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Acute renal insufficiency

Carlos G Musso, Alejandrina Castañeda, María Giordani, Cesar Mombelli, Silvia Groppa, Nora Imperiali, Guillermo Rosa Diez
Kidney transplant patients (KTPs), and particularly those with advanced chronic kidney rejection, may be affected by opportunistic infections, metabolic alterations and vascular and oncologic diseases that promote clinical conditions that require a variety of treatments, the combinations of which may predispose them to hyponatremia. Salt and water imbalance can induce abnormalities in volemia and/or serum sodium depending on the nature of this alteration (increase or decrease), its absolute magnitude (mild or severe) and its relative magnitude (body sodium:water ratio)...
August 2018: Clinical Kidney Journal
Nobuyoshi Matsuoka, Mie Akaike, Takashi Murayama, Hideya Hashimoto, Yoshifumi Hirokawa, Tatsu Inoki
A 73-year-old female was hospitalized with thrombotic microangiopathy (TMA) diagnosis because of consciousness disturbance, anemia, thrombocytopenia, renal dysfunction, and electrocardiogram abnormality. The patient died on day 12 of the symptom onset. The immunohistochemical analysis of microclot found in the autopsy of coronary artery confirmed TMA. It was suggested that the relationship to collagen disease by antinuclear antibody positive and the necessity of initiating circulation management and plasma exchange immediately before approximately 1×104 of platelets for the prognosis...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Guiming Cheng, Xun Tang, Jun Zhang
Type II diabetes is associated with a low quality of life and inflammation, and is often accompanied by varying degrees of chronic renal failure. Chronic renal failure is considered one of the most important factors that aggravates diabetes and contributes to renal insufficiency in patients with diabetes though cellular fibrosis. It has previously been reported that hepatocyte growth factor (HGF) serves extensive biological roles, and is a multifunctional antifibrotic factor that is involved in kidney development, acute injury and regeneration...
July 19, 2018: Molecular Medicine Reports
Jun-Li Tsai, Shang-Feng Tsai
Renal transplant is the preferred choice of treatment for end-stage renal diseases. To avoid rejection, increasingly potent immunosuppressants are administered to recipients of kidney transplants. Complications, when there is excess immunosuppression, include possible lethal infections, which reduce allograft survival and compromise patient survival. When there is insufficient immunosuppression, rejections could impair allograft outcomes. Moreover, recurrent primary diseases could also threaten allograft outcomes...
July 31, 2018: Experimental and Clinical Transplantation
Tracy J Cheun, Lalithapriya Jayakumar, Maureen K Sheehan, Matthew J Sideman, Lori L Pounds, Mark G Davies
BACKGROUND: Critical hand ischemia owing to below-the-elbow atherosclerotic occlusive disease is relatively uncommon. The aim of this study was to examine the outcomes in patients presenting with critical ischemia owing to below-the-elbow arterial atherosclerotic disease who underwent nonoperative and operative management. METHODS: A database of patients undergoing operative and nonoperative management for symptomatic below-the-elbow atherosclerotic disease between 2006 and 2016 was retrospectively queried...
July 28, 2018: Journal of Vascular Surgery
Geng Qian, Chang-Fu Liu, Jun Guo, Wei Dong, Jin Wang, Yun-Dai Chen
OBJECTIVES: This study aimed to explore the adequate hydration with nitrates for patients with chronic kidney disease (CKD) and congestive heart failure (CHF) to reduce the risk of contrast-induced nephropathy (CIN) and at the same time avoid the acute heart failure. METHODS: 394 consecutive patients with CKD and CHF undergoing coronary procedures were randomized to either adequate hydration with nitrates (n=196) or to routine hydration (control group; n=198). The adequate hydration group received continuous intravenous infusion of isosorbide dinitrate combined with intravenous infusion of isotonic saline at a rate of 1...
July 27, 2018: Clinical Cardiology
Shiyong Zeng, Jinle Lin, Wenwu Zhang
Acute kidney injury (AKI) is a common complication in patients with sepsis, with poor prognosis and high mortality. The pathogenesis of sepsis-induced acute kidney injury (SAKI) is closely related to renal hemodynamic abnormalities, inflammatory injury and adaptive mechanism. It is insufficient for previous criteria based on urine output and creatinine to the early diagnosis of SAKI. The emergence of new biomarkers may make up for deficiencies in early diagnosis. And significant progress has also been made in the treatment of SAKI...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Chi-Wei Chen, Yen-Hung Wu, Shun-Ching Chien, Jhong-Ching Lin
RATIONALE: Paraquat, an agent highly toxic to humans and animals, is a widely used herbicide and also commonly used for suicide attempts in Taiwan. The most common route of intoxication is oral ingestion, and parenteral poisoning is respectively rare. PATIENT CONCERNS: A 39-year-old illicit abuser of heroin and amphetamine injected 0.5 mL of 24% paraquat directly into his right cephalic vein due to hallucination. The patient was brought to our emergency department for management 4 hours after injection...
July 2018: Medicine (Baltimore)
Christian-Alexander Behrendt, Henrik C Rieß, Thea Schwaneberg, Axel Larena-Avellaneda, Tilo Kölbel, Nikolaos Tsilimparis, Kostas Spanos, Eike S Debus, Art Sedrakyan
OBJECTIVE/BACKGROUND: Colonic ischaemia (CI) is a severe complication following abdominal aortic aneurysm (AAA) repair, leading to high morbidity and mortality. The aim of the study was to determine the incidence, predictors, and outcomes of CI following AAA repair. METHODS: National claims from Germany's third largest insurance provider, DAK-Gesundheit, were used to investigate CI after intact (iAAA) and ruptured (rAAA) AAA repairs. Patients undergoing endovascular (EVAR) or open surgical (OSR) repairs between January 2008 and December 2017 were included in the study...
July 20, 2018: European Journal of Vascular and Endovascular Surgery
Omar Emiliano Aparicio-Trejo, Edilia Tapia, Laura Gabriela Sánchez-Lozada, José Pedraza-Chaverri
Nowadays, chronic kidney disease (CKD) is considered a worldwide public health problem. CKD is a term used to describe a set of pathologies that structurally and functionally affect the kidney, it is mostly characterized by the progressive loss of kidney function. Current therapeutic approaches are insufficient to avoid the development of this disease, which highlights the necessity of developing new strategies to reverse or at least delay CKD progression. Kidney is highly dependent on mitochondrial homeostasis and function, consequently, the idea that mitochondrial pathologies could play a pivotal role in the genesis and development of kidney diseases has risen...
July 17, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Ignacio Novo-Veleiro, Antonio Pose-Reino, Alejandra Gullón, Jesús Díez-Manglano, José-María Cepeda, Francesc Formiga, Miguel Camafort, José-María Mostaza, Carmen Suárez
AIM: Renal insufficiency is associated with medical complications in patients with non-valvular atrial fibrillation (NVAF). However, data for elderly patients are scarce. Thus, the main objectives of the present study were to analyze the characteristics of elderly patients with NVAF and acute or chronic renal disease, describe their management in real-life conditions, and detect factors associated with complications. METHODS: The NONAVASC registry includes patients > 75 years with NVAF, hospitalized by any cause in 64 Spanish Internal Medicine departments...
July 17, 2018: Aging Clinical and Experimental Research
Saeed Safari, Behrouz Hashemi, Mohammad Mehdi Forouzanfar, Mehrnoush Shahhoseini, Meysam Heidari
Introduction: Elimination of preventable deaths due to acute kidney injury (AKI) in low-income countries by 2025 is an important healthcare goal at the international level. The present study was designed with the aim of evaluating the prevalence and outcome of AKI in patients presenting to emergency department. Methods: The present cross-sectional, retrospective study was performed on patients that presented to the emergency departments of 3 major teaching hospitals, Tehran, Iran, between 2005 and 2015 and were diagnosed with AKI...
2018: Emergency (Tehran, Iran)
Yuhei Noda, Yosuke Saka, Akihisa Kato, Tetsushi Mimura, Tomohiko Naruse
Thrombocytopenia, anasarca, fever, renal insufficiency, and organomegaly constitute TAFRO syndrome, a variant of Castleman disease. We describe a patient with TAFRO syndrome who underwent renal biopsy. A 79-year-old woman was referred to us with fever and leg edema. She also had thrombocytopenia, pleural effusion, ascites, and acute kidney injury, and was admitted to our hospital. Her response to initial therapy with corticosteroid and cyclosporine was poor. Therefore, she received 4 doses of rituximab per week, which resulted in clinical improvement, including recovery of thrombocytopenia...
2018: Clinical nephrology. Case studies
Dong-Hee Na, Deokbi Hwang, Sujin Park, Hyung-Kee Kim, Seung Huh
Purpose: The aims of the present study are to determine the outcomes after acute aortic occlusion (AAO) and analyze the risk factors for in-hospital mortality. Materials and Methods: We retrospectively analyzed 24 patients who were diagnosed with AAO from 2002 to 2017 in our registered data. Demographic and radiologic characteristics of AAOs were retrospectively collected. Perioperative treatment outcomes including in-hospital mortality were also assessed and the risk factors of in-hospital mortality were analyzed...
June 2018: Vascular Specialist International
Heidi Reich, Sadia Dimbil, Ryan Levine, Dominick Megna, Savannah Mersola, Jignesh Patel, Michelle Kittleson, Lawrence Czer, Jon Kobashigawa, Fardad Esmailian
OBJECTIVES: Combined heart-kidney transplantation has successful outcomes. With an increasing number of patients with end-stage heart disease, there is a high incidence of significant renal insufficiency that may necessitate combined heart-kidney transplant. Outcomes for heart-kidney transplant recipients aged ≥65 years are not well described. METHODS: Between 2010 and 2015, 163 recipients ≥65 years of age were transplanted in a single centre: 12 heart-kidney and 151 isolated heart transplants...
July 3, 2018: Interactive Cardiovascular and Thoracic Surgery
Ewan D McNicol, Emily Rowe, Tess E Cooper
BACKGROUND: Children who undergo surgical procedures in ambulatory and inpatient settings are at risk of experiencing acute pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce moderate to severe pain without many of the side effects associated with opioids. However, NSAIDs may cause bleeding, renal and gastrointestinal toxicity, and potentially delay wound and bone healing. Intravenous administration of ketorolac for postoperative pain in children has not been approved in many countries, but is routinely administered in clinical practise...
July 7, 2018: Cochrane Database of Systematic Reviews
Magdalena Stârcea, Cristina Gavrilovici, Andra Elsayed, Mihaela Munteanu, Vasile Valeriu Lupu, Elena Cojocaru, Ingrith Miron, Lucian Miron
RATIONALE: Though to be rare, calcific uremic arteriolophathy (CUA) is an ectopic calcification entity causing pain and disabilities in patients with chronic renal insufficiency, thus increasing the morbidity and mortality. PATIENT CONCERN: We report a case of four years old boy admitted with acute respiratory failure. Physical examination revealed: irritability, purple subcutaneous hard nodules, tachypnea, dry spasmodic cough, respiratory rate 45/min, heart rate 110/min, blood pressure 100/60 mmHg, with normal heart sounds, no murmurs, hepatomegaly with hepato-jugular reflux...
July 2018: Medicine (Baltimore)
Menno V Huisman, Frederikus A Klok
Venous thromboembolism (VTE) in acute medically ill patients is a leading cause of in-hospital morbidity and mortality. A majority of these VTE events occur post-discharge, and patients remain at increased VTE risk for up to 3 months post-discharge. Recent clinical trials of extended-duration thromboprophylaxis with enoxaparin, rivaroxaban, and apixaban in acute medically ill patients did not demonstrate a net clinical benefit compared with in-hospital thromboprophylaxis, and were shown to be associated with higher risks of major bleeding...
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
Francesca Veronesi, Stefania Pagani, Paola Torricelli, Giuseppe Filardo, Carola Cavallo, Brunella Grigolo, Milena Fini
Evolutionary medicine has proven helpful to understand the origin of human disease, e.g. in identifying causal roles of recent environmental changes impacting on human physiology (environment-phenotype mismatch). In contrast, diseases affecting only a limited number of members of a species often originate from evolutionary trade-offs for usually physiologic adaptations assuring reproductive success in the context of extrinsic threats. For example, the G1 and G2 variants of the APOL1 gene supporting control of Trypanosoma infection come with the trade-off that they promote the progression of kidney disease...
July 3, 2018: Histology and Histopathology
Dinesha Maduri Vidanapathirana, Subashinie Jayasena, Eresha Jasinge, Blanka Stiburkova
BACKGROUND: Renal hypouricemia is a rare heterogeneous inherited disorder characterized by impaired tubular uric acid transport, reabsorption insufficiency and /or acceleration of secretion. The affected individuals are predisposed to nephrolithiasis and recurrent episodes of exercise-induced acute kidney injury. Type 1 is caused by dysfunctional variants in the SLC22A12 gene (URAT1), while type 2 is caused by defects in the SLC2A9 gene (GLUT9). To date, more than 150 patients with the loss-of-function mutations for the SLC22A12 gene have been found (compound heterozygotes and/or homozygotes), most of whom are Japanese and Koreans...
June 29, 2018: BMC Pediatrics
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