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https://www.readbyqxmd.com/read/28918595/successful-pregnancy-in-a-ckd-patient-on-a-low-protein-supplemented-diet-an-opportunity-to-reflect-on-ckd-and-pregnancy-in-mexico-an-emerging-country
#1
Julia Nava, Silvia Moran, Veronica Figueroa, Adriana Salinas, Margy Lopez, Rocio Urbina, Abril Gutierrez, Jose Luis Lujan, Alejandra Orozco, Rafael Montufar, Giorgina B Piccoli
Pregnancy is probably the most important challenge in young women with chronic kidney disease (CKD). The challenge is greater in developing countries, in which access to dialysis is uneven, and prenatal care for CKD patients is not uniformly available. This case report summarizes some of the challenges faced by pregnant CKD women in a developing country. A 35-year-old woman, affected by an undiagnosed kidney disease, experienced preeclampsia at 24 years of age, and started dialysis in emergency at age 31 in the context of severe preeclampsia in her second pregnancy...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28912780/inflammatory-markers-for-arterial-stiffness-in-cardiovascular-diseases
#2
REVIEW
Ioana Mozos, Clemens Malainer, Jarosław Horbańczuk, Cristina Gug, Dana Stoian, Constantin Tudor Luca, Atanas G Atanasov
Arterial stiffness predicts an increased risk of cardiovascular events. Inflammation plays a major role in large arteries stiffening, related to atherosclerosis, arteriosclerosis, endothelial dysfunction, smooth muscle cell migration, vascular calcification, increased activity of metalloproteinases, extracellular matrix degradation, oxidative stress, elastolysis, and degradation of collagen. The present paper reviews main mechanisms explaining the crosstalk between inflammation and arterial stiffness and the most common inflammatory markers associated with increased arterial stiffness, considering the most recent clinical and experimental studies...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28905546/-hypertension-in-people-of-african-descent
#3
Fabien Cane, Sofia Zisimopoulou, Antoinette Pechère-Bertschi
Hypertension in people of African descent presents an increased prevalence, an earlier and more severe target organ damage and is harder to control compared to other ethnicities. Preeclampsia and gestational hypertension are more frequent in black women. The physiological phenomenon of night time blood pressure dipping is often blunted. The low renin hypertension phenotype seems to be caused by an increase in sodium retention at renal level. The treatment of choice is calcium channel blockers and thiazide diuretics along with a renin-angiotensin-aldosterone blocker for kidney protection...
September 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28889777/assessment-of-neonatal-adrenal-size-using-high-resolution-2d-ultrasound-and-its-correlation-with-birth-demographics-clinical-outcomes
#4
Tijen Karsli, Diana Strickland, Jeffrey Livingston, Qiang Wu, Maroun J Mhanna, Prem S Shekhawat
OBJECTIVE: Assessment of adrenal function in a sick neonate remains a challenge in spite of major advances in neonatal care. We used 2D ultrasound of adrenal glands to assess maturity of adrenal glands in extremely preterm infants and sick term and near term infants. STUDY DESIGN: We collected demographics details of 99 mother-infants pairs (24-41 weeks) and obtained 2D ultrasound scans of adrenal glands in first week of life to measure adrenal volume, fetal zone size and adrenal to kidney ratios...
September 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28796431/acute-kidney-injury-in-a-postpartum-woman-with-paroxysmal-nocturnal-hemoglobinuria-a-case-report-and-literature-review
#5
Masatoshi Nishimoto, Masaru Matsui, Hideo Tsushima, Kaori Tanabe, Miho Tagawa, Ken-Ich Samejima, Yasuhiro Akai, Yoshihiko Saito
Paroxysmal nocturnal hemoglobinuria is a rare clonal hematopoietic stem cell disorder characterized by intravascular hemolysis, hemoglobinuria, and inflammatory thrombotic state. Intravascular hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) can lead to acute and chronic renal injury through hemoglobin-mediated toxicity. A 32-year-old pregnant woman with myelodysplastic syndrome was admitted to our hospital with severe preeclampsia. Shortly after an urgent caesarean section, she became obtunded and showed signs of acute kidney injury (AKI) with anuria, severe intravascular hemolysis, and hypermagnesemia...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28761227/acute-kidney-injury-in-pregnancy-specific-disorders
#6
REVIEW
J Prakash, V C Ganiger
The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28748119/uric-acid-in-the-pathogenesis-of-metabolic-renal-and-cardiovascular-diseases-a-review
#7
REVIEW
Usama A A Sharaf El Din, Mona M Salem, Dina O Abdulazim
The association between uric acid (UA) on one side and systemic hypertension (Htn), dyslipidemia, glucose intolerance, overweight, fatty liver, renal disease and cardiovascular disease (CVD) on the other side is well recognized. However, the causal relationship between UA and these different clinical problems is still debatable. The recent years have witnessed hundreds of experimental and clinical trials that favored the opinion that UA is a probable player in the pathogenesis of these disease entities. These studies disclosed the strong association between hyperuricemia and metabolic syndrome (MS), obesity, Htn, type 2 diabetes mellitus (DM), non-alcoholic fatty liver disease, hypertriglyceridemia, acute kidney injury, chronic kidney disease (CKD), coronary heart disease (CHD), heart failure and increased mortality among cardiac and CKD patients...
September 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28737682/cadmium-handling-toxicity-and-molecular-targets-involved-during-pregnancy-lessons-from-experimental-models
#8
REVIEW
Tania Jacobo-Estrada, Mitzi Santoyo-Sánchez, Frank Thévenod, Olivier Barbier
Even decades after the discovery of Cadmium (Cd) toxicity, research on this heavy metal is still a hot topic in scientific literature: as we wrote this review, more than 1440 scientific articles had been published and listed by the PubMed.gov website during 2017. Cadmium is one of the most common and harmful heavy metals present in our environment. Since pregnancy is a very particular physiological condition that could impact and modify essential pathways involved in the handling of Cd, the prenatal life is a critical stage for exposure to this non-essential element...
July 22, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28711077/acute-kidney-injury-in-pregnancy
#9
Belinda Jim, Vesna D Garovic
Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711075/diabetic-nephropathy-and-pregnancy
#10
Kate Bramham
Women with diabetic nephropathy have challenging pregnancies, with pregnancy outcomes far worse than expected for the stage of chronic kidney disease. The underlying mechanisms that cause the adverse events remain poorly understood, but it is a widely held belief that substantial endothelial injury in these women likely contributes. Maternal hypertension, preeclampsia, and cesarean section rates are high, and offspring are often preterm and of low birth weight, with additional neonatal complications associated with glycemic control...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711072/chronic-kidney-disease-and-pregnancy
#11
Michelle A Hladunewich
Women with chronic kidney disease (CKD) are at risk for adverse pregnancy-associated outcomes, including progression of their underlying renal dysfunction, a flare of their kidney disease, and adverse pregnancy complications such as preeclampsia and preterm delivery. Earlier-stage CKD, as a rule, is a safer time to have a pregnancy, but even women with end-stage kidney disease have attempted pregnancy in recent years. As such, nephrologists need to be comfortable with pregnancy preparation and management at all stages of CKD...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28611078/midterm-egfr-and-adverse-pregnancy-outcomes-the-clinical-significance-of-gestational-hyperfiltration
#12
Sehoon Park, Seung Mi Lee, Joong Shin Park, Joon-Seok Hong, Ho Jun Chin, Ki Young Na, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
BACKGROUND AND OBJECTIVES: Although hemodynamic adaptation plays a crucial role in maintaining gestation, the clinical significance of midterm renal hyperfiltration (MRH) on pregnancy outcomes is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was an observational cohort study. Women with a singleton pregnancy and a serum creatinine measurement during their second trimester were followed at two university hospitals in Korea between 2001 and 2015. Those with substantial renal function impairment or who delivered during the second trimester were not considered...
July 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28609144/therapeutic-benefit-of-mesenchymal-stem-cells-in-pregnant-rats-with-angiotensin-receptor-agonistic-autoantibody-induced-hypertension-implications-for-immunomodulation-and-cytoprotection
#13
Dan Zhang, Lihua Fu, Leilei Wang, Lin Lin, Lihong Yu, Lijun Zhang, Tao Shang
Immunomodulation by mesenchymal stem cells (MSCs) is potentially important for maintaining peripheral tolerance. Preeclampsia may be due to maternal immune rejection of the genetically foreign fetus. This study aimed to investigate the biological function of human umbilical cord-derived mesenchymal stem cells (HU-MSCs) for the treatment of angiotensin receptor agonistic autoantibody (AT1-AA)-induced hypertension during pregnancy. HU-MSCs were isolated, cultured, and labeled in vitro. AT1-AA and HU-MSCs were administered to pregnant rats...
August 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28590567/vitamin-d-insufficiency-preterm-delivery-and-preeclampsia-in-women-with-type-1-diabetes-an-observational-study
#14
Marianne Vestgaard, Anna L Secher, Lene Ringholm, Jens-Erik B Jensen, Peter Damm, Elisabeth R Mathiesen
INTRODUCTION: The aim was to evaluate whether vitamin D insufficiency is associated with preterm delivery and preeclampsia in women with type 1 diabetes. MATERIAL AND METHODS: An observational study of 198 pregnant women with type 1 diabetes. 25-Hydroxy-Vitamin D and HbA1c were measured in blood samples in early (median 8 weeks, range 5-14) and late (34 weeks, range 32-36) pregnancy. Kidney involvement (microalbuminuria or nephropathy) at inclusion, smoking status at inclusion, preterm delivery (<37 weeks) and preeclampsia (blood pressure ≥140/90 mmHg and proteinuria) were registered...
June 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28546662/pregnancy-outcome-in-patients-with-solitary-kidney
#15
Vineet V Mishra, Kavita M Mistry, Sakshi S Nanda, Sumesh Choudhary, Rohina Aggarwal, Khushali Gandhi
BACKGROUND: Solitary kidney may be congenital or as a result of nephrectomy. There is a lot of literature available on quality of life in these patients, but there is limited data on pregnancy outcome. OBJECTIVES: To study pregnancy outcome in patients with solitary kidney either congenital or due to nephrectomy. MATERIALS AND METHODS: Study Design This is a retrospective observational study conducted at tertiary health center in Ahmedabad, from 2011 to 2014...
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28445873/pregnancy-outcomes-in-patients-with-glomerular-disease-attending-a-single-academic-center-in-north-carolina
#16
Michelle M O'Shaughnessy, Meghan A Jobson, Katy Sims, Abigail L Liberty, Patrick H Nachman, William F Pendergraft
BACKGROUND: Contemporary data regarding pregnancy outcomes in US patients with primary glomerular diseases are lacking. We aimed to report fetal and maternal outcomes among women with biopsy-proven primary glomerular disease who received obstetric care at a single large academic US center. METHODS: All women with a biopsy-confirmed primary glomerular disease diagnosis and without end-stage kidney disease who received obstetric care at the University of North Carolina (UNC) Hospitals (1996-2015) were identified using the Glomerular Disease Collaborative Network registry and the UNC Hospitals Perinatal Database...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28438765/longitudinal-characterization-of-renal-proximal-tubular-markers-in-normotensive-and-preeclamptic-pregnancies
#17
Elisabeth Codsi, Vesna D Garovic, Maria L Gonzalez-Suarez, Natasa Milic, Kristi S Borowski, Carl H Rose, Norman P Davies, Kianoush B Kashani, John C Lieske, Wendy M White
Glomerular damage is common in preeclampsia (PE), but the extent and etiology of tubular injury are not well understood. The aim of this study was to evaluate tubular injury in patients with PE and to assess whether it predates clinical disease. We performed a prospective cohort study of 315 pregnant women who provided urine samples at the end of the second trimester and at delivery. This analysis included women who developed PE (n = 15), gestational hypertension (GH; n = 14), and normotensive controls (NC; n = 44)...
May 1, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28434090/a-best-practice-position-statement-on-the-role-of-the-nephrologist-in-the-prevention-and-follow-up-of-preeclampsia-the-italian-study-group-on-kidney-and-pregnancy
#18
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Donatella Spotti, Franca Giacchino, Rossella Attini, Monica Limardo, Stefania Maxia, Antioco Fois, Linda Gammaro, Tullia Todros
Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide...
June 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28420898/comparison-of-kidney-function-between-gestational-hypertension-and-preeclampsia
#19
Etsuko Nobumoto, Hisashi Masuyama, Jota Maki, Takeshi Eguchi, Shoko Tamada, Takashi Mitsui, Eriko Eto, Kei Hayata, Yuji Hiramatsu
Although gestational hypertension (GH) is thought to be different from preeclampsia (PE), in Japan GH and PE are usually treated as the same disease (i.e., pregnancy-induced hypertension). Here we sought to determine whether there are any differences in fetal growth and maternal kidney function between pregnancies with PE and those with GH. We retrospectively analyzed 61 GH patients and 60 PE patients with singleton pregnancies who delivered at Okayama University Hospital (2008-2015). We compared maternal and perinatal outcomes and maternal kidney function parameters between the GH and PE pregnancies...
April 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28405801/urine-exosomes-from-healthy-and-hypertensive-pregnancies-display-elevated-level-of-%C3%AE-subunit-and-cleaved-%C3%AE-and-%C3%AE-subunits-of-the-epithelial-sodium-channel-enac
#20
Maria R Nielsen, Britta Frederiksen-Møller, Rikke Zachar, Jan S Jørgensen, Mie R Hansen, Rikke Ydegaard, Per Svenningsen, Kristian Buhl, Boye L Jensen
Preeclampsia is characterized by hypertension, proteinuria, suppression of plasma renin-angiotensin-aldosterone, and impaired urine sodium excretion. Aberrantly filtered plasmin in urine may activate proteolytically the γ-subunit of the epithelial sodium channel (ENaC) and promote Na(+) reabsorption and urine K(+) loss. Plasma and urine was sampled from patients with preeclampsia, healthy pregnant controls and non-pregnant women, and from patients with nephrostomy catheters. Aldosterone concentration, urine plasminogen, and protein were determined...
April 12, 2017: Pflügers Archiv: European Journal of Physiology
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