scholarly journals Crystal-Associated Colitis with Ulceration Leading to Hematochezia and Abdominal Pain

2016 ◽  
Vol 10 (2) ◽  
pp. 332-337 ◽  
Author(s):  
Meeta Desai ◽  
Aaron Reiprich ◽  
Nancy Khov ◽  
Zhaohai Yang ◽  
Abraham Mathew ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Acute Inflammation ◽  
Mucosal Injury ◽  
Mucosal Damage ◽  
Lower Gi Bleeding ◽  
History Of ◽  
Radiation Colitis ◽  
Exchange Resins ◽  
Stage Renal Disease ◽  
End Stage

Lower GI bleeding is a common cause for hospitalization in adults. Medication-associated mucosal injury is an important clinical entity that can result in significant morbidity and mortality. We present the case of a 45-year-old woman with a 3-month history of intermittent abdominal cramping and rectal bleeding. Her medical history was extensive and included end-stage renal disease and a remote history of endometrial carcinoma that was treated with radiation. Initial workup was concerning for ischemic and radiation colitis, however, histology was most consistent with acute inflammation and ulceration associated with crystal fragments. Sevelamer and cholestyramine are commonly used ion-exchange resins that have been associated with mucosal damage. Both medications were discontinued and her symptoms resolved. Our case highlights an underrecognized but important cause of hematochezia.

Case of eustachian valve endocarditis and the importance of synergistic antibiotic therapy

2021 ◽  
Vol 14 (6) ◽  
pp. e242553
Author(s):  
Dilpat Kumar ◽  
James Boyer ◽  
Warsha Fnu ◽  
Harry Boamah
Keyword(s):  
End Stage Renal Disease ◽  
Altered Mental Status ◽  
Blood Levels ◽  
Chronic Haemodialysis ◽  
Dialysis Catheter ◽  
Left Forearm ◽  
Eustachian Valve ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 46-year-old woman with a history of end-stage renal disease on chronic haemodialysis presented with 1 week of fever, chills, altered mental status and hand pain. She was febrile and ill-appearing on presentation with a pulse rate of 102 beats per minute. She had a tunnelled dialysis catheter in her right neck. Hand examination demonstrated a swollen, erythematous and tender wrist. Cardiovascular examination demonstrated no murmurs. CT of the hand showed abscesses involving the left forearm. Blood and abscess cultures grew methicillin-resistant Staphylococcus aureus (MRSA). Transesophageal echocardiography (TEE) showed a 1.0×1.0 cm mobile vegetation involving the eustachian valve (EV), confirming EV endocarditis. She remained bacteraemic for 18 days despite being on vancomycin with appropriate blood levels. Vancomycin was switched to daptomycin and ceftaroline, which cleared her cultures. Repeat TEE showed improved vegetation size. Our case highlights the rarity and management of EV endocarditis and the importance of synergy for treatment of persistent MRSA bacteraemia.

History of hypertension in patients treated for end-stage renal disease

1997 ◽  
Vol 15 (4) ◽  
pp. 451-456 ◽  
Author(s):  
Thomas V. Perneger ◽  
Paul K. Whelton ◽  
Michael J. Klag
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Infantile Nephropathic Cystinosis in Sulaimani Pediatric Teaching Hospital: A Retrospective Cohort Study

2018 ◽  
Vol 3 (1) ◽  
pp. 5-8
Author(s):  
Hunar Jamal Hussein ◽  
Khalid Hama Salih ◽  
Adnan Mohammed Hasan
Keyword(s):  
Cohort Study ◽  
End Stage Renal Disease ◽  
Retrospective Cohort ◽  
Positive Family History ◽  
The Other ◽  
P Value ◽  
History Of ◽  
Infantile Cystinosis ◽  
Stage Renal Disease ◽  
End Stage

Cystinosis is a rare metabolic autosomal recessive disorder which characterized by intralysosomal accumulation of cystine. There are three forms; infantile nephropathic is the commonest forms. to evaluate clinical presentations and outcome of infantile cystinosis. A retrospective cohort study conducted in Sulaimani Pediatric Teaching Hospital on 25 patients with infantile cystinosis during May 1, 2014, to June 1, 2017. This study has depended on clinical symptoms and signs, and corneal crystallization for the diagnosis of cystinosis. Gender of the patients was 13 (52%) females and 12 (48%) males. The ages were ranged between (1-12 years) with a mean age of (6.25 years). Eight (32%) patients were from Sulaimani city, but the other 17 (68%) patients were from outside of Sulaimani. Moreover, a 17 (68%) of them were Arabic and the other eight (32%) were Kurdish ethnic groups. The study showed a 20 (80%) positive consanguinity with 19 (76%) positive family history of infantile cystinosis. Additionally, the age of first presentations was between (0.25-2 years) with a mean of (0.8 years). Clinical features included a 100% for polyuria, polydipsia, and failure to thrive. Furthermore, 10 (40%) presented with constipation, 23 (92%) photophobia and 5 (20%) blond hair. Complications included 24 (96%) rickets, 14 (56%) renal insufficiency, 5 (20%) hypothyroidism, 4 (16%) genu valgum, 3 (12%) growth hormone deficiency, and 3 (12%) developed end-stage renal disease. Subsequently, two patients died (8%) due to end-stage renal disease. Finally, there was a statistically significant relationship between both renal insufficiency (P-value = 0.042) and hypothyroidism (P-value < 0.001) with Kurdish ethnicity. Conclusion: Incidence of cystinosis was high among consanguineous parents and those patients who had a positive family history of cystinosis. Furthermore, the delay in diagnosis was due to atypical presentations and unavailability of specific investigations.

scholarly journals A Case of Psoriasis Vulgaris Treated with Brodalumab in a Hemodialysis Patient with End-Stage Renal Disease due to Diabetic Nephropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Masafumi Ishibashi ◽  
Rie Shiiyama
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Psoriasis Vulgaris ◽  
Lavage Fluid ◽  
Skin Lesions ◽  
Dietary Control ◽  
Serious Adverse Events ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Psoriasis vulgaris is not frequently seen in patients on hemodialysis. However, these patients have limited treatment for psoriasis due to concerns about complications. We report the case of a psoriatic patient with end-stage renal disease on hemodialysis, safely treated with brodalumab. A 60-year-old man who presented with a 20-year history of recalcitrant severe psoriasis. He had diabetes from 40 years ago, and hemodialysis was initiated due to the progression of renal dysfunction two months ago. He was treated with brodalumab, and skin lesions improved markedly. He began to have a chronic cough four months after starting brodalumab. CT showed diffuse ground-glass shadow and pleural effusion in both lungs. Transbronchial lung biopsy showed no findings suggestive of interstitial pneumonia. In bronchoalveolar lavage fluid, mycobacteria and fungi were not identified. The T-SPOT.TB test was negative. It was considered to be a symptom of overflow due to excessive fluid volume based on insufficient dietary management. Brodalumab was continued, and respiratory symptoms improved with proper weight setting and adequate dietary control. No recurrence of rash has been seen 12 months after the initiation of brodalumab. There were no serious adverse events.

scholarly journals Electroconvulsive Therapy in a Renal Transplantation Patient: A Rare Combination of Disease and Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Giovanni Malaty ◽  
Kerilyn Godbe ◽  
Mehdi Elmouchtari ◽  
Gurjot Malhi ◽  
Justin White ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Renal Disease ◽  
Electroconvulsive Therapy ◽  
End Stage Renal Disease ◽  
Psychotic Symptoms ◽  
Safety And Efficacy ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

The safety and efficacy of electroconvulsive therapy (ECT) for the treatment of psychiatric disorders have been demonstrated in a wide variety of patients, including postoperative patients and those who are pregnant. While several reports highlight the safety of this treatment in heart and liver transplantation patients, there is a relative lack of literature detailing the safety profile of ECT in an individual with recent kidney transplantation. Here, we explore the case of a patient with a recent renal transplant secondary to diabetes-related end-stage renal disease (ESRD) who underwent a successful course of ECT treatment. A 57-year-old Caucasian male with a past psychiatric history of schizoaffective disorder, bipolar type, and a past medical history of end-stage renal disease with recent right renal transplantation was admitted to the inpatient psychiatry unit. The admission was via a temporary detention order (TDO) for suicidality and auditory hallucinations promoting self-harm. The patient’s depressive and delusional history was well-documented and had been refractory to several courses of psychotherapeutic and pharmacologic management. Electroconvulsive therapy was subsequently initiated and was well-tolerated. Treatments progressively alleviated his depressive and psychotic symptoms and did not adversely affect the function of his transplanted kidney, which was closely monitored throughout the treatment process. This case demonstrated the safety and efficacy of ECT treatment in an individual with recent renal transplant and may prompt further trials into establishing safety and efficacy in larger study populations.

scholarly journals Risk of End-Stage Renal Disease in Psoriatic Patients: Real-World Data from a Nationwide Population-Based Cohort Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Eun Lee ◽  
Ju Hee Han ◽  
Chul Hwan Bang ◽  
Seung Ah Yoo ◽  
Kyung Do Han ◽  
...  
Keyword(s):  
Cohort Study ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Treated Group ◽  
Population Based ◽  
Control Group ◽  
Real World Data ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Abstract Psoriasis is a chronic inflammatory skin disorder mediated by the T-cell–related immune response. Psoriatic patients may have a variety of comorbidities, but their risk of end-stage renal disease (ESRD), particularly according to the subtype of psoriasis, is unclear. We investigated the risk of ESRD in patients with psoriasis according to the subtype of psoriasis and history of systemic therapy for psoriasis. A total of 2,121,228 adults (1,590,921 in the control group and 530,307 in the psoriasis group) were enrolled in this nationwide population-based cohort study until 2015. During follow-up, 1,434 of the subjects in the psoriasis group developed ESRD. After adjusting for confounding factors, psoriasis was associated with the risk of ESRD (hazard ratio (HR) 1.58, 95% confidence interval [95% CI] 1.47–1.68). The psoriatic arthritis group (HR 7.60, 95% CI 1.90–30.41) had a higher risk of ESRD than the control group. Interestingly, no such association was detected in the systemically treated group (HR 1.07, 95% CI 0.80–1.41). Moreover, the acitretin-treated group had a lower risk of ESRD (HR 0.658, 95% CI, 0.494–0.875) than the non-systemically treated group. In conclusion, the risk of developing ESRD in patients with psoriasis differed according to the type of treatment and the presence of arthritis.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

POCUS Journal ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 24-25 ◽  
Author(s):  
Michael Cenkowski, MD ◽  
Amer M. Johri, MD ◽  
Raveen Pal, MD ◽  
Jennifer Hutchison, RDCS
Keyword(s):  
Blood Pressure ◽  
End Stage Renal Disease ◽  
Point Of Care ◽  
Vital Signs ◽  
Point Of Care Ultrasound ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.

MO979THERAPEUTIC OPTIONS FOR RECURRENCE OF PRIMARY FOCAL SEGMENTAL GLOMERULONEPHRITIS (FSGS) IN THE RENAL ALLOGRAFT: SINGLE-CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Kalliopi Vallianou ◽  
Smaragdi Marinaki ◽  
Chrysanthi Skalioti ◽  
Sophia Lionaki ◽  
Maria Darema ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Renal Allograft ◽  
Management Strategies ◽  
Single Center ◽  
Single Center Experience ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Mean Time ◽  
New Onset

Abstract Background and Aims Focal Segmental Glomerulosclerosis (FSGS) recurrence after kidney transplantation (KTx) is relatively frequent and is associated with poor graft survival. The aim of this study was to investigate which management strategies were associated with better outcomes in our cohort of KTx recipients with primary FSGS. Method We retrospectively collected data on patients with primary FSGS who received a KTx between 1993 and 2019. A history of biopsy proven FSGS in native kidneys and new onset of significant proteinuria early post-KTx led to the diagnosis of recurrence, which was confirmed by graft biopsy. Results From 1993 to 2019 we performed 46 KTxs in patients with primary FSGS. We identified 26 episodes of recurrence in 25 patients, 67% of them occurring in males. They were younger at the time of KTx (33.8 vs 41.1 years old, p=0.067) and had progressed to end stage renal disease (ESRD) faster after FSGS diagnosis (61.4 vs 111.2 months, p=0.038), while they were less likely to have received prophylactic plasmapheresis (61.5% vs 90%, p=0.029). 76.7% of recurrences were found early, after a median of 0.5 months (IQR 0.1-1) with a median proteinuria was 8.5 (IQR 4.9-11.9) g/day. All patients with recurrence were treated with plasmapheresis, while 8 (30.7%) additionally received rituximab, 1 (3.8%) abatacept and 4 (15.4%) ACTH. 7 (27%) patients experienced complete and 11 (42.3%) partial remission after a mean time of 3 (±1.79) and 4.4 (±2.25) months respectively. Prognosis was worse for patients who experienced a recurrence. 11 (42.3%) patients lost their graft from FSGS in a median time of 33 (IQR 17.5-43.3) months. Conclusion In this series of patients, primary FSGS recurred frequently after KTx. Prophylacic plasmapheresis was shown efficacious in avoiding FSGS recurrence, while timely diagnosis and plasmapheresis-based regimens induced remission in more than half of the patients.

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