scholarly journals Use of Hypertonic Continuous Venovenous Hemodiafiltration to Control Intracranial Hypertension in an End-Stage Renal Disease Patient

2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
Stephen I. Rifkin ◽  
Ali R. Malek ◽  
Reza Behrouz
Keyword(s):  
Renal Disease ◽  
Cerebral Edema ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
Continuous Venovenous Hemodiafiltration ◽  
Alternative Treatment Option ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Continuous venovenous hemodiafiltration (CVVHDF) using solutions designed to maintain hypernatremia is described in an end-stage renal disease (ESRD) patient with cerebral edema (CE) due to an intracerebral hemorrhage (ICH). Hypernatremia was readily achieved and maintained without complication. CVVHDF should be considered as an alternative treatment option in ESRD patients with cerebral edema who require hypertonic saline therapy.

scholarly journals Nurse’s Experience As Educator in Hemodialysis Care to End Stage Renal Disease Patient in Hospital X: a Phenomenology Study

2019 ◽  
Author(s):  
Karolus Yosef Woitila Wangi ◽  
Dessy Permata Sela ◽  
Christina Evi Ambarsar
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
Lifestyle Changes ◽  
Future Research ◽  
Ethical Perspective ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End Stage Renal Disease (ESRD) is progressive and irreversible damage to kidney function,which can reduce the quality of life of patients and death due to accumulation of uremia toxins in the blood. Hemodialysis is a temporary therapy used to prolong the life of the patient. The uncertainty of the treatment provides a unique response which became an interesting phenomenon for researchers to conduct research Sethe qualitative strategy for explore the nurses’ experience and to describe it especially in the nurses’ role as educator in hemodialysis care to ESRD patient in Hospital X.Aim of this study to provide an overview of nurse’s experience as educator in ESRD patients during hemodialysis therapy in the Hemodialysis Unit Hospital X. this research used a qualitative method with a phenomenological approach has been conducted. The data collection technique used was using in-depth interviews. A purposive sampling was used to recruited the participant and, namely ten nurses were involded in this study with inclusion critearia as follows: (1) work as an executive nurse in HD unit, (2) have minimum Diploma III as basic education level. Data analysis using Colaizzi’s method and then using thematic analysis. Four themes were found in this study: lifestyle changes, uncooperative patients, responsive patients, and patients do not want to stop dialysis. Future research can be conduct in fourth theme concerning withdrawal dialysis in ESRD patients in various perspectives including: ethical perspective and decision making for futile treatment, health coverage policies, and palliative care.

scholarly journals Indoxyl Sulfate-Mediated Metabolic Alteration of Transcriptome Signatures in Monocytes of Patients with End-Stage Renal Disease (ESRD)

Toxins ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 621
Author(s):  
Hee Young Kim ◽  
Su Jeong Lee ◽  
Yuri Hwang ◽  
Ga Hye Lee ◽  
Chae Eun Yoon ◽  
...  
Keyword(s):  
Renal Disease ◽  
Immune Cells ◽  
End Stage Renal Disease ◽  
Metabolic Pathways ◽  
Esrd Patient ◽  
Indoxyl Sulfate ◽  
Uremic Toxin ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End-stage renal disease (ESRD) is the final stage of chronic kidney disease, which is increasingly prevalent worldwide and is associated with the progression of cardiovascular disease (CVD). Indoxyl sulfate (IS), a major uremic toxin, plays a key role in the pathology of CVD via adverse effects in endothelial and immune cells. Thus, there is a need for a transcriptomic overview of IS responsive genes in immune cells of ESRD patients. Here, we investigated IS-mediated alterations in gene expression in monocytes from ESRD patients. Transcriptomic analysis of ESRD patient-derived monocytes and IS-stimulated monocytes from healthy controls was performed, followed by analysis of differentially expressed genes (DEGs) and gene ontology (GO). We found that 148 upregulated and 139 downregulated genes were shared between ESRD patient-derived and IS-stimulated monocytes. Interaction network analysis using STRING and ClueGo suggests that mainly metabolic pathways, such as the pentose phosphate pathway, are modified by IS in ESRD patient-derived monocytes. These findings were confirmed in IS-stimulated monocytes by the increased mRNA expression of genes including G6PD, PGD, and TALDO1. Our data suggest that IS causes alteration of metabolic pathways in monocytes of ESRD patients and, thus, these altered genes may be therapeutic targets.

scholarly journals Calcium Stimulation Test for Insulinoma Localization in an End-stage Renal Disease Patient on Diazoxide

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Stephanie Kim ◽  
Miles Conrad ◽  
Eunice Chuang ◽  
Larry Cai ◽  
Umesh Masharani ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
The Body ◽  
Stimulation Test ◽  
Delay In Diagnosis ◽  
Calcium Stimulation ◽  
Stage Renal Disease ◽  
End Stage

Abstract Insulinomas are rare, and even rarer in patients with end-stage renal disease (ESRD). Clear criteria for the biochemical diagnosis of insulinomas in patients with renal failure have not been established, and hypoglycemia is often attributed to the renal disease itself, frequently leading to a delay in diagnosis. We describe a case of a patient who presented with asymptomatic recurrent hypoglycemia during hemodialysis. Disease progression and biochemical testing strongly suggested an insulinoma. Computed tomography (CT) of the abdomen and pelvis, 111In-pentetreotide scintigraphy and endoscopic ultrasound did not localize a pancreatic tumor. A calcium stimulation test was performed while the patient was taking diazoxide due to severe hypoglycemia with fasting for a couple of hours without treatment. The test showed a marked increase in insulin after calcium infusion in the dorsal pancreatic artery, localizing the tumor to the body and tail of the gland. Exploratory surgery easily identified a tumor at the body of the pancreas and pathology confirmed an insulin-secreting pancreatic neuroendocrine tumor. On follow-up, there was resolution of the hypoglycemia. We review the challenges of diagnosing an insulinoma in ESRD and describe a successful intra-arterial calcium stimulation test done in an ESRD patient while continuing diazoxide.

Increased Levels Of Tissue Factor, Adhesion Molecules, Nitric Oxide and Adiponectin In End Stage Renal Disease. A Complex Interplay

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4742-4742
Author(s):  
Jawed Fareed ◽  
Kristiyana Kaneva ◽  
Debra Hoppensteadt ◽  
Vinod Bansal
Keyword(s):  
Nitric Oxide ◽  
Renal Disease ◽  
Tissue Factor ◽  
Adhesion Molecules ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Dialysis Session ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction End stage renal disease (ESRD) represents the fifth (final) stage of chronic kidney disease characterized by an established kidney failure (GFR <15 mL/min/1.73 m2). To further understand the pathophysiology of ESRD, this study was designed to measure the circulating levels of tissue factor (TF), adhesion molecules, such as p-selectin (P-Sel), soluble ICAM (s-ICAM), nitric oxide and adiponectin (AD). Methods This study included 119 ESRD patients undergoing maintenance hemodialysis in conjunction with an ongoing IRB approved protocol on the profiling of inflammatory markers in this syndrome. Citrated blood plasma samples were collected from these patients prior to the routine dialysis session. Nitric oxide levels (NO) were measured using a commercial kit from R&D systems (Minneapolis, Minnesota) and ELISA based methods for TF, P-Sel, s-ICAM and adiponectin were also purchased from R&D systems. Chromogenic and thrombin substrate method were used to measure the anti-Xa activity thrombin generation. Results Tissue factor levels were found to be increased in the ESRD group (20.4±6.1pg/ml) vs the control (11.9±2.8pg/ml). The nitric oxide level was markedly higher in the ESRD group (32±17uM) vs the controls (7±3uM). The p-selectin levels were also elevated in the ESRD group (46±20ng/ml) vs the control (31±3ng/ml). The soluble ICAM levels were higher in the ESRD group (250±112ng/ml) vs the control (180±19ng/ml). Interestingly, the adiponectin levels were also increased in the ESRD group (19.2±9.3ug/ml) vs the control (11.2±4.1ug/ml). The pre-dialysis samples of the ESRD patients exhibited detectable levels of heparin. Summary/Conclusions These studies suggest that TF, NO, p-selectin and s-ICAM levels are increased in the ESRD patient. It is of interest to note that despite that a significant number of ESRD patients were diabetic; the AD levels were increased in this group. These results suggest that while ESRD represents a pro-inflammatory/hypercoagulable state, the repeated administration of heparin and other drugs may contribute to the regulation of the hemostatic process and inflammatory balance. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Combination of Probiotic and Calcium Carbonate Decrease Monocyte Count of End-Stage Renal Disease Patient

2018 ◽  
Vol 13 (3) ◽  
pp. 297-303
Author(s):  
Ari Yulistianingsih ◽  
Mohammad Sulchan ◽  
Taufik Maryusman ◽  
Shofa Chasani
Keyword(s):  
Calcium Carbonate ◽  
Treatment Group ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Esrd Patient ◽  
Disease Patient ◽  
Control Group ◽  
Monocyte Count ◽  
Stage Renal Disease ◽  
End Stage

Elevated monocyte count is correlated to the decrease of renal function and disease progressivity on end-stage renal disease (ESRD) patients. Probiotic that utilize lactobacillus species is known to play a role in maintaining imunity system balance by inducing the monocyte apoptosis. The combination between probiotic and calcium carbonate could increase probiotic colonization in the gatrointestinal tract. The aim of this study was to analyze the effect of probiotic and calcium carbonate combination toward reduction of monocyte count on ESRD patient at Rumah Sehat Terpadu Dompet Dhuafa Bogor Hospital. This study was true experimental research with randomized pre-post test control group design. Twenty four ESRD patient were randomly enrolled into treatment group (n=12) and control (n=12). The treatment group received probiotic and calcium carbonate, whereas control group received standardized calcium carbonate for 21 days. There was a significant decrease of monocyte (p=0.03) after administration of probiotic and calcium carbonate.

Abstract 16970: Statin Reduce Mortality and Major Cardiovascular Events in End-stage Renal Disease Patient, a Taiwan Cohort Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kai-Hung Cheng ◽  
Chih-Sheng Chu ◽  
Yu-Han Chang ◽  
Tzongshi Lu ◽  
Wen-Ter Lai
Keyword(s):  
Heart Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Disease Patient ◽  
Control Group ◽  
Research Database ◽  
Cardiac Events ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction and Hypothesis: Coronary artery disease (CAD) is the leading cause of mortality in end-stage renal disease (ESRD) patients. Vitamin D deficiency is common in patients with ESRD, and therapeutic use of Calcitriol may improve cardiovascular outcomes. Studies indicate that Statin can reduce incidences of major adverse cardiac events (MACE), and mortality in CAD. However, both 4D and AURORA studies report Statin cannot reduce MACE and mortality in ESRD patients. The goal of our study is to assess the effects of Statin and Calcitriol administration in ESRD. Methods: A total of 837 subjects selected from 12342 ESRD patients from Taiwan’s National Health Insurance Research Database were stratified into four groups (Control (n=498), S: Statin (n=131), C: Calcitriol (n=130), SC: Statin and Calcitriol (n=78)). We analyze their mediation history for twelve years since their ESRD diagnosed. One way ANOVA with Bonferroni correction, chi-square test, fisher's exact and Cox proportional hazard regression were used for statistics. Statistical significances were set at a P< 0.05. Results: Our data (Adjusted Hazard Ratio (HR), 95% Confidence Interval (CI)) showed that mortality was significant reduced when treated with Statin (0.6, 0.43-0.84), Calcitriol, (0.5, 0.35-0.72), Statin and Calcitriol (0.51, 0.31-0.82) in comparison with control group, respectively. Interestingly, these significant changes were first observed at 10th-year in S and SC groups, but at 12th-year in C group. In addition, Statin reduced MACE (0.55, 0.37-0.81) and heart failure (0.51, 0.27-0.95) incidences. Furthermore, Calcitriol also reduced MACE (0.37, 0.23-0.59), stroke (0.34, 0.16-0.72) and heart failure (0.46, 0.25-0.86) incidences as well as SC treatment decreased MACE (0.38, 0.22-0.68), stroke (0.45, 0.21-0.97), and heart failure (0.26, 0.09-0.73) incidences. Conclusions: Our data show for the first time that Statin alone can reduce incidences of mortality, MACE and heart failure but not stroke in ESRD. And, combination of Statin and Calcitriol provides best outcomes in ESRD patients with heart failure among these groups. This finding may provide important information in developing therapeutic strategies for the roles of Statin and Calcitriol in ESRD.

Adipokines and Gut Hormones in End-Stage Renal Disease

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peptide Yy ◽  
Gut Hormones ◽  
Poor Quality ◽  
Mortality And Morbidity ◽  
Novel Therapeutic Strategies ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

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