Clinical parameters before and after the transition to dialysis
Hemodialysis International,Volume 22, Issue 2, Page 235-244, April 2018.
Authors: Borrego Garcia E, Ruiz Sancho AL, Plaza Lara E, Díaz Gómez L, Delgado Ureña A PMID: 31955900 [PubMed - as supplied by publisher]
Authors: Valga F, Monzón T, Henriquez F, Anton-Pérez G PMID: 31955899 [PubMed - as supplied by publisher]
Publication date: Available online 21 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Dana Miskulin, Daniel E. Weiner, Harold J. Manley
Publication date: Available online 21 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Anne M. Butler, J. Bradley Layton, Vikas R. Dharnidharka, Leah J. McGrath
Much of medical data is buried in the free text of clinical notes and not captured by structured data, such as administrative codes. Natural language processing (NLP) can locate and use information that resides in unstructured free text. Chan et al. demonstrate that NLP is sensitive for identifying symptoms in hemodialysis patients. These findings highlight the benefit NLP may bring to nephrology and should prompt discussion of important considerations for NLP system design and implementation.
Although our Dialysis Outcomes and Practice Patterns Study reported a relatively slow international decrease of hepatitis C virus (HCV) prevalence and incidence in hemodialysis (HD) units from 1996 to 20121 (before the direct-acting antiviral era), Huang et al. now report their direct-acting antiviral–based elimination of HCV from a single HD unit in Taiwan.2 Such eradication of HCV will reduce the clinical burden associated with HCV infection. In addition, HCV eradication should prevent HCV nosocomial transmission.
We read the report by Jadoul et al.1 with great interest in a recent issue in Kidney International. The World Health Organization has set ambitious goals for hepatitis C virus (HCV) eradication using the “micro-elimination” approach.2 Taiwan has one of the highest prevalence and incidence of end-stage kidney disease worldwid e. HCV infection is an important complication among our hemodialysis patients.3 With the advent of the new direct-acting antivirals, complete eradication of HCV infection is one of our key priorities.
A 25-year-old male with end-stage kidney disease from obstructive uropathy and neurogenic bladder presented to the emergency room with generalized tonic-clonic seizures. Two weeks before this presentation, the patient was started on hemodialysis via nontunneled precurved hemodialysis catheter, which was inserted into the right internal jugular vein. A cranial computed tomography obtained for the seizures revealed subcutaneous emphysema of the scalp and air bubbles within the dural venous sinuses (Figure 1a).
Higher serum alkaline phosphatase (sALP) levels associate with a poor prognosis in maintenance hemodialysis patients. However, little is known about the meaning of lower sALP in this population. We hypothesized that lower sALP concentrations may express nutritional status and survival accordingly.
ConclusionOur results suggest that RT for HD patients is clinically tolerable. However, some patients can experience severe infections related to treatment.