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Journal of Nephrology

Fabrizio Grosjean, Mara De Amici, Catherine Klersy, Gianluca Marchi, Antonio Sciortino, Federica Spaltini, Maurizio Pin, Valentina Grazioli, Anna Celentano, Benedetta Vanini, Giorgia Testa, Vincenzo Sepe, Teresa Rampino, Andrea Maria D'Armini
OBJECTIVES: The only curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). PEA requires cardiopulmonary bypass (CPB) which is associated with a high acute kidney injury (AKI) risk. Circulating endothelin-1 (ET-1) levels are elevated in CTEPH, and ET-1 plays a pivotal role in AKI. Because AKI is burdened by high morbidity and mortality, we aimed to evaluate the association between preoperative ET-1 and the risk to develop AKI in CTEPH individuals who undergo PEA...
September 18, 2018: Journal of Nephrology
Nicolás Roberto Robles, Francesco Fici, Guido Grassi
Aggressive reduction of blood pressure (BP) may increase cardiovascular events (the J-curve phenomenon) in certain populations. There is a high number of available studies of antihypertensive treatment that provide strong evidence for J-shaped relationships between both diastolic and systolic BP and main cardiovascular outcomes. Nonetheless, most available studies were observational, and randomized trials might not have or lost their statistical power in post-hoc analysis. Contrariwise, most of prospective trial to demonstrate the benefits of intensive blood pressure control were inconclusive...
September 17, 2018: Journal of Nephrology
Filippo Mariano, Marta Leporati, Paola Carignano, Maurizio Stella, Marco Vincenti, Luigi Biancone
BACKGROUND: This study assessed the contribution of intracorporeal (IC) and extracorporeal clearance (EC) of furosemide in patients with septic acute kidney injury (AKI), and the relationship between plasma concentrations and urine volume. METHODS: Prospective cohort observational study of 15 patients with septic AKI undergoing continuous veno-venous hemodiafiltration (CVVHDF) divided according to urine volume (< 500 ml/12 h, Oliguria group, n = 5; > 500 ml/12 h, Diuresis group, n = 10) during continuous infusion of furosemide (120 mg/12 h) at steady-state condition...
September 17, 2018: Journal of Nephrology
Alfredo Leaños-Miranda, Inova Campos-Galicia, Karla Leticia Ramírez-Valenzuela, María Guadalupe Berumen-Lechuga, Irma Isordia-Salas, Carlos José Molina-Pérez
OBJECTIVE: Chronic kidney disease (CKD) pregnancies are at high risk of developing adverse outcomes. In non-pregnant subjects with CKD, higher urinary IgM levels are associated with poor renal survival and higher rates of cardiovascular deaths. In this study, we assessed whether urinary IgM levels are associated with an increased risk of adverse pregnancy outcomes (APO) in CKD pregnancies. METHODS: We performed a nested case-control study within a cohort of CKD patients with singleton pregnancies attended at a tertiary care hospital...
September 11, 2018: Journal of Nephrology
Ilaria Petrucci, Anna Clementi, Concetto Sessa, Irene Torrisi, Mario Meola
Chronic kidney disease (CKD) includes all clinical features and complications during the progression of various kidney conditions towards end-stage renal disease (ESRD). These conditions include immune and inflammatory disease such as: primary and hepatitis C virus (HCV)-related glomerulonephritis; infectious disease such as pyelonephritis with or without reflux and tuberculosis; vascular disease such as chronic ischemic nephropathy; hereditary and congenital disease such as polycystic disease and congenital cystic dysplasia; metabolic disease including diabetes and hyperuricemia; and systemic disease (collagen disease, vasculitis, myeloma)...
September 6, 2018: Journal of Nephrology
Marilina Tampoia, Francesca Migliucci, Chiara Villani, Letizia Abbracciavento, Michele Rossini, Ruggiero Fumarulo, Loreto Gesualdo, Vincenzo Montinaro
Autoantibodies against phospholipase A2 receptor (PLA2R) are a sensitive and specific marker for idiopathic membranous nephropathy (IMN). The aim of our study was to redefine the cut-off value for the measurement of anti-PLA2R autoantibody levels by an automated enzyme immunoassay, in a large single-center cohort of Italian IMN patients at the time of diagnosis. Sixty-seven consecutive incident patients, with biopsy-proven IMN, were recruited. All patients were naïve to preceding immunosuppressive therapeutic regimens...
September 5, 2018: Journal of Nephrology
Dadi Helgason, Thorir E Long, Solveig Helgadottir, Runolfur Palsson, Gisli H Sigurdsson, Tomas Gudbjartsson, Olafur S Indridason, Ingibjorg J Gudmundsdottir, Martin I Sigurdsson
BACKGROUND: We studied the incidence and risk factors of acute kidney injury (AKI) following coronary angiography (CA) and examined short- and long-term outcomes of patients who developed AKI, including progression of chronic kidney disease (CKD). METHODS: This was a retrospective study of all patients undergoing CA in Iceland from 2008 to 2015, with or without percutaneous coronary intervention. All procedures were performed with iso-osmolar contrast. AKI was defined according to the SCr component of the KDIGO criteria...
September 5, 2018: Journal of Nephrology
Maharajan Raman, Darren Green, Rachel J Middleton, Philip A Kalra
BACKGROUND: In older patients with chronic kidney disease (CKD), the risk of progression to end stage renal disease and cardiovascular death both differ compared to younger patients. This likely reflects differences in case mix and co-morbid burdens. We sought to establish the extent to which age itself is an independent biomarker of adverse outcome in CKD. METHODS: This was an analysis of the Salford Kidney Study, a prospective, longitudinal, observational study of 2,667 patients with eGFR < 60 ml/min/1...
September 5, 2018: Journal of Nephrology
Smita Mary Matthai, Shibu Jacob, Anup J Devasia, Mandeep Bindra, Vinoi George David, Santosh Varughese
Pregnancy offers a precious window of opportunity to diagnose previously undetected or new onset kidney diseases in emerging countries like India, where access to medical, educational and health care facilities are not equitably distributed across varied sections of society. We report a case of a 33 year-old primi gravida who had a successful pregnancy following what was initially considered to represent preeclampsia at 38 weeks of gestation, in whom a subsequent kidney biopsy for persistence of pregnancy-related acute kidney injury (Pr-AKI) revealed light chain deposition disease (LCDD)...
September 5, 2018: Journal of Nephrology
Sen Kan, Weichen Zhang, Jianping Mao, Mengjing Wang, Li Ni, Minmin Zhang, Qian Zhang, Jing Chen
BACKGROUND: Secondary hyperparathyroidism is characterized by parathyroid gland (PG) hyperplasia, and excessive synthesis and secretion of parathyroid hormone (PTH). Reduced vitamin D receptor (VDR) density has shown to play an essential role in PG hyperplasia progression; nevertheless, its exact mechanism remains unclear. VDR has shown to suppress the inflammation mediator NF-κB-mediated gene transcription. The aim of this study is to examine whether NF-κB is involved in the pathogenesis of parathyroid hyperplasia...
August 31, 2018: Journal of Nephrology
Gianpaolo Reboldi, Giorgio Gentile, Fabio Angeli, Paolo Verdecchia
In patients with chronic kidney disease (CKD), hypertension is a major challenge because of its high prevalence, the consequent increase in cardiovascular morbidity and mortality, and the risk it confers specifically to the progression of kidney disease. Hence, establishing evidence-based blood pressure targets and treatment strategies is a clinical priority of paramount importance. Over the last few years, different guidelines have advocated different blood pressure treatment thresholds and goals in CKD patients, including a target < 140/90 mmHg and a more intensive target-lower than 130/80 mmHg-in the presence of albuminuria ≥ 300 mg/daily...
August 30, 2018: Journal of Nephrology
Laura Sarno, Antonella Tufano, Giuseppe Maria Maruotti, Pasquale Martinelli, Mario M Balletta, Domenico Russo
Pregnancy can be a dangerous trigger for patients with paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), or hemolysis, elevated liver enzymes and low platelet (HELLP) syndrome. Due to the possibility of several serious complications, pregnancy is somewhat discouraged in the presence of the above diseases. Eculizumab is a humanized antibody that may dramatically change the clinical course of PNH, aHUS and HELLP syndrome. However, data on the safety of eculizumab in pregnancy are scarce...
August 29, 2018: Journal of Nephrology
Sandro Mazzaferro, Lida Tartaglione, Carmelo Cascone, Nicola Di Daniele, Antonello Pani, Massimo Morosetti, Marco Francisco, Maurizio Nordio, Maria Leonardi, Mauro Martello, Cristina Grimaldi, Mario Cozzolino, Silverio Rotondi, Marzia Pasquali
BACKGROUND: When medical therapy is unable to achieve biochemical control of secondary hyperparathyroidism, parathyroidectomy (PTX) is indicated, fortunately in a minority of patients. Thus, data on PTX prevalence and biochemical control are limited and, in particular in Italy, date back to 1999. METHODS: We designed a prospective, observational and multicenter study to collect data from dialysis units distributed throughout the Italian regions. Clinical data were collected with a dedicated data sheet...
August 28, 2018: Journal of Nephrology
Siôn Edryd Williams
No abstract text is available yet for this article.
August 28, 2018: Journal of Nephrology
Andreana De Mauri, Matteo Vidali, Doriana Chiarinotti, Giorgio Bellomo, Roberta Rolla
BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2 ) is a serine lipase that enhances the instability of the atherosclerotic plaques. While in the general and cardiac population Lp-PLA2 is recognized as an important determinant of cardiovascular (CV) accidents, no data are available for the renal population. The aim of this study was to evaluate the relationship between Lp-PLA2 and acute CV events in hemodialyzed patients. METHODS: We enrolled 102 dialyzed patients, 63% male, age 71 years (59-78), 35% with diabetes, 54% hypertension, 40% coronary artery disease and 31% peripheral vascular disease...
August 27, 2018: Journal of Nephrology
Antonio Rodriguez-Poncelas, Gabriel Coll-de-Tuero, Jordi Blanch, Marc Comas-Cufí, Marc Saez, Maria Antònia Barceló
BACKGROUND: Glomerular hyperfiltration is well recognized as an early renal alteration in subjects with diabetes mellitus. However, what is not well-known is whether hyperfiltration also occurs in the early stages of hyperglycaemia, for instance in prediabetes. Identifying subjects with glomerular hyperfiltration from among those with prediabetes might be helpful to implement preventive and therapeutic strategies. This study aimed to investigate the association of prediabetes with glomerular hyperfiltration and its associated variables...
August 27, 2018: Journal of Nephrology
Tamryn K Law, Ron Wald, Marc Goldstein, Gauri R Karur, Ming-Yen Ng, Angela Y M Wang, Djeven P Deva, Anish Kirpalani, Rachel M Wald, Mercedeh Kiaii, Jonathon Leipsic, Kim A Connelly, Andrew T Yan
BACKGROUND: Left atrial (LA) volume is a well-established cardiovascular prognosticator in patients with end-stage renal disease. Although dialysis intensification is associated with left ventricular mass regression, there are limited data regarding LA remodeling. Using cardiac magnetic resonance imaging (CMR), we examined changes in LA size and function relative to ventricular remodeling and cardiac biomarkers after dialysis intensification. METHODS: In this prospective 2-centre cohort study, 37 patients receiving conventional hemodialysis (CHD, 4 h/session, 3×/week) were converted to in-centre nocturnal hemodialysis (INHD 7-8 h/session, 3×/week); 30 patients remained on CHD...
August 24, 2018: Journal of Nephrology
Giorgina Barbara Piccoli, Hafedh Fessi
No abstract text is available yet for this article.
August 2, 2018: Journal of Nephrology
Carmela Cosola, Maria Teresa Rocchetti, Alice Sabatino, Enrico Fiaccadori, Biagio Raffaele Di Iorio, Loreto Gesualdo
In chronic kidney disease (CKD), the progressive decline in the renal excretory function leads to accumulation of urea and toxins in the blood. The CKD-associated dysbiosis of gut microbiota further contributes to uremia by increasing intestinal toxins production. Gut microbiota is involved in a complex network of human organs, mediated by microbial metabolites: in CKD, gut-heart and gut-brain axes may have a role in increased cardiovascular risk and neuropsychiatric disorders. While the cardiovascular toxicity of some microbial molecules is well known, their presumptive neurotoxicity needs to be confirmed by specific studies...
August 1, 2018: Journal of Nephrology
Giorgina Barbara Piccoli
A recent paper, entitled "Validation of an effective, low cost, free/open access 3D-printed stethoscope", recently appeared on PLoS One, reports on the validation of a 3D-printed stethoscope that costs about 100 times less than the classic Littman most of us carry in our pockets. The stethoscope model, called Glia, can be downloaded for free. This unusual paper may deepened our understanding of inequalities in health care around the world, but may also show how much we can learn from the inventive approaches employed by colleagues struggling to provide health care when they literally have nothing...
July 31, 2018: Journal of Nephrology
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