Fluid resuscitation in patients with end-stage renal disease on hemodialysis presenting with severe sepsis or septic shock: A case control study

Due to the potential risk of volume overload, physicians are hesitant to aggressively fluid-resuscitate septic patients with end-stage renal disease (ESRD) on hemodialysis (HD). Our study indicates that aggressive fluid resuscitation appears to be safe in ESRD patients.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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CONCLUSIONS: Compared with the reported general population, the HD patients are susceptible to COVID-19 infection, especially older men and those with other underlying diseases. Moreover, HD patients have more severe infection and inflammation with less symptoms and worse outcome. COVID-19 infection can cause dialysis patients lower immunity, stronger inflammation, malnutrition, and internal environment disorder. Neutrophils/lymphocytes ratio does not reflect the severity of the HD patients with COVID-19. PMID: 32722980 [PubMed - as supplied by publisher]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Capnocytophaga canimorsus is a commensal organism colonized in oral flora of dogs and cats and causes severe sepsis through bite wound in immunocompromised patients. To date, hemodialysis has not been reported as a risk ofC. canimorsus infection. A 75-year-old woman with end-stage renal disease secondary to hypertension suddenly developed septic shock. She reared 6 cats in her home, but no bite or scratch wound was found on her body. She was empirically treated with piperacillin-tazobactam and temporally received continuous hemodiafiltration. On the fifth day after sampling, blood culture revealedC. canimorsus as the cause...
Source: Case Reports in Nephrology and Dialysis - Category: Urology & Nephrology Source Type: research
ConclusionsCF-LVADs have not reduced mortality, possibly due to utilization in patients with comorbid conditions. Future trials are necessary for improved patient selection and reduced post-procedural complications.
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research
CONCLUSION: Determining pressure injury risk in critically ill patients is complex and challenging. One common pathophysiological factor is impaired tissue oxygenation and perfusion, which may be nonmodifiable. Improved risk quantification is needed and may be realized in the near future by leveraging the clinical information available in the electronic medical record through the power of predictive analytics. PMID: 32355967 [PubMed - in process]
Source: American Journal of Critical Care - Category: Nursing Authors: Tags: Am J Crit Care Source Type: research
We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infect...
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
CONCLUSIONS: The incidence of pregnancy-related AKI remains high in the maternal ICU setting. Septic shock, hypovolemic shock, and higher APACHE II and SOFA scores were independently associated dialysis therapy (hemodialysis in all cases). KDIGO stages 2 and 3 were less frequent than KDIGO stage 1 in patients with gestational hypertension. Norepinephrine and hemodialysis therapy were independently associated with maternal mortality in patients with pregnancy-related AKI. KDIGO stage 3 was associated with higher maternal mortality. PMID: 32072506 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
This study seeks to examine the association between the inflammatory background and the need for catecholamine treatment in hemodynamically instable patients having septic shock and acute kidney injury during HCO-CVVHD. There were 38 patients (F/M; 16/22, mean age 63 ± 16 years) included in the study. The initial content of the cytokines IL-4, IL-12, IL-17, and TNFα, C-reactive protein, and the score of the Sequential Organ Failure Assessment (SOFA) were assessed. The receiver operating characteristic (ROC) plot showed that a combination consisting of IL-17 × SOFA ≤22.3 was a ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
We report a case of a 59-year-old female patient with vegetative native mitral valve endocarditis caused by Stenotrophomonas maltophilia (SM). She had hemodialysis-dependent chronic renal failure, but no immunosuppressive disease. Echocardiography showed mobile vegetation on her native mitral valve. Right femoral artery embolectomy and mitral valve replacement were performed simultaneously. She awakened from anesthesia, but she passed away due to septic shock complications. To the best of our knowledge, this was the first case in whom native mitral valve endocarditis caused by SM was observed (despite of absence of any imm...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 23 October 2019Source: Journal of Critical CareAuthor(s): Kartikeya Rajdev, Lazer Leifer, Gurkirat Sandhu, Benjamin Mann, Sami Pervaiz, Saad Habib, Abdul Hasan Siddiqui, Bino Joseph, Seleshi Demissie, Suzanne El-SayeghAbstractDue to the potential risk of volume overload, physicians are hesitant to aggressively fluid-resuscitate septic patients with end-stage renal disease (ESRD) on hemodialysis (HD). Primary objective: To calculate the percentage of ESRD patients on HD (Case) who received ≥30 mL/Kg fluid resuscitation within the first 6 h compared to non-ESRD patients (Control) tha...
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
Authors: Barcelos STA, Dall'Oglio VM, de Araújo A, Cerski CTS, Álvares-da-Silva MR Abstract Hepatic sinusoidal obstruction syndrome (HSOS) is a hepatic vascular disease histologically characterized by edema, necrosis, detachment of endothelial cells in small sinusoidal hepatic and interlobular veins and intrahepatic congestion, which leads to portal hypertension and liver dysfunction. In the Western world, most HSOS cases are associated with myeloablative pretreatment in a hematopoietic stem cell transplantation setting. Here we report a case of a 54 years old female patient, otherwise healthy, with n...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
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