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Clinical Nephrology

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https://www.readbyqxmd.com/read/29350175/update-on-the-nephrotoxicity-of%C3%A2-novel%C3%A2-anticancer-agents%C3%A2
#1
Eliezer Zachary Nussbaum, Mark A Perazella
Anticancer drug-induced kidney disease is a problem commonly encountered by nephrologists. The number of medications employed by oncologists causing acute and chronic kidney injury as well as electrolyte and acid-base disturbances has increased significantly over the past several decades. While conventional chemotherapeutic drugs induce a number of kidney lesions, emergence of very effective and well-tolerated targeted therapies and novel immunotherapies has increased the occurrence of drug-induced acute and chronic kidney injury in cancer patients...
January 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29350174/automated-peritoneal-dialysis-could-rapidly-improve-left-heart-failure-by-increasing-peritoneal-dialysis-ultrafiltration-a-single-center-observational-clinical-study%C3%A2
#2
Cong Yang, Jixing Liu, Nirong Gong, Yanhong Lin, Yanfang He, Zhixiu Yi, Liping Hu, Jianping Jiang, Jun Ai
Ultrafiltration failure (UFF) is a major cause of water retention, left heart failure (LHF), and peritoneal dialysis (PD) failure. Automated peritoneal dialysis (APD) might have better ultrafiltration (UF) than continuous ambulatory peritoneal dialysis (CAPD). Here, we have studied whether short-term APD could increase UF and improve LHF. 47 patients were included in this study from December 1, 2015, to January 1, 2017. All patients had been treated with CAPD before they came to our center and were treated with APD in the hospital...
January 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29350173/membranoproliferative-glomerulonephritis-and-interstitial-nephritis-in-the-setting-of-epstein-barr-virus-related-hemophagocytic-syndrome%C3%A2
#3
Iolanda Godinho, Estela Nogueira, Sofia Jorge, António Teixeira Alves, António Gomes da Costa
BACKGROUND: Hemophagocytic syndrome (HPS) is a rare, aggressive disorder characterized by dysregulation of lymphocyte and macrophage activity, which culminates in tissue infiltration with hemophagocytosis and ultimately organ failure. Renal involvement frequently ensues and usually results in acute tubular necrosis with associated interstitial inflammation. Less frequently, glomerulopathy can also be found. CASE: We report a case of a 24-year-old Caucasian woman with previous asymptomatic hematuria, mild proteinuria, and normal renal function who presented to us with fever...
January 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29350172/comparison-of-dialysate-and-plasma-ntprobnp-in-prediction-of-clinical-outcomes-of%C3%A2-diabetic-and-nondiabetic-peritoneal-dialysis-patients%C3%A2
#4
Suleyman Koz, Idris Sahin, Mansur Kayatas, Sema Tulay Koz
BACKGROUND: Plasma level of N-terminal pro-brain natriuretic peptide (P-NTproBNP) is a useful marker in prediction of mortality in peritoneal dialysis (PD) patients. However, the predictive value of spent dialysate counterpart (D-NTproBNP) of plasma NTproBNP on mortality and dropout is not known. MATERIALS AND METHODS: Simultaneous P-NTproBNP and D-NTproBNP assays were performed after an overnight dwell in 44 scheduled ambulatory PD patients. Patients were followed for ~ 47 months...
January 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29319493/cyclosporine-for-the-treatment-of-lupus-nephritis-in-patients-with-systemic-lupus-erythematosus
#5
Tzu-Han Yang, Tsai-Hung Wu, Yuh-Lih Chang, Hsien-Tzung Liao, Chia-Chen Hsu, Chang-Youh Tsai, Yueh-Ching Chou
AIMS: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). MATERIALS AND METHODS: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded...
January 10, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29319492/risk-of-complications-with-use-of-aspirin-during-renal-biopsy-a-systematic-review
#6
Vinayak Kumar, Matthew D Mitchell, Craig A Umscheid, Jeffrey S Berns, Jonathan J Hogan
BACKGROUND: Bleeding is a well-known complication of percutaneous renal biopsy (PRB). Thus, antiplatelet agents are routinely held for most patients undergoing elective PRB to decrease bleeding risk. MATERIALS AND METHODS: In this systematic review, we examine the association between antiplatelet use and bleeding during PRB. MEDLINE and EMBASE were searched from inception to December 2016 using terms that included "renal biopsy", "antiplatelet","aspirin", and "bleeding"...
January 10, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29292693/efficacy-and-safety-of-everolimus-plus-low-dose-calcineurin-inhibitor-vs-mycophenolate-mofetil-plus-standard-dose-calcineurin-inhibitor-in-renal-transplant-recipients-a-systematic-review-and-meta-analysis%C3%A2
#7
Lihong He, Jin Deng, Bo Yang, Wei Jiang
BACKGROUND: To seek an optimized immunotherapy which can preserve renal function while maintaining low acute rejection rates, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of everolimus (EVR) plus low-dose calcineurin inhibitor (CNI) vs. mycophenolate mofetil (MMF) plus standard-dose CNI regimen after kidney transplantation (KT). MATERIALS AND METHODS: We searched for RCTs comparing the outcomes of EVR plus low-dose CNI and MMF plus standard-dose CNI regimen after KT and identified eligible RCTs according to strict inclusion and exclusion criteria...
January 2, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29292692/beh%C3%A3-et-s-syndrome-and-focal-segmental-glomerulosclerosis-with-nephrotic-syndrome-successful-treatment-with-etanercept%C3%A2
#8
Deanne Leonard, Cherise Cortese, Hani M Wadei, Ivan E Porter Ii, Nabeel Aslam
Behçet's syndrome (BS) often presents with aphthous and genital ulcers, uveitis, and erythema nodosum. Renal involvement has been reported with most cases presenting with renal amyloidosis, IgA nephropathy, or crescentic glomerulonephritis. We describe a case of a 49-year-old woman with relapsing BS symptoms coinciding with new-onset development of nephrotic syndrome. Renal biopsy showed focal segmental glomerulosclerosis (FSGS) that was treated with prednisone and etanercept for BS therapy. Both proteinuria and BS symptoms responded to treatment with complete remission...
January 2, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29292691/trend-of-peritoneal-transport-and-impact-on-patient-survival-a-10-year-follow-up-cohort-study%C3%A2
#9
Chen Jiang, Wai Kei Lo
BACKGROUND: Peritoneal transport has an impact on clinical outcomes, but it is not constant in peritoneal dialysis (PD) patients. Large-scale, longitudinal data in different types of transport patients are lacking. This study aimed to elucidate the changing trend of peritoneal transport and its impact on patient outcomes. MATERIALS AND METHODS: All patients who entered the PD program in a local hospital in Hong Kong from 1995 to 2012 and underwent more than one peritoneal equilibration test (PET) were analyzed retrospectively, excluding those with peritonitis before the first PET...
January 2, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29249235/kidney-stone-composition-in-the-kingdom-of-saudi-arabia%C3%A2
#10
Abdulrazack Amir, Brian R Matlaga, Justin B Ziemba, Salwa Sheikh
INTRODUCTION: Urolithiasis is a globally-distributed disease; however, its prevalence varies across countries and regions. Countries in the Middle East have been reported to have particularly high nephrolithiasis prevalence rates. To date, however, we have an incomplete understanding of the composition of stones seen in this region. Therefore, we performed a study to characterize stone composition over a 14-year period in the Eastern Province of the Kingdom of Saudi Arabia (KSA). MATERIALS AND METHODS: A retrospective review of all adult patients who had the composition of their upper urinary tract calculi analyzed at Johns Hopkins Aramco Healthcare (JHAH) between 1999 and 2013 was performed...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249234/high-dose-melphalan-and-autologous-hematopoietic-stem-cell-transplant-in-patient%C3%A2-with-c3-glomerulonephritis-associated%C3%A2-with-monoclonal-gammopathy%C3%A2
#11
Nicola Lepori, Wisit Cheungpasitporn, Sanjeev Sethi, David Murray, Shaji Kumar, Nelson Leung, Karthik V Giridhar, Fernando C Fervenza
There is currently no standard treatment for monoclonal immunoglobulin (MIg)-associated C3 glomerulopathy, and treatment is often dictated by the extent of the monoclonal gammopathy. Although chemotherapy treatment for MIg-associated C3 glomerulopathy may stabilize renal function, the overall renal prognosis of MIg-associated C3 glomerulopathy is still poor with frequent progression to end-stage renal disease. We present a case of a 55-year-old man with IgG-κ gammopathy-associated C3 glomerulonephritis (C3GN) with bone marrow biopsy demonstrating 5 - 10 κ-restricted plasma cells...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249233/abatacept-efficacy-in-steroid-resistant-minimal-change-disease-revealed-by-the-speed-of-proteinuria-reduction-after-the-start-of-abatacept%C3%A2
#12
David Dado, Samir Parikh, Isabelle Ayoub, Brad Rovin, Tibor Nadasdy, Lee Hebert
A unique characteristic of the response of minimal-change disease (MCD) or focal and segmental glomerulosclerosis (FSGS) to steroid therapy is that the remission of proteinuria occurs quickly, for example, within 4 - 6 weeks of the onset of steroid therapy, even in those with severe nephrotic syndrome. Remission of proteinuria in MCD and FSGS can also occur spontaneously (not steroid induced). However, spontaneous remission usually proceeds over several months or longer. Recently, there have been several reports that abatacept can induce proteinuria remission in MCD and FSGS...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249232/an-integrated-pathology-and-ultrasonography-based-simulation-for-training-in-performing-kidney-biopsy%C3%A2
#13
Shree G Sharma, John M Arthur, Stephen M Bonsib, Kevin D Phelan, Manisha Singh, Nithin Karakala, Kelly W Bulloch, Vandana Dua Niyyar, Juan Carlos Q Velez
BACKGROUND: Medical practice trends and limitations in trainees' duty hours have diminished the interest and exposure of nephrology fellows to percutaneous kidney biopsy (PKB). We hypothesized that an integrated nephrology-pathology-led simulation may be an effective educational tool. MATERIALS AND METHODS: A 4-hour PKB simulation workshop (KBSW), led by two ultrasonography (US)-trained nephrologists and two nephropathologists, consisted of 6 stations: 1) diagnostic kidney US with live patients, 2) kidney pathology with plasticine models of embedded torso cross-sections, 3) US-based PKB with mannequin (Blue Phantom™), 4) kidney pathology with dissected cadavers, 5) US-based PKB in lightly-embalmed cadavers, and 6) tissue retrieval adequacy examination by microscope...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249231/hemoglobinuric-acute-kidney-injury-in-a-patient-with-a-kinked-prosthetic-aortic-graft%C3%A2
#14
Hema V Sheelvanth, Khaleel A Sayeed, William A Whittier
Acute kidney injury (AKI) due to intravascular hemolysis has been well described in paroxysmal nocturnal hemoglobinuria (PNH) and in cardiac valvular dysfunction. However, reported cases of hemoglobinuric AKI from prosthetic aortic grafts are sparse. We present a case of microangiopathic hemolytic anemia and hemoglobinuric AKI presenting 9 days after repair of an ascending aortic dissection with a prosthetic graft. After an unremarkable recovery following the initial procedure, the patient presented on postoperative day 9 with dyspnea, fatigue, and cola-colored urine...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249230/full-age-spectrum-equation-may-be-an-alternative-method-to-estimate-the-glomerular-filtration-rate-in-chinese-patients-with-chronic-kidney-disease%C3%A2
#15
Lingxiong Chai, Meifang Wang, Kedan Cai, Qun Luo, Haihong Yi, Jianyong Wu
OBJECTIVE: To assess the performance of the full age spectrum (FAS) equation in comparison to other equations in subjects with chronic kidney disease (CKD) for the first time in China. MATERIALS AND METHODS: The measured glomerular filtration rate (mGFR) obtained by the 99mTc-diethylenetriamine pentaacetic acid renogram was used as the reference standard. Bias, precision, and accuracy were analyzed to identify which of these four equations performed better: FAS equation, the Modification of Diet in Renal Disease (MDRD) equation, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the Berlin Initiative Study-1 (BIS-1) equation...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249229/thrombotic-microangiopathy-in-patients-with-diabetic-nephropathy-is-associated-with-low-vegf-expression-and-end-stage-renal-disease%C3%A2
#16
Kriscia Hernández-Arteaga, Virgilia Soto-Abraham, Monserrat Pérez-Navarro, Bernardo de León-Garza, Adrian Rodríguez-Matías, M Guadalupe Olvera-Soto, Rafael Valdez-Ortiz
BACKGROUND: Thrombotic microangiopathy (TMA) has been associated with diabetic nephropathy, but its pathogenesis is unknown. OBJECTIVES: To determine the role of vascular endothelial growth factor (VEGF) expression in patients with TMA and diabetes mellitus. MATERIALS AND METHODS: Retrospective cohort study, patients were divided into diabetic nephropathy patients either without thrombotic microangiopathy (DN-TMA) or with thrombotic microangiopathy (DN+TMA)...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29249228/adult-nephrotic-syndrome-complicated-by-spontaneous-pneumococcal-peritonitis-a-case-report
#17
Ilia Makedonov, Edward G Clark, Prabhu Kanchi, Pierre Antoine Brown
No abstract text is available yet for this article.
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29231162/evaluation-of-clinical-outcomes-among-nonvalvular-atrial-fibrillation-patients-treated-with-rivaroxaban-or-warfarin-stratified-by-renal%C3%A2-function%C3%A2
#18
Matthew R Weir, Lloyd Haskell, Jeffrey S Berger, Veronica Ashton, François Laliberté, Concetta Crivera, Kip Brown, Patrick Lefebvre, Jeffrey Schein
BACKGROUND: Renal dysfunction increases the risk of thromboembolic and bleeding events in patients with nonvalvular atrial fibrillation (NVAF). MATERIALS AND METHODS: Adult NVAF patients with ≥ 6 months prior to first warfarin or rivaroxaban dispensing were selected from the IMS Health Real-World Data Adjudicated Claims database (05/2011 - 06/2015) with electronic medical records. Ischemic stroke events, thromboembolic events (venous thromboembolism, myocardial infarction, or ischemic stroke), and major bleeding events were compared between patients by renal function identified by 1) relevant ICD-9-CM diagnosis codes and 2) estimated creatinine clearance (eCrCl)...
December 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29231161/pleural-and-pericardial-effusion-in-a-long-term-pd-patient-a-defying-diagnosis%C3%A2
#19
Iolanda Godinho, Joana M Dias, Natacha Rodrigues, Hugo Silva, Sofia Jorge, Cristina P Abreu, José A Lopes
Peritoneopleural shunt is an uncommon complication of peritoneal dialysis (PD) usually presenting early as a right pleural transudate. Peritoneopericardial shunt is an even rarer entity in PD, almost never occurring spontaneously. We present the case of a 37-year-old woman on PD for 24 months exhibiting a left pleural and pericardial effusion following pneumonia. Pleural fluid was initially compatible with an exudate with a high glucose concentration and later with a transudate. In order to clarify the suspicion of an ongoing shunt an abdominal scintigraphy was performed confirming the diagnosis of a peritoneopleuropericardial communication...
December 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29231160/oxaliplatin-induced-acute-tubulointerstitial-nephritis-two-case-reports%C3%A2
#20
You-Jung Choi, Kook-Hwan Oh, Hye-Ryun Kang, Soo-Jin Lee
Oxaliplatin is a platinum compound commonly used in the treatment of advanced colorectal cancer. This report describes two patients who had received repetitive combination chemotherapy including oxaliplatin for the treatment of metastatic colon cancer and who visited the emergency department with acute kidney injury several days after experiencing a hypersensitivity reaction to oxaliplatin. In both cases, the pathologic diagnosis was acute tubulointerstitial nephritis, and corticosteroid therapy resulted in improved renal function...
December 12, 2017: Clinical Nephrology
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