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Anticoagulation and dialysis access practice in home haemodialysis in the UK. 英国家庭血液透析中的抗凝和透析通路实践。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr132
Cormac Breen
{"title":"Anticoagulation and dialysis access practice in home haemodialysis in the UK.","authors":"Cormac Breen","doi":"10.1093/ndtplus/sfr132","DOIUrl":"10.1093/ndtplus/sfr132","url":null,"abstract":"<p><p>Anticoagulation is an important component of haemodialysis treatment in all settings. The therapeutic options available for anticoagulation of home haemodialysis are similar to those for haemodialysis in other settings. However, dialysis sessions with a wide range of treatment durations are undertaken at home, which can require different approaches to anticoagulation. Conference delegates were asked about the types of anticoagulation used in home dialysis and about surveillance strategies for monitoring vascular access, and the results are presented and discussed. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 Suppl 3","pages":"iii19-iii20"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/7c/sfr132.PMC4421460.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33161907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Home dialysis-an international perspective. 家庭透析——一个国际视角。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr129
Martin Wilkie
{"title":"Home dialysis-an international perspective.","authors":"Martin Wilkie","doi":"10.1093/ndtplus/sfr129","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr129","url":null,"abstract":"<p><p>Background. There is strong evidence from a range of long-term conditions of improved outcomes where patients are involved in self-management. Against this background, the international trend for home dialysis continues to decline, with centre-based haemodialysis continuing its dominance. Methods. An opinion-based commentary exploring practice patterns and drivers for home dialysis internationally. Data are drawn from a number of sources including the 2010 United States Renal Data System report. Results. Drivers behind the use of home dialysis are complex including factors relating to the patient and their carers, health care team, health care system, geography and cultural factors. There are important examples where local champions or public health initiatives have had a positive impact on the use of home dialysis; however, in many settings significant barriers remain. Better systems for giving patient information, shared decision making and involving patients in their own care may have the potential to act as a driver for change. Conclusion. Centre-based haemodialysis continues to dominate renal replacement therapy internationally with notable exceptions. Such dominance suggests that most patients worldwide do not get much choice when it comes to modality selection. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 Suppl 3","pages":"iii4-iii6"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33161914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Unusual skin lesions in a haemodialyzed patient. 血液透析病人不寻常的皮肤损伤。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr120
M G Zeier, Imani Masimango, Nathalie Demoulin, Alice Leroy, Samir Saadi, Laura Labriola
{"title":"Unusual skin lesions in a haemodialyzed patient.","authors":"M G Zeier,&nbsp;Imani Masimango,&nbsp;Nathalie Demoulin,&nbsp;Alice Leroy,&nbsp;Samir Saadi,&nbsp;Laura Labriola","doi":"10.1093/ndtplus/sfr120","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr120","url":null,"abstract":"A 71-year-old woman of Turkish origin presented in July 2009 to our haemodialysis unit with multiple painless, non-pruritic, reddish-purple skin lesions on legs and feet. She had been on peritoneal dialysis from July 2006 to December 2008 for presumed diabetic nephropathy and then shifted to haemodialysis due to recurrent peritonitis. She was under low-dose steroids since February 2008 for seropositive polyarthritis. Steroids were increased in May 2009 following a third sub-occlusive episode due to sclerosing encapsulating peritonitis. At presentation, she was taking methylprednisolone (12 mg per day), aspirin, omeprazole, atorvastatin, gabapentin, clonazepam, calcium carbonate and insulin. Clinical examination showed multiple infracentimetric dark red to violaceous non-tender macules, papules and nodules on legs and feet (Figure 1). No ulceration or necrosis was visible. No inguinal lymph nodes were palpable. Physical examination revealed no other new finding.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"443-4"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33187140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scorpion sting nephropathy. 蝎子蜇伤肾病。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr148
Stalin Viswanathan, Chaitanya Prabhu
{"title":"Scorpion sting nephropathy.","authors":"Stalin Viswanathan,&nbsp;Chaitanya Prabhu","doi":"10.1093/ndtplus/sfr148","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr148","url":null,"abstract":"<p><p>Scorpion envenomations are ubiquitous, but nephropathy is a rare manifestation, reported mainly from the Middle East and North Africa. Rapid venom redistribution from blood, delayed excretion from the kidneys, direct toxicity of venom enzymes, cytokine release and afferent arteriolar constriction have been seen in experimental animals. Haemoglobinuria, acute tubular necrosis, interstitial nephritis and haemolytic-uraemic syndrome have been documented in human victims of scorpion envenomation. Epidemiology, venom components and toxins, effects on the laboratory mammals especially the kidneys and reports of renal failure in humans are reviewed in this article. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"376-82"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33311848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 28
Outcomes on home haemodialysis: registry challenges. 家庭血液透析的结果:登记挑战。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr126
Mark S MacGregor
{"title":"Outcomes on home haemodialysis: registry challenges.","authors":"Mark S MacGregor","doi":"10.1093/ndtplus/sfr126","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr126","url":null,"abstract":"<p><p>Health care policy is encouraging expansion of home haemodialysis, aiming to improve patient outcomes and reduce cost. However, most patient outcome data derive from retrospective observational studies, with all their inherent weaknesses. Conventional thrice weekly home haemodialysis delivers a 22-51% reduction in mortality, but why should that be? Frequent and/or nocturnal haemodialysis reduces mortality by 36-66%, with comparable outcomes to deceased donor kidney transplantation. Approaches which might improve the quality of future observational studies are discussed. Patient-relevant outcomes other than mortality are also discussed. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 Suppl 3","pages":"iii32-iii35"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33161913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A pseudo-dominant form of Gitelman's syndrome. 吉特尔曼综合征的一种伪显性形式。
NDT Plus Pub Date : 2011-12-01 Epub Date: 2011-08-22 DOI: 10.1093/ndtplus/sfr094
Renaud de La Faille, Marion Vallet, Annabelle Venisse, Valérie Nau, Carole Collet-Gaudillat, Pascal Houillier, Xavier Jeunemaitre, Rosa Vargas-Poussou
{"title":"A pseudo-dominant form of Gitelman's syndrome.","authors":"Renaud de La Faille,&nbsp;Marion Vallet,&nbsp;Annabelle Venisse,&nbsp;Valérie Nau,&nbsp;Carole Collet-Gaudillat,&nbsp;Pascal Houillier,&nbsp;Xavier Jeunemaitre,&nbsp;Rosa Vargas-Poussou","doi":"10.1093/ndtplus/sfr094","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr094","url":null,"abstract":"<p><p>Gitelman's syndrome is an autosomal recessive salt losing nephropathy caused by inactivated mutations of the SLC12A3 gene, encoding the NaCl cotransporter of the distal convoluted tubule. We report a French family with five affected members over two generations suggesting a dominant transmission. After SLC12A3 sequencing of seven individuals, four mutations were detected. Pseudo-dominant transmission was explained by the union of a compound heterozygous woman (two mutations on one allele and one mutation on the other) with a heterozygous healthy man. This study shows the importance of complete genetic analysis of families with unusual presentation. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"386-9"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33311850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Haemodialysis-induced syncope due to Chiari II malformation. 由Chiari II型畸形引起的血液透析性晕厥。
NDT Plus Pub Date : 2011-12-01 Epub Date: 2011-08-02 DOI: 10.1093/ndtplus/sfr095
Donal J Sexton, Kara M Vaughan, Carthage Moran, William D Plant, Michael R Clarkson, Joseph A Eustace
{"title":"Haemodialysis-induced syncope due to Chiari II malformation.","authors":"Donal J Sexton,&nbsp;Kara M Vaughan,&nbsp;Carthage Moran,&nbsp;William D Plant,&nbsp;Michael R Clarkson,&nbsp;Joseph A Eustace","doi":"10.1093/ndtplus/sfr095","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr095","url":null,"abstract":"<p><p>Spina bifida (SB) is associated with chronic kidney disease as a result of vesicoureteric reflux. A proportion of patients progress to end-stage kidney disease (ESKD). Haemodialysis (HD) is probably the most common modality in ESKD, as intra-abdominal malformations and previous surgery can make peritoneal dialysis more challenging. The Chiari malformations also frequently occur in these patients. We report a case of recurrent syncope induced by HD in a patient with SB and the Chiari II malformation. Sparse data exist on the complications of HD in this patient population and on the approach to the management of dialysis-induced syncope in these individuals. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"390-1"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33311851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A 19-year-old at 37 weeks gestation with an acute acetylsalicylic acid overdose. 19岁妊娠37周急性乙酰水杨酸过量。
NDT Plus Pub Date : 2011-12-01 Epub Date: 2011-09-16 DOI: 10.1093/ndtplus/sfr104
Huma Farid, Monica H Wojcik, Kenneth B Christopher
{"title":"A 19-year-old at 37 weeks gestation with an acute acetylsalicylic acid overdose.","authors":"Huma Farid,&nbsp;Monica H Wojcik,&nbsp;Kenneth B Christopher","doi":"10.1093/ndtplus/sfr104","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr104","url":null,"abstract":"<p><p>Acute salicylate overdose in pregnancy is potentially fatal for both the mother and fetus and presents a unique challenge in intensive care management. While suggested thresholds exist for hemodialysis in adults with toxic salicylate ingestion, it is unclear if these thresholds remain appropriate for the gravid patient, particularly given that medications such as acetylsalicylic acid may cross the placental barrier and accumulate in the fetal bloodstream. We describe a case of a gravid patient at ∼37 weeks gestational age with a self-reported acetylsalicylic acid ingestion of 32.5 g and review prior cases of both acute and chronic salicylate ingestion in pregnancy in order to determine the clinical precedent for hemodialysis in this situation. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"394-6"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33313789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Fibrillary glomerulonephritis: presenting as crescentic glomerulonephritis causing rapidly progressive renal failure. 原纤维性肾小球肾炎:表现为新月形肾小球肾炎，引起迅速进行性肾衰竭。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr146
Shalini Nilajgi, John Paul Killen, Richard Baer, Patricia Renaut, Murty Mantha
{"title":"Fibrillary glomerulonephritis: presenting as crescentic glomerulonephritis causing rapidly progressive renal failure.","authors":"Shalini Nilajgi,&nbsp;John Paul Killen,&nbsp;Richard Baer,&nbsp;Patricia Renaut,&nbsp;Murty Mantha","doi":"10.1093/ndtplus/sfr146","DOIUrl":"https://doi.org/10.1093/ndtplus/sfr146","url":null,"abstract":"<p><p>We report an unusual case of fibrillary glomerulonephritis (FGN) presenting as rapidly progressive renal failure and extensive crescent formation along with linear staining of capillary walls of the glomeruli on immunofluorescence, mimicking anti-glomerular basement membrane (anti-GBM) antibody-mediated disease. Laboratory results for circulating anti-GBM antibodies were negative. The subsequent electron microscopic findings were that of presence of electron-dense deposits in the glomerular mesangium and capillary walls, comprising of non-branching fibrils with an average diameter of 16 nm consistent with a diagnosis of FGN. This case illustrates the crucial role of electron microscopy in differential diagnosis of crescentic glomerulonephritis. </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"413-5"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ndtplus/sfr146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33313796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Glycated albumin is the preferred marker for assessing glycaemic control in advanced chronic kidney disease. 糖化白蛋白是评估晚期慢性肾病患者血糖控制情况的首选指标。
NDT Plus Pub Date : 2011-12-01 DOI: 10.1093/ndtplus/sfr140
Frederiek E Vos, John B Schollum, Robert J Walker
{"title":"Glycated albumin is the preferred marker for assessing glycaemic control in advanced chronic kidney disease.","authors":"Frederiek E Vos, John B Schollum, Robert J Walker","doi":"10.1093/ndtplus/sfr140","DOIUrl":"10.1093/ndtplus/sfr140","url":null,"abstract":"<p><p>Diabetic nephropathy is the most common aetiology of end-stage kidney disease (ESKD). Strict glycaemic control reduces the development and progression of diabetes-related complications, and there is evidence that improved metabolic control improves outcomes in diabetic subjects with advanced chronic kidney disease (CKD). Glycaemic control in people with kidney disease is complex. Changes in glucose and insulin homeostasis may occur as a consequence of loss of kidney function and dialysis. The reliability of measures of long-term glycaemic control is affected by CKD and the accuracy of glycated haemoglobin (HbA1c) in the setting of CKD and ESKD is questioned. Despite the altered character of diabetes in CKD, current guidelines for diabetes management are not specifically adjusted to this patient group. The validity of indicators of longer term glycaemic control has been the focus of increased recent research. This review discusses the current understanding of commonly used indicators of metabolic control (HbA1c, fructosamine, glycated albumin) in the setting of advanced CKD (Stages 4 and 5, glomerular filtration rate <30 mL/min/1.73m(2)). </p>","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"4 6","pages":"368-75"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/17/sfr140.PMC4421676.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33311847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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