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Purpose: Sodium polystyrene sulfonate (SPS) is a cation-exchanging resin that has been widely used for several decades as first-line therapy of mild chronic hyperkalemia in patients with chronic kidney disease (CKD). However, evidence to prove the long-term tolerability and efficacy of SPS for the treatment of this condition is still missing. Methods: In this retrospective, observational study, we enrolled 26 outpatients with stages 3-4 CKD who received oral therapy with low-dose SPS for mild chronic hyperkalemia in the Outpatient Nephrology clinic of our Department during 2010-2016. We obtained medical records on side effects potentially attributable to SPS use, and we analyzed the changes in serum electrolytes before and after the initiation of SPS therapy. Results: Serum potassium levels fell from 5.9 ± 0.4 to 4.8 ± 0.5 mmol/l ( P < 0.001) over a median follow-up of 15.4 months (range 3-27 months). SPS use was associated with a slight, but significant elevation in serum sodium levels (139.5 ± 2.9 vs 141.2 ± 2.4, P = 0.006), whereas serum calcium and phosphate remained unchanged before and after the initiation of SPS. We recorded ten episodes of recurrent serum potassium elevation ≥ 5.5 mmol/l, none of which required hospitalization or acute dialysis. No episode of colonic necrosis or any other serious drug-related adverse event was observed. SPS therapy was well-tolerated, since only 1 out of 26 patients discontinued SPS at 3 months due to gastrointestinal intolerance. Conclusion: This study suggests that low-dose SPS is well-tolerated and can effectively normalize elevated serum potassium over several weeks in CKD outpatients with mild chronic hyperkalemia. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to describe a case-series of an underestimated complication of vascular access for haemodialysis like seroma Background: Seroma is a rare complication of vascular surgery complicated by infection, thrombosis and pseudoaneurysm. The differential diagnosis is aneurysm and haematoma. Patients-methods: We report eight cases of seroma of vascular access for haemodialysis: one arteriovenous and seven created by using PTFE graft. Three cases were managed intraoperatively by vacuum drainage, two by vacuum drainage postoperatively, two by complete resection of seroma and vacuum drainage and one with ligation of vascular access. Vascular access function was preserved in seven cases. Conclusion: The diagnosis and treatment of seroma should be performed as early as possible in order to reassure the normal function of vascular access. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To identify demographic, clinical, and biological characteristics of older nondisabled patients who develop new disability in basic activities of daily living (BADL) during medical illnesses requiring hospitalization. DESIGN: Longitudinal observational study. SETTING: Geriatric and Internal Medicine acute care units. PARTICIPANTS: Data are from 1,686 patients aged 65 and older who independent in BADL 2 weeks before hospital admission, enrolled in the 1998 survey of the Italian Group of Pharmacoepidemiology in the Elderly Study. MEASUREMENTS: Study outcome was new BADL disability at time of hospital discharge. Sociodemographic, functional status, and clinical characteristics were collected at hospital admission; acute and chronic conditions were classified according to the International Classification of Disease, ninth revision; fasting blood samples were obtained and processed with standard methods. RESULTS: At the time of hospital discharge 113 patients (6.7%) presented new BADL disability. Functional decline was strongly related to patients' age and preadmission instrumental activities of daily living status. In a multivariate analysis, older age, nursing home residency, low body mass index, elevated erythrocyte sedimentation rate, acute stroke, high level of comorbidity expressed as Cumulative Illness Rating Scale score, polypharmacotherapy, cognitive decline, and history of fall in the previous year were independent and significant predictors of BADL disability. CONCLUSION: Several factors might contribute to loss of physical independence in hospitalized older persons. Preexisting conditions associated with the frailty syndrome, including physical and cognitive function,comorbidity, body composition, and inflammatory markers, characterize patients at high risk of functional decline. [ABSTRACT FROM AUTHOR]