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1.
Niger J Clin Pract ; 23(11): 1542-1547, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33221779

RESUMO

Background: The relationships among serum Apelin, Asymmetric- dimethylarginine (ADMA), N-terminal probrain natriureticpeptide (NT-proBNP) levels, and blood pressures in dialysis patients are not well known. Materials and Methods: Age and sex matched 30 hemodialysis (HD), 30 peritoneal dialysis (PD) patients, and 20 healthy controls were recruited. Serum apelin-36, ADMA, NT-proBNP levels, and blood pressures of both patients and healthy controls were measured and compared. Results: Serum ADMA and Apelin levels in HD patients were significantly higher than in PD patients. In multiple regression analyses the predictors of higher serum apelin levels were higher BMI, higher ADMA and lower systolic blood pressure. The predictors of serum ADMA levels were being on HD. The predictors of serum NT-proBNP levels were lower serum albumin and higher systolic blood pressure. Conclusion: Being on HD is a predictor of high ADMA levels. HD might be less effective on ADMA removal than PD. It seems that higher serum apelin levels related with lower sytolic blood pressure levels, whereas higher NT-proBNP levels related with higher sytolic blood pressure levels indicating potential roles as independent prognostic factors for systolic hypertension in dialysis patients.


Assuntos
Apelina/sangue , Arginina/análogos & derivados , Pressão Sanguínea/fisiologia , Falência Renal Crônica/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Adulto , Idoso , Arginina/sangue , Biomarcadores/sangue , Determinação da Pressão Arterial , Feminino , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Diálise Peritoneal , Diálise Renal
2.
BMC Nephrol ; 21(1): 470, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33172405

RESUMO

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has substantially impacted the provision of medical services. During the pandemic, many medical services, including facilities providing care to patients with end stage renal disease faced challenges in safeguarding patients and staff while providing clinical care. This study aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance hemodialysis to understand the research gaps and propose recommendations for future research. METHODS: Using the terms: "Dialysis" OR "RRT" OR "Renal replacement therapy" AND "SARS-COV-2" OR "COVID-19" OR "novel coronavirus" OR "2019-nCov", we performed a multi-step systematic search of the literature in the English language in Pubmed, Scopus, Embase, and Web of Science published from December 1, 2019, to May 13, 2020. Two authors separately screened the title and abstracts of the documents and ruled out irrelevant articles. We obtained a full report of the papers that met our inclusion criteria and screened the full texts. We conducted a descriptive analysis of the characteristics of the included articles and performed a narrative synthesis of the results. We conducted this scoping review in accordance with the PRISMA-ScR Checklist. RESULTS: We included 22 articles in this scoping review. Perspectives (n = 9), editorials (n = 4), and case series (n = 5) were the most common types of articles. Most articles were from Italy and the United States. Seventeen (77.3%) of the articles focused on the topic of recommendation for outpatient hemodialysis units. While many of the recommendations overlapped in several articles, there were also many unique recommendations. CONCLUSIONS: most of the articles are based on single-center experience, which spontaneously developed best practices. Many of these practices have formed the basis for policies and guidelines that will guide future prevention of infection and management of patients with End Stage Renal Disease (ESRD) and COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Falência Renal Crônica/terapia , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Diálise Renal/normas , Adulto , Temperatura Corporal , Criança , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Amigos , Pessoal de Saúde/educação , Hemodiálise no Domicílio , Humanos , Pandemias/prevenção & controle , Educação de Pacientes como Assunto , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Quarentena/métodos , Terapia de Substituição Renal , Avaliação de Sintomas
3.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(10): 1203-1207, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33198864

RESUMO

OBJECTIVE: To analyze the long-term prognosis of undergoing drug-eluting stent implantation (DES) or coronary artery bypass grafting (CABG) in patients with unprotected left main (ULM) coronary artery disease complicated with chronic renal failure (CRF). METHODS: Patients with UML coronary artery disease complicated with CRF admitted to the department of cardiology intensive care unit (ICU) and cardiac surgery ICU of Beijing Anzhen Hospital Affiliated to Capital Medical University were enrolled. According to the estimated glomerular filtration rate (eGFR), the patients were divided into two layers, and the clinical characteristics of DES patients and CABG patients were analyzed. Log-Rank method and Cox regression were used to analyze the coronary artery disease and long-term clinical prognosis of patients with two surgical strategies. RESULTS: A total of 353 patients were enrolled, including 150 patients with eGFR < 45 mL×min-1×1.73 m-2 (DES 67 cases, CABG 83 cases), eGFR 45-59 mL×min-1×1.73 m-2 in 203 cases (DES 80 cases, CABG 123 cases). In terms of demography and clinical history, compared with CABG group, DES group had lower proportion of complete revascularization and lower proportion of chronic totalocclusion (CTO) and multi vessel disease in each eGFR level. All patients were followed up for an average of (30.74±15.05) months. Log-Rank analysis showed that there was no significant difference in the incidence of major cardiovascular and cerebrovascular adverse events (MACCE), all-cause death, cardiogenic death and stroke between DES group and CABG group in each eGFR level. In eGFR 45-59 mL×min-1×1.73 m-2, the proportion of target vessel revascularization (TVR) in DES group was higher than that in CABG group (18.8% vs. 0.8%, P < 0.01); in eGFR < 45 mL×min-1×1.73 m-2, the incidence of myocardial infarction in DES group was higher than that in CABG group (10.4% vs. 1.2%, P < 0.05). Cox analysis showed that after adjusting for age, gender, history of hypertension, diabetes, left ventricular ejection fraction, smoking history, previous cerebrovascular disease, complete revascularization, multiple vessel disease and CTO, TVR proportion in DES group was still higher than that in CABG group in eGFR 45-59 mL×min-1×1.73 m-2 [hazard ratio (HR) = 46.463, 95% confidence interval (95%CI) was 4.558-473.693, P = 0.001]; in eGFR < 45 mL×min-1×1.73 m-2, the incidence of myocardial infarction in DES group was still higher than that in CABG group (HR = 14.098, 95%CI was 1.123-176.988, P = 0.040), there was no difference in TVR proportion between the two methods. CONCLUSIONS: eGFR < 45 mL×min-1×1.73 m-2 is an independent risk factor for DES in ULM patients. DES is safe and effective for ULM patients with CRF, but for patients with more severe CRF (eGFR < 45 mL×min-1×1.73 m-2), there was more myocardial infarction in DES group than that in CABG group, which should be carefully selected.


Assuntos
Doença da Artéria Coronariana , Stents Farmacológicos , Falência Renal Crônica , Intervenção Coronária Percutânea , Ponte de Artéria Coronária , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/cirurgia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Prognóstico , Volume Sistólico , Resultado do Tratamento , Função Ventricular Esquerda
5.
Rev Med Liege ; 75(S1): 41-47, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33211421

RESUMO

COVID-19 has been the center of global attention and concern for the last months. Patients undergoing dialysis and especially those treated at the hospital are likely to be infected, due to their mandatory presence at the hospital several times a week and due to their intrinsic fragility in regard of chronic kidney disease, often an older age, and the presence of many associated comorbidities. Thereby, patients with chonic kidney disease treated by haemodialysis have higher odds of a more severe COVID-19 infection with a high mortality rate. Prevention is thus a high priority for these patients.


Assuntos
Infecções por Coronavirus , Falência Renal Crônica , Pandemias , Pneumonia Viral , Diálise Renal , Idoso , Betacoronavirus , Humanos , Falência Renal Crônica/terapia
6.
Biomedica ; 40(Supl. 2): 50-67, 2020 10 30.
Artigo em Espanhol | MEDLINE | ID: mdl-33152188

RESUMO

At the end of 2019, in Wuhan, China, the outbreak of a new coronavirus began and quickly spread throughout the world infecting and claiming thousands of lives. To date, certain comorbidities are known to be risk factors for unsatisfactory disease outcomes, but little has been reported regarding hemodialysis patients despite being a population at high risk of infection, complications, and death. Here we describe the clinical course, clinical manifestations and complications of COVID-19 in seven patients on permanent hemodialysis. We also make recommendations for the management of patients with chronic kidney disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Falência Renal Crônica/complicações , Pneumonia Viral/complicações , Diálise Renal , Adulto , Bacteriemia/complicações , Técnicas de Laboratório Clínico , Colômbia/epidemiologia , Terapia Combinada , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Diabetes Mellitus Tipo 2/complicações , Suscetibilidade a Doenças , Feminino , Humanos , Hipertensão/complicações , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Diálise Renal/métodos , Fatores Socioeconômicos , Infecções Estafilocócicas/complicações
8.
Wiad Lek ; 73(9 cz. 2): 2068-2072, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33148861

RESUMO

Cancer in dialysis patients is a common problem and is one of the most common reasons of mordibity and mortality in developed countries. An impaired renal function leads to the accumulation in the blood products of nitrogen transformation, which negatively affect organ function, especially the immune system. The Standardized Cancer Incidence is higher in patients with end-stage kidney failure than in the general population and reaches 1,18-1,42. The cancer risk is three times higher in dialysis patients over age 65 years and is more common among hemodialysis than peritoneal dialysis patients. The most common type of cancer occurring in this group of patients is urinary tract cancer which often develops on the basis of acquired cysts and in patients previously treated with cyclophosphamide. Nonetheless, patients with kidney problems are not regularly tested for these diseases and the only group that is screened for cancer are patients tested for kidney transplantation. Some problems in this topic are briefly presented in this article.


Assuntos
Nefropatias , Falência Renal Crônica , Transplante de Rim , Neoplasias , Diálise Peritoneal , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Neoplasias/complicações , Neoplasias/epidemiologia , Diálise Renal/efeitos adversos
9.
Niger J Clin Pract ; 23(10): 1375-1380, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047693

RESUMO

Background: Chronic renal failure can cause anxiety, stress, and decrease the life quality. Therefore, this may lead to sleep bruxism, temporomandibular disorders (TMDs), and related health problems. Aim: This study evaluated the incidence of sleep bruxism and TMDs in patients undergoing hemodialysis and compared it with that of healthy individuals. Subjects and Methods: A total of 137 patients (68 hemodialysis patients and 69 healthy individuals) participated in this study. They all filled out a form about age, sex, educational status, marital status, sleep disorders, sleep bruxism, temporomandibular problems, and ice/hard things chewing habits. We performed a muscle examination and used a questionnaire to evaluate the causes of TMD. Parafunctional habits and emotional stress status were examined with these YES/NO question forms. Teeth attritions and six common symptoms (limited mouth opening, deviation/deflexion, clicking, muscle sensitivity, pain, and presence of linea alba) of TMDs and sleep bruxism were evaluated via a clinical examination. The level of significance was determined at P < 0.05. Results: Parafunctional habits such as sleep bruxism (55.1%) (P = 0.010), emotional stress (69.1%) (P = 0.006), sleep disorders (47,1%) (P = 0.000), unilateral chewing (54.4%) (P = 0.040), gum-chewing (45.6%) (P = 0.000), ice chewing (23.5%) (P = 0,000), and hard things biting habits (7.4%) (P = 0.028) were statistically higher in the hemodialysis group than the control group. Deviation/deflexion and presence of linea alba were more frequent in the hemodialysis group than the control group. Conclusions: It can be concluded that hemodialysis patients are more sensitive to TMDs, sleep bruxism and related dental health problems than healthy individuals.


Assuntos
Falência Renal Crônica/complicações , Bruxismo do Sono/epidemiologia , Transtornos da Articulação Temporomandibular/epidemiologia , Adulto , Feminino , Humanos , Incidência , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Diálise Renal/efeitos adversos , Bruxismo do Sono/complicações , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações , Turquia/epidemiologia , Adulto Jovem
10.
Mymensingh Med J ; 29(4): 793-799, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33116079

RESUMO

Prevalence of heart failure (HF) among end stage renal disease (ESRD) patients is high and HF remains the main cardiovascular co-morbidity at dialysis initiation. There is paucity of data comparing change of NYHA class, improvement of ejection fraction (EF) and major cardiac events in ESRD patients with concomitant heart failure on haemodialysis to those on peritoneal dialysis. The objective of the study was to compare the cardiac outcome of continuous ambulatory peritoneal dialysis (CAPD) & hemodialysis (HD) in chronic kidney disease 5 (CKD5) patients with HF. This prospective observational study was carried out from March 2018 to February 2019 in seventy CKD 5 patients with HF who opted for CAPD or HD. Seven patients dropped out during the follow-up & sixty three patients (CAPD=31; HD=32) were followed up for symptomatic assessment of cardiac status in terms of NYHA class as well as echocardiography and serum haemoglobin at baseline and at 3rd & 6th month. Major cardiovascular events like non fatal MI, non fatal stroke & death duo to cardiovascular diseases and co-morbidities were recorded during the study period. Statistical analysis was done using SPSS 22.0. Mean age was 53.33±6.38 and 54.23±10.15 years & male to female ratio was 1.81:1 and 1.46:1 in CAPD and HD groups respectively. Both NYHA class & left ventricular ejection fraction (EF) were significantly increased after six months compared to baseline in each group and significantly more increased in the CAPD group than the HD group. Left ventricular internal diameter in diastole (LVIDd) was reduced significantly after six months compared to baseline in both groups and there was no significant difference in LVIDd reduction between the CAPD and HD groups. Major cardiovascular events were found to occur more frequently in the HD group. According to NYHA functional class, echocardiographic findings and major cardiovascular events during six months, improvement of cardiac function in CKD 5 patients with HF was better on CAPD in comparison to HD.


Assuntos
Insuficiência Cardíaca , Falência Renal Crônica , Diálise Peritoneal Ambulatorial Contínua , Insuficiência Renal Crônica , Feminino , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Diálise Renal , Volume Sistólico , Função Ventricular Esquerda
11.
BMC Nephrol ; 21(1): 449, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33109103

RESUMO

The pandemic of coronavirus disease 2019 (CoVID-19) has been an unprecedented period. The disease afflicts multiple organ systems, with acute kidney injury (AKI) a major complication in seriously ill patients. The incidence of AKI in patients with CoVID-19 is variable across numerous international studies, but the high incidence of AKI and its associated worse outcomes in the critical care setting are a consistent finding. A multitude of patterns and mechanisms of AKI have been elucidated, and novel strategies to address shortage of renal replacement therapy equipment have been implemented. The disease also has had consequences on longitudinal management of patients with chronic kidney disease and end stage kidney disease. Kidney transplant recipients may be especially susceptible to CoVID-19 as a result of immunosuppression, with preliminary studies demonstrating high mortality rates. Increased surveillance of disease with low threshold for testing and adjustment of immunosuppression regimen during acute periods of illness have been recommended.


Assuntos
Lesão Renal Aguda/etiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Falência Renal Crônica/terapia , Transplante de Rim , Pneumonia Viral/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/terapia , Fatores Etários , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Cuidados Críticos , Disparidades em Assistência à Saúde , Humanos , Imunossupressão/efeitos adversos , Imunossupressão/métodos , Incidência , Falência Renal Crônica/complicações , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Transplante de Rim/mortalidade , Pandemias , Peptidil Dipeptidase A , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Insuficiência Renal Crônica/complicações , Terapia de Substituição Renal/instrumentação , Fatores de Risco , Fatores Sexuais , Transplantados , Populações Vulneráveis
12.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026199

RESUMO

Lombardy was violently hit by Covid-19 between the end of February and the beginning of March 2020. On 09.05.2020 there were 81225 total registered Covid-19+ cases (8051 / million inhabitants) with 14924 deaths (1479 deaths / million inhabitants). The province of Cremona presented a higher number of Covid-19+ cases and a worse relative mortality than the already high regional average. Patients on regular hemodialysis treatment present a high risk of infection due to the co-pathologies present, while healthcare workers may represent a risk for themselves and for the patients, due to the treatment environment and the close contact with them. All patients and healthcare workers of the Dialysis Center in Crema were evaluated (oro-pharyngeal swab for viral RNA research, qualitative anti-Covid-19 antibodies, quantitative IgG antibodies, co-pathologies), regardless of the symptomatology, over a 60-day period. Hemodialysis patients have a risk of infection that is 12.7 times that of the local population, while healthcare workers outperform the patients for Covid-positivity (30.3% vs 21.6%). Lethality in infected patients is high (31% of Covid-19+ subjects), while it is zero among healthcare professionals. The antibody response (qualitative and quantitative) in Covid-19+ patients is adequate, when compared to that of Covid-19+ healthcare staff. In our Center, the most critical phase lasted about 45 days but, thanks to the measures taken, it was possible to make the dialysis area Covid-free, as it remains after 128 days.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Falência Renal Crônica/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Diálise Renal , Adulto , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Emergências , Feminino , Pessoal de Saúde , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Itália/epidemiologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Orofaringe/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Risco , Taxa de Sobrevida
13.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026200

RESUMO

The epidemic wave that hit Italy from February 21st, 2020, when the Italian National Institute of Health confirmed the first case of SARS­CoV­2 infection, led to a rapid and efficient reorganization of Dialysis Centers' activities, in order to contain large-scale spread of disease in this clinical setting. We herein report the experience of the Hemodialysis Unit of Parma University Hospital (Azienda Ospedaliero-Universitaria, Parma, Italy) and the Dialysis Centers of Parma territory, in the period from March 1st, 2020 to June 15, 2020. Among patients undergoing chronic haemodialysis, 37/283 (13%) had positive swabs for SARS­CoV­2, 9/37 (24%) died because of COVID-19. Twenty-three patients required hospitalization, while the remaining were managed at home. The primary measures applied to contain the infection were: the strengthening of personal protective equipment use by doctors and nurses, early identification of infected subjects by performing oro-pharyngeal swabs in every patient and in the healthcare personnel, the institution of a triage protocol when entering Dialysis Room, and finally the institution of two separate sections, managed by different doctors and dialysis nurses, to physically separate affected from unaffected patients and to manage "grey" patients. Our experience highlights the importance and effectiveness of afore-mentioned measures in order to contain the spread of the virus; moreover, we observed a higher lethality rate of COVID-19 in dialysis patients as compared to the general population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Unidades Hospitalares de Hemodiálise/organização & administração , Reestruturação Hospitalar , Falência Renal Crônica/terapia , Pandemias , Pneumonia Viral/epidemiologia , Diálise Renal , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Diagnóstico Precoce , Emergências , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Hemodiálise no Domicílio/estatística & dados numéricos , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Itália/epidemiologia , Falência Renal Crônica/epidemiologia , Nasofaringe/virologia , Pandemias/prevenção & controle , Isolamento de Pacientes , Diálise Peritoneal , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Utilização de Procedimentos e Técnicas , Triagem
14.
BMJ Case Rep ; 13(10)2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028570

RESUMO

In March 2020, a 74-year-old man affected by end-stage renal disease and on peritoneal dialysis was referred to an emergency room in Modena, Northern Italy, due to fever and respiratory symptoms. After ruling out COVID-19 infection, a diagnosis of chronic obstructive pulmonary disease exacerbation was confirmed and he was thus transferred to the nephrology division. Physical examination and blood tests revealed a positive fluid balance and insufficient correction of the uraemic syndrome, although peritoneal dialysis prescription was maximised. After discussion with the patient and his family, the staff decided to start hybrid dialysis, consisting of once-weekly in-hospital haemodialysis and home peritoneal dialysis for the remaining days. He was discharged at the end of the antibiotic course, after an internal jugular vein central venous catheter placement and the first haemodialysis session. This strategy allowed improvement of depuration parameters and avoidance of frequent access to the hospital, which is crucial in limiting exposure to SARS-CoV-2 in an endemic setting.


Assuntos
Infecções por Coronavirus , Falência Renal Crônica , Pandemias , Diálise Peritoneal/métodos , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Diálise Renal/métodos , Idoso , Antibacterianos/administração & dosagem , Betacoronavirus , Terapia Combinada/métodos , Terapia Combinada/tendências , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Diagnóstico Diferencial , Unidades Hospitalares de Hemodiálise , Humanos , Controle de Infecções/métodos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Exacerbação dos Sintomas
16.
Rev Assoc Med Bras (1992) ; 66(9): 1229-1234, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027450

RESUMO

OBJECTIVE: To evaluate the effects of hemodialysis, peritoneal dialysis, and renal transplantation on the quality of life of patients with end-stage renal disease (ESRD) and analyze the influencing factors. METHODS: A total of 162 ESRD patients who received maintenance hemodialysis, continuous ambulatory peritoneal dialysis, and renal transplantation from February 2017 to March 2018 in our hospital were divided into a hemodialysis group, a peritoneal dialysis group, and a renal transplantation group. The baseline clinical data, serum indices, as well as environmental factors such as education level, marital status, work, residential pattern, household income, and expenditure were recorded. The quality of life was assessed using the short-form 36-item (SF-36) scale reflecting the Physical Component Summary (PCS) and the Mental Component Summary (MCS). One-way analysis of variance and logistic stepwise multiple regression analysis were performed to analyze the factors influencing the quality of life. RESULTS: The renal transplantation group had the highest average scores for all dimensions of the SF-36 scale. The PCS and MCS scores of this group were higher than those of the hemodialysis and peritoneal dialysis groups. The peritoneal dialysis group had higher scores for physical functioning, physical role, bodily pain, general health, mental health, PCS, and MCS than those of the hemodialysis group. Age, HGB, GLU, and ALP were the main factors influencing PCS. Age, education level, residential pattern, medication expenditure, and monthly per capita income mainly affected MCS. CONCLUSION: In terms of quality of life, renal transplantation is superior to peritoneal dialysis and hemodialysis.


Assuntos
Falência Renal Crônica , Transplante de Rim , Diálise Peritoneal , Humanos , Falência Renal Crônica/terapia , Qualidade de Vida , Diálise Renal
17.
BMC Nephrol ; 21(1): 419, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004002

RESUMO

BACKGROUND: Infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally. Preliminary reports suggest a high incidence of infection and mortality with SARS-CoV-2 in patients receiving kidney replacement therapy (KRT). The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing KRT in Scotland. METHODS: Study design was an observational cohort study. Data were linked between the Scottish Renal Registry, Health Protection Scotland and the Scottish Intensive Care Society Audit Group national data sets using a unique patient identifier (Community Health Index (CHI)) for each individual by the Public Health and Intelligence unit of Public Health, Scotland. Descriptive statistics and survival analyses were performed. RESULTS: During the period 1st March 2020 to 31st May 2020, 110 patients receiving KRT tested positive for SARS-CoV-2 amounting to 2% of the prevalent KRT population. Of those affected, 86 were receiving haemodialysis or peritoneal dialysis and 24 had a renal transplant. Patients who tested positive were older and more likely to reside in more deprived postcodes. Mortality was high at 26.7% in the dialysis patients and 29.2% in the transplant patients. CONCLUSION: The rate of detected SARS-CoV-2 in people receiving KRT in Scotland was relatively low but with a high mortality for those demonstrating infection. Although impossible to confirm, it appears that the measures taken within dialysis units coupled with the national shielding policy, have been effective in protecting this population from infection.


Assuntos
Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus , Falência Renal Crônica , Transplante de Rim/estatística & dados numéricos , Pandemias , Pneumonia Viral , Terapia de Substituição Renal , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/cirurgia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Mortalidade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Sistema de Registros/estatística & dados numéricos , Terapia de Substituição Renal/métodos , Terapia de Substituição Renal/estatística & dados numéricos , Escócia/epidemiologia
18.
PLoS One ; 15(10): e0241263, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095841

RESUMO

Kidney disease is a recognised risk factor for poor COVID-19 outcomes. Up to 30 June 2020, the UK Renal Registry (UKRR) collected data for 2,385 in-centre haemodialysis (ICHD) patients with COVID-19 in England and Wales. Overall unadjusted survival at 1 week after date of positive COVID-19 test was 87.5% (95% CI 86.1-88.8%); mortality increased with age, treatment vintage and there was borderline evidence of Asian ethnicity (HR 1.16, 95% CI 0.94-1.44) being associated with higher mortality. Compared to the general population, the relative risk of mortality for ICHD patients with COVID-19 was 45.4 and highest in younger adults. This retrospective cohort study based on UKRR data supports efforts to protect this vulnerable patient group.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Sistema de Registros , Diálise Renal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/virologia , Análise de Dados , Inglaterra/epidemiologia , Feminino , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/etnologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , País de Gales/epidemiologia , Adulto Jovem
19.
Vasc Health Risk Manag ; 16: 419-427, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116552

RESUMO

Purpose: Central venous lesions (CVLs) can adversely affect hemodialysis access maturation and maintenance, which in turn worsen patient morbidity and access circuit patency. In this study, we assessed several clinical variables, patient characteristics, and clinical consequences of symptomatic central vein stenosis and obstruction in patients who underwent renal replacement therapy in the form of hemodialysis. Patients and Methods: The medical records of all hemodialysis patients with clinically symptomatic CVLs who underwent digital subtraction angiography treatment at King Abdullah University Hospital between January 2017 and December 2019 were retrieved. Patient characteristics and the clinical and anatomical features of CVLs were analyzed retrospectively. Pearson's chi-square tests of association were used to identify and assess relationships between patient characteristics and CVLs. Results: The study cohort comprised 66 patients with end-stage renal disease who developed symptomatic central vein stenosis. Of the 66 patients, 56.1% were men, and their mean age was approximately 52 years. Most (62.1%) of the patients were determined to have a history of central catheter insertion into the jugular vein. Hypertension was the most common comorbidity (78.8%, p<0.001), followed by type 2 diabetes mellitus (47.0 %, p<0.01). The incidence of stenosis was found to be significantly higher in the brachiocephalic vein than in other central veins (43.9%, p<0.001). A repeated central catheter insertion in a patient was predictive of central venous occlusion (p<0.05). Stenotic lesions were found to be associated with a significantly higher success rate than occlusive lesions (91.2%, p<0.01). Conclusion: Multiple central venous catheters (CVCs) are found to be associated with occlusive CVLs and unfavorable recanalization outcomes. Multiple CVC should be avoided by creating a permanent vascular access in a timely fashion for patients with chronic kidney disease and by avoiding the ipsilateral insertion of CVC and AVF.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Cateterismo Venoso Central/efeitos adversos , Procedimentos Endovasculares , Falência Renal Crônica/terapia , Diálise Renal , Doenças Vasculares/terapia , Veias , Adulto , Idoso , Comorbidade , Constrição Patológica , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Incidência , Jordânia/epidemiologia , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/epidemiologia , Doenças Vasculares/fisiopatologia , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem , Veias/fisiopatologia
20.
Medicine (Baltimore) ; 99(44): e23002, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126381

RESUMO

BACKGROUND: Chronic renal failure (CRF) is a common kidney disease characterized by a slow and progressive decline in kidney function. Clinical practice suggests that traditional Chinese medicinal enemas have a therapeutic effect on CRF. To assess the therapeutic efficacy and safety of traditional Chinese medicinal enemas in treating CRF, we created a protocol for a systematic review to inform future clinical applications. METHODS: We completed a literature search of all clinical randomized controlled trials evaluating traditional Chinese medicinal enemas on CRF in the following five English and four Chinese databases completed before August 2020: Medline, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library database, Chinese National Knowledge Infrastructure (CNKI), WANFANE Database, Chinese Scientific and Technological Periodical Database (VIP) and Chinese Biomedical Database (CBM). The primary outcomes evaluated blood urea nitrogen levels, uric acid levels, endogenous creatinine clearance rate, and serum creatinine, and the secondary outcomes included clinical efficacy and adverse effects of treatment. Two independent researchers performed data extraction and quality assessment. RevMan5.3 software was used to assess data quality and bias. This protocol was conducted according to the Preferred Reporting Item for Systematic Review and Meta-analysis Protocol (PRISMA-P) statement. RESULTS: This study will provide a rational synthesis of current evidence for traditional Chinese medicinal enemas for the treatment of CRF. CONCLUSION: This study presents evidence on whether traditional Chinese medicinal enemas are an effective and safe intervention for CRF patients. REGISTRATION NUMBER: INPLASY202080052.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Falência Renal Crônica/terapia , Administração Retal , Medicamentos de Ervas Chinesas/administração & dosagem , Humanos , Projetos de Pesquisa
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