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Acute on Chronic Renal Disease

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https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#1
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28619098/interventions-to-prevent-hemodynamic-instability-during-renal-replacement-therapy-for-acute-kidney-injury-a-systematic-review-protocol
#2
Adrianna Douvris, Swapnil Hiremath, Lauralyn McIntyre, Lindsey Sikora, Catherine Weber, Edward G Clark
BACKGROUND: Hemodynamic instability during renal replacement therapy (HIRRT) in the form of intradialytic hypotension (IDH) is a frequent complication of hemodialysis in end-stage kidney disease (ESKD), and most studies have focused on this chronic population. However, HIRRT is also an important concern for critically ill ICU patients with acute kidney injury (AKI), complicating an estimated 30% of dialysis treatments in this population. HIRRT can exacerbate organ hypoperfusion in the setting of critical illness and may negatively impact renal recovery in the AKI population...
June 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28616216/warfarin-related-nephropathy-induced-by-three-different-vitamin-k-antagonists-analysis-of-13-biopsy-proven-cases
#3
Léonard Golbin, Cécile Vigneau, Guy Touchard, Eric Thervet, Jean-Michel Halimi, Théophile Sawadogo, Nathan Lagoutte, Pascale Siohan, Elie Zagdoun, Alexandre Hertig, Nathalie Rioux-Leclercq, Thierry Frouget
Background: Acute kidney injury (AKI) with renal tubular obstruction by red blood cell casts (RBCC) has been described in patients treated with warfarin and is known as warfarin-related nephropathy (WRN). Methods: To determine whether other vitamin K antagonists (VKA) cause WRN, we retrospectively collected and analyzed the clinical and histological data of 13 patients treated with different VKA (seven with fluindione, four with warfarin and two with acenocoumarol) in seven French hospitals. Results: They all developed gross hematuria following overanticoagulation complicated by severe AKI (median serum creatinine concentration = 693 μmol/L)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28615146/novel-insights-into-acute-kidney-injury-chronic-kidney-disease-continuum-and-the-role-of-renin-angiotensin-system
#4
REVIEW
Yu-Hsiang Chou, Tao-Min Huang, Tzong-Shinn Chu
Acute kidney injury (AKI) is an independent risk factor for chronic kidney disease (CKD). If injury is mild, a repair process can be adaptive and lead to complete renal recovery. However, severe injury will be accompanied by a maladaptive repair which usually leads to nephron loss, fibrosis, vascular rarefaction, and chronic inflammation. Although various mechanisms underlying AKI-CKD transition have been explored, no intervention has been proved effective to block the transition until very recently. A lack of consensus for monitoring renal function and defining renal recovery after AKI should be the reasons for the slow advance in the discovery of a timely pharmacologic treatment to block AKI-CKD transition...
June 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28614117/role-of-amp-activated-protein-kinase-in-kidney-tubular-transport-metabolism-and-disease
#5
Roshan Rajani, Nuria M Pastor-Soler, Kenneth R Hallows
PURPOSE OF REVIEW: AMP-activated protein kinase (AMPK) is a metabolic sensor that regulates cellular energy balance, transport, growth, inflammation, and survival functions. This review explores recent work in defining the effects of AMPK on various renal tubular epithelial ion transport proteins as well as its role in kidney injury and repair in normal and disease states. RECENT FINDINGS: Recently, several groups have uncovered additional functions of AMPK in the regulation of kidney and transport proteins...
June 12, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#6
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28599300/cancer-and-the-kidney-dangereoux-liasons-or-price-paid-for-the-progress-in-medicine
#7
REVIEW
Jolanta Małyszko, Leszek Kozlowski, Klaudia Kozłowska, Maciej Małyszko, Jacek Małyszko
A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28586398/the-protective-effects-of-zhen-wu-tang-against-cisplatin-induced-acute-kidney-injury-in-rats
#8
Qi Liu, Shouyu Hu, Yi He, Jiashu Zhang, Xiaona Zeng, Fengtao Gong, Li'na Liang
Acute kidney injury (AKI) is a common clinical condition that confers a risk of progression of chronic kidney disease and a high risk of death. The purpose of the current study is to investigate the anti-apoptotic and anti-fibrotic effects of Zhen-Wu-Tang (ZWT) on cisplatin (CIS)-induced renal injury and elucidate the involvement of nuclear factor (erythroid-derived 2)-like 2 (Nrf2), the PI3K/Akt signaling pathway, transforming growth factor (TGF)-β and the Wnt/β-catenin signaling pathway in the positive effects of Zhen-Wu-Tang on the kidneys...
2017: PloS One
https://www.readbyqxmd.com/read/28583827/association-between-proton-pump-inhibitor-use-and-risk-of-progression-of-chronic-kidney-disease
#9
Derk C F Klatte, Alessandro Gasparini, Hong Xu, Pietro de Deco, Marco Trevisan, Anna L V Johansson, Björn Wettermark, Johan Ärnlöv, Cynthia J Janmaat, Bengt Lindholm, Friedo W Dekker, Josef Coresh, Morgan E Grams, Juan J Carrero
BACKGROUND & AIMS: Proton pump inhibitors (PPI) have been associated with acute kidney injury (AKI) and recent studies suggest that they may be associated with the risk of chronic kidney disease (CKD). METHODS: We performed a retrospective analysis using the Stockholm creatinine measurements database, which contains information on diagnoses, dispensation claims, and laboratory test results for all citizens in the Stockholm region from 2007 through 2010. We identified new users of PPIs (n= 105305) and new users of H2 blockers (H2B; n= 9578); data on renal outcomes were collected for a median 2...
June 2, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28580358/belatacept-as-an-alternative-to-calcineurin-inhibitors-in-patients-with-solid-organ-transplants
#10
REVIEW
Dhiren Kumar, Spencer LeCorchick, Gaurav Gupta
The goal of immunosuppression in transplantation has shifted to improving long-term outcomes, reducing drug-induced toxicities while preserving the already excellent short-term outcomes. Long-term gains in solid organ transplantation have been limited at least partly due to the nephrotoxicity and metabolic side effects of calcineurin inhibitors (CNIs). The alloimmune response requires activation of the costimulatory pathway for T cell proliferation and amplification. Belatacept is a molecule that selectively blocks T cell costimulation...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28573734/il-17a-blockade-or-deficiency-does-not-affect-progressive-renal-fibrosis-following-renal-ischaemia-reperfusion-injury-in-mice
#11
Anja Thorenz, Nicole Völker, Jan Hinrich Bräsen, Rongjun Chen, Mi-Sun Jang, Song Rong, Hermann Haller, Torsten Kirsch, Gertrud Vieten, Christian Klemann, Faikah Gueler
OBJECTIVES: IL-17A contributes to acute kidney injury and fibrosis. Therefore, we asked whether IL-17A deficiency or treatment with a IL-17A blocking antibody impacts severe renal ischaemia reperfusion injury (IRI) and the progression to chronic kidney disease (CKD). METHODS: IL-17A-deficient and wild-type (WT) mice underwent transient unilateral renal pedicle clamping for 45 min to induce IRI and subsequent renal fibrosis. Furthermore, a neutralizing anti-IL-17A antibody (mAb) was injected into WT mice before induction of renal IRI intravenously...
June 2, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28572883/impact-of-creatinine-methodology-on-glomerular-filtration-rate-estimation-in-diabetes
#12
Marijana Vučić Lovrenčić, Vanja Radišić Biljak, Kristina Blaslov, Sandra Božičević, Lea Smirčić Duvnjak
AIM: To evaluate the influence of creatinine methodology on the performance of chronic kidney disease (CKD)-Epidemiology Collaboration Group-calculated estimated glomerular filtration rate (CKD-EPI-eGFR) for CKD diagnosis/staging in a large cohort of diabetic patients. METHODS: Fasting blood samples were taken from diabetic patients attending our clinic for their regular annual examination, including laboratory measurement of serum creatinine and eGFR. RESULTS: Our results indicated an overall excellent agreement in CKD staging (kappa = 0...
May 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28570592/a-prospective-study-of-the-demographics-management-and-outcome-of-patients-with-acute-kidney-injury-in-cape-town-south-africa
#13
Thandiwe A L Dlamini, Peter J Heering, Tawanda Chivese, Brian Rayner
AIM: To study the demographics and outcome of acute kidney injury (AKI) at Groote Schuur Hospital, Cape Town, South Africa. METHODS AND FINDINGS: A prospective observational study of AKI fulfilling the Kidney Disease: Improving Global Outcomes definition, from 8 July 2012 to 8 July 2013. Ethics approval was granted by the University of Cape Town Human Research Ethics Committee. Consent was waived because patient data was de-identified and patient management was not adversely affected by the study...
2017: PloS One
https://www.readbyqxmd.com/read/28570326/renal-disease-and-neurology
#14
Sara E Hocker
PURPOSE OF REVIEW: Neurologic dysfunction is prevalent in patients with acute and chronic renal disease and may affect the central nervous system, peripheral nervous system, or both. Neurologic manifestations may result directly from the uremic state or as a consequence of renal replacement therapy. Early recognition of neurologic dysfunction may provide opportunities for intervention and reduced morbidity. RECENT FINDINGS: Advances in the understanding of neurologic complications of renal disease and its treatments have led to more widespread recognition and earlier identification of encephalopathy syndromes such as cefepime neurotoxicity and posterior reversible encephalopathy syndrome (PRES), dramatic reductions in the incidence of dialysis disequilibrium syndrome and dialysis dementia, and improved survival in disorders such as von Hippel-Lindau disease and thrombotic thrombocytopenic purpura...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28560004/impact-of-impaired-cardiac-function-on-the-progression-of-chronic-kidney-disease-role-of-pharmacomodulation-of-valsartan
#15
Chih-Chao Yang, Hon-Kan Yip, Kuan-Hung Chen, Cheuk-Kwan Sun, Yen-Ta Chen, Han-Tan Chai, Pei-Hsun Sung, Hsin-Ju Chiang, Sheung-Fat Ko, Sheng-Ying Chung, Chih-Hung Chen, Kun-Chen Lin, Pao-Yuan Lin, Jiunn-Jye Sheu
Although chronic kidney disease (CKD) is known to aggravate cardiovascular disease in the setting of cardiorenal syndrome (CRS), the impact of impaired cardiac function on the progression of CKD has seldom been reported. This study tested the impact of acute myocardial infarction on a rodent CKD model and the therapeutic effect of valsartan in this setting. Adult male Sprague-Dawley rats (n = 50) equally divided into group 1 (sham control), group 2 (CKD induced by 5/6 nephrectomy), group 3 (AMI by ligation of left coronary artery), group 4 (CKD+AMI), group 5 (CKD+AMI+valsartan, orally 10 mg/kg/day)...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28558744/tocilizumab-in-the-treatment-of-twelve-cases-with-aa-amyloidosis-secondary-to-familial-mediterranean-fever
#16
Serdal Ugurlu, Aysa Hacioglu, Yasaman Adibnia, Vedat Hamuryudan, Huri Ozdogan
BACKGROUND: There is no established treatment of AA amyloidosis, a long-term complication of various chronic inflammatory diseases associated with increased mortality, such as familial Mediterranian fever (FMF). Recently there are few reports pointing out that tocilizumab(TCZ), an anti IL-6 agent may be effective in AA amyloidosis resistant to conventional treatments. We report our data on the effect of TCZ in patients with FMF complicated with AA amyloidosis. METHODS: FMF patients with histologically proven AA amyloidosis, treated with TCZ (8 mg/kg per month) were followed monthly and the changes in creatinine, creatinine clearance, the amount of 24-hour urinary protein, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were noted throughout the treatment period...
May 30, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28554920/physical-activity-immune-function-and-inflammation-in-kidney-patients-the-pink-study-a-feasibility-trial-protocol
#17
Patrick James Highton, Jill Neale, Thomas J Wilkinson, Nicolette C Bishop, Alice C Smith
INTRODUCTION: Patients with chronic kidney disease (CKD) display increased infection-related mortality and elevated cardiovascular risk only partly attributed to traditional risk factors. Patients with CKD also exhibit a pro-inflammatory environment and impaired immune function. Aerobic exercise has the potential to positively impact these detriments, but is under-researched in this patient population. This feasibility study will investigate the effects of acute aerobic exercise on inflammation and immune function in patients with CKD to inform the design of larger studies intended to ultimately influence current exercise recommendations...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28551821/short-and-long-term-outcomes-after-non-severe-acute-kidney-injury
#18
Carlos Arias-Cabrales, Eva Rodríguez, Sheila Bermejo, Adriana Sierra, Carla Burballa, Clara Barrios, María José Soler, Julio Pascual
BACKGROUND: Severe acute kidney injury (AKI) is associated with chronic kidney disease (CKD), cardiovascular events and increased mortality. However, little is known about the prognosis in hospitalized population suffering from non-severe AKI episodes. The aim of this study is to determine the impact of non-severe AKI episodes in cardiovascular events, mortality and CKD, on short and long term. METHODS: Retrospective cohort study to 360 patients who met the criteria for diagnosis of AKI according ADQI guidelines with full recovery of renal function after the AKI episode, admitted between January 2000 and December 2010 in our hospital...
May 27, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28546044/endovascular-repair-of-thoraco-abdominal-and-arch-aneurysms-in-patients-with-connective-tissue-disease-using-branched-and-fenestrated-devices
#19
Rachel E Clough, Teresa Martin-Gonzalez, Katrien Van Calster, Adrien Hertault, Rafaëlle Spear, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
INTRODUCTION: Prophylactic open surgery is the standard practice in patients with connective tissue and thoraco-abdominal (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study was to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. METHODS: All patients with connective tissue disease that underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single high volume centre between 2004 and 2015 were included...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28544060/predictive-factors-upon-discontinuation-of-renal-replacement-therapy-for-long-term-chronic-dialysis-and-death-in-acute-kidney-injury-patients
#20
Tingting Yang, Si Sun, Liping Lin, Mei Han, Qiang Liu, Xiaoxi Zeng, Yuliang Zhao, Yupei Li, Baihai Su, Songmin Huang, Lichuan Yang
The specific timing for discontinuing renal replacement therapy (RRT) in acute kidney injury (AKI) patients is debatable. The predictive abilities of variables at the time of discontinuation of RRT for the long-term prognoses of patients have not been explored. This study aimed to explore the prognostic factors upon discontinuation of RRT for long-term chronic dialysis and death of patients with acute RRT-requiring AKI, thus improving decision making regarding the discontinuation of RRT and the follow-up of patients thereafter...
May 23, 2017: Artificial Organs
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