Renal failure
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Recent studies have suggested that carbon monoxide (CO) inhalation can reduce ischemia-reperfusion injury of kidneys. The purpose of the present study was to determine whether the direct application of CO using tricarbonylchloro (glycinato) ruthenium II (CORM3) would reduce cold-rewarm-associated apoptosis in renal tubular epithelial (RPTE) cells. RPTE cells were subjected to 48 hours of cold followed by 24 hours of rewarming with increasing concentrations (0-500 microM) of CORM3. ⋯ Prior treatment of RPTE cells with siRNAs against HO-1 was able to completely abolish the CORM3 mediated induction of HO-1 mRNA and protein. The abolition of HO-induction with siRNAs did reduce CORM3-mediated protection against cold rewarm-induced apoptosis; however, CORM3 was able to significantly protect RPTE cells against cold-rewarm injury: apoptosis was 33.7 +/- 0.9% vs. 15.4 +/- 0.5% vs. 62.8 +/- 1.5% vs. 23.5 +/- 3.4 in control cold-rewarm vs. cold-rewarm + CORM3 (100 microM) vs. cold-rewarm + HO-1 siRNA vs. cold-rewarm + CORM3 (100 microM) + HO-1 siRNA (n = 4). These results suggest that increased levels of CO alone can protect against cold-rewarm-induced apoptosis.
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Non-dialytic treatment (NDT) has become a recognized and important modality of treatment in end stage renal disease (ESRD) in certain groups of chronic kidney disease (CKD) patients. However, little is known about the prognosis of these NDT patients in terms of hospitalization rates and survival. We analyzed our experience in managing these NDT with a multidisciplinary team (MDT) approach over a three-year period. ⋯ Our prospective study is the first and currently the largest observational study of a multidisciplinary approach in the management of NDT patients. SCG was an independent prognostic factor in predicting survival. In those patients who chose not to dialyse, SCG provides a potentially useful indication of expected prognosis.
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The authors analyzed 309 central venous catheters (CVC) inserted in 147 hemodialysis patients before the maturation of the first or new arteriovenous fistula. One clinical manifestations of sepsis after CVC insertion was found. In all, 33.7% of the catheters were removed because of early minor complications: CVC occlusion, inadequate blood flow in CVC, shattered suture and malposition of CVC, fever, signs of infection at the site of CVC insertion, and bleeding at the site of CVC insertion. The most frequently isolated pathogenic bacteria at the tips of the catheters were coagulase-negative staphylococci highly sensitive to vancomycin and gentamicin.
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Serum levels of lipids and lipoproteins were determined in 98 post-renal transplant fasting patients, and lipids and non-high density lipoprotein-cholesterol (non-HDL-C) and lipid ratios in the same post-renal transplant non-fasting patients were compared. The reference group was 87 healthy subjects. All patients were divided into two groups: patients with dyslipidemia (n = 69) and patients with normolipidemic (n = 29). ⋯ We think the finding that nonfasting labs that are reliable for non-HDL-C as well as total cholesterol is important, as fasting labs are not always available. Disturbances of lipids, lipoproteins, and TRLs depend not only on the kind of treatment, but due to multiple factors can accelerate cardiovascular complications in post-renal transplant patients with dyslipidemia and also with normolipidemic. Further studies concerning this problem should be completed.
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To describe long-term quality of life, intensive care, and hospital mortality in patients with acute renal and respiratory failure treated with one of two methods of renal replacement therapy (RRT). ⋯ (1) The method of RRT used in ICU patients with ARF had no influence on survival; (2) The long-term survivors of multi-organ failure have poor physical health.