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https://www.readbyqxmd.com/read/29771702/pathogenesis-of-cerebral-edema-in-patients-with-acute-renal-and-liver-failure-and-the-role-of-the-nephrologist-in-the-management
#1
Tamim Hamdi
PURPOSE OF REVIEW: Acute liver failure (ALF) is a severe and complex illness and one of the most daunting conditions managed in the ICU. Because the renal care is intertwined with multiple disciplines, the aim of this review is to examine the multifactorial pathogenesis of cerebral edema in ALF, covering basic established facts as well as recent advances in our understanding of this condition. RECENT FINDINGS: Acetaminophen remains the most common cause of ALF in the United States and many European countries...
May 15, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29767399/a-decreased-soluble-klotho-level-with-normal-egfr-fgf23-serum-phosphate-and-fep-in-an-adpkd-patient-with-enlarged-kidneys-due-to-multiple-cysts
#2
Takahiro Kanai, Kazuhiro Shiizaki, Hiroyuki Betsui, Jun Aoyagi, Takanori Yamagata
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder. ADPKD is characterized clinically by the presence of multiple bilateral renal cysts that lead to chronic renal failure. The cysts evolve from renal tubular epithelial cells that express the Klotho gene. Notably, Klotho acts as a co-receptor for fibroblast growth factor 23 (FGF23); in this context, it induces phosphaturia and maintains serum phosphate at a normal level. Many reports have shown that decreases in the soluble Klotho level and increases in the FGF23 level are associated with glomerular filtration rate (GFR) decline, but a recent study observed these changes in patient with normal eGFR...
May 16, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29765783/multiorgan-failure-and-refractory-lactic-acidosis-due-to-pasteurella-multocida-septicemia-in-a-patient-with-no-animal-exposure
#3
Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Introduction: Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock. Case Presentation: A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29765485/spontaneous-hemoperitoneum-resulting-from-segmental-arterial-mediolysis
#4
Emily Olivares, Harlan Vingan, Qiao Zhou
Segmental arterial mediolysis is a rare but potentially life-threatening arteropathy of medium to large arteries that can be managed with endovascular treatment for patients who are hemodynamically unstable. We present a case of segmental arterial mediolysis in a 73-year-old woman who developed spontaneous hemoperitoneum in the emergency department after initially presenting with unrelated upper respiratory complaints. Her initial computed tomography revealed an aneurysm arising off the right hepatic artery...
June 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29750039/impact-of-an-inline-extracorporeal-membrane-oxygenation-hemofilter-system-in-neonatal-acute-kidney-injury
#5
Mohammed Azar, Abdulrahman Alamir, Abdullah Thabet Al Qahtani, Al Mokali Khamisa, Khalid Alfakeeh
Extracorporeal membrane oxygenation (ECMO) is considered a recognized lifesaving support for patients with cardiorespiratory failure. Acute kidney injury (AKI) and fluid overload are significant morbidity factors resulting in serious complications. The inline hemofilter system (IHS) and the continuous renal replacement therapy (CRRT) machine are different methods of renal replacement therapy for patients with ECMO. IHS is the alternate, safe dialysis modality of choice because it is user-friendly, inexpensive, and efficiently removes fluid overload and renal diffusive clearance...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29749327/effects-of-hemodialysis-combined-with-hemoperfusion-on-severe-acute-pancreatitis
#6
Zhenhe Li, Guixia Wang, Guodong Zhen, Yuliang Zhang, Jiaqiang Liu, Shanmei Liu
BACKGROUND/AIMS: Severe acute pancreatitis (SAP) is characterized by persistent organ failure. This research aimed to evaluate the effect of hemodialysis combined with hemoperfusion on SAP. MATERIALS AND METHODS: Thirty-seven patients who were treated with hemoperfusion combined with hemodialysis were included in group O, and 31 patients treated with conventional therapy and hemoperfusion were included as control (group C). Leukocyte count, neutrophil percentage, amylase (AMY), blood urine nitrogen (BUN), creatinine (Cr), and total bilirubin (TBIL) were noted...
March 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29748101/results-from-the-study-to-assess-outcomes-after-endovascular-repair-for-multiple-thoracic-aortic-diseases-summit
#7
Nikolaos Tsilimparis, Sebastian Debus, Min Chen, Qing Zhou, Mary-Margaret Seale, Tilo Kölbel
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) is currently the treatment of choice for most diseases of the descending thoracic aorta. Using data from the Study to Assess Outcomes After Endovascular Repair for Multiple Thoracic Aortic Diseases (SUMMIT) study we investigated the outcomes of TEVAR for different aortic diseases and risk factors associated with the outcomes. METHODS: The SUMMIT study included aggregated data of 521 TEVAR patients from five Cook-sponsored multicenter trials evaluating thoracic endografts of the Zenith platform (William Cook Europe, ApS, Bjaeverskov, Denmark)...
May 7, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29738877/oral-tranexamic-acid-is-equivalent-to-topical-tranexamic-acid-without-drainage-in-primary-total-hip-arthroplasty-a-double-blind-randomized-clinical-trial
#8
Ze-Yu Luo, Duan Wang, Wei-Kun Meng, Hao-Yang Wang, Hui Pan, Fu-Xing Pei, Zong-Ke Zhou
PURPOSE: To compare the efficacy of multiple doses of oral tranexamic acid (TXA) with topical TXA administration in reducing blood loss following total hip arthroplasty (THA). PATIENTS AND METHODS: In this double-blinded trial, 117 patients undergoing primary THA were randomized to receive 2 g TXA orally 2 h preoperatively, and two doses of 1 g TXA postoperatively (oral group) or 3 g of TXA topical administration in the operating room (topical group). The primary outcome was a reduction in hemoglobin concentration...
May 1, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29735391/cardiovascular-disease-risk-prediction-equations-in-400-000-primary-care-patients-in-new-zealand-a-derivation-and-validation-study
#9
Romana Pylypchuk, Sue Wells, Andrew Kerr, Katrina Poppe, Tania Riddell, Matire Harwood, Dan Exeter, Suneela Mehta, Corina Grey, Billy P Wu, Patricia Metcalf, Jim Warren, Jeff Harrison, Roger Marshall, Rod Jackson
BACKGROUND: Most cardiovascular disease risk prediction equations in use today were derived from cohorts established last century and with participants at higher risk but less socioeconomically and ethnically diverse than patients they are now applied to. We recruited a nationally representative cohort in New Zealand to develop equations relevant to patients in contemporary primary care and compared the performance of these new equations to equations that are recommended in the USA. METHODS: The PREDICT study automatically recruits participants in routine primary care when general practitioners in New Zealand use PREDICT software to assess their patients' risk profiles for cardiovascular disease, which are prospectively linked to national ICD-coded hospitalisation and mortality databases...
May 4, 2018: Lancet
https://www.readbyqxmd.com/read/29728723/pushing-the-limits-of-immune-related-response-a-case-of-extreme-pseudoprogression
#10
Alvin S Wong, Yee-Liang Thian, Jeevesh Kapur, Cheng-Nang Leong, Patrick Kee, Chun-Tsu Lee, Martin B Lee
The advent of immune checkpoint targeted immunotherapy has seen a spectrum of immune-related phenomena in both tumor responses and toxicities. We describe a case of pseudoprogression that pushes the limits of immune-related response criteria and challenges the boundaries and definitions set by trial protocols. A middle-aged man with conventional clear cell renal cell carcinoma (RCC) had received multiple prior systemic treatments including vascular endothelial growth factor receptor tyrosine kinase inhibitors, as well as multiple surgeries and radiotherapy treatments...
May 4, 2018: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/29725932/light-chain-cast-nephropathy-practical-considerations-in-the-management-of-myeloma-kidney-what-we-know-and-what-the-future-may-hold
#11
REVIEW
Sandhya Manohar, Samih H Nasr, Nelson Leung
PURPOSE OF REVIEW: To update and evaluate the current knowledge on pathogenesis and management of light chain cast nephropathy. Light chain cast nephropathy (LCCN) is the leading cause of acute renal failure in patients with multiple myeloma and is currently recognized as a myeloma defining event. RECENT FINDINGS: The immunoglobulin free light chain plays an integral role in the pathogenesis of LCCN. The level of free light chain (FLC) in the blood and urine is directly associated with the risk of developing LCCN...
May 3, 2018: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/29725741/-metabolic-management-and-nutrition-in-critically-ill-patients-with-renal-dysfunction-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#12
W Druml, M Joannidis, S John, A Jörres, M Schmitz, J Kielstein, D Kindgen-Milles, M Oppert, V Schwenger, C Willam, A Zarbock
BACKGROUND: Intensive care patients with renal failure or insufficiency comprise a heterogeneous group of subjects with widely differing metabolic patterns and nutritional requirements. They include subjects with various stages of acute kidney injury (AKI), acute-on-chronic renal failure (A-CKD), without/with renal replacement therapy (RRT), chronic kidney disease (CKD), and subjects on regular hemodialysis or peritoneal dialysis therapy (HD/PD). GOALS: Development of recommendations by the renal section of DGIIN (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichische Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) for the metabolic management and the planning, indication, implementation, and monitoring of nutrition therapy in this heterogeneous group of patients...
May 3, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29724188/the-effect-of-spironolactone-on-calcineurin-inhibitor-induced-nephrotoxicity-a-multicenter-randomized-double-blind-clinical-trial-the-spiren-trial
#13
Line Aas Mortensen, Helle C Thiesson, Birgitte Tougaard, Martin Egfjord, Anne Sophie Lind Fischer, Claus Bistrup
BACKGROUND: Calcineurin inhibitor induced nephrotoxicity contributes to late allograft failure in kidney transplant patients. Evidence points towards aldosterone to play a role in the development of fibrosis in multiple organs. Animal studies have indicated a beneficial effect of mineralocorticoid receptor antagonists preventing calcineurin inhibitor induced nephrotoxicity. Only few studies have explored this effect in humans. The objective of this study is to evaluate the effect of spironolactone on glomerular filtration rate and fibrosis in kidney transplant patients...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29710508/puerarin-improves-methotrexate-induced-renal-damage-by-up-regulating-renal-expression-of-oat1-and-oat3-in-vivo-and-in-vitro
#14
Qi Liu, Zhihao Liu, Xiaokui Huo, Changyuan Wang, Qiang Meng, Huijun Sun, Pengyuan Sun, Jinyong Peng, Xiaodong Ma, Kexin Liu
The regulation of renal transporters such as organic anion transporter (OATs) is a new target for treatment of acute renal failure. The purpose of this study was to investigate whether the effect of puerarin (Pur) on renal damage induced by methotrexate (MTX) is related to the expression of renal Oat1/3 in vivo and in vitro, and to explore the related mechanisms. Effect of Pur on the renal damage caused by MTX was evaluated by assessment of the changes of endogenous metabolites, toxins and H&E staining...
April 23, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29707413/end-stage-renal-failure-is-an-independent-risk-factor-for-1-year-mortality-after-hip-fracture-surgery
#15
Louise Woon Theng Lo, Xu Yanling, Andrew Chia Chen Chou, Tet Sen Howe, John Carson Allen, Joyce Suang Bee Koh
Introduction: End-stage renal failure (ESRF) with its associated comorbidities increase postoperative mortality in hip fracture patients. This study investigated the association of ESRF with various comorbidities in patients on dialysis and assessed rates ESRF as an independent risk factor for all-cause postoperative 1- year mortality rates. Methods: This was a retrospective cohort study on patients aged 55 years and older who underwent their first nonpathological, low-energy hip fracture surgery at an Asian tertiary hospital from June 2007 to 2012...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29706818/multiple-admissions-to-the-coronary-care-unit-due-to-falsely-elevated-cardiac-troponin
#16
Mohamed Ayan, Zaid Gheith, Aneesha Ananthula, Mohsin Salih, Srikanth Vallurupalli, Jawahar L Mehta
The measurement of cardiac troponin, released from injured cardiomyocytes, is of paramount importance in the diagnosis of acute myocardial infarction. Elevated troponin can be encountered, however, in patients with cardiomyopathy, significant cardiac arrhythmias, vasculitis, right-sided heart strain, critical systemic illnesses, stroke, drug toxicity (such as Adriamycin), poisons (such as snake venoms), renal failure, seizure, and rhabdomyolysis. If the clinical picture is not consistent with any of these causes, a false-positive result should be considered...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29702430/metabolic-products-of-the-intestinal-microbiome-and-extremes-of-atherosclerosis
#17
Chrysi Bogiatzi, Gregory Gloor, Emma Allen-Vercoe, Gregor Reid, Ruth G Wong, Bradley L Urquhart, Vincent Dinculescu, Kelsey N Ruetz, Thomas J Velenosi, Michael Pignanelli, J David Spence
BACKGROUND AND AIMS: There is increasing awareness that the intestinal microbiome plays an important role in human health. We investigated its role in the burden of carotid atherosclerosis, measured by ultrasound as total plaque area. METHODS: Multiple regression with traditional risk factors was used to identify three phenotypes among 316/3056 patients attending vascular prevention clinics. Residual score (RES; i.e. the distance off the regression line, similar to standard deviation) was used to identify the 5% of patients with much less plaque than predicted by their risk factors (Protected, RES <-2), the 90% with about as much plaque as predicted (Explained, RES -2 to 2), and the 5% with much more plaque than predicted (Unexplained RES >2)...
April 17, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29701196/-research-progress-in-renal-injury-relevant-to-primary-sj%C3%A3-gren-s-syndrome
#18
Yao Zou, Guanghui Ling, Jing Tian, Jinwei Chen, Yan Ge
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease characterized by lymphoplasmacytic infiltration of the exocrine glands that results in multiple organs and systems damage. Renal injury affects 0.3%-27.0% patients. The most frequent form of nephropathy in pSS is tubulointerstitial nephritis. The main clinical manifestation is renal tubular acidosis. The renal prognosis in patients with pSS is usually favorable, but renal failure may occur. At present, it still lacks of strict consensus or guideline for the treatment...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29701006/nanotherapeutics-for-multiple-myeloma
#19
REVIEW
Alexander Zheleznyak, Monica Shokeen, Samuel Achilefu
Multiple myeloma (MM) is an age-related hematological malignancy with an estimated 30,000 new cases and 13,000 deaths per year. A disease of antibody-secreting malignant plasma B-cells that grow primarily in the bone marrow (BM), MM causes debilitating fractures, anemia, renal failure, and hypercalcemia. In addition to the abnormal genetic profile of MM cells, the permissive BM microenvironment (BMM) supports MM pathogenesis. Although advances in treatment options have significantly enhanced survival in MM patients, transient perfusion of small-molecule drugs in the BM does not provide sufficient residence to enhance MM cell-drug interaction, thus allowing some myeloma cells to escape the first line of treatment...
April 26, 2018: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/29698721/fixed-but-not-autoadjusting-positive-airway-pressure-attenuates-the-time-dependent-decline-in-glomerular-filtration-rate-in-patients-with-obstructive-sleep-apnea
#20
Oreste Marrone, Fabio Cibella, Jean-Louis Pépin, Ludger Grote, Johan Verbraecken, Tarja Saaresranta, John A Kvamme, Ozen K Basoglu, Carolina Lombardi, Walter T McNicholas, Jan Hedner, Maria R Bonsignore
BACKGROUND: The impact of treating obstructive sleep apnea (OSA) on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different continuous positive airway pressure (CPAP) modalities. The aim of this study was to evaluate the respective influence of fixed and auto-adjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database (ESADA) cohort...
April 23, 2018: Chest
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