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acute kidney injury and cancer

Helena S Gouveia, Sílvia O Lopes, Ana Luísa Faria
Tumour lysis syndrome (TLS) is a rare oncological emergency in solid tumours. Because it is associated with bad short-term prognosis, early recognition and treatment are mandatory. This case refers to a middle-aged woman who presented with stage IV colon cancer, with massive hepatic involvement. After three cycles of first-line FOLFOX (folinic acid, 5-fluorouracil and oxaliplatin), she developed acute kidney injury and hyperkalaemia that did not respond to standard measures. High suspicion of TLS prompted further corroborating investigations and early intensive care unit admission...
March 15, 2018: BMJ Case Reports
Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
Jie-Qiong Liu, Guang-Yan Cai, Shuang Liang, Wen-Ling Wang, Si-Yang Wang, Fang-Lei Zhu, Sa-Sa Nie, Zhe Feng, Xiang-Mei Chen
PURPOSE OF THE STUDY: The incidence of acute kidney injury (AKI) with a poor prognosis in the elderly has been increasing each year. This study aimed to investigate the clinical characteristics of and risk factors for death from AKI in the elderly and help improve prognosis. STUDY DESIGN: This study was a retrospective cohort study based on data from adult patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of AKI in the elderly were compared with those in younger patients...
March 7, 2018: Postgraduate Medical Journal
Ryo Koda, Hirofumi Watanabe, Masafumi Tsuchida, Noriaki Iino, Kazuo Suzuki, Go Hasegawa, Naofumi Imai, Ichiei Narita
BACKGROUND: Acute tubulointerstitial nephritis (ATIN) has been increasingly recognized as an important manifestation of kidney injury associated with the use of immune checkpoint inhibitors (anti-PD-1 and anti-CTLA-4). While the exact pathophysiology remains unknown, corticosteroids are the mainstay of management. CASE PRESENTATION: We describe a 67-year-old man with stage IV non-small-cell lung cancer who developed kidney injury during treatment with the anti-PD-1 antibody nivolumab...
February 27, 2018: BMC Nephrology
Elizabeth Fox, Kristin Levin, Yan Zhu, Blair Segers, Naomi Balamuth, Richard Womer, Rochelle Bagatell, Frank Balis
LESSONS LEARNED: Using a randomized crossover design and continuous variables such as change in hearing threshold and biomarkers of acute renal injury as short-term endpoints, it was determined that pantoprazole, an organic cation transporter 2 inhibitor, did not ameliorate cisplatin-associated nephrotoxicity or ototoxicity.Cystatin C is a robust method to estimate glomerular filtration rate in patients with cancer. Using a patient-reported outcome survey, all patients identified tinnitus and subjective hearing loss occurring "at least rarely" after cycle 1, prior to objective high-frequency hearing loss measured by audiograms...
February 14, 2018: Oncologist
Fanghua Li, Zhiwen Liu, Chengyuan Tang, Juan Cai, Zheng Dong
Cisplatin, a widely used cancer therapy drug, induces nephrotoxicity or acute kidney injury (AKI), but the underlying mechanism remains unclear, and renal protective approaches are not available. Fibroblast growth factor (FGF)21 is an endocrine factor that regulates glucose uptake, metabolism, and energy expenditure. However, recent work has also implicated FGF21 in cellular stress response under pathogenic conditions. The role and regulation of FGF21 in AKI are unclear. Here, we show that FGF21 was dramatically induced during cisplatin treatment of renal tubular cells in vitro and mouse kidneys in vivo...
January 22, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Maurizio Gallieni, Laura Cosmai, Camillo Porta
BACKGROUND: Renal complications are a relevant clinical issue in patients with cancer; conversely, cancer in patients affected by kidney diseases is a growing problem mainly due to the aging of the general population. Onco-Nephrology is a novel subspecialty addressing these issues. SUMMARY: Acute kidney injury (AKI) is an important cause of morbidity and mortality in cancer patients, and recognizes a number of different causes, which can impact, directly and indirectly, on kidney function...
2018: Contributions to Nephrology
Cierra N Sharp, Mark A Doll, Judit Megyesi, Gabrielle B Oropilla, Levi J Beverly, Leah J Siskind
Cisplatin is used to treat many solid cancers, but its dose-limiting side effect is nephrotoxicity, causing acute kidney injury in 30% of patients. Previously, we have developed a mouse model that better recapitulates the cisplatin dosing regimen humans receive, and found that repeated dosing of cisplatin induces interstitial renal fibrosis. Chronic kidney disease is progressive and is characterized by chronic inflammation, worsening interstitial fibrosis, development of glomerulosclerosis, and endothelial dysfunction...
January 31, 2018: American Journal of Physiology. Renal Physiology
Toru Miyazaki, Tomoko Yamazaki, Ryoichi Sugisawa, M Eric Gershwin, Satoko Arai
Circulating immunoglobulin M (IgM) exists in a pentameric form, possessing a polyreactive nature that responds not only to foreign antigens but also to autoantigens; thus, it is involved in both beneficial and detrimental immune responses, including protection from infection and the progression of autoimmunity. On the other hand, IgM also behaves as a carrier of the apoptosis inhibitor of macrophage (AIM) protein, storing a large amount of the inactivated form of AIM in the blood through this association. Under different disease conditions, AIM can dissociate from IgM locally or systemically to exert its function, inducing the removal of various biological debris such as excess fat, bacteria, cancer cells or dead cell debris...
January 29, 2018: Cellular & Molecular Immunology
Jinhua Tang, Yingfeng Shi, Na Liu, Liuqing Xu, Xiujuan Zang, Peibin Li, Juanlian Zhang, Xiaoqing Zheng, Andong Qiu, Shougang Zhuang
Histone deacetylase 6 (HDAC6) has been shown to be involved in various pathological conditions, including cancer, neurodegenerative disorders and inflammatory diseases. Nonetheless, its specific role in drug-induced nephrotoxicity is poorly understood. Cisplatin (dichlorodiamino platinum) belongs to an inorganic platinum - fundamental chemotherapeutic drug utilized in the therapy of various solid malignant tumors. However, the use of cisplatin is extremely limited by obvious side effects, for instance bone marrow suppression and nephrotoxicity...
February 14, 2018: Clinical Science (1979-)
Eliezer Zachary Nussbaum, Mark A Perazella
Anticancer drug-induced kidney disease is a problem commonly encountered by nephrologists. The number of medications employed by oncologists causing acute and chronic kidney injury as well as electrolyte and acid-base disturbances has increased significantly over the past several decades. While conventional chemotherapeutic drugs induce a number of kidney lesions, emergence of very effective and well-tolerated targeted therapies and novel immunotherapies has increased the occurrence of drug-induced acute and chronic kidney injury in cancer patients...
March 2018: Clinical Nephrology
Minoru Ando
Hematopoietic stem cell transplantation (SCT) recipients are exposed to a large amount of anti-cancer drugs, immunosuppressors, and irradiation during the peri-SCT period. Thus, they have to overcome serious adverse events related to unavoidable but toxic procedures, including organ disorders. In particular, acute kidney injury (AKI) is one of the most critical complications, because it influences the mortality of patients. A few patients who survive AKI may develop nephrotic syndrome, and precedent AKI is also closely associated with chronic and progressive loss of the renal function in post-SCT patients...
January 11, 2018: Internal Medicine
Shveta S Motwani, Gearoid M McMahon, Benjamin D Humphreys, Ann H Partridge, Sushrut S Waikar, Gary C Curhan
Purpose Cisplatin-associated acute kidney injury (C-AKI) is common. We sought to develop and validate a predictive model for C-AKI after the first course of cisplatin. Methods Clinical and demographic data were collected on patients who received cisplatin between 2000 and 2016 at two cancer centers. C-AKI was defined as a 0.3 mg/dL rise in serum creatinine within 14 days of receiving cisplatin. Using multivariable logistic regression models with C-AKI as the primary outcome, we created a scoring model from the development cohort (DC) and tested it in the validation cohort (VC)...
January 10, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Hassan Izzedine, Mark A Perazella
Acute kidney injury (AKI) is a growing problem with untoward economic and medical consequences. Anticancer drug toxicity remains an important and increasing cause of AKI. Importantly, drug-induced AKI affects all nephron segments-vasculature, glomerulus, tubules, and interstitium. Recent studies have increased insight into the subcellular mechanisms of drug-induced AKI that include direct cellular toxicity and immune-mediated effects. Identification of patients with high-risk cancer before drug exposure may allow prevention or at least a reduction in the development and severity of nephrotoxicity...
July 2017: KI Reports
Michal Majewski, Natalia Kasica, Anna Jakimiuk, Piotr Podlasz
Defects in tryptophan metabolism on the l-kynurenine pathway (KP) are implicated in a number of human diseases, including chronic kidney disease, brain edema or injury, tuberculosis and malaria - as well as cancer, neurodegenerative and autoimmune disorders. However, it is unclear to what extent detrimental effects of exposure to tryptophan metabolites might impact the early development of organism. Thus, this study examined the effects of KP exposure in zebrafish embryos starting at the blastula period (4hpf) and the segmentation stage (24hpf)...
January 6, 2018: Toxicology and Applied Pharmacology
Sibel Gunes, Varol Sahinturk, Sema Uslu, Adnan Ayhanci, Sedat Kacar, Ruhi Uyar
Cyclophosphamide (CP) is a common anticancer drug, but its use in cancer treatment is limited due to its severe toxicities induced mainly by oxidative stress in normal cells. Reactive oxygen species (ROS) lead to multiple organ injuries, including the kidneys. Selenium (Se) is a nutritionally essential trace element with antioxidant properties. In the present study, the possible protective effect of Se on CP-induced acute nephrotoxicity was investigated. Forty-two Sprague-Dawley rats were equally divided into six groups of seven rats in each...
December 30, 2017: Biological Trace Element Research
Gonçalo Nunes, Hélder Coelho, Marta Patita, Rita Barosa, Pedro Pinto Marques, Lídia Roque Ramos, Maria José Brito, Aurora Tomaz, Jorge Fonseca
The authors describe a 31-year-old man admitted due to progressive weight loss, diarrhea and massive hepatomegaly. Laboratory data showed anemia (haemoglobin 11.7 g/dl), abnormal liver tests (total bilirubin 1.4 g/dl, aspartate aminotransferase 70 U/l, alanine aminotransferase 37 U/l and alkaline phosphatase 520 U/l). Abdominal ultrasound (US) displayed a large heterogeneous liver with a segment IV 25 mm nodule. Magnetic resonance revealed a 4 cm pancreatic tail mass and several liver nodules consistent with metastasis...
December 28, 2017: Clinical Journal of Gastroenterology
Tao Wang, Yan Zhang, Qingxia Li, Shumin Jia, Changjin Shi, Kai Niu, Bing Liu
Acute kidney injury (AKI) in cancer patients may disrupt anticarcinogenic treatment and greatly increase associated mortality rates. The present study reported on the management of cancer patients with AKI and, from the nephrologic viewpoint, on the significance of fine volume control during the continuous renal replacement therapy (CRRT). The records of 117 cancer patients with AKI treated over three years were reviewed and their data were compared with those of 120 healthy controls. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria with serum creatinine levels determined on initial admission and for the diagnosis of AKI...
December 2017: Experimental and Therapeutic Medicine
Olufunmilayo O Adeyemi, Ismail O Ishola, Ifeoluwa D Ajani
Background Cisplatin-induced acute liver and kidney injuries are serious problems in cancer patients during treatment of solid tumours. Objective This study sought to investigate possible protective effect of ethanolic fruit extract of Citrullus colocynthis (CC) against cisplatin-induced hepato-renal toxicity in rats. Methods Thirty male albino rats (150-200 g) were divided into five groups (n=6) and treated as follows: group 1: vehicle (10 mL/kg, p.o.; normal control); group 2: vehicle (10 mL/kg); groups 3-5: CC (100, 200 or 400 mg/kg, p...
December 13, 2017: Journal of Complementary & Integrative Medicine
You-Jung Choi, Kook-Hwan Oh, Hye-Ryun Kang, Soo-Jin Lee
Oxaliplatin is a platinum compound commonly used in the treatment of advanced colorectal cancer. This report describes two patients who had received repetitive combination chemotherapy including oxaliplatin for the treatment of metastatic colon cancer and who visited the emergency department with acute kidney injury several days after experiencing a hypersensitivity reaction to oxaliplatin. In both cases, the pathologic diagnosis was acute tubulointerstitial nephritis, and corticosteroid therapy resulted in improved renal function...
February 2018: Clinical Nephrology
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