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Journal of Nephrology

Piergiorgio Messa, Carlo Maria Alfieri, Emanuele Montanari, Mariano Ferraresso, Roberta Cerutti
Autosomal dominant polycystic kidney disease (ADPKD) is the first genetic cause of end-stage renal disease (ESRD) and the number of these patients who are listed for or receive a kidney transplant (KTx) is continuously increasing over time. Hence, nephrologists are involved not only in the handling of ADPKD patients during the long course of the disease, but also in programming and performing a renal transplant. The handling of all these processes implies the complete awareness of a number of critical points related to the decisions to be taken both before and after the transplant intervention...
October 20, 2016: Journal of Nephrology
P Fabbrini, K Finkel, M Gallieni, G Capasso, M Cavo, A Santoro, S Pasquali
Acute kidney injury (AKI) is a frequent complication of multiple myeloma and is associated with increased short-term mortality. Additionally, even a single episode of AKI can eventually lead to end-stage renal disease (ESRD), significantly reducing quality of life and long-term survival. In the setting of multiple myeloma, severe AKI (requiring dialysis) is typically secondary to cast nephropathy (CN). Renal injury in CN is due to intratubular obstruction from precipitation of monoclonal serum free light chains (sFLC) as well as direct tubular toxicity of sFLC via stimulation of nuclear factor (NF)κB inflammatory pathways...
October 18, 2016: Journal of Nephrology
Henrique Palomba, Isac Castro, Luis Yu, Emmanuel A Burdmann
BACKGROUND: Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain. METHODS: A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up...
October 4, 2016: Journal of Nephrology
Abbas Rana, Bhamidipati Murthy, Zachery Pallister, Michael Kueht, Ronald Cotton, N Thao N Galvan, Whiston Etheridge, Hau Liu, John Goss, Christine O'Mahony
Careful management of immunosuppression is paramount to prevent acute rejection in kidney transplantation. We studied a cohort of 139,875 kidney transplant recipients from the Organ Procurement and Transplantation Network (OPTN) database between 2002 and 2013. We confirmed the analysis with a cohort of 35,277 who received thymoglobulin induction with tacrolimus maintenance, and a third cohort of 12,161 recipients who received basiliximab induction with tacrolimus maintenance. We performed multivariate logistic regression analyses on data from all three cohorts and identified independent risk factors for treated acute rejection at 1 year...
September 29, 2016: Journal of Nephrology
Valeria Cernaro, Alessandra Sfacteria, Claudia Rifici, Francesco Macrì, Giulia Maricchiolo, Antonio Lacquaniti, Carlo Alberto Ricciardi, Antoine Buemi, Giuseppe Costantino, Domenico Santoro, Michele Buemi
BACKGROUND: Gentamicin is an aminoglycoside antibiotic widely used in the treatment of infections caused by Gram-negative bacteria. The main limitation to its therapeutic effectiveness is the potential nephrotoxicity. Erythropoietin has a tissue protective effect widely demonstrated in the kidney. The aim of the present study was to evaluate the renoprotective effects of erythropoietin in a model of zebrafish (Danio rerio) after administration of gentamicin. METHODS: Sixty adult zebrafish were subdivided into three groups: group A was treated with gentamicin; group B received gentamicin and, 24 h later, epoetin alpha; group C received drug diluent only...
September 27, 2016: Journal of Nephrology
Zbigniew Heleniak, Magdalena Cieplińska, Tomasz Szychliński, Dymitr Rychter, Kalina Jagodzińska, Alicja Kłos, Izabela Kuźmiuk, Marzena Jakimowicz Tylicka, Leszek Tylicki, Bolesław Rutkowski, Alicja Dębska-Ślizień
AIMS: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the cornerstone of pain management. There are no detailed data on NSAIDs use in Poland, especially in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the frequency, circumstances, and causes of NSAIDs use as well as knowledge of their side-effects in patients with CKD. METHOD: This cross-sectional study was conducted in 972 individuals with CKD, enrolled in a written survey originally developed by the authors...
September 27, 2016: Journal of Nephrology
Scott Sibbel, Bradley J Maroni, Steven M Brunelli
Residence at higher altitude has been associated with improved anemia parameters and lower mortality rates among end-stage renal disease (ESRD) patients. However, these associations were observed prior to the 2011 shift in erythropoiesis-stimulating agent (ESA) dosing. To determine the impact of altitude on contemporary ESRD patients, a retrospective observational analysis was conducted in which patients were ascribed to one of four altitude categories as of 1 Jan 2012 and outcomes were assessed during 2012...
September 19, 2016: Journal of Nephrology
Domenico Rendina, Gianpaolo De Filippo, Fernando Gianfrancesco, Riccardo Muscariello, Michele Schiano di Cola, Pasquale Strazzullo, Teresa Esposito
BACKGROUND: Genetic factors play a key role in the pathogenesis of hypocitraturia, a common risk factor for nephrolithiasis. The Na(+)-dicarboxylate cotransporter NaDC1, encoded by the sodium-dicarboxylate cotransporter (SLC13A2) gene, is a major determinant of urinary citrate excretion and its biological functions are regulated also by the vitamin D/Vitamin D receptor (VDR) biological system. The aim of this case-control study was to evaluate the possible epistatic interaction between VDR (rs731236)and SLC13A2 (rs11567842) allelic variants in the pathogenesis of hypocitraturia...
September 17, 2016: Journal of Nephrology
Stephan Kemmner, Mareike Verbeek, Uwe Heemann
Acute kidney injury and long-term renal dysfunction are common problems following bone morrow transplantation (BMT) and highly related to mortality. The frequency and risk of renal dysfunction are directly related to the method of BMT, with myeloablative allogeneic BMT being associated to the highest risk followed by non-myeloablative allogeneic and myeloablative autologous BMT. The type of BMT is, thus, more important than co-factors such as advanced age, comorbidities, or high baseline serum creatinine. The causes for renal failure are multiple and include chemotherapy and high-dose radiation with fluid loss by diarrhea or vomiting, sepsis or nephrotoxic drugs such as calcineurin inhibitors and antimicrobials...
September 2, 2016: Journal of Nephrology
Carlo Basile, Andrew Davenport, Peter J Blankestijn
The mortality rate of patients on maintenance dialysis remains alarmingly high, at approximately 15-20 % per year. Increasing dialyzer urea clearance has not been shown to improve survival and hence interest has shifted towards convective therapies, such as hemodiafiltration (HDF) which can remove middle molecular weight uremic toxins, which have been suggested to increase mortality in patients with end-stage kidney disease. During the last few years, four large prospective randomized controlled trials (RCTs) have been conducted in different European countries to compare survival outcomes in prevalent patients receiving conventional hemodialysis with online post-dilution HDF (OL HDF)...
September 1, 2016: Journal of Nephrology
Massimo Sandrini, Valerio Vizzardi, Francesca Valerio, Sara Ravera, Luigi Manili, Roberto Zubani, Bernardo J A Lucca, Giovanni Cancarini
INTRODUCTION: Incremental dialysis consists in prescribing a dialysis dose aimed towards maintaining total solute clearance (renal + dialysis) near the targets set by guidelines. Incremental peritoneal dialysis (incrPD) is defined as one or two dwell-times per day on CAPD, whereas standard peritoneal dialysis (stPD) consists in three-four dwell-times per day. PATIENTS AND METHODS: Single-centre cohort study. Enrollement period: January 2002-December 2007; end of follow up (FU): December 2012...
August 31, 2016: Journal of Nephrology
E Mancini, C Perazzini, L Gesualdo, F Aucella, A Limido, F Scolari, S Savoldi, M Tramonti, L Corazza, M Atti, S Severi, P Bolasco, A Santoro
BACKGROUND: Intradialytic hypotension (IDH) has a dramatic impact on the main outcomes of dialysis patients. Early warning of hemodynamic worsening during dialysis would enable preventive measures to be taken. Blood oxygen saturation (SO2) is used for hemodynamic monitoring in the critical care setting and may provide useful information about IDH onset. AIM: To evaluate whether short- and medium-term variations in the SO2 signal (ST-SO2var, MT-SO2var,) during dialysis are a predictor of IDH...
August 29, 2016: Journal of Nephrology
Vincenzo Bellizzi, Giuseppe Conte, Silvio Borrelli, Adamasco Cupisti, Luca De Nicola, Biagio R Di Iorio, Gianfranca Cabiddu, Marcora Mandreoli, Ernesto Paoletti, Giorgina B Piccoli, Giuseppe Quintaliani, Maura Ravera, Domenico Santoro, Serena Torraca, Roberto Minutolo
This position paper of the study group "Conservative treatment of Chronic Kidney Disease-CKD" of the Italian Society of Nephrology addresses major practical, unresolved, issues related to the conservative treatment of chronic renal disease. Specifically, controversial topics from everyday clinical nephrology practice which cannot find a clear, definitive answer in the current literature or in nephrology guidelines are discussed. The paper reports the point of view of the study group. Concise and practical advice is given on several common issues: renal biopsy in diabetes; dual blockade of the renin-angiotensin-aldosterone system (RAAS); management of iron deficiency; low protein diet; dietary salt intake; bicarbonate supplementation; treatment of obesity; the choice of conservative therapy vs...
August 27, 2016: Journal of Nephrology
Marcello Tonelli, Anita Lloyd, Neesh Pannu, Scott Klarenbach, Pietro Ravani, Kailash Jindal, Jennifer MacRae, Larry Unsworth, Braden Manns, Brenda Hemmelgarn
BACKGROUND: Rural-dwelling hemodialysis patients have less frequent contact with nephrologists than urban-dwelling patients, and are known to have higher mortality. We hypothesized that rural-dwelling hemodialysis patients would have more evidence of poorly controlled extracellular fluid volume (ECVF) than otherwise similar urban-dwellers. METHODS: We studied prevalent hemodialysis patients within a single renal program in Alberta, Canada and assessed ECFV using bioimpedance spectroscopy (BIS)...
August 23, 2016: Journal of Nephrology
Veronica Agatha Lopes van Balen, Julia Jeltje Spaan, Tom Cornelis, Marc Erich August Spaanderman
BACKGROUND: Preeclampsia (PE), an endothelial disease that affects kidney function during pregnancy, is correlated to an increased future risk of cardiovascular and chronic kidney disease. The Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline emphasizes the combined role of glomerular filtration rate (GFR) and albuminuria in determining the frequency of monitoring of kidney function. OBJECTIVES: In this study we evaluated the prevalence of CKD in women with a history of PE...
August 5, 2016: Journal of Nephrology
Jenny I Shen, Anjali B Saxena, Maria E Montez-Rath, Lynn Leng, Tara I Chang, Wolfgang C Winkelmayer
BACKGROUND: There is evidence that angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) may reduce cardiovascular (CV) risk in patients undergoing peritoneal dialysis (PD), but no studies have compared the effectiveness between these drug classes. In this observational cohort study, we compared the association of ARB vs. ACEI use on CV outcomes in patients initiating PD. METHODS: We identified from the US Renal Data System all adult patients who initiated PD from 2007 to 2011 and participated in Medicare Part D, a federal prescription drug benefits program, for the first 90 days of dialysis...
August 2, 2016: Journal of Nephrology
Wenjun Yan, Lijuan Wang, Tianlun Huang, Gaosi Xu
AIM: Non-thyroidal illness syndrome (NTIS) is common among patients with advanced chronic kidney disease (CKD) and is strongly associated with poor prognosis. However, it remains unclear in how to correct this disorder and this study aimed to evaluate the effectiveness of sodium bicarbonate (SB) and N-acetyl-cysteine (NAC) for correcting NTIS status. METHODS: Patients with CKD stage 3-4 were single-blind, placebo-controlled treated with placebo, SB, or NAC for 18 weeks...
August 2, 2016: Journal of Nephrology
Jun-Jun Luan, Guang-Qun Xing
OBJECTIVES: Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) are a group of systemic autoimmune disorders characterized by necrotizing inflammation of small- to medium-sized blood vessels. The pathogenesis of patients with AAV are still in investigation. In this study, we explored the involvement of LL-37 and nucleic acids in AAV. METHODS: 15 patients with AAV diagnosed according to the Chapel Hill definition between October 2014 and July 2015 in the department of Nephrology of Huangdao, affiliated Hospital of Qingdao University were enrolled...
July 30, 2016: Journal of Nephrology
Catarina Carvalho, Catarina Moniz Alves, João Miguel Frazão
Chronic kidney disease (CKD) patients present specific bone and mineral metabolism disturbances, which account for important morbidity and mortality. The term renal osteodystrophy, classically used for the nomination of CKD-associated bone disorder, has been limited to the histologic description of bone lesions, requiring the use of bone biopsy. Biochemical markers and imaging tools do not adequately predict the complex bone changes that are observed in renal osteodystrophy. Parathyroid hormone, which is a universally used biomarker of bone turnover in clinical practice, lacks specificity and sensitivity...
October 2016: Journal of Nephrology
Vincenzo Bellizzi, Stefano Bianchi, Piergiorgio Bolasco, Giuliano Brunori, Adamasco Cupisti, Giovanni Gambaro, Loreto Gesualdo, Pasquale Polito, Domenico Santoro, Antonio Santoro
The conservative management of chronic kidney disease (CKD) includes nutritional therapy (NT) with the aim to reduce the intake of proteins, phosphorus, organic acids, sodium, and potassium, while ensuring adequate caloric intake. While there is evidence that NT may help to prevent and control metabolic alterations in CKD, the criteria for implementing a low-protein regimen in CKD are still debated. There is no final consensus on the composition of the diet, nor indications for specific patient settings or different stages of CKD...
October 2016: Journal of Nephrology
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