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Clinical Nephrology

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https://www.readbyqxmd.com/read/28332476/new-onset-hepatitis-c-virus-associated-glomerulonephritis-following-sustained-virologic-response-with-direct-acting-antiviral-therapy%C3%A2
#1
Muriel Ghosn, Matthew B Palmer, Catherine E Najem, Danny Haddad, Peter A Merkel, Jonathan J Hogan
Glomerulonephritis (GN) is an important extra-hepatic manifestation of infection with hepatitis C virus (HCV). HCV-associated GN occurs due to HCV-induced lymphoproliferation, leading to the generation of pathogenic immune complexes, including complexes containing cryoglobulins. The management of HCV-associated extra-hepatic disease is focused on viral eradication, with direct-acting antiviral agents leading to high rates of sustained virologic remission. There have been a few reports of relapsing cryoglobulinemic vasculitis after sustained virologic remission was achieved with interferon-based therapies...
March 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28332475/association-of-urinary-uromodulin-with-kidney%C3%A2-function-decline-and-mortality-the%C3%A2-health-abc-study%C3%A2
#2
Pranav S Garimella, Ronit Katz, Joachim H Ix, Linda F Fried, Stephen B Kritchevsky, Prasad Devarajan, Michael R Bennett, Chirag R Parikh, Michael G Shlipak, Tamara B Harris, Orlando M Gutiérrez, Mark J Sarnak
BACKGROUND: Urine uromodulin (uUMOD) is a protein secreted by the kidney tubule. Recent studies have suggested that higher uUMOD may be associated with improved kidney and mortality outcomes. METHODS: Using a case-cohort design, we evaluated the association between baseline uUMOD levels and ≥ 30% estimated glomerular filtration rate (eGFR) decline, incident chronic kidney disease (CKD), rapid kidney function decline, and mortality using standard and modified Cox proportional hazards regression...
March 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28332474/brain-swelling-during-dialysis-a-randomized-trial-comparing-low-flux-hemodialysis-with-pre-dilution-hemodiafiltration%C3%A2
#3
Niels Johansen, Krista Dybtved Kjaergaard, Christian Daugaard Peters, Michael Pedersen, Bente Jespersen, Jens Dam Jensen
Osmotic changes in plasma are assumed to cause cerebral swelling in hemodialysis patients. We investigated the acute effect of low-flux hemodialysis (HD) (removal of small molecules) and pre-dilution hemodiafiltration (pre-HDF) (additional removal of larger molecules) on cerebral compartment volumes using quantitative magnetic resonance imaging (MRI) in chronic uremic patients. Twelve patients underwent a session of HD and pre-HDF in a randomized crossover study with equal ultrafiltration. MRI was performed immediately before and after dialysis...
March 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28332473/correlation-analysis-of-renal-ultrasound-elastography-and-clinical-and-pathological-changes-in-patients-with-chronic-kidney-disease%C3%A2
#4
Lingyan Peng, Tingting Zhong, Qiuling Fan, Yanjun Liu, Xuemei Wang, Lining Wang
OBJECTIVE: To analyze the correlations of renal tissue elastography with clinical biochemical indicators and pathological changes in patients with chronic kidney disease (CKD) as well as to explore the potential for renal tissue elastography as a new, noninvasive method for the dynamic monitoring of renal disease progression, efficacy assessment, and prognosis evaluation. METHODS: Patients admitted to the Department of Nephrology of the First Affiliated Hospital of China Medical University from August 2014 to January 2015 who had undergone renal biopsies were selected...
March 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28291506/immunotactoid-glomerulopathy-leading-to-the-discovery-of-poems-syndrome%C3%A2
#5
Carole Philipponnet, Jean-Louis Kemeny, Cyril Garrouste, Martin Soubrier, Anne-Elisabeth Heng
Monoclonal gammopathy of renal significance (MGRS) can manifest in many different ways depending on the nature of the immunoglobulin and its physicochemical properties. MGRS can lead to the discovery of a hematological malignancy. We report the case of a 32-year-old female patient who underwent renal biopsy on account of an impure nephrotic syndrome associated with immunoglobulin (Ig)G κ monoclonal gammopathy. Histological analysis revealed membranoproliferative glomerulonephritis with IgG, IgM, κ, λ, and C3 deposits...
March 14, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28291505/the-high-prevalence-of-reversible-subclinical-hypothyroidism-with-elevated-serum-thyroglobulin-levels-in-chronic-kidney-disease-patients%C3%A2
#6
Toru Sanai, Ken Okamura, Shuichi Rikitake, Makoto Fukuda, Koji Onozawa, Mai Sanematsu, Tsuyoshi Takashima, Motoaki Miyazono, Yuji Ikeda
BACKGROUND: We examined the thyroid function of non-dialysis-dependent chronic kidney disease (CKD) patients in Japan. METHODS: Serum-free thyroxine, free triiodothyronine, thyroid-stimulating hormone (TSH), and thyroglobulin (Tg) levels were evaluated in 37 CKD patients. CKD was defined as sustained kidney damage for more than 3 months and was classified as CKD 1+2 (n = 11), 3+4 (n = 10), or 5 (n = 16), which were defined by glomerular filtration rates of ≥ 60, 15 - 59, or < 15 mL/min/1...
March 14, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28291504/hepcidin-clearance-is-associated-with-erythropoietin-requirement-in-stable-hemodialysis-patients%C3%A2
#7
Damien Ashby, Mark Busbridge, Sarah Hildebrand, Candice Clarke, Georgina Aldous, Mitul Palan, Kevin Murphy, Neill Duncan, Peter Choi
BACKGROUND: The discovery of hepcidin, the hormone regulating iron absorption and transport, has improved the understanding of anemia and erythropoietin treatment. Excessive hepcidin signaling causes anemia in chronic inflammatory conditions by restricting iron delivery to the bone marrow. Hepcidin is normally eliminated in the urine, and the high levels seen in renal failure are thought to contribute to renal anemia and resistance to erythropoietin. METHODS: Clearance of hepcidin by hemodialysis was investigated in this study by measurement of plasma hepcidin before and after a single dialysis session in 204 patients...
March 14, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28257282/wt1-mutation-associated-nephropathy-a%C3%A2-single-center-experience%C3%A2
#8
Zhihui Yue, Haiyan Wang, Hongrong Lin, Juan Yang, Ting Liu, Yulin Liu, Huamu Chen, Liangzhong Sun
This study explored Wilms' tumor 1 (WT1) mutations in children with, or suspected of having, steroid-resistant nephrotic syndrome (SRNS), referred to or treated in our hospital in the past 6 years as well as the correlation between genotype and phenotype in WT1 mutation-associated nephropathy in Chinese patients. In total, 76 patients participated in the study. WT1 mutations were identified in 15 patients, 5 of whom harbored splice-site mutations in intron 9. Four of these 5 patients exhibited early onset of nephropathy and rapid deterioration of renal function...
March 3, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211786/sieving-and-extraction-of-peptides-and-proteins-during-hemofiltration-a-systematic-review%C3%A2
#9
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/28177278/does-spontaneous-remission-occur-in-polyarteritis-nodosa-%C3%A2
#10
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/28128727/membranous-nephropathy-occurring-with-type%C3%A2-2%C3%A2-diabetes-mellitus%C3%A2
#11
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
#12
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
#13
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/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/28079514/esrd-epidemiology-and-treatment-in-developing-countries-in-southeast-asia
#15
Sydney C W Tang
No abstract text is available yet for this article.
January 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28266910/obesity-and-kidney-disease-hidden-consequences-of-the-epidemic
#16
Csaba P Kovesdy, Susan L Furth, Carmine Zoccali
No abstract text is available yet for this article.
April 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28244367/transition-from-lupus-podocytopathy-to-diffuse-proliferative-lupus-nephritis-without-proteinuria-in-childhood-onset-systemic-lupus-erythematosus
#17
Shuichiro Fujinaga, Tomohiko Nishino, Akira Mizutani, Koji Sakuraya, Shunsuke Sakurai
No abstract text is available yet for this article.
April 2017: Clinical Nephrology
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
#18
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 <i>Escherichia coli</i> (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/DKA. His hospital course was complicated by <i>Clostridium septicum</i> sepsis with colonic perforation...
April 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
#19
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...
April 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28177279/sodium-glucose-co-transporter-2-inhibitors-and-their-nephroprotective-potential%C3%A2
#20
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...
April 2017: Clinical Nephrology
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