Renal failure
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Comparative Study
Effects of prophylactic antibiotics before peritoneal dialysis catheter implantation on the clinical outcomes of peritoneal dialysis patients.
Peritoneal dialysis (PD) related infections, such as peritonitis, are still the main obstacle for the development of PD. Prophylactic antibiotic as one of the interventions to prevent early peritonitis was recommended to use before PD catheter insertion by International Society for Peritoneal Dialysis (ISPD) guidelines, In our hospital, however, since 2012, the prophylactic antibiotics for insertion of PD catheters were not allowed to use because of our hospital's regulation. In order to analyze the outcomes of PD patients without using prophylactic antibiotics before the PD catheter insertion, we compared the PD patients with or without prophylactic antibiotics before PD catheter insertion. ⋯ Our study does not show any beneficial effect of antibiotic prophylaxis in reducing the postoperative peritonitis.
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A few studies have shown that urinary kidney injury molecule-1 (uKIM-1) levels are increased in acute kidney injury (AKI); however, the correlation between uKIM-1 and histological tubular injury, which is considered to be the gold standard for evaluating renal damage and predicting prognosis, is still unclear. We performed this study to determine whether the predicted value of uKIM-1 is correlated with renal KIM-1 (tKIM-1) expression and tissue damage in AKI patients. ⋯ The uKIM-1 level corresponds with the severity of renal histological damage and can be a potential reliable predictor of adverse renal outcomes in ATI patients. Moreover, combining uKIM-1 and sKIM-1 can increase the sensitivity and specificity of the diagnosis of severe ATI.
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Background: Soluble transferrin receptor (sTfR) is a biomarker of erythropoiesis, which is often impaired in dialysis patients. The aim of our study was to evaluate sTfR levels in chronically dialyzed patients and assess potential determinants of its levels. Methods: We performed a cross-sectional study by evaluating 246 end-stage renal disease patients undergoing dialysis and 32 healthy controls. ⋯ In multiple linear regression analysis, ESA dose, RPI, serum iron, diabetes, and hepcidin levels were independently associated with sTfR levels in dialysis patients and, thus, with erythropoiesis. Conclusion: Our data suggest that, besides RPI and ESA dose, diabetes and hepcidin are closely related to erythropoiesis in dialysis patients. The influence of diabetes on sTfR levels deserves further investigation.
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Whether exercise can improve cardiovascular health in kidney transplant recipients (KTRs) is unclear. Therefore, we performed a systematic review of the effects of exercise on cardiovascular risk factors in this population setting. ⋯ Exercise intervention in KTRs improves arterial stiffness but does not consistently contribute to the modification of other CVD risk factors like hypertension, dyslipidemia, hyperglycemia, decreased kidney function and obesity. Exercise also improves exercise tolerance and QOL in KTRs.
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Observational Study
Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services.
Background: Frailty is an aging-associated state of increased vulnerability, which raises the risk of adverse outcomes. Chronic kidney disease is associated with higher prevalence of frailty. Our aim was to estimate frailty prevalence in a hemodialysis population and its influence on short-term outcomes. ⋯ The incidence ratio of visits to emergency services was 3216, 1735, and 1545 visits/1000 patient-years for each group (p < .001). Conclusions: Hemodialysis patients present high frailty prevalence. Frailty is associated with poor short-term outcomes and higher rates of mortality, visits to hospital emergency services, and hospitalization.