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Acute And Kidney And Disease

Yoshitaka Furuto, Hirotsugu Hashimoto, Akio Namikawa, Haruki Outi, Hiroko Takahashi, Hajime Horiuti, Kazuho Honda, Yuko Shibuya
BACKGROUND: Lenvatinib is a tyrosine kinase inhibitor with novel binding ability. It is considered the standard of care for metastatic thyroid cancer; moreover, whether it is indicated for other malignant tumors has been examined. Lenvatinib increases the risk of kidney injury in some patients. In comparison with sorafenib, which is a conventional tyrosine kinase inhibitor (TKI), lenvatinib results in more side effects, including hypertension and proteinuria. We describe a case of secondary focal segmental glomerulosclerosis (FSGS) that developed following treatment of metastatic thyroid cancer with lenvatinib and reviewed the mechanisms of renal impairment...
October 19, 2018: BMC Nephrology
Alyssa A Riley, Mary Watson, Carolyn Smith, Danielle Guffey, Charles G Minard, Helen Currier, Ayse Akcan Arikan
BACKGROUND: To evaluate changes in population characteristics and outcomes in a large single-center pediatric patient cohort treated with continuous renal replacement therapy (CRRT) over a 10 year course, coincident with multiple institutional practice changes in CRRT delivery. METHODS: A retrospective cohort study with comparative analysis of all patients treated from 2004 to 2013 with CRRT in the neonatal, pediatric, and cardiovascular intensive care units within a free-standing pediatric tertiary care hospital...
October 19, 2018: BMC Nephrology
P Muggeo, E Calore, N Decembrino, S Frenos, F De Leonardis, A Colombini, F Petruzziello, K Perruccio, M Berger, R Burnelli, G A Zanazzo, N Santoro, S Cesaro
BACKGROUND: Invasive mucormycosis is a rare but frequently fatal fungal disease. The acute and rapidly progressive evolution causes unfavourable outcome in 22-59% of patients and its treatment represents a clinical challenge, especially in immunocompromised patients. Current data in pediatric oncological patients are limited. OBJECTIVES: The infection Working Group of the Italian Association of Pediatric Hematology and Oncology (AIEOP) analyzed the episodes of invasive mucormycosis occurred between 2009 and 2016...
October 18, 2018: Mycoses
Jeff Murray, Abilash Balmuri, Alok Saurav, Aiman Smer, Venkata Mahesh Alla
Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Coronary angiography (CAG) and percutaneous coronary intervention (PCI) are frequently performed in patients presenting with a non-ST elevation myocardial infarction (NSTEMI). Utilizing the National Inpatient Sample database, we assessed the trends in utilization of CAG, PCI, and coronary artery bypass grafting in 3,654,586 admissions with NSTEMI from 2001 to 2012. The rates of CAG were 54%, 36.1%, and 45.9%, respectively, in patients with normal renal function, patients with CKD not on renal replacement therapy (RRT), and patients with CKD requiring RRT...
September 8, 2018: American Journal of Cardiology
J W Song, W K Lee, S Lee, J K Shim, H J Kim, Y L Kwak
BACKGROUND: Repeated remote ischaemic conditioning (RIC) during weaning from cardiopulmonary bypass and in the early postoperative period may confer protection against acute kidney injury (AKI). We evaluated the effect of repeated RIC on the incidence of AKI in patients undergoing valvular heart surgery. METHODS: Patients were randomised into either the RIC (n=120) or control (n=124) group. A pneumatic tourniquet was placed on each patient's thigh. Upon removal of the aortic cross-clamp, three cycles of inflation for 5 min at 250 mm Hg (with 5 min intervals) were applied in the RIC group...
November 2018: British Journal of Anaesthesia
D Legouis, M Jamme, P Galichon, S Provenchère, A Boutten, D Buklas, J-L Hanouz, A Hertig
BACKGROUND: Chronic kidney disease (CKD) is a frequent and serious complication of cardiac surgery. This study was designed to establish a scoring system, calculated in the immediate postoperative period, to assess the risk of CKD at 1 yr in patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: We conducted a cohort study including patients with preoperative estimated glomerular filtration rate above 60 ml min-1 (1.73 m)-2 who underwent cardiac surgery with cardiopulmonary bypass...
November 2018: British Journal of Anaesthesia
D R McIlroy, R Bellomo, F T Billings, K Karkouti, J R Prowle, A D Shaw, P S Myles
BACKGROUND: Renal injury is a common perioperative complication. The adoption of renal endpoints, standardised and valid for use in perioperative clinical trials, would enhance the quality of perioperative clinical research. The Standardised Endpoints in Perioperative Medicine (StEP) initiative was established to derive standardised endpoints for use in perioperative clinical trials. METHODS: A systematic review was conducted to identify renal endpoints currently reported in perioperative clinical trials...
November 2018: British Journal of Anaesthesia
Pavan K Bhatraju, Leila R Zelnick, Jerald Herting, Ronit Katz, Carmen Mikacenic, Susanna Kosamo, Eric D Morrell, Cassianne Robinson-Cohen, Carolyn S Calfee, Jason D Christie, Kathleen D Liu, Michael A Matthay, William O Hahn, Victoria Dmyterko, Natalie S J Slivinski, Jim A Russell, Keith R Walley, David C Christiani, W Conrad Liles, Jonathan Himmelfarb, Mark M Wurfel
OBJECTIVE: The aim of this study was to identify and test whether AKI sub-phenotypes have prognostic and therapeutic implications. METHODS: First, latent class analysis methodology was applied independently in two critically ill populations (Discovery: n=794 and Replication: n=425) with AKI. Second, a parsimonious classification model was developed to identify AKI sub-phenotypes. Third, the classification model was applied to patients with AKI in the Vasopressin in Septic Shock (VASST: n=271) clinical trial and differences in treatment response were determined...
October 18, 2018: American Journal of Respiratory and Critical Care Medicine
Xi Liu, Wei Cao, Jia Qi, Qing Li, Min Zhao, Zhuyun Chen, Jingfeng Zhu, Zhimin Huang, Lin Wu, Bo Zhang, Yanggang Yuan, Changying Xing
Leonurine, a major bioactive component from Herba Leonuri, shows therapeutic potential in several diseases, including diabetes, cardiovascular disease, bovine mastitis and depression. In kidney, it was reported that leonurine was performing a protective effect in both acute kidney injury and renal fibrosis mice models. The aim of this study is to investigate the effect of leonurine in podocyte injury. In the mice model of adriamycin (ADR) -induced nephropathy, the application of leonurine significantly prevented early kidney damage, macrophage infiltration and proteinuria...
October 18, 2018: Free Radical Research
Teng-Hsiang Chang, Ping-Fang Chiu, Chun-Chieh Tsai, Chin-Hua Chang, Chia-Lin Wu, Chew-Teng Kor, Jhao-Rong Li, Cheng-Ling Kuo, Ching-Shan Huang, Cheng-Chung Chu, Chih-Ming Lin, Chia-Chu Chang
BACKGROUND AND PURPOSE: Recombinant tissue plasminogen activator (rt-PA) administration is the most prevalent treatment for acute ischemic within golden time. However, the effects of rt-PA on the kidney function in such patients remain unknown. This study determined long-term renal outcomes in patients with acute ischemic stroke receiving systemic rt-PA. METHODS: We enrolled patients who were hospitalized for acute ischemic stroke from January 2001 to January 2017...
October 17, 2018: Nephrology
Kentaro Sakashita, Kengo Murata, Yukiko Takahashi, Miake Yamamoto, Kana Oohashi, Yu Sato, Miyako Kitazono, Akihiko Wada, Mikio Takamori
Objective The standard anti-tuberculosis (TB) regimen occasionally causes acute kidney injury (AKI). The major etiology is rifampicin-induced acute interstitial nephritis. However, the standard management of AKI induced by anti-TB drugs has yet to be established. Patients and Methods We retrospectively reviewed patients with TB who developed AKI after starting standard anti-TB treatment between 2006 and 2016 at a single TB center. The clinical characteristics and the management are described. Results Among 1,430 patients with active TB, 15 (1...
October 17, 2018: Internal Medicine
Vijitha Burra, P S Nagaraja, Naveen G Singh, V Prabhakar, N Manjunatha
Background: Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI. Therefore, we tested role of serum phosphorus in prediction of AKI as a biomarker after cardiac surgery in children. Methodology: We prospectively evaluated 51 children aged between 3 weeks and 12 years undergoing elective cardiac surgery...
October 2018: Annals of Cardiac Anaesthesia
K Bhaskaran, Ganapathy Arumugam, P V Vinay Kumar
Context and Aims: Off-pump coronary artery bypass graft (OPCABG) is a form of CABG surgery. It is performed without the use of cardiopulmonary bypass machine as a surgical treatment for coronary heart disease. Acute kidney injury (AKI) is one of the common postoperative complications of OPCABG. Previous studies suggest important differences related to intravenous fluid (IVF) chloride content and renal function. We hypothesize that perioperative use of chloride restricted IVFs may decrease incidence and severity of postoperative AKI in patients undergoing OPCABG...
October 2018: Annals of Cardiac Anaesthesia
Yusuke Nakade, Yasunori Iwata, Kengo Furuichi, Masashi Mita, Kenji Hamase, Ryuichi Konno, Taito Miyake, Norihiko Sakai, Shinji Kitajima, Tadashi Toyama, Yasuyuki Shinozaki, Akihiro Sagara, Taro Miyagawa, Akinori Hara, Miho Shimizu, Yasutaka Kamikawa, Kouichi Sato, Megumi Oshima, Shiori Yoneda-Nakagawa, Yuta Yamamura, Shuichi Kaneko, Tetsuya Miyamoto, Masumi Katane, Hiroshi Homma, Hidetoshi Morita, Wataru Suda, Masahira Hattori, Takashi Wada
Gut microbiota-derived metabolites play important roles in health and disease. D-amino acids and their L-forms are metabolites of gut microbiota with distinct functions. In this study, we show the pathophysiologic role of D-amino acids in association with gut microbiota in humans and mice with acute kidney injury (AKI). In a mouse kidney ischemia/reperfusion model, the gut microbiota protected against tubular injury. AKI-induced gut dysbiosis contributed to the altered metabolism of D-amino acids. Among the D-amino acids, only D-serine was detectable in the kidney...
October 18, 2018: JCI Insight
Zhiyou Cai, Wenbo He, Feng-Juan Zhuang, Yan Chen
OBJECTIVE: Plasma high hypersensitive C-reactive protein (hs-CRP) levels are associated with risk and prognosis of vascular diseases. The clinical implications of markedly elevated hs-CRP levels are more discovered in the onset and development of stroke. The aim of this study is to determine the association of plasma hs-CRP levels on the prognosis in patients with acute ischemic stroke. METHODS: Retrospective analysis of a single-center database of consecutive cases for acute cerebral infarction (ACI) from January 1st 2012 to December 30th 2016 was performed...
October 17, 2018: International Journal of Neuroscience
Kang Su Cho, In Kap Ko, James J Yoo
Kidney diseases including acute kidney injury and chronic kidney disease are among the largest health issues worldwide. Dialysis and kidney transplantation can replace a significant portion of renal function, however these treatments still have limitations. To overcome these shortcomings, a variety of innovative efforts have been introduced, including cell-based therapies. During the past decades, advances have been made in the stem cell and developmental biology, and tissue engineering. As part of such efforts, studies on renal cell therapy and artificial kidney developments have been conducted, and multiple therapeutic interventions have shown promise in the pre-clinical and clinical settings...
November 2018: Yonsei Medical Journal
Il Young Kim, June Hyun Kim, Min Jeong Kim, Dong Won Lee, Cheol Gu Hwang, Miyeun Han, Harin Rhee, Sang Heon Song, Eun Young Seong, Soo Bong Lee
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of death in patients with chronic kidney disease (CKD). Left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD) are known as predictors of CVD in these patients. Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury. Recently, elevated NGAL levels have been reported in patients with CVD. This study aimed to evaluate the association between plasma NGAL levels and LVH/LVDD in patients with CKD...
2018: PloS One
Christopher E Forsmark, Dana K Andersen, John T Farrar, Megan Golden, Aida Habtezion, Sohail Z Husain, Liang Li, Julia Mayerle, Stephen J Pandol, Aliye Uc, Zixi Zhu, Dhiraj Yadav
The lack of effective therapeutic agents specifically tailored for chronic pancreatitis (CP) has hampered clinical care and negatively impacted patients' lives. New mechanistic insights now point to novel therapies, which involve both recently developed and/or repurposed agents. This working group focused on 2 main outcomes for CP: pain and progression of disease. The goal is to frame the essential aspects of trial design including patient-centered outcomes, proposed methods to measure the outcomes of pain and progression, and study design considerations for future trials to facilitate rapid drug development for patients with CP...
November 2018: Pancreas
Mark E Lowe, Marc T Goodman, Gregory A Coté, Marshall J Glesby, Mark Haupt, Nicholas J Schork, Vikesh K Singh, Dana K Andersen, Stephen J Pandol, Aliye Uc, David C Whitcomb
Recurrent acute pancreatitis (RAP) is a complex clinical syndrome with significant morbidity, unpredictable outcomes, and limited treatment options. The National Institute of Diabetes and Digestive and Kidney Disease sponsored a workshop on July 25, 2018, in Pittsburgh, Pennsylvania, to address research gaps impeding development of effective therapies for pancreatitis. The RAP working group identified challenges to clinical progress using existing definitions, risk assessment, diagnostic and severity criteria, disease trajectories, outcomes, and research methods...
November 2018: Pancreas
Maisam Abu-El-Haija, Anna S Gukovskaya, Dana K Andersen, Timothy B Gardner, Peter Hegyi, Stephen J Pandol, Georgios I Papachristou, Ashok K Saluja, Vikesh K Singh, Aliye Uc, Bechien U Wu
A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to focus on research gaps and opportunities on drug development for pancreatitis. This conference was held on July 25, 2018, and structured into 3 working groups (WG): acute pancreatitis (AP) WG, recurrent AP WG, and chronic pancreatitis WG. This article reports the outcome of the work accomplished by the AP WG to provide the natural history, epidemiology, and current management of AP; inform about the role of preclinical models in therapy selection; and discuss clinical trial designs with clinical and patient-reported outcomes to test new therapies...
November 2018: Pancreas
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