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Clinical Nephrology

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https://www.readbyqxmd.com/read/28211788/hemolytic-uremic-syndrome-complicated-by-clostridium-septicum-bacteremia-and-new-onset-type-1-diabetes-mellitus-report-of-a-case%C3%A2
#1
Anna C Iddings, Asha N Shenoi, Alba Morales Pozzo, Stefan G Kiessling
We report the unusual case of a 5-year-old male hospitalized for management of diabetic ketoacidosis (DKA) and new-onset type 1 diabetes mellitus (T1DM) who developed acute renal injury secondary to hemolytic uremic syndrome (HUS). He was diagnosed with Shiga toxin-producing entero-hemorrhagic Escherichia coli (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/DKA. His hospital course was complicated by Clostridium septicum sepsis with colonic perforation. This patient's diagnosis of new-onset T1DM just prior to HUS is novel...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211787/clinical-factors-influencing-the-decision-to-order-red-blood-cell-transfusions-for-a-sample-of-us-dialysis-patients%C3%A2
#2
J Mark Stephens, John P Caloyeras, John Holmen, Victoria A Kumar, Spiros Tzivelekis, Allan Pollock
AIM: To characterize the clinical context for the decision to order red blood cell (RBC) transfusions in dialysis patients. MATERIALS AND METHODS: Retrospective review of medical records from three integrated health systems serving chronic dialysis patients. Subjects were randomly selected from all patients who received at least one transfusion between January 2009 and December 2013. Data abstracted included transfusion setting, prescribing clinician type, patient demographics and hemoglobin (Hb) concentration prior to transfusion, and cataloguing and prioritizing of clinical factors for their contribution to the decision to transfuse...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211786/sieving-and-extraction-of-peptides-and-proteins-during-hemofiltration-a-systematic-review%C3%A2
#3
J Scott Baird
The relationship between the sieving coefficient (SC) or extraction ratio (ER) and the molecular weight (MW) of peptide and protein solutes during hemofiltration has not been investigated; it is possible that the SC and ER correlate with MW, permitting an estimate of peptide and protein clearance by hemofiltration in the absence of empiric data. A search for studies of the SC and/or ER for peptide and protein solutes during hemofiltration identified data for β2-microglobulin, brain natriuretic peptide, carperitide, IL-1β, IL-1RA, IL-6, IL-8, lysozyme, myoglobin, neutrophil gelatinase-associated lipocalin, procalcitonin, retinol-binding protein, TNF-α, soluble TNFR-1, soluble TNFR-II, and vasopressin using polyacrylonitrile, polysulfone, polyamide, and cellulose hemofilters...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28177279/sodium-glucose-co-transporter-2-inhibitors-and-their-nephroprotective-potential%C3%A2
#4
Natalia G Vallianou, Kyriakos Trigkidis, Christos Kazazis
Chronic kidney disease among patients with diabetes is on the rise. The sodium glucose co-transporters 2 inhibitors are a new class of glucose-lowering agents, which act through a novel mechanism by producing a decline in glucose reabsorption in the kidney, thereby increasing glucosuria and decreasing serum glucose levels. Data suggest that they possess nephroprotective properties. It is noteworthy that the efferent glomerular arteriole is 10 - 100 times more sensitive to the vasoconstrictive properties of angiotensin II than the afferent one and this might account for the consequently higher intra-glomerular capillary pressure, which is believed to be the cornerstone of diabetic nephropathy...
February 8, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28177278/does-spontaneous-remission-occur-in-polyarteritis-nodosa-%C3%A2
#5
Simon Beyaert, Menno Pruijm, Salah Dine Qanadli, Peter Vollenweider, Matthieu Halfon
BACKGROUND: Polyarteritis nodosa (PAN) is a systemic vasculitis involving mainly medium-sized arteries and, rarely, small-sized arteries. The diagnosis is principally based on clinical exams, biopsy of an affected organ, and/or arteriography of renal or mesenteric arteries. Once diagnosed, immunosuppressive agents, such as glucocorticoids and cyclophosphamide, are generally introduced as soon as possible. Whether spontaneous remission of PAN occurs is therefore largely unknown. PRESENTATION: We describe the case of a 51-year-old woman who presented with a 4-day-history of intense pain in her left flank, hypertension, fever, microscopic hematuria, and acute renal failure...
February 8, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28157068/clinical-and-pathological-characteristics-of-fabry-disease-combined-with-iga-nephropathy-in-chinese-patients%C3%A2
#6
Nannan Yang, Xia Wang, Feng Xu, Caihong Zeng, Jinquan Wang, Zhihong Liu
AIMS: To improve diagnosis and treatment, we characterized Fabry disease combined with IgA nephropathy and its response to treatment clinically and pathologically in Chinese patients. MATERIALS AND METHODS: Clinical and pathological characteristics of 6 Chinese patients with renal biopsy-proven Fabry disease combined with IgA nephropathy were retrospectively analyzed. RESULTS: There were 4 males and 2 females in this study. All of the 6 patients presented with proteinuria...
February 3, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28157067/serum-klotho-levels-in-acute-kidney-injury%C3%A2
#7
Eric Seibert, Daniel Radler, Christof Ulrich, Sylvia Hanika, Roman Fiedler, Matthias Girndt
AIMS: Klotho is a co-receptor for FGF-23 and key regulator of phosphate excretion. Soluble klotho modulates ion-channel expression and growth factor sensitivity. In chronic kidney disease (CKD), impaired klotho expression has been demonstrated. Likewise, reduced soluble klotho levels in serum and urine have been established in rodents in experimental acute kidney injury (AKI). In contrast, no data on soluble serum klotho levels in human AKI has been presented to date. MATERIAL AND METHODS: A cross-sectional case-control study of klotho serum levels in 30 subjects with AKI and 126 control subjects with kidney functions ranging from normal to end-stage renal disease (ESRD)...
February 3, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28128729/do-patients-receiving-hemodialysis-regret-starting-dialysis-a-survey-of-affected-patients%C3%A2
#8
Elizabeth A Gilman, Molly A Feely, Daniel Hildebrandt, Jithinraj Edakkanambeth Varayil, Elisa Y Chong, Amy W Williams, Paul S Mueller
AIMS: End-stage renal disease (ESRD) is associated with high morbidity and mortality. A prior study showed that many Canadian patients regretted their decision to start dialysis. We sought to determine if US patients also regretted dialysis. MATERIALS AND METHODS: We surveyed hemodialysis patients within 55 miles of Rochester, MN, with a 25-question survey about their perceptions of their health, preparedness for dialysis, advance care planning, and regrets about starting dialysis...
January 27, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28128728/peritoneal-dialysis-is-a-reasonable-option-in-patients-with-cardiovascular-disease%C3%A2
#9
Sara Querido, Patrícia Quadros Branco, Henrique Silva Sousa, Teresa Adragão, Pedro Araújo Gonçalves, Maria Augusta Gaspar, José Diogo Barata
INTRODUCTION: Peritoneal dialysis (PD) has been proposed as a therapeutic option for patients with end-stage renal disease (ESRD) and cardiovascular (CV) disease. The study presented here aimed to compare incident PD patients with and without CV disease at baseline, in order to determine the impact of CV disease in the outcomes of long-term PD patients. METHODS: This is a prospective cohort study performed at a single PD unit where 112 consecutive incident patients admitted to the PD program during 5 years were studied...
January 27, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28128727/membranous-nephropathy-occurring-with-type%C3%A2-2%C3%A2-diabetes-mellitus%C3%A2
#10
Yujun Qian, Ke Zuo, Shijun Li, Caihong Zeng, Zhihong Liu, Yan Wu
BACKGROUND: The incidence of type 2 diabetes mellitus (T2DM) is increasing, and membranous nephropathy (MN) occurs frequently with T2DM. We investigated the clinicopathological features and outcomes of patients with T2DM and MN. METHODS: A total of 137 patients with biopsy-proven MN and T2DM were enrolled in this retrospective study. Another 100 MN patients without diabetes mellitus served as a control group. The clinicopathological features, treatment responses, and outcomes were analyzed and compared between groups...
January 27, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28128726/the-safety-of-achieved-iron-stores-and-their-effect-on-iv-iron-and-esa-use-post-hoc-results-from-a-randomized-trial-of-ferric-citrate-as-a-phosphate-binder-in-dialysis%C3%A2
#11
Kausik Umanath, Barbara Greco, Diana I Jalal, Molly McFadden, Mohammed Sika, Mark J Koury, Robert Niecestro, Lawrence G Hunsicker, Tom Greene, Julia B Lewis, Jamie P Dwyer
Iron stores assuring optimal efficacy/safety for erythropoiesis are unknown in the dialysis population. Using multicenter trial data, we related safety profiles, erythropoiesis-stimulating agent (ESA), and intravenous iron dosing to achieved iron stores in 441 subjects randomized 2 : 1 to ferric citrate or active control as their phosphate binder over 52 weeks. Intravenous iron was given at each site's discretion if ferritin ≤ 1,000 ng/mL and transferrin saturation ≤ 30%. Multivariable time-dependent Cox regression jointly related the primary safety outcome (composite of cardiac, infection, gastrointestinal, and hepatobiliary serious adverse events) to moving averages of ferritin and transferrin saturation over the preceding 90 days with covariate adjustment...
January 27, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28102817/validating-identification-of-patients-with-small-vessel-vasculitis-with-or-without-renal-involvement-using-administrative-healthcare-records
#12
Michelle M O'Shaughnessy, XingXing S Cheng, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
No abstract text is available yet for this article.
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28102816/clinicopathological-features-diagnosis-and-treatment-of-iga-nephropathy-with-minimal-change-disease-related-to-exposure-to-mercury-containing-cosmetics-a-case-report%C3%A2
#13
Hong-Xin Niu, Shen-Heng Li, Hong-Ying Li, Yi-Hua Chen, Wei-Wei Liu, Pei-Lin Li, Hai-Bo Long
AIM: Membranous nephropathy and minimal change disease (MCD) have been involved in mercury-induced nephrotic syndrome. IgA nephropathy is not known to be a common pathological type. In the present article, we report a case of IgA nephropathy with MCD following exposure to mercury-containing skin lightening cream. MATERIAL AND METHODS: The patient was a 39-year-old woman who presented with nephrotic syndrome. She had a 6-month history of using as many as 8 kinds of skin-lightening creams, and urinary mercury excretion was high...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28102815/assessment-of-the-characteristics-and-quality-of-life-of-patients-with-uremic-peripheral-neuropathy%C3%A2
#14
Xiu-Zhi Yu, Shi Lu, Wei Gou, Wei Wang, Shui-Hong Zou, Yin-Xia Han, Wei-Wei Wang, Jin-Yuan Zhang
OBJECTIVES: This study seeks to examine the characteristics and health-related quality of life (HRQL) of patients with uremic peripheral neuropathy. METHODS: Uremic patients undergoing maintenance hemodialysis (MHD) at our hospital were enrolled in this study. Data collection began in January 2011 and ended in June 2011. The patients were divided into two groups, the lesion group (110 cases) and the non-lesion group (168 cases), based on the presence or absence of peripheral neuropathy...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28102814/successful-induction-of-peritoneal-dialysis-in%C3%A2-a%C3%A2-patient-with-massive-hydrothorax-due-to%C3%A2-pleuroperitoneal-communication%C3%A2
#15
Takahiro Uchida, Yuji Yamada, Toshihiko Imakiire, Naoki Oshima, Hiroo Kumagai
A 74-year-old woman with liver cirrhosis and chronic kidney disease (CKD) who had complained of chronic abdominal distension due to prominent ascites presented with sudden dyspnea. Chest radiography showed massive right pleural effusion that shifted the mediastinum. Peritoneal scintigraphy using 99mTc-macroaggregated albumin revealed pleuroperitoneal communication (PPC). As her hydrothorax was refractory and frequent thoracentesis did not improve her respiratory distress, thoracoscopic surgery was performed for repair of the diaphragm defect...
January 19, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28079514/esrd-epidemiology-and-treatment-in-developing-countries-in-southeast-asia
#16
Sydney C W Tang
No abstract text is available yet for this article.
January 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28025959/hypokalemia-associated-with-acute-colonic-pseudo-obstruction-in-an-esrd-patient
#17
Khaled Boobés, Robert M Rosa, Daniel Batlle
Ogilvie's syndrome, or acute colonic pseudo-obstruction, is characterized by massive dilation of the colon without mechanical obstruction. Water and electrolytes often can be sequestered in the dilated intestinal loops resulting in profuse and watery diarrhea as well as hypokalemia. We report an anuric, end-stage renal disease (ESRD) patient undergoing peritoneal dialysis (PD) who developed acute colonic pseudo-obstruction causing a prolonged hospitalization. He also developed severe hypokalemia with a serum potassium (K+) as low as 2...
December 27, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27900940/acute-kidney-injury-in-allopurinol-induced-dress-syndrome-a-case-report-of-concurrent-tubulointerstitial-nephritis-and-kidney-limited-necrotizing-vasculitis%C3%A2
#18
Anthony J Esposito, Ryan C Murphy, Mirna N Toukatly, Osama W Amro, Bryan R Kestenbaum, Behzad Najafian
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but potentially fatal adverse drug reaction with variable renal involvement. We report the case of a man who presented with allopurinol-induced DRESS and acute kidney injury (AKI) requiring hemodialysis. Kidney biopsy revealed eosinophilic tubulointerstitial nephritis and necrotizing vasculitis of the intralobular arteries without systemic markers of vasculitis. After cyclophosphamide and glucocorticoids, his symptoms and AKI resolved. To our knowledge, this is the first case of kidney-limited necrotizing vasculitis, questioning whether a biopsy should be routinely performed in patients with DRESS accompanied by severe AKI...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/28177280/orlistat-and-acute-kidney-injury-a-case-report
#19
Ertugrul Erken, Orcun Altunoren, Ozkan Gungor
No abstract text is available yet for this article.
March 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28074773/low-dose-dialysis-combined-with-low-protein-intake-can-maintain-nitrogen-balance-in-peritoneal-dialysis-patients-in-poor-economies%C3%A2
#20
Chun-Yan Su, Tao Wang, Xin-Hong Lu, Sha Ma, Wen Tang, Pei-Yu Wang
OBJECTIVE: Due to limited economic conditions, we tried to provide "fitted" dialysis doses instead of the doses recommended by the international guidelines to the individual patients. In the present cross-sectional study, we studied the dialysis adequacy and nutritional status of 5 peritoneal dialysis patients who had a low dialysis dose (2 bags, 4,000 mL/day). METHODS: The 3-day dietary records were reviewed to calculate patients' energy, protein, and nitrogen intake (NI)...
February 2017: Clinical Nephrology
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