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1.

001-es BibID:BIBFORM061605
Első szerző:Agarwal, Mohit
Cím:Severe Symptomatic Hypocalcemia after Denosumab Administration in an End-Stage Renal Disease Patient on Peritoneal Dialysis with Controlled Secondary Hyperparathyroidism / Mohit Agarwal, Éva Csongrádi, Christian A. Koch, Luis A. Juncos, Vonda Echols, Mihály Tapolyai, Tibor Fülöp
Dátum:2013
Megjegyzések:We report the 1st case of severe, symptomatic hypocalcemia after denosumab (RANKLinhibitor) treatment in a peritoneal dialysis patient with secondary hyperparathyroidismand osteoporosis. A 58-year-old Caucasian female has been receiving chronicambulatory peritoneal dialysis for four years secondary to polycystic kidney disease.Laboratory studies revealed: albumin-corrected calcium 9.0 mg/dL, phosphorus 5 mg/dL,alkaline phosphatase (ALP) 58 U/L [normal, 40-105], albumin 3.4 gm/dL [normal, 3.6-5.4]and intact parathyroid hormone (PTH) 315 pg/mL [normal, 40-72]. Marked osteoporosiswas noted on the DXA scan, preventing her from renal transplantation considerations.She had failed conventional medical treatment, including per os calcium, monthlyergocalciferol (50,000 units/month), activated vitamin-D analog (doxercalciferol) andrenal-failure adjusted alendronate (70 mg twice a month). She was started onsubcutaneous denosumab 60 mg every 6 months. After her first dose, she developed aprogressive drop of calcium, phosphorus, bicarbonate and magnesium, in spite ofmassive escalation of doxercalciferol and calcium supplementation. Hypocalcemianadired at 6.3 mg/dL with symptomatic tetany, requiring a brief hospitalizationapproximately 7 weeks after denosumab treatment. Her elevated PTH rose furthertransiently (647 pg/mL), along with ALP (123 U/L). Bone-mineral parameters normalizedapproximately 3 months after denosumab administration. The observed phenomenonresembled the phenotype of "hungry bone syndrome" observed after surgicalparathyroidectomy.Conclusion: Treatment decisions based on bone densitometry results alone are nottransposable between patients with or without end-stage renal disease. Denosumab maylead to critical hypocalcemia in dialysis patients and further aggravate existing secondaryhyperparathyroidism.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:British Journal of Medicine & Medical Research. - 3 : 4 (2013), p. 1398-1406. -
További szerzők:Csongrádi Éva (1969-) (szakorvos) Koch, Christian A. Juncos, Luis A. Echols, Vonda Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
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2.

001-es BibID:BIBFORM061604
Első szerző:Csongrádi Éva (szakorvos)
Cím:The Efficacy of Intravenous versus Subcutaneous Recombinant Erythropoietin in Obese African-African Patients in a Southeast U.S. Dialysis Cohort / Éva Csongrádi, Michael Shoemaker-Moyle, Lajos Zsom, Catherine Wells, Zsolt Lengvárszky, Mihály Tapolyai, Tibor Fülöp
Dátum:2014
Megjegyzések:Aims: To correct renal anemia, subcutaneous (SC) route of recombinant humanerythropoietin (rhuEPO) administration has been associated with increased efficacy anddecreased dose requirements, when compared with intravenous (IV) route. The effect ofobesity as a potential modifier during rhuEPO administration has not been well explored.Study Design: Single-center, Longitudinal Cohort Study.Place and Duration of Study: University of Mississippi Medical Center OutpatientDialysis Unit, between February and November of 2009.Methodology: We performed IV to SC rhuEPO conversion for 86 in-center dialysispatients and, following a six-month equilibration period, we monitored outcomes over aperiod of three months. We obtained baseline demographic parameters, calculated BodyMass Index (BMI) and monitored iron saturation, ferritin, hemoglobin (Hgb) along withrhuEPO requirements. Patients were divided into 3 categories based on BMI [<25 (n=27),25-35 (n=38), >35 (n= 21) kg/m2]. Results are reported either as percents, means with SDor median with 25-75% interquartile range, as appropriate.Results: The cohort was all African-American, 48.8% male, aged 54.7 (13.3) years andBMI calculated at 29.9 (7.4) kg/m2. Baseline iron saturation was 24 (10.6)%, ferritinmeasured 641 (277) ng/mL. Hgb remained unchanged during the observation period:11.1 (1.3) vs. 11.2 (1.3) gm/dL. Initial rhuEPO weekly dose for the entire cohort was19,729 (17,448) Units/week (U/week); final dose 17,482 (14,860) U/week, with closecorrelation between initial and final doses (r: 0.653, P<0.0001). Weekly rhuEPO doseremained virtually unchanged in BMI categories 1 and 2 [13,927 (10,938) vs. 13,297(10,247) U/week; 20,684 (15,788) vs. 20,997 (17.917)] (P=NS for both) but decreased inthe category 3: 25,459 (24,403) vs. 16,444 (12,749) (P=0.081). However, BMI had noindependent effect in linear regression modeling with multiple covariates (age, BMI, ironsaturation, ferritin) included.Conclusion: Obesity may affect relative efficacy of rhuEPO conversion; additionalstudies may be needed.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:British Journal of Medicine & Medical Research. - 4 : 1 (2014), p. 184-193. -
További szerzők:Shoemaker-Moyle Michael (orvos) Zsom Lajos (1968-) (belgyógyász, nefrológus) Wells Catherine (tudományos segédmunkatárs) Lengvárszky Zsolt (matematikus informatikus) Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
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3.

001-es BibID:BIBFORM077000
Első szerző:Fülöp Tibor (kardiológus)
Cím:Successful Practice Transitioning Between Hemodialysis and Hemodiafiltration in Outpatient Units : ten Key Issues for Physicians to Remember / Fülöp Tibor, Tapolyai Mihály B., Zsom Lajos, Molnar Miklos Z., Abdul Salim Sohail, Újhelyi László, Becs Gergely, Balla József, Hamrahian Mehrdad
Dátum:2018
ISSN:0160-564X
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Artificial Organs. - 42 : 9 (2018), p. 925-932. -
További szerzők:Tapolyai Mihály (1968-) (nefrológus) Zsom Lajos (1968-) (belgyógyász, nefrológus) Molnár Miklós Abdul Salim, Sohail Újhelyi László (1956-) (belgyógyász) Becs Gergely Balla József (1959-) (belgyógyász, nephrológus) Hamrahian, S. Mehrdad (orvos)
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4.

001-es BibID:BIBFORM061608
Első szerző:Fülöp Tibor (kardiológus)
Cím:The safety and efficacy of bedside removal of tunneled hemodialysis catheters by nephrology trainees / Fülöp Tibor, Tapolyai Mihály, Qureshi, Naseem A., Beemidi, Vikram R., Gharaibeh, Kamel A., Hamrahian, S. Mehrdad, Szarvas, Tibor, Kovesdy, Csaba P., Csongrádi, Éva
Dátum:2013
ISSN:0886-022X
Megjegyzések:BACKGROUND:Some nephrologists remove tunneled hemodialysis catheters (TDC) at the bedside, but this practice has never been formally studied. Our hypothesis was that bedside removal of TDC is a safe and effective procedure affording prompt removal, including in cases of suspected infection.METHODS:We reviewed our consecutive 3-year experience (2007-2009) with bedside TDC removal at the University of Mississippi Renal Fellowship Program. Data were collected on multiple patients and procedure-related variables, success and complication rates. Association between clinical characteristics and biomarkers of inflammation and myocardial damage was examined using correlation coefficients.RESULTS:Of 55 inpatient TDC removals (90.9% from internal jugular location), 50 (90.9%) were completed without hands-on assistance from faculty. Indications at the time of removal included bacteremia, fever or clinical sepsis with hemodynamic instability or respiratory failure. All procedures were successful, with no cuff retention noted; one patient experienced prolonged bleeding which was controlled with local pressure. Peak C-reactive protein (available in 63.6% of cohort) was 12.9???8.4?mg/dL (reference range: <0.49) and median troponin-I (34% available) was 0.534?ng/mL (IQR 0.03-0.9) (reference range: <0.034) and they did not correlate with each other. Abnormal troponin-I was associated with proven bacteremia (p?<?0.05) but not with systolic and diastolic BP or clinical sepsis.CONCLUSION:Our results suggest that bedside removal of TDC remains a safe and effective procedure regardless of site or indications. Accordingly, TDC removal should be an integral part of competent Nephrology training.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Renal Failure. - 35 : 9 (2013), p. 1264-1268, -
További szerzők:Tapolyai Mihály (1968-) (nefrológus) Qureshi, Naseem A. Beemidi, Vikram R. (orvos) Gharaibeh, Kamel A. (orvos) Hamrahian, S. Mehrdad (orvos) Szarvas Tibor (matematikus informatikus) Kovesdy Csaba P. (orvos) Csongrádi Éva (1969-) (szakorvos)
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5.

001-es BibID:BIBFORM068276
Első szerző:Gharaibeh, Kamel A. (orvos)
Cím:Pulmonary embolization with tunneled hemodialysis catheter-associated blood stream infection : the perils of systemic anticoagulation / Kamel A. Gharaibeh, Éva Csongrádi, Michael Shoemaker-Moyle, Anna Lerant, Mihály Tapolyai, Tibor Fülöp
Dátum:2012
Megjegyzések:A 35-year old African-American male withend-stage renal disease on hemodialysisthrough a tunneled dialysis catheter (TDC) presentedwith fever, diffuse aches and generalizeddistress. Blood cultures (BC) wereobtained and empirical broad-spectrum antibiotictherapy started. After urgent renal dialysis,TDC was pulled at the bedside. Chest computedtomography (CT) diagnosed pulmonaryembolism and systemic i.v. heparin was initiated.BC grew Gram positive cocci (methicillinsensitiveS. aureus) and cardiac echocardiogramconfirmed acute bacterial endocarditis.Due to declined mental status, CT imaging wasobtained revealing massive intracranial hemorrhageleading to the patient's death. Furtherchest CT review revealed only hemodynamicallynon-significant pulmonary emboli in somesegmental and subsegmental arteries.Pulmonary embolization may be an expectedoccurrence with removal of infected TDC; systemicanticoagulation may not be warranted insuch cases and may lead to catastrophicintracranial hemorrhage. This case draws ourattention to the perils of rigid adherence to protocoland the failure of considering the needs ofspecial patient cohorts and individualized care.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Nephrology Reviews. - 4 : 2 (2012), p. 73-75. -
További szerzők:Csongrádi Éva (1969-) (szakorvos) Shoemaker-Moyle Michael (orvos) Lerant, Anna (orvos) Tapolyai Mihály (1968-) (nefrológus) Fülöp Tibor (1957-) (kardiológus)
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6.

001-es BibID:BIBFORM061636
Első szerző:Musa, Abdeen Farah
Cím:Targeted parathyroid gland reduction and long-term metabolic control of tertiary hyperparathyroidism / Abdeen Farah Musa, David R. Clarke, Kamel A. Gharaibeh, Mihaly Tapolyai, Eva Csongradi, Karen T. Pitman, Tibor Fulop
Dátum:2014
ISSN:0272-6386
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
folyóiratcikk
Megjelenés:American Journal of Kidney Diseases. - 63 : 5 (2014), p. A46. -
További szerzők:Clarke, David R. Gharaibeh, Kamel A. (orvos) Tapolyai Mihály (1968-) (nefrológus) Csongrádi Éva (1969-) (szakorvos) Pitman, Karen T. (orvos) Fülöp Tibor (1957-) (kardiológus)
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