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Samsone VG, Rimsevicius L, Kantauskaite M, Sukackiene D, Janusaite MM, Vaisnyte B, Miglinas M. Improved heart failure after closure of arteriovenous fistula. Clin Case Rep 2022; 10:e6184. [PMID: 35957788 PMCID: PMC9360343 DOI: 10.1002/ccr3.6184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 11/14/2022] Open
Abstract
The population of patients with end‐stage renal disease is rapidly growing and hemodialysis remains the most common treatment option. We present a case of a young patient with arteriovenous fistula (AVF)‐related heart failure, and a review of the main hemodynamic changes after AVF formation and ligation procedures. AVF is the gold standard vascular access for hemodialysis. It has the longest potency, is cost‐effective, and carries low risk of infections. We present a review of hemodynamic changes after AVF formation and ligation procedure. A decision for vascular access, as well as dialysis modality, should be individualized.
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Affiliation(s)
| | | | - Marta Kantauskaite
- Nephrology Center, Faculty of Medicine Vilnius University Vilnius Lithuania
| | - Diana Sukackiene
- Nephrology Center, Faculty of Medicine Vilnius University Vilnius Lithuania
| | | | - Birute Vaisnyte
- Nephrology Center, Faculty of Medicine Vilnius University Vilnius Lithuania
| | - Marius Miglinas
- Nephrology Center, Faculty of Medicine Vilnius University Vilnius Lithuania
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Puodziukaite L, Serpytis M, Kundrotaite A, Sipylaite J, Miglinas M, Janusaite MM, Asakiene E, Milisauskaite E, Zelvys A, Aliancevic O, Jancoriene L. Kidney transplantation from a SARS-CoV-2-positive donor for the recipients with immunity after COVID-19. Transpl Infect Dis 2021; 23:e13666. [PMID: 34097791 PMCID: PMC8209852 DOI: 10.1111/tid.13666] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/11/2021] [Accepted: 05/28/2021] [Indexed: 01/05/2023]
Abstract
The coronavirus (COVID‐19) pandemic is evolving very quickly and has affected healthcare systems worldwide. Many uncertainties remain about transplantation from a SARS‐CoV‐2‐positive donor as only a few cases have been reported. Here, we present the successful transplantation of 2 kidneys from a 52‐year‐old male donor with active (2 weeks of COVID‐19‐like symptoms and positive nasopharyngeal swab SARS‐CoV‐2 polymerase chain reaction on the day of organ recovery) SARS‐CoV‐2 disease. The immediate postoperative course of both recipients was uneventful. This case emphasizes that patients with SARS‐CoV‐2 may be safe organ donors.
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Affiliation(s)
- Lina Puodziukaite
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Anesthesiology and Intensive Care, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Mindaugas Serpytis
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Anesthesiology and Intensive Care, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Aurelija Kundrotaite
- Center of Anesthesiology and Intensive Care, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Jurate Sipylaite
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Anesthesiology and Intensive Care, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Marius Miglinas
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Marta Monika Janusaite
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Egle Asakiene
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Erika Milisauskaite
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Urology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Arunas Zelvys
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Urology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Oleg Aliancevic
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Ligita Jancoriene
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Maneikis K, Ringeleviciute U, Bacevicius J, Dieninyte-Misiune E, Burokaite E, Kazbaraite G, Monika Janusaite M, Dapkeviciute A, Zucenka A, Peceliunas V, Kryzauskaite L, Kasiulevicius V, Ringaitiene D, Zablockiene B, Zvirblis T, Marinskis G, Jancoriene L, Griskevicius L. Mitigating arrhythmia risk in Hydroxychloroquine and Azithromycin treated COVID-19 patients using arrhythmia risk management plan. Int J Cardiol Heart Vasc 2020; 32:100685. [PMID: 33335973 PMCID: PMC7734220 DOI: 10.1016/j.ijcha.2020.100685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 12/27/2022]
Abstract
Aims To assess cardiac safety in COVID-19 patients treated with the combination of Hydroxychloroquine and Azithromycin using arrhythmia risk management plan. Methods and results We retrospectively examined arrhythmia safety of treatment with Hydroxychloroquine and Azithromycin in the setting of pre-defined arrhythmia risk management plan. The data was analyzed using R statistical package version 4.0.0. A two-tailed p-value<0.05 was considered significant. 81 patients were included from March 23rd to May 10th 2020. The median age was 59 years, 58.0% were female. The majority of the study population (82.7%) had comorbidities, 98.8% had radiological signs of pneumonia. Fourteen patients (17.3%) experienced QTc ≥ 480 ms and 16 patients (19.8%) had an increase of QTc ≥ 60 ms. Seven patients (8.6%) had QTc prolongation of ≥ 500 ms. The treatment was discontinued in 4 patients (4.9%). None of the patients developed ventricular tachycardia. The risk factors significantly associated with QTc ≥ 500 ms were hypokalemia (p = 0.032) and use of diuretics during the treatment (p = 0.020). Three patients (3.7%) died, the cause of death was bacterial superinfection with septic shock in two patients, and disseminated intravascular coagulation with multiple organ failure in one patient. None of these deaths were associated with cardiac arrhythmias. Conclusion We recorded a low incidence of QTc prolongation ≥ 500 ms and no ventricular tachycardia events in COVID-19 patients treated with Hydroxychloroquine and Azithromycin using cardiac arrhythmia risk management plan.
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Affiliation(s)
- Kazimieras Maneikis
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ugne Ringeleviciute
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Justinas Bacevicius
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Egle Dieninyte-Misiune
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Emilija Burokaite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Gintare Kazbaraite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Marta Monika Janusaite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Austeja Dapkeviciute
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Andrius Zucenka
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Valdas Peceliunas
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lina Kryzauskaite
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vytautas Kasiulevicius
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Donata Ringaitiene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Anesthesiology, Intensive Care and Pain Management Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Birute Zablockiene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Tadas Zvirblis
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Germanas Marinskis
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Ligita Jancoriene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Laimonas Griskevicius
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Miglinas M, Cesniene U, Janusaite MM, Vinikovas A. Cerebrovascular Disease and Cognition in Chronic Kidney Disease Patients. Front Cardiovasc Med 2020; 7:96. [PMID: 32582768 PMCID: PMC7283453 DOI: 10.3389/fcvm.2020.00096] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 05/06/2020] [Indexed: 12/16/2022] Open
Abstract
Chronic kidney disease (CKD) affects both brain structure and function. Patients with CKD have a higher risk of both ischemic and hemorrhagic strokes. Age, prior disease history, hypertension, diabetes, atrial fibrillation, smoking, diet, obesity, and sedimentary lifestyle are most common risk factors. Renal-specific pathophysiologic derangements, such as oxidative stress, chronic inflammation, endothelial dysfunction, vascular calcification, anemia, gut dysbiosis, and uremic toxins are important mediators. Dialysis initiation constitutes the highest stroke risk period. CKD significantly worsens stroke outcomes. It is essential to understand the risks and benefits of established stroke therapeutics in patients with CKD, especially in those on dialysis. Subclinical cerebrovascular disease, such as of silent brain infarction, white matter lesions, cerebral microbleeds, and cerebral atrophy are more prevalent with declining renal function. This may lead to functional brain damage manifesting as cognitive impairment. Cognitive dysfunction has been linked to poor compliance with medications, and is associated with greater morbidity and mortality. Thus, understanding the interaction between renal impairment and brain is important in to minimize the risk of neurologic injury in patients with CKD. This article reviews the link between chronic kidney disease and brain abnormalities associated with CKD in detail.
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Affiliation(s)
- Marius Miglinas
- Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ugne Cesniene
- Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Marta Monika Janusaite
- Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Arturas Vinikovas
- Nephrology and Kidney Transplantation Unit, Nephrology Center, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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