James J Paparello

Learn More
BACKGROUND Hyponatremia is common in neurocritical care and is associated with poor outcome, but the optimal treatment is not known. We wished to test the hypothesis that for neurocritical care patients with severe hyponatremia (Na < 130 mmol/l) or hyponatremia (Na < 135 mmol/l) with depressed Glasgow Coma Scale (GCS) that conivaptan use would lead to(More)
The mortality rate among dialysis patients is high. Although guidelines have been in place to improve outcomes in dialysis patients, new emphasis is being placed on better management of patients who are pre-end-stage renal disease (pre-ESRD)-patients with chronic kidney disease (CKD). Spearheaded by the National Kidney Foundation, the National Institute of(More)
Statins are lipid-lowering agents that specifically, competitively, and reversibly inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonic acid, the rate-limiting step in the formation of cholesterol. A large body of evidence from numerous, well-controlled, randomized trials(More)
Chronic kidney disease and cardiovascular disease share many risk factors. Injury to the vascular endothelium, measured by elevated levels of serum C-reactive protein (CRP), may play a role in kidney and cardiovascular disease. We therefore examined the association of CRP with microalbuminuria, a marker of early kidney injury. We conducted a cross-sectional(More)
There is increasing emphasis on chronic kidney disease (CKD), owing to its prevalence and its association with cardiovascular risk. Important issues concerning treatment of CKD are delaying its progression, improving patients' quality of life, and decreasing related mortality. These issues can be addressed with certain therapeutic options, targeting(More)
The performance of distortion product otoacoustic emissions (DPOEs) as a frequency-specific test of sensorineural hearing loss was evaluated in 142 ears of human adults with normal middle-ear function. The DPOE was measured with the stimulus levels of the two tones equal to 65 dB SPL (re 20 mu Pa) and the ratio between the two frequencies 1.2. In the DPOE(More)
We present a case of a 51-year-old woman who developed thrombocytopenia associated with dialysis treatments. Laboratory values revealed a platelet count of 50,000 or less postdialysis, with recovery of platelet count during her interdialytic period. An extensive work up including infectious serology and heparin-induced thrombocytopenia test was negative.(More)
This study examines whether stabilization of the glomerular filtration rate (GFR) is possible in patients with advanced chronic kidney disease (CKD), managed in a CKD clinic. A cohort of 82 patients with stages 4 and 5 CKD was followed for a period of 2 years after initiation of erythropoietin for anemia to determine the GFR and the frequency of primary(More)
BACKGROUND Simulation-based-mastery-learning (SBML) is an effective method to train nephrology fellows to competently insert temporary, non-tunneled hemodialysis catheters (NTHCs). Previous studies of SBML for NTHC-insertion have been conducted at a local level. OBJECTIVES Determine if SBML for NTHC-insertion can be effective when provided at a national(More)
Physicians utilize the measurement of the urea reduction ratio (URR) and Kt/V as surrogates for the adequacy of hemodialysis, as well as to follow the course of patients longitudinally. These measurements are affected by the duration of a dialysis treatment, the type and size of the dialyzer membrane used during the treatment, the blood flow rate during the(More)