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Chronic Dialysis (chronic + dialysis)
Terms modified by Chronic Dialysis Selected AbstractsSexual function in women receiving maintenance dialysisHEMODIALYSIS INTERNATIONAL, Issue 1 2010Srikanth SEETHALA Abstract While substantial attention has been paid to the issue of sexual dysfunction in men on chronic dialysis, less is known about this problem in women with end-stage renal disease. We sought to assess sexual dysfunction in women on chronic dialysis and determine whether patients discuss this problem with their providers and receive treatment. We prospectively enrolled women receiving chronic hemodialysis or peritoneal dialysis in Pittsburgh, PA. We asked patients to complete the 19-item Female Sexual Function Index (FSFI) to assess sexual function and a 5-item survey that assessed whether patients had discussed sexual dysfunction with their providers and/or received treatment for this problem in the past. We enrolled 66 patients; 59 (89%) on hemodialysis and 7 (11%) on peritoneal dialysis. All patients completed the FSFI, of whom 53 (80%) had FSFI scores <26.55, consistent with the presence of sexual dysfunction. Of 37 patients who were married or residing with a significant other, 27 (73%) had sexual dysfunction. Among 24 participants who reported having been sexually active over the previous 4 weeks, 11 (46%) had sexual dysfunction. Only 21% of patients with sexual dysfunction had discussed this problem with their gynecologist, renal or primary provider, and 3 (6%) reported having received treatment. Sexual dysfunction is common in women on dialysis, even among patients who are married or residing with a significant other and those who are sexually active. However, few women discuss this issue with their providers or receive treatment. [source] Endoscopic minilaparotomy radical nephrectomy for chronic dialysis patientsINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2002Yukio Kageyama Abstract Background: To assess the feasibility of laparoscope-guided minilaparotomy (endoscopic minilaparotomy) for renal cell carcinoma in patients on chronic dialysis. Methods: Endoscopic retroperitoneal minilaparotomy using a 30° telescope was carried out through single skin incision (5,8 cm) in eight patients with renal cell carcinoma who were on chronic dialysis. Outcomes of the operations were compared to those in eight patients on chronic dialysis with renal cell carcinoma who underwent standard translumbar radical nephrectomy. Results: Resection of the tumor was successfully completed without complication and the postoperative course was uneventful in both of the treatment groups. No significant difference in mean operative time or mean blood loss was observed between the treatment groups. Wound pain was minimal and analgesics were generally not required in the minilaparotomy group. The endoscopic laparotomy group resumed full diet and began walking earlier than the group that underwent standard radical nephrectomy. Conclusions: Endoscopic minilaparotomy seems to be a valuable alternative treatment for renal cell carcinoma in patients on chronic dialysis. [source] Antineutrophil cytoplasmic antibody-associated glomerulonephritis in TaiwaneseNEPHROLOGY, Issue 5 2004PEIR-HAUR HUNG SUMMARY: Aims: This retrospective study defined the clinical features and outcome of antineutrophil cytoplasmic antibody-associated glomerulonephritis in 18 seropositive Taiwanese patients (11 male, seven female; median age 64 years; range 21,82 years) with biopsy-proven pauci-immune necrotizing crescentic glomerulonephritis. Results: Fourteen patients had a diagnosis of systemic vasculitis including 10 with microscopic polyangiitis and four with Wegener's granulomatosis; the remaining four had only glomerulonephritis. At onset, 100% of the systemic vasculitis patients had pulmonary lesions with or without haemoptysis, and 29% presented with seizure in the absence of a defined brain lesion. Median serum creatinine concentration was 362.4 µmol/L (range 61.9,857.5 µmol/L) and dialysis therapy was needed in six patients. During follow up (median 16.5 months; range 2,72 months), treatment included cyclophosphamide and corticosteroids (n = 8) or corticosteroids alone (n = 7). In some patients, treatment improved (n = 4) or stabilized (n = 4) renal function. But chronic dialysis was needed in the other 10 patients. Follow-up death occurred because of sepsis (n = 3) and haemorrhage (n = 2). Patient survival rates were 78% (1 year) and 72% (5 years). Renal survival rates were 56 and 39% at 1 and 5 years, respectively. Of the candidate clinical and pathological parameters, chronic glomerular lesions in renal biopsy were the only determinant of poor renal outcome (P = 0.006). Conclusion: Antineutrophil cytoplasmic antibody-associated glomerulonephritis should be considered in nephritic patients with extrarenal manifestations, especially pulmonary infiltrate, unexplained seizure, and fever of an unknown origin in Taiwanese patients. Renal biopsy should be performed before initiating immunosuppressive therapy because the most common cause of mortality was sepsis. [source] Perspectives of chronic renal failureNEPHROLOGY, Issue 2002Kiyoshi Kurokawa SUMMARY: End-stage renal disease (ESRD) is a major source of morbidity and the increasing number of chronic dialysis patients is a significant health-care issue in many developed as well as developing countries. In the present brief review the current status of chronic dialysis is discussed; and Japan and the USA, two major countries in which chronic dialysis programmes are well developed, are compared. Also discussed is the economic impact, the status of renal transplantation and its future possibilities, recent efforts to halt progression of chronic renal disease, in particular, diabetic nephropathy (which has become the major cause of ESRD in many developed countries), and future perspectives in renal research. It is hoped that, in the future, perhaps by the mid-21st century, chronic dialysis may become the exception in therapy through our efforts. [source] Ultrasound assessment of large joint amyloidosis in haemodialysisNEPHROLOGY, Issue 1-2 2000Marc Lanteri SUMMARY: Dialysis-related amyloidosis (DRA), associated with beta-2 microglobulin deposition, is a common cause of morbidity in patients with renal failure undergoing chronic dialysis. The non-invasive diagnosis of DRA in its early stages is difficult. High resolution ultrasound (US) was used to examine the shoulder, hip and knee joints of 25 chronic haemodialysis patients, and features distinctive of DRA were determined. Distinctive US features were associated with increased total duration of dialysis (15 ± 5 vs 4 ± 2 years), carpal tunnel syndrome (9/10 cases) and shoulder joint discomfort (19 vs three joints). These features include altered rotator cuff echogenicity (hyperechoic and hypoechoic areas; 20/48 joints), hypoechoic material in the biceps sheath (16/48), erosions of bone (15/48) and reduced biceps tendon fibril echogenicity (12/48). These changes are unique in the experience of the current authors, but histological proof that they are definitely the result of DRA has not yet been possible. Tears of the rotator cuff tendons (14/50) were not consistently associated with symptoms (7/14). Tendon thickness was also increased (as has been described previously). The hip capsule thickness was increased in patients with signs of DRA in the shoulder, but no specific changes in texture were seen. Asymptomatic knee joint effusions were present in 40/50 joints (80%). These features detectable on high resolution US allow the non-invasive early detection of DRA and are useful in the diagnosis and management of this condition. [source] The Clinical Impact of an Early Decline in Kidney Function in Patients Following Heart TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2009M. Cantarovich Renal dysfunction is a well-known complication following heart transplantation. We examined an early decline in kidney function as a predictor of progression to end-stage renal disease and mortality in heart transplant recipients. We performed a retrospective cohort study of 233 patients who received a heart transplant between July 1985 and July 2004, and who survived >1 month. The decline in estimated creatinine clearance (CrCl) was used to predict the outcomes of need for chronic dialysis or mortality >1-year posttransplant. The earliest time to chronic dialysis was 484 days. A 30% decline in CrCl between 1 month and 12 months predicted the need for chronic dialysis (p = 0.01), all-cause mortality (p < 0.0001) and time to first CrCl ,30 mL/min at >1-year posttransplant (p = 0.02). A 30% decline in CrCl between 1 month and 3 months also independently predicted the need for chronic dialysis (p = 0.04) and time to first CrCl , 30 mL/min at >1-year posttransplant (p = 0.01). In conclusion, an early drop in CrCl within the first year is a strong predictor of chronic dialysis and death >1-year postheart transplantation. Future studies should focus on kidney function preservation in those identified at high risk for progression to end-stage kidney disease and mortality. [source] |