scholarly journals Erythropoietin-Resistant Anemia Secondary to Zinc-Induced Hypocupremia in a Hemodialysis Patient

2021 ◽  
pp. 167-175
Author(s):  
Stephanie Munie ◽  
Pairach Pintavorn
Keyword(s):  
Copper Deficiency ◽  
Hemodialysis Patient ◽  
Esrd Patient ◽  
Serological Testing ◽  
Zinc Supplement ◽  
Excessive Intake ◽  
Stage Renal Disease ◽  
End Stage ◽  
Work Up ◽  
Excess Zinc

Excessive intake of zinc is a known but often forgotten cause of copper deficiency, and its consequences in the context of end-stage renal disease (ESRD) are not widely discussed. Zinc-induced copper deficiency (ZICD) can result in erythropoietin (EPO)-resistant anemia and may not be considered as a possible etiology when conducting the work-up. We present a case wherein an ESRD patient had been receiving excess zinc for several months and subsequently experienced EPO-resistant anemia. Our patient’s GI work-up was negative, and increased doses of iron and EPO-stimulating agent were ineffective. She underwent a bone marrow biopsy and more serological testing. She was ultimately diagnosed with ZICD, and cessation of her zinc supplement and initiation of copper replacement proved effective in restoring EPO responsiveness. Awareness of ZICD as a possible factor in EPO-resistant anemia could lead to an expedited diagnosis and avoid an unnecessary and extensive work-up.

scholarly journals Living Kidney Donation: Practical Considerations on Setting Up a Program

2021 ◽  
Vol 2 (1) ◽  
pp. 75-86
Author(s):  
Maria Irene Bellini ◽  
Vito Cantisani ◽  
Augusto Lauro ◽  
Vito D’Andrea
Keyword(s):  
Good Practice ◽  
Kidney Donation ◽  
Living Kidney Donation ◽  
Exchange Programs ◽  
Paired Exchange ◽  
Stage Renal Disease ◽  
End Stage ◽  
Additional Value ◽  
Work Up

Living kidney donation represents the best treatment for end stage renal disease patients, with the potentiality to pre-emptively address kidney failure and significantly expand the organ pool. Unfortunately, there is still limited knowledge about this underutilized resource. The present review aims to describe the general principles for the establishment, organization, and oversight of a successful living kidney transplantation program, highlighting recommendation for good practice and the work up of donor selection, in view of potential short- and long-terms risks, as well as the additional value of kidney paired exchange programs. The need for donor registries is also discussed, as well as the importance of lifelong follow up.

scholarly journals Contrasting PTH Response of Denosumab Use in Dialysis Patients: A Report of 2 Cases

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 59
Author(s):  
Soo Min Jang ◽  
Smitha Anam ◽  
Tara Pringle ◽  
Paul Lahren ◽  
Sergio Infante
Keyword(s):  
Calcium Release ◽  
Hemodialysis Patient ◽  
Compensatory Mechanism ◽  
Normal Range ◽  
Mineral And Bone Disorder ◽  
Bone Disorder ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Pth Level

A common complication of end-stage renal disease (ESRD) is mineral and bone disorder. Yet, many anti-osteoporotic drugs are contraindicated in ESRD patients. Denosumab, a monoclonal antibody, does not require renal dose adjustment. However, its use is uncertain due to a lack of safety and efficacy of data in this population. Two hemodialysis patient cases of contrasting responses in parathyroid hormone (PTH) after denosumab administration were observed. Patient 1, a 62-years-old male received denosumab 60 mg at Day 0. His calcium decreased from 8.8 mg/dL to 6.8 mg/dL on Day 30. The PTH level increased from 265 pg/mL to 372 pg/mL after 30 days. Calcium and PTH levels approached normal range after increasing doses of vitamin D/calcium supplements, and calcitriol. Patient 2, a 72-years-old male on hemodialysis also received denosumab 60 mg on Day 0. His baseline calcium and PTH were 9.2 mg/dL and 420 pg/mL, respectively. On Day 30, his calcium level decreased (6.8 mg/dL) but, PTH level drastically increased (>5000 pg/mL). Denosumab commonly causes hypocalcemia and hyperparathyroidism since it inhibits osteoclast activation, reduces calcium release from bone and increases PTH levels as a compensatory mechanism. With a wait-and-watch approach, Patient 2’s levels approached the normal range (calcium 9.6 mg/dL and PTH 274 pg/mL at Day 90).

scholarly journals Catheter-Related ESBL-Producing Leclercia adecarboxylata Septicemia in Hemodialysis Patient: An Emerging Pathogen?

2020 ◽  
Vol 2020 ◽  
pp. 1-3 ◽  
Author(s):  
Roaa Sultan Alosaimi ◽  
Mai Muhmmed kaaki
Keyword(s):  
End Stage Renal Disease ◽  
Hemodialysis Patient ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Emerging Pathogen ◽  
First Case ◽  
Stage Renal Disease ◽  
End Stage ◽  
Multidrug Resistant Strain ◽  
Producer Strains

We report a multidrug-resistant strain of Leclercia adecarboxylata which was responsible for a catheter-related bacteremia, in a 50-year-old female with an end-stage renal disease on hemodialysis. The isolated strain was an extended beta-lactamase producer. Based on a literature review of L. adecarboxylata, there have been only two reports of extended beta-lactamase producer strains. To our knowledge, this is the first case reported in Saudi Arabia.

scholarly journals Indoxyl Sulfate-Mediated Metabolic Alteration of Transcriptome Signatures in Monocytes of Patients with End-Stage Renal Disease (ESRD)

Toxins ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 621
Author(s):  
Hee Young Kim ◽  
Su Jeong Lee ◽  
Yuri Hwang ◽  
Ga Hye Lee ◽  
Chae Eun Yoon ◽  
...  
Keyword(s):  
Renal Disease ◽  
Immune Cells ◽  
End Stage Renal Disease ◽  
Metabolic Pathways ◽  
Esrd Patient ◽  
Indoxyl Sulfate ◽  
Uremic Toxin ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End-stage renal disease (ESRD) is the final stage of chronic kidney disease, which is increasingly prevalent worldwide and is associated with the progression of cardiovascular disease (CVD). Indoxyl sulfate (IS), a major uremic toxin, plays a key role in the pathology of CVD via adverse effects in endothelial and immune cells. Thus, there is a need for a transcriptomic overview of IS responsive genes in immune cells of ESRD patients. Here, we investigated IS-mediated alterations in gene expression in monocytes from ESRD patients. Transcriptomic analysis of ESRD patient-derived monocytes and IS-stimulated monocytes from healthy controls was performed, followed by analysis of differentially expressed genes (DEGs) and gene ontology (GO). We found that 148 upregulated and 139 downregulated genes were shared between ESRD patient-derived and IS-stimulated monocytes. Interaction network analysis using STRING and ClueGo suggests that mainly metabolic pathways, such as the pentose phosphate pathway, are modified by IS in ESRD patient-derived monocytes. These findings were confirmed in IS-stimulated monocytes by the increased mRNA expression of genes including G6PD, PGD, and TALDO1. Our data suggest that IS causes alteration of metabolic pathways in monocytes of ESRD patients and, thus, these altered genes may be therapeutic targets.

scholarly journals Calcium Stimulation Test for Insulinoma Localization in an End-stage Renal Disease Patient on Diazoxide

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Stephanie Kim ◽  
Miles Conrad ◽  
Eunice Chuang ◽  
Larry Cai ◽  
Umesh Masharani ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
The Body ◽  
Stimulation Test ◽  
Delay In Diagnosis ◽  
Calcium Stimulation ◽  
Stage Renal Disease ◽  
End Stage

Abstract Insulinomas are rare, and even rarer in patients with end-stage renal disease (ESRD). Clear criteria for the biochemical diagnosis of insulinomas in patients with renal failure have not been established, and hypoglycemia is often attributed to the renal disease itself, frequently leading to a delay in diagnosis. We describe a case of a patient who presented with asymptomatic recurrent hypoglycemia during hemodialysis. Disease progression and biochemical testing strongly suggested an insulinoma. Computed tomography (CT) of the abdomen and pelvis, 111In-pentetreotide scintigraphy and endoscopic ultrasound did not localize a pancreatic tumor. A calcium stimulation test was performed while the patient was taking diazoxide due to severe hypoglycemia with fasting for a couple of hours without treatment. The test showed a marked increase in insulin after calcium infusion in the dorsal pancreatic artery, localizing the tumor to the body and tail of the gland. Exploratory surgery easily identified a tumor at the body of the pancreas and pathology confirmed an insulin-secreting pancreatic neuroendocrine tumor. On follow-up, there was resolution of the hypoglycemia. We review the challenges of diagnosing an insulinoma in ESRD and describe a successful intra-arterial calcium stimulation test done in an ESRD patient while continuing diazoxide.

scholarly journals Nurse’s Experience As Educator in Hemodialysis Care to End Stage Renal Disease Patient in Hospital X: a Phenomenology Study

2019 ◽  
Author(s):  
Karolus Yosef Woitila Wangi ◽  
Dessy Permata Sela ◽  
Christina Evi Ambarsar
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
Lifestyle Changes ◽  
Future Research ◽  
Ethical Perspective ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End Stage Renal Disease (ESRD) is progressive and irreversible damage to kidney function,which can reduce the quality of life of patients and death due to accumulation of uremia toxins in the blood. Hemodialysis is a temporary therapy used to prolong the life of the patient. The uncertainty of the treatment provides a unique response which became an interesting phenomenon for researchers to conduct research Sethe qualitative strategy for explore the nurses’ experience and to describe it especially in the nurses’ role as educator in hemodialysis care to ESRD patient in Hospital X.Aim of this study to provide an overview of nurse’s experience as educator in ESRD patients during hemodialysis therapy in the Hemodialysis Unit Hospital X. this research used a qualitative method with a phenomenological approach has been conducted. The data collection technique used was using in-depth interviews. A purposive sampling was used to recruited the participant and, namely ten nurses were involded in this study with inclusion critearia as follows: (1) work as an executive nurse in HD unit, (2) have minimum Diploma III as basic education level. Data analysis using Colaizzi’s method and then using thematic analysis. Four themes were found in this study: lifestyle changes, uncooperative patients, responsive patients, and patients do not want to stop dialysis. Future research can be conduct in fourth theme concerning withdrawal dialysis in ESRD patients in various perspectives including: ethical perspective and decision making for futile treatment, health coverage policies, and palliative care.

scholarly journals Antimicrobial Dosing Error in Intermittent & Continuous Hemodialysis

2021 ◽  
Vol 2 (3) ◽  
pp. 8-9
Author(s):  
Saja M Alhabardi ◽  
◽  
Maha Almoliki ◽  
Albatoul Almeshari ◽  
Maha Alammari ◽  
...  
Keyword(s):  
Hemodialysis Patient ◽  
Immunocompromised Patient ◽  
Epidemiological Studies ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Dosing Error ◽  
Antibiotic Drugs ◽  
Life Saving ◽  
Stage Renal Disease ◽  
End Stage ◽  
Continuous Hemodialysis

Antibiotic drugs are the most frequently prescribed medications among hospitalized patients for life-saving purposes, mainly in immunocompromised patient, like in patient with end stage renal disease on hemodialysis (HD) or those who had documented bacterial infection. Antibiotics disposition and their pharmacokinetics and pharmacodynamics properties are affected in hemodialysis patient which increases the number of antibiotics dosing errors. Several epidemiological studies found that the majority of medication error related to antibiotics occurred during the prescribing phase (30.8%). However, there is missing data about the prevalence of errors in antibiotics dosing in HD patients.

scholarly journals Late diagnosis of Fabry Disease in hemodialysis patient

2019 ◽  
pp. 48-53
Author(s):  
S. Fomina ◽  
O. Ovska
Keyword(s):  
Renal Disease ◽  
Fabry Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patient ◽  
Late Diagnosis ◽  
Medical Community ◽  
Clinical Criteria ◽  
Lysosomal Disorders ◽  
Stage Renal Disease ◽  
End Stage

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.

FEASIBILITY OF SMART HEMODIALYSIS PATIENT CARE USING SENSORS EMBEDDED IN PERSONALIZED 3D PRINTING CAST

2019 ◽  
Vol 19 (02) ◽  
pp. 1940017
Author(s):  
WEI-LING CHEN ◽  
TSUNG-LUNG YANG ◽  
PO-LEI LEE ◽  
CHUNG-DANN KAN
Keyword(s):  
Patient Care ◽  
Hemodialysis Patient ◽  
The United States ◽  
Annual Data ◽  
Dialysis Access ◽  
Frequency Spectra ◽  
Content Index ◽  
The Status ◽  
Stage Renal Disease ◽  
End Stage

The ever-increasing incidence of end-stage renal disease (ESRD) has already become a major burden to health budgets and a threat to public health nationwide in Taiwan. According to the United States Renal Data System Annual Data Report in 2015, the prevalence and incidence of ESRD in Taiwan are the highest in the world. Moreover, for the population of 82 thousand ESRD patients receiving hemodialysis treatments, the total cost is up to NT$34.2 billion annually out of the National Health Insurance (NHI) program budget. This project is to design a wearable medical device which can measure and monitor the fluid dynamics of the dialysis access using sensor of phonoangiography (PAG) for exploring vascular pitch pattern and sensor of Photoplethysmography (PPG) for estimating the flow volume as a double checking of the AV access condition. We use arteriovenous access (AVA) stenosis detector based on phonoangiography technique and autoregressive model to detect access stenosis and simultaneously estimate the status of AVA life cycle by tracking and obtaining changes in frequency spectra domain. It helps hemodialysis patients to be aware earlier of the dysfunction of AVA and reminds them to make a return visit. The purpose of the complement deployment of vital sign sensors is to improve the prognosis and optimize overall health by providing analysis of physiological signals, including water content index, pulse oximetry, and blood pressure at the same time. With these sensors, the concept of holistic hemodialysis patient care (HHPC) might be proved.

Sign in / Sign up

Export Citation Format

Share Document