scholarly journals Change of Hospitalization Status Among Patients With End-Stage Kidney Disease Before and After Receiving Chronic Hemodialysis

2021 ◽  
Author(s):  
Hsiu-Lan Li ◽  
Pei-Hui Tai ◽  
Yi-Ting Hwang ◽  
Shih-Wei Lin ◽  
Li-Ching Lan
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Tract Infection ◽  
Hospital Admission ◽  
End Stage Kidney Disease ◽  
Study Results ◽  
Before And After ◽  
One Year ◽  
End Stage

Abstract Background:Compared with other diseases, end-stage kidney disease (ESKD) carries a greater risk of comorbidities including diabetes and anemia and has a higher hospital admission rate. The cause of hospital admission appears to be a common factor affecting the prognosis of patients with ESKD. Therefore, this study conducted a retrospective cohort analysis on all patients diagnosed with ESKD and receiving hemodialysis, investigating whether the type of their diagnosis for hospital admission changed before and after they started hemodialysis.Methods:This study recruited 592 patients with ESKD who received hemodialysis at any period between January 2005 and November 2017 and had been assigned the International Classification of Diseases Ninth Revision Clinical Modification (ICD-9-CM) code for ESKD. The patients’ demographic data and hospitalization status one year before and two years after they received hemodialysis were analyzed. A McNemar test was conducted to analyze the diagnostic changes from before to after hemodialysis in patients with ESKD.Results:The study’s sample of patients with ESKD comprised more women (51.86%) than men and had an average age of 67.15 years. The numbers of patients admitted to hospital for the following conditions all decreased significantly after they received hemodialysis: type 2 (non-insulin-dependent and adult-onset) diabetes; native atherosclerosis; urinary tract infection; gastric ulcer without mention of hemorrhage, perforation, or obstruction; pneumonia; reflux esophagitis; duodenal ulcer without mention of hemorrhage, perforation, or obstruction; and bacteremia. Most patients exhibited one or more of the following comorbidities: diabetes (n = 407, 68.75%), hypertension (n = 491, 82.94%), congestive heart failure (n = 161, 27.20%), ischemic heart disease (n = 125, 21.11%), cerebrovascular accident (n = 93, 15.71%), and gout (n = 96, 16.22%). An analysis of variance (ANOVA) indicated that changes in the ICD-9-CM codes for native atherosclerosis, urinary tract infection, pneumonia, and hyperkalemia were associated with age. Patients who developed pneumonia before or after they received hemodialysis tended to be older (range: 69–70 years old). Conclusions:This study investigated the causes of hospital admission among patients with ESKD one year before and two years after they received hemodialysis. This study results revealed hypertension to be the most common comorbidity. Regarding cause of admission, pneumonia was more prevalent in older than in younger patients. Moreover, changes in the ICD-9-CM codes of native atherosclerosis, urinary tract infection, pneumonia, and hyperkalemia were significantly correlated with age. Therefore, when administering comprehensive nursing care and treatment for ESKD, clinicians should not focus only on comorbidities but also consider factors (e.g., age) that can affect patient prognosis.

Congenital abnormalities of the kidneys and urinary tract

2019 ◽  
pp. 57-86
Author(s):  
Lesley Rees ◽  
Nicholas J.A Webb ◽  
Detlef Bockenhauer ◽  
Marilynn G. Punaro
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Tract Infection ◽  
Renal Injury ◽  
Incidental Findings ◽  
Renal Damage ◽  
Congenital Abnormalities ◽  
End Stage Kidney Disease ◽  
End Stage

Congenital abnormalities of the kidneys and urinary tract (CAKUT) are the commonest cause of renal problems in children, ranging from asymptomatic or incidental findings to a cause of urinary tract infection and obstruction, renal damage, and end-stage kidney disease. The investigation and management of CAKUT depend on the potential for causing renal injury.

scholarly journals END STAGE POLYCYSTIC KIDNEY DISEASE: THE STUDY FOR UPPER URINARY TRACT INFECTION ^|^amp; HEMORRHAGE INTO THE CYSTS

1994 ◽  
Vol 85 (11) ◽  
pp. 1673-1678
Author(s):  
Shinichi Ohshima ◽  
Tamio Fujita ◽  
Yoshinari Ono ◽  
Norio Katoh ◽  
Osamu Matsuura ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Tract Infection ◽  
Polycystic Kidney Disease ◽  
Upper Urinary Tract ◽  
Polycystic Kidney ◽  
End Stage

scholarly journals Thiamine Diphosphate Status and Dialysis-Related Losses in End-Stage Kidney Disease Patients Treated with Hemodialysis

2017 ◽  
Vol 44 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Magdalena Jankowska ◽  
Paweł Rudnicki-Velasquez ◽  
Hanna Storoniak ◽  
Przemysław Rutkowski ◽  
Bolesław Rutkowski ◽  
...  
Keyword(s):  
Body Weight ◽  
Kidney Disease ◽  
Dietary Intake ◽  
Whole Blood ◽  
Vitamin B1 ◽  
Thiamine Diphosphate ◽  
End Stage Kidney Disease ◽  
Before And After ◽  
End Stage ◽  
The Impact

Aim: (1) To describe the whole blood content of thiamine diphosphate (TDP), a biologically active form of vitamin B1 in end-stage kidney disease patients treated with hemodialysis (HD); (2) to establish the impact of a single HD procedure on TDP blood concentrations; and (3) to describe potential explanatory variables influencing TDP dialysis related losses, including dialysis prescription, vitamin B1 dietary intake and supplementation. Methods: Single-center, cross-sectional study in 50 clinically stable maintenance HD patients. The assessment of whole blood TDP with the High Performance Liquid Chromatography method, before and after a single, middle-week dialysis session and analysis of clinical and laboratory parameters potentially influencing TDP status Results: We report a significant difference in TDP levels before and after HD sessions - 42.5 (95% CI 38.7-46.2) μg/L and 23.6 (95% CI 18.9-28.2) μg/L, respectively (p = 0.000). The magnitude of intradialytic TDP changes is highly variable among individuals and is negatively associated only with the body weight of the patients (p < 0.013). Vitamin B1 dietary intake and supplementation do not influence whole blood TDP and dialysis-related loss of TDP. Conclusions: TDP, a bioactive compound of vitamin B1, is substantially lost during the HD procedure, and the magnitude of its loss is associated with the patient's body weight but it is not influenced by vitamin B1 dietary intake and standard supplementation dose.

scholarly journals National Imaging and Antibiotic Practice Patterns in Children Presenting With Urinary Tract Infection to Community Practices: Little Impact From the American Academy of Pediatrics Guidelines?

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1302-1308
Author(s):  
Brian M. Inouye ◽  
Zachary R. Dionise ◽  
Ruiyang Jiang ◽  
Steven Wolf ◽  
Leigh Nicholl ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Diagnostic Imaging ◽  
American Academy ◽  
Odds Ratio ◽  
Practice Patterns ◽  
American Academy Of Pediatrics ◽  
Antibiotic Utilization ◽  
Before And After

Our objective was to use community-based, national databases to evaluate diagnostic imaging and antibiotic prophylaxis practice patterns before and after the release of the 2011 American Academy of Pediatrics guidelines for acute febrile urinary tract infection. Using the National Ambulatory and Hospital Ambulatory Medical Care Surveys, urinary tract infection encounters were identified for patients aged 2 months to 18 years. Primary outcomes were utilization of antibiotics (as proxy for prophylaxis) and diagnostic imaging during encounters. Weighted multivariate logistic regression models were used to examine the association between time period (before and after 2011) and each of the primary outcomes. Among 8 588 035 weighted encounters, adjusting for covariates, there was insufficient evidence to suggest a difference between time periods for antibiotic utilization (odds ratio = 0.66, P = .12) or diagnostic imaging (odds ratio = 1.16, P = .56). Thus, we did not find evidence of changes in antibiotic utilization or diagnostic imaging practice patterns after the release of the 2011 American Academy of Pediatrics guidelines.

scholarly journals Urinary Tract Infection in Children: A Review of the Established Practice Guidelines

2020 ◽  
pp. 57-65
Author(s):  
Samuel Uwaezuoke ◽  
Adaeze Ayuk ◽  
Uzoamaka Muoneke
Keyword(s):  
Chronic Kidney Disease ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Disease ◽  
Tract Infection ◽  
Practice Guidelines ◽  
Renal Scarring ◽  
Clinical Excellence ◽  
Radiological Investigation ◽  
Delayed Treatment

Urinary tract infection (UTI) is a significant cause of morbidity in children. Delayed treatment is associated with complications that may result in chronic kidney disease and, subsequently, end-stage kidney disease. Over the years, clinical practice guidelines have advanced to ensure the best global practices in treating the infection and preventing its progression to chronic kidney disease. The established practice guidelines address five main questions: 1) which children should have their urine tested; 2) how the sample should be obtained; 3) which radiological tests are recommended after a diagnosis of UTI; 4) how the infection should be treated; 5) and how affected children should be followed up. There is a substantial overlap in the recommendations of the American Academy of Pediatrics (AAP) guidelines and the UK’s National Institute for Health and Clinical Excellence (NICE) guidelines. Subtle differences, however, exist between the two established guidelines. An evidence-based paradigm shift of some traditional concepts about UTI in children has contributed to the revision and update of these guidelines. Further research is needed to clarify the role of host and genetic factors in renal scarring, as well as the diagnostic criteria for UTI. This narrative review aims to discuss the current recommendations of these established practice guidelines with an emphasis on the diagnosis, radiological investigation, treatment, and follow-up of UTI in children.

Design of a wearable device for real-time screening of urinary tract infection and kidney disease based on smartphone

The Analyst ◽  
2018 ◽  
Vol 143 (12) ◽  
pp. 2812-2818 ◽  
Author(s):  
Jianyu Zhou ◽  
Tao Dong
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Quantitative Analysis ◽  
Kidney Disease ◽  
Tract Infection ◽  
Real Time ◽  
Low Cost ◽  
Wearable Device ◽  
Urine Samples

In this study, we developed a novel wearable and low-cost device for qualitative screening of glucose (GLU), leukocytes (LEU), and nitrite (NIT) and for semi-quantitative analysis of blood (BLD) and proteins (PRO) in the urine samples.

URINARY TRACT INFECTION IN CHILDREN

PEDIATRICS ◽  
1969 ◽  
Vol 44 (5) ◽  
pp. 677-684
Author(s):  
Duncan E. Govan ◽  
John M. Palmer
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospital Admissions ◽  
Upper Urinary Tract ◽  
Cure Rate ◽  
Before And After ◽  
Tract Infections ◽  
Urethral Dilation

To study the influence of successful ureterovesicoplasty on incidence of recurrent urinary infection, two groups of infected children were compared in this regard before and after urologic evaluation. Of 280 new pediatric urologic hospital admissions, 55.6% had urinary tract infections. Sixty-six of these 156 infected children had vesicoureteral reflux. Bacteriologic localization of infection site was performed in both children with and without reflux at the time of diagnostic cystoscopy. Both groups were specifically treated with short-term antibiotic therapy and empiric urethral dilation. Operative vesicoureteroplasty was carried out in 62 children with reflux, with an overall cure rate of 83.8%. Distal urethral stenosis was not a contributing factor in this population nor did urethral caliber relate to the incidence of reflux. Only 3 of 35 children without reflux were found to have bacteriologically proved upper urinary tract infection. Similarly, only 32% of these children without reflux had clinical histories suggestive of recurrent pyelonephritis. In the children with reflux undergoing bacteriologic localization while infected, no nonrefluxing ureters were found infected, and only one third of the refluxing ureters so studied had proved upper urinary tract infection. Historical evidence for clinical pyelonephritis was present in 79% of the population with reflux; but, after successful cure of reflux, only 7% of these children continued to have pyelonephritic episodes. The long-term incidence of recurrent urinary tract infection was virtually identical, however, in the children undergoing successful antireflux surgery and the children without reflux following ureteral dilation. This relationship indicates that reflux plays little role in the etiology of bacteriunia but has a profound influence on urinary tract infection morbidity in children.

End-stage kidney disease on dialysis: an observational study of modality change from maximum conservative management

2021 ◽  
pp. bmjspcare-2020-002839
Author(s):  
Alvin Shrestha ◽  
Aine Burns
Keyword(s):  
Kidney Disease ◽  
Conservative Management ◽  
Fluid Overload ◽  
Common Symptom ◽  
End Stage Kidney Disease ◽  
Kaplan Meier ◽  
Comorbidity Index ◽  
Poor Outcomes ◽  
One Year ◽  
End Stage

ObjectivesA rising burden from end-stage kidney disease with poor outcomes in the frail, elderly population has seen the emergence of a non-dialytic option, also known as maximum conservative management (MCM). Despite an established MCM programme in our institution, it was anecdotally observed that some MCM patients would end up being dialysed short and long term. We explored treatment modality changes from MCM to renal replacement therapy (RRT), the reasons surrounding the change, and aimed to quantify survival in this cohort of patients.Methods44 patients were identified as being MCM, who changed modalities to RRT, from 2000 to 2015, using the Royal Free Hospital Renal Unit’s database. Electronic health records were reviewed retrospectively. Associations with 12-month mortality were explored and Kaplan-Meier method used to predict survival.ResultsThe most common modality change was to haemodialysis (81%), with one transplantation, and rest peritoneal dialysis. 28 patients commenced dialysis as unplanned starters, with the most common symptom being fluid overload. One-year survival was associated with increased age (75 vs 83, p=0.004, for alive vs dead) and had lower mean Charlson Comorbidity Index (6.2 vs 7.3, p=0.021). Median survival of 65 months following RRT initiation was predicted by the Kaplan-Meier method.ConclusionsPatients changed modalities from MCM to RRT due to symptoms, the most common being fluid overload. Despite an unplanned change to RRT, survival appears to be significant at 65 months in this study, indicating clinicians are continuing to offer RRT to patients appropriately.

scholarly journals Resistance profile for pathogens causing urinary tract infection in a pediatric population, and antibiotic treatment response, at a university hospital 2010-2011

2014 ◽  
pp. 39-44 ◽  
Author(s):  
Catalina María Vélez Echeverri ◽  
Lina María Serna-Higuita ◽  
Ana Katherina Serrano Gayubo ◽  
Carolina Ochoa-García ◽  
Luisa Rojas Rosas ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pediatric Population ◽  
Resistance Rate ◽  
Empirical Treatment ◽  
Common Symptom ◽  
Female Ratio ◽  
E Coli ◽  
Study Results

Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity and long-term hypertension and chronic kidney disease. Objectives To describe the demographic characteristics, infectious agents, patterns of antibiotic resistance, etiologic agent and profile of susceptibility and response to empirical treatment of UTI in a pediatric population. Methods: This is a descriptive, retrospective study. Results: Included in the study were 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had a history of previous UTI. 72.0% of the patients had positive urine leukocyte count (>5 per field), urine gram was positive in 85.0% of samples and gram negative bacilli accounted for 77.8% for the total pathogens isolated. The most frequent uropathogens isolated were Escherichia coli and Klebsiella pneumoniae. Our E.coli isolates had a susceptibility rate higher than 90% to most of the antibiotics used, but a resistance rate of 42.6% to TMP SMX and 45.5% to ampicillin sulbactam. 6.3% of E. coliwas extended-spectrum beta-lactamases producer strains. The most frequent empirical antibiotic used was amikacin, which was used in 66.0% of the patients. 17 of 90 patients who underwent voiding cistouretrography (VCUG) had vesicoureteral reflux. Conclusion: This study revealed that E. coli was the most frequent pathogen of community acquired UTI. We found that E. coli and other uropathogens had a high resistance rate against TMP SMX and ampicillin sulbactam. In order to ensure a successful empirical treatment, protocols should be based on local epidemiology and susceptibility rates.

Sign in / Sign up

Export Citation Format

Share Document