Hemodialysis International最新文献

{"title":"Purulent Pericarditis as an Initial Manifestation of Infective Endocarditis in a Hemodialysis Patient: A Case Report","authors":"Abraham Edgar Gracia-Ramos,&nbsp;Antonio Cortés-Ortíz,&nbsp;Cecilio Morales-Flores,&nbsp;Lourdes Alejandra Quintero-Arias","doi":"10.1111/hdi.13219","DOIUrl":"10.1111/hdi.13219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Infective endocarditis can present with a wide range of cardiac and extra-cardiac symptoms. However, purulent pericarditis as a presenting sign has rarely been documented in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Description</h3>\u0000 \u0000 <p>We present a case of a 47-year-old woman on hemodialysis who presented to the emergency department due to dyspnea and edema in her lower extremities. A chest X-ray revealed an enlarged cardiac silhouette, while a computed tomography (CT) scan showed a large pericardial effusion. A transthoracic echocardiogram indicated vegetation on the tricuspid valve and pericardial effusion, with echocardiographic signs of cardiac tamponade. Emergent drainage of the pericardial space was performed, during which purulent material was obtained. Methicillin-resistant \u0000 <i>Staphylococcus aureus</i>\u0000 was identified in blood cultures collected upon admission and in the cultures from the pericardial effusion. The patient received intensive antibiotic therapy; however, despite the treatment and after a complicated hospital course, she succumbed to the illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Diagnosing purulent pericarditis in hemodialysis patients with infective endocarditis requires a high level of suspicion because typical symptoms of pericarditis are uncommon, and there is a tendency to initially attribute nonspecific constitutional symptoms to the underlying infection itself. Aggressive treatment with pericardial drainage and appropriate antibiotic therapy may prevent catastrophic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"414-418"},"PeriodicalIF":1.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Recurrent Calcium Phosphate Stones in a Patient Undergoing Renal Replacement Therapy: A Case Report and Literature Review on Renal Stone Prevention Strategies","authors":"Parasto Asnaashari,&nbsp;Pran M. Kar,&nbsp;Saif Borgan,&nbsp;Olga Karasik","doi":"10.1111/hdi.13211","DOIUrl":"10.1111/hdi.13211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urolithiasis is a common malady afflicting 8.8% of the general population. Its occurrence is also not uncommon in patients undergoing renal replacement therapy. Despite the leaping scientific advancement achieved in managing and preventing urolithiasis in the general population, there remains limited data regarding its prevention in patients undergoing renal replacement therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>We present a case of recurrent urolithiasis in a patient with end-stage renal disease on renal replacement therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We performed a literature review on urolithiasis in patients with ESKD undergoing renal replacement therapy, emphasizing evidence-based available preventative strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 3","pages":"410-413"},"PeriodicalIF":1.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Density Lipoprotein Apheresis for Treatment of Focal Segmental Glomerulosclerosis","authors":"Maximilian Dawson,&nbsp;Shaarav Ghose,&nbsp;Nathaniel Abdelnour,&nbsp;Raghav Shah,&nbsp;Adithya Sreenivas,&nbsp;Kinnari Vala,&nbsp;Sidharth Kumar Sethi,&nbsp;Rupesh Raina","doi":"10.1111/hdi.13208","DOIUrl":"10.1111/hdi.13208","url":null,"abstract":"<div>\u0000 \u0000 <p>Focal segmental glomerulosclerosis (FSGS) has become one the leading causes of kidney disease in the United States. With the incidence of FSGS rising over the past decade, capable treatment options have been a large focus in research. One therapy that shows promise is low density lipoprotein apheresis (LDL-A). This procedure removes lipoproteins containing apolipoprotein-B from the blood, thus reducing the lipid load on the renal system. LDL-A also improves responsiveness to the standard FSGS therapy of corticosteroids and cyclosporine. This paper describes the current LDL-A techniques, offers insight to existing clinical studies employing this therapy, and ultimately highlights LDL-A as a treatment option for FSGS, post-renal transplant, and nephrotic syndrome.</p>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"137-149"},"PeriodicalIF":1.2,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrogenic Ascites: A Case Series With Review of Literature","authors":"K. K. Athish,&nbsp;Shobhana Nayak-Rao","doi":"10.1111/hdi.13216","DOIUrl":"10.1111/hdi.13216","url":null,"abstract":"<div>\u0000 \u0000 <p>Nephrogenic ascites, or ascites associated with renal failure, is most commonly observed in patients with end-stage renal disease undergoing hemodialysis, though it can occur less frequently in earlier stages of renal failure. While its exact cause is likely multifactorial, several contributing mechanisms are commonly recognized. These include delayed diagnosis of chronic kidney disease, reduced peritoneal lymphatic reabsorption, malnutrition, increased permeability of the peritoneal membrane, and the effects of dialysis and ultrafiltration in uremia. Nephrogenic ascites typically affects cachectic, under-dialyzed, and malnourished patients and carries a poor long-term prognosis. This paper presents a series of eight cases involving patients with refractory ascites subsequently diagnosed as being of renal origin and provides a review of this condition.</p>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"247-252"},"PeriodicalIF":1.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Hemodynamic Effects of Low Versus High Dialysate Bicarbonate Concentration in Hemodialysis Patients”","authors":"","doi":"10.1111/hdi.13215","DOIUrl":"10.1111/hdi.13215","url":null,"abstract":"<p>\u0000 \u0000 <span>Jensen, JSK</span>, <span>Jørgensen, IH</span>, <span>Buus, NH</span>, <span>Jensen, JD</span>, <span>Peters, CD</span>. <span>Hemodynamic Effects of Low Versus High Dialysate Bicarbonate Concentration in Hemodialysis Patients</span>. <i>Hemodialysis International</i> <span>2024</span>; <span>28</span>(<span>3</span>): <span>290</span>–<span>303</span>. https://doi.org/10.1111/hdi.13162.\u0000 </p><p>In Figure 3, the individual drops of each participant in orthostatic blood pressure appeared to involve more than the 12 participants used for analysis, as described in the methods section of the paper. The new version of Figure 3 (see below) accurately reflects the blood pressure drop in only the 12 participants who were used for analysis.</p><p>Importantly, the mean orthostatic drop in blood pressure remains unchanged, and the overall conclusions and interpretations of the data are unaffected by this error.</p><p>We apologize for any confusion this may have caused.</p>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"237"},"PeriodicalIF":1.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodialysis Prescription and In-Hospital Cardiac Arrest in Patients With Acute Kidney Injury: A Single-Center Study","authors":"Huseyin Dongelli,&nbsp;Mehmet Ası Oktan,&nbsp;Cihan Heybeli,&nbsp;Yelda Deligoz Bildacı,&nbsp;Berfu Korucu,&nbsp;Caner Cavdar,&nbsp;Serpil Muge Deger","doi":"10.1111/hdi.13207","DOIUrl":"10.1111/hdi.13207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cardiac arrest is a common cause of death among patients undergoing maintenance hemodialysis; however, the prevalence and risk factors for cardiac arrest in the setting of acute kidney injury (AKI) are not studied in detail.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who received hemodialysis for AKI between 2014 and 2024 were classified as those who experienced cardiac arrest during hemodialysis (group A) and patients who had cardiac arrest during hospitalization outside the hemodialysis session (group B). Logistic regression analysis was performed to determine the odds of cardiac arrest during the hemodialysis session versus outside the session.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Among the 1702 patients who received hemodialysis for AKI, 33 (0.02%) experienced cardiac arrest at the time of hemodialysis (group A), and 100 (0.06%) had cardiac arrest outside the session (group B). Previous history of atrial fibrillation was more common in group A (39% vs. 19%, <i>p</i> = 0.017). Groups were comparable in terms of oxygen or vasopressor requirement and baseline mean serum creatinine. Metabolic acidosis was more severe, and serum blood urea nitrogen and calcium levels were higher in group B (<i>p</i> &lt; 0.05). Ultrafiltration rates were higher in group A than in group B (mean 10.6 mL/h/kg vs. 6.2 mL/h/kg, <i>p</i> &lt; 0.001). There were more deaths in group A within the first 24 h following cardiac arrest (79% vs. 48%, <i>p</i> &lt; 0.05); however, spontaneous recirculation and overall in-hospital mortality were comparable. In the multivariate regression model, atrial fibrillation (OR = 4.91, 95% CI 1.35–17.8, <i>p</i> = 0.016), lower pre-dialysis serum calcium levels (OR = 2.66, 95% CI 1.25–5.65, <i>p</i> = 0.011), and higher ultrafiltration volume (OR = 10.9, 95% CI 3.90–30.5, <i>p</i> &lt; 0.001) were independently associated with an increased risk of cardiac arrest during hemodialysis sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>History of atrial fibrillation, lower pre-dialysis serum calcium levels, and higher ultrafiltration volumes are associated with an increased risk of cardiac arrest during hemodialysis than cardiac arrest outside the hemodialysis session in the AKI setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"156-163"},"PeriodicalIF":1.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Spiritual Well-Being on Hope Among Hemodialysis Patients: A Latent Profile Analysis","authors":"Xu-Hua Zhou,&nbsp;Lin Chen,&nbsp;Ying-Jun Zhang,&nbsp;Li He,&nbsp;Li Liu,&nbsp;Mei Shi,&nbsp;Rui You","doi":"10.1111/hdi.13210","DOIUrl":"10.1111/hdi.13210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Spiritual well-being was a critical component of quality of life for hemodialysis patients. However, existing research primarily concentrates on the overall level of spiritual well-being and associated factors, often neglecting the heterogeneity within the hemodialysis patients regarding their patterns of spiritual well-being. In addition, the effect of spiritual well-being on hope levels in hemodialysis patients remains unclear. This study aimed to examine the latent profiles of spiritual well-being among hemodialysis patients and to explore their effect on hope.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A convenience sampling method was employed between July 2023 and March 2024 to recruit hemodialysis patients from three teaching hospitals in Sichuan Province as study participants. All participants complied with a demographic questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, and the Herth Hope Index. A latent profile analysis was adopted to identify the latent profiles of spiritual well-being among hemodialysis patients, and hierarchical linear regression was conducted to examine their role in hope.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Two latent profiles of spiritual well-being were identified based on the participants' responses, designated as “Spiritual burnout group”(<i>n</i> = 246, 74.4%) and “Spiritual fulfillment group” (<i>n</i> = 51, 25.6%). Different latent profiles of spiritual well-being among hemodialysis patients have a significant positive effect on the level of hope (Δ<i>R</i>\u0000 ² = 0.224, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The spiritual well-being of hemodialysis patients was identified as suboptimal and demonstrated a significant positive association with their level of hope. Healthcare providers could identify the different profiles of spiritual well-being in HD patients and deliver targeted interventions to guide them to positively live in harmony with themselves, others, and the environment to improve their level of hope.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"222-230"},"PeriodicalIF":1.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Medication Regimen Complexity on Patient-Related and Clinical Outcomes in Patients Undergoing Hemodialysis","authors":"Jing Xin Goh,&nbsp;Wubshet Tesfaye,&nbsp;Connie Van,&nbsp;Kamal Sud,&nbsp;Shrey Seth,&nbsp;Surjit Tarafdar,&nbsp;Ronald L. Castelino","doi":"10.1111/hdi.13214","DOIUrl":"10.1111/hdi.13214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is limited data on medication regimen complexity on outcomes in patients with kidney failure receiving hemodialysis (HD) in different settings. This study aims to quantify medication regimen complexity and assess its impact on patient-related and clinical outcomes in facility-based and home-based HD-treated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study targeted patients undergoing HD at a large metropolitan dialysis center in Australia. Baseline data and hospitalizations were recorded through a retrospective audit of electronic medical records, while other outcome data were collected prospectively. Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI). Medication adherence was evaluated with the 4-item Morisky-Green-Levine Scale (MGLS), whereby participants were deemed not adherent if they responded “yes” to any of the questions. EQ-5D-5L and EQ VAS scores were used to assess health-related quality of life (HRQoL) with higher scores indicating better health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of 174 eligible adults, 145 (80 facility-based and 65 home HDs) patients participated. Participants of both facility-based and home HD were predominantly men (65% and 75.4%, respectively) with a mean age of 62 ± 13 years and 56 ± 12 years, respectively. Home HD participants had a higher median MRCI than those on facility-based HD [26.0 (IQR 20.6–33.0) vs. 20.8 (IQR 13.6–28.4), respectively; <i>p</i> = 0.005]. While there was no significant difference in the non-adherence rate, home HD participants had higher scores for both EQ-5D-5L [0.917 (IQR 0.745–0.984) vs. 0.798 (IQR 0.302–0.956), respectively; <i>p</i> = 0.006] and EQ VAS [60 (IQR 50–75) vs. 50 (IQR 40–70), respectively; <i>p</i> = 0.034]. Home HD participants also had a fewer number of hospitalizations in the prior (1 year 0 (IQR 0–1) vs. 1 (IQR 0–1), respectively; <i>p</i> = 0.042).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The higher complexity of the medication regimen for home HD compared to facility-based HD participants may be due to the shift in dose administration responsibility of several parenteral medications. Despite the higher complexity, home HD patients had better outcomes, including HRQoL and hospitalizations compared to facility-based HD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"231-236"},"PeriodicalIF":1.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Dialysis Fatigue Is Not Associated With Perceived Stress in Patients on Hemodialysis","authors":"Maurizio Bossola,&nbsp;Marta Di Giovanni,&nbsp;Ilaria Mariani,&nbsp;Enrico Di Stasio,&nbsp;Laura Angioletti,&nbsp;Michela Balconi","doi":"10.1111/hdi.13209","DOIUrl":"10.1111/hdi.13209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study explored the relationship between post dialysis fatigue (PDF) and dialysis recovery time (DRT) with perceived stress and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted on 223 patients on hemodialysis (HD). We collected demographic, laboratory and clinical variables [including depression and perceived stress levels measured with the Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI-II)] to explore their association with PDF and DRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of the total, 120 patients suffered PDF and 103 did not. Groups differed in Charlson comorbidity index, dialysate sodium concentration, dialysate temperature, and BDI score, but had similar perceived stress levels. Logistic regression identified BDI and Charlson scores as independently associated with PDF. Of 130 patients, DRT was ≤ 120 min, and in 73, it was &gt; 120 min, with higher BDI scores in the latter. Stratifying by perceived stress levels showed no significant differences in PDF or DRT. However, PDF and DRT were higher in patients with BDI &gt; 17, and perceived stress levels strongly correlated with BDI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While PDF and DRT are not significantly linked to perceived stress, they are strongly associated with depression levels in HD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"214-221"},"PeriodicalIF":1.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Cefepime Dosing in Patients With Pseudomonas aeruginosa Infections Undergoing Renal Replacement Therapies","authors":"Wasim S. El Nekidy,&nbsp;Khaled Alzaman,&nbsp;Emna Abidi,&nbsp;Muriel Ghosn,&nbsp;Khaled Ismail,&nbsp;Islam M. Ghazi,&nbsp;Rania El Lababidi,&nbsp;Mohamad Mooty,&nbsp;Amir Malik,&nbsp;Amna Alshamsi,&nbsp;Ali Almheiri,&nbsp;Jihad Mallat","doi":"10.1111/hdi.13204","DOIUrl":"10.1111/hdi.13204","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Data regarding the efficacy of cefepime in treating patients with \u0000 <i>Pseudomonas aeruginosa</i>\u0000 infections undergoing renal replacement therapy (RRT) are limited. Therefore, we conducted a study to investigate the outcomes of recommended cefepime dosing in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective descriptive cohort study was conducted between May 2015 and December 2022 on patients diagnosed with active sepsis secondary to \u0000 <i>P. aeruginosa</i>\u0000 infection, requiring cefepime treatment and undergoing RRT. The primary endpoint was 30-day all-cause mortality, with secondary endpoints including clinical cure, microbiologic cure, infection recurrence rate, and incidence of adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 132 patients met the inclusion criteria. Of these, 81 (62.4%) were male, with a median age of 69 years and a median BMI of 27 kg/m². The most common diagnoses were pneumonia (58.3%), followed by bacteremia (18.9%). The median minimum inhibitory concentration (MIC) of cefepime for \u0000 <i>P. aeruginosa</i>\u0000 was 2 mcg/mL. The median dose of cefepime was 2000 mg every 12 h in those undergoing continuous venovenous hemofiltration and 1000 mg every 24 h in those undergoing intermittent hemodialysis, with a median duration of therapy of 8 days. The median Charlson Comorbidity index for survivors was 9 (8–11), while it was 7.5 (5.25–9.75) for non-survivors (<i>p</i> = 0.754). The 30-day survival rate was achieved in 96 patients (72.7%), the clinical cure was achieved in 58.3% of subjects, and a microbiologic cure rate of 31%. The 30-day reinfection rate was 9.1%, with no documented adverse events associated with the doses used. Multivariable logistic regression analysis identified the use of vasopressors (Odds Ratio 4.6, 95% CI 1.3–17.1) and white blood cell count at the end of therapy (Odds Ratio 1.1, 95% CI 1.01–1.4) as the main predictors of all-cause mortality in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results suggest that the utilized doses of cefepime in patients with \u0000 <i>P. aeruginosa</i>\u0000 infections undergoing RRT were effective. Larger study is needed to confirm our findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 2","pages":"172-178"},"PeriodicalIF":1.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}