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Clinical Nephrology

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https://www.readbyqxmd.com/read/28619128/bioimpedance-based-rather-than-weight-based-ultrafiltration-prescription-for-children-on%C3%A2-maintenance-hemodialysis%C3%A2
#1
Gianluigi Ardissino, Mirco Belingheri, Michela Perrone, Francesca Tel, Dario Consonni, Sara Testa
The determination of dry weight (DW) in young children on hemodialysis (HD) remains challenging. Bioimpedance analysis (BIA) is a potentially helpful means of estimating the need for ultrafiltration and monitoring body fluids in patients on renal replacement therapy, but its role has not yet been clearly defined. The aim of this paper is to share our experience of prescribing ultrafiltration on the basis of BIA parameters alone. The body weight (BW), resistance (Rx), and reactance (Xc) of a 3-year-old girl on chronic HD were recorded pre- and post-HD over a period of 16 months...
June 16, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28619127/bone-mineral-disturbances-in-patients-with-chronic-kidney-disease-stage-5-not-yet-on-dialysis
#2
Andreja Marn Pernat, Matej Zrimšek
AIMS: This retrospective study evaluates the success of a treatment strategy for secondary hyperparathyroidism in our cohort of patients with chronic kidney disease stage 5 who were not yet on dialysis. MATERIALS AND METHODS: 81 predialysis patients from the outpatient clinic of the Department of Nephrology, University Medical Center Ljubljana were reviewed. We focused on serum markers for bone mineral metabolism including intact parathyroid hormone (PTH), phosphate, corrected calcium, and the usage of phosphate-binding agents and vitamin D analogs...
June 16, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601129/fabry-disease-diagnostic-methods-in-nephrology-practice
#3
Bojan Vujkovac
Fabry disease (FD; OMIM 301500) is a rare X-linked systemic disease caused by a mutation of the GLA gene. Consequently, there is very low, or even absent, activity of the lysosomal enzyme α-galactosidase A (α-Gal A), resulting in the progressive accumulation of glycosphingolipids (predominantly, globotriaosylceramide (GL-3)) in various cells of different organs. Chronic progressive proteinuric kidney disease is one of the hallmarks of this disease, and it constitutes an important component of this condition's clinical picture...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601128/expanded-valganciclovir-prophylaxis-in-kidney-transplant-recipients-is-associated-with-lower-incidence-of-cytomegalovirus-infection
#4
Željka Večerić-Haler, Boštjan Bizjak, Karmen Romozi, Miha Arnol
AIMS: The aim of this study was to compare the efficacy and safety of two subsequent CMV prophylaxis regimens for prevention of cytomegalovirus (CMV) infection and disease in our kidney transplant recipients (KTRs). METHODS: In an historic-cohort of KTRs, two CMV prophylaxis protocols were compared: short protocol in which CMV IgG seronegative recipients (R-) of CMV IgG seropositive donors (D+) received valganciclovir for 3 months post-transplant (group 1: 2005 - 2010); and expanded protocol in which prophylaxis for high-risk recipients was extended to 6 months, and a 3-month prophylaxis for D+/R+ and D-/R+ was introduced (group 2: 2011 - 2016)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601127/increase-in-spot-urine-protein-excretion-is-associated-with-late-kidney-graft-rejection-and-predicts-rejection-phenotype
#5
Miha Arnol, Manca Oblak, Gregor Mlinšek, Jelka Lindič, Aljoša Kandus, Dušan Ferluga, Nika Kojc, Jadranka Buturović-Ponikvar
AIMS: A noninvasive test that foretells kidney graft rejection before loss of kidney function would be desirable. We hypothesized that an increase in estimated protein excretion rate (ePER) from spot urine samples is associated with graft rejection and predicts rejection phenotype. METHODS: 151 patients who had undergone first-indication kidney biopsy due to graft dysfunction beyond 3 months after transplant were identified from a national cohort of 616 transplant recipients between 2000 and 2012 (25%)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601126/the-impact-of-gene-polymorphisms-in-angiotensin-receptor-1-and-aldosterone-synthase-in-peritoneal-dialysis-patients
#6
Alijana Trošt Rupnik, Damjan Kovač, Jernej Pajek, Joško Osredkar, Janja Marc, Jelka Lindič
AIM: Longevity of peritoneal membrane is an important issue in patients treated with peritoneal dialysis (PD). In our study, we studied the impact of angiotensin receptor 1 (AGT R1) and aldosterone synthase (CYP11B2) gene polymorphism on peritoneal concentrations of interleukin-6 (PI-IL-6), vascular endothelial growth factor (PI-VEGF), plasminogen activator inhibitor-1 (PI-PAI-1), transforming growth factor-β (PI-TGF-β), and cancer antigen-125 (PI-CA-125) as known markers of peritoneal fibrosis...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601125/hyperuricemia-and-long-term-survival-in-patients-with-chronic-kidney-disease-undergoing-hemodialysis
#7
Tadej Petreski, Sebastjan Bevc, Robert Ekart, Radovan Hojs
INTRODUCTION: Uric acid (UA), a breakdown product of purines, has been associated with mortality in different populations. Less is known about associations between hyperuricemia and mortality in chronic kidney disease (CKD) patients, later undergoing hemodialysis (HD), during a long observation period. The aim of this study was to determine the impact of elevated UA levels on long-term (19.5 years) survival of CKD patients. METHODS: 120 CKD patients (49 female, 71 male) enrolled in our study were observed from their first visit at the patients' nephrology outpatient clinic (NOC)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601124/impact-of-short-term-nutritional-supplementation-on-surrogate-markers-of-undernutrition-in-hemodialysis-patients-prospective-real-life-interventional-study
#8
Andreja Ocepek, Sebastjan Bevc, Robert Ekart
INTRODUCTION: Hemodialysis (HD) patients are at increased risk for undernutrition, especially protein wasting. We present the results of a prospective study in HD patients after 4 months of intervention with oral nutritional supplements (ONS). METHODS: After a 3-month wash-out period, 92 HD patients were enrolled in the study. Patients were tested for undernutrition with composite parameters, laboratory tests, bioelectrical impedance analysis (BIA), and hand-grip strength test (HGS)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601123/physical-function-and-25-hydroxyvitamin-d-in-dialysis-patients-lessons-learned-from-the-slovenian-diagib-study
#9
Maja Bučar Pajek, Ivan Čuk, Gregor Mlinšek, Joško Osredkar, Jernej Pajek
AIMS: Vitamin D stores in dialysis patients may be associated with their muscle function and physical performance. We analyzed associations of 25-hydroxyvitamin D levels with functional test results in prevalent hemodialysis patients and healthy controls. METHODS: Study sample included 54 dialysis patients and 81 healthy controls who performed a 6-minute walk test, sit-to-stand test, handgrip strength measurement, and self-rated habitual adjusted activity score with Human Activity Profile questionnaire...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601122/subendocardial-viability-ratio-and-ejection-duration-as-parameters-of-early-cardiovascular-risk-in-children
#10
Nataša Marčun-Varda, Sara Nikolic, Mirjam Močnik
AIM: The purpose of this study was to investigate subendocardial viability ratio (SEVR) and ejection duration (ED) in children and adolescents with common cardiovascular risk factors such as arterial hypertension, obesity, and hypercholesterolemia. METHODS: Four groups of pediatric patients were analyzed: 31 children and adolescents had hypertension, 36 were overweight, 49 were overweight and had hypertension, and 70 had hypercholesterolemia. The patients were compared to a control group of 50 healthy individuals...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601121/relationship-between-subendocardial-viability-ratio-and-hemoglobin-in-patients-with-chronic-kidney-disease
#11
Robert Ekart, Sebastjan Bevc, Nina Hojs, Tina Stropnik Galuf, Martin Hren, Benjamin Dvoršak, Maša Knehtl, Eva Jakopin, Igor Krajnc, Radovan Hojs
AIMS: Pulse wave analysis (PWA) uses the technique of applanation tonometry to obtain a peripheral pulse pressure waveform from which central hemodynamic information is derived. Using PWA, subendocardial viability ratio (SEVR) can be measured. SEVR represents a noninvasive measure of myocardial perfusion. It is related to the work of the heart, the oxygen consumption, and the energy supply of the heart. Anemia is a common complication of chronic kidney disease (CKD). A complex relationship exists between CKD, cardiovascular disease (CVD), and anemia...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601120/measurement-of-breath-ammonia-for-detection-of-patients-with-chronic-kidney-disease
#12
Sebastjan Bevc, Eva Mohorko, Mitja Kolar, Polona Brglez, Andrej Holobar, Daniela Kniepeiss, Matej Podbregar, Nejc Piko, Nina Hojs, Maša Knehtl, Robert Ekart, Radovan Hojs
BACKGROUND: In a healthy individual, ammonia is converted to urea in the liver. Urea is then transported through the bloodstream and then excreted into the urine by the kidneys. In patients with chronic kidney disease (CKD), the accumulated urea is degraded by salivary urease into ammonia, which is then excreted by breathing. Breath ammonia can therefore be used for detecting the increased nitrogen-bearing wastes. In our pilot study, an electrochemical sensor was used to measure and analyze breath ammonia in healthy volunteers and patients with CKD...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601119/the-predictive-value-of-urinary-vascular-endothelial-growth-factor-vegf-on-worsening-kidney-function-in-proteinuric-chronic-kidney-disease
#13
Nuša Avguštin, Žiga Rotar, Jernej Pajek, Damjan Kovač, Joško Osredkar, Jelka Lindič
OBJECTIVES: To evaluate the role of urinary vascular endothelial growth factor (VEGF) as an early predictor of chronic kidney disease (CKD) progression in patients with glomerular diseases. METHODS: We prospectively included patients with proteinuria and CKD grade 1 - 5 due to glomerular disease at the time of kidney biopsy. At baseline, we collected demographics, comorbidities, smoking history, serum creatinine (sCr), proteinuria, and urinary VEGF in collected 24-hour urine...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601118/determination-of-red-blood-cells-in-urinary-sediment-do-ph-and-specific-gravity-of-urine-matter
#14
Nuša Avguštin, Alexander Jerman, Žiga Rotar, Špela Borštnar, Andrej Škoberne, Jelka Lindič
INTRODUCTION: It has been postulated that erythrocyte cell lysis in urine is common in the case of low urine specific gravity and high urine pH. We aimed to verify the influence of urine dipstick pH and specific gravity on erythrocyturia in the urine sediment in the case of positive dipstick hemoglobinuria. METHODS: We retrospectively collected data on dipstick specific gravity, pH, and urine sediment analysis done by nephrologists in the clinical and research urine laboratory at the Department of Nephrology, University Medical Center Ljubljana...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28601117/tubular-urinary-indexes-reliably-distinguish-between-primary-tubulointerstitial-and-primary-glomerular-diseases-in-patients-referred-for-kidney-biopsy
#15
Andrej Škoberne, Špela Borštnar, Nuša Avguštin, Damjan Kovač, Andreja Aleš Rigler, Željka Večerić-Haler, Jernej Pajek, Mladen Krsnik, Nika Kojc, Dušan Ferluga, Jelka Lindič
AIMS: Kidney biopsy remains the gold standard for accurately diagnosing renal diseases. Urinalysis and assessment of renal function are the cornerstones for assessment of patients prior to biopsy. There is significant overlap in the results of routine urine parameters (proteinuria, erythrocyturia, leukocyturia) among different kidney diseases, which hinders the possibility of adequately estimating disease etiology prior to the biopsy. The aim of our study was to assess whether diverse markers of glomerular and tubular proteinuria - urinary albumin, IgG, α-1-microglobulin (α-1-m) and N-acetyl-β-D-glucosaminidase (NAG) - are capable of distinguishing between patients with primary tubulointerstitial (TID) and primary glomerular disease (GLOM)...
June 9, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28593836/predictors-and-generation-of-risk-equations-for-albuminuria-progression-in-type-2-diabetes%C3%A2
#16
Miriam Giordano Imbroll, Daniele Agius Lauretta, Trevor Tabone, Stephen Fava
BACKGROUND: Diabetes is the most common cause of end-stage renal disease and is associated with increased mortality. Although only a proportion of type 2 diabetic subjects develop albuminuria or progress, it is not currently possible to identify those patients who will develop this complication or who will progress. AIM: The aim of the study was to identify baseline risk factors for the development and progression of albuminuria in a cohort with type 2 diabetes and use this data to generate risk equations...
June 8, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28589875/secondary-peritonitis-associated-with-infective-endocarditis-and-vertebral-osteomyelitis-in-a-peritoneal-dialysis-patient
#17
Yao-Ko Wen
No abstract text is available yet for this article.
June 7, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28587714/real-world-effectiveness-of-sucroferric-oxyhydroxide-in-patients-on-chronic-hemodialysis-a-retrospective-analysis-of-pharmacy-data%C3%A2
#18
Daniel W Coyne, Linda H Ficociello, Vidhya Parameswaran, Ludmila Anderson, Sharanya Vemula, Norma J Ofsthun, Claudy Mullon, Franklin W Maddux, Robert J Kossmann, Stuart M Sprague
AIMS: Hyperphosphatemia has been associated with an increased risk of mortality in patients with end-stage renal disease. We sought to assess the real-world effectiveness of sucroferric oxyhydroxide (SO), an iron-based phosphate binder (PB), in control of serum phosphorus levels, and to determine the associated pill burden in hemodialysis patients. MATERIALS AND METHODS: Adult, in-center hemodialysis patients first prescribed SO through a renal pharmacy service as part of routine clinical care between April 1, 2014 and March 31, 2015 were included in the analysis...
June 7, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28561732/ferric-citrate-controls-serum-phosphorus-in-dialysis-patients-retrospective-data%C3%A2
#19
Debra J Hain, Meredith Marinaro, David W Koeper, Melissa A Rosenthal, Salvatore Chillemi, Jennifer M Huffman, Teresa Gerbeling, James M Pritsiolas, Lisa C Loram, Pablo E Pergola
Ferric citrate is an approved phosphate binder for use in patients with chronic kidney disease on dialysis. Clinical trials demonstrated that ferric citrate controlled serum phosphorus levels and increased iron stores. The aim of this retrospective chart review was to evaluate real-world bone mineral and anemia parameter data from patients treated with ferric citrate. 92 adult dialysis patients taking ferric citrate (average starting dose of 6 tablets/day) for at least 6 months were included. Bone mineral, anemia, and iron biomarker levels were extracted from patient medical records before and during the first 6 months of ferric citrate treatment; 21 (23%) patients were phosphate binder naïve, and 71 (77%) patients had been on other phosphate binders...
May 31, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28502324/favorable-long-term-outcomes-of-isolated-liver%C3%A2-transplantation-in-a-child-with-atypical-hemolytic-uremic-syndrome-caused-by-a%C3%A2-novel%C3%A2-complement-factor-h-mutation%C3%A2
#20
Heeyeon Cho, Yeonhee Lee
Atypical hemolytic uremic syndrome (aHUS) is a rare syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury that is usually caused by complement dysregulation. Complement factor H (CFH) is a regulator of the complement system produced in the liver, and CFH gene mutations are the most frequent causes of aHUS. To date, the therapeutic options for aHUS with CFH mutations have consisted of plasma infusions, plasma exchange, kidney transplantation, isolated liver transplantation, or combined liver and kidney transplantation...
May 15, 2017: Clinical Nephrology
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