scholarly journals Intracardiac fistula: an unusual complication of catheter-related blood stream infection

JRSM Open ◽  
2017 ◽  
Vol 8 (9) ◽  
pp. 205427041772823 ◽  
Author(s):  
Abhilash Koratala ◽  
Hussain Aboud ◽  
Robert Gibson ◽  
Karen K Hamilton
Keyword(s):  
End Stage Renal Disease ◽  
Blood Stream Infection ◽  
Significant Risk ◽  
Blood Stream ◽  
Unusual Complication ◽  
Early Use ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage ◽  
High Index Of Suspicion

Lesson In end stage renal disease patients on dialysis, the use of catheter as a vascular access is associated with a significant risk of sepsis compared to an arterio-venous fistula. Our case emphasizes the importance of having high index of suspicion for unusual complications in patients presenting with possible catheter-related blood stream infection and early use of complementary tools such as trans-oesophageal echocardiography whenever applicable.

scholarly journals Colistin Induced Neurotoxicity in a Patient with End Stage Kidney Disease and Recovery with Conventional Hemodialysis

2015 ◽  
Vol 8 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Radhika Chemmangattu Radhakrishnan ◽  
Shibu Jacob ◽  
Harish Ratnakarrao Pathak ◽  
Veerasami Tamilarasi
Keyword(s):  
Bacterial Infections ◽  
Blood Stream Infection ◽  
Signs And Symptoms ◽  
Blood Stream ◽  
Multidrug Resistant ◽  
End Stage Kidney Disease ◽  
Neurotoxic Effects ◽  
Stage Renal Disease ◽  
End Stage ◽  
Conventional Hemodialysis

Colistin is widely used in the treatment of multidrug resistant bacterial infections. Nephrotoxicity and neurotoxicity are risks associated with colistin use. We report the case of a 50 year old lady with end stage renal disease, treated with colistin for catheter related blood stream infection and developed muscle weakness and parasthesia. Concomitant use of meropenem may have precipitated neurotoxicity of colistin. Conventional hemodialysis was effective in reversing her signs and symptoms. Clinicians should be aware of the risk of neurotoxicity while using colistin, especially after a loading dose in patients with renal impairment. According to our knowledge, this is the first report of conventional hemodialysis reversing the neurotoxic effects of colistin.

scholarly journals Clostridioides difficile infection in patients with end stage renal disease. Is it preventable?

2020 ◽  
pp. 11-21
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Significant Risk ◽  
Medical Personnel ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Stage Renal Disease ◽  
End Stage ◽  
Healthcare Associated

Clostridioides difficile infection (CDI) is a leading cause of a healthcare-associated diarrhea worldwide. Recently, an increased number of new cases and growing mortality due to CDI have been observed. Patients suffering from end-stage renal disease (ESRD) are most exposed to CDI. It has been proven that CDI in patients receiving renal replacement therapy (RRT) significantly increases mortality, prolongs hospitalization and increases the cost of treatment. Important risk factors of CDI in ERSD patients include hospitalization or stay in an intensive care unit in the last 90 days, HIV infection, bacteremia, prolonged antibiotic therapy and hypoalbuminemia. Cirrhosis, age over 65 years, hypoalbuminemia, longer hospitalization time and use of antibiotics are significant risk factors of death. Effective methods of preventing CDI include hand hygiene with soap and water, isolation of infected patients in a private room with a dedicated toilet, the use of masks, gloves, disinfection of the environment and systematic education and control of medical personnel, as well as rational antibiotic policy. In addition, it is important to avoid antibiotics with a proven risk of CDI, caution use of proton pump inhibitors (PPI) and H2 receptor antagonists. It is also important in the prevention of CDI in people with ERSD, to apply a fast diagnostic since the onset of the first symptoms. The use of probiotics and bile acids in the primary prevention of CDI requires further research. It seems that knowledge of these factors and methods of prevention will significantly reduce morbidity and mortality due to CDI.

Impact of clinical parameters and vascular haemodynamics on arterio-venous fistula maturation in patients with end stage renal disease: A prospective study on Indian patients

2021 ◽  
pp. 112972982110011
Author(s):  
Nalini Kanta Ghosh ◽  
Hemanga Kumar Bhattacharjee ◽  
Omprakash Prajapati ◽  
Asuri Krishna ◽  
Atin Kumar ◽  
...  
Keyword(s):  
Renal Disease ◽  
Radial Artery ◽  
End Stage Renal Disease ◽  
Clinical Parameters ◽  
Indian Patients ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Fistula Maturation

Background: About 18%–65% of Arterio-Venous fistula (AVF) made to facilitate haemodialysis in end stage renal disease patient fail to mature. This study was designed to evaluate the impact of clinical parameters and vascular haemodynamics on maturation of AVF on Indian patients. Material and methods: This was a prospective observational study. Eligible patients’ clinical profiles and vascular haemodynamics by Doppler ultrasonography were noted. All patients underwent radio-cephalic AVF on the non-dominant arm under local anaesthesia. Clinical definition was used to assess success rate of AVFs which is defined as successful six settings of satisfactory dialysis. Data were analysed using Stata/12.0 software. Independent t-test, chi-square test, logistic regression analysis and multivariate analysis were used. The p-value of <0.05 was considered significant. Results: A total of 205 patients were enrolled and analysed. Among clinical factors, age, sex, serum creatinine, hypertension had no significant association with failure (p = 0.5, 0.08, 0.76 and 0.74). Patient’s BMI and presence of diabetes had significant impact on outcome ( p < 0.001 and 0.02 respectively). Among vascular haemodynamics, radial vein diameter of >2.5 mm and radial artery flow rate >40 ml/min had no significant association with failure ( p = 0.12 and 0.28). Diameter of radial artery (>2 mm) and intra-operatively immediate thrill were independent predictor of success (p = 0.002 and <0.001). Conclusion: In the present study rate of fistula, maturation was 73.2% without any post-operative radiological intervention. Radial artery diameter >2 mm and presence of immediate thrill post-operatively were significantly associated with successful cannulation.

scholarly journals Successful treatment of collapsing focal segmental glomerulosclerosis in a patient

2020 ◽  
Vol 10 (4) ◽  
pp. e43-e43
Author(s):  
Luísa Helena Pereira ◽  
Ana Cabrita ◽  
Mário Góis ◽  
Helena Viana ◽  
Sandra Sampaio ◽  
...  
Keyword(s):  
Renal Disease ◽  
Focal Segmental Glomerulosclerosis ◽  
End Stage Renal Disease ◽  
Oral Corticosteroid ◽  
Segmental Glomerulosclerosis ◽  
Number Of Patients ◽  
Collapsing Fsgs ◽  
Stage Renal Disease ◽  
End Stage ◽  
High Index Of Suspicion

Focal segmental glomerulosclerosis (FSGS) is a recognized cause of renal disease worldwide. The collapsing variant is distinct from the others, characterized clinically by a more severe nephrotic syndrome generally resistant to immunosuppressive therapy. It is known that a great number of patients progress to end-stage renal disease. Recognizing this lesion in biopsy is frequently challenging owing to the focal nature of the process which highlights the need for keeping a high index of suspicion for the diagnosis. We report and discuss a case of a non-HIV collapsing FSGS, followed by a complete (unexpected) renal recovery after an oral corticosteroid course.

EFFECT OF KIDNEY TRANSPLANTATION ON CONTROLLING ARTERY-VENOUS FISTULA SIDE EFFECTS IN END STAGE RENAL DISEASE

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 763
Author(s):  
S M.M. Ghoreishi ◽  
S A. Tabatabaie ◽  
T Ghoraishi ◽  
A A. Beigi ◽  
A Mirmohammadsadeghy ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Side Effects ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Interplay between Superoxide Dismutase, Glutathione Peroxidase, and Peroxisome Proliferator Activated Receptor Gamma Polymorphisms on the Risk of End-Stage Renal Disease among Han Chinese Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Chia-Ter Chao ◽  
Yen-Ching Chen ◽  
Chih-Kang Chiang ◽  
Jenq-Wen Huang ◽  
Cheng-Chung Fang ◽  
...  
Keyword(s):  
Superoxide Dismutase ◽  
Glutathione Peroxidase ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Significant Risk ◽  
Han Chinese ◽  
Chinese Patients ◽  
Peroxisome Proliferator ◽  
Stage Renal Disease ◽  
End Stage

Background. Single nucleotide polymorphisms (SNPs) of antioxidants, including superoxide dismutase 2 (SOD2) and glutathione peroxidase 1 (GPX1), play an important role in the risk for cancer and metabolic disorders. However, little is known regarding the effect of antioxidant SNPs on renal events.Methods. We prospectively enrolled multicenter patients with end-stage renal disease (ESRD) and those without chronic kidney disease (CKD) of Han Chinese origin, with SOD2 (Val16Ala), GPX1 (Pro197Leu), and PPAR-γ(Pro12Ala, C161T) genotyped. Multiple regression analyses were conducted to evaluate the significant risk determinants for ESRD.Results. Compared to ESRD patients, non-CKD subjects were more likely to have T allele at SOD2 Val16Ala (p=0.036) and CC genotype at PPAR-γPro12Ala (p=0.028). Regression analysis showed that TT genotype of SOD2 Val16Ala conferred significantly lower ESRD risk among patients without diabetes (odds ratio 0.699;p=0.018). GPX1 SNP alone did not alter the risk. We detected significant interactions between SNPs including PPAR-γPro12Ala, C161T, and GPX1 regarding the risk of ESRD.Conclusion. This is the first and largest study on the association between adverse renal outcomes and antioxidant SNPs among Han Chinese population. Determination of SOD2 and PPAR-γSNPs status might assist in ESRD risk estimation.

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