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Acute kidney injury, chronic kidney disease

Shaoqun Shu, Jiefu Zhu, Zhiwen Liu, Chengyuan Tang, Juan Cai, Zheng Dong
BACKGROUND: Acute kidney injury (AKI) may lead to the development of chronic kidney disease (CKD), i.e. AKI-CKD transition, but the underlying mechanism remains largely unclear. Endoplasmic reticulum (ER) stress is characterized by the accumulation of unfolded or misfolded proteins in ER resulting in a cellular stress response. The role of ER stress in AKI-CKD transition remains unknown. METHODS: In this study, we examined ER stress in the mouse model of AKI-CKD transition after unilateral renal ischemia-reperfusion injury (uIR)...
October 9, 2018: EBioMedicine
Luke Masha, Shareez Peerbhai, David Boone, Fisayomi Shobayo, Aman Ghotra, Bindu Akkanti, Yelin Zhao, Igor Banjac, Igor D Gregoric, Biswajit Kar
Abnormalities in markers of liver injury after venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation are of unclear distribution and clinical significance. This study included all consecutive adult patients from a single institution who underwent VA-ECMO cannulation between May 2012 and September 2016 and had liver function panels drawn during their admission (n = 223). Data points include: age, sex, body mass index, diagnosis, duration of ECMO cannulation, duration of hospitalization, pre-ECMO cardiac arrest, central nervous system (CNS) injury, the presence of chronic kidney disease or acute renal failure, renal replacement therapy utilization, lactate levels, duration of pre-ECMO intubation, admission and peak bilirubin/aspartate aminotransferase (AST)/alanine aminotransferase (ALT)/alkaline phosphatase (ALP) levels, and time to peak bilirubin/AST/ALT/ALP in relation to cannulation...
October 9, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Satoko Arai, Toru Miyazaki
An internal system designed to ward off and remove unnecessary or hazardous materials is intrinsic to animals. In addition to exogenous pathogens, a number of self-molecules, such as apoptotic or necrotic dead cells, their debris, and the oxides or peroxides of their cellular components, are recognized as extraneous substances. It is essential to eliminate these internal pathogens as quickly as possible because their accumulation can cause chronic inflammation as well as autoimmune responses, possibly leading to onset or progression of certain diseases...
October 11, 2018: Seminars in Immunopathology
Bojana Misheva, Roy Hajjar, Hugo Chapdelaine, Herawaty Sebajang, Frank Schwenter
An ectopic pancreas, also known as pancreatic rest or heterotopic pancreas, consists of pancreatic tissue found in a location with no continuity with the anatomic pancreas. This lesion can occasionally cause gastrointestinal obstruction, ulceration or become inflamed and cause ectopic pancreatitis. We present the case of a 29-year-old immunocompromised female patient due to a previous kidney transplant. She presented with nausea and vague abdominal discomfort and was admitted for investigation and treatment of an acute kidney injury...
October 2018: Journal of Surgical Case Reports
Claudio Ronco, Antonio Bellasi, Luca Di Lullo
It is well established that a large number of patients with acute decompensated heart failure present with various degrees of heart and kidney dysfunction usually primary disease of heart or kidney often involve dysfunction or injury to the other. The term cardiorenal syndrome increasingly had been used without a consistent or well-accepted definition. To include the vast array of interrelated derangements and to stress the bidirectional nature of heart-kidney interactions, a new classification of the cardiorenal syndrome with 5 subtypes that reflect the pathophysiology, the time frame, and the nature of concomitant cardiac and renal dysfunction was proposed...
September 2018: Advances in Chronic Kidney Disease
Emmanuel Canet, Rinaldo Bellomo
PURPOSE OF REVIEW: The present article reviews the recent literature on the main aspects of perioperative acute kidney injury (AKI). RECENT FINDINGS: AKI occurs in 1 in every 10 surgical patients, with cardiac, orthopedic, and major abdominal surgeries being the procedures associated with the highest risk. Overall, complex operations, bleeding, and hemodynamic instability are the most consistent procedure-related risk factors for AKI. AKI increases hospital stay, mortality, and chronic kidney disease, gradually with severity...
October 10, 2018: Current Opinion in Critical Care
Mario Naranjo, Kevin Bryan Lo, Kenechukwu Mezue, Janani Rangaswami
Pulmonary hypertension is not uncommon in patients with renal disease and vice versa; therefore, influences treatments and outcomes. There is a large body of literature on pulmonary hypertension in patients with kidney disease, its prognostic implications, economic burden, and management strategies. However, the converse, namely the hemodynamic effects of pulmonary hypertension on kidney function (acute and chronic kidney injury) is less studied and described. There is also increasing interest in the effects of pulmonary hypertension on kidney transplant outcomes...
October 8, 2018: Current Cardiology Reviews
Viviane Ferreira, Miguel Moysés Neto, Jose Abrão Cardeal da Costa
The goal of this study was to identify the occurrence of secondary infection due to the use of temporary double-lumen catheters for hemodialysis in 96 patients with acute kidney injury or acute chronic kidney disease. For each patient, we collected a swab from the skin localized in the insertion of catheter before antisepsis; blood cultures from the catheter lumen, peripheral vein, and central venous access in withdrawing catheter; and cultures of catheter tips. Catheters were implanted into a femoral vein in 56...
May 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Zachary Bouck, Graham C Mecredy, Noah M Ivers, Moumita Barua, Danielle Martin, Peter C Austin, Joshua Tepper, R Sacha Bhatia
Importance: International nephrology societies advise against nonsteroidal anti-inflammatory drug (NSAID) use in patients with hypertension, heart failure, or chronic kidney disease (CKD); however, recent studies have not investigated the frequency or associations of use in these patients. Objectives: To estimate the frequency of and variation in prescription NSAID use among high-risk patients, to identify characteristics associated with prescription NSAID use, and to investigate whether use is associated with short-term, safety-related outcomes...
October 8, 2018: JAMA Internal Medicine
Julia Marcheque, Benedetta Bussolati, Marie Csete, Laura Perin
Significant progress has been made to advance stem cell products as potential therapies for kidney diseases: various kinds of stem cells can restore renal function in preclinical models of acute and chronic kidney injury. Nonetheless this literature contains contradictory results, and for this reason, we focus this review on reasons for apparent discrepancies in the literature, because they contribute to difficulty in translating renal regenerative therapies. Differences in methodologies used to derive and culture stem cells, even those from the same source, in addition to the lack of standardized renal disease animal models (both acute and chronic), are important considerations underlying contradictory results in the literature...
October 9, 2018: Stem Cells Translational Medicine
M Spacek, K Kunze, J Mehrholz
This study describes the course of renal recovery after dialysis in a specific population of chronically critically ill patients with a history of prolonged and complicated treatment in an intensive care unit. This study shows that, in a specialized center, patients can be successfully weaned from dialysis even months after acute kidney injury (AKI). Of the patients who could be recompensated (33%), approximately 20% achieved renal recovery more than 3 months after the start of dialysis. The duration of renal recovery after AKI did not differ between those patients with pre-existing chronic kidney disease (CKD) and those without...
October 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Linda C Kelahan, Terry S Desser, Megan L Troxell, Aya Kamaya
Ultrasound assessment of the kidneys in patients with renal impairment has been described in various ways in the critical care, nephrology, and radiology literature, resulting in a somewhat heterogeneous picture of the gray-scale and Doppler ultrasound manifestation of acute kidney injury (AKI). Given that ultrasound assessment can potentially identify reversible causes of AKI or identify underlying chronic kidney disease, it is important for radiologists to be aware of the common etiologies of AKI and the spectrum of ultrasound findings...
October 8, 2018: Ultrasound Quarterly
Yu-Hsiang Chou, Tzong-Shinn Chu, Shuei-Liong Lin
Acute kidney injury (AKI) can increase the risk of developing incident chronic kidney disease (CKD). The severity, frequency and duration of AKI are crucial predictors of poor renal outcome. A repair process after AKI can be adaptive and kidney recovers completely after a mild injury. However, severe injury will lead to a maladaptive repair, which frequently progresses to nephron loss, vascular rarefaction, chronic inflammation and fibrosis. Although different mechanisms underlying AKI-CKD transition have been extensively discussed, no definite intervention has been proved effective to block or to retard the transition until recently...
October 2018: Nephrology
Mei-Yi Wu, Mai-Szu Wu
Taiwan renal care system is an evolving learning health-care system. There are four facets of this system. From the early history of dialysis and Taiwan Renal Registry Data System, it facilitates the generation of data to knowledge. National multidisciplinary pre-end-stage renal disease care project and outcome enhances knowledge to practice. Early chronic kidney disease (CKD) programs and 2015 Taiwan CKD clinical guidelines implicate the practice to customer, and then explore the causes of CKD help to resume customer to data...
October 2018: Nephrology
Kranti A Mapuskar, Hsiang Wen, Danniele G Holanda, Prerna Rastogi, Emily Steinbach, Rachel Han, Mitchell C Coleman, Massimo Attanasio, Dennis P Riley, Douglas R Spitz, Bryan G Allen, Diana Zepeda-Orozco
Severe and recurrent cisplatin-induced acute kidney injury (AKI) as part of standard cancer therapy is a known risk factor for development of chronic kidney disease (CKD). The specific role of superoxide (O2 •- )-mediated disruption of mitochondrial oxidative metabolism in CKD after cisplatin treatment is unexplored. Cisplatin is typically administered in weekly or tri-weekly cycles as part of standard cancer therapy. To investigate the role of O2 •- in predisposing patients to future renal injury and in CKD, mice were treated with cisplatin and a mitochondrial-specific, superoxide dismutase (SOD) mimetic, GC4419...
September 27, 2018: Redox Biology
Ahmed S Yassin, Oluwole Adegbala, Ahmed Subahi, Hossam Abubakar, Emmanuel Akintoye, Mohamed Abdelrahamn, Abdelrahman Ahmed, Anika Agarwal, Mohamed Shokr, Mohit Pahuja, Mahir Elder, Amir Kaki, Theodore Schreiber, Tamam Mohamad
Multiple studies evaluated the outcomes and complications rate of Takotsubo Syndrome (TTS) in patients with and without advanced chronic kidney disease (CKD), revealed conflicting results. This study aims to assess the clinical outcomes and impact of advanced CKD on patients hospitalized with Takotsubo Syndrome. Patients who presented with Takotsubo cardiomyopathy between 2010 and 2014 were identified in the National Inpatient Sample (NIS) database using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and subsequently were divided into two groups, with advanced CKD and without advanced CKD...
September 27, 2018: International Journal of Cardiology
Patrick R Brown, Omar Sadiq, Alexander Weick, Adrienne Lenhart, Mohammad Elbatta, Christopher Fernandez, Anas Kutait, Robert Pompa, Syed-Mohammed Jafri
Ledipasvir-sofosbuvir, a once-a-day, oral combination pill, was approved in 2014 for the treatment of chronic hepatitis C infection. Initial trials did not comment on nephrotoxicity; however, recent data suggest a risk of acute kidney injury (AKI) with the use of the medication. We assessed the rates of AKI in patients undergoing ledipasvir-sofosbuvir in a large, urban tertiary care center. This single-center retrospective observation study included all patients undergoing therapy from October 1, 2014, to October 1, 2015...
October 2018: Hepatology Communications
Rimda Wanchoo, Carolina Bernabe Ramirez, Jacqueline Barrientos, Kenar D Jhaveri
Chronic lymphocytic leukemia (CLL) is the most commonly diagnosed adult leukemia in the USA and Western Europe. Kidney disease can present in patients with CLL as a manifestation of the disease process such as acute kidney injury with infiltration or with a paraneoplastic glomerular disease or as a manifestation of extra renal obstruction and tumor lysis syndrome. In the current era of novel targeted therapies, kidney disease can also present as a complication of treatment. Tumor lysis syndrome associated with novel agents such as the B-cell lymphoma 2 inhibitor venetoclax and the monoclonal antibody obinutuzumab are important nephrotoxicities associated with these agents...
October 2018: Clinical Kidney Journal
Bart De Moor, Johan F Vanwalleghem, Quirine Swennen, Koen J Stas, Björn K I Meijers
Renal stimulation tests document the dynamic response of the glomerular filtration rate (GFR) after a single or a combination of stimuli, such as an intravenous infusion of dopamine or amino acids or an oral protein meal. The increment of the GFR above the unstimulated state has formerly been called the renal functional reserve (RFR). Although the concept of a renal reserve capacity has not withstood scientific scrutiny, the literature documenting renal stimulation merits renewed interest. An absent or a blunted response of the GFR after a stimulus indicates lost or diseased nephrons...
October 2018: Clinical Kidney Journal
Lars J J Bolt, Tim Anton Sigterman, Atilla G Krasznai, Cees-Jan J M Sikkink, Geert-Willem H Schurink, Lee Hans Bouwman
INTRODUCTION: Percutaneous transluminal angioplasty (PTA) is often complicated due to postcontrast acute kidney injury (PC-AKI) in patients diagnosed with chronic kidney disease (CKD). Hydration therapy is the cornerstone in the prevention of PC-AKI. Furosemide forced diuresis with matched hydration using the RenalGuard system enables a steady balance between diuresis and hydration. A randomised controlled trial will be performed in order to investigate whether furosemide forced diuresis with matched hydration in combination with the RenalGuard system decreases incidence of PC-AKI in patients with CKD receiving a PTA of the lower extremities...
October 4, 2018: BMJ Open
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