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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AbstractBackgroundIron deficiency is a common cause of anemia in pediatric patients with hemodialysis-dependent chronic kidney disease (CKD-5HD). Ferric pyrophosphate citrate (FPC, Triferic ®) donates iron directly to transferrin, bypassing the reticuloendothelial system and avoiding iron sequestration. Administration of FPC via dialysate or intravenously (IV) may provide a suitable therapeutic option to current IV iron preparations for these patients.MethodsThe pharmacokinetics and safety of FPC administered via dialysate and IV to patients aged
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsIn pediatric dialysis patients, ferric citrate may be able to concurrently lower phosphate levels and treat iron deficiency. However, larger studies are needed to further evaluate safety and efficacy in the pediatric chronic kidney disease population.
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsOur findings support the presence of erythropoiesis inhibitory substances in uremic sera. EPO/EPO-R-dependent mechanisms may play a role in inhibiting erythropoiesis. The in vitro bioassay described herein may serve as an indicator of rHuEPO responsiveness which may encourage further investigation of underlying mechanisms of EPO resistance.
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
This study aimed to evaluate plasma concentrations of leptin and total ghrelin in children with chronic kidney disease (CKD) and assess their roles in protein-energy wasting (PEW).MethodsThis study consisted of three different CKD populations [CKD group (20 patients with non-dialysis CKD), dialysis group (39 patients on dialysis), and kidney transplant (KTx) group (35 KTx recipients)] and control group (18 healthy children). Plasma leptin and total ghrelin levels were measured. Multi-frequency bioimpedance analysis was used for the assessment of fat and lean mass. PEW was defined using criteria including body mass, muscle ...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
CONCLUSION: This analysis provides us with knowledge on those patients who may benefit from an earlier preparation in RRT. We suggest that patients with previous cardiac events, especially with a risk of gastrointestinal bleeding, should start the preparation for RRT even with GFR rates of 20-25ml/min. In spite of the retrospective nature of this study, and taking into account the difficulties of carrying out clinical trials in this population, we propose this suggestion as complementary to the current recommendations for a scheduled start using this technique. PMID: 30219338 [PubMed - as supplied by publisher]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Secondary hyperparathyroidism (SHPT) is a frequent condition in the presence of chronic kidney disease (CKD). In CKD patients, SHPT is reported to increase both morbidity and mortality, especially cardiovascular. The difficulty in the treatment of SHPT in clinical practice is frequently encountered from a not always adequate conduct of the clinicians and a common non-compliance to the therapy of CKD patients. In this review, the greatest difficulties from clinicians and CKD-patients ’ point of view in the treatment of SHPT will be addressed, with particular attention to those related to dialysis features, nutritional...
Source: Blood Purification - Category: Hematology Source Type: research
Authors: Chen T, Lee VW, Harris DC Abstract The decision about when to start dialysis for end-stage kidney disease (ESKD) is complex and is influenced by many factors. ESKD-related symptoms and signs are the most common indications for dialysis initiation. Creatinine-based formulae to estimate glomerular filtration rate (GFR) are inaccurate in patients with ESKD and, thus, the decision to start dialysis should not be based solely on estimated GFR (eGFR). Early dialysis initiation (ie, at an eGFR> 10 mL/min/1.73 m2) is not associated with a morbidity and mortality benefit, as shown in the Initiating Dialysis Earl...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
Authors: Levy G, Shi JM, Cheetham TC, Rashid N Abstract CONTEXT: Hyperuricemia is an independent risk factor for progression of kidney disease. OBJECTIVE: To determine whether lowering serum uric acid level (sUA) to below 6 mg/dL (target) improves mild to moderate chronic kidney disease (CKD) and whether CKD stage influences the benefit of lowering sUA to target. DESIGN: Retrospective epidemiologic cohort study conducted over 8 years. Estimated glomerular filtration rate (eGFR) was required in the 6 months preceding the index date (defined as first occurrence of sUA
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
(Oxford University Press USA) A new study in Nephrology Dialysis Transplantation indicates that consuming more caffeine may help reduce the risk of death for people with chronic kidney disease.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Conclusion: Community acquired AKI is a major health problem with high morbidity and mortality.Nephron
Source: Nephron - Category: Urology & Nephrology Source Type: research
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