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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two hundred subclavian dialysis catheters were placed in 148 patients who kept them in place for a total of 2,798 days. Catheterization time ranged from 1 to 79 days with an average of 14.0 +/- 1.0 days per catheter and 18.9 +/- 1.0 days per patient. Twenty nine catheters were infected, 17 of which were the source of bacteremias due to Staphylococcus epidermidis in 13 cases and to Staphylococcus aureus in 4 cases. The incidence of sepsis was not significantly greater in diabetic patients, in patients with corticotherapy or in patients presenting an underlying systemic disease. On the contrary, the incidence was greater in hospitalized patients (15 bacteremias during 1,948 catheter days) than in ambulatory patients (2 bacteremias during 850 catheters-days) as well as during a period corresponding to a greater number of untrained nurses enrolled in the dialysis team. During this period, 6 sepsies occurred in 19 catheters (other periods: 7 sepsies/116 catheters, p less than 0.01). 6 of 28 nurses had less than 3 months of professional experience (other periods: 1 of 25, p less than 0.01). These data underline the key role of nurse training in the prevention of catheter-related infections.
Nephron 1986
PMID:Infections associated with subclavian dialysis catheters: the key role of nurse training. 394 49

Diffuse crescentic glomerulonephritis was observed in a 40-year-old male patient who had a ventriculoatrial shunt implanted after a traffic accident 10 years previously. Immediately after treatment with immunosuppressants and plasma pheresis, signs of meningitis and septicemia developed. The responsible organism isolated was Staphylococcus albus. After the shunt was removed, clinical signs and renal function improved, associated with normalization of hypocomplementemia and disappearance of cryoglobulin and circulating immune complexes. Repeat renal biopsy performed 5 months after the removal of the shunt revealed mild mesangial proliferative and sclerotic glomerulonephritis with fibrous crescents. No apparent deposits observed in the initial biopsy were found on ultrastructural and immunofluorescent examinations. The reported cases with serial renal biopsies before and after the removal of the shunt were reviewed.
Nephron 1985
PMID:Shunt nephritis: histological dynamics following removal of the shunt. Case report and review of the literature. 400 Mar 30

Urine protein excretion patterns have been studied in 42 patients with sepsis and compared with that in 21 healthy controls. Patients with sepsis were shown to have highly significant increases in fractional clearances for beta 2-microglobulin, albumin, amylase and immunoglobulin G as compared with the controls. Analysis of the pattern of protein excretion demonstrates that the proteinuria is of the tubular rather than the glomerular type. There was no evidence that administration of aminoglycoside antibiotics contributed to the production of tubular proteinuria, and in particular these drugs did not appear to affect the excretion of beta 2-microglobulin.
Nephron 1982
PMID:Patterns of urinary protein excretion in patients with sepsis. 618 21

We describe 26 pregnancies in 19 patients with lupus nephritis. There were 4 spontaneous abortions, 2 therapeutic abortions, 4 stillbirths and 1 neonatal death. 10 deliveries were preterm and 2 fetuses were small for gestational age. 8 pregnancies were not accompanied by change of renal symptoms. Mild signs of renal involvement appeared during pregnancy in 4 patients. 6 patients showed an increase in proteinuria already present before pregnancy without renal function deterioration. A moderate worsening of renal function was observed in 3 patients. 4 patients, 3 of whom had an apparent onset of systemic lupus erythematosus during pregnancy, developed anuric acute renal failure after delivery or after late spontaneous abortion. 2 of them died from sepsis and disseminated intravascular coagulation while 2 had complete recovery of renal function. A high rate of complications was observed in patients not adequately treated during pregnancy. Renal biopsy before gestation was not predictive of the outcome of nephropathy during pregnancy, and change of histology in repeated biopsies was frequently observed.
Nephron 1984
PMID:Lupus nephropathy and pregnancy. A study of 26 pregnancies in patients with systemic lupus erythematosus and nephritis. 669 Oct 1

Monoarticular septic arthritis without disseminating sepsis occurred in 4 patients following renal transplantation. The septic arthritis was preceded by an infection with the same organism in an extraarticular location (3 urinary tract, 1 upper respiratory). All patients were on prednisone-azathioprine immunosuppressive regimen but none had granulocytopenia. Prompt antibiotic therapy resulted in quick resolution of the joint infection in 3 patients. Impaired host defenses, possible inadequate prior antibiotic therapy, and intrinsic joint alterations are potential contributing factors to the development of septic arthritis following renal transplantation.
Nephron 1982
PMID:Septic arthritis following renal transplantation. 704 16

The outcome and metabolic control was studied in 60 critically ill patients with acute renal failure (ARF) treated by continuous arteriovenous hemodiafiltration (CAVHD) in a single surgical intensive care unit. Mean age (+/- SEM) was 60 +/- 2 years with a male predominance (80%). The majority of patients required mechanical ventilation (83%) and/or vasopressor support (70%) and suffered from multiorgan failure [mean number of organ system failures 3.3 +/- 0.3 (range 1-6)]. CAVHD resulted in a rapid decline of serum urea and creatinine levels during the first 72 h (urea 47.4 +/- 2.3 to 30.3 +/- 1.4 mmol/l, p < 0.05, and creatinine 572 +/- 27 to 361 +/- 23 mumol/l, p < 0.05); thereafter, controlled steady-state levels were achieved with serum urea levels kept below 30 mmol/l with full protein alimentation and often despite hypotension, surgery and septicemia. Significant electrolyte derangements could be easily corrected and maintained within normal limits. Bicarbonate homeostasis could be restored within 48 h in patients with severe metabolic acidosis (HCO3- < 20 mmol/l) with use of bicarbonate as a buffering anion (17 +/- 0.5 to 23.2 +/- 0.6, p < 0.05). CAVHD allowed rapid removal of excess body and lung water (up to 5 liters/day) without hemodynamic instability. Despite a mean pretreatment APACHE II score of 26.5, 26 patients (43%) survived until discharge from the intensive care unit, of whom 23 (38%) survived to leave hospital. Requirement of mechanical ventilation or vasopressor support, higher APACHE II scores and septicemia were all associated with a poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephron 1995
PMID:High-risk surgical acute renal failure treated by continuous arteriovenous hemodiafiltration: metabolic control and outcome in sixty patients. 756 1

The association of a spondyloepiphyseal dysplasia and disproportionate short stature with focal glomerular sclerosis is reported in two girls. Renal disease manifested by proteinuria at the age of 2.5 and 11 years, leading to treatment-resistant nephrotic syndrome over 15 and 45 months, respectively. One patient went into end-stage renal failure shortly after nephrotic syndrome developed, the other died from sepsis. The association of spondyloepiphyseal dysplasia and focal glomerular sclerosis with nephrotic syndrome may represent a distinct disease entity.
Nephron 1994
PMID:Focal glomerular sclerosis and nephrotic syndrome in spondyloepiphyseal dysplasia. 813 43

A prospective epidemiologic survey of bacterial infections in chronic hemodialysis patients was conducted from September 1, 1989 to February 28, 1990 in 27 dialysis units. Of the 1,455 patients enrolled in the study, 55 presented 63 episodes of bacteremia (incidence of 0.7 bacteremia per 100 patient-months). The portal of entry of sepsis was the vascular access in 50.8% of the episodes. The causative microorganisms were most often gram-positive cocci (69.8%). 23% of the teremic patients had a serum ferritin > 1,000 micrograms/l versus 7% of the nonbacteremic infected patients (p = 0.005). 39.7% of the patients had undergone a surgical operation during the month preceding the bacteremia. Eight patients had a recurrence during the study period and 8 had a metastatic localization: spondylodiscitis 2, septic pulmonary embolus 2, endocarditis 1, arthritis 1, liver abscess 1 and endophthalmia 1. 66% of the episodes required a hospitalization that lasted an average of 20 days. Mortality rate was 6.3%. This prospective study showed a trend towards a reduction in incidence and mortality of bacteremia in patients on chronic hemodialysis.
Nephron 1993
PMID:Bacteremia in patients on chronic hemodialysis. A multicenter prospective survey. 850 43

It is unknown whether continuous renal replacement techniques result in diminished morbidity and mortality when compared to conventional dialytic techniques. To investigate this issue a previously described, retrospectively studied group of critically ill patients with severe acute renal failure treated by conventional dialysis (CD) was compared to a prospectively studied group of similar patients treated by acute continuous hemodiafiltration (ACHD). A combined retrospective and prospective clinical and laboratory investigation was carried out for 234 consecutive critically ill patients with severe acute renal failure in the intensive care unit of a tertiary institution. Biochemical, clinical and outcome data in all patients treated by conventional dialytic techniques (intermittent hemodialysis and/or peritoneal dialysis) during a 5-year period were retrospectively analyzed, and a prospective analysis of the same biochemical, clinical and outcome data in all patients treated by acute continuous hemodiafiltration was done over a similar time span, with statistical comparison of findings. One hundred and fifty patients were treated by ACHD and 84 by CD. ACHD patients were more severely ill (mean APACHE II score: 28.2 vs. 25.8; p < 0.01) and older (mean age: 59.9 vs. 55.5 years; p < 0.01). There were no significant differences in the incidence of sepsis, bacteremia and need for mechanical ventilation. ACHD resulted in better control of uremia (mean steady-state plasma urea level: 20.1 vs. 31.7 mmol/l; p < 0.001) and hyperphosphatemia (mean serum phosphate: 1.26 vs. 1.95 mmol/l) after 24 h of initiation of therapy. It also allowed the administration of full nutritional support in a significantly greater percentage of patients (91.3 vs. 64.8%; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Nephron 1995
PMID:Severe acute renal failure: a comparison of acute continuous hemodiafiltration and conventional dialytic therapy. 853 50

An elderly man with end-stage renal disease required intensive hemodialysis therapy because of sepsis-induced hypercatabolism. We were able to prevent the occurrence of hypophosphatemia by using a phosphorus-enriched dialysate during hemodialysis treatments.
Nephron 1996
PMID:Use of a phosphorus-enriched dialysate in a hypercatabolic renal failure patient receiving intensive hemodialysis therapy. 873 Apr 47


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