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Infections may be deadly for many dialysis patients

  • - Urology / Nephrology News
  • May 25, 2012
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  • Viewed: 4139
  
Tags: | american society of nephrology | dialysis | hemodialysis | kidney failure |

An infection called peritonitis commonly arises in the weeks before many dialysis patients die, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings suggest that peritonitis may be a deadly condition for some kidney failure patients.

Most kidney failure patients on dialysis get their treatments at a clinic, through hemodialysis. But about 10% to 20% receive treatments at home through peritoneal dialysis, where fluids are first pumped into the abdominal cavity to collect wastes from the blood and are later removed from the body. Unfortunately this fluid can become infected, causing a condition called peritonitis. This occurs as commonly as twice a year to once every five or six years.

Neil Boudville (University of Western Australia, in Perth) and his colleagues evaluated whether peritonitis affects the survival of patients on peritoneal dialysis. They looked at information from all kidney failure patients (1,316 individuals) who received dialysis in Australia and New Zealand from May 2004 through December 2009 and who died while undergoing treatment or soon after.

Compared with the rest of the year, patients were more likely to develop peritonitis during the 120 days prior to their death, and even more so during the final month before their death. Specifically, they were six times as likely to develop peritonitis during the 30 days prior to their death compared with six months earlier.

“We have therefore proposed a potential new definition for a cause of death - “peritonitis-associated death” - being any death within 30 days of an episode of peritonitis,” said Prof Boudville.

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Study co-authors include Anna Kemp, PhD, Philip Clayton, Wai Lim, PhD, Sunil Badve, Carmel Hawley, Stephen McDonald PhD, Kathryn Wiggins, MD, Kym Bannister, MD, Fiona Brown PhD.

Highlights

  An infection called peritonitis commonly arises in the weeks before many patients on peritoneal dialysis die.
  More studies are needed to determine whether peritonitis causes premature death in dialysis patients.

10% to 20% of dialysis patients receive peritoneal dialysis.

Disclosures: Neil Boudville has previously received research funds from Roche, travel grants from Roche, Amgen and Jansen Cilag, and speaking honoraria from Roche. Wai Lim is on the Advisory Board for Novartis, Genzyme, Bristol Myer Squibb and Pfizer, he has also received research grants from Novartis, Genzyme and Pfizer, plus speaking honoraria from Novartis and Genzyme. David Johnson is a consultant for Baxter Healthcare Pty Ltd and Fresenius Medical Care and has previously received research funds from Baxter. He has also received speakers’ honoraria and research grants from Fresenius Medical Care and Baxter. Kym Bannister is a consultant for Baxter Healthcare Pty Ltd, on their Clinical Advisory Board and received speaking honoraria. Fiona Brown is a consultant for Baxter and Fresenius and has received travel grants from Amgen and Roche. Stephen McDonald has received speaking honoraria from AMGEN Australia, Fresenius Australia and Solvay Pharmaceuticals and travel grants from AMGEN Australia, Genzyme Australia and Jansen-Cilag. The remaining authors have no competing financial interests to declare.

The article, entitled “Recent Peritonitis Associates with Mortality Among Patients Treated with Peritoneal Dialysis,” will appear online at http://jasn.asnjournals.org/ on May 24, 2012, doi: 10.1681/ASN.2011121135.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

AMOXICILLIN Adverse Reactions

AMOXICILLIN is one of the most commonly used antibiotics in the world. It belongs to the spectrum of β-lactam antibiotics, and is the drug of choice when it comes to treating bacterial infections, as it is well absorbed even when given orally. Hence, it is used to treat a variety of infections, including infections of the ear, nose throat, skin infections, urinary tract infections, lower respiratory tract infections, gonorrhea and other sexually transmitted infections etc. AMOXICILLIN for sinus infection treatment is also a very well-known use of this drug. Thus, its multipurpose use makes this drug a very popular one among medical practitioners. However, amoxicillin side effects are something that doctors need to be well aware of, so as to prevent them from occurring, as they can be life-threatening at times.

One of the most serious and dangerous of all side effects is anaphylactic reaction. An anaphylactic reaction is defined as a life-threatening type 1 hypersensitivity reaction to a drug which is given internally or orally. Around 1500 patients die yearly due to an anaphylactic reaction in the United States. However, this serious allergic response of the body only occurs in those patients that have a true allergy to penicillin and its derivatives, as opposed to people who present with pseudo-anaphylaxis or an anaphylactoid reaction. An anaphylactic reaction is characterized by the following signs and symptoms:

  - Normally, a true anaphylactic reaction with systemic signs and symptoms begin showing within 72 hours of exposure to the allergen, without the need of further exposure. Skin involvement is one of the first signs seen. This includes generalized hives, skin rashes, itchiness, flushing. Fever is often experienced by people, along with the skin rashes.
  - Swelling of lips, tongue and/or throat is also seen, as this is the body’s way of responding and fighting the inflammation.
  - Respiratory distress, in the form of difficulty in breathing, shortness of breath, wheezing etc. may also be seen.
  - Some patients may also complain of gastrointestinal problems like severe abdominal cramps, stomach pain, diarrhea etc.
  - Other serious effects that may occur if immediate action is not taken to deal with the symptoms includes coronary artery spasms, which may lead to myocardial infarction. Consequently, there may also be a sudden drop in blood pressure, which may lead to lightheadedness and fatigue, along with loss of consciousness.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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Tracy Hampton
.(JavaScript must be enabled to view this email address)
312-339-9067
American Society of Nephrology

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