scholarly journals Use of tocilizumab, remdesivir, and high-dose methylprednisolone prevents intubation in an ESRD patient with COVID-19 pneumonia

2022 ◽  
Vol 10 ◽  
pp. 2050313X2110690
Author(s):  
Ramzan Judge ◽  
Stephanie Kolaski ◽  
Farhan Qadeer
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
National Institutes Of Health ◽  
High Dose ◽  
Pulse Dose ◽  
High Dose Methylprednisolone ◽  
Stage Renal Disease ◽  
End Stage ◽  
Respiratory Droplets

Coronavirus disease 2019 (COVID-19) has affected over 200 million patients worldwide. COVID-19 is transmitted through respiratory droplets from patient to patient or by touching a surface that has been contaminated by an infected patient. Many COVID-19 patients have other comorbidities, such as end-stage renal disease. Currently, management of COVID-19 in patients with end-stage renal disease is unclear. Some studies have shown improvement in this population with the use of tocilizumab, a humanized interleukin-6 monoclonal antibody, in addition to the standard therapy as per guidelines published by the National Institutes of Health. In this case report, we present a patient case where the use of remdesivir, tocilizumab, and pulse-dose methylprednisolone significantly improved symptoms and inflammatory biomarkers associated with COVID-19 in a patient with end-stage renal disease.

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.

Increased Levels Of Tissue Factor, Adhesion Molecules, Nitric Oxide and Adiponectin In End Stage Renal Disease. A Complex Interplay

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4742-4742
Author(s):  
Jawed Fareed ◽  
Kristiyana Kaneva ◽  
Debra Hoppensteadt ◽  
Vinod Bansal
Keyword(s):  
Nitric Oxide ◽  
Renal Disease ◽  
Tissue Factor ◽  
Adhesion Molecules ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Dialysis Session ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction End stage renal disease (ESRD) represents the fifth (final) stage of chronic kidney disease characterized by an established kidney failure (GFR <15 mL/min/1.73 m2). To further understand the pathophysiology of ESRD, this study was designed to measure the circulating levels of tissue factor (TF), adhesion molecules, such as p-selectin (P-Sel), soluble ICAM (s-ICAM), nitric oxide and adiponectin (AD). Methods This study included 119 ESRD patients undergoing maintenance hemodialysis in conjunction with an ongoing IRB approved protocol on the profiling of inflammatory markers in this syndrome. Citrated blood plasma samples were collected from these patients prior to the routine dialysis session. Nitric oxide levels (NO) were measured using a commercial kit from R&D systems (Minneapolis, Minnesota) and ELISA based methods for TF, P-Sel, s-ICAM and adiponectin were also purchased from R&D systems. Chromogenic and thrombin substrate method were used to measure the anti-Xa activity thrombin generation. Results Tissue factor levels were found to be increased in the ESRD group (20.4±6.1pg/ml) vs the control (11.9±2.8pg/ml). The nitric oxide level was markedly higher in the ESRD group (32±17uM) vs the controls (7±3uM). The p-selectin levels were also elevated in the ESRD group (46±20ng/ml) vs the control (31±3ng/ml). The soluble ICAM levels were higher in the ESRD group (250±112ng/ml) vs the control (180±19ng/ml). Interestingly, the adiponectin levels were also increased in the ESRD group (19.2±9.3ug/ml) vs the control (11.2±4.1ug/ml). The pre-dialysis samples of the ESRD patients exhibited detectable levels of heparin. Summary/Conclusions These studies suggest that TF, NO, p-selectin and s-ICAM levels are increased in the ESRD patient. It is of interest to note that despite that a significant number of ESRD patients were diabetic; the AD levels were increased in this group. These results suggest that while ESRD represents a pro-inflammatory/hypercoagulable state, the repeated administration of heparin and other drugs may contribute to the regulation of the hemostatic process and inflammatory balance. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Use of Hypertonic Continuous Venovenous Hemodiafiltration to Control Intracranial Hypertension in an End-Stage Renal Disease Patient

2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
Stephen I. Rifkin ◽  
Ali R. Malek ◽  
Reza Behrouz
Keyword(s):  
Renal Disease ◽  
Cerebral Edema ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
Continuous Venovenous Hemodiafiltration ◽  
Alternative Treatment Option ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Continuous venovenous hemodiafiltration (CVVHDF) using solutions designed to maintain hypernatremia is described in an end-stage renal disease (ESRD) patient with cerebral edema (CE) due to an intracerebral hemorrhage (ICH). Hypernatremia was readily achieved and maintained without complication. CVVHDF should be considered as an alternative treatment option in ESRD patients with cerebral edema who require hypertonic saline therapy.

scholarly journals EFEKTIFITAS LOGOTERAPI MEDICAL MINISTRY TERHADAP MOTIVASI PASIEN HEMODIALISA DENGAN HARGA DIRI RENDAH DI RUMAH SAKIT DI KOTA PADANG

2020 ◽  
Vol 4 (2) ◽  
pp. 274-281
Author(s):  
Rizka Ausrianti
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Intervention Group ◽  
Self Esteem ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Post Test ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis is procedure that conducted for End-Stage Renal Disease (ESRD) patient . This will lead to changes in the life of the patient such as psychosocial changes : low self-esteem, which can resulting in decreased motivation. This research aims to investigate the influence of logotherapy medical ministry on motivation on hemodialysis patients with low self-esteem in Padang City. Design used in this research is "Quasy Experimental Pre-Post Test With Control Group." Sample the number of was 86 respondents, consisting of 43 respondents for the intervention group and 43 respondents for the control group with consecutive sampling.The result shows the influence of logotherapy medical ministry on motivation after logotheraphy of medical ministry to the intervention group. In groups control showed no effect of logotherapy of medical ministry on motivation. It is recomended that hemodialysis with low self- asteem patient need to have specialist logotherapy of medical ministry.

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