Journal of nephrology
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Journal of nephrology · Aug 2015
Multicenter StudyClinical determinants of reduced physical activity in hemodialysis and peritoneal dialysis patients.
The phenotype associated to reduced physical activity (PA) in dialysis patients is poorly documented. We here evaluate weekly PA in two independent cohorts. ⋯ There is a high prevalence of sedentary behavior in dialysis patients. Better physical activity was consistently associated with younger age, lower presence of comorbidities and better nutritional status. Pedometers represent a simple and inexpensive tool to objectively evaluate physical activity in this patient population.
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Journal of nephrology · Jun 2015
Observational StudySix-year single-center survey on AKI requiring renal replacement therapy: epidemiology and health care organization aspects.
Evidence regarding hospital-based acute kidney injury (AKI) reveals a continuous increase in incidence over the years, at least in intensive care units (ICU). Fewer reports are available for non critically-ill patients admitted to general or specialist wards other than ICU (non-ICU). The consequence of greater incidence is an increase in therapies such as dialysis; but how the health care organization deals with this problem is not clearly known. ⋯ Over the 6-year period, the local healthcare organization had to dispense 80% more dialysis treatments/year in terms of total number and hours of treatment. One-fifth of surviving patients needed to continue dialysis after hospital discharge. Our data highlight the public health importance of AKI and the need for adequate resources for Nephrology.
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Journal of nephrology · Apr 2015
Randomized Controlled Trial Multicenter StudyAcute kidney injury after cardiac surgery: is minocycline protective?
Acute kidney injury (AKI) after cardiac bypass surgery (CABG) is common and carries a significant association with morbidity and mortality. Since minocycline therapy attenuates kidney injury in animal models of AKI, we tested its effects in patients undergoing CABG. ⋯ Minocycline did not protect against AKI post-CABG.
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Journal of nephrology · Apr 2015
Editorial ReviewRegional citrate anticoagulation for renal replacement therapies in patients with acute kidney injury: a position statement of the Work Group "Renal Replacement Therapies in Critically Ill Patients" of the Italian Society of Nephrology.
Patients with acute kidney injury (AKI) on renal replacement therapy (RRT) are at increased risk for bleeding but usually require anticoagulation of the extracorporeal circuit, a key prerequisite for delivery of an adequate RRT dose. To this end, many anti-hemostatic strategies have been proposed, unfractionated heparin--with all of its significant drawbacks and complications--being the most common method used so far. In this clinical context, regional citrate anticoagulation (RCA) could represent the most promising strategy, and it has been endorsed by recent guidelines on AKI. ⋯ To this purpose, the most relevant clinical studies and recent guidelines on AKI with special regard to anti-hemostatic strategies for RRT circuit maintenance have been reviewed and commented. Experts from the Working Group "Renal Replacement Therapies in Critically Ill Patients" of the Italian Society of Nephrology have prepared this position paper, which discusses the basic principles, advantages and drawbacks of RCA based on the available safety and efficacy data. Advice is given on how to use and monitor RCA in the different RRT modalities, in order to avoid complications while maximizing the delivery of the prescribed RRT dose.
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Journal of nephrology · Feb 2015
Randomized Controlled TrialDiuretic response to colloid and crystalloid fluid loading in critically ill patients.
In the critically ill patient, fluid loading is commonly done to stabilise hemodynamics and increase diuresis, whereas the absence of diuresis may predispose to harmful overloading. The goal of the current study was to evaluate the diuretic response and determinants thereof upon crystalloid and colloid fluid loading. ⋯ In critically ill patients with clinical hypovolemia, diuresis increases more during saline than colloid fluid loading, only partly dependent of a fall in plasma COP.