scholarly journals Vancomycin Induced Thrombocytopenia – Protracted Course in a Hemodialysis Patient

2019 ◽  
Vol 12 (3) ◽  
pp. 749-754 ◽  
Author(s):  
Nisha Elizabeth Ajit ◽  
Sindhu Priya Devarashetty ◽  
Samip Master

Vancomycin induced thrombocytopenia (VIT) is an uncommon side effect of vancomycin which can manifest from mild petechiae to life-threatening bleed. Decreased renal clearance of vancomycin results in prolonged thrombocytopenia by antibody-mediated platelet destruction in the presence of vancomycin. Improvement in thrombocytopenia is achieved with the elimination of vancomycin. We describe a patient with end stage renal disease who experienced a protracted course of thrombocytopenia from vancomycin. We illustrate the mechanism of thrombocytopenia and the treatment modalities used by us and those described in literature. VIT is an important differential in patients with thrombocytopenia admitted to the hospital.

Sarcoma ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Sheron Latcha ◽  
Robert G. Maki ◽  
Gary K. Schwartz ◽  
Carlos D. Flombaum

Background. Pharmacokinetic data on clearance of ifosfamide in hemodialysis patients are limited. Consequently, these patients are excluded from therapy with this agent. We review the outcomes for patients at our institution with end stage renal disease on dialysis who received ifosfamide for metastatic sarcoma.Patients and Methods. We treated three patients with end stage renal disease on hemodialysis with escalating doses of ifosfamide. Data on radiographic response to therapy, WBC and platelet counts, signs or symptoms of infection, neuropathy and bladder toxicity are reported. Starting doses of ifosfamide were based on review of the literature available with subsequent modifications based on each patient's prior exposure to myelosuppressive agents and on symptoms of neurotoxicity and the degree of myelosuppression following each cycle of chemotherapy.Results. Myelosuppression was the most common side effect from therapy, but no patient developed a life threatening infection, neurotoxicity, or hematuria. One patient developed epistaxis in the setting of thrombocytopenia while on warfarin therapy. All patients had clinical evidence for therapeutic response and two had documented radiographic improvement following ifosfamide administration.Conclusion. Ifosfamide can be used safely in combination with hemodialysis in patients with end stage renal disease.


2010 ◽  
Vol 31 (9) ◽  
pp. 1230-1249
Author(s):  
Emily F. Shortridge ◽  
Cara V. James

African Americans are disproportionately represented among patients with end-stage renal disease (ESRD). ESRD is managed with a strict routine that might include regular dialysis as well as dietary, fluid intake, and other lifestyle changes. In a disease such as this, with such disruptive treatment modalities, marriage, specifically, and its ties to well-being have the potential to significantly affect adherence to medical treatment and lifestyle recommendations as well as downstream health outcomes such as disease progression and mortality. The authors used data from the Dialysis Morbidity and Mortality Study, Wave 2, of the U.S. Renal Data System Database, a prospective study of 4,000 ESRD patients selected from a random sample of 25% U.S. dialysis facilities, to investigate these research questions. They found that married African American ESRD patients had marginally better outcomes on several clinical and psychosocial measures, which they hypothesize may be attributable to the instrumental and emotional support conferred by marriage.


1984 ◽  
Vol 13 (4) ◽  
pp. 327-343 ◽  
Author(s):  
Gerald M. Devins ◽  
Yitzchak M. Binik ◽  
Tom A. Hutchinson ◽  
David J. Hollomby ◽  
Paul E. Barré ◽  
...  

The emotional impact of the intrusiveness of illness and patients' reduced control over several aspects of life were examined in the context of end-stage renal disease. A sample of thirty-five hemodialysis, ten continuous ambulatory peritoneal dialysis (CAPD), and twenty-five posttransplant patients participated in a standardized interview in which a series of eight self-report measures of positive and negative mood, life happiness, self-esteem, depression, and somatic symptoms of distress were obtained. Attending staff also completed a depression rating scale for each participant. Data reduction via principal-components analysis yielded two factors, corresponding to negative and positive mood, and these were submitted to covariance analyses in which age, general nonrenal health, and defensiveness were controlled statistically. Patients' perceptions of increased intrusiveness, and their perceptions of limited control over eleven life dimensions, each correlated significantly and uniquely with increased negative and decreased positive mood, suggesting that each of these two factors contributes importantly and independently to patients' distress. An “objective” continuum of intrusiveness, constructed by ranking the various treatment modalities represented in the sample, also related significantly to positive (but not to negative) mood levels.


2015 ◽  
Vol 63 (7) ◽  
pp. 386-394 ◽  
Author(s):  
Taro Nakatsu ◽  
Nobushige Tamura ◽  
Shigeki Yanagi ◽  
Shoichi Kyo ◽  
Takaaki Koshiji ◽  
...  

Author(s):  
Sullivan John D

From the establishment of nearly universal health coverage for end stage renal disease in 1972 to 2021, the primary treatment modality has been in-center hemodialysis despite significant advances in home therapies such as peritoneal dialysis and home hemodialysis. There are many theories as to why peritoneal and home hemodialysis lack so far behind in prescriptions with profitability and or a patient’s compliance or support leading the logical explanations. But 2020 was a different year with the surge in COVID-19 cases.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
M. Hanif Prasetya 'Adhi ◽  
Yanny Trisyani ◽  
Etika Emaliyawati

End stage renal disease (ESRD) is a serious chronic disease that resulted from complications of chronic renal failure and a final diagnosis that requires treatment modalities such as dialysis or continuous ambulatory peritoneal dialysis (CAPD). However, CAPD is rarely selected as renal replacement therapy by ESRD patients in Indonesia. Therefore, the phenomenon associated with patients undergoing CAPD is unclear, especially in Indonesia. The purpose of this study was to explore the lived experiences of ESRD patients undergoing CAPD therapy. The research method employed qualitative descriptive phenomenology. The participants in this study were 10 ESRD patients with CAPD. Data collection utilized semi-structured interviewed and data was analyzed using the Colaizzi approach. The result of the study was explained through 6 themes. These are: 1) Condition improved with CAPD, 2) Freedom of activity, 3) Between feeling better and bored 4) Health is increased, 5) It is sustained life, 6) Resignation to accept illness. In conclusion, the patients with CAPD felt  significant positive changes in their life and CAPD is considered life-sustaining for the participants, as the majority of the symptoms was decreased significantly. Therefore, the partisipants felt their conditions improved better. The unpleasant sides of CAPD are feeling bored. The support  of the family  is important as it  produced strength and passion for patients in undergoing CAPD.


Author(s):  
S. Fomina ◽  
O. Ovska

The Fabry Disease in young white man with End Stage Renal Disease was reported. Diagnosis was detected at stage of hemodialysis treatment despite sings which admitted as clinical criteria were found at childhood but did not identify during 20 years due limited awareness of medical community about lysosomal disorders.


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