Timing of initiation of renal replacement therapy in acute kidney injury: an updated meta-analysis of randomized controlled trials.

Timing of initiation of renal replacement therapy in acute kidney injury: an updated meta-analysis of randomized controlled trials. Ren Fail. 2020 Nov;42(1):77-88 Authors: Zhang L, Chen D, Tang X, Li P, Zhang Y, Tao Y Abstract Purpose: The results from randomized controlled trials (RCTs) concerning the timing of initiation of renal replacement therapy (RRT) for patients with acute kidney injury (AKI) are still inconsistent.Materials and methods: We searched for RCTs, as well as relevant references, focusing on the timing of RRT for AKI patients in the Medline, Embase, Cochrane Library, Google Scholar and Chinese databases from their inception to December 2018.Results: We included 18 RCTs from 1997 to 2018 involving 2856 patients. Pooled analyses of all RCTs showed no significant difference in mortality between early initiation and delayed initiation of RRT (RR 0.98, 95% CI: 0.89 to 1.08, p = .7) (I2 = 2%), and similar results were found in critically ill and community-acquired AKI patients, as well as in a subgroup of patients with sepsis and in cardiac surgery recipients. There was also no difference in the incidence of dialysis independence (RR 0.75, 95% CI: 0.47 to 1.2, p = .2) (I2 = 0). However, an early RRT strategy was associated with a significantly higher incidence of the need for RRT for AKI patients (RR 1.24, 95% CI: 1.13 to 1.36, p 
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research

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Ziting Wang, Pradeep Durai, Ho Yee TiongIndian Journal of Urology 2020 36(2):89-94There is an increasing gulf between demand and supply for kidneys in end-stage renal failure patients worldwide, especially Asia. Renal transplantation is often the treatment of choice for long-suffering patients who have to undergo dialysis on a regular basis. The utilization of expanded criteria donors (ECDs) to address the donor pool shortage has been proven to be a legitimate solution. Metzger first described the classification of standard criteria donor and ECD in 2002. Since then, the criterion has undergone various modifications, with ...
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
We present a 50-year-old male who underwent PCNL for renal pelvic calculus. Since the day of the surgery, he had low-grade fever (100°F) which worsened (102°F) from the 2nd postoperative day. His preoperative urine culture was sterile. His platelet counts started dropping and NS1 antigen for dengue was positive. He also developed anemia (hemoglobin: 7g%) and platelet counts dropped to 17,000/cmm. He developed anuria on the 7th postoperative day, with serum creatinine rising to 7 mg%. He required two sessions of hemodialysis and urine output improved. There is a need for high index of suspicion for dengue,...
Source: Indian Journal of Urology - Category: Urology & Nephrology Authors: Source Type: research
Renal failure is a serious complication associated with multiple myeloma that can occur in up to 50% of cases at diagnosis.1 Although the introduction of novel antimyeloma agents has improved outcomes, severe renal impairment is still associated with an early risk of death in patients with multiple myeloma.2,3 Renal injury occurs in multiple myeloma secondary to the direct toxic effect of monoclonal light chains precipitating in the renal tubules.4 Other potential contributors to myeloma-related renal impairment include hypercalcemia, dehydration, and use of nephrotoxic agents such as analgesics, antibiotics, and contrast dye.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Case Report Source Type: research
Ignoring a problem won ’t make it go away. I say this all the time, with love and compassion, to my patients who are having trouble accepting a diagnosis. Ignoring your Type 2 Diabetes, for example, won’t make it any less real. It will only land you in renal failure and on dialysis, or with a […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions COVID-19 coronavirus Infectious Disease Source Type: blogs
AbstractSummaryThe receptor activator of nuclear factor-kappa B ligand (RANKL)/RANK/osteoprotegerin system is dysregulated in hyperparathyroid bone diseases. The introduction of denosumab preceding elective surgery as an alternative option when surgery is not possible immediately.IntroductionThe effects of denosumab on vascular calcification in patients with chronic renal failure and low bone mass have been a subject of interest. Therefore, this investigation aimed to determine the short-term changes in vascular calcification after denosumab treatment using a serial electrocardiography-gated computed tomography (CT) to mea...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
CONCLUSION: A lower SUA level in HD patients was associated with a higher risk of all-cause mortality and CV mortality. Moreover, higher SUA concentrations may be cardioprotective in HD patients. PMID: 32223483 [PubMed - in process]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
N-terminal pro-brain natriuretic peptide (NT-pro BNP) increases in patients with heart failure and renal failure. Hemodialysis is a useful treatment to these patients. The aim of this study was to conduct a systematic and meta-analysis to evaluate the influence of hemodialysis on NT-pro BNP concentration.
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In this study, we determined the relationships between serum sclerostin and all-cause mortality, the prevalence of cardiovascular events (CVEs), and coronary artery calcifications (CACs) in dialysis patients.Methods: A total of 165 dialysis patients (84 hemodialysis [HD] and 81 peritoneal dialysis [PD]) were enrolled in this study. We performed multivariable linear regression analysis to test the relationships between serum sclerostin levels and demographics and clinical parameters. We also performed Cox proportional hazard regression analysis to determine independent predictors of overall survival and CVEs.Results: The me...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Authors: Wang Y, Li Y, Wang H, Ma Y, Ma D, Tian D, Liu B, Zhou Z, Yang W, Li X, Cui J, Chen L Abstract Background: Early-start peritoneal dialysis (PD) is an effective option for patients need unplanned dialysis. However, there are few studies on the long-term prognosis of early-start PD patients.Methods: In this retrospective study, 635 eligible patients from 1 March 1996 to 30 September 2016 were included, and divided into three groups according to the duration of break-in period: 3 days or less, 4-13 days and more than 14 days. Patients started PD within 2 weeks and after 2 wee...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
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Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
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