scholarly journals Seizure occurrence in patients with chronic renal insufficiency in regular hemodialysis program

2005 ◽  
Vol 63 (3b) ◽  
pp. 757-760 ◽  
Author(s):  
Fulvio Alexandre Scorza ◽  
Marly de Albuquerque ◽  
Ricardo Mario Arida ◽  
Roberta Monterazzo Cysneiros ◽  
Tânia Maria Guedes Henriques ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Convulsive Status Epilepticus ◽  
Dialysis Therapy ◽  
Paulo State ◽  
History Of ◽  
Clonic Seizures ◽  
Convulsive Seizures ◽  
Stage Renal Disease ◽  
End Stage ◽  
Regular Hemodialysis

Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.

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.

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.

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

Prevalence of Peripheral Arterial Disease among End Stage Renal Disease Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R R W Morkos ◽  
A M Shabana ◽  
A S Elserafy ◽  
H F Hanna
Keyword(s):  
End Stage Renal Disease ◽  
Arterial Disease ◽  
Control Group ◽  
P Value ◽  
Asymptomatic Patients ◽  
Function Test ◽  
Peripheral Arterial ◽  
Stage Renal Disease ◽  
End Stage ◽  
Regular Hemodialysis

Abstract Background Patients with End Stage Renal Disease are more susceptible to develop Peripheral Arterial Disease. so, screening is helpful for early diagnosis. Objectives The aim of this study is to screen and calculate the prevalence of asymptomatic patients on regular hemodialysis for presence of PAD. Aim of Study The aim of this study is to screen and calculate the prevalence of asymptomatic patients on regular hemodialysis for presence of PAD. Patients and Methods The study included 100 asymptomatic patients on regular hemodialysis and below 60 years old to be screened for presence of PAD. Patients who refused the test, above 60 years old, or diabetic have been excluded from the study. All selected patients have been subjected to complete history taking, full clinical examination including extremities examination, Lab workup including; CBC, liver function test, kidney function test, A1C level, lipid profile, Resting 12 lead ECG, Echocardiography to assess systolic function, valvular disease, and resting SWMA, and ABI assessment using the Doppler. Patients then were divided into two groups; control group who has negative PAD with ABI > 0.9 and study group who has PAD with ABI ≤ 0.9. Results It was found that the prevalence of PAD among ESRD patients is 26%. Regarding the laterality; 21% had bilateral PAD and the rest 5% had unilateral disease. The results showed that females had statistically significant higher risk of developing PAD that males. 55% of patients were females and the other 45% were males. 36.4% of females studied had positive ABI but only 13.3% of studied males found positive for PAD. The p value was 0.017. The study showed also that A1C level in patients who have no diabetes carries statistically significant results. The mean A1C level for the study group was 5.56 ± 0.70 and the control group was 4.92 ± 0.73. The p value was 0.000. The A1C level cut off value was > 5.3. This means that patients who have A1C > 5.3 should be paid more attention and be screened because they have higher risk to develop PAD. Conclusion Renal impairment is an important risk factor for developing PAD in absence of traditional risk factors such as DM, hypertension, or dyslipidemia. Prevalence of PAD was 26% in our study. ABI is a simple non-invasive modality of screening for PAD. Females are at higher risk to develop PAD than males by ∼ 2.7 fold. Although diabetes is absent, A1C level > 5.3 is significantly correlating with the risk of PAD.

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