scholarly journals Stenotrophomonas maltophilia: an emerging pathogen in dialysis units

2014 ◽  
Vol 63 (11) ◽  
pp. 1407-1410 ◽  
Author(s):  
Andreana De Mauri ◽  
Massimo Torreggiani ◽  
Doriana Chiarinotti ◽  
Stefano Andreoni ◽  
Gianlorenzo Molinari ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stenotrophomonas Maltophilia ◽  
Treatment Algorithm ◽  
Chronic Dialysis ◽  
Morbidity And Mortality ◽  
Emerging Pathogen ◽  
Stage Renal Disease ◽  
End Stage ◽  
Systemic Infections

Infection is an important cause of morbidity and mortality among patients with end stage renal disease. Stenotrophomonas maltophilia is an unusual yet emerging pathogen in dialysis units. We performed a systematic PubMed/Medline and Scopus review of peer-reviewed English papers on S. maltophilia infections among patients undergoing chronic dialysis, with regard to vascular accesses, systemic infections and environment contaminations. Moreover, we suggest a treatment algorithm to preserve the patient and the permanent dialysis catheters.

Clinical Considerations in Hemodialysis Access Intervention

2018 ◽  
pp. 594-614
Author(s):  
Eric K. Hoffer
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
End Stage Renal Disease ◽  
Morbidity And Mortality ◽  
Dialysis Access ◽  
Hemodialysis Access ◽  
National Kidney Foundation ◽  
Clinical Considerations ◽  
Stage Renal Disease ◽  
End Stage

Interventional radiologists developed and refined the endovascular approaches to maintenance of the permanent arteriovenous vascular accesses that are integral to the provision of hemodialysis for patients with end stage renal disease. As methods of percutaneous arteriovenous fistula creation expand the scope of IR, this chapter reviews the clinical indications and preferences pertinent to dialysis access creation with respect to National Kidney Foundation Recommendations. Accesses remain imperfect, plagued by the development of flow-limiting intimal hyperplastic stenoses, and require monitoring and maintenance to minimize complications, morbidity and mortality. The measures of dialysis access function used in the surveillance of vascular accesses that indicate potential stenosis, and the utility of pre-occlusion recanalization of these stenoses are discussed. Complications specific to dialysis access interventions are also addressed.

End-Stage Renal Disease Patients with Low Serum Albumin: Is Peritoneal Dialysis an Option?

2019 ◽  
Vol 39 (6) ◽  
pp. 562-567 ◽  
Author(s):  
Tripti Singh ◽  
Brad C. Astor ◽  
Sana Waheed
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
Chronic Dialysis ◽  
Lower Mortality ◽  
Dialysis Modality ◽  
Stage Renal Disease ◽  
End Stage ◽  
Low Serum

Introduction Low serum albumin is associated with high mortality in patients with end-stage renal disease (ESRD) on chronic dialysis. Clinicians are reluctant to offer peritoneal dialysis (PD) as an option for dialysis for patients with low serum albumin due to concerns of loss of albumin with PD, but evidence supporting differences in outcomes is limited. We evaluated mortality based on dialysis modality in patients with very low serum albumin (< 2.5 g/dL). Methods We analyzed United States Renal Data System (USRDS) data from 2010 to 2015 to assess mortality by modality adjusted for age, sex, race, employment, number of comorbidities, and year of dialysis initiation. Results Low serum albumin (< 2.5 g/dL) was present in 78,625 (19.9%) of 395,656 patients with ESRD on chronic dialysis. Patients with low serum albumin were less likely to use PD as their first modality than those with higher albumin (3.1% vs 10.9%; p < 0.001). Use of PD was associated with lower mortality compared with hemodialysis (HD) (hazard ratio [HR] = 0.88, 95% confidence interval [CI] 0.81 – 0.95, p < 0.05) in patients with low serum albumin. This difference was more pronounced in patients who had glomerulonephritis (HR = 0.72) or hypertension (HR = 0.81) than in those with end-stage renal disease (ESRD) due to diabetes mellitus or other causes. Conclusion Peritoneal dialysis is less likely to be the first dialysis modality in patients with low serum albumin requiring dialysis. However, PD is associated with lower mortality than HD in patients with low serum albumin on dialysis. We recommend advocating the use of PD in patients with low serum albumin.

scholarly journals Impact of hypertension on cardiomyopathy, morbidity and mortality in end-stage renal disease

1996 ◽  
Vol 49 (5) ◽  
pp. 1379-1385 ◽  
Author(s):  
Robert N. Foley ◽  
Patrick S. Parfrey ◽  
John D. Harnett ◽  
Gloria M. Kent ◽  
David C. Murray ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Morbidity And Mortality ◽  
Stage Renal Disease ◽  
End Stage

Postoperative Morbidity and Mortality After Elective Anterior Cervical Fusion in Patients with Chronic and End-Stage Renal Disease

2016 ◽  
Vol 95 ◽  
pp. 480-485 ◽  
Author(s):  
Rafael De la Garza Ramos ◽  
Amit Jain ◽  
Jonathan Nakhla ◽  
Rani Nasser ◽  
Varun Puvanesarajah ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Postoperative Morbidity ◽  
Anterior Cervical Fusion ◽  
Morbidity And Mortality ◽  
Cervical Fusion ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Baseline Predictors of Mortality among Predominantly Rural-Dwelling End-Stage Renal Disease Patients on Chronic Dialysis Therapies in Limpopo, South Africa

PLoS ONE ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. e0156642 ◽  
Author(s):  
Ramon A. Tamayo Isla ◽  
Oluwatoyin I. Ameh ◽  
Darlington Mapiye ◽  
Charles R. Swanepoel ◽  
Aminu K. Bello ◽  
...  
Keyword(s):  
South Africa ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Chronic Dialysis ◽  
Predictors Of Mortality ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Risks and Benefits of Kidney Transplantation during the COVID Pandemic: Transplant or Not Transplant?

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0002532021
Author(s):  
Maria Ajaimy ◽  
Luz Liriano-Ward ◽  
Jay A Graham ◽  
Enver Akalin
Keyword(s):  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Donor Selection ◽  
Waiting List ◽  
Morbidity And Mortality ◽  
Kidney Transplant Recipients ◽  
Risks And Benefits ◽  
Stage Renal Disease ◽  
End Stage

COVID-19 disease has significantly affected the transplant community by leading to decreased transplant activity and increased waiting list time. As expected, COVID-19 causes substantial mortality in both end-stage renal disease and kidney transplant populations. This is due to underlying chronic kidney disease and a high prevalence of comorbid conditions such as diabetes mellitus, hypertension, and cardiovascular disease in this group. Transplant programs have faced the difficult decision of weighing the risks and benefits of transplantation during the pandemic. On one hand there is a risk of COVID-19 exposure leading to infection while patients are on maximum immunosuppression. Alternatively, there are risks of delaying transplantation, which will increase waitlist-time and may lead to waitlist-associated morbidity and mortality. Cautious and thoughtful selection of both the recipient's and donor's post-transplant management is required during the pandemic to mitigate the risk of morbidity and mortality associated with COVID-19. In this review article we aimed to discuss previous publications related to clinical outcomes of COVID-19 disease in kidney transplant recipients, end-stage renal disease patients on dialysis or on the transplant waiting-list and precautions transplant centers should take in decision making for recipient and donor selection and immunosuppressive management during the pandemic. Nevertheless, transplantation in this milieu does seem to be the correct decision with a careful patient and donor selection with safeguard protocols for infection prevention. Each center should do risk assessment based on their patient's age and medical comorbidities, waitlist time, degree of sensitization, cold ischemia time, status of vaccination, and severity of pandemic in their region.

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