Search results for " DIALYSIS"
showing 10 items of 177 documents
Cigarette Smoking is Associated with Decreased Bone Gla-protein (BGP) Levels in Hemodialysis Patients
2018
Background: Bone Gamma-carboxyglutamic acid (Gla)-protein (BGP or osteocalcin) is a vitamin K-dependent protein involved in the regulation of bone mineralization. Smoking is a risk factor for osteoporosis. Methods: We carried out a secondary analysis of the Vitamin K Italian (VIKI) study to investigate the association between cigarette smoking and BGP levels in patients with end stage renal disease. Data were collected in 370 haemodialysis patients, 37% (136) smokers (or ex-smokers) and 63% (234) nonsmokers. Vascular calcifications and vertebral fractures (quantitative morphometry) were identified on spine radiographs. Results: Smokers had significantly lower BGP levels (152 vs. 204 μg/L, p…
Pomalidomide plus low-dose dexamethasone in patients with relapsed/refractory multiple myeloma and renal impairment: Results from a phase ii trial
2018
Purpose Renal impairment (RI) limits treatment options in patients with relapsed/refractory multiple myeloma (RRMM). Here, we prospectively studied pomalidomide plus low-dose dexamethasone (LoDEX) in patients with RRMM and moderate or severe RI, including those receiving hemodialysis. Patients and Methods MM-013, a noncomparative, European phase II trial, enrolled three patient cohorts: moderate RI (cohort A; estimated glomerular filtration rate, 30 to < 45 mL/min/1.73 m2); severe RI (cohort B; estimated glomerular filtration rate, < 30 mL/min/1.73 m2); and severe RI that requires hemodialysis (cohort C). Patients received pomalidomide 4 mg/d on days 1 to 21 and LoDEX 20 or 40 mg once…
Non-invasive tunnelled catheter reposition (NTCR): A simple and safe method to restore central tunnelled catheter function for haemodialysis
2020
AbstractDespite all efforts, still many end-stage kidney disease (ESKD) patients are dialysed using a central tunnelled catheter (CTC) as vascular access. When the CTC blood flow becomes ineffective, a number of protocols are advised. However, all of them are time- and cost-consuming. The manoeuvre of a non-invasive tunnelled catheter reposition (NTCR) was introduced to restore the CTC function. NTCR was based on gentle movements of the CTC, with or without a simultaneous flushing of the CTC lines, which resulted in a quick reposition of the CTC tip. This study comprises the analysis of a total of 297 NTCRs, which were performed in 114 patients, thus enabling an effective blood flow after 1…
Is there association between chronic kidney disease and dental caries? A case-controlled study
2018
Background The purpose of this study was to assess the association between chronic kidney diseases (CKD) and dental caries. Material and Methods 107 patients with CKD and 107 with no systemic alteration were randomly included. DMFT (decayed, missing, and filled teeth), plaque index, colony-forming units (CFU) of Streptococcus mutans and salivary composition (IgA total, IgA anti- Streptococcus mutans, calcium and urea) were evaluated. McNemar and Wilcoxon tests were used to compare test and control groups. Spearman test was used to correlate time of hemodialysis and variables studied. Associations between variables were evaluated by logistic regression analysis. Results The number of filled …
Optimization of anemia treatment in hemodialysis patients via reinforcement learning
2013
Objective: Anemia is a frequent comorbidity in hemodialysis patients that can be successfully treated by administering erythropoiesis-stimulating agents (ESAs). ESAs dosing is currently based on clinical protocols that often do not account for the high inter- and intra-individual variability in the patient's response. As a result, the hemoglobin level of some patients oscillates around the target range, which is associated with multiple risks and side-effects. This work proposes a methodology based on reinforcement learning (RL) to optimize ESA therapy. Methods: RL is a data-driven approach for solving sequential decision-making problems that are formulated as Markov decision processes (MDP…
The effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on hepatitis B vaccination in haemodialysis patients.
1996
Haemodialysis patients often fail to respond to hepatitis B vaccination. In this pilot study, 15 patients previously non-responsive to at least three 40 micrograms doses of hepatitis B vaccine were given 0.5, 5 or 10 micrograms kg-1 granulocyte-macrophage colony-stimulating factor (GM-CSF) subcutaneously 24 h prior to booster vaccination with a hepatitis B vaccine. Seven of the 15 patients developed antibody to hepatitis B surface antigen (HBsAb) (35-7240 IU L-1) upon initial vaccination with GM-CSF and two of four individuals responded with low HBsAb titres of 15 and 60 IU L-1 when revaccinated with hepatitis B surface antigen (HBsAg) and twice the dose of GM-CSF. The application of GM-CSF…
Protein oxidation in chronic kidney disease.
2013
An imbalance between oxidative processes and antioxidant systems has been widely demonstrated in chronic kidney diseases (CKD). In this study we enrolled 26 healthy subjects, 27 patients with CKD on conservative treatment (CT-CKD) with various degrees of renal failure, and 31 CKD subjects in haemodialysis treatment (HD-CKD), evaluated before and after a standard haemodialysis session. In each group we measured protein carbonyl groups (PC) as an index of protein oxidation, lipid peroxidation (TBARS) and two plasma markers of leukocyte activation, elastase and myeloperoxidase (MPO). In CT-CKD subjects the PC level was significantly higher than in normal controls, and it was negatively correla…
Active hepatitis B vaccination of dialysis patients and medical staff
1984
AbstractActive hepatitis B vaccination of dialysis patients and medical staff. One hundred six patients with terminal renal insufficiency and 29 medical personnel were given three doses of hepatitis B vaccine at an interval of 0, 1, and 6 months (Merck, Sharp and Dohme, West Point, Pennsylvania, part of a joint study no. 649). Chronic hemodialysis patients (N = 99) received 40 µg vaccine (V) i.m. Uremic patients, who were just about to start chronic dialysis treatment (N = 7), were given 40 µg V, and at the first vaccination 3ml hyperimmune globulin (HBIG) in addition. The medical personnel was alternately vaccinated with 20 µg V (N = 8), 40 µg (N = 11), 40 µg V, and 3ml HBIG at the first v…
Encapsulating peritoneal sclerosis: do not be too late for the right diagnosis! Case report and short literature review
2020
Encapsulating peritoneal sclerosis (EPS) is a rare clinical syndrome characterized by an acquired, inflammatory fibrocollagenous membrane encasing the small intestine, resulting in symptoms of bowel obstruction. It is still unclear whether early surgical intervention has an advantage over conservative management, but, in most reviewed case reports, it is preferred to preserve the surgical management in patients not responding to conservative measures, or when bowel ischaemia is occurring. We report a case of a 58-year old patients, affected by chronic renal failure, on treatment with peritoneal dialysis, in which a late diagnosis of encapsulating peritoneal sclerosis was made, and where sur…
Incidence of hepatitis C virus infection in patients with chronic kidney disease on conservative therapy
2011
SummaryHepatitis C virus (HCV) infection is a never-ending public health problem. Many studies have investigated the incidence of HCV infection among dialysis patients, but there have only been a few epidemiological studies in renal conservative therapy. We studied 320 subjects with pre-dialysis chronic kidney disease living in Sicily, Italy. The incidence of HCV infection was 6.25%. In Europe, incidence ranges from 0.2% to 3.5%. It appears that the incidence of HCV infection is higher in the studied patient population than in the population as a whole.