Urgent-start dialysis: Comparison of complications and outcomes between peritoneal dialysis and haemodialysis.

This study aimed to compare infectious and mechanical complications related to urgent-start PD and HD. Secondary outcomes were to identify risk factors for complications and mortality related to urgent-start dialysis. METHODS: A quasi-experimental study with incident patients receiving PD and HD in a Brazilian university hospital, between July 2014 and December 2017. Subjects included individuals with final-stage chronic kidney disease who required immediate RRT, that is, HD through central venous catheter or PD in which the catheter was implanted by a nephrologist and utilized for 72 h, without previous training. Patients with PD were subjected, initially, to high-volume PD for metabolic compensation. After hospital discharge, they remained in intermittent PD in the dialysis unit until training was completed. Mechanical and infectious complications were compared, as well as the recovery of renal function and survival. RESULTS: In total, 93 patients were included in PD and 91 in HD. PD and HD groups were similar regarding age (58 ± 17 vs. 60 ± 15 years; p = 0.49), frequency of diabetes mellitus (37.6% vs. 50.5%; p = 0.10), other comorbidities (74.1% vs. 71.4%; p = 0.67) and biochemical parameters at the beginning of RRT, that is, creatinine (9.1 ± 4.1 vs. 8.0 ± 2.8; p = 0.09), serum albumin (3.1 ± 0.6 vs. 3.3&...
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research

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This study was aimed to investigate the impact of CKD, DM, or both diseases on the risk of CRC and to evaluate sex differences therein. MATERIALS AND METHODS: Using data from the National Health Insurance Service-Health Examination Cohort in Korea, we conducted a 1:2 matched case-control study. The disease groups consisted of CKD-/DM+ (n=17700), CKD+/DM- (n=22643), and CKD+/DM+ groups (n=8506). After 1:2 matching by age, sex, and health examination year and month, the healthy control group consisted of 97698 individuals. RESULTS: Multivariate Cox regression analysis showed that the CKD-/DM+, CKD+/DM-, and CKD+/DM...
Source: Yonsei Medical Journal - Category: Universities & Medical Training Authors: Tags: Yonsei Med J Source Type: research
Authors: Tomiyama H, Shiina K Abstract The brachial-ankle pulse wave velocity (brachial-ankle PWV), which is measured simply by wrapping pressure cuffs around the four extremities, is a simple marker to assess the stiffness of the medium- to large- sized arteries. The accuracy and reproducibility of its measurement have been confirmed to be acceptable. Risk factors for cardiovascular disease, especially advanced age and high blood pressure, are reported to be associated with an increase of the arterial stiffness. Furthermore, arterial stiffness might be involved in a vicious cycle with the development/progression o...
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
CONCLUSIONS: Higher dietary CML intake was associated with higher SAF only among participants with neither diabetes nor CKD, which may be explained by high AGE formation in diabetes and decreased excretion in CKD or by dietary modifications in these disease groups. The dAGE-SAF associations were also modified by the time difference between measurements. Our results suggest that dAGEs can influence tissue AGE accumulation and possibly thereby age-related diseases. This trial was registered at the Netherlands National Trial Register as NTR6831 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6831) and at the WHO In...
Source: The American Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Am J Clin Nutr Source Type: research
CONCLUSIONS: This study showed increased prevalence of oral findings in CKD patients. It also revealed that Diabetes mellitus cannot be a contributing factor for increased prevalence of oral manifestations of CKD patients. PMID: 32407059 [PubMed - as supplied by publisher]
Source: Minerva Stomatologica - Category: Dentistry Tags: Minerva Stomatol Source Type: research
Authors: Khunti K, Davies MJ, Seidu S Abstract Introduction: Early initiated and long-term sustained intensive glucose control is associated with a significantly decreased risk of cardiovascular events and all-cause mortality, over and above the well-established decline in the risk of microvascular disease. Based on the recent cardiovascular outcome trial (CVOT) data, this review focuses on the various benefits of the newer medications with their positioning in the treatment algorithm and explores the place of the older medications in the management of type 2 diabetes mellitus (T2DM).Areas covered: We searched the ...
Source: Expert Review of Pharmacoeconomics and Outcomes Research - Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research
AbstractType 2 diabetes mellitus (T2DM) affects millions of people worldwide, elevating their risk of developing a range of complications, including chronic kidney disease (CKD). People with T2DM and CKD (i.e., diabetic kidney disease, DKD) have an increased risk of progressing to end-stage kidney disease (ESKD), experiencing cardiovascular complications, and premature death. Despite this, DKD is primarily addressed through management of risk factors, and there are few pharmaceutical treatments capable of reversing or delaying disease progression. Canagliflozin is a sodium glucose co-transporter  2 inhibitor that was ...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
In conclusion, the evidence for state‐of‐the‐art heart failure treatments with regard to exercise capacity and quality of life is limited and appears not robust enough to permit recommendations for heart failure. The treatment of co‐morbidities may be important fo r these patient‐related outcomes. Additional studies on functional capacity and quality of life in heart failure are required.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Review Source Type: research
CONCLUSIONS: The combination of high ALP and low iPTH was independently associated with increased all-cause and cardiovascular mortality in PD patients, suggesting that ALP and iPTH have the potential to predict clinical outcomes and might be useful risk assessment tools in PD patients. Further studies exploring the observed association between combination of ALP with iPTH and mortality are warranted. PMID: 32363998 [PubMed - as supplied by publisher]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
Authors: Ramachandran M, Loi B, Mat Ariff N, Ng OC, Zahari Sham SY, Thambiah SC, Samsudin IN Abstract INTRODUCTION: Metformin is the first-line pharmacological therapy for type 2 diabetes mellitus (T2DM). Guidelines recommend metformin to be given at reduced dosages for those with an estimated glomerular filtration rate (eGFR)
Source: Malaysian Journal of Pathology - Category: Pathology Tags: Malays J Pathol Source Type: research
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