Pub Date : 2022-05-31DOI: 10.2174/1874303x-v15-e2203290
B. Varghese, Arul Rajagopalan, J. Arunachalam, A. Prasath, R. Durai
The COVID-19 pandemic has led to an increase in critically ill patients with renal failure, with many requiring renal replacement therapies. Unfortunately, many of them are too critically ill to tolerate intermittent hemodialysis. In the setting of limited resources, we did bedside acute intermittent peritoneal dialysis for critically ill COVID-19 patients with hemodynamic instability with or without ventilator support admitted to our intensive care unit. The aim of the study was to determine the outcome of intermittent peritoneal dialysis in critically ill COVID-19 patients. Our retrospective observational study included 91 patients with critically ill SARS-CoV2 infection and renal failure admitted to the intensive care unit of our hospital from July 2020 to September 2021, who underwent acute intermittent peritoneal dialysis. The demographic, laboratory, and treatment parameters were compared between survivors and non-survivors. Variables, like increased mean age (49.88 vs. 59.07 years), presence of diabetes mellitus (36.4% vs. 63.8%), increased lung involvement (57.3% vs. 75.0%), mechanical ventilation (15.2% vs. 70.7%), systolic (84.3 vs. 77.5 mm of Hg) and diastolic (59.09 vs. 42.93 mm of Hg) blood pressures, were associated with poor outcomes. The use of hypertonic PD (63.6% vs. 37.9%), better urea reduction ratios (44.33 vs. 39.84), and increased PD cycles (66.52 vs. 44.26) were associated with a better outcome. Complications, like haemorrhage and peritonitis, occurred in 10.9%. PD is a cost-effective bedside RRT that can be considered an effective option in critically ill COVID-19 patients. Good urea clearance, hemodynamic stability, and minimal resource requirements are also the features that favour peritoneal dialysis.
COVID-19大流行导致肾衰竭危重患者增加，其中许多人需要肾脏替代治疗。不幸的是，他们中的许多人病情严重，无法忍受间歇性血液透析。在资源有限的情况下，我们对重症监护室收治的血液动力学不稳定的COVID-19危重患者进行了床边急性间歇腹膜透析，无论是否有呼吸机支持。该研究的目的是确定重症COVID-19患者间歇腹膜透析的结果。我们的回顾性观察研究纳入了2020年7月至2021年9月在我院重症监护室接受急性间歇腹膜透析的91例重症SARS-CoV2感染并肾功能衰竭患者。比较幸存者和非幸存者的人口学、实验室和治疗参数。变量，如平均年龄增加(49.88比59.07岁)，糖尿病的存在(36.4%比63.8%)，肺受累增加(57.3%比75.0%)，机械通气(15.2%比70.7%)，收缩压(84.3比77.5毫米汞柱)和舒张压(59.09比42.93毫米汞柱)，与不良预后相关。使用高渗PD (63.6% vs. 37.9%)、更好的尿素还原率(44.33 vs. 39.84)和增加PD周期(66.52 vs. 44.26)与更好的结果相关。并发症如出血和腹膜炎发生率为10.9%。PD是一种具有成本效益的床边RRT，可被认为是COVID-19危重患者的有效选择。良好的尿素清除率、血流动力学稳定性和最小的资源需求也是有利于腹膜透析的特点。
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Pub Date : 2022-04-27DOI: 10.2174/1874303x-v15-e2203140
Suyog Shetty, S. Bhat, A. Choudhary, B. Hameed, Mummalaneni Sitaram, M. Shah, S. Reddy
This article aimed to study the prevalent practices in the treatment and follow-up of urethral strictures. Moreover, the article aimed to investigate the present opinion among urologists as the treatment practices for urethral stricture disease are mostly dependent on the treating surgeon’s expertise and preference in the absence of widely followed standard guidelines. A questionnaire was formulated based on the responses from experts. From October to December 2020, all members of the urological society of India received a mailed questionnaire on a web-based survey platform. Practicing urologists from across the country are among its members. A total of 2554 urologists were contacted by mail, and 282 (11%) urologists provided a response. The majority were doing 5 to 15 urethroplasties a year. A newly diagnosed short segment bulbar urethral stricture would be a candidate for a visualized internal urethrotomy (VIU), according to 69.5% of urologists. Recurrence after one attempt at VIU prompted 80% to switch to urethroplasty as the next choice. During preoperative evaluation, 100% of respondents wanted a retrograde urethrogram, 74% deemed micturating cystourethrogram necessary, and 60% wanted a urethroscopy. At discharge, the majority preferred silicone Foley catheters, and the preferred size was 16F (54%). The patients were discharged with both suprapubic catheter and Foley in situ by most urologists. During follow-up, 60.99% wanted uroflowmetry, and the duration of follow-up varied. This survey on urethral stricture management amongst urologists shows that there is wide variation in the management of stricture urethra. This survey underscores the need for large-scale, long-term studies to formulate a guideline for the management of urethral stricture disease, thereby bringing uniformity in the care provided.
{"title":"Prevalent Practices in Male Anterior Urethral Stricture Management: A Survey","authors":"Suyog Shetty, S. Bhat, A. Choudhary, B. Hameed, Mummalaneni Sitaram, M. Shah, S. Reddy","doi":"10.2174/1874303x-v15-e2203140","DOIUrl":"https://doi.org/10.2174/1874303x-v15-e2203140","url":null,"abstract":"\u0000 \u0000 This article aimed to study the prevalent practices in the treatment and follow-up of urethral strictures. Moreover, the article aimed to investigate the present opinion among urologists as the treatment practices for urethral stricture disease are mostly dependent on the treating surgeon’s expertise and preference in the absence of widely followed standard guidelines.\u0000 \u0000 \u0000 \u0000 A questionnaire was formulated based on the responses from experts. From October to December 2020, all members of the urological society of India received a mailed questionnaire on a web-based survey platform. Practicing urologists from across the country are among its members.\u0000 \u0000 \u0000 \u0000 A total of 2554 urologists were contacted by mail, and 282 (11%) urologists provided a response. The majority were doing 5 to 15 urethroplasties a year. A newly diagnosed short segment bulbar urethral stricture would be a candidate for a visualized internal urethrotomy (VIU), according to 69.5% of urologists. Recurrence after one attempt at VIU prompted 80% to switch to urethroplasty as the next choice. During preoperative evaluation, 100% of respondents wanted a retrograde urethrogram, 74% deemed micturating cystourethrogram necessary, and 60% wanted a urethroscopy. At discharge, the majority preferred silicone Foley catheters, and the preferred size was 16F (54%). The patients were discharged with both suprapubic catheter and Foley in situ by most urologists. During follow-up, 60.99% wanted uroflowmetry, and the duration of follow-up varied.\u0000 \u0000 \u0000 \u0000 This survey on urethral stricture management amongst urologists shows that there is wide variation in the management of stricture urethra. This survey underscores the need for large-scale, long-term studies to formulate a guideline for the management of urethral stricture disease, thereby bringing uniformity in the care provided.\u0000","PeriodicalId":213268,"journal":{"name":"The Open Urology & Nephrology Journal","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125671618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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