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Stage progression and need for renal replacement therapy in a renal protection programme in Colombia. A cohort study / Carlos Enrique Yepes Delgado    

Público ISBD Título : Stage progression and need for renal replacement therapy in a renal protection programme in Colombia. A cohort study Otros títulos : Progreso de estadio y requerimiento de terapia de reemplazo renal en un programa de protección renal en Colombia. Estudio de cohorte Tipo de documento : documento electrónico Autores : Carlos Enrique Yepes Delgado, Fecha de publicación : 2017 Títulos uniformes : Nefrología Idioma : Inglés (eng) Palabras clave : Chronic renal failure  renal replacement therapy  end-stage renal failure  evaluation of the effectiveness of interventions  preventive health services Resumen : Background: Due to the global burden represented by chronic kidney disease (CKD),the World Health Organization encouraged the implementation of renal protection programmes (RPP) to affect its incidence through prevention and control measures. Objectives: To assess the effectiveness of a Colombian RPP in terms of its effect on the stage progression of CKD and the need for renal replacement therapy (RRT). Methods: An analytical study that monitored 2 cohorts of patients diagnosed with CKD. Thestudy compares the behaviour of clinical and renal impairment indicators from patients exposed to a RPP with that of patients following conventional treatment (CT). The population of both intervention groups was considered when determining the sample size. The incidence rate was calculated as well as patient survival (Kaplan–Meier). In addition, a multivariate analysis (Cox) was used to calculate the influence that exposure to the RPP had on the outcomes of the patients following the RPP and those following CT. Results: The patients exposed to the RPP took longer to advance to the next CKD stage and require RRT. The incidence rate for progression is higher for the patients following CT (0.050, CI 95%: 0.040–0.064) compared to those in the RPP (0.034, CI 95%: 0.030–0.039). The ratio of incidence rates was 1.480 (CI 95%: 1.21–1.90). The hazard of progression was lower for the RPP (HR: 0.855, CI 95%: 0.74–0.98), as was the hazard of requiring RRT (HR: 0.797, CI 95%: 0.606–1.049) Conclusions: The RPP is a secondary prevention strategy against CKD which has an effect on the stage progression of CKD and the need for RRT. Early patient detection has a positive effect on the outcomes studied. Mención de responsabilidad : Carlos Enrique Yepes Delgado, Sara Pérez Dávila, Marcela Montoya Jaramillo, Beatriz Elena Orrego Orozco Referencia : Nefrologia. 2017 May - Jun;37(3):330-337. DOI (Digital Object Identifier) : 10.1016/j.nefro.2016.11.023 PMID : 28648207 Derechos de uso : CC BY-NC-ND En línea : https://www.revistanefrologia.com/es-linkresolver-progreso-estadio-requerimiento [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4078 Stage progression and need for renal replacement therapy in a renal protection programme in Colombia. A cohort study = Progreso de estadio y requerimiento de terapia de reemplazo renal en un programa de protección renal en Colombia. Estudio de cohorte [documento electrónico] / Carlos Enrique Yepes Delgado,  . - 2017. Obra : Nefrología Idioma : Inglés (eng) Palabras clave : Chronic renal failure  renal replacement therapy  end-stage renal failure  evaluation of the effectiveness of interventions  preventive health services Resumen : Background: Due to the global burden represented by chronic kidney disease (CKD),the World Health Organization encouraged the implementation of renal protection programmes (RPP) to affect its incidence through prevention and control measures. Objectives: To assess the effectiveness of a Colombian RPP in terms of its effect on the stage progression of CKD and the need for renal replacement therapy (RRT). Methods: An analytical study that monitored 2 cohorts of patients diagnosed with CKD. Thestudy compares the behaviour of clinical and renal impairment indicators from patients exposed to a RPP with that of patients following conventional treatment (CT). The population of both intervention groups was considered when determining the sample size. The incidence rate was calculated as well as patient survival (Kaplan–Meier). In addition, a multivariate analysis (Cox) was used to calculate the influence that exposure to the RPP had on the outcomes of the patients following the RPP and those following CT. Results: The patients exposed to the RPP took longer to advance to the next CKD stage and require RRT. The incidence rate for progression is higher for the patients following CT (0.050, CI 95%: 0.040–0.064) compared to those in the RPP (0.034, CI 95%: 0.030–0.039). The ratio of incidence rates was 1.480 (CI 95%: 1.21–1.90). The hazard of progression was lower for the RPP (HR: 0.855, CI 95%: 0.74–0.98), as was the hazard of requiring RRT (HR: 0.797, CI 95%: 0.606–1.049) Conclusions: The RPP is a secondary prevention strategy against CKD which has an effect on the stage progression of CKD and the need for RRT. Early patient detection has a positive effect on the outcomes studied. Mención de responsabilidad : Carlos Enrique Yepes Delgado, Sara Pérez Dávila, Marcela Montoya Jaramillo, Beatriz Elena Orrego Orozco Referencia : Nefrologia. 2017 May - Jun;37(3):330-337. DOI (Digital Object Identifier) : 10.1016/j.nefro.2016.11.023 PMID : 28648207 Derechos de uso : CC BY-NC-ND En línea : https://www.revistanefrologia.com/es-linkresolver-progreso-estadio-requerimiento [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4078

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Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability / Byron Enrique Piñeres Olave  

Público ISBD Título : Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability Tipo de documento : documento electrónico Autores : Byron Enrique Piñeres Olave, Fecha de publicación : 2016 Títulos uniformes : Critical Care Medicine Idioma : Inglés (eng) Palabras clave : Acute kidney injury  critical care outcomes  epidemiology  pediatric intensive care units  renal replacement therapy  sepsis Resumen : Objectives: The prevalence of septic acute kidney injury and impact on functional status of PICU survivors are unknown. We used data from an international prospective severe sepsis study to elucidate functional outcomes of children suffering septic acute kidney injury. Design: Secondary analysis of patients in the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study: acute kidney injury was defined on the study day using Kidney Disease Improving Global Outcomes definitions. Patients with no acute kidney injury or stage 1 acute kidney injury (“no/mild acute kidney injury”) were compared with those with stage 2 or 3 acute kidney injury (“severe acute kidney injury”). The primary outcome was a composite of death or new moderate disability at discharge defined as a Pediatric Overall Performance Category score of 3 or higher and increased by 1 from baseline. Setting: One hundred twenty-eight PICUs in 26 countries. Patients: Children with severe sepsis in the Sepsis PRevalence, OUtcomes, and Therapies study. Interventions: None. Measurements and Main Results: One hundred two (21%) of 493 patients had severe acute kidney injury. More than twice as many patients with severe acute kidney injury died or developed new moderate disability compared with those with no/mild acute kidney injury (64% vs 30%; p Mención de responsabilidad : Julie C Fitzgerald, Rajit K Basu, Ayse Akcan-Arikan, Ledys M Izquierdo, Byron E Piñeres Olave, Amanda B Hassinger, Maria Szczepanska, Akash Deep, Duane Williams, Anil Sapru, Jason A Roy, Vinay M Nadkarni, Neal J Thomas, Scott L Weiss, Susan Furth, Sepsis PRevalence, OUtcomes, and Therapies Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators Network Referencia : Crit Care Med. 2016 Dec;44(12):2241-2250. DOI (Digital Object Identifier) : 10.1097/CCM.0000000000002007 PMID : 27513354 En línea : https://journals.lww.com/ccmjournal/Abstract/2016/12000/Acute_Kidney_Injury_in_P [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3952 Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability [documento electrónico] / Byron Enrique Piñeres Olave,  . - 2016. Obra : Critical Care Medicine Idioma : Inglés (eng) Palabras clave : Acute kidney injury  critical care outcomes  epidemiology  pediatric intensive care units  renal replacement therapy  sepsis Resumen : Objectives: The prevalence of septic acute kidney injury and impact on functional status of PICU survivors are unknown. We used data from an international prospective severe sepsis study to elucidate functional outcomes of children suffering septic acute kidney injury. Design: Secondary analysis of patients in the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study: acute kidney injury was defined on the study day using Kidney Disease Improving Global Outcomes definitions. Patients with no acute kidney injury or stage 1 acute kidney injury (“no/mild acute kidney injury”) were compared with those with stage 2 or 3 acute kidney injury (“severe acute kidney injury”). The primary outcome was a composite of death or new moderate disability at discharge defined as a Pediatric Overall Performance Category score of 3 or higher and increased by 1 from baseline. Setting: One hundred twenty-eight PICUs in 26 countries. Patients: Children with severe sepsis in the Sepsis PRevalence, OUtcomes, and Therapies study. Interventions: None. Measurements and Main Results: One hundred two (21%) of 493 patients had severe acute kidney injury. More than twice as many patients with severe acute kidney injury died or developed new moderate disability compared with those with no/mild acute kidney injury (64% vs 30%; p Mención de responsabilidad : Julie C Fitzgerald, Rajit K Basu, Ayse Akcan-Arikan, Ledys M Izquierdo, Byron E Piñeres Olave, Amanda B Hassinger, Maria Szczepanska, Akash Deep, Duane Williams, Anil Sapru, Jason A Roy, Vinay M Nadkarni, Neal J Thomas, Scott L Weiss, Susan Furth, Sepsis PRevalence, OUtcomes, and Therapies Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators Network Referencia : Crit Care Med. 2016 Dec;44(12):2241-2250. DOI (Digital Object Identifier) : 10.1097/CCM.0000000000002007 PMID : 27513354 En línea : https://journals.lww.com/ccmjournal/Abstract/2016/12000/Acute_Kidney_Injury_in_P [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3952

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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    

Público ISBD 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

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