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Incarcerated dialysis patient sues surgeon over infection and injuries - Southeast Texas Record

A Henderson County resident filed a lawsuit against a Huntsville doctor asserting medical negligence in a case dating to 2011.

John Crocker of Athens sued Dr. Dave Khurana in Galveston County District Court on July 6, alleging liability in a series of medical procedures that he claims caused critical infection and injuries between 2011 and 2014.

According to the suit, the plaintiff was diagnosed with renal failure in late August 2011 and referred to Khurana for treatment. After surgery to implant a catheter, he began home dialysis in October 2011.

The suit states that due to an alleged violation of his pre-existing parole status, Crocker was remanded to a state hospital in Huntsville on April 18, 2013, by the Texas Department of Criminal Justice. While negotiating continued dialysis treatment, Crocker claims, he discovered that his catheter no longer functioned, having caused him to develop peritonitis at the implant site in May 2013.

The suit states that the patient’s infection was an aggressive strain of E. coli and staph; and that following additional surgery, his pain worsened and fluid leaked from his wound continuously for three days, impeding further dialysis.

According to the filing, a CT scan revealed that Crocker’s bladder had been punctured during surgery; he underwent yet another procedure. When he recovered sufficiently, he claims, he was denied his previous treatment method and forced to endure aggressive hemo-dialysis provided by the prison hospital for almost a year until his April 24, 2014, release.

Alleging negligence, severe physical pain, mental anguish, impairment, and medical expenses, Crocker blames the defendant for substandard care. He claims that Khurana failed to flush and properly maintain the peritoneal catheter, resulting in infection and multiple surgeries.

The plaintiff seeks up to $250,000 in compensation for damages, pre- and post-judgment interest, attorney’s fees, expenses and costs. The plaintiff is represented by Dale Trimble of the Trimble Firm in Conroe.

Galveston County District Court case number 15-CV-0676.

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ESRD Risk with Radical and Partial Nephrectomy Comparable - Renal and ... - Renal and Urology News
July 09, 2015 ESRD Risk with Radical and Partial Nephrectomy Comparable - Renal and ... - Renal and Urology News
Radical and partial nephrectomy for renal cell carcinoma are associated with a similar risk of end-stage renal disease (ESRD), according to research. Radical and partial nephrectomy for renal cell carcinoma are associated with a similar risk of end-stage renal disease (ESRD), according to a study conducted in Taiwan. 

Wei-Yu Lin, MD, of Chang Gung Memorial Hospital in Chiayi, and colleagues studied a nationwide population-based cohort of 7,670 patients with RCC who underwent radical nephrectomy (RN) or partial nephrectomy (PN). From this group, the researchers propensity score matched 1,212 PN patients to 2,424 RN patients. The median follow-up for this cohort was 48 months. 

ESRD developed in 70 patients (2.9%) in the RN group, for an incidence rate of 6.9 cases per 1,000 person-years, and 23 patients (1.9%) in the PN group, for an incidence rate of 5.5 cases per 1,000 person-years, the researchers reported in PLOS One (2015;10:e0126965). In adjusted analyses, the difference between treatment groups was not statistically significant. 

The authors stated that their investigation is the first Asian study on this topic.

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ESRD Risk with Radical and Partial Nephrectomy Comparable - Renal and Urology News
July 09, 2015 ESRD Risk with Radical and Partial Nephrectomy Comparable - Renal and Urology News
Radical and partial nephrectomy for renal cell carcinoma are associated with a similar risk of end-stage renal disease (ESRD), according to research. Radical and partial nephrectomy for renal cell carcinoma are associated with a similar risk of end-stage renal disease (ESRD), according to a study conducted in Taiwan. 

Wei-Yu Lin, MD, of Chang Gung Memorial Hospital in Chiayi, and colleagues studied a nationwide population-based cohort of 7,670 patients with RCC who underwent radical nephrectomy (RN) or partial nephrectomy (PN). From this group, the researchers propensity score matched 1,212 PN patients to 2,424 RN patients. The median follow-up for this cohort was 48 months. 

ESRD developed in 70 patients (2.9%) in the RN group, for an incidence rate of 6.9 cases per 1,000 person-years, and 23 patients (1.9%) in the PN group, for an incidence rate of 5.5 cases per 1,000 person-years, the researchers reported in PLOS One (2015;10:e0126965). In adjusted analyses, the difference between treatment groups was not statistically significant. 

The authors stated that their investigation is the first Asian study on this topic.

...

 
Post-Transplant UTI Risk Factors Identified - Renal and Urology News - Renal and Urology News
July 09, 2015 Post-Transplant UTI Risk Factors Identified - Renal and Urology News - Renal and Urology News
Female kidney recipients have a nearly 7-fold higher risk of UTI than their male counterparts.

Female gender, ureteral catheterization, and comorbidities are among the risk factors for urinarytract infection (UTI) among renal transplant recipients, new study findings suggest. 

The observational, cross-sectional study, by Alparslan Ersoy, MD, of Uludag University Medical School in Bursa, Turkey, and colleagues, included 213 patients who underwent renal transplantation. Of these, 106 were diagnosed with 171 episodes of UTI, with recurrent UTI in 39 cases (36.8%). First UTIs occurred at a mean of 13.7 months after transplantation. The UTI group had a significantly greater proportion of female recipients than the non-UTI group (60.4% vs. 21.5%). 

The rate and duration of ureteral catheterization were significantly greater in the UTI than non-UTI group (48.1% vs. 28% and 66.1 vs. 55.9 days, respectively), as was the proportion of patients with comorbidities (43.4% vs. 27.1%). 

In regression analysis, female gender, ureteral catheterization, and co-morbid diseases were independently associated with a significant 6.8, 2.8, and 2.3 times increased risk of UTI, respectively. The risk of recurrent UTIs was 4.2 times higher among diabetic than non-diabetic recipients. Among patients with recurrent UTI, 1 had 5 episodes, 4 had 4 episodes, 15 had 3 episodes, and 19 had 2 episodes. 

The UTI and non-UTI groups were similar with respect to donor type, primary disease, diabetes mellitus, acute rejection, and surgical complications, according to the investigators. 

In a separate study of 1,019 transplant recipients presented at the meeting, researchers in Kuwait identified age, female gender, thymoglobulin induction, pretransplant urologic problems, and hepatitis C as risk factors for recurrent UTI in renal transplant recipients. The investigators divided patients into 2 groups: patients who had recurrent UTI (group 1) and those who had no or non-recurrent UTI) (group 2). Group 1 was significantly younger than group 2 (34.9 vs. 42.8 years); they also had a significantly higher proportion of female patients. Recurrent UTI did not adversely impact graft or patient survival. 

These new studies add to a growing body of literature on UTI risk factors after kidney transplantation. In a recently published study in Medicine(2015;94:e594), researchers demonstrated that vitamin D deficiency is an independent risk factor for post-transplant UTI. A study published in Transplantation Proceedings (2014;46:3455-3458) found that the only risk factor for UTI after renal transplantation was gender, with female recipients at higher risk than male recipients. 

Also in Transplantation Proceedings (2014;46:1757-1759), investigators reported on a study that identified older age (independent of gender), biopsy-proven acute rejection episodes, and receipt of kidneys from deceased donors as UTI risk factors. For female recipients, an additional risk factor was the number of pretransplant pregnancies. Researchers reported in Transplantation(2013;96:732-738) that their study of 1,166 kidney transplant recipients showed that post-transplant UTI risk factors included female gender, prolonged use of Foley catheters, ureteral stents, age, and delayed graft function.

...

 
Post-Transplant UTI Risk Factors Identified - Renal and Urology News
July 09, 2015 Post-Transplant UTI Risk Factors Identified - Renal and Urology News
Female kidney recipients have a nearly 7-fold higher risk of UTI than their male counterparts.

Female gender, ureteral catheterization, and comorbidities are among the risk factors for urinarytract infection (UTI) among renal transplant recipients, new study findings suggest. 

The observational, cross-sectional study, by Alparslan Ersoy, MD, of Uludag University Medical School in Bursa, Turkey, and colleagues, included 213 patients who underwent renal transplantation. Of these, 106 were diagnosed with 171 episodes of UTI, with recurrent UTI in 39 cases (36.8%). First UTIs occurred at a mean of 13.7 months after transplantation. The UTI group had a significantly greater proportion of female recipients than the non-UTI group (60.4% vs. 21.5%). 

The rate and duration of ureteral catheterization were significantly greater in the UTI than non-UTI group (48.1% vs. 28% and 66.1 vs. 55.9 days, respectively), as was the proportion of patients with comorbidities (43.4% vs. 27.1%). 

In regression analysis, female gender, ureteral catheterization, and co-morbid diseases were independently associated with a significant 6.8, 2.8, and 2.3 times increased risk of UTI, respectively. The risk of recurrent UTIs was 4.2 times higher among diabetic than non-diabetic recipients. Among patients with recurrent UTI, 1 had 5 episodes, 4 had 4 episodes, 15 had 3 episodes, and 19 had 2 episodes. 

The UTI and non-UTI groups were similar with respect to donor type, primary disease, diabetes mellitus, acute rejection, and surgical complications, according to the investigators. 

In a separate study of 1,019 transplant recipients presented at the meeting, researchers in Kuwait identified age, female gender, thymoglobulin induction, pretransplant urologic problems, and hepatitis C as risk factors for recurrent UTI in renal transplant recipients. The investigators divided patients into 2 groups: patients who had recurrent UTI (group 1) and those who had no or non-recurrent UTI) (group 2). Group 1 was significantly younger than group 2 (34.9 vs. 42.8 years); they also had a significantly higher proportion of female patients. Recurrent UTI did not adversely impact graft or patient survival. 

These new studies add to a growing body of literature on UTI risk factors after kidney transplantation. In a recently published study in Medicine(2015;94:e594), researchers demonstrated that vitamin D deficiency is an independent risk factor for post-transplant UTI. A study published in Transplantation Proceedings (2014;46:3455-3458) found that the only risk factor for UTI after renal transplantation was gender, with female recipients at higher risk than male recipients. 

Also in Transplantation Proceedings (2014;46:1757-1759), investigators reported on a study that identified older age (independent of gender), biopsy-proven acute rejection episodes, and receipt of kidneys from deceased donors as UTI risk factors. For female recipients, an additional risk factor was the number of pretransplant pregnancies. Researchers reported in Transplantation(2013;96:732-738) that their study of 1,166 kidney transplant recipients showed that post-transplant UTI risk factors included female gender, prolonged use of Foley catheters, ureteral stents, age, and delayed graft function.

...

 
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