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Journal of Nephrology

Dermot O'Kane, Graham S Baldwin, Damien M Bolton, Joseph J Ischia, Oneel Patel
Acute kidney injury (AKI) as a result of ischaemia-reperfusion represents a major healthcare burden worldwide. Mortality rates from AKI in hospitalized patients are extremely high and have changed little despite decades of research and medical advances. In 1986, Murry et al. demonstrated for the first time the phenomenon of ischaemic preconditioning to protect against ischaemia-reperfusion injury (IRI). This seminal finding paved the way for a broad body of research, which attempted to understand and ultimately harness this phenomenon for human application...
January 11, 2019: Journal of Nephrology
Vincenzo La Milia, Chiara Ravasi, Fabio Carfagna, Elena Alberghini, Ivano Baragetti, Laura Buzzi, Francesca Ferrario, Silvia Furiani, Gaia Santagostino Barbone, Giuseppe Pontoriero
BACKGROUND: The clinical benefits of on-line hemodiafiltration (HDF) versus high-flux membranes hemodialysis (hf-HD) are still debated. In fact, although a superiority of one treatment over the other, especially in terms of mortality, did not emerge from the analysis of clinical trials, improved intradialytic vascular stability and cardiovascular mortality have been observed in patients undergoing HDF rather than hf-HD; the lower removal of sodium (Na+ ) during HDF seems to play a major role...
January 10, 2019: Journal of Nephrology
C Alfieri, A Regalia, G Moroni, D Cresseri, F Zanoni, M Ikehata, P Simonini, M P Rastaldi, G Tripepi, C Zoccali, C Chatziantoniou, Piergiorgio Messa
Renal biopsy (RBx) informs about kidney transplantation (KTx) prognosis. In our observational study the prevalence of histological anomalies and the prognostic role of CD45, vimentin (VIM) and periostin (POSTN) in KTx-RBx have been evaluated. One hundred forty-six KTx-RBx (2009-2012) were analysed for general histology and in immunohistochemistry for CD45, VIM and POSTN. Clinical data of the 146-KTx patients were collected at the RBx time (T0), 6 and 12 months before and after RBx. Follow-up time was 21 ± 14 months...
January 10, 2019: Journal of Nephrology
Courtenay M Holscher, Satinderjit S Locham, Christine E Haugen, Sunjae Bae, Dorry L Segev, Mahmoud B Malas
Prior studies have shown that beginning hemodialysis (HD) with a hemodialysis catheter (HC) is associated with worse mortality than with an arteriovenous fistula (AVF) or arteriovenous graft (AVG). We hypothesized that transplant waitlisting would modify the effect of HD access on mortality, given waitlist candidates' more robust health status. Using the US Renal Data System, we studied patients with incident ESRD who initiated HD between 2010 and 2015 with an AVF, AVG, or HC. We used Cox regression including an interaction term for HD access and waitlist status...
January 2, 2019: Journal of Nephrology
Albino Eccher, Letizia Lombardini, Ilaria Girolami, Francesca Puoti, Gianluigi Zaza, Giovanni Gambaro, Amedeo Carraro, Giovanni Valotto, Luca Cima, Luca Novelli, Desley Neil, Umberto Montin, Aldo Scarpa, Matteo Brunelli, Alessandro Nanni Costa, Antonia D'Errico
Guidelines for donor selection have changed to expand the donor pool, considering potential donors affected by a neoplasm. Aim of this retrospective study is to look at the use of organs from donors with a current or history of neoplasm within the Italian Transplant Network. Data, collected and validated by Italian National Health Institute for the time interval 2006-2015, have been reviewed retrospectively by mean of multivariable pivot tables. Donors with neoplasia represented about 5% of all donors, resulting in about 4% of all transplants...
January 2, 2019: Journal of Nephrology
Carlo Garofalo, Silvio Borrelli, Toni De Stefano, Michele Provenzano, Michele Andreucci, Gianfranca Cabiddu, Vincenzo La Milia, Valerio Vizzardi, Massimo Sandrini, Giovanni Cancarini, Adamasco Cupisti, Vincenzo Bellizzi, Roberto Russo, Paolo Chiodini, Roberto Minutolo, Giuseppe Conte, Luca De Nicola
BACKGROUND: Incremental dialysis may preserve residual renal function and improve survival in comparison with full-dose dialysis; however, available evidence is limited. We therefore compared all-cause mortality and residual kidney function (RKF) loss in incremental and full-dose dialysis and time to full-dose dialysis in incremental hemodialysis (IHD) and incremental peritoneal dialysis (IPD). METHODS: We performed a systematic review and meta-analysis of cohort studies of adults with ESRD starting IHD and IPD...
January 2, 2019: Journal of Nephrology
Sandra Marie Dumanski, Sofia Bano Ahmed
In both women and men, chronic kidney disease (CKD) is associated with decreased fertility. Though a multitude of factors contribute to the reduction in fertility in this population, progressively impaired function of the hypothalamic-pituitary-gonadal axis appears to play a key role in the pathophysiology. There is limited research on strategies to manage infertility in the CKD population, but intensive hemodialysis, kidney transplantation, medication management and assisted reproductive technologies (ART) have all been proposed...
January 2, 2019: Journal of Nephrology
Steven M Brunelli, Dena E Cohen, Gilbert Marlowe, Daniel Liu, Levi Njord, David Van Wyck, George Aronoff
Heparin is widely used to prevent coagulation during hemodialysis. Although systemic anticoagulants and antiplatelet agents are commonly prescribed in the hemodialysis population, the safety and efficacy of heparin in the presence of these medications is unclear. This retrospective cohort study considered adult hemodialysis patients treated in the United States (August 2015-July 2017). For each month, patients were ascribed a three-part exposure status (heparin use, anticoagulant use, antiplatelet agent use) based on electronic health records...
January 2, 2019: Journal of Nephrology
Ying Gao, Guiyun Wang, Yang Li, Chenxiao Lv, Zunsong Wang
BACKGROUND: The relationship between oral activated charcoal (OAC) and hyperphosphatemia and vascular calcification is not completely clear. We observed and recorded the effects of OAC on hyperphosphatemia and vascular calcification in stage 3-4 chronic kidney disease (CKD). METHODS: In a randomized controlled study, we included 97 patients with stage 3-4 CKD. In the first phase of the experiment, the patients were randomly divided into the OAC group and placebo group...
December 26, 2018: Journal of Nephrology
Silvia Coelho, José Nuno Fonseca, Joana Gameiro, Sofia Jorge, José Velosa, José António Lopes
BACKGROUND: Acute Kidney Injury (AKI) is a very frequent complication in the Acute Liver Failure (ALF) population associated with negative outcomes. We aim to evaluate the impact of AKI duration on the outcomes of an ALF population. METHODS: A 20-year retrospective analysis of ALF patients admitted to an Intensive Care Unit (ICU) was performed. Chronic liver failure, chronic kidney disease on renal replacement therapy, dialysis requirement within the week prior or an ICU stay of less than 48 h after AKI diagnosis, were exclusion criteria...
December 19, 2018: Journal of Nephrology
Pierpaolo Di Nicolò, Antonio Granata
The use of renal resistive indices (RRIs) for the study of renal microcirculation has in the past been proposed for the identification of renal organ damage or even to specifically identify injury to some areas of the renal parenchyma. Nevertheless, according to the most recent evidences from literature this organ-based conception of RRIs has been proven to be partial and unable to explain the RRIs variations in clinical settings of sepsis or combined organ failure of primitively extrarenal origin or, more generally, the deep connection between RRIs and hemodynamic factors such as compliance and pulsatility of the large vessels...
December 11, 2018: Journal of Nephrology
Cecilia Bellincioni, Giuseppe Garigali, Giovanni B Fogazzi
BACKGROUND: Isolated microscopic hematuria is a condition characterized by the presence in the urine of an "abnormal" number of erythrocytes in the absence of proteinuria. Several studies have been published on this condition, but with heterogeneous inclusion criteria and variable outcomes at follow-up. In this retrospective study, we describe a selected and homogenous cohort of patients who presented with isolated microscopic hematuria of glomerular origin. METHODS: We included in the study patients with isolated microscopic hematuria of glomerular origin (> 1 erythrocyte/high power field at 400× and ≥ 40% dysmorphic erythrocytes and/or ≥ 5% acanthocytes and proteinuria ≤ 150 mg/24 h) with a follow-up of > 60 months from the first documentation of microscopic hematuria...
December 10, 2018: Journal of Nephrology
Kamonwan Tangvoraphonkchai, Andrew Davenport
BACKGROUND: Increased vascular stiffness is associated with low bone mineral density (BMD) in the general population, and both are risk factors for mortality. We wished to determine whether vascular stiffness is associated with BMD in peritoneal dialysis (PD) patients. METHODS: We measured vascular stiffness by aortic pulse wave velocity (aPWV), BMD by dual electron absorptiometry (DXA) scanning, and body composition using bioimpedance. RESULTS: We reviewed DXA scans in 125 PD patients, 56...
December 10, 2018: Journal of Nephrology
Sorino Claudio, Scichilone Nicola, Pedone Claudio, Negri Stefano, Visca Dina, Spanevello Antonio
A significant interaction between kidneys and lungs has been shown in physiological and pathological conditions. The two organs can both be targets of the same systemic disease (eg., some vasculitides). Moreover, loss of normal function of either of them can induce direct and indirect dysregulation of the other one. Subjects suffering from COPD may have systemic inflammation, hypoxemia, endothelial dysfunction, increased sympathetic activation and increased aortic stiffness. As well as the exposure to nicotine, all the foresaid factors can induce a microvascular damage, albuminuria, and a worsening of renal function...
December 6, 2018: Journal of Nephrology
Jill Vanmassenhove, Wim Van Biesen, Raymond Vanholder, Norbert Lameire
There has been considerable progress over the last decade in the standardization of the acute kidney injury (AKI) definition with the publication of the RIFLE, AKIN, KDIGO and ERBP classification criteria. However, these classification criteria still rely on imperfect parameters such as serum creatinine and urinary output. The use of timed urine collections, kinetic eGFR (estimated glomerular filtration rate), real time measurement of GFR and direct measures of tubular damage can theoretically aid in a more timely diagnosis of AKI and improve patients' outcome...
December 6, 2018: Journal of Nephrology
Paolo Greco, Giuseppe Regolisti, Umberto Maggiore, Elena Ferioli, Filippo Fani, Carlo Locatelli, Elisabetta Parenti, Caterina Maccari, Ilaria Gandolfini, Enrico Fiaccadori
BACKGROUND: The choice of the specific modality and treatment duration of renal replacement therapy (RRT) to adopt in metformin-associated lactic acidosis (MALA) is still debated. We aimed to verify if sustained low-efficiency dialysis (SLED) is a rational choice in patients with MALA and acute kidney injury (AKI). METHODS: We collected serial serum metformin measurements, clinical parameters, and outcome data in ten consecutive patients (mean age 77 years [range 58-88], 5 males) admitted to our renal intensive care unit for suspected MALA associated with AKI and hemodynamic instability...
December 6, 2018: Journal of Nephrology
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No abstract text is available yet for this article.
December 5, 2018: Journal of Nephrology
Tobias Feldreich, Christoph Nowak, Tove Fall, Axel C Carlsson, Juan-Jesus Carrero, Jonas Ripsweden, Abdul Rashid Qureshi, Olof Heimbürger, Peter Barany, Peter Stenvinkel, Nicolas Vuilleumier, Philip A Kalra, Darren Green, Johan Ärnlöv
INTRODUCTION: Proteomic profiling of end-stage renal disease (ESRD) patients could lead to improved risk prediction and novel insights into cardiovascular disease mechanisms. Plasma levels of 92 cardiovascular disease-associated proteins were assessed by proximity extension assay (Proseek Multiplex CVD-1, Olink Bioscience, Uppsala, Sweden) in a discovery cohort of dialysis patients, the Mapping of Inflammatory Markers in Chronic Kidney disease cohort [MIMICK; n = 183, 55% women, mean age 63 years, 46 cardiovascular deaths during follow-up (mean 43 months)]...
November 29, 2018: Journal of Nephrology
Francesca Viazzi, Giuseppina Tiziana Russo, Antonio Ceriello, Paola Fioretto, Carlo Giorda, Salvatore De Cosmo, Roberto Pontremoli
The Associazione Medici Diabetologi (AMD) annals initiative is an ongoing observational survey promoted by AMD. It is based on a public network of about 700 Italian diabetes clinics, run by specialists who provide diagnostic confirmation and prevention and treatment of diabetes and its complications. Over the last few years, analysis of the AMD annals dataset has contributed several important insights on the clinical features of type-2 diabetes kidney disease and their prognostic and therapeutic implications...
November 27, 2018: Journal of Nephrology
Pascaline M Alix, Flora Brunner, Anne Jolivot, Muriel Doret, Laurent Juillard
Pregnancy in women with end-stage renal disease is rare. Multiple pregnancies carry a high risk of complications even in healthy individuals. We report the case of a 36-year-old woman who had four pregnancies while she was on dialysis, including one twin pregnancy. The last pregnancy occurred while in the 14th year of hemodialysis. At 8 weeks of gestation (WG), ultrasonography diagnosed a dichorionic diamniotic twin pregnancy. The frequency of dialysis was increased from 3 to 6 times a week and each session lasted 4 h...
November 26, 2018: Journal of Nephrology
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