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Clinical Nephrology

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https://www.readbyqxmd.com/read/27900943/collagen-type-iii-glomerulopathy-case-report-and-review-of-the-literature
#1
Xinghua Chen, Huiming Wang, Wanwen Xu, Jili Zhu
To summarize the clinical and pathological features of collagen type III glomerulopathy, the present report describes a case of collagen type III glomerulopathy and reviewed more than 60 cases recorded by other groups in English literature over the last few years. A 24-year-old female patient was admitted because of lower limbs edema, without any other discomforts. The lab examination of the patient reported proteinuria (2.42 g/24 h urine), microscopic hematuria, and the serum creatinine was 71 μmol/L. She received renal biopsy...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27900942/association-between-chronic-kidney-disease-and-cancer-mortality-a-report-from-the-allhat
#2
Dhruti P Chen, Barry R Davis, Lara M Simpson, William C Cushman, Jeffrey A Cutler, Mirela Dobre, Charles E Ford, Gail T Louis, Paul Muntner, Suzanne Oparil, Linda B Piller, Sara L Pressel, Mark J Sarnak, Paul K Whelton, Jackson T Wright, Mahboob Rahman
BACKGROUND/OBJECTIVES: Chronic kidney disease (CKD) and cancer are both common in older patients; whether CKD increases risk for cancer is unclear. This study evaluated CKD as a risk factor for cancer mortality in a large cohort of hypertensive patients. STUDY DESIGN: We did post-hoc analyses of in-trial and post-trial data from participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). SETTING AND PARTICIPANTS: Participants were ≥ 55 years old with hypertension and one other additional risk factor for coronary heart disease...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27900941/the-kidney-in-sickle-hemoglobinopathies%C3%A2
#3
Medha Airy, Garabed Eknoyan
With improvements in the care of patients with sickle hemoglobinopathies, sickle cell disease (SCD) has evolved from a disease that was fatal in childhood into one in which most survive past their 5th decade and some into old age. As a result, the renal complications of sickle hemoglobinopathies, which are age dependent, have emerged as a common and serious complication of SCD. Approximately 14 - 18% of mortality in SCD is attributed to chronic kidney disease (CKD), which develops in 1/3 of individuals with SCD and progresses to end-stage renal disease in 4 - 18% of them...
November 30, 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
#4
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/27900939/incidence-and-implications-of-silent-hydronephrosis-following-percutaneous-nephrolithotomy%C3%A2
#5
Lawrence Dagrosa, Rachel Moses, Vernon Pais
OBJECTIVE: While routine renal imaging following ureteroscopy for urinary calculi has been recommended to screen for asymptomatic "silent" obstruction, the rate of silent obstruction following percutaneous nephrolithotomy (PCNL) remains poorly defined, and no consensus recommendations exist on routine postoperative imaging. At our institution, we sought to assess the incidence of silent hydronephrosis (SH), as a screen for obstruction, following PCNL. METHODS: The records of all 162 patients who met study inclusion criteria were reviewed...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27900938/calcitriol-in-the-treatment-of-iga-nephropathy-with-non-nephrotic-range-proteinuria-a-meta-analysis-of-randomized-controlled-trials%C3%A2
#6
Jin Deng, Xin Zheng, Hongping Xie, Lu Chen
OBJECTIVE: The aim of the present study was to investigate the efficacy and safety of calcitriol for treating Chinese patients with IgA nephropathy presenting as non-nephrotic range proteinuria, and a comprehensive meta-analysis was conducted using the related randomized controlled trials (RCTs). METHODS: We searched for RCTs of calcitriol for the treatment of IgA nephropathy in the CNKI, CBM, Cochrane Central Register of Controlled Trials, PUBMED, and EMBASE databases...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27879189/gemcitabine-induced-hemolytic-uremic-syndrome-treated-with-eculizumab-or-plasmapheresis-two-case-reports%C3%A2
#7
María Esperanza López Rubio, Raquel Rodado Martínez, María Luisa Illescas, Encarnación Mateo Bosch, Mercedes Martínez Díaz, Lourdes de la Vara Inesta, Basilio Cabezuelo, María Elisa Morales Albuja, Eladio Lucas Guillén, Luisa Jimeno García
BACKGROUND: Drug-induced hemolytic-uremic syndrome (HUS) has shown good response to eculizumab (ECU). We present 2 cases of patients with gemcitabine-induced HUS (GEM-HUS), one of whom was treated with ECU and the other with conventional treatment. Patient 1: A 74-year-old male with resected adenocarcinoma of the pancreas started adjuvant treatment with GEM, but after 5 months GEM was discontinued due to acute kidney injury and severe hypertension. Laboratory analyses identified microangiopathic hemolytic anemia (MHA) and thrombocytopenia...
November 23, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27841148/calciphylaxis-in-a-nondialysis-patient-treated-with-sodium-thiosulfate-and-high-dose-of-oxygen%C3%A2
#8
Anawin Sanguankeo, Natanong Thamcharoen, Sikarin Upala
BACKGROUND: Calciphylaxis in a nondialysis patient is a rare condition and is characterized by calcific deposition in tissue. We present a case of calciphylaxis in a nondialysis patient who was diagnosed by clinical presentation and skin biopsy and was treated with sodium thiosulfate with improvement of skin lesions. CASE: A 43-year-old female with type 2 diabetes and atrial fibrillation taking oral anticoagulation medication presented with reddish drainage from the right buttock...
November 14, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27841147/why-would-serum-phosphorus-correlate-with-cardiovascular-risk-and-how-is-the-clinician-supposed-to-use-this-information-%C3%A2
#9
Eleanor Lederer
Numerous recent studies have demonstrated an association between serum phosphorus and cardiovascular risk, even in individuals with normal kidney function and with serum phosphorus levels considered within the acceptable range. Whether serum phosphorus serves as a biomarker, as a causative agent, or both remains unclear. Additionally, the impact of other important considerations, such as the time of day when the phosphorus is measured, the diet of the individual, and the age of the individual, on interpretation of this association has not been determined...
November 14, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27805564/coronary-artery-calcification-in-ckd-5d-%C3%A2-patients-is-tied-to-adverse-cardiac-function-%C3%A2-and-increased-mortality%C3%A2
#10
Paul Anaya, Gustav A Blomquist, Daniel L Davenport, Marie-Claude Monier-Faugere, Vincent L Sorrell, Hartmut H Malluche
BACKGROUND: Coronary artery calcification (CAC) is common in patients with chronic kidney disease on hemodialysis (CKD-5D) and is an important predictor of mortality. However, cardiac functional links between CAC and mortality have not been well established. This study tested the hypothesis that CAC increases mortality by adversely affecting cardiac function. METHODS: Patients were recruited from 37 regional dialysis centers. 2-D and Doppler echocardiographic analyses were performed, and CAC was measured using 64-slice computed tomography...
November 2, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27805562/acute-kidney-injury-in-leptospirosis-the-kidney-disease-improving-global-outcomes-kdigo-criteria-and-mortality%C3%A2
#11
Flávio Teles, Júlia Vanessa de Mendonça Uchôa, Darina Mirelli Barreto Mendonça, André Falcão Pedrosa Costa
Acute kidney injury (AKI) is one of the most serious complications of leptospirosis. In recent years, studies have evaluated this complication using the risk, injury, failure, loss, and end-stage kidney disease and the acute kidney injury network classification systems. More recently, the kidney disease improving global outcomes (KDIGO) criteria have been developed to increase accuracy in detecting AKI. The aim of the present study was to determine the prevalence and factors associated with AKI and mortality in patients with leptospirosis, using KDIGO criteria...
November 2, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27781419/low-dose-mycophenolate-mofetil-in-tablet-form-or-capsule-form-combined-with-tacrolimus-in-the-early-period-after-kidney-transplantation-a-prospective-randomized-trial%C3%A2
#12
Su Lee, Chan-Duck Kim, Kyu Huh, Baik-Hwan Cho, Man Ju, Dong Lee, Hong Cho, Jong-Won Park, Jung Lee, Samuel Lee, Byung So, Chang-Kwon Oh, Yu Kim
AIMS: The tablet form (500 mg) of mycophenolate mofetil (MMF) provides more convenience of taking drugs and cost-effectiveness than the capsule form (250 mg). We examined the efficacy and safety of MMF in its different forms combined with tacrolimus in kidney transplant recipients. METHODS: This multicenter, 26-week, randomized trial was performed to compare the efficacy and safety of the tablet form of MMF versus the capsule form of MMF in 156 kidney transplant recipients...
October 26, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27737531/a-prospective-observational-study-of-effectiveness-and-safety-of-iron-isomaltoside-in-patients-with-chronic-renal-failure-and-iron-deficiency-anemia%C3%A2
#13
Patrick Biggar, Frank Leistikow, Andreas Walper
AIMS: The aim of this study was to investigate the effectiveness, safety, and tolerability of iron isomaltoside in routine practical care of iron deficiency anemia (IDA) in patients with chronic renal failure. METHODS: The study included 698 patients with IDA on dialysis or with nondialysis chronic kidney disease (CKD) stages 3 - 5 designated by their physicians for treatment with iron isomaltoside. Data were recorded at baseline and after 3 and 9 months. Effectiveness data included measurement of hemoglobin (Hb), hematocrit, s-iron, transferrin saturation (TSAT), and s-ferritin...
October 14, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27737530/igg4-related-disease-and-idiopathic-membranous-nephropathy-%C3%A2-the-clothes-do-not-make-the-man-%C3%A2
#14
Mercedes Acevedo Ribó, Francisco Javier Ahijado Hormigos, Francisco Díaz, Marta Romero Molina, Maria Angeles Fernandez Rojo, Maria Antonia Garcia Rubiales, Eugenio García Diaz
This case report describes a patient with a previous history of autoimmune pancreatitis secondary to IgG4-related disease, who developed an overt nephrotic syndrome due to membranous nephropathy, surprisingly idiopathic. In all the previously described cases with both concurrent diseases, membranous nephropathy was considered to be secondary to the IgG4-related disease based on the absence of anti-PLA2R1 autoantibodies, and nephrotic syndrome usually remitted after treatment with steroids alone. However, in our patient positivity of serum anti-PLA2R1 autoantibodies together with a normal serum IgG4 level, and the absence of the other most commonly associated diseases were compatible with an idiopathic membranous nephropathy...
October 14, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27719739/early-recognition-of-gonadal-dysgenesis-in-congenital-nephrotic-syndrome%C3%A2
#15
Supamit Ukarapong, Gary Berkovitz, Kenneth McElreavey, Anu Bashamboo, Yong Bao
Mutation of the Wilms tumor suppressor gene (WT1) has been recognized as one of the etiologies of steroid-resistant nephrotic syndrome (SRNS). The mutation is also responsible for gonadal dysgenesis in 46,XY individuals. Early recognition of the presence of Y chromosome is of particular importance because of the high risk of gonadal tumor. We present here three cases of steroid-resistant nephrotic syndrome with WT1 mutation and 46,XY karyotype. Patient 1 and 2 have intron splice site (IVS9+5G > A) mutation...
October 10, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27719738/bendamustine-induced-nephrogenic-diabetes-insipidus%C3%A2
#16
Benjamin Derman, Milli Jain, Elizabeth McAninch, Casey Gashti
A 59-year-old man presented with polyuria and polydipsia immediately following his sixth cycle of rituximab and bendamustine for chronic lymphocytic leukemia. He initially compensated by increasing his oral fluid intake at home, but later developed septic shock and was admitted with orders to be kept nil per os (NPO). This prompted an episode of acute hypernatremia during which he exhibited continued polyuria with inappropriately dilute urine. Desmopressin challenge yielded no response in the urine osmolality, indicating a nephrogenic source of his diabetes insipidus (DI)...
October 10, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27719736/regression-of-vascular-calcification-in-a-parathyroidectomized-patient-on-dialysis-with-untreated-hypocalcemia-over-12-year-follow-up%C3%A2
#17
Pablo Molina, José L Górriz, Sandra Beltrán, Belén Vizcaino, Luis M Pallardó
Although some experimental targets involved in calcium deposition are emerging, no intervention has been described to reliably reverse vascular calcification (VC). We report a case of severe VC regression in a parathyroidectomized patient on hemodialysis over 12-year follow-up, highlighting the use of calcium-free phosphate binders and a 2.5 mEq/L calcium dialysate for reducing calcium loading, despite persistent asymptomatic hypocalcemia occurrences. This case suggests that phosphate-binder choice and calcium dialysate concentration could be influenced by other components of CKD-MBD besides biochemical parameters, such as the presence of VC, so concluding that asymptomatic hypocalcemia may not be as harmful as once supposed, and conferring greater prognostic weight to the presence of VC than to calcium levels...
October 10, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27805563/computed-tomography-for-the-management-of%C3%A2-exit-site-and-tunnel-infections-in-peritoneal-dialysis-patients%C3%A2
#18
Keina Nozaki, Yuka Kamijo, Mineo Nakatsuka, Takeshi Azuma, Tohru Nakagawa, Hideyo Miyazaki, Tetsuya Fujimura, Hiroshi Fukuhara, Haruki Kume, Yoshitaka Ishibashi, Yukio Homma
PURPOSE: To evaluate the effectiveness of computed tomography (CT) for detection of exit-site and tunnel infections with a Tenckhoff catheter. MATERIALS AND METHODS: The study enrolled patients with exit-site or tunnel infections who underwent ultrasonography (US), CT scans, and subsequent catheter removal or partial catheter reimplantation from 2010 to 2014. Control cases on peritoneal dialysis who underwent abdominal CT scans for other reasons were randomly selected...
December 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27730807/association-between-1-25-dihydroxyvitamin-d-and-left-atrial-diameter-in-pre-dialysis-chronic-kidney-disease-patients%C3%A2
#19
Daijo Inaguma, Hibiki Shinjo, Akihito Tanaka, Eri Ito, Naoki Kamegai, Akiko Kato, Minami Mizutani, Hiroya Shimogushi, Yasuhiro Otsuka, Asami Takeda, Midori Hasegawa, Yukio Yuzawa
OBJECTIVE: To investigate the correlation between serum 1,25-dihydroxyvitamin D (1,25D) levels and left atrial diameter (LAD) using echocardiography in pre-dialysis chronic kidney disease (CKD). SUBJECTS AND METHODS: From an initial population of 487 patients (109 met the exclusion criteria), a total of 378 patients with CKD stage 3a - 5 who had not undergone dialysis or kidney transplantation were included in the study. The relationship between serum 1,25D levels and LAD was examined...
November 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27730806/successful-return-to-peritoneal-dialysis-after-a-case-of-relapsing-sphingomonas-paucimobilis-peritonitis%C3%A2
#20
Jonathan Owen, Vaughan Washco, Efrain Reisin
Sphingomonas paucimobilis is an uncommon source of peritonitis in patients undergoing peritoneal dialysis (PD). Although only a small number of cases have been reported, treatment failure rate is extremely high, with removal of the peritoneal dialysis catheter noted in ~ 50% of reported cases. The potential damage to the peritoneal membrane from peritonitis with this organism and the ability to return to PD after infection is unknown. We report a unique case in which a patient was able to successfully return to PD after relapsing Sphingomonas paucimobilis peritonitis, without apparent effects to dialysis clearance or ultrafiltration...
November 2016: Clinical Nephrology
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