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Journal of Nephrology

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https://www.readbyqxmd.com/read/28332137/correction-of-dilutional-anemia-induces-renal-dysfunction-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-a-consequence-of-microcirculatory-alterations
#1
Güçlü Aykut, Meltem Kilercik, Cem Arıtürk, Halim Ulugöl, Uğur Aksu, Türkan Kudsioğlu, Nazan Atalan, Nihan Yapıcı, Hasan Karabulut, Fevzi Toraman
BACKGROUND: In this study we aimed to evaluate the effects of dilutional anemia resulting from cardiopulmonary bypass (CPB) and its correction with red blood cell (RBC) transfusion on tissue oxygenation and renal function in diabetic patients undergoing coronary artery bypass grafting (CABG). METHOD: 70 diabetic patients who underwent elective CABG and whose hematocrit values had been between 24-28% at any time during CBP were prospectively randomized and equally allocated to two groups: patients who received RBC during CPB (group I, n = 35) vs...
March 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28321822/the-exciting-bench-to-bedside-journey-of-cell-therapies-for-acute-kidney-injury-and-renal-transplantation
#2
REVIEW
Sergio Dellepiane, Davide Medica, Alessandro Domenico Quercia, Vincenzo Cantaluppi
Acute kidney injury (AKI) is characterized by an increasing incidence and poor outcomes in both developed and undeveloped countries. AKI is also acquiring importance in the setting of kidney transplantation (KT): besides all the classical forms of AKI that KT patients may undergo, several transplant-specific injuries can also lead to the loss of graft function. The mechanisms of tissue damage in native and grafted kidneys share several common pathogenic elements. Since appropriate therapeutic treatments are still lacking-probably due to the disease complexity-clinicians are forced to provide only supportive care...
March 21, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28317077/de-novo-cancer-in-patients-on-dialysis-and-after-renal-transplantation-north-western-italy-1997-2012
#3
Valentina Mazzucotelli, Pierluca Piselli, Diana Verdirosi, Claudia Cimaglia, Giovanni Cancarini, Diego Serraino, Silvio Sandrini
BACKGROUND: Kidney transplant recipients (KTR) are known to have a higher risk of cancer than the general population, especially of malignancies related to oncogenic viral infections. This study assessed the incidence of de novo malignancies (DNMs) in patients receiving kidney transplantation and in dialysis patients (DP) on the waiting list for transplantation at the same centre. The aim was to quantify the contribution of post-transplant immunosuppression to the underlying risk of developing a DNM in dialysis patients on the waiting list for kidney transplant...
March 19, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28303461/economic-burden-of-chronic-kidney-disease-in-korea-using-national-sample-cohort
#4
Seon-Ha Kim, Min-Woo Jo, Dun-Sol Go, Dong-Ryeol Ryu, Jongha Park
BACKGROUND: Determining the cost of a disease is one of the approaches to estimate the burden of the disease. This study was aimed to estimate the socioeconomic burden of chronic kidney disease (CKD) by CKD stages and treatment strategies in Korea. METHODS: This was a population-based study designed to estimate the cost of CKD according to CKD stages and treatment strategies from a societal perspective in Korea using multiple data sources. Costs of CKD stages III, IV, and V, hemodialysis (HD), and peritoneal dialysis (PD) were estimated with a prevalence-based method...
March 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28286934/relationship-between-diurnal-blood-pressure-and-renal-histopathological-changes-in-white-coat-hypertension
#5
Erhan Tatar, Adam Uslu, Funda Tasli, Murat Karatas
BACKGROUND: Multiple epidemiological studies have clearly demonstrated the macrovascular risks associated with white coat hypertension (WCH) or sustained hypertension (SH). In patients with WCH, there is no literature available on renal histopathological changes and that on blood pressure pattern and native kidney outcome is scant. We aimed to clarify the relationship between blood pressure variables and pathological features of kidney biopsies in living kidney donors with WCH. METHODS: This cross-sectional study included living kidney donors with WCH (n = 10) and SH (n = 10), and 20 healthy kidney donors with similar demographic features (control group)...
March 12, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28224376/a-case-of-atypical-hemolytic-uremic-syndrome-in-a-second-renal-transplant
#6
Nicholas A Zwang, Bing Ho, Yashpal S Kanwar, Brad Lewis, Matthew Cusick, John J Friedewald, Lorenzo Gallon
Atypical hemolytic uremic syndrome (aHUS) has gained increased visibility over several years as an important cause of renal failure. Unfortunately, diagnosis is often difficult because individual courses can be highly variable depending the causative genetic mutations. Here we present the case of a patient with a failed renal allograft and acute failure of a second allograft who was ultimately diagnosed with aHUS. Interestingly, he developed early de novo donor specific antibodies (DSA) after the second renal transplant in context of likely recurrent aHUS...
February 21, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28211034/infectious-complications-as-the-leading-cause-of-death-after-kidney-transplantation-analysis-of-more-than-10-000-transplants-from-a-single-center
#7
Flávio de Castro Rodrigues Ferreira, Marina Pontello Cristelli, Mayara Ivani Paula, Henrique Proença, Claudia Rosso Felipe, Helio Tedesco-Silva, José Osmar Medina-Pestana
AIM: To identify specific causes of graft failure in a large sample of kidney transplant patients from a middle-income, developing country. METHODS: Retrospective cohort study analyzing all consecutive single kidney transplants (KTs) performed at a single center in Brazil between January 1st 1998 and December 31st 2013. The database closing date was December 31st 2014. RESULTS: Out of 10,400 KTs, there were 1191 (11.45%) deaths with a functioning graft, 40 cases (0...
February 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28205136/a-comparative-study-of-the-risk-profile-of-hemodialysis-patients-in-a-for-profit-network-and-in-two-regional-registries-of-the-italian-society-of-nephrology
#8
Maurizio Postorino, Claudia Amato, Elena Mancini, Paola Carioni, Graziella D'Arrigo, Attilio Di Benedetto, Fabrizio Cerino, Carmela Marino, Antonio Vilasi, Giovanni Tripepi, Stefano Stuard, Giovanbattista Capasso, Antonio Santoro, Carmine Zoccali
In 2013, the Italian Society of Nephrology joined forces with Nephrocare-Italy to create a clinical research cohort of patients on file in the data-rich clinical management system (EUCLID) of this organization for the performance of observational studies in the hemodialysis (HD) population. To see whether patients in EUCLID are representative of the HD population in Italy, we set out to compare the whole EUCLID population with patients included in the regional HD registries in Emilia-Romagna (Northern Italy) and in Calabria (Southern Italy), the sole regions in Italy which have systematically collected an enlarged clinical data set allowing comparison with the data-rich EUCLID system...
February 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28197971/abnormal-ankle-brachial-index-and-risk-of-cardiovascular-or-all-cause-mortality-in-patients-with-chronic-kidney-disease-a-meta-analysis
#9
REVIEW
Hai-Yan Chen, Fang Wei, Li-Hua Wang, Zhe Wang, Jia Meng, Hai-Bo Yu, Rui-Ning Zhang, Gui-Jiang Sun, Ai-Li Jiang, Lin Wang
Prognostic role of ankle-brachial index (ABI) in patients with chronic kidney disease (CKD) is controversial. We aimed to evaluate whether abnormal ABI was an independent predictor of cardiovascular or all-cause mortality in CKD patients with or without hemodialysis by conducting a meta-analysis. We systematically searched Pubmed and Embase databases for prospective observational studies that investigated baseline abnormal ABI and subsequent cardiovascular or all-cause mortality risk in CKD patients with or without hemodialysis...
February 15, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28181150/effectiveness-of-targeted-screening-for-chronic-kidney-disease-in-the-community-setting-a-systematic-review
#10
Pankti A Gheewala, Syed Tabish R Zaidi, Matthew D Jose, Luke Bereznicki, Gregory M Peterson, Ronald L Castelino
BACKGROUND: Targeted screening interventions for chronic kidney disease (CKD) are increasingly being implemented in various community settings. However, the overall success of these programs is uncertain. Therefore, the aim of this review is to determine whether targeted screening is effective in detecting people with undiagnosed CKD. METHODS: We performed a systematic literature review, and included studies of targeted screening intervention implemented in any community-based setting...
February 8, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28120282/treatment-of-atrial-fibrillation-with-warfarin-among-older-adults-with-end-stage-renal-disease
#11
Jingwen Tan, Sunjae Bae, Jodi B Segal, Junya Zhu, Dorry L Segev, G Caleb Alexander, Mara McAdams-DeMarco
BACKGROUND: There is increasing evidence questioning the use of warfarin for atrial fibrillation (AF) among older adults with end stage renal disease (ESRD). We assessed the patterns and determinants of warfarin utilization among these patients in the US. METHODS: We assembled a cohort of older adults (age ≥65) undergoing dialysis with incident AF from July 2007 to November 2011 from the US Renal Data System (USRDS). We used descriptive statistics to characterize warfarin utilization within 30 days of AF discharge, and logistic regression to quantify patient characteristics associated with warfarin initiation...
January 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28211033/renin-angiotensin-system-inhibitors-in-kidney-transplantation-a-benefit-risk-assessment
#12
EDITORIAL
Claudio Ponticelli, David Cucchiari
No abstract text is available yet for this article.
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27589851/renal-dysfunction-following-bone-marrow-transplantation
#13
REVIEW
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...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27586123/why-choose-high-volume-online-post-dilution-hemodiafiltration
#14
REVIEW
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)...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27568307/controversial-issues-in-ckd-clinical-practice-position-statement-of-the-ckd-treatment-working-group-of-the-italian-society-of-nephrology
#15
REVIEW
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...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27485007/comparative-effectiveness-of-angiotensin-receptor-blockers-vs-angiotensin-converting-enzyme-inhibitors-on-cardiovascular-outcomes-in-patients-initiating-peritoneal-dialysis
#16
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...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27394428/safety-and-efficacy-of-denosumab-in-osteoporotic-hemodialysed-patients
#17
Francescaromana Festuccia, Maryam Tayefeh Jafari, Alessandra Moioli, Claudia Fofi, Simona Barberi, Stefano Amendola, Salvatore Sciacchitano, Giorgio Punzo, Paolo Menè
BACKGROUND AND AIMS: In elderly subjects, renal insufficiency and osteoporosis often coexist with high risk of fracture and elevated socio-economic burden. Today a large number of effective anti-osteoporotic drugs are available but generally they are contraindicated in patients with chronic kidney disease (CKD) because of their progressive accumulation. Denosumab, instead, does not require dose adjustments for different degrees of renal impairment so it can be a valid treatment in osteoporotic patients with CKD...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27245689/monitoring-alloimmune-response-in-kidney-transplantation
#18
REVIEW
Oriol Bestard, Paolo Cravedi
Currently, immunosuppressive therapy in kidney transplant recipients is generally performed by protocols and adjusted according to functional or histological evaluation of the allograft and/or signs of drug toxicity or infection. As a result, a large fraction of patients are likely to receive too much or too little immunosuppression, exposing them to higher rates of infection, malignancy and drug toxicity, or increased risk of acute and chronic graft injury from rejection, respectively. Developing reliable biomarkers is crucial for individualizing therapy aimed at extending allograft survival...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27206762/proton-pump-inhibitors-and-symptomatic-hypomagnesemic-hypoparathyroidism
#19
P Fatuzzo, G Portale, V Scollo, L Zanoli, Antonio Granata
Hypomagnesemia is a common but often overlooked problem in hospitalized patients. Unrecognized hypomagnesemia can cause serious complications. The association of hypokalemia and hypocalcemia is strongly evocative of a magnesium deficiency. Research into the causes of hypomagnesemia is imperative, as it will definitely change the approach, treatment and prognosis. We report the case of a 65-year-old man with chronic hypocalcemia and hypokalemia associated with cerebellar syndrome, a solitary seizure and cerebellar hyperintensities on magnetic resonance imaging...
April 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/27165160/healthcare-costs-of-the-progression-of-chronic-kidney-disease-and-different-dialysis-techniques-estimated-through-administrative-database-analysis
#20
Alessandro Roggeri, Daniela Paola Roggeri, Carlo Zocchetti, Maurizio Bersani, Ferruccio Conte
BACKGROUND: Chronic kidney disease (CKD) progression is associated with significant comorbidities and costs. In Italy, limited evidence of healthcare resource consumption and costs is available. We therefore aimed to investigate the direct healthcare costs in charge to the Lombardy Regional Health Service (RHS) for the treatment of CKD patients in the first year after starting hemodialysis and in the 2 years prior to dialysis. METHODS: Citizens resident in the Lombardy Region (Italy) who initiated dialysis in the year 2011 (Jan 1 to Dec 31) were selected and data were extracted from Lombardy Regional databases on their direct healthcare costs in the first year after starting dialysis and in the 2 years prior to it was analyzed...
April 2017: Journal of Nephrology
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