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Acute Kidney Insufficiency

Juan Gustavo Vázquez-Rodríguez, Dulce Yadira Barboza-Alatorre
Background: In severe preeclampsia (SP), pregnancy interruption is the first recommendation. However, some patients receive expectant treatment. Objetive: To determine maternal and perinatal results of expectant treatment of SP in the intensive care unit (ICU) of a high-specialty hospital. Methods: Observational, descriptive and retrospective study; the files of 40 pregnant patients with SP managed in the ICU with expectant treatment were reviewed...
November 30, 2018: Revista Médica del Instituto Mexicano del Seguro Social
Jesmar Buttigieg, Hatem Ali, Ajay Sharma, Ahmed Halawa
The presence of pre-formed donor-specific antibodies (DSAs) in kidney transplantation is associated with worse overall outcomes compared with DSA-negative transplantation. A positive complement-dependant cytotoxic crossmatch presents a high immunological risk, while a negative flow cytometry crossmatch is at the lower end of the risk spectrum. Yet, the presence of low-level DSA detected by Luminex alone, that is, positive Luminex and negative flow (PLNF) cytometry crossmatch lacks robust scientific exploration...
November 30, 2018: Nephrology, Dialysis, Transplantation
Ryuichiro Abe, Atsuhiro Matsumoto, Ryota Sakaguchi, Koichi Toda, Yoshiki Sawa, Akinori Uchiyama, Yuji Fujino
Objective: We assessed what predicts nutritional adequacy at day 14 following implantation of left ventricular assist device (LVAD). Method: We retrospectively reviewed the cases of 97 adult patients who underwent LVAD implantation at our institution from June 2011 to June 2016. We divided the patients into two groups based on the administered enteral nutrition (EN) calories on post-operative day (POD) 14: the EN calories of group SEN (sufficient enteral nutrition) were >80% of their total target calories, or the EN calories of group IEN (insufficient enteral nutrition) were <80% of their total target calories...
2018: Nutrition and Metabolic Insights
Jing Zhang, Ying Guo, Qi Jin, Li Bian, Ping Lin
Background: Contrast-induced nephropathy (CIN) is a complication after the intravascular administration of a contrast medium injection. Previous studies have investigated statins as therapy for CIN due to its positive results in the prevention of contrast-induced acute kidney injury (CI-AKI). Nevertheless, the beneficial effects of rosuvastatin pretreatment in preventing CIN in patients with acute coronary syndromes still remain controversial. In this study, we performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the beneficial impact of rosuvastatin in the prevention of CI-AKI in acute coronary syndrome patients...
2018: Drug Design, Development and Therapy
Shunsuke Yamada, Hokuto Arase, Toshifumi Morishita, Akihiro Tsuchimoto, Kumiko Torisu, Takehiro Torisu, Kazuhiko Tsuruya, Toshiaki Nakano, Takanari Kitazono
A 57-year-old woman with pre-dialysis chronic kidney disease (CKD) was hospitalized because of fever and fatigue. On admission, increased inflammatory response and pyuria with bacteriuria were observed. Pyelonephritis was successfully treated with antibiotics, whereas her fatigue continued and she developed progressive hypercalcemia and hyponatremia; serum sodium level, 116 mEq/L and corrected serum calcium level, 13.4 mg/dL. Plasma concentrations of adrenocorticotropic hormone and cortisol and serum luteinizing hormone were under the detection level...
November 19, 2018: CEN Case Reports
Hrafnhildur Linnet Runolfsdottir, Runolfur Palsson, Inger MSch Agustsdottir, Olafur S Indridason, Vidar O Edvardsson
BACKGROUND: Adenine phosphoribosyltransferase (APRT) deficiency is a hereditary purine metabolism disorder that causes kidney stones and chronic kidney disease (CKD). The purpose of this study was to examine the course of APRT deficiency in patients who presented in childhood. METHODS: The disease course of 21 (35%) patients in the APRT Deficiency Registry of the Rare Kidney Stone Consortium, who presented with manifestations of APRT deficiency and/or were diagnosed with the disorder before the age of 18 years, was studied...
November 15, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Maxime Nguyen, Damien Denimal, Auguste Dargent, Pierre-Grégoire Guinot, Laurence Duvillard, Jean-Pierre Quenot, Bélaïd Bouhemad
BACKGROUND: In septic shock, both systemic vasodilatation and glomerular arteriole dilatation are responsible for the drop in glomerular filtration observed in early acute kidney injury. Angiotensin II has been showed to act on both mechanisms. Our objective was to evaluate the impact of renin angiotensin system activation, on hemodynamic deficiency and renal outcome in patient with septic shock and to assess whether urinary sodium could be a reliable test for high plasma renin concentration screening...
November 6, 2018: Shock
Dirk De Bacquer, Delphine De Smedt, Kornelia Kotseva, Catriona Jennings, David Wood, Lars Rydén, Viveca Gyberg, Bahira Shahim, Philippe Amouyel, Jan Bruthans, Almudena Castro Conde, Renata Cífková, Jaap W Deckers, Johan De Sutter, Mirza Dilic, Maryna Dolzhenko, Andrejs Erglis, Zlatko Fras, Dan Gaita, Nina Gotcheva, John Goudevenos, Peter Heuschmann, Aleksandras Laucevicius, Seppo Lehto, Dragan Lovic, Davor Miličić, David Moore, Evagoras Nicolaides, Raphael Oganov, Andrzej Pajak, Nana Pogosova, Zeljko Reiner, Martin Stagmo, Stefan Störk, Lale Tokgözoğlu, Dusko Vulic, Martin Wagner, Guy De Backer
The EUROASPIRE surveys (EUROpean Action on Secondary Prevention through Intervention to Reduce Events) demonstrated that most European coronary patients fail to achieve lifestyle, risk factor and therapeutic targets. Here we report on the 2-year incidence of hard cardiovascular (CV) endpoints in the EUROASPIRE IV cohort. EUROASPIRE IV (2012-2013) was a large cross-sectional study undertaken at 78 centres from selected geographical areas in 24 European countries. Patients were interviewed and examined at least 6 months following hospitalization for a coronary event or procedure...
October 23, 2018: European Journal of Epidemiology
Riccardo Cocchieri, Rainer Petzina, Mauro Romano, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Vinayak Bapat, Hardy Baumbach, Helen Sims, Cornelia Deutsch, Peter Bramlage, Jana Kurucova, Martin Thoenes, Derk Frank
OBJECTIVES: There is lack of data regarding the longer-term outcomes of patients undergoing transaortic (TAo) transcatheter aortic valve implantation (TAVI). We aimed to provide a contemporary snapshot of the types and frequencies of events in the year following TAo-TAVI. METHODS: The Registry of the Utilization of the TAo-TAVI approach using the Edwards SAPIEN Valve (ROUTE) is a multicentre, European, prospective, observational registry of aortic stenosis patients undergoing TAo-TAVI...
October 20, 2018: European Journal of Cardio-thoracic Surgery
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
Channabasappa Shivaprasad, Yalamanchi Aiswarya, Atluri Sridevi, Biswas Anupam, Goel Amit, Boppana Rakesh, Pulikkal A Annie, Kolly Anish
PURPOSE: Hypopituitarism (HP) is an uncommon consequence of Russell's viper envenomation (RVE). Delayed hypopituitarism (DHP) presents months to years after recovering from snake bites (SB). The clinical presentation, manifestations, and outcomes of DHP following RVE have not been systematically studied. Here, we present a case series of HP following RVE with delayed diagnosis and conduct a literature review. METHODS: We retrospectively reviewed data of eight DHP cases and literature to outline the presentation, manifestations, hormonal profiles, and radiological features of DHP following RVE...
October 13, 2018: Pituitary
Chung Hee Baek, Hyosang Kim, Hoon Yu, Won Seok Yang, Duck Jong Han, Su-Kil Park
BACKGROUND BK nephropathy (BKN) affects graft function and increases the risk of graft failure. The reduction of immunosuppression is the main treatment for BKN. However, acute rejection may develop following immunosuppression reduction, and data regarding the risk factors of acute rejection during the post-reduction period are insufficient. MATERIAL AND METHODS Of 758 patients who received a kidney transplantation (KT) between 2008 and 2011, 79 who underwent immunosuppression reduction as BKN treatment were enrolled...
October 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Jonathan Maurice Chemouny, Aurélie Sannier, Guillaume Hanouna, Laure Champion, Francois Vrtovsnik, Eric Daugas
RATIONALE: Malakoplakia is a rare disease characterized by the presence of nongranulomatous macrophage infiltration. In most cases, it affects the urinary tract. Malakoplakia can cause acute kidney injury when it is localized in the kidneys. PATIENT CONCERNS: Here, we report the case of a 65-year-old female patient with renal malakoplakia responsible for hypercalcemia. During her initial assessment, she was also diagnosed 25-OH vitamin D insufficiency, for which she was prescribed oral cholecalciferol...
October 2018: Medicine (Baltimore)
Laura K Young, Shona Z Matthew, J Graeme Houston
OBJECTIVES: Recent safety concerns regarding gadolinium-based contrast agents (GdCAs) concluded with the suspension of some agents from the European market, yet a clinical consequence remains unknown. We used electronic health records to investigate the incidence of potential toxicity to gadoteric acid (Dotarem®) within our local population, including those with renal insufficiency (RI). METHODS: Data for patients who underwent contrast-enhanced MRI were identified, stratified by renal function at time of scan and retrospectively followed using routinely collected health data...
October 1, 2018: European Radiology
Fabrice Barlesi, Johan Vansteenkiste, David Spigel, Hidenobu Ishii, Marina Garassino, Filippo de Marinis, Mustafa Özgüroğlu, Aleksandra Szczesna, Andreas Polychronis, Ruchan Uslu, Maciej Krzakowski, Jong-Seok Lee, Luana Calabrò, Osvaldo Arén Frontera, Barbara Ellers-Lenz, Marcis Bajars, Mary Ruisi, Keunchil Park
BACKGROUND: Antibodies targeting the immune checkpoint molecules PD-1 or PD-L1 have demonstrated clinical efficacy in patients with metastatic non-small-cell lung cancer (NSCLC). In this trial we investigated the efficacy and safety of avelumab, an anti-PD-L1 antibody, in patients with NSCLC who had already received platinum-based therapy. METHODS: JAVELIN Lung 200 was a multicentre, open-label, randomised, phase 3 trial at 173 hospitals and cancer treatment centres in 31 countries...
September 21, 2018: Lancet Oncology
B Nagaraju Naik, Ashish Bhalla, Navneet Sharma, Jitender Mokta, Surjit Singh, Prakamya Gupta, Ashutosh Rai, Sridhar Subbiah, Anil Bhansali, Pinaki Dutta
Purpose: Endocrinal insufficiency caused by vasculotoxic snake envenomation is under-recognized and is mostly confined to a specific geographic area. We conducted a prospective study to determine the prevalence and pattern of pituitary-target gland insufficiencies caused by snake envenomation. Materials and Methods: The hormonal evaluation of patients who had suffered from vasculotoxic snake envenomation was done at baseline and at 6 months of follow-up. Those patients with a documented hormonal insufficiency underwent magnetic resonance imaging (MRI) of the hypothalamo-pituitary area...
September 2018: Neurology India
Siu-Hin Wan, Joshua P Slusser, David O Hodge, Horng H Chen
Objective: To determine the risks of acute kidney injury development and long-term clinical outcomes of patients with hypertensive crisis. Patients and Methods: This was a population study of Olmsted County residents with hypertensive crisis between January 1, 2000, and December 31, 2008, with follow-up until June 30, 2016. Results: The results demonstrated that those with underlying chronic kidney disease upon admission for hypertensive crisis, defined as a systolic blood pressure above 180 mm Hg or diastolic blood pressure above 120 mm Hg, were more likely to develop acute kidney injury during hospitalization (odds ratio, 6...
June 2018: Mayo Clinic proceedings. Innovations, quality & outcomes
Chun Zhang, Ting Lin, Jingyao Zhang, Huan Liang, Ying Di, Na Li, Jie Gao, Wenjing Wang, Sinan Liu, Zheng Wang, Hongli Jiang, Chang Liu
OBJECTIVE: To evaluate the clinical effect and safety of regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) after hepatectomy. METHODS: A retrospective analysis of the clinical data of all patients with AKI after hepatectomy for CRRT admitted to surgical intensive care unit (ICU) of the First Affiliated Hospital of Xi'an Jiaotong University from January 19th, 2013 to January 19th, 2018 was performed...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Ramy M Hanna, Umut Selamet, Patrick Bui, Shih-Fan Sun, Olivia Shenouda, Niloofar Nobakht, Marina Barsoum, Farid Arman, Anjay Rastogi
Pembrolizumab is an immune checkpoint inhibitor that targets the programmed cell death protein 1 (PD-1) antigen and induces an immune response against tumor tissues. It has been successful in inducing remission in patients with severe metastatic disease, often refractory to other chemotherapeutic agents. The risk of injury of other organ systems has been noted with reported cases of glomerular disease and endocrine disease. In addition, hypophysitis as well as dermatological and gastroenterological side effects have been reported...
May 2018: Case Reports in Nephrology and Dialysis
Nathan M Lee, Lev Deriy, Timothy R Petersen, Vallabh O Shah, Michael P Hutchens, Neal S Gerstein
OBJECTIVE: Administration of excess chloride in 0.9% normal saline (NS) decreases renal perfusion and glomerular filtration rate, thereby increasing the risk for acute kidney injury (AKI). In this study, the effect of NS versus Isolyte use during cardiac surgery on urinary levels of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor-binding protein 7 [TIMP-2] × [IGFBP7] and postoperative risk of AKI were examined. DESIGN: Prospective, randomized, and single-blinded trial...
August 1, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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