scholarly journals Сardiorenal Syndrome in Patients on Renal Replacement Therapy

2021 ◽  
Author(s):  
Shutov Evgeny ◽  
Filatova Natalia
Keyword(s):  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Small Vessel Disease ◽  
Artery Bypass ◽  
Fibroblast Growth Factor 23 ◽  
Pacemaker Implantation ◽  
Cardiac Pacemaker ◽  
Residual Renal Function ◽  
Venous Fistula

In this chapter authors discusses cardiorenal relationships in patients with renal replacement therapy (RRT) which are considered as a separate type of cardiorenal syndrome (CRS). Frequency and severity of CRS in patients on dialysis are correlated with quantity of years of the dialysis treatment; depend on quality of dialysis regimen and level of residual renal function. RRT-associated cardiac pathology are including left ventricular hypertrophy, ischemic cardiomyopathy, congestive heart failure, coronary atherosclerosis and calcinosis, severe arrhythmias. The article analyzes role of malnutrition and dialysis-induced cachexia, bio-incompatibility of dialysis membranes, oxidative stress and inflammation, arterio-venous fistula, decrease of residual renal function in the development of dialysis-induced CRS. The review examines the mechanisms of progressive myocardial ischemia induced by dialysis: myocardial stunning, hemodialysis-induced hypotension, uremic small vessel disease. Prevention of dialysis-induced CRS includes a choice of the optimal RRT method (peritoneal dialysis or hemodialysis), соntrol of dialysis regimen, residual renal function, biocompatibility of membrane, inflammatory markers, body mass index, serum level albumin, phosphate, calcium, parathyroid hormone, fibroblast growth factor-23. Electrocardiogram, ultrasonic monitoring and coronarography reveals indications for соnservative cardioprotective therapy and angioplasty interventions, including coronary artery bypass surgery and cardiac pacemaker implantation, in patients with dialysis-induced CRS.

Type of Renal Replacement Therapy and Residual Renal Function May Affect Prohepcidin and Hepcidin

Renal Failure ◽  
2009 ◽  
Vol 31 (10) ◽  
pp. 876-883 ◽  
Author(s):  
Jolanta Malyszko ◽  
Jacek S. Malyszko ◽  
Piotr Kozminski ◽  
Michal Mysliwiec
Keyword(s):  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Residual Renal Function

scholarly journals Application of model of incremental haemodialysis, based on residual renal function, at the initiation of renal replacement therapy

2017 ◽  
Vol 37 (1) ◽  
pp. 39-46
Author(s):  
José L. Merino ◽  
Patricia Domínguez ◽  
Blanca Bueno ◽  
Yésika Amézquita ◽  
Beatriz Espejo ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Residual Renal Function

scholarly journals Residual Renal Function in Children Treated with Chronic Peritoneal Dialysis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Maria Roszkowska-Blaim ◽  
Piotr Skrzypczyk
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Urine Volume ◽  
Residual Renal Function ◽  
Chronic Peritoneal Dialysis ◽  
Water Excretion ◽  
Tract Infections

Residual renal function (RRF) in patients with end-stage renal disease (ESRD) receiving renal replacement therapy is defined as the ability of native kidneys to eliminate water and uremic toxins. Preserved RRF improves survival and quality of life in adult ESRD patients treated with peritoneal dialysis. In children, RRF was shown not only to help preserve adequacy of renal replacement therapy but also to accelerate growth rate, improve nutrition and blood pressure control, reduce the risk of adverse myocardial changes, facilitate treatment of anemia and calcium-phosphorus balance abnormalities, and result in reduced serum and dialysate fluid levels of advanced glycation end-products. Factors contributing to RRF loss in children treated with peritoneal dialysis include the underlying renal disease such as hemolytic-uremic syndrome and hereditary nephropathy, small urine volume, severe proteinuria at the initiation of renal replacement therapy, and hypertension. Several approaches can be suggested to decrease the rate of RRF loss in pediatric patients treated with chronic peritoneal dialysis: potentially nephrotoxic drugs (e.g., aminoglycosides), episodes of hypotension, and uncontrolled hypertension should be avoided, urinary tract infections should be treated promptly, and loop diuretics may be used to increase salt and water excretion.

scholarly journals Peritoneal Dialysis in the elderly

2018 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
William White ◽  
Edwina Brown
Keyword(s):  
Quality Of Life ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Fluid Balance ◽  
Older Patients ◽  
The Elderly ◽  
Residual Renal Function

AbstractPeritoneal dialysis (PD) can provide an improved quality of life to older patients requiring renal replacement therapy (RRT) compared to in-centre haemodialysis (HD). Frailty in the elderly poses challenges to PD, which may be met by assisted PD, and integration with geriatric and palliative services. The focus of PD care in the elderly should be on meeting patients’ goals, controlling symptoms, maintaining fluid balance and maintaining residual renal function

The role of arterio-venous fistula in formation of pulmonary hypertension in patients on renal replacement therapy. A Review

2019 ◽  
Vol 21 (1) ◽  
pp. 19-31
Author(s):  
R.T. Ishakov ◽  
◽  
E.M. Zeltyn-Abramov ◽  
N.G. Potheshkina ◽  
N.I. Belavina ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Venous Fistula

Secondary Oxalate Nephropathy: Causes and Clinicopathological Characteristics of a Case Series

Nephron ◽  
2021 ◽  
pp. 1-8
Author(s):  
Shaoshan Liang ◽  
Lijuan Li ◽  
Dacheng Chen ◽  
Dandan Liang ◽  
Feng Xu ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Replacement Therapy ◽  
Renal Biopsy ◽  
Replacement Therapy ◽  
Case Series ◽  
Common Cause ◽  
Renal Function Recovery ◽  
Function Recovery ◽  
Renal Biopsies ◽  
Oxalate Nephropathy

<b><i>Introduction:</i></b> Secondary oxalate nephropathy (OxN) is associated with a variety of causes and has not been well characterized in Chinese population. To investigate the etiology, clinicopathological features, and outcomes of secondary OxN, we report a case series from a single center in China. <b><i>Methods:</i></b> A retrospective analysis of 68 patients diagnosed with secondary OxN by renal biopsy from January 2013 to February 2019 in Jinling Hospital was performed. <b><i>Results:</i></b> Secondary OxN accounted for 0.23% of the renal biopsies and 2.31% of patients who received renal biopsies due to acute kidney injury (AKI). A total of 49 men and 19 women with an average age of 51.6 ± 11.8 years were enrolled. The most common cause was iatrogenic medication, followed by oxalate-rich diet and industry exposure. Stage 1, 2, and 3 AKI and AKI on chronic kidney disease (ACKD) were found in 4.4, 8.8, 69.1, and 17.6% of the patients, respectively. The peak serum creatinine during hospitalization was 8.62 ± 4.67 mg/dL. The median urinary oxalate excretion was 51.5 (23.2–147.1) mg/24 h. Kidney biopsy showed extensive calcium oxalate crystal deposits with acute tubulointerstitial nephritis. Thirty-four patients (50.0%) required renal replacement therapy. At the end of a follow-up that lasted 8.7 (0.1–72.1) months, 81.0% of patients achieved renal function recovery in 50 (14–432) days. Patients with renal function recovery had a lower rate of ACKD, a higher level of hemoglobin, a lower level of urine lysozyme, and a lower degree of interstitial fibrosis/tubular atrophy, interstitial inflammation, and global glomerulosclerosis than those in the nonrecovery group. <b><i>Conclusions:</i></b> In this case series of secondary OxN, the most common cause was iatrogenic medication, and it presented with AKI or ACKD. Half of the patients required renal replacement therapy, and in most of them, the renal function was reversible. Renal biopsy played an important role in diagnosis and prognosis evaluation.

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 Postoperative acute kidney injury requiring continuous renal replacement therapy and outcomes after coronary artery bypass grafting: a nationwide cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tak Kyu Oh ◽  
In-Ae Song
Keyword(s):  
Cohort Study ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Cox Regression ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Population Based ◽  
Bypass Grafting ◽  
All Cause Mortality ◽  
Postoperative Aki

Abstract Background Previous studies reported that patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) after cardiac surgery were at a higher risk of postoperative mortality. However, the impact of AKI and CRRT on long-term mortality has not yet been identified. Therefore, we investigated whether postoperative AKI requiring CRRT was associated with one-year all-cause mortality after coronary artery bypass grafting (CABG). Methods For this population-based cohort study, we analyzed data from the National Health Insurance Service database in South Korea. The cohort included all adult patients diagnosed with ischemic heart disease who underwent isolated CABG between January 2012 and December 2017. Results A total of 15,115 patients were included in the analysis, and 214 patients (1.4%) required CRRT for AKI after CABG during hospitalization. They received CRRT at 3.1 ± 8.5 days after CABG, for 3.1 ± 7.8 days. On multivariable Cox regression, the risk of 1-year all-cause mortality in patients who underwent CRRT was 7.69-fold higher. Additionally, on multivariable Cox regression, the 30-day and 90-day mortality after CABG in patients who underwent CRRT were 18.20-fold and 20.21-fold higher than the normal value, respectively. Newly diagnosed chronic kidney disease (CKD) requiring renal replacement therapy (RRT) 1 year after CABG in patients who underwent CRRT was 2.50-fold higher. In the generalized log-linear Poisson model, the length of hospital stay (LOS) in patients who underwent CRRT was 5% longer. Conclusions This population-based cohort study showed that postoperative AKI requiring CRRT was associated with a higher 1-year all-cause mortality after CABG. Furthermore, it was associated with a higher rate of 30-day and 90-day mortality, longer LOS, and higher rate of CKD requiring RRT 1 year after CABG. Our results suggest that CRRT-associated AKI after CABG may be associated with an increased risk of mortality; hence, there should be interventions in these patients after hospital discharge.

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