Seroconversion following Heplisav-B, hepatitis B vaccine (recombinant), adjuvanted, in patients with end-stage renal disease at an urban safety net hospital.

Purpose: Heplisav-B is a novel recombinant adjuvanted vaccine for hepatitis B virus (HBV) that has been approved as a 2-dose regimen and shown to have similar seroconversion rates in healthy adults as single-antigen HBV vaccines. More data are needed to determine whether similarly high rates of seroconversion and immunity are observed in immunocompromised patient populations such as in patients with end-stage renal disease (ESRD) on hemodialysis.

Methods: Patients with ESRD who presented for emergency-only hemodialysis and either were HBV vaccine naive or had a hepatitis B surface antibody (anti-HBs) titer of less than 10 IU/mL received 3 standard 20-μg doses of Heplisav-B at week 0, week 4 (±2 weeks), and week 24 (±2 weeks), with anti-HBs titer measured at week 28 (±2 weeks).

Management of an i.v. fluid shortage through use of electronic medical record alerts.

Purpose: Evaluation of mechanisms used to cope with an i.v. fluid shortage to determine if prescribing habits were changed and if substitution of an i.

Management of hyperkalemia in hospitalized patients.

Purpose: The aim of this study was to determine the incidence of treatment of hyperkalemia in hospitalized patients.

Methods: This is a prospective chart review of adults in a tertiary care hospital with hyperkalemia (serum potassium [K] ≥5.1 mEq/L) over a 6-month period.

Once-weekly vancomycin for patients receiving high-flux hemodialysis.

Purpose: The effectiveness of a once-weekly vancomycin dosing protocol for patients receiving long-term high-flux hemodialysis (HFHD) in the outpatient setting was studied.

Methods: Eligible patients were at least 18 years old, required hemodialysis for at least two months before study enrollment, and were not known to have any active infection. All patients received outpatient dialysis at a 1000-bed urban teaching hospital three times per week through a high-flux synthetic dialyzer.

Role of acetylcysteine in the prevention of contrast-media-induced nephrotoxicity.

The role of acetylcysteine in the prevention of contrast-media-induced nephrotoxicity was retrospectively studied. The medical records of patients undergoing cardiac catheterization between January 2000 and March 2002 were reviewed. The outcomes of patients with serum creatinine (SCr) concentrations above 1.

Alteplase versus urokinase in restoring blood flow in hemodialysis-catheter thrombosis.

The effectiveness of alteplase and urokinase in restoring adequate hemodialysis blood-flow rates was examined. A retrospective review of the medical records of hemodialysis patients with central venous catheters receiving alteplase or urokinase for presumed catheter thrombosis between June 1997 and December 2000 was conducted. Patients received 1 mL of alteplase 1 mg/mL or 1 mL of urokinase 5000 units/mL in each catheter port.