scholarly journals Erythrocyte Sedimentation Rate in Patients with Renal Insufficiency and Renal Replacement Therapy

2021 ◽  
Author(s):  
Anna Buckenmayer ◽  
Lotte Dahmen ◽  
Joachim Hoyer ◽  
Sahana Kamalanabhaiah ◽  
Christian S. Haas
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Replacement Therapy ◽  
Sedimentation Rate ◽  
Inflammatory Markers ◽  
Erythrocyte Sedimentation ◽  
Esrd Patients

Abstract Background: The erythrocyte sedimentation rate (ESR) is a simple laboratory diagnostic tool for estimating systemic inflammation. It remains unclear, if renal function affects ESR, thereby compromising its validity. This pilot study aims to compare prevalence and extent of ESR elevations in hospitalized patients with or without kidney disease. In addition, the impact of renal replacement therapy (RRT) modality on ESR was determined.Methods: In this single-center, retrospective study, patients were screened for ESR values. ESR was compared in patients with and without renal disease and/or RRT. In addition, ESR was correlated with other inflammatory markers, the extent of renal insufficiency and clinical characteristics.Results: A total of 203 patients was identified, showing an overall elevated ESR in the study population (mean 51.7±34.6 mm/h). ESR was significantly increased in all patients with severe infection, active vasculitis or cancer, respectively, independent from renal function. Interestingly, there was no difference in ESR between patients with and without kidney disease or those having received a prior renal transplant or being on hemodialysis. However, ESRD patients treated with peritoneal dialysis presented with a significantly higher ESR (78.3±33.1 mm/h, p<0.001), while correlation with other inflammatory markers was not persuasive.Conclusions: We showed that ESR: (1) does not differ between various stages of renal insufficiency; (2) may be helpful as a screening tool also in patients with renal insufficiency; and (3) is significantly increased in ESRD patients on peritoneal dialysis per se, while it seems not to be affected by hemodialysis or renal transplantation (see graphical abstract as supplementary material).

scholarly journals PERITONEAL DIALYSIS: CAUSES OF INADEQUACY OF THE TECHNIQUE

2014 ◽  
pp. 52-57
Author(s):  
A. I. Mogylnyk
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Replacement Therapy ◽  
Chronic Stage

In recent years peritoneal dialysis is gaining an increasing prevalence in the treatment of patients with chronic stage V kidney disease. The possibility of long–term use of this technique of renal replacement therapy remains limited. This article provides insight onto possible causes of peritoneal dialysis failure in patients with terminal renal insufficiency.

scholarly journals The Clinical Utility of Kinetic Glomerular Filtration Rate in the Assessment of Renal Function and Prediction of Outcomes Among Critically Ill Patients With Acute Kidney Injury: A Single-Center Retrospective Cohort Study

2021 ◽  
Vol 5 (1) ◽  
pp. 611-620
Author(s):  
Shari Ann Atanacio ◽  
Maria Rachel Uy
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Urine Output ◽  
Filtration Rate ◽  
Kidney Injury

Objective: To determine the discriminatory ability of kinetic glomerular filtration rate (kGFR) to detect acute kidney injury (AKI) when compared with established GFR equations and criteria and relating it to mortality, renal replacement therapy initiation and renal recovery. Methods: This was a retrospective analysis using data from chart review of 109 intensive care unit (ICU) patients at the University of Santo Tomas Hospital (USTH). The renal function estimates using Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi), modification of diet in renal disease (MDRD), Kidney Disease Improving Global Outcomes Acute Kidney Injury (KDIGO AKI), as well as kinetic GFR equations were compared and correlated with renal and cardiovascular outcomes. Results: The renal function assessed by kGFR, CKD-Epi, MDRD and KDIGO staging based on serum creatinine (SCr) showed no significant association with mortality outcomes. However, AKI diagnosed based on urine output (UO), and combined SCr and urine output (KDIGO) showed association with all-cause mortality. The UO detected severe stages of AKI while SCr (based on KDIGO) better identified the earlier stages of AKI. The criteria for KDIGO AKI when combined also shows mortality prediction since it joins together the effects of SCr and UO. There was a remarkable 3.5 times increase  in hemodialysis initiation (p=0.0001) and 12.89 times increase in peritoneal dialysis initiation (p=0.01) for every stage increase in the KDIGO classification. kGFR, CKD-Epi and MDRD have 5%, 6%, and 6% decrease, respectively in the odds of initiating hemodialysis. There was however, no association for peritoneal dialysis. Conclusion: kGFR was the least able in detecting AKI and KDIGO AKI criteria remains to be the standard in identifying AKI in the critical care setting. Increase in SCr was a sensitive tool in diagnosing AKI due to its ability to detect AKI based on a small increase in SCr regardless of the baseline renal function. Decreasing UO, however, is the prognosticating variable in KDIGO AKI criteria, in that it portends higher probability of initiation of renal replacement therapy (RRT) and ultimately higher mortality when present.

The Use of Nocturnal Home Hemodialysis as Salvage Therapy for Patients Experiencing Peritoneal Dialysis Failure

2007 ◽  
Vol 27 (6) ◽  
pp. 669-674 ◽  
Author(s):  
Joseph H.S. Wong ◽  
Andreas Pierratos ◽  
Dimitrios G. Oreopoulos ◽  
Reem Mohammad ◽  
Fatima Benjamin–Wong ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Salvage Therapy ◽  
Primary Objective ◽  
Home Hemodialysis ◽  
Creatinine Concentration ◽  
Suitable Alternative ◽  
Humber River ◽  
Esrd Patients

Background Failure of peritoneal dialysis (PD) results in poor quality of life and worsening morbidity in patients with end-stage renal disease (ESRD). Traditionally, hospital-based conventional hemodialysis has been the only option for this patient population. We hypothesized that nocturnal home hemodialysis (NHD), 3 – 6 sessions per week, 6 – 8 hours per session, is a suitable alternative salvage therapy for this vulnerable patient group. Methods This is a descriptive cohort study of all consecutive ESRD patients failing PD that were converted to NHD at the University Health Network and Humber River Regional Hospital from 2003 to 2005. Our primary objective was to describe the changes in clinical and biochemical indices before and after conversion from PD to NHD. Results 69 patients required transfer from PD to another form of renal replacement therapy during the period of interest. Our pilot cohort included 8 ESRD patients (5 males, 3 females; age 53 ± 7 years). Mean duration on PD was 4.8 ± 4.6 years. NHD delivered a higher dose of dialysis, as reflected by lower plasma creatinine concentration 1 year after beginning NHD (from 1107 ± 312 μmol/L with PD to 649 ± 309 μmol/L, p = 0.01) and a rise in standardized Kt/V (from 2.21 ± 0.73 with PD to 4.49 ± 1.92 after 6 months of NHD, to 4.51 ± 1.77 after 1 year of NHD; p < 0.001). There was a progressive and sustained rise in plasma albumin after conversion to NHD (from 31 ± 4 g/L with PD to 36 ± 4 g/L after 6 months of NHD, to 39 ± 2 g/L after 1 year of NHD; p = 0.001). Hemoglobin concentrations increased (from 102 ± 13 to 125 ± 7 g/L, p = 0.03), while erythropoietin requirement tended to fall (from 17500 ± 8669 to 9197 ± 7573 U/week). Plasma phosphate fell (from 2.1 ± 0.6 to 1.1 ± 0.3 mmol/L, p = 0.01) despite a decrease in phosphate binder requirement. Blood pressure profile also tended to improve after conversion to NHD. Conclusion Nocturnal HD represents a promising, viable, alternative renal replacement therapy for patients experiencing PD failure. The clinical impact of transferring ESRD patients failing PD to NHD deserves further investigation.

scholarly journals Geographical Variation in Peritoneal Dialysis Catheter Insertion and Initiation within the United States

2016 ◽  
Vol 36 (6) ◽  
pp. 691-693
Author(s):  
Achint Patel ◽  
Harshil Shah ◽  
Shanti Patel ◽  
Girish N. Nadkarni ◽  
Jaime Uribarri
Keyword(s):  
United States ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Geographical Variation ◽  
The United States ◽  
Catheter Insertion ◽  
Peritoneal Dialysis Catheter ◽  
The West ◽  
Esrd Patients

Peritoneal dialysis (PD) is an effective but underutilized renal replacement therapy modality. There are limited data regarding geographical variation in PD catheter insertion and utilization of PD as a first renal replacement therapy in the United States. We explored the variation in catheter insertion and initiation of PD utilizing 2 large, nationally representative databases. The incidence of catheter insertion differed significantly by geographical region, being highest in the South (7.30/100 end-stage renal disease [ESRD] patients; 95% confidence [CI] interval 6.78 – 7.81) and lowest in the West (5.91/100 ESRD patients; 95% CI 5.43 – 6.38). Peritoneal dialysis initiation also differed by region, being highest in the West (7.10/100 ESRD patients; 95% CI 6.83 – 7.30) and lowest in the Northeast (5.12/100 ESRD patients; 95% CI 4.87 – 5.30). Interestingly, the Northeast region, with the lowest rate of PD utilization, had the highest number of nephrologists per population (3.95/100,000 persons), and the West, with the highest PD utilization, had the lowest number of nephrologists (2.54/100,000 persons). Reasons for this variation should be explored further and efforts should be made to standardize PD implementation throughout the United States.

Renal disease

2018 ◽  
Author(s):  
Quentin Milner
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Impaired Renal Function ◽  
Anaesthetic Management

This chapter describes the anaesthetic management of the patient with renal disease. The topics include estimation of renal function, chronic kidney disease, renal replacement therapy (including haemodialysis), acute renal failure, and the patient with a transplanted kidney. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. The effects of impaired renal function on the elimination of anaesthetic drugs are discussed.

Acute nephrotoxicity and neurotoxicity associated with concentrated star fruit juice consumption

2020 ◽  
Vol 13 (12) ◽  
pp. e234460
Author(s):  
Isolda Prado de Negreiros Nogueira Maduro ◽  
Alba Regina Jorge Brandão ◽  
Karla Cristina Petruccelli Israel
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Case Report ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Fruit Juice ◽  
Neurological Dysfunction ◽  
Star Fruit

Star fruit toxicity has been hugely described in patients with chronic kidney disease, either on conservative or renal replacement therapy. This is a case report of a man, without prior kidney or neurological dysfunction, who appeared to develop nephrotoxicity and neurotoxicity less than 12 hours after drinking concentrated star fruit juice (approximately 20 units of the fruit). He received timely renal replacement therapy and renal function fully recovered after discharge.

scholarly journals Incidence of end stage renal disease on renal replacement therapy in Nepal

1970 ◽  
Vol 7 (3) ◽  
pp. 301-305 ◽  
Author(s):  
R Hada ◽  
S Khakurel ◽  
RK Agrawal ◽  
RK Kafle ◽  
SB Bajracharya ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Female Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country. Objectives: The objective of this study is to find out the incidence of ESRD on renal replacement therapy and their out come. Materials and methods: It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients file, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profile, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis. Results: Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 ± 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT. Conclusion: The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to find out of cause of ESRD and to institute preventive measures.Key words: End stage renal disease; Renal replacement therapy; Haemodialysis; Intermittent peritoneal dialysis; Incidence of end stage renal disease; Nepal. DOI: 10.3126/kumj.v7i3.2742 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 302-305

scholarly journals Effect of renal replacement therapy on selected arachidonic acid derivatives concentration

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Elżbieta Cecerska-Heryć ◽  
Rafał Heryć ◽  
Magda Wiśniewska ◽  
Natalia Serwin ◽  
Bartłomiej Grygorcewicz ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Control Group ◽  
Transplant Patients ◽  
Activated Platelets ◽  
Kidney Transplant Patients ◽  
Arachidonic Acid Derivatives

Abstract Background Platelet activation is an important side effect of dialysis, resulted in a subsequent release of arachidonic acid (AA) from activated platelets. AA is involved in many pathologic conditions, such as inflammation, asthma, cancer, diabetes, hypertension, and the pathogenesis of kidney disease. The aim of this study was to define whether the dialysis type affects the concentration of AA derivatives in patients with chronic kidney disease. Methods 117 patients were qualified to the study group. Based on the type of renal replacement therapy, patients were divided into the following groups: hemodialysis (HD A – before/HD B - after hemodialysis), peritoneal dialysis (PD), kidney transplant patients (TE - before/TE A – after transplantation) and conservative treatment (CT) (30; 30; 27; 30 patients, respectively). The control group consisted of 30 healthy volunteers (NK). The ELISA methods were used to measure the concentrations of TXB2, 5-HETE, 12-HETE, and 15-HETE in the blood serum. Results Renal replacement therapy significantly influences the concentration of TXB2 (mean ± SD [ng/mL]: HD A- 34.6 ± 9; HD B- 28.3 ± 15.2; PD- 28.3 ± 15.2; CT- 34.2 ± 8.0; TE- 36.7 ± 42.9; TE A- 27.9 ± 8.8; NK– 19.6 ± 15; p = 0.010), 5-HETE (mean ± SD [ng/mL]: HD A- 284.2 ± 428.4; HD B- 304.8 ± 516.2; PD – 530.0 ± 553.3; CT- 318.7 ± 366.0; TE- 525.6 ± 358.0; TE A – 409.8 ± 377.1; NK 838.1 ± 497.8; p < 0.001) and 15-HETE (HD A—18.1 ± 8.7; HD B- 42.2 ± 14; PD – 36.3 ± 13.8; CT- 33.7 ± 14.0; TE- 19.5 ± 10.2; TE A – 34.4 ± 16.3; NK 22.2 ± 17.8; p < 0,001). There was a significant relationship between the type of renal replacement therapy and the duration of dialysis, and the concentration of TXB2, 12-HETE acid, and 15-HETE. Conclusions The type of renal replacement therapy significantly affects the concentration of AA derivatives. Peritoneal dialysis is the best method of dialysis, taking into account the concentration of arachidonic acid derivatives.

scholarly journals Peritonites in peritoneal dialysis patients

2018 ◽  
Author(s):  
Emanuelle Barbara Dias Tomaz ◽  
Plínio Trabasso ◽  
Gabriela Jorge Trigo Alves ◽  
Rodrigo Bueno de Oliveira
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Dialysis Patients ◽  
Fungal Peritonitis ◽  
Bacteria And Fungi ◽  
Etiological Agents

Peritonitis is one of the most common complications of the population with chronic kidney disease on peritoneal dialysis. The most frequent etiological agents are bacteria and fungi, the latter being responsible for 2 to 5% of the total cases of this type of infection. Fungal peritonitis is severe and its occurrence requires immediate removal of the catheter and transfer of renal replacement therapy for hemodialysis. The present study aimed to retrospectively study the risk factors and clinical outcomes of patients at the Centro Integrado de Nefrologia (CIN) of the Hospital das Clínicas da UNICAMP, who presented bacterial or fungal peritonitis, comparing them to peritoneal dialysis patients who did not present peritonitis.

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