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Clinical Nephrology

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https://www.readbyqxmd.com/read/28933341/c4d-expressing-glomerulopathy-and-proteinuria-post-transplantation-of-a-%C3%A2-too-big-for-size-mismatched-kidney-allograft-an-unusual-case-with-good-outcome%C3%A2
#1
Francois Gougeon, Alexei V Mikhailov, Keisha Gibson, Tomasz Kozlowski, Harsharan K Singh, Volker Nickeleit
A 5-year-old severely growth-retarded child with tubulointerstitial, oliguric end-stage renal disease received an adult-size kidney transplant. Three years post grafting under standard triple immunosuppression (mycophenolate mofetil, tacrolimus, and prednisone) de novo nephrotic range proteinuria without the nephrotic syndrome developed. Graft function was normal (serum creatinine: 0.2 - 0.3 mg/dL), there were no donor-specific HLA antibodies (DSA), and the urine sediment was inactive. Two biopsies collected 3 and 4 years post-transplantation showed severe glomerular capillary wall remodeling and associated pseudolinear C4d staining as morphologic correlates for the proteinuria...
September 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28933340/renal-histology-and-mri-findings-in-a-%C3%A2-37-year-old-japanese-patient-with-autosomal-recessive-polycystic-kidney-disease%C3%A2
#2
Yusuke Ito, Akinari Sekine, Daisuke Takada, Junko Yabuuchi, Yuta Kogure, Toshiharu Ueno, Keiichi Sumida, Masayuki Yamanouchi, Noriko Hayami, Tatsuya Suwabe, Junichi Hoshino, Naoki Sawa, Kenmei Takaichi, Keiichi Kinowaki, Takeshi Fujii, Kenichi Ohashi, Hiroaki Kikuchi, Shintaro Mandai, Motoko Chiga, Takayasu Mori, Eisei Sohara, Shinichi Uchida, Yoshifumi Ubara
A 37-year-old Japanese man with a serum creatinine level of 2.5 mg/dL and hepatomegaly was admitted to our hospital for investigation of renal failure. Magnetic resonance imaging (MRI) showed hepatomegaly with small cystic lesions that had high signal intensity on T2-weighted images. There was no splenomegaly, and the kidneys were nearly normal in size with a few small cystic lesions. Renal biopsy revealed that interstitial fibrosis and tubular atrophy affected 60% of the cortex. There was cystic tubular dilation, mainly affecting the distal loop of Henle and distal tubules, since immunohistochemical staining of the dilated tubules was positive for cytokeratin 7 and Tamm-Horsfall protein but was negative for aquaporin 3 and CD10...
September 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28933339/incidence-and-outcome-of-lupus-nephritis-in-french-polynesia%C3%A2
#3
Antoine Delarche, Catherine Lumbroso, Alain Fournier, Ronan Delaval, Jacques Pourrat, Pascale Testevuide, Sylvie Leou, Christophe Cordonnier, Dominique Chauveau, Stanislas Faguer
OBJECTIVE: Outcomes of systemic lupus erythematosus (SLE) and lupus nephritis (LN) are highly heterogeneous among some populations because of interactions between genetic, epigenetic, environmental, and socioeconomic factors. A better characterization of social and ethnic disparities in mixed populations may thus help to develop individualized treatment regimens. MATERIALS AND METHODS: Retrospective observational study including all patients with LN diagnosed between January 1993 and January 2014 in the only Nephrology Department of French Polynesia...
September 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28899480/variability-in-hemoglobin-levels-in-hemodialysis-patients-in-the-current-era-a-retrospective-cohort-study
#4
David T Gilbertson, Yan Hu, Yi Peng, Bradley J Maroni, James B Wetmore
BACKGROUND: Given regulatory and reimbursement changes in anemia management, we examined hemoglobin variability in a contemporary cohort of maintenance hemodialysis patients. MATERIALS AND METHODS: The study population included > 200,000 hemodialysis patients with Medicare parts A and B as primary payer on October 1, 2012. Based on 25th and 75th percentiles, monthly hemoglobin values were categorized as low, intermediate, or high. Six variability categories were created by patterns during the 6-month observation period...
September 7, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28862130/unusual-association-of-adpkd-and-bullous-emphysema-a-case-report-and-literature-review
#5
Amar H Kelkar, Jeremiah E Crabb, Benjamin R Pflederer
No abstract text is available yet for this article.
September 1, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853705/urinary-creatinine-excretion-in-aki-just-another-look
#6
Frieder Keller
No abstract text is available yet for this article.
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853704/comparison-of-hypoalbuminemia-corrected-serum-calcium-using-bcp-albumin-assay-to-ionized-calcium-and-impact-on-prescribing-in-hemodialysis-patients%C3%A2
#7
Wenxin Cindy Pan, Wynnie Lau, Andre Mattman, Mercedeh Kiaii, Beverly Jung
BACKGROUND: Albumin-corrected calcium (cCa) is recommended over ionized calcium (iCa) in hemodialysis (HD) patients per the Kidney Disease: Improving Global Outcomes position statements due to cost and feasibility. Two common albumin assays, bromocresol green (BCG) and bromocresol purple (BCP), produce differing results in uremic patients. All previous studies compared iCa to cCa from a BCG assay. This study, using the BCP assay, aimed to compare cCa and total calcium, respectively, to iCa...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853703/potential-pitfalls-in-estimating-renal-injury-by-kdigo-overcome-by-measuring-creatinine-clearance-in-acute-kidney-injury%C3%A2
#8
John Mellas
Acute kidney injury (AKI) is a common and serious condition frequently encountered in hospitalized patients. The severity of kidney injury is defined by the KDIGO criteria which attempt to establish the degree of renal impairment. These criteria do not measure actual creatinine clearance (K) but rather represents static measures of a dynamic process in AKI and are fraught with potential for false positives and negatives results. This paper, presented in an educational format, uses a new, unique, simple, and accurate method for estimating actual K in AKI utilizing urine creatinine excretion over an established time interval...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853702/familial-antiglomerular-basement-membrane-disease-in-zero-human-leukocyte-antigen-mismatch-siblings%C3%A2
#9
Andrea Angioi, Wisit Cheungpasitporn, Sanjeev Sethi, An De Vriese, Nicola Lepori, Thomas Schwab, Fernando Fervenza
Reported cases of familial Antiglomerular basement membrane (anti-GBM) disease are extremely rare. The single gene mutations that may play a role in the development of familial anti-GBM disease are currently unidentified. While human leukocyte antigen (HLA)-DR15 is known to be associated with an increased risk of anti-GBM disease, HLA types in patients with familial anti-GBM disease have never been reported. We present a case of a 65-year-old woman with rapidly-progressive glomerulonephritis and pulmonary involvement, consistent with Goodpasture's syndrome...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853701/the-prevalence-and-risk-factors-of-abnormal-circadian-blood-pressure-in-patients-with-iga-nephropathy%C3%A2
#10
Shanshan Zhou, Junzhou Fu, Mingjing Liu, Shicong Yang, Qian Zhou, Xueqing Yu, Qiongqiong Yang
AIMS: To investigate the prevalence and risk factors of abnormal circadian blood pressure (BP) rhythm among IgA nephropathy (IgAN) patients. MATERIALS AND METHODS: 375 Chinese IgAN patients with biopsy-proven primary IgAN were recruited from June 2013 to December 2014 and divided into four groups based on circadian BP rhythm (dippers, non-dippers, reversed dippers, and extreme dippers) measured by 24-hour ambulatory BP monitoring. Demographic and clinicopathologic data were collected and analyzed...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853700/comparison-of-hemodialysis-with-medium-%C3%A2-cut-off-dialyzer-and-on-line-hemodiafiltration-on-the-removal-of-small-and-middle-sized-molecules%C3%A2
#11
Mohamed Belmouaz, Jeremy Diolez, Marc Bauwens, Fabien Duthe, Laure Ecotiere, Estelle Desport, Frank Bridoux
BACKGROUND: Recent data suggest that the use of medium cut-off (MCO) dialyzers in hemodialysis (HD) promotes greater clearance and reduction ratio (RR) for myoglobin and other large-sized molecules than on-line hemodiafiltration (ol-HDF), but its effects on β2-microglobulin are not clear. We compared RR and clearances of small and middle-sized molecules between high-flux ol-HDF and MCO (Theranova) dialyzer in HD (MCO-HD) as well as nutritional parameters. MATERIALS AND METHODS: We retrospectively analyzed 10 patients treated first with ol-HDF who were thereafter switched to MCO-HD over a 1-year period...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28853699/successful-therapy-with-mycophenolic-acid-in%C3%A2-a-membranous-glomerulonephritis-due-to%C3%A2-kimura-disease%C3%A2
#12
Julien Gaillard, Samuel Rotman, Christophe Girardet, François Spertini
Kimura disease (KD) is a rare inflammatory soft tissue disorder of unknown origin most frequent in Asians, the prevalence of which is growing in Western countries. Painless papules and/or nodules with a predilection for the head and the neck region, lymphadenopathies, parotid gland involvement, eosinophilia, and raised IgE levels are parts of its presentation. Renal involvement with various forms of glomerulonephritis, including membranous nephropathy (MN), can occur and is generally associated with a proteinuria that encompasses nephrotic syndrome...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28818189/hemodialysis-treatment-engenders-anxiety-and-emotional-distress%C3%A2
#13
Joel D Kopple, Bryan B Shapiro, Usama Feroze, Jun Chul Kim, Min Zhang, Yinan Li, David J Martin
AIMS: Anxiety is common in maintenance hemodialysis (MHD) patients. The extent to which anxiety is engendered by the dialysis treatment itself is not known. We investigated whether anxiety occurs with individual hemodialysis treatments and examined factors associated with these symptoms. MATERIALS AND METHODS: This was a cross-sectional study examining 246 MHD patients. Anxiety and other emotional distresses associated with hemodialysis treatments were examined with a questionnaire...
August 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28818188/healthcare-outcomes-in-undocumented-immigrants-undergoing-two-emergency-dialysis-approaches%C3%A2
#14
S Jawad Sher, Waqas Aftab, Ranjani N Moorthi, Sharon M Moe, Christopher S Weaver, Frank C Messina, Nancy M Martinez-Hoover, Melissa D Anderson, Michael T Eadon
BACKGROUND: Current estimates suggest 6,500 undocumented end-stage renal disease (ESRD) patients in the United States are ineligible for scheduled hemodialysis and require emergent dialysis. In order to remain in compliance with Emergency Medicaid, an academic health center altered its emergency dialysis criteria from those emphasizing interdialytic interval to a set emphasizing numerical thresholds. We report the impact of this administrative change on the biochemical parameters, utilization, and adverse outcomes in an undocumented patient cohort...
August 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28793955/optimization-of-therapeutic-drug-monitoring-of-vancomycin-in-patients-with-chronic-hemodialysis%C3%A2
#15
Lobna Ben Mahmoud, Yosr Chaabouni, Hanen Ghozzi, Houda Feriani, Ahmed Hakim, Mahmoud Kharrat, Chakib Marrakchi, Zouheir Sahnoun, Mounir Ben Jmaa, Khaled Zeghal, Jamil Hachicha
PURPOSE: To validate a simplified vancomycin monitoring algorithm in patients on chronic hemodialysis who required intravenous vancomycin for at least 3 weeks. MATERIALS AND METHODS: In this prospective study, all hemodialysis patients who were admitted between April 1, 2013, and March 31, 2015, in our unit for suspected or confirmed methicillin-resistant Staphylococcus aureus infection that required vancomycin were enrolled. All patients were categorized into two groups...
August 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28793954/interstitial-complement-c3-activation-and-macrophage-infiltration-in-patients-with-hypertensive-nephropathy%C3%A2
#16
Jiong Cui, Jianxin Wan, Danyu You, Zhenhuan Zou, Yi Chen, Zhenzhou Li, Qiujian Lian
BACKGROUND: The interplay between interstitial complement C3 activation and macrophage infiltration might play an important role in the pathogenesis of hypertensive nephropathy (HN), but human data are limited. We sought to investigate interstitial complement C3 expression and macrophage infiltration in HN as well as the relationships between C3 activation and macrophage infiltration, their association with clinicopathologic data, and changes in renal function. MATERIALS AND METHODS: Using immunohistochemistry, we analyzed 20 renal tissue specimens from HN patients and 40 control specimens for complement C3, angiotensin (AGT), angiotensin II, and macrophage marker CD68 levels...
August 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28793953/the-spectrum-of-biopsy-proven-secondary-glomerular-diseases-a-cross-sectional-study-in-china%C3%A2
#17
Ping Wang, Lijun Tang, Jing Yao, Hong Su, Yipeng Liu, Xianglei Kong, Wenbin Li, Meiyu Cui, Qing Sun, Junhui Zhen, Dongmei Xu
AIMS: The distribution of the spectrum of chronic kidney disease (CKD) has been found to vary with time. Limited information is available regarding the changing spectrum of secondary glomerular diseases (SGDs). To further investigate changes in the spectrum of SGDs, we performed a cross-sectional study. METHODS: From June 2010 to May 2015, 5,935 patients from 37 hospitals in Shandong Province were involved in this study. The study was divided into five periods according to 1-year intervals...
August 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28766493/evaluation-of-the-safety-and-immunogenicity-of-subcutaneous-hx575-epoetin-alfa-in-the-treatment-of-anemia-associated-with-chronic-kidney-disease-in-predialysis-and-dialysis-patients%C3%A2
#18
Nicole Casadevall, Vladimir Dobronravov, Kai-Uwe Eckardt, Sehsuvar Ertürk, Liliya Martynyuk, Susanne Schmitt, Gregor Schaffar, Anita Rudy, Andriy Krendyukov, Marité Ode
AIM: To assess the safety and immunogenicity of subcutaneous (SC) HX575 (epoetin-α) in dialysis- and nondialysis-dependent adult patients with chronic kidney disease (CKD). METHODS: Open-label, single-arm, multicenter study in patients (n = 416) from Germany, Italy, Poland, Romania, Russia, Turkey, and Ukraine. RESULTS: Mean (standard deviation (SD)) age was 52.3 (15.8) years, all patients were Caucasian, and similar proportions were male/female...
August 2, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28766491/a-case-of-severe-nephrotoxicity-associated-with-long-term-dietary-supplement-use
#19
Farrukh M Koraishy, Gilbert W Moeckel, David S Geller
Dietary supplements are widely used for their perceived health benefits without side effects and hence have minimal regulation. However, they have been associated with various toxicities including kidney disease. We report a 65-year-old male who had very heavy daily intake of dietary supplements for 3 years. He presented with acute kidney injury and nephrotic-range proteinuria. The renal biopsy showed acute tubular necrosis with vacuolization, acute interstitial nephritis, and secondary membranous nephropathy, consistent with an non-steroidal anti-inflammatory drug (NSAID)-like nephropathy...
August 2, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28737134/nephrotic-syndrome-in-primary-myelofibrosis-with-renal-extramedullary-hematopoiesis-and-glomerulopathy-in-the-jak-inhibitor-era
#20
Rachele Del Sordo, Rachele Brugnano, Carla Covarelli, Gioia Fiorucci, Franca Falzetti, Giorgio Barbatelli, Emidio Nunzi, Angelo Sidoni
Primary myelofibrosis (PMF) is an uncommon form of myeloproliferative neoplasm (MPN) characterized by a proliferation of predominantly megakaryocytes and granulocytes in the bone marrow that, in fully-developed disease, is associated with reactive deposition of fibrous connective tissue, extramedullary hematopoiesis (EMH), and splenomegaly. Kidney involvement is rare and clinically presents with proteinuria, nephrotic syndrome, and renal insufficiency. Renal damage can be due to EMH and glomerulopathy. Renal EMH presents three patterns: infiltration of the interstitium with possible renal failure caused by functional damage of parenchyma and vessels, infiltration of capsule and pericapsular adipose tissue, and sclerosing mass-like lesions that can cause hydronephrosis and hydroureter with obstructive uropathy and renal failure...
July 24, 2017: Clinical Nephrology
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