scholarly journals Baclofen Toxicity in a Chronic Kidney Disease Stage 5D Patient

2018 ◽  
Vol 1 (1) ◽  
pp. 53-55
Author(s):  
Sarju Raj Singh ◽  
Manisha Dhakal ◽  
Santosh Thapa ◽  
Sudha Khakurel
Keyword(s):  
Chronic Kidney Disease Stage ◽  
Clinical Manifestations ◽  
Disease Stage ◽  
Maintenance Hemodialysis ◽  
History Of ◽  
Muscular Spasm ◽  
Stage Renal Disease ◽  
End Stage ◽  
Intensive Hemodialysis ◽  
Infectious Etiology

The toxicity of Baclofen is extremely unusual. However, its predominant renal clearance makes its vulnerable in patients with impaired renal function. Clinical manifestations may begin as early as 2-3 days after starting the drug, even with a smaller dosage.A 73-year-old man with end-stage renal disease on maintenance hemodialysis was admitted to our emergency department with progressive confusion, hallucination and a generalized decrease in muscular tone. There was no significant metabolic or infectious etiology that could have clarified his condition. A thorough laboratory and imaging workup was negative too. A detailed history of his medication revealed that he had recently been prescribed baclofen for neck muscular spasm (10mg twice daily). He was then diagnosed with baclofen toxicity and was treated with intensive hemodialysis. During his admission, few sessions of hemodialysis on consecutive days, eventually produced expected clinical improvement and a complete return to his previous baseline mental status.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 54-56

scholarly journals CHANGES OF NONESSENTIAL TRACE ELEMENTS LEVELS IN WHOLE BLOOD OF END STAGE RENAL DISEASE ADULT PATIENTS

2017 ◽  
pp. 114-125
Author(s):  
O. O. Makarov ◽  
E. O. Pisarev ◽  
B. S. Sheiman ◽  
M. V. Kulizkiy ◽  
D. V. Peretyatko ◽  
...  
Keyword(s):  
Trace Elements ◽  
Whole Blood ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Blood Levels ◽  
Healthy Donors ◽  
Plasma Mass Spectrometry ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Aims: Accumulation of trace elements occurs in conditions of decreased or termination of kidneys functions. In some conditions increased trace elements can obtain toxic features. On other hand, researches are showing that concentration of some trace elements could be decreased in ERSD patients, too. The most important factor affecting trace element concentration in ERSD patient is the degree of renal failure and using of replacement therapy. Materials and methods: We determined the concentration of microelements (beryllium, boron, aluminum, vanadium, chromium, nickel, arsenic, rubidium, strontium, cadmium, cesium, barium, thallium and lead) in whole blood of 41 ESRD patients with chronic kidney disease stage VD, who were treated with hemodialysis / hemodiafiltration and in 61 conditionally healthy donors. Determination of whole bloods trace elements content was conducted using inductive coupled plasma mass- spectrometry (ICPMS).  Results: It is determinate that levels of beryllium, boron, aluminum, vanadium, chromium, strontium, cadmium, barium, thallium and lead is reliable increased in ESRD patients. Decreased levels are observed for nickel, arsenic, cesium and rubidium. Conclusions: ESRD is accompanied with substantial and multidirectional changes of trace elements blood levels. During researches has shown that in ESRD patients processes of trace elements accumulation are prevailing over elimination ones.

scholarly journals Clinical Manifestations of Cardiac Disease in Patients with End Stage Renal Disease Under Maintenance Hemodialysis in a Tertiary Level Hospital of Nepal

2016 ◽  
Vol 15 (1) ◽  
pp. 61-65
Author(s):  
Kumar Roka ◽  
Pratibha Bista Roka
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Low Voltage ◽  
Clinical Manifestations ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Maintenance Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction: End stage renal disease presents with multiple clinical and systemic manifestations. The aim of the present study was to identify the early cardiac and other morbidities in end stage renal disease (ESRD) patients who were under maintenance hemodialysis.Methods: This was an observational, prospective study conducted in fifty established ESRD patients of 20 to 74 years under maintenance hemodialysis in Nephrology unit of Shree Birendra Hospital. Clinical examination, laboratory parameters, electrocardiogram and echocardiography findings were used to identify the morbidities. Results: Among all patients enrolled in the study 88.7% had anemia, 64.2 % systolic murmurs, 62.26 % pedal edema, 73.6 % fatiguability, 71.7 % angina, 24.4 % palpitations and 13.2 % had breathlessness on exertion.  62.26% of the patients had hypertension and 13.20 % had diabetes. In the electrocardiogram, prolonged QTc was observed in 10.4%, followed by T wave inversion in 9.4 % and finally low voltage complex comprised 7.6 %. The echocardiogram showed left ventricular diastolic dysfunction in 58.5 %, left ventricular hypertrophy (overall type) 49 % and valvular lesion like mitral regurgitation and tricuspid regurgitation 83 % and 58.5 % respectively. Conclusion: Cardiac co-morbidities are common in patients diagnosed with ESRD on maintenance hemodialysis.

scholarly journals Subclavian vein angioplasty during arteriovenous fistula surgery: case report and literature review

2012 ◽  
Vol 11 (2) ◽  
pp. 154-157
Author(s):  
Marcus Vinícius Martins Cury ◽  
Marcelo Fernando Matielo ◽  
Ana Carolina Calixtro ◽  
Giuliano de Almeida Sandri ◽  
Marcos Roberto Godoy ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Subclavian Vein ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Stage Renal Disease ◽  
End Stage ◽  
Vein Stenosis ◽  
Subclavian Stenosis

Patients with chronic kidney disease stage 5 are generally treated by hemodialysis, preferentially performed via an arteriovenous fistula (AVF). We report the case of a 58-year-old male patient with diabetes mellitus, hypertension and end-stage renal disease in whom hemodialysis was conducted via a long-term catheter. His medical record described numerous central venous cannulations and several AVF creations. The patient developed subclinical subclavian stenosis that required creation of a new vascular access route. The purpose of this case report is to describe treatment of subclavian vein stenosis during AVF creation.

scholarly journals Chronic kidney disease in lithium-treated patients, incidence and rate of decline

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Arjan M. Van Alphen ◽  
Tessa M. Bosch ◽  
Ralph W. Kupka ◽  
Rocco Hoekstra
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Mood Stabilizer ◽  
Disease Stage ◽  
Stage 4 ◽  
Ckd Stage ◽  
Rate Of Decline ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Lithium-induced nephropathy is a known long-term complication, sometimes limiting the use of lithium as mood stabilizer. The aim of this study is to establish the incidence of chronic kidney disease and the rate of decline of renal function in patients using lithium and to identify risk factors. Methods We selected 1012 patients treated with lithium from the laboratory database of the Antes Centre for Mental Health Care spanning a period from 2000 to 2015. Serum lithium and creatinine concentrations were retrieved and eGFR was calculated using the 4-variable CKD-EPI formula. We calculated the incidence of renal insufficiency and the rate of decline. We compared patients with and without chronic kidney disease (CKD) stage 3 regarding duration of lithium exposure. Results Incidence of chronic kidney disease was 0.012 cases per exposed patient-year. Average decline of eGFR was 1.8 ml/min/year in patients who developed chronic kidney disease stage 3. Incidence of chronic kidney disease stage 4 was only 0.0004 per patient year. No cases of end stage renal disease were found in this cohort. Odds of reaching chronic kidney disease stage 3 were increased with longer duration of lithium exposure. Conclusions The use of lithium seems to be related to a higher incidence of chronic kidney disease. Longer duration of lithium exposure significantly increased the risk of renal failure.

scholarly journals Diabetic Muscle Infarction: A Rare Cause of Acute Limb Pain in Dialysis Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
G. De Vlieger ◽  
B. Bammens ◽  
F. Claus ◽  
R. Vos ◽  
K. Claes
Keyword(s):  
Compartment Syndrome ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Muscle Infarction ◽  
Low Dose Aspirin ◽  
Stage Renal Disease ◽  
End Stage

Diabetic muscle infarction is a rare microangiopathic complication occurring in patients with advanced diabetes mellitus. Diabetic patients with chronic kidney disease stage Vd are prone to develop this complication. The presenting symptom is a localized painful swelling of the affected limb. Symptoms usually resolve spontaneously during the following weeks, but frequent relapse can occur and in some cases swelling may lead to compartment syndrome. Biochemical blood analyses show an elevated C-reactive protein, but creatine kinase is often normal. Diagnosis can be made on clinical presentation and imaging, with magnetic resonance imaging as the gold standard. Histology is often not contributive. Treatment consists of rest, analgesics, rigorous glycemic control and low-dose aspirin. Severe cases of compartment syndrome require fasciotomy. In the current paper, we present two diabetic patients with cystic fibrosis, who are treated with automated peritoneal dialysis and suffered from episodic lower limb infarction. We subsequently review 48 episodes of diabetic muscle infarction previously reported in the literature in patients with end-stage renal disease.

scholarly journals Cholecalciferol therapy; is it the gold standard for vitamin D deficiency and mineral disorders in hemodialysis?

2020 ◽  
Vol 7 (1) ◽  
pp. e09-e09
Author(s):  
Mouna Jerbi ◽  
Hiba Ghabi ◽  
Hanene Gaied ◽  
Fathi Ben Hmida ◽  
Raja Aoudia ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Chronic Kidney Disease Stage ◽  
Hypovitaminosis D ◽  
Disease Stage ◽  
Severe Hypercalcemia ◽  
25 Hydroxy Vitamin D ◽  
Cholecalciferol Supplementation ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Vitamin D deficiency is frequently observed among dialysis patients. Previous studies suggested that 50 to 90% of end-stage renal disease patients are deficient in vitamin D. In Tunisia, studies regarding hypovitaminosis D in patients on dialysis are not numerous. Actually, many data support the use of native vitamin D in hemodialysis (HD) patients. In Tunisia, using native vitamin D is not part of therapeutic habits of all dialysis centers. Objectives: The aim of this study was to determine the prevalence of vitamin D deficiency in patients with chronic kidney disease stage 5 undergoing HD and to evaluate the effect of oral cholecalciferol supplementation, in intact parathormone (iPTH), serum calcium and serum phosphorus. Patients and Methods: We conducted a pre-experimental study among HD patients. Monthly oral supplementation with Cholecalciferol, was instituted for six months. Results: Forty-three participants were included. The mean 25-hydroxy vitamin D concentration was 17.89 ng/mL. Vitamin D deficiency was observed in 83.7% of our patients. We observed a significant increase in 25-hydroxy vitamin D and calcium levels and a significant decline in iPTH levels. No evidence of toxicity, nor severe hypercalcemia or hyperphosphatemia was noted. Conclusion: The supplementation with cholecalciferol seems reasonable and well tolerated in HD patients if reasonable doses are used with regular monitoring.

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