Overhydratation

BACKGROUND: The 1-year cumulative incidence of AKI reportedly is high (52%) in pediatric neoplastic disorders. About half of these events occur within 2 weeks. However, subclinical AKI episodes may remain unrecognized by the conventional creatinine-based approaches. We investigated the diagnostic value of urinary N-acetyl-β-D-glucosaminidase (uNAG) as an early marker of acute kidney injury (AKI). METHODS: In our retrospective study, 33 children with neoplastic disorders were inculded who had serial uNAG tests (at least 5 samples/patient) with a total of 367 uNAG measurements...

Endurance athletes, either professional or amateur, are consuming non steroidal anti-inflammatory drugs (NSAIDs) during their training and races. The goal is to decrease pain or to prevent a potential pain. These athletes, especially, the amateurs, do not do not know the side effects and have no medical supervision. In association with other risks factors such as overhydratation, NSAIDs increase the risk of exercise associated hyponatremia (EAH). Its frequency increases as the number of long distance events is increasing but it is still unknown...

In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented, and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease...

OBJECTIVE: Malnutrition is a known predictor of mortality in the general and hemodialysis populations. However, diagnosing malnutrition in dialysis patients remains problematic. Body composition monitoring (BCM) is currently used mainly for assessing overhydratation in hemodialysis patients, but it also offers the possibility of evaluating nutrition status. This study explored whether malnutrition diagnosed by BCM predicts mortality at up to 54 months follow-up in prevalent hemodialysis patients...

Bioelectrical impedance is a technique allowing a quick, repeatable and reliable assessment of body composition. This method was applied to detect total body water (TBW), fat (FAT) and fat-free mass (FFM) in 80 normal subjects, 65 diabetic (45 insulin-dependent [IDD], 20 non insulin-dependent [NIDD]) and 34 uremic diabetic patients (20 IDD, 14 NIDD) submitted to hemodialysis three times a week. Uremic patients were tested at the end of the dialytic session. Multivariated analysis adjusted for age, sex and disease showed the following results: body mass index (BMI) increased with age (p < 0...

Study of ACTH responsiveness to oral metyrapone and insulin hypoglycemia in children with repetitive nervous system manifestations (convulsions, coma, mental confusion apathy, tremor) has led to diagnosis of isolated ACTH deficiency in nine children within a three year period. Hypoglycemia was ascertained in five children; in four cases no hypoglycemia was proved, possibly because of promptly disappearance or because of other mechanisms accounting for clinical symptoms (occurrence of intracellular overhydratation associated with corticol deficiency is considered)...

Despite significant technical improvements (bicarbonate dialysate, volumetric ultrafiltration control) high intradialytic ultrafiltration is troublesome in children, specially in the proportion of patients presenting a normal or low blood pressure even with overweight. We used, in this group of children (overhydratated without vascular repercution) a modelling of both sodium and ultrafiltration during dialysis, in order to achieve dry body weight without increasing session time despite hypotension risks. The usefulness and practicability of sodium and ultrafiltration modelling together during dialysis in children is analysed in a short time study (for plasma volume changes calculation) and in a long term follow up study over a year (for clinical tolerance)...

Twenty-nine patients with terminal renal failure were treated by periodic hemodialysis for 2 to 18 months. Serial determinations of blood pressure, blood volume, cardiac output, exchangeable sodium and plasma renin activity were performed. Bilateral nephrectomy was performed in 17 patients and followed by a fall in blood pressure. Cardiac index was elevated in all patients but the blood pressure changes were mainly related to resistance changes. In non-nephrectomized patients, mean arterial pressure was directly correlated to plasma volume (P less than 0...