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Clinical Nephrology

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https://www.readbyqxmd.com/read/28737134/nephrotic-syndrome-in-primary-myelofibrosis-with-renal-extramedullary-hematopoiesis-and-glomerulopathy-in-the-jak-inhibitor-era
#1
Rachele Del Sordo, Rachele Brugnano, Carla Covarelli, Gioia Fiorucci, Franca Falzetti, Giorgio Barbatelli, Emidio Nunzi, Angelo Sidoni
Primary myelofibrosis (PMF) is an uncommon form of myeloproliferative neoplasm (MPN) characterized by a proliferation of predominantly megakaryocytes and granulocytes in the bone marrow that, in fully-developed disease, is associated with reactive deposition of fibrous connective tissue, extramedullary hematopoiesis (EMH), and splenomegaly. Kidney involvement is rare and clinically presents with proteinuria, nephrotic syndrome, and renal insufficiency. Renal damage can be due to EMH and glomerulopathy. Renal EMH presents three patterns: infiltration of the interstitium with possible renal failure caused by functional damage of parenchyma and vessels, infiltration of capsule and pericapsular adipose tissue, and sclerosing mass-like lesions that can cause hydronephrosis and hydroureter with obstructive uropathy and renal failure...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28737133/pretreatment-with-paricalcitol-attenuates-level-and-expression-of-matrix-metalloproteinases-in-a-rat-model-of-renal-ischemia-reperfusion-injury%C3%A2
#2
Sibel Ersan, Asli Celik, Mehmet Tanrisev, Isil Kose, Zahide Cavdar, Mehtat Unlu, Ayse Kocak, Cemre Ural, Banu Yilmaz, Timur Kose
BACKGROUND: Ischemia-reperfusion injury (IRI) is a leading cause of acute kidney injury (AKI). The inflammatory response that drives IRI involves upregulation of matrix metalloproteinases (MMPs), which results in proteolytic degradation of renal microvascular matrix. Evidence suggests a potential protective role of active vitamin D on ischemic injury by downregulating MMPs. In the present study, we aimed to determine the expression and level of MMP-2 and MMP-9 in renal IRI model and the potential beneficial effect of paricalcitol on both level and expression of MMPs and tubular injury caused by IRI...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28737132/differences-in-characteristics-and-outcomes-between-community-and-hospital-acquired-acute-kidney-injury-a-systematic-review-and-meta-analysis%C3%A2
#3
Ryota Inokuchi, Yoshitaka Hara, Hideo Yasuda, Noritomo Itami, Yoshio Terada, Kent Doi
INTRODUCTION: No comprehensive review has examined the difference between community-acquired (CA) and hospital-acquired (HA) acute kidney injury (AKI) in terms of patient characteristics, in-hospital mortality, and hospital stay length. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of observational studies, using MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Library from their inceptions to April 10, 2016. Observational studies that (1) were published in peer-reviewed journals; (2) compared CA-AKI with HA-AKI, irrespective of the AKI definition during the same period; and (3) investigated in-hospital mortality and length of hospital stay were studied...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28699888/predicting-augmented-renal-clearance-using-estimated-glomerular-filtration-rate-in-critically-ill-children%C3%A2
#4
Bongjin Lee, Jongyoon Kim, June Dong Park, Hyun Mi Kang, Yoon Sook Cho, Kwi Suk Kim
AIMS: Measured glomerular filtration rate (mGFR) is often used to identify augmented renal clearance (ARC). However, in the clinical setting, estimated GFR (eGFR) is obtained more quickly and inexpensively. We aimed to determine whether eGFR can identify ARC by evaluating the correlation between the eGFR and vancomycin trough level (VTL). MATERIALS AND METHODS: We retrospectively reviewed the records of patients aged ≤ 18 years who underwent vancomycin therapeutic drug monitoring at our tertiary hospital from July 2009 to June 2014...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28699887/upward-trend-of-dapsone-induced-methemoglobinemia-in-renal-transplant-community%C3%A2
#5
Sohail Abdul Salim, Lakshmi Ramachandran Nair, Venkataraman Palabindala, Iasmina Craici
Dapsone, a sulfone antibiotic, is used for prophylaxis of Pneumocystis jirovecii pneumonia in patients with documented sulfa allergy. Acquired methemoglobinemia caused by dapsone is not uncommon in patients with normal glucose-6-phosphate dehydrogenase (G6PD) levels. Discrepancy between oxygen saturation measured by pulse oximetry and arterial oxygen saturation (SpO2) readings, a phenomenon known as "saturation gap," is noted with cases of methemoglobinemia. Although its prevalence in renal transplant patients is poorly described, there is evidence that its incidence is increasing...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28699886/interleukin-1-inhibition-chronic-kidney-disease-mineral-and-bone-disorder-and-physical-function%C3%A2
#6
Kristen L Nowak, Adriana Hung, Talat Alp Ikizler, Heather Farmer-Bailey, Natjalie Salas-Cruz, Sudipa Sarkar, Andrew Hoofnagle, Zhiying You, Michel Chonchol
OBJECTIVE: Epidemiologic studies have suggested a link between chronic systemic inflammation and chronic kidney disease-mineral and bone disorder (CKD-MBD). Additionally, declining renal function is associated with worsening physical and cognitive function, which may potentially be explained by systemic inflammation, CKD-MBD, or both. We hypothesized that inhibiting inflammation with an interleukin-1 (IL-1) trap would improve markers of CKD-MBD as well as physical/cognitive function in patients with moderate-to-severe CKD...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28699885/does-helicobacter-pylori-infection-play-a-role-in-iron-deficiency-anemia-in-hemodialysis-patients
#7
Hisham El-Said, Aber Baki Attallah, Zainab A Ali-Eldin
BACKGROUND: Among the disorders that may affect patients with end-stage renal disease (ESRD), anemia is the most responsive to treatment; any reversible cause should be identified, and the most common reversible cause is iron deficiency. We investigated the relationship between Helicobacter pylori infection and iron deficiency anemia in a hemodialysis population. MATERIALS AND METHODS: This cross-sectional study included 90 adult patients with ESRD on maintenance hemodialysis...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28699884/survey-among-nephrologists-in-germany-current-practice-and-management-of-pregnant-women-on-dialysis%C3%A2
#8
Johannes Duffner, Lena Schulte-Kemna, Barbara Reister, Ulla Ludwig, Frieder Keller, Rene van Erp, Bernd Schröppel
BACKGROUND: To assess the experience and practice patterns of nephrologists in Germany with regard to the care of pregnant women on dialysis. METHODS: The 26-item internet survey sent by email asked for demographic information, subjective proficiency, maternal and fetal complications, treatment approaches and goals. RESULTS: Of the 2,015 surveys sent out, 200 (10%) were available for evaluation. 38% of respondents never provided care, whereas 62% treated at least one pregnant patient on dialysis...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28679466/successful-launch-of-an-abo-incompatible-kidney-transplantation-program-to-overcome-the-shortage-of-compatible-living-donors-experience-at-a-single-center%C3%A2
#9
Seung Hwan Song, Juhan Lee, Beom Seok Kim, Sinyoung Kim, Jae Geun Lee, Hyeon Joo Jeong, Yu Seun Kim, Myoung Soo Kim, Hyun Ok Kim, Soon Il Kim, Kyu Ha Huh
AIMS: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. METHODS: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups...
July 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28671062/a-12-week-dose-escalating-study-of-etelcalcetide-ono-5163-amg-416-%C3%A2-a-novel-intravenous-calcimimetic-for-secondary-hyperparathyroidism-in-%C3%A2-japanese-hemodialysis-patients%C3%A2
#10
Keitaro Yokoyama, Masafumi Fukagawa, Takashi Shigematsu, Takashi Akiba, Akifumi Fujii, Motoi Odani, Tadao Akizawa
AIMS: To evaluate dose-escalation of etelcalcetide (ONO-5163/AMG 416), a novel, intravenous (IV), long-acting calcium-sensing receptor agonist, for treatment of secondary hyperparathyroidism (SHPT) in Japanese hemodialysis patients. MATERIALS AND METHODS: In this multicenter study, IV injections of etelcalcetide (3 times a week for 12 weeks) were administered, with dose escalation every 4 weeks depending on changes in serum intact parathyroid hormone (iPTH) and corrected calcium (cCa)...
July 3, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28669380/acute-kidney-injury-in-critically-ill-adult-patients-with-seasonal-influenza-infection
#11
Ana Dovč, Vladimir Premru, Blaž Pečavar, Rafael Ponikvar
BACKGROUND: Acute kidney injury (AKI) occurs in 22.4 - 100% of critically-ill hospitalized patients with influenza infection. In up to 2/3, it is severe enough to necessitate renal replacement therapy. We aimed to document the incidence of AKI among patients with influenza-related critical illness and its relation to clinical outcomes. METHODS: We conducted a retrospective observational study of all adult patients with acute respiratory illness and laboratory-confirmed influenza infection admitted to non-surgical intensive care units at the University Medical Centre Ljubljana between January 1, 2016, and March 31, 2016...
July 2, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28664840/anticoagulation-assessment-methods-in-plasma-exchange-with-regional-citrate-anticoagulation-evaluation-of-post-filter-and-filtered-plasma-ionized-calcium
#12
Manja Antonič, Jakob Gubenšek, Jadranka Buturović-Ponikvar, Rafael Ponikvar
AIM: To assess the possibility of using filtered plasma instead of postfilter ionized calcium (iCa) for the assessment of anticoagulation in plasma exchange (PE) with citrate anticoagulation. METHODS: 140 PE treatments were performed using either 4% or 15% citrate at a comparable dose. Paired samples of postfilter blood and filtered plasma were taken for iCa measurements with a point-of-care analyzer. Anticoagulation was also assessed with a bedside clotting time and visual assessment of the circuit after procedures...
June 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28664839/effects-of-paricalcitol-on-biomarkers-of-inflammation-and-fibrosis-in-kidney-transplant-recipients-results-of-a-randomized-controlled-trial
#13
Manca Oblak, Gregor Mlinšek, Aljoša Kandus, Jadranka Buturović-Ponikvar, Miha Arnol
AIMS: Paricalcitol, a selective vitamin D activator, decreases proteinuria and may reduce graft failure risk in kidney transplant recipients. In this study, we evaluated the effect of paricalcitol on renin-angiotensin system (RAS) activity as well as interleukin (IL)-6 and transforming growth factor (TGF)-β plasma concentrations as biomarkers of inflammation and fibrosis. METHODS: This placebo-controlled, double-blind trial enrolled a national cohort of kidney transplant recipients with urinary protein-to-creatinine ratio (UPCR) ≥ 20 mg/mmol despite optimization of the RAS blockade...
June 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655393/the-role-of-single-nucleotide-polymorphisms-of-cyp3a-and-abcb1-on-tacrolimus-predose-concentration-in-kidney-transplant-recipients
#14
Gregor Mlinšek, Vita Dolžan, Katja Goričar, Jadranka Buturović-Ponikvar, Miha Arnol
BACKGROUND: Tacrolimus has a narrow therapeutic drug window but high inter- and intrapatient variability. Our aim is to construct a model able to predict optimal maintenance tacrolimus predose concentration (C0) in kidney transplant patients. Here we present our study design and genotype and variant allele frequencies for the selected single nucleotide polymorphisms of genes involved in tacrolimus metabolism in our national cohort of kidney transplant recipients. METHODS: In the observational part of the study, we intend to determine allelic variants of CYP3A4, CYP3A5, and ABCB1 gene in a national cohort of 700 kidney transplants recipients...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655392/outcome-of-polyomavirus-nephropathy-in-renal-transplant-patients-a-single-center-experience
#15
Nika Kojc, Andreja Aleš Rigler, Gregor Mlinšek, Damjan Kovač, Dušan Ferluga, Miha Arnol
BACKGROUND: Reduction of immunosuppression is a common therapeutic strategy in patients with polyomavirus nephropathy (PVN) but may be associated with acute rejection. This study aimed to evaluate the morphology of PVN in renal biopsies after reduction of immunosuppression. METHODS: Eight of 241 patients who received a kidney transplant between January 2012 and December 2015 presented with BK viremia and biopsy-proven PVN. Morphological evaluation according to Banff criteria and correlation with viremia and kidney function after immunosuppression reduction was performed...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655391/prevalence-and-risk-factors-for-nonvertebral-bone-fractures-in-kidney-transplant-recipients-a-single-center-retrospective-analysis
#16
Alexander Jerman, Jelka Lindič, Andrej Škoberne, Špela Borštnar, Maja Martinuč Bergoč, Uroš Godnov, Damjan Kovač
BACKGROUND: Complex and longstanding bone disease superimposed by harmful influences of immunosuppression is the reason for increased risk of bone fracture in kidney transplant recipients. The aim of our study was to analyze the incidence and prevalence of nonvertebral bone fractures and early (in the first post-transplant year) clinical and laboratory risk factors for suffering bone fracture in the long-term post-transplant period. METHODS: Clinical and laboratory data as well as bone mineral density (BMD) measurements of 507 first kidney transplant recipients who were transplanted in the period from 1976 to 2011 were analyzed...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655390/acute-granulomatous-interstitial-nephritis-and-acute-rejection-in-a-kidney-transplant-recipient-after-zoledronic-acid-therapy-a-case-report-and-review-of-the-literature
#17
Nuša Avguštin, Damjan Kovač, Nika Kojc, Gregor Mlinšek, Jelka Lindič
BACKGROUND: Acute granulomatous interstitial nephritis (AGIN) in native kidneys is most commonly linked to drugs. In allografts, it is a rare complication, and it occurs mostly with infections. CASE PRESENTATION: Our case report presents AGIN with simultaneous acute cellular rejections and acute tubular necrosis in a kidney transplant patient 2 weeks after intravenous application of zoledronic acid. A kidney biopsy showed signs of destructive AGIN with acute cellular rejection...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655389/role-of-dry-lean-body-mass-for-estimation-of-glomerular-filtration-rate-in-kidney-transplant-recipients
#18
Špela Borštnar, Jelka Lindič, Andrej Škoberne, Luka Ležaič, Aljaž Sočan, Aljoša Kandus, Damjan Kovač
BACKGROUND: The use of equations that predict glomerular filtration rate (GFR) in patients with a kidney graft is still a matter of debate. The purpose of this study was to determine the level of accuracy of GFR equations and the relevance of dry lean body mass in the assessment of GFR. METHODS: In a prospective clinical study, 100 patients with a kidney graft were included. Estimated GFR with Modification of Diet in Renal Disease equation (MDRD), Chronic Kidney Disease Epidemiology Collaboration equation (CKD EPI) with serum creatinine concentration (CKD EPI Cr), serum cystatin C concentration (CKD EPI CysC) or both (CKD EPI Cr-CysC), and creatinine clearance calculated with Cockcroft-Gault equation (CG) was compared with GFR measured by 51Cr-EDTA clearance (mGFR 51Cr-EDTA)...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655388/ultrasound-guided-percutaneous-endovascular-treatment-of-arteriovenous-fistula-graft
#19
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje, Tomaž Ključevšek
BACKGROUND: Ultrasound-guided percutaneous endovascular treatment of arteriovenous fistula (AVF) or graft failure is an alternative to radiologically-guided angioplastic methods. Its main advantages are that it can be used with open or percutaneous access, using no contrast media and no radiation. The aim of this study was to analyze the results of ultrasound-guided endovascular treatment of arteriovenous access failure. MATERIAL AND METHODS: Preoperative ultrasound was used to determine the degree of stenosis and the size of balloon used in angioplasty...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28655387/hemodialysis-treatment-of-cardiorenal-syndrome
#20
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje
AIMS: We evaluated the impact of hemodialysis on mortality and hospital readmission in patients with cardiorenal syndrome. METHODS: All patients were NYHA IV functional class and underwent laboratory testing, echocardiography, and cardiac functional testing. Hemodialysis was indicated in patients with progressive decline of kidney function and consequent failure to titrate heart failure medication as well as in patients with hypervolemia that was resistant to conservative treatment with more than 4 annual hospitalizations due to heart failure and/or concomitant chronic kidney disease stage III - IV...
June 28, 2017: Clinical Nephrology
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