©) (Fresenius Medical Care) for water treatment...
October 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28971236/gender-specific-association-between-dietary-acid-load-and-total-lean-body-mass-and-its-dependency-on-protein-intake-in-seniors
#11
A M Faure, K Fischer, B Dawson-Hughes, A Egli, H A Bischoff-Ferrari
Diet-related mild metabolic acidosis may play a role in the development of sarcopenia. We investigated the relationship between dietary acid load and total lean body mass in male and female seniors age ≥ 60 years. We found that a more alkaline diet was associated with a higher %TLM only among senior women. INTRODUCTION: The aim of this study was to determine if dietary acid load is associated with total lean body mass in male and female seniors age ≥ 60 years. METHODS: We investigated 243 seniors (mean age 70...
October 2, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28970366/experiences-of-living-with-assisted-peritoneal-dialysis-a-qualitative-study
#12
Ingrid Petersson, Annette Lennerling
BACKGROUND: People's experiences of living with assisted peritoneal dialysis (aPD) have not been studied previously. Assisted PD is successfully used as renal replacement therapy for elderly and disabled patients with end-stage renal disease. To be treated with aPD implies being dependent on lifelong treatment at home. The aim of this study was to explore adults' experiences of living with aPD. METHODS: In-depth interviews were conducted with 10 participants with aPD, median age 82...
September 28, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28969597/the-effect-of-regional-citrate-anti-coagulation-on-the-coagulation-system-in-critically-ill-patients-receiving-continuous-renal-replacement-therapy-for-acute-kidney-injury-an-observational-cohort-study
#13
Richard Fisher, Katie Lei, Mike J Mitchell, Gary W Moore, Helen Dickie, Linda Tovey, Siobhan Crichton, Marlies Ostermann
BACKGROUND: Regional anticoagulation with citrate is the recommended first line treatment for patients receiving continuous renal replacement therapy (CRRT). There is wide variability in filter patency which may be due to differences in patient characteristics and local practice. It is also possible that citrate has effects on primary and secondary haemostasis, fibrinolysis and platelet function that are still unknown. The primary aim of the study is to describe the effect of citrate on coagulation and fibrinolysis pathways in both the patient and the haemodialysis circuit...
October 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28967968/usefulness-of-questionnaires-on-advance-directives-in-haemodialysis-units
#14
Angel Rodríguez Jornet, Loreley Ana Betancourt Castellanos, Maria Isabel Bolós Contador, Juan Carlos Oliva Morera, José Antonio Ibeas López
Background: As renal replacement therapy has become universal practice in medicine, there is a need to consider whether this treatment is suitable for elderly people. These patients have high comorbidity and may require dialysis withdrawal in certain clinical circumstances. Advance directives (ADs) drawn up by patients facilitate treatment-related decisions if they lose cognitive capacity. Questionnaires dealing with possible extreme clinical circumstances can thus help clinicians and relatives reach pertinent decisions in such cases...
October 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28967418/recombinant-factor-viia-use-in-acute-type-a-aortic-dissection-repair-a-multicenter-propensity-score-matched-report-from-the-nordic-consortium-for-acute-type-a-aortic-dissection
#15
Igor Zindovic, Johan Sjögren, Anders Ahlsson, Henrik Bjursten, Simon Fuglsang, Arnar Geirsson, Richard Ingemansson, Emma C Hansson, Ari Mennander, Christian Olsson, Emily Pan, Susann Ullén, Tomas Gudbjartsson, Shahab Nozohoor
BACKGROUND: Surgery for acute type A aortic dissection (ATAAD) is often complicated by excessive bleeding. Recombinant factor VIIa (rFVIIa) effectively treats refractory bleeding associated with ATAAD surgery; however, adverse effects of rFVIIa in these patients have not been fully assessed. Here we evaluated rFVIIa treatment in ATAAD surgery using the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database. METHODS: This was a multicenter, propensity score-matched, retrospective study...
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28960806/regional-evidence-and-international-recommendations-to-guide-lipid-management-in-asian-patients-with-type-2-diabetes-with-special-reference-to-renal-dysfunction
#16
REVIEW
Titus Wl Lau, Kevin Ek Tan, Jason Cj Choo, T G Ng, Tavintharan S, Juliana C N Chan
The anticipated increase in the prevalence and incidence of type 2 diabetes in Asia, and its associated cardiovascular-renal complications will place a significant burden on patients, caregivers and society. Despite the proven effectiveness of lipid management in reducing these complications, there are major treatment gaps especially in Asian patients with young-onset diabetes and chronic kidney disease. Recent international guidelines recommended the adoption of absolute risk estimation of atherosclerosis and cardiovascular disease to guide treatment intensity...
September 28, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28948420/addition-of-silymarin-to-renin-angiotensin-system-blockers-in-normotensive-patients-with-type-2-diabetes-mellitus-and-proteinuria-a-prospective-randomized-trial
#17
Luminita Voroneanu, Dimitrie Siriopol, Raluca Dumea, Silvia Badarau, Mehmet Kanbay, Baris Afsar, Cristina Gavrilovici, Adrian Covic
BACKGROUND: In the last decade, despite constant investigation, no current single treatment has been able to decrease the incidence of diabetic nephropathy and to significantly reduce progression of diabetic CKD. METHODS: Patients with type 2 diabetes mellitus and proteinuria (>0.5 g/day) after a screening and treatment optimization phase were randomly assigned to receive silymarin or placebo. The primary outcome was a composite outcome: mortality, decline of eGFR > 50% and renal replacement therapy...
September 25, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28945064/-candidemia-and-invasive-candidiasis-approach-in-critically-ill-patients-role-of-the-echinocandins
#18
B Almirante, J Garnacho-Montero, E Maseda, F J Candel, S Grau, J Guinea, I Moreno, P Muñoz, S Ruiz-Santana
OBJECTIVE: Invasive infections caused by Candida spp. in critically ill patients may significantly worsen their prognosis, so it is of great importance to establish an early detection and a suitable therapeutic strategy. The objective of this study was to define the differential role of echinocandins in treating certain critical patient profiles. METHODS: A scientific committee of 9 experts in infectious diseases, critical care, microbiology, and hospital pharmacy reviewed the existing evidence on the treatment of candidemia and invasive candidiasis in critically ill patients...
September 25, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#19
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28931037/assessment-of-renal-function-in-routine-care-of-people-living-with-hiv-on-art-in-a-resource-limited-setting-in-urban-zambia
#20
Andreas Deckert, Florian Neuhann, Christina Klose, Thomas Bruckner, Claudia Beiersmann, John Haloka, Mannie Nsofwa, Greg Banda, Maik Brune, Helmut Reutter, Dietrich Rothenbacher, Martin Zeier
INTRODUCTION: Data on renal impairment in sub-Saharan Africa (SSA) remains scarce, determination of renal function is not part of routine assessments. We evaluated renal function and blood pressure in a cohort of people living with HIV (PLWH) on antiretroviral treatment (ART) in the Renal Care Zambia project (ReCaZa). METHODS: Using routine data from an HIV outpatient clinic from 2011-2013, we retrospectively estimated the glomerular filtration rate (eGFR, CKD-Epi formula) of PLWH on ART in Lusaka, Zambia...
2017: PloS One
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