Hyponatremia Predicts Poor Outcomes in Patients with Chronic Kidney Disease Undergoing Heart Surgery.

Hyponatremia Predicts Poor Outcomes in Patients with Chronic Kidney Disease Undergoing Heart Surgery. Ann Thorac Surg. 2018 May 08;: Authors: Shavit L, Merin O, Grenader T, Jacobson E, Waldenberg C, Bitran D, Fink D, Silberman S Abstract BACKGROUND: Preoperative hyponatremia adversely impacts outcomes of cardiothoracic surgery. However, in patients with chronic kidney disease, the association of sodium levels on postoperative events has never been evaluated. We investigated the impact of preoperative hyponatremia on outcomes after cardiac surgery in patients with non-dialysis-dependent chronic kidney disease. Primary endpoints were operative mortality and acute kidney injury requiring dialysis. Secondary endpoints were major infection and long-term survival. METHODS: The study is observational and includes all patients with stage III-IV chronic kidney disease (non-dialysis) undergoing cardiac surgery between February 2000-January 2016. Patients were stratified into 2 groups by preoperative sodium levels: Na
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research

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The objective of this study was to evaluate risk factors and the impact this complication on mortality and survival after cardiac surgery among patients without chronic kidney disease. Methods: In this retrospective study, we reviewed the medical records of 142 patients who underwent elective coronary artery bypass grafting, valve replacement (single or multiple), or both (simultaneously) at a tertiary care hospital. Results: Among the 142 patients evaluated, the mean age was 58.28 ±13.87 years and 80 (56.33%) were female. The postoperative incidence of acute renal injury was 43.66%. Univariate analysis between the ...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSION: Smoking confers a higher cardiovascular risk to CKD patients under conservative treatment as it is associated with higher levels of P. Further studies are needed to confirm and better elucidate this finding. PMID: 30534856 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
Publication date: Available online 10 December 2018Source: American Journal of Kidney DiseasesAuthor(s): Christopher T. Chan, Eric Wallace, Thomas A. Golper, Mitchell H. Rosner, Rebecca Kurnik Seshasai, Joel D. Glickman, Martin Schreiber, Patrick Gee, Michael V. RoccoHome dialysis therapy, including home hemodialysis and peritoneal dialysis, is underused as a modality for the treatment of chronic kidney failure. The National Kidney Foundation–Kidney Disease Outcomes Quality Initiative sponsored a home dialysis conference in late 2017 that was designed to identify the barriers to starting and maintaining patients on h...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
AbstractChronic hepatitis C virus (HCV) infection is common among patients with chronic kidney disease (CKD) and those on hemodialysis due to nosocomial infections and past blood transfusions. While a majority of HCV-infected patients with end-stage renal disease are asymptomatic, some may ultimately experience decompensated liver diseases and hepatocellular carcinoma. Administration of a combination of elbasvir/grazoprevir for 12  weeks leads to high sustained virologic response (SVR) rates in patients with HCV genotypes (GTs) 1a, 1b or 4 and stage 4 or 5 CKD. Furthermore, a combination of glecaprevir/pibrentasvir fo...
Source: Hepatology International - Category: Infectious Diseases Source Type: research
In conclusion, chronic kidney dysfunction causes degradation of sulfatides in the liver to decrease serum sulfatide levels. One explanation of these results is that indoxyl sulfate, a uremic toxin, accelerates the degradation of sulfatides in liver tissue.
Source: Glycoconjugate Journal - Category: Biochemistry Source Type: research
Publication date: November 2018Source: Advances in Chronic Kidney Disease, Volume 25, Issue 6Author(s): Douglas S. Johnson, Klemens B. MeyerThe leaders of 20th century kidney failure treatment took chances; 21st century leaders of integrated kidney care must do the same. Some risks are clinical, some are organizational, and some are financial. Decent and constructive leadership entails humility. A working practitioner is a better leader. Effective leaders empower their employees and collaborators to lead and encourage them to work together. Integrated kidney care leadership supports exchange of ideas within and among organ...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Publication date: November 2018Source: Advances in Chronic Kidney Disease, Volume 25, Issue 6Author(s): Sharmeela Saha, Jay B. WishThe responsibilities of a dialysis unit medical director are specified in the ESRD Conditions for Coverage and encompass multiple quality, safety, and educational domains. Many of these responsibilities require leadership skills that are neither intuitive nor acquired as part of the medical director's training. An effective medical director is able to shape the culture of the dialysis facility such that patients and staff feel free to communicate their concerns regarding suboptimal processes wi...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
This article reviews the roles, responsibilities, and opportunities of the position as established in a midsize nonprofit dialysis provider.
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Publication date: November 2018Source: Advances in Chronic Kidney Disease, Volume 25, Issue 6Author(s): Eleanor LedererThe position of chief of a division of nephrology in an academic medical center is a hands-on job, offering the opportunity to influence the future of the field through the creation of unique clinical, research, and education programs. Today, most academic centers face significant financial challenges, thus the division chief must develop a variety of skills to accomplish his or her goals. Interactions and relationships with the leadership of the academic center, including the hospital executives, can faci...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
This article includes Nephrology Oral History Project excerpts illustrating leadership contributions to dialysis machines, peritoneal dialysis catheters, and treatment best practices. In addition to individual contributions, improvements in treatment also come from patient and provider organizations leading the way and collectively advocating for change. Nephrology leaders continue to play a crucial role in improving dialysis outcomes and quality of life.
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
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