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Navigating the Complexities of Anterior Cord Syndrome in a 71-Year-Old: A Case Study of Vertebral Osteomyelitis and Methicillin-Resistant Staphylococcus aureus Bacteremia.
Cureus
December 2024
Internal Medicine, Merit Health Wesley, Hattiesburg, USA.
Anterior cord syndrome is a rare yet critical neurological condition that poses significant challenges in clinical management. We present the case of a 71-year-old male with a medical history of hypertension, uncontrolled type II diabetes mellitus, hypothyroidism, and end-stage renal disease requiring dialysis who presented to the emergency department with complaints of chills, back pain, abdominal pain, and vomiting episodes. Based on the severity of the patient's illness, it was decided that inpatient admission would be best.
View Article and Find Full Text PDFEffect of Acupuncture Intervention on Chronic Musculoskeletal Pain in Hemodialysis-Dependent Kidney Failure Patients: Study Protocol for a Randomized Controlled Clinical Trial.
J Pain Res
December 2024
Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Background: Chronic musculoskeletal pain is prevalent in individuals with hemodialysis-dependent renal failure (HDKF). The current opioid crisis highlights the urgent need for effective non-pharmacological pain management. Acupuncture, identified as a non-pharmacological intervention in clinical settings, holds promise for alleviating chronic musculoskeletal pain in HDKF patients, but well-designed studies assessing its specific effects in this population are lacking.
View Article and Find Full Text PDFCase Report: Buprenorphine for Palliation in a Patient with End Stage Renal Disease.
J Pain Palliat Care Pharmacother
December 2024
Department of Primary Care Pain Management, Bay Pines Veterans Health System, Bay Pines, Florida, USA.
End stage renal disease (ESRD) is known to be associated with pain, malaise and decreased quality of life. Pain management in the setting of dialysis is particularly challenging from a pharmacologic standpoint given altered pharmacokinetics of pain medications. Buprenorphine, a partial mu opioid receptor agonist, demonstrates superior safety profile compared to full mu opioid receptor agonists.
View Article and Find Full Text PDFImpact of renal impairment on the pharmacokinetic profile of intravenous difelikefalin, a kappa opioid receptor agonist for the treatment of pruritus.
BMC Nephrol
October 2024
Cara Therapeutics, Inc., Stamford, CT, USA.
Background: Difelikefalin is a selective kappa opioid receptor agonist that is approved for the treatment of moderate-to-severe pruritus associated with chronic kidney disease in adults undergoing hemodialysis (HD). In this study, we assessed the pharmacokinetics (PK) of intravenous (IV) difelikefalin in healthy subjects, in non-dialysis-dependent (NDD) subjects with varying stages of kidney disease, and in subjects with end-stage renal disease (ESRD) undergoing HD.
Methods: The PK and safety of single IV doses of difelikefalin (3.
A 47-year-old man who presented with scalp hair loss was transferred to our dialysis facility 3 months after hemodialysis initiation. He noticed systemic hair loss one month after the initiation of dialysis. Because the antipruritic drug nalfurafine was the only drug that had been newly added to his regular medication after he started hemodialysis, we stopped its prescription.
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