Efficacy, Safety, and Calcium Balance of an Accelerated Citrate Anticoagulated Membrane-Based Plasma Exchange Algorithm.

Introduction: To assess the safety, efficacy, and calcium flux of an accelerated algorithm for regional citrate anticoagulation in membrane-based plasma exchange.

Methods: This was an observational study in patients receiving citrate anticoagulated, membrane-based plasma exchange at the Canberra Hospital between July 2017 and May 2020. Data were collected prospectively using an electronic medical record and compared to data from our previous published algorithm.

How to adjust drug doses in chronic kidney disease.

Drugs excreted by the kidney require dose reduction in chronic kidney disease. This adjustment depends on the severity of the disease and what proportion of the drug is eliminated by the kidneys The estimated glomerular filtration rate can generally be used to guide dose adjustment in patients with stable kidney function. However, the formula can be misleading in some patient subsets and other approaches are required At extremes of body mass, the estimated glomerular filtration rate can under- or overestimate kidney function.

Successful Treatment of PD Peritonitis Due to .

is a rare cause of peritoneal dialysis-associated peritonitis (PD peritonitis). One documented case report described poor outcome despite treatment with appropriate antibiotics. Here, we report the successful treatment of PD peritonitis due to with 21 days of intraperitoneal (IP) antibiotics using the regimen described for , notably IP gentamicin (10 days) followed by IP cefepime and oral ciprofloxacin (11 days).

Calciphylaxis in a dialysis patient successfully treated with high-dose vitamin K supplementation.

Calciphylaxis has high mortality. Vitamin K deficiency is common in haemodialysis patients and may be a trigger for calciphylaxis due to its role in activating matrix Gla protein (a tissue inhibitor of calcification). We report the case of a 43-year-old female haemodialysis patient who developed calciphylaxis.

Uric acid lowering therapies for preventing or delaying the progression of chronic kidney disease.

Background: Non-randomised data have shown a link between hyperuricaemia and the progression or development of chronic kidney disease (CKD). If this is correct, urate lowering therapy might form an important part of chronic kidney disease care, reducing risks for cardiovascular outcomes and end-stage kidney disease.

Objectives: This review aims to study the benefits and harms of uric acid lowering therapy on the progression of CKD and other cardiovascular endpoints.

Regional citrate anticoagulation in hemodialysis: an observational study of safety, efficacy, and effect on calcium balance during routine care.

Background: Regional citrate hemodialysis anticoagulation is used when heparin is contraindicated, but most protocols require large infusions of calcium and frequent intradialytic plasma ionized calcium measurements.

Objectives: The objective of this study was to determine the safety, efficacy, and effect on calcium balance of regional citrate anticoagulation using sparse plasma ionized calcium sampling.

Design: The design of this study was observational.

Vitamin D in dialysis: defining deficiency and rationale for supplementation.

Vitamin D status is determined by the serum concentration of one of its metabolites, 25-hydroxy-D. Defining vitamin D deficiency based on its classical roles in gut calcium absorption and bone mineralization is problematic in dialysis patients and, until recently, was ignored in the nephrology literature. The newly recognized nonclassical functions of vitamin D include effects on the immune system, cardiovascular disease, and cancer.

Long-term high-dose cholecalciferol in patients with heavy proteinuria.

Four patients presenting with heavy proteinuria, vitamin D deficiency and secondary hyperparathyroidism were treated with cholecalciferol for 1.5-3 years. Doses of 7143-14286 U/day were necessary to achieve the calcidiol target of >75 nmol/L.

Antibiotic stability in commercial peritoneal dialysis solutions: influence of formulation, storage and duration.

Background: Peritoneal dialysis (PD)-associated peritonitis is treated by administration of antibiotics mixed with the PD solution. Data on antibiotic stability for solutions in current use are limited. The aim of this study was to determine the stability of cefepime, cephazolin and ampicillin in three commercial PD solutions.

Vitamin C supplementation in kidney failure: effect on uraemic symptoms.

Background: Vitamin C (ascorbate) deficiency and symptoms consistent with deficiency (fatigue, myalgia, dyspnoea, gingivitis, cardiovascular instability and depression) are common in patients with renal failure. This study aimed to determine if supplementation with ascorbate in patients with severe renal failure improved symptoms or cardiovascular stability, or was associated with adverse effects.

Methods: The study was a 3-month, double-blind, randomized trial of ascorbic acid 250 mg or matching placebo given thrice weekly.