Isotretinoin is a vitamin A-derived agent which is commonly used in the treatment of acne and may cause drug-related acute tubulointerstitial nephritis. What is Known: •Drug-related acute tubulointerstitial nephritis (ATIN) is one of the most common causes of childhood acute renal failures. What is New: •Isotretinoin may cause drug-related acute tubulointerstitial nephritis.
Background
Automated peritoneal dialysis (APD) is increasingly preferred worldwide. By using a software application (Homechoice with Claria sharesource system (CSS)) with a mod-M added to the APD device, details of the home dialysis treatment become visible for PD nurses and physicians, allowing for close supervision. We aimed to evaluate the perceptions of patients/caregivers, PD nurses, and physicians about the advantages and disadvantages of CSS.
Methods
Three different web-based questionnaires for patients/caregivers, nurses, and physicians were sent to 15 pediatric nephrology centers with more than 1 year of experience with CSS.
Results
Respective questionnaires were answered by 30 patients/caregivers, 22 pediatric nephrologists, and 15 PD nurses. Most of the nurses and physicians (87% and 73%) reported that CSS improved patient monitoring. A total of 73% of nurses suggested that CCS is not well known by physicians, while half of them reported reviewing CSS data for all patients every morning. Sixty-eight percent of physicians thought that CSS helps save time for both patients/caregivers and healthcare providers by reducing visits. However, only 20% of patients/caregivers reported reduced hospital visits. A total of 90% of patients/caregivers reported that being under constant monitoring made them feel safe, and 83% stated that the patient’s sleep quality improved.
Conclusions
A remote monitoring APD system, CSS, can be successfully applied with children for increased adherence to dialysis prescription by giving shared responsibility and may help increase the patient’s quality of life. This platform is more commonly used by nurses than physicians. Its potential benefits should be evaluated in further well-designed clinical studies with larger patient groups.
Graphical abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information
.
Supplementary Information
The online version contains a graphical abstract available at 10.1007/s00467-022-05563-9.
Background. Colistin is an antibiotic in the polymyxin group and is especially important in the elimination of multi-drug resistant gram negative bacteria. To date, there are many studies investigating colistin related side effects, especially nephrotoxicity. However, there are few studies involving premature neonates, and this study aimed to investigate the side effects of colistin in this particular patient group. Methods. Between January 2016 and May 2019, the medical records of premature neonates treated with colistin were retrospectively reviewed. The diagnosis of acute kidney injury (AKI) was performed according to the modified neonatal KDIGO criteria. Serum electrolyte levels were recorded at the initiation of colistin treatment and 4-7 days after. Results. A total of 47 premature neonates; with a median gestational age of 27 weeks and median weight of 970 g at birth were included in the study. The median postnatal day of colistin initiation was 24 days and mean duration of colistin therapy was 15.95 ± 3.70 days. Colistin was combined with aminoglycosides in 44.6% of the patients. Acute kidney injury was documented in 17.0% of premature neonates. (n = 6 for stage 1, n = 2 for stage 2, none of the patients had stage 3). In univariate analysis, gestational age and concomitant aminoglycoside use were associated with AKI development (OR, 0.446; 95% CI 0.238-0.832; p = 0.011 and OR, 1.324; 95% CI 1.023-7.584; p = 0.024). Mean magnesium level significantly decreased after colistin treatment (1.70 ± 0.84 vs. 1.57 ± 0.29, p = 0.017) and the frequency of hypomagnesemia increased after colistin use (78.7% vs. 91.5%, p = 0.031). Frequency of elevated AST increased from 23.4% to 44.7% following colistin use (p = 0.031). Conclusions. Colistin-related side effects observed in premature neonates are not as common as in pediatric patients. Electrolyte imbalance is observed more frequently in this age group following colistin use. We suggest strict serum electrolyte level monitoring, especially magnesium, in premature neonates that are receiving colistin.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.