Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Idiopathic membranoproliferative glomerulonephritis (MPGN) has a poor prognosis, with 90% of patients requiring dialysis treatment after 20 years regardless of therapy. Up to 34% of patients may die due to thrombotic complications or sepsis. This study investigates the influence of aspirin plus dipyridamole on proteinuria and renal function in nephrotic MPGN patients with moderately reduced glomerular filtration rate. Eighteen patients with biopsy-proven MPGN (15 type I, 3 type II) and nephrotic syndrome were randomly assigned to receive protein restriction, antihypertensive therapy (control group) or in addition aspirin and dipyridamole (treatment group). Patients were prospectively followed for a mean of 36 months. Serum creatinine remained unchanged after 36 months compared to baseline in both groups. In the treatment group proteinuria was reduced from 8.3 +/- 1.4 to 1.6 +/- 0.7 g/day (P < 0.05). In control patients proteinuria decreased from 7.1 +/- 1.6 to 4.3 +/- 1.1 g/day. After 36 months proteinuria was significantly lower in the treatment group compared to control (P < 0.02 Mann-Whitney rank sum test). In conclusion, aspirin plus dipyridamole may be of value in reversing nephrotic syndrome and associated risks in patients with MPGN and moderately reduced renal function.
Nephrol Dial Transplant 1994
PMID:Effect of aspirin and dipyridamole on proteinuria in idiopathic membranoproliferative glomerulonephritis: a multicentre prospective clinical trial. Collaborative Glomerulonephritis Therapy Study Group (CGTS) 797 86

Infection remains a major cause of morbidity and mortality in the dialysis patient. Most of these infections are bacterial and often lead to sepsis. In this review the possible influence of the biocompatibility of the dialysis membrane on the incidence of bacterial infections is discussed. Specifically, the role of the membrane on granulocyte function such as phagocytosis, adhesion, and production of reactive oxygen species is shown to be adversely affected by recurrent exposure to complement-activating membranes. Recent clinical studies also support the notion that dialysis with bioincompatible membranes is associated with a higher incidence of clinical infections than membranes that are more biocompatible.
Nephrol Dial Transplant 1994
PMID:Biocompatibility and risk of infection in haemodialysis patients. 806 5

Data on end-stage renal disease (ESRD) patients in Kuwait were collected retrospectively and prospectively starting in mid-1988. The study period covered 4 1/2 years from 1 January 1986 to 30 June 1990. Epidemiological characteristics of ESRD patients and their disposal by dialysis and transplantation were analysed and compared with previous reports from Kuwait, neighbouring countries, Europe, and USA. A total of 647 patients received renal replacement therapy (RRT) in Kuwait during the study period. This gave an incidence rate of 72 patients per year per million of population. The prevalence rate for patients on maintenance dialysis was 80.6 per million population in mid-1988. Nearly one-fifth of total patients (19.6%) were older than 60 years of age and one-third (30.8%) were identified as 'high risk' category. As for Kuwaiti nationals alone on RRT 29.7% were above 60 years of age and 44.2% were high-risk patients. We have noticed a steady decline in the number of patients who accepted continuous ambulatory peritonial dialysis (CAPD) for dialytic support. Chronic tubulointerstitial disease resulting from atrophic pyelonephritis was the leading cause of ESRD amongst both Kuwaiti nationals and expatriates. Though diabetic nephropathy was only the third leading cause of ESRD (14.7%) in the total population, it was more frequent (21.2%) among Kuwaitis. The gross mortality rate on dialysis was 14.7%. The major causes of death were related to cardiovascular diseases (60%) and sepsis (24.2%).(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1994
PMID:End-stage renal disease and renal replacement therapy in Kuwait--epidemiological profile over the past 4 1/2 years. 809 Mar 33

Clinical features, diagnosis and outcomes of persistently positive dialysate culture (PPDC) after apparent cure of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were investigated in 16 PPDC episodes observed in 16 elderly (age 62 +/- 8 years) men who had been on CAPD for 14 +/- 9 months. Seven patients (46.7%) were diabetic. Peritonitis was caused by S. aureus in 14 cases and S. epidermidis in 2 cases. Preexisting or simultaneous infectious foci were present in 15 cases, exit-site infection in 5, tunnel infection in 13, and intra-abdominal abscess in 2 cases. Indium scans were positive in 6/9 cases (67%). Two patients died with the peritoneal catheter in situ, one from intercurrent myocardial infarction and one from S. aureus sepsis with pneumonia. In another 14 cases the peritoneal catheters were removed because of either tunnel abscess (8 cases) or peritonitis recurrence (6 cases). PPDC following apparent cure of CAPD peritonitis is almost always associated with exit-site, tunnel, or intra-abdominal abscess and leads invariably to catheter loss. Associated mortality is substantial.
Adv Perit Dial 1993
PMID:Persistence of positive dialysate cultures after apparent cure of CAPD peritonitis. 810 23

A total of 139 patients with acute renal failure (ARF) were studied, of which 41 (29.4%) were elderly with mean age of 67.1 years and 98 (70.6%) were younger with mean age of 32.3 years. Surgical causes accounted for 65% of geriatric ARF while medical causes were predominant in the younger patients (55.1%). Amongst the surgical causes, prostate-related problems due to obstruction or following transurethral resection of prostate were seen in 20 patients (74%). Drugs and sepsis were the predominant causes of medical ARF in the geriatric patients (85.7%). Of all the causes of geriatric ARF, which included both medical and surgical, nephrotoxic drugs either alone or in combination with other predisposing factors were the cause in 22 (51%) patients. Haemodialysis was needed in 15 of geriatric (36.6%) and 64 of younger (65.3%) ARF patients. Recovery from ARF, as evidenced by normalization of serum creatinine, was delayed in the elderly as compared to the younger patients (32.0 versus 11.4 days, P < 0.001). Mortality, though higher in the elderly as compared to the younger patients, was not significantly different (9.75% versus 6.1%).
Nephrol Dial Transplant 1993
PMID:Acute renal failure in the elderly: experience from a single centre in India. 825 15

This paper describes the impact of Iraqi invasion and occupation on 196 end-stage renal failure (ESRD) patients maintained on dialysis treatment in Kuwait. Seventeen patients were abroad on holidays at the time of invasion, 77 fled the country for safety, and the rest (102) remained in Kuwait. Nearly half of those patients who remained in Kuwait died during the period of occupation. The mortality rate was as high as 95% in the intermittent cycler peritoneal dialysis (IPD) patients and 41% in haemodialysis patients compared to only 12.7% for those who left the country for treatment. Failure to reach dialysis centres, sepsis, myocardial infarction, and cerebral haemorrhage were the major causes of death. Shortage of skilled nurses was the major detrimental factor which necessitated major policy changes in the treatment programme. Those were (1) restriction of haemodialysis treatment hours and (2) discontinuation of IPD and transfer of patients to continuous ambulatory peritoneal dialysis (CAPD). The incidence of new ESRD Kuwaiti patients entering dialysis programme during the occupation period and soon afterwards was only 37 per million Kuwaiti population compared to 60 per million in the previous years.
Nephrol Dial Transplant 1993
PMID:The impact of Iraqi occupation on end-stage renal disease patients in Kuwait, 1990-1991. 838 40

Although subclavian vein stenosis is a well-known complication of haemodialysis subclavian catheters, little is known about its causes. Catheter-related infection is the most common complication of this technique, but its role in the genesis of late subclavian stenosis has not been established. We retrospectively analysed 80 subclavian catheterizations in a total of 54 chronic haemodialysis patients from a single center. Sixteen catheters had to be removed because of a well documented catheter-related infection: three catheter-related sepsis (2 with ipsilateral phlebitis), seven isolated fever with catheter tip colonization which disappeared after catheter removal, and six exit-site discharge with positive culture. For comparison we matched 14 contemporaneous catheters which were electively removed without evidence of infection and with a negative culture of the catheter tip. A venogram of the ipsilateral arm was performed in all the cases after more than 6 months of catheter removal. Both groups were remarkably similar with respect to age, sex, side of insertion, number of inserted catheters, time of indwelling, and time elapsed from removal to venography. Definite subclavian stenosis was three times more common among patients with previous catheter-related infection (75% versus 28%; P < 0.01). Interestingly, both patients with ipsilateral phlebitis showed total occlusion of the subclavian vein. Although all diabetic patients of the study (n = 6) suffered a catheter-related infection, the incidence of late subclavian stenosis was not more common than in non-diabetic infected patients. In summary, subclavian haemodialysis catheter-related infection is a major risk factor for the development of late subclavian vein stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1993
PMID:Subclavian catheter-related infection is a major risk factor for the late development of subclavian vein stenosis. 838 89

Thirty-six Permcath double-lumen catheters implanted in 36 chronic renal failure patients for haemodialysis treatment were prospectively studied. When catheter-related sepsis was suspected a quantitative blood culture was obtained simultaneously from the catheter and from a peripheral vein. If bacterial colonies in the catheter blood specimen were fourfold greater than identical bacterial colonies in the peripheral blood specimen, the test was considered indicative of catheter sepsis and an empirical antibiotic regimen was begun while the central line remained in situ. Eleven patients suffered 13 episodes of catheter-related sepsis. Staphylococcus epidermidis and Pseudomonas aeruginosa accounted for 77% of the strains isolated. All episodes were successfully treated with vancomycin or ciprofloxacin and yielded negative results on follow-up quantitative blood cultures. Fever subsided within the first 48 h of therapy and no complications occurred. None of these patients required catheter removal for cure of the catheter-related sepsis.
Nephrol Dial Transplant 1993
PMID:Successful treatment of haemodialysis catheter-related sepsis without catheter removal. 838 90

Catheter-related sepsis, principally with S. epidermidis, remains a main complication of continuous ambulatory peritoneal dialysis (CAPD). A possible reason for the antibiotic resistance often displayed by these infections is the presence of bacteria growing in a protective biofilm on the catheter surface. We developed a reproducible stable model of experimental peritoneal catheter-associated infection with S. epidermidis in the mouse and used this model to examine the therapeutic efficacy of vancomycin. The response to vancomycin treatment given daily (15 mg/kg body weight) for periods from 1-14 days, relating the proportion of successful outcome (sterilization of implant infection) over time, was typical of an S-shaped biological response curve. These results extend our previous observations in vitro of the activity of vancomycin against S. epidermidis biofilm preparations and serve as a rational basis for the experimental evaluation of synergy and antagonism in the treatment of implant-associated infection.
Perit Dial Int 1993
PMID:Vancomycin therapy of experimental peritoneal catheter-associated infection (Staphylococcus epidermidis) in a mouse model. 839 96

Thrombotic microangiopathy (TMA) can be a late complication of bone marrow transplantation (BMT). A patient is described in whom the haemolytic uraemic syndrome developed 10 months after BMT and who died of E. coli sepsis while on maintenance haemodialysis. The literature is reviewed, regarding clinical presentation, incidence, pathogenesis and therapy. TMA can be observed, after an interval of 3-12 months, in about 6-26% of patients following BMT. Reported cases vary considerably in clinical severity, from mild presentations to severe TMA with high mortality rates despite intensive therapy. Important pathogenetic roles are ascribed to the conditioning total body irradiation and the use of cyclosporin A, but other factors may be involved as well. Next to supportive therapy, plasma exchange and the use of ACE inhibitors may be of value in treating BMT-associated TMA.
Nephrol Dial Transplant 1996 Jul
PMID:Haemolytic uraemic syndrome following bone marrow transplantation. Case report and review of the literature. 867 33


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