Nefrología : publicación oficial de la Sociedad Española Nefrologia
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Review Case Reports
[Heparin-induced thrombocytopenia in hemodialysis. Case report and review of the literature].
Thrombocytopenia is a potential complication of heparin therapy. There are two forms of heparin-induced thrombocytopenia (HIT). Type-I HIT is characterized by a mild decrease in platelet count that occurs within the first 2-4 days after heparin initiation. ⋯ The mechanism of thrombocytopenia appears to be due to a direct effect of heparin on platelet activation. The second form (type-II) is an immune-mediated disorder characterized by severe thrombocytopenia, which may include both arterial and venous thrombosis. We present a case of type-II HIT occurred in a hemodialysis patient resulting in acute pulmonary embolism and peripheral venous thrombosis, and review the literature.
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Multicenter Study
[A burden questionnaire for caregivers of peritoneal dialysis patients].
Despite the interest generated by the increasing number of studies that measure Quality of Life among patients and caregivers, few of these studies measure the caregivers burden in Peritoneal Dialysis (PD). ⋯ A questionnaire has been created to measure burden and repercussions on caregivers of peritoneal dialysis patients. It can already be applied, as requirements of both reliability and validity are fulfilled. This questionnaire can be a useful tool to prevent caregivers' burnout.
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The most common causes of acute renal failure in the intensive care units are severe sepsis and septic shock. Mortality reported in this kind of patients is about 70%. The pathophysiology of acute renal failure in severe sepsis includes systemic hypotension, direct renal vasoconstriction, infiltration of the kidney by inflammatory cells, renal ischemia, intraglomerular thrombosis and intratubular obstruction. ⋯ Nowadays, and due to the high incidence and mortality of this disease, is very important to generate more concise knowledge about the genesis and development of acute renal failure in the septic patient.
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Review a large experience in the placement of tunnelled catheters to assess the outcomes with twin catheter system as hemodialysis access. ⋯ Placement of tunnelled twin catheters system using real-time sonography technique can be performed with excellent technical success, safety and acceptable catheter performance and outcomes for effective hemodialysis.