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11 results on '"Charmaine E. Lok"'

1. Cardiovascular magnetic resonance left ventricular strain in end-stage renal disease patients after kidney transplantation

Author

Inna Y. Gong, Bandar Al-Amro, G. V. Ramesh Prasad, Philip W. Connelly, Rachel M. Wald, Ron Wald, Djeven P. Deva, Howard Leong-Poi, Michelle M. Nash, Weiqiu Yuan, Lakshman Gunaratnam, S. Joseph Kim, Charmaine E. Lok, Kim A. Connelly, and Andrew T. Yan

Subjects
Kidney transplant, Cardiovascular magnetic resonance, Left ventricular peak systolic strain, Left ventricular ejection fraction, Left ventricular volume, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Cardiovascular disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) and kidney transplant (KT) patients. Compared with left ventricular (LV) ejection fraction (LVEF), LV strain has emerged as an important marker of LV function as it is less load dependent. We sought to evaluate changes in LV strain using cardiovascular magnetic resonance imaging (CMR) in ESRD patients who received KT, to determine whether KT may improve LV function. Methods We conducted a prospective multi-centre longitudinal study of 79 ESRD patients (40 on dialysis, 39 underwent KT). CMR was performed at baseline and at 12 months after KT. Results Among 79 participants (mean age 55 years; 30% women), KT patients had significant improvement in global circumferential strain (GCS) (p = 0.007) and global radial strain (GRS) (p = 0.003), but a decline in global longitudinal strain (GLS) over 12 months (p = 0.026), while no significant change in any LV strain was observed in the ongoing dialysis group. For KT patients, the improvement in LV strain paralleled improvement in LVEF (57.4 ± 6.4% at baseline, 60.6% ± 6.9% at 12 months; p = 0.001). For entire cohort, over 12 months, change in LVEF was significantly correlated with change in GCS (Spearman’s r = − 0.42, p 0.10). Conclusions Compared with continuation of dialysis, KT was associated with significant improvements in LV strain metrics of GCS and GRS after 12 months, which did not correlate with blood pressure change. This supports the notion that KT has favorable effects on LV function beyond volume and blood pessure control. Larger studies with longer follow-up are needed to confirm these findings.

Published
2018
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2. The Association of Daily Activity Levels and Estimated Kidney Function in Men and Women With Predialysis Chronic Kidney Disease

Author

Sarah L. West, Cindy Ma, Maryum Chaudhry, Scott G. Thomas, and Charmaine E. Lok

Subjects
accelerometry, chronic kidney disease, eGFR, exercise, physical activity, predialysis, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Chronic kidney disease (CKD) is often accompanied by complications including poor physical activity level. However, only a few studies have objectively characterized physical activity levels in predialysis CKD. Our study sought to measure daily activity levels by accelerometry in individuals with CKD (stages III−V) and to determine the association between daily activity and kidney function. Methods: We determined kidney function by means of the estimated glomerular filtration rate (eGFR) using the Modification of Diet and Renal Disease (MDRD) equation. Participants wore an accelerometer for 7 consecutive days, and we measured multiple physical activity outcomes including total daily activity, sedentary, light, and moderate−vigorous activity. Average durations and intensity of activity were determined according to stage of CKD. The association between kidney function and activity level was determined by regression analysis. Results: We analyzed data from 110 individuals (60% men and 40% women) with stages III to V CKD. The mean age of our participants was 64 years, mean body mass index was 27.5 kg/m2, and mean eGFR was 23.7 ± 1.2 ml/min/1.73 m2. Our participants were primarily sedentary (mean duration of inactivity = 1152 ± 100 minutes per day; 79% of day). Light activity was performed 280 ± 99 minutes per day, and individuals participated in only 6 ± 9 minutes per day of moderate−vigorous activity. The eGFR did not predict physical activity level (P > 0.05 for all). Discussion: Individuals with stages III to V CKD are sedentary, and do not meet the national recommendations of 150 minutes of moderate−vigorous activity per week. Further study is required to determine whether interventions to increase activity levels in patients with CKD are associated with improved health outcomes.

Published
2017
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3. Hemodialysis Infection Prevention Protocols Ontario—Shower Technique (HIPPO-ST): A Pilot Randomized Trial

Author

S. Daisy Kosa, Amiram Gafni, Andrew A. House, JulieAnn Lawrence, Louise Moist, Bharat Nathoo, Paul Tam, Alicia Sarabia, Lehana Thabane, George Wu, and Charmaine E. Lok

Subjects
catheter, hemodialysis, pilot study, randomized controlled trial, vascular access, Diseases of the genitourinary system. Urology, RC870-923
Abstract

We developed the Hemodialysis Infection Prevention Protocols Ontario—Shower Technique (HIPPO-ST) to permit hemodialysis (HD) patients with central venous catheters (catheters) to shower without additional infection risk. Our primary objective was to determine the feasibility of conducting a parallel randomized controlled trial (RCT) to evaluate the impact of HIPPO-ST on catheter-related bacteremia (CRB) in adult HD patients. Methods: Adult HD patients using catheters were recruited from 11 HD units. Patients were randomized to receive HIPPO-ST or standard care and were followed up for 6 months. Only CRB-outcome assessors were blinded. For the study to be considered feasible, 4 of 5 feasibility outcomes, each with its own statistical threshold for success, must have been achieved. Results: A total of 68 patients were randomized (33 HIPPO-ST and 35 control) and were followed up to 6 months. Of 5 measures of feasibility, 4 were achieved: (1) accurate CRB rate documented (threshold: κ level >0.80); (2) 97.8% (279/285) of satellite HD patients with catheters were screened (threshold: >95%); (3) 88% (23/26) in the HIPPO-ST arm were successfully educated by 6 months (threshold: >80%); and (4) 0% (0/29) patients in the control arm were “contaminated,” that is, using HIPPO-ST (threshold: 80%). The rate of CRB was similarly low in HIPPO-ST and control groups (0.68 vs. 0.88/1000 catheter days). Discussion: This HIPPO-ST pilot study demonstrated the feasibility of the larger HIPPO-ST study, especially given the high levels of education success with the HIPPO-ST arm and the low levels of contamination in the control arm.

Published
2017
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4. Contributors

Author

Cahyani Gita Ambarsari, Rachel A. Annunziato, Evamaria Anvari, Carlos E. Araya, Rossella Attini, Rose Mary Ayoob, Justine Bacchetta, Rossana Baracco, Joanne M. Bargman, Antonio Bellasi, Ezequiel Bellorin-Font, William M. Bennett, Scott Bieber, Mei Lin Z. Bissonnette, Geoffrey A. Block, Brendan Bowman, Patrick D. Brophy, Deborah J. Brouwer-Maier, Steven Brunelli, David Bushinsky, Jonathan Casavant, Roberta Cerutti, Vimal Chadha, Christopher T. Chan, Bipan Chand, Deepa H. Chand, Anthony Chang, Chaim Charytan, Joline L.T. Chen, Wei Chen, Andrew I. Chin, Yeoungjee Cho, William R. Clark, John H. Crabtree, Daniel Cukor, Serpil Muge Deger, Lucia Del Vecchio, Alonso R. Diaz, Stephanie L. Donahue, Ramanath Dukkipati, Claire Dunphy, Mohamed Elbokl, Fabrizio Fabrizi, Mohammed K. Faizan, Steven Fishbane, Molly Fisher, William Henry Fissell, Jorge Ignacio Fonseca-Correa, Bethany J. Foster, Seth B. Furgeson, Ashley M. Gefen, Guido Gembillo, F. John Gennari, Marc Ghannoum, Griet Glorieux, Sharlene Anuska Greenwood, Dieter Haffner, Rainer Himmele, Jean L. Holley, Daljit K. Hothi, T. Alp Ikizler, Sarbjit Vanita Jassal, Kirsten L. Johansen, David W. Johnson, Kamyar Kalantar-Zadeh, Pranay Kathuria, Irfan Khan, Paul L. Kimmel, Alan S. Kliger, Timothy Koh Jee Kam, Berfu Korucu, Pelagia Koufaki, Eugene C. Kovalik, Robin A. Kremsdorf, Martin Kreuzer, Mahesh Krishnan, Martin K. Kuhlmann, Danica Lam, Yu-Chi Lapid, Francesco Locatelli, Joseph B. Lockridge, Charmaine E. Lok, Etienne Macedo, John D. Mahan, Harold J. Manley, Kevin J. Martin, Nicola Matthews, Juliet Mayes, Ian E. McCoy, Christopher W. Mcintyre, Rajnish Mehrotra, Ravindra L. Mehta, Mark M. Mitsnefes, Michele H. Mokrzycki, Bogdan Momciu, Liz Mooney, Alvin H. Moss, Vinay Narasimha Krishna, Sharon J. Nessim, Allen R. Nissenson, Vandana Dua Niyyar, Ali Olyaei, Alejandra Orozco-Guillén, David I. Ortiz-Melo, Biff F. Palmer, Suetonia C. Palmer, Patrick S. Parfrey, Jeffery Perl, Giorgina B. Piccoli, Joanne D. Pittard, Connie M. Rhee, Ezequiel Ridruejo, Claudio Rigatto, Matthew B. Rivara, Darren M. Roberts, AnnaMarie Rodriguez, Mariano Rodriguez, Rudolph A. Rodriguez, Claudio Ronco, Mitchell H. Rosner, John H. Sadler, Valeria Saglimbene, Fabio R. Salerno, Domenico Santoro, Franz Schaefer, Christine B. Sethna, Hitesh H. Shah, Jenny I. Shen, Jeffrey Silberzweig, Rossella Siligato, Pamela S. Singer, Michael J.G. Somers, null Soo, Bruce Spinowitz, Deborah Stein, Emily Stonebrook, Giovanni F.M. Strippoli, Cheuk-Chun Szeto, Isaac Teitelbaum, Rebecca Thomas-Chen, Ashita J. Tolwani, Massimo Torreggiani, Avram Z. Traum, Luis G. Tulloch-Palomino, Tushar J. Vachharajani, Rudolph P. Valentini, Peter Noel Van Buren, René G. VanDeVoorde, Raymond Vanholder, Thanh-Mai Vo, Bradley A. Warady, Adam Weinstein, Katherine Wesseling-Perry, James B. Wetmore, Mark E. Williams, Jay B. Wish, and Joshua J. Zaritsky

Published
2023

5. Vascular Access

Author

Charmaine E. Lok and Vandana Dua Niyyar

Published
2023

6. Severe Caffeine Intoxication Treated With Hemodialysis: A Case Report

Author

Ian Randall, Charmaine E. Lok, and Mohamed Elbokl

Subjects
medicine.medical_treatment, Physiology, Case Report, lcsh:RC870-923, chemistry.chemical_compound, elimination, intoxication, Caffeine, Internal Medicine, medicine, Ingestion, Dialysis, hemodialysis, business.industry, toxicity, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Hypokalemia, Discontinuation, chemistry, Nephrology, Toxicity, Hemodialysis, medicine.symptom, business, Hypophosphatemia
Abstract

Caffeine is well known for its central nervous system–stimulating effect. Toxicity may occur following high-dose caffeine ingestions. We describe a case of caffeine intoxication secondary to reported ingestion of a large dose of caffeine (60,000 mg in tablet form) with an initial serum caffeine level of 608 μmol/L (known lethal serum level starting from 412 μmol/L). This case demonstrates the key clinical manifestations of caffeine intoxication and the effect of its associated massive adrenergic surge with neurologic symptoms, cardiovascular instability, metabolic abnormalities, and the significant risk of mortality. We highlight important kidney management considerations, including protective measures against electrolyte disturbances such as hypokalemia and hypophosphatemia, and the use of prolonged hemodialysis for caffeine elimination. We share our practical decision making and approach to dialysis discontinuation if serum caffeine level reporting is unavailable or delayed.

Published
2021

7. The Association of Daily Activity Levels and Estimated Kidney Function in Men and Women With Predialysis Chronic Kidney Disease

Author

Scott G. Thomas, Sarah L. West, Cindy Ma, Maryum Chaudhry, and Charmaine E. Lok

Subjects
Activity level, medicine.medical_specialty, 030232 urology & nephrology, Physical activity, Renal function, physical activity, lcsh:RC870-923, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Internal medicine, medicine, accelerometry, eGFR, In patient, Light Activity, exercise, predialysis, business.industry, 030229 sport sciences, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Physical activity level, Endocrinology, Nephrology, business, Body mass index, chronic kidney disease, Kidney disease
Abstract

Introduction Chronic kidney disease (CKD) is often accompanied by complications including poor physical activity level. However, only a few studies have objectively characterized physical activity levels in predialysis CKD. Our study sought to measure daily activity levels by accelerometry in individuals with CKD (stages III−V) and to determine the association between daily activity and kidney function. Methods We determined kidney function by means of the estimated glomerular filtration rate (eGFR) using the Modification of Diet and Renal Disease (MDRD) equation. Participants wore an accelerometer for 7 consecutive days, and we measured multiple physical activity outcomes including total daily activity, sedentary, light, and moderate−vigorous activity. Average durations and intensity of activity were determined according to stage of CKD. The association between kidney function and activity level was determined by regression analysis. Results We analyzed data from 110 individuals (60% men and 40% women) with stages III to V CKD. The mean age of our participants was 64 years, mean body mass index was 27.5 kg/m2, and mean eGFR was 23.7 ± 1.2 ml/min/1.73 m2. Our participants were primarily sedentary (mean duration of inactivity = 1152 ± 100 minutes per day; 79% of day). Light activity was performed 280 ± 99 minutes per day, and individuals participated in only 6 ± 9 minutes per day of moderate−vigorous activity. The eGFR did not predict physical activity level (P > 0.05 for all). Discussion Individuals with stages III to V CKD are sedentary, and do not meet the national recommendations of 150 minutes of moderate−vigorous activity per week. Further study is required to determine whether interventions to increase activity levels in patients with CKD are associated with improved health outcomes.

Published
2017

8. Chronic kidney disease and valvular heart disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies conference

Author

Wajeh Y. Qunibi, Wolfgang C. Winkelmayer, Patrick Rossignol, Chien Liang Chen, Mark A. Hlatky, Paolo Raggi, Charles J. Ferro, Xiaoqiang Ding, Charles A. Herzog, Philip A. Kalra, Mark J. Sarnak, Alexander C. Wiseman, Yuxin Nie, Charumathi Sabanayagam, J. Cavalcante, Thomas H. Marwick, Simon Winther, Jonathan C. Craig, Günther Laufer, Marcello Rattazzi, David C. Wheeler, John S. Gill, Kevin W. Lobdell, Charmaine E. Lok, Alexander Zarbock, David M. Charytan, Jolanta Malyszko, Gautam R. Shroff, L. Kristin Newby, Hideki Ishii, Debasish Banerjee, Daniel E. Weiner, Ulf Landmesser, Michael Cheung, Patrick S. Parfrey, Helen Pilmore, Roberto Pecoits-Filho, Krista L. Lentine, Christopher DeFilippi, Tara I. Chang, Angela C Webster, Mohamed Marwan, Patrick B. Mark, Anthony Yip, Kerstin Amann, Sripal Bangalore, Meg Jardine, Gérard M. London, Rukshana Shroff, Nicole M. Isbel, Carlo Briguori, Alan G. Jardine, Josiah Ruturi, Catherine M. Shanahan, Jagbir Gill, and Mario Gössl

Subjects
0301 basic medicine, Aortic valve, medicine.medical_specialty, Population, 030232 urology & nephrology, urologic and male genital diseases, 03 medical and health sciences, aortic stenosis, chronic kidney disease, end-stage kidney disease, mitral annular calcification, valvular heart disease, 0302 clinical medicine, Risk Factors, Internal medicine, Epidemiology, Prevalence, medicine, Humans, Mitral Valve Stenosis, Renal Insufficiency, Chronic, Risk factor, education, education.field_of_study, Mitral regurgitation, Endocarditis, business.industry, Calcinosis, Mitral Valve Insufficiency, Aortic Valve Stenosis, Congresses as Topic, medicine.disease, female genital diseases and pregnancy complications, Stenosis, 030104 developmental biology, medicine.anatomical_structure, Nephrology, Aortic Valve, Cardiology, cardiovascular system, Mitral Valve, business, Kidney disease
Abstract

Chronic kidney disease (CKD) is a major risk factor for valvular heart disease (VHD). Mitral annular and aortic valve calcifications are highly prevalent in CKD patients and commonly lead to valvular stenosis and regurgitation, as well as complications including conduction system abnormalities and endocarditis. VHD, especially mitral regurgitation and aortic stenosis, is associated with significantly reduced survival among CKD patients. Knowledge related to VHD in the general population is not always applicable to CKD patients because the pathophysiology may be different, and CKD patients have a high prevalence of comorbid conditions and elevated risk for periprocedural complications and mortality. This Kidney Disease: Improving Global Outcomes (KDIGO) review of CKD and VHD seeks to improve understanding of the epidemiology, pathophysiology, diagnosis, and treatment of VHD in CKD by summarizing knowledge gaps, areas of controversy, and priorities for research.

Published
2019

10. Contributors

Author

Rajiv Agarwal, Alessio Aghemo, Ali Al-Lawati, Michael Allon, Walter S. Andrews, Rachel A. Annunziato, Carlos E. Araya, Arif Asif, Rose M. Ayoob, Rossana Baracco, Joanne Bargman, Gerald A. Beathard, Antonio Bellasi, William M. Bennett, Jeffrey S. Berns, Scott Bieber, Geoffrey A. Block, Paola Boccardo, Andrew Brookens, Patrick D. Brophy, Steven Brunelli, John M. Burkart, David Bushinsky, Vito M. Campese, Celina Denise Cepeda, Vimal Chadha, Christopher T. Chan, Deepa H. Chand, Anthony Chang, Tara I. Chang, Chaim Charytan, Joline L.T. Chen, Wei Chen, Ronco Claudio, Allan J. Collins, John H. Crabtree, Lisa E. Crowley, Daniel Cukor, Simon J. Davies, Serpil Muge Deger, Thomas A. Depner, Jose A. Diaz-Buxo, Lesley C. Dinwiddie, Ramanath Dukkipati, Sarah E. Duncan, Fabrizio Fabrizi, Michel Fischbach, Steven Fishbane, William Henry Fissell, Bethany Foster, Miriam Galbusera, F. John Gennari, Marc Ghannoum, Sassan Ghazan-Shahi, Stuart L. Goldstein, Frank A. Gotch, Sharlene Greenwood, Dieter Haffner, Rainer Himmele, Janet E. Holland, Jean L. Holley, Clifford Holmes, Stephen R. Hooper, Daljit K. Hothi, Susan Hou, Alastair J. Hutchison, T. Alp Ikizler, Bertrand L. Jaber, Sarbjit Vanita Jassal, Kamyar Kalantar-Zadeh, Timothy Koh Jee Kam, Mark Kaplan, Pranay Kathuria, Jeffrey L. Kaufman, Ramesh Khanna, Neenoo Khosla, Paul L. Kimmel, Laura Kooienga, Pelagia Koufaki, Eugene C. Kovalik, Martin Kreuzer, Vinay Narasimha Krishna, Mahesh Krishnan, Martin K. Kuhlmann, Ravi S. Lakdawala, Danica Lam, Mark Lambie, Charmaine E. Lok, John D. Mahan, Harold J. Manley, Kevin J. Martin, Paul Martin, Piyush Mathur, Christopher W. McIntyre, Rajnish Mehrotra, Ravindra L. Mehta, Federica Mescia, Mark M. Mitsnefes, Gopesh K. Modi, Louise Moist, Divya G. Moodalbail, Michael L. Moritz, Alvin H. Moss, Federico Nalesso, Sharon J. Nessim, Shari K. Neul, Allen R. Nissenson, Ali J. Olyaei, David I. Ortiz-Melo, Biff F. Palmer, Suetonia C. Palmer, Patrick S. Parfrey, Melissa Pencille, Phuong-Chi T. Pham, Phuong-Thu T. Pham, Joanne D. Pittard, Giuseppe Remuzzi, Connie M. Rhee, Claudio Rigatto, Darren M. Roberts, Rudolph A. Rodriguez, Claudio Ronco, Deborah Rosenthal, John H. Sadler, Scott G. Satko, Franz Schaefer, David T. Selewski, Christine B. Sethna, Hitesh H. Shah, Ron Shapiro, Richard A. Sherman, Rukshana Shroff, Pamela Singer, Jodi M. Smith, Michael J.G. Somers, Euan Soo, Bruce S. Spinowitz, Deborah Stein, John C. Stivelman, Giovanni F.M. Strippoli, Lynsey Stronach, Paweena Susantitaphong, Cheuk-Chun Szeto, Rebecca Thomas, Ashita Tolwani, Avram Z. Traum, Tushar Vachharajani, Rudolph P. Valentini, René G. VanDeVoorde, Anand Vardhan, Thanh-Mai Vo, Thor A. Wagner, Bradley A. Warady, Katherine Wesseling-Perry, Spencer Westcott, James B. Wetmore, Keith Wille, Mark E. Williams, Jay B. Wish, Farhanah Yousaf, Ariane Zaloszyc, and Joshua Zaritsky

Published
2017

11. Vascular Access for Hemodialysis in Adults

Author

Charmaine E. Lok and Michael Allon

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Vascular access, medicine, Hemodialysis, Intensive care medicine, business
Published
2017

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