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  1. Article ; Online: Access site-related infections in patients receiving dialysis.

    Lam, John C / Kamar, Fareed B

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2024  Volume 196, Issue 11, Page(s) E380

    MeSH term(s) Humans ; Renal Dialysis/adverse effects ; Patients ; Catheter-Related Infections
    Language English
    Publishing date 2024-03-24
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.231300
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  2. Article: A Description of Advanced Chronic Kidney Disease Patients in a Major Urban Center Receiving Conservative Care.

    Kamar, Fareed B / Tam-Tham, Helen / Thomas, Chandra

    Canadian journal of kidney health and disease

    2017  Volume 4, Page(s) 2054358117718538

    Abstract: Background: Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting.: ... ...

    Abstract Background: Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting.
    Objective: To describe the characteristics of patients treated with conservative care for category G5 non-dialysis CKD in a Canadian context.
    Design: Retrospective chart review.
    Setting: Urban nephrology center.
    Patients: Patients with G5 non-dialysis CKD (estimated glomerular filtration rate <15 mL/min/1.73 m
    Measurements: Baseline patient demographic and clinical characteristics of conservative care follow-up, advanced care planning, and death.
    Methods: We undertook a descriptive analysis of individuals enrolled in a conservative care program between January 1, 2009, and June 30, 2015.
    Results: One hundred fifty-four patients were enrolled in the conservative care program. The mean age and standard deviation was 81.4 ± 9.0 years. The mean modified Charlson Comorbidity Index score was 3.4 ± 2.8. The median duration of conservative care participation was 11.5 months (interquartile range: 4-25). Six (3.9%) patients changed their modality to dialysis. One hundred three (66.9%) patients died during the study period. Within the deceased cohort, most (88.2%) patients completed at least some advanced care planning before death, and most (81.7%) of them died at their preferred place. Twenty-seven (26.7%) individuals died in hospital.
    Limitations: Single-center study with biases inherent to a retrospective study. Generalizability to non-Canadian settings may be limited.
    Conclusions: We found that individuals who chose conservative care were very old and did not have high levels of comorbidity. Few individuals who chose conservative care changed modality and accepted dialysis. The proportions of engagement in advanced care planning and of death in place of choice were high in this population. Death in hospital was uncommon in this population.
    Language English
    Publishing date 2017-07-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2765462-X
    ISSN 2054-3581
    ISSN 2054-3581
    DOI 10.1177/2054358117718538
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  3. Article: Antineutrophil Cytoplasmic Antibody Induction due to Infection: A Patient with Infective Endocarditis and Chronic Hepatitis C.

    Kamar, Fareed B / Hawkins, T Lee-Ann

    The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale

    2016  Volume 2016, Page(s) 3585860

    Abstract: While antineutrophil cytoplasmic antibody (ANCA) is often used as a diagnostic marker for certain vasculitides, ANCA induction in the setting of infection is much less common. In the case of infective endocarditis, patients may present with multisystem ... ...

    Abstract While antineutrophil cytoplasmic antibody (ANCA) is often used as a diagnostic marker for certain vasculitides, ANCA induction in the setting of infection is much less common. In the case of infective endocarditis, patients may present with multisystem disturbances resembling an autoimmune process, cases that may be rendered even trickier to diagnose in the face of a positive ANCA. Though not always straightforward, distinguishing an infective from an inflammatory process is pivotal in order to guide appropriate therapy. We describe an encounter with a 43-year-old male with chronically untreated hepatitis C virus infection who featured ANCA positivity while hospitalized with acute bacterial endocarditis. His case serves as a reminder of two of the few infections known to uncommonly generate ANCA positivity. We also summarize previously reported cases of ANCA positivity in the context of endocarditis and hepatitis C infections.
    Language English
    Publishing date 2016-03-21
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 1057056-1
    ISSN 1712-9532 ; 1180-2332
    ISSN 1712-9532 ; 1180-2332
    DOI 10.1155/2016/3585860
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3099: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  4. Article ; Online: Sudden onset of parathyroid hormone-independent severe hypercalcemia from reversal of tumoral calcinosis in a dialysis patient.

    Kamar, Fareed B / Mann, Bikaramjit / Kline, Gregory

    BMC nephrology

    2016  Volume 17, Issue 1, Page(s) 137

    Abstract: Background: Tumoral calcinosis is a rare manifestation of extraskeletal calcification, featuring large calcified cystic masses in the periarticular regions of large joints. In chronic kidney disease (CKD), this disorder is thought to evolve through a ... ...

    Abstract Background: Tumoral calcinosis is a rare manifestation of extraskeletal calcification, featuring large calcified cystic masses in the periarticular regions of large joints. In chronic kidney disease (CKD), this disorder is thought to evolve through a chronically elevated calcium-phosphorus solubility product leading to calcium precipitation in soft tissue. Treating tumoral calcinosis in these patients involves interventions to lower the calcium-phosphorus product such as reduction in vitamin D therapy and intensive hemodialysis regimens.
    Case presentation: We report the case of a 54-year old woman with polycystic kidney disease on peritoneal dialysis with widespread tumoral calcinosis in the context of hypercalcemic tertiary hyperparathyroidism who had been on long-term alfacalcidol therapy. After withdrawal of the vitamin D analogue and initiation of daily hemodialysis, there was rapid dissolution of her tumoral calcium deposits with the abrupt onset of parathyroid hormone (PTH)-independent transient hypercalcemia that resolved once the soft tissue deposits disappeared.
    Conclusions: Resorption of soft tissue calcific deposits may result in transient parathyroid hormone (PTH)-independent hypercalcemia. In CKD patients, this hypercalcemia causes a decrease in the PTH level, distinguishing it from tertiary hyperparathyroidism, though PTH may not be totally suppressed, the way it is seen in PTH-independent hypercalcemia in non-CKD patients.
    Language English
    Publishing date 2016-09-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-016-0355-y
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  5. Article: Hyperchloremic Metabolic Acidosis due to Cholestyramine: A Case Report and Literature Review.

    Kamar, Fareed B / McQuillan, Rory F

    Case reports in nephrology

    2015  Volume 2015, Page(s) 309791

    Abstract: Cholestyramine is a bile acid sequestrant that has been used in the treatment of hypercholesterolemia, pruritus due to elevated bile acid levels, and diarrhea due to bile acid malabsorption. This medication can rarely cause hyperchloremic nonanion gap ... ...

    Abstract Cholestyramine is a bile acid sequestrant that has been used in the treatment of hypercholesterolemia, pruritus due to elevated bile acid levels, and diarrhea due to bile acid malabsorption. This medication can rarely cause hyperchloremic nonanion gap metabolic acidosis, a complication featured in this report of an adult male with concomitant acute kidney injury. This case emphasizes the caution that must be taken in prescribing cholestyramine to patients who may also be volume depleted, in renal failure, or taking spironolactone.
    Language English
    Publishing date 2015-09-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2627652-5
    ISSN 2090-665X ; 2090-6641
    ISSN (online) 2090-665X
    ISSN 2090-6641
    DOI 10.1155/2015/309791
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  6. Article ; Online: Light Chain Crystal Podocytopathy in a Patient With Systemic Indolent B-Cell Lymphoma.

    Kamar, Fareed / Silverman, Melvin / John, Rohan / Chan, Christopher T / Prica, Anca / Kitchlu, Abhijat

    Kidney international reports

    2019  Volume 5, Issue 3, Page(s) 373–376

    Language English
    Publishing date 2019-12-06
    Publishing country United States
    Document type Case Reports
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2019.11.016
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  7. Article ; Online: Outcomes of the First and Second Hemodialysis Fistula: A Cohort Study.

    Kamar, Fareed / Quinn, Robert R / Oliver, Matthew J / Viecelli, Andrea K / Hiremath, Swapnil / MacRae, Jennifer / Miller, Lisa / Blake, Peter / Moist, Louise / Garg, Amit X / Lam, Ngan N / Kabani, Rameez / Clarke, Alix / Liu, Ping / Gillespie, Brenda / Ravani, Pietro

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2018  Volume 73, Issue 1, Page(s) 62–71

    Abstract: Rationale & objective: Fistulas are the preferred form of hemodialysis access; however, many fistulas fail to mature into usable accesses after creation. Data for outcomes after placement of a second fistula are limited.: Study design: Cohort study.!# ...

    Abstract Rationale & objective: Fistulas are the preferred form of hemodialysis access; however, many fistulas fail to mature into usable accesses after creation. Data for outcomes after placement of a second fistula are limited.
    Study design: Cohort study.
    Setting & participants: People who initiated hemodialysis therapy in any of 5 Canadian dialysis programs (2004-2012) and had at least 1 hemodialysis fistula placed.
    Predictor: Second versus initial fistula; receipt of 2 versus 1 fistula; second versus first fistula in recipients of 2 fistulas.
    Outcomes: Catheter-free fistula use during 1 year following initiation of hemodialysis therapy or following fistula creation, if created after hemodialysis therapy start; proportion of time with catheter-free use; time to catheter free use; time of functional patency.
    Analytical approach: Logistic regression; fractional regression.
    Results: Among the 1,091 study participants (mean age, 64±15 [SD] years; 63% men; 59% with diabetes), 901 received 1 and 190 received 2 fistulas. 38% of second fistulas versus 46% of first fistulas were used catheter free at least once. Average percentages of time that second and initial fistulas were used catheter free were 34% and 42%, respectively (OR, 0.72; 95% CI, 0.54-0.94). Compared with people who received 1 fistula, those who received 2 fistulas were less likely to achieve catheter-free use (26% vs 56%) and remain catheter free (23% vs 49% of time; OR, 0.30, 95% CI, 0.24-0.39). Among people who received 2 fistulas, the proportion of time that the second fistula was used catheter free was 11% higher with each 10% greater proportion of time that the first fistula was used catheter free (95% CI, 1%-22%). Model discrimination was modest (C index, 0.69).
    Limitations: Unknown criteria for patient selection for 1 or 2 fistulas; unknown reasons for prolonged catheter use.
    Conclusions: Outcomes of a second fistula may be inferior to outcomes of the initial fistula. First and second fistula outcomes are weakly correlated and difficult to predict based on clinical characteristics.
    MeSH term(s) Aged ; Arteriovenous Shunt, Surgical/statistics & numerical data ; Cohort Studies ; Female ; Humans ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Renal Dialysis ; Treatment Outcome
    Language English
    Publishing date 2018-08-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2018.06.007
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    Zs.A 1669: Show issues Location:
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  8. Article ; Online: Multi-Disciplinary Vascular Access Care and Access Outcomes in People Starting Hemodialysis Therapy.

    Gill, Simardeep / Quinn, Robert / Oliver, Matthew / Kamar, Fareed / Kabani, Rameez / Devoe, Daniel / Mysore, Priyanka / Pannu, Neesh / MacRae, Jennifer / Manns, Braden / Hemmelgarn, Brenda / James, Matthew / Tonelli, Marcello / Lewin, Adriane / Liu, Ping / Ravani, Pietro

    Clinical journal of the American Society of Nephrology : CJASN

    2017  Volume 12, Issue 12, Page(s) 1991–1999

    Abstract: Background and objectives: Fistulas, the preferred form of hemodialysis access, are difficult to establish and maintain. We examined the effect of a multidisciplinary vascular access team, including nurses, surgeons, and radiologists, on the probability ...

    Abstract Background and objectives: Fistulas, the preferred form of hemodialysis access, are difficult to establish and maintain. We examined the effect of a multidisciplinary vascular access team, including nurses, surgeons, and radiologists, on the probability of using a fistula catheter-free, and rates of access-related procedures in incident patients receiving hemodialysis.
    Design, setting, participants, & measurements: We examined vascular access outcomes in the first year of hemodialysis treatment before (2004-2005, preteam period) and after the implementation of an access team (2006-2008, early-team period; 2009-2011, late-team period) in the Calgary Health Region, Canada. We used logistic regression to study the probability of fistula creation and the probability of catheter-free fistula use, and negative binomial regression to study access-related procedure rates.
    Results: We included 609 adults (mean age, 65 [±15] years; 61% men; 54% with diabetes). By the end of the first year of hemodialysis, 102 participants received a fistula in the preteam period (70%), 196 (78%) in the early-team period (odds ratios versus preteam, 1.47; 95% confidence interval, 0.92 to 2.35), and 139 (66%) in the late-team period (0.85; 0.54 to 1.35). Access team implementation did not affect the probability of catheter-free use of the fistula (odds ratio, 0.87; 95% confidence interval, 0.52 to 1.43, for the early; and 0.89; 0.52 to 1.53, for the late team versus preteam period). Participants underwent an average of 4-5 total access-related procedures during the first year of hemodialysis, with higher rates in women and in people with comorbidities. Catheter-related procedure rates were similar before and after team implementation; relative to the preteam period, fistula-related procedure rates were 40% (20%-60%) and 30% (10%-50%) higher in the early-team and late-team periods, respectively.
    Conclusion: Introduction of a multidisciplinary access team did not increase the probability of catheter-free fistula use, but resulted in higher rates of fistula-related procedures.
    MeSH term(s) Aged ; Aged, 80 and over ; Arteriovenous Shunt, Surgical/statistics & numerical data ; Arteriovenous Shunt, Surgical/trends ; Catheterization/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Patient Care Team ; Renal Dialysis ; Renal Insufficiency, Chronic/therapy ; Reoperation/statistics & numerical data ; Reoperation/trends ; Retrospective Studies ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2017-09-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.03430317
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    Zs.A 6584: Show issues Location:
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