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Kidney Dial., Volume 4, Issue 3 (September 2024) – 3 articles

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9 pages, 537 KiB  
Article
Plasma Parathormone Levels during Citrate Anticoagulated Continuous Venovenous Hemofiltration in ICU Patients
by Carlos V. Elzo Kraemer, Natasha M. Appelman-Dijkstra, Bart E. P. B. Ballieux, Nadia A. du Fossé, David J. van Westerloo and Evert de Jonge
Kidney Dial. 2024, 4(3), 154-162; https://doi.org/10.3390/kidneydial4030013 - 20 Aug 2024
Viewed by 494
Abstract
Continuous venovenous hemofiltation (CVVH) with citrate anticoagulation has been shown to be associated with substantial losses of calcium and negative calcium balance in ICU patients, which may lead to excessive bone loss and osteoporosis. The aim of this study is to investigate whether [...] Read more.
Continuous venovenous hemofiltation (CVVH) with citrate anticoagulation has been shown to be associated with substantial losses of calcium and negative calcium balance in ICU patients, which may lead to excessive bone loss and osteoporosis. The aim of this study is to investigate whether plasma parathormone monitoring can identify patients with negative calcium balance during CVVH. This is a retrospective single-center study of all adult ICU patients treated with citrate CVVH from 2021 to 2023. PTH was measured routinely once per week. Calcium excretion in ultrafiltrate fluid and CVVH calcium balance were measured daily. In total, 274 PTH measurements were performed in 111 patients. In 61 measurements (22%), PTH was higher than the upper limit of normal (>8 pmol/L). If PTH was higher than normal, plasma ionized calcium was less than 1.16 mmol/L in 77% of cases and hypercalcemia was never present. In a subgroup of patients treated with CVVH for at least 36 h in the preceding 72 h, PTH values were similar for quartiles by cumulative calcium balance. Increased plasma concentrations of PTH are frequently found in ICU patients treated with citrate CVVH, but no association was found between PTH and the CVVH calcium balance over the last 72 h. Full article
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2 pages, 145 KiB  
Obituary
In Memory of George Bakris (1952–2024)
by Francesco Locatelli, Giorgina B. Piccoli and Peter Roth
Kidney Dial. 2024, 4(3), 152-153; https://doi.org/10.3390/kidneydial4030012 - 10 Jul 2024
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Abstract
Prof. Dr. George Bakris was an Editorial Board Member of Kidney and Dialysis. His invaluable contributions were instrumental in guiding the journal’s direction and enhancing its success. We are deeply grateful for his unwavering dedication, commitment, and active involvement in the journal’s [...] Read more.
Prof. Dr. George Bakris was an Editorial Board Member of Kidney and Dialysis. His invaluable contributions were instrumental in guiding the journal’s direction and enhancing its success. We are deeply grateful for his unwavering dedication, commitment, and active involvement in the journal’s development. Full article
8 pages, 475 KiB  
Brief Report
Outbreak of Ralstonia spp. and Burkholderia spp. Catheter-Related Bloodstream Infection in Hemodialysis Unit
by Mauro Valente, Francesca Orecchioni, Fabiana Brigante, Maria Ilaria Moretti, Roberta Mariani, Marcello Mario D’Errico, Marco Moretti, Marcello Tavio, Maria Soledad Ferreiro Cotorruelo, Massimo Marchi, Emanuele Moglie and Andrea Ranghino
Kidney Dial. 2024, 4(3), 144-151; https://doi.org/10.3390/kidneydial4030011 - 9 Jul 2024
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Abstract
The Ralstonia species (RB) and Burkholderia species (BB) are bacteria responsible for nosocomial infections in frail patients such as hemodialyzed (HD) patients. Here, we report how we managed an outbreak caused by RB and BB that occurred in a [...] Read more.
The Ralstonia species (RB) and Burkholderia species (BB) are bacteria responsible for nosocomial infections in frail patients such as hemodialyzed (HD) patients. Here, we report how we managed an outbreak caused by RB and BB that occurred in a dialysis unit. From the 7th to the 16th of April 2021, an infection due to RB and BB occurred in 7 out of 39 (17.9%) HD patients with central venous catheter (CVC). Disinfectants, CVC-lock therapy solutions, water by reverse osmosis unit (ROW) and dialysis concentrates were cultured, including the biofilm from the loading plastic tubes (LPTs) that connect the hemodialysis consoles (HCs) to the ROW delivery line. The antibiotic treatment was successful for all patients. RB and BB were isolated in the biofilm of 11/37 LPTs. Three out of 11 positive LPTs were associated with the infected patients. The ROW delivery line was modified to provide a whole disinfection with the HCs connected, avoiding the risk of new contamination of the LPTs. A filtration module of 0.01 mm was added prior to the ROW delivery line. Our experience suggests that outbreaks sustained by unusual bacteria such as RB and BB should be promptly investigated to treat the infected patients with the appropriate therapy and to identify the possible source of infection, making the needful changes to achieve a safer dialysis unit. Full article
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