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Acute on Chronic Renal Disease

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https://www.readbyqxmd.com/read/28920703/prognostic-usefulness-of-an-age-adapted-equation-for-renal-function-assessment-in-older-patients-with-acute-coronary-syndrome
#1
Lucía Rioboo Lestón, Emad Abu-Assi, Sergio Raposeiras-Roubin, Rafael Cobas-Paz, Berenice Caneiro-Queija, Jose Manuel Rodríguez-Rodríguez, Andres Íñiguez-Romo
BACKGROUND: Renal dysfunction negatively impacts survival in acute coronary syndrome patients. The Berlin Initiative Study creatinine-based (BIScrea) equation has recently been proposed for renal function assessment in older persons. However, up to now it is unknown if the superiority of the new BIScrea equation, with respect to the most recommended chronic kidney disease epidemiology collaboration creatinine-based (CKD-EPIcrea) formula, would translate into better risk prediction of adverse events in older patients with acute coronary syndrome...
September 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28917068/group-a-streptococcal-bacteraemia-experience-at-king-fahad-medical-city-in-riyadh-saudi-arabia
#2
Fawzyh J Al-Khadidi, Mohammed A AlSheheri, Tariq S AlFawaz, Mushira A Enani, Abdulaziz A AlAqeel, Dayel A AlShahrani
To identify clinical presentation, predisposing factors, and the outcome in patients with Group A Streptococcal bacteremia. Methods: This is a retrospective study of 33 pediatric and adult patients with Streptococcus pyogenes bacteremia, admitted at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia from 2007 to 2015. Results: Thirty-three patient records, documenting bacteremia with group A beta-hemolytic streptococcus, were reviewed. Approximately 51.5% were pediatric and 48.5% were adult patients, with a male to female ratio of 2:1...
October 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28916390/il-33-receptor-st2-deficiency-attenuates-renal-ischaemia-reperfusion-injury-in-euglycaemic-but-not-streptozotocin-induced-hyperglycaemic-mice
#3
M Sehnine, M Ferhat, S Sena, J M Gombert, J M Goujon, A Thierry, G Touchard, T Hauet, A Herbelin, S Hadjadj
AIM: Kidney hypoxia can predispose to the development of acute and chronic renal failure in diabetes. Ischaemia-reperfusion injury (IRI) causes inflammation, and diabetes is known to exacerbate this inflammatory response in the kidney, whereas alarmin IL-33 could act as an innate immune mediator during kidney IRI. Thus, the present study examined the impact of genetic IL-33 receptor ST2 deficiency (ST2-/-) on renal IRI in euglycaemic and hyperglycaemic mice. METHODS: Hyperglycaemia was induced with streptozotocin (STZ) in adult male C57BL/6JRj wild-type (WT) mice and ST2-/- mice...
September 12, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28911947/albumin-prevents-infections-in-patients-with-chronic-liver-failure-in-a-single-arm-feasibility-trial
#4
Louise China, Simon S Skene, Zainib Shabir, Alexander Maini, Yvonne Sylvestre, Kate Bennett, Scott Bevan, James O'Beirne, Ewan Forrest, Jim Portal, Steve Ryder, Gavin Wright, Derek W Gilroy, Alastair O'Brien
BACKGROUND & AIMS: Infections are life threatening to patients with acute decompensation and acute-on-chronic liver failure (AD/ACLF). Patients with AD/ACLF have prostaglandin E2-mediated immune suppression, which can be reversed by administration of albumin; infusion of 20% human albumin solution (HAS) might improve outcomes of infections. We performed a feasibility study to determine optimal trial design, assess safety, and validate laboratory assessments of immune function to inform design of a phase 3 trial...
September 11, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28899568/long-term-survival-after-acute-kidney-injury-following-ruptured-abdominal-aortic-aneurysm-repair
#5
Hamid Jalalzadeh, Reza Indrakusuma, Liffert Vogt, Sytse C van Beek, Anco C Vahl, Willem Wisselink, Mark J W Koelemay, Ron Balm
OBJECTIVE: Acute kidney injury (AKI) is a major complication of ruptured abdominal aortic aneurysm (RAAA). Severe AKI is associated with high morbidity and mortality in the short term. The objective of this study was to determine the association between AKI after RAAA repair and long-term survival. METHODS: We conducted a retrospective cohort study of all patients undergoing RAAA repair in three hospitals between 2004 and 2011. Outcomes were long-term survival after RAAA repair, incidence of postoperative AKI, and chronic dialysis rates...
September 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28893233/clinical-characteristics-of-adrenal-crisis-in-adult-population-with-and-without-predisposing-chronic-adrenal-insufficiency-a-retrospective-cohort-study
#6
Masahiro Iwasaku, Maki Shinzawa, Shiro Tanaka, Kimihiko Kimachi, Koji Kawakami
BACKGROUND: Adrenal crisis (AC) occurs in various clinical conditions but previous epidemiological studies in AC are limited to chronic adrenal insufficiency (AI) and sepsis. The aim of this study was to investigate characteristics of AC patients, including predisposing diseases and to describe candidate risk factors for AC such as comorbidities and glucocorticoid (GC) therapy. METHODS: We conducted a retrospective cohort study using a claims database on 7.4 million patients from 145 acute care hospitals between January 1, 2003 and April 30, 2014...
September 11, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28875342/undiagnosed-renal-sarcoidosis-in-a-patient-with-chronic-interstitial-nephritis
#7
REVIEW
Wenfang Dong, Bin Qiu, Hongfeng Liu, Leren He
A 53-year-old female was admitted to hospital, with acute elevation of SCr and hypercalcemia, on a 5-year history of chronic interstitial nephritis and stage III chronic kidney disease (CKD). Extensive workup failed to yield a definitive diagnosis concerning the cause of the disorder. Intense uptake of (18)F-FDG in the spleen and liver was detected by PET/CT imaging with negative angiotensin-converting enzyme (ACE) in serum. The spleen and the hypermetabolism nodules of the liver were resected for histopathologic examination and turned out to be noncaseating granulomas, likely sarcoidosis...
September 5, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28868299/tubuloreticular-inclusions-in-the-absence-of-systemic-lupus-erythematosus-and-hiv-infection-a-report-of-three-pediatric-cases
#8
Ayah Elmaghrabi, Elizabeth Brown, Ei Khin, Jared Hassler, Allen R Hendricks
Tubuloreticular inclusions (TRIs) are subcellular structures located within the cisternae of endoplasmic reticulum. Formation of TRIs has been linked to the exposure of excess interferon (IFN), either from endogenous or exogenous sources. In renal disease, TRIs have been most commonly associated with systemic lupus erythematosus (SLE), and human immunodeficiency virus-associated nephropathy (HIVAN). Case reports of patients with renal biopsies showing TRIs without underlying SLE or HIV are infrequent in adults, and to our knowledge none have been reported in children...
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28867699/frequency-of-acute-kidney-injury-caused-by-tazobactam-piperacillin-in-patients-with-pneumonia-and-chronic-kidney-disease-a-retrospective-observational-study
#9
Takeyori Morimoto, Hiroki Nagashima, Yasuko Morimoto, Shogo Tokuyama
 Tazobactam/piperacillin (TAZ/PIPC) is a combination antibiotic frequently used to treat pneumonia. It has recently been reported that TAZ/PIPC worsens renal function in patients with existing renal impairment. Creatinine clearance is generally between 10 and 40 mL/min in Japanese patients, so TAZ/PIPC is given at a dose of 2.25 g three times daily or 4.5 g twice daily. If pneumonia is severe or intractable, the dose frequency may be increased to 2.25 g four times daily and 4.5 g three times daily. We examined the effect of these different dosing regimens on renal function...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28865484/renal-ultrasound-provides-low-utility-in-evaluating-cardiac-surgery-associated-acute-kidney-injury
#10
Allen Young, Todd Crawford, Alejandro Suarez Pierre, J Trent Magruder, Charles Fraser, John Conte, Glenn Whitman, Christopher Sciortino
BACKGROUND: Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. METHODS: We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management...
September 2, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28863222/chronic-kidney-disease-in-pregnancy
#11
REVIEW
Abhilash Koratala, Deepti Bhattacharya, Amir Kazory
With the increasing prevalence of chronic kidney disease (CKD) worldwide, the number of pregnant women with various degrees of renal dysfunction is expected to increase. There is a bidirectional relation between CKD and pregnancy in which renal dysfunction negatively affects pregnancy outcomes, and the pregnancy can have a deleterious impact on various aspects of kidney disease. It has been shown that even mild renal dysfunction can increase considerably the risk of adverse maternal and fetal outcomes. Moreover, data suggest that a history of recovery from acute kidney injury is associated with adverse pregnancy outcomes...
September 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28856287/acute-on-chronic-hepatitis-a-case-report-of-autoimmune-hepatitis-primary-sclerosing-cholangitis-ulcerative-colitis-overlap-syndrome-in-a-15-year-old-patient
#12
Aneta Nalepa, Małgorzata Woźniak, Joanna Cielecka-Kuszyk, Marek Stefanowicz, Irena Jankowska, Maciej Dądalski, Joanna Pawłowska
Acute-on-chronic liver failure (ACLF) is a disease in which a rapid deterioration of liver function occurs in patients with chronic liver disease, and is usually associated with a precipitating event. We present the case of a boy with autoimmune hepatitis/primary sclerosing cholangitis/ulcerative colitis (AIH/PSC/UC) overlap syndrome, in whom liver function was stable for 4.5 years of treatment. At 15 years of age the patient was hospitalized due to a deterioration of his general condition, severe abdominal pain, diarrhoea, vomiting and weight loss...
March 2017: Clin Exp Hepatol
https://www.readbyqxmd.com/read/28853062/adjusting-health-spending-for-the-presence-of-comorbidities-an-application-to-united-states-national-inpatient-data
#13
Joseph L Dieleman, Ranju Baral, Elizabeth Johnson, Anne Bulchis, Maxwell Birger, Anthony L Bui, Madeline Campbell, Abigail Chapin, Rose Gabert, Hannah Hamavid, Cody Horst, Jonathan Joseph, Liya Lomsadze, Ellen Squires, Martin Tobias
BACKGROUND: One of the major challenges in estimating health care spending spent on each cause of illness is allocating spending for a health care event to a single cause of illness in the presence of comorbidities. Comorbidities, the secondary diagnoses, are common across many causes of illness and often correlate with worse health outcomes and more expensive health care. In this study, we propose a method for measuring the average spending for each cause of illness with and without comorbidities...
August 29, 2017: Health Economics Review
https://www.readbyqxmd.com/read/28851486/geriatric-rescue-after-surgery-gras-score-to-predict-failure-to-rescue-in-geriatric-emergency-general-surgery-patients
#14
Muhammad Khan, Asad Azim, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Chelsey Santino, Andrew Tang, Gary Vercruysse, Lynn Gries, Bellal Joseph
BACKGROUND: Geriatric-patients(GP) undergoing emergency-general-surgery(EGS) are vulnerable to develop adverse-outcomes. Impact of patient-level-factors on Failure-to-Rescue(FTR) in EGS-GP remains unclear. Aim of our study was to determine factors associated with FTR(death from major-complication) and devise simple-bedside-score that predicts FTR in EGS-GP. METHODS: 3-year(2013-15) analysis of patients, age≥65y on acute-care-surgery-service and underwent EGS. Regression analysis used to analyze factors associated with FTR and natural-logarithm of significant odds-ratio used to calculate estimated-weights for each factor...
August 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28846194/spectrum-of-biopsy-proven-renal-disease-in-south-asian-children-two-decades-at-a-tropical-tertiary-care-centre
#15
Anjali Mohapatra, Shailesh Kakde, Vellaichamy M Annapandian, Anna T Valson, Neelaveni Duhli, Anila Korula, Smita Mary Matthai, Anna B Pulimood, Vinoi G David, Suceena Alexander, Shibu Jacob, Santosh Varughese, Basu Gopal, Tamilarasi Veerasamy, George T John
AIM: We report findings from a large single centre paediatric renal biopsy cohort in South Asia. METHODS: We analyzed all renal biopsies performed on children aged ≤18 years between 1996 and 2015 at our centre. The clinical characteristics and histological diagnosis pertaining to each case, distribution of renal diseases in children with various clinical presentations, and changes in the pattern of kidney disease during the study period were analyzed. RESULTS: A total of 1740 paediatric kidney biopsies were performed during the study period...
August 28, 2017: Nephrology
https://www.readbyqxmd.com/read/28845467/proton-pump-inhibitors-and-kidney-disease-gi-upset-for-the-nephrologist
#16
Stephanie Toth-Manikowski, Morgan E Grams
Widely regarded as safe and effective, proton pump inhibitors (PPIs) are among the most commonly used medications in the world today. However, a spate of observational studies suggest an association between PPI use and adverse events, including infection, bone fracture, and dementia. This review details evidence linking the use of PPI therapy to the development of kidney disease, including early case reports of acute interstitial nephritis and subsequent large observational studies of acute kidney injury (AKI), chronic kidney disease (CKD), and end-stage renal disease (ESRD)...
May 2017: KI Reports
https://www.readbyqxmd.com/read/28844314/acute-kidney-injury-in-acute-on-chronic-liver-failure-where-does-hepatorenal-syndrome-fit
#17
REVIEW
Andrew Davenport, Mohammed Faisal Sheikh, Edmund Lamb, Banwari Agarwal, Rajiv Jalan
Renal dysfunction occurs in 25% to 50% of patients with cirrhosis admitted to the hospital with an acute episode of hepatic decompensation and may be due to underlying chronic kidney disease, an acute deterioration, or both. An acute deterioration in renal function in cirrhotic patients is now collectively referred to as acute kidney injury (AKI), which has been subclassified into different grades of severity that identify prognostic groups. Acute-on-chronic liver failure is characterized by acute hepatic and/or extrahepatic organ failure driven by a dysregulated immune response and systemic inflammatory response...
August 23, 2017: Kidney International
https://www.readbyqxmd.com/read/28840583/therapeutic-implications-of-granulocyte-colony-stimulating-factor-in-patients-with-acute-on-chronic-liver-failure-increased-survival-and-containment-of-liver-damage
#18
Biplob Kumar Saha, Mamun Al Mahtab, Sheikh Mohammad Fazle Akbar, Sheikh Mohammad Noor-E-Alam, Ayub Al Mamun, Sharker Mohammad Shahadat Hossain, Mohammad Ashraful Alam, Ahmed Lutful Moben, Faiz Ahmad Khondaker, Forhadul Islam Chowdhury, Ruksana Raihan, Salimur Rahman, Ashok Kumar Choudhury
BACKGROUND AND PURPOSE: Mobilization of bone marrow-derived stem cells by granulocyte colony stimulating factor (G-CSF) supports hepatic regeneration and may augment clinical improvement in patients with acute-on-chronic liver failure (ACLF). The aim of this study is to assess the impact of G-CSF on complications and transplant-free survival in patients with ACLF. METHODS: Thirty-two patients with ACLF defined by Asian Pacific Association for the Study of the Liver (APASL) criteria were openly randomized to control (group A) or intervention (group B) receiving G-CSF (5 μg/kg/day, for 6 consecutive days) in addition to standard medical therapy with antiviral drugs...
August 24, 2017: Hepatology International
https://www.readbyqxmd.com/read/28840097/a-case-of-delayed-exacerbation-of-interstitial-lung-disease-after-discontinuation-of-temsirolimus
#19
Rei Matsuki, Kenichi Okuda, Akihisa Mitani, Yasuhiro Yamauchi, Goh Tanaka, Haruki Kume, Yukio Homma, Munetoshi Hinata, Akimasa Hayashi, Junji Shibahara, Masashi Fukayama, Takahide Nagase
Temsirolimus is an inhibitor of mammalian target of rapamycin and interstitial lung disease (ILD) is known to be one of the adverse events associated with temsirolimus, which usually improves rapidly after discontinuation of the drug and rarely worsens thereafter. Herein, we report a case of delayed exacerbation of ILD after discontinuation of temsirolimus for metastatic renal cell carcinoma in an 86-year-old male with chronic ILD. The patient developed gradually worsening dyspnea five weeks after an initiation of temsirolimus and was admitted to our facility...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28835974/-hypercalcemic-crisis-and-hypocalcemic-tetany
#20
REVIEW
C Kasperk
A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. The analysis of serum levels for calcium, phosphorous, intact parathyroid hormone, electrophoresis and renal function parameters indicate which further radiological, scintigraphic or serum diagnostic steps are adequate to identify the cause of the patient's acute situation (i...
August 23, 2017: Der Internist
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