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Introduction: Dialysis patients have a 10–25 times higher risk of reactivation of tuberculosis (TB). In this study, we investigated the diagnostic ability of QuantiFERON (QFT)‐plus for TB in hemodialysis patients. QFT‐plus, an interferon gamma release assay, is characterized by its use of CD4 and CD8 T cell signals. Methods: Hemodialysis patients aged 20 years or older who underwent QFT‐plus measurement in our hospital were included, inclusion criteria being fever above 37°C, high inflammatory response, and infiltrative pulmonary shadows. Results: Forty‐six patients were enrolled. Of these, 15% were QFT positive, 4% were diagnosed with active TB, 76% were QFT negative, 8% had inconclusive results. Sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 87.5%, 28%, and 100%, respectively. Conclusions: QFT‐plus may be useful for the diagnosis of active TB in dialysis patients. Further studies in cohorts with larger sample sizes are expected. [ABSTRACT FROM AUTHOR]

Background: Delirium is an independent predictor of death in patients undergoing dialysis for end-stage renal disease (ESRD). However, it is unknown whether delirium during hospitalization at the start of hemodialysis (HD) in elderly populations is associated with early mortality. Methods: We conducted a retrospective cohort study to investigate the association between delirium and early mortality in the elderly after starting HD. The cohort consisted of patients ≥ 75 years who started dialysis for ESRD at the National Center for Global Health and Medicine from 2010 to 2017 and at Yokosuka Kyosai Hospital from 2007 to 2011. Delirium was defined as patients who showed new symptoms of transient confused thinking and reduced awareness of their environment and were prescribed antipsychotic medications. The primary outcome was death within 1 year. Data were analyzed using Cox proportional hazard models with adjustments for baseline characteristics. A multinomial logistic regression was used to identify the determinants of patients developing delirium. Results: We enrolled 259 patients (males, 60%); 33 patients were diagnosed with delirium. The primary outcome was observed in 19 patients with delirium (58%) and 24 patients without delirium (11%) (p < 0.01). Delirium was independently associated with all-cause mortality within 1 year after starting HD (hazard ratio 7.82, 95% confidence interval 4.26–14.3; adjusted hazard ratio 7.16, 95% confidence interval 3.49–14.7). Delirium was positively correlated with "cognitive impairment" as well as "the use of steroids." Conclusion: Delirium is independently associated with early mortality in the elderly after starting HD. [ABSTRACT FROM AUTHOR]

Dialysis interruption caused by voluntary quarantine against the coronavirus disease (COVID-19) in a patient on maintenance hemodialysis after returning from overseas to Japan Herein, we present the case of a Japanese patient on maintenance hemodialysis (HD) who was forced to interrupt HD for 7 days because of voluntary quarantine against the coronavirus disease (COVID-19) after returning from overseas. First, dialysis facilities where quarantine is possible for international travelers returning to Japan need to be secured for HD patients in quarantine. [Extracted from the article]

Three patients are reported: two with acute renal failure (ARF) and acute interstitial nephritis (AIN); and one with ARF and rapidly progressive glomerulonephritis (RPGN). In the latter two cases, a percutaneous renal biopsy was performed. In both AIN cases, 2-[18F] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography combined with computed tomography (PET-CT) showed high and diffuse FDG uptake in the renal parenchyma without excretion. Based on the diagnosis of AIN, probable offending drugs were discontinued. Consequently, ARF and AIN recovered gradually in both cases, though haemodialysis (HD) was performed several times. On the other hand, the patient who presented with ARF and RPGN did not accumulate FDG absolutely. Maintenance HD had to be initiated in this patient. FDG-PET-CT might become an auxiliary examination for the diagnosis and follow-up of AIN in oliguric or HD patients. [ABSTRACT FROM PUBLISHER]

Background. It is difficult to diagnose tuberculosis (TB) in dialysis patients because of the high rate of extrapulmonary TB in these patients compared with the general population. Recently, a new diagnostic test called QuantiFERON (QFT) has been developed and shown promise as a diagnostic tool for active TB diseases and latent TB infection. [ABSTRACT FROM PUBLISHER]