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Clinical Nephrology

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https://www.readbyqxmd.com/read/30232954/community-acute-kidney-injury-is-associated-with-short-and-long-term-adverse-outcomes-in-patients-admitted-with-acute-myocardial-infarction
#1
Roy O Mathew, Janani Rangaswami, Jennifer B Othersen, Bo Cai, Arif Asif, Mandeep S Sidhu, Sripal Bangalore
AIMS: The influence of community acute kidney injury on patients with myocardial infarction has not been explored. The Veterans Affair electronic health system was analyzed to test the hypothesis that patients who have myocardial infarction complicated by community acute kidney injury have higher short- and long-term mortality and cardiovascular outcomes than those who do not suffer acute kidney injury. MATERIALS AND METHODS: Odd ratios were calculated for in-hospital mortality...
September 20, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30232953/hepatitis-e-infection-in-solid-organ-transplant-recipients-an-overlooked-diagnosis
#2
Zay Htet, Mahdi Althaf, Mahzuz Karim
Hepatitis E virus (HEV) is gaining recognition as an important but under-recognized pathogen, particularly in immunocompromised individuals. It should be considered as a potential differential diagnosis in such patients presenting with acute hepatitis. We report a case of a kidney-pancreas transplant recipient who developed acute liver dysfunction; this was found to be due to HEV infection acquired through consumption of undercooked pork. His immunosuppression was cautiously reduced, and his liver biochemistry and viral PCR gradually normalized without the need for additional antiviral therapy...
September 20, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30232952/fluctuation-of-pre-hemodialysis-serum-sodium
#3
Nestor Oliva-Damaso, Eduardo Baamonde-Laborda, Elena Oliva-Damaso, Juan Payan, Alberto Marañes, Nicanor Vega-Diaz, Jose Carlos Rodriguez-Perez
INTRODUCTION: Low pre-hemodialysis (pre-HD) serum sodium or hyponatremia is associated with higher mortality. Pre-HD serum sodium can be more stable over time with low fluctuation compared to other serum parameters. MATERIALS AND METHODS: We examined variation of pre-HD serum sodium in 24 months and after this point examined all-cause mortality in a cohort of 261 patients followed-up for 48.8 (standard deviation (SD) = 19.1) months. 6,221 determinations of pre-HD serum sodium were made and corrected for glucose concentrations...
September 20, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30178741/the-diagnostic-dilemma-of-new-onset-crescentic-glomerulonephritis-following-pre-eclampsia
#4
Karim Soliman, Tibor Fülöp, David W Ploth
No abstract text is available yet for this article.
September 4, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30148449/a-randomized-controlled-clinical-trial-of-4-sodium-citrate-versus-heparin-as-locking-solution-for-temporary-dialysis-catheters-among-hemodialysis-patients
#5
Abdel Basset E Abdel Azim, Tamer W ElSaid, Heba W El Said, Walid Hemida, Salwa Zaghlool, Ahmed Ramadan, Zaghloul Gouda, Shereen El Masry, Wael Reda, Hala M Ali
BACKGROUND: Limited reports are available on the role of 4% citrate as a locking solution for temporary dialysis catheters. Hence, the aim of this study is to investigate the role of 4% citrate vs. heparin 5,000 µ/mL as a catheter-locking solution in a randomized controlled trial. MATERIALS AND METHODS: The trial was conducted in Egypt where the use of non-tunneled temporary catheters is prevalent compared to tunneled long-term catheters. The efficacy of catheter-locking solutions was compared regarding observation of rate of catheter dysfunction, low-flow pump, fever as a sign of central-line blood-stream infection (CLBSI), catheter-site infection, thrombosis, local bleeding, and systemic bleeding in each group of the study...
August 27, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106370/national-outcomes-of-in-hospital-cardiopulmonary-resuscitation-in-patients-with-acute-kidney-injury-years-2005-2011
#6
Fahad Saeed, Malik M Adil, Umar M Kaleem, Abdus Salam Khan, Jean L Holley, Sevag Damirjian
BACKGROUND: There is paucity of data on the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in patients with acute kidney injury (AKI). We analyzed the impact of acute kidney injury on in-hospital CPR-related outcomes. MATERIALS AND METHODS: We analyzed data from Nationwide Inpatient Sample (NIS 2005 - 2011) including patients with and without AKI who had undergone in-hospital CPR. Baseline characteristics, in-hospital complications and discharge outcomes were compared between the two groups...
August 14, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106369/the-impact-of-a-remote-monitoring-system-of-healthcare-resource-consumption-in-patients-on-automated-peritoneal-dialysis-apd-a-simulation-study
#7
Kiyotaka Uchiyama, Naoki Washida, Nobuyuki Yube, Takahiro Kasai, Keisuke Shinozuka, Kohkichi Morimoto, Akihito Hishikawa, Hiroyuki Inoue, Hidenori Urai, Aika Hagiwara, Kentaro Fujii, Shu Wakino, Souzana Deenitchina, Hiroshi Itoh
AIMS: Remote monitoring (RM) can improve management of chronic diseases. We evaluated the impact of RM in automated peritoneal dialysis (APD) in a simulation study. MATERIALS AND METHODS: We simulated 12 patient scenarios with common clinical problems and estimated the likely healthcare resource consumption with and without the availability of RM (RM+ and RM- groups, respectively). Scenarios were evaluated 4 times by randomly allocated nephrologist-nurse teams or nephrologist-alone assessors...
August 14, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106367/anca-associated-vasculitis-in-scleroderma-a-renal-perspective
#8
Sam Kant, Ami A Shah, Laura K Hummers, Fredrick M Wigley, Duvuru Geetha
AIMS: Overlap syndrome of ANCA-associated vasculitis (AAV) and scleroderma (SSc) is rare with conflicting data on renal outcomes. We describe the clinical characteristics and treatment outcome of ANCA-associated glomerulonephritis (AAG) in SSc patients followed at a single center. MATERIALS AND METHODS: We conducted a retrospective study of 3,570 patients in our SSc database to identify SSc patients who subsequently developed AAV with renal involvement. Patient demographics, serology, renal function, renal histology, and treatment outcomes were assessed...
August 14, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106366/prevention-of-contrast-induced-nephropathy-with-prostaglandin-e1-in-patients-undergoing-percutaneous-coronary-procedures-a-meta-analysis-of-24-randomized-controlled-trials
#9
Xiangying Liu, Yongfu Hang, Lei Shen, Jing Yang, Ling Zhou, Wengang Sha, Guoyuan Lu
BACKGROUND: Contrast-induced nephropathy (CIN) is the third most common cause of acute kidney injury in hospitalized patients. There have been many conflicting results across trials that have evaluated the prophylactic efficacy of prostaglandin E1 (PGE1) for prevention of CIN in patients undergoing percutaneous coronary procedures. PGE1 may have renal-protective effects due to its pleiotropic properties. The aim of this study was to evaluate the efficacy of PGE1 in preventing CIN. MATERIALS AND METHODS: We searched PubMed, Embase, Cochrane Library, Chinese Biomedical Literature, China National Knowledge Infrastructure, VIP Information/Chinese Scientific Journals, and WANFANG databases for randomized controlled trials (RCTs) comparing the preventive effects of PGE1 versus controls (conventional hydration, no PGE1, or placebo) on CIN in patients undergoing percutaneous coronary procedures from January 1999 to June 2016...
August 14, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106365/neutropenia-related-to-an-azathioprine-metabolic-disorder-induced-by-an-inosine-triphosphate-pyrophosphohydrolase-itpa-gene-mutation-in-a-patient-with-pr3-anca-positive-microscopic-polyangiitis
#10
Kosuke Honda, Akimitsu Kobayashi, Takahito Niikura, Tsukasa Hasegawa, Zenya Saito, Shuji Ito, Tomoya Sasaki, Kazumasa Komine, Seita Ishizuka, Yutaro Motoi, Takahiro Kubota, Hiroyasu Yamamoto, Takashi Yokoo
A 68-year-old Japanese man was monitored for chronic kidney disease (CKD), with unknown primary disease starting in 2014. His serum creatinine (sCr) was stable at ~ 2.5 mg/dL for ~ 2 years. Two weeks before admission, he had bloody sputum, and sCr increased to 4.63 mg/dL. Soon after admission, the patient developed a high fever with pigment spots on the legs. A kidney biopsy was performed. The kidney specimens showed necrotizing and crescentic glomerulonephritis without granuloma formation. An additional blood-sampling test revealed high titers of PR3-ANCA, and we diagnosed PR3-ANCA-positive microscopic polyangiitis (MPA)...
August 14, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30049301/prevention-of-contrastinduced-nephropathy-in-patients-after-percutaneous-coronary-intervention-a-single-center-prospective-study
#11
Michal Glaza, Boleslaw Rutkowski, Marek Szolkiewicz
No abstract text is available yet for this article.
July 27, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30021694/idiopathic-immune-complex-mediated-tubulointerstitial-nephritis-with-hypocomplementemia-and-neutrophil-rich-interstitial-infiltrates
#12
Haruka Ikuta, Jaegi Shim, Masahiro Takahashi, Mitsuteru Koizumi, Koichi Seta, Shigeo Hara, Kensei Yahata
A 69-year-old man presented with acute kidney injury, hypocomplementemia, antinuclear antibody, and anti-dsDNA antibody. He had no signs of systemic lupus erythematosus or Sjögren syndrome. He had not begun taking any new drugs in the preceding 6 months. Kidney biopsy revealed 13 glomeruli, 3 with global sclerosis. The remaining glomeruli showed slight mesangial proliferation. The interstitial inflammation was extensive, comprising mainly mature lymphocytes and plasma cells, neutrophils, and a few eosinophils...
July 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30021693/clostridium-difficile-infection-in-patients-with-chronic-kidney-disease-in-mexico
#13
Rayo Morfin-Otero, Elvira Garza-Gonzalez, Guillermo Garcia Garcia, Hector R Perez-Gomez, Sara A Aguirre-Diaz, Esteban Gonzalez-Diaz, Sergio Esparza-Ahumada, Alfonso Fernandez-Ramirez, Francisco Cardenas-Lara, Adrian Martinez-Melendez, Rodrigo Escobedo-Sanchez, Margarita Ibarra-Hernandez, Gerardo Leon Garnica, Eduardo Rodriguez-Noriega
BACKGROUND: Clostridium difficile infection (CDI) is a leading cause of healthcare-associated diarrhea worldwide. Patients with chronic kidney disease (CKD) are especially vulnerable, as they are exposed to CDI risk factors including frequent antibiotics. MATERIALS AND METHODS: In order to identify the risk factors for CDI in CKD patients, a 33-month long case-control study was carried out at a tertiary-care hospital in Mexico. CDI was confirmed at the genetic level, and univariate and multivariate analyses were performed to identify the association between risk factors, biomarkers, and outcome options (survival, relapse, death)...
July 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30021692/comparison-of-four-egfr-equations-in-assessing-complications-associated-with-chronic-loss-of-kidney-function-a-cross-sectional-study-in-a-chinese-population
#14
Bing Zhao, Hui Han, Xiaowei Yang, Rong Wang
There are various equations for estimating glomerular filtration rate (eGFR), mainly including abbreviated Modification of Diet in Renal Disease Study Equations (aMDRD), c-aMDRD for the Chinese population, Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI 2009) and Creatinine-Cystatin C equation (CKD-EPI 2012). Currently, it is unclear which eGFR equation more realistically predicts and reflects the development of complications closely associated with chronic loss of kidney function. Our study selected a total of 1,012 nondialysis patients at stages 2 through 4 chronic kidney disease (CKD) to assess these complications using eGFR calculated by these four equations...
July 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29956649/vitamin-d-and-cinacalcet-are-associated-with-increased-survival-in-peritoneal-dialysis-but-not-with-residual-renal-function-preservation
#15
Susie L Hu, Priyanka Joshi, Mark Kaplan, Judy Lefkovitz, Dominique S Michaud
BACKGROUND: Active vitamin D and cinacalcet, a treatment for secondary hyperparathyroidism and also with potential anti-inflammatory properties, have been associated with lower risk of death among dialysis patients. Vitamin D has also been described to decrease proteinuria in CKD patients. This study aims to assess the relationship of vitamin D and cinacalcet with survival and residual renal function preservation among peritoneal dialysis patients. MATERIALS AND METHODS: In a retrospective peritoneal dialysis cohort of 581 subjects, we assessed if vitamin D and cinacalcet therapy are associated with increased risk of death and residual renal function loss using Kaplan-Meier analysis and Cox proportional hazard analysis...
June 29, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30168414/analysis-of-the-risk-factors-of-acute-kidney-injury-in-patients-receiving-extracorporeal-membrane-oxygenation
#16
Xiaozu Liao, Zhou Cheng, Liqiang Wang, Binfei Li
BACKGROUND: Acute kidney injury (AKI) during extracorporeal membrane oxygenation (ECMO) affects the prognosis of patients. In the present study, we explored the risk factors for AKI through a retrospective analysis of relevant data of patients undergoing ECMO with AKI. MATERIALS AND METHODS: Retrospective analysis was performed on patients with AKI who were receiving ECMO. Patient data, including preoperative basic conditions, related clinical conditions during ECMO, and complications, were collected...
October 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106368/chronic-tubulointerstitial-kidney-disease-in-untreated-adenine-phosphoribosyl-transferase-aprt-deficiency-a-case-report
#17
Benjamin Cochran, Tereza Kovačíková, Kateřina Hodaňová, Martina Živná, Aleš Hnízda, Angela G Niehaus, Alex Bonnecaze, Gowrie Balasubraminiam, Irene Ceballos-Picot, Amret Hawfield, Kendrah Kidd, Stanislav Kmoch, Anthony J Bleyer
Adenine phosphoribosyltransferase (APRT) deficiency (OMIM #614723) is a rare autosomal recessive defect in the purine salvage pathway that causes excessive production of 2,8-dihydroxyadenine, leading to nephrolithiasis and chronic kidney disease (CKD). This case report describes the natural history of CKD in untreated APRT deficiency. We describe a novel APRT mutation (chr16:88877985 G / C; c.195 C>/G; p.His54Asp) presenting with CKD without nephrolithiasis. The patient initially required dialysis, but kidney function improved with allopurinol...
October 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30106364/subclinical-metabolic-and-cardiovascular-abnormalities-in-autosomal-dominant-polycystic-kidney-disease
#18
Radha Chirumamilla, Diana Mina, Salpi Siyahian, Meyeon Park
Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disease. It carries high lifetime morbidity not only due to chronic kidney disease, but also due to a higher risk of cardiovascular death. Multiple metabolic abnormalities associated with ADPKD including insulin resistance and hyperlipidemia as well as subclinical cardiovascular abnormalities, such as left ventricular hypertrophy (LVH), contribute to this cardiovascular risk. These conditions may manifest before evidence of worsening estimated glomerular filtration rate (eGFR)...
October 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30049302/a-case-of-atheroembolic-renal-disease-confirmed-by-skin-biopsy-and-successfully-treated-with-low-dose-prednisone
#19
Valentina Pistolesi, Francesca Di Mario, Laura Zeppilli, Konstantinos Giannakakis, Santo Morabito
No abstract text is available yet for this article.
October 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30049300/individualized-anemia-management-in-a-dialysis-facility-long-term-utility-as-a-single-center-quality-improvement-experience
#20
Adam E Gaweda, Alfred A Jacobs, George R Aronoff, Michael E Brier
BACKGROUND: Standard protocol-based approaches to erythropoiesis stimulating agent (ESA) dosing in anemia management of end-stage renal disease (ESRD) fail to address the inter-individual variability in patient's response to ESA. We conducted a single-center quality improvement project to investigate the long-term performance of a computer-designed dosing system. MATERIALS AND METHODS: The study was a retrospective case-control study with long-term follow-up. All hemodialysis patients who received treatment at University Kidney Center (Louisville, KY, USA) between September 1, 2009, and March 31, 2017, were included...
October 2018: Clinical Nephrology
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