These results suggest that the local delivery of antiproliferative agents using a thermosensitive, injectable biodegradable copolymer (ReGel) for sustained delivery is a promising strategy to inhibit neointimal hyperplasia of arteriovenous hemodialysis grafts.

No abstract

Continuous renal replacement therapy (CRRT) is an important modality to support critically ill patients, and the need for CRRT treatment has been increasing. However, CRRT management is costly, and the associated resources are limited. Thus, it remains challenging to identify patients that are likely to have a poor outcome, despite active treatment with CRRT. We sought to elucidate the factors associated with early mortality after CRRT initiation. We analyzed 240 patients who initiated CRRT at an academic medical center between September 2016 and January 2018. We compared baseline characteristics between patients who died within seven days of initiating CRRT (early mortality), and those that survived more than seven days beyond the initiation of CRRT. Of the patients assessed, 130 (54.2%) died within seven days of CRRT initiation. Multivariate logistic regression models revealed that low mean arterial pressure, low arterial pH, and high Sequential Organ Failure Assessment score before CRRT initiation were significantly associated with increased early mortality in patients requiring CRRT. In conclusion, the mortality within seven days following CRRT initiation was very high in this study. We identified several factors that are associated with early mortality in patients undergoing CRRT, which may be useful in predicting early outcomes, despite active treatment with CRRT.

Left ventricular hypertrophy (LVH) is an independent risk factor for cardiac death. This study evaluates the prevalence and patterns of LVH in patients with predialysis chronic renal failure (CRF) and analyses the relationship between LVH and various predisposing factors. Sixty-two CRF patients were recruited from the renal clinic with serum creatinine over 2 mg/dl. Using echocardiography, we calculated the left ventricular mass index (LVMI) and relative wall thickness (RWT), and classified the patients into four groups (Group 1: normal, Group 2: concentric remodelling, Group 3: concentric hypertrophy, Group 4: eccentric hypertrophy). Prevalence and patterns of LVH in patients with CRF were as follows; 6.5% in Groups 1 and 2, 56.5% in Group 3 and 30.5% in Group 4. LVMI increases with progressive renal function decline. There were linear correlations between LVMI and systolic and diastolic blood pressure (BP), serum creatinine (Scr) and intact parathyroid hormone (PTH) in patients with predialysis CRF and also inverse linear correlations between LVMI and creatinine clearance (Ccr) and hemoglobin. In conclusion, we demonstrate the high prevalence of LVH (87%) in patients with predialysis CRF and concentric hypertrophy (56.5%) was the main pattern of LVH. Several factors such as anemia, systolic and diastolic BP, renal function and PTH influence LVMI.