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https://www.readbyqxmd.com/read/28812394/the-use-of-sustained-low-efficiency-dialysis-sled-in-massive-paracetamol-overdose
#1
Anselm Wong, Roger L K Tong, Liam Ryan, Tim Crozier, Andis Graudins
CONTEXT: Massive paracetamol ingestion causing mitochondrial dysfunction is uncommon. Use of sustained low-efficiency dialysis (SLED) to improve acidaemia and enhance paracetamol elimination has not been previously described. CASE DETAILS: A 44-year-old male presented to the emergency department 2.5 hours post overdose of 200 g (2.5 g/kg) of paracetamol. Examination revealed a BP 85/60 mmHg, pulse 112 bpm, temperature 33.9 °C and blood glucose of 13...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28810844/effect-of-tolvaptan-on-renal-handling-of-water-and-sodium-gfr-and-central-hemodynamics-in-autosomal-dominant-polycystic-kidney-disease-during-inhibition-of-the-nitric-oxide-system-a-randomized-placebo-controlled-double-blind-crossover-study
#2
Safa Al Therwani, My Emma Sofie Malmberg, Jeppe Bakkestroem Rosenbaek, Jesper Noergaard Bech, Erling Bjerregaard Pedersen
BACKGROUND: Tolvaptan slows progression of autosomal dominant polycystic kidney disease (ADPKD) by antagonizing the vasopressin-cAMP axis. Nitric oxide (NO) stimulates natriuresis and diuresis, but its role is unknown during tolvaptan treatment in ADPKD. METHODS: Eighteen patients with ADPKD received tolvaptan 60 mg or placebo in a randomized, placebo-controlled, double blind, crossover study. L-NMMA (L-NG-monomethyl-arginine) was given as a bolus followed by continuous infusion during 60 min...
August 15, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28810244/increasing-haemodialytic-clearances-as-residual-renal-function-declines-an-incremental-approach
#3
Kamonwan Tangvoraphonkchai, Andrew Davenport
Many patients with chronic kidney disease start undergoing thrice-weekly haemodialysis (HD), aiming for an HD sessional dialyzer urea clearance target, irrespective of whether they have residual renal function (RRF). While increasing sessional dialyzer urea clearance above a target of 1.2 has not been shown to improve patient survival, it has been shown that the preservation of RRF improves patient self-reported outcomes and survival. Observational studies have suggested that initiating twice-weekly HD schedules leads to greater preservation of RRF...
August 16, 2017: Blood Purification
https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#4
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28808888/has-time-come-for-the-use-of-direct-oral-anticoagulants-in-the-extended-prophylaxis-of-venous-thromboembolism-in-acutely-ill-medical-patients-yes
#5
Walter Ageno
Betrixaban is a direct factor Xa inhibitor with a renal excretion of only approximately 5-7%. On June 23rd 2017, it became the first direct oral anticoagulant to receive Food and Drug Administration approval for the prevention of venous thromboembolism in acutely ill medical patients, and the first anticoagulant agent to be approved for extended-duration thromboprophylaxis after hospital discharge in this setting. Approval followed the results of the APEX trial, a phase III clinical trial comparing betrixaban (80 mg) administered for 35-42 days with enoxaparin (40 mg) administered for 10 ± 4 days...
August 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28807212/comparison-of-normothermic-and-hypothermic-perfusion-in-porcine-kidneys-donated-after-cardiac-death
#6
Matthew F Blum, Qiang Liu, Basem Soliman, Paul Dreher, Toshihiro Okamoto, Emilio D Poggio, David A Goldfarb, William M Baldwin, Cristiano Quintini
BACKGROUND: Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. METHODS: Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28805266/hypothermic-pulsatile-preservation-of-kidneys-from-uncontrolled-deceased-donors-after-cardiac-arrest
#7
Xavier Matillon, Fabrice Danjou, Palmina Petruzzo, Olivier Thaunat, Thomas Rimmele, Claire Delsuc, Alexandre Faure, Maud Rabeyrin, Vannary Meas Yedid, William Hanf, Emmanuel Morelon, Lionel Badet, Ricardo Codas
Kidneys from uncontrolled donors after cardiac arrest (uDCD) suffer from a period of warm ischemia between cardiac arrest and cold flushing. Aim of the study was to evaluate renal outcomes of uDCD kidneys selected on the basis of renal Resistance Index (RI) and its influence on graft function and survival. The study included 44 kidneys procured from 26 uDCD starting 1.1.2006 until 31.12.2013. The donors (Maastricht category II) underwent cardiopulmonary resuscitation by assisted ventilation and chest compression; the organs were preserved with "in situ" cold perfusion or a normothermic regional perfusion...
August 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28802734/adding-markers-of-organ-damage-to-risk-score-models-improves-cardiovascular-risk-assessment-prospective-analysis-of-a-large-cohort-of-adult-outpatients
#8
Giuliano Tocci, Ilaria Figliuzzi, Vivianne Presta, Nadia Attalla El Halabieh, Barbara Citoni, Roberta Coluccia, Allegra Battistoni, Andrea Ferrucci, Massimo Volpe
INTRODUCTION: Global cardiovascular (CV) risk stratification is recommended in all outpatients. Risk score charts, however, do not include markers of organ damage (OD). AIM: To evaluate the potential added value of including different markers of subclinical OD to US Framingham, European SCORE and Italian Cuore risk score calculators. METHODS: We prospectively evaluated adult outpatients, who underwent blood pressure (BP) assessment and global CV risk stratification...
July 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28801723/a-review-of-the-role-of-immune-cells-in-acute-kidney-injury
#9
REVIEW
Anthony Bonavia, Kai Singbartl
Acute kidney injury (AKI) is a systemic disease occurring commonly in patients who are critically ill. Etiologies of AKI can be septic or aseptic (nephrotoxic, or ischemia-reperfusion injury). Recent evidence reveals that innate and adaptive immune responses are involved in mediating damage to renal tubular cells and in recovery from AKI. Dendritic cells, monocytes/macrophages, neutrophils, T lymphocytes, and B lymphocytes all contribute to kidney injury. Conversely, M2 macrophages and regulatory T cells are essential in suppressing inflammation, tissue remodeling and repair following kidney injury...
August 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28801477/type-2-diabetes-mellitus-and-impaired-renal-function-are-associated-with-brain-alterations-and-poststroke-cognitive-decline
#10
Einor Ben Assayag, Roy Eldor, Amos D Korczyn, Efrat Kliper, Shani Shenhar-Tsarfaty, Oren Tene, Jeremy Molad, Itzhak Shapira, Shlomo Berliner, Viki Volfson, Ludmila Shopin, Yehuda Strauss, Hen Hallevi, Natan M Bornstein, Eitan Auriel
BACKGROUND AND PURPOSE: Type 2 diabetes mellitus (T2DM) is associated with diseases of the brain, kidney, and vasculature. However, the relationship between T2DM, chronic kidney disease, brain alterations, and cognitive function after stroke is unknown. We aimed to evaluate the inter-relationship between T2DM, impaired renal function, brain pathology on imaging, and cognitive decline in a longitudinal poststroke cohort. METHODS: The TABASCO (Tel Aviv brain acute stroke cohort) is a prospective cohort of stroke/transient ischemic attack survivors...
August 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28801268/positron-emission-tomography-pet-guided-glioblastoma-targeting-by-a-fullerene-based-nanoplatform-with-fast-renal-clearance
#11
Yayun Peng, Dongzhi Yang, Weifei Lu, Xiongwei Hu, Hao Hong, Ting Cai
Various carbonaceous nanomaterials, including fullerene, carbon nanotube, graphene, and carbon dots, have attracted increasing attention during past decades for their potential applications in biological imaging and therapy. In this study, we have developed a fullerene-based tumor-targeted positron emission tomography (PET) imaging probe. Water-soluble functionalized C60 conjugates were radio-labeled with (64)Cu and modified with cyclo (Arg-Gly-Asp) peptides (cRGD) for targeting of integrin αvβ3 in glioblastoma...
August 8, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#12
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28795146/refining-the-policy-for-timing-of-kidney-transplant-waitlist-qualification
#13
Benjamin J Lee, Charles E McCulloch, Barbara A Grimes, Sindhu Chandran, Isabel Elaine Allen, Cynthia Delgado, Chi-Yuan Hsu
BACKGROUND: Earlier qualification for the kidney transplant waitlist expedites transplant and is therefore associated with improved outcomes. U.S. Organ Procurement and Transplantation Network policies state that "measured or calculated creatinine clearance or glomerular filtration rate less than or equal to 20 mL/min" triggers waitlist time accrual. The choice of qualification method is somewhat arbitrary, and the policy implies that decline in renal function is monotonic. METHODS: (1) We used survival analysis to quantify temporal differences in waitlist qualification by applying 3 kidney-function-estimating equations (Cockcroft-Gault, Modification of Diet in Renal Disease study, Chronic Kidney Disease Epidemiology Collaboration) to serial creatinine measurements from 3 patient cohorts: 1 of waitlisted patients at a major U...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28793036/effect-of-mild-hypothermia-on-renal-ischemia-reperfusion-injury-after-cardiopulmonary-resuscitation-in-a-swine-model
#14
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded...
July 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#15
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
https://www.readbyqxmd.com/read/28790147/hepatocyte-specific-deletion-of-egfr-in-mice-reduces-hepatic-abcg2-transport-activity-measured-with-11-c-erlotinib-and-positron-emission-tomography
#16
Alexander Traxl, Karin Komposch, Elisabeth Glitzner, Thomas Wanek, Severin Mairinger, Oliver Langer, Maria Sibilia
The epidermal growth factor receptor (EGFR) regulates cellular expression levels of breast cancer resistance protein (humans: ABCG2, rodents: Abcg2) via its downstream signaling pathways. Drugs that inhibit EGFR signaling (e.g. tyrosine kinase inhibitors, antibodies) may lead to ABCG2-mediated drug-drug interactions (DDIs) by changing disposition of concomitantly administered ABCG2 substrate drugs. In this study we used positron emission tomography (PET)/magnetic resonance (MR) imaging to compare disposition of the model Abcg2 substrate [(11)C]erlotinib in a mouse model of hepatocyte-specific deletion of EGFR (EGFR(Δhep) mice, n = 5) with EGFR(fl/fl) control mice (n = 6), which have normal EGFR expression levels in all tissues...
August 8, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28783603/strategies-for-transitioning-macrocyclic-peptides-to-cell-permeable-drug-leads
#17
REVIEW
Louise J Walport, Richard Obexer, Hiroaki Suga
The ready availability of potent peptide binders for any desired target highlights their potential impact as therapeutic agents. Despite their versatility, however, peptides tend to display unfavourable pharmacological properties, such as low bioavailability, high renal clearance and proteolytic degradation rates, and low cell permeability. Fortunately, an increasing number of promising strategies to produce novel peptides and furnish pre-existing scaffolds with more drug-like properties are now becoming available...
August 4, 2017: Current Opinion in Biotechnology
https://www.readbyqxmd.com/read/28777197/elabela-improves-cardio-renal-outcome-in-fatal-experimental-septic-shock
#18
David Coquerel, Frédéric Chagnon, Xavier Sainsily, Lauralyne Dumont, Alexandre Murza, Jérôme Côté, Robert Dumaine, Philippe Sarret, Éric Marsault, Dany Salvail, Mannix Auger-Messier, Olivier Lesur
OBJECTIVES: Apelin-13 was recently proposed as an alternative to the recommended β-adrenergic drugs for supporting endotoxin-induced myocardial dysfunction. Since Apelin-13 signals through its receptor (Apelin peptide jejunum) to exert singular inotropic/vasotropic actions and to optimize body fluid balance, this candidate pathway might benefit septic shock management. Whether the newly discovered ELABELA (ELA), a second endogenous ligand of the Apelin peptide jejunum receptor highly expressed in the kidney, further improves cardio-renal impairment remains unknown...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28774999/sexual-dimorphic-pattern-of-renal-transporters-and-electrolyte-homeostasis
#19
Luciana C Veiras, Adriana C C Girardi, Joshua Curry, Lei Pei, Donna L Ralph, An Tran, Regiane C Castelo-Branco, Nuria Pastor-Soler, Cristina T Arranz, Alan S L Yu, Alicia A McDonough
Compared with males, females have lower BP before age 60, blunted hypertensive response to angiotensin II, and a leftward shift in pressure natriuresis. This study tested the concept that this female advantage associates with a distinct sexual dimorphic pattern of transporters along the nephron. We applied quantitative immunoblotting to generate profiles of transporters, channels, claudins, and selected regulators in both sexes and assessed the physiologic consequences of the differences. In rats, females excreted a saline load more rapidly than males did...
August 3, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28771355/peptide-half-life-extension-di-valent-small-molecule-albumin-interactions-direct-the-systemic-properties-of-glucagon-like-peptide-glp-1-analogs
#20
Esben M Bech, Manuel Cristo Maldonado, Pernille Wismann, Kasper K Sørensen, Søren Blok van Witteloostuijn, Mikkel B B Thygesen, Niels Vrang, Jacob Jelsing, Søren L Pedersen, Knud J Jensen
Non-covalent binding of biopharmaceuticals to human serum albumin protects against enzymatic degradation and renal clearance. Herein, we investigated the effect of mono- or di-valent small-molecule albumin binders for half-life extension of peptides. For proof-of-principle, the clinically relevant glucagon-like peptide 1 (GLP-1) was functionalized with diflunisal, indomethacin, or both. In vitro, all GLP-1 analogs had sub-nanomolar GLP-1 receptor potency. Surface plasmon resonance revealed that both small-molecules were able to confer albumin affinity to GLP-1, and indicated that affinity is increased for di-valent analogs...
August 3, 2017: Journal of Medicinal Chemistry
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