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To review the current literature about albumin dialysis-based liver support. RECENT FINDINGS: The literature suggests that the molecular adsorbent recirculating system of albumin dialysis is a useful tool to treat acute liver failure, decompensated chronic liver disease, and to provide a bridge for patients to liver transplantation. The reported clinical benefits include an improvement in central and local haemodynamics as well as organ functions (liver, brain, kidney). The treatment can contribute to liver regeneration and prolongation of patient survival. Proper patient selection is critical for clinical success. SUMMARY: Albumin regeneration has developed into a central component of modern liver support technologies. Albumin dialysis using the molecular adsorbent recirculating system is the most frequently used and best studied liver support technique at present time. Ongoing and future clinical studies will help define the place of albumin dialysis in liver failure therapy.

Článek

Novinky v léčbě peritonitidy u peritoneálně dialyzovaných pacientů
[Update on the treatment of peritonitis in peritoneal dialysis patients]

This is no different with peritoneal dialysis (PD), where the prevention and treatment of peritonitis ...

Klaboch, Jan
Autor Autorita I. interní klinika LF UK a FN Plzeň

Aktuality v nefrologii. 2022 ; 28 (2) : 45-47.

ISSN 1210-955X
Medvik
Zdroj

Infekce zůstávají důležitým problémem, s nímž se prakticky potýkají všechny obory medicíny. Nejinak je tomu u peritoneální dialýzy (PD), kde je prevence a léčba peritonitidy klíčovou součástí péče. Doporučení zabývající se tímto tématem vydává již od roku 1983 Mezinárodní společnost pro peritoneální dialýzu (ISPD). V letošním roce byla publikována jejich další aktualizovaná verze, která nám přináší některé novinky. Byly definovány nové kategorie peritonitid (asociované s PD katétrem, enterální, pre-PD peritonitida). Byl aktualizován a zpřísněn požadavek na maximální incidenci peritonitid (0,4 epizody na rok léčby). Je kladen vyšší důraz na vypuštění dialyzátu před invazivními gastroenterologickými a gynekologickými vyšetřeními. Dalšími preventivními opatřeními je korekce hypokalemie a neužívání antagonistů H2-receptorů. Pokud jde o empirickou antibiotickou léčbu, je novinkou možnost užívat monoterapii cefepimem. K terapii aminoglykosidy je pak doporučováno rutinně přidávat N-acetylcystein k prevenci ototoxicity. Novinky jsou i v přístupu k refrakterní peritonitidě, peritonitidě způsobené Corynebacterii a dalšími agens. Publikovaná doporučení poskytují cenný soubor aktuálních odpovědí na problémy, s nimiž se v běžné praxi často setkáváme.

Infections remain an important problem facing virtually all medical disciplines. This is no different with peritoneal dialysis (PD), where the prevention and treatment of peritonitis is a key part of care. The International Society for Peritoneal Dialysis (ISPD) has been issuing recommendations on this subject since 1983. This year, their next updated version was published, which brings us some news. New categories of peritonitis (associated with PD catheter, enteral, pre-PD peritonitis) have been defined. The requirement for a maximum peritonitis rate has been updated and tightened (0.4 episodes per year of treatment). There is a greater emphasis on PD fluid drainage before invasive gastroenterological and gynecological examinations. Other preventive measures are the correction of hypokalaemia and the avoidance of H2-receptor antagonists. In empirical antibiotic treatment, the possibility of using cefepime monotherapy is a novelty. It is recommended to add N-acetylcysteine routinely to aminoglycoside therapy to prevent ototoxicity. There are also new approaches to refractory peritonitis, peritonitis caused by Corynebacteria and other agents. The published recommendations provide a valuable set of answers to the problems we often encounter in common practice.

Článek

Poznámky z audiokonference týkající se infekce hepatitidou C (HCV), diagnostikovanou u dvou pacientů ze Skotska po dialyzační terapii na Malorce
[Minutes of the audio-conference on hepatitis C virus (HCV) infection in two Scottish patients after dialysis treatment in Mallorca]

ECDC in Stockholm organized an audio conference to provide update and information exchange for the EU ...

Částková, Jitka
Autor Autorita Odbor epidemiologie infekčních nemocí COČ, SZÚ

Zprávy epidemiologie a mikrobiologie. 2010 ; 19 (11) : 331-332.

ISSN 1803-6422
Medvik
Zdroj

ECDC ve Stockholmu uspořádalo audiokonferenci, která umožnila výměnu aktuálních informací pro členské státy EU, jejichž pacienti s renálním postižením byli dialyzováni na Malorce v období 1. srpna – 17. listopadu 2010 a u nichž byla zjištěna nebo jsou v riziku onemocnění hepatitidou C.

ECDC in Stockholm organized an audio conference to provide update and information exchange for the EU Member States whose renal patients had undergone dialysis between August 1 and November 17, 2010 and were found to be HCV positive or are at risk of being HCV positive.

MeSH
ambulantní zařízení organizace a řízení MeSH
dialýza ledvin * škodlivé účinky MeSH
hepatitida C * diagnóza MeSH
hlášení nemocí MeSH
kontrola infekčních nemocí MeSH
lidé středního věku MeSH
lidé MeSH
senioři MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
kazuistiky MeSH
Geografické názvy
Skotsko MeSH
Španělsko MeSH

Kniha

Clinical nephrology, dialysis and transplantation. Part 1, 2 : a continously updated textbook

Malluche, H. H. (Hartmut H.)
Autor Autorita

Deisenhofen : Dustri-Verlag Dr.Karl Feistle, 1999

1st ed. 2 sv.

Publikační typ
učebnice MeSH

Článek

2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis

OBJECTIVE: To update the 2012 EULAR/ERA-EDTA recommendations for the management of lupus nephritis (LN ...

Annals of the rheumatic diseases. 2020 ; 79 (6) : 713-723. [pub] 20200327

Ann Rheum Dis
ISSN 1468-2060
Medvik
Zdroj

OBJECTIVE: To update the 2012 EULAR/ERA-EDTA recommendations for the management of lupus nephritis (LN). METHODS: Following the EULAR standardised operating procedures, a systematic literature review was performed. Members of a multidisciplinary Task Force voted independently on their level of agreeement with the formed statements. RESULTS: The changes include recommendations for treatment targets, use of glucocorticoids and calcineurin inhibitors (CNIs) and management of end-stage kidney disease (ESKD). The target of therapy is complete response (proteinuria <0.5-0.7 g/24 hours with (near-)normal glomerular filtration rate) by 12 months, but this can be extended in patients with baseline nephrotic-range proteinuria. Hydroxychloroquine is recommended with regular ophthalmological monitoring. In active proliferative LN, initial (induction) treatment with mycophenolate mofetil (MMF 2-3 g/day or mycophenolic acid (MPA) at equivalent dose) or low-dose intravenous cyclophosphamide (CY; 500 mg × 6 biweekly doses), both combined with glucocorticoids (pulses of intravenous methylprednisolone, then oral prednisone 0.3-0.5 mg/kg/day) is recommended. MMF/CNI (especially tacrolimus) combination and high-dose CY are alternatives, for patients with nephrotic-range proteinuria and adverse prognostic factors. Subsequent long-term maintenance treatment with MMF or azathioprine should follow, with no or low-dose (<7.5 mg/day) glucocorticoids. The choice of agent depends on the initial regimen and plans for pregnancy. In non-responding disease, switch of induction regimens or rituximab are recommended. In pure membranous LN with nephrotic-range proteinuria or proteinuria >1 g/24 hours despite renin-angiotensin-aldosterone blockade, MMF in combination with glucocorticoids is preferred. Assessment for kidney and extra-renal disease activity, and management of comorbidities is lifelong with repeat kidney biopsy in cases of incomplete response or nephritic flares. In ESKD, transplantation is the preferred kidney replacement option with immunosuppression guided by transplant protocols and/or extra-renal manifestations. Treatment of LN in children follows the same principles as adult disease. CONCLUSIONS: We have updated the EULAR recommendations for the management of LN to facilitate homogenization of patient care.