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Advances in Chronic Kidney Disease

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https://www.readbyqxmd.com/read/28778367/getting-to-the-heart-of-the-matter-review-of-treatment-of-cardiorenal-syndrome
#1
REVIEW
Kausik Umanath, Sitaramesh Emani
Acute decompensated heart failure is a common cause of hospitalization with worsening kidney function or acute kidney injury often complicating the admission, which can result in further dysfunction of both systems in the form of a cardiorenal syndrome. Therapy in this arena has been largely empiric as rigorous clinical trial data to inform therapeutic choices are lacking. Here we review and discuss the available clinical evidence for common approaches to the management of this condition. A multidisciplinary approach to the care of patients with cardiorenal syndrome that relies on the experience of nephrologists and cardiologists to individualize treatment is critical given the paucity of rigorous clinical trial data...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778366/dual-organ-duel-the-hepatorenal-axis
#2
REVIEW
Ladan Golestaneh, Joel Neugarten
Recent developments in our understanding of the pathogenesis of kidney disease in the setting of liver failure have highlighted that kidney injury, rather than occurring in isolation, is a marker of systemic disease and poor prognosis. The differential diagnosis of kidney disease associated with liver failure is broader than formerly described and new biopsy data, along with better acute kidney injury classification tools, have increased appreciation for distinct pathophysiological mechanisms. Evidence suggests that acute kidney injury contributes to worsening hepatic failure by directly injuring hepatic cells and by imposing restrictions on therapeutic strategies for portal hypertension...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778365/follow-up-care-in-acute-kidney-injury-lost-in-transition
#3
REVIEW
Samuel A Silver, Edward D Siew
Acute kidney injury (AKI) is an increasingly common condition that is associated with long-term health outcomes. Recent studies have demonstrated that AKI, particularly when severe or persistent, is associated with all-cause mortality, CKD, ESRD, cardiovascular events, and reduced quality of life. However, data from multiple health care systems indicate that most patients do not see a nephrologist, although 1 study has suggested patients with AKI requiring dialysis may benefit from doing so. These observations raise the greater questions of what are the elements of care that may improve outcomes in survivors of AKI and which survivors need to be seen...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778364/information-technology-and-acute-kidney-injury-alerts-alarms-bells-and-whistles
#4
REVIEW
F Perry Wilson
The goal of this review is to describe the rationale for alerting systems for acute kidney injury, the challenges associated with alert implementation, and the efficacy (or lack thereof) of acute kidney injury alerts to date.
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778363/kidney-toxicities-associated-with-novel-cancer-therapies
#5
REVIEW
Joannie Lefebvre, Ilya G Glezerman
Targeted therapies that act via unique molecular pathways and interfere with cancer cell growth and tumor progression have dramatically changed the cancer treatment paradigm. However, although, ideally, these therapies intend to target only cancer cells, they do often affect nonmalignant tissue. Numerous renal side effects have been reported to date. This article will review clinical presentation, presumed pathophysiology, and treatment of kidney side effects of targeted therapies. Feasibility of the continuation of cancer therapy despite renal toxicity will also be addressed...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778362/acute-kidney-injury-in-transplant-setting-differential-diagnosis-and-impact-on-health-and-health-care
#6
REVIEW
Bassam G Abu Jawdeh, Amit Govil
Acute kidney injury (AKI) is common in kidney transplant recipients. In addition to the usual causes of AKI in native kidneys, certain features and risk factors are unique to kidney allografts. In this article, we will present an overview of the common transplant-specific AKI etiologies that include increased susceptibility to hemodynamic-mediated AKI, acute rejection, medication-induced AKI, recurrence of native kidney disease, infections, urinary tract obstruction, vascular thrombosis and post-transplant lymphoproliferative disorder...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778361/antibiotic-dosing-in-continuous-renal-replacement-therapy
#7
REVIEW
Alexander R Shaw, Bruce A Mueller
Appropriate antibiotic dosing is critical to improve outcomes in critically ill patients with sepsis. The addition of continuous renal replacement therapy makes achieving appropriate antibiotic dosing more difficult. The lack of continuous renal replacement therapy standardization results in treatment variability between patients and may influence whether appropriate antibiotic exposure is achieved. The aim of this study was to determine if continuous renal replacement therapy effluent flow rate impacts attaining appropriate antibiotic concentrations when conventional continuous renal replacement therapy antibiotic doses were used...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778360/continuous-renal-replacement-therapy-reviewing-current-best-practice-to-provide-high-quality-extracorporeal-therapy-to-critically-ill-patients
#8
REVIEW
Michael J Connor, Nithin Karakala
Continuous renal replacement therapy (CRRT) use continues to expand globally. Despite improving technology, CRRT remains a complex intervention. Delivery of high-quality CRRT requires close collaboration of a multidisciplinary team including members of the critical care medicine, nephrology, nursing, pharmacy, and nutrition support teams. While significant gaps in medical evidence regarding CRRT persist, the growing evidence base supports evolving best practice and consensus to define high-quality CRRT. Unfortunately, there is wide variability in CRRT operating characteristics and limited uptake of these best practices...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778359/fluid-resuscitation-principles-of-therapy-and-kidney-safe-considerations
#9
REVIEW
Ajay Srivastava
Fluid resuscitation in the acutely ill must take into consideration numerous elements, including the intravenous solution itself, the phase of resuscitation, and the strategies toward volume management which are paramount. With the advancement in the understanding and implementation of aggressive fluid resuscitation has also come a greater awareness of the resultant fluid toxicity, especially in those that suffer acute kidney injury, and the realization that there is continued ambiguity with regard to volume mitigation and removal in the resuscitated patient...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778358/epidemiology-of-aki-utilizing-large-databases-to-determine-the-burden-of-aki
#10
REVIEW
Simon Sawhney, Simon D Fraser
Large observational databases linking kidney function and other routine patient health data are increasingly being used to study acute kidney injury (AKI). Routine health care data show an apparent rise in the incidence of population AKI and an increase in acute dialysis. Studies also report an excess in mortality and adverse renal outcomes after AKI, although with variation depending on AKI severity, baseline, definition of renal recovery, and the time point during follow-up. However, differences in data capture, AKI awareness, monitoring, recognition, and clinical practice make comparisons between health care settings and periods difficult...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778357/acute-kidney-injury-a-paradigm-in-quality-and-patient-safety
#11
EDITORIAL
Charuhas V Thakar
No abstract text is available yet for this article.
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28778356/the-aki-clinic-for-fragile-patients
#12
EDITORIAL
Jerry Yee, Ruth C Campbell
No abstract text is available yet for this article.
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501082/a-high-content-screening-technology-for-quantitatively-studying-podocyte-dynamics
#13
REVIEW
Jochen Reiser, Ha Won Lee, Vineet Gupta, Mehmet M Altintas
Podocytes form the visceral layer of a kidney glomerulus and express a characteristic octopus-like cellular architecture specialized for the ultrafiltration of blood. The cytoskeletal dynamics and structural elasticity of podocytes rely on the self-organization of highly interconnected actin bundles, and the maintenance of these features is important for the intact glomerular filtration. Development of more differentiated podocytes in culture has dramatically increased our understanding of the molecular mechanisms regulating podocyte actin dynamics...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501081/the-impact-of-excess-ligand-on-the-retention-of-nonionic-linear-gadolinium-based-contrast-agents-in-patients-with-various-levels-of-renal-dysfunction-a-review-and-simulation-analysis
#14
REVIEW
John P Prybylski, Michael Jay
The role of gadolinium (Gd)-based contrast agents (GBCAs) in the pathophysiology of nephrogenic systemic fibrosis (NSF) is now uncontested. Although the definitive mechanism has not been established, the association with weaker GBCA ligands and with reduced renal clearance supports a hypothesis that Gd release from the GBCAs is a key process in precipitating the disease. Prevention strategies often include the use of more stable GBCA ligands in patients with reduced kidney function, but animal models and some clinical data suggest that better patient outcomes can be achieved when excess ligand is administered with weaker GBCAs; this is particularly significant for OptiMARK, which contains a nonionic, linear ligand similar to gadodiamide, the active ingredient in Omniscan, but contains twice the amount of excess ligand...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501080/intravenous-contrast-induced-nephropathy-the-rise-and-fall-of-a-threatening-idea
#15
REVIEW
Lyndon Luk, Jonathan Steinman, Jeffrey H Newhouse
Contrast-induced nephropathy (CIN) has been considered to be a cause of renal failure for over 50 years, but careful review of past and recent studies reveals the risks of CIN to be overestimated. Older studies frequently cited the use of high-osmolality contrast media, which have since been replaced by low-osmolality contrast media, which have lower risks for nephropathy. In addition, literature regarding CIN typically describes the incidence following cardiac angiography, whereas the risk of CIN from intravenous injection is much lower...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501079/functional-magnetic-resonance-imaging-of-the-kidneys-with-and-without-gadolinium-based-contrast
#16
REVIEW
Jeff L Zhang
Assessment of renal function with magnetic resonance imaging (MRI) has been actively explored in the past decade. In this review, we introduce the principle of MRI and review recent progress of MRI methods (contrast enhanced and noncontrast) in assessing renal function. Contrast-enhanced MRI using ultra-low dose of gadolinium-based agent has been validated for measuring single-kidney glomerular filtration rate and renal plasma flow accurately. For routine functional test, contrast-enhanced MRI may not replace the simple serum-creatinine method...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501078/the-role-of-pet-scanning-in-the-evaluation-of-patients-with-kidney-disease
#17
REVIEW
Namrata Krishnan, Mark A Perazella
Patients with underlying kidney disease are often required to undergo imaging for a variety of purposes including diagnosis and prognosis. A test that is being increasingly used with for this group of patients is the positron emission test (PET) scan. In addition, combining the nuclear medicine technique (PET) with computed tomography scan allows additional imaging advantages over either alone. These imaging modalities are commonly used for a number of extrarenal indications (ie, cancer, coronary artery disease, central nervous system disease, infectious diseases, and others)...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501077/recent-advances-in-magnetic-resonance-imaging-assessment-of-renal-fibrosis
#18
REVIEW
Jia Li, Changlong An, Lei Kang, William E Mitch, Yanlin Wang
CKD is a global public health problem. Renal fibrosis is a final common pathway leading to progressive loss of function in CKD. The degree of renal fibrosis predicts the prognosis of CKD. Recent studies have shown that bone marrow-derived fibroblasts contribute significantly to the development of renal fibrosis, which may yield novel therapeutic strategy for fibrotic kidney disease. Therefore, it is imperative to accurately assess the degree of renal fibrosis noninvasively to identify those patients who can benefit from antifibrotic therapy...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501076/intravenous-contrast-friend-or-foe-a-review-on-contrast-induced-nephropathy
#19
REVIEW
Catherine Do
Intravenous iodinated contrast is used in many contrasted imaging studies ranging from computed tomography to angiography. The risks of contrast-induced nephropathy (CIN) and its incidence have not been clearly defined. Most iodinated contrast media used today are hypertonic compared with serum osmolality and pose biological risks. However, the risk of CIN in the general population may be overestimated. Confounding risk factors may contribute to acute kidney injury other than attributable risk of contrast exposure...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28501075/gadolinium-retention-and-toxicity-an-update
#20
REVIEW
Miguel Ramalho, Joana Ramalho, Lauren M Burke, Richard C Semelka
Until 2006, the main considerations regarding safety for all gadolinium-based contrast agents (GBCAs) were related to short-term adverse reactions. However, the administration of certain "high-risk" GBCAs to patients with renal failure resulted in multiple reported cases of nephrogenic systemic fibrosis. Findings have been reported regarding gadolinium deposition within the body and various reports of patients who report suffering from acute and chronic symptoms secondary to GBCA's exposure. At the present state of knowledge, it has been proved that gadolinium deposits also occur in the brain, irrespective of renal function and GBCAs stability class...
May 2017: Advances in Chronic Kidney Disease
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