Sepsis ESRD

INTRODUCTION: In view of ever-increasing end-stage renal disease (ESRD) population but inadequate availability of suitable donors, ABO-incompatible (ABOi) transplantation can be an important void filler. However, at present, ABOi transplantation is limited to a few centers in India and there is a lack of adequate experience and expertise to guide this program to other centers in the country. METHODS: Data of all the ABOi transplants performed from 2012 to 2021 in a tertiary care hospital was retrospectively analyzed...

OBJECTIVE: Serum creatinine is a byproduct of muscle metabolism, and low creatinine is postulated to be associated with diminished muscle mass. This study examined the association between low pre-operative serum creatinine and post-operative outcomes. METHODS: This retrospective cohort study utilized the 2014-2021 National Surgical Quality Improvement Program to identify patients undergoing surgery with gynecologic oncologists. Patients with missing pre-operative creatinine, end-stage renal disease, sepsis, septic shock, dialysis, or pregnancy were excluded...

BACKGROUND: pRIFLE (Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease), KDIGO (Kidney Disease Improving Global Outcomes) and pROCK (Pediatric Reference Change Value Optimized for AKI) are diagnostic criteria used for acute kidney injury (AKI) incidence evaluation. The aim of this study was to explore the diagnostic consistency, incidence and mortality rate, clinical signs, and influencing factors of renal injury related to sepsis in children diagnosed by three different AKI diagnostic criteria, and then evaluate which one was more valuable...

Acute kidney injury (AKI) is a common clinical syndrome characterized by a rapid deterioration in renal function, manifested by a significant increase in creatinine and a sharp decrease in urine output. The incidence of morbidity and mortality associated with AKI is on the rise, with most patients progressing to chronic kidney disease or end-stage renal disease. Treatment options for patients with AKI remain limited. Circular RNA (circRNA) is a wide and diverse class of non-coding RNAs that are present in a variety of organisms and are involved in gene expression regulation...

Large granular lymphocytic (LGL) leukemia is a rare chronic lymphoproliferative disorder originating from natural killer cells or T lymphocytes. In this report, we present the case of a 66-year-old female initially treated for sepsis, with   methicillin-sensitive Staphylococcus aureus  identified on initial blood culture prompting intravenous (IV) antibiotic therapy. The patient met systemic inflammatory response syndrome criteria upon admission due to severe neutropenia. Persistent fever led to neurological symptoms, and imaging revealed lung abnormalities along with chronic changes on the CT scan of the head...

BACKGROUND: Despite multimodal therapy, 5-year overall survival for locally advanced head and neck squamous cell carcinoma (HNSCC) is about 50%. We assessed the addition of pembrolizumab to concurrent chemoradiotherapy for locally advanced HNSCC. METHODS: In the randomised, double-blind, phase 3 KEYNOTE-412 trial, participants with newly diagnosed, high-risk, unresected locally advanced HNSCC from 130 medical centres globally were randomly assigned (1:1) to pembrolizumab (200 mg) plus chemoradiotherapy or placebo plus chemoradiotherapy...

Penile calciphylaxis is a rare presentation of calcific uremic arteriolopathy and can be a life-threatening condition usually seen in patients with end-stage renal failure with hemodialysis. The clear etiopathogenesis of calciphylaxis is not fully understood, but it is postulated to be characterized by the accumulation of calcium in the microvessels of adipose tissue and skin, which leads to ischemia and necrosis, causing painful ulcerations, and could potentially be complicated by sepsis and mortality...

BACKGROUND: This study aims to establish the significance of social determinants of health and prevalent co-morbidities on multiple indicators for quality of care in patients admitted to the Burn and Surgical Intensive Care Unit (ICU). METHODS: We performed a retrospective analysis of population group data for patients admitted at the Burn and Surgical ICU from January 1, 2016, to November 18, 2019. The primary outcomes were length of hospital stay (LOS), mortality, 30-day readmission, and hospital charges...

IMPORTANCE: Dialysis patient care technicians (PCTs) play a critical role in US in-center hemodialysis (HD) care, but little is known about the association of PCT staffing with patient outcomes at US HD facilities. OBJECTIVE: To estimate the associations of in-center HD patient outcomes with facility-level PCT staffing. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study, with data analysis performed from March 2023 to January 2024...

Posterior urethral valve (PUV) is a common cause of obstructive uropathy in children, leading to renal failure and frequently associated with vesicoureteral reflux (VUR), which can rapidly progress to end-stage renal disease (ESRD). We describe a rare presentation of high-grade VUR opacifying the renal pyramids in a 5-month-old child with sepsis and renal failure.

A 58-year-old woman with poorly controlled diabetes, peripheral vascular disease, and end-stage renal disease requiring hemodialysis was referred for 18F-FDG PET/CT to evaluate for source of sepsis. She had history of prior left forefoot and right second toe amputation, as well as left lower-limb dry gangrene for which she declined surgical management. We present a case of a nonamputated lower limb demonstrating regions of absolute photopenia, consistent with dry gangrene.

Managing sepsis and fluid resuscitation in patients with chronic kidney disease or end-stage renal disease is challenging for health care providers. Nurses are essential for early identification and treatment of these patients. Nurse education on assessing perfusion and implementing 3-hour bundled care can improve mortality rates in patients with sepsis. In this scoping review, initial screening identified 1176 articles published from 2015 through 2023 in the National Library of Medicine database; 29 articles were included in the literature summary and evidence synthesis...

AIM: Acute kidney injury (AKI) worsens the outcome in a significant number of hospitalized patients. Risk models mainly address cardiac surgery, while significantly less attention is paid to AKI after major abdominal surgery (MAS). This study aims to evaluate the incidence, along with risk factors, and intrahospital outcomes of AKI after MAS. MATERIAL AND METHODS: Our retrospective study included 200 adult patients treated with MAS (in the same institution). Exclusion criteria were obstructive nephropathy, contrast-induced nephropathy, and dialysis dependence whether due to end-stage renal disease (ESRD) or AKI before MAS...

INTRODUCTION: The main stages of flexible ureteroscopy in patients with renal stones are usually performed under X-ray guidance. Long-term exposure of ionizing radiation can have negative effects on the patients with nephrolithiasis and the operating team. AIM: To study the results of retrograde intrarenal surgery (RIRS) without fluoroscopic guidance. MATERIALS AND METHODS: The results of flexible ureteroscopy (fURS) without X-ray-guidance in 76 patients were analyzed...

Rare and sometimes fatal, spontaneous hepatic rupture (SHR) is frequently documented in conjunction with various benign and malignant hepatic tumors, peliosis hepatis (PH), amyloidosis, and polyarteritis nodosa. PH is a rare disease characterized by the presence of sinusoidal dilation and blood-filled cysts throughout the hepatic parenchyma. Handling and identifying this condition can be challenging, particularly in the absence of a history of liver cirrhosis or a tumor. The present case involves a 61-year-old male with a SHR and PH, accompanied by a significant history of end-stage renal disease (ESRD) over the past year...

BACKGROUND Liver transplantation is a life-saving intervention for patients with a diagnosis of acute liver failure or end-stage liver disease. Despite advances in surgical techniques and immunosuppressive therapies, primary nonfunction remains a concern, often necessitating retransplantation. In these scenarios, the anhepatic state, achieved through total hepatectomy with a temporary portacaval shunt, serves as a bridge to retransplantation. However, the challenge lies in the uncertain survival period and several potential complications associated with this procedure...

Calcific uremic arteriolopathy, or calciphylaxis, is a highly morbid, life-threatening syndrome of microvascular calcification leading to progressive skin necrosis. It affects 1-4% of the population with end-stage renal disease (ESRD) and is rarely seen in other conditions. The one-year mortality rate is 80% for patients with ulcerations. There is no evidence-based treatment, and the response to therapy is poor; thus, it creates a serious therapeutic challenge for clinicians. Our aim is to discuss a diagnostic approach and management of calciphylaxis and to raise awareness about this condition among the medical community...

BACKGROUND: Intracerebral hemorrhage (ICH) carries significant morbidity and mortality. Previous single-center retrospective analysis suggests that end-stage renal disease (ESRD) is a risk factor for severe ICH and worse outcomes. This investigation aims to examine the impact of ESRD on ICH severity, complications, and outcomes using a multicenter national database. METHODS: The International Classification of Disease, Ninth and Tenth Revision Clinical Modification codes were used to query the National Inpatient Sample for patients with ICH and ESRD between 2010 and 2019...

BACKGROUND: Peritoneal dialysis is a popular option for patients with end-stage renal disease. A recent presidential executive order has incentivized in-home end-stage renal disease treatments, leading to an increase in peritoneal dialysis use. Guidelines exist for creating and maintaining peritoneal dialysis access without addressing the optimal technique. This study evaluates nationwide peritoneal dialysis catheter placement practices and their long-term outcomes. METHODS: Retrospective cohort analysis of Nationwide Readmission Database from 2017 to 2019...

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) or hemophagocytic syndrome (HPS) is a life-threatening and relatively rare condition that usually presents as a multisystem febrile illness. It is associated with excessive activation of the immune system and hypercytokinemia, leading to an unregulated aggregation of macrophages and lymphocytes. Here, we present the first likely case of HLH with metastatic pancreatic carcinoma being the underlying etiology. CASE: A 44-year-old male with past medical history significant for heart transplant for which he was on tacrolimus, End-Stage Renal Disease (ESRD) on hemodialysis, recently treated CMV viremia, and necrotizing pancreatitis presented to the emergency with complaints of chills, decreased appetite, worsening non-bloody emesis, and dull left upper quadrant abdominal pain with radiation to the back for four days...