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Urinary tract infection leading to hospital admission during the first year after kidney transplantation: A retrospective cohort study / Fabián Alberto Jaimes Barragán
Título : Urinary tract infection leading to hospital admission during the first year after kidney transplantation: A retrospective cohort study Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2016 Títulos uniformes : Transplantation Reports Idioma : Inglés (eng) Palabras clave : CKD Chronic kidney disease CKF Chronic kidney failure ESRD end stage renal disease HD hemodialysis KTR kidney transplant recipients MDR Multidrug resistant MMF mycophenolate mofetil mTOR mammalian target of rapamycin PD peritoneal dialysis RRT renal replacement therapy UTI Urinary tract infection TMP/SMX Trimethoprim-sulfamethoxazole XDR Extensively drug-resistant Resumen : Introduction: Urinary tract infection (UTI) is the most common infectious problem in kidney transplant recipients (KTR). It has been associated with risk factors inherent to the transplant and it could negatively affect clinical outcomes. The aim of this study was to describe demographic, clinical and microbiological characteristics of patients with UTI. Methods: We underwent a retrospective study reviewing the database of kidney transplants patients in a national reference center in Colombia. We included patients admitted for inpatient treatment related to urinary tract infection in the first year after transplantation. Results: We describe clinical information from 65 patients, the mean age was 46 years, the most common comorbidity was hypertension (n=48/62, 77.4%) followed by diabetes mellitus (n=11/62, 17.7%); 77% (n=50/65) of the infections were diagnosed in the first 6 months after transplant and 70% (n=45/65) had pyelonephritis. Acute dysfunction of the graft was the most common complication in 59% (n=33/56) of cases. The most common etiological agent described was E. coli in 67% (n=37/55) of patients followed by Klebsiella pneumoniae (n=13/55). Bacteremia was present in 25% of cases. Infection with extended-spectrum betalactamases producing bacteria was present in 42% (n=18/42) of our isolations and multidrug resistance was documented in 39% (n=21/54) of isolates. Conclusion: Most UTI leading to hospitalization in KTR occur in the first six months. Pyelonephritis explains the majority of clinical diagnosis. The rate of blood stream infections and multidrug resistance bacteria is high, justifying an empiric broad-spectrum antibiotic treatment. Mención de responsabilidad : Santiago Giraldo-Ramírez, Oscar Emilio Díaz-Portilla, Andrés Felipe Miranda-Arboleda, Jorge Henao-Sierra, Lina María Echeverri-Toro, Fabian Jaimes DOI (Digital Object Identifier) : 10.1016/j.tpr.2016.09.001 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2451959616300154 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4616 Urinary tract infection leading to hospital admission during the first year after kidney transplantation: A retrospective cohort study [documento electrónico] / Fabián Alberto Jaimes Barragán, . - 2016.
Obra : Transplantation Reports
Idioma : Inglés (eng)
Palabras clave : CKD Chronic kidney disease CKF Chronic kidney failure ESRD end stage renal disease HD hemodialysis KTR kidney transplant recipients MDR Multidrug resistant MMF mycophenolate mofetil mTOR mammalian target of rapamycin PD peritoneal dialysis RRT renal replacement therapy UTI Urinary tract infection TMP/SMX Trimethoprim-sulfamethoxazole XDR Extensively drug-resistant Resumen : Introduction: Urinary tract infection (UTI) is the most common infectious problem in kidney transplant recipients (KTR). It has been associated with risk factors inherent to the transplant and it could negatively affect clinical outcomes. The aim of this study was to describe demographic, clinical and microbiological characteristics of patients with UTI. Methods: We underwent a retrospective study reviewing the database of kidney transplants patients in a national reference center in Colombia. We included patients admitted for inpatient treatment related to urinary tract infection in the first year after transplantation. Results: We describe clinical information from 65 patients, the mean age was 46 years, the most common comorbidity was hypertension (n=48/62, 77.4%) followed by diabetes mellitus (n=11/62, 17.7%); 77% (n=50/65) of the infections were diagnosed in the first 6 months after transplant and 70% (n=45/65) had pyelonephritis. Acute dysfunction of the graft was the most common complication in 59% (n=33/56) of cases. The most common etiological agent described was E. coli in 67% (n=37/55) of patients followed by Klebsiella pneumoniae (n=13/55). Bacteremia was present in 25% of cases. Infection with extended-spectrum betalactamases producing bacteria was present in 42% (n=18/42) of our isolations and multidrug resistance was documented in 39% (n=21/54) of isolates. Conclusion: Most UTI leading to hospitalization in KTR occur in the first six months. Pyelonephritis explains the majority of clinical diagnosis. The rate of blood stream infections and multidrug resistance bacteria is high, justifying an empiric broad-spectrum antibiotic treatment. Mención de responsabilidad : Santiago Giraldo-Ramírez, Oscar Emilio Díaz-Portilla, Andrés Felipe Miranda-Arboleda, Jorge Henao-Sierra, Lina María Echeverri-Toro, Fabian Jaimes DOI (Digital Object Identifier) : 10.1016/j.tpr.2016.09.001 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2451959616300154 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4616 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001114 AC-2016-095 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2016-095.pdfAdobe Acrobat PDF Effectiveness of an secondary prevention program in chronic kidney disease / Carlos Enrique Yepes Delgado
Título : Effectiveness of an secondary prevention program in chronic kidney disease Tipo de documento : documento electrónico Autores : Carlos Enrique Yepes Delgado, Fecha de publicación : 2013 Títulos uniformes : Open Journal of Nephrology Idioma : Inglés (eng) Palabras clave : Chronic kidney disease renal protection program effectiveness clinical markers progression of renal damage renal replacement program Resumen : Background: There are many programs which focus on late-stage chronic kidney disease (CKD), and it is considered that further evidence needs to be generated regarding the effectiveness of the programs used before renal replacement therapy. Study Design: A cohort study. Settings & Participants: Patients over 15 years of age who had been diagnosed with CKD according to the KDOQI (Kidney Disease Outcomes Quality Initiative) guidelines and who had undergone conventional treatment (CT) or a renal protection program (RPP). These were patients of two Colombian health insurance companies. Predictors: Age, sex, marital status, comorbidities, CKD stage, and clinical indicators. Outcomes: First CKD progression, and need for renal replacement therapy (RRT). Measures: Clinical marker. Results: The RPP is structurally and functionally different from the CT. It offers the interdisciplinary management of patients, a greater number of medical appointments, and patients start to receive treatment at younger ages and at earlier stages of their condition. The clinical markers of the patients following the RPP are within adequate ranges, and their renal function is less impaired, despite the differences in basal conditions. Upon finishing the study, we found that patients who received CT had a higher risk of receiving nephrotoxic drugs and not receiving nephroprotective drugs. The explanatory variables for the first progression were age, stage, history of dyslipidemia, and hemoglobin, potassium, and albumin levels. These variables, together with glycemia levels were also valid for RRT, except for history of dyslipidemia, as it was not significant. Upon adjusting for the explanatory variables, it was found that belonging to the RPP and attending more appointments had a protective effect in the process of controlling renal damage. Limitations: A possible selection bias. Conclusions: Belonging to a structured renal protection program is an effective way to keeping the clinical markers associated with renal impairment within normal ranges. Mención de responsabilidad : Carlos Enrique Yepes Delgado, Yanett Marcela Montoya Jaramillo, Beatriz Elena Orrego Orozco, Paulina Bernal Ramírez, Luz Denise González, José Miguel Abad Echeverri, María Patricia Arbeláez Montoya Referencia : OJNeph. 2013;3(3):139-47. DOI (Digital Object Identifier) : 10.4236/ojneph.2013.33026 Derechos de uso : CC BY En línea : http://www.scirp.org/journal/paperinformation.aspx?paperid=36760 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3695 Effectiveness of an secondary prevention program in chronic kidney disease [documento electrónico] / Carlos Enrique Yepes Delgado, . - 2013.
Obra : Open Journal of Nephrology
Idioma : Inglés (eng)
Palabras clave : Chronic kidney disease renal protection program effectiveness clinical markers progression of renal damage renal replacement program Resumen : Background: There are many programs which focus on late-stage chronic kidney disease (CKD), and it is considered that further evidence needs to be generated regarding the effectiveness of the programs used before renal replacement therapy. Study Design: A cohort study. Settings & Participants: Patients over 15 years of age who had been diagnosed with CKD according to the KDOQI (Kidney Disease Outcomes Quality Initiative) guidelines and who had undergone conventional treatment (CT) or a renal protection program (RPP). These were patients of two Colombian health insurance companies. Predictors: Age, sex, marital status, comorbidities, CKD stage, and clinical indicators. Outcomes: First CKD progression, and need for renal replacement therapy (RRT). Measures: Clinical marker. Results: The RPP is structurally and functionally different from the CT. It offers the interdisciplinary management of patients, a greater number of medical appointments, and patients start to receive treatment at younger ages and at earlier stages of their condition. The clinical markers of the patients following the RPP are within adequate ranges, and their renal function is less impaired, despite the differences in basal conditions. Upon finishing the study, we found that patients who received CT had a higher risk of receiving nephrotoxic drugs and not receiving nephroprotective drugs. The explanatory variables for the first progression were age, stage, history of dyslipidemia, and hemoglobin, potassium, and albumin levels. These variables, together with glycemia levels were also valid for RRT, except for history of dyslipidemia, as it was not significant. Upon adjusting for the explanatory variables, it was found that belonging to the RPP and attending more appointments had a protective effect in the process of controlling renal damage. Limitations: A possible selection bias. Conclusions: Belonging to a structured renal protection program is an effective way to keeping the clinical markers associated with renal impairment within normal ranges. Mención de responsabilidad : Carlos Enrique Yepes Delgado, Yanett Marcela Montoya Jaramillo, Beatriz Elena Orrego Orozco, Paulina Bernal Ramírez, Luz Denise González, José Miguel Abad Echeverri, María Patricia Arbeláez Montoya Referencia : OJNeph. 2013;3(3):139-47. DOI (Digital Object Identifier) : 10.4236/ojneph.2013.33026 Derechos de uso : CC BY En línea : http://www.scirp.org/journal/paperinformation.aspx?paperid=36760 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3695 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000268 AC-2013-036 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2013-036.pdfAdobe Acrobat PDF